(Test Bank) Pathophysiology For The Health Professions

Gould,Dyer, 4

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Test Bank

4th Edition

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Test Bank for Pathophysiology For The Health Professions, The downloadable file consists of 737 pages, and the total size of the file is 32.92 MB. Purchase now only for highly discounted price.

Author(s): Gould, Dyer

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Study Note Preview

HANDY TABLESIt may be noted that the normal values presented in various texts differ somewhat. Institutions publish a specific set of normal values to be used as a baseline reference by individuals using that laboratory. Always check the reported values against these norms. Blood Conventional Units SI Units Arterial Blood Gases Pao2 95–100 mm Hg Paco2 35–42 mm Hg pH 7.35–7.45 Bicarbonate (H co 3−) 22–26 mEq/L Base excess −2.4 to +2.3 mEq/L Arterial o2 saturation (Sa o2) 96%–98% CellsRed blood cells (erythrocytes, RB cs) 4.2–5.9 million (106)/mm34.2–5.9 × 1012/L Platelets (thrombocytes) 150,000–350,000/mm3150–350 × 109/L White blood cells (leukocytes, WB cs) 4500–10,500/mm34.5–10.5 × 109/L Differential Neutrophils (57%–70%) 2000–7500/mm3 Lymphocytes (20%–25%) 2000–4000/mm3 Eosinophils (2%–4%) 400–450/mm3 Monocytes (3%–8%) 500–1000/mm3 Basophils (0.5%–1%) 40–100/mm3 Hemoglobin Male 13.5–18 g/100 mL (135–180 g/L) 8.1–11.2 mmol/L Female 12–16 g/100 mL (120–160 g/L) 7.4–9.9 mmol/L Reticulocytes 0.5%–2.5% erythrocytes Hematocrit Male 45%–52% 0.45–0.52 Female 37%–48% 0.37–0.48 Erythrocyte sedimentation rate (ESR) Male 1–13 mm/hr Female 1–20 mm/hr Red cell volume 25–35 mL/kg body weight Mean corpuscular volume 86–98 µm3 ElectrolytesSodium (Na +) 135–142 mEq/L 135–142 mmol/L Potassium (K+) 3.8–5 mEq/L 3.8–5 mmol/L calcium ( ca2+) 4–5 mEq/L 2–2.6 mmol/L Magnesium (Mg2+) 3 mEq/L 1.25–1.75 mmol/L chloride ( cl−) 95–102 mEq/L 95–102 mmol/L NutrientsAmino acids (total) 35–65 mg/dL 1.5–2.5 mmol/L Glucose (fasting) 70–110 mg/dL 3.9–5.6 mmol/L Iron (total) 60–150 µg/dL 11–27 µmol/L Lipids (total) 400–800 mg/dL 4–8 g/L cholesterol 150–250 mg/dL 4–6.5 mmol/L HDL >40 mg/dL LDL <180 mg/dL Fatty acids (total) 8–20 mg/dL 0.08–0.2 g/L Triglycerides 75–160 mg/dL 0.85–1.9 mmol/L Phospholipids 150–380 mg/dL 1.5–3.8 g/L Vitamin B 12 150–900 pg/ mL 150–670 pmol/L ProteinsAlbumin 3.2–4.5 g/dL 32–45 g/L Fibrinogen 200–400 mg/dL 2–4 g/L Immunoglobulins 0.5–1.5 g/dL 5–16 g/L IgG 640–1350 mg/100 mL 6.4–13.5 g/L IgM 85–350 mg/100 mL 0.8–3.5 g/L IgA 70–300 mg/100 mL 0.7–3 g/L IgE 3–150 mg/100 mL 0.03–1.5 g/L IgD 0–8 mg/100 mL 0 HormonesAdrenocorticotropin (A cTH) 15–70 pg/ mL 3.3–15.4 pmol/L cortisol 8 AM 5–25µg/100 mL 0.14–0.69 µmol/L 8 PM <10µg/100 mL 0–0.28 µmol/L Triiodothyr onine (T 3) 75–95 ng/100 mL 1.16–3 nmol/L WastesBilirubin (direct) maximum 0.3 mg/dL 5 µmol/L Bilirubin (indirect) 0.1–1.0 mg/dL 1.7–17 µmol/L creatinine 0.6–1.2 mg/dL 53–105 µmol/L Nonprotein nitrogen 20–35 mg/dL 14.3–25 mmol/L Urea nitr ogen 8–22 mg/dL 2.9–8 mmol/L Uric acid 2–6 mg/dL 0.12–0.36 mmol/LUrine pH 4.5–8 (av. 6) Sodium 75–200 mg/24 hr Potassium 25–100 mEq/L Ammonia 20–70 mEq/L creatinine 1–2 g/24 hr Urea 25–35 g/24 hr Uric acid 0.6–1 g/24 hr Glucose 0 Protein 0–150 mg/24 hr (trace) Acetone 0 Bilirubin 0 Hemoglobin/cells 0 casts 0 Bacteria <10,000/ mL Appearance clear, pale yellowCerebrospinal Fluid (CSF) Appearance clear, colorless Pressure 70–180 mm H 2o Albumin 11–48 mg/100 mL Glucose 50–75 mg/100 mL cells occasional WB c Bilirubin 0 Blood Clotting Times Bleeding time 4–8 minutes Duke: earlobe 1–3 minutes clotting time 5–15 minutes (Lee White, room temperature) INR Values vary with lab technology and with anticoagulation therapy Prothrombin time 11–16 seconds Prothrombin/International normalized ratio (PT/INR)1.5–2.5 seconds Activated partial thromboplastin time (APTT)25–38 seconds clot retraction time begins in 30–60 minutes 50% complete in 2 hours Blood Coagulation Factors Factor Name Information I Fibrinogen Plasma protein synthesized in liver: forms fibrin II Prothrombin Plasma protein synthesized in liver (vitamin K required): forms thrombin III Tissue thromboplastin Released from damaged tissue (extrinsic pathway) and platelets (intrinsic pathway); phospholipid involved in activation of clotting process IV calcium ions Requir ed for many stages of coagulation process V and VI Proaccelerin; labile factor or accelerator globulin Synthesized in liver: used in prothrombin activation VII Proconvertin; serum prothrombin conversion accelerator (SP cA)Synthesized in liver (vitamin K required); used in extrinsic pathway VIII Antihemophilic factor (AHF) Deficit causes hemophilia A IX Plasma thromboplastin component (PT c), christmas factor , antihemophilic factor BSynthesized in liver (vitamin K required) X Stuart factor Synthesized in liver (vitamin K required); required for both extrinsic and intrinsic pathways XI Plasma thromboplastin antecedent (PTA), antihemophilic factor cSynthesized in liver; used for activation of intrinsic pathway XII Hageman factor Required in activation of intrinsic pathway XIII Fibrin stabilizing factor (FSF) From platelets—cross-links fibrin to stabilize clot pH Scale Pancreatic secretion pH 8.0 Bile pH 7.6–8.6 Blood pH 7.35–7.45 Saliva pH 6–7.4 (av. 6.9) Urine pH 5–8 (av. 6) Gastric fluids pH 2More alkaline (basic) 7-Neutral14 0Fewer hydrogen ions More acidicMore hydrogen ionsSerum Enzymes and Isoenzymes and Markers Alanine aminotransferase (ALT, formerly SGPT)Elevated in damage to liver, heart, muscle, pancreas, kidneys Prostatic acid phosphatase (PAP) Elevated with metastatic prostatic cancer Alkaline phosphatase (ALP) Elevated in bone disease, liver damage Aspartate aminotransferase (AST, formerly SG oT)Elevated in damage to liver, heart, and muscle c-reactive protein Elevated with inflammation cardiac specific troponin Elevated in myocardial infarction creatine kinase ( cK, formerly cPK) Elevated with heart and skeletal muscle damage cK MB 2 (isoenzyme) Elevated with MI Gamma-glutamyl-transferase (GGT) Elevated with liver damage due to alcohol Lactate dehydrogenase (LDH) Elevated with liver, heart, kidney, lung damage LDH 1 and LDH 2 (isoenzymes) Elevated with MI Alpha-fetoprotein (AFP) A marker for some ovarian tumors, some liver tumors carcinoembryonic antigen ( cEA) A marker for intestinal tumors Prostate-specific antigen (PSA) A marker for recurrent prostatic cancerHANDY TABLESREGISTER TODAY! Evolve Resources for Gould and Dyer: Pathophysiology for the Health Professions, 4th Edition, offers the following features: Challenge Assignments Quickie Timed TestsTest BankCase StudiesAdditional ExercisesAnswer Key to Study QuestionsHerbal RemediesAdditional DisordersMaster GlossaryReady ReferencesWeblinksContent UpdatesTo access your Student Resources, visit: http://evolve.elsevier.com/Gould/pathophysiology/Barbara E. Gould, MEd Professor Emerita School of Health SciencesSeneca college of Applied Arts and Technology Toronto, ontario, canada Ruthanna Dyer, PhD Assistant ProfessorFaculty of Science and EngineeringYork UniversityToronto, ontario, canada 3251 Riverport Lane St. Louis, Missouri 63043 PATHOPHYSIOLOGY FOR THE HEALTH PROFESSIONS, FOURTH EDITION ISBN: 978-1-4377-0965-0 Copyright © 2011, 2006, 2002, 1997 by Saunders, an imprint of Elsevier Inc. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary.Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility.With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions.To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. ISBN-13: 978-1-4377-0965-0 Publisher: Jeanne Olson Managing Editor: Billie SharpDevelopmental Editor: Melissa K. BoylePublishing Services Manager: Julie EddyProject Manager: Marquita ParkerDesign Direction: Paula Catalano Printed in Canada Last digit is the print number: 9 8 7 6 5 4 3 2 1 W orking together to grow libraries in developing countries www.elsevier.com | www.bookaid.org | www.sabre.org To my family with my thanks for the love and inspiration you give me. B.E.G. To my first teacher, Naomi, with fond remembrance and to my family: my thanks and appreciation for your support. R.A.D. To all who have contributed in some way to this work: students, colleagues, friends, extended family, and health care providers, with appreciation.This page intentionally left blankviiRenee Becker, AAS certified Medical Transcriptionist Exact-Med/UTT c Transcription Training Program Direct ND career & Tech Ed Teacher certification Program Director Exact-Med/United Tribes Transcription Training Bismark, North Dakota Elizabeth A. Berro, MA, RN, PNP clinical Instr uctor BS Nurse Education Lienhard School of NursingPace UniversityPleasantville, New York Roslyn L. Chester, BA, MS, RDH Allied Health and Human Services DepartmentBaltimore city community college Baltimore, Maryland Julie A. Evancho, RNC, CWS, LNHATeaching AssistantRobert T. White LPN SchoolAlliance city Schools Alliance, ohio Kim Garrett, MS, RN, APRN-ACNP, CCRN Assistant ProfessorAdult Health and Gerontological NursingRush University college of Health Sciences chicago, Illinois Education and Infection control Director Ely Bommenson community Hospital & Nursing Home Ely, Minnesota Krishna Head, MHS, CRADC certified Recipr ocal Alcohol and Drug counselor TASc, Inc. chicago, Illinois Nixie Hnetkovsky, BS, MS Instructor Life Science DepartmentFrontier community college Fairfield, Illinois Reviewers Linda Kimble, RN, MSN, CNPHealth Educator/ consultant curriculum Development consultant East canton, ohio Aaron K. Koseki, PhD, RRT chair and Professor Health Sciences DepartmentKapiolani community college Honolulu, Hawaii Giulianne Krug, MA, OTR/L clinical Assistant Professor Department of occupational Therapy and occupational Science University of Missouri columbia, Missouri Joanne Lavin, RN, CS, EdD Professor Department of NursingKingsborough community college Brooklyn, New York Debra Morrison, RN, BScN, MN(C)FacultySchool of Health and community Services Durham college oshawa, ontario J. Steve Smith, MD Instructor, Pathophysiology clinical coordinator clinical Laboratory Sciences Program University of West FloridaPensacola, Florida Erich K. Stabenau, PhD Professor and chair Biology DepartmentBradley University Peoria, IllinoisThis page intentionally left blankixWelcome to the fourth edition of Pathophysiology for the Health Professions. I greatly appreciate the work of Ruthanna Dyer in the preparation of this edition. We have worked together for many years, sharing ideas and principles essential to the development of effective curriculum and improve-ment of the teaching/learning process. Now Ruthann has applied her expertise to this revision. There has been much satisfaction and pleasure as this new edition came together. The basic format, content, and approach of former editions continue in this edition. Many sections have been updated and validated to reflect new information. As in earlier editions of this text, most topics stand alone or are cross-referenced to facilitate use by diverse pro- Foreword fessional programs. The ancillary package has been altered to better utilize current technology. I hope stu-dents and faculty in the health professions continue to benefit from this work, in both theory and practice. Development of this text over the years has been a team effort. I would like to take this opportunity to thank all contributors, reviewers, colleagues, and stu-dents who have been invaluable in the creation of each edition. I wish to acknowledge the staff at Elsevier who have facilitated the production process. And always, I am grateful to my family, who encourage and sustain my efforts. BARBARA E. GOULDThis page intentionally left blankxiThe study of pathophysiology provides a foundation of essential information for you to apply in your specialty area. It is a powerful tool to use in your care of patients who come to you with a wide variety of diseases and associated therapies. This textbook is intended to facili-tate your learning, and we hope you find it both useful and interesting. Many aids to learning have been incorporated in the design of this book, and are intended to maximize your learning. So, before you begin your course, take a few moments to read the preface to acquaint yourself with the general format, guidelines for users, list of contents, and special features. Then examine the tables and illus-trations found on the insides of the front and back covers, and the material in the appendices at the back of the book. Glance over the introductory material in chapter 1 and several other chapters to check out the organization and style of presentation, the type of illus-trations, the special boxes and questions. The numerous figures and charts will be helpful in developing an understanding of complex disease processes. Note that review material to refresh your memory on key points and prepare you for pathophysiology is available at the beginning of each chapter. This quick review of anatomy and physiology can save you “learning time” and moments of frustration as you move through the new information in pathophysiology. Many new scientific and medical terms will be used in this course. These are defined within the text and in the glossary. Numerous cross-references are included to help you better utilize this book and are particularly helpful if you study topics in a different order than that in the textbook. Perhaps in the practical component of your program you may find it necessary to look up a diagnosis in this textbook before you have studied the topic in class. Each chapter is quite readable prior to a A Note to Students formal lecture. The tables and flow charts illustrating disease processes provide useful summaries for you to consolidate information following lectures or for review purposes. The questions and case studies in each chapter are helpful in preparing for examinations, and you may use these as models to create specific applications in your professional field or additional questions and answers for self-evaluation (this technique is also an excellent study tool). As you proceed through this book, we suggest you note any information that you think is significant in your specialty area or is of special interest to you for any other reason. Such relationships build more links in your memory banks! Whenever possible, check the current professional journals in your area for updates, and add to your notes. Because professionals require a specific knowledge base for safe practice, it is essential to comprehend and be able to apply your course material. We hope that this textbook expedites the process and provides a stimulus to acquire additional knowledge. Additional resources are listed at the end of each chapter and in the appendices. Also available to promote productive study time are the Study Guide and the Evolve web site (found at http://evolve.elsevier.com/Gould/pathophysiology/). These provide a variety of activities for review and self-evaluation developed spe-cifically for this textbook. We wish you success and much pleasure in your chosen profession and welcome your comments and suggestions, which may be forwarded to us through the publisher. BARBARA E. GOULD RUTHANNA DYERThis page intentionally left blankxiiiThis textbook provides an introduction to pathophysiol- ogy for students in a variety of academic programs for the health professions at colleges and universities. Because students bring to their courses a diversity of backgrounds and needs, essential concepts of disease processes, such as infection and tumors are emphasized. Major disorders are described as well as selected addi-tional diseases with the intention of providing informa-tion on a broad spectrum of diseases with one or more distinguishing features for each. Understanding these fundamentals enables the student to apply that knowl-edge to other disorders that will be encountered in clini-cal practice or in subsequent courses in specialized areas of pathophysiology. An incredible amount of medical information is available, and it is hoped that this approach will facilitate the introduction and mastery of fundamental concepts. It is anticipated that additional information pertinent to the individual’s professional needs may be added to classroom presentations and assignments. We trust that students will enjoy studying these topics and proceed with enthusiasm to more detailed studies within their individual specialties. ORGANIZATION The textbook is organized into three major sections fol-lowed by the appendices: Section I—fundamental concepts and processes in pathophysiology:• Introduction to pathophysiology includes medical terminology and basic cellular changes. • Topics such as inflammation and healing, tumors, infection, abnormal immune responses, and fluid, electrolyte, and acid-base imbalances are covered. • The core information for each topic is complemented by the inclusion of a specific disease as an immediate clinical application at the end of each chapter.Section II—relationship of developmental stages and other factors to pathophysiology and various disease conditions:• Normal physiologic changes related to adolescence, pregnancy, and aging, with their relevance and impact on disease processes and the treatment of the affected individual, are described. • Specific disorders associated with these develop - mental stages ar e discussed. • other factors such as stress, substance abuse, or pain that have a significant role in the effects of disease or affect the care of such patients are addressed. Preface • A brief introduction to pharmacology and other ther-apies r einforces pathophysiology and initiates the health team concept.Section III—specific disorders, traditionally organized by body systems:• Selection is based on incidence and occurrence, as well as on the need to present a variety of patho-physiologic processes and etiologies to the student. • For major disor ders, information is provided on pathophysiology, etiology, clinical manifestations, significant diagnostic tests, common treatment modalities, and potential complications. • other selected diseases are presented in less detail, but significant, unique features are highlighted.Appendices—additional information: • Ready References include BMI tables for children and teens, lists of anatomic terms, abbreviations and acronyms, a selection of diagnostic tests, an example of a medical history, a disease index, and drug index. • A glossary and a list of additional resources complete this resource. FORMAT AND FEATURES The basic format as well as the simple, concise approach remains unchanged from the previous editions. Some material has been reorganized to improve the flow of information and facilitate comprehension. Many fea-tures related to the presentation of information in this textbook continue as before.• Simple generic learning objectives are included for each chapter. An instructor may modify or add appli-cable objectives for a specific professional program. • A transition from normal anatomy and physiology to pathophysiology is provided by a challenge ques- tion at the end of the review section, asking the student to predict “What can go wrong with this structure or system?” It is hoped that the student will utilize previously learned knowledge to facilitate progress in the new domain. • cross-r eferences are included, facilitating access to information. • In the discussion of a particular disorder, the patho- physiology is presented first because this “sets the stage,” describing the basic change(s) in the body. once the student understands the essence of the problem, he or she can easily identify the role of predisposing factors or causes, and relate the result-