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NR507 Advanced Pathophysiology 2024-2025
NR507- Advanced Pathology Final Exam Review
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Questions Correctly Good Luck: -
Risk factors for GERD - =Answer>> -Obesity
-Hiatal Hernia (traps gastric contents above the
diaphram)
-Drugs or chemicals that relax the LES (antibiotics, Ca
channel blockers, bisphosphates
-pregnancy
symptoms of GERD - =Answer>> burning or reflux 30-
90 min after a meal
symptoms worsen in reclining position
symptoms are better in upright position
symptoms improve with an antacid
Sour taste, lump in the throat, cough, hoarseness,
worsening asthma episodes, epigastric pain and chest
pain may also be reported.
Warning signs of GERD - =Answer>> over the age of
50.
dysphasia (difficulty swallowing food)
odynophagia (painful swallowing)
Nausea and vomiting
weight loss
melena
early satiety (feeling full after very little food)
tests to diagnose GERD - =Answer>> Upper GI series
Endoscopy
Esophageal manometry
Esophageal pH
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Intussusception refers to... - =Answer>> part of the
bowel that invaginates itself.
A pseudo obstruction - =Answer>> does not involve
actual matter that causes an obstruction. Rather, it is
related to myopathy (bowel does not function) or
neuropathy (innervation of the nerves is altered).
By definition, a volvulus is - =Answer>> a twisting of
the bowel.
A hiatal hernia is - =Answer>> a diaphragmatic hernia
that protrudes (herniates) through the upper part of the
stomach through the diaphragm and into the thorax
due to dilation of the gastroesophageal junction (GJ).
There are four types of hiatal hernias:
-Sliding hiatal hernia. This is where the junction of the
esophagus slides up past the GE junction.
-Paraesophageal hernia. In a paraesophageal hernia,
the contents of the abdomen slide up around the
esophagus and into the chest. The GE junction in the
type 2 hernia does not go up into the chest.
-Mixed hiatal hernia. This is a combination of both Type
1 and Type 2 hernias. The GE junction slides up into the
chest and the fundus of the stomach slides up and
around.
-The type 4 hernia is an aggravated Type 3 where other
organs other than the stomach slide up into the chest
including the colon and small bowel and spleen.
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Symptoms include acute, severe chest of epigastric
pain, nausea, vomiting and GI bleeding.
In a bowel obstruction, - =Answer>> the patient
presents with nausea, vomiting, cramping abdominal
pain, constipation, diarrhea, distended abdomen, fever,
tachycardia. It can be of the small intestine or the large
intestine. In an obstruction, the food "piles up".
Normally in the intestine, we find bacteria but when the
bacteria are exposed to food stuck in the stomach, it
will begin to grow.
Regardless of the cause of the obstruction, the bowel
contents accumulate in the area resulting in gas. This
gas causes the bowel to extend causing venous
compression which decreases oxygen supply to the
area that can lead to intestinal cell death. This further
aggravates bowel distention.
Decreased oxygenation also promotes anaerobic
bacteria in the bowel to enter the circulation resulting
in sepsis.
With venous compression, fluid is secreted in the bowel
that results in water and electrolyte loss. This results in
hypotension that can lead to shock.
Nerves in the bowel are also triggered that sends
signals to the brain to stimulation the vomiting
response. Note that vomiting does not relieve the
vomiting response. Vomiting results in further loss of
water and electrolytes that also contributes to
hypotension and shock.
In a nutshell, shock can result from hypotension or
sepsis.
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