WGU D027 Advanced Pathopharmacology
Study Guide with complete solution
1. CeliacTDisease
a. LiningTofTtheTsmallTintestineTandTintolerantTofTgluten.
i. MoreTpronouncedTinTtheTduodenumTandTjejunum.
b. SignsTandTSymptoms
i. AbdominalTpainTandTdistention
ii. DiarrheaT–Tpale,Tgreasy,Tbulky,Tfoul
iii. MalnutritionTcomplications
1. Rickets
2. OccultTblood
3. Anemia
iv. EarlyTbleedsTand/orTbruises
v. HypomagnesemiaTandThypocalcemia
1. Irritability,Ttremors,Tconvulsions,Ttetany,TboneTpain,Tosteomalacia
c. LabTValue:
i. IgA-tTg
ii. IgA-EMA
iii. TotalTIgA
1. IfTdeficient,TIgG,TIgA-DGP,TorTIgG-AGATmayTalsoTbeTordered.
d. Testing:
i. SerologicTmeasurementsTofTIgATantibodiesTandTHLA-DQ2TorTHLA-DQ8
ii. EndoscopyTwithTsmallTintestineTbiopsy
iii. DuodenalTbiopsy
e. AvoidTBROW
i. Barley,TRye,TOats,TWheat
2. Sjogren’sTSyndrome
a. MostlyTinTolderTwomenTbutTcanToccurTatTanyTageTandTaffectsTprimarilyTthose
TwithTRheumatoidTarthritisTorTSLE
b. DryTeyesTandTdryTmouth
c. Testing:TSSA+TandTSSB+
3. Herbs
a. Cinnamon
i. Uses
1. LowersTbloodTglucose
2. LowersTcholesterol
3. LowersThypertension
4. LowersTriskTforTbleeding
ii. AdverseTEffects
1. BreastfeedingTwomenTshouldTavoidTasTtreatment.
2. AvoidTwithTdiabeticTdrugs,Tanticoagulants,TandTheartTmedications.
b. GingkoTBiloba
i. Uses
1. HaltTprogressionTofTdementia.
2. UsedTforTerectileTdysfunction
ii. AdverseTEffects
, 1. IncreasesTbleeding
a. AvoidTanticoagulantsTandTantiplatelets.
2. LowersTseizureTthreshold.
c. Glucosamine
i. Uses
1. ForTosteoarthritis
d. GreenTTea
i. Uses
1. LoseTweight,TmentalTclarity
ii. AdverseTEffects
1. Hepatotoxicity.
2. AvoidTtakingTwithTvasodilators,Tstimulants,TandTpsychoacti
veTmedications.
3. ContainsTsmallTamountTofTvitaminTKT–
TmayTdecreaseTeffectsTofTwarfarin.
e. Lavender
i. Uses
1. IncreasesTrelaxation
2. UsedTforTanxiety,Tstress,TandTinsomnia
ii. AdverseTEffects
1. Constipation,THA,TandTincreasedTappetite
2. CautionTwhenTusingTCNSTdepressants.
3. MayTdecreasedTbloodTpressure.TAvoidTtakingTwithTa
nti-Thypertensives.
4. HypoplasticTLeftTHeartTSyndrome
a. Structures
i. LEFTTventricleTisTunderdevelopedTorTtooTsmall.
ii. MitralTvalvesTareTnotTformedTorTareTveryTsmall.
iii. AorticTvalveTisTnotTformedTorTisTveryTsmall.
iv. AscendingTaortaTisTunderdevelopedTorTveryTsmall.
v. AtrialTseptalTdefectT–TaTholeTbetweenTtheTleftTandTrightTatria.
b. FetalTshunts
i. PatentTductusTarteriosus:TarteryTconnectingTaortaTtoTpulmonaryTartery.
ii. PatentTforamenTovale:TholeTconnectingTrightTatriumTtoTleftTatrium.
c. SurvivalTrates
i. 3–5-yearTsurvivalTratesTofT70%TforTinfantsTwhoThaveTtheTStageTITrepair.
ii. ChildrenTwhoTsurviveTtoT12TmonthsThaveT90%TsurvivalTrate.
d. Testing:Techocardiogram
e. Treatment:T3TstagesTofTsurgicalTprocedure
i. StageTIT(NorwoodTProcedure):T1-2TweeksTold
1. EnlargesTaortaTandTconnectTtoTtheTrightTventricle.
2. ShuntTtoTtheTpulmonaryTarteryTisTcreatedT(eitherTfromTaortaTorTr
ightTventricle).
3. PatentTductusTarteriosusTisTclosed.
ii. StageTIIT(GlennTProcedure):T4-6TmonthsTold
1. SVCTisTconnectedTtoTtheTpulmonaryTartery.
2
, 2. ShuntTfromTNorwoodTisTremoved.
iii. StageTIIIT(FontanTProcedure):T18TtoT36TmonthsTold
1. IVCTisTconnectedTtoTtheTpulmonaryTartery.
2. HoleTmadeTfromTtheTIVCTconduitTattachedTtoTtheTrightTatrium.
f. SignsTandTSymptoms:Toxygen-richTbloodTbypassesTpoorly-
functioningTleftTheartTthroughTtheTPDATandTPFO.
i. CyanosisTofTtheTskin,Tlips,TandTnails
ii. Pallor
iii. Sweaty,Tclammy,TorTcoolTskin
iv. TroubleTbreathing
v. RapidTorTpoundingTheartTrate
vi. ColdTfeet
vii. PoorTpulsesTinTtheTfeet
viii. PoorTfeeding
g. Tests
i. DuringTpregnancy
1. PrenatalTtestsTtoTcheckTforTbirthTdefectsTandTotherTconditions
2. UltrasoundTtoTidentifyTHLLS
3. EchocardiogramTtoTshowTtheTstructuresTofTtheTheartTandThow
Tit’sTworkingTwithTtheTdefect.
ii. AfterTbirth
1. BasedTonTsignsTandTsymptomsTthroughTpallorTandTcyanosis.
2. NewbornTwillTexperienceTsignsTandTsymptomsTonceTduc
tusTarteriosusTandTforamenTovaleTclose.
h. Medications
i. TubeTfeedings
ii.T MedicationsTtoTstrengthenTheartTmuscles,TlowerTbloodTpressure,TandTre
moveTextraTfluid.
5. Parathyroid
a. Function
i. ProducesTparathyroidThormoneTthatTregulatesTcalciumTinTtheTbloodstre
amTandTtissues.
1. TheTmoreTPTHThormoneTreleased,TtheTmoreTcalciumTtheTbo
nesTreleaseTtoTtheTbloodTstream,TlosingTdensityTandThardne
ss.
b. LabTValues
i. CalciumT(8.6-10.3Tmg/dL)
ii. PTH:T11-51Tpg/mL
c. SignsTandTSymptoms
i. Hyperparathyroidism
1. Osteoporosis
2. KidneyTstones
3. ExcessiveTurination
4. AbdominalTpain
5. Fatigue,TtiringTeasily
6. Forgetfulness
7. BoneTandTjointTpain
3
, ii. Hypoparathyroidism:THighTPTH,TlowTT3TandTT4.
1. Paresthesia
2. TwitchingTfacialTmuscles
3. MuscleTpainsTandTcramps
4. MoodTchanges
5. DryTandTroughTskin
d. Tests
i. Ultrasound
ii. BoneTdensitometry
iii. BodyTCT/MRI
e. Medications
i. Hyperparathyroidism
1. Calcimimetics
2. HormoneTreplacementTtherapy:ThelpsTbonesTretainTcalcium
3. Bisphosphonates:TslowsTandTpreventsTboneTloss
f. Treatment
i. Hypoparathyroidism
1. MaintainTaTlowTserumTcalciumTlevelTinTtheTlowTnormalTrangeTo
rT0.5Tmg/dLTbelowTnormal.
6. Hutchinson-GilfordTProgeriaTSyndrome
a. ProgressiveTgeneticTdisorderTcausingTchildrenTtoTageTrapidly.TNoTcure.
i. AppearsTinTtheTfirstTyearTorTtwoTinTlife.
b. CausedTbyTaberrantTsplicingTofTtheTLMNATmakingTprotein-progerin.
i. AbnormalTversionTofTlaminTATproteinTcausesTtheTnuclearTenvelope
TsurroundingTtheTnucleusTtoTbeTunstableTandTprogressivelyTdamage
sTtheTnucleus,TcausingTitTtoTdieTprematurely.
ii. TestTforTLMNATmutation.
c. Assessment
i. MeasureTheightTandTweight
ii. PlotTmeasurementsTonTaTnormalTgrowthTcurveTchart.
iii. TestThearingTandTvision.
d. SignsTandTSymptoms
i. ShortTstatureTorTslowTgrowth
ii. SlowThairTgrowth
iii. Alopecia
iv. JointTabnormalities
v. WrinkleTandTdrynessTofTskin
vi. FTTTandTdelayedTtoothTdevelopment.
e. Treatment
i. StatinsT–TdecreaseTliver’sTproductionTofTharmfulTcholesterol
ii. Nitroglycerin
iii. NSAIDsTtoTrelieveTpainTandTdecreaseTinflammation.
iv. BoneTmedicationsTforTstrengtheningTandTbuilding.
v. Occupational/PhysicalTtherapyTtoTrestoreTmuscleTstrengthTandTfunction.
f. LifeTExpectancy
i. AgesT10xTfaster
4
Study Guide with complete solution
1. CeliacTDisease
a. LiningTofTtheTsmallTintestineTandTintolerantTofTgluten.
i. MoreTpronouncedTinTtheTduodenumTandTjejunum.
b. SignsTandTSymptoms
i. AbdominalTpainTandTdistention
ii. DiarrheaT–Tpale,Tgreasy,Tbulky,Tfoul
iii. MalnutritionTcomplications
1. Rickets
2. OccultTblood
3. Anemia
iv. EarlyTbleedsTand/orTbruises
v. HypomagnesemiaTandThypocalcemia
1. Irritability,Ttremors,Tconvulsions,Ttetany,TboneTpain,Tosteomalacia
c. LabTValue:
i. IgA-tTg
ii. IgA-EMA
iii. TotalTIgA
1. IfTdeficient,TIgG,TIgA-DGP,TorTIgG-AGATmayTalsoTbeTordered.
d. Testing:
i. SerologicTmeasurementsTofTIgATantibodiesTandTHLA-DQ2TorTHLA-DQ8
ii. EndoscopyTwithTsmallTintestineTbiopsy
iii. DuodenalTbiopsy
e. AvoidTBROW
i. Barley,TRye,TOats,TWheat
2. Sjogren’sTSyndrome
a. MostlyTinTolderTwomenTbutTcanToccurTatTanyTageTandTaffectsTprimarilyTthose
TwithTRheumatoidTarthritisTorTSLE
b. DryTeyesTandTdryTmouth
c. Testing:TSSA+TandTSSB+
3. Herbs
a. Cinnamon
i. Uses
1. LowersTbloodTglucose
2. LowersTcholesterol
3. LowersThypertension
4. LowersTriskTforTbleeding
ii. AdverseTEffects
1. BreastfeedingTwomenTshouldTavoidTasTtreatment.
2. AvoidTwithTdiabeticTdrugs,Tanticoagulants,TandTheartTmedications.
b. GingkoTBiloba
i. Uses
1. HaltTprogressionTofTdementia.
2. UsedTforTerectileTdysfunction
ii. AdverseTEffects
, 1. IncreasesTbleeding
a. AvoidTanticoagulantsTandTantiplatelets.
2. LowersTseizureTthreshold.
c. Glucosamine
i. Uses
1. ForTosteoarthritis
d. GreenTTea
i. Uses
1. LoseTweight,TmentalTclarity
ii. AdverseTEffects
1. Hepatotoxicity.
2. AvoidTtakingTwithTvasodilators,Tstimulants,TandTpsychoacti
veTmedications.
3. ContainsTsmallTamountTofTvitaminTKT–
TmayTdecreaseTeffectsTofTwarfarin.
e. Lavender
i. Uses
1. IncreasesTrelaxation
2. UsedTforTanxiety,Tstress,TandTinsomnia
ii. AdverseTEffects
1. Constipation,THA,TandTincreasedTappetite
2. CautionTwhenTusingTCNSTdepressants.
3. MayTdecreasedTbloodTpressure.TAvoidTtakingTwithTa
nti-Thypertensives.
4. HypoplasticTLeftTHeartTSyndrome
a. Structures
i. LEFTTventricleTisTunderdevelopedTorTtooTsmall.
ii. MitralTvalvesTareTnotTformedTorTareTveryTsmall.
iii. AorticTvalveTisTnotTformedTorTisTveryTsmall.
iv. AscendingTaortaTisTunderdevelopedTorTveryTsmall.
v. AtrialTseptalTdefectT–TaTholeTbetweenTtheTleftTandTrightTatria.
b. FetalTshunts
i. PatentTductusTarteriosus:TarteryTconnectingTaortaTtoTpulmonaryTartery.
ii. PatentTforamenTovale:TholeTconnectingTrightTatriumTtoTleftTatrium.
c. SurvivalTrates
i. 3–5-yearTsurvivalTratesTofT70%TforTinfantsTwhoThaveTtheTStageTITrepair.
ii. ChildrenTwhoTsurviveTtoT12TmonthsThaveT90%TsurvivalTrate.
d. Testing:Techocardiogram
e. Treatment:T3TstagesTofTsurgicalTprocedure
i. StageTIT(NorwoodTProcedure):T1-2TweeksTold
1. EnlargesTaortaTandTconnectTtoTtheTrightTventricle.
2. ShuntTtoTtheTpulmonaryTarteryTisTcreatedT(eitherTfromTaortaTorTr
ightTventricle).
3. PatentTductusTarteriosusTisTclosed.
ii. StageTIIT(GlennTProcedure):T4-6TmonthsTold
1. SVCTisTconnectedTtoTtheTpulmonaryTartery.
2
, 2. ShuntTfromTNorwoodTisTremoved.
iii. StageTIIIT(FontanTProcedure):T18TtoT36TmonthsTold
1. IVCTisTconnectedTtoTtheTpulmonaryTartery.
2. HoleTmadeTfromTtheTIVCTconduitTattachedTtoTtheTrightTatrium.
f. SignsTandTSymptoms:Toxygen-richTbloodTbypassesTpoorly-
functioningTleftTheartTthroughTtheTPDATandTPFO.
i. CyanosisTofTtheTskin,Tlips,TandTnails
ii. Pallor
iii. Sweaty,Tclammy,TorTcoolTskin
iv. TroubleTbreathing
v. RapidTorTpoundingTheartTrate
vi. ColdTfeet
vii. PoorTpulsesTinTtheTfeet
viii. PoorTfeeding
g. Tests
i. DuringTpregnancy
1. PrenatalTtestsTtoTcheckTforTbirthTdefectsTandTotherTconditions
2. UltrasoundTtoTidentifyTHLLS
3. EchocardiogramTtoTshowTtheTstructuresTofTtheTheartTandThow
Tit’sTworkingTwithTtheTdefect.
ii. AfterTbirth
1. BasedTonTsignsTandTsymptomsTthroughTpallorTandTcyanosis.
2. NewbornTwillTexperienceTsignsTandTsymptomsTonceTduc
tusTarteriosusTandTforamenTovaleTclose.
h. Medications
i. TubeTfeedings
ii.T MedicationsTtoTstrengthenTheartTmuscles,TlowerTbloodTpressure,TandTre
moveTextraTfluid.
5. Parathyroid
a. Function
i. ProducesTparathyroidThormoneTthatTregulatesTcalciumTinTtheTbloodstre
amTandTtissues.
1. TheTmoreTPTHThormoneTreleased,TtheTmoreTcalciumTtheTbo
nesTreleaseTtoTtheTbloodTstream,TlosingTdensityTandThardne
ss.
b. LabTValues
i. CalciumT(8.6-10.3Tmg/dL)
ii. PTH:T11-51Tpg/mL
c. SignsTandTSymptoms
i. Hyperparathyroidism
1. Osteoporosis
2. KidneyTstones
3. ExcessiveTurination
4. AbdominalTpain
5. Fatigue,TtiringTeasily
6. Forgetfulness
7. BoneTandTjointTpain
3
, ii. Hypoparathyroidism:THighTPTH,TlowTT3TandTT4.
1. Paresthesia
2. TwitchingTfacialTmuscles
3. MuscleTpainsTandTcramps
4. MoodTchanges
5. DryTandTroughTskin
d. Tests
i. Ultrasound
ii. BoneTdensitometry
iii. BodyTCT/MRI
e. Medications
i. Hyperparathyroidism
1. Calcimimetics
2. HormoneTreplacementTtherapy:ThelpsTbonesTretainTcalcium
3. Bisphosphonates:TslowsTandTpreventsTboneTloss
f. Treatment
i. Hypoparathyroidism
1. MaintainTaTlowTserumTcalciumTlevelTinTtheTlowTnormalTrangeTo
rT0.5Tmg/dLTbelowTnormal.
6. Hutchinson-GilfordTProgeriaTSyndrome
a. ProgressiveTgeneticTdisorderTcausingTchildrenTtoTageTrapidly.TNoTcure.
i. AppearsTinTtheTfirstTyearTorTtwoTinTlife.
b. CausedTbyTaberrantTsplicingTofTtheTLMNATmakingTprotein-progerin.
i. AbnormalTversionTofTlaminTATproteinTcausesTtheTnuclearTenvelope
TsurroundingTtheTnucleusTtoTbeTunstableTandTprogressivelyTdamage
sTtheTnucleus,TcausingTitTtoTdieTprematurely.
ii. TestTforTLMNATmutation.
c. Assessment
i. MeasureTheightTandTweight
ii. PlotTmeasurementsTonTaTnormalTgrowthTcurveTchart.
iii. TestThearingTandTvision.
d. SignsTandTSymptoms
i. ShortTstatureTorTslowTgrowth
ii. SlowThairTgrowth
iii. Alopecia
iv. JointTabnormalities
v. WrinkleTandTdrynessTofTskin
vi. FTTTandTdelayedTtoothTdevelopment.
e. Treatment
i. StatinsT–TdecreaseTliver’sTproductionTofTharmfulTcholesterol
ii. Nitroglycerin
iii. NSAIDsTtoTrelieveTpainTandTdecreaseTinflammation.
iv. BoneTmedicationsTforTstrengtheningTandTbuilding.
v. Occupational/PhysicalTtherapyTtoTrestoreTmuscleTstrengthTandTfunction.
f. LifeTExpectancy
i. AgesT10xTfaster
4
