NR507 – Advanced Pathophysiology – Chamberlain University – Final
Exam Study Notes with Correct Answers
Generalized tonic-clonic seizures: - correct answer -wide-spread and uncontrolled neuron
activity in the entire cerebral cortex
-occur in 10% of patients who have epilepsy
-excessive neuronal discharge in the motor nerves through the brain.
Generalized tonic seizures: - correct answer this seizure is characterized by unconsciousness
and muscle rigidity.
Post-ictal phase - correct answer (lasts one to two hours): characterized by confusion,
unresponsiveness and muscle flaccidity.
-Following the post-ictal state, there will be a return to normal state of consciousness
Clonic phase - correct answer (lasts one minute): continuous discharge of neurons gets
interrupted.
-characterized by small durations of relaxation, occur because of inhibitory mechanisms of the
brain to try to control the wide-spread neuronal activity
-patient will exhibit spasms and jerking, perceived as violent shaking of muscles.
Generalized clonic seizures: - correct answer this seizure is characterized by muscle spasms.
Generalized absence seizure: - correct answer -common in children
-caused by a genetic abnormality
-characterized by sudden and brief loss of consciousness without muscle tone
-last for only a few seconds
-no associated post-ictal confusion.
Wide variety of options available, is based on needs of the patient - correct answer
Anticonvulsants
Removes the cause of the seizure - correct answer Surgery
Ketogenic diet - correct answer Produces energy other than glucose to be used by the brain
Nerve stimulation - correct answer Controls the seizure by influencing neurotransmitter release
,An individual having a focal seizure without dyscognitive features will _______ - correct answer
have no impairment of consciousness
Febrile seizures most often ___________ medication as they ___________. - correct answer do
not need, resolve on their own.
Tonic-clonic phase results in: - correct answer 1. The muscles of the body become contracted.
without any relaxation.
2. Loss of consciousness.
3. Ictal cry. This is a typical sound produced by the tonic contractions of the laryngeal muscles
and muscles of expiration.
4. Respiratory impairment that results in cyanosis.
5. Tonic contraction of the jaw muscles that can cause tongue biting.
6. Increased sympathetic activity. This will cause increased heart rate and blood pressure
Tonic-clonic phase lasts __________ - correct answer 10-20 seconds
Tonic-clonic phase is due to __________________ - correct answer the excessive discharge of
neurons in the motor nerves
Underlying cause of BPH - correct answer 5delta-reductace activity increases with age
-increases dihydrotestosterone levels
-normal prostate cells respond to the increase in dihydrotestosterone levels by living longer and
multiplying
acute kidney injury/acute renal failure - correct answer sudden loss of kidney function
Reversible
S/S:
-oliguria (<30mL/hr)
-increased BUN & creatinine
-fluid & electrolyte abnormalities
Prerenal - correct answer Most common type of Acute Renal Failure
Sudden & severe drop in BP (shock) or interruption of blood flow to the kidneys from severe
injury or illness
-causes: hypotension, decreased CO, decreased blood volume
,Intrarenal (intrinsic) - correct answer Direct damage to the kidneys by inflammation, toxins,
drugs, infection, or decreased blood supply.
-Causes: acute tubular necrosis (ATN), acute glomerulonephritis, and other glomerulopathies
Postrenal - correct answer Sudden obstruction of urine flow due to enlarged prostate, kidney
stones, bladder tumors, or injury.
Prerenal labs - correct answer -increased creatinine
-increased BUN
-increased BUN/creatinine ratio 20:1
-concentrated urine (high osmolarity)
Intrinsic renal failure labs - correct answer -increased creatining
-increased BUN
-BUN/creatinine ratio <15:1
-dilute urine
Best way to differentiate between prerenal and intrinsic renal failure - correct answer
BUN/creatinine ratio
Most common damage to the kidneys in intrinsic (intrinsic) renal disease is ___________ -
correct answer tubular (85%)
others are:
glomerular (5%)
interstitial (8%)
vascular (<2%)
Chronic Kidney Disease (CKD) - correct answer Progressive loss of renal function that can
develop as a complication of unresolved AKI or systemic diseases, including HTN, DM (most
significant risk factor), SLE or intrinsic kidney disease.
Risk factor for development of UTI - correct answer Pregnancy
Help prevent a UTI - correct answer Increase water consumption
Complicated UTI can be caused by ____ - correct answer a structural urinary tract disorder
a symptom of a lower urinary tract infection - correct answer urgency
UTI's are more common for ______ - correct answer women, especially when:
, -sexually active
-pregnant
-during post-menopause with estrogen deficiency
-being treated with antibiotics (normal flora diminished)
Lower UTI - correct answer Cystitis
Lower UTI s/s - correct answer urgency
burning
frequency
dysuria
suprapubic pain
cloudy urine
odorous urine
acute pyelonephritis - correct answer Upper UTI
•Specific diagnosis is established by:
-Urine culture
-Urinalysis (WBC casts indicates pyelonephritis, but may not always be present)
-Complicated pyelonephritis requires blood cultures and urinary tract imaging
Upper UTI s/s - correct answer symptoms associated with cystitis
fever
flank pain
costovertebral angle (CVA) tenderness
N&V
malaise
signs of shock if infection entered circulation
classic triad (vomiting, flank pain, fever)
pyelonephritis classic triad - correct answer vomiting, flank pain, fever
Urine sample to determine lower vs. upper UTI - correct answer Lower (cystitis)
Exam Study Notes with Correct Answers
Generalized tonic-clonic seizures: - correct answer -wide-spread and uncontrolled neuron
activity in the entire cerebral cortex
-occur in 10% of patients who have epilepsy
-excessive neuronal discharge in the motor nerves through the brain.
Generalized tonic seizures: - correct answer this seizure is characterized by unconsciousness
and muscle rigidity.
Post-ictal phase - correct answer (lasts one to two hours): characterized by confusion,
unresponsiveness and muscle flaccidity.
-Following the post-ictal state, there will be a return to normal state of consciousness
Clonic phase - correct answer (lasts one minute): continuous discharge of neurons gets
interrupted.
-characterized by small durations of relaxation, occur because of inhibitory mechanisms of the
brain to try to control the wide-spread neuronal activity
-patient will exhibit spasms and jerking, perceived as violent shaking of muscles.
Generalized clonic seizures: - correct answer this seizure is characterized by muscle spasms.
Generalized absence seizure: - correct answer -common in children
-caused by a genetic abnormality
-characterized by sudden and brief loss of consciousness without muscle tone
-last for only a few seconds
-no associated post-ictal confusion.
Wide variety of options available, is based on needs of the patient - correct answer
Anticonvulsants
Removes the cause of the seizure - correct answer Surgery
Ketogenic diet - correct answer Produces energy other than glucose to be used by the brain
Nerve stimulation - correct answer Controls the seizure by influencing neurotransmitter release
,An individual having a focal seizure without dyscognitive features will _______ - correct answer
have no impairment of consciousness
Febrile seizures most often ___________ medication as they ___________. - correct answer do
not need, resolve on their own.
Tonic-clonic phase results in: - correct answer 1. The muscles of the body become contracted.
without any relaxation.
2. Loss of consciousness.
3. Ictal cry. This is a typical sound produced by the tonic contractions of the laryngeal muscles
and muscles of expiration.
4. Respiratory impairment that results in cyanosis.
5. Tonic contraction of the jaw muscles that can cause tongue biting.
6. Increased sympathetic activity. This will cause increased heart rate and blood pressure
Tonic-clonic phase lasts __________ - correct answer 10-20 seconds
Tonic-clonic phase is due to __________________ - correct answer the excessive discharge of
neurons in the motor nerves
Underlying cause of BPH - correct answer 5delta-reductace activity increases with age
-increases dihydrotestosterone levels
-normal prostate cells respond to the increase in dihydrotestosterone levels by living longer and
multiplying
acute kidney injury/acute renal failure - correct answer sudden loss of kidney function
Reversible
S/S:
-oliguria (<30mL/hr)
-increased BUN & creatinine
-fluid & electrolyte abnormalities
Prerenal - correct answer Most common type of Acute Renal Failure
Sudden & severe drop in BP (shock) or interruption of blood flow to the kidneys from severe
injury or illness
-causes: hypotension, decreased CO, decreased blood volume
,Intrarenal (intrinsic) - correct answer Direct damage to the kidneys by inflammation, toxins,
drugs, infection, or decreased blood supply.
-Causes: acute tubular necrosis (ATN), acute glomerulonephritis, and other glomerulopathies
Postrenal - correct answer Sudden obstruction of urine flow due to enlarged prostate, kidney
stones, bladder tumors, or injury.
Prerenal labs - correct answer -increased creatinine
-increased BUN
-increased BUN/creatinine ratio 20:1
-concentrated urine (high osmolarity)
Intrinsic renal failure labs - correct answer -increased creatining
-increased BUN
-BUN/creatinine ratio <15:1
-dilute urine
Best way to differentiate between prerenal and intrinsic renal failure - correct answer
BUN/creatinine ratio
Most common damage to the kidneys in intrinsic (intrinsic) renal disease is ___________ -
correct answer tubular (85%)
others are:
glomerular (5%)
interstitial (8%)
vascular (<2%)
Chronic Kidney Disease (CKD) - correct answer Progressive loss of renal function that can
develop as a complication of unresolved AKI or systemic diseases, including HTN, DM (most
significant risk factor), SLE or intrinsic kidney disease.
Risk factor for development of UTI - correct answer Pregnancy
Help prevent a UTI - correct answer Increase water consumption
Complicated UTI can be caused by ____ - correct answer a structural urinary tract disorder
a symptom of a lower urinary tract infection - correct answer urgency
UTI's are more common for ______ - correct answer women, especially when:
, -sexually active
-pregnant
-during post-menopause with estrogen deficiency
-being treated with antibiotics (normal flora diminished)
Lower UTI - correct answer Cystitis
Lower UTI s/s - correct answer urgency
burning
frequency
dysuria
suprapubic pain
cloudy urine
odorous urine
acute pyelonephritis - correct answer Upper UTI
•Specific diagnosis is established by:
-Urine culture
-Urinalysis (WBC casts indicates pyelonephritis, but may not always be present)
-Complicated pyelonephritis requires blood cultures and urinary tract imaging
Upper UTI s/s - correct answer symptoms associated with cystitis
fever
flank pain
costovertebral angle (CVA) tenderness
N&V
malaise
signs of shock if infection entered circulation
classic triad (vomiting, flank pain, fever)
pyelonephritis classic triad - correct answer vomiting, flank pain, fever
Urine sample to determine lower vs. upper UTI - correct answer Lower (cystitis)
