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NSG 3280 EXAM 1 (GALEN) NEWEST 2025 ACTUAL
EXAM TEST BANK| NSG3280 PATHOPHYSIOLOGY
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What is the definition of pathogenesis? - ANSWER - Development or evolution of disease, from initial stimulus to expression Signs of disease - ANSWER - Objective data - ex: clinical exams, biochemical analysis, diagnostic imaging, labs, seeing a patient vomit Symptoms of disease - ANSWER - Subjective data, can only be reported by affected individual - ex: a patient stating they are experiencing nausea What is the definition of epidemiology? - ANSWER - Study of patterns of disease Endemic - ANSWER - A disease that is native to a local region Epidemic - ANSWER - Disseminated to many individuals at the same time
Pandemic - ANSWER - Affects large geographic regions, spreading worldwide Primary prevention - ANSWER - Prevention by altering susceptibility or reducing exposure for susceptible individuals - ex: improved nutrition, economy, housing, sanitation, immunizations. Primary - Prevention Secondary prevention - ANSWER - Early detection, screening, & management of disease - ex: annual physicals, Secondary - Screening Tertiary prevention - ANSWER - Rehabilitative/supportive care, attempts to alleviate disability and restore effective functioning - ex: medical, physical therapy, pharmacotherapy, psychotherapy, radiation therapy, chemo, immunotherapy, surgery, Tertiary - Therapy What are factors of cellular aging? - ANSWER - DNA damage, reduced proliferative capacity of stem cells, accumulation of metabolic damage What is somatic death? - ANSWER - Death of the entire organism, absence of breathing and heartbeat, body temp falls, skin becomes pale, blood & body fluids collect in dependent areas, rigor mortis occurs followed by muscle flaccidity, postmortem autolysis, brain death Gluconeogenesis - ANSWER - Creation of glucose using non- carbohydrate sources such as protein/amino acids in the liver
Alpha (a) cells - ANSWER - Produce glucagon, stimulates liver to release its storage of glycogen into glucose (glycogenolysis) What is insulin and what are its actions? - ANSWER - Synthesized in the pancreas by beta cells of the islet of langerhans, glucose stimulates release of insulin from pancreatic beta cells Facilitates entry of glucose into cell, enchance protein synthesis and prevent muscle breakdown, inhibit gluconeogensis (conversion of glycogen to glucose), enhance fat deposition by preventing fat breakdown (lipolysis) & inducing lipid formation (prevents ketosis), stimulates growth by enhancing secretion of IGF-1 (somatomedin) Homeostasis - ANSWER - Maintaining internal conditions in a stable state by keeping parameters relatively the same, state where all systems are in balance around a "set-point", a tendency to stabilize an organism's functional systems despite changes internally and externally Allostasis - ANSWER - Supports and helps the body to achieve a steady state, the organism's overall stability is accomplished through change Stress - ANSWER - Physical and mental state of tension, response by the body to internal and external demands, real or perceived threat to homeostasis Stressor - ANSWER - Anything that throws the body out of allostatic balance
Stress response - ANSWER - Body's efforts to try to restore balance, meant to be helpful however can become damaging when repeatedly activated or when it does not cease Alarm stage of GAS - ANSWER - "fight or flight" response, surge of energy to evade or confront danger. Hypothalamus detects stimuli, hypothalamus secretes corticotropin- releasing hormone (CRH), CRH activates sympathetic nervous system (SNS), SNS stimulates adrenal medulla to release catecholamines (epinephrine & norepinephrine), increase in catecholamines enables the body to take action and fight or flight. At the same time, paraventricular nucleus (PVN) in hypothalamus secretes CRH to stimulate the anterior pituitary gland to release adrenocorticotropic hormone (ACTH), ACTH causes the adrenal cortex to release substantial amounts of glucocorticoids (cortisol), once pituitary gland is activated the alarm stage progresses to resistance. Resistance/adaptation stage of GAS - ANSWER - Trying to restore back to normal. Sympathetic nervous system (SNS) and adrenal medulla & cortex function at full force to mobilize resources (glucose, free fatty acids, amino acids) to manage the stressor. Exhaustion stage of GAS - ANSWER - Occurs when body is no longer able to return to homeostasis after prolonged exposure to a stressor, when energy sources are depleted death occurs due to the organism's inability to adapt. HPA axis, sympathetic-adrenal-medullary system, immune system, and other systems work to help body adapt to and
Cortisol - ANSWER - Primary glucocorticoid, affects protein metabolism, promotes appetite, has inflammatory effects, too much cortisol overtime can lead to pro-inflammatory effects Aldosterone - ANSWER - Primary mineralocorticoid, promotes reabsorption of sodium and water, increases blood pressure Endorphins and enkephalins - ANSWER - endogenous opioids, natural pain relievers, raise pain threshold, reduce pain, produce sensation & euphoria Immune cytokines - ANSWER - Secreted by macrophages during the stress response, enhance pain and immune system response, prolonged stress can suppress immune functioning Glycolysis - ANSWER - The breakdown of glucose by enzymes, releasing energy and pyruvic acid for cell metabolism. 1 glucose = 2 ATP & 2 pyruvate. Citric acid cycle (Krebs cycle) - ANSWER - Takes place in mitochondria, results in complete oxidation of glucose, ends with production of ATP by oxidative phosphorylation Oxidative phosphorylation - ANSWER - Results in the formation of ATP by reaction of ATP & inorganic phosphate
Na+ K+ pump - ANSWER - Active transporter that moves three Na+ out of a cell and two K+ into the cell against their respective concentration gradients, P-type ATPase present in plasma membranes, maintains cell volume & controls solute concentration inside the cell, maintains steep concentration gradient to keep sodium out and potassium in Hydropic swelling - ANSWER - Cellular swelling due to accumulation of water, first manifestation of most reversible cell injuries, malfunction of Na+ K+ pump, - megaly. Large, pale cytoplasm, dilated endoplasmic reticulum, swollen mitochondria Intracellular accumulations - ANSWER - May result in cellular injury due to toxic substances or provoked immune response, or because they occupy space needed for cellular functions. Accumulations are not injurious, they are an indication of injury. Atrophy - ANSWER - Decreased cell size and reduced function in response to disuse, denervation, ischemia, nutrient starvation, interruption of endocrine signals, persistent cell injury - ex: immobilization by cast or bedrest resulting in shrinkage of skeletal muscle cells
Caseous necrosis - ANSWER - Characteristic of lung damage secondary to tuberculosis, resembles clumpy cheese Gangrene & all types - ANSWER - Cellular death involving a large area of tissue, results from interruption of blood supply to particular part of the body Dry: not getting blood, form of coagulative necrosis, blackened/dry/wrinkled Wet: form of liquefactive necrosis found in internal organs, can be fatal Gas: infection of necrotic tissue by anaerobic bacteria, formation of gas bubbles in damaged muscle tissue, can be fatal Apoptosis - ANSWER - Regulated cell death, does not cause inflammation, cell suicide Ischemia - ANSWER - Interruption of blood flow to an area Hypoxia - ANSWER - Lack of oxygen Ischemia-reperfusion injury - ANSWER - Damage after blood supply to tissues has been restored, calcium overload, formation of free radicals, inflammation
Nutritional injury - ANSWER - May result from poor intake, altered absorption, impaired distribution by the circulatory system, or inefficient cellular uptake Infectious & immunologic injury - ANSWER - Bacteria - release exo & endotoxins in the body, destructive enzymes that create an immune reaction that harms the body Virus - enter host cell, replicate themselves, body has easier time fighting viruses Chemical injury - ANSWER - Toxic chemicals can injure cells directly, whereas others become injurious only when metabolized into reactive chemicals by the body - ex: heavy metals, toxic gasses Physical & mechanical injury - ANSWER - Extremes in temperature, abrupt changes in atmospheric pressure, mechanical deformation, electricity, ionizing radiation DNA is susceptible to damage from radiation exposure Fed state - ANSWER - Occurs after ingestion of a meal, characterized by utilization & storage of ingested energy nutrients, glucose from ingested food in primary energy source. Glucose levels rise after eating food, beta cells in the pancreas release insulin into the blood, liver takes up excess glucose and stores it as
up of glucose, catecholamines increase production of free fatty acids and inhibit glucose uptake in the periphery leading to hyperglycemia, infections can stimulate hyperglycemia Prediabetes - Etiology/Pathogenesis - ANSWER - Impaired glucose tolerance & impaired fasting glucose tolerance (IFG), mildly elevated fasting glucose levels, development of insulin resistance Prediabetes - Diagnostics - ANSWER - Fasting plasma glucose: 100- 125 2hr oral glucose test: 140- 190 HgbA1c: 5.7%-6.4% (3-6 months) Prediabetes - Clinical manifestations - ANSWER - None usually noted Type 1 DM - Etiology - ANSWER - May be immune-mediated or idiopathic - chromosome 6, MHC genes Type 1 DM - Pathogenesis - ANSWER - Autoimmune destruction of beta cells of pancreas, process mediated by macrophages & t- lymphocytes with detectable antibodies to various beta cells, insulin secretion becomes inadequate & glucose is unable to enter the tissues & plasma glucose levels rise Type 1 DM - Diagnostics - ANSWER - Random blood glucose sampling: 200
Fasting blood glucose: > Blood glucose concentration: > HgbA1c: >6.5% (3-6) months Type 1 DM - Clinical manifestations - ANSWER - Polyuria, polydipsia, polyphagia, glucosuria, fatigue, sudden weight loss, wounds that won't heal, blurry vision, numbness & tingling in feet or hands, vaginal infections, sexual problems Type 2 DM - Etiology/Pathogenesis - ANSWER - Most common form of DM, exact cause unknown, insulin resistance to the action of insulin on peripheral tissues, b cell dysfunction leads to a relative lack of insulin, suspect decreased number of insulin receptors or abnormal location of glucose transporters, as diseases progresses insulin production may be impaired Type 2 DM - Risk factors & Clinical manifestations - ANSWER - Obesity, sedentary lifestyle, non-white, 3 p's may be more subtle Type 2 DM - Diagnostics - ANSWER - Fasting plasma glucose: > Random plasma glucose: > 2hr oral glucose test: > HgbA1c: >6.5% (3-6 months) History & physical
1: Pathology - ANSWER - the study and diagnosis of disease through examination of organs, tissues, cells, and bodily fluids. 1: Etiology - ANSWER - the study of the causes of diseases 1: risk factor - ANSWER - Something which increases risk or susceptibility. 1: pathogenesis - ANSWER - the development or evolution of a disease, from initial stimulus to the ultimate expression of the manifestations 1: signs of disease - ANSWER - manifestations of disease that are observed 1: symptoms - ANSWER - subjective feelings of an abnormality in the body 1: syndrome - ANSWER - etiology of a particular set of signs and symptoms has not yet been determined 1: latent period - ANSWER - interval between exposure of a tissue to an injurious agent and the first appearance of signs and symptoms
1: prodromal period - ANSWER - refers to the appearance of the first signs and symptoms indicating the onset of a disease 1: Stage of manifest illness/acute phase - ANSWER - disease reaches its full intensity, and signs and symptoms attain their greatest severity 1: latent/ silent period - ANSWER - signs and symptoms may become mild or disappear for a time 1: acute condition - ANSWER - relatively severe manifestations but runs a short coarse measured in hours, days, or a few weeks 1: chronic condition - ANSWER - can begin in the acute phase and become prolonged when the body's defenses are insufficient to overcome the causative agent and can last for months 1: exacerbation - ANSWER - sudden increase in the severity of a disease 1: remission - ANSWER - an abatement or decline in severity of the signs and symptoms of a disease 1: convalescence - ANSWER - stage of recovery after a disease, injury, or surgical operation
1: Specificity - ANSWER - probability that a test will be negative when applied to a person who does not have a given condition 1: influencers of physiologic parameters? - ANSWER - Age, gender, genetic and ethnic background, geographic area, and time of day 1: acclimatization - ANSWER - a normal adaptive response 1: epidemiology - ANSWER - study of patterns of a disease 1: endemic disease - ANSWER - disease that is native to a local region (a town or county) 1: epidemic - ANSWER - disease is disseminated to many people at the same time (a country) 1: pandemic - ANSWER - disease that spreads widely across a large area (the world) 1: principal factors affecting patterns of disease in human populations? - ANSWER - age, ethnic group, gender, socioeconomic factors and lifestyle considerations, and geographic location
1: developmental process - ANSWER - changes in function that occur during the early years of life 2: homeostasis - ANSWER - maintaining internal conditions in a stable state by keeping parameters relatively the same/ the state of being in which all systems are in balance around a fairly narrow ideal "set point" 2: allostasis - ANSWER - ability to successfully adapt to changes 2: stress - ANSWER - physical, chemical, or emotional factor that produces tension in the body or mind 2: stressor - ANSWER - anything that throws the body out of allostatic balance 2: general adaptation syndrome (GAS) - ANSWER - Alarm reaction, Stage of existence, Stage of exhaustion 2: alarm - ANSWER - Fight or Flight Response idiopathic - ANSWER - unknown cause Eitology - ANSWER - cause of disease
