NURS 611 – ADVANCED PATHOPHYSIOLOGY
Study Guide Questions for Exam 3
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Study Guide Questions for Exam 3
1.Explain the pathophysiology
... [Show More] associate with Type 1 and Type 2 DM.
Type 1 diabetes occurs as a result of the body's immune system attacking the insulin producing beta cells of the pancreas, although it is not clear why this happens. A lack of insulin in the blood means inadequate amounts of glucose are taken up by cells of the body to provide energy for cellular functions. Consequently, glucose remains in the blood leading to a high blood sugar level. Exactly what causes the immune system to do this is not yet clearly understood. Type 2 diabetes mellitus consists of an array of dysfunctions characterized by hyperglycemia and resulting from the combination of resistance to insulin action, inadequate insulin secretion, and excessive or inappropriate glucagon secretion.
2.Explain what occurs in panhypopituitarism.
Panhypopituitarism is the term correctly associated with the lack of all anterior pituitary hormones.
3.List the clinical manifestations of hypothyroidism.
Constipation, decreased heat rate, and lethargy. The lower levels of thyroid hormone result in decreased energy metabolism resulting in constipation, bradycardia, and lethargy.
4.Differentiate diabetes insipidus, diabetes mellitus and SIADH.
Diabetes insipidus is a result of insufficient ADH.
5.What causes the microvascular complications of DM.
Microvascular complications are a result of capillary basement membranes thickening and endothelial cell hyperplasia.
6.What is the cause of diabetes insipidus.
Diabetes insipidus is a result of insufficient ADH.
7.Describe the pathophysiological changes associated with Addison’s Disease.
Addison disease (or Addison's disease) is adrenocortical insufficiency due to the destruction or dysfunction of the entire adrenal cortex. It affects glucocorticoid and mineralocorticoid function. The
onset of disease usually occurs when 90% or more of both adrenal cortices are dysfunctional or destroyed.
8.Describe the pathophysiological changes associated with hypoparathyroidism.
Hypoparathyroidism is a condition of parathyroid hormone (PTH) deficiency. Primary hypoparathyroidism is a state of inadequate PTH activity. In the absence of adequate PTH activity, the ionized calcium concentration in the extracellular fluid falls below the reference range. Primary hypoparathyroidism, the subject of this article, is a syndrome resulting from iatrogenic causes or one of many rare diseases. Secondary hypoparathyroidism is a physiologic state in which PTH levels are low in response to a primary process that causes hypercalcemia.
9.What are the causes and pathophysiological changes associate with ketoacidosis?
Diabetic ketoacidosis (DKA) results from dehydration during a state of relative insulin deficiency, associated with high blood levels of sugar level and organic acids called ketones. Diabetic ketoacidosis is associated with significant disturbances of the body's chemistry, which resolve with proper therapy. Diabetic ketoacidosis usually occurs in people with type 1 (juvenile) diabetes mellitus (T1DM), but diabetic ketoacidosis can develop in any person with diabetes. Since type 1 diabetes typically starts before age 25 years, diabetic ketoacidosis is most common in this age group, but it may occur at any age. Males and females are equally affected.
10.What is acromegaly?
Acromegaly is a hormonal disorder that develops when your pituitary gland produces too much growth hormone during adulthood. When this happens, your bones increase in size, including those of your hands, feet and face. Acromegaly usually affects middle-aged adults.
11.Differentiate hypothyroidism and Graves’ disease.
Hypothyroidism is a lack of thyroid hormone. Graves' disease is over production of thyroid hormone.
12.Describe the pathophysiology related to chronic DM.
Chronic symptoms of diabetes are due to vascular damage from persistent hyperglycemia. Vascular
damage leads to end-organ damage. Other conditions associated with diabetes, such as hypertension, dyslipidemia (as well as smoking) accelerate the development of vascular damage and the chronic complications of diabetes, which are the following: Microvascular complications are a significant cause of morbidity. Persistent hyperglycemia is the major cause for the microvascular complications which are highly specific for diabetes. retinopathy with potential loss of vision, nephropathy leading to kidney failure, peripheral neuropathy leading to pain, foot ulcers, and limb amputation, autonomic neuropathy causing gastrointestinal, genitourinary, cardiovascular symptoms and sexual dysfunction. Macrovascular complications are the main cause of mortality. Although persistent hyperglycemia may contribute to macrovascular complications, it is the associated conditions (hypertension,
dyslipidemia, and smoking) that account for most of the burden of the macrovascular complications. Coronary heart disease is the major cause of death for patients with diabetes, peripheral vascular disease, and cerebrovascular disease. Unfortunately, many patients with diabetes remain asymptomatic for long periods, so that the first presentation of the disease is frequently a chronic complication. Indeed, about 50% of newly diagnosed type 2 diabetes will already have developed a vascular.
13.What happens during hypoglycemia?
Hypoglycemia occurs when there is an excess of insulin in relation to the available glucose.
14.What is the metabolic syndrome?
Metabolic syndrome is a cluster of conditions — increased blood pressure, a high blood sugar level, excess body fat around the waist and abnormal cholesterol levels — that occur together
15.Describe how DM causes peripheral neuropathy.
Diabetic neuropathies are a family of nerve disorders caused by diabetes. People with diabetes can, over time, develop nerve damage throughout the body. Some people with nerve damage have no symptoms. Others may have symptoms such as pain, tingling, or numbness—loss of feeling—in the hands, arms, feet, and legs. Nerve problems can occur in every organ system, including the digestive
tract, heart, and sex organs. About 60 to 70 percent of people with diabetes have some form of neuropathy. People with diabetes can develop nerve problems at any time, but risk rises with age and longer duration of diabetes. The highest rates of neuropathy are among people who have had diabetes for at least 25 years. Diabetic neuropathies also appear to be more common in people who have problems controlling their blood glucose, also called blood sugar, as well as those with high levels of blood fat and blood pressure and those who are overweight. What causes diabetic neuropathies? The causes are probably different for different types of diabetic neuropathy. Researchers are studying how prolonged exposure to high blood glucose causes nerve damage. Nerve damage is likely due to a combination of factors: metabolic factors, such as high blood glucose, long duration of diabetes, abnormal blood fat levels, and possibly low levels of insulin neurovascular factors, leading to damage to the blood vessels that carry oxygen and nutrients to nerves autoimmune factors that cause inflammation in nerves mechanical injury to nerves, such as carpal tunnel syndrome inherited traits that increase susceptibility to nerve disease lifestyle factors, such as smoking or alcohol use.
16.Trace the electrical activity of the heart.
SA node-Atria-AV node-Purkinje fibers-ventricles
17.Identify the location of the neurotransmitters in the heart.
Myocardium and coronary vessels
18.Define adrenergic receptors.
Class of receptors named after the action of adrenalin(e), the alternative name for epinephrine. Alpha receptors, which are stimulated by norepinephrine and blocked by agents such as phenoxybenzamine, are categorized into two classes, α1 and α2, which have different actions. α1 adrenergic actions include contraction of the iris, decreased motility in the intestine, and potassium and water secretions from the salivary glands. α2 adrenergic receptors inhibit adenylate cyclase, rather than activating it. Beta receptors, which are stimulated by epinephrine and blocked by agents such as propranolol, are also categorized into two types; β1 adrenergic receptors, which produce lipolysis and [Show Less]