NURS 5350 Advanced Pathophysiology Exam 2 Units
5–8 2026–2027 – Study Guide, Questions & Answers
1. What are the four clinical stages of the process of infection and describe each?:
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Incubationphase:periodfrominitialexposuretotheonsetofofthefirstsymptoms;canlasthourstoyears.
j j j j j j j j j j j j j j j j j j j
Prodromalphase:Startswithinitialsymptomsisoftenverymildwithfeelingsofdiscomfortandtiredness. Invasionphase:
j j j j j j j j j j j j j j j j j
invasionisfartherandattectsotherbodytissues,symptomsofillnessareattheirworst.
j j j j j j j j j j j j j j j
Convalescence phase: (RECOVERY) recovery occurs and symptoms decline, or the disease is fatal, or has period of latency.
j j j j j j j j j j j j j j j j j
2. Whatactivatesalmosteveryaspectofinflammation?:Lipopolysaccharide(LPS).
j j j j j j j j
3. Clinicalmanifestationsofinfection?:fatigue j j j j
malaise
j
weakness
concentrationloss
j j
aching
j
lossofappetite
j j
FEVER: HALLMARK SIGN
j j
leukocytosis
4. What is virulence?: Capacityofapathogentocauseseveredisease;Howpotent.
j j j j j j j j j j j j
5. InfectiousDiseaseClassification:Endemic?:Diseaseswithrelativelyhigh,butconstant,rates of j j j j j j j j j j j
infection in a particular population.
j j j j j
6. InfectiousDiseaseClassification:Epidemic?:Numberofnewinfectionsinaparticularpop-ulation j j j j j j j j j j j
that greatly exceeds the number usually observed.
j j j j j j j
7. Infectious Disease Classification: Pandemic?: An epidemic that spreads over a large area such as a
j j j j j j j j j j j j j j
continent or worldwide.
j j j
8. Bacterial Infection: Gram + vs Gram -: Gram-Positive:Abovediaphragm. j j j j j j j j j
Gram-Negative: Below diaphragm. j j
9. WhatareExotoxins?:Enzymesreleasedduringgrowthcausingspecificresponses.
j j j j j j j j j
10. What are Endotoxins?: Contained in cell walls of gram negative bacteria and released during lysis of
j j j j j j j j j j j j j j j
bacteria.
j
1/43j j
,11. How do antibiotics work against bacterial infections?: Antibiotics work by prohibiting protein
j j j j j j j j j j j
synthesis.
j
12. Whatbacteriaisthemajorcauseofhospitalacquired(noscomial)infections and j j j j j j j j j j j
antibiotic resistance?: Staphylococcusaureus.
j j j j
13. What are fungal infections?: Systemicinfectionisusuallyfromimmunosuppression.
j j j j j j j j j
Fungal infections are so toxic to humans as fungus have similar cell compositions to human cells.
j j j j j j j j j j j j j j j
14. What is the most common fungal infection?: Candidaalbicans j j j j j j j j
15. How is tissue damage caused with parasitic infections?: Tissuedamagebyparasites is
j j j j j j j j j j j j
secondarytoreleaseofenzymesthatdestroysurroundingextracellularmatrixandtissue.
j j j j j j j j j j j j
16. What is the most common parasitic infection worldwide?: Malaria. j j j j j j j j
17. What ismalaria?:Malariaisalife-threateningdiseasecausedbyparasitesthataretransmittedtopeople through
j j j j j j j j j j j j j j j j
the bites of infected mosquitos.
j j j j j
Infected anopheles mosquito. j j
Parasiteentersthebloodstream,survivesintheliver,andinvadesparenchymalcells.
j j j j j j j j j j j
Liver cells rupture and thousands of parasites enter blood, infecting RBCs.
j j j j j j j j j j
18. What is the most common affliction of humans and includes the common j j j j j j j j j j j
jcold,coldsores,hepatitis,HIV?:ViralDiseases.
j j j j j j
19. Whatisthevirallifecycle?:1.Attachment-itattachesorbindsitselftothehost
j j j j j j j j j j j j j j j
2. Penetratesthehostcell. j j j
3. Releases genetic information into the host cytoplasm (RNA viruses enter the host nucleus; DNA viruses enter host nucleus and
j j j j j j j j j j j j j j j j j j
may integrate into host DNA; May make mRNA.
j j j j j j j j
20. InfluenzaVirus:Whywehavetogetnewantiviraleachyear?:Surfaceproteins j j j j j j j j j j j j
undergochangeeachyear.
j j j j
21. HIV facts in US?: About 13% of the people who have HIV don't know it and need testing.
j j j j j j j j j j j j j j j j j
EstimatednewHIVinfectionsdeclined12%from36,500in2017to32,100in2021.
j j j j j j j j j j j j j
22. Clinicalmanifestations of HIV? Diagnosis?: Windowperiod:infectiousbutasymptomatic. j j j j j j j j j
Fatigue, headache, muscleaches, fever (may be asymptomatic for years).
j j j j j j j j j
2/43 j j
,Diagnosis:CD4+ T-cellnumbersareat orbelow200 cells/uL(dependingonage). j j j j j j j j j j j j
23. What are antimicrobials? What are their mechanisms?: Naturalproductsoffungus,
j j j j j j j j j j
bacteria, and organisms to kill or inhibit the growth of other microorganisms.
j j j j j j j j j j j j
Bacteriostatic:Preventsgrowth. j j
j Bactericidal: Directly kills microorganisms. j j j
Mechanism: Inhibits production and function of the cell wall, blocks DNA replication, inhibits protein synthesis, and interferes
j j j j j j j j j j j j j j j j
with folic acid metabolism.
j j j j
24. What are antivirals?: Are sometimes less successful because viruses use host enzymes.
j j j j j j j j j j j
25. What is the definition of stress?: Stressisviewedasthestateofattairsrisingwhenapersonrelates to
j j j j j j j j j j j j j j j j j j j
situations in certain ways.
j j j j
Causespsychologicandphysicalresponses.
j j j j
26. Whatareexamples of stressors? Definition of stressors?: Infection, noise, decreased oxygen
j j j j j j j j j j j
supply, pain, malnutrition, heat, cold, trauma, prolonged exertion, radiation, responses to life events, obesity, old age, drugs,
j j j j j j j j j j j j j j j j j
disease, surgery, and medical treatment.
j j j j j
Elicit a stress response or stress system through actions of the nervous and endocrine systems.
j j j j j j j j j j j j j j
27. What is the General Adaptation Syndrome? (GAS). Three phases?: Alarm Phase: j j j j j j j j j j
Arousalofbodydefenses-fightorflight(Activatessympatheticnervoussystem).
j j j j j j j j j j
Stage of Resistance or Adaptation: Mobilization that contributes to fight or flight (Begins with actions of adrenal hormones:
j j j j j j j j j j j j j j j j j
Cortisol, epinephrine, and noepinephrine).
j j j j
StageofExhaustion(allostaticoverload):Progressivebreakdownofcompensatorymechanisms(mayleadtodisease).
j j j j j j j j j j j j j
28. What is the Hypothalamic-Pituitary-Adrenal (HPA) Axis? How does it relate j j j j j j j j j
to GAS?: Stress and/or stressor hit your brain and hypothalamus secrets CORTISOL RELEASING HORMONE (CRH). CRH
j j j j j j j j j j j j j j j j
thengoesto AnteriorPituitaryand secretsAdreno-corticotropichormone(ACTH)whichgoesto theAdrenal Glands and
j j j j j j j j j j j j j j j j j
stimulate the Cortex of Adrenal Glands which stimulates release of Cortisol which goes back to the brain and identifies stress and
j j j j j j j j j j j j j j j j j j j j j
causes Metabolic ettects.
j j j
3/43 j j
, 29. Describe the Stress Response Neural Recognition Pathway?: Limbic Sys- j j j j j j j j
tem->Brainstem (locus ceruleus)-> Norepinephrine (increased arousal, increased vigilance, increased anxiety).
j j j j j j j j j
Norepinephrine goesto sympathetic nervous system (SNS) and adrenal medulla which releases epinephrine.
j j j j j j j j j j j j
30. Catecholamines: Norepinephrine: Actions?: Raises blood pressure by constricting the pe- j j j j j j j j j
ripheral vessels. j
Dilatespupilsoftheeye.
j j j j
Causespiloerection. j
Increases sweat gland action in the armpits and palms.Binds
j j j j j j j j j
to a-adrenergic receptor.
j j j
31. Catecholamines: Epinephrine: Actions?: Has greater influence in cardiac action (inotropic and j j j j j j j j j j
chronotropic).
j
Vasodilation occurs. j
Metabolicregulation occursincreasingtheglucose levels.
j j j j j j
Bindsandactivatesbotha-andb-adrenergicreceptors.
j j j j j j j
32. What does the Anterior Pituitary Gland release during stress response?: Pro-
j j j j j j j j j j
lactin
Endorphins
Growth Hormone (GH) j j
Adrenocorticotropic Hormone (ACTH)
j j j
Stimulates Adrenal Gland to release Cortisol. j j j j j
33. Glucocorticoid: Cortisol?: A KEY INDICATOR OF STRESS. j j j j j j
Stimulates gluconeogenesis (making glucose out of noncarbohydrates) thus elevating blood glucose.
j j j j j j j j j j
Increases gastric secretions in the mouth and intestines potentially causing gastric ulcers.
j j j j j j j j j j j
34. Cortisol: How is it connected to obesity?: Contributestothedevelopmentofmetabolic
j j j j j j j j j j j j
syndrome and the pathogenesis of obesity.
j j j j j j
Development of diabetes is secondary to cortisol-induced obesity. j j j j j j j
4/43j j
5–8 2026–2027 – Study Guide, Questions & Answers
1. What are the four clinical stages of the process of infection and describe each?:
j j j j j j j j j j j j j
Incubationphase:periodfrominitialexposuretotheonsetofofthefirstsymptoms;canlasthourstoyears.
j j j j j j j j j j j j j j j j j j j
Prodromalphase:Startswithinitialsymptomsisoftenverymildwithfeelingsofdiscomfortandtiredness. Invasionphase:
j j j j j j j j j j j j j j j j j
invasionisfartherandattectsotherbodytissues,symptomsofillnessareattheirworst.
j j j j j j j j j j j j j j j
Convalescence phase: (RECOVERY) recovery occurs and symptoms decline, or the disease is fatal, or has period of latency.
j j j j j j j j j j j j j j j j j
2. Whatactivatesalmosteveryaspectofinflammation?:Lipopolysaccharide(LPS).
j j j j j j j j
3. Clinicalmanifestationsofinfection?:fatigue j j j j
malaise
j
weakness
concentrationloss
j j
aching
j
lossofappetite
j j
FEVER: HALLMARK SIGN
j j
leukocytosis
4. What is virulence?: Capacityofapathogentocauseseveredisease;Howpotent.
j j j j j j j j j j j j
5. InfectiousDiseaseClassification:Endemic?:Diseaseswithrelativelyhigh,butconstant,rates of j j j j j j j j j j j
infection in a particular population.
j j j j j
6. InfectiousDiseaseClassification:Epidemic?:Numberofnewinfectionsinaparticularpop-ulation j j j j j j j j j j j
that greatly exceeds the number usually observed.
j j j j j j j
7. Infectious Disease Classification: Pandemic?: An epidemic that spreads over a large area such as a
j j j j j j j j j j j j j j
continent or worldwide.
j j j
8. Bacterial Infection: Gram + vs Gram -: Gram-Positive:Abovediaphragm. j j j j j j j j j
Gram-Negative: Below diaphragm. j j
9. WhatareExotoxins?:Enzymesreleasedduringgrowthcausingspecificresponses.
j j j j j j j j j
10. What are Endotoxins?: Contained in cell walls of gram negative bacteria and released during lysis of
j j j j j j j j j j j j j j j
bacteria.
j
1/43j j
,11. How do antibiotics work against bacterial infections?: Antibiotics work by prohibiting protein
j j j j j j j j j j j
synthesis.
j
12. Whatbacteriaisthemajorcauseofhospitalacquired(noscomial)infections and j j j j j j j j j j j
antibiotic resistance?: Staphylococcusaureus.
j j j j
13. What are fungal infections?: Systemicinfectionisusuallyfromimmunosuppression.
j j j j j j j j j
Fungal infections are so toxic to humans as fungus have similar cell compositions to human cells.
j j j j j j j j j j j j j j j
14. What is the most common fungal infection?: Candidaalbicans j j j j j j j j
15. How is tissue damage caused with parasitic infections?: Tissuedamagebyparasites is
j j j j j j j j j j j j
secondarytoreleaseofenzymesthatdestroysurroundingextracellularmatrixandtissue.
j j j j j j j j j j j j
16. What is the most common parasitic infection worldwide?: Malaria. j j j j j j j j
17. What ismalaria?:Malariaisalife-threateningdiseasecausedbyparasitesthataretransmittedtopeople through
j j j j j j j j j j j j j j j j
the bites of infected mosquitos.
j j j j j
Infected anopheles mosquito. j j
Parasiteentersthebloodstream,survivesintheliver,andinvadesparenchymalcells.
j j j j j j j j j j j
Liver cells rupture and thousands of parasites enter blood, infecting RBCs.
j j j j j j j j j j
18. What is the most common affliction of humans and includes the common j j j j j j j j j j j
jcold,coldsores,hepatitis,HIV?:ViralDiseases.
j j j j j j
19. Whatisthevirallifecycle?:1.Attachment-itattachesorbindsitselftothehost
j j j j j j j j j j j j j j j
2. Penetratesthehostcell. j j j
3. Releases genetic information into the host cytoplasm (RNA viruses enter the host nucleus; DNA viruses enter host nucleus and
j j j j j j j j j j j j j j j j j j
may integrate into host DNA; May make mRNA.
j j j j j j j j
20. InfluenzaVirus:Whywehavetogetnewantiviraleachyear?:Surfaceproteins j j j j j j j j j j j j
undergochangeeachyear.
j j j j
21. HIV facts in US?: About 13% of the people who have HIV don't know it and need testing.
j j j j j j j j j j j j j j j j j
EstimatednewHIVinfectionsdeclined12%from36,500in2017to32,100in2021.
j j j j j j j j j j j j j
22. Clinicalmanifestations of HIV? Diagnosis?: Windowperiod:infectiousbutasymptomatic. j j j j j j j j j
Fatigue, headache, muscleaches, fever (may be asymptomatic for years).
j j j j j j j j j
2/43 j j
,Diagnosis:CD4+ T-cellnumbersareat orbelow200 cells/uL(dependingonage). j j j j j j j j j j j j
23. What are antimicrobials? What are their mechanisms?: Naturalproductsoffungus,
j j j j j j j j j j
bacteria, and organisms to kill or inhibit the growth of other microorganisms.
j j j j j j j j j j j j
Bacteriostatic:Preventsgrowth. j j
j Bactericidal: Directly kills microorganisms. j j j
Mechanism: Inhibits production and function of the cell wall, blocks DNA replication, inhibits protein synthesis, and interferes
j j j j j j j j j j j j j j j j
with folic acid metabolism.
j j j j
24. What are antivirals?: Are sometimes less successful because viruses use host enzymes.
j j j j j j j j j j j
25. What is the definition of stress?: Stressisviewedasthestateofattairsrisingwhenapersonrelates to
j j j j j j j j j j j j j j j j j j j
situations in certain ways.
j j j j
Causespsychologicandphysicalresponses.
j j j j
26. Whatareexamples of stressors? Definition of stressors?: Infection, noise, decreased oxygen
j j j j j j j j j j j
supply, pain, malnutrition, heat, cold, trauma, prolonged exertion, radiation, responses to life events, obesity, old age, drugs,
j j j j j j j j j j j j j j j j j
disease, surgery, and medical treatment.
j j j j j
Elicit a stress response or stress system through actions of the nervous and endocrine systems.
j j j j j j j j j j j j j j
27. What is the General Adaptation Syndrome? (GAS). Three phases?: Alarm Phase: j j j j j j j j j j
Arousalofbodydefenses-fightorflight(Activatessympatheticnervoussystem).
j j j j j j j j j j
Stage of Resistance or Adaptation: Mobilization that contributes to fight or flight (Begins with actions of adrenal hormones:
j j j j j j j j j j j j j j j j j
Cortisol, epinephrine, and noepinephrine).
j j j j
StageofExhaustion(allostaticoverload):Progressivebreakdownofcompensatorymechanisms(mayleadtodisease).
j j j j j j j j j j j j j
28. What is the Hypothalamic-Pituitary-Adrenal (HPA) Axis? How does it relate j j j j j j j j j
to GAS?: Stress and/or stressor hit your brain and hypothalamus secrets CORTISOL RELEASING HORMONE (CRH). CRH
j j j j j j j j j j j j j j j j
thengoesto AnteriorPituitaryand secretsAdreno-corticotropichormone(ACTH)whichgoesto theAdrenal Glands and
j j j j j j j j j j j j j j j j j
stimulate the Cortex of Adrenal Glands which stimulates release of Cortisol which goes back to the brain and identifies stress and
j j j j j j j j j j j j j j j j j j j j j
causes Metabolic ettects.
j j j
3/43 j j
, 29. Describe the Stress Response Neural Recognition Pathway?: Limbic Sys- j j j j j j j j
tem->Brainstem (locus ceruleus)-> Norepinephrine (increased arousal, increased vigilance, increased anxiety).
j j j j j j j j j
Norepinephrine goesto sympathetic nervous system (SNS) and adrenal medulla which releases epinephrine.
j j j j j j j j j j j j
30. Catecholamines: Norepinephrine: Actions?: Raises blood pressure by constricting the pe- j j j j j j j j j
ripheral vessels. j
Dilatespupilsoftheeye.
j j j j
Causespiloerection. j
Increases sweat gland action in the armpits and palms.Binds
j j j j j j j j j
to a-adrenergic receptor.
j j j
31. Catecholamines: Epinephrine: Actions?: Has greater influence in cardiac action (inotropic and j j j j j j j j j j
chronotropic).
j
Vasodilation occurs. j
Metabolicregulation occursincreasingtheglucose levels.
j j j j j j
Bindsandactivatesbotha-andb-adrenergicreceptors.
j j j j j j j
32. What does the Anterior Pituitary Gland release during stress response?: Pro-
j j j j j j j j j j
lactin
Endorphins
Growth Hormone (GH) j j
Adrenocorticotropic Hormone (ACTH)
j j j
Stimulates Adrenal Gland to release Cortisol. j j j j j
33. Glucocorticoid: Cortisol?: A KEY INDICATOR OF STRESS. j j j j j j
Stimulates gluconeogenesis (making glucose out of noncarbohydrates) thus elevating blood glucose.
j j j j j j j j j j
Increases gastric secretions in the mouth and intestines potentially causing gastric ulcers.
j j j j j j j j j j j
34. Cortisol: How is it connected to obesity?: Contributestothedevelopmentofmetabolic
j j j j j j j j j j j j
syndrome and the pathogenesis of obesity.
j j j j j j
Development of diabetes is secondary to cortisol-induced obesity. j j j j j j j
4/43j j
