Patho Final

A patient comes in with hypertonic muscles, hyperreflexia of the muscles and spastic paralysis. The nurse should be suspecting what?

a. Parkinson’s Disease

b Upper Motor Neuron Lesions

c. Lower Motor Neuron Lesions

d. Multiple Sclerosis

A patient comes in with hypertonic muscles, hyperreflexia of the muscles and spastic paralysis. The nurse should be suspecting what?

a. Parkinson’s Disease

b Upper Motor Neuron Lesions

c. Lower Motor Neuron Lesions

d. Multiple Sclerosis

b. Upper Motor Lesions

A patient comes is currently in the ICU. They have flaccid paralysis, hypotonic muscles, hyporeflexia and denervation atrophy. What does the nurse suspect the patient has?

a. Upper Motor Neuron Lesions

b. Extrapyramidal Neural Lesion

c. Lower Motor Neuron Lesion

d. Pyramidal Motor Lesion

c. Lower Motor Neuron Lesion

The Pyramidal Motor System originates in the motor cortex and its degeneration results in:

a. a patient’s inability to write with a pencil properly.

b. a patient’s inability to hold their back straight.

c. a patient’s inability to walk to their bedroom.

d. a patient’s inability to raise their arms equally.

a. a patient’s inability to write with a pencil properly.

Basal Ganglia cells and its associated disorders are a part of which system?

a. Motor Neuron System

b. Pyramidal System

c. Extrapyramidal System

d. Myelin Sheath System

c. Extrapyramidal System

What diseases are associated with basal ganglia?

MS, PD, epilepsy, CP

What is Multiple Sclerosis?

a. A decrease in dopamine, affect the basal ganglia of the brain

b. Muscle wasting due to genetics.

c. A demyelinating disease of the CNS

d. A neurologic disorder that selectively affects motor function

c. A demyelinating disease of the CNS

What are the Upper Motor Symptoms of ALS?

a. Dysphagia and Dysphonia

b. Dysfunction and Functional Incontinence

c. Paraplegia

d. Weakness and Impaired Fine Motor Control

d. Weakness and Impaired Fine Motor Control

What are the Lower Motor Neuron symptoms for ALS?

a. Spasticity or Stiffness

b. Weakness and Impaired Fine Motor Control

c. Dysphasia and Dysarthria

d. Dysphagia and Dysphonia

d. Dysphagia and Dysphonia

What are the 4 Cardinal Signs of PD?

a. Dysarthria, hypophonia, dysphagia and bradykinesia

b. Tremors, bradykinesia, rigidity and postural instability

c. Gait disorders, microphagia, rigidity and tremors

d. Dysarthria, dysphagia, tremors and postural instability

b. Tremors, bradykinesia, rigidity and postural instability

What are the 7 motor symptoms of PD?

Tremors, bradykinesia, rigidity, postural instability, gait disorders, dysarthria/hypophonia, dysphagia, and microphagia

What is a Spinal Cord Injury?

a. When one of the bones of the spine crack

b. When a person becomes a paraplegic due to a degenerative spine.

c. When the spinal cord is surgically altered.

d. Damage to the neurons of the spine.

d. Damage to the neurons of the spine.

What is a good example of a Confused patient?

a. A patient is slow but complete in their response. They grimace when their finger is squished.

b. A patient is completely awake and moving around but does not who they are.

c. A patient cannot respond to any stimuli and has their eyes closed.

d. A patient responds with minimal words but is very drowsy.

b. A patient is completely awake and moving around but does not who they are.

What is an example of a patient who is Obtunded?

a. A person can open their mouth when asked, but continually falls asleep and can only be aroused by sternal rubs.

b. A patient lays in their bed with their eyes open and the only movement they make is the occasional twitch of their arms.

c. A patient takes a long time to respond to questions and takes a long time to move their legs when asked.

d. A patient knows where they are, but cannot follow simple commands.

a. A person can open their mouth when asked, but continually falls asleep and can only be aroused by sternal rubs.

What is an example of a Stuporous patient?

a. A patient responds to questions with minimal words, but they appear drowsy constantly.

b. A patient is typically asleep and cannot speak, but they can be woken up with vigorous sternal rubs.

c. A patient is oriented, but they take at least 30 seconds to respond to a questions asking what their name is.

d. A patient is slow in speech and cannot move their arms immediately when asked.

b. A patient is typically asleep and cannot speak, but they can be woken up with vigorous sternal rubs.

What are some of the major causes of hypofunction of hormones (SATA)?

a. congenital effects

b. hormone producing tumor

c. excessive stimulation

d. infection

e. neoplastic growth

a. congenital effects, d. infection and e. neoplastic growth

What is a cause of hyperfunction of hormones?

a. congenital effects

b. increased growth of endocrine glands

c. aging

d. receptor defects

b. increased growth of endocrine glands

What is an example of a primary endocrine disorder?

a. Hypothyroidism that is caused by your thyroid exploding.

b. Hypothyroidism caused because the thyroid is not being stimulated by the anterior pituitary gland.

c. Hypothyroidism is cause because the hypothalamus releasing enough TSH.

d. Hypothyroidism is caused because a tumor has cut off blood flow to the brain.

a. Hypothyroidism that is caused by your thyroid exploding.

What is an example of a secondary endocrine disorders?

a. The adrenal glands are fully intact and functioning, but a tumor is slowly covering its receptors so they can’t receive any more signals.

b. The adrenal gland cells have begun to break down and cannot produce anymore hormones.

c. The hypothalamus was impacted by a stroke and cannot stimulate the adrenal glands anymore.

d. The adrenal glands are beginning to get necrotic due to high blood sugar.

a. The adrenal glands are fully intact and functioning, but a tumor is slowly covering its receptors so they can’t receive any more signals.

What is an example of a tertiary disorder?

a. The pancreas’ beta cells are slowly dying, meaning they cannot produce enough insulin.

b. The pancreas is normal, but its not being stimulate enough by glycogen in order to produce insulin.

c. The hypothalamus has developed a tumor and cannot stimulate the pancreas to produce insulin.

d. The pancreas has been removed and therefore cannot produce insulin which yeah

c. The hypothalamus has developed a tumor and cannot stimulate the pancreas to produce insulin.

Which organ produces TSH?

a. the thyroid gland

b. the hypothalamus

c. the anterior pituitary gland

d. the posterior pituitary gland

c. the anterior pituitary gland

What is the purpose of TRH?

a. it stimulates the release of T3 and T4

b. it’s stimulated by the release of T3 and T4 in order to produce TSH

c. it stimulates the release of TSH

d. its stimulated by the release of TSH in order to produce T3 and T4

c. it stimulates the release of TSH

What mechanisms within the body do T3 and T4 help regulate?

a. iodine levels

b. burning calories

c. internal temperature

d. the growth of organs'

e. the growth of skin and hair

f. the breakdown of alcohol

b. burning calories, c. internal temperature, e. the growth of skin and hair (and nails)

What is hypothyroidism and what can it be caused by?

a. an increase in the amount of thyroid hormone caused by severe stress

b. a decrease in the amount of thyroid hormone caused by Hashimoto’s

c. a decrease in the amount of thyroid hormone caused by too much iodine

d. an increase in the amount of thyroid hormone caused by untreated hypertension

a. an increase in the amount of thyroid hormone caused by severe stress —> this is hyperthyroidism

b. a decrease in the amount of thyroid hormone caused by Hashimoto’s

c. a decrease in the amount of thyroid hormone caused by too much iodine —> the first part is hypo-, the second half is a cause of hyper-

d. an increase in the amount of thyroid hormone caused by untreated hypertension — both hyper

What is a result of hypothyroidism?

a. Thyroiditis

b. Low Iodine Levels

c. High Iodine Levels

d. Decreased Metabolism

a. Thyroiditis —> cause of hypothyroidism

b. Low Iodine Levels —> cause of hypothyroidism

c. High Iodine Levels —> cause of hyperthyroidism

d. Decreased Metabolism

Which autoimmune disorder causes hyperthyroidism?

a. Grave’s Disease

b. Hashimoto’s Disease

c. Addison’s Disease

d. Cushing’s Disease

a. Grave’s Disease — causes hyperthyroidism

b. Hashimoto’s Disease - causes hypothyroidism

c. Addison’s Disease — causes adrenal hypofunction

d. Cushing’s Disease — causes adrenal hyperfunction

A patient comes in with high fever, tachycardia and agitation and restlessness. She says that about 20 minutes ago she experienced her first seizure. She says that recently her father, who she was very close to, has died. She claimed that “Stress doesn’t even begin to describe how I feel.” What do you suspect is going on with this patient?

a. Addison’s Diseases

b. Hyperthyroidism

c. Hypothyroidism

d. Thyroid Storm

d. Thyroid Storm — s/s of thyroid storm are high fever, tachycardiac, heart failure, angina, agitation, restlessness and delirium alongside seizures and coma

What is chronic adrenal hypofunction also known as?

a. Grave’s Disease

b. Hashimoto’s Disease

c. Cushing’s Disease

d. Addison’s Disease

d. Addison

True or False: Acute adrenal hypofunction is also known as Addison’s disease

False: only CHRONIC adrenal hypofunction can be called Addison’s disease

What is an example fo a primary cause of Addison’s disease?

a. TB or HIV

b. Pituitary Tumor

c. Hypothalamic Tumor

d. Decrease aldosterone

a. TB or HIV

b. Pituitary Tumor —> secondary

c. Hypothalamic Tumor —> tertiary

d. Decrease aldosterone —> lmmaaoooo idkk brooo this is my BS answer

What is a cause of an acute adrenal crisis (SATA)?
a. deficiency of mineralocorticoids

b. excess of mineralocorticoids

c. deficiency of glucocorticoids

d. excess of glucocorticoids

a. deficiency of mineralocorticoids and c. deficiency of glucocorticoids

A patient comes in with the following labs and with symptoms of dehydration:
Sodium: 125 mEq/L (LOW)
Chloride: 90 mEq/L (LOW)
Potassium: 5.5 mEq/L (HIGH)

The patient has also reported a weight loss of 10 pounds in two weeks and that her skin has become darker. What disease process do you think is going on?

a. HIV

b. Addison’s Disease

c. Cushing’s Disease

d. Thyroid Storm

b. Addison’s Disease

What is a cause of hypercortisolism (SATA)?

a. Increased corticotropin that leads to the growth of the adrenal cortex
b. A tumor producing excess corticotropin
c. An increase in the amount of synthetic glucocorticoids, mainly through new medications
d. Pituitary hypersecretion aka Cushing’s

all o’ dem

A 32 year old female patient comes in with the following labs:

Glucose: 300 mg/dL (HIGH)
BP: 165/80 (HIGH)
Potassium: 2.0 mEq/L (LOW)

The patient also complains of increased acid reflux after meals. She says she has also been having problems with her periods and that they’re causing new and weird symptoms. She states that she feels like she’s going through puberty again because of new break outs and increased hair growth. What disease process do you think she has?

a. Cushing’s Disease

b. Addison’s Disease

c. Thyroid Storm

d. Hyperthyroidism

a. Cushing’s disease

What occurs during Type I diabetes?
a. resistance occurs in target tissues

b. too much insulin is being made

c. beta cells in the pancreas start dying or are suppressed

d. fat in the body blocks off receptors

c. beta cells in the pancreas start dying or are suppressed

What are good management techniques that work to cure Type II diabetes, but not Type I (SATA)?

a. Rapid acting insulin
b. Metformin
c. Intermediate insulin
d. Change diet and lifestyle

b. Metformin and d. Change diet and lifestyle

What are some complications due to diabetes?

Neuropathy, retinopathy, CAD, CVA, foot ulcers, and infections

What is the glucose test that requires patients don’t have ANY caloric intake for 8 hours or more?

a. Random Blood Glucose

b. Hemoglobin A1C

c. Urine Test

d. Fasting Blood Glucose

d. Fasting Blood Glucose

What test measures the amount of glycenated hemoglobin?

tip: glycenated hemoglobin = amount of hemoglobin bound by glucose

a. Fasting Blood Glucose

b. Random Glucose Test

c. Hemoglobin A1C

d. Urine Test

c. Hemoglobin A1C

What is the goal for a Fasting Blood Glucose test?

a. less than 50

b. less than 100

c. less than 200

d. less than 300

b. less than 100

What two mechanisms are involved in heat loss from the body (SATA)?

a. Dilation of superficial blood vessels
b. Vasoconstriction of superficial blood vessels
c. Increased epinephrine
d. Huddling and shivering
e. Sweating

a. Dilation of superficial blood vessels and e. Sweating

Which mechanism of heat loss/heat gain includes radiation, conduction and convection?

a. Vasoconstriction of blood vessels
b. Huddling
c. Dilation of blood vessels
d. Sweating

c. Dilation of blood vessels

What is normal ICP?

a. 5-10 mmHg

b. 10-15 mmHg

c. 10-20 mmHg

d. 20-25 mmHg

c. 10-20 mmHg

How does a healthy brain primarily compensate for increased ICP?

a. by decreasing arterial volume

b. by increasing venous volume

c. by increasing the space the lesion occupies

d. by shifting the CSF

d. by shifting the CSF

What is a simplified version of the Monro-Kellie hypothesis?

a. decreasing a level of any components of the brain will increase ICP

b. increasing the level of any components of the brain will decrease ICP
c. a change in the level of any components of the brain will change the ICP
d. increasing fluids in the brain will help alleviate the pressure from the body to automatically adjust for ICP

c. a change in the level of any components of the brain will change the ICP

A young 17 year old boy comes into the ER with shortness of air, restlessness, and confusion. The patient is moaning in pain from his headache. The patient seems very drowsy and throws his arms sporadically without any reason. His pupils are also two different sizes and he can’t complete the cardinal fields of gaze. His left arm can be raised higher than his right. What do you think he’s presenting with?

a. Late signs of increased ICP
b. Thyroid Storm
c. Diabetic Ketoacidosis
d. Early signs of increased ICP

d. Early signs of increased ICP — early sings include restlessness, confusion, increasing drowsiness, increased respiratory effort, purposeless movements, pupillary changes and impaired ocular movement, Weakness in one extremity or side

A 45 year old female patient comes in with a systolic blood pressure of 187, and a very fluctuating pulse. The pulse bounces back between below 40 and then the next minute sky rockets to 120 beat per minute. The patients temperature is also climbing to alarming rates. The patient suddenly violently vomits and then passess out. What do you think is going on with the patient?

a. Diabetic Ketoacidosis
b. Cushing’s Disease
c. Late signs of increased ICP
d. Early signs of increased ICP

c. Late signs of increased ICP — signs include Vital Signs: increase in SBP, bradycardia, pulse may change from tachy and bradycardia, temperature increases,  Projectile vomiting, further deterioration of LOC

What is decortication?

a. Straight and flexed arms

b. Arms bent at 90 degrees

c. Arms fixed above the head

d. arms look like Cs

d. arms look like Cs

What respiratory pattern occurs during late stage ICP?

a. Bradypnea

b. Rales

c. Cheyne-Stokes

d. Rhonchi

c. Cheyne-Stokes

What is an example of a primary brain injury?

a. A man experiences brain swelling after contracting meningitis.

b. A man bumps his head on a brick wall and develops a subdural hematoma at the site of impact.

c. A woman begins to have necrotic tissue damage in her brain due to prolonged low oxygen levels.

d. A young boy develops a small benign tumor in his head, causing pressure to increase in his head leading to him passing out.

b. A man bumps his head on a brick wall and develops a subdural hematoma at the site of impact.

• the rest are secondary brain injuries

Where is an epidural hematoma located?

a. It develops as a result of a small tear between the dura and the arachnoid space.

b. Can occur anywhere, but mainly in the frontal or temporal lobe.

c. A rip in the veins that connect together on the surface of the cortex to dural sinuses.

d. Develops between the inner layer of bones of skull and dura.

d. Develops between the inner layer of bones of skull and dura.

What is an ischemic stroke?

a. caused by an interruption of blood flow in a cerebral vessel.

b. bleeding into the brain tissue from a blood vessel rupture.

c. can occur anywhere, but mainly in the frontal or temporal.

d. stroke caused by hypertension, aneurysms and AV malformations.

a. caused by an interruption of blood flow in a cerebral vessel.

What are some risk factors associated with hemorrhagic and ischemic stroke?

a. Atherosclerosis

b. Motor disabilities, dysarthria, and cognitive deficits

c. Hypertension, Diabetes, and asymptomatic carotid stenosis

d. Electrolyte imbalances

c. Hypertension, Diabetes, and asymptomatic carotid stenosis — more !!! —> sickle cell anemia, hyperlipidemia and A. Fib, smoking

answer B is all the deficits that can occur from hemorrhagic strokes

Where is a majority of the body’s potassium stored?

a. ICF

b. ECF

c. in the blood vessels

d. in the kidneys

a. ICF

Where is a majority of the body’s sodium and chloride stored?

a. ICF

b. ECF

c. in the blood vessels

d. in the kidneys

b. ECF

If the body goes into metabolic acidosis, what will be the body’s reaction to compensate for it?

a. Decrease respirations

b. Increase respirations

c. Decrease HCO3- production

d. Increase HCO3- production

b. Increase respirations

If the body enters in a state of respiratory alkalosis, how will the body compensate for it?

a. Decrease respirations

b. Increase respirations

c. Decrease HCO3- production

d. Increase HCO3- production

c. Decrease HCO3- production — usually this takes to long, so then we as nurses must intervene!! but before we intervene, this is the body’s first strategy

What is the order of the three stages of hemostasis?
a. Blood Coagulation, Formation of the Platelet Plug, and Vessel Spams

b. Formation of the Platelet Plug, Blood Coagulation and Vessels Spams

c. Vessel Spasm, Formation of the Platelet Plug and Blood Coagulation

d. Vessels Spams, Blood Coagulation and Formation of the Platelet Plug

c. Vessel Spasm, Formation of the Platelet Plug and Blood Coagulation

During what stage in the hemostasis process requires von Willebrand factor?

a. Vessel Spams

b. Formation of the Platelet Plug

c. Activation, Adhesion and Aggregation

d. Blood Coagulation

b. Formation of the Platelet Plug

What conditions increase platelet function (SATA)?

a. atherosclerosis

b. increased lipids

c. pregnancy

d. contraceptives

e. smoking

a. atherosclerosis, b. increased lipids and e. smoking — others!!! — diabetes, smoking, increased platelet count

What conditions increase the concentration of coagulation factors (SATA)?

a. pregnancy

b. contraceptives

c. atherosclerosis

d. postsurgical state

e. immobility

a. pregnancy, b. contraceptives, d. postsurgical state and e. immobility

What causes arterial thrombi?
a. conditions that increase the concentration of coagulation factors

b. conditions that increase platelet adherence and cause vessel damage

c. conditions that cause stasis of blood

d. a result of diseases that decrease platelet function

b. conditions that increase platelet adherence and cause vessel damage

What is thrombocytopenia?

a. a decreased in the amount of white blood cells

b. an increase in the amount of platelets

c. a decrease in the amount of platelets

d. an increase in the amount of white blood cells

c. a decrease in the amount of platelets

What causes thrombocytopenia (SATA)?

a. A decreased in platelet production.

b. An increase in the sequestration of platelets in the spleen.

c. An decrease in the sequestration of platelets in the spleen.

d. A decreased platelet survival.

a. A decreased in platelet production.

b. An increase in the sequestration of platelets in the spleen.

c. An decrease in the sequestration of platelets in the spleen.

d. A decreased platelet survival.

What are the three phases of the wound-healing process?

a. Inflammatory Phase, Proliferative Phase and Wound Contraction and Remodeling

b. Wound Contraction and Remodeling, Proliferative Phase and Inflammatory Phase

c. Proliferative Phase, Wound Contraction and Remodeling, and Inflammatory Phase

d. Wound Contraction and Remodeling, Inflammatory Phase and Proliferative Phase

a. Inflammatory Phase, Proliferative Phase and Wound Contraction and Remodeling

Describe what goes on during each phase of the wound healing process.

Inflammatory:

Proliferative:

Wound Contraction and Remodeling:

Inflammatory: Neutrophils and Macrophages come to remove debris within 24 hours

Proliferative: Fibroblasts come, angiogenesis and endothelial cell proliferation occurs and epithelization occurs

Wound Contraction and Remodeling: starts 3 wks after injury and decreases in vascularity; lasts 6 months

What are some mild manifestations of anemia?

a. Reduction in RBC, WBC and platelets

b. Lightheadedness, pale, SOB with activity or rest and PICA

c. Chronic Kidney Failure

d. Weak, tired, concentration issues, numbness, and tingling of limbs

a. Reduction in RBC, WBC and platelets — a cause of aplastic anemia

b. Lightheadedness, pale, SOB with activity or rest and PICA — manifestations of severe anemia

c. Chronic Kidney Failure — occurs with chronic disease anemia

d. Weak, tired, concentration issues, numbness, and tingling of limbs

What is a dangerous amount of hemoglobin?

a. 15

b. 12

c. 10

d. 8

d. 8

What is preload?
a. resistance the left ventricle must overcome to circulate blood

b. volume of blood in ventricles at the end of diastole

c. resistance the right ventricle must overcome to circulate blood

d. volume of blood in ventricles at the end of systole

b. volume of blood in ventricles at the end of diastole

What is afterload?
a. resistance the left ventricle must overcome to circulate blood

b. volume of blood in ventricles at the end of diastole

c. resistance the right ventricle must overcome to circulate blood

d. volume of blood in ventricles at the end of systole

a. resistance the left ventricle must overcome to circulate blood

What are factors that increase afterload (SATA)?

a. hypovolemia

b. hypertension

c. vasoconstriction

d. heart failure

e. regurgitation of cardiac valves

b. hypertension and c. vasoconstriction increase afterload

a. hypovolemia, d. heart failure and e. regurgitation of cardiac valves all increase preload

What are organs and vessels that are associated with pulmonary circulation?

a. right heart, pulmonary artery, capillaries and veins

b. left heart, aorta and its branches

c. capillaries supplying the brain and peripheral tissues

d. systemic venous system and the vena cava

a. right heart, pulmonary artery, capillaries and veins

the rest are things associated with systemic circulation

What goes on with the valves during systole?

a. SL valves close and AV valves open

b. AV valves open and SL valves open

c. AV valves close and SL valves close

d. AV valves close and SL valves open

d. AV valves close and SL valves open

a. SL valves close and AV valves open —> occurs during diastole

What is the definition of MAP? What level is indicated with poor perfusion?

a. the pressure in the body during ventricular relaxation; poor = <90

b. the average pressure in the body during ventricular contraction and relaxation; poor = <65

c. the pressure in the body during ventricular isovolumetric relaxation; poor = <75

d. the average pressure in the body during ventricular contraction; poor = <50

b. the average pressure in the body during ventricular contraction and relaxation; poor = <65

• normal amount of MAP is 90-100 mmHg

Describe how baroreceptors help regulate blood pressure.

The baroreceptors are part of the neural mechanisms of regulation. They sense a change in the stretch of the vessel wall and adjust the heart rate, the strength of cardiac contraction, and smooth the muscle tone

How do the sympathetic and parasympathetic nervous systems adjust the heart rate and blood pressure?

SYMP: spinal cord —> increases heart rate

PARASYMP: vagus nerve —> decrease blood pressure

Explain the RAAS system

look at pic

What can Addison’s disease be caused by?
a. HIV

b. TB

c. autoimmune disorders

d. Cushing’s

a, b and c

Describe each of the outcomes for target organ damage, due to untreated hypertension:

• heart:

• brain:

• peripheral vascular:

• kidney:

• retina:

• emergency:

• heart: hypertrophy

• brain: dementia, cognitive impairment, and ischemic stroke

• peripheral vascular: atherosclerosis

• kidney: glomerular hypoperfusion

• retina: blindness

• emergency: HYPERTENSIVE EMERGENCY

What are examples of Acute Coronary Syndromes (SATA)?
a. Unstable angina

b. Left sided heart failure

c. Chronic Stable Angina

d Left Ventricular Hypertrophy

d. Right Sided heart failure

a. unstable angina

A 75 year old male patients comes into the ER with severe and crushing chest pain. He has pale, cool skin and anxiety. His heart rate is 112. He’s sent in for an ACG and they find that his ST levels are through the roof. When they go to perform emergency surgery, he has a complete occlusion. What type of angina does he have?

a. Chronic

b. STEMI

c. NSTEMI

d. Unstable

b. STEMI

A patient comes in with pain during exertion and periods of rest lasting longer than 20 minutes. This pain has been occurring for the past month, and each time the pain appears . He’s hooked up to an ECG and there is no evidence of any changes in ST or any cardiac biomarker changes. In the CT scan, they find a non-occlusive heart block. What type of angina does the patient have?

a. Chronic

b. STEMI

c. NSTEMI

d. Unstable

d. Unstable

A patient comes into the ER with pain in her chest. She rates it a 6/10. The HCP hooks her up to an ECG and finds some ST elevation and some elevated cardiac markers. When they take her in to get a CT scan done, they find that some of the tissue in her heart has began to become necrotic and that the occulsuion is almost complete. What type of angina does the patient have?

a. Chronic

b. STEMI

c. NSTEMI

d. Unstable

c. NSTEMI

What is chronic stable angina?

A fixed coronary obstruction that decreases how much blood flow the heart gets yet causes the heart to work harder.

A patient comes in with difficulty breathing and weakness all over their body. They tell you they have difficulty breathing at night and they have a cough that won’t go away. They claim that every time they try to lay down at night, they can’t breath so they are currently spending most nights on a recliner. You decide to do a respiratory assessment and find that they have crackles in their lungs. What do you suspect the patient is suffering from?

a. Right sided heart failure

b. Pericarditis

c. Pneumothorax

d. Left Sided Heart Failure

d. Left Sided Heart Failure

A patient comes in reporting increased swelling around their midsection and legs. They are constantly lethargic and have been gaining weight recently, despite not eating due to nausea. You look at the veins on their neck and they appear swollen and distended. You listen to their heart and find that the heart beat is irregular. What do you think they are suffering from?

a. Pleural Effusion

b. Pleuritis

c. Right Sided Heart Failure

d. Left Sided Heart Failure

c. Right Sided Heart Failure

How does aging affect the heart?

a. increases vascular flexibility and decreases the compliance of the heart.

b. increases vascular stiffness and decreases the compliance of the heart.

c. decreases vascular stiffness and increases the compliance of the heart.

d. decreases vascular stiffness and decreases the compliance of the heart.

b. increases vascular stiffness and decreases the compliance of the heart.

Through what side of the heart does deoxygenate blood leave?

A. Right heart

b. Left Heart

A. Right heart- it leaves through the right heart.

• oxygenated blood renters through the left heart.

What type of pressure in the lungs is always negative, but sometimes more negative than others?
a. Intrapulmonary Pressure

b. Intrapleural Pressure

c. Intrathoracic Pressure

d. Atmospheric Pressure

c. Intrathoracic Pressure — always negative, but sometimes more negative than others

• intrathoracic pressure is ALWAYS NEGATIVE and doesn’t fluctuate

What is the relationship between pressure and volume?
Explain how pressure and volume change during inhalation and exhalation:

Pressure and volume are inversely related

During inhalation, volume is high so pressure is low

During exhalation, volume is low so pressure is high

What is perfusion?

a. the flow of blood through the lungs

b. the transfer of gases between air filled spaces in the lungs and blood

c. the movement of air between the atmosphere and the respiratory portions of the lungs

d. what is required for exchange of gases between the air and alveoli

a. the flow of blood through the lungs — PERFUSION

b. the transfer of gases between air filled spaces in the lungs and blood — DIFFUSION

c. the movement of air between the atmosphere and the respiratory portions of the lungs — VENTILATION

d. what is required for exchange of gases between the air and alveoli

Which of the following answers are moderate manifestations of hypoxemia?

a. attributed to other causes, increase in ventilation, pulmonary vasoconstriction and increased RBC production

b. increase in heart rate, peripheral vasoconstriction, diaphoresis, increase in BP, and impairment of mental performance

c. confusion, impaired judgment, restlessness, agitation, combative behavior and delirium

d. stupor, coma, death

a. attributed to other causes, increase in ventilation, pulmonary vasoconstriction and increased RBC production — CHRONIC

b. increase in heart rate, peripheral vasoconstriction, diaphoresis, increase in BP, and impairment of mental performance — MILD

c. confusion, impaired judgment, restlessness, agitation, combative behavior and delirium — MODERATE

d. stupor, coma, death — SEVERE

An older comes in with shortness of air and irregular breathing. You notices he’s using abdominal breathing and he’s sweating very hard. He has pursed lip breathing and a high heart rate of 108. What do you think he has?

a. Left sided heart failure

b. Moderate hypoxemia

c. Mild hypoxemia

d. Hypercapnia

d. Hypercapnia

A patient comes in with fever and difficulty breathing after experiencing pneumonia. You check their vital signs and labs and notice that they have a heart rate of 115 and increased WBCs. You send them in for an xray for diagnoses and then the HCP performs a thoracentesis. What do you suspect the patient has?

a. Pneumothorax

b. Pleural Effusion

c. Atelectasis

d. Pleuritis

b. Pleural Effusion - causes include disease, tumors and HF

A patient comes in after being stabbed in the chest. They are experiencing rapid and shallow breathing, hypoxia and sudden angina. The HCP performs a 3 way dressing on them and decided to take them into emergency surgery to sew up the hole. What do you think the patient suffered from?

a. Pneumothorax

b. Pleural Effusion

c. Atelectasis

d. Pleuritis

a. Pneumothorax - specifically iatrogenic

A patient comes in with a pillow straddled to their chest. They tell you they’re scared they’re having a heart attack because the pain is moving to their chest. They have one sided pain that is localized to the lower area of the left chest. Before sending them to lab, you have them take a deep breath. They tell you the pain significantly increases with a deep breath. What do you think they’re suffering from?
a. Pneumothorax

b. Pleural Effusion

c. Atelectasis

d. Pleuritis

d. Pleuritis

A patient comes in with difficulty and rapid breathing. The patient’s breathing rate is 32 p/m and their heart rate is at 124 BPM. They are very cyanotic and when you go to listen to their lungs, you notice that the lower left lobe has no sounds at all. You also notice some intercostal retraction. What do you think the patient is suffering from?

a. Pneumothorax

b. Pleural Effusion

c. Atelectasis

d. Pleuritis

c. Atelectasis

What GFR level is an indication of ESRD?

a. >90

b. <60

c. <30

d. <15

d. <15

What are some common causes of UTIs?

Causes: developmental defects (congenital problems), calculi, pregnancy, BPH, scar tissue resulting from infection and inflammation, tumors, neurologic disorders such as SCI

What is anatomic obstruction?

a. the diagnoses of UTIs through x ray, ultrasounds and CT scans

b. Obstruction caused by something other than a block in the urinary system - ie: neurogenic bladder, constipation and detrusor muscle instability.

c. Obstruction caused by a block in the urinary system — ie: kidney stones, pregnancy, BPH, and anatomic malformations.

d. any UTI causes by an infection

a. the diagnoses of UTIs through x ray, ultrasounds and CT scans — DIAGNOSES PROCESS

b. Obstruction caused by something other than a block in the urinary system - ie: neurogenic bladder, constipation and detrusor muscle instability. — FUNCTIONAL

c. Obstruction caused by a block in the urinary system — ie: kidney stones, pregnancy, BPH, and anatomic malformations. — ANATOMIC

d. any UTI causes by an infection — E. COLI