NURS 5315: ADVANCED PATHO EXAM 1
QUESTIONS WITH VERIFIED ANSWERS.
Atrophy - Correct Answer-E. Cells decrease in size
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)
Hyperplasia - Correct Answer-E: cells increase in number, mitosis (cell
division) must occur, size of cell does not change
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
Dysplasia - Correct Answer-E. Not true adaptation; Cells abnormal change in
size, shape, organization (classified as mild, moderate, severe)
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
Metaplasia - Correct Answer-E: reversible change, one type of cell changes to
another type for survival
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
Hypoxia injury - Correct Answer-E. inadequate oxygenation of tissues
P. decrease in mitochondrial function, decreased production of ATP increases
anaerobic metabolism. eventual cell death.
C.M. hypoxia, cyanosis, cognitive impairment, lethargy
Free radical and ROS - Correct Answer-E. normal byproduct of ATP
production, will overwhelm the mitochondria- exhaust intracellular
antioxidants
P. lipid peroxidation, damage proteins, fragment DNA
C.M. development in Alzheimer's, heart disease, Parkinson's disease,
Amyotrophic Lateral Sclerosis
Ethanol - Correct Answer-E. mood altering drug, long term effects on liver
and nutritional status
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
Oncosis - Correct Answer-Na and H2O enter cell and cause swelling. Organ
increases in weight, becomes distended and pale. Associated with high fever,
hypocalcemia, certain infections
Fatty Infiltration - Correct Answer-intracellular accumulation of lipids in the
liver
liver fails to metabolize lipids. usually from ETOH or high fat diet. can lead to
cirrhosis
dystrophic calcification - Correct Answer-accumulation of Ca in dead or dying
tissues
calcium salt clump and harden- interfere with cellular structure and function
r/t pulmonary TB, atherosclerosis, injured heart valves, chronic pancreatitis
metastatic calcification - Correct Answer-accumulation of Ca in normal tissue
,result of hypercalcemia r/t hyperparathyroidism, hyperthyroidism, toxic
levels of Vit D. Can also r/t hyperphosphatemia in renal failure
urate accumulation - Correct Answer-sodium urate crystals are deposited in
tissues- group of disorders collectively called gout- acute arthritis, chronic
gouty arthritis, tophus, nephritis
Coagulative Necrosis - Correct Answer-kidneys, heart, adrenals- secondary to
hypoxia
Liquefactive Necrosis - Correct Answer-nerve cells- brain- accumulation of
pus
Caseous Necrosis - Correct Answer-lung disease- usually TB- tissue looks like
clumped cheese
Fat Necrosis - Correct Answer-breast, pancreas, abdominal structures-
creates soaps
Gangrenous Necrosis - Correct Answer-Dry- dark shriveled skin
Wet- internal organs- can lead to death
Gas- from clostridium- antitoxins and hyperbaric therapy
Gout - Correct Answer-E. disturbances in serum urate levels. uncommon for
< 30 years old.
P. uric acid is deposited in the tissues of kidney, heart, earlobes, and joints.
C.M. inflammation, painful joints. result of diuretic use or diet high in cream
sauces, red wine, or red meat
Rhabdomyolysis - Correct Answer-E. cell hypoxia caused by severe muscle
trauma, hyperthermia, crush injuries, or severe dehydration
P. hypoxia to cell causes failure of the Na-K pump, causing accumulation of
intracellular sodium, oncosis, and eventual cell death. Cell death releases
enzymes such as CK, uric acid, LDH, AST, etc.
C.M. Causes: trauma, hyperthermia, crush injuries, severe dehydration; s/s:
CK is 5x upper normal limit, muscle pain, weakness, dark, reddish-brown
urine, hypercalcemia, renal failure
Alpha Fetoprotein Origin - Correct Answer-Liver and germ cell tumors
, Carcinoembryonic Antigen - Correct Answer-GI, pancreas, lung, breast
tumors
Prostate Specific Antigen - Correct Answer-prostate tumors
Carcino- - Correct Answer-from epithelial tissue- renal cell carcinoma
Sarco- - Correct Answer-from connective tissue- chondrosarcoma
Carcinoma in situ - Correct Answer-preinvasive epithelial malignant tumors
of glandular or squamous cells- cervix
Lung ca metastasis - Correct Answer-Multiple organs including brain
Colorectal ca metastasis - Correct Answer-Liver, lungs
Testicular ca metastasis - Correct Answer-Liver, lungs, brain
Prostate ca metastasis - Correct Answer-Bones (especially lumbar spine),
liver
Head and neck ca metastasis - Correct Answer-Liver, bones, lymphatics
Ovarian ca metastasis - Correct Answer-Peritoneal surfaces, diaphragm,
omentum, liver
Sarcoma metastasis - Correct Answer-Lungs
Melanoma metastasis - Correct Answer-In transit lymphatics, lung, liver,
brain, GI tract
Mechanisms of ca metastasis - Correct Answer-Local invasion, followed by
invasion of surrounding tissues. Cells then may invade blood and lymphatic
vessels. They must survive in circulation, then enter and survive in a new
location. Then the cells can multiply and form a new tumor.
TNM staging system - Correct Answer-T= tumor size >/= correlates with
metastatic ability
N= whether lymph nodes are involved
M= extra nodal involvement (liver, lungs)
QUESTIONS WITH VERIFIED ANSWERS.
Atrophy - Correct Answer-E. Cells decrease in size
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)
Hyperplasia - Correct Answer-E: cells increase in number, mitosis (cell
division) must occur, size of cell does not change
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
Dysplasia - Correct Answer-E. Not true adaptation; Cells abnormal change in
size, shape, organization (classified as mild, moderate, severe)
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
Metaplasia - Correct Answer-E: reversible change, one type of cell changes to
another type for survival
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
Hypoxia injury - Correct Answer-E. inadequate oxygenation of tissues
P. decrease in mitochondrial function, decreased production of ATP increases
anaerobic metabolism. eventual cell death.
C.M. hypoxia, cyanosis, cognitive impairment, lethargy
Free radical and ROS - Correct Answer-E. normal byproduct of ATP
production, will overwhelm the mitochondria- exhaust intracellular
antioxidants
P. lipid peroxidation, damage proteins, fragment DNA
C.M. development in Alzheimer's, heart disease, Parkinson's disease,
Amyotrophic Lateral Sclerosis
Ethanol - Correct Answer-E. mood altering drug, long term effects on liver
and nutritional status
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
Oncosis - Correct Answer-Na and H2O enter cell and cause swelling. Organ
increases in weight, becomes distended and pale. Associated with high fever,
hypocalcemia, certain infections
Fatty Infiltration - Correct Answer-intracellular accumulation of lipids in the
liver
liver fails to metabolize lipids. usually from ETOH or high fat diet. can lead to
cirrhosis
dystrophic calcification - Correct Answer-accumulation of Ca in dead or dying
tissues
calcium salt clump and harden- interfere with cellular structure and function
r/t pulmonary TB, atherosclerosis, injured heart valves, chronic pancreatitis
metastatic calcification - Correct Answer-accumulation of Ca in normal tissue
,result of hypercalcemia r/t hyperparathyroidism, hyperthyroidism, toxic
levels of Vit D. Can also r/t hyperphosphatemia in renal failure
urate accumulation - Correct Answer-sodium urate crystals are deposited in
tissues- group of disorders collectively called gout- acute arthritis, chronic
gouty arthritis, tophus, nephritis
Coagulative Necrosis - Correct Answer-kidneys, heart, adrenals- secondary to
hypoxia
Liquefactive Necrosis - Correct Answer-nerve cells- brain- accumulation of
pus
Caseous Necrosis - Correct Answer-lung disease- usually TB- tissue looks like
clumped cheese
Fat Necrosis - Correct Answer-breast, pancreas, abdominal structures-
creates soaps
Gangrenous Necrosis - Correct Answer-Dry- dark shriveled skin
Wet- internal organs- can lead to death
Gas- from clostridium- antitoxins and hyperbaric therapy
Gout - Correct Answer-E. disturbances in serum urate levels. uncommon for
< 30 years old.
P. uric acid is deposited in the tissues of kidney, heart, earlobes, and joints.
C.M. inflammation, painful joints. result of diuretic use or diet high in cream
sauces, red wine, or red meat
Rhabdomyolysis - Correct Answer-E. cell hypoxia caused by severe muscle
trauma, hyperthermia, crush injuries, or severe dehydration
P. hypoxia to cell causes failure of the Na-K pump, causing accumulation of
intracellular sodium, oncosis, and eventual cell death. Cell death releases
enzymes such as CK, uric acid, LDH, AST, etc.
C.M. Causes: trauma, hyperthermia, crush injuries, severe dehydration; s/s:
CK is 5x upper normal limit, muscle pain, weakness, dark, reddish-brown
urine, hypercalcemia, renal failure
Alpha Fetoprotein Origin - Correct Answer-Liver and germ cell tumors
, Carcinoembryonic Antigen - Correct Answer-GI, pancreas, lung, breast
tumors
Prostate Specific Antigen - Correct Answer-prostate tumors
Carcino- - Correct Answer-from epithelial tissue- renal cell carcinoma
Sarco- - Correct Answer-from connective tissue- chondrosarcoma
Carcinoma in situ - Correct Answer-preinvasive epithelial malignant tumors
of glandular or squamous cells- cervix
Lung ca metastasis - Correct Answer-Multiple organs including brain
Colorectal ca metastasis - Correct Answer-Liver, lungs
Testicular ca metastasis - Correct Answer-Liver, lungs, brain
Prostate ca metastasis - Correct Answer-Bones (especially lumbar spine),
liver
Head and neck ca metastasis - Correct Answer-Liver, bones, lymphatics
Ovarian ca metastasis - Correct Answer-Peritoneal surfaces, diaphragm,
omentum, liver
Sarcoma metastasis - Correct Answer-Lungs
Melanoma metastasis - Correct Answer-In transit lymphatics, lung, liver,
brain, GI tract
Mechanisms of ca metastasis - Correct Answer-Local invasion, followed by
invasion of surrounding tissues. Cells then may invade blood and lymphatic
vessels. They must survive in circulation, then enter and survive in a new
location. Then the cells can multiply and form a new tumor.
TNM staging system - Correct Answer-T= tumor size >/= correlates with
metastatic ability
N= whether lymph nodes are involved
M= extra nodal involvement (liver, lungs)
