Test Bank - Advanced Physiology & Pathophysiology

.3 Possible Outcomes of Hepatitis - ANSWER-HBsAg totally cleared = immune stage inactive carrier stage = no injury or inflammation of hepatocytes but patient can suffer from acute flares if virus cannot be cleared and replication continues for >6 months = chronic hepatitis .Absorption Atelectasis - ANSWER-collapsed lung combined with fluid exudation alveoli are isolated by a mucous plug and closed pore of Kohn, resulting in atelectasis ∙can fill with stasis fluid caising infection alveoli in West Zone 3 (lowest lung layer) are the most susceptible to this disorder b/c of their lower ventilation/perfusion ratio ∙lower ventilation increases the probability of obstruction while higher perfusion increases the chances of fluid exudation and infection prevention and treatment is opening the pores of Kohn through deep breaths or positive pressure breathing which bypasses the mucous plugs and restores ventilation .Acute Complications of Diabetes - ANSWER-hypoglycemia diabetic ketoacidosis hyperosmolar hyperglycemic nonketotic syndrome (HHNKS or HONKS) .Acute Respiratory Distress Syndrome (ARDS) - ANSWER-results from diffuse pulmonary endothelial injury injury results from exposure to environmental pollutants such as asbestos injury will cause H2O, solutes and macromolecules to diffuse from intravascular space/capillaries into lung parenchyma and alveoli → pulmonary edema ∙pulmonary edema many times will co-exist with sepsis, resulting in further lung injury via inflammatory mediators ARDS many times signals beginning of multiple organ system failure .Adrenal Glands - ANSWER-composed of an outer cortex and inner medulla ∙cortex makes up ~80% of weight, composed of 3 distinct layers that produce different hormones zona glomerulosa is outermost layer and produces mineralocorticoids which regulate the retention of sodium by the body ∙major minerolocorticoid is aldosterone, which is regulated by the renin-angiotensin system next later is zona fasciculate, which produces glucocorticoids in response to ACTH stimulation ∙mainly produces cortisol ∙cortisol is involved in carbohydrate metabolism inducing hyperglycemia but also has immunosuppressant and anti-inflammatory properties ∙also exerts negative feedback on both ACTH from anterior pituitary and CRH from hypothalamus innermost layer is the zona reticularis, which produces the androgens ∙most DHEA, which can then be converted into other sex steroids adrenal medulla is composed of chromaffin cells (aka pheochcromocytes) that release catechoalines epinephrine and norepinephrine directly into blood .Adrenocortical Insufficiency - ANSWER-Addison's disease is an autoimmune destruction of the adrenal glands, resulting in the loss of produced hormones ∙symptoms include muscle weakness, weight loss, low blood sugar and depression from the loss of cortisol, as well as salt craving and low BP from the loss of aldosterone ∙b/c cortisol is not present, you have the overproduction of ACTH which will lead to hyperpigmentation of the skin b/c ACTH shares the same first AAs with alpha-MSH treatment is to replace the missing hormones .Adrenogenital Syndrome - ANSWER-each class of steroids is converted to their ultimate end product by a series of enzymes ∙if you knock out one of those enzymes, such as 21beta-hydroxylase, the precursors will be shunted into another pathway in congenital adrenal hyperplasia this is what happens ∙patient is no longer able to produce cortisol and instead overproduces DHEA which results in virilization of the patient, including cliteromegaly, hirsutism and changes in fat and muscle deposition ∙additionally, b/c there is no cortisol to exert negative feedback on the pituitary, ACTH is elevated, which only exacerbates the problem ∙treatment is to give cortisol, in an effort to restore balance patients may also have adrenocortical neoplasms → tumors that overproduce DHEA resulting in the same symptoms ∙removing the tumor is an effective treatment .Aggregation - ANSWER-irreversible process reliant on GP IIb/IIIa from activation step ∙recognizes and binds to fibrinogen the cross-linking of GP IIb/IIIa draws in additional platelets, providing sufficient material for the clot .3 Possible Outcomes of Hepatitis - ANSWER-HBsAg totally cleared = immune stage inactive carrier stage = no injury or inflammation of hepatocytes but patient can suffer from acute flares if virus cannot be cleared and replication continues for >6 months = chronic hepatitis .Absorption Atelectasis - ANSWER-collapsed lung combined with fluid exudation alveoli are isolated by a mucous plug and closed pore of Kohn, resulting in atelectasis ∙can fill with stasis fluid caising infection alveoli in West Zone 3 (lowest lung layer) are the most susceptible to this disorder b/c of their lower ventilation/perfusion ratio ∙lower ventilation increases the probability of obstruction while higher perfusion increases the chances of fluid exudation and infection prevention and treatment is opening the pores of Kohn through deep breaths or positive pressure breathing which bypasses the mucous plugs and restores ventilation .Acute Complications of Diabetes - ANSWER-hypoglycemia diabetic ketoacidosis hyperosmolar hyperglycemic nonketotic syndrome (HHNKS or HONKS) .Acute Respiratory Distress Syndrome (ARDS) - ANSWER-results from diffuse pulmonary endothelial injury injury results from exposure to environmental pollutants such as asbestos injury will cause H2O, solutes and macromolecules to diffuse from intravascular space/capillaries into lung parenchyma and alveoli → pulmonary edema ∙pulmonary edema many times will co-exist with sepsis, resulting in further lung injury via inflammatory mediators ARDS many times signals beginning of multiple organ system failure .Adrenal Glands - ANSWER-composed of an outer cortex and inner medulla ∙cortex makes up ~80% of weight, composed of 3 distinct layers that produce different hormones zona glomerulosa is outermost layer and produces mineralocorticoids which regulate the retention of sodium by the body ∙major minerolocorticoid is aldosterone, which is regulated by the renin-angiotensin system next later is zona fasciculate, which produces glucocorticoids in response to ACTH stimulation ∙mainly produces cortisol ∙cortisol is involved in carbohydrate metabolism inducing hyperglycemia but also has immunosuppressant and anti-inflammatory properties ∙also exerts negative feedback on both ACTH from anterior pituitary and CRH from hypothalamus innermost layer is the zona reticularis, which produces the androgens ∙most DHEA, which can then be converted into other sex steroids adrenal medulla is composed of chromaffin cells (aka pheochcromocytes) that release catechoalines epinephrine and norepinephrine directly into blood .Adrenocortical Insufficiency - ANSWER-Addison's disease is an autoimmune destruction of the adrenal glands, resulting in the loss of produced hormones ∙symptoms include muscle weakness, weight loss, low blood sugar and depression from the loss of cortisol, as well as salt craving and low BP from the loss of aldosterone ∙b/c cortisol is not present, you have the overproduction of ACTH which will lead to hyperpigmentation of the skin b/c ACTH shares the same first AAs with alpha-MSH treatment is to replace the missing hormones .Adrenogenital Syndrome - ANSWER-each class of steroids is converted to their ultimate end product by a series of enzymes ∙if you knock out one of those enzymes, such as 21beta-hydroxylase, the precursors will be shunted into another pathway in congenital adrenal hyperplasia this is what happens ∙patient is no longer able to produce cortisol and instead overproduces DHEA which results in virilization of the patient, including cliteromegaly, hirsutism and changes in fat and muscle deposition ∙additionally, b/c there is no cortisol to exert negative feedback on the pituitary, ACTH is elevated, which only exacerbates the problem ∙treatment is to give cortisol, in an effort to restore balance patients may also have adrenocortical neoplasms → tumors that overproduce DHEA resulting in the same symptoms ∙removing the tumor is an effective treatment .Aggregation - ANSWER-irreversible process reliant on GP IIb/IIIa from activation step ∙recognizes and binds to fibrinogen the cross-linking of GP IIb/IIIa draws in additional platelets, providing sufficient material for the clot