EXAM ONE REVIEW 1
Blueprint Exam 1 PATHO – (Modules 1 &2)
Module 1: Basic/Central Concepts of Pathophysiology: Cell, Tissues, and
Proliferation
Module 2: (a) Fluid-Electrolyte and Acid-Base Balance & (b) Mechanism of Self
Defense
1. Cancer etiology – obesity, alcohol (Lidia) (Cancer Epidemiology ppt)
Cancer Etiology in the presence of obesity and alcohol consumption
• Obesity
• Is associated with endometrial, colorectal, kidney, esophageal, breast (postmenopausal),
pancreatic, and several other cancers.
• Causes a poorer outcome for some cancers
• Physical activity
• Decreases the risk of cancer.
• Decreases insulin and insulin-like growth factors.
• Decreases obesity.
• Decreases inflammatory mediators.
• Decreases circulating sex/metabolic hormones
• Improves immune function.
• Reduces the risk for breast, colon, and endometrial cancers,
independent of weight changes.
• After a cancer diagnosis, physical activity is associated with improved
cancer-specific and overall survival with early-stage breast, prostate, and
colorectal cancers.
• Increases insulin resistance–producing hyperinsulinemia.
• Insulin promotes insulin-like growth factor 1.
• Adipose tissue secretes adipokines
• Circadian disruptions may affect cancer growth.
• Alcohol consumption
• Is classified as a human carcinogen.
,EXAM ONE REVIEW 2
• Increases the risk for oral cavity, pharynx, larynx, esophageal, liver, colorectal, and
breast cancers.
• A combination of cigarette smoking and alcohol consumption increases a person’s risk
for malignant tumors.
● Damage to cells. When we drink alcohol, our bodies turn it into a chemical, called
acetaldehyde. Acetaldehyde can damage our cells and can also stop cells from
repairing this damage.
● Changes to hormones. Alcohol can increase the levels of some hormones in our
bodies such as oestrogen and insulin. Hormones are chemical messengers, and
higher levels of oestrogen and insulin can make cells divide more often. This
increases the chance that cancer will develop.
● Changes to cells in the mouth and throat. Alcohol can make it easier for cells in
the mouth and throat to absorb harmful chemicals that cause damage.
● https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/alcohol-and-
cancer/how-does-alcohol-cause-cancer
●
2. Isotonic fluid – composition/maintenance (Genessis)
Refresher: sodium and water are closely related and lead to a loss/gain
of total water volume. Increased plasma osmolality occurs with water
deficit or sodium excess in relation to total body water. Increased
osmolality stimulates hypothalamic osmoreceptors causing thirst. ADH
will work to restore the body to normal levels of fluid.
a. Isotonic fluid loss causes dehydration and hypovolemia. In severe
cases, hypovolemic shock can occur.
i. Ex: if pt loses pure plasma or ECF, fluid volume is depleted
but electrolytes remain normal (TB 378)
ii. Causes: severe wound drainage, hemorrhage, excessive
sweating
,EXAM ONE REVIEW 3
iii. Note: ECF will decrease with weight loss, dryness of
skin/mucous membranes, dec. urine output, high hematocrit
iv. s/s: rapid HR, flattened neck veins, can present with normal
or decreased BP
b. Isotonic fluid excess causes hypervolemia. As plasma volume
expands, hypervolemia occurs with weight gain. The dilution effect of
excess plasma volume will decrease (TB 378) hematocrit and plasma
protein concentration. Increased capillary hydrostatic pressure leads
to edema formation which can lead to pulmonary edema and heart
failure development.
i. Causes: excessive IVF, hypersecretion of aldosterone, drug
effects such as cortisone, kidney failure.
ii. s/s: neck veins may distend, BP increase.
iii. Tx: diuretics
3. Know about serum potassium and sodium and clinical features
related to fluctuations in Na, K (Steven)
1. Potassium (3.5-5.0mEq/L): (textbook page 118)
a. Major intracellular electrolyte
b. Concentration gradient maintained via sodium-potassium ATPase pump
c. Major determinant of resting potential of cells, transmission, and
conduction of nerve impulses, maintenance of normal cardiac rhythms,
and contraction of skeletal and smooth muscles
d. Hypokalemia (<3.5 mEq/l) (textbook page 120)
i. Neuromuscular excitability decreases, membrane
hyperpolarization
1. Skeletal muscle weakness
2. Smooth muscle atony (constipation, intestinal distension,
anorexia, nausea, vomiting, paralytic ileus)
3. Cardiac dysrhythmias (EKG changes include flattened T
waves, U wave, ST depression, peaked P wave, prolonged
QT interval)
4. Glucose intolerance
5. Impaired urinary concentrating ability
e. Hyperkalemia: (>5.0mEq/L): (textbook page 122)
i. Neuromuscular excitability increases, membrane hypopolarization:
1. Restlessness, tingling of lips and fingers
2. Intestinal cramping, diarrhea
3. Muscle weakness, loss of muscle tone, flaccid muscle
paralysis
4. Cardiac dysrhythmias (peaked T waves, shortened QT
interval, depressed ST segment, prolonged PR interval,
widened QRS)
, EXAM ONE REVIEW 4
2. Sodium (135-145mEq/L): (textbook page 111)
a. Primary extracellular cation
b. Regulated by aldosterone and natriuretic peptides (ANP, BNP) and
urodilatin
c. Influences water distribution via extracellular osmotic forces
d. Plays a role in nerve impulse conduction, regulation of acid-base balance,
cellular chemical reactions, transport of substances across the cellular
membrane
e. Hyponatremia (<135mEq/L): (textbook page 116)
i. Causes plasma hypoosmolality and cellular swelling
ii. Classified into
1. hypovolemic hyponatremia
a. hypotension, tachycardia, decreased urine output
2. euvolemic hyponatremia
3. hypervolemic hyponatremia
a. Weight gain, edema, ascites, JVD
iii. Neurologic symptoms: lethargy, headache, confusion,
apprehension, seizures, coma
f. Hypernatremia (>145mEq/L): (textbook page 114)
i. Causes plasma hyperosmolality and cellular shrinking
(intracellular dehydration Neurologic symptoms: weakness,
lethargy, muscle twitching, hyperreflexia, confusion, coma,
seizures
****Note: sodium causes neurologic symptoms, whereas potassium causes
neuromuscular symptoms
4. Hyper/hypocalcemia and hype/hypormagnesmia – Etiology and
manifestations
5. Know how to differentiate between neurofibromatosis I & II (Kiebra D)
Neurofibromatosis- Involves neurogenic tumors
a. Neurofibromatosis I: lisch nodules, neurofibromas, skin fold freckling, cafe au lait
spots, prone to seizures
b. Neurofibromatosis II: cranial and spinal meningiomas, tinnitus, headache, most
common tumors are called vestibular schwannomas
5. Know nucleus, ribosomes, lysosomes, mRNA, rRNA, tRNA -
miranda
- Nucleus: surrounded by nuclear envelope
- primary role is cell division and to control genetic information of the
cell
Blueprint Exam 1 PATHO – (Modules 1 &2)
Module 1: Basic/Central Concepts of Pathophysiology: Cell, Tissues, and
Proliferation
Module 2: (a) Fluid-Electrolyte and Acid-Base Balance & (b) Mechanism of Self
Defense
1. Cancer etiology – obesity, alcohol (Lidia) (Cancer Epidemiology ppt)
Cancer Etiology in the presence of obesity and alcohol consumption
• Obesity
• Is associated with endometrial, colorectal, kidney, esophageal, breast (postmenopausal),
pancreatic, and several other cancers.
• Causes a poorer outcome for some cancers
• Physical activity
• Decreases the risk of cancer.
• Decreases insulin and insulin-like growth factors.
• Decreases obesity.
• Decreases inflammatory mediators.
• Decreases circulating sex/metabolic hormones
• Improves immune function.
• Reduces the risk for breast, colon, and endometrial cancers,
independent of weight changes.
• After a cancer diagnosis, physical activity is associated with improved
cancer-specific and overall survival with early-stage breast, prostate, and
colorectal cancers.
• Increases insulin resistance–producing hyperinsulinemia.
• Insulin promotes insulin-like growth factor 1.
• Adipose tissue secretes adipokines
• Circadian disruptions may affect cancer growth.
• Alcohol consumption
• Is classified as a human carcinogen.
,EXAM ONE REVIEW 2
• Increases the risk for oral cavity, pharynx, larynx, esophageal, liver, colorectal, and
breast cancers.
• A combination of cigarette smoking and alcohol consumption increases a person’s risk
for malignant tumors.
● Damage to cells. When we drink alcohol, our bodies turn it into a chemical, called
acetaldehyde. Acetaldehyde can damage our cells and can also stop cells from
repairing this damage.
● Changes to hormones. Alcohol can increase the levels of some hormones in our
bodies such as oestrogen and insulin. Hormones are chemical messengers, and
higher levels of oestrogen and insulin can make cells divide more often. This
increases the chance that cancer will develop.
● Changes to cells in the mouth and throat. Alcohol can make it easier for cells in
the mouth and throat to absorb harmful chemicals that cause damage.
● https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/alcohol-and-
cancer/how-does-alcohol-cause-cancer
●
2. Isotonic fluid – composition/maintenance (Genessis)
Refresher: sodium and water are closely related and lead to a loss/gain
of total water volume. Increased plasma osmolality occurs with water
deficit or sodium excess in relation to total body water. Increased
osmolality stimulates hypothalamic osmoreceptors causing thirst. ADH
will work to restore the body to normal levels of fluid.
a. Isotonic fluid loss causes dehydration and hypovolemia. In severe
cases, hypovolemic shock can occur.
i. Ex: if pt loses pure plasma or ECF, fluid volume is depleted
but electrolytes remain normal (TB 378)
ii. Causes: severe wound drainage, hemorrhage, excessive
sweating
,EXAM ONE REVIEW 3
iii. Note: ECF will decrease with weight loss, dryness of
skin/mucous membranes, dec. urine output, high hematocrit
iv. s/s: rapid HR, flattened neck veins, can present with normal
or decreased BP
b. Isotonic fluid excess causes hypervolemia. As plasma volume
expands, hypervolemia occurs with weight gain. The dilution effect of
excess plasma volume will decrease (TB 378) hematocrit and plasma
protein concentration. Increased capillary hydrostatic pressure leads
to edema formation which can lead to pulmonary edema and heart
failure development.
i. Causes: excessive IVF, hypersecretion of aldosterone, drug
effects such as cortisone, kidney failure.
ii. s/s: neck veins may distend, BP increase.
iii. Tx: diuretics
3. Know about serum potassium and sodium and clinical features
related to fluctuations in Na, K (Steven)
1. Potassium (3.5-5.0mEq/L): (textbook page 118)
a. Major intracellular electrolyte
b. Concentration gradient maintained via sodium-potassium ATPase pump
c. Major determinant of resting potential of cells, transmission, and
conduction of nerve impulses, maintenance of normal cardiac rhythms,
and contraction of skeletal and smooth muscles
d. Hypokalemia (<3.5 mEq/l) (textbook page 120)
i. Neuromuscular excitability decreases, membrane
hyperpolarization
1. Skeletal muscle weakness
2. Smooth muscle atony (constipation, intestinal distension,
anorexia, nausea, vomiting, paralytic ileus)
3. Cardiac dysrhythmias (EKG changes include flattened T
waves, U wave, ST depression, peaked P wave, prolonged
QT interval)
4. Glucose intolerance
5. Impaired urinary concentrating ability
e. Hyperkalemia: (>5.0mEq/L): (textbook page 122)
i. Neuromuscular excitability increases, membrane hypopolarization:
1. Restlessness, tingling of lips and fingers
2. Intestinal cramping, diarrhea
3. Muscle weakness, loss of muscle tone, flaccid muscle
paralysis
4. Cardiac dysrhythmias (peaked T waves, shortened QT
interval, depressed ST segment, prolonged PR interval,
widened QRS)
, EXAM ONE REVIEW 4
2. Sodium (135-145mEq/L): (textbook page 111)
a. Primary extracellular cation
b. Regulated by aldosterone and natriuretic peptides (ANP, BNP) and
urodilatin
c. Influences water distribution via extracellular osmotic forces
d. Plays a role in nerve impulse conduction, regulation of acid-base balance,
cellular chemical reactions, transport of substances across the cellular
membrane
e. Hyponatremia (<135mEq/L): (textbook page 116)
i. Causes plasma hypoosmolality and cellular swelling
ii. Classified into
1. hypovolemic hyponatremia
a. hypotension, tachycardia, decreased urine output
2. euvolemic hyponatremia
3. hypervolemic hyponatremia
a. Weight gain, edema, ascites, JVD
iii. Neurologic symptoms: lethargy, headache, confusion,
apprehension, seizures, coma
f. Hypernatremia (>145mEq/L): (textbook page 114)
i. Causes plasma hyperosmolality and cellular shrinking
(intracellular dehydration Neurologic symptoms: weakness,
lethargy, muscle twitching, hyperreflexia, confusion, coma,
seizures
****Note: sodium causes neurologic symptoms, whereas potassium causes
neuromuscular symptoms
4. Hyper/hypocalcemia and hype/hypormagnesmia – Etiology and
manifestations
5. Know how to differentiate between neurofibromatosis I & II (Kiebra D)
Neurofibromatosis- Involves neurogenic tumors
a. Neurofibromatosis I: lisch nodules, neurofibromas, skin fold freckling, cafe au lait
spots, prone to seizures
b. Neurofibromatosis II: cranial and spinal meningiomas, tinnitus, headache, most
common tumors are called vestibular schwannomas
5. Know nucleus, ribosomes, lysosomes, mRNA, rRNA, tRNA -
miranda
- Nucleus: surrounded by nuclear envelope
- primary role is cell division and to control genetic information of the
cell
