NURS 5315 ADVANCED PATHOPHYSIOLOGY
FINAL EXAM WITH COMPLETE ANWERS
100%
Ovarian cancer site of metastasis? - CORRECT ANSWER-Peritoneal surfaces, omentum (fold of
peritoneum connecting the stomach with other abdominal organs), *liver*
The increased NADH/NAD+ ratio in the liver from ethanol causes: - CORRECT ANSWER-1. Pyruvate -->
lactic acid, causing lactic acidosis
2. Oxaloacetate --> malate. This prevents gluconeogenesis and leads to hypoglycemia
3. Glyceraldehyde-3-phosphate --> glycerol 3- phosphate and combines with fatty acids to form
triglycerides in the liver, known as hepatosteatosis
4. Decreases citric acid cycle production of NADH and leads to using Acetyl-CoA for ketogenesis and
lipogenesis
What can Reactive Oxygen Species cause? - CORRECT ANSWER-Heart disease, Alzheimers, Parkinsons,
Amyotrophic Lateral Sclerosis (ALS), CV disease, HTN, HLD, DM, ischemic heart disease, HF, OSA. Lipid
perioxidation, damage proteins, fragment DNA, less *protein synthesis*, chromatin destruction, damage
mitochondria
What is the body's defense against ROS? - CORRECT ANSWER-Antioxidants (Vitamin E, Vitamin C,
cysteine, glutathione, albumin, ceruloplasmin, transferrin)
How are free radicals produced? - CORRECT ANSWER-1. Normal cellular respiration
2. Absorption of extreme energy sources (radiation, UV light)
3. Metabolism of exogenous chemicals, drugs, and pesticides
4. Transition of metals
5. Nitric oxide acting like a chemical mediator and a free radical
action potential - CORRECT ANSWER-Process of conducting an impulse. Activates the neuron --> the
neuron depolarizes --> then repolarizes
,Threshold potential - CORRECT ANSWER-Point at which depolarization must reach in order to initiate an
action potential
Hypokalemia and action potentials - CORRECT ANSWER-HYPERpolarized (more negative, ex. -100). Less
excitable. Decreased neuromuscular excitability: weakness, smooth muscle atony, paresthesia, cardiac
dysrhythmias
Hyperkalemia and action potentials - CORRECT ANSWER-HYPOpolarized (more positive, ex: closer to 0).
More excitable. Peaked T waves.
When resting membrane potential=threshold potential, it is BAD = cardiac standstill, paresthesia,
paralysis
Hypocalcemia and action potentials - CORRECT ANSWER-Increased permeability to Na+. More excitable.
Tetany, hyperreflexia, circumoral paresthesia, seizures, dysrhythmias.
Hypercalcemia and action potentials - CORRECT ANSWER-Decreased permeability to Na+. Less excitable.
Weakness, hyporeflexia, fatigue, lethargy, confusion, encephalopathy, depressed T waves
Atrophy - CORRECT ANSWER-Occurs as a result of decrease in work load, pressure, use, blood supply,
nutrition, hormonal stimulation, or nervous stimulation. Once the cell has decreased in size, it has now
compensated for decreased blood supply, nerve supply, nutrient supply, hormonal supply, and has
achieved new homeostasis. Cells are alive but have diminished function and may lead to cellular death.
Atrophy examples - CORRECT ANSWER-Physiologic atrophy- shrinking of the thymus gland during
childhood.
Disuse atrophy- someone that ends up being paralyzed
Hypertrophy - CORRECT ANSWER-Increase in SIZE of cells, which will lead to increase in size of organ.
Caused by hormonal stimulation or increased functional demand.
Hypertrophy examples - CORRECT ANSWER-physiologic hypertrophy- skeletal hypertrophy when a
person does heavy work or weight lifting / when a kidney is surgically removed, the other kidney
increases in size
, pathologic hypertrophy- cardiomegaly results from an increased workload in hypertensive patients /
*left ventricular hypertrophy*
Hyperplasia - CORRECT ANSWER-Increase in NUMBER of cells. Results from increased rate of mitosis.
Can ONLY happen in cells that are capable of mitosis (cell division).
Hyperplasia examples - CORRECT ANSWER-1. Thickening of skin because of hyperplasia of epidermal
cells.
2. Hormonal hyperplasia- occurs in estrogen dependent organs like uterus and breast.
3. Compensatory hyperplasia- liver regenerates, callus on skin
4. Pathologic hyperplasia- estrogen is unopposed by progesterone and the endometrial lining undergoes
hyperplasia and increased risk for endometrial cancer
Dysplasia - CORRECT ANSWER-abnormal changes in the size, shape, and organization of mature cells due
to persistent, severe cell injury or irritation
Dysplasia examples - CORRECT ANSWER-Pre cancer pap smears often show dysplastic cells of the cervix
that must undergo treatment.
Metaplasia - CORRECT ANSWER-Changed cell that is REVERSIBLE (one cell is replaced by another cell).
Exposure to chronic stressors, injury or irritation, like smoking or hydrochloric acid from heart burn
Metaplasia examples - CORRECT ANSWER-Most common is change from columnar cells to squamous
cells (chronic smokers).
Less common is change from squamous to columnar cells, like in Barrett Esophagus caused by heart
burn.
Carcinoma in situ - CORRECT ANSWER-Pre-invasive epithelial malignant tumors of glandular or
squamous origin. Sites including cervix, skin, oral cavity, esophagus, and bronchus
Hypoxic injury - CORRECT ANSWER-1. Decrease in oxygen in the air (high altitudes, asphyxiation,
drowning)
2. Loss of hemoglobin function (hemorrhage or sickle cell anemia)
FINAL EXAM WITH COMPLETE ANWERS
100%
Ovarian cancer site of metastasis? - CORRECT ANSWER-Peritoneal surfaces, omentum (fold of
peritoneum connecting the stomach with other abdominal organs), *liver*
The increased NADH/NAD+ ratio in the liver from ethanol causes: - CORRECT ANSWER-1. Pyruvate -->
lactic acid, causing lactic acidosis
2. Oxaloacetate --> malate. This prevents gluconeogenesis and leads to hypoglycemia
3. Glyceraldehyde-3-phosphate --> glycerol 3- phosphate and combines with fatty acids to form
triglycerides in the liver, known as hepatosteatosis
4. Decreases citric acid cycle production of NADH and leads to using Acetyl-CoA for ketogenesis and
lipogenesis
What can Reactive Oxygen Species cause? - CORRECT ANSWER-Heart disease, Alzheimers, Parkinsons,
Amyotrophic Lateral Sclerosis (ALS), CV disease, HTN, HLD, DM, ischemic heart disease, HF, OSA. Lipid
perioxidation, damage proteins, fragment DNA, less *protein synthesis*, chromatin destruction, damage
mitochondria
What is the body's defense against ROS? - CORRECT ANSWER-Antioxidants (Vitamin E, Vitamin C,
cysteine, glutathione, albumin, ceruloplasmin, transferrin)
How are free radicals produced? - CORRECT ANSWER-1. Normal cellular respiration
2. Absorption of extreme energy sources (radiation, UV light)
3. Metabolism of exogenous chemicals, drugs, and pesticides
4. Transition of metals
5. Nitric oxide acting like a chemical mediator and a free radical
action potential - CORRECT ANSWER-Process of conducting an impulse. Activates the neuron --> the
neuron depolarizes --> then repolarizes
,Threshold potential - CORRECT ANSWER-Point at which depolarization must reach in order to initiate an
action potential
Hypokalemia and action potentials - CORRECT ANSWER-HYPERpolarized (more negative, ex. -100). Less
excitable. Decreased neuromuscular excitability: weakness, smooth muscle atony, paresthesia, cardiac
dysrhythmias
Hyperkalemia and action potentials - CORRECT ANSWER-HYPOpolarized (more positive, ex: closer to 0).
More excitable. Peaked T waves.
When resting membrane potential=threshold potential, it is BAD = cardiac standstill, paresthesia,
paralysis
Hypocalcemia and action potentials - CORRECT ANSWER-Increased permeability to Na+. More excitable.
Tetany, hyperreflexia, circumoral paresthesia, seizures, dysrhythmias.
Hypercalcemia and action potentials - CORRECT ANSWER-Decreased permeability to Na+. Less excitable.
Weakness, hyporeflexia, fatigue, lethargy, confusion, encephalopathy, depressed T waves
Atrophy - CORRECT ANSWER-Occurs as a result of decrease in work load, pressure, use, blood supply,
nutrition, hormonal stimulation, or nervous stimulation. Once the cell has decreased in size, it has now
compensated for decreased blood supply, nerve supply, nutrient supply, hormonal supply, and has
achieved new homeostasis. Cells are alive but have diminished function and may lead to cellular death.
Atrophy examples - CORRECT ANSWER-Physiologic atrophy- shrinking of the thymus gland during
childhood.
Disuse atrophy- someone that ends up being paralyzed
Hypertrophy - CORRECT ANSWER-Increase in SIZE of cells, which will lead to increase in size of organ.
Caused by hormonal stimulation or increased functional demand.
Hypertrophy examples - CORRECT ANSWER-physiologic hypertrophy- skeletal hypertrophy when a
person does heavy work or weight lifting / when a kidney is surgically removed, the other kidney
increases in size
, pathologic hypertrophy- cardiomegaly results from an increased workload in hypertensive patients /
*left ventricular hypertrophy*
Hyperplasia - CORRECT ANSWER-Increase in NUMBER of cells. Results from increased rate of mitosis.
Can ONLY happen in cells that are capable of mitosis (cell division).
Hyperplasia examples - CORRECT ANSWER-1. Thickening of skin because of hyperplasia of epidermal
cells.
2. Hormonal hyperplasia- occurs in estrogen dependent organs like uterus and breast.
3. Compensatory hyperplasia- liver regenerates, callus on skin
4. Pathologic hyperplasia- estrogen is unopposed by progesterone and the endometrial lining undergoes
hyperplasia and increased risk for endometrial cancer
Dysplasia - CORRECT ANSWER-abnormal changes in the size, shape, and organization of mature cells due
to persistent, severe cell injury or irritation
Dysplasia examples - CORRECT ANSWER-Pre cancer pap smears often show dysplastic cells of the cervix
that must undergo treatment.
Metaplasia - CORRECT ANSWER-Changed cell that is REVERSIBLE (one cell is replaced by another cell).
Exposure to chronic stressors, injury or irritation, like smoking or hydrochloric acid from heart burn
Metaplasia examples - CORRECT ANSWER-Most common is change from columnar cells to squamous
cells (chronic smokers).
Less common is change from squamous to columnar cells, like in Barrett Esophagus caused by heart
burn.
Carcinoma in situ - CORRECT ANSWER-Pre-invasive epithelial malignant tumors of glandular or
squamous origin. Sites including cervix, skin, oral cavity, esophagus, and bronchus
Hypoxic injury - CORRECT ANSWER-1. Decrease in oxygen in the air (high altitudes, asphyxiation,
drowning)
2. Loss of hemoglobin function (hemorrhage or sickle cell anemia)
