Pathophysiology Midterm - Jersey College Questions and answers

Pathophysiology Midterm - Jersey College Questions and answers Secondary level of prevention Happens after an illness or serious risk factors have already been diagnosed. Tertiary level of protection Focuses on helping people manage complicated, long-term health problems Biopsy Examination of living tissue Prognosis The probability of specific outcomes Etiology Concerns the causative factors in a particular disease Epidemiology The science of tracking the pattern or occurrence of disease Latent Stage "silent stage" No clinical signs are evident, characterizes some diseases Acute Stage Short-term that develops quickly with marked signs Chronic Stage Often milder developing gradually Morbidity The disease rates within a group Mortality Indicate the relative number of deaths resulting from a particular disease Symptoms Subjective feelings, such as pain or nausea Precipitating Factor condition that triggers an acute episode (seizure) Remission mark the course or progress of a disease; manifestations subside Complication new, secondary or additional problems that arise after the original disease begin Apoptosis Cell death Atrophy Decrease in the size of cells Anaplasia cells that are undifferentiated with variable nuclear and cell structures What is gangrene? An area of necrotic tissue that has been invaded by bacteria. Why does gangrene smell? May cause a buildup of gases with tissue and further reduce blood supply Hypertrophy Increase in the size of individual cells Dysplasia cells vary in size and shape, large nuclei are frequently present Signs & Symptoms of dehydration Dry mucous membranes, decreased skin turgor, Low BP, Low pulse, fatigue, Increased HCT, decreased mental function, confusion, and loss of consciousness Serum Sodium Level: 135 mEq/L Hyponatremia Anorexia, nausea, cramps, fatigue, lethargy, muscle weakness, headache, confusion, seizures, decreased BP Hypernatremia Thirst, tongue and mucosa are dry and sticky, weakness, lethargy, agitation, edema, elevated BP Serum potassium level 3.5-5.5 Hypokalemia Cardiac arrhythmias, cardiac arrest, anorexia, nausea, constipation, fatigue, muscle twitch, weakness, leg cramps, shallow respirations, paresthesias, postural hypotension, polyuria, nocturia, Serum pH elevated (alkalosis) Hyperkalemia Arrhythmias, cardiac arrest, nausea, diarrhea, muscle weakness, paralysis beginning in legs, parathesias (finger, toes, face, tongue) oliguria, Serum pH decreased (acidosis) Signs & symptoms of hypocalcemia Tetany (involuntary skeletal muscle spasm, carpopedal spasm, laryngospasm), tingling fingers, mental confusion, irritability, arrhythmias, weak hear contractions Normal Serum pH 7.35-7.45 COPD: Acidosis or Alkalosis? Respiratory Acidosis Therapeutic desired action by stimulating or inhibiting cell function Idiosyncratic Paradoxic; Unexpected or unusual responses to drugs Pain is what? Subjective, unpleasant sensation, feeling of discomfort resulting from stimulation of pain receptors Referred pain with common examples Pain is perceived at a site distant from the source; pain in the left neck and arm for heart attack or ischemia of the heart; Pain in the shoulder due to stretching of the diaphragm Phantom pain Pain or another sensation such as itching or tingling after amputation Central Pain pain that is caused by dysfunction or damage to the brain or spinal cord. Ex: abscess, infarction, hemorrhage, tumor, or damage Ischemic Pain profound, sudden loss of blood flow to an organ or tissues in a specific area of the body. Ex: aching, burning or prickling to a shooting pain What causes inflammation Direct physical damage, caustic chemicals, ischemia or infarction, allergic reactions, extremes of heat or cold, foreign bodies What does Erythrosedimentation (ESR) tell us? The rate at which RBC's settle out of a blood specimen (containing anticoagulant); an elevation in ESR is a general characteristic of inflammation. Serous Drainage watery exudates consist primarily of fluid with small amounts of protein and white blood cells Purulent Drainage exudates are thick, yellow-green in color, and contain more leukocytes and cell debris as well as microorganisms. Signs & symptoms of inflammation mild fever, malaise (feeling unwell), fatigue, headache, and anorexia What cells respond to inflammation? Neutrophils Adverse effects of steriods Atrophy of lymphoid tissue and reduced numbers of WBCs, Catabolic effects (increased tissue breakdown with decreased protein synthesis) osteoporosis, muscle wasting, and tendency of thinning and breakdown of skin and mucosa, delayed healing, delayed growth in children, retention of sodium and water often leading to high BP and edema What are the steps to break the chain of infection - Transmission: Direct (saliva, blood, feces, semen, exudates) Indirect (respiratory droplet on hands or surfaces, insect bites (vectors), contaminated food and water) - Entry: Mouth, nose, broken skin, vagina - Susceptible Host: Health status, point of entry, number of microbes - Incubation period (asymptomatic) - Infectious Disease - Reservoir: Source (person, animal, insect, environment, in the home, workplace, or community (bus,store) Sterilization exposure to heat using several methods, autoclaving Disinfection chemical solutions that are known to destroy microorganisms or their toxins on inanimate objects Antisepsis chemicals applied to the body that do not usually cause tissue damage, such as isopropyl alcohol-70%, which is the active ingredient in hand sanitizers Septicemia caused by multiplication of pathogens in the blood Lymphadenopathy manifest by swollen and tender lymph nodes What are the organs of the immune system? lymph nodes, spleen, tonsils, intestinal lymphoid tissue, and the lymphatic circulation What are the lab findings that responds if a worm infection is present? (WBC) Eosinophils Natural Active Pathogens enter body and cause illness; antibodies from in host Artificial Active Vaccine (live or attenuated organisms) is injected into person. No illness results, but antibodies form Natural Passive Antibodies passed directly from mother to child to provide temporary protection (breastmilk) Artificial Passive Antibodies injected into person (antiserum) to provide temporary protection or minimize severity of infection Which types of reactions are anaphylactic? - Skin: pruritus, tingling, warmth, hives - Respiration: difficulty in breathing, cough, wheezing, tight feeling - Cardiovascular: decreased BP - CNS: anxiety and fear (early); weakness, dizziness, and loss of consciousness Diagnostic test for joint disease (procedure) Arthroscopy: Insertion of a lens directly into the joint Electromyograms: measure the electrical charge associated with muscle contraction adn are helpful in differentiating muscle disorders from neurologic disease Open fracture is at risk for? More damage to soft tissue, including the blood vessels and nerves, and much higher risk for infection Compartment Syndrome Develops shortly after the fracture occurs when there is more extensive inflammation, such as with crush injuries. Increased pressure of fluid within the fascia compresses the nerves and blood vessels, causing severe pain and ischemia or necrosis of the muscle. Normal RBC count 4.2-5.9 million Normal WBC count WBC: (leukocytes): 4,500-10,500 What does erythropoietin change? Originates from the kidneys, stimulates erythrocyte production in the red bone marrow in response to tissue hypoxia. Signs & Symptoms of Anemia - Pallor of skin and mucous membranes - Fatigue, lethargy, and cold intolerance - Irritibility - Degenerative changes - Stomatitis - Menstrual irregularities - Delayed healing - Tachycardia, heart palpitations, dyspnea, and syncope (fainting) Treatment for Pernicious Anemia Vitamin B12 injections Signs & Symptoms of Polycythemia Plethoric and cyanotic (deep bluish-red tone of the skin and mucosa), sluggish blood flow, Hepatomegaly, and splenomegaly, pruritus, increased BP, pulse is full and bounding, dyspnea, headache, visual disturbances, Thromboses of extremities, liver, or kidneys as well as brain or heart, CHF, High uric acid levels Normal Heart contuction SA Node - Internodal pathways - Atrioventricular (AV) Node - AV bundle (bundle of HIS) - right and left bundle branches - purkinje fibers What causes the sounds of a heart murmur? Valvular abnormalities or abnormal shunts of blood. Lab tests for MI, what enzymes are we looking for? Troponin blood test: measures the levels of blood proteins called troponins Nonmodifiable risk factors for cardiac disease? Age, Gender, Genetic or familial factor Dietary modifications to reduce heart disease Healthy diet, regular exercise, moderation in alcohol intake, cessation of smoking, safe sexual practices, immunizations, monitoring body weight and BP, basic screening for cholesterol and cancer Signs & Symptoms of MI - Pain: Chest pain, left arm, shoulder, jaw, or neck - Pallor, nausea, dizziness, weakness, dyspnea - Marked anxiety or fear - Hypotension - Low-grade fever Treatments for MI (nurses) - MONA Anticoagulants, thrombolytic agents, medication to reduce dysrhythmias, defibrillation, or a pacemaker, bypass surgery, cardiac rehab Medical Diagnosis Refers to the identification of a specific disease through evaluation of signs and symptoms, lab tests or other tools. More than one factor is usually required to verify a diagnosis. Preventative measures of disease Closely linked to etiology and predisposing factors for a specific disease. Preventive measures include vaccinations, dietary or lifestyle modifications, removal of harmful materials in the environment, and cessation of potentially harmful activities such as smoking. Neoplasia "new growth" commonly called a tumor. Objective symptoms Signs are objective indicatiors of disease that are obvious to someone other than the affected individual e.g. fever or a skin rash Importance of medical history essential to identify any impact health care activities might have on a patient's condition, or how a patient's illness might complicate care. Andalusia Refers to cells that are undifferentiated with variable nuclear and cell structures and numerous meiotic figures Labs that changes with dehydration Increased HCT, increased electrolyte, in urine: specific gravity, low volume Timing medication dosage to keep a therapeutic level Optimum dosing schedules are establisted for each drug based on factors such as absorption, transport in the blood, half life of the particular drug and biotransformation Speech/language pathologist specialist in assessment and treatment of those with communication or swallowing problems Naturopathic Based on promoting natural massage, exercise and freash air as a way of life, thus enhancing health and preventing disease. Acupuncture, herbal medicines, nutrition, massage and physical manipulations all have roles. Sublingual meds very simple to use, portable, time frame to work (immediate, directly into blood, little loss of drug) convenient rapid action, tablets soft and unstable Non-contact therapeutic touch energy exchanged betweent two people to relieve pain and anxiety to promote healing Osteopathy Osteopaths are medical doctors who use all the traditional treatment methods such as surgery and drugs, but in addition, promote the body's natural healing processes by incorporating manipulations of the muscoskeletal system both in diagnosis and treatment Ayurveda this system of medicine originated in India and is practiced today. Its goal is to balance body dosas or factors so that a healthy mind and body result Pt education on codeine Codeine is a narcotic, a morphine derivative, acting at the opiate receptors in the CNS. Taking it with food or milk can reduce gastric irritation, Block the pain pathway in the spinal cord and brain and also alter the perception of pain in a positive manner. In long term use tolerance develops, narcotics have a number of adverse affects and concern is with addiction. Nonpharmacological treatment for pain stress reduction, relaxation therapy, distraction, applications of heat and cold, massage, physiotherapy modalities, exercise, therapeutic touch, hypnosis imaging and acupuncture Fungi Found everywhere, on animals, plants, humans, and foods, growth of various types of fungi can be observed easily on cheese, fruit or bread. Fungal or mycotic infection results from single celled yeasts or multicellular molds. These organisms are classified as eukaryotic and consist of single cells or chain of cells Bacteria Unicellular organisms that do not require living tissue to survive, Vary in shape, arrangement Virus Small obligate intracellular parasite that requires a living host cell for replication. The need for viruses for living tissue complicates any laboratory procedure to grow or test viruses Amoeba Motile group of protozoa, moving by extending part of their cytoplasm and flowing forward(ambeoid movement) They engulf food in the same order