Patho Exam 1 NSG 533 Latest Update -

Patho Exam 1 NSG 533 Latest Update - Actual Exam 215 Questions with 100% Verified Correct Answers Guaranteed A+ Verified by Professor

"unknown" etiology of disease - CORRECT ANSWER: idiopathic and cryptogenic

3 main systems regulate total body sodium - CORRECT ANSWER: 1. RAAS System -

Decreased renal perfusion is sensed by the juxtaglomerular cells in the kidney resulting in increase renin secretion and activation of RAAS. Angiotensin causes vasoconstriction and stimulates the release of aldosterone - promotes sodium retention.

• Natriuretic Peptide System - Volume receptors in great veins and atria are sensitive

to small changes in venous and atrial filling. Increased atrial filling results in release of ANF/ANP and BNF/BNP which promotes sodium excretion.

• Pressure receptors in the aorta and carotid are stimulated by volume depletion and

activate sympathetic nervous system - renal retention of sodium.

4 common mechanisms of cell injury and death - CORRECT ANSWER: 1. ATP

Depletion

• Oxygen and oxygen-derived free radicals
• intracellular calcium and loss of calcium state
• defects in membrane permeability

4 most common mechanisms of edema - CORRECT ANSWER: 1. Increased capillary

hydrostatic pressure

• Decreased capillary oncotic pressure
• Increased capillary membrane permeability 1 / 4

• lymphatic channel obstruction
• sodium and water retention

4 Phases of fluid therapy - CORRECT ANSWER: Rescue - fluid admin for immediate

treatment, life threatening Optimization - adjust fluid type, rate, and amount Stabilize - neutral or slight neg fluid balance De-escal - decrease admin and mobilize excess fluid balance

• essential components of pathophysiology - CORRECT ANSWER: 1. Etiology (the why

of disease, the reason for it)

• Epidemiology (risk factors and distributions in populations, incidence and prevalence

in disease)

• Pathogenesis (disease mechanisms; the sequence of events that occurs between the

stimulus event and the manifestations of the disease)

• Clinical Manifestations (signs, symptoms, diagnostic criteria)
• Outcomes (cure, remission, chronicity, death)

Acidemia - CORRECT ANSWER: Increase in hydrogen or loss of a base

Acute Kidney Injury - CORRECT ANSWER: Increase creatinine by 0.3mg/dl or more

within 48 hours Increase to 1.5 or more from baseline within the past 7 days UO < 0.5ml/kg/hr >6hours

Non-oliguria >500ml/day Oliguria <500ml/day Anuria <100ml/day 2 / 4

Acute Tubular Necrosis - CORRECT ANSWER: damage to the renal tubules due to

presence of toxins in the urine or to ischemia (aminoglycoside, NSAIDs, CT contrast)

aging is thought to be the result of: - CORRECT ANSWER: 1. faulty DNA repair mechanisms ahd metabolic (free radical) damage

• reduced antioxidants

AKI Clinical Course - Diuretic Stage - CORRECT ANSWER: -1 to 2 weeks

-self limiting as kidney tubular patency restored -urine concentration, not returned -continued healing, kidneys begin regaining lost function -at risk for fluid volume deficit -monitor daily weights, VS, I's and O's, assess for edema, skin turgor, mucous membrane, hypokalemia

AKI Clinical Course - Initiating Stage - CORRECT ANSWER: -Hours to days

-S/S of impairment -Etiology is investigated -Tx plan for reversal -Endocrine function not affected

AKI Clinical Course - Oliguric Stage - CORRECT ANSWER: -5 to 15 days

-Healing may begin -Tubule cell regen. but destroyed basement membrane replaced with scar tissue -Tubules may be clogged with inflammatory products -Decreased GFR -Decreased urine production 3 / 4

-Decreased kidney clearance -If persists, endocrine functions are alt.-hyperK -GI bleed -infection

AKI Clinical Course - Recovery Stage - CORRECT ANSWER: -Months to years

-Scar tissue replaces basement membranes -Nephrons become patent -Tubular cells regenerate -Functional loss not always clinically significant -Urine osmo increases -Urine volume stability -Uremia resolves -Pt education

Alkalosis - CORRECT ANSWER: Decrease of hydrogen ion or increase in base

Anion gap - CORRECT ANSWER: Difference between total cations in the ECF and total anions in the ECF

Cations - sodium and a little potassium Anions - chloride and bicarb

Normal anion gap is 10 to 14

Anion gap calculation - CORRECT ANSWER: Na - (Cl + HCO3)

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