Pathophysiology Exam 1 Questions & Answers 100% Correct

Define: homeostasis - Answer a state of balance maintained by brain structures and self-regulating feedback mechanisms. Loss of homeostasis results in disease. Why study pathophysiology? - Answer it focuses on the disease and manifestations of disease and not just the tx. therefore it is essential to understand the norm physiology within the body and then advance to the pathophysiology. This allows the nurse to really understand what is going on with the pt. and ultimately leading to better pt care Define: etiology - Answer the cause of the disease i.e. bacteria, trauma, poisons and nutritional factors Define: pathogenesis - Answer sequence of cellular and tissue events that take place from the time of initial contact with an etiologic agent Define: morphology - Answer refers to the fundamental structure or form of cells or tissu What is a clinical manifestation? - Answer the way a disease presents signs and symptoms such as a fever Define: sign, symptoms, and syndrome - Answer 1) signs: is a manifestation that is noted by the observer 2) subjective complaints that are noted by the observer 3) syndrome: a compilation of sings and symptoms that are characteristics of a specific disease i.e. chronic fatigue syndrome What is a dx? - Answer designation to the cause or nature of a health problem What is a clinical course and the two types? - Answer 1) the evolution of the disease 2)chronic disease-continuous long term 3) acute disease- is relatively severe but self-limiting define: epidemiology - Answer the study of disease in a population Incidence vs. prevalence - Answer 1) incidence is the number of new case arising in a population during a specific time 2) prevalance is the number of people in a population that have a particular disease at a given time What is a carrier status? - Answer it refers to an individual who harbors an organism but may have few or no clinical manifestations What is sequalae? - Answer any abnormal condition that follows and is the result of a disease, treatment or injury, such as paralysis after poliomyelitis, deafness after treatment with an ototoxic drug or scar formation after a laceration What is the latent period? - Answer the interval between exposure to an infectious organism or a carcinogen and the clinical appearance of disease What is the cell? - Answer smallest functinal unit that an organism can be divided into and retain the characteristics necessary for life What does the metabolism do and what structures aid in the process? - Answer 1) controls transport of materials from extracellular fluids to the interior of the cell 2) aids in the regulation of cell growth and proliferation 3) main structure is the lipid bilayer-impermeable barrier to all but lipid-soluble substances 4)proteins carry out most of specific functions in the cell membrane 5) intimate relationship between cell membrane and cell coat What is the job of the cell membrane? - Answer aka plasma membrane; acts as semipermeable structure that separates the intracellular and extracellular environments. Fluid structure that is made up of carbohydrates, lipids, and proteins WHat are the different membrane transport types? - Answer 1) diffusion: molecules and particles that move "downhill" from an area of higher concentration to an area of lower concentration 2) Simple diffusion: molecules move through an opening or through intermolecular spaces w/o interaction w/ a carrier protein 3) Facilitated diffusion: requires a transport protein 4) osmosis: when water moves from side w/ lower concentration of particles to side with higher concentration Define: osmolality - Answer the concentration of osmotically active particles in solution expressed in osmols or milliosmols per liter of solution What are the types of tissue? - Answer 1) epithelial 2) connective 3) muscle 4) nervous What is the epithelial tissue? - Answer covers the outer surface, lines the internal surfaces and forms glandular tissue. Contains basement membrane, which attaches epithelial cells to adjacent connective tissue and provides flexible support What are the types of epithelial tissue? - Answer 1) squamous- thin, flat 2) cuboidal- cube shaped 3) columnar- column shaped What is the connective tissue? - Answer most abundant tissue in the body. Connexts and binds certain tissue. Produces extracellular matrix that supports and holds tissues together. ex. bone, adipose and cartilage What are the types of connective tissue? - Answer 1) loose 2) adipose 3) reticular 4) dense What is the muscle tissue? - Answer primary function is contraction. Responsible for movement of the body and its parts and for changes in the size and shape of internal organisms What are the types? - Answer 1) skeletal-actin and myosin-give striped or striated appearance 2) cardiac 3) smooth- lacks striations What are the types of nervous tissue? - Answer 1) CNS-brain and spinal chord 2) PNS- nerve fibers and ganglia that exists What are the terms of cell adaptation? - Answer cells may adapt to change by undergoing change Define: atrophy - Answer decrease in cell size. Reduces oxygen consumption and other cellular functions by decreasing the # and size of there organelles and other structures. Caused by disuse, denervation, loss of endocrine stimulation, inadequate nutrition and ischemia Define: hypertrophy - Answer increase in cell size and an increase in the amount of functioning tissue mass. Increased work load imposed upon the organ/body part; skeletal and cardiac muscle. Thickening of the heart muscle Define: hyperplasia - Answer an increase in the number of cells in an organ/tissue. Occurs in tissues with cells that are capable of mitosis division, alter and activate genes that control cell replication and growth and are an important response in wound healing. Hypertrophy and hyperplasia are triggered by the same mechanism and therefore occur simultaneously. Define: metaplasia - Answer reversible change in which one adult cell type (epithelial) is replaced by another adult cell type. The conversion of the cell type never oversteps the boundaries of the primary tissue type Define: dysplasia - Answer deranged cell growth of a specific tissue that results in cells that vary in size, shape, and organization. Usually seen with chronic irritation or inflammation and is a strong precursor to cancer Somatic cell vs Gamate - Answer -somatic cells have a full set of chromosomes (diploid) -gametes have half the number of chromosomes (haploid). Sperm and eggs would be an example of gametes Define: DNA - Answer genetic instructions for protein synthesis which is contained in the cell nucleus, which has chemical structure Define: Gene - Answer a gene is the basic physical and functional unit of heredity. Genes which are made up of DNA act as instructions to make molecules called proteins Define: chromosome - Answer structure in the nucleus of a cell containing linear thread of DNA which functions in the transmission of genetic information. The chromosomes are arranged in pairs. One member of the pair is inherited from the father and the other from the mother Define: 1)autosomal 2) x-linked 3) dominant 4) recessive - Answer 1)autosomal- any chromosome other than a sex chromosome 2) x-linked- heterozygous females are known as carriers for x-linked defects 3) dominant- expressed in either a homozygous or a heterozygous pairing 4)recessive- expressed only in homozygous pairing What is normal body fluid composition? - Answer The balance between H2O and electrolytes. WHen the balance is lost, disease happens What do body fluids transport? - Answer gases, nutrients, and wastes and also maintain overall function of the body. They distributed b/t 2 compartments What are the two fluid compartments? - Answer 1) intracellular 2) extracellular What is intracellular fluid? - Answer fluid that is inside the cell about 2/3 H2O. Contains a large amount of K+ What is extracellular fluid? - Answer fluid that is outside of the cells, including tissue spaces, interstitial and blood vessels ****1/3 of it is water and contains large amounts of Na and Chloride What are the three compartments of extracellular fluid? - Answer 1) intravascular: fluid inside the cell in the cytoplasm. Its in the vessels (plasma). This is the space where you take peoples blood 2) Interstitial: fluid is i the tissue between the cells ( too much causes edema) 3) 3rd space: fluid present in space around organs and cavities in sacs (chest/abdomen) What is the primary barrier for substances moving between the ECF and ICF compartments? - Answer The cell membrane How does fluid move between the spaces? - Answer 1) diffusion 2) osmosis 3) Osmotic pressure 4) Hydrostatic pressure What is osmotic pressure? - Answer "pulling" pressure of H2O across the membrane. Something that is highly concentrated wants more H2O(solvent) so it can become more dilute What is oncontic pressure? - Answer - when large particles can't make it through the membrane, (protein) attracts water back into the vascular space What is isotonic? - Answer (balanced) fluid that has same osmolality as your body has serum. Giving isotonic fluids increase volume but the concentration stayed the same. No osmotic pressure What is hydrostatic pressure? - Answer blood that comes in from artery to the capillary is "pushed" out into the interstitial space (tissue) by the pressure. No proteins only, O2 H2O small things. How does osmosis work with the fluid movement between the spaces? - Answer -Lipid soluble O2 and CO2 and smaller solute particles pass through semipermeable membrane freely. Water moves from side with more concentration of water and less solute particles to a side with less water and more concentration of solute particles (low to high) - Na and K+ rely on transport mechanisms for movement across the membranes What hormones are associated with fluid regulation? - Answer -antidiuretic hormone(ADH) -Aldosterone -Natriuretic Hormone What is a antidiuretic hormone? - Answer -fast and relieves from the pituitary glands, and increases the permeability of tubules/ducts of the kidney to water which regulates the amount of water that is lost in the urine What does aldosterone do? - Answer -slow-secreted from the adrenal cortex, it works at the tubules of the kidneys increasing the Na reabsorption, while increasing potassium elimination. -increase Na gain attracts water causing water gain, thus when you gain Na, you loose K+ What is a natriuretic hormone? - Answer -Rapid: is released from the heart in response to atrial stretch and overfilling, increases the excretion of Na and water but eh tubules of the kidney What is fluid overload? - Answer Isotonic expansion of the ECF compartment with increases in both interstitial and vascular volumes What is associated with fluid overload? - Answer -weight gain over short pd of time. Mild=2%, Moderate=5%, Severe= >8% -edema -distended neck veins, full bounding pulse, increase in central venous pressure -Bun/Hematocrit may decrease -when in the lungs: (pulmonary edema) SOB, respiratory crackles, cough. Sever could lead to asciteds and plural effusion. What is fluid deficit? - Answer a decrease in ECF and circulating blood volume What is associated to fluid deficit? - Answer -weight loss -increased thrust, oliguria and high urine-specific gravity -decreased skin and tissue turgor -dry mucous membranes -sunken and soft eyeballs -postural hypotension, weak rapid puls -decreased vein filling -shock What are causes of change in sodium? - Answer 1) hypernatremia-(high sodium, not enough water) implies a serum level above 145 mEq/L and a serum osmolality greater than 295 Osm/kg. 2) Hypoatremia-(low sodium too much water) a serum sodium concentration of less than 135 mEq/L What is the most common electrolyte disorder seen in the hospital, especially the elderly due to decreased renal function and limited sodium intake? - Answer Hypoatremia How does one become hypoatremia? - Answer sodium is lost through kidneys; leaves through sweat glands; dietary and enters GI tract What ion is a magnet with water? - Answer Sodium, where ever it goes water follows. It is the main cation and is (+). Involved in nerve impulse conduction, membrane transport, cellular chemical reactions When does Hypernatremia occur? - Answer -When there is an excess loss of body fluids that have a lower than normal concentration of Na+ so that water is lost in excess of Na+. Increased loss can come from respiratory tract during fever or exercise, from watery diarrhea or when osmotic ally active feeding tubes are given. -Hyper- water moves out of cell, Na+ goes to ECF->water needs to dilute ->cells shrink What are some neurologic effects of hypernatremia? - Answer - Thirst, decreased urine output because of renal water conserving mechanisms, body temp is increased, skin is warm and flushed, pulse is rapid and thready, blood pressure drops, mucus membranes become dry, mouth is dry and sticky, tongue is rough and fissured, swallowing is difficult, subq tissues assume firm, rubbery texture, decreased reflexes, agitation, headache, restlessness, coma and seizures may develop When does Hyponatremia occur? - Answer when water and Na+ is lost but the loss of water exceeds the associated loss of Na+ and then only the water is replaced --Hypo- H2O moves inside cells to balance levels of Na+ -> cells swells What is the most common electrolyte disorder? - Answer Hyponatermia- excessive sweating leads to loss of H2O and Na+ What are some neurologic effects of Hyponatremia? - Answer acute onset within 48 hrs. Fingerprint edema is a sign of excess intracellular water, muscle crams, weakness, fatigue, GI, manifestations, such as nausea, vomiting, abdominal cramps, diarrhea, apathy, lethargy and headache can progress to disorientation, confusion, gross motor weakness and depression of deep tendon reflexes, seizures and coma will occur when serum Na+ levels reach extremely low levels ---Severe water intoxication What is a major intracellular ion + only 5% of it is in the vessels and mainly in the cells? - Answer Potassium What is hypokalemia? - Answer refers to a decreas in serum potassium level below 3.5 mEq/L. Serum levels can occur as the potassium moves between the ECF and ICF What are causes of Hypokalemia? - Answer -inadequate intake -excessive GI, renal and skin losses -redistribution between the ICF and ECF What is hyperkalemia? - Answer an increase in serum potassium level above 5 mEq/L What are causes of hyperkalemia? - Answer -decreased renal elimination -movement of potassium from ICF to ECF -excessively rapid rate of administration of K+ What are the effects of changes of hypokalemia mainly concerned about cardia effects? - Answer -cardiac arrhythmias; produces changes ECG, a decrease in the resting membrane potential, causing prolongation of the PR interval. Prolongs the rate of ventricular depolarization and lengthens the relative refractory period, causing a depression in the ST segment, flattening the T wave and appearance of the prominent U wave. (pg 181 and 182). Risk of arrythmias are increased in people taking diuretics that increase urinary loss of K+ What are the effects of changes of Hyperkalemia mainly concerned about cardiac effects? - Answer -cardiac arrest; decreased membrane excitability, producing a delay in atrial and ventricular depolarization and it increases the rate of ventricular depolarization. If serum potassium levels continue to rise, delayed depolarization of the atria and ventricles produces further changes in the ECG. Prolongation of the PR interval, widening of the QRS complex with no change in its configuration and decrease amplitude, widening and eventful disappearance of the p wave. a) slow heart rate b) ventricular fibrillation and cardiac arrest are terminal events What happens to intracellular and intravascular/serum levels in acidosis? - Answer 1) pH is low (acidic)-> k+ moves out (increasing the level) 2) pH is high (basic) -> K+ moves in (decreasing the level) pH acid vs. base: - Answer 1) acid: molecule that can dissociate and release a hydrogen ion 2) base: is an ion or molecule that can accept or combine with hydrogen -metabolic activities of the body require precise regulation of acid-base balance, which is reflected in the pH of the ECF -Low pH=acidic -High pH=base (alkaloid -normal pH 7.35-7.45 What is a carbonic acid bicarbonate buffer? - Answer -its an ECF buffer that uses H2CO3 acid as its weak acid an bicarbonate sale as sodium bicarbonate (NaHCO3) as its weak base What does carbonic acid bicarbonate buffer substitute for? - Answer it substitutes weak H2CO3 for a strong acid such as hydrochloric acid or the weak bicarbonate base for a strong base such as sodium hydroxide T/F carbonic acid-bicarbonate buffer components deadly be added or removed from the body - Answer True ______ can conserve or form a new HCO3 when excess acid is added and it can excrete HCO3 when excess base is added. - Answer kidney This is the second line of defense against acid-base disturbances. - Answer Lungs, which is the respiratory control of the CO2 How do the lungs help regulate acid/base balance? - Answer -regulates the volatile carbonic acid by changing the rate of depth of respiration -increase ventilation, decrease partial pressure of carbon dioxide -decrease ventilation, increase partial pressure carbon dioxide -chemoreceptors is brain stem and peripheral chemoreceptors in carotid and aortic bodies sense change in partial carbon dioxide and pH in blood and alter ventilator rate -respiratory control of pH is 50-75% effective -carbon diozide removed from body increases pH (less acidic) -increase rate and depth of breathing, blows off more carbon dioxide -to preserve carbon diozide decrease pH- more acid -conserve carbon dioxide, slow down breathing