Path 1000 Midterm 1 Questions with Verified Correct Answers (Graded A+), Exams of Nursing

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Path 1000 Midterm 1 Questions with Verified

Correct Answers (Graded A+) Latest Update 2025

Pathophysiology --- correct answer --- the study of changes in the body's physiology that result from disorder or disease

Pathogenesis --- correct answer --- the development of a disease

Clinical Manifestations --- correct answer --- the presence or absence of disease often marked by signs and symptoms

Diagnosis --- correct answer --- identifying the type of illness or problem by examination of the symptoms

Etiology --- correct answer --- the cause of a disease or condition

Idiopathic --- correct answer --- unknown cause of a disease

Iatrogenic --- correct answer --- disease caused by a treatment or procedure error

Epidemiology --- correct answer --- study of the distribution and determinants of health-related or events in a population

Incidence --- correct answer --- rate of occurrence

Ex: number of new cases of a disease in a population over a specific period of time (1 in 3 may catch a disease)

Prevalence --- correct answer --- the number of people in a population who have the disease or condition over a specific time period

Ex: 1 in 10 have the disease

Endemic --- correct answer --- the expected or normal incidence to a population or geographical area

Ex: chicken pox

Epidemic --- correct answer --- dramatic increase in a condition to a large number of people at the same time in a geographical area

Pandemic --- correct answer --- high numbers of a disease in various regions/across continents

Morbidity --- correct answer --- disease rates within a group

Mortality --- correct answer --- deaths that result from a particular disease in a population

Ex: death rate due to TB

Hypoxic Injury --- correct answer --- most common cause of cellular injury resulting in Ischemia (reduced blood supply

Homeostasis --- correct answer --- the body's ability to regulate and maintain health and equilibrium in its functions

How is homeostasis linked to pathophysiology? --- correct answer --- a small change to the internal body throws homeostasis out of order, which will lead to illness and diseases

Prognosis --- correct answer --- probable outcome of a patient's conditon

Sign --- correct answer --- a clinical finding verified by the examiner

Primary Disease Prevention --- correct answer --- altering behaviours to prevent a disease from occurring

Ex: vaccination

Secondary Disease Prevention --- correct answer --- performing early detection to prevent a disease from occurring

Ex: medical examinations

Complications --- correct answer --- the development of a disease in a person already coping with an existing disorder

Ex: secondary bacterial infection

Sequelae --- correct answer --- unwanted outcomes of a primary condition

Ex: ototoxic drugs causing deafness

Eight Chief Cellular Function --- correct answer --- 1. Movement - muscle to bone causes movement

2. Conductivity - electric response to stimuli
3. Metabolic Absorption - taking and using nutrients
4. Secretion - mucus
5. Excretion - getting rid of waste
6. Respiration - taking in O2 for nutrients

7. Reproduction - tissue growth
8. Communication

Four Ways Cells Adapt to Environment --- correct answer --- 1. Atrophy - decrease in cellular size and functional components (aging, early development)

2. Hypertrophy - increase in the size of a cell in response to a mechanical stimuli
3. Hyperplasia - the increase in the number of cells due to increased cellular division
   • Compensatory Hyperplasia: an adaptive mechanism that enables certain organs to regenerate
   • Hormonal Hyperplasia: enlargement of estrogen dependent organs (breasts/uterus)
4. Metaplasia - reversible replacement of one mature cell type by another less mature cell type (ex: smoking causes changes to lung cells)

Dysplasia --- correct answer --- abnormal changes in the size, shape and organization of mature cells (not considered a true adaptive process)

Is dysplasia the same thing as cancer? --- correct answer --- although dysplasia functions similar to cancer and is often located next to cancerous growths, it doesn't indicate cancer and may never progress to it

Five Progressive Changes of a Cell --- correct answer --- 1. Atrophy

2. Hypertrophy
3. Hyperplasia
4. Metaplasia

5. Dysplasia

Transformation Zone --- correct answer --- merging site of the 2 types of cells

• common site for HPV changes

Cell Injury --- correct answer --- when a cell cannot maintain homeostasis

• cell injury can be reversible or irreversible

When is a cell injury irreversible? --- correct answer --- once change to the nucleus occur and cell membranes are disrupted will then lead to cell death

What causes hypoxic injury? --- correct answer --- hypoxia or lack of proficient oxygen within a cell

• loss of hemoglobin and decreased RBC production

What causes ischemia reperfusion injury? --- correct answer --- the restoration of blood flow and oxygen to areas of the body recently suffering from ischemia

What does ischemia reperfusion injury cause? --- correct answer --- restoration of oxygen causes inflammation & oxidative damage to tissue

Free Radical --- correct answer --- a molecule that is unstable and highly reactive because it contains unpaired electrons

Reactive Oxygen Species (ROS) --- correct answer --- type of compound that can change DNA, RNA and intracellular proteins

Reperfusion Injury --- correct answer --- when you have ischemia the blood supply gets compromised, then the blockage is alleviated, and the new blood forms reactive oxygen species causing mitochondrial dysfunction (reduced energy production ATP)

Chemical Injury --- correct answer --- interaction between a toxic substance & cell plasma membrane

Five Substances Linked to Causing Chemical Injury --- correct answer --- 1. Drugs

2. Pollutants
3. Herbicides/Insecticides
4. Ethanol
5. Poisons - lead/CO

Asphyxial Injury --- correct answer --- suffocation, strangulation, drowning and chemical asphyxiants

Infectious Injury --- correct answer --- injury from pathogens such as bactera, viruses and fungi invading/ destroying cells

Components of the Immune System & Inflammatory System That Can Injure Cells --- correct answer --- 1. Histamine

2. Antibodies
3. Complement Systems
4. Phagocytic Cells

What are the two types of cellular accumulation that take place after a cellular injury? --- correct answer --- - Accumulation of normal cellular substances:

• Water
• Proteins
• Lipids

• Carbohydrates
• Accumulation of abnormal substances:
• Infectious agents
• Inflammatory mediators

Cellular Swelling --- correct answer --- the most common degenerative change that is caused by the shift of extracellular water into cells

What causes cellular swelling? --- correct answer --- when a cell is injured it begins to produce less ATP, which in return effects the cells ability to transport outside the cell. The increase of sodium in the cell pushes potassium out of the cell allowing water to be draw in

What happens if cellular swelling affects all the cells in an organ? --- correct answer --- the organ increases in weight and becomes distended and pale

What four things begin to happen once a cell is affected by injury? --- correct answer --- 1. ATP depletion

2. Free radicals
3. Increased cellular calcium
4. Non-selective membrane permeability

What is the result of prolonged cell injury? --- correct answer --- cellular death

Necrosis --- correct answer --- tissue death that is not reversible

Five Types of Tissue Necrosis --- correct answer --- 1. Coagulation - clumping → protein destruction causes the protein albumin to change from gelatinous and transparent to a firm opaque state

2. Liquefactive - liquid/puss → injured brain cells release hydrolases that digests brain tissue; tissue becomes soft, liquefies and segregates, forming cysts (may be caused by staph, strep or E.Coli infections)
3. Caseous - mixture of coagulation and liquefactive → a thick, yellowish "cheesy" substance forms
4. Fatty → cellular dissolution (dissolving) caused by powerful enzymes called lipases, that occur in the breast, pancreas and other abdominal structures
5. Gangrenous - dry, wet or gas → death of tissue from severe hypoxic injury that causes the skin to look mummified

Apoptosis --- correct answer --- the process of programmed cell death, where cells that die recruit phagocytes to engulf the remains of the dead cell, reducing inflammation

How is Apoptosis and Necrosis different? --- correct answer --- Apoptosis is self-containing death that doesn't spread

Necrosis is uncontrolled cell death that spreads

Hypovolemia --- correct answer --- a state of decreased blood volume caused by decreased volume of blood plasma

-Signs/Symptoms:

• Clammy skin
• Low BP

•Rapid heart beat

Hypervolemia --- correct answer --- an increase in blood volume caused by too much fluid in the blood

• Signs/Symptoms:
• Thirst
• Hypertension
• Edema

Hypernatremia --- correct answer --- high sodium levels caused by increased Na+ intake or water deficit

• Signs/Symptoms:
• Thirst
• Hypertension
• Edema
• Weigh gain
• Bounding pulse
• Treatment:
• Give an isotonic salt-free fluid

Hyponatremia --- correct answer --- deficient sodium levels in the blood resulting in swelling of the cells

• Etiology:
• Inadequate intake, diuretics and excess water
• Signs/Symptoms:
• Edema
• Lethargy
• Hypotension

• Tachycardia
• Muscle weakness
• Seizures
• Treatment:
• Restriction of water intake is required

Hypokalemia --- correct answer --- deficient potassium in the blood

• Etiology:
• Decreased potassium intake, losses from GI tract, and renal losses
• Signs/Symptoms:
• Mild losses - asymptomatic
• Severe losses - skeletal muscle weakness, cardiac dysrhythmias from membrane excitability
• Treatment:
• Involves an estimation of total body K+ losses and correction of acid-base imbalances

Hyperkalemia --- correct answer --- excessive potassium in the blood

• Etiology:
• Decrease renal excretion (renal failure) increased K+ intake, medications (K+ sparing diuretics)
• Signs/Symptoms:
• Mild - neurovascular irritability, nausea, vomiting, diarrhea
• Severe - muscle weakness, loss of tone and paralysis, cardiac arrest

• Treatment:
• Calcium gluconate can be administered or administration of glucose

Hypocalcaemia --- correct answer --- low serum calcium

• Etiology:
• Decreased D or PTH levels
• Impaired intestinal absorption
• Nutritional deficiencies
• Signs/Symptoms:
• Increase neuromuscular excitability
• Parasthesia around the mouth, fingers, hands and feet
• Muscle spams
• Dysrhythmias
• Severe symptoms - seizures, tetany (continuous muscle spasm), cardiac arrest
• Treatment:
• Severe cases require emergency treatment of IV 10% calcium gluconate

Hypophosphatemia --- correct answer --- low serum phosphate

• Etiology:
• Intestinal malabsorption
• Increased renal excretion
• Vitamin D deficiency
• Signs/Symptoms:

• Affects RBC, WBC and platelets
• Muscle weakness
• Affects bone reabsorption
• Treatment:
• Rate and amount of replacement are determined by the cause and presenting symptoms

Hyperphosphatemia --- correct answer --- excessive phosphate in the blood

• Etiology:
• Chemotherapy
• Phosphate enemas/laxatives
• Hypoparathyroidism
• Signs/Symptoms - (related to hypocalcemia from high phosphate levels):
• Neuromuscular excitability
• Muscle spasms
• Intestinal cramping
• Hyperactive bowel
• Treatment:
• Aluminum hydroxide may be administered because it binds to phosphate in the GI tract

Hypermagnesemia --- correct answer --- elevated serum magnesium level

• Etiology:
• Renal failure, magnesium containing antacids

• Signs/Symptoms:
• Muscle contractions
• Muscle weakness
• Loss of deep tendon reflexes
• Bradycardia
• Hypotension nausea
• Treatment:
• Avoidance of magnesium-containing substances and removal of magnesium by dialysis

Acidosis --- correct answer --- pH < 7.

Alkalosis --- correct answer --- pH > 7.

What is considered to be a healthy blood pH and how is it maintained? --- correct answer --- A pH of 7.35-7.45 is considered to be healthy. This level is maintained by having a 1:20 ration of carbonic acid to bicarbonate base

Order of Buffering Systems Reacting to Acid-Base Imbalance --- correct answer --- 1. Protein Buffering

• Protein function either as an acid or base. Responds in seconds to acid- base imbalance
• Combines with hemoglobin (Hb) to form HHb (non-oxygen carrying) or HbCO2 (carries CO2)

2. Respiratory Buffering

• Responsible for increasing or decreasing respiratory rate to regulate CO2. Occurs within minutes

• Academia → increase H+ results in the increase of ventilation = decreased CO2 levels
• Alkalemia → decreased H+ results in the decrease of ventilation = increase of CO2 levels

3. Renal Buffering

• The kidneys are responsible for excreting H+ or retaining bicarbonate (HCO3) to produce a more acidic or alkaline urine
• Reacts in hours to days

Metabolic Alkalosis --- correct answer --- increased bicarbonate levels or decreased metabolic acids

• Causes:
• Vomiting
• Gastric suctioning
• Diuretics
• Bicarb intake

Metabolic Acidosis --- correct answer --- the increase in non-carbonic acid levels or decrease bases from extracellular fluid (ECF) - the body is producing too much acid

• Causes:
• Renal failure
• Increase in lactic acid formation
• Increase in ketones from lack of insulin

Respiratory Acidosis --- correct answer --- hypoventilation leads to production of CO

• Etiology:
• Depression of the respiratory centre
• Paralysis of resp muscles
• Disorders of lung parenchyma
• Clinical Manifestations:
• Changes to resp patterns
• Headache
• Restlessness
• Lethargy
• Muscle twitching
• Tremors
• Convulsions

Respiratory Alkalosis --- correct answer --- hyperventilation leads to the decrease of plasma concentration of CO

• Etiology:
• High altitude
• Pulmonary disease
• Heart failure
• Fever
• Anemia

• Clinical Manifestations:
• Changes to resp pattern
• Dizziness
• Confusion
• Parasthesias

Intracellular Fluid (ICF) --- correct answer --- fluid within cells, 2/3 of the body's water

Extracellular Fluid (ECF) --- correct answer --- body fluids located outside of the cells

• Two Main ECF Compartments:

1. Interstitial Fluid
2. Intravascular Fluid

How does water move between ICF and ECF? --- correct answer --- Water moves freely by diffusion through the cell membrane and through aquaporins (water channels that provide permeability to water)

Edema --- correct answer --- the excess accumulation of fluid within the interstitial spaces. Often a problem of fluid distribution and odes not necessarily indicate a fluid excess

• Pathophysiology:
• Related to an increase in the forces causing fluid filtration from the capillaries or lymphatic channels into the tissues

Four Common Mechanism Used to Maintain Fluid Balance --- correct answer --- 1. Increased capillary hydrostatic pressure

2. Decreases plasma oncotic pressure
3. Increased capillary membrane permeability
4. Lymphatic obstruction

Capillary Hydrostatic Pressure --- correct answer --- facilitates the outward movement of water from the capillary to the interstitial space

Capillary Oncotic Pressure - -- correct answer --- osmotically attracts water from the interstitial space back into the capillary

Interstitial Hydrostatic Pressure --- correct answer --- facilitates the inward movement of water from the interstitial space into the capillary

Interstitial Oncotic Pressure --- correct answer --- osmotically attracts water from the capillary into the interstitial space

Localized Edema --- correct answer --- edema that occurs only to the site of tissue injury

• Edema of the brain, larynx or lungs is a condition that can be life- threatening

Generalized Edema --- correct answer --- when there is a uniform distribution of fluid in interstitial spaces throughout the body

• Ex: dependent edema, in which fluid accumulates in gravity-dependent areas of the body (hands/feet)

Hypotonic Alterations --- correct answer --- when the concentration of ECF is less than normal

• Most common causes:
• Sodium deficit in ECF
• Water excess in ECF

Antibiotic Resistance --- correct answer --- occurs when bacteria develops the ability to defeat the drugs designed to kill them. When bacteria becomes resistant, antibiotics cannot fight them, and the bacteria multiplies

• Causes:
• Genetic mutations
• Ability to inactive the antibiotic
• Alteration of metabolic pathway
• Preventing the entrance of an antibiotic
• Overuse
• Lack of compliance

Six Components of the Infectious Process Cycle --- correct answer --- 1. Infectious agent (can be opportunistic)

2. Reservoir (humans, animals, plants, insects...)
3. Portal of exit (GI tract, GU tract, skin...)
4. Mode of Transmission (direct - skin to skin, kissing, intercourse. Indirect

• airborne)

5. Portal of Entry (GI, GU, skin...)
6. Susceptible Host

Communicability --- correct answer --- easily transmitted from person to person

Infectivity --- correct answer --- ability to survive and multiple inside a body

Pathogenicity --- correct answer --- ability to produce disease

Portal of Entry --- correct answer --- a way for pathogen to enter the body

Toxigenicity --- correct answer --- pathogen produces a type of toxin

Virulence --- correct answer --- strength of the pathogen (the stronger the pathogen, the more likely the body to become sick)

Pathogens Mechanism of Action to Resist Immune System --- correct answer --- - Destroy/block components of immune system

• Production of toxins
• Production of antioxidants
• Production of surface molecules that can bind antibodies
• Mimic self antigens
• Produces antigens that are similar to self-antigens
• Prevent activation by complement system
• Prevents opsonization
• Change antigenic profile
• Mutation of antigens that change surface molecule → delays immune response due to failure to recognize new antigen
• Virus has the ability to change antigenic profile, reasons why there is no cure for a cold

Bacteria --- correct answer --- - One celled with a cell wall

• No nucleus
• Produce by cell division
• Some are part of normal flora
• Can survive outside of a host

• Overgrowth can be harmful
• Produce endotoxins and release exotoxins
• Use adhesion through pili to attach to cells
• Classified as Gram - or Gram +, shape (morphology), aerobic (with O2) or anaerobic (no O2)

Gram+ Bacteria --- correct answer --- - Retains the gram stain

• Cell wall contains certain amino acids
• Wall gives strength & structure
• Antibiotics target the cell wall

Gram- Bacteria --- correct answer --- - Does not retain gram stain

• Cell wall contains limited amino acids
• Cell wall has a endotoxin layer → protects bacteria from certain antibiotics

Exotoxins --- correct answer --- (produced by bacteria to kill cells and disrupt tissue)

• Toxic molecules
• Proteins released during bacterial growth
• Damage cell membranes & inhibit cell protein synthesis
• Specific to sites in the body - neurotoxins (brain)/enterotoxins (GI)

Endotoxins --- correct answer --- (produced by bacteria to kill cells and disrupt tissue)

• Contained in the cell wall of gram- bacteria

• Released from the bacteria cell membrane during growth or when being treated with antibiotics causing lysis of the bacteria
• Produce pyrogens → stimulate the relate of inflammatory mediators (produces fever and local/systemic effects of inflammations)

Bacteremia --- correct answer --- bacteria present in the blood

Septicemia --- correct answer --- gram- sepsis due to bacteria growth in the blood

• Bacteria releases large amount of endotoxins → endotoxic shock

Antimicrobial Mechanism of Action --- correct answer --- - Inhibits production of bacterial cell wall or membrane

• Inhibits protein synthesis
• Blocking of DNA replication
• Interferes with folic acid metabolism

Breaking The Chain of Infection --- correct answer --- 1. Universal Precautions - mode of transmission

2. Sterilization - infectious agent
3. Covering secretions - portal of exit
4. Treat underlying disease - susceptible host
5. Antimicrobial drugs - reservoirs
6. Cover entry points - portal of entry

Three Lines of Defence --- correct answer --- 1. Skin & mucous membranes

• Physical & mechanical barriers = coughing, sneezing
• Biochemical barriers = tears, sweat, earwax

2. Inflammatory Response (non specific)

• Essential for healing
• Includes - ability to recognize injury, activate a response, and shut down the response when injury has passed
• End result is either repair & regeneration/scarring or chronic inflammation

3. Immune response (specific)

Acute Inflammation --- correct answer --- - Sudden onset

• Begins immediately following injury
• Goal is to remove injurious agent & limit extent of tissue damage
• Involves neutrophils
• Regeneration & restoration

What happens during Acute Inflammation? --- correct answer --- • Increase blood flow to site (vascular response)

• Increase healing cells at site (cellular response)
• Prepare for tissue repair

Two Types of Vascular Response --- correct answer --- 1.Inflammatory Mediators (mast cell)

• Histamine/Leukotrienes/Prostaglandins (signals pain)
• Localized vasodilation - dilation of the blood vessel for increased blood flow
• Increased permeability - allows movement of cells into damaged cells and exudate exits the tissues

2. Plasma Protein System

• Complement
• Classic Complement (helps/enhances) antibodies & phagocytic cells to destroy pathogens directly
• Clotting
• Forms fibrous meshwork
• Prevents spread of infection
• Traps microorganisms
• Forms a clot to stop bleeding
• Kinin
• Increased vascular permeability
• Dilates blood vessels
• Induces pain
• Causes smooth muscle contraction

Cellular Response --- correct answer --- uses mast cells and phagocytic cells (neutrophils/macrophages) to act at the site of injury & prepare for healing

Mast Cell --- correct answer --- central cell of inflammation

• Degranulation to release histamine (activates acute inflammation)
• Allow for chemotaxis of neutrophils
• Synthesize inflammatory mediators (leukotrienes & prostaglandins)

Phagocytes --- correct answer --- ingests and disposes damaged cells & foreign material

➢ Neutrophils

• Ingests bacteria, dead cells and cellular debris
• Appears within 6 hours of inflammation
• Incapable of division
• 4 days life span
• Becomes a component of purulent exudate

➢ Macrophages

• Long term defence
• Remove cells and cellular debris
• Suppress further inflammation and initiate healing

➢ Natural Killer Cells

• Complement the effects of cytotoxic T-cells
• Recognizes & eliminate infected cells and cancer cells

Manifestations of Inflammation --- correct answer --- - Local

• Redness, heat, pain, swelling, loss of function, exudate (serous/sanguineous/sero-sang/purulent)
• Systemic
• Fever - kills microorganisms
• Leukocytosis - bone marrow triggers to produce more neutrophils
• Plasma protein synthesis - produced by the liver

Chronic Inflammation --- correct answer --- - Repeated episodes of infection

• Prolonged and persistent inflammation
• May last 2 weeks or longer
• Involves macrophages, lymphocytes & plasma
• Granuloma formation/scarring (replacement of destroyed tissue with collagen (non-functional)

Resolution & Repair Sequence --- correct answer --- Healing (filling, sealing & shrinking) → offending agent destroyed and removed → feedback systems (plasma systems) deactivate the inflammatory response → allows the tissue to heal → regeneration & restoration

Regeneration vs. Healing --- correct answer --- - Regeneration occurs if normal function & anatomy is restored

➢ Ex: primary intention healing wound has well approximated edges

• If damage is too extensive, healing occurs through replacement (scar)

➢ Ex: 2nd intention healing-wound is not approximated

Phases of Wound Healing --- correct answer --- 1. Inflammatory Phase

• Coagulation and infiltration of cells for wound healing
• Including angiogenesis (formation of new blood vessels)

2. Proliferative Phase

• Lasts as long as 2 weeks
• Wound is sealed, macrophages recruit fibroblasts

3. Remodelling and Maturation Phase

• Complete within 2 years