2024 | NURS 5315: Advanced Pathophysiology
UTA Exam 1 LATEST UPDATED 2024
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)
Infarct Correct Answer: Cellular Effect:necrosis which results from sudden
insufficiency of arterial blood flow Clinical Implications:- irreversible myocardial
injury (MI)
Apoptosis Correct Answer: Cellular Effect: programmed cell death, normal
process
Clinical Implications: Death by apoptosis causes loss of cells in many pathologic
states including: Severe cell injury, Accumulation of misfolded proteins, Infections
(part. viral), Obstruction in tissue ducts
dysregulated apoptosis - excessive or insufficient apoptosis. ex: survival of
mutated cells can increase cancer risk.
Increased apoptosis is known to occur in ischemic injury (MI and stroke)-
prevents cellular proliferation resulting in a gigantic body
,Coagulative Necrosis Correct Answer: - occurs in the kidneys, heart, and adrenal
glands most commonly secondary to hypoxia - hypoxia by chemical injury (esp.
mercuric chloride) or severe ischemia
Liquefactive Necrosis Correct Answer: - results from ischemic injury to neurons &
glial cells in the brain- nerve cell necrosis- can also result from bacterial
infections: staphylococci, streptococci, E. Coli
Caseous Necrosis Correct Answer: - necrosis specific to lung tissue and occurs
in TB- combination of coagulative and liquefactive necrosis
Fat Necrosis Correct Answer: - necrosis breast, pancreas and other abdominal
structures- cellular dissolution caused by powerful enzymes called lipases
Gangrenous Necrosis Correct Answer: - tissue death resulting from severe tissue
hypoxia- commonly occurring b/c of arteriosclerosis, or blockage, of major
arteries, esp. in the lower leg- dry gangrene: result of coagulative necrosis- wet
gangrene: develops when neutrophils invade the site causing liquefactive
necrosis- gas gangrene: caused by infection of injured tissue by Clostridium (can
be deadly)
Ethanol Metabolism Pathway Correct Answer: Most of the ethanol in the body is
broken down in the liver by an enzyme called alcohol dehydrogenase (ADH),
which transforms ethanol into a toxic compound called acetaldehyde (CH3CHO),
a known carcinogen. However, acetaldehyde is generally short-lived; it is quickly
broken down to a less toxic compound called acetate (CH3COO-) by another
enzyme called aldehyde dehydrogenase (ALDH). Acetate then is broken down to
carbon dioxide and water, mainly in tissues other than the liver. *The enzymes
cytochrome P450 2E1 (CYP2E1) and catalase also break down alcohol to
,acetaldehyde. However, CYP2E1 only is active after a person has consumed
large amounts of alcohol, and catalase metabolizes only a small fraction of
alcohol in the body. Small amounts of alcohol also are removed by interacting
with fatty acids to form compounds called fatty acid ethyl esters (FAEEs). These
compounds have been shown to contribute to damage to the liver and pancreas.
Hepatocellular damage:Fatty Liver Correct Answer: Alcohol is metabolized by
alcohol dehydrogenase (ADH) into acetaldehyde, then further metabolized by
aldehyde dehydrogenase (ALDH) into acetic acid, which is finally oxidized into
carbon dioxide (CO2) and water ( H2O).[6] This process generates NADH, and
increases the NADH/NAD+ ratio. A higher NADH concentration induces fatty acid
synthesis while a decreased NAD level results in decreased fatty acid oxidation.
Subsequently, the higher levels of fatty acids signal the liver cells to compound it
to glycerol to form triglycerides. These triglycerides accumulate, resulting in fatty
liver.
Hepatocellular damage:Alcoholic Hepatitis Correct Answer: Alcoholic hepatitis is
characterized by the inflammation of hepatocytes. Between 10% and 35% of
heavy drinkers develop alcoholic hepatitis. This is called alcoholic steato necrosis
and the inflammation appears to predispose to liver fibrosis. Inflammatory
cytokines (TNF-alpha, IL6 and IL8) are thought to be essential in the initiation
and perpetuation of liver injury by inducing apoptosis and necrosis. One possible
mechanism for the increased activity of TNF-α is the increased intestinal
permeability due to liver disease. This facilitates the absorption of the gut-
produced endotoxin into the portal circulation. The Kupffer cells of the liver then
phagocytose endotoxin, stimulating the release of TNF-α. TNF-α then triggers
apoptotic pathways through the activation of caspases, resulting in cell death.
, 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
UTA Exam 1 LATEST UPDATED 2024
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)
Infarct Correct Answer: Cellular Effect:necrosis which results from sudden
insufficiency of arterial blood flow Clinical Implications:- irreversible myocardial
injury (MI)
Apoptosis Correct Answer: Cellular Effect: programmed cell death, normal
process
Clinical Implications: Death by apoptosis causes loss of cells in many pathologic
states including: Severe cell injury, Accumulation of misfolded proteins, Infections
(part. viral), Obstruction in tissue ducts
dysregulated apoptosis - excessive or insufficient apoptosis. ex: survival of
mutated cells can increase cancer risk.
Increased apoptosis is known to occur in ischemic injury (MI and stroke)-
prevents cellular proliferation resulting in a gigantic body
,Coagulative Necrosis Correct Answer: - occurs in the kidneys, heart, and adrenal
glands most commonly secondary to hypoxia - hypoxia by chemical injury (esp.
mercuric chloride) or severe ischemia
Liquefactive Necrosis Correct Answer: - results from ischemic injury to neurons &
glial cells in the brain- nerve cell necrosis- can also result from bacterial
infections: staphylococci, streptococci, E. Coli
Caseous Necrosis Correct Answer: - necrosis specific to lung tissue and occurs
in TB- combination of coagulative and liquefactive necrosis
Fat Necrosis Correct Answer: - necrosis breast, pancreas and other abdominal
structures- cellular dissolution caused by powerful enzymes called lipases
Gangrenous Necrosis Correct Answer: - tissue death resulting from severe tissue
hypoxia- commonly occurring b/c of arteriosclerosis, or blockage, of major
arteries, esp. in the lower leg- dry gangrene: result of coagulative necrosis- wet
gangrene: develops when neutrophils invade the site causing liquefactive
necrosis- gas gangrene: caused by infection of injured tissue by Clostridium (can
be deadly)
Ethanol Metabolism Pathway Correct Answer: Most of the ethanol in the body is
broken down in the liver by an enzyme called alcohol dehydrogenase (ADH),
which transforms ethanol into a toxic compound called acetaldehyde (CH3CHO),
a known carcinogen. However, acetaldehyde is generally short-lived; it is quickly
broken down to a less toxic compound called acetate (CH3COO-) by another
enzyme called aldehyde dehydrogenase (ALDH). Acetate then is broken down to
carbon dioxide and water, mainly in tissues other than the liver. *The enzymes
cytochrome P450 2E1 (CYP2E1) and catalase also break down alcohol to
,acetaldehyde. However, CYP2E1 only is active after a person has consumed
large amounts of alcohol, and catalase metabolizes only a small fraction of
alcohol in the body. Small amounts of alcohol also are removed by interacting
with fatty acids to form compounds called fatty acid ethyl esters (FAEEs). These
compounds have been shown to contribute to damage to the liver and pancreas.
Hepatocellular damage:Fatty Liver Correct Answer: Alcohol is metabolized by
alcohol dehydrogenase (ADH) into acetaldehyde, then further metabolized by
aldehyde dehydrogenase (ALDH) into acetic acid, which is finally oxidized into
carbon dioxide (CO2) and water ( H2O).[6] This process generates NADH, and
increases the NADH/NAD+ ratio. A higher NADH concentration induces fatty acid
synthesis while a decreased NAD level results in decreased fatty acid oxidation.
Subsequently, the higher levels of fatty acids signal the liver cells to compound it
to glycerol to form triglycerides. These triglycerides accumulate, resulting in fatty
liver.
Hepatocellular damage:Alcoholic Hepatitis Correct Answer: Alcoholic hepatitis is
characterized by the inflammation of hepatocytes. Between 10% and 35% of
heavy drinkers develop alcoholic hepatitis. This is called alcoholic steato necrosis
and the inflammation appears to predispose to liver fibrosis. Inflammatory
cytokines (TNF-alpha, IL6 and IL8) are thought to be essential in the initiation
and perpetuation of liver injury by inducing apoptosis and necrosis. One possible
mechanism for the increased activity of TNF-α is the increased intestinal
permeability due to liver disease. This facilitates the absorption of the gut-
produced endotoxin into the portal circulation. The Kupffer cells of the liver then
phagocytose endotoxin, stimulating the release of TNF-α. TNF-α then triggers
apoptotic pathways through the activation of caspases, resulting in cell death.
, 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
