Essentials of Pathophysiology – Final Exam Review Sheet
Covers Material from Modules 1-10
Be sure to look over review sheets from Exam #1 and #2 – all previous information is fair game for the Final
exam
1. Review the different levels of disease prevention such as primary, secondary, and tertiary as well as
examples for each.
Primary: “Preventing”; altering susceptibility or reducing exposure of disease for people. Example:
Vaccinations and Handwashing because you are preventing contraction of disease or risk.
Secondary: “Screening”; early detection, screening, and management of disease to catch disease early
before it spreads. Example: PAP smears for STDs, lab work for HBA1C check, mammogram.
Tertiary: “Treating” and preventing further complications from a disorder or disease after the person
has the condition. Example: Rehab for hip surgery, relearning ADL’s after amputation, Wound care after
stroke to prevent pressure ulcers.
2. Review the differences between the sympathetic vs the parasympathetic nervous systems. What
happens to the body during “fight-or-flight” response?
Sympathetic Response: Pupils dilate, salivation inhibited, increase in HR, bronchodilation of airway,
increased respirations, glucose release, inhibit GI/GU.
Parasympathetic Response: Pupils constrict, salivation occurs, decreased HR, bronchoconstriction,
decreased respiration, GI/GU systems resume action.
3. Review the functions of the various organelles of the cell such as the nucleus, mitochondria, ribosome
lysosome, endoplasmic reticulum, peroxisome, golgi apparatus
Nucleus: control center of the cell, where DNA and genes are stored, produces mRNA to help build
body proteins. Can have 1 or more (liver cells), or none (RBCs).
We always count DNA from blood from the WBC’s.
Mitochondria: Powerhouse of the cell. Provides energy in ATP, and has its own set of DNA.
Ribosome: produces RNA to produce proteins through transcriptions of DNA and translation of RNA
into a protein. Can be floating or attached to the Rough ER.
Lysosomes: helps breakdown and digest dead cells, organelles, or tissues.
ER:
Rough ER: folded membranes that move proteins around the cell. Has ribosomes attached to it
and helps produce proteins for the cell membranes.
Smooth ER: ribosomes not attached to smooth ER, helps in the Liver and kidney cells to
detoxify, lipid metabolism, synthesis of hormones, and calcium storage.
Peroxisome: membrane cells that contain oxidase and catalase to detoxify harmful chemicals,
breakdown hydrogen peroxide and filter metabolic wastes.
Golgi Body: stacked membranes that act as the sorter and packager for proteins from the ER. Helps
move things in and out of cell.
4. Review the difference between active and passive immunity, know examples for each type.
Passive Immunity: the transfer of preformed antibodies against specific antigens from a protected or
immunized individual to an unprotected or non immunized person. Provides immediate and short term
, protection. No memory cells are produced. IgA and IgE. Passes protection. Examples: mom to fetus
through placenta or mom to infant through breast milk. Serotherapy. Lasts short months
Active Immunity: a protective state owing to the immune system response as a result of active infectio
or immunization. It has to be activated in the body and the body has to fight it to have long term
immunity. Ex: Vaccinations as they contain altered toxins that retain the ability to produce memory
cells. Second exposure activates a quicker response. Lasts long time
5. What is edema? Review the various factors that can contribute to edema.
Edema: accumulation of fluid in the interstitial space. Leads to tissue swelling.
Causes: Increase in the forces that move fluid from capillaries to interstitial compartments or decrease
in the opposite.
Factors: Increase in hydrostatic forces in the capillaries that increases the blood volume, increased
capillary permeability, CHF, HYPTN, decrease in plasma proteins like albumin (causes liver to hold onto
more water- ascites, cirrhosis), blockage of lymph drainage.
6. What is a hypersensitivity? Review the four different types of hypersensitivities: Type I (Anaphylactic),
Type II (Cytotoxic), Type III (Immune complex), Type IV (Delayed cell-mediated). Know examples and
mediating factors for each type.
Hypersensitivity: an overreaction to antigens or allergens that is beyond the normal range, leading to
damage. Mediating factors
Type 1: anaphylactic. Occurs within 2-30mins of exposure. Can be systemic or localized. Binds to IgE
and mast cells that release histamine, leukotrienes, and prostaglandins to create inflammation. IGE
MEDIATOR
S/S: hives, runny nose, eczema, throat constriction, ,localized edema, wheezing, tachycardia,
anaphylaxis.
Treat: antihistamines to block histamine, beta adrenergics to bronchodilator , corticosteroids, to
decrease inflammation. IgE therapy, epinephrine given during anaphylaxis through IV or through IM in
epipens.
Type 2: Cytotoxic hypersensitivity. Involve IgG and IgM antibodies. Examples are blood transfusion
reactions when the wrong blood is given, hemolytic disease of the newborn when mom is Rh negative
and baby is Rh+ and the antibodies destroy the babies red blood cells and attack the fetus. Can also be
present when antibodies attack healthy organs. Graves disease has the thyroid attacked causing
increase in thyroid hormone. Myasthenia Gravis has the nervous system nerves not being able to bind
the acetylcholine to communicate with each other. Causing muscle weakness. igm/igg
Type 3: Immune complexes. The igG antibodies are stuck beneath the membranes of cells. Can activat
immune responses that can damage tissues. Ex: RA, lupus.
Type 4: delayed cell mediated: there is a delayed cell reaction caused by the T cells. Antigens are
phagocytized and are sensitized to receptors on the t cell. Reexposure causes the memory cells to
release destructive cytokines. Ex: TB test- 48 hrs later must be read due to delay. Contact dermatitis.
7. Review the differences between benign and malignant tumors.
Benign Tumor: Localized growth that is curable. They more closely resemble the original tissue type,
they grow slowly, have little vascularity, rarely necrotic, and usually have similar function to the original
cells. Can be fatal depending on the location (brain, heart,etc), usually grows at the original areas of the
body. Encapsulated.
Malignant Tumor: usually cancerous. They ignore growth controlling signals and replicate despite
signals from the environment. They can escape signals and can die. they can also display different
, functions poorly or not at all related to the tissue. Greater degree of differentiation means that it is
more aggressive. Can move around with a poor prognosis. Anaplasia, metastasis.
8. Review signs and symptoms of peptic ulcer disease.
S/S: epigastric burning pain that is usually relieved by food or antacids (gastric ulcers present on empt
stomach but can be after food, duodenal ulcers present 2-3 hours after food and is relieved by food).
Can also be life threatening as GI bleeding can occur without warning and cause a drop in H/H and dar
tarry stools and hematemesis.
H. pylori: has a key role in promoting both gastric and duodenal ulcer formation and thrives in acidic
areas. It slows down ulcer healing and can reoccur frequently, and taking it away can help ulcers heal.
Reduce w/ antacids and antibiotics
9. Review differences between functional and mechanical bowel obstructions, know examples for each
Functional Bowel obstruction: problem with the act of the bowel actually moving, such as things that
inhibit movement from surgery, medications, opioids, low fiber diets that can slow motility or shut off
the GI system from the SNS stimulation.
Mechanical Obstruction: adhesions, hernia, tumors, impacted feces, volvus or twisting of the intestines
intussusception.
10. Review signs and symptoms of appendicitis. How do we assess for this condition?
S/S: Periumbilical pain, RLQ pain, presence of a positive McBurneys point when one presses on the
belly button and hip region and when the pressure is removed, the client has pain, nausea, vomiting,
fever, diarrhea, RLQ tenderness, systemic signs of infection.
Assess with the McBurney’s point technique when pressing on the belly button and RLQ hip region and
removing the pressure causes intense pain, indicates positive appendicitis. Rebound tenderness
11. Review signs and symptoms of liver disease. Review complications of liver disease such as ascites,
hepatic encephalopathy and esophageal varices. How are esophageal varices managed/treated?
S/S: hepatocellular failure (jaundice, decreased clotting, hypoalbuminemia, decreased vitamin D and K
and portal hypertension (GI congestion due to blockage of blood, more esophageal or gastric varies,
hemorrhoids, enlarged spleen,)
Jaundice: green yellow staining of tissues from increased level of bilirubin as the liver cannot
metabolize extra bilirubin. Found on eyes, skin, and mouth.
Ascites: pathological accumulation of fluid in the peritoneal cavity due to the loss of albumin in the
liver, causing fluid to be free amongst the cells. It can cause a lot of pain in the abdomen, and it must
be drained with a parenthesis.
Hepatic Encephalopathy: neuropsychiatric syndrome from too much ammonia in the blood as the liver
cannot break it down. Dementia=ammonia and psychotic symptoms common along with jerking.
Esophageal Varices: a complication of portal hypertension resulting from alcoholism or hepatitis.
Causes the vessels in the esophagus to become dilated and bleed, and the rupturing can be forceful
enough for one to bleed out. Treat: reduce the hypertension, banding the varices to prevent rupturing
and bleeding by cutting of the flow with a band.
Another name for end stage liver disease is CIRRHOSIS
Covers Material from Modules 1-10
Be sure to look over review sheets from Exam #1 and #2 – all previous information is fair game for the Final
exam
1. Review the different levels of disease prevention such as primary, secondary, and tertiary as well as
examples for each.
Primary: “Preventing”; altering susceptibility or reducing exposure of disease for people. Example:
Vaccinations and Handwashing because you are preventing contraction of disease or risk.
Secondary: “Screening”; early detection, screening, and management of disease to catch disease early
before it spreads. Example: PAP smears for STDs, lab work for HBA1C check, mammogram.
Tertiary: “Treating” and preventing further complications from a disorder or disease after the person
has the condition. Example: Rehab for hip surgery, relearning ADL’s after amputation, Wound care after
stroke to prevent pressure ulcers.
2. Review the differences between the sympathetic vs the parasympathetic nervous systems. What
happens to the body during “fight-or-flight” response?
Sympathetic Response: Pupils dilate, salivation inhibited, increase in HR, bronchodilation of airway,
increased respirations, glucose release, inhibit GI/GU.
Parasympathetic Response: Pupils constrict, salivation occurs, decreased HR, bronchoconstriction,
decreased respiration, GI/GU systems resume action.
3. Review the functions of the various organelles of the cell such as the nucleus, mitochondria, ribosome
lysosome, endoplasmic reticulum, peroxisome, golgi apparatus
Nucleus: control center of the cell, where DNA and genes are stored, produces mRNA to help build
body proteins. Can have 1 or more (liver cells), or none (RBCs).
We always count DNA from blood from the WBC’s.
Mitochondria: Powerhouse of the cell. Provides energy in ATP, and has its own set of DNA.
Ribosome: produces RNA to produce proteins through transcriptions of DNA and translation of RNA
into a protein. Can be floating or attached to the Rough ER.
Lysosomes: helps breakdown and digest dead cells, organelles, or tissues.
ER:
Rough ER: folded membranes that move proteins around the cell. Has ribosomes attached to it
and helps produce proteins for the cell membranes.
Smooth ER: ribosomes not attached to smooth ER, helps in the Liver and kidney cells to
detoxify, lipid metabolism, synthesis of hormones, and calcium storage.
Peroxisome: membrane cells that contain oxidase and catalase to detoxify harmful chemicals,
breakdown hydrogen peroxide and filter metabolic wastes.
Golgi Body: stacked membranes that act as the sorter and packager for proteins from the ER. Helps
move things in and out of cell.
4. Review the difference between active and passive immunity, know examples for each type.
Passive Immunity: the transfer of preformed antibodies against specific antigens from a protected or
immunized individual to an unprotected or non immunized person. Provides immediate and short term
, protection. No memory cells are produced. IgA and IgE. Passes protection. Examples: mom to fetus
through placenta or mom to infant through breast milk. Serotherapy. Lasts short months
Active Immunity: a protective state owing to the immune system response as a result of active infectio
or immunization. It has to be activated in the body and the body has to fight it to have long term
immunity. Ex: Vaccinations as they contain altered toxins that retain the ability to produce memory
cells. Second exposure activates a quicker response. Lasts long time
5. What is edema? Review the various factors that can contribute to edema.
Edema: accumulation of fluid in the interstitial space. Leads to tissue swelling.
Causes: Increase in the forces that move fluid from capillaries to interstitial compartments or decrease
in the opposite.
Factors: Increase in hydrostatic forces in the capillaries that increases the blood volume, increased
capillary permeability, CHF, HYPTN, decrease in plasma proteins like albumin (causes liver to hold onto
more water- ascites, cirrhosis), blockage of lymph drainage.
6. What is a hypersensitivity? Review the four different types of hypersensitivities: Type I (Anaphylactic),
Type II (Cytotoxic), Type III (Immune complex), Type IV (Delayed cell-mediated). Know examples and
mediating factors for each type.
Hypersensitivity: an overreaction to antigens or allergens that is beyond the normal range, leading to
damage. Mediating factors
Type 1: anaphylactic. Occurs within 2-30mins of exposure. Can be systemic or localized. Binds to IgE
and mast cells that release histamine, leukotrienes, and prostaglandins to create inflammation. IGE
MEDIATOR
S/S: hives, runny nose, eczema, throat constriction, ,localized edema, wheezing, tachycardia,
anaphylaxis.
Treat: antihistamines to block histamine, beta adrenergics to bronchodilator , corticosteroids, to
decrease inflammation. IgE therapy, epinephrine given during anaphylaxis through IV or through IM in
epipens.
Type 2: Cytotoxic hypersensitivity. Involve IgG and IgM antibodies. Examples are blood transfusion
reactions when the wrong blood is given, hemolytic disease of the newborn when mom is Rh negative
and baby is Rh+ and the antibodies destroy the babies red blood cells and attack the fetus. Can also be
present when antibodies attack healthy organs. Graves disease has the thyroid attacked causing
increase in thyroid hormone. Myasthenia Gravis has the nervous system nerves not being able to bind
the acetylcholine to communicate with each other. Causing muscle weakness. igm/igg
Type 3: Immune complexes. The igG antibodies are stuck beneath the membranes of cells. Can activat
immune responses that can damage tissues. Ex: RA, lupus.
Type 4: delayed cell mediated: there is a delayed cell reaction caused by the T cells. Antigens are
phagocytized and are sensitized to receptors on the t cell. Reexposure causes the memory cells to
release destructive cytokines. Ex: TB test- 48 hrs later must be read due to delay. Contact dermatitis.
7. Review the differences between benign and malignant tumors.
Benign Tumor: Localized growth that is curable. They more closely resemble the original tissue type,
they grow slowly, have little vascularity, rarely necrotic, and usually have similar function to the original
cells. Can be fatal depending on the location (brain, heart,etc), usually grows at the original areas of the
body. Encapsulated.
Malignant Tumor: usually cancerous. They ignore growth controlling signals and replicate despite
signals from the environment. They can escape signals and can die. they can also display different
, functions poorly or not at all related to the tissue. Greater degree of differentiation means that it is
more aggressive. Can move around with a poor prognosis. Anaplasia, metastasis.
8. Review signs and symptoms of peptic ulcer disease.
S/S: epigastric burning pain that is usually relieved by food or antacids (gastric ulcers present on empt
stomach but can be after food, duodenal ulcers present 2-3 hours after food and is relieved by food).
Can also be life threatening as GI bleeding can occur without warning and cause a drop in H/H and dar
tarry stools and hematemesis.
H. pylori: has a key role in promoting both gastric and duodenal ulcer formation and thrives in acidic
areas. It slows down ulcer healing and can reoccur frequently, and taking it away can help ulcers heal.
Reduce w/ antacids and antibiotics
9. Review differences between functional and mechanical bowel obstructions, know examples for each
Functional Bowel obstruction: problem with the act of the bowel actually moving, such as things that
inhibit movement from surgery, medications, opioids, low fiber diets that can slow motility or shut off
the GI system from the SNS stimulation.
Mechanical Obstruction: adhesions, hernia, tumors, impacted feces, volvus or twisting of the intestines
intussusception.
10. Review signs and symptoms of appendicitis. How do we assess for this condition?
S/S: Periumbilical pain, RLQ pain, presence of a positive McBurneys point when one presses on the
belly button and hip region and when the pressure is removed, the client has pain, nausea, vomiting,
fever, diarrhea, RLQ tenderness, systemic signs of infection.
Assess with the McBurney’s point technique when pressing on the belly button and RLQ hip region and
removing the pressure causes intense pain, indicates positive appendicitis. Rebound tenderness
11. Review signs and symptoms of liver disease. Review complications of liver disease such as ascites,
hepatic encephalopathy and esophageal varices. How are esophageal varices managed/treated?
S/S: hepatocellular failure (jaundice, decreased clotting, hypoalbuminemia, decreased vitamin D and K
and portal hypertension (GI congestion due to blockage of blood, more esophageal or gastric varies,
hemorrhoids, enlarged spleen,)
Jaundice: green yellow staining of tissues from increased level of bilirubin as the liver cannot
metabolize extra bilirubin. Found on eyes, skin, and mouth.
Ascites: pathological accumulation of fluid in the peritoneal cavity due to the loss of albumin in the
liver, causing fluid to be free amongst the cells. It can cause a lot of pain in the abdomen, and it must
be drained with a parenthesis.
Hepatic Encephalopathy: neuropsychiatric syndrome from too much ammonia in the blood as the liver
cannot break it down. Dementia=ammonia and psychotic symptoms common along with jerking.
Esophageal Varices: a complication of portal hypertension resulting from alcoholism or hepatitis.
Causes the vessels in the esophagus to become dilated and bleed, and the rupturing can be forceful
enough for one to bleed out. Treat: reduce the hypertension, banding the varices to prevent rupturing
and bleeding by cutting of the flow with a band.
Another name for end stage liver disease is CIRRHOSIS
