NURS 5315 - Advanced Pathophysiology Test
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3 Summer 2024 Study Guide with complete
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solutions. UTA a- a-
Post Concussive Syndrome
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moderate traumatic brain injuries
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-Women are at higher risk
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-Age increases risk
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-Symptoms may occur 3-12 months post injury
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-Symptoms: Headaches, dizziness, anxiety, difficulties with
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learning/memory/attention, depression a-
Signs: Global brain atrophy on imaging & signs of organic brain injury
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(changes not r/t mental illness) on imaging 1 year post injury
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Heart Failure Risk Factors
a- a- a- a-a- a- -Age (most common over 65 y/o)
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-Ischemic heart diseasea- a-
-Obesity
-Diabetes
-Hypertension
-Excessive ETOH use a- a-
-Congenital heart disease a- a-
-Valvular heart disease
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-Myocarditis
,-Cardiomyopathy (stiffening of heart muscle) a- a- a- a-
-Renal failure
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Heart Failure Clinical Manifestations
a- a- a- a-a- a- -Volume overload a-
-Poor perfusion secondary to pump failure
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Atherosclerosis Causes a- a-a- a- -Begins with tissue injury a- a- a- a-
Sources of injury:
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CIGARETTES (toxins) a-
Hypertension (increased force of the blood hitting the blood vessel can
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weaken it) a-
Diabetes a-
Hyperlipidemia (lipids take place of endothelial cells lining the blood
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vessel, initiating an inflammatory response)
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Patho of Atherosclerosis r/t Hyperlipidemia - Inflammatory Response
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1. Tissue injury to endothelial cells lining the blood vessel.
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2. Endothelial cells become inflammed and unable to produce sufficient
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antithrombotic and vasodilating cytokines, increasing risk for clot
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formation and creating a tighter space for plaques and clots to grow.
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3. Macrophages and platelets are called to the area of injury, further
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congesting the growing plaque area.
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4. LDL replaces endothelial cells in the lining of the blood vessel.
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5. Macrophages engulf the LDL particles.
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,6. Macrophages eat too much LDL, causing them to burst and become
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foam cells (under a microscope they look like sea foam)
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7. Accumulation of foam cells causes a fatty streak. Fatting streak further
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triggers inflammatory responses, repeating the whole cycle, and growing
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the fatty streak.
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8. Smooth muscle hyperplasia from all the inflammation grows, produces
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collagen, and covers the fatty streak to create a fibrous plaque.
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9. The plaque may calcify, protrude into the vessel, and occlude blood
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flow, resulting in ischemia or infarction.
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Hyperlipidemia a-a- a- Leading cause of coronary artery disease
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Most commonly affects promximal portions of coronary arteries, larger
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branches of carotid arteries, circle of Willis (base of brain), large vessels of
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lower extremities, renal arteries, mesenteric (intestinal) arteries
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Consequences of Atherosclerosis a- a- a-a- a- Reduced blood flow a- a-
Coronary artery disease, myocardial infarction, carotid artery disease,
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cerebral vascular disease, stroke, mesenteric ischemia, peripheral vascular
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disease, renal artery stenosis
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Congenital Heart Disease a- a- a-a- a- -Most common heart disease affecting
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children
-Etiology is unknown in 90% of cases
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, Causes:
Genetic/environmental factors (multifactorial factors) a- a- a-
Primary genetic factors (single gene disorders, chromosome disorders)
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Sole environmental factors (Accutane/isotretinoin for acne, alcohol,
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maternal rubella infection) a- a-
Maternal Risk Factors: a- a-
Age over 45, prior child with heart defect, poorly controlled diabetes
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during pregnancy, alcohol, congenital infection during pregnancy
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(rubella), aspirin, lupus, Dilantin/phenytoin/diphenylhydantoin for seizures
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LEFT to RIGHT shunt (Congenital heart defect)
a- a- -Oxygenated blood
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from the left side of the heart mixes with unoxygenated blood in the
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right side of the heart.
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-Oxygen saturation on left side is usually 95%, whereas right side is 75%
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- As blood mixes, right side's oxygen saturation increases to 80% or more
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-VOLUME OVERLOAD occurs on RIGHT side of heart occurs, leading to
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PULMONARY HYPERTENSION, which causes RIGHT VENTRICULAR
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HYPERTROPHY, (secondary to pulm. hptn.), and LEFT VENTRICULAR a- a- a- a- a- a- a- a-
HYPERTROPHY(secondary to blood being returned to left ventricle) a- a- a- a- a- a- a-
Eisenmenger Syndrome: Reversal of left to right shunt to a right to left
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shunt.
Eisenmenger Syndrome 1. Increased blood flow returns to lungs
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rather than to the rest of the body.
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2. Blood vessels become stiff and narrow - permanent damage.
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