NURS 617 PHARM EXAM 3
COMPREHENSIVE EXAM SCRIPT VERIFIED
QUESTIONS COMPLETE ANSWERS
GRADED APLUS
◉ Necrosis
Answer: Unregulated; cell swelling, membrane rupture,
inflammation; patterns: coagulative, liquefactive, caseous, fat,
fibrinoid.
◉ Apoptosis
Answer: Programmed; cell shrinkage, chromatin condensation,
membrane blebs, apoptotic bodies; caspase-mediated; no
inflammation.
◉ Total body water (TBW)
Answer: ≈ 60% body weight (varies by age/sex/adiposity).
◉ Intracellular fluid (ICF)
Answer: ~ 2/3 TBW (high K⁺, Mg²⁺, phosphate, proteins).
◉ Extracellular fluid (ECF)
,Answer: ~ 1/3 TBW → interstitial (~3/4 ECF) + plasma (~1/4 ECF)
(high Na⁺, Cl⁻, HCO₃⁻).
◉ Sensible water loss
Answer: Measurable—urine, feces, sweat (variable).
◉ Insensible water loss
Answer: Not easily measured—evaporation from skin (non-sweat)
and respiratory tract.
◉ Intracellular edema
Answer: Failure of Na⁺/K⁺-ATPase, hyponatremia, hypoxia/ischemia
→ water influx.
◉ Extracellular edema
Answer: Increased capillary hydrostatic pressure, decreased plasma
oncotic pressure (hypoalbuminemia), increased capillary
permeability (inflammation), lymphatic obstruction.
◉ Anti-edema mechanisms
Answer: Lymphatic drainage; intact endothelial glycocalyx; plasma
oncotic pressure (albumin); renal Na⁺/water excretion;
neurohormonal modulation (RAAS, ANP/BNP).
, ◉ Fluid balance by system
Answer: Renal: GFR, tubule Na⁺/water handling; RAAS; ADH-
regulated water reabsorption; pressure natriuresis.
◉ Regulation of blood volume
Answer: RAAS (renin→Ang II→aldosterone → Na⁺/water retention,
vasoconstriction), ADH (water reabsorption), thirst, sympathetic
tone, ANP/BNP (oppose RAAS).
◉ Blood pressure response to volume change
Answer: ↓Volume → ↓baroreceptor firing → ↑SNS, ↑renin, ↑ADH →
↑HR, vasoconstriction, Na⁺/water retention. ↑Volume →
↑baroreceptor firing → ↓SNS/renin, ↑ANP/BNP → vasodilation,
natriuresis/diuresis.
◉ Vasopressin (ADH)
Answer: Inserts aquaporin-2 in collecting duct (V2 receptors) →
free-water reabsorption; V1 vasoconstriction at higher levels.
◉ Aldosterone
Answer: Principal cells—↑ENaC/Na⁺-K⁺-ATPase → Na⁺ retention/K⁺
secretion; expands ECV.
◉ Atrial natriuretic peptide (ANP)
COMPREHENSIVE EXAM SCRIPT VERIFIED
QUESTIONS COMPLETE ANSWERS
GRADED APLUS
◉ Necrosis
Answer: Unregulated; cell swelling, membrane rupture,
inflammation; patterns: coagulative, liquefactive, caseous, fat,
fibrinoid.
◉ Apoptosis
Answer: Programmed; cell shrinkage, chromatin condensation,
membrane blebs, apoptotic bodies; caspase-mediated; no
inflammation.
◉ Total body water (TBW)
Answer: ≈ 60% body weight (varies by age/sex/adiposity).
◉ Intracellular fluid (ICF)
Answer: ~ 2/3 TBW (high K⁺, Mg²⁺, phosphate, proteins).
◉ Extracellular fluid (ECF)
,Answer: ~ 1/3 TBW → interstitial (~3/4 ECF) + plasma (~1/4 ECF)
(high Na⁺, Cl⁻, HCO₃⁻).
◉ Sensible water loss
Answer: Measurable—urine, feces, sweat (variable).
◉ Insensible water loss
Answer: Not easily measured—evaporation from skin (non-sweat)
and respiratory tract.
◉ Intracellular edema
Answer: Failure of Na⁺/K⁺-ATPase, hyponatremia, hypoxia/ischemia
→ water influx.
◉ Extracellular edema
Answer: Increased capillary hydrostatic pressure, decreased plasma
oncotic pressure (hypoalbuminemia), increased capillary
permeability (inflammation), lymphatic obstruction.
◉ Anti-edema mechanisms
Answer: Lymphatic drainage; intact endothelial glycocalyx; plasma
oncotic pressure (albumin); renal Na⁺/water excretion;
neurohormonal modulation (RAAS, ANP/BNP).
, ◉ Fluid balance by system
Answer: Renal: GFR, tubule Na⁺/water handling; RAAS; ADH-
regulated water reabsorption; pressure natriuresis.
◉ Regulation of blood volume
Answer: RAAS (renin→Ang II→aldosterone → Na⁺/water retention,
vasoconstriction), ADH (water reabsorption), thirst, sympathetic
tone, ANP/BNP (oppose RAAS).
◉ Blood pressure response to volume change
Answer: ↓Volume → ↓baroreceptor firing → ↑SNS, ↑renin, ↑ADH →
↑HR, vasoconstriction, Na⁺/water retention. ↑Volume →
↑baroreceptor firing → ↓SNS/renin, ↑ANP/BNP → vasodilation,
natriuresis/diuresis.
◉ Vasopressin (ADH)
Answer: Inserts aquaporin-2 in collecting duct (V2 receptors) →
free-water reabsorption; V1 vasoconstriction at higher levels.
◉ Aldosterone
Answer: Principal cells—↑ENaC/Na⁺-K⁺-ATPase → Na⁺ retention/K⁺
secretion; expands ECV.
◉ Atrial natriuretic peptide (ANP)
