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MEPN Patho
MEPN Pathophysiology Study Outline
| Question | Answer |
|---|---|
| Cheyne-Stokes respirations | characteristics- alternating periods of shallow breathing with apnea |
| seen in dying process and CHF | Cheyne-Stokes respirations |
| hypercapnia | increase of PaCO2 in blood; >45-50 mmHg |
| Partial Seizure | begins locally; superficial focus |
| simple partial seizure | without impairment of consciousness |
| complex partial seizure | with impairment of consciousness |
| generalized seizure | bilaterally symmetric and without local onset; consciousness always impaired or lost |
| status epilepticus | subsequent seizures before the regain of consciousness from preceding seizure |
| aura | mini seizure or "feeling" of impending doom |
| prodromal phase | malaise or headache hours to days before seizure onset |
| tonic phase | state of muscle contraction with excessive muscle tone |
| clonic phase | state of alternating contraction and relaxation of muscles |
| postictal phase | time period immediately following the cessation of seizure activity |
| Alzheimer disease | cortical nerve cell looks like a tangled mess |
| Alzheimer's damage | plaques, tangles, transmitter defects, abnormal amyloid deposition; neurofibrillary tangle/senile plaque; may be genetically abnormal prions |
| Parkinson disease manifestsations | forward, perpetual gait, tremors, pill-rolling, rigidity, akinesia (poverty of mvt.), postural abnormalities |
| degeneration of basal ganglia (corpus striatum) involving the dopaminergic nigrostriatal pathway | Parkinson's Disease |
| Epilepsy causes | disease marked by recurrent seizures; repetitive abnormal electrical discharges within the brain |
| Idiopathic Seizures | spontaneously without known cause; possibly genetic |
| Symptomatic Seizures | identifiable cause |
| Cryptogenic Seizures | symptomatic without abnormalities |
| Epilepsy triggers | hypoglycemia, fatigue, lack of sleep, emotional or physical stress, febrile illness, large amounts of water ingestion, constipation, stimulant use, hyperventilation, etc. |
| cor pulmonale (old term) | pulmonary heart disease; R ventricular enlargement (hypertrophy, dilation, or both); secondary to pulmonary HTN cause by disorders of lungs or chest wall; edema |
| cor pulmonale manifestations | obscure at rest; decreased cardiac output with exercise; chest pain; peripheral edema, hepatic congestion, and jugular venous distention; underlying lung disease |
| PND | paroxysmal nocturnal dyspnea |
| noc SOB in laying position | PND |
| PND R/t | obesity, COPD, chronic bronchitis |
| sit up | to relieve PND s/s |
| PND reason/cause | obstructive apnea; wake up unaware, anxiety, LOC |
| PND D/t | L ventricular failure; results from the fluid in the lungs caused by redistribution of body water while the individual is recumbent |
| Orthopnea | laying generalized SOB |
| dyspnea from pulmonary congestion when lying down; horizontal position redistributes body water, causes abdominal contents exert pressure on diaphragm, decreases efficiency of respiratory muscles | orthopnea |
| Pulmonary edema | fluid in lungs; most common in L-sided heart failure;hear rales/crackles;type of V/Q shunting |
| Asthma symptoms | inspiration/expiration wheezing, non-productive cough, tachycardia |
| Chronic bronchitis | inspiratory/expiratory wheezing, 'slightly' productive cough, tachycardia |
| causes of chronic bronchitis | smoking, occupational chemical exposure |
| chronic mucous production stimulation without expectoration | chronic bronchitis |
| Emphysema | abnormal permanent or gas exchange pathways and fibrosis/scarring; no return, permanent back-up |
| emphysema causes | smoking |
| s/s of emphysema | barrel-chest (overusing accessory muscles) expiration is prolonged because hypercapnic- trying to push off/exhale CO2; air trapped in overinflated alveoli; no or decreased cilia 2ndary to smoking |
| Pul. Fibrosis | people exposed to inhaled toxins; TB, AIDs, ARDS: disease/chem. irritant; no cough, cilia |
| Black lung | coal miners |
| "dusting" chemical inhalation | kids; permanent lung damage; can't inflate |
| layers of scar tissue for alveoli | fibrosis |
| Atelectasis | alveoli collapse lung/ compression- put on ventilator |
| possible cause ot atelectasis | OD of O2 during surgery |
| Bronchiectasis | persistent abnormal bronchi dilation; foreign body infection; CF kids;mucous plugs |
| Aspiration | foreign material into lungs; people with altered consciousness/vomiting uncontrollably and trying to get a breath; esophageal varices |
| GI bleeds- blood aspiration | most toxic thing to have in lungs |
| most commonly aspirated side | R side of lung because of early branching |
| Bronchiolitis | inflammation destruction of small airways; if had as kid, becomes chronic as adult; viral infection of already diseased airway |
| DM I | no working beta cells |
| DM II | some working beta cells/ alpha cells stimulate gluconeogenesis in liver to increase serum glucose; noc wake up with high BS |
| DM II macrovascular manifestations | CAD |
| DM II microvascular manifestations | nephropathy, retinopathy, neuropathy |
| Complications of urinary obstruction | above/below; back-up/ pooling; hypertrophy/dysfunction |
| Renal stones | diet restriction based on make-up of stones/predisposition |
| calcium oxalate most common type | renal stone |
| restrict calcium | tx for calcium oxalate renal stones |
| renal stones often recurrences/clusters | bacteria/ bladder infection leads to cystitis |
| Pyelonephritis | kidney infection; high fever, flank pain (hammer test) |
| Nephrotic syndrome | excreting >3.5 g/day of protein in urine; destroying glomerular cell matrix filter; kids- glom. neph. channels |
| strep. A bacteria | can cause pyelonephritis |
| manifestations of pyelonephritis | edema; also excrete fat, lipids, sloughing in tubules; liver pulls more proteins/lipis out in bloodstream; vicious cycle |
| tx for pyelonephritis | kidney transplant |
| Prerenal | vascular constriction, HTN, above kidney |
| Intrarenal | glomerular nephritis; tubular necrosis, etc. within functional units of kidney |
| Postrenal | obstruct urinary system; stones, etc. |
| Chronic gastritis | elderly disease; aging, thinning, degeneration |
| What kind of anemia does a gastrectomy pt. experience? | pernicious anemia |
| Abd. Visceral pain | dull, vague; lots of testing/exam time |
| GERD- functional cause | sphincter issue (secondary- H. pylori) |
| Duodenal ulcers | H. Pylori- cause |
| Portal HTN and esophageal varicies | vomit- aspirate; esophageal bleeding/ back-up pressure |
| LDL | bad cholesterol goal < 100 |
| HTN and pathologic changes in kidney | RAS upreglulation or Renin; JG cells manufacture Renin; toxic at certain level; activate to Ang. II |
| Pulmonary emboli source | DVTs from vascular tree below lung |
| thrombi travel from legs to | lungs |
| thrombi travel from arms to | above (CVA) |
| Stages of progression of CAD | 1 inflammation, 2 ischemia, 3 infarction, 4 necrosis |
| Risk of CAD as it relates to HTN and DM | smoking, family history, age, heart structural issues, past MI, diet, exercise, HTN, diabetes, wt. loss, cholesterol |
| HDL | good cholesterol goal >60 |
| Prinzmetal angina- when usually | noc vasospasm |
| Shift to the left in CBC differential- what does it mean? | ***band shift; elevation; left- out of control/ acute infection; right- under control/ correct antibiotics used |
| kidney stones cause | obstruction and stasis of urine contributing to bacteriuria and hydronephrosis; irritation of epithelial lining with entrapment of bacteria |
| neurogenic bladder | neurologic impairment interfering with normal bladder contraction with residual urine and ascending infection |
| macrocytic-normochromic anemia | large, abnormally shaped erythrocytes but normal hemoglobin concentrations |
| microcytic-hypochromic anemia | small, abnormally shaped erythrocytes and reduced hemoglobin concentration |
| normocytic-normochromic anemia | destruction or depletion of normal erythroblasts or mature erythrocytes |
| pernicious anemia; folate deficiency anemia | macrocytic-normochromic anemia |
| iron deficiency anemia; thalassemia; sideroblastic anemia | microcytic-hypochromic anemia |
| posthemorrhagic anemia; hemolytic, sickle cell, and aplastic anemia; anemia of chronic disease | normocytic-normochromic anemia |
| lack of vitamin B12, folate, or premature cell death | pernicious anemia; folate deficiency anemia |
| lack of iron, dysfunctional iron uptake, or impaired synthesis of alpha or beta chain of hemoglobin A | iron deficiency anemia; thalassemia; sideroblastic anemia |
| blood loss, abnormal shape, lysis, increased demand or premature destruction of erythrocytes | posthemorrhagic anemia; hemolytic, sickle cell, and aplastic anemia; anemia of chronic disease |
| Hep A transmission | fecal-oral (contaminated food or water) |
| found in feces, bile, and sera of infected individuals | Hep A |
| Hep B transmission | STD; contact with infected blod, body fluids, or contaminated needles |
| Hep C virus | IV drug use |
| Hep D | only occurs in individuals with Hep B |
| relies on Hep B virus for replication | Hep D |
| Hep E transmission | developing countries fecal-oral; contaminated water |
| Hep G | new strain; sexually transmitted, unknown |
| parietal pain | localized and intense; arises from organs themselves |
| visceral pain | dull, poorly localized and difficult to describe; related to the corresponding skin dermatomes of the affected organ |
| referred pain | visceral pain felt at some distance from a diseased or an affected organ |
| GERD | gastroesophageal reflux disease |
| reflux of chyme from the stomach to the esophagus | GERD |
| most common portal hypertension manifestation | vomiting of blood from bleeding esophageal varices |
| splenomegaly | enlargement of the spleen |
| thrombocytopenia | decreased platelet count |
| most common manifestation of splenomegaly | thrombocytopenia; secondary to portal hypertension increasing intrasplenic blood pressure |
| progression of atherosclerosis | damaged endothelium, fatty streak, fibrous plaque, complicated lesion |
| chronic coronary obstruction results in recurrent predictable chest pain | stable angina |
| abnormal vasospasm of coronary vessels results in unpredictable chest pain | Prinzmetal angina |
| myocardial ischemia that does not cause detectable symptoms | silent ischemia |
| angina pectoris | substernal chest discomfort, ranging from a sensation of heaviness or pressure to moderately severe pain |
| Prinzmetal angina issues | often occurs at night during REM sleep and may have a cyclic pattern of occurrence; hyperactivity of the SNS |
| rheumatic fever | diffuse, inflammatory disease caused by a delayed immune response to infection by group A beta-hemolytic streptococcus |
| rheumatic heart disease | untreated rheumatic fever causes scarring and deformity of cardiac structures |
| responsible for hypertrophy of the myocardium associated with hypertension | ang. II |
| aneurysm | localized dilation or outpouching of a vessel wall or cardiac chamber |
| most common cause of aneurysm | atherosclerosis |
| reason atherosclerosis is most common cause of aneurysms | plaque formation erodes the vessel wall |
| stimulates release of catecholamines which increase heart rate and peripheral vascular constriction; blood pressure increases along with cardiac workload and oxygen demand | nicotine |
| stimulate release of free fatty acids; raises LDL and lowers HDL levels | elevated catecholamine levels from nicotine use |
| R sided heart failure | pressure rise in systemic venous circulation resulting in peripheral edema and hepatosplenomegaly |
| L sided heart failure | causes pulmonary edema, myocardial hypertrophy and ischemia; dyspnea on exertion, fatigue |
| evidenced by rales on auscultation, pleural effusions | L sided heart failure |
| shift to the left on CBC differential | bandshift out of control; signifies acute infection; increase in leukocytes |
| shift to the right on CBC differential | bandshift under control; correct antibiotics being used; return to normal |
| AML- acute myelogenous leukemia | abnormal proliferation of myeloid precursos cells, decreased rate of apoptosis, and an arrest in cellular differentiation; complications of bleeding and infection |
| CLL- chronic lymphocytic leukemia | malignant transformation and progressive accumulation of monoclonal B lymphocytes; failure of B cells to mature into plasma cells that synthesize immunoglobulins |
| CML- chronic myelogenous leukemia | invasion of bone marrow by fibrous tissue |
| distinguishing and diagnostic marker for CML | presence of Philadelphia chromosome |
| MM- multiple myeloma | neoplastic proliferation of immunocytes called plasma cells |
| manifestations of MM | cortical and medullary bone lysis and infiltrate bone marrow; pain, renal failure, recurrent bacterial infections, fatigue, wt. loss, weakness, anorexia |
| may cause hypercalcemia characterized by neurologic disturbances: confusion, lethargy, weakness; also other renal complications | multiple myeloma- MM |
| HL- Hodgkin lymphoma | marked by presence of Reed-Sternberg (RS) cells surrounded by a background of benign-appearing host inflammatory cells |
| HL clinical manifestations | enlarged painless mass, found mostly in the neck, pain exacerbated with alcohol ingestion; asymptomatic mediastinal mass; leukopenia |
| NHL- Non-Hodgkin lymphoma | progressive clonal expansion of B cells, T cells, NK cells; oncogenes activated by chromosomal translocations |
Created by:
jjannett
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