Patho final - endocrine, NR 507 Endocrine System, NR507 Midterm, NR 507 Final, CNS: Sensory and Motor Disorders

___________ involves an implantable device that directly sends electrical signals to the basal ganglia which counteracts the aberrant signaling in Parkinson's disease. - answer-deep brain stimulation A 21-year-old patient reports to the primary care clinic complaining of urinary urgency, frequency and burning. She also reports a small amount of vaginal discharge that contains an odor. It is likely that the NP will perform a vaginal exam at this visit. - answer-true A 25 year- old female presents to the primary care office with urinary burning and frequency for the last 3 days. She denies any fever, chills, back pain. Her gynecological history is negative and reports no vaginal discharge. The only new information reported is that she recently had sexual intercourse with a new male partner. The NP obtains a urinalysis and determines that the urine contains leukocytes, RBCs, nitrites, and WBCs. No casts are identified. Based on symptom presentation and UA results, the patient can be diagnosed with: - answer-cystitis A 42-year-old female presents to the primary care clinic with a three- month history of "feeling low", poor energy, inability to concentrate and irritability. She is concerned about her loss of interest in her usual social activities of walking with her friends and participating in her sewing group. She is especially concerned about her recent 15-pound weight gain. Other reported symptoms are frequent headaches, difficulty getting out of bed in the morning, and feeling worthless. She denies suicide ideation. She reports a family history of depression (mother and sister) and denies any consumption of drugs and alcohol. She is divorced and has a grown son who lives approximately one hour away but rarely sees because of his work schedule. The patient is interested in knowing if her symptoms are related to depression. Upon initial evaluation, the NP considers if the patient meets the criteria for MDD by consulting the DS - answer-Depressed mood Fatigue/loss of energy Loss of interest/Anhedonia Feeling worthless or having excessive guilt Insomnia or hypersomnia Poor concentration Recurrent thoughts of death, suicide, a suicide plan or attempt Psychomotor agitation or retardation A 45-year-old male presents to the primary care office with right flank pain that he describes as unremitting; he also reports nausea and vomiting. The NP performs an exam and observes him writhing in pain on the exam table with the inability to find a comfortable position. He is afebrile, BP 156/88 mmHg and HR 106/min. Right flank is mildly tender on palpation. Abdominal exam is negative for any abnormality. A urinalysis was performed and revealed 1+ blood. Urine microscopy also revealed 10-20 RBCs per high-power field (hpf). A kidney stone is suspected. The patient reports no prior history of a kidney stone. After providing the patient an analgesic, where the patient reported mild relief, the NP had the patient transferred to the emergency room for intravenous fluids, pain management and further work-up for the kidney stone. Upon follow-up in the office a week later, the patient reported that he was diagnosed with - answer-adequate hydration balanced diet A 54-year-old female reports to the primary care office with complaints of frequent urination. She reports that she is "leaking" urine several times a day, especially when she coughs, sneezes, or lifts a heavy object. She indicates that she has not experienced any dysuria or any urgency. The NP looked at the patient's previous urine culture obtained approximately 1 month ago and determined that it was negative. Other than her urinary complaints, she is in otherwise good health. BP 128/76; HR 78 bpm; T 98.6; Ht. 5'4"; Wt: 180lbs.; BMI 30.9. The NP performs a physical exam and all findings are normal. The urinalysis obtained was negative as well. Based on patient's symptoms and negative physical exam, she has a typical 1. blank. The leaking occurs when the abdominal pressure increases during coughing, sneezing, and lifting. We can rule out urge incontinence because the denied urgency with her urination. We could not - answer-1. stress incontinence 2. stress incontinence A common event during Cellular reproduction resulting in the Constant occurrence of isolated Cancer cells - answer-Cell transformation A common organism that causes a urinary tract infection include: - answer-Staphylococcus saprophyticus. E coli A deficiency of intrinsic factor will result in - answer-Pernicious anemia A goiter may appear in hypothyroidism because of the overproduction of TSH. - answer-True A lung volume measurement that indicates air trapping in a COPD patient is : - answer-Increase residual volume A mood disorder is a mental illness that causes the individual to have dramatic shifts in emotions, mood and energy levels. - answer-true A multi-focal neuropathy is purely a motor neuropathy that is characterized by motor deficits in the distribution of single nerve without associated sensory loss caused by vasculitis or diabetes. True False - answer-true A non - megaloblastic anemia would be caused by - answer-Liver disease A panic attack involves a very stressful situation where the individual develops an intense fear that something bad will happen. - answer-true A patient with chronic bronchitis is at risk for developing pneumonia due to : - answer-Mucus plugs A patient with chronic bronchitis is most likely to experience : - answer-Respiratory acidosis due to inability to exhale CO2 A patient with human immunodeficiency virus ( HIV ) was admitted to the acute care facility with difficulty breathing . He is diagnosed with Pneumocytis carinii . Pneumocystis carinii an example of : - answer-A secondary immune disease A patient with mitral regurgitation would most likely present with - answer-a blowing , holosystolic murmur A patient with mitral stenosis would most likely present with : - answer-Rumbling , decrescendo diastolic murmur heard at apex of the heart A patient with normal lungs should be able to exhale what % of the forced vital capacity within the first second - answer-80% A pre-renal cause of acute renal failure is: - answer-hypotension a predominant cause of secondary immune deficiencies worldwide - answer-Malnutrition A renal disease most often associated with autoimmunity is : - answer-Glomerulonephritis A sphincter malfunction that prevents urine from flowing out of the bladder would most likely result in: - answer-overflow incontinence A strong social network has been proven to lead to a better outcome for individuals with MDD. - answer-true A subjective finding in interstitial lung disease is rhonchi in the upper posterior airways - answer-False A symptom of a lower urinary tract infection includes: - answer-urgency A transferrin deficiency will most likely result in : - answer-Iron - deficiency anemia active phase - answer-more severe symptoms like delusions, hallucinations, disorganized speech or behavior or catatonic behavior Acute renal failure - answer-Oliguria (< 30ml/hr). Increased blood urea nitrogen (BUN) and creatinine. Fluid and electrolyte abnormalities. Adrenal cortex effects - answer-Maintenance of gland size Depletion of ascorbic acid Activation of adenylyl cyclase Conversion of cholesterol to pregnenolone Maintenance of enzymes active in converting pregnenolone to other steroids Accumulation of cholesterol for steroid hormone synthesis Secretion of cortisol and adrenal androgens Aldosterone promotes sodium reabsorption and potassium excretion in the kidneys. - answer-This statement is true. Allergic contact dermatitis is an example of hypersensitivity reaction - answer-Type 4 alpha cells - answer-responsible for secreting glucagon Although less common , transferrin deficiencies and mitochondrial defects can lead to iron deficiency anemia - answer-True Amitriptyline (Elavil) is an alpha-agonist that increases synaptic concentration of serotonin and/or norepinephrine. - answer-false (Amitriptyline is a tricyclic anti-depressant) An EMG can help determine if the neuropathy is axonal, demyelinating or both. True False - answer-true An example of a primary immunodeficiency is : - answer-Chronic Granulomatous Disease An example of a secondary immunodeficiency is - answer-Pneumocystis Carinii An expected chest x - ray finding for a patient with COPD is a - answer-flattened diaphragm An immature , undifferentiated ( generic ) cell that is capable of infinite cellular division when stimulated - answer-Stem cell An individual who has received an incorrect blood transfusion will exhibit signs of - answer-Hemolytic anemia An individual who presents with Diabetic Ketoacidosis (DKA) will have a blood glucose level of >250 mg/dL. - answer-This statement is true. An objective finding in a patient with ILD include productive cough - answer-False Anaphylaxis is what type of hypersensitivity reaction? - answer-type 1 and total lung capacity ( TLC ) are reduced . The The NP reviews the results of a patient's pulmonary function tests and notes that the FEV1 , FVC , FEV1 / FVC ratio is normal . Based on interpretation , this reflects : - answer-Restrictive lung disease Anemia can be caused from which of the following ? ( Select all that apply . ) - answer-Impaired red blood cell production, Increased red blood cell destruction, Excessive blood loss Anemia of inflammation and chronic disease - answer-Microcytic Normochromic Antiseizure medication can be used in severe panic attacks. - answer-true Aplastic anemia can be caused by - answer-Antibiotics Are less common and occur due to a defect on the development of the immune system - answer-primary immunodeficiency Are patients with structural heart disease ( i.e. reduced ejection fraction , left ventricular hypertrophy , chamber enlargement ) who have not yet developed symptoms of heart failure . - answer-Stage B Asthma is a chronic disease characterized by : - answer-Intermittent , reversible airflow obstruction Asthma results in : - answer-Decreased alveolar ventilation At least half of individuals with renal stones will have a reoccurrence within 10 years of the prior stone. - answer-true atypical depression - answer-improved mood when exposed to pleasurable or positive events Autonomic neuropathy involves damage to the nerves that regulate body functions that is out of the individual's control. True False - answer-true Autonomic neuropathy involves damage to the nerves that regulate body functions that is within the individual's control. True False - answer-false Avolition is the lack of content in speech. - answer-false (decrease in motivation to complete certain goals) B. R. is a 20-year-old college student who reports feeling anxious "about everything", restlessness and irritability. She reports no significant past medical or mental health history. She states that her anxiety started about 6 months ago when she decided to change her major to pre-med and complete an application to participate in a summer pre-med preparation program. During an open house meeting with the medical school academic advisors attended by all students applying for the summer program, she learned that only 50 students would be selected out of 450 applications to participate in the summer program. Despite wanting to enter the summer program, she felt that she would be unable to cope with the pressure associated with a short summer program or the rejection if she was not selected. She told the NP that she did not feel "good enough" to be selected as she compared herself to the other applicants. She said that - answer-Generalized anxiety disorder Before any invasive procedure , what should be administered to Immune - Compromised individuals ? - answer-Prophylactic antimicrobial drugs Benzodiazepines are drugs that reduce depression associated with the individual's anxiety. - answer-false (psychoactive drugs that reduce anxiety by providing calming effect on individual) Best describes the symptoms of Systemic Lupus Erythematosus ( SLE ) - answer-Tissue inflammation , vasculitis , rash , tissue inflammation beta cells - answer-responsible for secreting insulin and amylin inhibits glucagon secretion Bipolar 1 - answer-More severe One or more manic or mixed episodes leading to: Serious problems Hospitalization Psychotic features Bipolar 2 - answer-One or more hypomanic episodes (4 days or more), and no maniaOne or more major depressive episodes (2 weeks or more) Catatonic behavior involves bizarre movements, posture, and responsiveness. - answer-true Categories of Increased Risk for Diabetes (Prediabetes) - answer-1. FPG 100 to 125 mg/dL 2. 2-hr PG in the range of 140 to 199 mg/dL during an OGTT 3. HbA1c 5.7% to 6.4% Cells that contain abnormal types of hemoglobin are more susceptible to infection by the parasite that causes malaria - answer-False Cells that contain abnormal types of hemoglobin are more susceptible to infection by the parasite that causes malaria - answer-False Characteristics of myxedema include non-pitting edema around eyes. - answer-True Choose the drugs that are commonly associated with development of a medication - induced interstitial lung disease ( ILD ) : - answer-Nitrofurantoin Amiodarone Methotrexate Chromaffin cells are the site of production for epinephrine and norepinephrine. - answer-This statement is true. Chronic bronchitis will decrease which of the following parameters ? - answer-Decreased forced expiratory flow ( FEV1 ) . Chronic granulomatous disease of Childhood DiGeorge Syndrome Job Sundrome Common Variable Immunodeficiency Familial Mediterranean fever - answer-Primary Immunodeficiencies Chvostek sign is elicited by tapping the cheek that will result in twitching of the upper lip - answer-True. associated with hypocalcemia Clinical manifestations of DKA - answer-Kussmaul respirations: the individual hyperventilates to compensate for the metabolic acidosis Postural dizziness Central nervous system depression Ketonuria Anorexia, nausea, vomiting Abdominal pain Acetone breath Dehydration Thirst Polyuria Hyperglycemia causes an osmotic diuresis that leads to polyuria along with dehydration. Large amounts of glucose are lost in the urine because the blood glucose is higher than the renal threshold. Electrolyte abnormalities also occur: Hyponatremia Hypophosphatemia Hypomagnesemia The most significant electrolyte disturbance is hypokalemia. The potassium drops because of a shift out of the cell and into the blood caused by the metabolic acidosis. The blood potassium level, though may appear normal Clinical manifestations of HHNKS - answer-Patients with HHNKS will have an extremely high glucose level. As a result, there will be glycosuria and polyuria. Because of the amount of glycosuria, the patient is at risk for developing severe volume depletion, increased serum osmolarity, intracellular dehydration and loss of potassium and other electrolytes. Neurological symptoms (stupor and coma) may appear as well and worsen with the degree of hyperosmolarity. Co-morbidities of Cushing's syndrome - answer-include diabetes, osteoporosis, psychiatric disorders, muscle weakness, hypokalemia, infections. Cognitive behavioral therapy has major advantages over medications in the long-term treatment of anxiety - answer-true cognitive symptoms - answer-Memory Ability to learn new things Understanding Symptoms are subtle and may only be detected when specific tests are performed. For example, the individual may not be able to keep up with several tasks at once. Complicated UTI - answer-UTI extends beyond the bladder Caused by structural or functional urinary tract abnormalities or untreated UTI Infants and older adults affected Associated with: indwelling catheters, renal calculi, diabetes, pregnancy Conduction nerve studies can help determine if the neuropathy is axonal, demyelinating or both. True False - answer-true Cor Pulmonale is : - answer-Right ventricular failure secondary to pulmonary hypertension Coronary artery disease ( CAD ) is mainly the result of : - answer-Longstanding atherosclerosis Cortisol secretion is regulated by the hypothalamus and the anterior pituitary - answer-true Cortisol secretion is regulated by the hypothalamus and the anterior pituitary. - answer-True Criteria to diagnose Diabetes Type 1 and 2 - answer-FPG ≥126 mg/dL (7.0 mmol/L). Fasting is defined as no caloric intake for at least 8 h* OR 2-h PG ≥200 mg/dL (11.1 mmol/L) during OGTT. The test should be performed as