Final Patho Exam 3

PCOS: Pathophysiology, Insulin resistance with HPO axis dysfunction leading to hyperandrogenemia and ovulatory dysfunction

PCOS: Biochemical hallmark, Hyperandrogenemia is the key lab finding in PCOS

PCOS: Typical menstrual pattern, Oligo-amenorrhea with irregular or absent menses due to anovulation

PCOS: Classic manifestations, Hirsutism acne scalp hair loss central weight gain glucose intolerance

PCOS: Insulin link, Hyperinsulinemia worsens ovarian androgen production

NCLEX—PCOS first-line clue, Irregular cycles plus clinical hirsutism in a patient with central adiposity suggests PCOS

Active recall—Why does PCOS cause acne and hirsutism?, Excess androgens from ovarian dysregulation

Active recall—What is often elevated in PCOS besides androgens?, Insulin (hyperinsulinemia)

PCOS: Pathophysiology, Insulin resistance causes ↑LH, ↓FSH, and ↑androgens leading to anovulation and cyst formation

PCOS: Key symptoms, Irregular menses, acne, scalp thinning, central weight gain, insulin resistance

Active recall – Why does PCOS cause infertility?, Anovulation from disrupted HPO axis function

Endometriosis: Pathophysiology, Ectopic endometrial tissue outside uterus that bleeds with cycles causing inflammation scarring adhesions

Endometriosis: Pain pattern, Cyclic pelvic pain and dysmenorrhea often with dyspareunia

Endometriosis: Infertility link, Adhesions and inflammation can impair fertility

Active recall—Mechanism of pain in endometriosis, Ectopic tissue responds to hormones → bleeding inflammation adhesion pain

NCLEX—Common presentation, Reproductive-age patient with chronic pelvic pain worse during menses and dyspareunia

Pelvic Inflammatory Disease (PID): Cause, Ascending infection—commonly chlamydia or gonorrhea—spreads to uterus tubes ovaries

PID: Key exam finding, Cervical motion tenderness with pelvic pain fever abnormal discharge

Active recall—Long-term risk of PID, Scarring adhesions leading to infertility and ectopic risk

NCLEX—Likely pathogens in PID, Chlamydia trachomatis and Neisseria gonorrhoeae

Benign Prostatic Hyperplasia (BPH): Pathophysiology, Age-related prostate enlargement driven by DHT causing urethral compression

BPH: Lower urinary tract symptoms, Frequency urgency nocturia weak stream hesitancy incomplete emptying

Active recall—Why nocturia in BPH?, Bladder outlet obstruction increases residuals leading to nighttime voids

NCLEX scenario, 70-year-old man with frequent urination, weak stream, and nocturia likely has BPH

Menorrhagia: Definition, Excessive menstrual bleeding >80 mL or >7 days

Menorrhagia: Causes, Anovulation structural lesions (fibroids polyps) or coagulation disorders

Active recall—Clinical impact, Heavy flow with clots fatigue anemia symptoms affecting daily activities

Testicular cancer: Epidemiology, Most common solid tumor in men ages 15–35

Testicular cancer: Presentation, Painless testicular mass heaviness ± gynecomastia

Active recall—Key risk factor, History of cryptorchidism increases risk

Menopause: Endocrine pattern, Ovarian follicle depletion with ↓estrogen/progesterone and ↑FSH/LH

Menopause: Diagnostic feature, Amenorrhea ≥12 months with vasomotor symptoms

Active recall—Common symptoms, Hot flashes night sweats mood and sleep changes vaginal dryness bone loss risk

NCLEX—Lab expectation in menopause, Elevated FSH and LH with low estrogen

Cryptorchidism: Definition, Failure of one or both testes to descend into the scrotum

Cryptorchidism: Risks, Infertility and increased malignancy risk due to higher intra-abdominal temperature

Active recall—Exam clue, Nonpalpable testis or mass in inguinal canal with asymmetric scrotum

Erectile dysfunction: Etiologies, Vascular neurologic hormonal and psychogenic factors affect erection

ED: Manifestations, Trouble achieving or maintaining erection with reduced libido and performance anxiety

Meningitis: Pathophysiology, Inflammation of meninges with increased ICP; bacterial viral or fungal

Meningitis: Classic signs, Fever severe headache nuchal rigidity photophobia altered mental status

Meningitis: Special findings, Positive Kernig and Brudzinski signs ± petechial rash in meningococcal disease

NCLEX—Emergency action for suspected meningitis, Implement droplet precautions and urgently initiate evaluation

Active recall—Why is ICP increased in meningitis?, Inflammatory edema and impaired CSF dynamics

Abnormal posturing: Decorticate, Flexed arms with extended legs indicates cortical damage with intact brainstem

Abnormal posturing: Decerebrate, Extended arms and legs with head arched back indicates brainstem dysfunction

Active recall—Prognosis clue, Persistent abnormal posturing signals severe brain injury and poorer outcomes

Multiple Sclerosis: Core mechanism, Autoimmune T-cell mediated CNS demyelination with sclerotic plaques

MS: Common manifestations, Optic neuritis fatigue numbness spasticity coordination and cognitive changes

MS: Course, Often relapsing–remitting with variable neurologic deficits

Active recall—Consequence of demyelination, Impaired nerve conduction causing neurologic symptoms

Stroke vs TIA: Distinction, Stroke causes permanent brain injury; TIA causes transient deficits without infarction

Stroke/TIA: FAST, Facial droop Arm weakness Speech difficulty → Time to call 911

Active recall—TIA time course, Symptoms typically resolve within 24 hours often under 1 hour

Alzheimer’s disease: Pathology, Amyloid plaques neurofibrillary tangles ACh deficiency with cortical/hippocampal atrophy

Alzheimer’s: Manifestations, Progressive memory loss disorientation poor judgment personality changes loss of ADLs

Active recall—Neurotransmitter change, Decreased acetylcholine in cortical pathways

Seizures/Epilepsy: Mechanism, Abnormal excessive neuronal firing with excitatory-inhibitory imbalance

Seizure types: Tonic-clonic, LOC rigidity rhythmic jerking followed by postictal confusion and fatigue

Seizure types: Absence, Brief staring spells with impaired awareness

Active recall—Postictal state, Period of confusion and fatigue after generalized seizures

Cerebral palsy: Definition, Nonprogressive motor disorder from early brain injury affecting tone posture movement

CP: Presentations, Spastic athetoid or ataxic patterns with delayed motor milestones ± seizures or intellectual disability

Huntington’s disease: Genetics, Autosomal dominant CAG repeat expansion causing basal ganglia degeneration and GABA loss

Huntington’s: Manifestations, Choreiform movements progressive cognitive decline and psychiatric symptoms

Parkinson’s disease: Pathophysiology, Degeneration of substantia nigra dopaminergic neurons with Lewy bodies

Parkinson’s: Motor signs, Resting tremor bradykinesia rigidity postural instability shuffling gait masked facies

Active recall—Neurotransmitter imbalance, ↓Dopamine relative to acetylcholine in basal ganglia circuits

Spinal cord injury: Injury phases, Primary mechanical damage followed by secondary inflammation ischemia apoptosis

SCI: Deficits, Loss of motor/sensory function below lesion with autonomic bowel bladder and sexual dysfunction

Spinal shock: Definition, Transient areflexia and flaccid paralysis below injury resolving over weeks to months

Active recall—Vitals clue in spinal shock, Bradycardia hypotension and loss of temperature regulation (poikilothermia)

Migraine: Mechanism, Neurovascular disorder with trigeminal activation cortical spreading depression and CGRP/serotonin roles

Migraine: Symptoms, Unilateral throbbing headache with photophobia phonophobia N/V ± aura

Active recall—Common triggers, Stress certain foods hormones and sleep changes

Increased intracranial pressure (ICP): Concept, Elevated pressure in rigid skull from increased brain blood or CSF lowers perfusion

ICP: Signs, Morning headache vomiting altered LOC papilledema Cushing triad (↑BP ↓HR irregular respirations)

Active recall—Herniation risk, Rising ICP can cause brain herniation and death