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Post Concussive Syndrome -Affects about 80% of people with mild-moderate traumatic brain injuries -Women are at higher risk -Age increases risk -Symptoms may occur 3-12 months post injury -Symptoms: Headaches, dizziness, anxiety, difficulties with learning/memory/attention, depression Signs:...

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  • 19 september 2024
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NURS 5315 - Advanced Pathophysiology Test
a- a- a- a- a- a-




3 Summer 2024 Study Guide with complete
a- a- a- a- a- a- a-




solutions. UTA a- a-




Post Concussive Syndrome
a- -Affects about 80% of people with mild-
a- a-a- a- a- a- a- a- a- a-


moderate traumatic brain injuries
a- a- a-




-Women are at higher risk
a- a- a- a-




-Age increases risk
a- a-




-Symptoms may occur 3-12 months post injury
a- a- a- a- a- a-




-Symptoms: Headaches, dizziness, anxiety, difficulties with
a- a- a- a- a- a-



learning/memory/attention, depression a-




Signs: Global brain atrophy on imaging & signs of organic brain injury
a- a- a- a- a- a- a- a- a- a- a- a-


(changes not r/t mental illness) on imaging 1 year post injury
a- a- a- a- a- a- a- a- a- a-




Heart Failure Risk Factors
a- a- a- a-a- a- -Age (most common over 65 y/o)
a- a- a- a- a-




-Ischemic heart diseasea- a-




-Obesity
-Diabetes

-Hypertension

-Excessive ETOH use a- a-




-Congenital heart disease a- a-




-Valvular heart disease
a- a-




-Myocarditis

,-Cardiomyopathy (stiffening of heart muscle) a- a- a- a-




-Renal failure
a-




Heart Failure Clinical Manifestations
a- a- a- a-a- a- -Volume overload a-




-Poor perfusion secondary to pump failure
a- a- a- a- a-




Atherosclerosis Causes a- a-a- a- -Begins with tissue injury a- a- a- a-




Sources of injury:
a- a-




CIGARETTES (toxins) a-




Hypertension (increased force of the blood hitting the blood vessel can
a- a- a- a- a- a- a- a- a- a- a-


weaken it) a-




Diabetes a-




Hyperlipidemia (lipids take place of endothelial cells lining the blood
a- a- a- a- a- a- a- a- a- a-


vessel, initiating an inflammatory response)
a- a- a- a-




Patho of Atherosclerosis r/t Hyperlipidemia - Inflammatory Response
a- a- a- a- a- a- a- a-a- a-


1. Tissue injury to endothelial cells lining the blood vessel.
a- a- a- a- a- a- a- a- a-




2. Endothelial cells become inflammed and unable to produce sufficient
a- a- a- a- a- a- a- a- a- a-



antithrombotic and vasodilating cytokines, increasing risk for clot
a- a- a- a- a- a- a- a-


formation and creating a tighter space for plaques and clots to grow.
a- a- a- a- a- a- a- a- a- a- a-




3. Macrophages and platelets are called to the area of injury, further
a- a- a- a- a- a- a- a- a- a- a- a-


congesting the growing plaque area.
a- a- a- a-




4. LDL replaces endothelial cells in the lining of the blood vessel.
a- a- a- a- a- a- a- a- a- a- a-




5. Macrophages engulf the LDL particles.
a- a- a- a- a-

,6. Macrophages eat too much LDL, causing them to burst and become
a- a- a- a- a- a- a- a- a- a- a- a-


foam cells (under a microscope they look like sea foam)
a- a- a- a- a- a- a- a- a-




7. Accumulation of foam cells causes a fatty streak. Fatting streak further
a- a- a- a- a- a- a- a- a- a- a- a-


triggers inflammatory responses, repeating the whole cycle, and growing
a- a- a- a- a- a- a- a- a-



the fatty streak.
a- a-




8. Smooth muscle hyperplasia from all the inflammation grows, produces
a- a- a- a- a- a- a- a- a- a-


collagen, and covers the fatty streak to create a fibrous plaque.
a- a- a- a- a- a- a- a- a- a- a-




9. The plaque may calcify, protrude into the vessel, and occlude blood
a- a- a- a- a- a- a- a- a- a- a- a-



flow, resulting in ischemia or infarction.
a- a- a- a- a-




Hyperlipidemia a-a- a- Leading cause of coronary artery disease
a- a- a- a- a-




Most commonly affects promximal portions of coronary arteries, larger
a- a- a- a- a- a- a- a- a-


branches of carotid arteries, circle of Willis (base of brain), large vessels of
a- a- a- a- a- a- a- a- a- a- a- a- a-


lower extremities, renal arteries, mesenteric (intestinal) arteries
a- a- a- a- a- a-




Consequences of Atherosclerosis a- a- a-a- a- Reduced blood flow a- a-




Coronary artery disease, myocardial infarction, carotid artery disease,
a- a- a- a- a- a- a- a-


cerebral vascular disease, stroke, mesenteric ischemia, peripheral vascular
a- a- a- a- a- a- a- a-


disease, renal artery stenosis
a- a- a-




Congenital Heart Disease a- a- a-a- a- -Most common heart disease affecting
a- a- a- a- a-


children

-Etiology is unknown in 90% of cases
a- a- a- a- a- a-

, Causes:
Genetic/environmental factors (multifactorial factors) a- a- a-




Primary genetic factors (single gene disorders, chromosome disorders)
a- a- a- a- a- a- a-




Sole environmental factors (Accutane/isotretinoin for acne, alcohol,
a- a- a- a- a- a- a-



maternal rubella infection) a- a-




Maternal Risk Factors: a- a-




Age over 45, prior child with heart defect, poorly controlled diabetes
a- a- a- a- a- a- a- a- a- a- a-



during pregnancy, alcohol, congenital infection during pregnancy
a- a- a- a- a- a- a-


(rubella), aspirin, lupus, Dilantin/phenytoin/diphenylhydantoin for seizures
a- a- a- a- a-




LEFT to RIGHT shunt (Congenital heart defect)
a- a- -Oxygenated blood
a- a- a- a- a-a- a- a- a-


from the left side of the heart mixes with unoxygenated blood in the
a- a- a- a- a- a- a- a- a- a- a- a- a-


right side of the heart.
a- a- a- a- a-




-Oxygen saturation on left side is usually 95%, whereas right side is 75%
a- a- a- a- a- a- a- a- a- a- a- a-




- As blood mixes, right side's oxygen saturation increases to 80% or more
a- a- a- a- a- a- a- a- a- a- a- a-




-VOLUME OVERLOAD occurs on RIGHT side of heart occurs, leading to
a- a- a- a- a- a- a- a- a- a- a-


PULMONARY HYPERTENSION, which causes RIGHT VENTRICULAR
a- a- a- a- a- a-



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
a- a- a- a- a- a- a- a- a- a- a- a- a-



shunt.


Eisenmenger Syndrome 1. Increased blood flow returns to lungs
a- a-a- a- a- a- a- a- a- a- a-


rather than to the rest of the body.
a- a- a- a- a- a- a-




2. Blood vessels become stiff and narrow - permanent damage.
a- a- a- a- a- a- a- a- a-

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