PATHOPHYSIOLOGY EXAM 3 Study Guide and Content Review

Explain blood gas levels for acute respiratory failure • Respiratory Failure - when the lungs cannot fulfill their function, failing to do this. • Blood gas levels for failure: • Measuring gas pressures . Give ...

Explain blood gas levels for acute respiratory failure • Respiratory Failure - when the lungs cannot fulfill their function, failing to do this. • Blood gas levels for failure: • Measuring gas pressures . Give 5 conditions likely to lead to respiratory failure. Explain the relationship of decreased ventilation of respiratory acidosis. • CO2 is causing acidosis. How can a gas cause the vascular system to become acidic? ◦ If you increase H+, what happens to K+? Explain renal compensation to respiratory acidosis. Kidney is the other system that can affect the blood pH 5. Primary lung cancer is classified according to histological types General (Pulmonary neoplasms) Bronchiogenic Carcinoma Squamous cell carcinoma Adenocarcinomas • In glandular portion of bronchial tree originating in epithelial cells peripheral glandular tissue Large cell carcinoma • Not terribly common; malignant cells are large. Small cell carcinoma • Worst one of all; most uncommon 6. Explain the following about pulmonary tuberculosis: • 1/3 of world's population has TB (mostly in underdeveloped countries) Causative organism • Genus is Mycobacterium ("Myco" = fungi). Tuberculin skin test and diagnosis • ALL skin tests are always based on antigen-antibody Cavity formation 7. Know normal blood values for the following: RBC - Red Blood Corpusle Hgb (Hemoglobin) • Normal values: HCT (hematocrit) • Normal values: Red Cell Indices or indicators (MCV, MCHC, MCH collectively): WBC • White Blood Cell PMN • Not used clinically • Poly-morphonuclear neutrophil Monocytes • 1-8% • Great big cells; occasional granules Platelets • Normal: 150,000 - 400,000 mm3 • Not cells, but pieces of a cell (pinched off piece of cytoplasm of megakaryocyte). RBC - general info: • ONLY carry O2 and CO2 -- ultimate in function and design Etiological Classification (there are the only 2 possibilities): Explain iron deficiency anemia Impressive anemias: impressive how anemic people can be and still be functioning Explain megaloblastic anemia Explain sickle cell anemia and explain how general anesthesia or altitudes affect this disease. General lymphoma notes • Lymphomas are similar to leukemias, but a little different Explain Hodgkin and define the stages of this disease. • Younger age group (18-35) Explain the difference between Hodgkin and Non-Hodgkin’s lymphomas Non-Hodgkin’s: 20. Explain plasma cells and abnormal immunoglobulins in relationship to multiple myeloma Explain the difference between multiple myeloma and Waldenstrom’s macroglobulinemia Waldenstrom's macroglobulinemia: (won’t see often) . Coagulation: vascular defects • Pts present with what looks like a bleeding/coagulation problem, but it's a vascular problem 22. Define thrombocytosis and thrombocytopenia Thrombocytosis Thrombocytopenia Coagulation • Following injury to a blood vessel, the local vessels constrict (normal response) Coagulation Stages: cascade/waterfall Know the 3 stages, factors involved in each stage (but not the sequence), end result of each stage ▪ Most of the time when pt has clotting disorder, it's result of one single factor deficiency. • Two ways to get coagulation problems due to factor deficiencies: Explain Factor VIII (8) and Factor IX (9) in relationship to hemophilia A and B. Explain PTT and PT in relationship to the intrinsic and extrinsic pathways • Most coagulation tests are screening procedures/tests Which coagulation factors are synthesized by liver and which are synthesized by Vitamin K? Acquired coagulation problems: Decreased production Vitamin K required to activate factors Fibrinolysis • Coagulation process forms the clot AND lyses the formed fibrous clot . Explain the pathology of DIC Coagulation factor problems via increased consumption Define and explain the following: GI goes from mouth to anus; supplementary stuff in between Esophageal spasm • Accidently swallow something Chronic reflux esophagitis • Most common problem in the esophagus inflames the esophagus Hiatus Hernia • Protrusion of part of stomach/contents of stomach back up into lower part of esophagus Esophageal tumors • Benign tumors of the esophagus are rare 28. Define: gastritis, acute superficial gastritis and chronic atrophic gastritis Gastritis • Inflammation of the gastric mucosa Acute superficial gastritis Chronic atrophic gastritis Explain peptic ulcer disease: area of ulceration, role of H. pylori, clinical sxs & complications • Stomach ulcers ◦ 90% of all ulcers in the lesser curvature of stomach as compared to the greater curvature Discuss common causes of malabsorption Pathology of the Small Intestines is often manifested by malabsorption: Define celiac disease and explain the role of gluten • Characterized by an atrophy of the villi in the small intestine Explain lactase deficiency disease • Genetic Explain regional enteritis defining pathology of terminal ileum • AKA Crohn's disease • Chronic inflammatory disease that classically affects the terminal ileum: 80% of the time Define appendicitis and give probable CBC values (complete blood count) • Most common reason for abdominal surgery in young adults Locate McBurney’s point • Appendix is located externally at McBurney’s point Define peritonitis. • Inflammation of the peritoneum= infected Distinguish between non-mechanical and mechanical obstruction Intestinal obstructions can be: Explain diverticular disease of the colon. In the large intestine Define ulcerative colitis: etiology, 3 common clinical types related to frequency of symptoms. • A non-specific inflammatory disease of the colon 40. Define the 3 types of polyps • Growths that occur from the mucosal lining and extend out (back through the muscle lining) 41. Explain carcinoma of the colon and rectum; give areas involved and clinical features • Most common sites (colon and rectum) to get a malignancy in GI system Explain hemorrhoids defining etiology • Essentially the same thing as varicose veins, but in colon Anal fissure (tear in anal canal) Anorectal abscess • Anorectal abscess can develop Anal Fistula • Sometimes higher incidence in gay man who practice anal intercourse Ancillary GI: • Liver, biliary tract and pancreas Explain the 4 general mechanisms by which hyperbilirubinemia can occur. • Increased production of bilirubin (excess production) • Impaired hepatic uptake of bilirubin ◦ Albumin-connected bilirubin transported to liver  disconnected from the albumin ◦ Gilbert's syndrome: on a continuum ▪ An individual has a deficiency in the enzyme that conjugates bilirubin • Decrease in liver's ability to excrete bilirubin ◦ Bilirubin connected to the albumin, taken to liver, no drugs interfering with disconnection; Compare and contrast hepatitis A and B. • Viral hepatitis Explain cirrhosis of the liver and the relationship of alcoholism to this disease. • Cirrhosis of liver is primarily seen in chronic alcoholics Explain biliary cirrhosis. • Still cirrhosis of the liver, but the cirrhosis tends to occur around the bile ducts Explain liver cell failure including associated Hematologic disorders Symptoms of liver and biliary cirrhosis: Explain portal hypertension and explain why esophageal bleeding is common. Define cholecystitis and explain etiologic factors. Explain acute pancreatitis and discuss etiology Explain amylase role in pancreatitis Explain the difference between chronic and acute pancreatitis. Cancer of the Liver • Primary cancer of the liver and gall bladder is uncommon • Liver is one of top 3 cancer metastasizing sites (along with bone, lung) • Primary cancer of the pancreas