Maryville Nurs611 - Patho Exam 3 2023 All Questions and Answers| Verified 100% Correct Solutions
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Nurs611
Maryville Nurs611 - Patho Exam 3 2023
All Questions and Answers| Verified
100% Correct Solutions
Explain the pathophysiology associate with Type 1 and Type 2 DM Correct Answer
Is the result of an autoimmune mediated specific loss of beta cells in the pancreatic
islet. One of the basic patho of...
Maryville Nurs611 - Patho Exam 3 2023
All Questions and Answers| Verified
100% Correct Solutions
Explain the pathophysiology associate with Type 1 and Type 2 DM Correct Answer
Is the result of an autoimmune mediated specific loss of beta cells in the pancreatic
islet. One of the basic patho of type 2 DM is the development of insulin resistant
tissue cells.
Explain what occurs in panhypopituitarism. Correct Answer Panhypopituitarism is
the term correctly associated with the lack of all anterior pituitary hormones.
List the clinical manifestations of hypothyroidism. Correct Answer The individual
develops a low basal metabolic rate, cold intolerance, lethargy, tiredness, and
slightly lower basal body temperature.
Differentiate diabetes insipidus, diabetes mellitus and SIADH. Correct Answer
DM: is not a single disease but a group of clinical heterogeneous disorders that have
glucose intolerance in common.
DI: is an insufficiency of ADH, leading to polyuria and polydipsia.
SIADH: is characterized by high levels of ADH in the absence of normal physiologic
stimuli for its release.
The symptom common to all these conditions is thirst.
What causes the microvascular complications of DM. Correct Answer
Microvascular complications are a result of capillary basement membranes
thickening and endothelial cell hyperplasia.
What is the cause of diabetes insipidus. Correct Answer Inability of the kidney to
increase permeability of water. This causes excretions of large volumes of dilute
urine, leading to increase in plasma osmolality.
Describe the pathophysiological changes associated with Addison's Disease.
Correct Answer Addison disease is a result of hyposecretion of adrenal cortex
hormones.
Describe the pathophysiological changes associated with hypoparathyroidism.
Correct Answer The most common cause of hyperparathyroidism is damage
caused during thyroid surgery. In hypothyroidism a lack of circulating PTH causes a
depressed serum calcium level resulting in the symptomatology mentioned in the
stem.
What are the causes and pathophysiological changes associate with ketoacidosis?
Correct Answer In a state of relative insulin deficiency there is an increase in insulin
counter regulating hormones including catecholamine's, cortisol, glucagon, and GH.
,Catecholamine's, cortisol, glucagon and GH antagonize insulin by increasing glucose
production. In addition, these hormones decrease use of glucose. Profound insulin
deficiency results in decrease glucose uptake, increase fat mobilization with release
if fatty acids, and accelerated gluconeogenesis and ketogenesis. Ordinarily, ketones
are used by tissues as an energy source to regenerate bicarbonate. Hyperkalemia is
a result of a compensatory mechanism directed at eliminating metabolic acidosis.
What is acromegaly? Correct Answer Acromegaly is a term for adults who have
been exposed to continuously high levels of GH, whereas the term gigantism is
reserved for children and adolescents.
Differentiate hypothyroidism and Graves' disease Correct Answer One of the
cause's hypothyroidism is a deficiency of endemic iodine. Hypothyroidism are the
lower levels of thyroid hormone, without the negative feedback of TH in the pituitary,
there is an increase secretion of TSH that may lead to goiter. As a result in
decreased energy metabolism resulting in constipation, regulatory mechanisms are
overridden by abnormal immunologic mechanisms that result in the stimulation of
excessive TH. The systemic symptoms of thyrotoxic crisis include hyperthermia and
tachycardia; the remaining options are not associated with this disorder.
Describe the pathophysiology related to chronic DM Correct Answer A number of
serious complications are associated with any type of DM and include microvascular
(retinopathy, nephropathy, and neuropathy) and macrovascular (CAD, CVA, PVD)
disease and infection.
What happens during hypoglycemia? Correct Answer A person with type 1 DM
experiences hunger, lightheadedness, tachycardia, pallor, HA and confusion. The
most likely cause of these symptoms is hypoglycemia, which is often caused by a
lack of systemic glucose resulting from muscular activity.
What is the metabolic syndrome? Correct Answer It also has been called the
insulin resistance syndrome or syndrome X. It is a clustering of clinical traits
occurring together that increase the risk for accelerated cardiovascular disease and
type 2 DM. Combination of medical disorders that increase the risk of developing
cardiovascular disease and DM.
Describe how DM causes peripheral neuropathy Correct Answer It is a form of
"dying back" neuropathy, in which the distal portions of the neurons are initially and
eventually more severely affected. The earliest morphologist change in both the
peripheral nerves and CNS is axonal degeneration that preferentially involves
sensory nerve fibers, particularly the smaller polymodal unmyelinated peripheral C
fibers and the larger myelinated A delta fibers.
Trace the electrical activity of the heart. Correct Answer Normally electrical
impulses arise in the SA nose, which is often called the pacemaker of the heart.
The SA node is located at the junction of the right atrium and superior vena cava,
just above the tricuspid valve.
Numerous automatic nerve endings are
,within the node.
The SA node is heavily innervated by both sympathetic and parasympathetic nerve
fibers.
The SA node P cells, so-called because they are pale and primitive appearance, are
assumed to be the site of impulse formation.
The action potential is transmitted from the atrial to the ventricular myocardium
through fibers of the conduction system, traveling first to the AV node then the
bundle of his and finally through the bundle branches of the interventricular septum
to Purkinje fibers of the heart wall.
Identify the location of the neurotransmitters in the heart. Correct Answer
Sympathetic neural stimulation of the myocardium and coronary vessels depends on
the presence of adrenergic receptors, which bind specifically with neurotransmitters
of the sympathetic nervous system.
Define adrenergic receptors. Correct Answer Sympathetic neural stimulation of
the myocardium and coronary vessels depends on the presence of adrenergic
receptors, which bind specifically with neurotransmitters of the sympathetic nervous
system.
Discuss left-ventricular end diastolic pressure. Correct Answer This is a concept
expressed in Frank Starling law, cardiac muscle, like other muscle, increases its
strength of contraction when it's stretched.
Define Frank-Starling law Correct Answer As stated in Frank-Starling law, the
volume of blood in the heart at the end of diastole (the length of its muscle fibers) is
directly related to the force (strength) of contraction during the next systole.
Discuss the effect of angiotensin II on the heart. Correct Answer Angiotensin II is
a powerful vasoconstrictor and stimulates the secretion of aldosterone from the
adrenal gland. Angiotensin II is also growth promoter in cardiovascular tissues,
resulting in monocyte and vascular hypertrophy and progression of hypertension.
Neural effects of angiotensin II include stimulation of thirst, release of ADH, and
increases in sympathetic nervous system output. Angiotensin II also causes
structural changes in blood vessels (remodeling) that contribute to permanent
increases in peripheral resistance and make vessels more vulnerable to endothelial
dysfunction and platelet aggregation.
Define pulsus paradoxus. Correct Answer Pulsus paradoxus means that the
arterial blood pressure during expiration exceeds arterial pressure during inspiration
by more than 10 mmHg. This clinical finding reflects impairment of diastolic filling of
the left ventricle plus reduction of blood volume within all 4 cardiac chambers.
List the indicators for an acute myocardial infarction (AMI). Correct Answer When
coronary blood flow is interrupted for an extended period, myocyte necrosis occurs,
these results in an MI. In the majority of cases of MI, the decrease in coronary flow is
the result of atherosclerotic CAD, other causes include coronary spasm and
, coronary artery embolism. The first s/s of acute MI is usually sudden, severe CP. It's
not possible to distinguish between angina and MI by s/s alone, although pain
associated with MI tends to be more severe and prolonged. It may be described as
heavy and crushing, such as a "truck sitting on my chest," radiation to the neck, jaw,
back, shoulder or left arm is common. Some individuals (especially older adults or
those with DM) experience no pain, thereby having a "silent" infarction. Infarction
often stimulates a sensation of unrelenting indigestion. Nausea and vomiting may
occur because of reflex stimulation of vomiting centers by pain fibers. Vasovagal
reflexes from the area of the infracted myocardium also may affect the GI tract.
Catecholamine release results in sympathetic stimulation, producing diaphoresis and
peripheral vasoconstriction that cause the skin to become cool and clammy.
List the clinic indicator for a coronary thrombus. Correct Answer These individuals
usually have marked elevations in the ST segments on ECH and are categorized as
having a STEMI.
Define pericarditis Correct Answer It's an acute inflammation of pericardium. Most
individuals with acute pericarditis describe several days of fever, myalgias, and
malaise followed by the sudden onset of severe CP that worsens with respiratory
movements and with lying down. Although the pain may radiate to the back, it's
generally felt in the anterior chest and may be confused initially with the pain of acute
MI. Individuals with acute pericarditis also may report dysphagia, restlessness,
irritability, anxiety, and weakness. It is also the most common cardiovascular
complication of HIV infection.
List the causes and types of cardiomyopathy Correct Answer Cardiomyopathies
are a diverse group of disease that primarily affects the myocardium. Most are the
result of underlying cardiovascular disorders, such as ischemic heart disease and
HTN. Cardiomyopathies also can be secondary to infectious disease, exposure to
toxins, systemic connective tissue disease, infiltrative and proliferative disorders, or
nutritional deficiencies. Dilated cardiomyopathy causes decreased ejection fraction,
increased end diastolic and residual volumes, decreased ventricular stroke volume,
and biventricular failure. Dilated cardiomyopathy (congestive cardiomyopathy) is
characterized by ventricular dilation and grossly impaired systolic function, leading to
dilated heart failure. Hypertrophic caridomyopathy is characterized by thickening of
the septal wall, which may cause outflow obstruction to the left ventricular outflow
tract. Restrictive cardiomyopathy may occur idopathically or as a cardiac
manifestation of systemic diseases, such as scleroderma, amylodosis, sarcoidosis,
lymphoma, and hemochromatosis, or a number of inherited storage diseases.
Discuss the effect of HTN on the kidney Correct Answer In the kidney
vasoconstriction and resultant decreased renal perfusion cause tubular ischemia and
preglomerular arteriopathy.
Describe the blood flow through the heart Correct Answer The pumping action of
the heart consists of contractions and relaxation of the myocardial layer of the heart
wall. Each ventricular contraction and the relaxation that follows it constitute one
cardiac cycle. During relaxation, termed diastole, blood fills the ventricles. The
contraction that follows, termed systole, propels the blood out of the ventricles and
into the circulation.
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