`Pathophysiology Final Exam Study Guide - Modules 7-10 (Vocabulary Flashcards)
Abnormal Posturing and Postures
Decerebrate posturing (extensor): Arms extended, internally rotated; legs extended with plantar flexion. Indicates brainstem damage.
Decorticate posturing (flexor): Arms flexed toward core, wrists flexed; legs extended. Indicates damage above the brainstem.
Increased Intracranial Pressure (ICP)
Pathophysiology: Increased pressure from brain edema, mass lesions, or CSF accumulation.
Early cues: ext{Headache}, ext{nausea/vomiting}, ext{altered LOC}, ext{restlessness}, ext{confusion}
Pupil changes (sluggish response)
Late cues: Cushing’s triad: ext{hypertension with widened pulse pressure}, ext{bradycardia}, ext{irregular respirations}
Severe altered consciousness, fixed dilated pupils, posturing
Multiple Sclerosis (MS)
Pathophysiology: Autoimmune demyelination of CNS neurons; plaques form in brain and spinal cord.
Etiology: Autoimmune process with genetic predisposition and environmental triggers.
Cues: Fatigue, visual disturbances, weakness, spasticity, coordination problems, cognitive changes, heat intolerance.
Cerebral Palsy (CP)
Pathophysiology: Non-progressive brain damage affecting movement and posture.
Cues: Spasticity, abnormal reflexes, delayed motor development, abnormal gait, intellectual disability (variable).
Hydrocephalus
Pathophysiology: Excess CSF accumulation in brain ventricles due to overproduction, obstruction, or poor absorption.
Cues: Infants — enlarged head, bulging fontanelles, vomiting. Adults — headache, gait disturbance, incontinence, dementia.
Transient Ischemic Attack (TIA) vs CVA (Stroke)
TIA: Temporary neurological deficits lasting <24\ hours (usually <1\ hour), no permanent damage.
CVA (Stroke): Permanent brain damage from ischemia or hemorrhage.
Cerebrovascular Accident (CVA/Stroke)
Ischemic stroke (85%):
Pathophysiology: Thrombotic or embolic occlusion of cerebral vessels.
Cues: Gradual onset, focal neurological deficits.
Hemorrhagic stroke (15%):
Pathophysiology: Rupture of cerebral blood vessel.
Cues: Sudden severe headache, rapid deterioration, increased ICP signs.
Alzheimer's Dementia
Pathophysiology: Beta-amyloid plaques and neurofibrillary tangles cause neuronal death.
Cues: Progressive memory loss, language difficulties, behavioral changes, disorientation.
Diagnostic criterion: Cognitive decline in multiple domains affecting daily function.
Seizure Disorders
Types:
Simple partial: Focal, consciousness preserved.
Complex partial: Focal, consciousness impaired.
Generalized: Involves both hemispheres.
Status epilepticus: Seizure >30\ ext{minutes} or repeated seizures without recovery.
Parkinson’s Disease
Pathophysiology: Degeneration of dopamine-producing neurons in the substantia nigra.
Cues: Tremor at rest, rigidity, bradykinesia, postural instability, mask-like face.
Huntington’s Disease / Chorea
Pathophysiology: Genetic disorder causing progressive degeneration of basal ganglia.
Cues: Choreiform movements, personality changes, progressive dementia, family history.
Spinal Cord Transection
Complete transection effects by level:
C1-C4: Quadriplegia, respiratory paralysis.
C5-C8: Quadriplegia, some arm function preserved.
T1-T12: Paraplegia, arms normal.
L1-S5: Variable leg weakness, bowel/bladder dysfunction.
Paraplegia: Lower extremity paralysis.
Quadriplegia: All four-extremity paralysis.
Spinal Shock
Definition: Temporary loss of reflexes below the level of spinal cord injury, lasting days to weeks.
Migraine
Definition: Recurrent severe headache often with aura, nausea, photophobia, phonophobia.
Cues: Unilateral throbbing headache, visual aura, nausea/vomiting, sensitivity to light/sound.
Bacterial Meningitis
Pathophysiology: Bacterial infection of meninges causing inflammation.
Cues: Fever, severe headache, neck stiffness (nuchal rigidity), photophobia, altered mental status, petechial rash.
Brain Cancer
Pathophysiology: Primary or metastatic tumors causing increased ICP and disrupted brain function.
Cues: Morning headaches, nausea/vomiting, seizures, focal neurological deficits, personality changes.
Hematological Disorders
Sickle Cell Anemia and Crisis
Pathophysiology: Genetic mutation causing abnormal hemoglobin, leading to sickling of RBCs.
Crisis pathophysiology: Vaso-occlusive episodes from sickled cells blocking circulation.
Cues during crisis: Severe pain, fever, swelling, fatigue, shortness of breath.
Iron Deficiency Anemia
Pathophysiology: Inadequate iron for hemoglobin synthesis.
Etiology: Poor dietary intake, blood loss, malabsorption.
Cues: Fatigue, weakness, pale skin, brittle nails, ice craving, restless leg syndrome.
Pernicious Anemia / B12 Deficiency
Pathophysiology: Lack of intrinsic factor prevents B12 absorption, leading to megaloblastic anemia.
Etiology: Autoimmune destruction of parietal cells, dietary deficiency.
Cues: Fatigue, weakness, neurological symptoms (paresthesia, ataxia), glossitis.
Leukemia
Pathophysiology: Malignant proliferation of white blood cells in bone marrow.
Cues: Fatigue, frequent infections, easy bruising/bleeding, lymphadenopathy, bone pain.
Lymphoma
Pathophysiology: Malignant transformation of lymphocytes in the lymphatic system.
Cues: Painless lymphadenopathy, fever, night sweats, weight loss, fatigue.
Reproductive System Disorders
Reproductive Terms:
Menorrhagia: Heavy menstrual bleeding.
Dyspareunia: Painful intercourse.
Dysmenorrhea: Painful menstruation.
Amenorrhea: Absence of menstruation.
Pelvic Inflammatory Disease (PID)
Pathophysiology / Etiology: Ascending infection from cervix/vagina to upper reproductive tract (often STI-related).
Cues: Pelvic pain, fever, abnormal discharge, dyspareunia, irregular bleeding.
Polycystic Ovarian Syndrome (PCOS)
Risk factors: Insulin resistance, family history, obesity.
Cues: Irregular menstruation, hirsutism, acne, obesity, infertility.
Menopause vs Perimenopause
Menopause: Permanent cessation of menstruation (12+ \text{ months amenorrhea}).
Perimenopause: Transitional period before menopause with irregular cycles.
Incontinence Types:
Stress: Urine loss with increased abdominal pressure.
Urge: Sudden, intense urge to urinate.
Overflow: Bladder doesn’t empty completely.
Functional: Loss of urine caused by physical or cognitive impairment.
Neurogenic: Neurologic conditions affecting bladder control.
Benign Prostatic Hypertrophy (BPH)
Pathophysiology: Non-malignant enlargement of prostate gland.
Cues: Urinary hesitancy, weak stream, nocturia, incomplete emptying, urgency.
Erectile Dysfunction (ED)
Pathophysiology: Inability to achieve/maintain erection due to vascular, neurological, hormonal, or psychological factors.
Cues: Difficulty achieving or maintaining erection, reduced sexual desire.
Testicular Cancer
Risk factors: Cryptorchidism, family history, age (15-35), race (white).
Cues: Painless testicular mass, heaviness in scrotum, back/abdominal pain.
Prostate Cancer
Risk factors: Age >50, African American race, family history, high-fat diet.
Cues: Often asymptomatic early; later: urinary symptoms, bone pain, weight loss.
Cryptorchidism
Definition: Undescended testicle(s).
Cardiovascular Disorders
Steps of Hemostasis:
1. Vasoconstriction: Immediate vessel narrowing.
2. Platelet plug formation: Platelets adhere and aggregate.
3. Coagulation cascade: Fibrin clot formation.
4. Clot retraction and dissolution: Healing and clot removal.
Thrombus Formation:
Pathophysiology: Virchow’s triad — Endothelial injury, blood stasis, hypercoagulability lead to clot formation.
Hypertension (HTN):
Risk factors: Age, obesity, sodium intake, stress, genetics, smoking.
Respiratory Disorders
Respiratory Terms:
Dyspnea, Orthopnea, Hypoxia, Hypoxemia, Hypercapnia.
COPD: Emphysema vs Chronic Bronchitis
Emphysema:
Definition: Destruction of alveolar walls, loss of elastic recoil.
Cues: Dyspnea, barrel chest, pursed-lip breathing, weight loss.
Chronic Bronchitis:
Definition: Chronic productive cough \ge 3 \text{ months} for 2 \text{ consecutive years}.
Cues: Productive cough, wheeze, cyanosis, weight gain.
Common risk factor: Smoking.
Asthma / Status Asthmaticus
Pathophysiology: Chronic airway inflammation with bronchospasm, mucus production, edema.
Cues: Wheezing, dyspnea, chest tightness, cough.
Status asthmaticus: Life-threatening acute asthma attack unresponsive to treatment.
Pneumonia
Pathophysiology: Infection of lung parenchyma causing inflammatory response with alveolar filling (exudate, fluid, cellular debris), impaired gas exchange, and V/Q mismatch.
Cues: Sudden onset, productive cough, chest pain.
Nosocomial (Hospital-acquired):
Pathophysiology: Infection acquired \ge 48\ \text{hours} after hospital admission, often caused by antibiotic-resistant organisms (MRSA, Pseudomonas, Klebsiella).
Cues: Fever, purulent sputum, worsening oxygenation, new infiltrates on chest X-ray, often more severe than community-acquired.
Aspiration:
Pathophysiology: Inhalation of gastric contents, food, or liquids into lungs causing chemical pneumonitis and/or bacterial infection.
Cues: Witnessed aspiration event, cough, dyspnea, fever, infiltrates in dependent lung segments (right lower lobe common), foul-smelling sputum.
Pneumothorax
Definition: Air in pleural space causing lung collapse.
Pleural Effusion
Definition: Excess fluid in pleural space.
Tuberculosis (TB)
Pathophysiology: Mycobacterium tuberculosis infection causing granuloma formation.
Note: AIRBORNE!
Cues: Persistent cough, hemoptysis, night sweats, weight loss, fatigue.
Pulmonary Embolism (PE)
Pathophysiology: Blood clot blocking pulmonary artery.
Risk factors: Immobility, surgery, cancer, oral contraceptives, pregnancy.
Cues: Sudden dyspnea, chest pain, tachycardia, hemoptysis.
Cystic Fibrosis (CF)
Pathophysiology: Genetic defect causing thick, sticky secretions in lungs and pancreas.
Cues: Chronic cough, recurrent infections, poor growth, salty-tasting skin, pancreatic insufficiency.
Influenza
Pathophysiology: Viral infection that can affect both upper and lower respiratory tracts.
Cues: Usually LOW-GRADE\ fever, headaches, chills, dry cough, body aches, nasal congestion, sore throat, sweating, malaise.
Types: A (most severe and common in the U.S.), B (less severe), C (usually causes small outbreaks).
Hyperventilation vs Hypoventilation
Hyperventilation: Excessive breathing leading to decreased CO_2.
Hypoventilation: Inadequate breathing leading to increased CO_2.
Respiratory Acidosis vs Alkalosis
Respiratory Acidosis: CO_2 retention (hypoventilation), pH < 7.35.
Respiratory Alkalosis: CO_2 loss (hyperventilation), pH > 7.45.
Notes on Formulas and Key Values
TIA duration criterion: <24\ hours (often <1\ hour).
Stroke distribution: Ischemic stroke accounts for \approx 85\% of cases; hemorrhagic is about \approx 15\%.
Status epilepticus duration: >30\ minutes for a single seizure or repeated seizures without recovery between them.
TB transmission note: Airborne transmission risk requires appropriate respiratory isolation and precautions.
Menopause criteria: 12\text{ months amenorrhea}.
Cystic Fibrosis characteristic: Thick secretions leading to recurrent infections and pancreatic insufficiency.
Anemia terminology:
Iron deficiency anemia: low iron availability for hemoglobin synthesis.
Pernicious anemia: B12 deficiency due to lack of intrinsic factor.
Connections to Foundational Principles
Hemostasis steps illustrate sequential cascade from vascular injury to clot resolution, a practical example of regulatory feedback and tissue repair.
Virchow’s triad connects endothelial injury, stasis, and hypercoagulability to thrombus formation, a core concept in vascular pathophysiology.
Neurodegenerative diseases (MS, Alzheimer’s, Parkinson’s, Huntington’s) show how immune-mediated, toxic, and genetic factors disrupt neural integrity and neurotransmission.
Respiratory pathophysiology highlights gas exchange imbalances (hypoxemia, hypercapnia) and compensatory mechanisms affecting acid-base status.
Real-World Relevance and Practical Implications
Early ICP cues like headache and altered LOC require rapid assessment to prevent herniation; Cushing’s triad signals impending brain herniation.
Recognizing TIA as a warning sign for potential stroke emphasizes urgent evaluation and secondary prevention.
COPD subtypes (emphysema vs chronic bronchitis) influence management strategies, including bronchial hygiene, oxygen therapy, and risk factor modification (smoking cessation).
TB being airborne underscores the importance of airborne precautions and public health notification.
Incontinence types guide bladder management strategies in urology and geriatrics, impacting quality of life and independence.
Cancer pathophysiology informs screening (e.g., prostate, testicular) and symptom-based workups (pain, weight loss, night sweats).
Summary of Key Definitions and Concepts (quick reference)
Decerebrate posture: Brainstem damage pattern with extensor limbs.
Decorticate posture: Higher brain region damage pattern with flexed arms toward core.
ICP: Elevated intracranial pressure from edema, lesions, or CSF imbalance.
MS: Autoimmune demyelination with CNS plaques.
CP: Non-progressive brain injury affecting movement/posture.
TIA: Temporary deficit without lasting damage.
CVA/Stroke: Acute brain injury due to ischemia or hemorrhage.
Ischemic vs Hemorrhagic stroke: occlusion vs vessel rupture.
Alzheimer’s disease: Plaques and tangles leading to dementia.
Seizure types: Focal with/without impaired consciousness, generalized, status epilepticus.
PD: Dopaminergic neuron loss in substantia nigra.
Huntington’s: Basal ganglia degeneration with chorea.
Spinal cord injury levels: define motor/sensory loss and autonomic dysfunction by level.
Migraine: Recurrent unilateral headache with aura possible.
Meningitis: M meninges infection with characteristic neck stiffness.
Pneumonia: Inflammation with alveolar filling; distinctions for nosocomial and aspiration etiologies.
PE: Vascular occlusion in pulmonary artery.
TB: Airborne mycobacterial infection with granulomas.
COPD subtypes: Emphysema vs chronic bronchitis.
Influenza types A/B/C: Severity and outbreak patterns.
Acid-base: Respiratory acidosis/alkalosis and corresponding pH and CO2 changes.
If you’d like, I can reorganize these notes by exam topics (e.g., pathophysiology first, then cues, then diagnostic/clinical implications) or tailor a condensed table for quick review.