MCCN SDAP X - Pathophysiology Final Exam All Questions And Correct
Answers 100% Verified
Discuss PSA in persons with BPH - ANSWER Increased PSA (Prostate Specific Antigen)
could be a sign for BPH but does not automatically mean cancer
Increased size of gland results in increased PSA; age also increases PSA
Lists treatment options for BPH - ANSWER Relieve obstruction and allow free flow urine
from bladder.
Other treatments could be:
Watch and wait,
Chemical treatment
Surgery-
Transurethral Resection of the Prostate (TURP). This is done to open up the urethra and
reestablish flow of urine out of the bladder
Discusses the pathophysiology of prostate cancer - ANSWER The most common male
cancer - adenocarcinomas, origin of epithelial cells.
Groups who are at higher risk for prostate cancer - ANSWER Highest among African
American males and later diagnosed.
Lowest among Asian and Native Americans.
Incidence increases rapidly after 50.
More than 80% of the cases are diagnosed in men over 65 years old.
Discussion of American Cancer Society recommendations regarding at what age to
start screening for prostate cancer. - ANSWER Screening should be done at age 50 for
men who are at average risk of prostate cancer.
Screening should be done at age 45 for those at risk (African- American men, men with
first degree relative --father, brother, son, who had prostate cancer before the age of
65) of developing prostate cancer
,Screening should be done at age 40 for men who are at higher risk (more than a first
degree relative who had prostate cancer).
Men who have PSA less than 2.5 ng/ml may need to be retested only every 2 years
Screenings should be done every year for those men who have a PSA of 2.5 ng/ml or
higher
Signs and symptoms of prostate cancer - ANSWER Often asymptomatic until late in the
disease (obstruction of urethra)
Discusses PSA criteria that are used to determine need for biopsy - ANSWER A PSA
above 10-but not absolute
Discusses the role of random biopsy for prostate cancer - ANSWER Random biopsies
are continually finding low grade cancer in about 1/4 men who undergo the biopsy. They
often undergo unnecessary treatment as not much is known about the cancer. Imaging
scans are much better at determining the level of urgency for treatment.
Discusses when endoscopy may be necessary - ANSWER A guaiac test is done to
diagnose lower GI problems. If the test gave no clear results to confirm the problem, an
endoscopy may be done to see if there were upper GI problems.
Lists etiologies for GI bleed - ANSWER Mallory-Weiss tear, Over the counter
nonsteroidal anti inflammatory drugs (NSAIDs), ulcers, malignancy, inflammatory bowel
disease, angiodysplasia, hemorrhoids
Recognizes signs and symptoms related to GI bleeding - ANSWER Hematemesis (blood
in vomit), melena (black due to action of enzymes on blood), hematochezia (blood in
stool), hemoptysis (coughing blood), shock state is possible, but unusual, increased
RBC count, increased hemoglobin & hematocrit
Overview of management of GI bleed Treatment is blood vessel coagulation for bleeding
from the stomach/duodenum, address the underlying pathophysiology; resection of the
small bowel, enteroscopy &/or laser therapy for angiodysplasia and irritable bowel
syndrome. Medical therapies include corticosteroids
,Pathogenesis of a peptic ulcer associated with NSAID - ANSWER NSAIDS damage
epithelial cells & decrease formation of mucus within the stomach
Discusses the pathogenesis of a peptic ulcer related to H. pylori - ANSWER H. pylori is a
bacteria that causes an infection producing ulcers, causes 70% of gastric, and 100% of
duodenal ulcers
Puts the steps in order: from ingestion of the H. pylori perforation and peritonitis -
ANSWER Ingest H. pylori, Urease f/ bacteria converts urea in stomach to ammonia &
CO2, bacteria is protected f/ acid pH, bacteria moves through mucus layer,
inflammation (peritonitis) of gastric cells, inflammation weakens epithelial lining, erosion
can occur (ulcer)
Describes diagnostic tests for H. pylori PUD - ANSWER Definitive diagnosis is
esophagogastroduodenoscopy and tissue test for H. pylori (rapid urease test, histology
test & tissue culture test), can also test for H. pylori with blood test, stool test (tests for
Ag), & urea breath test
Describes the CLASS ACT for persons with suspected PUD - ANSWER Character:
gnawing stomach pain
Location: epigastric
Aggravating: empty stomach
Associated S/S: nausea
Timing/ Tx: comes & goes, often occurs several hours after meals & at night when
stomach is empty, may be relieved by food or antacid therapy
Recognizes treatment measure for PUD depends on the etiology - ANSWER Treat H.
pylori w/ antibiotics, neutralize HCl & reduce HCl formation (proton pump inhibitors:
Prilosec), H2 blockers (histamine receptor blockers)
, Identifies the definitive treatment for PUD related to H. pylori - ANSWER Antibiotics
Complications of PUD- ANSWER hemorrhage, perforations and gastric outlet
obstruction
Findings compatible with the diagnosis of PUD - ANSWER presence of ulcer and positive
for H. pylori if it is the cause
pyloric obstruction This is caused by edema, spasm, or contraction of scar tissue and
interference with the free passage of gastric contents through the pylorus or adjacent
areas. Symptoms include early satiety, feeling of epigastric fullness and heaviness after
meals, gastroesophageal reflux, weight loss, and abdominal pain. With severe
obstructions there is vomiting of undigested foods.
perforation and peritonitis ANSWER Perforation occurs when an ulcer erodes through
all of the layers of the stomach or duodenum wall. About 5% of people with PUD get this.
With perforation, gastric contents enter the peritoneum and causes peritonitis. The pain
will radiate into the back, severe night distress and inadequate pain relief from eating
foods or taking antacids.
Lists signs and symptoms and explains rationale of complications ANSWER S/S:
abdominal pain, rigid, tender abdomen.
The upper GI is exposed to acid-pepsin. These ulcers can affect one or all layers of the
stomach and duodenum. The ulcer may penetrate only the mucosal surface or it may
extend into the smooth muscle layers. On occasion the ulcer can penetrate the outer
wall of the stomach or duodenum. Healing involves replacement with scar tissues.
Pyloric sphincter-inflammation, fibrosis and scarring can lead to bloating, vomiting,
weight loss.
hemorrhage - ANSWER Hemorrhage is caused by bleeding from granulation tissue or
from erosion of an ulcer into the artery or vein. 20% of individuals with PUD have
hemorrhage. Bleeding may be sudden, severe and without warning. Evidence of
bleeding may consist of hematemesis or melena. Acute hemorrhage is manifested by
Answers 100% Verified
Discuss PSA in persons with BPH - ANSWER Increased PSA (Prostate Specific Antigen)
could be a sign for BPH but does not automatically mean cancer
Increased size of gland results in increased PSA; age also increases PSA
Lists treatment options for BPH - ANSWER Relieve obstruction and allow free flow urine
from bladder.
Other treatments could be:
Watch and wait,
Chemical treatment
Surgery-
Transurethral Resection of the Prostate (TURP). This is done to open up the urethra and
reestablish flow of urine out of the bladder
Discusses the pathophysiology of prostate cancer - ANSWER The most common male
cancer - adenocarcinomas, origin of epithelial cells.
Groups who are at higher risk for prostate cancer - ANSWER Highest among African
American males and later diagnosed.
Lowest among Asian and Native Americans.
Incidence increases rapidly after 50.
More than 80% of the cases are diagnosed in men over 65 years old.
Discussion of American Cancer Society recommendations regarding at what age to
start screening for prostate cancer. - ANSWER Screening should be done at age 50 for
men who are at average risk of prostate cancer.
Screening should be done at age 45 for those at risk (African- American men, men with
first degree relative --father, brother, son, who had prostate cancer before the age of
65) of developing prostate cancer
,Screening should be done at age 40 for men who are at higher risk (more than a first
degree relative who had prostate cancer).
Men who have PSA less than 2.5 ng/ml may need to be retested only every 2 years
Screenings should be done every year for those men who have a PSA of 2.5 ng/ml or
higher
Signs and symptoms of prostate cancer - ANSWER Often asymptomatic until late in the
disease (obstruction of urethra)
Discusses PSA criteria that are used to determine need for biopsy - ANSWER A PSA
above 10-but not absolute
Discusses the role of random biopsy for prostate cancer - ANSWER Random biopsies
are continually finding low grade cancer in about 1/4 men who undergo the biopsy. They
often undergo unnecessary treatment as not much is known about the cancer. Imaging
scans are much better at determining the level of urgency for treatment.
Discusses when endoscopy may be necessary - ANSWER A guaiac test is done to
diagnose lower GI problems. If the test gave no clear results to confirm the problem, an
endoscopy may be done to see if there were upper GI problems.
Lists etiologies for GI bleed - ANSWER Mallory-Weiss tear, Over the counter
nonsteroidal anti inflammatory drugs (NSAIDs), ulcers, malignancy, inflammatory bowel
disease, angiodysplasia, hemorrhoids
Recognizes signs and symptoms related to GI bleeding - ANSWER Hematemesis (blood
in vomit), melena (black due to action of enzymes on blood), hematochezia (blood in
stool), hemoptysis (coughing blood), shock state is possible, but unusual, increased
RBC count, increased hemoglobin & hematocrit
Overview of management of GI bleed Treatment is blood vessel coagulation for bleeding
from the stomach/duodenum, address the underlying pathophysiology; resection of the
small bowel, enteroscopy &/or laser therapy for angiodysplasia and irritable bowel
syndrome. Medical therapies include corticosteroids
,Pathogenesis of a peptic ulcer associated with NSAID - ANSWER NSAIDS damage
epithelial cells & decrease formation of mucus within the stomach
Discusses the pathogenesis of a peptic ulcer related to H. pylori - ANSWER H. pylori is a
bacteria that causes an infection producing ulcers, causes 70% of gastric, and 100% of
duodenal ulcers
Puts the steps in order: from ingestion of the H. pylori perforation and peritonitis -
ANSWER Ingest H. pylori, Urease f/ bacteria converts urea in stomach to ammonia &
CO2, bacteria is protected f/ acid pH, bacteria moves through mucus layer,
inflammation (peritonitis) of gastric cells, inflammation weakens epithelial lining, erosion
can occur (ulcer)
Describes diagnostic tests for H. pylori PUD - ANSWER Definitive diagnosis is
esophagogastroduodenoscopy and tissue test for H. pylori (rapid urease test, histology
test & tissue culture test), can also test for H. pylori with blood test, stool test (tests for
Ag), & urea breath test
Describes the CLASS ACT for persons with suspected PUD - ANSWER Character:
gnawing stomach pain
Location: epigastric
Aggravating: empty stomach
Associated S/S: nausea
Timing/ Tx: comes & goes, often occurs several hours after meals & at night when
stomach is empty, may be relieved by food or antacid therapy
Recognizes treatment measure for PUD depends on the etiology - ANSWER Treat H.
pylori w/ antibiotics, neutralize HCl & reduce HCl formation (proton pump inhibitors:
Prilosec), H2 blockers (histamine receptor blockers)
, Identifies the definitive treatment for PUD related to H. pylori - ANSWER Antibiotics
Complications of PUD- ANSWER hemorrhage, perforations and gastric outlet
obstruction
Findings compatible with the diagnosis of PUD - ANSWER presence of ulcer and positive
for H. pylori if it is the cause
pyloric obstruction This is caused by edema, spasm, or contraction of scar tissue and
interference with the free passage of gastric contents through the pylorus or adjacent
areas. Symptoms include early satiety, feeling of epigastric fullness and heaviness after
meals, gastroesophageal reflux, weight loss, and abdominal pain. With severe
obstructions there is vomiting of undigested foods.
perforation and peritonitis ANSWER Perforation occurs when an ulcer erodes through
all of the layers of the stomach or duodenum wall. About 5% of people with PUD get this.
With perforation, gastric contents enter the peritoneum and causes peritonitis. The pain
will radiate into the back, severe night distress and inadequate pain relief from eating
foods or taking antacids.
Lists signs and symptoms and explains rationale of complications ANSWER S/S:
abdominal pain, rigid, tender abdomen.
The upper GI is exposed to acid-pepsin. These ulcers can affect one or all layers of the
stomach and duodenum. The ulcer may penetrate only the mucosal surface or it may
extend into the smooth muscle layers. On occasion the ulcer can penetrate the outer
wall of the stomach or duodenum. Healing involves replacement with scar tissues.
Pyloric sphincter-inflammation, fibrosis and scarring can lead to bloating, vomiting,
weight loss.
hemorrhage - ANSWER Hemorrhage is caused by bleeding from granulation tissue or
from erosion of an ulcer into the artery or vein. 20% of individuals with PUD have
hemorrhage. Bleeding may be sudden, severe and without warning. Evidence of
bleeding may consist of hematemesis or melena. Acute hemorrhage is manifested by
