WGU PATHOPHYSIOLOGY D236 STUDY GUIDE COMPLETE QUESTIONS AND CORRECT ANSWERS

WGU PATHOPHYSIOLOGY D236 STUDY GUIDE COMPLETE QUESTIONS AND CORRECT ANSWERS “What is the primary determinant of oncotic pressure? - CORRECT ANSWER Albumin" "Form of osmotic pressure exerted by proteins - CORRECT ANSWER Oncotic Pressure" "What is the difference between adult and child immunity? - CORRECT ANSWER Naive T Cells" "Normal calcium level - CORRECT ANSWER 8.5-10.5" "Hypocalcemia is indicated by what lab result? S/Sx? - CORRECT ANSWER Calcium < 8.5 Overexcitability of the muscles Muscle twitching Paresthesia (numbness/tingling) Chvostek and Trousseau sign (twitching on the cheek when touched) Cardiac dysrhythmias" "Hypercalcemia is indicated by what lab result? S/Sx? - CORRECT ANSWER Calcium > 10.5 Muscle weakness Loss of muscle tone Spontaneous fractures Kidney stones Cardiac dysrhythmias" "Normal magnesium level - CORRECT ANSWER 1.6-2.6" "Hypomagnesemia is indicated by what lab result? S/Sx? - CORRECT ANSWER Magnesium level < 1.6 Tremors Hyperreflexia Insomnia Muscle cramps Irregular heart beat" "Hypermagnesemia is indicated by what lab result? S/Sx? - CORRECT ANSWER Magnesium level > 2.6 Hyporeflexia Lethargy Respiratory depression N/V Slow/Irregular heart beat" "An adolescent male patient is brought to the emergency department after spending a long day at the beach. The patient's head, neck, and trunk from the waist upwards and legs from the knees downward are bright red and edematous. The patient is crying and reports 8 out of 10 on the pain scale and an inability to find a comfortable position. What is the most likely classification of this burn? Superficial Thickness / Partial or Intermediate Thickness / Full Thickness / Fourth Degree - CORRECT ANSWER Superficial / First Degree Burn Superficial burns are reddened and painful." "Burn that requires surgery, forms more scars and are less painful? Superficial thickness / Partial or Intermediate Thickness / Full Thickness / 4th Degree - CORRECT ANSWER Deep partial thickness / Second Degree Burn -Blisters/weeps -Risk of infection/scarring increase with depth of burn" "Describe an intracranial bleed in the epidural space - CORRECT ANSWER Typically caused by a head injury and usually with a skull fracture. Occurs between the skull bone and the outmost membrane layer, the dura mater. High pressure bleeding is a prominent feature. You may briefly lose consciousness." "Describe an intracranial bleed in the subdural space - CORRECT ANSWER Collection of blood on the surface of your brain. Typically caused by your head moving rapidly forward and stopping, such as a car accident or shaken baby syndrome. More common in older people and people with a history of heavy alcohol use." "What are the s/sx of Multiple Sclerosis? - CORRECT ANSWER #Episodes of muscle weakness #Numbness #Blurred vision #Fatigue" "What is Huntington's and what are s/sx? - CORRECT ANSWER Autosomal dominant inherited disorder. S/Sx do not develop until adulthood and include movement (spasticity); chorea (lack of control), cognitive function, depression, psychosis, dementia, degeneration of neurons." "A provider is providing care for a patient following a hemorrhagic cerebrovascular accident (CVA). The patient asks the provider to explain what happened during the CVA. Which response by the provider is best? - CORRECT ANSWER "A blood vessel in your brain broke open, causing bleeding in your brain and a lack of blood flow to an area."" "An older adult patient presents to the emergency department after dropping a pot of boiling water onto their feet. The skin on the patient's left foot is white with profound swelling of the ankle. The patient denies any significant pain. What is the most likely classification of this burn? Superficial thickness / Partial or Intermediate Thickness / Full Thickness / Fourth Degree - CORRECT ANSWER Full thickness/Third Degree Burn Full thickness burns may be white and the surrounding area is edematous. Due to the damage the nerve endings, pain is minimal or absent." "Riluzole (Rilutek) used for what? - CORRECT ANSWER Medication used to treat amyotrophic lateral sclerosis (ALS; Lou Gehrig's disease). Class of medications called benzothiazoles. It works by changing the activity of certain natural substances in the body that affect nerves and muscles." "A provider is working with a patient who is recovering from a subarachnoid hemorrhage caused by a cerebral aneurysm. The patient asks the provider to explain what happened. What is the best response by the provider? "You experienced a spasm of the arteries in your brain, which prevented blood flow to an area." "When you fell and hit your head, a blood vessel broke and you experienced bleeding into your brain." "A clot developed in an artery of your brain, which increased the blood pressure and caused the artery to rupture." "An artery in your brain had a weakened area, which ruptured, causing bleeding into your brain." - CORRECT ANSWER "An artery in your brain had a weakened area, which ruptured, causing bleeding into your brain." A cerebral aneurysm results when the muscle layer of an artery is weakened and an outpouching occurs. When the weakened area ruptures, bleeding into the brain occurs." "Right sided heart failure compensation? - CORRECT ANSWER #Tachycardia #Pallor #Daytime oliguria (low urine output)" "What is endothelial dysfunction and what can it be caused by? - CORRECT ANSWER A type of non-obstructive CAD in which there are no artery blockages, but the large vessels on the heart's surface constrict (narrow) instead of dilating (opening). Can be caused by several conditions, including diabetes, metabolic syndromes, HTN, smoking and physical inactivity." "What is cardiac valve disease? - CORRECT ANSWER One or more of the valves in your heart don't work properly" "What is cardiac valve regurgitation? - CORRECT ANSWER Regurgitation (or leakage of the valve). When the valve(s) do not close completely, it causes blood to flow backward through the valve. This reduces forward blood flow and can lead to volume overload in the heart." "What is cardiac valve stenosis? - CORRECT ANSWER Stenosis (or narrowing of the valve). When the valve(s) opening becomes narrowed, it limits the flow of blood out of the ventricles or atria. The heart is forced to pump blood with increased force to move blood through the narrowed or stiff (stenotic) valve(s)." "What is the main cause of mitral valve stenosis? - CORRECT ANSWER Rheumatic fever, which is related to strep infections." "What is mitral valve stenosis? - CORRECT ANSWER Narrowing of the mitral valve, restricting blood flow into the main pumping chamber (left ventricle). **Can cause fatigue and SOB." "What is the difference between Hodgkin's Lymphoma and Non Hodgkin's Lymphoma? - CORRECT ANSWER The main difference between the two is the specific lymphocyte each involves. **Hodgkin's is marked by the presence of Reed-Sternberg cells, which are not present in non-Hodgkin's lymphoma." "Signs and Symptoms of Hodgkins Lymphoma - CORRECT ANSWER #Painless swelling of lymph nodes in the neck, armpits, or groin. #Persistent fatigue #Fever #Night sweats #Losing weight without trying #Severe itching #Pain in lymph nodes after drinking alcohol #Electrolyte imbalance causing palpitations, diarrhea, muscle weakness" "What is Non-Hodgkin's Lymphoma? - CORRECT ANSWER A cancer that starts in white blood cells called lymphocytes, which are part of the body's immune system. Non-Hodgkin lymphomas happen when white blood cells known as lymphocytes mutate or change. Includes any type of lymphoma except Hodgkin's. Lymphomas start in either B or T cells, but B-cell lymphomas are most common." "What is lymphedema? Swelling or accumulation of fluid due to blockage Enlargement in one or more lymph nodes, usually due to infection Enlarged lymph nodes that become palpable and tender Cancers of lyphocytes residing in the lymphatic vessels. - CORRECT ANSWER The swelling or accumulation of the fluid due to a blockage in the lymphatic system caused by scar tissues from damaged lymph vessels or lymph nodes. It is often seen in patients who had their lymph nodes removed and had surgery or radiation to remove cancer." "What is lymphadenitis? Swelling or accumulation of fluid due to blockage Enlargement in one or more lymph nodes, usually due to infection Enlarged lymph nodes that become palpable and tender Cancers of lyphocytes residing in the lymphatic vessels. - CORRECT ANSWER Enlargement in one or more lymph nodes, usually due to infection. Lymph nodes are filled with white blood cells that help the body fight infections." "What is lymphadenopathy? Swelling or accumulation of fluid due to blockage Enlargement in one or more lymph nodes, usually due to infection Enlarged lymph nodes that become palpable and tender Cancers of lyphocytes residing in the lymphatic vessels. - CORRECT ANSWER Enlarged lymph nodes that become palpable and tender." "What are lymphomas? - CORRECT ANSWER Cancers of lymphocytes residing in the lymphatic vessels or nodes." "To prevent changes in pH, the body employs what 3 buffer systems? - CORRECT ANSWER Proteins Phosphates Carbonic acid-bicarbonate system" "Carbonic acid bicarbonate system first line of defense is ____________, second line of defense is _______________. - CORRECT ANSWER Respirations; Kidneys" "HIV causes __________ issues, and targets ______________ cells. - CORRECT ANSWER Immunity, CD4" "Melissa's temperature is 101.1 F (37 C) and her oxygen saturation is 89% on room air. During auscultation of Melissa's lungs, the provider notes crackles and rhonchi in her RLL. A CXR reveals infiltrates in the RLL of the lung. What disease process is Melissa most likely experiencing? - CORRECT ANSWER Pneumonia **an inflammatory (and typically infectious) disease." "Is pneumonia an upper or lower airway disease? - CORRECT ANSWER Lower airway, specifically the alveoli. Crackles and rhonchi are suggestive of lower airway inflammation, as fluid and pus from the inflammatory process create these sounds." "What could be the causative agent of pneumonia? - CORRECT ANSWER Bacteria but can also be caused by viruses or fungi." "Infections that affect the nose, throat, and sinuses are called ________ ________________ _________ __________________. Examples of this include _______________. - CORRECT ANSWER Upper respiratory infection (URTIs) #Common cold #Sinue, nose, throat #Epiglottitis #Laryngitis #Pharyngitis (sore throat) #Mono #Rhinitis #Croup" "Infections that occur in the airways and lungs are called ___________ ___________________ ________ _________________. Examples of this include _______________. - CORRECT ANSWER Lower respiratory tract infection (LRTIs) #Bronchitis #Pneumonia #Brinchiolitis #Tuberculosis #Asthma" "A long term lung disease caused by inhaling large amounts of crystalline silica dust is called ______________. - CORRECT ANSWER Silicosis" "What are the causes of asthma? - CORRECT ANSWER #Bronchial obstruction due to hypersensitive or responsive airways #Extrinsic asthma: triggered by type 1 hypersensitivity reactions #Intrinsic asthma: adult onset; due to hyperresponsive airway tissue" "What are the risk factors of an asthma attack? - CORRECT ANSWER #Triggers: cold, exercise, stress, inhalant or irritants" "What are causes of aspiration? What other disorders pose a significant risk for aspiration? - CORRECT ANSWER Anything that interferes with the epiglottis from closing. #Fatigue #Acid reflux #Loss of mental ability (CVA, altered LOC, MS) #Loss of muscle tone or coordination #Pneumonia (bacterial or viral) Risk: PE, ARDS, HF, Lung CA, TB, GERD" "What is atelectasis? - CORRECT ANSWER The collapse of a small number of alveoli resulting in reduced gas exchange. The full inflation of bronchioles is inhibited in this process." "What is hypoxia? - CORRECT ANSWER Deficiency in the amount of oxygen reaching the tissues. The gas exchange across the alveolar membrane is impacted." "What is the most common cause of gastroenteritis? - CORRECT ANSWER Viruses (70% of cases)" "What are s/sx of gastroenteritis? - CORRECT ANSWER #Diarrhea (watery, usually nonbloody - bloody means you have a different, more severe infection) #N/V or both #Stomach cramps/pain #Occasional muscle aches/headache #Low-grade fever" "What is cirrhosis and how does it develop? - CORRECT ANSWER Liver diseases cause liver cells to become damaged and die. Scar tissue replaces liver cells and affects the function of the liver leading to cirrhosis. **In cirrhosis, stellate cells overproduce collagenous fibrous tissue, which takes over the liver." "What are common causes of cirrhosis? - CORRECT ANSWER -ETOH -Viral hepatitis (HEP C) - Autoimmune hepatitis -Drugs and chemicals (aetaminophen or anything else hepatotoxic)" "Complications of cirrhosis? - CORRECT ANSWER #Ascites #Edema #Portal hypertension (elevated BP throghout entire portal venous system) #Esophageal varices (engorged varicose veins on the low esophagus weaken/rupture). #Encephalopathy #Respiratory distress #Coagulation defects" "Hepatocytes do not function properly in cirrhosis, leading to the following: _____________, _________________, ___________________, _______________, _____________, __________________. - CORRECT ANSWER #Inability to detoxify compound in the blood #Increased toxin exposure #Decreased bile - decreased lipid digestion/absorption #Hyperbilirubinemia - jaundice #Bleeding resulting from portal HTN #Decreased synthesis of clotting factors - excessive bleeding #Hepatic encephalopathy - confusion, impaired cognition" "What is pancreatitis? - CORRECT ANSWER Inflammation of the pancreas that causes pancreatic insufficiency, malabsorption, and diabetes. Pancreatitis can be an acute or chronic disorder." "What is acute pancreatitis and what are its causes and manifestations? - CORRECT ANSWER Acute pancreatitis is a sudden, short-term episode of inflammation. Causes: #Gallstones #Excessive alcohol use #High blood triglycerides #Abdominal injury #Certain medications and toxins Manifestations: #Abdominal pain #N/V (following significant alcohol intake) #Cullen sign (blue discoloration around the umbilicus is a hallmark)" "What is chronic pancreatitis and what are its causes, manifestations, and complications? - CORRECT ANSWER Chronic pancreatitis is the recurring destruction of the pancreatic tissue that results in atrophy, fibrosis, scarring and the development of calcification within the gland. Causes: #Gallstones (obstruct the flow of bile and pancreatic secretions into the duodenum; backs up into the pancreas and it starts autodigesting itself). #Alcohol (increased secretion of pancreatic enzymes and sphincter of oddi contracts; enzymes pack up into pancreas). Manifestations: #Severe epigastric pain #Vomiting Complications: #Hemorrhage #Hypovolemic shock (massive inflammatory response that causes capillary leak) #Circulatory collapse #Peritonitis (enzymes escape into peritoneal cavity, causing inflammation)" "A patient reports a family history of renal cancer to the provider and asks how to reduce the risk of experiencing renal cancer. What advice should the provider include in patient teaching? - CORRECT ANSWER Do not smoke tobacco and avoid exposure to second-hand smoke, maintain a healthy weight, aim for a blood pressure of less than 130/80 and test your urine for blood yearly." "Decreased perfusion, medication or toxins, infections, and injuries can result in _______. - CORRECT ANSWER AKI (acute kidney injury)" "What is an acute kidney injury (AKI)? What are the manifestations, causes, and complications? - CORRECT ANSWER AKI refers to kidney dysfunction of short duration or any sudden, severe impairment of kidney function Manifestations: #Elevated creatinine and BUN levels #Fluid overload #Electrolyte imbalances #Metabolic acidosis Causes: #Prerenal: anything in the body that prevents perfusion to the kidneys (hemorrhage, dehydration, shock, HF) #Intrarenal: direct damage to the kidneys (glomerulonephritis, pyelonephritis) #Postrenal: obstruction of urine flow after the kidney (tumor, PBH, kidney stone) Complications: #Chronic renal failure" "High blood pressure and diabetes often cause ________________________. - CORRECT ANSWER Chronic renal failure **Results in anemia due to lack of erythropoietin production" "What is cholestasis? What are the 2 types? - CORRECT ANSWER Significant reduction of bile secretion and flow from liver to duodenum. 1. Intrahepatic - result of diseased hepatocytes or disease of intrahepatic bile ducts. 2. Extrahepatic - result of a duct obstruction outside the liver (such as gallstones or pancreatic tumor)." "How can choledocholithiasis lead to acute pancreatitis? Why would this result in damage to pancreatic cells? - CORRECT ANSWER Occurs when bile flow is obstructed by a gallstone in the common bile duct. This can lead to a backup of digestive enzymes from the pancreas that can perform autodigestion and damage pancreatic cells." "What is urolithiasis? What are 3 different types and part of the urinary system do they occur? - CORRECT ANSWER Calculi (stones) that form in the urinary system. Nephrolithiasis (kidney stones) Ureterolithiasis (Ureter stones) Cystolithiasis (bladder stones)" "What factors might be responsible for calculi forming and what are the possible ramifications if a stone cannot be passed in the urine? - CORRECT ANSWER #Factors that can lead to stone formation are urine becomes saturated with stone-forming salts (calcium, struvite, uric acid, cystine); cause can be chemical, metabolic, or genetic #Stasis of urine allows for crystal formation which is commonly caused by urinary obstruction or neurogenic bladder; as the stone is pushed through the ureter it can cause bleeding, buildup of pressure, low urine flow, leading to back flow of toxic urine in the kidney, which could lead to possible damage of the nephrons and kidney failure" "An ascending lower urinary tract infection (more commonly in women or during pregnancy) often leads to which condition? Glomerulonephritis Pyelonephritis Nephrolithiasis Acute kidney injury - CORRECT ANSWER Pyelonephritis" "What is kidney cancer? - CORRECT ANSWER Occurs when cells in the kidney grow out of control, clump together, and form a malignant tumor. **The most common risk factor for developing kidney cancer is smoking!" "What is bladder cancer? What are s/sx and treatment options? - CORRECT ANSWER Common type of cancer that begins in the cells of the bladder. Malignant cells present in the urine. Symptoms: #Painless hematuria is the cardinal feature #UTI symptoms (urgency, frequency, dysuria) #Usually deep within the bladder - rarely presents as a palpable mass Tx: #Transurethral resection of the tumor #Chemotherapy, immunotherapy, radiation #Radical cystectomy with urinary diversion may be necessary for large invasive tumors" "What is cystitis (UTI)? S/Sx? - CORRECT ANSWER Inflammation of the urinary bladder. It is often caused by infection and is usually accompanied by frequent, painful urination. #Pelvic pain #Increased urge to urinate #Pain with urination #Blood in the urine" "What is the most common urological disorder? - CORRECT ANSWER Urinary tract infection (UTI)" "What are s/sx of kidney infection (pyelonephritis)? - CORRECT ANSWER #Back/Flank pain #N/V #Fever" "Brad is a 42-year-old patient who comes into the emergency department complaining of severe right flank pain. He reports that it started about 24 hours ago. The pain is severe and radiates into his groin. He is also having n/v. What renal disease process would you suspect when a patient presents with flank pain? Are they acute or chronic diseases? - CORRECT ANSWER Both pyelonephritis and renal calculi can cause flank pain. Typically flank pain is associated with acute infections or inflammation of the kidney, rather than chronic diseases." "Most renal calculi (kidney stones) are made up of ___________ ___________________ and are believed to be due to hyperabsorption of ______________ from the digestive tract. - CORRECT ANSWER calcium oxalate, calcium" "Brad's creatinine and BUN levels were within normal limits a month ago and now are acutely elevated. Would this be considered acute kidney injury of chronic renal failure? - CORRECT ANSWER AKI" "A patient with a history of multiple sclerosis presents with a fever, nausea, and vomiting, that began several days ago. The patient also reports mild flank pain. Which disorder is the patient most likely experiencing? - CORRECT ANSWER Pyelonephritis **A history of MS (risk for neurogenic bladder) combined with indications of infection suggest pyelonephritis." "A patient presents with severe left-sided flank pain. The patient was working extensively outside yesterday on a hot day and did not drink much water. The patient's medication list indicates regular use of a calcium-containing antacid for heartburn. Which disorder is the patient most likely experiencing? Glomerulonephritis Pyelonephritis Polycystic kidney disease Renal calculi - CORRECT ANSWER Renal calculi **Dehydration combined with a high dietary intake of calcium can cause the formation of renal calculi, which manifests as severe flank pain." "What is the strongest risk factor for bladder cancer? - CORRECT ANSWER Smoking" "Shelia is a 42 year old female who presents to her health clinic complaining of chronic fatigue, brittle nails, and constipation. She wonders if these are symptoms of menopause because her menstrual cycle has also become very irregular. What endocrine disorder would you suspect? - CORRECT ANSWER Hypothyroidism **Without adequate thyroid hormone, the body's metabolic processes slow down." "When looking at Shelia's (who's been diagnosed with hypothyroidism) bloodwork, would you expect her T3 and T4 levels to be high or low? What about her TSH? - CORRECT ANSWER #T3 /T4 levels are low due to inadequate production #TSH is high because the pituitary recognizes the low thyroid hormone levels and signals the thyroid gland to produce more" "Henry is a 12 year old patient with a hx of T1DM who was brought to the ED by his parents. They report that he started having n/v today, his breathing sounded different, and he was very lethargic. They mention that he recently had bronchitis. What would you suspect that Henry is experiencing? - CORRECT ANSWER Diabetic ketoacidosis (DKA) which is a complication of diabetes. **An infection such as bronchitis can trigger increased glucose levels and increases the risk for DKA." "Cerebral edema is a complication of _______ due to increased blood volume and dilutional hyponatremia. This complication can result in papilledema or compression of the optic disc. - CORRECT ANSWER DKA Early s/sx of cerebral edema include headache, confusion, and lethargy but in severe cases seizures, pupil changes and respiratory arrest may occur." "What is diabetes insipidus (DI)? - CORRECT ANSWER A condition characterized by either a deficiency of antidiuretic hormone (ADH), or an insensitivity to ADH. **Blood glucose levels are normal. Kidneys can't properly concentrate the urine. **Can cause an imbalance of minerals (sodium/potassium) in your blood that maintain the fluid balance in your body." "What blood and urine test can help diagnose diabetes insipidus (DI)? - CORRECT ANSWER #Sodium level - will be high #Osmolality (serum or plasma) - will be high #Osmolality (urine) - will be low #Polydipsia (excessive thirst)" "What is a goiter and what is it caused by? - CORRECT ANSWER A goiter is an enlarged thyroid gland and is caused by low iodine in the diet. **The body needs iodine to produce thyroid hormone." "What is Addison's disease? And what are s/sx? - CORRECT ANSWER Adrenal insufficiency; the patient will be low in cortisol and aldosterone but their potassium will be high. #Salt craving #Extreme fatigue #Areas of darkened skin #N/V/D #Muscle/Joint pain" "What is Cushing's disease? And what are s/sx? - CORRECT ANSWER When the body has too much of the hormone cortisol. This can result from the body making too much cortisol, or from taking medicines called glucocorticoids, which affect the body the same way as cortisol. #Weight gain in face or trunk (Moon face/Buffalo hump) #Apple shaped fat distribution #Darkening skin under breast, belt line and neck. #Purple stretch marks (striae) #Easy bruising #Poor wound healing #Women develop hirsutism (male pattern hair growth)" "What is DKA, what is it characterized by, and what s/sx would you expect to see? - CORRECT ANSWER A condition that develops in persons with no insulin reserves. Diagnosis criteria: #Glucose >250 #Arterial pH <7.3 #Bicarb (HCO3) <15 #Hypokalemia S/Sx: #N/V #Profound dehydration #Possible tachycardia & hypotension **Hyperventilation decreases the CO2 level which in turn lessons the hydrogen concentration of the bloodstream. **More H+ is acidic, less H+ is basic/alkaline" "What is Grave's disease and how does it manifest? - CORRECT ANSWER An autoimmune disorder that is caused by hyperthyroidism. Symptoms: #Exophthamos (bulging eyes) #Goiter (enlarged thyroid glands) #Nervousness #Insomnia #Sensitivity to heat #Weight loss #Potential cardiac arrythmia" "Describe the negative feedback loop utilized by the endocrine system. - CORRECT ANSWER Occurs when the build up of one molecule leads to the repression of the response that creates the molecule." "Why is DKA a more significant problem for T1DM than T2DM? - CORRECT ANSWER T1DM results form complete lack of insulin where T2DM is insulin resistance **No insulin causes the body to respond as if it is starving, so glucagon will be released from the pancreas, leading to rampant lipid breakdown, resulting in a high level of ketones in the blood- however, in T2DM there is still some insulin, and this concentration will be enough to prevent DKA from occurring" "A patient presents with a puffy face, acne, elevated BP, and muscle weakness. What disorder is consistent with this patient's symptoms? Hyperthyroidism Adrenal insufficiency Hashimoto thyroiditis Cushing's disease - CORRECT ANSWER Cushing's" "What is endometriosis and what are s/sx? - CORRECT ANSWER A disorder in which endometrial tissue grows outside the uterus. Symptoms: #Dysmenorrhea (painful periods) #Pelvic pain and cramping (may begin before and extend several days into a menstrual period) #Lower back and abdominal pain #Pain with intercourse #Pain with bowel movement or urination #Excessive bleeding #Infertility #Fatigue #Diarrhea, constipation, bloating or nausea (especially during menstrual periods)" "What is ovarian cancer? What are the causes? What markers indicate ovarian cancer? Pick 2 CEA TP53 PSA AFP HE4 - CORRECT ANSWER TP53 / HE4 Cancer of the ovaries #Genetic causes, especially TP53 activation #HE4 biomarker: protein that is produced by most epithelial ovarian cancer cells" "What is pelvic inflammatory disease (PID) and what are s/sx? - CORRECT ANSWER Inflammation and infection of organs in the pelvic region, most often occurs when sexually transmitted bacteria spread from your vagina to your uterus, fallopian tubes, or ovaries. (Gonorrhea or chlamydia are the most common) Symptoms: #Can be nonexistent or mild, may not even notice symptoms until trouble getting pregnant #Mild to severe abdominal or pelvic pain #Abnormal or heavy vaginal discharge with odor #Abnormal uterine bleeding, especially during or after intercourse, or between cycles #Pain during intercourse #Fever, sometimes with chills #Painful, frequent, or difficult urination" "What is polycystic ovarian syndrome (PCOS) and what are s/sx? - CORRECT ANSWER A disorder of the hypothalamic-pituitary-ovary axis which the hormonal signals are disordered and the patient experiences elevated levels of androgens such as testosterone #Infertility #Irregular menstrual cycles #Hirsutism (facial hair)" "What is cryoblation and what is it used as a primary treatment for? - CORRECT ANSWER A procedure in which an extremely cold liquid and an instrument called a cryoprobe is used to freeze and destroy abnormal tissue. Used as a primary treatment for: #Prostate cancer #Bone cancer #Cervical cancer #Eye cancer" "A female patient presents with irregular menstrual cycles and hirsutism. Lab work reveals elevated androgen levels. Which is the most likely diagnosis for this patient? Pelvic inflammatory disease Adenomyosis Endometriosis Polycystic ovarian syndrome - CORRECT ANSWER Polycystic ovarian syndrome (PCOS)" "What is true about Crohn's disease? Choose 3 answers It is an infectious disease. It is an inflammatory disease. It is an autoimmune disease. It is a chronic disease. It is a disease of the large intestine only. - CORRECT ANSWER #It is an inflammatory disease. #It is an autoimmune disease. #It is a chronic disease." "A patient presents with severe abdominal pain, nausea, and vomiting following several days of heavy alcohol intake. The provider notes a dark blue discoloration around the umbilicus (Cullen sign). What is the patient most likely experiencing? - CORRECT ANSWER Acute pancreatitis" "A patient has been diagnosed with renal cancer. What manifestations would the provider expect to see? - CORRECT ANSWER Hematuria" "A patient has been diagnosed with end stage renal disease (ESRD) and will be undergoing hemodialysis. What is true about hemodialysis? It involves infusing dialysate solution into the abdominal cavity. It slowly filters the blood over a 24-hour cycle. It can cause significant fluid shifts and place the client at risk for hypotension. It can be administered at the bedside via peripheral intravenous access. - CORRECT ANSWER It can cause significant fluid shifts and place a patient at risk for hypotension. **Hemodialysis is performed over a relatively short period and can cause large fluid shifts, resulting in hypotension." "A patient presents with acute pelvic pain and fevers. Testing reveals the presence of N. gonorrhoeae. MRI reveals thickened, inflamed fallopian tubes and uterus. Which diagnosis is consistent with these manifestations? Ectopic pregnancy Endometriosis Cervicitis Pelvic inflammatory disease - CORRECT ANSWER Pelvic inflammatory disease (PID) When an infection, (commonly gonorrhea or chlamydia) affects the uterus and fallopian tubes, this results in PID." "What qualifies a patient for hypertension stage 1? - CORRECT ANSWER Systolic 130-139 or Diastolic 80-89" "What qualifies a patient for hypertension stage 2? - CORRECT ANSWER Systolic > 140 or Diastolic > 90" "What qualifies a patient for a hypertensive crisis? - CORRECT ANSWER Systolic >180 and/or Diastolic >120" "What qualifies a patient for elevated blood pressure? - CORRECT ANSWER Systolic 120-129 and Diastolic <80" "Acute elevations in BP can cause the rupture of cerebral blood vessels or what type of stroke? - CORRECT ANSWER Hemorrhagic stroke" "Although _________________ stroke accounts for about 10% of all strokes, the mortality is very high. - CORRECT ANSWER Hemorrhagic stroke" "Because HTN accelerates the formation of atherosclerosis, there is an increased risk of plaque formation in the cerebral arteries, which leads to thrombotic or embolic obstruction within the brain. This can be manifested by a _______ or __________________ stroke. - CORRECT ANSWER TIA, ischemic" "Antiplatelet agents, heparin, and warfarin can be used to prevent __________________ stroke. - CORRECT ANSWER Ischemic" "Atrial Fibrillation can cause thrombus formation and embolism to the brain. It is a frequent cause of _________________ stroke. - CORRECT ANSWER Ischemic" "A(n) __________________ stroke is caused by a thrombus or embolus that lodges in a cerebral artery and blocks blood flow to the brain tissue. This leads to cerebral infarction, which is the death of brain cells. - CORRECT ANSWER Ischemic" "A(n) ___________________ stroke is caused by rupture of a cerebral artery, leading to compression and toxicity of brain cells and loss of cerebral blood flow. Approximately 85% of strokes are due to ischemia, whereas 15% are hemorrhagic strokes - CORRECT ANSWER Hemorrhagic" "Approximately 85% of strokes are due to ___________________, whereas 15% are _____________________ strokes. - CORRECT ANSWER Ischemia, hemorrhagic" "________________ strokes result from an obstruction in cerebral blood flow by a thrombus or embolus. A clot or thrombus commonly arises from one of three mechanisms: arteriosclerosis of a cerebral artery, atrial fibrillation. - CORRECT ANSWER Ischemic" "_____________________ stroke occurs when a cerebral artery ruptures and can no longer bring blood to the brain tissue.· - CORRECT ANSWER Hemorrhagic" "The major predisposing factor of hemorrhagic stroke is _______________________. - CORRECT ANSWER Hypertension" "What are involved in the development of atherosclerosis? Choose 3 responses. Endothelial injury Microhemorrhage formation Foam cell formation Fatty streak formation Arterial wall bulge - CORRECT ANSWER Endothelial injury Foam cell formation Fatty streak formation" "Human immunodeficiency virus (HIV) targets CD4 cells. What is true about CD4 cells? Choose 3 answers. They are a type of T lymphocyte. They are a type of plasma cell. They mature with the thymus gland. They form major histocompatibility complexes. They are involved in cell-mediated immunity. - CORRECT ANSWER They are a type of T lymphocyte. They mature with the thymus gland. They are involved in cell-mediated immunity." "A patient describes experiencing intermittent episodes of chest pain associated with activity. The chest pain resolves within 4-5 minutes with rest or the administration of nitroglycerin. What is the patient experiencing? Choose 2 responses. Stable angina Unstable angina Prinzmetal angina Myocardial infarction Myocardial ischemia - CORRECT ANSWER Stable angina Myocardial ischemia **Chest pain that is consistently triggered by activity and resolves with rest or nitroglycerin within a short time period is stable angina. The chest pain is a symptom of myocardial ischemia—the heart is not receiving enough blood flow during the time period when the patient is experiencing pain." "The provider is caring for a patient with aplastic anemia. When the patient asks the provider about what is causing the anemia, which is the best response by the provider? Aplastic anemia is due to an inadequate supply of B12. Aplastic anemia is due to the lack of production of red blood cells by the bone marrow. Aplastic anemia is due to an increased breakdown in red blood cells. Aplastic anemia is due to the loss of red blood cells during menses. - CORRECT ANSWER Aplastic anemia is due to the lack of production of red blood cells by the bone marrow." "What is true about obstructive lung disorders? Choose 2 answers. They impair lung ventilation. They impair lung inflation. They impair lung perfusion. They can be caused by cigarette smoking. They can be caused by immunosuppression. - CORRECT ANSWER They impair lung ventilation. They can be caused by cigarette smoking." "What is true about hypercapnia? Choose 2 answers It is defined as a partial pressure of carbon dioxide (pCO2) > 45 mm Hg. It is defined as a partial pressure of oxygen (pO2) < 60 mm Hg. It is defined as a respiratory rate < 12 breaths/minute. It activates the respiratory center to increase breathing rate. It triggers erythropoietin production. - CORRECT ANSWER It is defined as a partial pressure of carbon dioxide (pCO2) > 45 mm Hg. It activates the respiratory center to increase breathing rate." "What is true about the pleural space? Choose 3 answers. It lies between the chest wall and the lung tissue. It has a negative pressure. It develops positive pressure with inspiration. It normally contains approximately 50 ml of fluid. If air or fluid enters the pleural space, it results in restrictive pulmonary disease. - CORRECT ANSWER It lies between the chest wall and the lung tissue. It has a negative pressure. If air or fluid enters the pleural space, it results in restrictive pulmonary disease." "At what stage of chronic kidney disease does the client require dialysis or a transplant? Stage IV Stage III Stage II Stage V - CORRECT ANSWER Stage V **In Stage V chronic kidney disease, the patient is in renal failure and requires dialysis and transplant." "Which viral pathogen does not have the potential to cause chronic hepatitis? Hepatitis A Hepatitis D Hepatitis C Hepatitis B - CORRECT ANSWER Hepatitis A **Hepatitis A causes an acute illness only and does not progress to chronic hepatitis." "A patient opted to undergo an orchiectomy as part of antiandrogen therapy for prostate cancer.What is the rationale behind this treatment? Removing the testicles significantly decreases testosterone production, a hormone that can trigger the growth of prostate cancer. Removing the spermatic ducts reduces the risk for the cancer to spread beyond the prostate by limiting a route for metastasis. Removing the testicles significantly decreases progesterone production, which triggers the growth of progesterone-positive prostate cancer. Removing the prostate reduces the risk for the cancer to spread beyond the initial organ by reducing the original tumor. - CORRECT ANSWER Removing the testicles significantly decreases testosterone production, a hormone that can trigger the growth of prostate cancer." "A patient is diagnosed with a pituitary tumor. Which disorders could develop as a result of this tumor? Choose 3 answers. Graves' disease Diabetes insipidus Acromegaly Syndrome of inappropriate antidiuretic hormone Thyroid nodules - CORRECT ANSWER Diabetes insipidus Acromegaly Syndrome of inappropriate antidiuretic hormone **Diabetes insipidus can be caused by a pituitary tumor due to the lack of antidiuretic hormone secretion. Acromegaly can be caused by a pituitary tumor due to the hypersecretion of growth hormone. The syndrome of an inappropriate antidiuretic hormone can be caused by a pituitary tumor due to hypersecretion of antidiuretic hormone." "One of the short-term acute complications of type 1 diabetes is blurred vision. What is the pathophysiological reason for this complication? Elevated glucose levels damage the capillaries of the eyes. Elevated glucose levels change the osmolarity of aqueous fluid. Elevated glucose levels cause cellular dehydration. Elevated glucose levels trigger low retinal metabolism. - CORRECT ANSWER Elevated glucose levels change the osmolarity of aqueous fluid." "How do the kidneys compensate for alkalosis? By retaining more H+ and excreting more HCO3- By excreting more H+ and retaining more HCO3- By excreting both more H+ and more HCO3- By retaining both more H+ and more HCO3- - CORRECT ANSWER By retaining more H+ and excreting more HCO3- **More H+ is acidic, less H+ is basic/alkaline" "Risk factors for hypertensive crisis - CORRECT ANSWER #Kidney Failure #Anemia #Diabetes #Dehydration" "What disease makes you crave salt? - CORRECT ANSWER Addison" "Irritable bowel syndrome causes ______________________ AND ___________________________. - CORRECT ANSWER diarrhea, constipation" "True or False: Rheumatoid arthritis is a chemical injury to endothelial cells. - CORRECT ANSWER True" "What is the relationship between rhabdomyolysis and myoglobin? - CORRECT ANSWER Rhabdomyolysis is the breakdown of skeletal muscle due to direct or indirect muscle injury. This can lead to the release of myoglobin into the bloodstream, which can cause kidney damage if not treated immediately." "What are signs of Hoshimoto's disease? - CORRECT ANSWER **No early symptoms** #Fatigue #Weight gain #Depression #Slowed heart rate #Heavy or abnormal menstrual periods #Sensitivity to cold #Puffiness of face #Difficulty to conceive #Dry skin #Enlargement of thyroid gland Hashimoto's thyroiditis is an autoimmune disorder that affects the thyroid gland." "Webbed neck, short stature, underdeveloped breast - CORRECT ANSWER Turner syndrome" "What is the effect of hypoventilation on pH? - CORRECT ANSWER Decreases pH and increases H+ **More H+ is acidic, less H+ is basic/alkaline" "In diabetes insipidus, what remains normal? - CORRECT ANSWER Blood glucose" "Woman is complaining of a lump in her throat and difficulty swallowing, what is the probable diagnosis? - CORRECT ANSWER Thyroid cancer" "Spina bifida can be prevented by taking __________________________ before and during pregnancy. - CORRECT ANSWER Folic acid" "What is myocarditis? - CORRECT ANSWER Inflammation and damage of the heart muscle, known as myocardium. Caused by a viral infection, but can also be caused by an infection of bacteria, fungi, parasite or a reaction to a drug." "Metabolic alkalosis is (increased or decreased) pH and (increased or decreased) HCO3 (bicarb) which can cause excessive vomiting, how would this be treated? - CORRECT ANSWER increased, increased, give antiemetics." "Lots of H+ ions = (high or low) pH - CORRECT ANSWER Low pH **More H+ is acidic, less H+ is basic/alkaline." "Respiratory acidosis or alkalosis is marked by changes in the ___________. - CORRECT ANSWER PCO2 High CO2 (>45) = Acidosis Low CO2 (<35) = Alkalosis" "Metabolic acidosis or alkalosis is marked by changes in the ___________. - CORRECT ANSWER HCO3 High HCO3 (>26) = Alkalosis Low HCO3 (<22) = Acidosis" "Respiratory Acidosis (CO2 high / pH low) causes / tx. - CORRECT ANSWER CNS depression, obstructive lung disease, hypoventilation Tx: intubation, administer bicarb" "Respiratory Alkalosis (CO2 low / pH high) causes / tx. - CORRECT ANSWER Hyperventilation, hypoxemia Tx: CO2 rebreather mask" "Metabolic Alkalosis (HCO3 high / pH high) causes / tx. - CORRECT ANSWER Hypovolemia, hypokalemia Tx: Administer antiemetic medication" "Metabolic Acidosis (HCO3 low / pH low) causes / tx. - CORRECT ANSWER DKA, severe dehydration, lactic acidosis. Tx: Sodium Bicarb" "Sprain or Strain: Overstretching of a ligament. It can be caused by a force that displaces a joint from its normal alignment. - CORRECT ANSWER Sprain **Common location is the ankle" "Sprain or Strain: Overstretching of tendons or muscles. Pain, weakness and limited ROM are symptoms. - CORRECT ANSWER Strain **Often in the lower back and hamstring" "What conditions fall under the COPD umbrella? - CORRECT ANSWER #Emphysema #Chronic Bronchitis #Refractory Asthma" "What is Paget's disease? - CORRECT ANSWER Interferes with your body's normal recycling process, in which new bone tissue gradually replaces old bone tissue. Over time, bones can become fragile and misshapen. The pelvis, skull, spine and legs are most commonly affected." "How does squamous cell carcinoma appear? - CORRECT ANSWER Usually red, scaly patch or a firm bump on the skin. The lesion may also resemble a wart or an open sore with raised, crusty edges." "How does melanoma present? - CORRECT ANSWER Rapidly enlarging blue-to-black asymmetrical lesion with irregular borders, larger than 76mm." "What are the characteristics of basal cell carcinoma? - CORRECT ANSWER Commonly occurs on the face, presents as shiny, translucent or pearly domes, accompanied by telangiectasis less than 6mm." "Condition where you can see things in front of you well but would need to turn your head to see anything in your peripheral vision. Macular degeneration Retinal detachment Glaucoma Cataracts - CORRECT ANSWER Glaucoma" "Condition where you can see things in your peripheral vision but straight ahead there is a dark spot in the center of your vision. Macular degeneration Retinal detachment Glaucoma Cataracts - CORRECT ANSWER Macular degeneration" "Condition where you have moments of bright flashes of light and most of the time you see just black. Macular degeneration Retinal detachment Glaucoma Cataracts - CORRECT ANSWER Retinal detachment" "Type of anemia that there is a lack of production of red blood cells by the bone marrow. - CORRECT ANSWER Aplastic anemia" "In DKA, HCO3/Bicarb is (consumed or excreted) therefore the anion gap (increases or decreases). - CORRECT ANSWER consumed, increases" "Bone fracture that occurs when a small piece of bone attached to a tendon or ligament gets pulled away from the main part of the bone. Greenstick fracture Transverse fracture Avulsion fracture Comminuted fracture - CORRECT ANSWER Avulsion fracture Greenstick = small, slender crack in bone Transverse = straight break across bone Comminuted = break in 3-4 places" "What happens in dehydrated patients? _________ levels are high and _______________ is activated. - CORRECT ANSWER ADH, RAAS" "Fluid and electrolyte levels are regulated by _________________, which regulates actions such as thirst, ADH, the kidneys, and RAAS. - CORRECT ANSWER Osmoreceptors" "What are the causes of dehydration? - CORRECT ANSWER #Excessive loss #Inadequate intake #Both" "What s/sx are associated with dehydration? - CORRECT ANSWER #Dry mucous membranes #Decreased skin turgor #Decreased urine output #Low blood pressure #Tachycardia #Weak heart rate #Confusion" "A patient with a viral illness and severe vomiting has an elevated CO2 level and pH of 7.53. She is breathing slowly. What condition does she have? - CORRECT ANSWER Metabolic alkalosis The patient's pH and CO2 levels are both elevated (moving in the same direction). This indicates metabolic alkalosis. The CO2 level is high because her respiratory system is attempting to compensate for the high pH by exhaling less and retaining more CO2." "Normal CO2 level - CORRECT ANSWER 35-45" "Normal pH level - CORRECT ANSWER 7.35-7.45" "Normal HCO3 level - CORRECT ANSWER 22-26" "Michael's pulmonary edema leads to respiratory acidosis. How does pH impact Michael's basal metabolic panel? Choose 3 answers. His CO2 level is increased because his lungs have difficulty removing it from the bloodstream. His calcium level is reduced because the elevated concentration of H+ makes it easier for Ca+ to bind to albumin. His CO2 level is decreased because his lungs have difficulty adding it into the bloodstream. His sodium level is decreased due to hypervolemia. His K+ is elevated because, as H+ moves inside of cells in an attempt to get it out of the bloodstream, K+ moves from cells into the bloodstream. - CORRECT ANSWER His CO2 level is increased because his lungs have difficulty removing it from the bloodstream. His sodium level is decreased due to hypervolemia. His K+ is elevated because, as H+ moves inside of cells in an attempt to get it out of the bloodstream, K+ moves from cells into the bloodstream." "A hormone panel was done on a patient with congestive heart failure and fluid volume overload. Which elevated hormone on the patient's chart is indicative of the body's attempt to reduce the fluid overload? Antidiuretic hormone (ADH) Brain natriuretic peptide (BNP) Aldosterone Renin - CORRECT ANSWER BNP BNP is released when fluid volume excess is present." "Normal sodium level - CORRECT ANSWER 135-145" "Hyponatremia is indicated by what lab result? S/Sx? - CORRECT ANSWER Na < 135 Loss of energy or fatigue Nausea and vomiting Headache Confusion Muscle spasms Low blood pressure Dark scanty urine Irritability, disorientation and neurological manifestations Seizures" "Hypernatremia is indicated by what lab result? S/Sx - CORRECT ANSWER Na > 145 Excessive thirst Extreme fatigue Confusion Muscle twitching or spasms Restlessness Seizures" "Normal potassium level - CORRECT ANSWER 3.5-5.0" "Hypokalemia is indicated by what lab result? S/Sx - CORRECT ANSWER K < 3.5 #Muscle fatigue/cramping #Nausea, vomiting, constipation #Cardiac dysrhythmias #Paresthesia (numbness/tingling)" "Hyperkalemia is indicated by what lab result? S/Sx? - CORRECT ANSWER K > 5.0 Muscle weakness/paralysis Paresthesia (numbness/tingling) Cardiac dysrhythmias Cardiac arrest/MI" "Tay-Sachs Disease - CORRECT ANSWER An autosomal recessive inherited genetic disorder caused by a recessive allele (chromosome 15) that leads to the accumulation of certain lipids in the brain. Seizures, blindness, and degeneration of motor and mental performance usually become manifest a few months after birth, followed by death within a few years." "Marfan Syndrome - CORRECT ANSWER Inherited autosomal dominant trait (only one abnormal copy of the Marfan gene inherited from one parent) FBN1 gene. Genetic connective tissue disorder that can affect aorta and heart valve structures. **If one parent has Marfan syndrome, each child has a 50% chance of inheriting the abnormal gene and developing the condition. If both parents have the condition, the risk of their child inheriting the abnormal gene and developing Marfan syndrome increases to 75%." "Turner Syndrome - CORRECT ANSWER A chromosomal disorder in females in which either an X chromosome is missing, making the person XO instead of XX, or part of one X chromosome is deleted. Underdeveloped ovaries (sterile) Short stature (under 4' 7") Amenorrhea Webbing of the neck Edema Underdeveloped breasts/wide nipples" "Respiratory rate increases during exercise. How does this increased respiratory rate allow the body to maintain a homeostatic pH level? - CORRECT ANSWER The increased exhalation of CO2 helps to increase pH. (The increased respiratory rate allows more CO2 to be exhaled. Since CO2 reacts with water to form carbonic acid, getting rid of more CO2 through increased respiration will raise pH)" "An ICU patient's arterial blood gas results show low pH and low CO2 levels. The patient's respiratory rate is increased. What is the name of this condition? - CORRECT ANSWER Metabolic acidosis (Since the pH is low, and the pH and CO2 are trending in the same direction, the condition is metabolic acidosis. The low CO2 indicates that CO2 is not causing the acidosis. The increased respiratory rate lowers blood CO2 in an attempt to compensate for the metabolic acidosis.)" "Your patient has pulmonary edema, which raises levels of CO2 in the blood. What helps the patient's body to compensate for this increase? The kidneys conserve H+ and conserve HCO3- The kidneys excrete more H+ and conserve HCO3- The kidneys conserve H+ and excrete more HCO3- The kidneys excrete more H+ and excrete more HCO3- - CORRECT ANSWER The kidneys excrete more H+ and conserve HCO3- (The increased CO2 level will generate more carbonic acid. The body must compensate for the decreased pH. Excreting more H+ and conserving HCO3- will both help to increase pH.)" "Heberden and Bouchard's nodes are indicative of what disease process? - CORRECT ANSWER Osteoarthritis" "You receive a patient who has experienced a burn on the right leg. The burn has small blisters, is markedly pinkish red, and has a shiny and moist appearance. When the patient is asked about pain level, the patient describes it as severe. What level of burn does this patient present? Superficial thickness / Partial or intermediate thickness / Full Thickness / Fourth Degree - CORRECT ANSWER Second Degree (partial thickness) Second degree: Partial thickness burns can be either superficial partial thickness or deep partial thickness, depending on the degree of tissue necrosis of the dermal layer. These burns can char the epidermis and papillary dermal layer, with resultant edema and formation of epidermal blisters. Burned skin is wet, raw, and pink or cherry red in color that blanches with pressure." "Identify degrees of burn, and other s/s to that degree burn - CORRECT ANSWER First-degree (Superficial) burns affect only the outer layer of the skin. They cause pain, redness, and swelling (no blistering/scarring). Second-degree (Partial or intermediate thickness) burns affect both the outer and underlying layer of skin. They cause pain, redness, swelling, and blistering. Pink/Cherry in color that blanches. Third-degree (Full thickness) burns affect the deep layers of skin. High risk of infection. Fourth-degree burns involve muscle or bone." "A 56-year-old female presents with superficial partial-thickness burns to the anterior head and neck, front and back of the left arm, front of the right arm, posterior trunk, front and back of the right leg, and back of the left leg. Calculate the total body surface area percentage that is burned using the Rule of Nines. - CORRECT ANSWER 63% The Rule of Nines is a rapid method used during the prehospital and emergent phase of care. The body is divided into regions that present 9%, or multiples of 9, with the exception of the perineum, which is 1% of BSA (body surface area). The face and back of the head are 4.5% each, so the entire head is 9%, the anterior and posterior portion of the arm is 9%, and the total for each leg is 18%. Anterior head and neck (4.5%), front and back of the left arm (9%), front of the right arm (4.5%), posterior trunk (18%), front and back of the right leg (18%), back of the left leg (9%) which equals 63%." "Describe an intracranial bleed in the subarachnoid space - CORRECT ANSWER Occurs between the brain and the thin tissues that cover the brain. The most common cause is trauma but it can also be d/t the rupture of a major blood vessel in the brain (intracerebral aneurysm). A sudden, sharp headache usually comes before a subarachnoid hemorrhage. Typical symptoms also include loss of consciousness and vomiting." "Describe an intracranial bleed in the intracerebral space - CORRECT ANSWER Occurs inside the brain. Not usually the result of an injury. Prominent warning sign is the sudden onset of neurological deficits. Symptoms progress over minutes to hours and include headache, difficulty speaking, n/v, decreased consciousness, weakness in one part of the body, and elevated blood pressure." "Cerebral Concussion (Mild Traumatic Brain Injury) - CORRECT ANSWER Individuals with mild TBI can develop postconcussive syndrome (PCS), which includes headaches, lethargy, mental dullness, and other symptoms that can persist for several months after a TBI." "Signs and symptoms of cerebral contusion - CORRECT ANSWER Severe headache, dizziness, vomiting, increased size of one pupil, and sudden weakness in an arm or leg. The person may seem restless, agitated, or irritable. Often, the person has memory loss. These symptoms can last for several hours to several weeks, depending on the severity of the injury. As the brain tissue swells, the person may feel increasingly drowsy or confused. Vitals may show decreased heart rate and respirations and hypertension, which are signs of pressure on the brainstem." "What is the cause of Bell's Palsy? - CORRECT ANSWER Unknown, but thought to be due to virus, or autoimmunity. Doctors believe that the most likely cause of Bell's palsy in pregnant women is the Herpes virus. #Cold sores and genital herpes (herpes simplex) #Chickenpox and shingles (herpes zoster) #Infectious mononucleosis (Epstein-Barr) #Cytomegalovirus infections #Respiratory illnesses (adenovirus) #German measles (rubella) #Mumps (mumps virus) #Flu (influenza B) #Hand-foot-and-mouth disease (coxsackievirus)" "What are signs/symptoms of cerebral edema? - CORRECT ANSWER # Headache # Neck pain or stiffness # Nausea or vomiting # Dizziness # Irregular breathing # Vision loss or changes # Memory loss # Inability to walk # Difficulty speaking # Stupor # Seizures # Loss of consciousness" "What neuro conditions cause flat emotions and sleep disturbances? - CORRECT ANSWER #Alzheimer's #Schizophrenia #Parkinson's disease" "What are the s/sx of Parkinson's? - CORRECT ANSWER #Gait changes #Resting tremor #Increased muscle tone (rigidity) #Slow gait/movements (bradykinesia)" "What are the s/sx of Amyotrophic Lateral Sclerosis (Lou Gehrig's disease)? - CORRECT ANSWER Upper motor neurons become sclerotic and die Weakness in upper and lower extremities, head drop, speech changes, dysphagia. Treatment: Riluzole (Rilutek) - works by changing the activity of certain natural substances in the body that affect nerves and muscles." "The provider is caring for a client who reports experiencing episodes of muscle weakness, accompanied by profound fatigue and blurry vision. Which diagnosis is the most consistent with these signs? - CORRECT ANSWER Multiple Sclerosis" "Hypertension causes traumatic damage to the endothelium of the arteries. Which organs have arteries that are at a particular risk for damage? - CORRECT ANSWER Brain, heart, eyes, and kidneys" "Which problem causes a myocardial infarction or heart attack? - CORRECT ANSWER An occlusion of a coronary artery most commonly from a thrombus (blood clot)." "What are the characteristics of primary/essential hypertension? - CORRECT ANSWER Idiopathic; common "silent killer" BP consistently > 130/80" "What are the characteristics of secondary hypertension? - CORRECT ANSWER Results from other disease or disorder Renal disease; endocrine disorder; pheochromocytoma (adrenal tumor)" "What are the characteristics of malignant/resistant hypertension? - CORRECT ANSWER Severe, rapidly progressing; uncontrolled Diastolic pressure extremely high Many complications" "What are the risk factors, manifestations, and complications of hypertension? - CORRECT ANSWER Risk Factors: Age, sex, heredity, lifestyle Manifestations: Asymptomatic, vague symptoms (fatigue, malaise, morning headache) Complications: Sclerosis, narrowing of vessels, atheroma formation (fatty build up in arteries)" "What are the causes of heart failure? - CORRECT ANSWER MI (left ventricle) CAD HTN Chronic lung disease (R ventricle needs to work harder to push blood through pulmonary circulation if there is an obstructive lung disease) Valve problems" "What are the compensatory mechanisms of heart failure? - CORRECT ANSWER #Renin and aldosterone secretion (vasoconstriction and blood volume is increased) #SNS response (increases heart rate/vasoconstriction - epinephrine and norepinephrine) #Cardiac hypertrophy (increased size of the heart)" "What are complications of heart failure? - CORRECT ANSWER #Cardiogenic shock #Acute pulmonary edema #Organ failure" "What lab test is an indication of heart failure? - CORRECT ANSWER B-Type Natriuretic Peptide (BNP) - a hormone produced by the heart. BNP > 500 are considered indicative of heart failure." "What are causes of left sided heart failure? - CORRECT ANSWER #MI #Valve stenosis #HTN (has to push after the afterload)" "What is the RAAS system? - CORRECT ANSWER Renin-angiotensin-aldosterone system - a major mechanism in the regulation of arterial blood pressure. It is a compensatory mechanism that raises blood pressure and increases blood volume in response to decreased renal perfusion." "What is the patho of left sided heart failure? - CORRECT ANSWER Decreased cardiac output and pulmonary congestion" "What are the manifestations of left sided heart failure? - CORRECT ANSWER Forward Effects (in the body - not getting oxygenated blood) #Fatigue and weakness #Exercise intolerance Backward Effects (in the lungs - blood backing up to the lungs) #Dyspnea #Orthopnea #Pink-frothy sputum #SOB #Rales/Crackles" "What does the body do to compensate for left sided heart failure? - CORRECT ANSWER #Tachycardia #Pallor #Daytime oliguria (low urine output)" "What are the causes of right sided heart failure? - CORRECT ANSWER #MI (R Ventricle) #Valve stenosis #Pulmonary disease/hypertension (has to push through the lungs)" "What is the patho of right sided heart failure? - CORRECT ANSWER Decreased cardiac output and systemic congestion" "What are the manifestations of right sided heart failure? - CORRECT ANSWER Forward Effects (to the lungs) #Dyspnea #Fatigue and weakness #Exercise intolerance Backward Effects (systemic congestion/fluid back up - cannot maintain venous return) #Edema (feet, legs, buttocks, ascites, hepato and splenomegaly) #JVD (jugular vein distention)" "What is mitral valve regurgitation? - CORRECT ANSWER A condition in which the heart's mitral valve does not close tightly, which allows blood to flow backward in the heart causing backup of blood and hydrostatic pressure into the left atrium, pulmonary veins, and pulmonary capillaries - resulting in pulmonary edema." "What is heart vegetation? - CORRECT ANSWER Abnormal growths (vegetations) that contain collections of bacteria may form in the heart at the site of the infection and damage the heart valves, which can cause them to leak. **Can lead to endocarditis." "What is endocarditis? - CORRECT ANSWER A life-threateni