Pathophysiology Midterm Complete Exam 2026 Nightingale College

Pathophysiology Midterm Complete Exam 2026 Nightingale College Pathophysiology The study of the underlying changes in body physiology (molecular, cellular, and organ systems) that result from disease or injury. Pathology The investigation of structural alterations in cells, tissues, and organs, which can help identify the cause of a particular disease. Diagnosis The naming or identification of a disease - is made from an evaluation of the evidence accumulated from the presenting signs and symptoms, health and medical history, physical examination, laboratory tests, and imaging. Etiology The study of the CAUSE of disease Epidemiology The study of tracking patterns or disease occurrence and transmission among populations and by geographic areas Nucleus Controls and regulates the activities of the cell (e.g., growth and metabolism) and carries the genes, structures that contain the hereditary information Cytoplasm An aqueous solution. The medium for chemical reaction. It provides a platform upon which other organelles can operate within the cell. All of the functions for cell expansion, growth and replication are carried out in the cytoplasm of a cell. Ribosomes Provide sites for cellular protein synthesis. Endoplasmic Reticulum Specializes in synthesis, folding, and transport of protein and lipid components of most organelles. A new role is sensing cellular stress. Golgi apparatus Responsible for processing and packaging proteins onto secretory vesicles that break away from the complex and migrate to various intracellular and extracellular destinations, including plasma membrane. Lysosomes Contain enzymes for digesting most cellular substances to their basic form, such as amino acids, fatty acids, and carbohydrates (sugars). Peroxisomes Pathophysiology Pathophysiology Contain oxidase enzymes that detoxify alcohol, hydrogen peroxide, and other harmful chemicals Mitochondria Powerhouse of the cell, organelle that is the site of ATP (energy) production Cytoskeleton Network of protein filaments within some cells that helps the cell maintain its shape and is involved in many forms of cell movement Plasma Membrane The membrane at the boundary of every cell that acts as a selective barrier, thereby regulating the cell's chemical composition. Signaling processes 1. They display plasma membrane-bound signaling molecules (receptors) that affect the cell itself and other cells in direct physical contact 2. They affect receptor proteins inside the target cell and the signal molecule has to enter the cell to bind to them 3. They form protein channels (gap junctions) that directly coordinate the activities of adjacent cells Atrophy Type of adaptive cellular mechanism: decrease in cell size Hypertrophy Type of adaptive cellular mechanism:: increase in cell size Hyperplasia Type of adaptive cellular mechanism:: increase in cell number Metaplasia Type of adaptive cellular mechanism: reversible replacement of one mature cell type by another, less mature cell type or a change in cell phenotype Dysplasia Type of adaptive cellular mechanism: deranged cellular growth, is not considered a true cellular adaptation but rather atypical hyperplasia Dominant alleles The allele whose effects are observable Recessive alleles The allele whose effects are hidden DNA Directs the synthesis of all the body's proteins What are the 3 structural components of DNA? 1. The five-carbon monosaccharide deoxyribose 2. A phosphate molecule Pathophysiology Pathophysiology 3. Four types of nitrogenous bases Mutations Any alteration of genetic material Genotype The composition of genes at a given locus Phenotype The outward appearance of an individual, which is the result of both genotype and environment Alleles Different forms of a gene Genes DNA segments that serve as the key functional units in hereditary transmission. Heterozygous When the alleles are not identical Homozygous having two identical alleles for a trait Epigenetics Encoded by chemical modifications to DNA and associated histone proteins, helps determine which of an individual's genes are active in which cells Down Syndrome A trisomy of chromosome 21, is the best-known disease caused by a chromosome aberration. It affects 1 in 800 to 1 in 1000 live births. These genetic mechanisms lead to Gaucher's Disease Missing the enzyme that breaks down fatty substances called lipids. Lipids start to build up in certain organs such as your spleen and liver. These genetic mechanisms lead to Zellweger Disease Caused by defects in any one of 13 genes, termed PEX genes, required for the normal formation and function of peroxisomes. These genetic mechanisms lead to Turner syndrome The presence of a single X chromosome and no homologous X or Y chromosome, so that the individual has a total of 45 chromosomes (45,X karyotype). These genetic mechanisms lead to Kleinfelter syndrome There are at least two X chromosomes and one Y chromosome in each cell (47,XXY karyotype). These genetic mechanisms lead to Impact of alcohol use during pregnancy Culturing neural stem cells in the presence of ethanol leads to dense methylation and inactivation of loci typically active in neurons. Alters fetal expression of the DNA methyltransferases (DNMTs). Pathophysiology Pathophysiology Blunt force injuries Mechanical injury to the body resulting in the tearing, shearing, or crushing Asphyxiation Caused by the failure of cells to receive or use oxygen. Deprivation of oxygen may be partial (hypoxia) or total (anoxia) Suffocation Type of asphyxial Injury: the process of dying as a result of lack of oxygen, can result from either a lack of oxygen in the environment or from a blockage of the respiratory airways Strangulation Type of asphyxial Injury: caused by compression of the blood vessels and air passages resulting from external pressure on the neck. The compression causes hypoxia from impaired blood flow to the brain. Chemical Asphyxiants Type of asphyxial Injury: chemicals that prevent the delivery of oxygen to the tissues or block oxygen utilization (CO2, cyanide, hydrogen sulfide, and methane) Drowning Type of asphyxial Injury: death from inhalation of and suffocation by a liquid, usually water. Pathophysiology, clinical manifestations of alterations in water movement Edema caused by: (1) increased capillary hydrostatic pressure, (2) decreased plasma oncotic pressure, (3) increased capillary membrane permeability, and (4) lymphatic channel obstruction. Metabolic acidosis Compensatory mechanism involving respiratory C02 elimination (hyperventilation) is for what condition? metabolic alkalosis Compensatory mechanism involving respiratory C02 retention (hypoventilation) is for what condition? respiratory acidosis Compensatory mechanism involving renal bicarbonate retention and hydrogen elimination is for what condition? respiratory alkalosis Compensatory mechanism involving renal bicarbonate elimination and hydrogen retention is for what condition? innate response Natural barriers and inflammation is a major component of _______________ acute inflammation Fever, leukocytosis, increased plasma protein synthesis are systemic manifestations of _______________ Pathophysiology Pathophysiology Combined deficiencies Clinical manifestations of _______________ include bleeding secondary to thrombocytopenia (low platelet counts), eczema, and recurrent infections (e.g., otitis media, pneumonia, herpes simplex, cytomegalovirus). Identify the clinical manifestations of spinal cord and vertebral injury ... Disorders of Expression Hypermimesis, hypomimesis, and apraxia/dyspraxia Migraine without Aura Type of migraine involving just vomiting Risk factors for cerebrovascular disease (CVD) • Poorly controlled or uncontrolled arterial hypertension • Smoking, which increases the risk of stroke by 2 to 4 times • Insulin resistance and diabetes mellitus • Atrial fibrillation • Polycythemia (excess red blood cells) and thrombocythemia (excess platelets) • High total cholesterol or low high-density lipoprotein (HDL) cholesterol, elevated lipoprotein-a • Congestive heart disease and peripheral vascular disease • Hyperhomocysteinemia • Sickle cell disease • Postmenopausal hormone therapy • High sodium intake 2300 mg; low potassium intake 4700 mg • Obesity • Sleep apnea • Depression • Chlamydia pneumoniae infection • Physical inactivity • Family history of ischemic stroke Multiple sclerosis Clinical manfestations of _______________ involve paresthesias of the face, trunk, or limbs; weakness; impaired gait; or urinary incontinence, indicating diffuse CNS involvement. Visual impairment is associated with optic neuritis. Cerebellar and corticospinal involvement presents as nystagmus, ataxia, and weakness, with all four limbs involved. Intention tremor and slurred speech may also occur. Subarachnoid hemorrhage (SAH) Clinical manfestations of _______________ involve hemorrhaging confined to the subarachnoid space, but may not present local signs. If bleeding spreads into the brain tissue, hemiparesis/paralysis, dysphasia, or homonymous hemianopia (visual field loss on the same side of both eyes) may be present. Pathophysiology Pathophysiology Types of headaches Migraine with or without aura, cluster headache/proximal hemicrania, tension-type headache neuromuscular junction disorders The pathophysiology of _______________ is characterized by a results from a defect in nerve impulse transmission at the neuromuscular junction. The postsynaptic AChRs on the muscle cell's plasma membrane are no longer recognized as "self" and elicit T-cell dependent formation of IgG autoantibodies. The autoantibodies fix onto AChR sites, blocking the binding of acetylcholine. Positive feedback loops Type of feedback loop that enhance or amplify changes; this tends to move a system away from its equilibrium state and make it more unstable. Addison disease The below describes the evaluation and treatment of _______________. Evaluation: Serum and urine levels of cortisol are depressed with primary hypocortisolism, and ACTH levels are increased. Because of dehydration, blood urea nitrogen levels may increase. The serum glucose level is low. Eosinophil and lymphocyte counts often are elevated. Treatment: Lifetime glucocorticoid and mineralocorticoid replacement therapy, together with dietary modifications and correction of any underlying disorders diabetes insipidus The clinical manifestation of _______________ can be described by polyuria, nocturia, continuous thirst, and polydipsia. Hyperthyroidism The clinical manifestation of _______________ consists of thinning of the hair, exophthalmos, enlarged thyroid, heart failure (tachycardia), weight loss, diarrhea, warm skin/sweaty palms, hyperreflexia, pretibial edema thyroid storm The following are events that lead to a _______________: TH levels rise dramatically and death can occur within 48 hours without treatment. The condition may develop spontaneously but usually occurs in individuals who have undiagnosed or partially treated Graves disease and who are subjected to physiologic stress, such as infection, pulmonary or cardiovascular disorders, trauma, seizures, surgery (especially thyroid surgery), obstetric complications, or dialysis. Contusion (bruise) Example of blunt-force injury: as a result of bleeding into the skin or underlying tissue. initially red-purple, then blue-black, then yellow-brown or green. Pathophysiology Pathophysiology hematoma type of contusion: collection of blood in soft tissue subdural hematoma type of contusion: blood between inner surface of dura mater and surface of brain laceration Example of blunt-force injury: tear or rip resulting when tensile strength of skin or tissue is exceeded. Characterized as ragged and irregular with abraded edges Avulsion Extreme type of laceration: wide area of tissue is pulled away Sharp-Force Injury Cutting and piercing injuries accounted for 2734 deaths in 2007 Icised Wound Type of sharp-force injury: wound that is longer than it is deep Stab Wound A type of sharp-force injury: a wound that is deeper than it is long Punctre Wound A type of sharp-force injury: instruments or objects with sharp points but without sharp edges produce puncture wounds Chopping Wound A type of sharp-force injury: heavy edged instruments (axes, hatchets, propeller blades) produce wounds with a combination of sharp- and blunt-force characteristics Gunshot Wounds Either penetrating (bullet in the body) or perforating (bullet exits the body) Entrance Wound All gunshot wounds have this common feature Contact Range Wound Type of gunshot wound: when the muzzle of the gun rests on or presses into the skin surface Intermediate (distant) range entrance wound Type of gunshot wound: surrounded by gunpowder tattooing or stippling Intermediate range entrance wound Type of gunshot wound: occurs when flame, soot, or gunpowder does not reach skin surface but bullet does Exit Wound Type of gunshot wound that has the same appearance regardless of range of fire Wounding potential of bullets most damage done by bullet is result of amount of energy transferred to tissue impacted speed of bullet has much greater effect than increased size Pathophysiology Pathophysiology lethality of wound depends on what structures damaged Role of histamine To induce vasodilation and increased capillary permeability Role proinflammatory cytokines Vital in the destruction of many pathogenic microorganisms Hemostasis (coagulation) First phase of wound healing: platelet activation & fibrin clot Inflammation Second phase of wound healing: macrophages, cytokines, neutrophils, & lymphocytes Proliferation/tissue formation Third phase of wound healing: angiogenesis, fibroblast activation, granulation tissue formation, and cytokines & growth factors Remodeling & Maturation Fourth phase of wound healing: fibroblasts Hypertrophic Scar Type of scar resulting from dysfunctional wound healing characterized as raised skin but remains within original boundaries of the wound Keloid Type of scar resulting from dysfunctional wound healing characterized by raised skin but extends beyond original bounds of wound and invades surrounding tissue Primary immune response Reaction of the immune system when it contacts an antigen for the first time. secondary immune response Reaction of the immune system when it contacts an antigen for the second and subsequent times. Type I hypersensitivities (IgE) Examples of this type of hypersensitivity are seasonal allergic rhinitis, Asthma Type II hypersensitivities (IgG, IgM) Examples of this type of hypersensitivity are autoimmune thrombocytopenic purpura, Graves disease, autoimmune hemolytic anemia Type III hypersensitivities (IgG IgM) Examples of this type of hypersensitivity are systemic lupus erythematosus Type IV hypersensitivities No immunoglobulin associated as it is a cell-mediated reaction. Examples of this type of hypersensitivity are contact sensitivity to poison ivy, metals (jewelry), and latex Hyperacute rejection Type of transplant rejection involving immediate, rare, and occurs because of the presence of preexisting antibodies (type II reaction) to HLA antigens on the vascular endothelial cells in the grafted tissue. Pathophysiology Pathophysiology Acute rejection Type of transplant rejection involving a cell-mediated immune response that occurs within days to months after transplantation. This type of rejection occurs when the recipient develops an immune response against unmatched HLA antigens after transplantation. Chronic rejection Type of transplant rejection that may occur after a period of months or years of normal function. It is characterized by slow, progressive organ failure. Occurs most often in recipients who were poorly matched to their donor, have comorbidities (e.g., diabetes, hypertension), who received a graft that was damaged during the transplantation procedure, or who have required treatment for multiple acute rejection episodes. Bacteremia occurs when bacteria are present in the blood Sepsis occurs when bacteria are growing in the blood and release large amounts of toxins bacteremia and sepsis Clinical manifestations of _______________ and _______________ involve fever, activate platelets, and promote intravascular coagulation or increase capillary permeability sufficient to permit escape of large volumes of plasma into surrounding tissue contributing to hypotension and, in severe cases, cause septic shock and or multiple organ failure with increased risk for mortality Midbrain Major functions of the _______________ include a relay center for motor and sensory tracts, as well as a center for auditory and visual reflexes. Spinal cord A Major function of the _______________ is the connection of the brain and the body through a long nerve cable, somatic and autonomic reflexes, motor pattern control, and sensory and motor modulation. Forebrain Major functions of the _______________ is telencephalon (the two cerebral hemispheres) and that it allows conscious perception of internal and external stimuli, thought and memory processes, and voluntary control of skeletal muscles. Diencephalon (the deep portion of the forebrain) and processes incoming sensory data. Hindbrain Major functions of the _______________ is that it allows sampling and comparison of sensory data, which are received from the periphery and motor impulses of the cerebral hemispheres, for the purpose of coordination and refinement of skeletal muscle movement. disorders of temperature regulation Hyperthermia, hypothermia, and body trauma Pathophysiology Pathophysiology Hyperthermia Disorder of temperature regulation that can produce nerve damage, coagulation of cell proteins, and death. At 41° C (105.8° F), nerve damage produces convulsions in the adult. Death results at 43° C (109.4° F). Hypothermia Disorder of temperature regulation when the core body temperature less than 35° C 95° F. Produces depression of the CNS and respiratory system, vasoconstriction, alterations in microcirculation and coagulation, and ischemic tissue damage. Major body trauma Disorder of temperature regulation that results in damage to the CNS, inflammation, increased intracranial pressure, or intracranial bleeding typically produces a body temperature of greater than 39° C (102.2° F). This sustained noninfectious fever, often referred to as a central fever, appears with or without bradycardia. A central fever does not induce sweating and is very resistant to antipyretic therapy. Olfactory and taste dysfunctions hyposmia, anosmia, parosmia, hypogeusia, ageusia, dysgeusia, and olfactory hallucinations. Hyposmia Type of olfactory and taste dysfunction that is characterized by impaired sense of smell Anosmia Type of olfactory and taste dysfunction that is characterized by complete loss of sense of smell Parosmia Type of olfactory and taste dysfunction that is characterized by abnormal or perverted sense of smell olfactory hallucinations Type of olfactory and taste dysfunction that is characterized by smelling odors that are not really present Hypgeusia Type of olfactory and taste dysfunction that is characterized by decrease in taste sensation Aguesia Type of olfactory and taste dysfunction that is characterized by absence of the sense of taste Dysgeusia Type of olfactory and taste dysfunction that is characterized by perversion of taste in which substances possess an unpleasant flavor (i.e., metallic) Alterations in arousals Pathophysiology Pathophysiology Brain death (total brain death), cerebral death (irreversible coma), persistent vegetative state, minimally conscious state (MCS, minimally preserved consciousness), and locked-in syndrome Cerebral death (irreversible coma) Alteration of arousal involving death of the cerebral hemispheres exclusive of the brainstem and cerebellum. Brain damage is permanent, and the individual is forever unable to respond behaviorally in any significant way to the environment. Persistent vegetative state Alteration of arousal involving complete unawareness of the self or surrounding environment and complete loss of cognitive function. Recovery is unlikely if the state persists for 12 months. Minimally conscious state (MCS, minimally preserved consciousness) Alteration of arousal that are characaterized by possible ability to follow simple commands, manipulate or reach for objects, gesture or give yes/no responses, have intelligible speech, and have movements such as blinking or smiling. Individuals may remain permanently in this state or progress to minimal ability to understand and communicate. Locked-in syndrome Alteration of arousal involving complete paralysis of voluntary muscles with the exception of eye movement. Decorticate Posturing/rigidity involving upper extremity flexion, lower extremity extension Response: Slowly developing flexion of arm, wrist, and fingers with adduction in the upper extremity and extension, internal rotation, and plantar flexion of lower extremity Decerebrate Posturing/rigidity involving upper and lower extremity extensor responses Response: Opisthotonos (hyperextension of vertebral column) with clenching of teeth; extension, abduction, and hyperpronation of arms; and extension of lower extremities. In acute brain injury, shivering and hyperpnea may accompany unelicited recurrent decerebrate spasms Hypermimesis Disorder of expression that commonly manifests as pathologic laughter or crying. Pathologic laughter is associated with right hemisphere injury, and pathologic crying is associated with left hemisphere injury. Hypomimesis Disorder of expression that manifests as aprosody—the loss of emotional language. Receptive aprosody involves an inability to understand emotion in speech and facial expression. Expressive aprosody involves the inability to express emotion in speech and facial expression. Aprosody is associated with right hemisphere damage. Apraxia/dyspraxia Pathophysiology Pathophysiology A disorder of learned skilled movements with difficulty planning and executing coordinated motor movements. The term is often used interchangeably with dyspraxia. It can be developmental, beginning at birth (developmental apraxia), or associated with vascular disorders (common in stroke), trauma, tumors, degenerative disorders, infections, or metabolic disorders. Migraine with Aura Type of migraine involving vomiting, then visual, sensory, language, and motor disturbance Cluster headache/proximal hemicrania Type of migraine involving lacrimation, rhinorrhea, Horner syndrome Negative feedback loop Type of feedback loop that dampens or buffers change; this tends to hold a system to some equilibrium state making it more stable Hyperaldosteronism Clinical manifestations of _______________ involves the thinning of scalp hair, emotional instability, acne, moon face, increased facial hair, buffalo hump, osteoporosis, cardiac hypertrophy/hypertension, truncal obesity, striae of skin, easy bruising, muscle wasting, DM Pathophysiology