NURS 213 Proctored Exam 5 2024
Disease process - etiology, pathogenesis, morphologic changes, clinical
manifestations, diagnosis, and clinical course
Immunosenescence - the weakening of both the innate and adaptive
immune system with increasing age
Multicausality - the combination of internal processes and influences from
the environment that cause cell changes with aging
Physiological reserve - decrease in the ability to repair damage
Senescence - progressive loss of ability to replicate over time
Apoptosis - genetically programmed cell death. Example: ovaries during
menopause
Necrosis - cells die due to stressors
Infarction - consequence of prolonged ischemia. Example: myocardial
infarction
Gangrene - prolonged ischemia, infarction, and necrosis, followed by
exposure to bacteria that thrive on dead tissue
Atrophy - cells revert to a smaller size. Caused by loss of hormonal
stimulation, malnutrition, ischemia, or age
Hypertrophy - increase in cell size
, • Physiological: normal with exercise
• Pathological: increase without increase in supportive structures (e.g.,
high BP leading to higher workload for the LV)
Hyperplasia - increase in the number of cells. Example: pregnancy
stimulates mitotic division of breast gland cells, keloid
Metaplasia - replacement of one type of tissue with another that is not
normally found there. Example: GERD
Dysplasia - deranged cell growth, precancerous. Example: cervical
dysplasia seen in Pap smear
Anaplasia - cancerous
Hypoxic cell injury - most common; caused by ischemia, anemia, low
oxygen environments, pneumonia, suffocation, airway obstruction
Free radical cell injury - oxidative phosphorylation, small amounts of
reactive oxygen molecules are byproducts. Found in cigarette smoke and
toxins, damaging cells' DNA. Counteract with antioxidants (vitamins A, E,
C)
Acute inflammation
• Stage 1: vascular permeability; histamine and bradykinin enable
vasodilation, increasing permeability for fluids, wbcs, and platelets.
Area becomes warm, red (erythema), and swollen.
, • Stage 2: cellular chemotaxis; chemical signals attract more platelets
and wbcs to the site. WBC cytokines modulate response. Margination
occurs as wbcs line up.
• Stage 3: systemic response; symptoms throughout the body, such as
fever, pain, lymphadenopathy, lethargy, etc.
Chronic inflammation - characterized by macrophages, causing tissue
damage. Granuloma forms when macrophages aggregate and transform
into epithelial-like cells leading to tubercle formation.
Acute inflammation - characterized by neutrophils, which are the first to
the site
Skin wound healing (3 processes)
1. Inflammation
2. Proliferation: fibroblast synthesizes collagen, forming granulation
tissue
3. Maturation and remodeling
Exudate - purulent drainage, a protein-rich filtrate containing wbcs,
microbial organisms, and cellular debris
Primary intention - clean laceration that requires simple re-
epithelialization when edges are approximated. Example: surgical
laceration
Secondary intention - a wound with a large gap in tissue. Some tissue
has been gouged out. Example: decubitus ulcer
, Tertiary intention - large gap from missing tissue has been contaminated
and needs a drainage tube while healing; may require a skin graft
Mast cells - release histamine
Histamine - inflammatory mediator released from basophils, platelets, and
mast cells. Causes vasodilation. Symptoms include sneezing, runny nose,
eye tearing in the URT. Antihistamine: Benadryl
5 Cardinal signs of inflammation - heat, redness, swelling, pain, loss of
function
Chromosomal aberration - alteration in chromosome structure; breakage
• Polyploidy: more than the diploid number of each chromosome.
Triploid (3 copies) and tetraploid (4 copies) do not survive
• Aneuploidy: does not contain multiples of 23. Trisomy (3 copies of 1
chromosome), monosomy (1 copy of any chromosome)
Autosomal Aneuploidy - Down syndrome (trisomy 21). Not sex-linked.
• 80% have lower IQ
• 40% have heart disease
• Leukemia risk, weak immune system
• Adults are susceptible to early Alzheimer’s disease
• All males are sterile
Sex Chromosome Aneuploidy
Disease process - etiology, pathogenesis, morphologic changes, clinical
manifestations, diagnosis, and clinical course
Immunosenescence - the weakening of both the innate and adaptive
immune system with increasing age
Multicausality - the combination of internal processes and influences from
the environment that cause cell changes with aging
Physiological reserve - decrease in the ability to repair damage
Senescence - progressive loss of ability to replicate over time
Apoptosis - genetically programmed cell death. Example: ovaries during
menopause
Necrosis - cells die due to stressors
Infarction - consequence of prolonged ischemia. Example: myocardial
infarction
Gangrene - prolonged ischemia, infarction, and necrosis, followed by
exposure to bacteria that thrive on dead tissue
Atrophy - cells revert to a smaller size. Caused by loss of hormonal
stimulation, malnutrition, ischemia, or age
Hypertrophy - increase in cell size
, • Physiological: normal with exercise
• Pathological: increase without increase in supportive structures (e.g.,
high BP leading to higher workload for the LV)
Hyperplasia - increase in the number of cells. Example: pregnancy
stimulates mitotic division of breast gland cells, keloid
Metaplasia - replacement of one type of tissue with another that is not
normally found there. Example: GERD
Dysplasia - deranged cell growth, precancerous. Example: cervical
dysplasia seen in Pap smear
Anaplasia - cancerous
Hypoxic cell injury - most common; caused by ischemia, anemia, low
oxygen environments, pneumonia, suffocation, airway obstruction
Free radical cell injury - oxidative phosphorylation, small amounts of
reactive oxygen molecules are byproducts. Found in cigarette smoke and
toxins, damaging cells' DNA. Counteract with antioxidants (vitamins A, E,
C)
Acute inflammation
• Stage 1: vascular permeability; histamine and bradykinin enable
vasodilation, increasing permeability for fluids, wbcs, and platelets.
Area becomes warm, red (erythema), and swollen.
, • Stage 2: cellular chemotaxis; chemical signals attract more platelets
and wbcs to the site. WBC cytokines modulate response. Margination
occurs as wbcs line up.
• Stage 3: systemic response; symptoms throughout the body, such as
fever, pain, lymphadenopathy, lethargy, etc.
Chronic inflammation - characterized by macrophages, causing tissue
damage. Granuloma forms when macrophages aggregate and transform
into epithelial-like cells leading to tubercle formation.
Acute inflammation - characterized by neutrophils, which are the first to
the site
Skin wound healing (3 processes)
1. Inflammation
2. Proliferation: fibroblast synthesizes collagen, forming granulation
tissue
3. Maturation and remodeling
Exudate - purulent drainage, a protein-rich filtrate containing wbcs,
microbial organisms, and cellular debris
Primary intention - clean laceration that requires simple re-
epithelialization when edges are approximated. Example: surgical
laceration
Secondary intention - a wound with a large gap in tissue. Some tissue
has been gouged out. Example: decubitus ulcer
, Tertiary intention - large gap from missing tissue has been contaminated
and needs a drainage tube while healing; may require a skin graft
Mast cells - release histamine
Histamine - inflammatory mediator released from basophils, platelets, and
mast cells. Causes vasodilation. Symptoms include sneezing, runny nose,
eye tearing in the URT. Antihistamine: Benadryl
5 Cardinal signs of inflammation - heat, redness, swelling, pain, loss of
function
Chromosomal aberration - alteration in chromosome structure; breakage
• Polyploidy: more than the diploid number of each chromosome.
Triploid (3 copies) and tetraploid (4 copies) do not survive
• Aneuploidy: does not contain multiples of 23. Trisomy (3 copies of 1
chromosome), monosomy (1 copy of any chromosome)
Autosomal Aneuploidy - Down syndrome (trisomy 21). Not sex-linked.
• 80% have lower IQ
• 40% have heart disease
• Leukemia risk, weak immune system
• Adults are susceptible to early Alzheimer’s disease
• All males are sterile
Sex Chromosome Aneuploidy
