NUR2063 Essentials of Pathophysiology Final Exam Study Outline

NUR2063 Essentials of Pathophysiology Final Exam Study Outline MODULE 1: THE CELL STRUCTURE AND FUNCTION • Chapter 1: What is Pathophysiology? O Definitions: Etiology, pathogenesis, acute, chronic, exacerbation, remission, etc. O Signs vs. Symptoms O Levels of Disease Prevention: Primary vs. Secondary vs. Tertiary • Chapter 2: Homeostasis, Allostasis, & Adaptive Responses to Stressors o What is homeostasis? Allostasis? ▪ What is allostatic load? Allostatic overload? o What is stress? How does it affect homeostasis and allostasis? ▪ Neurohormones of stress response: catecholamines, adrenocortical steroids, endorphins, etc. • Examples of each • What does each do? • Chapter 3: Cellular Metabolism (PP. 34-39) O What is cellular metabolism? What is the cell’s energy currency? • Chapter 24: Fluid and Electrolyte Homeostasis and Imbalances O Compartments of body fluid: Extracellular vs. Intracellular vs. Interstitial vs. Vascular vs. Transcellular O Hormones Involved in Fluid balance: ADH, Aldosterone, natriuretic peptides ▪ How do they work? What do they do? ▪ RAAS! • What is it? What is the cause of RAAS initiation? What are the results? O Electrolyte Imbalances: Sodium, Potassium, Magnesium, Calcium, Phosphate ▪ Normal ranges of each electrolyte MODULE 2: CELLULAR RESPONSES, ADAPTATION, & DYSFUNCTION: • Chapter 8: Infectious Processes o What are the links in the chain of infection transmission? ▪ Definitions & examples of each link • Chapter 9: Inflammation & Immunity o What is immunity? o Cells involved in immunity ▪ Leukocytes: Neutrophils, lymphocytes, monocytes/macrophages, eosinophils, & basophils • Subtypes of each (i.e. segs and bands are subtypes of neutrophils)… what do they do? • What does each cell do? What type of infectious agent do they fight off? o What is inflammation? ▪ Clinical manifestations of inflammation: • Five cardinal symptoms of LOCALIZED inflammation • Systemic S/Sx of inflammation o Antibody-mediated vs. cell-mediated immunity ▪ Define/describe each. ▪ What is active immunity? Passive? Natural? Artificial? • Provide examples of each. • Chapter 10: Alterations in Immune Function o Types of Hypersensitivity Reactions: I, II, III, & IV ▪ Define/describe each ▪ Examples o What happens when our immune system is deficient? • Chapter 7: Neoplasms o Biology of normal vs. malignant cells o Risk factors for cancer (including primary vs. secondary prevention) o 4 stages of carcinogenesis ▪ Know each stage (initiation  metastasis). What happens in each stage? • What is the name for a gene that initiates cancerous behavior? MODULE 3: SKIN & MUSCULOSKELETAL DISORDERS: • Chapter 51: Alterations in Musculoskeletal Function: Trauma, Infection & Disease o Types of MSK injuries to: Ligaments, tendons, joint capsules, fasciae, bursae, nerves, nerve roots, dura mater, contractile soft tissue, muscles/tendons, blunt force trauma ▪ Complications: • Compartment Syndrome—Define/describe, etiology, S/Sx o Healing process ▪ How does wound healing occur? ▪ What occurs during each stage? What would you assess in each stage? ▪ How do you classify wound drainage? ▪ Scar tissue – how does it form? Any associated complications? o Types/extents of fractures ▪ Complications of fractures: Delayed healing, delayed union, osteomyelitis, malunion, osteonecrosis, fat embolism syndrome, etc. o Bone structure disorders: Scoliosis, osteoporosis, Rickets, etc. ▪ Define/describe each ▪ Clinical Manifestations o Skeletal Muscle Diseases: Muscular dystrophy, polymyositis, dermatomyositis, myasthenia gravis, fibromyalgia ▪ Define/describe each that is listed in your notes ▪ Complications (i.e. Myasthenic crisis) • Chapter 52: Alterations in Musculoskeletal Function: Rheumatic Disorders o Disorders of MSK function: Osteoarthritis, Lyme Disease, Rheumatoid arthritis, SLE,Scleroderma, ankylosing spondylitis, acute rheumatic fever (post-infectious) ▪ Define/describe each that is listed in your notes ▪ Know for each: inflammatory or noninflammatory? ▪ Clinical Manifestations • Chapter 53: Alterations in the Integumentary System o Decubitus ulcers ▪ Define/describe & stage ▪ Etiology MODULE 4: PATHOPHYSIOLOGY OF THE GI AND GU SYSTEMS • Chapter 36: Gastrointestinal Disorders O What does our GI Tract do? O Definitions: dysphagia, esophageal pain, abdominal pain, n/v, intestinal gas, constipation, diarrhea, stomatitis, etc. O Gastrointestinal Disorders: Cold sores, GERD, Hiatal Hernia, Mallory-Weiss Syndrome, gastritis, gastroenteritis, PUD, IBD (Crohn’s & UC), antibiotic- associated/pseudomembraneous colitis (C. diff), necrotizing enterocolitis, appendicitis, diverticular disease, IBS, intestinal obstructions (intussusception, Hirschsprung’s, etc.), malabsorption disorders (Celiac, Tropical Sprue), colyn polyps ▪ What is the disorder? ▪ Etiology ▪ Clinical Manifestations • Chapter 27: Intrarenal Disorders O What do our kidneys do? O Intrarenal Disorders: Congenital abnormalities (Renal Agenesis/Hypoplasia, cystic kidney diseases), neoplasms, infections (acute vs. chronic pyelonephritis), obstructions (nephrolithiasis, strictures, tumors), & glomerulopathies (glomerulonephritis, nephrotic syndrome) ▪ Define ▪ Etiology & risk factors ▪ Clinical Manifestations ▪ Treatments • Medications, surgery, etc. ▪ Complications (if applicable) • Chapter 28: Acute Kidney Injury & Chronic Kidney Disease O What is an AKI? ▪ Etiology: Prerenal vs. Intrarenal vs. Postrenal • Pathogenesis involved with each ▪ Clinical Manifestations O What is CKD? ▪ Etiology & risk factors ▪ Pathogenesis Chapter 29: Disorders of the Lower Urinary Tract O Types of Incontinence: Stress, Urge, Mixed, Overflow, Functional ▪ Definitions & Causes O Lower UT Disorders: Enuresis, Overactive bladder syndrome, interstitial cystitis, neurogenic bladder, neoplasms, VUR, urethritis, Cystitis (esp. UTI), urolithiasis ▪ Etiology & Pathogenesis ▪ Clinical Manifestations ▪ Complications (if applicable) MODULE 5: PATHOPHYSIOLOGY OF THE GENITOURINARY AND REPRODUCTIVE SYSTEMS: • Chapter 31: Male Genitourinary Disorders o Identify the common causes of and clinical findings in acquired penile disorders and congenital anomalies. o Identify the common causes of primary and secondary impotence. o Describe the usual clinical manifestations and significance of testicular cancer, testicular torsion, cryptorchidism, and hydrocele or spermatocele. o Identify the clinical manifestations that would lead to a suspicion of prostatitis o Explain how benign prostatic hyperplasia can be distinguished from prostate cancer. o Identify the clinical manifestations indicative of prostatic enlargement. • Chapter 33: Alterations in Female Genital and Reproductive Function o Identify the differentiating factors of the common menstrual disorders, reproductive tract cancers, and benign growths and inflammation/infection of the GU system. o Identify the common etiologic factors leading to uterine prolapse, uterine retrodisplacement, cystocele, and rectocele. o Identify causes, clinical manifestations, complications, and the pathogenesis of PID. o Describe how the pain of endometriosis can be differentiated from that of dysmenorrhea. o Explain the rationale for routine Papanicolaou testing (Pap smears) for cervical cancer. o Identify the factors contributing to the high mortality rate of ovarian cancer. o Explain how benign and malignant breast lumps can be clinically differentiated. • Chapter 34: Sexually Transmitted Infections (STI’s) o Describe the characteristic clinical manifestations and lesions of gonorrhea and chlamydial infection. o Describe how the pathologic changes and clinical manifestations of syphilis differ during the incubation, primary, secondary, and tertiary phases. o Distinguish the lesions of herpes simplex, syphilis, and lymphogranuloma venereum. o Identify which sexually transmitted diseases remain localized, and which have systemic consequences. o Describe the causative organisms and characteristic lesions of the following localized sexually transmitted diseases: chancroid, granuloma inguinale, molluscum contagiosum, and condylomata acuminata (genital warts). MODULE 6: ENDOCRINE PATHOPHYSIOLOGY: • Chapter 40: Disorders of Endocrine Function o What do our hormones do? (refer to table in notes/ppt) o Thyroid Hormone Imbalances (Hypo/Hyperthyroidism) ▪ Etiology ▪ Clinical manifestations o Adrenocortical hormone imbalances (Addison’s, Cushing’s) ▪ Etiology ▪ Clinical manifestations o Hyperaldosteronism ▪ Clinical manifestations o ADH Imbalances (DI, SIADH) ▪ Etiology ▪ Clinical manifestations ▪ Treatment • Chapter 41: Diabetes Mellitus o What is DM? o How are our glucose levels regulated? ▪ Hormones: What do insulin and glucagon do? ▪ Neural: How do catecholamines (SNS/PNS) affect blood glucose? ▪ Exercise: How does exercise affect our BG? ▪ Stress: How does stress affect our BG? o Glucose Intolerance Disorders (Prediabetes, DM Type 1, DM Type 2, GDM) ▪ What is a normal BG level? ▪ Pathophysiology (Etiology & Pathogenesis) ▪ Clinical Manifestations • 3 Poly’s: • Others? ▪ Complications of DM • Acute Hyperglycemia & Hypoglycemia o Etiology o Clinical Manifestations o Complications • DKA & NHHS o Etiology: severe hyperglycemia – BG level > o Clinical Manifestations MODULE 7: NEUROLOGIC PATHOPHYSIOLOGY • Chapter 44: Acute Disorders of Brain Disfunction o What are the proposed mechanisms and potential consequences of primary and secondary brain injury? o Which brain components determine intracranial pressure, and under what conditions might each contribute to elevated intracranial pressure? o How are level of consciousness and cranial nerve reflexes used to assess changes in neurologic status in the brain-injured patient? o What are the common manifestations of types of traumatic brain injury (focal, polar, diffuse) and hemorrhage (epidural, subdural, subarachnoid)? o How do the three most common causes of stroke (thrombi, emboli, and hemorrhage) differ with regard to risk factors, prevention strategies, and acute management? o How do the clinical manifestations of ischemic stroke vary depending on the location of cerebral artery obstruction? o What are the common long-term sequelae of stroke, and how are they managed? o What are the causes and usual presentations of cerebral aneurysm and arteriovenous malformation? o How do brain abscess, meningitis, and encephalitis differ with regard to usual infective organisms, cerebrospinal fluid analysis findings, clinical manifestations, and treatment? • Chapter 45: Chronic Disorders of Neurologic Function o How are the various types of seizures recognized, classified, and treated? o How is Alzheimer dementia diagnosed and managed? o What are the similarities between Alzheimer dementia and vascular dementia? o What are the proposed neurotransmitter alterations in Parkinson disease, and how are drugs used to restore balance? o What are the similarities and differences between multiple sclerosis and amyotrophic lateral sclerosis? o How are congenital disorders, such as cerebral palsy, hydrocephalus, and spina bifida, manifested in the newborn? o How does the level of spinal cord injury relate to expected functional losses and clinical manifestations? o What are the roles of immune mechanisms in Guillain-Barré syndrome, amyotrophic lateral sclerosis, and multiple sclerosis? o What are the causes of facial paralysis, in Bell palsy and how is this condition different from other chronic disorders of neurologic function? MODULE 8: RESPIRATORY SYSTEM PATHOPHYSIOLOGY • Chapter 21: Alterations in Pulmonary Function o What factors affect the distribution of ventilation, perfusion, and diffusion? o How are oxygen and carbon dioxide transported in the circulation? o What pathophysiologic factors might alter ventilation-perfusion matching in the lungs? o How can functional respiration be assessed clinically? o What are characteristic of acute respiratory failure? o What are the risk factors and complications of pulmonary venous thromboembolism and pulmonary hypertension? o What are the various types of pulmonary malignancies? • Chapter 22: Obstructive Pulmonary Disorders o What are the clinical manifestations and common causes of acute airway obstruction? o What are the pathogenesis and clinical manifestations for conditions that cause obstruction of the airway lumen? o What is the role of inflammation in the development of asthma? o How does the underlying genetic defect in cystic fibrosis lead to pulmonary and exocrine gland dysfunction? o How does smoking cause both the alveolar destruction of emphysema and the bronchial damage of chronic bronchitis? • Chapter 23: Restrictive Pulmonary Disorders o How do fibrotic lung disorders develop? o What is the pathogenesis of acute (adult) respiratory distress syndrome? o How do abnormal accumulations (fluid or air) in the pleural space affect lung function? o What neuromuscular disorders are associated with reduced lung compliance? o What chest wall deformities are associated with reduced lung compliance? o What is the pathogenesis of pneumonia? o What is the pathogenesis of tuberculosis? MODULE 9: HEMATOLOGY PATHOPHYSIOLOGY • Chapter 13: Alterations in Oxygen Transport o What factors are necessary for normal red blood cell production? o How are laboratory tests used to detect anemia and polycythemia? o What are the general effects of anemia on body systems? o How are history, clinical manifestations, and laboratory studies used to differentiate the various forms of anemia? o How are history, clinical manifestations, and laboratory studies used to differentiate the various forms of polycythemia? o What is the pathogenesis of sickle cell anemia? • Chapter 14: Alterations in hemostasis and blood coagulation o How do platelets and factors of the clotting cascade contribute to hemostasis? o What findings from the patient history, physical examination, or laboratory studies would indicate a potential bleeding disorder? o How are laboratory tests used to differentiate the various coagulation disorders? o What vascular alterations result in abnormalities of hemostasis? o What are the common causes of platelet deficiencies, excesses, and dysfunction? o What are the common causes of inherited and acquired disorders of coagulation? • Chapter 11: Malignant disorders of white blood cells o How do the various types of leukemia, lymphoma, and plasma cell myelomas differ based on the type of malignant transformation? o How do the clinical presentations, prognosis, and management of types of acute and chronic leukemia differ? o Why are malignant disorders of white blood cells commonly associated with bone marrow depression? o How is Hodgkin disease clinically and histologically differentiated from other types of lymphoma? o What is the purpose and process of staging procedures for lymphomas? MODULE 10: PATHOPHYSIOLOGY OF CARDIAC AND VASCULAR DISORDERS • Chapter 15: Alterations in Blood Flow o Alterations in Arterial Flow (Arteriosclerosis/Atherosclerosis, Buerger’s Disease, Raynaud Syndrome, Aneurysms, Acute Arterial Occlusion) ▪ Etiology & Risk factors ▪ Pathogenesis ▪ Clinical Manifestations ▪ Complications (if applicable) o Alterations in Venous Flow (Valvular incompetence, Varicose Veins, Chronic Venous Insufficiency) ▪ Etiology & Risk factors ▪ Pathogenesis ▪ Clinical Manifestations • Chapter 16: Alterations in Blood Pressure o Hypertension ▪ Stages ▪ Primary vs. Secondary ▪ Risk factors and Etiology ▪ Complications o OH ▪ Etiology ▪ Pathogenesis ▪ Clinical Manifestations • Chapter 18: Alterations in Cardiac Function o Coronary Heart Disease (CHD/CAD), Atherosclerosis, ACS (angina, MI) ▪ What is ACS? ▪ Etiology • Including modifiable vs. nonmodifiable risk factors • Stable vs. Unstable plaques… what makes a plaque unstable and at risk for MI? ▪ What is angina? ▪ Pathogenesis of ACS ▪ Clinical Manifestations ▪ Complications? (SCD, HF, ischemic cardiomyopathy, etc.) o Endocardial Vascular Diseases ▪ Stenosis vs. Regurgitation vs. Prolapse ▪ Mitral valve disorders (stenosis, regurgitation, prolapse) • Etiology • Pathogenesis • Clinical Manifestations ▪ Aortic Valve disorders (Stenosis, Regurgitation) • Etiology • Pathogenesis • Clinical Manifestations ▪ Rheumatic Heart Disease & Infective Endocarditis • Etiology • Pathogenesis • Clinical Manifestations o Myocardial Disease (Myocarditis, Cardiomyopathy) ▪ Etiology ▪ Pathogenesis • Classifications of Cardiomyopathy (dilated vs. Hypertrophic vs. restrictive) ▪ Clinical Manifestations o Pericardial diseases (pericardial effusion vs. pericarditis) ▪ Etiology ▪ Pathogenesis ▪ Clinical Manifestations • Chapter 19: Heart Failure o What is HF? ▪ Impaired ability to…. ▪ What does it cause? (What does our heart do?) o Classifications: ▪ Systolic vs. Diastolic Dysfunction • Definitions • Etiology • Pathogenesis ▪ Left-sided vs. Right-sided failure • What type of HF is more common? • Biventricular heart failure • Clinical Manifestations o Forward symptoms vs. Backward symptoms o How does the body compensate for HF?