PATHOPHYSIOLOGY Final EXAM Questions and Answers Latest (2024 / 2025) (Verified Answers)

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Pathophysiology Final Exam u u




Review
Hypopituitarism
Etiologyu ou Congenital,u geneticdisease
o Destructionuofutheuglandu(surgery/uradiation)
o Tumor/umassulesionsuouPituitaryuinfection
o Deficiencyuofuhypothalamicuhormones

Disorders of the posterior pituitary
u u u u


ADH
• ADH:upeptideusynthesizedubyucellsuinutheuhypothalamusu-
>utransportedualonguauneuralupathwayu->ustoreuinupituitary
• NerveuimpulsesucausesustoreduADHutoubeureleaseduintoucirculationubaseduonuserumu
osmolalityu(soubaseduonuwhatuyourubodyuneeds)uouTooumuchuconcentrationu–
uyouuholdupeeutoubalance
▪ Veryusweetujuice,uyouudiluteuituwithuwaterusouyouuholduituinuouTooulittleuc
oncentration-uyouuletuituout
▪ Unsweetenedujuice,uyouupeeuituoututoumakeuitusweet
ExertsueffectsuonutubularucellsuofutheukidneyutoucauseureabsorptionuofuwateruOsmolality
uisuhowuconcentrateduorudilutedutheuserumuis
SensitiveuchangesuinubloodupressureuanducanuleadutoutheureleaseuofuADH
AbnormalusynthesisuofuADHubecauseuofutrauma,ustress,usevereupain,unauseauanducertainu
medications
YouucanucheckuforuosmolalityuonuaubloodutestuUsu
allyu280-310uosm/L
Isotonicu–u300
Lactateuringers,unormalusalineu0.9%u
Hypertonicu–uaboveu300
Hypotonic-ulessuthanu300
Triggeruisuhigherutheuosmolalityutheuhigherutheuconcentration

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SecretesuADHuanduADHuvasoconstrictsuandukeepsufluiduonuboarduCome
sufromuposteriorupituitary

SIADH vs DI
u u



DiabetesuinsipidusuI SIADH
(syndromeuofuinappropriateuADH)
nsipidusu–nouflavor SuperuincreaseduADH




ADHu(regulatesuH2O)uan Deficiency Excessiveusecretion
duvasoconstriction


Serumuosmolality ↑blooduveryuconcentrated ↓blooduveryudiluted

Urineuosmolality ↓ ↑

Urineuoutput Highuurineuoutput Lowuurineuoutput
(diluted)u5-24uLuperuday




Fluiduvolumeustatus Deficit Overload

Sodiumulevel Hypernatremia Hyponatremia


• Diabetesuinsipidusuisuaudisorderuofutheuposteriorulobeuofutheupituitary
• Vasodepressor
• Diabetesuinsipidusuareuunableutouconcentrateutheiruurineuanduexcretesulargeuvolumesuofu
urineuouCNSucomponentutouitubecauseuofusomethinguinutheuADHuex:uheadutrauma,usurg
ery
• Whenukidneysudon’turespondutouADH
• DrugsuthatucauseuDI-uelectrolyteudisorders…
• Weucanuevaluateuantidiureticuhormoneulevelsualonguwithuosmolalityuofutheuurine
• Ifuyouucan’tuexcreteuurineuitustaysuinutheutissueuouPolyuria:ulotsuofuurineuouSodiumuisulowub
ecauseuthereuisuaulotuofufluiduouSyndromeuofuADHuisuauresultuofubrainutumors
• Brainutumorsucanustartusecretinguhormones
ou-surgeryuo
-temperatureuchanges

Disorders of the thyroid
u u u


• ThyroidureleasesuT3uanduT4

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• Bothuareucarriedubyubindinguproteins
• T3ustimulatesumetabolism
• T4uisuinactiveuuntiluconverteduintouT3uinutheutissuesuouNeedsuiodineutouactivate
• Bothuexertunegativeufeedbackuonutheuhypothalamus
• Locateduinutheularynx
• TSHuisuveryuimportantuinuhypouanduhyperthyroidismuanduhowuweumeasureuthyroidu
function

Actions of the thyroid hormone
u u u u


• Mostumajoruorgansuareuaffectedubyualteredulevelsuofuthyroiduhormone
ouMetabolicurate
▪ Glucose,ufat,uanduproteinuusage
▪ Lipidsumobilizedufromuadiposeutissue
▪ Catabolismuofucholesterolubyutheuliver
▪ MuscleuproteinuisubrokenudownuanduuseduasufueluouCardiovascularufunction
▪ Increaseuinuoxygenuconsumption
▪ Increaseuinuvasodilation
▪ Increaseuinuhearturateuanducontractility,uBP
▪ TachycardiauouGIufunction
▪ Absorptionuisuincreased
▪ GIusecretions
▪ Hungry
▪ HyperactiveubowelusoundsuouNeuromuscularueffects
▪ Reactumoreuvigorously
• Hypereflexsive

Clinical manifestations
u


• MetabolicurateuouBasalumetabolicurateucanuincreaseubyu60-
100%uaboveunormaluwithutheulargeuamountsuofuT4uareupresentuouIncreaseuuseuofu
protein,uglucoseuandufat

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lOM oA R u u
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Muscleuproteinsubrokenudownuanduuseduasufuel
ouChangesuinucholesterol
• CardiovascularufunctionuouWithuincreaseumetabolism=uriseuinuoxygenuc
onsumption,uproductionuofuenduproducts
o Vasodilation
o Increaseublooduvolume,ucardiacuoutput,uHRuanducontractility
• GIuFunction
ouIncreaseuinumotilityuanduproductionuofuGIusecretionsu(diarrhea)uouIncreaseuinua
ppetiteuouWeightuloss
• NeuromuscularueffectsuouChangesuinuskeletalumuscleureaction
▪ Hyperthyroid:ufineumuscleutremor,uextremeunervousness,uanxiety
▪ IncreaseduHR,upalpitations

Diagnostics
• T3
o Lowuinuprimaryuhypothyroidism
• T4
o Measuresuunbounduportionu(producesueffects)uouFreeuT4udecreaseduinuprimaryuh
yperthyroidism
• TSH
ou Differentiatesubetweenuprimaryuandusecondaryuthyroidudisorders
• Radioiodineuuptakeutest
• UltrasounduouCystsuorulesions
• CT/MRI
• NeedleubiopsyuouDoneuwithuguideduultrasound
□uWillutelluifubenignuorumalignant

WeureallyulookuatuTSHuanduisuimportantuinutheunegativeufeedbackuloop
HypothyroidismuisuelevateduTSHubecauseuitukeepsusendingutheusignalutouincreaseuT3uanduT4uW
eumonitorumedicationutherapyuthroughuthis
TSHuincreased,uT3uanduT4udecreased

Hyperthyroidism
• Excessivelyuhighulevelsuofucirculatinguthyroiduhormone
• CommonucausesuouGravesudisease
▪ Enlargeduthyroid