NORWICH NR548 2022 January Discussions Latest (Full)

Question # 00816347 Posted By: Ferreor Updated on: 12/24/2021 12:39 AM Due on: 12/24/2021
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NR548 Advanced Pathophysiology

Week 1 Discussion

You should have already picked one of the following topics in the Week 01 Choose Topic for Discussion Forum.

Now that you have picked a topic, post an overview to the discussion board. Describe the topic you chose and end your initial post with a question for your peers to reply to and move the conversation forward, i.e.: "How does changes in Sodium/Potassium affect ATP metabolism?".

Function of ATP metabolism

Membrane transport associated with:





Cell nucleus being control center

Functions of the cellular organelles

Function of the cell membrane


NR548 Advanced Pathophysiology

Week 2 Discussion


Pick one of the following three cases and present your case summary:

A 7-year-old boy is a patient in the intensive care unit you work at. He was on a camping trip with his family when he accidentally fell on the campfire causing severe second- and third-degree burns over 60% of his body. The clinical care team tells his parents that it will be critical to maintain their son's airway and keep his fluid levels high.

The father is confused and asks you why his son's fluid level is important after a burn. How would you explain this to him?

After your explanation, the father nods that he understands. He then asks how you will measure his son's fluid levels. How would you respond?

As a clinician with knowledge of physiology, which aspects of this boy's condition would you be most concerned about?

A 19-year-old college sophomore presents complaining of frequent diarrhea, abdominal cramping, and weight loss for 2 weeks. Upon further questioning, you learn that 6 weeks ago, he returned from an overseas summer trip to Africa. You suspect he has a parasitic GI infection.

If he asked you how it is possible he could have gotten such an infection weeks ago but not had symptoms until recently, how would you respond?

What other illnesses might you consider that may be responsible for his symptoms?

A 26-year-old female presents into the office you work at concerned that she has been exposed to chicken pox. She recalls having had chicken pox at 8 years old. You advise her that it is very unlikely that she will again get chicken pox because of her adaptive immunity.

How would you explain to her what adaptive immunity is?

If she was still concerned that she may develop chicken pox, what are some alternatives you could provide for her?


NR548 Advanced Pathophysiology

Week 4 Discussion


Pick one of following three cases and present your case summary:

People who have chronic high blood pressure often have stiff and noncompliant arteries due to atherosclerosis. Explain how this will affect the following:

Blood flow through the arteries

Left ventricular afterload

Considering the normal function of endothelial cells, describe what you think would be the major clinical manifestations of endothelial dysfunction.

The student you are precepting asks about the difference between mitral regurgitation and mitral stenosis. She does not really understand the difference between the two disorders. How would you explain the following?

Primary pathophysiologic differences between mitral stenosis and mitral regurgitation.

Distinguishing clinical manifestations of each of the two disorders and their underlying mechanisms.


NR548 Advanced Pathophysiology

Week 5 Discussion


Pick one of the following three cases and present your case summary:

Two-week-old Tabitha has infant respiratory distress syndrome. Eighty-year-old Anthony has emphysema, and 50-year-old Jenny has pulmonary fibrosis.

Why are the mechanics of breathing greatly compromised in each one of these cases?

Sixty-year-old Philip has been having difficulty catching his breath for about 2 months. He finds that he gets shortness of breath even when resting. He has also been spitting up blood and has a wet cough and is hoarse. He states that he has had chest pain off and on, but now it has become more severe. He describes it as central chest pain. Philip was treated for a basal cell carcinoma of his upper lip 12 months ago, and he has been a heavy smoker for 40 years.

As the provider for Philip, what things would you consider in this case?

You are the education coordinator at a local hospital. You have been asked to give a presentation to the hospital nurses on pulmonary embolisms and cor pulmonale.

How would you describe to these clinicians the physiology that plays a vital role in the development of these diseases?

What factors do you think are most important for them to know as they treat patients? Can one contribute to the formation of the other?


NR548 Advanced Pathophysiology

Week 7 Discussion


Pick one of the following three cases and present your case summary:

Bertha is a 71-year-old woman who takes daily medication for Hashimoto thyroiditis. Last winter, she developed pneumonia. Although she did her best to run errands for her husband, she got tired easily and needed to rest frequently. One day, after shoveling the snow outside, her husband came inside to find Bertha lying on the sofa covered in blankets. Her face appeared puffy and her eyelids hung. When he spoke to her, Bertha's voice was hoarse and her words did not make sense to him. Her respirations were also shallow and slow.

You as the provider suspect low thyroid hormone levels were causing the signs.  What would you suspect the TSH and T4 test results would be for this patient?

Using your knowledge of the function of thyroid hormone in the body,explain why Bertha's respiratory rate was decreased? Why might pleural a effusion be present in someone with hypothyroidism?

Marcee is a 52-year-old woman who worked at a reception desk at a company's main office. She took some time off when she was treated for colorectal cancer. The Dukes classification was stage I, and the treatment protocol involved surgery and radiation therapy. No one in her family had a history of the disease. Marcee does not drink or smoke, but she does not pay close attention to her diet. At work, her meals consisted mainly of the foods she got from vending machines at the cafeteria. At home, she preferred to heat up frozen dinners or any prepackaged food that required minimal preparation time.

Review Marcee's diet. What factors in her dietary choices might contribute to the development of colorectal cancer?

Colorectal cancer often arises from adenomatous polyps. What are the development and histologic features of these polyps?

Colorectal cancer may be a complication in individuals with ulcerative colitis. How are the "pseudopolyps" seen in this disease different from the polyps discussed above?

Robert is a 68-year-old who has dealt with alcoholism for over 30 years. He has cirrhosis and is anemic. His appetite has declined, and he regularly complains of abdominal pain. Recently, while preparing himself a sandwich, he cut his finger deeply with a knife. The wound bled profusely, and he used a kitchen towel to stop the flow. Refusing to go and seek medical assistance, he put ice on his finger and wrapped the towel around it. He sat down in his recliner with his hand over his head and fell asleep.

Anemia and clotting disorders are common features of alcoholic liver disease. What are the mechanisms that cause these hematologic disorders?

What gastrointestinal bleed is associated with a high mortality rate in those with advanced cirrhosis? What is the pathophysiology of this condition?

Acute pancreatitis is sometimes seen in the alcoholics, particularly after binge drinking. Why are tachycardia and hypotension indications of this condition?


NR548 Advanced Pathophysiology

Week 8 Discussion


Pick one of the following three cases and present your case summary:

Will is a 68-year-old male with a history of hypertension. Eight months ago, he started regular dialysis therapy for ESRD. Before that, his physician was closely monitoring his condition because he had polyuria and nocturia. Soon it became difficult to manage his hypertension. He also lost his appetite, became weak, easily fatigued and had edema around his ankles. Will debated with his physician about starting dialysis, but she insisted, before the signs and symptoms of uremia increased; the treatment was absolutely necessary.

What is the difference between azotemia and uremia?

What is the cause of Will's weakness and fatigue?

What cardiac complication of this disease may be contributing to bilateral ankle edema?

Nine-year-old Joshua cannot fly on a plane without experiencing dizziness and vomiting. Fifty-four–year-old Melissa has a constant ringing in her ears and complains sometimes that she cannot hear out of her left ear and feels like she is spinning at times.

Explain how the concept of sensory function applies to their situations.

If you also were to care for 43-year-old Sylvia, who experienced vertigo and vomiting but was diagnosed with a tumor of the fourth ventricle, how does her situation differ from Joshua and Melissa's?

Imagine the existence of a "chocolate control center" in the hypothalamic region of the brain. This chocolate control center has direct neural connections to stimulate a chocolate-producing gland that synthesizes chocolate and releases it directly into the bloodstream. Stimuli for this chocolate system include emotional stress and low blood chocolate levels. Physiologic effects of this endogenous chocolate hormone include euphoria. This chocolate system operates under a negative feedback system of control.

How would this system respond to a chocolate overdose?

What would be the clinical manifestations of this response?





NR548 Advanced Pathophysiology

Week 10 Discussion


Pick one of the following three cases and present your case summary:

Riku is a 19-year-old college student. One morning, after a long night of studying, Riku woke up and made himself a hot cup of coffee and toast. Much to his surprise, when he brought the cup to his mouth to drink, the coffee it spilled onto the table. Riku went to the bathroom mirror and noticed the left side of his face seemed to droop. He quickly got dressed and ran to the medical clinic on the college campus. As he ran, his left eye began to feel scratchy and dry, but he could not blink in response. You are the NP in the clinic and took a careful history and completed a cranial nerve exam. You concluded that Riku had Bell palsy, an inflammatory condition of the facial nerve most likely caused by a virus.

What are the differences between afferent and efferent neurons? What are the efferent components of the facial nerve and their actions?

At healthy myoneural junction, acetylcholine is responsible for stimulating muscle activity.

What mechanisms are in place to prevent the continuous stimulation of a muscle fiber after the neurotransmitter is released from the presynaptic membrane?

An 18-year-old college freshman presents to the health clinic for evaluation of a "bump below my left knee." He plays soccer for the college team and, during a game, was recently hit hard by another player directly below his knee. Subsequently, he noticed excruciating deep pain that would wake him even when sleeping and had difficulty weight bearing on his leg. He saw his team's trainers who told him to stay off the limb and take ibuprofen for the pain. He has been using crutches, but cannot get rid of the intense pain, and feels that his leg is just not healing. He does not want to miss anymore of the soccer season and says his coach told him to come have his knee checked out at the clinic.

After the evaluation, the clinicians are discussing the next step, suspecting a possible osteosarcoma. The patient overhears their discussion, and when you walk into the room, very concernedly asks you, "Osteosarcoma. That's a cancer right? Why do you think I have cancer?" How would you respond to him?

After hearing your answer, he urgently asks you, "But if I do have it, will this ruin my soccer season? I have an athletic scholarship, and if I don't play, I'll lose it." How would you minimize his concerns while giving him truthful answers?

Devon, age 64 years, is a veteran who received extensive burns over half his body when his ship was bombed. As a complication from burns, Devon required an above-knee amputation of his right leg 19 years ago. Devon complains of constant feeling of coldness and shooting pain in his right foot. To what extent are the concepts of somatosensory function and pain interrelated here?

Describe the pathophysiology of this type of pain.

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