NR507 Final Exam Study Guide Week 5-8 Graded A+

NR507 – Advanced Pathophysiology Exam Study Guide – Final Study Guide Exam Format: Cumulative Question Type: Multiple Choice Number of Questions: 100 Time Allotted: 120 minutes Testing Timeframe: The final exam will only be available starting on Wednesday Week 8 at 12:01 am MT until Saturday Week 8 at 11:59 pm MT. 1. Exam Coverage Content Areas: • Week 5: Gastrointestinal and Neurobiological Pathologies • Week 6: Endocrine Pathologies • Week 7: CNS Sensory and Motor Pathologies • Week 8: Brain and Dermatological Pathologies 2. Key Concepts to Study Gastrointestinal pathologies: • Pathophysiology of GERD involves several mechanisms that allow the contents of the stomach especially acid and digestive enzymes like pepsin) to reflux into the esophagus leading to mucosal injury and symptoms like heartburn and regurgitation. • Signs and symptoms of GERD Heartburn Burning sensation in the chest (retrosternal) Often worse after meals or when lying down Improves with antacids Regurgitation Sour or bitter-tasting fluid in the throat or mouth Especially when bending over or lying flat Dysphagia (difficulty swallowing) May indicate esophageal inflammation or stricture formation Chest pain Non-cardiac in nature Burning or squeezing, often mistaken for angina Atypical s/s Chronic cough Hoarseness or voice changes Sore throat or frequent throat clearing Asthma-like symptoms or worsening of asthma Laryngitis Dental erosion (due to acid exposure) Globus sensation (feeling of a lump in the throat) • Pharmacologic management of GERD PPI – 1st Line -omeprazole Inhibit H⁺/K⁺-ATPase in gastric parietal cells → suppress gastric acid secretion. Taken 30–60 min before meals (best before breakfast) Superior to H2 blockers for healing erosive esophagitis Typically used for 4–8 weeks; long-term use if symptoms persist or in severe cases H2 Receptor Agonists – famotidine Block H2 receptors on parietal cells → ↓ acid secretion For mild or intermittent symptoms Less effective than PPIs for healing esophagitis Can be used at bedtime for nocturnal symptoms (often in combination with daytime PPI) Antacids Neutralizes gastric acid -Calcium carbonate (tums) Short acting Alginates (gavison) use with antacids Forms gel raft – helps prevent reflux Prokinetic Agents Increases tone and improves gastric emptying Used with PPIs in some cases • Risk factors for esophageal stricture Chronic GERD (most common) Esophagitis Esophageal surgery or radiation Ingestion of corrosive substances -caustic ingestion – alkali and acid burns Prolonged NG tube Hiatal hernia Medications -pill induced esophagitis (potassium chloride, NSAIDs) Smoking and alcohol • Hiatal hernia treatment depends on the type, severity of symptoms, and the presence of complications sliding hernia most common stomach and JE junction slide into esophagus commonly associated with GERD