NUR 376 PATHOPHYSIOLOGY EXAM 1
Brian,75age7528,75began75an75aerobic75exercise75program75275years75ago.75Brian75now7
5competes75in75long-
distance75cycling75events75and75considers75himself75to75be75an75endurance75athlete75w
ho75is75in75the75"best75shape75of75his75life."75An75echocardiogram75reveals75a75slightly75
enlarged75left75ventricle.75What75cellular75change75or75injury75that75is75best75exemplified
75by75the75case75scenario.75-75answer--Physiologic75hypertrophy
An75ADAPTIVE75type75of75hypertrophy75that75occurs75due75to75extensive75exercise,75wh
ereby75the75heart75will75create75new75blood75vessel75branches75(angiogenesis)75and75th
ere75is75increased75mitochondria,75ATP,75and75actin/myosin75filaments75in75the75muscle.
Recently,75Karen75learned75that75not75only75does75HIV75directly75attack75CD475cells,75b
ut75the75presence75of75the75virus75seems75to75activate75pathways75responsible75for75pro
grammed75cell75death75in75CD475cells.75Thus,75HIV75infection75appears75to75increase75t
he75rate75of75"suicide"75for75CD475cells.75-75answer--Apoptosis
Define75dysplasia75-75answer--
Compared75to75normal75cells,75cells75demonstrating75dysplasia75are75atypical75in75size75
and75shape.75Dysplasia75does75not75mean75the75cells75are75cancerous.75However,75so
me75screening75tests,75such75as75the75Pap75smear,75examine75tissues75to75determine75i
f75any75cellular75changes75are75taking75place.75Any75changes75in75the75cells75can75then7
5be75monitored75over75time.
A75biopsy75of75a75skin75lesion75is75conducted75on75Leann,75a7548-year-
old75woman.75Biopsy75results75revealed75proliferating75cells75that75were75well-
differentiated75and75resembled75surrounding75cells.75The75cells75were75contained75withi
n75a75well-defined75area.75-75answer--Benign75neoplasia.
Neoplasia75is75uncontrolled75and75unregulated75cell75growth.75The75mass75of75tissue75re
sulting75is75known75as75a75"neoplasm."75In75a75benign75neoplasm,75the75cells75do75not75
have75the75characteristics75associated75with75malignancy.75The75cells,75although75canc
erous,75are75well-
differentiated,75meaning75they75resemble75normal,75mature75cells.75The75cells75are75als
o75in75a75contained75area75and75are75unlikely75to75spread.
Miguel,75a75retired75warehouse75supervisor,75had75a75myocardial75infarction.75Further75
evaluation75revealed75he75had75significant75blockage75in75his75left75descending75coronar
, y75artery.75The75blockage75resulted75in75ischemia75and75cell75death75for75those75cells75s
erved75by75the75artery.75-75answer--Necrosis
Necrosis75is75premature75cell75death75caused75by75cell75injury.75Necrosis75differs75from7
5apoptosis,75in75that75the75cellular75destruction75results75from75some75form75of75trauma,7
5rather75than75genetic75programming.75May75lead75to75GANGRENE75which75is75when75
dead75tissue75houses75bacteria.
Julianne,75who75suffers75from75familial75hypercholesterolemia,75presents75with75xantho
mas.75Xanthomas75are75excess75cholesterol75deposits,75which75appear75as75yellow75ski
n75lesions.75What75cell75process75is75this75-75answer--Intracellular75accumulation.
Some75disease75processes75stimulate75intracellular75accumulations75of75particles,75suc
h75as75calcium,75cholesterol,75and75triglycerides,75glucose,75among75other75substances.
75In75familial75hypercholesterolemia,75a75genetic75defect75causes75decreased75cellular75
uptake75of75cholesterol,75resulting75in75high75serum75cholesterol75levels.75Cholesterol75d
eposits,75known75as75xanthomas,75may75appear75to75form75under75the75skin.
Janae75experienced75a75frightening75ATV75accident,75in75which75her75ATV75flipped75ove
r75and75she75ended75up75catching75a75portion75of75her75upper75arm75on75a75barbed75wir
e75fence.75Although75Janae's75injuries75healed75fully,75enlarged,75keloid75scar75formatio
ns75remain75at75the75injury75site.75-75answer--Hyperplasia
cell75proliferation,75known75as75hyperplasia,75was75stimulated75as75a75result75of75her75inj
ury.75A75keloid75results75from75overgrowth75of75granulation75tissue75during75the75wound7
5repair75process.
Hypertension75that75leads75to75workload75on75the75left75ventricle75and75thus75enlargeme
nt75would75be75deemed?75-75answer--Pathological75hypertrophy.75
No75blood75vessel75growth75and75increased75workload75would75lead75to75ischemia75and
75enlargement75of75the75heart.75
NCLEX75TIP:75Left75ventricular75hypertrophy75would75lead75to75displacement75of75the75
PMI75during75chest75palpation.
Hyperplasia75occurs75from75which75two75mechanisms?75-75answer--
An75INCREASE75in75the75number75of75cells75in75a75tissue75or75organ.
1)75hormonal75(estrogen75stimulating75the75mitotic75division75of75breast75gland75cells;75al
so75BPH75in75older75males)
2)75overcompensation75during75regeneration75(keloid75scars)
Andy75has75undergone75a75colonoscopy75because75his75family75has75a75history75of75col
on75cancer.75Biopsy75of75the75colon75reveals75poorly75differentiated75cells75in75the75sam
Brian,75age7528,75began75an75aerobic75exercise75program75275years75ago.75Brian75now7
5competes75in75long-
distance75cycling75events75and75considers75himself75to75be75an75endurance75athlete75w
ho75is75in75the75"best75shape75of75his75life."75An75echocardiogram75reveals75a75slightly75
enlarged75left75ventricle.75What75cellular75change75or75injury75that75is75best75exemplified
75by75the75case75scenario.75-75answer--Physiologic75hypertrophy
An75ADAPTIVE75type75of75hypertrophy75that75occurs75due75to75extensive75exercise,75wh
ereby75the75heart75will75create75new75blood75vessel75branches75(angiogenesis)75and75th
ere75is75increased75mitochondria,75ATP,75and75actin/myosin75filaments75in75the75muscle.
Recently,75Karen75learned75that75not75only75does75HIV75directly75attack75CD475cells,75b
ut75the75presence75of75the75virus75seems75to75activate75pathways75responsible75for75pro
grammed75cell75death75in75CD475cells.75Thus,75HIV75infection75appears75to75increase75t
he75rate75of75"suicide"75for75CD475cells.75-75answer--Apoptosis
Define75dysplasia75-75answer--
Compared75to75normal75cells,75cells75demonstrating75dysplasia75are75atypical75in75size75
and75shape.75Dysplasia75does75not75mean75the75cells75are75cancerous.75However,75so
me75screening75tests,75such75as75the75Pap75smear,75examine75tissues75to75determine75i
f75any75cellular75changes75are75taking75place.75Any75changes75in75the75cells75can75then7
5be75monitored75over75time.
A75biopsy75of75a75skin75lesion75is75conducted75on75Leann,75a7548-year-
old75woman.75Biopsy75results75revealed75proliferating75cells75that75were75well-
differentiated75and75resembled75surrounding75cells.75The75cells75were75contained75withi
n75a75well-defined75area.75-75answer--Benign75neoplasia.
Neoplasia75is75uncontrolled75and75unregulated75cell75growth.75The75mass75of75tissue75re
sulting75is75known75as75a75"neoplasm."75In75a75benign75neoplasm,75the75cells75do75not75
have75the75characteristics75associated75with75malignancy.75The75cells,75although75canc
erous,75are75well-
differentiated,75meaning75they75resemble75normal,75mature75cells.75The75cells75are75als
o75in75a75contained75area75and75are75unlikely75to75spread.
Miguel,75a75retired75warehouse75supervisor,75had75a75myocardial75infarction.75Further75
evaluation75revealed75he75had75significant75blockage75in75his75left75descending75coronar
, y75artery.75The75blockage75resulted75in75ischemia75and75cell75death75for75those75cells75s
erved75by75the75artery.75-75answer--Necrosis
Necrosis75is75premature75cell75death75caused75by75cell75injury.75Necrosis75differs75from7
5apoptosis,75in75that75the75cellular75destruction75results75from75some75form75of75trauma,7
5rather75than75genetic75programming.75May75lead75to75GANGRENE75which75is75when75
dead75tissue75houses75bacteria.
Julianne,75who75suffers75from75familial75hypercholesterolemia,75presents75with75xantho
mas.75Xanthomas75are75excess75cholesterol75deposits,75which75appear75as75yellow75ski
n75lesions.75What75cell75process75is75this75-75answer--Intracellular75accumulation.
Some75disease75processes75stimulate75intracellular75accumulations75of75particles,75suc
h75as75calcium,75cholesterol,75and75triglycerides,75glucose,75among75other75substances.
75In75familial75hypercholesterolemia,75a75genetic75defect75causes75decreased75cellular75
uptake75of75cholesterol,75resulting75in75high75serum75cholesterol75levels.75Cholesterol75d
eposits,75known75as75xanthomas,75may75appear75to75form75under75the75skin.
Janae75experienced75a75frightening75ATV75accident,75in75which75her75ATV75flipped75ove
r75and75she75ended75up75catching75a75portion75of75her75upper75arm75on75a75barbed75wir
e75fence.75Although75Janae's75injuries75healed75fully,75enlarged,75keloid75scar75formatio
ns75remain75at75the75injury75site.75-75answer--Hyperplasia
cell75proliferation,75known75as75hyperplasia,75was75stimulated75as75a75result75of75her75inj
ury.75A75keloid75results75from75overgrowth75of75granulation75tissue75during75the75wound7
5repair75process.
Hypertension75that75leads75to75workload75on75the75left75ventricle75and75thus75enlargeme
nt75would75be75deemed?75-75answer--Pathological75hypertrophy.75
No75blood75vessel75growth75and75increased75workload75would75lead75to75ischemia75and
75enlargement75of75the75heart.75
NCLEX75TIP:75Left75ventricular75hypertrophy75would75lead75to75displacement75of75the75
PMI75during75chest75palpation.
Hyperplasia75occurs75from75which75two75mechanisms?75-75answer--
An75INCREASE75in75the75number75of75cells75in75a75tissue75or75organ.
1)75hormonal75(estrogen75stimulating75the75mitotic75division75of75breast75gland75cells;75al
so75BPH75in75older75males)
2)75overcompensation75during75regeneration75(keloid75scars)
Andy75has75undergone75a75colonoscopy75because75his75family75has75a75history75of75col
on75cancer.75Biopsy75of75the75colon75reveals75poorly75differentiated75cells75in75the75sam
