Maryville NUR 611 Patho Exam 3;

Explain the pathophysiology associate with Type 1 and Type 2 DM. DM 1 - ANSWER Is the result of an autoimmune mediated specific loss of beta cells in the pancreatic islet. One of the basic patho of type 2 DM is the development of insulin resistant tissue cells. Explain what occurs in panhypopituitarism - ANSWER Panhypopituitarism is the term correctly associated with the lack of all anterior pituitary hormones. List the clinical manifestations of hypothyroidism - ANSWER The individual develops a low basal metabolic rate, cold intolerance, lethargy, tiredness, and slightly lower basal body temperature. Differentiate diabetes insipidus, diabetes mellitus and SIADH - ANSWER DM: is not a single disease but a group of clinical heterogeneous disorders that have glucose intolerance in common. DI: is an insufficiency of ADH, leading to polyuria and polydipsia. SIADH: is characterized by high levels of ADH in the absence of normal physiologic stimuli for its release. The symptom common to all these conditions is thirst. What causes the microvascular complications of DM - ANSWER Microvascular complications are a result of capillary basement membranes thickening and endothelial cell hyperplasia. What is the cause of diabetes insipidus - ANSWER Inability of the kidney to increase permeability of water. This causes excretions of large volumes of dilute urine, leading to increase in plasma osmolality. Describe the pathophysiological changes associated with Addison's disease - ANSWER Addison disease is a result of hyposecretion of adrenal cortex hormones. Describe the pathophysiological changes associated with hypoparathyroidism - ANSWER The most common cause of hyperparathyroidism is damage caused during thyroid surgery. In hypothyroidism a lack of circulating PTH causes a depressed serum calcium level resulting in the symptomatology mentioned in the stem. What are the causes and pathophysiological changes associate with ketoacidosis? - ANSWER In a state of relative insulin deficiency there is an increase in insulin counter regulating hormones including catecholamine's, cortisol, glucagon, and GH. Catecholamine's, cortisol,glucagon and GH antagonize insulin by increasing glucose production. In addition, these hormones decrease use of glucose. Profound insulin deficiency results in decrease glucose uptake, increase fat mobilization with release if fatty acids, and accelerated gluconeogenesis and ketogenesis. Ordinarily, ketones are used by tissues as an energy source to regenerate bicarbonate. Hyperkalemia is a result of a compensatory mechanism directed at eliminating metabolic acidosis. What is acromegaly? - ANSWER Acromegaly is a term for adults who have been exposed to continuously high levels of GH, whereas the term gigantism is reserved for children and adolescents. Differentiate hypothyroidism and Graves' disease - ANSWER One of the cause's hypothyroidism is a deficiency of endemic iodine. Hypothyroidism are the lower levels of thyroid hormone, without the negative feedback of TH in the pituitary, there is an increase secretion of TSH that may lead to goiter. As a result in decreased energy metabolism resulting in constipation, regulatory mechanisms are overridden by abnormal immunologic mechanisms that result in the stimulation of excessive TH. The systemic symptoms of thyrotoxic crisis include hyperthermia and tachycardia; the remaining options are not associated with this disorder. Describe the pathophysiology related to chronic DM - ANSWER A number of serious complications are associated with any type of DM and include microvascular (retinopathy, nephropathy, and neuropathy) and macrovascular (CAD, CVA, PVD) disease and infection. What happens during hypoglycemia? - ANSWER A person with type 1 DM experiences hunger, lightheadedness, tachycardia, pallor, HA and confusion. The most likely cause of these symptoms is hypoglycemia, which is often caused by a lack of systemic glucose resulting from muscular activity. What is the metabolic syndrome? - ANSWER It also has been called the insulin resistance syndrome or syndrome X. It is a clustering of clinical traits occurring together that increase the risk for accelerated cardiovascular disease and type 2 DM. Combination of medical disorders that increase the risk of developing cardiovascular disease and DM. Describe how DM causes peripheral neuropathy - ANSWER It is a form of "dying back" neuropathy, in which the distal portions of the neurons are initially and eventually more severely affected. The earliest morphologist change in both the peripheral nerves and CNS is axonal degeneration that preferentially involves sensory nerve fibers, particularly the smaller polymodal unmyelinated peripheral C fibers and the larger myelinated A delta fibers. Trace the electrical activity of the heart. - ANSWER Normally electrical impulses arise in the SA nose, which is often called the pacemaker of the heart.The SA node is located at the junction of the right atrium and superior vena cava, just above the tricuspid valve. Numerous automatic nerve endings are within the node. The SA node is heavily innervated by both sympathetic and parasympathetic nerve fibers. The SA node P cells, so-called because they are pale and primitive appearance, are assumed to be the site of impulse formation. The action potential is transmitted from the atrial to the ventricular myocardium through fibers of the conduction system, traveling first to the AV node then the bundle of his and finally through the bundle branches of the interventricular septum to Purkinje fibers of the heart wall. Identify the location of the neurotransmitters in the heart. - ANSWER Sympathetic neural stimulation of the myocardium and coronary vessels depends on the presence of adrenergic receptors, which bind specifically with neurotransmitters of the sympathetic nervous system.