NR 507 Advanced Pathophysiology Final - Edapt Questions fully solved & Updated ( Professor verified )

What is a symptom of a lower urinary tract infection?

Urgency

What is true regarding complicated UTIs?

Can be caused by a structural urinary tract disorder

What can help prevent a UTI?

Increased water consumption

True/False: Women are at higher risk of developing UTI because they have a shorter urethra

True

What is a risk factor for developing a UTI?

Pregnancy

What is true regarding an uncomplicated UTI?

- Occurs in the normal urinary tract

- Responds well to short-course of antibiotics

What is true regarding a complicated UTI?

- UTI that extends beyond the bladder

- Infants & older adults are usually affected

- Caused by structural/functional urinary tract abnormalities or a untreated UTI

What will the urinalysis of a patient with a UTI show?

WBCs & casts

The NP knows an uncomplicated UTI because

the UTI responds well to a short-course of antibiotic therapy

Highly suspective that causative bacteria of UTI is gram negative because of the presence of

Nitrites

A common organism that causes a UTI includes

Staphylococcus saprophyticus

True/False: There is a significant risk for men with BPH to develop cellular mutations that lead to prostate cancer

False

True/False: The peripheral zone of the prostate is the largest zone

True

On digital rectal exam to assess quality of prostate, NP would be concerned with a hard nodule because

it indicates prostate cancer

The patient most often develops symptoms of BPH when

the prostatic urethra becomes obstructed

True/False: The purpose of straining in BPH is to overcome the obstruction encountered during urination

True

What is the reaction of 5-Alpha reductase inhibitors?

To cause shrinkage of the prostate gland

Where are the hyper plastic nodules of BPH located?

Periurethral zone

Why are men who have BPH prone to develop UTIs?

Because of the stagnation of urine in the bladder that promotes bacterial growth.

True/False: PSA helps liquefy semen post-ejaculation

True

True/False: The underlying cause of BPH is that normal prostate cells respond to increases in dihydrotestosterone that causes them to live longer & multiply

True

What is the most common type of formed stone?

Calcium stone

What is the type of stone formed during a UTI?

Struvite stone

True/False: The gold standard for diagnosing a renal stone is a urinalysis

False- CT scan is the gold standard for diagnosing a renal stone

True/False: Renal stones are formed when calcium & oxalate in the urine combine

True

True/False: Renal calculi are typically confined to the bladder

False - Renal calculi can be found in the ureter or the bladder

Why can hematuria be seen with kidney stones?

BTrecause the stone injures the urinary structures as it passes through them

True/False: Renal colic is caused by the passing of the stone through the ureter

True

True/False: At least half of individuals with renal stones will have a reoccurrence within 10 years of their prior stone.

True

True/False: Lithotripsy is an invasive procedure used to break up the stone

False

What is the most common stone found in the patient with gout?

Uric acid stone

This relay station in the brain plays a major role in regulation micturition (urination)

Pontine micturition center

True/False: The location of the internal sphincter is under the urogenital diaphragm

False - located in the bladder

True/False: The elevator ani muscle plays a role in constriction of the external sphincter

True

Which of the following actions will relax the detrusor muscle of the bladder?

Activation of beta-2 receptors by the SNS

True/False: When the bladder is empty, the detrusor muscle relaxes, and the internal & external sphincters constrict

True

Stress Incontinence

Leaking of urine with sensation of need to urinate

What is the Patho of stress incontinence?

Detrusor muscle hyperactivity which leads to urine leakage

Neurogenic Incontinence

Unimpeded urine leakage

Neurogenic Incontinence Patho

Neurological lesions alter the nervous system impulses that innervate the detrusor muscle, results in decreased bladder compliance & decreased sphincter tone

Overflow Incontinence

Leaking of urine associated with urgency, frequency, dribbling & hesitancy

Overflow Incontinence Patho

Leaking due to a restrained urine in the bladder which leads to over distention

True/False: The major cause of stress incontinence in women is hyper mobility of external sphincter

True

Which of the following is a transient cause of urinary incontinence?

Urinary tract infection

What is the Patho of neurogenic bladder?

Lesions that alter nervous system impulses that innervate the detrusor muscle to decrease bladder compliance & decreased sphincter tone

Involuntary loss of urine caused by dementia or immobility is known as

Functional incontinence

A sphincter malfunction that prevents urine from flowing out of bladder would result in

Overflow incontinence

True/False: One of the major markers for glomerular filtration rate is creatinine

True

True/False: The most common cause of acute renal failure is due to pre-renal failure

True

What is an example of pre-renal cause of acute renal failure?

Hypotension

What is one of the first Patho responses to decreased GFR in acute renal failure is what?

Activation of the renin-angiotensin-aldosterone system

What is the most common type of acute renal failure?

Pre-renal failure

True/False: Patients with acute renal failure have HYPOkalemia

False - Hyperkalemia

True/False: Creatinine gets freely filtered from the glomerulus

True

True/False: In post-renal failure, the damage occurs in the collecting duct

True

In intrinsic renal failure, sodium & water excretion is increased which leads to dilute urine

True

What is the best indicator of good prognosis for recovery from acute renal failure?

Kidneys respond well to Furosemide

What is the number one cause of end-stage renal disease?

Diabetes Mellitus & hypertension

Stage III Kidney Disease is signified when GFR drops below what #?

Drops below 60

Why do those with renal failure have anemia?

There is a reduced production of erythropoietin, which is responsible for triggering in the production of RBCs rather than the lack of iron/decrease in RBCs

What is a complication of decreased GFR?

Anemia

What is the result of Vitamin D deficiency?

Hypocalcemia

What is end-stage renal disease signified with GFR?

GFR less than 15

What is the major acid/base disturbance in renal failure?

Metabolic Acidosis

When can you use diuretic therapy to stimulate kidney function (What stage of renal failure)

Stages I, II & III

Dietary management of patient with CKD includes

Low potassium, low sodium & low phosphate diet

True/False: The decision to begin dialysis is guided by the patient's symptoms rather than the GFR

True

What is GERD caused by?

Loss of muscle tone at the lower esophageal sphincter

What are typical GERD symptoms?

Heart burn & regurgitation

What is a risk factor for the development of GERD?

Obesity

What is the bacteria associated with GERD?

H. pylori

What is an atypical S&S of GERD?

Chest pain

What S&S indicate GERD?

Sour taste in mouth, globs, odynophagia & dysphagia

What is the gold standard for treatment of GERD?

PPI

What is an 'alarm' finding in a person with GERD symptoms?

Iron-deficiency anemia (can indicate bleeding)

What is a pseudo bowel obstruction due to?

Myopathy or neuropathy

What are complications of a bowel obstruction?

Ischemic bowel, perforation, peritonitis

True/False: A volvulus is the twisting of the bowel

True

Intussusception

Refers to part of the bowel that invaginates itself

Hiatal Hernia

Patients can be asymptomatic

The result of gas accumulation in the bowel is called

Venous compression, decreased oxygen & sepsis

Anti-prostaglandin drugs cause gastric mucosal injury by

Decreasing the thickness of the mucosa

True/False: Stomach pain that increases after a meal is characteristic of a gastric ulcer

True

What contributes to the development of an ulcer (medication)

Regular use of NSAIDs

What age is least likely to have a gastric ulcer?

Age less than 50 years old

Stomach pain that decreases after a meal is characteristic of what type of ulcer?

Duodenal ulcer

Intermittent upper abdominal pain & burning 2 hours after meals are symptoms of

Duodenal ulcers

True/False: Smoking is a risk factor for inflammatory bowel disease

True

The presence of anemia found in patient with Crohn's disease indicates

Vitamin B12 malabsorption (mucosal blood loss for Vitamin B12 malabsorption)

What is a complication associated with Crohn's disease (imaging)

Cobblestone appearance of GI. lining

The damage from Crohn's disease occurs where in the GI tract?

Terminal ileum is the primary site of damage

Symptoms of Ulcerative Colitis

Rectal bleeding, bloody diarrhea & anemia

The pathology of Crohn's disease & Ulcerative Colitis involve

Macrophages & neutrophils attacking the intestinal wall

Under normal liver function, what vitamin do the hepatic stellate cells store?

Vitamin A

What are classic signs of cirrhosis

Bumpy & rough appearance, colonies of fibrotic tissue

True/False: Cirrhosis is a reversible condition if treated aggressively

False

What sign indicates the patient with cirrhosis has a high bilirubin level?

Dark brown urine because of the hepatocytes conjugating bilirubin

What occurs in the last stage of cirrhosis?

Esophageal due to back up of fluid

What are the most common antidepressants prescribed?

SSRIs

What gland is responsible for regulating the sleep-wake cycle?

Pineal gland