PATHOPHYSIOLOGY EXAM 1 RASMUSSEN
UNIVERSITY
Stages of general adaptation syndrome - answer- 1. Alarm
Initial reaction
Sympathetic nervous system
2. Resistance
Adaptation
Limit stressor
3. Exhaustion
Adaptation failing
Disease develops
Edema - answer- Excess fluid in the interstitial space
Dehydration (ECF volume deficit) - answer- Can occur independently without electrolyte
defects
Decrease in fluid level leads to increase in level of blood solutes
Cell shrinkage
Hypotension
Hypovolemia or fluid volume deficit - answer- Decreased fluid in the intravascular space
Hypotonic Hydration - answer- (fluid overload)
Causes of Fluid Deficit - answer- Inadequate fluid intake
Poor oral intake
Inadequate IV fluid replacement
Excessive fluid or sodium losses:
Gastrointestinal losses Excessive diaphoresis Prolonged hyperventilation Hemorrhage
Nephrosis Diabetes mellitus Diabetes insipidus Burns Open wounds Ascites Effusions
Excessive use of diuretics Osmotic diuresis
Deydration Manisfestations - answer- thirst, altered level of consciousness,
hypotension, tachycardia, weak and thready pulse, flat jugular veins, dry mucous
membranes, decreased skin turgor, oliguria, weight loss, and sunken fontanelles
Cancer Benign - answer- Slow, progressive, localized, well defined, resembles host
(more differentiated), grows by expansion, does not usually cause death
,Cancer Malignant - answer- Rapid growing, spreads (metastasis) quickly, fatal, highly
undifferentiated
Sodium - answer- Normal range: 135-145 mEq/L.
• Most significant cation and prevalent electrolyte of extracellular fluid.
• Controls serum osmolality and water balance. Plays a role in acid-base balance.
• Facilitates muscles and nerve impulses.
• Main source is dietary intake.
• Excreted through the kidneys and gastrointestinal tract.
Hypernatremia - answer- Sodium > 145 mEq/L
Serum osmolarity increases
• Results in fluid shifts
Causes of Hypernatremia - answer- Excessive sodium ingestion Hypertonic IV saline
(3% saline) administration
Cushing's syndrome
Corticosteroid use
Diarrhea
Excessive sweating
Prolonged episode of hyperventilation
Diuretic use Diabetes insipidus
Decreased water ingestion
Loss of thirst sensation
Inability to drink water
Third spacing
Vomiting
Hypocalcemia Manifestations: - answer- dysrhythmias, electrocardiogram changes,
increased bleeding tendencies, anxiety, confusion, depression, irritability, fatigue,
lethargy, paresthesia, increased deep tendon reflexes, tremors, muscle spasms,
seizures, laryngeal spasms, increased bowel sounds, abdominal cramping, and positive
Trousseau's and Chvostek's signs
Нуросalcemia Treatment - answer- Identify and manage underlying cause Calcium
replacement (oral or intravenous) Vitamin D Decrease phosphorus
Phosphorus - answer- Normal range: 2.5-4.5 mg/dL.
Mostly found in the bones; small amounts are in the bloodstream.
Plays a role in bone and tooth mineralization, cellular metabolism, acid base balance,
and cell membrane formation.
Main source is dietary intake.
Excreted through the kidneys.
Hyperphosphatemia - answer- Phosphorus > 4.5 mg/dL
, Hyperphosphatemia Causes - answer- Deficient excretion: renal failure,
hypoparathyroidism, adrenal insufficiency, hypothyroidism, and laxatives Excessive
intake or cellular exchange: cellular damage, hypocalcemia, and acidosis
Hypophosphatemia - answer- Phosphorus < 2.5 mg/dL
Hypophosphatemia Causes - answer- Excessive excretion or cellular exchange: renal
failure, hyperparathyroidism, and alkalosis Deficient intake: malabsorption, vitamin D
deficiency, magnesium and aluminum antacids, alcoholism, and decreased dietary
intake
Hypophosphatemia Treatment: - answer- Identify and manage the underlying cause
Phosphorus replacement (oral or intravenous)
Magnesium - answer- Normal range: 1.8-2.5 mEq/L.
An intracellular cation. Mostly stored in the bone and muscle.
Plays a role in muscle and nerve function, cardiac rhythm, immune function, bone
strength, blood glucose management, blood pressure, energy metabolism, and protein
synthesis.
Main source is dietary intake. Excreted through the kidneys.
Hypermagnesemia - answer- Magnesium > 2.5 mEq/L
Hypomagnesemia - answer- Magnesium < 1.8 mEq/L
Hypomagnesemia Treatment: - answer- magnesium replacement (oral or intravenous)
Signs of Inflammation: - answer- redness, heat, swelling, pain, loss of function
Hypersensitivity - answer- Inflated response to antigen Leads to inflammation, which
destroys healthy tissue Can be immediate or delayed
Hypersensitivity types: - answer- Type I: IgE mediated
Type II: cytotoxic hypersensitivity reaction
Type III: immune complex-mediated
Type IV: delayed hypersensitivity reaction
Type I, IgE mediated - answer- Produces an immediate response.
Local or systemic.
Allergen activates T-helper cells that stimulate B cells to produce IgE.
-IgE coats mast cells and basophils, sensitizing them to the allergen.
At next exposure, the antigen binds with the surface IgE, releasing mediators and
triggering the complement system.
Repeated exposure to large doses of allergen is necessary to cause this response.
UNIVERSITY
Stages of general adaptation syndrome - answer- 1. Alarm
Initial reaction
Sympathetic nervous system
2. Resistance
Adaptation
Limit stressor
3. Exhaustion
Adaptation failing
Disease develops
Edema - answer- Excess fluid in the interstitial space
Dehydration (ECF volume deficit) - answer- Can occur independently without electrolyte
defects
Decrease in fluid level leads to increase in level of blood solutes
Cell shrinkage
Hypotension
Hypovolemia or fluid volume deficit - answer- Decreased fluid in the intravascular space
Hypotonic Hydration - answer- (fluid overload)
Causes of Fluid Deficit - answer- Inadequate fluid intake
Poor oral intake
Inadequate IV fluid replacement
Excessive fluid or sodium losses:
Gastrointestinal losses Excessive diaphoresis Prolonged hyperventilation Hemorrhage
Nephrosis Diabetes mellitus Diabetes insipidus Burns Open wounds Ascites Effusions
Excessive use of diuretics Osmotic diuresis
Deydration Manisfestations - answer- thirst, altered level of consciousness,
hypotension, tachycardia, weak and thready pulse, flat jugular veins, dry mucous
membranes, decreased skin turgor, oliguria, weight loss, and sunken fontanelles
Cancer Benign - answer- Slow, progressive, localized, well defined, resembles host
(more differentiated), grows by expansion, does not usually cause death
,Cancer Malignant - answer- Rapid growing, spreads (metastasis) quickly, fatal, highly
undifferentiated
Sodium - answer- Normal range: 135-145 mEq/L.
• Most significant cation and prevalent electrolyte of extracellular fluid.
• Controls serum osmolality and water balance. Plays a role in acid-base balance.
• Facilitates muscles and nerve impulses.
• Main source is dietary intake.
• Excreted through the kidneys and gastrointestinal tract.
Hypernatremia - answer- Sodium > 145 mEq/L
Serum osmolarity increases
• Results in fluid shifts
Causes of Hypernatremia - answer- Excessive sodium ingestion Hypertonic IV saline
(3% saline) administration
Cushing's syndrome
Corticosteroid use
Diarrhea
Excessive sweating
Prolonged episode of hyperventilation
Diuretic use Diabetes insipidus
Decreased water ingestion
Loss of thirst sensation
Inability to drink water
Third spacing
Vomiting
Hypocalcemia Manifestations: - answer- dysrhythmias, electrocardiogram changes,
increased bleeding tendencies, anxiety, confusion, depression, irritability, fatigue,
lethargy, paresthesia, increased deep tendon reflexes, tremors, muscle spasms,
seizures, laryngeal spasms, increased bowel sounds, abdominal cramping, and positive
Trousseau's and Chvostek's signs
Нуросalcemia Treatment - answer- Identify and manage underlying cause Calcium
replacement (oral or intravenous) Vitamin D Decrease phosphorus
Phosphorus - answer- Normal range: 2.5-4.5 mg/dL.
Mostly found in the bones; small amounts are in the bloodstream.
Plays a role in bone and tooth mineralization, cellular metabolism, acid base balance,
and cell membrane formation.
Main source is dietary intake.
Excreted through the kidneys.
Hyperphosphatemia - answer- Phosphorus > 4.5 mg/dL
, Hyperphosphatemia Causes - answer- Deficient excretion: renal failure,
hypoparathyroidism, adrenal insufficiency, hypothyroidism, and laxatives Excessive
intake or cellular exchange: cellular damage, hypocalcemia, and acidosis
Hypophosphatemia - answer- Phosphorus < 2.5 mg/dL
Hypophosphatemia Causes - answer- Excessive excretion or cellular exchange: renal
failure, hyperparathyroidism, and alkalosis Deficient intake: malabsorption, vitamin D
deficiency, magnesium and aluminum antacids, alcoholism, and decreased dietary
intake
Hypophosphatemia Treatment: - answer- Identify and manage the underlying cause
Phosphorus replacement (oral or intravenous)
Magnesium - answer- Normal range: 1.8-2.5 mEq/L.
An intracellular cation. Mostly stored in the bone and muscle.
Plays a role in muscle and nerve function, cardiac rhythm, immune function, bone
strength, blood glucose management, blood pressure, energy metabolism, and protein
synthesis.
Main source is dietary intake. Excreted through the kidneys.
Hypermagnesemia - answer- Magnesium > 2.5 mEq/L
Hypomagnesemia - answer- Magnesium < 1.8 mEq/L
Hypomagnesemia Treatment: - answer- magnesium replacement (oral or intravenous)
Signs of Inflammation: - answer- redness, heat, swelling, pain, loss of function
Hypersensitivity - answer- Inflated response to antigen Leads to inflammation, which
destroys healthy tissue Can be immediate or delayed
Hypersensitivity types: - answer- Type I: IgE mediated
Type II: cytotoxic hypersensitivity reaction
Type III: immune complex-mediated
Type IV: delayed hypersensitivity reaction
Type I, IgE mediated - answer- Produces an immediate response.
Local or systemic.
Allergen activates T-helper cells that stimulate B cells to produce IgE.
-IgE coats mast cells and basophils, sensitizing them to the allergen.
At next exposure, the antigen binds with the surface IgE, releasing mediators and
triggering the complement system.
Repeated exposure to large doses of allergen is necessary to cause this response.
