Advanced pathophysiology 2025
NURS Advanced Pathophysiology
(Questions And Answers) 100% Approved
Ovarian cancer site of metastasis? - ✔✔✔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: - ✔✔✔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? - ✔✔✔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? - ✔✔✔Antioxidants (Vitamin E, Vitamin C, cysteine, glutathione,
albumin, ceruloplasmin, transferrin)
How are free radicals produced? - ✔✔✔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
pg. 1
,Advanced pathophysiology 2025
action potential - ✔✔✔Process of conducting an impulse. Activates the neuron --> the neuron depolarizes -->
then repolarizes
Threshold potential - ✔✔✔Point at which depolarization must reach in order to initiate an action potential
Hypokalemia and action potentials - ✔✔✔HYPERpolarized (more negative, ex. -100). Less excitable.
Decreased neuromuscular excitability: weakness, smooth muscle atony, paresthesia, cardiac dysrhythmias
Hyperkalemia and action potentials - ✔✔✔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 - ✔✔✔Increased permeability to Na+. More excitable. Tetany,
hyperreflexia, circumoral paresthesia, seizures, dysrhythmias.
Hypercalcemia and action potentials - ✔✔✔Decreased permeability to Na+. Less excitable. Weakness,
hyporeflexia, fatigue, lethargy, confusion, encephalopathy, depressed T waves
Atrophy - ✔✔✔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 - ✔✔✔Physiologic atrophy- shrinking of the thymus gland during childhood.
Disuse atrophy- someone that ends up being paralyzed
Hypertrophy - ✔✔✔Increase in SIZE of cells, which will lead to increase in size of organ. Caused by
hormonal stimulation or increased functional demand.
Hypertrophy examples - ✔✔✔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
pg. 2
, Advanced pathophysiology 2025
pathologic hypertrophy- cardiomegaly results from an increased workload in hypertensive patients / *left
ventricular hypertrophy*
Hyperplasia - ✔✔✔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 - ✔✔✔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 - ✔✔✔abnormal changes in the size, shape, and organization of mature cells due to persistent,
severe cell injury or irritation
Dysplasia examples - ✔✔✔Pre cancer pap smears often show dysplastic cells of the cervix that must undergo
treatment.
Metaplasia - ✔✔✔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 - ✔✔✔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 - ✔✔✔Pre-invasive epithelial malignant tumors of glandular or squamous origin. Sites
including cervix, skin, oral cavity, esophagus, and bronchus
Hypoxic injury - ✔✔✔1. Decrease in oxygen in the air (high altitudes, asphyxiation, drowning)
2. Loss of hemoglobin function (hemorrhage or sickle cell anemia)
3. Decrease in production of red blood cells (anemia or leukemia)
pg. 3
NURS Advanced Pathophysiology
(Questions And Answers) 100% Approved
Ovarian cancer site of metastasis? - ✔✔✔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: - ✔✔✔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? - ✔✔✔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? - ✔✔✔Antioxidants (Vitamin E, Vitamin C, cysteine, glutathione,
albumin, ceruloplasmin, transferrin)
How are free radicals produced? - ✔✔✔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
pg. 1
,Advanced pathophysiology 2025
action potential - ✔✔✔Process of conducting an impulse. Activates the neuron --> the neuron depolarizes -->
then repolarizes
Threshold potential - ✔✔✔Point at which depolarization must reach in order to initiate an action potential
Hypokalemia and action potentials - ✔✔✔HYPERpolarized (more negative, ex. -100). Less excitable.
Decreased neuromuscular excitability: weakness, smooth muscle atony, paresthesia, cardiac dysrhythmias
Hyperkalemia and action potentials - ✔✔✔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 - ✔✔✔Increased permeability to Na+. More excitable. Tetany,
hyperreflexia, circumoral paresthesia, seizures, dysrhythmias.
Hypercalcemia and action potentials - ✔✔✔Decreased permeability to Na+. Less excitable. Weakness,
hyporeflexia, fatigue, lethargy, confusion, encephalopathy, depressed T waves
Atrophy - ✔✔✔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 - ✔✔✔Physiologic atrophy- shrinking of the thymus gland during childhood.
Disuse atrophy- someone that ends up being paralyzed
Hypertrophy - ✔✔✔Increase in SIZE of cells, which will lead to increase in size of organ. Caused by
hormonal stimulation or increased functional demand.
Hypertrophy examples - ✔✔✔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
pg. 2
, Advanced pathophysiology 2025
pathologic hypertrophy- cardiomegaly results from an increased workload in hypertensive patients / *left
ventricular hypertrophy*
Hyperplasia - ✔✔✔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 - ✔✔✔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 - ✔✔✔abnormal changes in the size, shape, and organization of mature cells due to persistent,
severe cell injury or irritation
Dysplasia examples - ✔✔✔Pre cancer pap smears often show dysplastic cells of the cervix that must undergo
treatment.
Metaplasia - ✔✔✔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 - ✔✔✔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 - ✔✔✔Pre-invasive epithelial malignant tumors of glandular or squamous origin. Sites
including cervix, skin, oral cavity, esophagus, and bronchus
Hypoxic injury - ✔✔✔1. Decrease in oxygen in the air (high altitudes, asphyxiation, drowning)
2. Loss of hemoglobin function (hemorrhage or sickle cell anemia)
3. Decrease in production of red blood cells (anemia or leukemia)
pg. 3
