NUR 2063 Pathophysiology Exam 2
What is gastritis? - ANS Inflammation of the stomach lining. The lining will be red and inflamed
and irritated
What are the causes of gastritis? - ANS Ingestion of irritating substances such a alcohol,
aspirin, NSAIDS, viruses and bacteria
What is GERD? - ANS the back flow of gastric contents into the esophagus through the lower
esophageal sphincter. The inflammation occurs from the reflex of highly acidic stomach acid that
comes up.
What are the causes of GERD? - ANS Any condition or agent that alters closure of the lower
esophageal sphincter or increases in abdominal pressure, fatty food, caffeine, large amounts of
alcohol, smoking, pregnancy and anatomical features like hiatal hernia
What are complications of GERD? - ANS Barrett's esophagus where columnar tissue replaces
normal squamous tissue in the distal esophagus that carries a high risk for cancer. Progression
can lead to ulcers and scarring. Esophageal strictures, pulmonary symptoms such as cough,
asthma and laryngitis from reflux in breathing passages.
What are the signs and symptoms of peptic ulcer disease? - ANS epigastric burning pain that
is usually relieved by food or antacids (gastric ulcers present on empty stomach but can be after
food, duodenal ulcers present 2-3 hours after food and is relieved by food). Can also be life
threatening as GI bleeding can occur without warning and cause a drop in H/H and dark tarry
stools and hematemesis.
What is the role of H.pylori in peptic ulcer disease? - ANS promotes both gastric and duodenal
ulcer formation and thrives in acidic areas. It slows down ulcer healing and can reoccur
frequently, and taking it away can help ulcers heal.
What is pseudomembranous colitis?(C.diff) - ANS acute inflammation and necrosis of large
intestine. The intestinal lining cannot absorb well.
What is the cause of pseudomembranous colitis? - ANS clostridium difficile, exposure to long
term antibiotics that off set the e.coli and c.diff balance in intestine
What are the manifestations of pseudomembranous colitis? - ANS foul smelling/bloody stool,
abdominal pain, fever, leukocytosis, sepsis, colonic perforation.
,How do we treat pseudomembranous colitis? - ANS stop current antibiotics, treat ischemia and
contributing conditions, give oral antibiotics like metronidazole or vancomycin, fecal transplant
or colectomy if severe
How do we prevent the spread of pseudomembranous colitis? - ANS wearing appropriate PPE
and washing hands with soap and water only
What are the signs and symptoms of appendicitis? - ANS Periumbilical pain, RLQ pain,
presence of a positive McBurneys point with pain, nausea, vomiting, fever, diarrhea, RLQ
tenderness, systemic signs of infection
How do we assess for appendicitis? - ANS McBurney's point technique when pressing on the
belly button and RLQ hip region and removing the pressure causes intense pain, indicates
positive appendicitis
What are the causes of bowel obstructions? - ANS previous surgery of the intestines with
adhesions, congenital abnormalities of the bowel, metastatic cancer of the intestinal tract or
female reproductive organs, accumulation of fluid, gas, water and electrolytes in the bowel.
What is a functional bowel obstruction? - ANS a problem with the act of the bowel actually
moving, such as things that inhibit movement from surgery, medications, opioids, low fiber diets
that can slow motility or shut off the GI system from the SNS stimulation.
What is a mechanical bowel obstruction? - ANS due to adhesions, hernia, tumors, impacted
feces, volvus or twisting of the intestines, intussusception
What are the signs and symptoms of liver disease? - ANS hepatocellular failure (jaundice,
decreased clotting, hypoalbuminemia, decreased vitamin D and K) and portal hypertension (GI
congestion due to blockage of blood, more esophageal or gastric varies, hemorrhoids, enlarged
spleen,)
Explain what jaundice is? - ANS green- yellow staining of tissues from increased level of
bilirubin as the liver cannot metabolize extra bilirubin
Where can you find jaundice on assessment? - ANS eyes, skin, and mouth
Explain what ascites is? - ANS pathological accumulation of fluid in the peritoneal cavity due to
the loss of albumin in the liver, causing fluid to be free amongst the cells. It can cause a lot of
pain in the abdomen, and it must be drained with a parenthesis
Explain hepatic encephalopathy? - ANS neuropsychiatric syndrome from too much ammonia in
the blood as the liver cannot break it down. results in dementia and psychotic symptoms
common along with jerking
,What is another name for end stage liver disease? - ANS cirrhosis
What are the signs and symptoms of gallstones? - ANS sudden pain in the RUQ/ center of the
abdomen, back pain, and nauseas and vomiting.
Why do gallstones occur? - ANS due to often a blockage of a duct from a cholesterol filled
stone
What are the three stages of gallstone formation? - ANS supersaturation, nucleation, hypo
motility
Explain supersaturation phase - ANS bile is saturated with cholesterol, causing precipitation of
cholesterol
Explain nucleation phase - ANS the bile crystals begin to stick together and become larger
stones
Explain hypo motility phase - ANS the bile is stasis allowing the stones to grow more
What are some of the risk factors for gallstones? - ANS prolonged fasting, rapid weight loss,
pregnancy, estrogen, obesity
What are the signs and symptoms of pancreatitis? - ANS steady and dull pain in the center or
LUQ of abdomen, severe tenderness on palpation that radiates to the back, nausea and
vomiting, abdominal distention with hypoactive bowel sounds, low grade fevers
What are the causes of pancreatitis? - ANS alcoholism is most causes, biliary tract disease
where the enzymes attack the pancreas, hypertriglyceridemia
What are the three function of the kidneys - ANS excretion, elimination, regulation
Explain what excretion is? - ANS removal of organic waste products from body fluids
Explain what elimination is? - ANS discharge of the waste products from the body
Explain what regulation is? - ANS regulating blood volume, ion concentration, blood pH and
nutrients
What are signs and symptoms indicating one may have a renal disorder? - ANS pain in the
back flank area that is felt at the CVA angle on percussion, tenderness, abnormal urinalysis
findings
, What types of things are abnormal regarding urinalysis? - ANS dark, strong smelling urine,
bacteria in the urine, cloudy urine, ketones or glucose or proteins in the urine, blood in the urine
(except during menses)
What is polycystic kidney disease? - ANS an inherited condition of the kidney resulting in one
having fluid filled cysts on one or both kidneys. if left untreated renal failure with need for
dialysis or kidney transplant occurring
What causes polycystic kidney disease? - ANS it is inherited genetically
What are the types of polycystic kidney disease? - ANS autosomal recessive and dominant
What is a nephron(s)? - ANS they are in the kidney and helps to filter blood and remove waste
products
How many nephrons do the kidneys have? - ANS 1-2 million
What is hematuria? - ANS blood found in the urine not due to menstruation
What is proteinuria? - ANS protein found in the urine
What does it mean when one has ketones in their urine? - ANS they have type 1 diabetes
What is nephrolithiasis? - ANS kidney stones that obstruct the ureters and kidneys that cause
lots of pained urinary stasis
What is another term for kidney stones? - ANS renal calculi
What are kidney stones made up of? - ANS calcium deposits and uric acid
What is pyelonephritis? - ANS infected and inflamed kidneys
What causes pyelonephritis? - ANS e.coli from the lower urinary tract that ascends
What are the signs and symptoms of pyelonephritis? - ANS CVA tenderness most common,
fever, chills, N/V, anorexia or not willing to eat
What can we do the prevent pyelonephritis? - ANS remove catheters are early as possible to
prevent UTIs and possible spread
What are the signs and symptoms of post infectious acute glomerulonephritis? - ANS Smoky
or coffee colored urine, proteinuria, edema as they cannot urinate, decreased output