NURS 611 Path ophysiology Maryville University New Latest Versio n Update d 2023 -2024 with All Questions and 100% Correct Answers Why is there an increase in osmotic pressure in cells after an MI? ------- Correct Answer --------- Hypoxia causes decreased ATP, which stops the NaK pump. Cells retain Na and take on H2O (osmosis) making the cell swell. Uncompensated --------- Correct Answer --------- If the pH is abnormal and CO2 OR HCO3 abnormal Partial compensation --------- Correct Answer --------- If the pH is abnormal and CO2 AND HCO3 abnormal Lead --------- Correct Answer --------- Which chemical interferes with excretion of urate and affets nervous and hematopoietic system What are the causes of hyponatremia? ------- Correct Answer --------- Dilution, NV, dehydration, burns, GI suction List the top five electrolytes and their normal values ------- Correct Answer --------- Mg 1.5-3 Ca 8.5 -12 Na 135 -145 K 3.5 -5 Phos 2.0 -4.7 What is heart rate X stroke volume? HR X SV= What percentage do the kidneys expect? ------- Correct Answer --------- Cardiac output 20 -25% Describe a disease process where metaplasia wo uld happen. ------- Correct Answer -----
---- Smoker's bronchial lining would replace with stratified squamous epithelial cells which tolerate the smoke environment better but do not have cilia to help move mucus. What do natriuretic peptides do? What stim ulates them? Where are they? ------- Correct Answer --------- Decrease the bp and excrete Na and H2O after sensing high bp, high vol in atria ANP, myocardial BNP. What happens to myocytes of heart with chronic HTN? ------- Correct Answer --------- Hypertr ophy with thin walls. Cardiomegaly. CF is autosomal recessive and seen mainly in what children? Describe what a Punnett square of CF would look like, why? ------- Correct Answer --------- Most lethal in white children. Mom would have Dd and dad would have Dd. The dd would be the CF child, 25% chance. What is penetrance? Is it the same as expressivity? ------- Correct Answer --------- Penetrance is number of people that have the gene AND show the phenotype in a population. Expressivity is to what extent the phenotype shows on a scale of less to most severity. What is the difference between incidence rate and relative risk? ------- Correct Answer --
------- Incidence rate is number of new cases in given amount of time.Relative risk is incidence rate of exposed divided by incidence rate of unexp osed. What are the genes for breast cancer? How does a first degree relative with the disease affect the patient's risk? Does that include cousins? ------- Correct Answer --------- BRCA1 and 2, doubles with first degree relative including cousin. Describ e epigenetics and give an example. Is this type of risk reversible? ------- Correct Answer --------- Environmental changes to DNA is reversible, asthma due to pollution. Remove pt from pollution. Trisomy 21 is autosomal recessive and phenotypically looks like? ------- Correct Answer --------- Flat nose bridge, low set ears, protruding tongue, IQ 25 -70 What are the ECG changes in hyper and hypo K? ------- Correct Answer --------- HyperK—tall Twaves, vfib, wide QRS and hypopolarization hypoK —short Twaves, bradycardia, AV block (also paralytic ileus and decreased tonicity) What is the function of ribosomes? Where are they produced? ------- Correct Answer ----
----- Produced in the nucleolus. Synthesize proteins as does the ER. What happens with a stab lacera tion to the liver? ------- Correct Answer --------- Decreased albumin production, liver synthesizes amino acids. Low vol r/t bleeding. Instigates RAAS and ADH both if severe fluid loss Can part of the liver be removed? How much? How do the cells react? ------- Correct Answer --------- Yes, 70% can rebuild using hyperplasia What are the Ca normal values? What other interstitial component should be looked at? Why? ------- Correct Answer --------- 8.5-12 also look at albumin because 40% is bound to Ca What can NG suction with high output cause? ------- Correct Answer --------- Metabolic alkalosis With lower extremity edema would you see a low or high albumin? ------- Correct Answer --------- Low albumin, decreased oncotic pressure resulting in edema Your p atient is in renal failure and has numbness and tingling around the mouth and in the hands and feet. What electrolytes are out of balance? ------- Correct Answer --------- Low Ca and high Phos Name and give reasons for the 3 high risk patients for fluid i mbalances. ------- Correct Answer --------- Infant -high ECF percentage available for loss, Elderly - decreased thirst and decreased RAAS , Obese - increased adipose tissue is not water friendly When methylated mRNA becomes overexpressed it becomes an _______ causing cancer __________. ------- Correct Answer --------- oncomir, metastasis Huntington's disease is autosomal dominant and a good example of age dependent penatrence. What type of counse ling should be suggested? ------- Correct Answer -------
-- Genetic counseling Describe what happens to a cell during an MI. Can it be restored? If so, when? ------- Correct Answer --------- Ischemia happens first which can be restored if O2 is returned. Hypoxia causes necrosis which is not reversible. This damages the cells by stopping the ATP production, allowing more water and Na into the cell. The nucleus dies off and organelles swell, burst and a formation of vacuoles and cavities. Describe natural ag ing clinical manifestations. ------- Correct Answer --------- Stiffness, HTN (capillaries not as elastic), sarcopenia, decreased thirst, atrophy, hypoK, decreased acid in stomach slows GI motility, decreased immune What is the cause of many medication err ors? ------- Correct Answer --------- System error. For example a medication goes through many hands before administration. What are the s/s of dehydration? ------- Correct Answer --------- Decreased, concentrated urine, lethargy, thirst, dry mucous membr anes, decreased bp What receptors cause Thirst and where do they come from? ------- Correct Answer -------
-- The hypoTHalumus, Osmoreceptors stimulated by increased osmolarity, decreased vol, decreased bp. Triggers the posterior pituitary to release ADH. How is ADH stimulated through baroreceptors? ------- Correct Answer --------- Baroreceptors located in R/L atria, carotid sinus and pulmonary arteries detect decrease in volume and BP. Baroreceptors then signal the hypothalamus to release ADH. A pure K d eficiency is caused by __________? ------- Correct Answer --------- Diuretics What is onc otic pressure? ------- Correct Answer --------- The concentration of albumin in the interstitial space is the oncotic pressure. What is hydrostatic pressure? ------- Correct Answer --------- Hydrostatic pressure is bp.
---- Smoker's bronchial lining would replace with stratified squamous epithelial cells which tolerate the smoke environment better but do not have cilia to help move mucus. What do natriuretic peptides do? What stim ulates them? Where are they? ------- Correct Answer --------- Decrease the bp and excrete Na and H2O after sensing high bp, high vol in atria ANP, myocardial BNP. What happens to myocytes of heart with chronic HTN? ------- Correct Answer --------- Hypertr ophy with thin walls. Cardiomegaly. CF is autosomal recessive and seen mainly in what children? Describe what a Punnett square of CF would look like, why? ------- Correct Answer --------- Most lethal in white children. Mom would have Dd and dad would have Dd. The dd would be the CF child, 25% chance. What is penetrance? Is it the same as expressivity? ------- Correct Answer --------- Penetrance is number of people that have the gene AND show the phenotype in a population. Expressivity is to what extent the phenotype shows on a scale of less to most severity. What is the difference between incidence rate and relative risk? ------- Correct Answer --
------- Incidence rate is number of new cases in given amount of time.Relative risk is incidence rate of exposed divided by incidence rate of unexp osed. What are the genes for breast cancer? How does a first degree relative with the disease affect the patient's risk? Does that include cousins? ------- Correct Answer --------- BRCA1 and 2, doubles with first degree relative including cousin. Describ e epigenetics and give an example. Is this type of risk reversible? ------- Correct Answer --------- Environmental changes to DNA is reversible, asthma due to pollution. Remove pt from pollution. Trisomy 21 is autosomal recessive and phenotypically looks like? ------- Correct Answer --------- Flat nose bridge, low set ears, protruding tongue, IQ 25 -70 What are the ECG changes in hyper and hypo K? ------- Correct Answer --------- HyperK—tall Twaves, vfib, wide QRS and hypopolarization hypoK —short Twaves, bradycardia, AV block (also paralytic ileus and decreased tonicity) What is the function of ribosomes? Where are they produced? ------- Correct Answer ----
----- Produced in the nucleolus. Synthesize proteins as does the ER. What happens with a stab lacera tion to the liver? ------- Correct Answer --------- Decreased albumin production, liver synthesizes amino acids. Low vol r/t bleeding. Instigates RAAS and ADH both if severe fluid loss Can part of the liver be removed? How much? How do the cells react? ------- Correct Answer --------- Yes, 70% can rebuild using hyperplasia What are the Ca normal values? What other interstitial component should be looked at? Why? ------- Correct Answer --------- 8.5-12 also look at albumin because 40% is bound to Ca What can NG suction with high output cause? ------- Correct Answer --------- Metabolic alkalosis With lower extremity edema would you see a low or high albumin? ------- Correct Answer --------- Low albumin, decreased oncotic pressure resulting in edema Your p atient is in renal failure and has numbness and tingling around the mouth and in the hands and feet. What electrolytes are out of balance? ------- Correct Answer --------- Low Ca and high Phos Name and give reasons for the 3 high risk patients for fluid i mbalances. ------- Correct Answer --------- Infant -high ECF percentage available for loss, Elderly - decreased thirst and decreased RAAS , Obese - increased adipose tissue is not water friendly When methylated mRNA becomes overexpressed it becomes an _______ causing cancer __________. ------- Correct Answer --------- oncomir, metastasis Huntington's disease is autosomal dominant and a good example of age dependent penatrence. What type of counse ling should be suggested? ------- Correct Answer -------
-- Genetic counseling Describe what happens to a cell during an MI. Can it be restored? If so, when? ------- Correct Answer --------- Ischemia happens first which can be restored if O2 is returned. Hypoxia causes necrosis which is not reversible. This damages the cells by stopping the ATP production, allowing more water and Na into the cell. The nucleus dies off and organelles swell, burst and a formation of vacuoles and cavities. Describe natural ag ing clinical manifestations. ------- Correct Answer --------- Stiffness, HTN (capillaries not as elastic), sarcopenia, decreased thirst, atrophy, hypoK, decreased acid in stomach slows GI motility, decreased immune What is the cause of many medication err ors? ------- Correct Answer --------- System error. For example a medication goes through many hands before administration. What are the s/s of dehydration? ------- Correct Answer --------- Decreased, concentrated urine, lethargy, thirst, dry mucous membr anes, decreased bp What receptors cause Thirst and where do they come from? ------- Correct Answer -------
-- The hypoTHalumus, Osmoreceptors stimulated by increased osmolarity, decreased vol, decreased bp. Triggers the posterior pituitary to release ADH. How is ADH stimulated through baroreceptors? ------- Correct Answer --------- Baroreceptors located in R/L atria, carotid sinus and pulmonary arteries detect decrease in volume and BP. Baroreceptors then signal the hypothalamus to release ADH. A pure K d eficiency is caused by __________? ------- Correct Answer --------- Diuretics What is onc otic pressure? ------- Correct Answer --------- The concentration of albumin in the interstitial space is the oncotic pressure. What is hydrostatic pressure? ------- Correct Answer --------- Hydrostatic pressure is bp.
