PATHO NR 507 FINAL EXAM 2025-2026 WITH
CORRECT ACCURATE ANSWERS
The relationship of insulin resistance on the development of primary
hypertension - CORRECT ANSWERS- The RAAS has multiple effects on the
cardiovascular system. The best known pathway includes the release of renin,
the synthesis of angiotensin II (ang II) through angiotensin-converting
enzyme (ACE), and stimulation of the AT1 receptor with secretion of
aldosterone. Activation of the AT1 receptor causes systemic vasoconstriction
and renal salt and water retention, and stimulates tissue growth and
inflammation. AT1 activation also contributes to insulin resistance.
Insulin resistance is common in hypertension, even in individuals without
clinical diabetes. Insulin resistance is associated with endothelial injury and
affects renal function, causing renal salt and water retention. Insulin
resistance is associated with overactivity of the SNS and the RAAS. It is
interesting to note that in many individuals with diabetes treated with drugs
that increase insulin sensitivity, blood pressure often declines, even in the
absence of antihypertensive drugs. The interactions between obesity,
hypertension, insulin resistance, and lipid disorders in the metabolic
syndrome result in a high risk of cardiovascular disease
Insulin resistance and neurohumoral dysfunction contribute to sustained
systemic vasoconstriction and increased peripheral resistance
Defects in the normal secretion of natriuretic hormones and the impact on
renal system - CORRECT ANSWERS- Increased vascular volume is related to a
decrease in renal excretion of salt, often referred to as a shift in the pressure-
natriuresis relationship. This means that for a given blood pressure,
individuals with hypertension tend to secrete less salt in their urine.
,The natriuretic hormones modulate renal sodium (Na+) excretion and require
adequate potassium, calcium, and magnesium to function properly. The
natriuretic hormones include atrial natriuretic peptide (ANP), B-type
natriuretic peptide (BNP), C-type natriuretic peptide (CNP), and urodilatin.
These hormones induce diuresis; enhancement of renal blood flow and
glomerular filtration rate, systemic vasodilatation, and suppression of
aldosterone; and inhibition of the SNS. Dysfunction of these hormones, along
with alterations in the RAAS and the SNS, cause an increase in vascular tone
and a shift in the pressure-natriuresis relationship. When there is inadequate
natriuretic function, serum levels of the natriuretic peptides rise in an attempt
to compensate. In hypertension, increased ANP and BNP levels are linked to
an increased risk for ventricular hypertrophy, atherosclerosis, and heart
failure. Salt retention leads to water retention and increased blood volume,
which contributes to an increase in blood pressure. Subtle renal injury results,
with renal vasoconstriction and tissue ischemia. Tissue ischemia causes
inflammation of the kidney and contributes to dysfunction of the glomeruli
and tubules and promotes additional sodium retention. Increasing dietary
intake of potassium, calcium, and magnesium can enhance natriuretic peptide
function.
body's process for adapting to high hormone level - CORRECT ANSWERS- To
adapt to high levels of hormones, some cells have the capacity to decrease the
number of receptors for that hormone through the process of down-
regulation.
Uterine prolapse - CORRECT ANSWERS- Uterine prolapse is descent of the
cervix or entire uterus into the vaginal canal. In severe cases the uterus falls
completely through the vagina and protrudes from the introitus. Symptoms of
other pelvic floor disorders also may be present.
,Cushing's Syndrome - CORRECT ANSWERS- excessive ACTH
(Adrenocorticotropic hormone) production most commonly caused by an
adrenal adenoma or a non-pituitary adenoma as is often seen with lung
cancer. Clinical signs and symptoms: weight gain and hyperpigmentation of
skin.
Effects of increased sympathetic nervous system activity due to primary
hypertension - CORRECT ANSWERS- Increased activity of the sympathetic
nervous system (SNS) not only increases heart rate and peripheral resistance
but also causes vascular remodeling with narrowing and vasospasm of
arteries. The SNS contributes to insulin resistance, which is associated with
endothelial dysfunction and decreased production of vasodilators, such as
nitric oxide. The SNS also has procoagulant properties, making vascular spasm
and thrombosis more likely. All of these factors contribute to sustained
increases in blood pressure.
Complications of unstable plaque in the coronary arteries - CORRECT
ANSWERS- thickening and hardening of the vessel are caused by the
accumulation of lipid-laden macrophages within the arterial wall, which leads
to the formation of a lesion called a plaque. Atherosclerosis is not a single
disease but rather a pathologic process that can affect vascular systems
throughout the body, resulting in ischemic syndromes that can vary widely in
their severity and clinical manifestations. It is the leading cause of coronary
artery and cerebrovascular disease. Atherosclerosis presents with symptoms
and signs that result from inadequate tissue perfusion because of obstruction
of the vessels that supply them. Partial vessel obstruction may lead to
transient ischemic events, often associated with exercise or stress. Once the
lesion becomes complicated, increasing obstruction with superimposed
thrombosis may result in tissue infarction. Obstruction of peripheral arteries
can cause significant pain and disability. CAD caused by atherosclerosis is the
, major cause of myocardial ischemia and is one of the most important health
issues in the United States. Atherosclerotic obstruction of the vessels
supplying the brain is the major cause of stroke.
forms of dyslipidemia associated with the development of the fatty streak in
atherosclerosis - CORRECT ANSWERS- High LDL
In atherosclerosis, LDL adheres to the injured endothelium and is oxidized by
macrophages to form the fatty streak. Low-density lipoprotein molecules
(LDL) becoming oxidized by free radicals, particularly oxygen free (ROS).
When oxidized LDL comes in contact with an artery wall, a series of reactions
occur to repair the damage to the artery wall caused by oxidized LDL.
events that initiate the process of atherosclerosis - CORRECT ANSWERS-
Vascular endothelial injury can result from atherosclerosis (plaque deposits
on arterial walls). Atherosclerosis initiates platelet adhesion and aggregation,
promoting the development of atherosclerotic plaques that enlarge, causing
further damage and occlusion. Other causes of vessel endothelial injury may
be related to hemodynamic alterations associated with hypertension and
turbulent blood flow. Injury is also caused by radiation injury, exogenous
chemical agents (toxins from cigarette smoke), endogenous agents
(cholesterol), bacterial toxins or endotoxins, or immunologic mechanisms.
signs and symptoms of increased left atrial and pulmonary venous pressures
in left sided heart failure - CORRECT ANSWERS- Shortness of breath
(dyspnea) when patient exert or when patients lie down
Fatigue and weakness
Swelling (edema) in the legs, ankles and feet
Rapid or irregular heartbeat
CORRECT ACCURATE ANSWERS
The relationship of insulin resistance on the development of primary
hypertension - CORRECT ANSWERS- The RAAS has multiple effects on the
cardiovascular system. The best known pathway includes the release of renin,
the synthesis of angiotensin II (ang II) through angiotensin-converting
enzyme (ACE), and stimulation of the AT1 receptor with secretion of
aldosterone. Activation of the AT1 receptor causes systemic vasoconstriction
and renal salt and water retention, and stimulates tissue growth and
inflammation. AT1 activation also contributes to insulin resistance.
Insulin resistance is common in hypertension, even in individuals without
clinical diabetes. Insulin resistance is associated with endothelial injury and
affects renal function, causing renal salt and water retention. Insulin
resistance is associated with overactivity of the SNS and the RAAS. It is
interesting to note that in many individuals with diabetes treated with drugs
that increase insulin sensitivity, blood pressure often declines, even in the
absence of antihypertensive drugs. The interactions between obesity,
hypertension, insulin resistance, and lipid disorders in the metabolic
syndrome result in a high risk of cardiovascular disease
Insulin resistance and neurohumoral dysfunction contribute to sustained
systemic vasoconstriction and increased peripheral resistance
Defects in the normal secretion of natriuretic hormones and the impact on
renal system - CORRECT ANSWERS- Increased vascular volume is related to a
decrease in renal excretion of salt, often referred to as a shift in the pressure-
natriuresis relationship. This means that for a given blood pressure,
individuals with hypertension tend to secrete less salt in their urine.
,The natriuretic hormones modulate renal sodium (Na+) excretion and require
adequate potassium, calcium, and magnesium to function properly. The
natriuretic hormones include atrial natriuretic peptide (ANP), B-type
natriuretic peptide (BNP), C-type natriuretic peptide (CNP), and urodilatin.
These hormones induce diuresis; enhancement of renal blood flow and
glomerular filtration rate, systemic vasodilatation, and suppression of
aldosterone; and inhibition of the SNS. Dysfunction of these hormones, along
with alterations in the RAAS and the SNS, cause an increase in vascular tone
and a shift in the pressure-natriuresis relationship. When there is inadequate
natriuretic function, serum levels of the natriuretic peptides rise in an attempt
to compensate. In hypertension, increased ANP and BNP levels are linked to
an increased risk for ventricular hypertrophy, atherosclerosis, and heart
failure. Salt retention leads to water retention and increased blood volume,
which contributes to an increase in blood pressure. Subtle renal injury results,
with renal vasoconstriction and tissue ischemia. Tissue ischemia causes
inflammation of the kidney and contributes to dysfunction of the glomeruli
and tubules and promotes additional sodium retention. Increasing dietary
intake of potassium, calcium, and magnesium can enhance natriuretic peptide
function.
body's process for adapting to high hormone level - CORRECT ANSWERS- To
adapt to high levels of hormones, some cells have the capacity to decrease the
number of receptors for that hormone through the process of down-
regulation.
Uterine prolapse - CORRECT ANSWERS- Uterine prolapse is descent of the
cervix or entire uterus into the vaginal canal. In severe cases the uterus falls
completely through the vagina and protrudes from the introitus. Symptoms of
other pelvic floor disorders also may be present.
,Cushing's Syndrome - CORRECT ANSWERS- excessive ACTH
(Adrenocorticotropic hormone) production most commonly caused by an
adrenal adenoma or a non-pituitary adenoma as is often seen with lung
cancer. Clinical signs and symptoms: weight gain and hyperpigmentation of
skin.
Effects of increased sympathetic nervous system activity due to primary
hypertension - CORRECT ANSWERS- Increased activity of the sympathetic
nervous system (SNS) not only increases heart rate and peripheral resistance
but also causes vascular remodeling with narrowing and vasospasm of
arteries. The SNS contributes to insulin resistance, which is associated with
endothelial dysfunction and decreased production of vasodilators, such as
nitric oxide. The SNS also has procoagulant properties, making vascular spasm
and thrombosis more likely. All of these factors contribute to sustained
increases in blood pressure.
Complications of unstable plaque in the coronary arteries - CORRECT
ANSWERS- thickening and hardening of the vessel are caused by the
accumulation of lipid-laden macrophages within the arterial wall, which leads
to the formation of a lesion called a plaque. Atherosclerosis is not a single
disease but rather a pathologic process that can affect vascular systems
throughout the body, resulting in ischemic syndromes that can vary widely in
their severity and clinical manifestations. It is the leading cause of coronary
artery and cerebrovascular disease. Atherosclerosis presents with symptoms
and signs that result from inadequate tissue perfusion because of obstruction
of the vessels that supply them. Partial vessel obstruction may lead to
transient ischemic events, often associated with exercise or stress. Once the
lesion becomes complicated, increasing obstruction with superimposed
thrombosis may result in tissue infarction. Obstruction of peripheral arteries
can cause significant pain and disability. CAD caused by atherosclerosis is the
, major cause of myocardial ischemia and is one of the most important health
issues in the United States. Atherosclerotic obstruction of the vessels
supplying the brain is the major cause of stroke.
forms of dyslipidemia associated with the development of the fatty streak in
atherosclerosis - CORRECT ANSWERS- High LDL
In atherosclerosis, LDL adheres to the injured endothelium and is oxidized by
macrophages to form the fatty streak. Low-density lipoprotein molecules
(LDL) becoming oxidized by free radicals, particularly oxygen free (ROS).
When oxidized LDL comes in contact with an artery wall, a series of reactions
occur to repair the damage to the artery wall caused by oxidized LDL.
events that initiate the process of atherosclerosis - CORRECT ANSWERS-
Vascular endothelial injury can result from atherosclerosis (plaque deposits
on arterial walls). Atherosclerosis initiates platelet adhesion and aggregation,
promoting the development of atherosclerotic plaques that enlarge, causing
further damage and occlusion. Other causes of vessel endothelial injury may
be related to hemodynamic alterations associated with hypertension and
turbulent blood flow. Injury is also caused by radiation injury, exogenous
chemical agents (toxins from cigarette smoke), endogenous agents
(cholesterol), bacterial toxins or endotoxins, or immunologic mechanisms.
signs and symptoms of increased left atrial and pulmonary venous pressures
in left sided heart failure - CORRECT ANSWERS- Shortness of breath
(dyspnea) when patient exert or when patients lie down
Fatigue and weakness
Swelling (edema) in the legs, ankles and feet
Rapid or irregular heartbeat
