APPLIED PATHOPHYSIOLOGY A CONCEPTUAL APPROACH
CERTIFICATION EVALUATION QUESTIONS AND ANSWERS
◉ What are the clinical manifestations of cerebral atrophy? Answer:
focal (localized to particular region) or global (entire brain);
characterized by cognitive impairment (damage to temporal and
frontal lobes), movement disorders (basal ganglia damage), etc.
◉ How do you diagnose cerebral atrophy? Answer: identifying signs
and symptoms, often from other observers first; PET, SPECT, CT, MRI
scans
◉ What is cardiac hypertrophy and what are its etiologies? Answer:
cardiac muscle disease resulting from excessive workload and
functional demand; no specifically known cause besides a genetic
trait
◉ What is the pathophysiologic pathway that occurs in cardiac
hypertrophy? Answer: increased pressure in pulmonary or systemic
circulation --> hypertrophy of ventricles --> lower contraction
efficiency and smaller chamber --> lower cardiac output
,◉ What are the clinical manifestations of cardiac hypertrophy?
Answer: shortness of breath, syncope (fainting), angina
◉ How do you diagnose cardiac hypertrophy? Answer: genetic
testing, EKG, echocardiogram, stress test
◉ What is acromegaly and what are its etiologies? Answer:
condition of hyperplasia (increase in cell number) prompted by
excessive growth hormone stimulation/hyperpituitarism and IGF
◉ What is the pathophysiologic pathway that occurs in acromegaly?
Answer: (with failure of negative feedback loop), somatostatin
doesn't do its job (inhibitory effect on pituitary) --> hypothalamus
secretes only GHRH --> proliferation --> IGF stimulation -->
excessive growth
*Hypothalamus usually releases GHRH (promoting growth
hormone) and somatostatin (inhibiting growth hormone)
◉ What are the clinical manifestations of acromegaly? Answer: soft
tissue swelling, enlarged hands and feet, altered facial features and
reproductive functioning, deep voice, pain and numbness in hands
◉ How do you diagnose acromegaly? Answer: elevated levels of IGF
and growth hormone in blood
,◉ what cell type comprises the endocervix? ectocervix? what is the
location where these two cell types merge? Answer: columnar
epithelium; squamous epithelium; transformation zone
◉ What is cervical metaplasia/dysplasia and what are its etiologies?
Answer: changing of cell structure in the transformation zone of
cervix; epithelial cells can be injured by infection, irritation, trauma
and are characterized by abnormal growth/disordered
differentiation
◉ What is the pathophysiologic pathway that occurs in cervical
metaplasia/dysplasia? Answer: infection, irritation, trauma -->
alterations in chromatin (genetic material of DNA) --> abnormal
differentiation
◉ What are the clinical manifestations of cervical
metaplasia/dysplasia? Answer: no signs or symptoms; risk factors
include smoking, early onset sexual activity, multiple partners,
exposure to HPV
◉ How do you diagnose cervical metaplasia/dysplasia? Answer: Pap
smear (cervical sampling), colposcopy (cervical sampling),
diagnostic excisional procedure (laser conization, cold-knife
conization)
, ◉ What are the steps in the inflammatory process? Answer: 1.
vascular response: increase blood flow to injury site
2. cellular response: alert healing products to attend to injury site
3. remove injured tissue/prepare site for healing
◉ What is the vascular response? Answer: increase of blood flow to
site of an injury; blood vessel dilation and more permeable blood
vessels
◉ What is the cellular response? Answer: alerting healing products
to attend to injury site
◉ What are inflammatory mediators and why are they important?
Answer: potent chemicals that facilitate process of widening and
constricting blood vessels, primarily produced by white blood cells
◉ what is a mast cell? what process is involved in releasing
inflammatory mediators? Answer: white blood cells that are like the
first responders on the scene of an injury; they release inflammatory
mediators in the form of extracellular granules (process is called
degranulation)
◉ what are the steps of the cellular response? Answer: 1. chemotaxis
(moving certain cells to the injury site)
2. cellular adherence to vessel wall
CERTIFICATION EVALUATION QUESTIONS AND ANSWERS
◉ What are the clinical manifestations of cerebral atrophy? Answer:
focal (localized to particular region) or global (entire brain);
characterized by cognitive impairment (damage to temporal and
frontal lobes), movement disorders (basal ganglia damage), etc.
◉ How do you diagnose cerebral atrophy? Answer: identifying signs
and symptoms, often from other observers first; PET, SPECT, CT, MRI
scans
◉ What is cardiac hypertrophy and what are its etiologies? Answer:
cardiac muscle disease resulting from excessive workload and
functional demand; no specifically known cause besides a genetic
trait
◉ What is the pathophysiologic pathway that occurs in cardiac
hypertrophy? Answer: increased pressure in pulmonary or systemic
circulation --> hypertrophy of ventricles --> lower contraction
efficiency and smaller chamber --> lower cardiac output
,◉ What are the clinical manifestations of cardiac hypertrophy?
Answer: shortness of breath, syncope (fainting), angina
◉ How do you diagnose cardiac hypertrophy? Answer: genetic
testing, EKG, echocardiogram, stress test
◉ What is acromegaly and what are its etiologies? Answer:
condition of hyperplasia (increase in cell number) prompted by
excessive growth hormone stimulation/hyperpituitarism and IGF
◉ What is the pathophysiologic pathway that occurs in acromegaly?
Answer: (with failure of negative feedback loop), somatostatin
doesn't do its job (inhibitory effect on pituitary) --> hypothalamus
secretes only GHRH --> proliferation --> IGF stimulation -->
excessive growth
*Hypothalamus usually releases GHRH (promoting growth
hormone) and somatostatin (inhibiting growth hormone)
◉ What are the clinical manifestations of acromegaly? Answer: soft
tissue swelling, enlarged hands and feet, altered facial features and
reproductive functioning, deep voice, pain and numbness in hands
◉ How do you diagnose acromegaly? Answer: elevated levels of IGF
and growth hormone in blood
,◉ what cell type comprises the endocervix? ectocervix? what is the
location where these two cell types merge? Answer: columnar
epithelium; squamous epithelium; transformation zone
◉ What is cervical metaplasia/dysplasia and what are its etiologies?
Answer: changing of cell structure in the transformation zone of
cervix; epithelial cells can be injured by infection, irritation, trauma
and are characterized by abnormal growth/disordered
differentiation
◉ What is the pathophysiologic pathway that occurs in cervical
metaplasia/dysplasia? Answer: infection, irritation, trauma -->
alterations in chromatin (genetic material of DNA) --> abnormal
differentiation
◉ What are the clinical manifestations of cervical
metaplasia/dysplasia? Answer: no signs or symptoms; risk factors
include smoking, early onset sexual activity, multiple partners,
exposure to HPV
◉ How do you diagnose cervical metaplasia/dysplasia? Answer: Pap
smear (cervical sampling), colposcopy (cervical sampling),
diagnostic excisional procedure (laser conization, cold-knife
conization)
, ◉ What are the steps in the inflammatory process? Answer: 1.
vascular response: increase blood flow to injury site
2. cellular response: alert healing products to attend to injury site
3. remove injured tissue/prepare site for healing
◉ What is the vascular response? Answer: increase of blood flow to
site of an injury; blood vessel dilation and more permeable blood
vessels
◉ What is the cellular response? Answer: alerting healing products
to attend to injury site
◉ What are inflammatory mediators and why are they important?
Answer: potent chemicals that facilitate process of widening and
constricting blood vessels, primarily produced by white blood cells
◉ what is a mast cell? what process is involved in releasing
inflammatory mediators? Answer: white blood cells that are like the
first responders on the scene of an injury; they release inflammatory
mediators in the form of extracellular granules (process is called
degranulation)
◉ what are the steps of the cellular response? Answer: 1. chemotaxis
(moving certain cells to the injury site)
2. cellular adherence to vessel wall
