NURS 6501- ADVANCED PATHOPHYSIOLOGY FINAL EXAM
FORM B/NURS 6501 ADVANCED PATHOPHYSIOLOGY FINAL
EXAM FORM B 100 REAL EXAM QUESTIONS AND ANSWERS
Explain how cells are connected to form tissues and organs? - ANSWER: Cellular
receptors such as protein molecules on the plasma membrane, cytoplasm, or
nucleus. Proteins that bind with ligands must fit together. The plasma membrane
receptors: Determine with which ligands a cell will bind. Determine how the cell will
respond to the binding. Ligand-receptor complex initiates interactions causing
adenylyl cyclase to transform adenosine triphosphate (ATP) to messenger molecules
that stimulate specific response in the cell. This will allow cells to form tissues and
organs.
Describe the different types of tissues and their functions. Epithelial, Connective,
Muscle, Neural. - ANSWER: Epithelial- covers most of the internal and external body
surfaces, simple, stratified, squamous, cuboidal, columnar, pseudo stratified. The
structures are Cilia and microvilli. Functions- protection, absorption, secretion, and
excretion.
Connective- serve as the ground substance, the fibers are collagenous (white),
elastic (yellow), and reticular. There are loose and dense connective tissue examples
are cartilage, bone, vascular, adipose, and organs. Functions- They are the
framework for forming organs, binding, supporting, and storing excess nutrients.
Muscle Tissue- are composed of myocytes, examples are smooth, skeletal, cardiac.
Functions- contractile tissue, enabling both voluntary and involuntary movement.
Neural Tissue- Structure: Neurons, synapses, cell body, axons, and dendrites.
Functions: Receive and transmit electrical impulses very rapidly across junctions
called synapses such as Neurotransmitters.
Mitochondria within the cells are responsible for: - ANSWER: a. Cellular respiration
and energy production via metabolism of carbohydrates, lipids, and amino acids.
The process of catabolism involves three phases in which order? - ANSWER: b.
Digestion, glycolysis, and Krebs cycle.
A patient has an annual Pap smear and gynecologic examination. Three years ago,
immediately before her third pregnancy, the pathologic report of her Pap smear
indicated she had hormonal hyperplasia. Her current Pap smear indicates she has
atypical hyperplasia or dysplasia. What is the difference between these? - ANSWER:
Atypical hyperplasia- is a term used when there is an abnormal pattern of growth of
cells within the ducts and/ or lobules that are not cancerous.
Hyperplasia means that there are more cells than usual and they are no longer lined
up in just the 2 layers of cells. By looking under the microscope some of the growth
looks more abnormal.
,Dysplasia- is a term used in pathology to refer to an abnormality in maturation of
cells within a tissue. This generally consists of an expansion of immature cells, with a
corresponding decrease in the number and location of mature cells.
Dysplasia is often indicative of an early neoplastic process. Example is Epithelial
dysplasia of the cervix (from an abnormal pap smear) consists of an increased
population of immature (basal-like) cells which are restricted to the mucosal surface,
and have not invaded through the basement membrane to the deeper soft tissues.
A patient has been smoking one pack of cigarettes per day for 20 years. Describe the
possible cellular changes that have occurred in his bronchial linings that can make
him more prone to upper respiratory infections - ANSWER: Smoking damage is slow
and progressive and deadly. Smoking affects the normal process of how our
respiratory system removes trapped dirt and disease causing organisms, which cilia
sweep toward the mouth, where it can be eliminated. The first inhalation starts the
process of the cilia slowly losing their function and becoming paralyzed and then
disappears all together. The smoker's cough is now the end result. The cilium no
longer removes the mucus effectively and the person must cough it up. The
respiratory tract is now vulnerable for lung congestion and a place for pathogenic
organisms to start developing. The cough leads to chronic bronchitis caused by the
destroyed cilia. The bronchioles lose elasticity and are no longer able to absorb the
pressure within the alveoli enough to rupture the delicate alveolar walls; this is the
classic sign for emphysema. Progressing emphysema may be cellular changes leading
to lung cancer. First the outer border of the bronchial lining begins to divide more
rapidly than usual. Eventually, these displace the ciliated cells. The nuclei begin to
look like cancer cells, large and distorted with abnormal numbers and chromosomes.
The damage at this point can be repaired is smoking ceases. However, if it doesn't
these cells may eventually break through the basement membrane and begin
dividing within the lung tissue, forming a tumor with the potential of spreading
throughout lung tissue
A patient is diagnosed with a cerebral embolus (CVA). Explain how hypoxia causes
the intracellular ion balance to change. - ANSWER: The regulation of both
intracellular pH (pHi) and extracellular pH (pHo) of brain cells is critically important
because many cellular processes are sensitive to changes in pHi and/or pHo. These
pH-sensitive processes include enzymes and transporters, as well as voltage- and
ligand-gated channels that can influence neuronal activity. The pH sensitivity of
glutamate-stimulated and voltage-gated Ca2+ channels is particularly relevant to ion
disturbances associated with hypoxia and ischemia, when increases in intracellular
Ca2+ ([Ca2+]i) can be neurotoxic. Ischemia/hypoxia generally leads to decreases in
both pHi and pHo in brain cells, although the pattern and magnitude of the pH
changes can vary among preparations If the primary insult were a fall in pHi( i.e., at
constant pHo), then brain cells would attempt to regulate their pHi by extruding acid,
that is, transporting acid into or taking up HCO3 from the extracellular space. The
resulting secondary decrease in pHo could contribute to tissue damage
A 95-year-old patient expresses frustration due to the constant stiffness she suffers.
What are some examples of a decrease in her tissue and systemic function as a result
, of the aging process? - ANSWER: Aging is the result of accumulated DNA damage,
decreased proliferative capacity of stem cells, and accumulated metabolic damage
(Kumar, Abbas & Aster, 2010). Some of the decreased tissue and systemic function
is: Cardiovascular- decreased vessel elasticity caused by calcification of connective
tissue(increased pulmonary vascular resistance), decrease number of heart muscle
fibers with increased size of individual fibers(hypertrophy). Decreased filling
capacity, decreased stroke volume, decreased sensitivity of baroreceptors,
degeneration of vein valves.
Respiratory- decreased chest wall compliance resulting from calcification of costal
cartilage, decreased alveolar ventilation, decreased respiratory muscle strength, Air
trapping and decreased ventilation due to degeneration of lung tissue (decreased
elasticity).
Renal/Urinary- decreased of all of the following: glomerular filtration rate due to
nephron degeneration, ability to concentrate urine, ability to regulate H+
concentration.
Gastrointestinal- decreased of all of the following: Muscular contraction, esophageal
emptying, bowel motility, production of HCL, enzymes, and intrinsic factor, hepatic
enzyme production and metabolic capacity, thinning of stomach mucosa.
Neurologic/Sensory - Nerve cells degenerate and atrophy, decreased of all of the
following: Of 25-45% of neurons, number of neurotransmitters, rate of conduction of
nerve impulses, loss of taste buds, loss of auditory hair cells and sclerosis of
eardrum. Musculoskeletal- decrease muscle mass, increased bone demineralization,
Increased joint degeneration, erosion, and calcification.
Immune- decreased inflammatory response, decrease in Tcell function owing to
involution of thymus gland. Integumentary- Decreased subcutaneous fat, decreased
elastin, Atrophy of sweat glands, Atrophy of epidermal arteriole
Which of the following would likely be the most immunogenic? - ANSWER: d. Cold
virus
Immunogenicity is the ability of a particular substance, such as an antigen or
epitope, to provoke an immune response in the body of a human or animal. Some
proteins cause the body to produce antibodies but most have no effect on the safety
and efficacy of the medicine. Immunogenicity rarely induces a clinically relevant
reaction. The cold virus is viewed as invader, which causes the body to try to attack
the virus causing immunity to the antigen present
What are examples of antigens that are derived from pathogens, environmental
agents, and other sources? - ANSWER: Antigens are proteins that are found on the
surface of the pathogen. Antigens are unique to that pathogen. The whooping cough
bacterium, for example, will have different antigens on its surface from the TB
bacterium. When an antigen enters the body, the immune system produces
antibodies against it. A type of white blood cell called a lymphocyte recognizes the
antigen as being foreign and produces antibodies specific to the antigen, which is
then engulfed and digested by macrophages.
FORM B/NURS 6501 ADVANCED PATHOPHYSIOLOGY FINAL
EXAM FORM B 100 REAL EXAM QUESTIONS AND ANSWERS
Explain how cells are connected to form tissues and organs? - ANSWER: Cellular
receptors such as protein molecules on the plasma membrane, cytoplasm, or
nucleus. Proteins that bind with ligands must fit together. The plasma membrane
receptors: Determine with which ligands a cell will bind. Determine how the cell will
respond to the binding. Ligand-receptor complex initiates interactions causing
adenylyl cyclase to transform adenosine triphosphate (ATP) to messenger molecules
that stimulate specific response in the cell. This will allow cells to form tissues and
organs.
Describe the different types of tissues and their functions. Epithelial, Connective,
Muscle, Neural. - ANSWER: Epithelial- covers most of the internal and external body
surfaces, simple, stratified, squamous, cuboidal, columnar, pseudo stratified. The
structures are Cilia and microvilli. Functions- protection, absorption, secretion, and
excretion.
Connective- serve as the ground substance, the fibers are collagenous (white),
elastic (yellow), and reticular. There are loose and dense connective tissue examples
are cartilage, bone, vascular, adipose, and organs. Functions- They are the
framework for forming organs, binding, supporting, and storing excess nutrients.
Muscle Tissue- are composed of myocytes, examples are smooth, skeletal, cardiac.
Functions- contractile tissue, enabling both voluntary and involuntary movement.
Neural Tissue- Structure: Neurons, synapses, cell body, axons, and dendrites.
Functions: Receive and transmit electrical impulses very rapidly across junctions
called synapses such as Neurotransmitters.
Mitochondria within the cells are responsible for: - ANSWER: a. Cellular respiration
and energy production via metabolism of carbohydrates, lipids, and amino acids.
The process of catabolism involves three phases in which order? - ANSWER: b.
Digestion, glycolysis, and Krebs cycle.
A patient has an annual Pap smear and gynecologic examination. Three years ago,
immediately before her third pregnancy, the pathologic report of her Pap smear
indicated she had hormonal hyperplasia. Her current Pap smear indicates she has
atypical hyperplasia or dysplasia. What is the difference between these? - ANSWER:
Atypical hyperplasia- is a term used when there is an abnormal pattern of growth of
cells within the ducts and/ or lobules that are not cancerous.
Hyperplasia means that there are more cells than usual and they are no longer lined
up in just the 2 layers of cells. By looking under the microscope some of the growth
looks more abnormal.
,Dysplasia- is a term used in pathology to refer to an abnormality in maturation of
cells within a tissue. This generally consists of an expansion of immature cells, with a
corresponding decrease in the number and location of mature cells.
Dysplasia is often indicative of an early neoplastic process. Example is Epithelial
dysplasia of the cervix (from an abnormal pap smear) consists of an increased
population of immature (basal-like) cells which are restricted to the mucosal surface,
and have not invaded through the basement membrane to the deeper soft tissues.
A patient has been smoking one pack of cigarettes per day for 20 years. Describe the
possible cellular changes that have occurred in his bronchial linings that can make
him more prone to upper respiratory infections - ANSWER: Smoking damage is slow
and progressive and deadly. Smoking affects the normal process of how our
respiratory system removes trapped dirt and disease causing organisms, which cilia
sweep toward the mouth, where it can be eliminated. The first inhalation starts the
process of the cilia slowly losing their function and becoming paralyzed and then
disappears all together. The smoker's cough is now the end result. The cilium no
longer removes the mucus effectively and the person must cough it up. The
respiratory tract is now vulnerable for lung congestion and a place for pathogenic
organisms to start developing. The cough leads to chronic bronchitis caused by the
destroyed cilia. The bronchioles lose elasticity and are no longer able to absorb the
pressure within the alveoli enough to rupture the delicate alveolar walls; this is the
classic sign for emphysema. Progressing emphysema may be cellular changes leading
to lung cancer. First the outer border of the bronchial lining begins to divide more
rapidly than usual. Eventually, these displace the ciliated cells. The nuclei begin to
look like cancer cells, large and distorted with abnormal numbers and chromosomes.
The damage at this point can be repaired is smoking ceases. However, if it doesn't
these cells may eventually break through the basement membrane and begin
dividing within the lung tissue, forming a tumor with the potential of spreading
throughout lung tissue
A patient is diagnosed with a cerebral embolus (CVA). Explain how hypoxia causes
the intracellular ion balance to change. - ANSWER: The regulation of both
intracellular pH (pHi) and extracellular pH (pHo) of brain cells is critically important
because many cellular processes are sensitive to changes in pHi and/or pHo. These
pH-sensitive processes include enzymes and transporters, as well as voltage- and
ligand-gated channels that can influence neuronal activity. The pH sensitivity of
glutamate-stimulated and voltage-gated Ca2+ channels is particularly relevant to ion
disturbances associated with hypoxia and ischemia, when increases in intracellular
Ca2+ ([Ca2+]i) can be neurotoxic. Ischemia/hypoxia generally leads to decreases in
both pHi and pHo in brain cells, although the pattern and magnitude of the pH
changes can vary among preparations If the primary insult were a fall in pHi( i.e., at
constant pHo), then brain cells would attempt to regulate their pHi by extruding acid,
that is, transporting acid into or taking up HCO3 from the extracellular space. The
resulting secondary decrease in pHo could contribute to tissue damage
A 95-year-old patient expresses frustration due to the constant stiffness she suffers.
What are some examples of a decrease in her tissue and systemic function as a result
, of the aging process? - ANSWER: Aging is the result of accumulated DNA damage,
decreased proliferative capacity of stem cells, and accumulated metabolic damage
(Kumar, Abbas & Aster, 2010). Some of the decreased tissue and systemic function
is: Cardiovascular- decreased vessel elasticity caused by calcification of connective
tissue(increased pulmonary vascular resistance), decrease number of heart muscle
fibers with increased size of individual fibers(hypertrophy). Decreased filling
capacity, decreased stroke volume, decreased sensitivity of baroreceptors,
degeneration of vein valves.
Respiratory- decreased chest wall compliance resulting from calcification of costal
cartilage, decreased alveolar ventilation, decreased respiratory muscle strength, Air
trapping and decreased ventilation due to degeneration of lung tissue (decreased
elasticity).
Renal/Urinary- decreased of all of the following: glomerular filtration rate due to
nephron degeneration, ability to concentrate urine, ability to regulate H+
concentration.
Gastrointestinal- decreased of all of the following: Muscular contraction, esophageal
emptying, bowel motility, production of HCL, enzymes, and intrinsic factor, hepatic
enzyme production and metabolic capacity, thinning of stomach mucosa.
Neurologic/Sensory - Nerve cells degenerate and atrophy, decreased of all of the
following: Of 25-45% of neurons, number of neurotransmitters, rate of conduction of
nerve impulses, loss of taste buds, loss of auditory hair cells and sclerosis of
eardrum. Musculoskeletal- decrease muscle mass, increased bone demineralization,
Increased joint degeneration, erosion, and calcification.
Immune- decreased inflammatory response, decrease in Tcell function owing to
involution of thymus gland. Integumentary- Decreased subcutaneous fat, decreased
elastin, Atrophy of sweat glands, Atrophy of epidermal arteriole
Which of the following would likely be the most immunogenic? - ANSWER: d. Cold
virus
Immunogenicity is the ability of a particular substance, such as an antigen or
epitope, to provoke an immune response in the body of a human or animal. Some
proteins cause the body to produce antibodies but most have no effect on the safety
and efficacy of the medicine. Immunogenicity rarely induces a clinically relevant
reaction. The cold virus is viewed as invader, which causes the body to try to attack
the virus causing immunity to the antigen present
What are examples of antigens that are derived from pathogens, environmental
agents, and other sources? - ANSWER: Antigens are proteins that are found on the
surface of the pathogen. Antigens are unique to that pathogen. The whooping cough
bacterium, for example, will have different antigens on its surface from the TB
bacterium. When an antigen enters the body, the immune system produces
antibodies against it. A type of white blood cell called a lymphocyte recognizes the
antigen as being foreign and produces antibodies specific to the antigen, which is
then engulfed and digested by macrophages.
