Study Questions For Unit 3

Question 1

How does atherosclerosis cause hypertension??

Answer 1

Atherosclerosis decreases blood flow to the kidney causing release of renin and then renin converts into angiotensin (1, then 2)..angiotensin 2 causes the adrenals to secrete aldosterone which causes na+ retention water following na+ releasing k+ increasing blood pressured

Question 2

What are the common causes of pyelonephritis??

Answer 2

Most serious tract infection.
Bacterial infection the spreads retrograde from the lower urinary tract-> E. Coli 75-95% of cases
Bacteria from one infection in body spreading through blood stream to urethra (acute)
(Chronic) intense inflammation causes abscesses to form in renal pelvis and interstitial tissue..fibrosis present

Question 3

Describe the manifestations and treatments for pyelonephritis.

Answer 3

Manifestations: fever, flank pain, UA-leukocytosis, pyuria,
^ bacteria and wbc..dysuria, urinary urgency, and ^ frequency

Treatment: antibiotics, alleviation of reflux obstruction and other infection, renal dialysis if severe

Question 4

What is the usual cause of glomerulonephritis?

Answer 4

-usual cause will be an immune mediated injury: group a streptococci-> strep throat and strep skin lesion

Question 5

Describe the pathology of glomerulonephritis?

Answer 5

• it will initial strep infection
• immune complexes damage glomerular basement membrane and cause it to become more permeable
• acute inflammatory response: leak WBC, RBC and plasma proteins

Manifest: Urinary- hematuria, dark urine & oliguria, Edema- hypoproteinemia and NA+ and fluid retention, Hypertension

Question 6

What may cause renal failure ??

Answer 6

• impaired blood flow to the kidneys: severe burns, blood or fluid loss, heart attack, sever dehydration, sever anaphylaxis
• damage to kidneys: emboli, glomerulonephritis, lupus, toxins
• Urine blockage in the kidneys: bladder, cervical,colon emboli in the urinary tract, kidney stones, BPH

Question 7

Describe manifestations and treatment for renal failure??

Answer 7

• lab findings: ^ BUN, Uric acid, creatine, and ammonia
• decrease pH
• abnormal electrolyte levels
• chronic: anemia decrease erythropoietin

Treatment: hemodialysis (acute, chronic, and end-stage(transplant)

Question 8

What are the differences between restrictive and obstructive lung disease?

Answer 8

• Restrictive: decrease volumes during PFT , Lesion: alveoli, internal chest wall, external chest wall, primarily occurs during inspiration (it’s difficult to fully fill lungs with air) ex:ARDS, Ptx, Scoliosis
• Obstructive: decrease flow rates during PFT, Lesion: usually in the airways, Primarily occurs during exhalation (it’s difficult to exhale all the air in the lungs) ex: COPD, emphysema, bronchitis, airway inflammation will cause obstruction

Question 9

What may cause an asthma attack??

Answer 9

-allergens, infections, stress, emotion , noxious fumes, cold air physical exertion

Pathology: trigger agent causes: mast cells to degranulate and release histamine, IgE and antigen attach to cell, Direct stimulation of parasympathetic nerve fibers by irritant, histamine causes inflammatory reaction, construction of smooth muscle -> bronchospasm

Question 10

Describe the 3 manifestations of airway inflammation??

Answer 10

• Mucosal adema
• Bronchospasm
• Production of thick mucus: encroach on the airway linen, harder for air to flow through airways ( harder to get O2 in and harder to get CO2 out

Question 11

How is COPD treated??

Answer 11

-it can be various ways that can be treated if you are a smoker then smoking cessation is a must, bronchodilator may be used, steroids inhaled or oral, oxygen therapy and even surgery could occur.

Question 12

Describe 3 ways that pulmonary adema can occur and tell how each is treated??

Answer 12

1. Congestive heart failure due to poor pumping function (treated by using diuretics water pills along with other medications for heart failure)
2. ARDS-alveoli become compromised as a result of underlying inflammatory response, and this leads to leaky alveoli that can fill up with fluid from the blood vessels. Treated by a mechanical breathing machine.
3. pulmonary embolism-(blood clot which has traveled to the lungs), transfusion-related acute lung injury

Question 13

What factors can cause a pulmonary embolism??

Answer 13

• deep veins of the legs (deep venous thrombosis)
• fatty tissue from the marrow of long bones (fracture occurs)

-heart failure, prolonged sitting, coagulation disorders, trauma,

Question 14

Describe the pathology of emphysema??

Answer 14

-proteolytic enzymes activated in the lung(genetic deficiency of alpha 1 antitrypsin)
-proteolytic enzymes cause:
•Destruction of alveolar septa( adjacent alveoli fuse=big hyper-in later alveoli)
•Destruction of pulmonary capillary bed (obstruction of pulmonary artery, less surface area for gas exchange)
•destruction of elastic tissue in alveolar walls ( inflate easily, but don’t return to normal shape during exhalation) air cannot be adequately exhaled (air trapping) O2 decreased and CO2 increase filling up the lungs

Question 15

Describe two common types of bronchogenic carcinoma??

Answer 15

-squamous cell carcinomas: tumors develop in the large central airways, most common form of lung cancer seen in smokers

Adenocarcinoma: tumors arise from grandular cells in the peripheral airways, invade in pleura, chest wall, and mediastinal structures

Question 16

What signs do TB and lung cancer have in common??

Answer 16

continuous cough, hemoptysis, weight loss, fever, chest pain, dyspnea, and loss of appetite) and radiological images are similar

Question 17

How is TB treated??

Answer 17

• prevents further transmission of TB

- four drugs should be used with treating TB : isoniazid, rifampin, pyrazinamide, ethbutol

Question 18

Which gland is the master gland??

Answer 18

-the pituitary gland because its hormones control other parts of the endocrine system, namely the thyroid gland, adrenal glands, ovaries, and testes.

Question 19

What is pneumoconiosis?

Answer 19

-environmentally induced interstitial lung disease resulting from inhaling particulate matter.
Etiology: occupational exposure, coals liner pneumoconiosis, silicosis, asbestos
Pathology: macrophages ability to scavenge particles is overwhelmed(load of dust is severe) causes chronic inflammatory process, results in fibrosis, scar tissue

Question 20

What is the proper name for valley fever??

Answer 20

-San Joaquin valley fever also is known as coccidioidomycosis ( fungal disease caused by coccidioides immitis) spore is inhales when dust from soil is aerosolized

Question 21

Define respiratory failure and state how it is treated??

Answer 21

• any disease process or injury that interferes with gas exchange oxygen levels decrease and CO2 levels increase
• mechanical ventilation is used to treat it

Question 22

What usually causes 1 croup and 2 epiglottitis??

Answer 22

-

Question 23

Name the hormones and their functions for each of the endocrine glands?? I’m

Answer 23

• thymus: This gland makes white blood cells called T-lymphocytes that fight infection and are crucial as a child’s immune system develops. The thymus starts to shrink after puberty.
• pituitary:(master gland) over sees other glands and maintain the levels for each one
• Adrenal: regulates sat water and blood pressure
• thyroid and parathyroid: tsh to regulate metabolism and maintain blood calcium levels(para)
• Ovary: secrete female hormones estrogen and progesterone
• Testis: sex hormones like testosterone.

Question 24

What are the manifestations of hypopituitarism and hyperpituitarism??

Answer 24

• hyper: gigantism excess growth hormone before puberty( excessive linear growth long bones, all growth parameters affected hand feet head, decreases mental and sexual development
• hypo: depends on which hormones are lost, extent of hormone deficiency, short stature and height , usually mentally sharp

Question 25

What may cause hypothyroidism??

Answer 25

-

Question 26

What are the manifestations of 1 Graves’ disease and myxedema?

Answer 26

-exopthalmos: grave disease

Question 27

What are the manifestations of cushings syndrome and Addison’s disease?

Answer 27

-

Question 28

What are the manifestations of hypoparathyroidism and hyperparathyroidism??

Answer 28

-

Question 29

What is pheochromocytoma??

Answer 29

-

Question 30

Chronic bronchitis

Answer 30

Persistent cough with sputum production for at least 3 months in at least 2 consecutive years.

Etiology: chronic irritation(smoking, pollution, fumes, chronic/recurrent infection)

Pathology: histologic -> hypertrophic and hyperplastic (^ mucus production and inhibits action of cilia) PSCCE becomes squamous ( non-ciliated) dysplasia

Question 31

What does emphysema do the chest?

Answer 31

It becomes to a barrel chest and increases retro sternal airspace

Question 32

Emphysema dominant: Pink Puffer

Answer 32

• good color(pink)
• barrel chest (air trapping) works hard to maintain acceptable levels of O2 and CO2
• SOB -> tachypnea, accessory muscle use, tripod position
• increase WOB consumes increase energy, emaciated appearance (thin)
• minimal sputum
• heart failure occurs late

Question 33

Chronic bronchitis dominant: blue bloater

Answer 33

Recurrent pulmonary infections 
Severe hypoxia (cyanosis-blue) 
Increase sputum production
Minimal weight loss 
Not as SOB doesn’t work as hard, decrease energy consumed 
Heart failures occurs early

Question 34

What is cor pulmonale? Etiology? Pathology?

Answer 34

It is heart failure due to lung disease

Pathology: hyperinflated alveoli compresses puliminary capillaries
Pulmonary hypertension develops this increases the work on the right heart
Hypotrophies and starts to fail, jugular venous distensión

Question 35

ARDS (acute resp distress syndrome) AKA Shock lung

Answer 35

-etiology: insults (resp direct pneumonia) (non-resp indirect fat embolism) insults cause diffuse alveolar damage
Pathophysiology: insult triggers vasoactive substances which damage he alveolar capillary membrane , non cardiogenic pulmonary edema, leads to progressive atelectasis
Manifest: rapidly dyspnea and SOB, severe apoxia ( supp oxygenation & ventilation)

Question 36

What are the four stages of pneumonia?

Answer 36

Stage 1 congestion: vascular engorgement, intra-alveolar fluid, small #s of neutrophils, often numerous bacteria
Stage 2 consolidation: vascular congestion persists, extravasation of RBC into alveolar spaces, increase numbers of neutrophils & fibrin , gross appearance of alveolar solidification
Stage 3 grey hepatization: red cells disintegrate, persistence of neutrophils & fibrin, alveoli still appear consolidated
Stage 4 resolution: cleared by cough, exudate is digested by enzymatic activity and cleared by macrophage activity

Question 37

Pulmonary adema

Answer 37

Increase hydrostatic (CHF fluid overload)
Decrease osmotic pressure
Altered capillary permeability

Pathology: fluid accumulates(first in the interstitium then alveoli)
Leads to: restriction, atelectasis (complete or partial collapse of a lung), poor gas exchange

Crackles and cough up thin pink frothy fluid