D236
Objective Assessment
STUDY GUIDE
Pathophysiology
Western Governors University
This document provides a focused study guide
• The guide is structured to help students
reinforce understanding, identify weak areas,
and prepare confidently for the assessment.
• you can review quickly and walk into exam
confident and prepared.
,Rhabdomyolysis: the breakdown of skeletal muscle tissue. In rhabdomyolysis, muscle
breakdown products, particularly myoglobin, accumulate in the bloodstream. At the
kidney, large amounts of myoglobin need to be Altered out of the blood at the nephrons.
Myoglobin is toxic to the nephrons and in large quantities will cause nephron tubule
dysfunction. Acute renal injury is common with rhabdomyolysis. Clinically, rhabdomyolysis
is exhibited by a triad of symptoms: myalgia, weakness, and myoglobinuria, demonstrated
by tea-colored urine. However, more than 50% of patients do not complain of muscle pain
or weakness, and the initial presenting symptom is dark urine (Tea colored Urine). An
elevated creatine kinase (CK) level is the most sensitive laboratory test for evaluating an
injury to muscle that has the potential to cause rhabdomyolysis (assuming no concurrent
cardiac or brain injury).
Phagocytosis: involves recognition and attachment of the leukocyte to the foreign matter,
engulfment, and degradation or killing of the ingested matter. During engulfment extensions
of the cytoplasm, called pseudopods, surround the foreign matter and pinch off, forming a
phagosome. The phagosome then contains the foreign matter, and lysosomal and granular
enzymes break it down.
Ovarian Cancer: HE4 Biomarkers, CA 125 Tumor Marker
Hypospadias: is a disorder in which the urethral orifice of the penis is positioned abnormally.
the urethral orifice is located on the ventral or underside of the penis instead of the glans.
Can be a cause of infertility. Requires surgical treatment. Hypo and Cryptorchidism
(undescended testes), (2) most common types of newborn male abnormalities
Appendicitis: Pain starts in the umbilical area then gradually becomes localized to right lower
quadrant of abdomen; called McBurney’s point. Extreme tenderness of right lower
quadrant. Perforation of the bowel and peritonitis are the major concerns of clinicians treating
disorders of the large intestine. The pain usually increases in severity over time
and localizes to the RLQ. The pain increases with any jarring movements, coughing, or
taking deep breaths. Nausea, vomiting, anorexia, fever, and chills are reported.
Constipation or diarrhea and abdominal bloating are usually present. Abdominal
distention and low-grade fever are usually present.
Patient wanting to remain stationary ¥ Psoas sign Examiner asks the
supine patient to actively flex the right thigh at the hip. If abdominal pain results,
this is positive for psoas sign.
¥ Jumping, coughing that hurts abdomen ¥ Rebound tenderness
The examiner deeply palpates the abdomen; upon release of the hand, the patient
feels intense pain.
¥ Guarding ¥ Roving’s sign The examiner palpates the LLQ of the abdomen. If pain in the
patients RLQ develops, this is positive for Roving’s sign.
,¥ Rectal pain * Obturator sign Internal and external rotation of the patients flexed right
hip causes pain in the RLQ
Lymphedema: Lymphatic blockage causing lymphedema or nerve impingement, which causes
numbness and tingling caused by enlarged lymph node.
Acute lymphocytic leukemia: ALL is an aggressive cancer that is more common in children
than adults. ALL accounts for 75% of all pediatric leukemia cases, with most affected
children under age 5. Onset is often subtle, and CLL is often discovered incidentally after a
blood cell count is performed for another reason. CNS sx: headache, easy bruising, and
Bleeding
crowding out healthy RBCs in the bone marrow, the patient may present with
anemia, which causes fatigue, weakness, dizziness, dyspnea, and pallor. Some
patients experience other vague symptoms, such as fevers, chills, night sweats,
and other flu like symptoms. Additionally, cancerous lymphoblast cells proliferate
within lymph nodes and the spleen and liver, increasing the size of these organs.
An enlarged lymph node or spleen is often the initial sign of ALL. Some patients experience
nausea or a feeling of fullness caused by an enlarged liver and spleen that places pressure on the
stomach; this can result in unintentional weight loss.
HPV: is a DNA virus in which approximately 70 distinct genetic types have been identified.
Several types of these are considered cancer-causing (oncogenic) viruses. Not all
cases of HPV go on to become cancer; however, the following have been associated
with the virus: Cancers of the cervix, vagina, and vulva in women ¥ Cancers of the penis in men
¥ Cancers of the anus and back of the throat, including the base of the tongue and tonsils
(oropharynx), in both women and men HPV infection is the most common STI in the world.
Condyloma acuminata, small wartlike lesions that are raised, ßat, or shaped like
cauliflower, may be present. There is no cure for HPV because it is a viral infection.
Infection occurs when mucosal epithelial cells in the host are exposed to HPV through a break in
the epithelial barrier, as would occur during sexual intercourse or after minor skin abrasions.
Hemodialysis: blood is drawn out of the body at a rate of 200 to 400 mL/minute and passed
through a device called a dialyzer. arteriovenous fistula created in the arm that can facilitate this
process. arteriovenous fistula created in the arm that can facilitate this process. tubular
connection between the brachiocephalic artery and cephalic vein is often surgically
implanted. Blood is drained from the brachiocephalic artery and pumped into a dialyzer,
which removes excess solutes and fluid from the blood. The blood is then returned to
the body via the cephalic vein. The dialysis solution is a sterile solution of electrolytes.
Urea and other waste products, such as potassium and phosphate, diffuse into the
dialysis solution. During the treatment, the patient’s entire blood volume (about 5,000
mL) circulates through the machine every 15 minutes. Electrolytes, serum albumin,
BUN, and serum creatinine are normalized during the dialysis procedure. The
procedure is usually required at least three times a week, and each session lasts 4 to 6
hours.
, Continuous renal replacement therapy (CRRT) is similar to hemodialysis; however, it
is a slower process used for patients who are hemodynamically unstable and fluid
overloaded. This continuous process takes smaller volumes of blood from the patient and filters
it through a dialyzer over 24 hours.
Chronic Renal Failure complications: CRF usually progresses to ESRD; as CRF progresses,
kidney function deteriorates to the point that the kidney is unable to excrete waste products or
control volume status, making dialysis or a kidney transplant the only options to support life. In
ESRD, there are body-wide adverse effects. As the disease progresses and other systems are
involved, the patient may develop respiratory compromise related to ßuid overload, HTN,
and uremic coma. Without definitive treatment, usually dialysis or transplantation, death will
occur. Encephalopathy, uremic frost and fetor, hypertension, hyperthyroidism, heart
Failure, infertility/ED, renal osteodystrophy, edema, high BUN/CR, anemia, electrolyte
imbalances, thrombocytopenia, peripheral neuropathy.
Prerenal Dysfunction: caused by decreased blood ßow and perfusion to the kidney. occurs
because of reduced cardiac output or severe hypovolemia (low blood volume). Large blood loss
from the body, as in hemorrhage, is a common cause of prerenal kidney injury caused
by ischemia.
Pancreatitis: inflammation of the pancreas that causes pancreatic insufficiency, malabsorption,
and diabetes. gallstones and alcohol abuse the most common causes. high blood
triglycerides, abdominal injury, and certain medications and toxins can also
cause. Chronic= alcohol. During the inflammatory process, the digestive enzymes
attack the pancreatic tissue, which causes autodigestion. chronic pancreatitis, recurring
inflammation occurs causing gradual destruction of the gland, leaving it nonfunctional,
fibrotic, and atrophied.
COPD: is a combination of chronic bronchitis, emphysema, and hyperreactive airway disease. It
is characterized by the features of these three disorders. ¥ What is the frequency and
quality of the cough? Is it productive of sputum? Is hemoptysis present? If so, how
much?¥ Has there been any wheezing?¥ Is there a history of smoking? If so, what is the
pack-year history?¥ Is secondhand smoke a problem at work or home?¥ Has there been
any weight loss? What is the patients pattern of exercise?¥ Is there a history of alcohol
use? Illicit drugs?¥ Is there a family history of respiratory illness? Signs and symptoms
of COPD include those of chronic bronchitis, emphysema, and asthma. Dyspnea
is usually the first symptom, initially occurring with heavy exertion. As the disease
progresses, dyspnea becomes increasingly worse with less and less vigorous exertion.
Cough or wheezing may be a chief complaint. The cough may be productive, and
sputum should be expectorated for culture. Productive cough, hypoxia, and cyanosis
are classic signs of chronic bronchitis. The hypoxia of chronic bronchitis stimulates
pulmonary arterial vasoconstriction. Over time, because of the high resistance against
the right ventricle, right ventricular failure occurs. The signs and symptoms of right-sided
heart failure, such as jugular venous distension, ascites, hepatosplenomegaly, and
ankle edema, develop after long-term chronic bronchitis. Impaired gas exchange
related to airflow obstruction- most concerning Observe the patient for signs of
Objective Assessment
STUDY GUIDE
Pathophysiology
Western Governors University
This document provides a focused study guide
• The guide is structured to help students
reinforce understanding, identify weak areas,
and prepare confidently for the assessment.
• you can review quickly and walk into exam
confident and prepared.
,Rhabdomyolysis: the breakdown of skeletal muscle tissue. In rhabdomyolysis, muscle
breakdown products, particularly myoglobin, accumulate in the bloodstream. At the
kidney, large amounts of myoglobin need to be Altered out of the blood at the nephrons.
Myoglobin is toxic to the nephrons and in large quantities will cause nephron tubule
dysfunction. Acute renal injury is common with rhabdomyolysis. Clinically, rhabdomyolysis
is exhibited by a triad of symptoms: myalgia, weakness, and myoglobinuria, demonstrated
by tea-colored urine. However, more than 50% of patients do not complain of muscle pain
or weakness, and the initial presenting symptom is dark urine (Tea colored Urine). An
elevated creatine kinase (CK) level is the most sensitive laboratory test for evaluating an
injury to muscle that has the potential to cause rhabdomyolysis (assuming no concurrent
cardiac or brain injury).
Phagocytosis: involves recognition and attachment of the leukocyte to the foreign matter,
engulfment, and degradation or killing of the ingested matter. During engulfment extensions
of the cytoplasm, called pseudopods, surround the foreign matter and pinch off, forming a
phagosome. The phagosome then contains the foreign matter, and lysosomal and granular
enzymes break it down.
Ovarian Cancer: HE4 Biomarkers, CA 125 Tumor Marker
Hypospadias: is a disorder in which the urethral orifice of the penis is positioned abnormally.
the urethral orifice is located on the ventral or underside of the penis instead of the glans.
Can be a cause of infertility. Requires surgical treatment. Hypo and Cryptorchidism
(undescended testes), (2) most common types of newborn male abnormalities
Appendicitis: Pain starts in the umbilical area then gradually becomes localized to right lower
quadrant of abdomen; called McBurney’s point. Extreme tenderness of right lower
quadrant. Perforation of the bowel and peritonitis are the major concerns of clinicians treating
disorders of the large intestine. The pain usually increases in severity over time
and localizes to the RLQ. The pain increases with any jarring movements, coughing, or
taking deep breaths. Nausea, vomiting, anorexia, fever, and chills are reported.
Constipation or diarrhea and abdominal bloating are usually present. Abdominal
distention and low-grade fever are usually present.
Patient wanting to remain stationary ¥ Psoas sign Examiner asks the
supine patient to actively flex the right thigh at the hip. If abdominal pain results,
this is positive for psoas sign.
¥ Jumping, coughing that hurts abdomen ¥ Rebound tenderness
The examiner deeply palpates the abdomen; upon release of the hand, the patient
feels intense pain.
¥ Guarding ¥ Roving’s sign The examiner palpates the LLQ of the abdomen. If pain in the
patients RLQ develops, this is positive for Roving’s sign.
,¥ Rectal pain * Obturator sign Internal and external rotation of the patients flexed right
hip causes pain in the RLQ
Lymphedema: Lymphatic blockage causing lymphedema or nerve impingement, which causes
numbness and tingling caused by enlarged lymph node.
Acute lymphocytic leukemia: ALL is an aggressive cancer that is more common in children
than adults. ALL accounts for 75% of all pediatric leukemia cases, with most affected
children under age 5. Onset is often subtle, and CLL is often discovered incidentally after a
blood cell count is performed for another reason. CNS sx: headache, easy bruising, and
Bleeding
crowding out healthy RBCs in the bone marrow, the patient may present with
anemia, which causes fatigue, weakness, dizziness, dyspnea, and pallor. Some
patients experience other vague symptoms, such as fevers, chills, night sweats,
and other flu like symptoms. Additionally, cancerous lymphoblast cells proliferate
within lymph nodes and the spleen and liver, increasing the size of these organs.
An enlarged lymph node or spleen is often the initial sign of ALL. Some patients experience
nausea or a feeling of fullness caused by an enlarged liver and spleen that places pressure on the
stomach; this can result in unintentional weight loss.
HPV: is a DNA virus in which approximately 70 distinct genetic types have been identified.
Several types of these are considered cancer-causing (oncogenic) viruses. Not all
cases of HPV go on to become cancer; however, the following have been associated
with the virus: Cancers of the cervix, vagina, and vulva in women ¥ Cancers of the penis in men
¥ Cancers of the anus and back of the throat, including the base of the tongue and tonsils
(oropharynx), in both women and men HPV infection is the most common STI in the world.
Condyloma acuminata, small wartlike lesions that are raised, ßat, or shaped like
cauliflower, may be present. There is no cure for HPV because it is a viral infection.
Infection occurs when mucosal epithelial cells in the host are exposed to HPV through a break in
the epithelial barrier, as would occur during sexual intercourse or after minor skin abrasions.
Hemodialysis: blood is drawn out of the body at a rate of 200 to 400 mL/minute and passed
through a device called a dialyzer. arteriovenous fistula created in the arm that can facilitate this
process. arteriovenous fistula created in the arm that can facilitate this process. tubular
connection between the brachiocephalic artery and cephalic vein is often surgically
implanted. Blood is drained from the brachiocephalic artery and pumped into a dialyzer,
which removes excess solutes and fluid from the blood. The blood is then returned to
the body via the cephalic vein. The dialysis solution is a sterile solution of electrolytes.
Urea and other waste products, such as potassium and phosphate, diffuse into the
dialysis solution. During the treatment, the patient’s entire blood volume (about 5,000
mL) circulates through the machine every 15 minutes. Electrolytes, serum albumin,
BUN, and serum creatinine are normalized during the dialysis procedure. The
procedure is usually required at least three times a week, and each session lasts 4 to 6
hours.
, Continuous renal replacement therapy (CRRT) is similar to hemodialysis; however, it
is a slower process used for patients who are hemodynamically unstable and fluid
overloaded. This continuous process takes smaller volumes of blood from the patient and filters
it through a dialyzer over 24 hours.
Chronic Renal Failure complications: CRF usually progresses to ESRD; as CRF progresses,
kidney function deteriorates to the point that the kidney is unable to excrete waste products or
control volume status, making dialysis or a kidney transplant the only options to support life. In
ESRD, there are body-wide adverse effects. As the disease progresses and other systems are
involved, the patient may develop respiratory compromise related to ßuid overload, HTN,
and uremic coma. Without definitive treatment, usually dialysis or transplantation, death will
occur. Encephalopathy, uremic frost and fetor, hypertension, hyperthyroidism, heart
Failure, infertility/ED, renal osteodystrophy, edema, high BUN/CR, anemia, electrolyte
imbalances, thrombocytopenia, peripheral neuropathy.
Prerenal Dysfunction: caused by decreased blood ßow and perfusion to the kidney. occurs
because of reduced cardiac output or severe hypovolemia (low blood volume). Large blood loss
from the body, as in hemorrhage, is a common cause of prerenal kidney injury caused
by ischemia.
Pancreatitis: inflammation of the pancreas that causes pancreatic insufficiency, malabsorption,
and diabetes. gallstones and alcohol abuse the most common causes. high blood
triglycerides, abdominal injury, and certain medications and toxins can also
cause. Chronic= alcohol. During the inflammatory process, the digestive enzymes
attack the pancreatic tissue, which causes autodigestion. chronic pancreatitis, recurring
inflammation occurs causing gradual destruction of the gland, leaving it nonfunctional,
fibrotic, and atrophied.
COPD: is a combination of chronic bronchitis, emphysema, and hyperreactive airway disease. It
is characterized by the features of these three disorders. ¥ What is the frequency and
quality of the cough? Is it productive of sputum? Is hemoptysis present? If so, how
much?¥ Has there been any wheezing?¥ Is there a history of smoking? If so, what is the
pack-year history?¥ Is secondhand smoke a problem at work or home?¥ Has there been
any weight loss? What is the patients pattern of exercise?¥ Is there a history of alcohol
use? Illicit drugs?¥ Is there a family history of respiratory illness? Signs and symptoms
of COPD include those of chronic bronchitis, emphysema, and asthma. Dyspnea
is usually the first symptom, initially occurring with heavy exertion. As the disease
progresses, dyspnea becomes increasingly worse with less and less vigorous exertion.
Cough or wheezing may be a chief complaint. The cough may be productive, and
sputum should be expectorated for culture. Productive cough, hypoxia, and cyanosis
are classic signs of chronic bronchitis. The hypoxia of chronic bronchitis stimulates
pulmonary arterial vasoconstriction. Over time, because of the high resistance against
the right ventricle, right ventricular failure occurs. The signs and symptoms of right-sided
heart failure, such as jugular venous distension, ascites, hepatosplenomegaly, and
ankle edema, develop after long-term chronic bronchitis. Impaired gas exchange
related to airflow obstruction- most concerning Observe the patient for signs of
