NR507 ADVANCED PATHOPHYSIOLOGY
MIDTERM QUIZ QUESTIONS WITH
ANSWERS
Hematology - Answer-Anemias, Involve RBCs, Most of body's iron stores come from the
recycling of iron from old RBCs
Iron Deficiency Anemia - Answer-Microcytic/Hypochromic Anemia, Caused by disorders
of hemoglobin synthesis, particularly iron deficiency, Ferritin is an important
measurement that reflects the body's total iron stores, The NP will order a ferritin level
to get an idea of the body's total iron stores, Low ferritin reflects anemia
Major Lab Marker for Anemia - Answer-Increased RBC distribution width (RDW) is one
of the earliest lab markers in developing microcytic or macrocytic anemia
Folate Deficiency - Answer-Can cause megaloblastic anemia, Alcoholics can easily get
folate deficiency
Ferritin level normal
Hgb low
Hct low
Vitamin B-12 Deficiency - Answer-Fatigue, Dyspnea, Peripheral Neuropathy in BLE
(numbness and tingling)
Risk Factors: Older adults, H-pylori infection
Affects Vitamin B-12 absorption
Hemolytic Anemia - Answer-Who is at risk?
RBCs destroyed, Mismatched blood types destroy RBCs.
Autoimmune hemolytic anemia due to autoantibodies against erythrocytes that the
immune system perceives as an antigen and then attacks it. Allergic reaction to a drug
causes drug-induced hemolytic anemia
Acute Blood Loss Anemia - Answer-Trauma victims who are losing blood, GI bleed
(Acute)
Aplastic Anemia - Answer-Diagnosis made by blood tests and bone marrow biopsy.
AA is suspected if levels of circulating erythrocytes, leukocytes and platelets diminished:
-Granulocyte count less than 500/ uL
, -Platelet count less than 20,000/ uL
-Absolute reticulocyte count less than or equal to 40 x 109/ L
Sickle Cell Anemia - Answer-Patients encountered who have sickle cell trait, Inherited a
normal Hb gene from one parent and an abnormal Hb gene from the other parent
Thalassemia - Answer-Inherited blood disorder causing decreased circulating
hemoglobin, Many possible genetic mutations
Heart Failure - Answer-Pathophysiology (Wk 2 Discussion)
Underlying patho is that there is less cardiac output to meet the body's oxygen
demands.
Over time there is decreased contractility, decreased stroke volume, increased left
ventricular end-diastolic volume (LVEDV)
When contractility is decreased, stroke volume falls, and LVEDV increases. This causes
dilation of the heart and an increase in preload.
Major risk factor is long standing hypertension. Preload = stretch Afterload = resistance
Differentiate between Right and Left Heart Failure - Answer-Sometimes right-sided
heart failure can occur due to left-sided heart failure due to the back up of fluid from the
left side to the right.
Sometimes right-sided heart failure can occur without there being left-sided heart
failure; this usually occurs because the person has long standing pulmonary issues
(COPD).
Patients will have classic R. sided heart failure symptoms without L. sided heart failure
symptoms: Right JVD distention, Peripheral edema, Hepatosplenomegaly
Stages of Heart Failure (ACC/AHA) - Answer--Stage A: patient has risk factors (CAD)
but no symptoms; no structural heart damage
-Stage B: patient has structural heart damage (MI), but still has no symptoms
-Stage C: patient is symptomatic with alteration in their daily functions due to dyspnea,
swelling, etc. This is where the NYHA functional classifications come into play
-Stage D: end-stage heart-failure - have maximized medications to treat it. May need
heart transplant or pacemaker
NYHA Functional Classifications- It's all about the impact on the patient's activity
caused by the HF symptoms: - Answer--Stage I: Mild- no limitation of physical activity;
Ordinary physical activity does not cause symptoms -Stage II: Mild- slight limitation of
physical activity; comfortable at rest; Ordinary physical activity results in fatigue,
palpitation, dyspnea or anginal pain.
-Stage III: Moderate- marked decrease in physical activity; marked limitation of physical
activity; comfortable at rest. Less than ordinary activity causes fatigue, palpitation,
dyspnea or anginal pain. -Stage IV: Severe- inability to carry on any physical activity
without discomfort. Symptoms of HF or the anginal syndrome may be present even at
rest. If any physical activity undertaken, discomfort is increased.
MIDTERM QUIZ QUESTIONS WITH
ANSWERS
Hematology - Answer-Anemias, Involve RBCs, Most of body's iron stores come from the
recycling of iron from old RBCs
Iron Deficiency Anemia - Answer-Microcytic/Hypochromic Anemia, Caused by disorders
of hemoglobin synthesis, particularly iron deficiency, Ferritin is an important
measurement that reflects the body's total iron stores, The NP will order a ferritin level
to get an idea of the body's total iron stores, Low ferritin reflects anemia
Major Lab Marker for Anemia - Answer-Increased RBC distribution width (RDW) is one
of the earliest lab markers in developing microcytic or macrocytic anemia
Folate Deficiency - Answer-Can cause megaloblastic anemia, Alcoholics can easily get
folate deficiency
Ferritin level normal
Hgb low
Hct low
Vitamin B-12 Deficiency - Answer-Fatigue, Dyspnea, Peripheral Neuropathy in BLE
(numbness and tingling)
Risk Factors: Older adults, H-pylori infection
Affects Vitamin B-12 absorption
Hemolytic Anemia - Answer-Who is at risk?
RBCs destroyed, Mismatched blood types destroy RBCs.
Autoimmune hemolytic anemia due to autoantibodies against erythrocytes that the
immune system perceives as an antigen and then attacks it. Allergic reaction to a drug
causes drug-induced hemolytic anemia
Acute Blood Loss Anemia - Answer-Trauma victims who are losing blood, GI bleed
(Acute)
Aplastic Anemia - Answer-Diagnosis made by blood tests and bone marrow biopsy.
AA is suspected if levels of circulating erythrocytes, leukocytes and platelets diminished:
-Granulocyte count less than 500/ uL
, -Platelet count less than 20,000/ uL
-Absolute reticulocyte count less than or equal to 40 x 109/ L
Sickle Cell Anemia - Answer-Patients encountered who have sickle cell trait, Inherited a
normal Hb gene from one parent and an abnormal Hb gene from the other parent
Thalassemia - Answer-Inherited blood disorder causing decreased circulating
hemoglobin, Many possible genetic mutations
Heart Failure - Answer-Pathophysiology (Wk 2 Discussion)
Underlying patho is that there is less cardiac output to meet the body's oxygen
demands.
Over time there is decreased contractility, decreased stroke volume, increased left
ventricular end-diastolic volume (LVEDV)
When contractility is decreased, stroke volume falls, and LVEDV increases. This causes
dilation of the heart and an increase in preload.
Major risk factor is long standing hypertension. Preload = stretch Afterload = resistance
Differentiate between Right and Left Heart Failure - Answer-Sometimes right-sided
heart failure can occur due to left-sided heart failure due to the back up of fluid from the
left side to the right.
Sometimes right-sided heart failure can occur without there being left-sided heart
failure; this usually occurs because the person has long standing pulmonary issues
(COPD).
Patients will have classic R. sided heart failure symptoms without L. sided heart failure
symptoms: Right JVD distention, Peripheral edema, Hepatosplenomegaly
Stages of Heart Failure (ACC/AHA) - Answer--Stage A: patient has risk factors (CAD)
but no symptoms; no structural heart damage
-Stage B: patient has structural heart damage (MI), but still has no symptoms
-Stage C: patient is symptomatic with alteration in their daily functions due to dyspnea,
swelling, etc. This is where the NYHA functional classifications come into play
-Stage D: end-stage heart-failure - have maximized medications to treat it. May need
heart transplant or pacemaker
NYHA Functional Classifications- It's all about the impact on the patient's activity
caused by the HF symptoms: - Answer--Stage I: Mild- no limitation of physical activity;
Ordinary physical activity does not cause symptoms -Stage II: Mild- slight limitation of
physical activity; comfortable at rest; Ordinary physical activity results in fatigue,
palpitation, dyspnea or anginal pain.
-Stage III: Moderate- marked decrease in physical activity; marked limitation of physical
activity; comfortable at rest. Less than ordinary activity causes fatigue, palpitation,
dyspnea or anginal pain. -Stage IV: Severe- inability to carry on any physical activity
without discomfort. Symptoms of HF or the anginal syndrome may be present even at
rest. If any physical activity undertaken, discomfort is increased.
