1
NSG
NSG 533/ NSG533 E XAM 1: (NEW 2025/
2026 UPDATE) ADVANCED PHARMACOLOGY
GUIDE| QUESTIONS & ANSWERS| GRADE A| 100%
CORRECT (VERIFIED SOLUTIONS)- WILKES
Chemically reactive molecules that are formed as natural oxidant species in cells during
mitochondrial respiration and energy generation. Most sources come from the mitochondria.
Made during the process of making ATP. - ANS ✓Reactive oxygen species (ROS)
Remove free radicals and ROS from our system. - ANS ✓Antioxidants
When free radicals are produced in amounts that overwhelm our antioxidants or when
antioxidants are decreased. - ANS ✓Oxidative Stress
What can occur within the cell when injury is induced by free radicals? - ANS ✓1.
membrane damage
2. protein modifications
3. mutations in DNA
4. Damage to cell signaling pathways
Genetic disturbances can be _______ if they involve the germ cell line of an individual -
ANS ✓inherited
NSG 533
, 2
NSG
Genetic disturbances can also be _______ by exposure to some mutagenic/ carcinogenic
environmental factors - ANS ✓acquired
Enzymes secreted by microorganisms can breakdown cell membranes once introduced into
the body= _______
Allows the organisms to dissolve surrounding tissues and allows them to move deeper into
the tissues, blood, and lymphatics. - ANS ✓lysis by enzymes
Certain viruses, once they have infected a cell, will cause membrane rupture as newly
produced viral particles (virions) leave the host cell= ________. Sometimes referred to as
lytic viruses. Examples include HIV and Hep B. - ANS ✓Lysis by virus
Involve the abnormal accumulation of substances that are normally found in the body
(endogenous agents) or not normally found in the body (exogenous agents). - ANS
✓Metabolic derangements
Give 2 examples of endogenous accumulations in the body. - ANS ✓1. Lipids: Fatty changes
occurs most often in liver cells but can also be problem in myocardial cells. Liver handles
fats and synthesizes complex fats and lipoproteins. Slow accumulation of fat within hepatic
or myocardial cells usually does not impair the function of those cells until the problem is
extreme. However, fatty change can occur in acute basis and can lead to acute heart or liver
failure.
2. Bilirubin: Pigment released when RBCs break down/destroyed. Bilirubin is
released/diffuses into blood where it is called unconjugated (indirect) bilirubin. Unconjugated
bilirubin is fat-soluble and can't be eliminated through kidney (urine). So, it's taken up by
NSG 533
, 3
NSG
liver cells bound to a substance called glucuronic acid and becomes bilirubin glucuronide or
conjugated (direct) bilirubin. Conjugated bilirubin is water-soluble and can be eliminated
through the kidney.
Describe the 2 ways in which conjugated bilirubin leaves the liver cells. - ANS ✓1. As
concentration of conjugated bilirubin in the liver cells increases, it begins to diffuse out of the
cell into the blood (down its concentration gradient).
2. In addition, some of the conjugated bilirubin becomes part of a substance called bile; bile
exits the liver cell through the hepatic duct and common bile duct and then into the
duodenum.
Explain 3 problems that may result in hyperbilirubinemia. - ANS ✓1. Excessive amounts of
Hgb breakdown occur, as with hemolytic anemia or after birth when babies rapidly destroy
their excess RBC mass. This results in excessive amounts of unconjugated bilirubin being
delivered to the liver at a rate greater than the liver can handle. Unconjugated bilirubin
accumulates in the blood. This is referred to as hemolytic jaundice.
2. Second problem area occurs when the amount of bilirubin released from RBC breakdown
is normal, but the liver cells are sick and are unable to uptake unconjugated bilirubin from the
blood, conjugate it, and/or excrete it into the bile. This is called hepatocellular jaundice
because the problem is within the liver cell.
3. The third problem occurs when there is an obstruction to the flow of bile in the hepatic
and/or common bile duct. Conjugated bilirubin accumulates in the liver cell and more
NSG 533
NSG
NSG 533/ NSG533 E XAM 1: (NEW 2025/
2026 UPDATE) ADVANCED PHARMACOLOGY
GUIDE| QUESTIONS & ANSWERS| GRADE A| 100%
CORRECT (VERIFIED SOLUTIONS)- WILKES
Chemically reactive molecules that are formed as natural oxidant species in cells during
mitochondrial respiration and energy generation. Most sources come from the mitochondria.
Made during the process of making ATP. - ANS ✓Reactive oxygen species (ROS)
Remove free radicals and ROS from our system. - ANS ✓Antioxidants
When free radicals are produced in amounts that overwhelm our antioxidants or when
antioxidants are decreased. - ANS ✓Oxidative Stress
What can occur within the cell when injury is induced by free radicals? - ANS ✓1.
membrane damage
2. protein modifications
3. mutations in DNA
4. Damage to cell signaling pathways
Genetic disturbances can be _______ if they involve the germ cell line of an individual -
ANS ✓inherited
NSG 533
, 2
NSG
Genetic disturbances can also be _______ by exposure to some mutagenic/ carcinogenic
environmental factors - ANS ✓acquired
Enzymes secreted by microorganisms can breakdown cell membranes once introduced into
the body= _______
Allows the organisms to dissolve surrounding tissues and allows them to move deeper into
the tissues, blood, and lymphatics. - ANS ✓lysis by enzymes
Certain viruses, once they have infected a cell, will cause membrane rupture as newly
produced viral particles (virions) leave the host cell= ________. Sometimes referred to as
lytic viruses. Examples include HIV and Hep B. - ANS ✓Lysis by virus
Involve the abnormal accumulation of substances that are normally found in the body
(endogenous agents) or not normally found in the body (exogenous agents). - ANS
✓Metabolic derangements
Give 2 examples of endogenous accumulations in the body. - ANS ✓1. Lipids: Fatty changes
occurs most often in liver cells but can also be problem in myocardial cells. Liver handles
fats and synthesizes complex fats and lipoproteins. Slow accumulation of fat within hepatic
or myocardial cells usually does not impair the function of those cells until the problem is
extreme. However, fatty change can occur in acute basis and can lead to acute heart or liver
failure.
2. Bilirubin: Pigment released when RBCs break down/destroyed. Bilirubin is
released/diffuses into blood where it is called unconjugated (indirect) bilirubin. Unconjugated
bilirubin is fat-soluble and can't be eliminated through kidney (urine). So, it's taken up by
NSG 533
, 3
NSG
liver cells bound to a substance called glucuronic acid and becomes bilirubin glucuronide or
conjugated (direct) bilirubin. Conjugated bilirubin is water-soluble and can be eliminated
through the kidney.
Describe the 2 ways in which conjugated bilirubin leaves the liver cells. - ANS ✓1. As
concentration of conjugated bilirubin in the liver cells increases, it begins to diffuse out of the
cell into the blood (down its concentration gradient).
2. In addition, some of the conjugated bilirubin becomes part of a substance called bile; bile
exits the liver cell through the hepatic duct and common bile duct and then into the
duodenum.
Explain 3 problems that may result in hyperbilirubinemia. - ANS ✓1. Excessive amounts of
Hgb breakdown occur, as with hemolytic anemia or after birth when babies rapidly destroy
their excess RBC mass. This results in excessive amounts of unconjugated bilirubin being
delivered to the liver at a rate greater than the liver can handle. Unconjugated bilirubin
accumulates in the blood. This is referred to as hemolytic jaundice.
2. Second problem area occurs when the amount of bilirubin released from RBC breakdown
is normal, but the liver cells are sick and are unable to uptake unconjugated bilirubin from the
blood, conjugate it, and/or excrete it into the bile. This is called hepatocellular jaundice
because the problem is within the liver cell.
3. The third problem occurs when there is an obstruction to the flow of bile in the hepatic
and/or common bile duct. Conjugated bilirubin accumulates in the liver cell and more
NSG 533
