Download Advanced Patho NURS 5315 exam 1| Questions With Verified Answers and more Exams Pathophysiology in PDF only on Docsity!
Advanced Patho NURS 5315 exam 1| Questions
With Verified Answers
Action potential Correct Answer: The process by which excitable cells transmit information from one to another. How is the action potential altered by a potassium imbalance? (Hyperkalemia) Correct Answer: The ECF has more K+ ions. The membrane potential becomes more positive (hypopolarized). Cells become MORE excitable. T waves peak. QRS complexes widen. Causes dysrhythmias, weakness, paresthesia. {If membrane potential becomes equal to threshold potential cardiac standstill occurs} How is the action potential altered by a potassium imbalance? (Hypokalemia) Correct Answer: The ECF has less K+ ions. The membrane potential becomes more negative or hyper-polarized. The cell becomes less excitable, depolarization takes longer, and takes a stronger stimulus. Causes weakness, atony, cardiac dystrhythmias. How is the action potential altered by a calcium imbalance? (hypercalemia) Correct Answer: Increase in ECF calcium to >10.5 mg/dl. It decreases the cell permeability to calcium. The cell becomes hyperpolarized (the distance between membrane potential and threshold potential widens).
The cell is less excitable and take more stimulus to depolarize. Causes: weakness, hyporeflexia, lethargy, confusion, shortened QT wave, depressed T wave.
response to cell injury or irritation. Not a true adaptive process. -Cervical dysplasia.
Metaplasia Correct Answer: Mature cell type is replaced by a different mature cell type. -Reversible, but can induce metestatic change. -Result of chronic stressor to the cell. -Chronic smokers who loose normal ciliated epithelial cells (columnar) and the cells are replaced with squamous cells. -Barrett's esophagus: Normal esophogeal epithelial cells are replaced with columnar type cells that are more like the intestine to withstand the acidity of reflux. Hypoxic injury Correct Answer: Most common type of cellular injury. Caused by lack of oxygen, loss of hemoglobin, decrease in RBC production, cardiopulmonary disease, ischemia and inflammation. Causes mitochondrial disfunction ↓ decreased ATP production, ↑anaerobic metabolism, metabolism ceases, cell dies. -Ischemia progresses to hypoxia. Causes intracellular enzymes to show up in labs. -Creatinine kinase - indicates muscle injury. -LDH - muscle, liver, lungs, heart, rbcs and brain. -AST - liver cells -ALT - liver cells -Troponin - heart Reperfusion injury Correct Answer: Occurs when O2 supply is restored to ischemic tissues. Causes ph alterations. Trigger reactive oxygen intermediates to be produced causing cell membrane damage and mitochondrial calcium overload. Causes opening of MPTP allowing ATP to escape causing apatosis. Free radical and Reactive Oxygen Species Correct Answer: Caused by a molecule
-ROS have roles in Alzheimers, ALS, Parkinsons. ROS cause lipid peroxidation and destroy the cell membrane. Lipid peroxidation damages proteins and fragments DNA. Ethanol Correct Answer: Mood altering CNS depressant. Causes nutrient deficiencies - Magnesium, B6, folic acid, thiamine, phosphorous. Causes inflammation, fatty liver, hepatomegaly and liver failure. -Metabolized by the liver to for acetyaldehyde in the cytoplasm of the cell. -Eventually causes lactic acidosis which prevents gluconeogenesis, increases triglycerides and heapatsteatosis. -Causes the utilization of Acetyl-coa, causing ketoacidosis and hepatosteatosis. Necrosis Correct Answer: Cell death from damage or injury. Rapid loss of cell membrane, organelle swelling, and mitochondrial dysfunction. -Leads to autolysis (complete autodigestion) Infarct Correct Answer: Necrosis from sudden insufficient arterial blood flow. Apoptosis Correct Answer: programmed cell death; normal death of cells that have completed their function and best serve the body by dying and getting out of the way Autophagy Correct Answer: (self-eating) Key to cellular proliferation. When cells lack nutrition autophagy happens. Senescence Correct Answer: Cessation of cellular proliferation Changes associated with aging Correct Answer: -Accumulation of damaged macromolecules.
-ROS accumulation -Progressive loss of tissues and organs over time. -Increased release of cytokines and proinflammatory substances. -Activation of the coagulation cascade that increases hyper-coagulability.
Role of Acetyl-coa in ketogenesis Correct Answer: During glucose deprivation the cells do not produce energy. Acetyl-coa is produced to turn fatty acids into energy. Acetyl- coa produces 3 ketone bodies.
Effect on oxaloacetate Correct Answer: Used in gluconeogensis. During starvation and uncontrolled DM, Oxaloacetate is completely used up, leaving more Acetyl-coa and therefore creation of more ketone bodies. Which causes ketoacidosis. Normal cell biology Correct Answer: Grows from a stem cell - programmed to become a certain type of body cell. Cancer cell biology Correct Answer: Grows unregulated. -Ignores signals to stop proliferating. -Can go undetected by the immune system. -Not encapsulated. Alpha-fetoprotein (AFP) - tumor marker Correct Answer: hepatic, germ cell Carcinoembryonic antigen (CEA) - Tumor marker Correct Answer: GI Pancrease Lung Breas t Beta human chorionic gonadotropin - tumor marker Correct Answer: germ cell Choriocarcinoma Prostate-specific antigen (PSA) - tumor marker Correct Answer: Prostate Carcino- Correct Answer: Epithelial tissue Hepatocellular carcinoma (epithelial tissue of the liver)
-oma Correct Answer: indicates tumor Carinoma in situ Correct Answer: Preinvasive Eary carcinoma of glandular or squamous epithelial tissue that has not broken through the basement membrane. -blastoma Correct Answer: Nerve tissue -Neuroblastoma Lung cancer metastasis Correct Answer: Brain Many organs Colorectal metastasis Correct Answer: Liver Lungs Testicular metastasis Correct Answer: Liver Lungs Brain Prostate Metastasis Correct Answer: Bone (Lumbar vertebrae) Liver Breast metastasis Correct Answer: Bone Lung Liver Brai n Head and neck metastasis Correct Answer:
Lymphatics Liver Bone
{If they loose function, genetic mutations occur and so does cancer risk}
These genes may mutate and be passed on in the sperm and egg - leads to cancer predisposition. BRCA Correct Answer: Gene that increases risk of breast and prostate cancer. Mechanism of cancer metastasis Correct Answer: Occurs when the tumor environment has changed to allow for the transposition of cancer cells. -The epithelial mesenchymal transition (EMT) is the process by which cancer cells change to one that can metastasize. -Local spread happens first. -Spreads to lymph nodes then to distant sites via blood and lymph. Paraneoplastic syndrome Correct Answer: a syndrome or other systemic disturbance associated with but not directly related to a primary tumor or its invasion/metastases. Examples: Fever, weight loss, hypercalcemia, neurologic findings, hematologic syndromes, hypercoagulable state. May be the first clinical manifestation of a tumor. Due to ectopic hormones/peptides produces by the tumor. Such syndromes warrant thorough investigation and search for a primary tumor. Cachexia Correct Answer: multiorgan syndrome -energy balance disorder -energy expenditure in cancer is increased. -Intake is usually decreased. -Wasting syndrome -Symptoms: loss of appetite, cardiac atrophy and dysfunction, gut barrier dysfunction, release of pro-inflammatory mediators, lipolysis, release of fatty acids, reduced albumin synthesis. -Increased apoptosis and inability to regenerate cells.
Paraneoplastic syndrome - endocrine Correct Answer: {Increase in cortisol causes rosy round face, weight gain, thinning skin, bruising, tired, weakness, HTN, increased BS, osteoporosis, extra hair} ⌾Small cell carcinoma of the lung ⌾Pancreatic carcinoma ⌾Neural tumors → ACTH or ACTH like substance← SIADH Paraneoplastic syndrome - endocrine Correct Answer: {Body makes too much ADH
- causes the body to retain water and lowers sodium} ⌾Small cell carcinoma of the lung ⌾Intracranial neoplasm → ADH or ANP ← Hypercalcemia Paraneoplastic syndrome - endocrine Correct Answer: {The cell is less excitable and take more stimulus to depolarize. Causes: weakness, hyporeflexia, lethargy, confusion, shortened QT wave, depressed T wave} ⌾Squamous cell carcinoma of the lung ⌾Breast carcinoma ⌾Renal carcinoma ⌾adult T cell lukemia/lymphoma → Parathyroid hormone-related protein - TGF-alpha - TNF - IL- 1 ← Hypoglycemia Paraneoplastic syndrome - endocrine Correct Answer: ⌾Fibrosarcoma ⌾other mesenchymal sarcomas ⌾hepatocellular carcinoma
→insulin or insulin-like substance←
