ADVANCED PATHOPHYSIOLOGY EXAM 1 NEWEST 2024
ACTUAL EXAM 200 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
|ALREADY GRADED A+
7 possible mechanisms of fatty accumulation - answer--increased movement of free fatty acids into the
liver
-Failure of metabolic process that converts fatty acids to phospholipids resulting in the preferential
conversion of the fatty acids to triglycerides
-increased synthesis of triglycerides from fatty acids
-decreased synthesis of apoproteins (lipid acceptors)
-failure of lipids to bind with apoproteins and form lipoproteins
-failure of mechanisms that transport lipoproteins out of the cell
-direct damage to the ER by free radicals released by alcohol's toxic effects
pathogenesis of bilirubin - answer--released when RBCs break down
-released into blood (unconjugated)
-fat-soluble, cannot be elimintated through urine
-unconjugated is taken up in the liver cells, bound to glucuronic acid, becomes conjugated bilirubin
-can now be eliminated through the kidney
-some becomes part of bile, some is eliminated in urine and feces giving yellow and brown color
(bilirubin is a pigment)
What is jaundice caused by - answer-excess bilirubin
what is excess bilirubin caused by - answer--diseases that cause destruction of RBC (hemolytic
jaundice)
-Diseases affecting the metabolism and excretion of bilirubin in the liver
-diseases that can obstruct the common bile duct (gallstones/pancreatic tumors)
,Effects of free cytosolic calcium - answer--normally removed by ATP dependent calcium pumps
-If abnormal permeability of calcium ion channels, direct damage to membranes, or depletion of ATP (i.e.
hypoxic injury)
-then calcium level increases
-if not buffered or pumped out, uncontrolled enzyme activation takes place
-leading to: phosphorylation of protein and chromatin fragmentation, membrane damage, cytoskeletal
disassembly (damage), nucleus chromatin damage
-often final pathway in many causes of cell death
pyknosis - answer-in some cells the nucleus shrinks and becomes a small dense (clumped together)
mass of genetic material. The pyknotic nucleus eventually dissolves (by karyolysis)
karyorrhexias - answer-a degenerative cellular process involving fragmentation of the nucleus and the
breakup of the chromatin into unstructured granules
karyolysis - answer-nuclear dissolution and lysis of chromatin from the action of hydrolytic enzymes.
Result of the action of hydrolytic lysosomal enzymes on DNA
Liquefactive necrosis - answer-brain infarct, bacterial infections; wet gangrene
type of necrosis which results in a transformation of the tissue into a liquid viscous mass.
coagulative necrosis - answer-primarily occurs in kidneys, heart, and adrenal
glands results from hypoxia caused by severe ischemia or chemical injury most
common
usually replaced by scar/fibrous tissue
caseous necrosis - answer-commonly results from tuberculous pulmonary
infection combination of coagulative and liquefactive the dead cells disintegrate
,but the debris is not digest completely by hydrolases tissues appear soft and
granular and resemble clumped cheese
Fat necrosis - answer-occurs in the breast, pancreas, and other abdominal structures
cellular dissolution caused by powerful enzymes called lipases
break down triglycerides releasing free fatty acids which combine with calcium, magnesium, and sodium
ions, creating soaps necrotic tissue appears opaque and chalk white
Gangrenous necrosis - answer-refers to death of tissue and results from severe hypoxic
injury commonly occurring becasuse of arteriosclerosis especially in lower leg with hypoxia
and subsequent bacterial invasion, the tissues undergo necrosis
dry gangrene - answer-an area that is free of infection and in which the line of demarcation between
live and dead tissue is apparent
tissue becomes dry and shrunken - mummified
wet gangrene - answer-often malodorous and the line of demarcation between live and dead tissue is
unclear until the infection is arrested
gas gangrene - answer-wet gangrene caused by clostridium perfringes, an organisms that produces gas
within the destroyed tissue. This accumulation of gas produces a distinctive sound on palpation of the
area called crepitus
systemic manifestations of cellular injury - answer-
fever increased heart rate increase in number of
leukocytes pain presence of cellular enzymes in
extracellular fluid lactate dehydrogenase
CK
AST
, ALT ALP
amylase
aldolase
tropinins
cellular processes involved in necrosis - answer--caused by an injurious agent, or -cells are induced to
commit suicide
-a disorganized sequence of events that stimulates the inflammatory process
-cellular changes after cell death and process of cellular autodigestion
-membrane integrity is lost and necrotic tissue leaks out causing inflammation in the surrounding tissue
apoptosis - answer--event that results in cell death
-quiet, organized, programmed process resulting in elimination of individual cells
Example of physiologic apoptosis - answer-removal of webbing between fingers in human fetus
example of pathologic apoptosis - answer-AIDS when the HIV induces T-cell apoptosis
T/F Apoptosis is associated with inflammation - answer-False
What is apoptosis initiated by - answer-activation of capase enzymes
what is necrosis initiated by - answer-
ischemia toxins physical stimuli
what is the time course for apoptosis - answer-12 - 24 hours
ACTUAL EXAM 200 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
|ALREADY GRADED A+
7 possible mechanisms of fatty accumulation - answer--increased movement of free fatty acids into the
liver
-Failure of metabolic process that converts fatty acids to phospholipids resulting in the preferential
conversion of the fatty acids to triglycerides
-increased synthesis of triglycerides from fatty acids
-decreased synthesis of apoproteins (lipid acceptors)
-failure of lipids to bind with apoproteins and form lipoproteins
-failure of mechanisms that transport lipoproteins out of the cell
-direct damage to the ER by free radicals released by alcohol's toxic effects
pathogenesis of bilirubin - answer--released when RBCs break down
-released into blood (unconjugated)
-fat-soluble, cannot be elimintated through urine
-unconjugated is taken up in the liver cells, bound to glucuronic acid, becomes conjugated bilirubin
-can now be eliminated through the kidney
-some becomes part of bile, some is eliminated in urine and feces giving yellow and brown color
(bilirubin is a pigment)
What is jaundice caused by - answer-excess bilirubin
what is excess bilirubin caused by - answer--diseases that cause destruction of RBC (hemolytic
jaundice)
-Diseases affecting the metabolism and excretion of bilirubin in the liver
-diseases that can obstruct the common bile duct (gallstones/pancreatic tumors)
,Effects of free cytosolic calcium - answer--normally removed by ATP dependent calcium pumps
-If abnormal permeability of calcium ion channels, direct damage to membranes, or depletion of ATP (i.e.
hypoxic injury)
-then calcium level increases
-if not buffered or pumped out, uncontrolled enzyme activation takes place
-leading to: phosphorylation of protein and chromatin fragmentation, membrane damage, cytoskeletal
disassembly (damage), nucleus chromatin damage
-often final pathway in many causes of cell death
pyknosis - answer-in some cells the nucleus shrinks and becomes a small dense (clumped together)
mass of genetic material. The pyknotic nucleus eventually dissolves (by karyolysis)
karyorrhexias - answer-a degenerative cellular process involving fragmentation of the nucleus and the
breakup of the chromatin into unstructured granules
karyolysis - answer-nuclear dissolution and lysis of chromatin from the action of hydrolytic enzymes.
Result of the action of hydrolytic lysosomal enzymes on DNA
Liquefactive necrosis - answer-brain infarct, bacterial infections; wet gangrene
type of necrosis which results in a transformation of the tissue into a liquid viscous mass.
coagulative necrosis - answer-primarily occurs in kidneys, heart, and adrenal
glands results from hypoxia caused by severe ischemia or chemical injury most
common
usually replaced by scar/fibrous tissue
caseous necrosis - answer-commonly results from tuberculous pulmonary
infection combination of coagulative and liquefactive the dead cells disintegrate
,but the debris is not digest completely by hydrolases tissues appear soft and
granular and resemble clumped cheese
Fat necrosis - answer-occurs in the breast, pancreas, and other abdominal structures
cellular dissolution caused by powerful enzymes called lipases
break down triglycerides releasing free fatty acids which combine with calcium, magnesium, and sodium
ions, creating soaps necrotic tissue appears opaque and chalk white
Gangrenous necrosis - answer-refers to death of tissue and results from severe hypoxic
injury commonly occurring becasuse of arteriosclerosis especially in lower leg with hypoxia
and subsequent bacterial invasion, the tissues undergo necrosis
dry gangrene - answer-an area that is free of infection and in which the line of demarcation between
live and dead tissue is apparent
tissue becomes dry and shrunken - mummified
wet gangrene - answer-often malodorous and the line of demarcation between live and dead tissue is
unclear until the infection is arrested
gas gangrene - answer-wet gangrene caused by clostridium perfringes, an organisms that produces gas
within the destroyed tissue. This accumulation of gas produces a distinctive sound on palpation of the
area called crepitus
systemic manifestations of cellular injury - answer-
fever increased heart rate increase in number of
leukocytes pain presence of cellular enzymes in
extracellular fluid lactate dehydrogenase
CK
AST
, ALT ALP
amylase
aldolase
tropinins
cellular processes involved in necrosis - answer--caused by an injurious agent, or -cells are induced to
commit suicide
-a disorganized sequence of events that stimulates the inflammatory process
-cellular changes after cell death and process of cellular autodigestion
-membrane integrity is lost and necrotic tissue leaks out causing inflammation in the surrounding tissue
apoptosis - answer--event that results in cell death
-quiet, organized, programmed process resulting in elimination of individual cells
Example of physiologic apoptosis - answer-removal of webbing between fingers in human fetus
example of pathologic apoptosis - answer-AIDS when the HIV induces T-cell apoptosis
T/F Apoptosis is associated with inflammation - answer-False
What is apoptosis initiated by - answer-activation of capase enzymes
what is necrosis initiated by - answer-
ischemia toxins physical stimuli
what is the time course for apoptosis - answer-12 - 24 hours
