exam 3 patho

Benign Prostatic Hyperplasia (BPH)

increased urinary frequency and urgency are common symptoms in ______ due to urethral obstruction

polycystic ovary syndrome (PCOS)

insulin resistance increases insulin levels which stimulates ovaries to produce more testosterone in what syndrome

pelvic inflammatory disease (PID)

infection causes scarring in fallopian tubes, obstruction egg and increasing risk of ectopic pregnancy

osteoporosis

decreased estrogen levels after menopause increases a women’s risk of developing what

fibromyalgia

central sensitization causes allodynia and widespread pain from non-painful stimuli in what condition

age related macular degeneration

gradual loss of central vision

cataracts

clouding of the lens of eye causing blurry vision and seeing halos around lights

glaucoma

gradual loss of peripheral vision due to increased intraocular pressure

wet age-related macular degeneration

involves formation of abnormal blood vessels

closed angle glaucoma

sudden increase in intraocular pressure due to blockage of iris

benign paroxysmal positional vertigo (BPPV)

brief vertigo episodes triggered by head position changes that dislodge otoconia in semicircular canals

malignant hyperthermia

genetic mutation in the RYR1 gene triggered by succinylcholine and halothane anesthetic gases causes excessive calcium release in muscles resulting in muscle stiffness and high temperature

type 1 diabetes mellitus

autoimmune destruction of beta cells leading to absolute insulin deficiency

type 2 diabetes mellitus

insulin resistance due to obesity and genetics

primary hyperthyroidism

diseases thyroid gland produces excess T3 and T4 despite normal or reduced TSH stimulation

graves’ disease

autoantibodies stimulate the thyroid to produce too much T3 and T4, leading to high metabolism with weight loss, heat intolerance, palpitations, and bulging eyes

hypothyroidism

insufficient production of thyroid hormone

hashimoto’s thyroiditis

hypothyroidism due to autoimmune destruction of thyroid gland

cushing’s syndrome

prolonged high cortisol

cushing’s disease

pituitary adenoma secretes high levels of cortisol, causing weight gain (abdomen & 'moon' face), purple striae on abdomen, hypertension.

addison’s disease

dysfunction of adrenal cortex with insufficient cortisol and aldosterone

acromegaly

excessive growth hormone due to pituitary adenoma

hyperparathyroidism

overproduction of parathyroid hormone leading to hypercalcemia

hypoparathyroidism

insufficient production of PTH leading to hypocalcemia

pheochromocytoma

rare tumor of adrenal medulla that secretes excessive catecholamines, causing severe headaches, palpitations, sweating, and high blood pressure

pheochromocytoma

hypertension, palpitations and sweating are manifestations of what condition

prolactinoma

pituitary tumor that produces excess prolactin

diabetic retinopathy

chronic hyperglycemia damages retinal blood vessels leading to microaneurysm, hemorrhage, and neovascularization

diabetic nephropathy

hyperglycemia damages glomeruli in kidneys causing proteinuria, and kidney dysfunction or failure

diabetic neuropathy

chronic hyperglycemia damages nerves leading to numbness, pain, and dysfunction

diabetic gastroparesis

chronic hyperglycemia impacts nerves serving pyloric outlet in stomach so food can't move through

atherosclerosis, MI, and heart failure

hyperglycemia, dyslipidemia and hypertension in those with diabetes causes coronary artery disease and puts patient at risk for what 3 conditions

epiglottitis

drooling, sore throat, high fever, stridor, tripod position are all symptoms present in what condition

epiglottitis

total obstruction of airway (do not put anything in the mouth!) is a potential complication of what condition

they are filled with fluid or pus

if there is limited intake of oxygen leading to ineffective gas exchange which results in hypoxemia what is wrong with the alveoli

to promote expansion of lungs and improve gas exchange due to depressed respiration from anesthesia, immobility, pain

Why do nurses have patients cough, deep breathe after surgery and use incentive spirometer?

Anesthesia, pain & immobility reduce deep breathing & coughing, leading to mucus accumulation and alveolar collapse

Why is the risk for atelectasis higher after surgery?

aspiration pneumonia

inhaled contents trigger inflammatory response and alveolar damage in what condition

dysphagia impairs body's ability to protect airway so contents get into the trachea and lungs where bacteria can colonize

Why are patients with stroke-related swallowing problems at risk for aspiration pneumonia?

empyema risk after pneumonia

bacteria from pneumonia invade pleural space, trigger inflammatory response, causing fibrin deposition and pus accumulation

bronchiectasis

permanent dilation of bronchi due to chronic inflammation and mucus accumulation

bronchiolitis

acute inflammation and obstruction of small airways caused by viral infections leading to narrowing and obstruction particularly in infants and children

COPD exacerbation

trigger like infection causes airway inflammation and hypersecretion of mucus, plus bronchoconstriction, which limits airflow and causes hypoxia and hypercapnea

breathing rate change

Ventilation is controlled by the medullary respiratory center, which monitors arterial carbon dioxide levels and directs the lungs to ventilate more if carbon dioxide levels are too high and less if levels are too low. this is a normal response that triggers what

chronic CO2 retention leads to desensitization of central chemoreceptors, resulting in the need to rely on low oxygen levels (hypoxic drive) to stimulate breathing

How COPD patient's body regulates breathing rates

asthma pathophysiology

Reversible but chronic airway inflammation, intermittent bronchoconstriction, excessive mucus production all causing episodic airflow obstruction when triggered by allergen, infection, exercise hyperresponsiveness

asthma, COPD, cystic fibrosis

bronchoconstriction and mucus lead to turbulent airflow, which causes the wheezing sound to occur with breathing in what obstructive disorders

status asthmaticus

severe bronchospasm, airway inflammation and mucus plugging with significant airflow obstruction and impaired gas exchange despite using medications for asthma

silent chest

ominous finding in asthma resulting from total obstruction of airflow so that wheezing and breath sounds are no longer heard

ventilation perfusion mismatch in hypoxemia

impaired alveolar perfusion, causes reduced blood flow, which decreases efficiency of gas exchange and causes hypoxemia

pneumothorax

air in plural space causes loss of negative pressure and results in lung collapse and impaired gas exchange

remove the air from the pleural space to relieve the pressure an allow the lung to re-expand

Why are chest tubes used for pneumothorax?

pulmonary fibrosis

progressive scarring/stiffening of lung tissue that negatively impacts gas exchange and compliance

ARDS (acute respiratory distress syndrome)

injury like with drowning or other issues, causes inflammation and destruction of the alveolar capillary membrane, resulting in increased permeability, fluid accumulation in alveoli, and impaired gas exchange

central fever

non-infectious fever caused by dysregulation of hypothalamus due to brain injury resulting in an uncontrolled rise in body temperature without physiologic responses of sweating or vasodilation that is resistant to antipyretic treatment

fever of unknown origin

persistent fever >101F lasting 3 weeks or more without an identified cause despite thorough investigation resulting from cytokine release that resets the hypothalamic set point, leading to sustained fever.

heat stroke

excessive heat exposure and impaired thermoregulation leading to core body temps >104F with CNS dysfunction due to failure of heat dissipation mechanisms,

cluster headache

severe, unilateral pain around eye/temple lasting 15 min to 3 hours plus tearing, nasal congestion, and ptosis with attacks occurring multiple times a day during a cluster period.

migraine headaches

unilateral throbbing pain, nausea, vomiting, sensitivity to light and sound, with or without an aura

infants

due to having a higher metabolic rate and greater body surface area relative to their weight, making them more susceptible to rapid changes in body temperatures, what population is more likely to develop high fevers

have an altered thermoregulatory set point in the hypothalamus and an age-related decrease production of proinflammatory cytokines

Why do the elderly have a blunted or absent febrile response

secondary hyperthyroidism

Normal thyroid responds to higher stimulation (TSH) from a diseased pituitary or hypothalamus (TRH--TSH) resulting in high T3 and T4

HHNKS (hyperglycemic hyperosmolar nonketotic syndrome)

complication in type 2 diabetes with extreme high glucose (>600) but no ketones in urine. Dangerous and deadly complication

DKA

results from insulin deficiency and counterregulatory hormone excess (glucagon, cortisol, catecholamines). This leads to uncontrolled lipolysis, increasing free fatty acids, which are converted into ketone bodies (β-hydroxybutyrate, acetoacetate) in the liver, causing metabolic acidosis.

somogyi effect

caused by a rebound from nocturnal hypoglycemia, often due to lack of snack or to high an evening insulin dose

dawn phenomenon

natural early morning rise in blood glucose due to growth signals

cardiogenic shock

diseased heart cannot generate enough cardiac output, leading to systemic hypoperfusion, widespread vessel dilation, and oxygen deprivation, with organ ischemia, lactic acidosis, and worsening cardiac function

calcium in MI

during myocardial contraction, calcium influx through L-type calcium channels triggers further calcium release, which then binds to troponin C, shifting tropomyosin and exposing binding sites on actin, allowing Actin-Myosin Cross-Bridging and contraction

right sided heart failure

left sided heart failure causes pulmonary congestion because the left ventricle cannot push out enough blood against the high afterload. This causes elevated pulmonary venous pressure, which increases the workload of the right ventricle, causing strain, myocyte injury, and resulting in what kind of complication of left sided heart failure

heart heals through fibrosis, which causes formation of scar tissue

what is the most common form of tissue healing after myocardial infarction (MI)?

After MI, scar tissue does not contract like normal myocardial tissue, resulting in permanent loss of function in the affected area

how does the formation of scar tissue (fibrosis) after MI impact the heart's ability to function

myocardial infarction

after reperfusion, oxidative stress, inflammatory cytokine release, and calcium overload contribute to reperfusion injury, causing additional myocardial damage rather than improving function, leading to arrhythmias and decreased cardiac output. this is due to repuerfusion injury after what

transient ischemic attack (TIA)

symptoms of neurologic dysfunction that usually resolve within an hour but increase the risk for developing a full stroke

ischemic stroke

blood clot blocks flow of blood to part of the brain, depriving it of oxygen. 2 types: thrombotic and embolic

thrombotic stroke

blood clot forms within a blood vessel in the brain, usually due to atherosclerosis

embolic stroke

blood clot/debris travels from another part of the body but gets stuck and blocks a vessel leading to a specific area of the brain

hemorrhagic stroke

blood vessel in brain ruptures causing bleeding into or around the brain

intracerebral hemorrhage

bleeding occurs within the brain, often due to high blood pressure

subarachnoid hemorrhage

bleeding occurs in space between brain and surrounding membrane, often due to aneurysms or arteriovenous malformations (AVMs

hemorrhagic stroke

sudden severe headache, nausea and vomiting loss of consciousness or altered mental state, weakness or numbness on one side of the body are manifestations of what kind of stroke

ischemic stroke

sudden numbness/weakness, especially on one side of the body (unilateral), confusion, trouble speaking or understanding speech, vision problems in one or both eyes, difficulty walking, dizziness, loss of balance or coordination are manifestations of what type of stroke

ischemic stroke

what type of stroke has a gradual onset compared to hemorrhagic strokes which can occur suddenly

ischemic strokes are treated with clot-busting medications to restore blood flow, hemorrhagic require interventions to stop the bleed and reduce  pressure on the brain

what is the difference in treating ischemic vs hemorrhagic stroke

hemiparesis

weakness of one side of body that affects motor pathways that control muscle movements.

aphasia

language disorder due to damage in a specific part of the brain

homonymous hemianopia

visual field loss on same side of both eyes

gaze preference

eye deviates to side of body with injury

broca’s area

expressive aphasia with difficulty speaking or expressing words (often a word salad) are manifestations of a stroke in what part of the brain

wernicke’s area

Receptive aphasia with difficulty comprehending language spoken to the patient is a manifestation of a stroke in what part of the brain

hemineglect

failure to recognize objects of stimuli on one side of the body

middle cerebral artery (MCA) stroke

Hemineglect, Contralateral hemiparesis and hemisensory loss, homonymous hemianopia, gaze preference toward lesion side, expressive aphasia (if Broca's area), or receptive aphasia (if Wernicke's area) are manifestations of what kind of stroke

anterior cerebral artery stroke (ACA)

contralateral leg weakness & sensory loss (leg more than arm), urinary incontinence, abulia (apathy), personality & behavioral changes, difficulty recognizing own limb movements are manifestations of what kind of stroke

posterior cerebral artery (PCA) stroke

contralateral homonymous hemianopia, visual hallucinations and cortical blindness, memory impairment, thalamic syndrome (contralateral sensory loss, pain, and dysesthesia) are manifestations of what type of stroke

vertebrobasilar stroke

crossed signs, dysarthria, dysphagia, ataxia, vertigo, nystagmus, diplopia, gaze palsies, possible locked in syndrome are manifestationsof what type of stroke

lacunar

pure motor hemiparesis, pure sensory stroke, ataxic hemiparesis, dysarthria-clumsy hand syndrome are manifestations of what stroke

saccular (berry aneurysm)

most common aneurysm, found in branching points of arteries at the base of the brain, particularly in the Circle of Willis. Associated with atherosclerosis and hypertension

fusiform aneurysm

widening or dilation of an artery, typically related to atherosclerosis

giant aneurysm

associated with chronic hypertension and issues that cause significant arterial wall weakening, leading to an aneurysm larger than 2.5 centimeters in diameter

prehypertension

SBP 120-139 OR DP 80 to 89

stage I hypertension

SBP 140-159 OR DBP 90-99