Pathophysiology Final NUR 2063 final exam well done.

Gastritis and Etiology and patho - answersinflammation of stomach's mucolas lining (can involve entire stomach or region) can be acute or chronic. may be caused by h. pylori infection (imbeds in mucosal layer activating toxins and enzymes that cause inflammation. NSAIDS, chronic alcohol consumption, stress, trauma, burns, or infections, autoimmune conditions manifestations of gastritis - answersindigestion, heartburn, epigastric pain, abdominal cramping, nausea, vomiting, anorexia, fever, malaise. hematemesis and dark, tarry stools indicate ulceration and bleeding. chronic gastritis increases risk for peptic ulcers, gastric cancer, anemia, and hemorrhage. gastritis diagnosis/treatment - answersh&p, GI tract x ray, egd, serum h. pylori antibodies, h. pylori breath test, stool analysis (h. pylori and occult blood treatment-acute is self limiting ususally resolves meds-antacids, acid-reducing agents, and mucosal barrier agents other strategies include those for GERD (diet, small meals, antacids) Peptic ulcer disease (PUD) - answersrefers to erosive lesions affecting the muscularis mucosa of the stomach or duodenum. ulcers vary in size and severity, ranging from superficial erosions to complete penetration through GI tract wall peptic ulcer disease etiology and patho - answersETIOLOGY: most commonly H. pylori and NSAID use. PATHO: develops because of an imbalance between destructive forces and protective mechanisms PUD duodenal ulcers - answersmost commonly associated with excessive acid or H. pylori infections typically present with epigastric pain relieved in the presence of food PUD gastric ulcers - answersless frequent-more deadly typically associated with malignancy and NSAIDS pain worsens with eating PUD Stress ulcers - answersdevelop because of major physiological stressor on body due to local tissue ischemia, tissue acidosis, bile salts entering stomach, and decreased GI motility most frequently develop in stomach; multiple ulcers can form within hours of the precipitating event often hemorrhage is the first indication (vomiting blood or blood in stool) PUD manifestations/treatment - answersepigastric, abd. pain, abd. cramping, heartburn, indigestion, chest pain, nausea/voimiting, melena (dark, tarry stools), fatigue, unexplained weight loss Treatment: same as gastritis: antacids, mucosal barrier agents, acid-reducing agents possible surgical repair Iron-deficiency Anemia - answersNot enough iron for hemoglobin production erythrocytes pale and small Etiology: decreased iron consumption/absorption, increased bleeding manifestations in addition to "anemia": brittle nails, headache/irritability, pica, cyanosis of sclera of eyes, delayed healing Anemia - answerscommon acquired or inherited disorder of erythrocytes that impairs the bloods oxygen-carrying capacity. ETIOLOGY: decrease in # of circulating erythrocytes, reduction in hemoglobin content, presence of abnormal hemoglobin MANIFESTATIONS: weakness, fatigue, pallor, syncope, dyspnea, tachycardia Pernicious anemia - answersB12 deficiency or megaloblastic anemia large, immature erythrocytes. usually lack of intrinsic factor (protein necessary for b12 absorption in stomach) b12 is needed for cell division and maturity. too little b12 gradually causes neuro problems because of the breakdown in myelin, neuro effects may be seen before anemia is diagnosed. Additional manifestations: bleeding gums, diarrhea, impaired smell, DTR loss, anorexia, personality/memory changes, + babinski sign, stomatitis, paresthesia of hands and feet, unsteady gait aplastic anemia - answersbone marrow fails to make enough blood cells leading to pancytopenia MANIFESTATIONS: general anemia, leukcytopenia, and recurrent infections can be caused by cancers, cancer treatment, pesticides Sickle cell anemia - answersgenetic, hemoglobin-s trait vs. gene crescent shape during times of hypoxia, can clump together and clog vessels. MANIFESTATIONS: swelling in hands and feet, sickle cell crisis, abd. pain, bone pain, jaundice, skin ulcers, stroke, chest pain tissue ischemia and necrosis. electrophoresis and stem cell transplant may cure thalassemia - answersgenetic, not RBC problem, hemoglobin problem. lack one or 2 proteins that make up hemoglobin MANIFESTATIONS: heart failure, splenomegaly, hepatomegaly, bone deformities, jaundice, fatigue, dyspnea Idiopathic thrombocytopenia purpura (ITP) - answershypocoagulopathy due to immune system destroying its own platelets (autoantibodies) Circulating IgG reacts with the platelets which are then destroyed in the spleen and liver. can be acute or chronic ETIOLOGY: idiopathic, autoimmune disease, live vaccines, immunodeficiency disorders, viral infections Manifestations: abnormal bleeding (petechiae, epistaxis [nose bleed], hematuria) ACUTE TREATMENT: glucocorticoid steroids, immunoglobulins, plasmapheresis and platelet pheresis CHRONIC TREATMENT: splenectomy, blood transfusions, immunosuppressants Thrombotic thrombocytopenia purpura - answerscoagulation disorter d/t deficiency of enzyme responsible for cleaving von Willebrand factor