NUR 2063 / NUR2063: Essentials of Pathophysiology Exam 2
m m m m m m m m
(Latest ) m m m
Know m them Etiology, m Signs/Symptoms, m Diagnosis/Diagnostics, m Clinicalm Manifestation, m
Risks, mTreatmentm and m Complicationsmfor mthe mfollowing:
▪ Gastritis
Gastritism– minflamm ation mofm them stom achmli ning
Acute m Gastriti sm–
m(justmacquired) mi ngestionm ofmtoxins, m alcohol, maspirin mor m other mirritati ng m
substances
Chronic- m2mmonthsmtombecomemchronic
TriggersmofmGastritis: mAlcohol, mcaffeine, mautoimm unemdisease, mviral mormbacteriamChro
nicmGastritis: mH mPylori mismalwaysmam factor
Hm Pylori m goesm verym deepm inm them lining m ofm them stom achm andm Itm causesm persistentm i nflam mati on
S/S: mN/Vm– mAnorexia- m postcrani al m discom fort
PostmCranialmDiscomfort- maftermeating- mgoesmawaymandmcomembackm1-
2mhrsmGastritis- mhematemesis- mbloodminmthemvomit-
mcoffeembrownmcolor mTreatm ent: mTreatmH mpylori mtreatmGERD, mchangemlifestyl
e, mPPI
▪ PepticmUlcermDisease
Inflammationm andm ulcerationmi nmthem stom ach m(aci dm and m pepsin) mGa
stric: mstomachm location
Duodenal: mm duodenalmmlocationm P
UDmismamcomplicati onm ofm Gastritis
PUDm ism caused m bym aspi rin, m Hm pylori, m m Nsaids, m m Stress, m m Smoking
mS/S m GastricmN/V m Anorexia m Chestm discom fort, m asym ptotic, m Dyspeps
ia
Duodenalm– mnormalmweight
Biggestmcomplicationmof mPUD- mGImbleeding mduemtomUlcermperforation-
mholeminmthemlining mandm bleed
Itmismlife-
threatening mi fmitmkeepmbleeding m(Anemi c, melectrolytesmimbalancem(losi ng mvolum e) mDuodenalm–
mBloodminmthem stool m– mblack mandmtarry
Bleeding mprofusely-
frank mwithm cloth mHem atem esis-
m Bleeding m in m vomiting
Treatment: m Corterym ofm perforation, m treatmentm ofm H. m pylori, m PPI, m Cessationm ofm smoking
▪ Ulcerative m Coliti sm andm Crohn’sm themdifference mmi nmthem mcomplicationsm Com pli ca
tionminmUCmMalnutritionm– m dehydration, mincreasedm risk m factormofm colonm cancerm7-
10myrs, mrarelyminmm egacolon
Complicationm ofmChron- m Fistulas, m perianalm fissures, m abscesses. mThemrisk m ofm colorectal m cancer
▪ Bowelm Obstructionm Manifestations
Obstructionsminm them jejunalm area: m Vomiting, m dehydration, m electrolytem depletionm Obstructi
onsmofmthem distalm portionm ofmthemsmallm bowlm ormi leum, m dehydrati on mtom hypovolemic mschock
Obstructionsm ofm them colon: m Massi vem gasm distenti on
Blockagemof mthem colonm bym a mtum ormis mthem most m comm onm causem ofm coloni cm obstructi onm and mpe
rforationmofmthem bowelm wallmadjacentmtomthemtumor.
▪ Whatmpercentagemof mthe mpancreas mis mdedicatedmto mendocrine mfunctions?
Onlym5%
▪ PancreaticmCancer
PancreaticmCancerm– m2%mofmallmcancers
, NUR 2063 / NUR2063: Essentials of Pathophysiology Exam 2
m m m m m m m m
(Latest ) m m m
Rankedm 4 m among m deathm inm allm malignancie
th
smRiskmFactors; mcigarettemsmoking, mobesity
S/S; mhead: mJaundi ce, mm alabsorption, m weight mloss tail: mAbdmpai n, mnausea’
, NUR 2063 / NUR2063: Essentials of Pathophysiology Exam 2
m m m m m m m m
(Latest ) m m m
▪ HepaticmEncephalopathy mis mdue mto?
Hepaticmencephalopathymism am decli nemin m brai nm functionm duemtom severe mli verm disease
, NUR 2063 / NUR2063: Essentials of Pathophysiology Exam 2
m m m m m m m m
(Latest ) m m m
Hepaticmencephalopathymism usuallym preci pitatedm bym certai nm well-
definedm clini calm developm ents, mincluding m hypokalemi a, mhyponatremia, m alkalosis, m hypoxia, mhyperca
rbia, minfection, m usem ofmsedati ves, m GIm hem orrhage, m protein mm ealmgorgi ng, mrenalm failure, mandm consti p
ation. mInmsom emm patients, m progressi vemli vermfailurem leadsmtom chroni cm encephalopathym withoutmotherm
exacerbati ng m factors.
Hepaticm encephalopathym ismgradedm 1m to m4:
• Gradem1: mConfusion, m subtle m behavioralm changes, m nom flap
• Gradem2: mDrowsy, m clearm behavi oral m changes, m flapm present
• Gradem3: mStuporousm butm can m followm com mands, mmarkedm confusion, mslurredm speech, m fla
pmpresent
• Gradem4: mCom a, m nom flap
▪ Gastroesophageal mVarices mManagement
- Initialmtreatm ent: mFluidmresuscitationmtomstop mbleeding mLar
- gemboremintravenousmli nesmarem placed
- Adminmofmparenteralm vitaminm Kmandm plasm a, m plateletmi nfusionmi fmthrom bocytopeni a
m ism
present
- Octreotidem acetatem (syntheti cm analog) m no mm orem vasopressi nm 3-
- 5m daysmMetocloprami demandmB m blockers
- EsophagogastroduodenoscopymEGDmtomdeterminemsitemofmbleeding
▪ DifferencembetweenmDiverticulosismand mDiverticulitis
Diverticulosism(diverticular m disease) m presencemofm diverticulami nmthemcolon.
Diverticulam arem acquiredm herniati onsm ofm them m ucosam andm submucosam throughm them m uscularm coa
tmofmthemcolon
Diverticulosism Them presence mofm one mor mm orem diverticulam vsm diverticulitismi nflam mati onmofm onemor
moremdiverti cula
m
▪ KidneymDisease- mAssessment- CVA
Painmassociatedm with mintrarenalm disordersm arem assessedm bym palpating m or mlight m percussionm ove
rmthemcostovertebralmanglem(CVA) m posteriorly mandmismrecordedmasmCVAm tenderness. m Painmis mtran
smittedmtomthemspi nalm cordm betweenmT10mandmL1
▪ KidneymCancer msigns mand msymptoms
Benignmrenalm neoplasm: m S/S m Hematuriam and m flank m pai nmSo
memmaymbemasym ptomaticm unti lm large
Renalmcellm carcinom a: mMetastati cm disease
Risk m factors: m sm oki ng, m obesitym andm hypertension m
S/SmCVAmtenderness, m hem aturia, m palpablem mass
▪ Dialysis- mBenefits mand mRisks
▪ Filtermbloodmand mri dmthemwaistm
Dialysismismthem onlymtherapeutic moptionm form thosem withm ESRDm unablemtom obtain mtransplantm
Eachmtreatmentmofm dialysi smremovemaboutm 2/3mofmthemtotalm bodym uream content
Dialysismmaintainmvolumemstatus
Preventm andm treatmaci d-
basemandm electrolytem disturbancesmPreventm andm treatmuremi
a
Supportm nutritionalmneeds.
mPreventmandmtreatminfecti o
nmOreventm andmtreatm anemi
amImprovem qualitymofm life
Lowermmortaltym andmm orbidity mrate
m m m m m m m m
(Latest ) m m m
Know m them Etiology, m Signs/Symptoms, m Diagnosis/Diagnostics, m Clinicalm Manifestation, m
Risks, mTreatmentm and m Complicationsmfor mthe mfollowing:
▪ Gastritis
Gastritism– minflamm ation mofm them stom achmli ning
Acute m Gastriti sm–
m(justmacquired) mi ngestionm ofmtoxins, m alcohol, maspirin mor m other mirritati ng m
substances
Chronic- m2mmonthsmtombecomemchronic
TriggersmofmGastritis: mAlcohol, mcaffeine, mautoimm unemdisease, mviral mormbacteriamChro
nicmGastritis: mH mPylori mismalwaysmam factor
Hm Pylori m goesm verym deepm inm them lining m ofm them stom achm andm Itm causesm persistentm i nflam mati on
S/S: mN/Vm– mAnorexia- m postcrani al m discom fort
PostmCranialmDiscomfort- maftermeating- mgoesmawaymandmcomembackm1-
2mhrsmGastritis- mhematemesis- mbloodminmthemvomit-
mcoffeembrownmcolor mTreatm ent: mTreatmH mpylori mtreatmGERD, mchangemlifestyl
e, mPPI
▪ PepticmUlcermDisease
Inflammationm andm ulcerationmi nmthem stom ach m(aci dm and m pepsin) mGa
stric: mstomachm location
Duodenal: mm duodenalmmlocationm P
UDmismamcomplicati onm ofm Gastritis
PUDm ism caused m bym aspi rin, m Hm pylori, m m Nsaids, m m Stress, m m Smoking
mS/S m GastricmN/V m Anorexia m Chestm discom fort, m asym ptotic, m Dyspeps
ia
Duodenalm– mnormalmweight
Biggestmcomplicationmof mPUD- mGImbleeding mduemtomUlcermperforation-
mholeminmthemlining mandm bleed
Itmismlife-
threatening mi fmitmkeepmbleeding m(Anemi c, melectrolytesmimbalancem(losi ng mvolum e) mDuodenalm–
mBloodminmthem stool m– mblack mandmtarry
Bleeding mprofusely-
frank mwithm cloth mHem atem esis-
m Bleeding m in m vomiting
Treatment: m Corterym ofm perforation, m treatmentm ofm H. m pylori, m PPI, m Cessationm ofm smoking
▪ Ulcerative m Coliti sm andm Crohn’sm themdifference mmi nmthem mcomplicationsm Com pli ca
tionminmUCmMalnutritionm– m dehydration, mincreasedm risk m factormofm colonm cancerm7-
10myrs, mrarelyminmm egacolon
Complicationm ofmChron- m Fistulas, m perianalm fissures, m abscesses. mThemrisk m ofm colorectal m cancer
▪ Bowelm Obstructionm Manifestations
Obstructionsminm them jejunalm area: m Vomiting, m dehydration, m electrolytem depletionm Obstructi
onsmofmthem distalm portionm ofmthemsmallm bowlm ormi leum, m dehydrati on mtom hypovolemic mschock
Obstructionsm ofm them colon: m Massi vem gasm distenti on
Blockagemof mthem colonm bym a mtum ormis mthem most m comm onm causem ofm coloni cm obstructi onm and mpe
rforationmofmthem bowelm wallmadjacentmtomthemtumor.
▪ Whatmpercentagemof mthe mpancreas mis mdedicatedmto mendocrine mfunctions?
Onlym5%
▪ PancreaticmCancer
PancreaticmCancerm– m2%mofmallmcancers
, NUR 2063 / NUR2063: Essentials of Pathophysiology Exam 2
m m m m m m m m
(Latest ) m m m
Rankedm 4 m among m deathm inm allm malignancie
th
smRiskmFactors; mcigarettemsmoking, mobesity
S/S; mhead: mJaundi ce, mm alabsorption, m weight mloss tail: mAbdmpai n, mnausea’
, NUR 2063 / NUR2063: Essentials of Pathophysiology Exam 2
m m m m m m m m
(Latest ) m m m
▪ HepaticmEncephalopathy mis mdue mto?
Hepaticmencephalopathymism am decli nemin m brai nm functionm duemtom severe mli verm disease
, NUR 2063 / NUR2063: Essentials of Pathophysiology Exam 2
m m m m m m m m
(Latest ) m m m
Hepaticmencephalopathymism usuallym preci pitatedm bym certai nm well-
definedm clini calm developm ents, mincluding m hypokalemi a, mhyponatremia, m alkalosis, m hypoxia, mhyperca
rbia, minfection, m usem ofmsedati ves, m GIm hem orrhage, m protein mm ealmgorgi ng, mrenalm failure, mandm consti p
ation. mInmsom emm patients, m progressi vemli vermfailurem leadsmtom chroni cm encephalopathym withoutmotherm
exacerbati ng m factors.
Hepaticm encephalopathym ismgradedm 1m to m4:
• Gradem1: mConfusion, m subtle m behavioralm changes, m nom flap
• Gradem2: mDrowsy, m clearm behavi oral m changes, m flapm present
• Gradem3: mStuporousm butm can m followm com mands, mmarkedm confusion, mslurredm speech, m fla
pmpresent
• Gradem4: mCom a, m nom flap
▪ Gastroesophageal mVarices mManagement
- Initialmtreatm ent: mFluidmresuscitationmtomstop mbleeding mLar
- gemboremintravenousmli nesmarem placed
- Adminmofmparenteralm vitaminm Kmandm plasm a, m plateletmi nfusionmi fmthrom bocytopeni a
m ism
present
- Octreotidem acetatem (syntheti cm analog) m no mm orem vasopressi nm 3-
- 5m daysmMetocloprami demandmB m blockers
- EsophagogastroduodenoscopymEGDmtomdeterminemsitemofmbleeding
▪ DifferencembetweenmDiverticulosismand mDiverticulitis
Diverticulosism(diverticular m disease) m presencemofm diverticulami nmthemcolon.
Diverticulam arem acquiredm herniati onsm ofm them m ucosam andm submucosam throughm them m uscularm coa
tmofmthemcolon
Diverticulosism Them presence mofm one mor mm orem diverticulam vsm diverticulitismi nflam mati onmofm onemor
moremdiverti cula
m
▪ KidneymDisease- mAssessment- CVA
Painmassociatedm with mintrarenalm disordersm arem assessedm bym palpating m or mlight m percussionm ove
rmthemcostovertebralmanglem(CVA) m posteriorly mandmismrecordedmasmCVAm tenderness. m Painmis mtran
smittedmtomthemspi nalm cordm betweenmT10mandmL1
▪ KidneymCancer msigns mand msymptoms
Benignmrenalm neoplasm: m S/S m Hematuriam and m flank m pai nmSo
memmaymbemasym ptomaticm unti lm large
Renalmcellm carcinom a: mMetastati cm disease
Risk m factors: m sm oki ng, m obesitym andm hypertension m
S/SmCVAmtenderness, m hem aturia, m palpablem mass
▪ Dialysis- mBenefits mand mRisks
▪ Filtermbloodmand mri dmthemwaistm
Dialysismismthem onlymtherapeutic moptionm form thosem withm ESRDm unablemtom obtain mtransplantm
Eachmtreatmentmofm dialysi smremovemaboutm 2/3mofmthemtotalm bodym uream content
Dialysismmaintainmvolumemstatus
Preventm andm treatmaci d-
basemandm electrolytem disturbancesmPreventm andm treatmuremi
a
Supportm nutritionalmneeds.
mPreventmandmtreatminfecti o
nmOreventm andmtreatm anemi
amImprovem qualitymofm life
Lowermmortaltym andmm orbidity mrate
