NURS 5315 – ADVANCED PATHOPHYSIOLOGY EXAM 1

NURS 5315 – ADV PATHO EXAM 1 Atrophy - E. Cells decrease in size P. Still functional; imbalance between protein synthesis and degradation. Essentially there is an increase in the catabolism of intracellular organelles, reducing structural components of cell Physiologic: thymus gland in early childhood Pathological: disuse (muscle atrophy d/ decrease workload, pressure, use, blood supply, nutrition, hormonal stimulation, or nervous stimulation) Hyperplasia - E: cells increase in number, mitosis (ce ll division) must occur, size of cell does not change Phys: increased rate of division, increase in tissue mass after damage or partial resection; may be compensatory, hormonal, or pathologic Patho: abnormal proliferation of normal cells usually caused by increased hormonal stimulation (endometrial). increase of production of local growth factors Ex: removal of part of the liver lead to hyperplasia of hepatocytes. uterine or mammary gland enlargement during pregnancy Dysplasia - E. Not true adaptation ; Cells abnormal change in size, shape, organization (classified as mild, moderate, severe) P. caused by cell injury/irritation, characterized by disordered cell growth. aka atypical hyperplasia or pre -cancer, a disorderly proliferation Physiologic: N/A Pathologic: squamous dysplasia of cervix from HPV shows up on pap smear, breast cancer development; pap smears often show dysplastic cells of the cervix that must undergo laser/surgical tx Metaplasia - E: reversible change, one type of cell changes to another type for survival P: reversible; results from exposure of the cells to chronic stressors, injury, or irritation; Cancer can arise from this area, stimulus induces a reprogramming of stem cells under the influence of cytokines and growth factors Ex: Patho: Columnar cells change to squamous cells in lungs of smoker or normal ciliated epithelial cells of the bronchial linings are replaced by stratified squamous epithelial cells.; Phys: Barrett Esophagus - normal squamous cells change to columnar epith elial cells in response to reflux, aka intestinal metaplasia Hypoxia injury - E. inadequate oxygenation of tissues P. decrease in mitochondrial function, decreased production of ATP increases anaerobic metabolism. eventual cell death. C.M. hypoxia, cy anosis, cognitive impairment, lethargy Free radical and ROS - E. normal byproduct of ATP production, will overwhelm the mitochondria - exhaust intracellular antioxidants P. lipid peroxidation, damage proteins, fragment DNA C.M. development in Alzheimer's, heart disease, Parkinson's disease, Amyotrophic Lateral Sclerosis Ethanol - E. mood altering drug, long term effects on liver and nutritional status P. metabolized by liver, generates free radicals C.M. CNS depression, nutrient deficiencies -Mag, Vit B6, thiamine, PO4, inflammation and fatty infiltration of liver, hepatomegaly, leads to liver failure irreversible Oncosis - Na and H2O enter cell and cause swelling. Organ increases in weight, become s distended and pale. Associated with high fever, hypocalcemia, certain infections Fatty Infiltration - intracellular accumulation of lipids in the liver liver fails to metabolize lipids. usually from ETOH or high fat diet. can lead to cirrhosis dyst rophic calcification - accumulation of Ca in dead or dying tissues calcium salt clump and harden - interfere with cellular structure and function r/t pulmonary TB, atherosclerosis, injured heart valves, chronic pancreatitis metastatic calcification - accumulation of Ca in normal tissue result of hypercalcemia r/t hyperparathyroidism, hyperthyroidism, toxic levels of Vit D. Can also r/t hyperphosphatemia in renal failure urate accumulation - sodium urate crystals are deposited in tissues - group of disorders collectively called gout - acute arthritis, chronic gouty arthritis, tophus, nephritis Coagulative Necrosis - kidneys, heart, adrenals - secondary to hypoxia Liquefactive Necrosis - nerve cells - brain - accumulation of pus Caseous Necrosis - lung disease - usually TB - tissue looks like clumped cheese Fat Necrosis - breast, pancreas, abdominal structures - creates soaps Gangrenous Necrosis - Dry- dark shriveled skin Wet - internal organs - can lead to death Gas- from clostridium - antitoxins and hyperbaric therapy Gout - E. disturbances in serum urate levels. uncommon for < 30 years old. P. uric acid is deposited in the tissues of kidney, heart, earlobes, and joints. C.M. inflammation, painful joints. result of diuretic use or diet high in cream sauces, red wine, or red meat Rhabdomyolysis - E. cell hypoxia caused by severe muscle trauma, hyperthermia, crush injuries, or severe dehydration P. hypoxia to cell causes failure of the Na -K pump, causing accumulation of intracellu lar sodium, oncosis, and eventual cell death. Cell death releases enzymes such as CK, uric acid, LDH, AST, etc. C.M. Causes: trauma, hyperthermia, crush injuries, severe dehydration; s/s: CK is 5x upper normal limit, muscle pain, weakness, dark, reddish -brown urine, hypercalcemia, renal failure Alpha Fetoprotein Origin - Liver and germ cell tumors Carcinoembryonic Antigen - GI, pancreas, lung, breast tumors Prostate Specific Antigen - prostate tumors Carcino - from epithelial tissue - renal cell carcinoma Sarco -