NURS 5315 ADVANCED PATHOPHYSIOLOGY
TEST 1 COMPREHENSIVE STUDY GUIDE
2026 FULL QUESTIONS AND SOLUTIONS GRADED A+
• Atrophy 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).
Answer: E. Cells decrease in size
• Steps of the Action Potential Repolarization Hyperpolarization.
Answer: Depolarization
• Depolarization Voltage gated Na channels open and allow Na to enter the
cell -> voltage inside the cell moves towards zero.
Answer: movement of the intracellular charge towards zero (more positive
charge)
• Repolarization -Na channels close, K channels open.
Answer: Once the intracellular charge reaches zero, the negative polarity of
the inside of the cell is restored back to its baseline of -70 to -85 mV
• Hyperpolarization.
Answer: when the cell's resting membrane potential is greater than -85mV.
Is less excitable, because there is a greater distance between the resting
membrane potential and the threshold potential.
• Hyperplasia 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.
Answer: E: cells increase in number, mitosis (cell division) must occur, size
of cell does not change
• In order for the action potential to be sucessful.
Answer: t has to depolarize by 15-20 mV (threshold potential) to reach -55
to -65 mV.
• An alteration in action potential may result from.
Answer: neurologic diseases, muscle disease or electrolyte imbalances.
• Dysplasia 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.
Answer: E. Not true adaptation; Cells abnormal change in size, shape,
organization (classified as mild, moderate, severe)
• Metaplasia 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 epithelial cells in response to
reflux, aka intestinal metaplasia.
Answer: E: reversible change, one type of cell changes to another type for
survival
• What is the main protein responsible for maintaining the correct balance of
extracellular Na and intracellular K, which is needed for cellular excitation
and membrane conductivity..
Answer: Na+-K+ ATPase
• Hypoxia injury P. decrease in mitochondrial function, decreased production
, of ATP increases anaerobic metabolism. eventual cell death. C.M. hypoxia,
cyanosis, cognitive impairment, lethargy.
Answer: E. inadequate oxygenation of tissues
• Resting membrane potential.
Answer: when the cell is in a nonexcited state and is at -70 to -85 mV.
• Free radical and ROS P. lipid peroxidation, damage proteins, fragment DNA
C.M. development in Alzheimer's, heart disease, Parkinson's disease,
Amyotrophic Lateral Sclerosis.
Answer: E. normal byproduct of ATP production, will overwhelm the
mitochondria- exhaust intracellular antioxidants
• Refractory Period.
Answer: is a period of time during most of the action potential which the
cell membrane resists stimulation and it cannot depolarize
• Absolute refractory period.
Answer: occurs when the membrane will not respond to ANY stimulus no
matter how strong.
• Relative Refractory Period.
Answer: occurs when the membrane is repolarizing and will only respond to
a very strong stimulus.
• Ethanol 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.
Answer: E. mood altering drug, long term effects on liver and nutritional
status
• Hyperpolarized Is less excitable, because there is a greater distance between
the resting membrane potential and the threshold potential..
Answer: when the cell's resting membrane potential is greater than -85mV.
• Hypopolarized Is more excitable because the resting membrane potential is
, closer to the threshold potential, there is less distance between them..
Answer: when the cell's resting membrane potential is closer to zero, for
instance it is -65mV.
• Oncosis.
Answer: Na and H2O enter cell and cause swelling. Organ increases in
weight, becomes distended and pale. Associated with high fever,
hypocalcemia, certain infections
• Action potential altered by hypokalemia -Hyperpolarized (cell becomes
more negative, ex: -100) -Affects the resting membrane potential of cells
-The cell is less likely to depolarize and transmit impulses Can cause a
decrease in neuromuscular excitability and leads to weakness, smooth
muscle atony, paresthesias, and cardiac dysrhythmias.
Answer: (serum outside of cell is low)
• Action potential altered by hyperkalemia -Also has an effect on the resting
membrane potential -If the ECF potassium increases without any change in
the ICF potassium levels, the resting membrane potential of the cell
becomes more positive. -The cells are more excitable and conduct impulses
more easily and more quickly because the resting membrane potential is
closer to the threshold potential. Therefore, the person will have peak T
waves on EKG. -As potassium rises, the resting membrane potential will
continue to become more positive and it will eventually become equal to the
threshold potential. As this happens the EKG will show a widening QRS
complex. If the resting membrane potential equals the threshold potential, an
action potential will not be generated and cardiac standstill will occur.
Paralysis and paresthesias may also occur..
Answer: Hypopolarized
• Fatty Infiltration liver fails to metabolize lipids. usually from ETOH or high
fat diet. can lead to cirrhosis.
Answer: intracellular accumulation of lipids in the liver
• dystrophic calcification calcium salt clump and harden- interfere with
cellular structure and function r/t pulmonary TB, atherosclerosis, injured
TEST 1 COMPREHENSIVE STUDY GUIDE
2026 FULL QUESTIONS AND SOLUTIONS GRADED A+
• Atrophy 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).
Answer: E. Cells decrease in size
• Steps of the Action Potential Repolarization Hyperpolarization.
Answer: Depolarization
• Depolarization Voltage gated Na channels open and allow Na to enter the
cell -> voltage inside the cell moves towards zero.
Answer: movement of the intracellular charge towards zero (more positive
charge)
• Repolarization -Na channels close, K channels open.
Answer: Once the intracellular charge reaches zero, the negative polarity of
the inside of the cell is restored back to its baseline of -70 to -85 mV
• Hyperpolarization.
Answer: when the cell's resting membrane potential is greater than -85mV.
Is less excitable, because there is a greater distance between the resting
membrane potential and the threshold potential.
• Hyperplasia 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.
Answer: E: cells increase in number, mitosis (cell division) must occur, size
of cell does not change
• In order for the action potential to be sucessful.
Answer: t has to depolarize by 15-20 mV (threshold potential) to reach -55
to -65 mV.
• An alteration in action potential may result from.
Answer: neurologic diseases, muscle disease or electrolyte imbalances.
• Dysplasia 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.
Answer: E. Not true adaptation; Cells abnormal change in size, shape,
organization (classified as mild, moderate, severe)
• Metaplasia 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 epithelial cells in response to
reflux, aka intestinal metaplasia.
Answer: E: reversible change, one type of cell changes to another type for
survival
• What is the main protein responsible for maintaining the correct balance of
extracellular Na and intracellular K, which is needed for cellular excitation
and membrane conductivity..
Answer: Na+-K+ ATPase
• Hypoxia injury P. decrease in mitochondrial function, decreased production
, of ATP increases anaerobic metabolism. eventual cell death. C.M. hypoxia,
cyanosis, cognitive impairment, lethargy.
Answer: E. inadequate oxygenation of tissues
• Resting membrane potential.
Answer: when the cell is in a nonexcited state and is at -70 to -85 mV.
• Free radical and ROS P. lipid peroxidation, damage proteins, fragment DNA
C.M. development in Alzheimer's, heart disease, Parkinson's disease,
Amyotrophic Lateral Sclerosis.
Answer: E. normal byproduct of ATP production, will overwhelm the
mitochondria- exhaust intracellular antioxidants
• Refractory Period.
Answer: is a period of time during most of the action potential which the
cell membrane resists stimulation and it cannot depolarize
• Absolute refractory period.
Answer: occurs when the membrane will not respond to ANY stimulus no
matter how strong.
• Relative Refractory Period.
Answer: occurs when the membrane is repolarizing and will only respond to
a very strong stimulus.
• Ethanol 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.
Answer: E. mood altering drug, long term effects on liver and nutritional
status
• Hyperpolarized Is less excitable, because there is a greater distance between
the resting membrane potential and the threshold potential..
Answer: when the cell's resting membrane potential is greater than -85mV.
• Hypopolarized Is more excitable because the resting membrane potential is
, closer to the threshold potential, there is less distance between them..
Answer: when the cell's resting membrane potential is closer to zero, for
instance it is -65mV.
• Oncosis.
Answer: Na and H2O enter cell and cause swelling. Organ increases in
weight, becomes distended and pale. Associated with high fever,
hypocalcemia, certain infections
• Action potential altered by hypokalemia -Hyperpolarized (cell becomes
more negative, ex: -100) -Affects the resting membrane potential of cells
-The cell is less likely to depolarize and transmit impulses Can cause a
decrease in neuromuscular excitability and leads to weakness, smooth
muscle atony, paresthesias, and cardiac dysrhythmias.
Answer: (serum outside of cell is low)
• Action potential altered by hyperkalemia -Also has an effect on the resting
membrane potential -If the ECF potassium increases without any change in
the ICF potassium levels, the resting membrane potential of the cell
becomes more positive. -The cells are more excitable and conduct impulses
more easily and more quickly because the resting membrane potential is
closer to the threshold potential. Therefore, the person will have peak T
waves on EKG. -As potassium rises, the resting membrane potential will
continue to become more positive and it will eventually become equal to the
threshold potential. As this happens the EKG will show a widening QRS
complex. If the resting membrane potential equals the threshold potential, an
action potential will not be generated and cardiac standstill will occur.
Paralysis and paresthesias may also occur..
Answer: Hypopolarized
• Fatty Infiltration liver fails to metabolize lipids. usually from ETOH or high
fat diet. can lead to cirrhosis.
Answer: intracellular accumulation of lipids in the liver
• dystrophic calcification calcium salt clump and harden- interfere with
cellular structure and function r/t pulmonary TB, atherosclerosis, injured
