Patho Exam 1

Front 1

NA+ normal ranges & where is it typically found

Back 1

135-145mEq/L

normally found outside the cell with chloride

Front 2

K+ normal range and where is it typically found?

Back 2

3.5-5.0, any change is serious

normally found inside the cell

Front 3

Serum osmolality normal range

Back 3

280-294

Front 4

Urine specific gravity

Back 4

1.010-1.025

Front 5

What are the 3 functions of Na+ in the body?

Back 5

Conduct/transmit nerve impulses

Muscle contraction (via interaction with calcium) and relaxation

Maintains proper balance of water and minerals in the body, & acid-base balance

Front 6

How much sodium should we take in per day on average?

Back 6

500mg

Front 7

What is hypernatremia?

Back 7

High concentration of sodium in the blood. Over 145 or a relative excess due to low fluid volume.

Front 8

Hypernatremia (>145) causes and s/s

Back 8

Causes: excess oral intake, IV fluid with high Na concentration, renal failure, excess aldosterone production

S/s: thirst first, headache, AMS, swelling in brain presses on skull, excitability, agitation, hyper-reflexes, twitching

Front 9

Relative hypernatremia causes & S/S

Back 9

Causes: decreased intake of water or increased water loss, watery emesis or diarrhea, fever, severe diaphoresis

S/S: dry mucus-membranes, weak peripheral pulses, decreased skin turgor, headache, dizziness, low-grade fever

Front 10

What is hyponatremia?

Back 10

Lack of adequate sodium. <135 or relative dilution due to fluid overload.

Front 11

Hyponatremia (<135) causes and S/S

Back 11

Causes: diuretics, reduced oral intake, renal disease, vomiting/diarrhea, wound drainage, NG tube

S/S: decreased excitability, lethargy, weakness, confusion, slower reflexes, possible week respirations

Front 12

Hyponatremia due to dilution causes, S/S

Back 12

Causes: excessive hydration (oral, iv), chronic renal failure

S/s: fluid overload, edema, crackles, increased BP, bounding pulse, increased respirations, weight gain

Front 13

What provides a reliable measure of fluid retention when assessing fluid volume increase in a patient with chronic kidney disease?

Back 13

Daily weight

Front 14

A patient with hyperkalemia may have what findings on an EKG

Back 14

Peaked T waves, widened QRS

Front 15

Hypokalemia s/s

Back 15

Fatigue, muscle weakness, reduced excitability of cells

Decreased BP due to low cardiac muscle excitability

Decreased peristaltic

Depression, confusion, lethargy

Front 16

With an elevated k+ level of 6.8, what should a nurses first step be to care for this patient?

Back 16

Obtain an EKG because hyperkalemia can lead to dysrhythmias and possible cardiac arrest.

Front 17

After a severe burn with IV fluids to resuscitate loss, a decrease in what indicates adequate rehydration?

Back 17

Decrease in heart rate. With low fluid volume, the heart rate increases to maintain adequate blood pressure.

Front 18

What would put a patient at risk for hyperkalemia?

Back 18

chronic renal failure

massive tissue trauma from injury

a diet with salt substitutes

severe burns

diabetic ketoacidosis

metabolic acidosis

K+ sparing diuretics

Missing dialysis

Adrenal insufficiency causing decreased aldosterone

Front 19

What would put a patient at risk for hypokalemia?

Back 19

diarrhea for several days

NPO

respiratory alkalosis

NG tube suctioning

Wound drainage

water intoxication

taking diuretics

increased aldosterone secretion

Front 20

What would put a patient at risk for hyponatremia?

Back 20

diuretics

diarrhea

fluid overload

vomiting

Front 21

What would put a patient at risk for hypernatremia?

Back 21

corticosteroid treatment

chronic renal failure

dehydration

hyperaldosteronism

Front 22

A patient is acidotic, what happening with their electrolytes?

Back 22

H+ moves into the cell and K+ leaves the cell, possibly leading to hyperkalemia

Front 23

A patient is alkalotic, what is happening with their electrolytes?

Back 23

H+ moves out of the cell, causing K+ to enter the celll. Can lead to hypokalemia.

Front 24

Cystic fibrosis - what type of inheritance?

What is the risk of a child having it with heterozygote parents?

Back 24

Autosomal recessive disease

25%

Front 25

What causes Down's syndrome? What is the majo risk factor? What are the characteristics? Life expectancy?

Back 25

-a mutation during meiosis , Trisomy 21

-risk increases with maternal age

-low muscle tone, short stature, a flat nasal bridge, and a protruding tongue

-60yrs

Front 26

factors that aid in the pathogenesis of cancer (10)

Back 26

-lack of contact inhibition signaling - cells can press on nearby tissues

-lack of apoptosis - abnormal cell growth indefinitely

-lack of tumor suppressor genes

-proto-onco gene mutates to form oncogene

-angiogenesis - tumor's own vasculature

-metastasis - to distant tissues & organs

-repeated carcinogen exposure

-aging

-immunosuppressants

-DNA repair genes not functioning

Front 27

cachexia

Back 27

weakness and wasting of the body due to chronic illness

Front 28

CAUTION-US

Back 28

Warning signs for cx

Changes in bladder or bowel habits

A sore that doesn't heal

Unusual bleeding or discharge

Thickening or lumps on skin

Indigestion or difficulty swallowing

Obvious changes in moles or the skin

Nagging cough or hoarseness of the voice

Unexplained anemia

Sudden weight loss

Front 29

What are tumor markers? What are some common markers?

Back 29

Substances, typically proteins present indicating the presence of a tumor. Often produced by the tumor itself, or by the body in response to a tumor's presence. Can provide information about the cancer's malignancy, response to treatment etc.

ex) PSA - prostate-specific antigen

ex) HCG - human chorionic gonadotropin

Front 30

What characterizes benign versus malignant tumors?

Back 30

benign - slow growth, does not invade, has well-differentiated cells that resemble original cell type

malignant - typically fast-growing tumor cells, metastasize to other organs/tissues, cells are less-differentiated and sometimes undistinguishable

Front 31

Biopsy

Back 31

-an examination of tissue removed from a living body to discover the presence, cause, or extent of a disease

-ONLY definitive method of cancer diagnosis

Front 32

Stage 1 cancer

Back 32

confined to the organ of origin

Front 33

stage 2 cancer

Back 33

locally intrusive to nearby tissues and has grown in size

Front 34

stage 3 cancer

Back 34

had spread to regional structures such as the lymph nodes nearby

Front 35

stage 4 cancer

Back 35

has metastasized to distant sites such as the lungs, bone, etc.

Front 36

proto-oncogene and oncogene definitions

Back 36

proto-oncogene: regulate growth and dev of cells by encoding for growth factors and growth factor receptors. if mutated, can form....

oncogene: a mutated gene that has the potential to cause cancer. can be inherited or activated by a virus.

Front 37

tumor suppressor gene

Back 37

produce proteins that normally oppose the action of an oncogene; inhibit cell division

inactivated during carcinogenesis

Front 38

ICF, ECF, Interstitial, Instavascular

Back 38

ICF - in cell, water and K+, and otherelectrolytes

ECF - includes everything else, blood, lymph, bone and tissues, transcellular fluids, large amounts of NA+ and other electrolytes

interstitial - part of ECF, fluid between cells, "third space"

intravascular: blood plasma

Front 39

osmosis

osmotic pressure

Back 39

movement of a solvent across a semipermeable membrane from lesser to greater concentration

the effect of colloids such as plasma proteins to PULL water across the cellular membrane

Front 40

hydrostatic pressure

Back 40

mechanical force of water pushing against the cellular membrane. greater at the arterial end of the capillary bed than at the venular end.

Front 41

hypovolemia definition, causes, and what occurs physiologically

S/S

Back 41

ECF volume deficit

caused by excessive fluid loss, reduced fluid intake

leads to decreased hydrostatic pressure and decreased fluid transport can lead to nutrient & energy deprivation

increased HR, thirst, release of ADH and production of aldosterone

S/S: weight loss, thirst, dry skin/muc mem, decreased UO, hypotension, tachycardia, dizziness, fatigue, flat veins on neck/hand, AMS

Front 42

hypervolemia def, causes and what occurs physiologically, S/S

Back 42

ECF volume expansion, excess body fluid with electrolytes left in normal range

caused by heart failure, cirrhosis, nephrotic syndrome, corticosteroids, renal failure, excess IV fluids

circulatory overload, fluid shifts into third space, edema, inhibits ADH/aldosterone with increased UO,

S/S: SOB, crackles, bounding pulse, weight gain, increased BP, edema, possible pulmonary edema/CHF

Front 43

aldosterone

Back 43

-produced in adrenal cortex of the kidney due to RAAS

-acts on kidneys to reabsorb Na+ and water

-release is stimulated by low BP, low blood volume

Front 44

ADH

Back 44

released from posterior pituitary,

acts on kidney to reabsorb only WATER and cause vasoconstriction

release is stimulated when osmoreceptors in hypothalamus recognize low blood volume and baroreceptors recognize low BP

Front 45

natriuretic peptides

Back 45

hormones secreted by the heart that inhibit Na+ reabsorption, increase glomerular filtration, and cause vasodilation

stimulated by inc BP and hypervolemia. baroreceptors in ventricles and aorta recognize it and cause its release.

Front 46

edema - what is it and what causes it

Back 46

Caused by:

-inc hydrostatic pressure due to venous obstruction or salt & water retention,

-decreased albumin due to liver disease,

-inc capillary permeability,

-blocked lymphatic channels

fluid pools out in the interstitial spaces

Front 47

albumin

Back 47

-keeps fluid IN the bloodstream by pulling it from the interstitial space

-decreases edema

-increases blood volute

made in liver

Front 48

Daily beverage intake average AND daily urine output average. Minimum UO per hour?

Back 48

1500 mL for both. Minimal expected UO is 30mL per hour

Front 49

RAAS Renin-Angiotensin Aldosterone System

Back 49

-stim by decrease in blood volume or BP

-renin (enzyme from kidney) + angiotensinogen -->angiotensin I which adds with ACE (enzyme from the lungs) to form angiotensin II which is an active protein

- 2 outcomes of angiotensin II:

vasoconstriction ,and

secretion of aldosterone from the adrenal gland (which causes inc Na+ and water reabsorption to inc blood volume and pressure, and releases K+ and H+ into the urine)

Front 50

atrophy def & example

Back 50

decrease in cell SIZE due to disuse, malnutrition, low perfusion, etc.

*occurs in hospital patients within 24hrs

ex) uterus atrophies post-menopause

ex) Alzheimer's is atrophy of brain cells

ex) adrenal gland atrophies due to prolonged steroid use

Front 51

hypertrophy def & example

Back 51

increase in cell SIZE due to inc. workload

ex) steroid use inc muscle cell size

ex) cardiac muscle inc in size if overworked & can cause HTN

Front 52

hyperplasiadef & example

Back 52

increase in NUMBER of cells due to inc. cell division

ex) BPH, or enlarged prostate. causes dysuria

ex) endometrial hyperplasia

Front 53

dysplasiadef & example

Back 53

alteration in cell size or shape, can precede cx

ex) cervical dysplasia found via PAP smear

Front 54

metaplasia def & example

Back 54

replacement of one cell type with another to better endure a change or stress

ex) smoking causes lung cells to be replaced with more durable cells

Front 55

aerobic glycolysis versus anaerobic glycolysis

Back 55

aerobic leads to production of 38 ATP plus CO2 plus water

anaerobic leads to production of 2 ATP and lactate

Front 56

hemophilia

Back 56

x-linked recessive inheritance,

lack of coagulation factors,

treated with factor-replacement injections or plasma infusion

Front 57

What does K+ do in the body?

Back 57

Helps with intracellular volume control

Excites tissues to depolarize which generates action potentials

Regulates protein synthesis

Converts glucose to glycogen

Front 58

What is the most common cause of cellular injury?

Back 58

Hypoxia