Essentials of Pathophysiology - Exam 1 review

3/28/24, 7:51 PM Essentials of Pathophysiology - Exam 1 review sheet updated about:blank 1/11 MODULE 1 Essentials of Pathophysiology – Exam #1 Review Sheet Covers Modules 1, 2, and 3 – Chapters 1, 2, 6, 12, and 13 1. Define pathophysiology. Pathophysiology is the study of abnormalities in physiologic functioning of living beings and seeks to reveal physiologic responses of organisms to disruptions in its internal or external environment What does the study of pathophysiology include? a. Etiology - study of causes or reasons for phenomena Identifies causal factors that, acting in concert, provoke a particular disease or injury Idiopathic – unknown cause or origin b. Pathogenesis - development or evolution of disease, from initial stimulus to ultimate expression of manifestations of the disease Affected by time, quantity, location, and morphologic changes c. Clinical manifestations – Signs: objective or observed manifestation of disease Example – rash, change in temperature Symptoms: subjective feeling of abnormality in the body Example – pain, nausea d. Treatment implications - Understanding the etiology, pathogenesis, and clinical consequences of a particular disorder/disease/illness may determine which treatments could be helpful.  Cultural considerations - each culture defines health and illness in a manner that reflects their experience  Age differences - a normal value for a person at one age may not be normal for a person at another age  Gender differences - a normal value for men may not be normal for women or vice versa; relevant in both health and disease  Comorbidities – additional diseases/conditions the individual is facing 2. Review the difference between signs and symptoms/objective versus subjective data a. Signs: objective or observed manifestation of disease (Dr. can see) Example – rash, change in temperature b. Symptoms: subjective feeling of abnormality in the body (patient can feel) Example – pain, nausea 3. What is epidemiology? - study of the patterns of disease involving populations Examining the occurrence, incidence, prevalence, transmission, and distribution of diseases in large groups of populations/people Review the different levels of disease prevention such as primary, secondary, and tertiary as well as examples for each. a. Primary - altering susceptibility or reducing exposure for susceptible persons Focus is on disease prevention Example – Immunizations b. Secondary - early detection, screening, and management of disease Example – cancer screening, performing monthly breast examinations c. Tertiary – preventing further complications from the initial disease/disorder Focuses on rehabilitation, supportive care, reducing disability, and restoring effective functioning Example – PT/OT following stroke 3/28/24, 7:51 PM Essentials of Pathophysiology - Exam 1 review sheet updated about:blank 2/11 MODULE 1 4. What is homeostasis? a state in which all systems are in balance, a state of equilibrium Maintaining internal conditions stable  To maintain homeostasis, the organism must be able to successfully adapt to challenges 5. Review the three different stages of the General Adaptation Syndrome (GAS) including the alarm stage, adaptation/resistance, and exhaustion stage. a. Alarm stage - fight-or-flight response as the result of stressful stimulus  Hypothalamic-pituitary-adrenal (HPA) axis  Provides a surge of energy and physical alterations to either evade or confront danger  hypothalamus secretes corticotropin-releasing hormone (CRH) to activate the sympathetic nervous system (SNS) and adrenocorticotropic hormone (ACTH)  SNS stimulates the adrenal medulla to release the catecholamines — norepinephrine and epinephrine  ACTH causes the adrenal cortex to release glucocorticoids, specifically cortisol b. Resistance or adaptation - activity of the nervous and endocrine systems in returning the body to homeostasis  Body must move beyond the alarm stage  Cortisol levels and the sympathetic nervous system return to normal  Fight-or-flight symptoms begin to decline  The body either adapts or alters its workings to limit problems or become desensitized to the stressor c. Exhaustion - point where body can no longer return to homeostasis after prolonged exposure to the stressor  Body becomes depleted and damage may appear, as homeostasis can no longer be maintained through compensatory mechanisms  As the body’s defenses are utilized, disease or death results  Examples - anxiety, depression, headaches, insomnia, infections, and cardiovascular disease What complications can occur if stressors are not resolved?  If stressor is not removed/overcome, exhaustion occurs 6. What hormones are released during the alarm stage and what effects do they have on the body?  Hypothalamic-pituitary-adrenal (HPA) axis  Provides a surge of energy and physical alterations to either evade or confront danger  hypothalamus secretes corticotropin-releasing hormone (CRH) to activate the sympathetic nervous system (SNS) and adrenocorticotropic hormone (ACTH)  SNS stimulates the adrenal medulla to release the catecholamines — norepinephrine and epinephrine  ACTH causes the adrenal cortex to release glucocorticoids, specifically cortisol 7. Review the differences between the sympathetic vs the parasympathetic nervous systems. 3/28/24, 7:51 PM Essentials of Pathophysiology - Exam 1 review sheet updated about:blank 3/11 Blurred content of page 3 3/28/24, 7:51 PM Essentials of Pathophysiology - Exam 1 review sheet updated about:blank 4/11 MODULE 1  Sorts and packages proteins produced in ER  Protein “packaging plant” – cell post office  Move materials within cell and out of the cell  Rough Endoplasmic reticulum  Series of folded membranes that move proteins around the cell  Continuous with nuclear membrane of nucleus  Rough ER – ribosomes attached to ER  Site of protein synthesis  Production of integral proteins and phospholipids found in cellular membranes  Smooth endoplasmic reticulum  Smooth ER – ribosomes not attached to smooth ER  Functions include: a. Detoxification b. Lipid metabolism c. Synthesis of hormones d. Calcium storage 9. Review the differences between extracellular fluid and intracellular fluid. Plasma membrane - flexible outer membrane of cell  Separates two of the body’s major fluid compartments  Intracellular fluid (ICF) - within cells  Extracellular fluid (ECF)- outside cells  Composed of a phospholipid bilayer  Contains several proteins, glucose molecules and lipids Which electrolytes are found in high concentration outside the cell versus inside the cell? u ECF has high concentration of sodium (Na ), chloride (Extracellular fluids (blood plasma and + interstitial fluid) are very similar to one another u Blood plasma has high protein concentration compared to intracellular fluid (ICF) u Cl– ), and HCO3 (sodium bicarbonate) – u ICF contains only small amounts of Na and Cl + – 10. Review how fluid is transported across the plasma membrane of the cell. Substances move through the plasma membrane by two different types of transport:  Passive transport – substances move down their concentration gradient  Substances move from HIGH concentration  LOW  Example – Osmosis, diffusion  Active transport – requires ATP  Substances moves against their concentration gradient  LOW concentration  HIGH Review the difference between diffusion and osmosis.  Diffusion - tendency of molecules or ions to distribute evenly throughout the environment  Passive membrane transport  Molecules move from areas where they are in high concentration to areas of low concentration Greater the difference in concentration - faster diffusion of particles occurs  Osmosis – process which allows for fluid (water) distribution between interstitial space and intracellular compartment  Osmolality = Concentration of solutes  High osmolality = high concentration of solutes (low concentration of water)  Low osmolality = low concentration of solutes (high concentration of water) 3/28/24, 7:51 PM Essentials of Pathophysiology - Exam 1 review sheet updated about:blank 5/11 MODULE 1  Water moves from an area of low osmolality (low solute concentration) to an area of higher osmolality (high solute) 11. Review ways that fluids enter the human body (intake) versus ways fluid is excreted (output) out of the body. Fluid can enter the body as preformed water, ingested food and drink, and, to a lesser extent, as metabolic water that is produced as a by-product of aerobic respiration and dehydration synthesis. Fluid can leave the body in three ways: 1. Urination 2. Excretion (feces) 3. Perspiration (sweating) 12. Review the differences between dehydration and hypotonic hydration. What are signs, symptoms, and causes for each?  Dehydration - when water output exceeds intake over a period of time (extracellular volume deficit)  Common occurrence after hemorrhage, severe burns, prolonged vomiting or diarrhea, profuse sweating, water deprivation, and diuretic abuse  Can also occur due to diseases such as diabetes mellitus or diabetes insipidus  Water from ECF is lost  osmolality of ECF increases – water moves from ICF to ECF  Signs and symptoms of dehydration include:  Dry or cotton mouth  Extreme thirst  Dry flushed skin  Decreased urine output (oliguria)  Prolonged dehydration may lead to weight loss, fever, and mental confusion, hypovolemic shock (decrease in blood volume)  Over hydration - also called water intoxication (hypotonic hydration)- Occurs when too much water is taken in too rapidly or renal activity is decreased  Concentration of water in ECF increases – causing ECF osmolality to drop  Inhibits release of ADH - less water is reabsorbed and excess water is quickly flushed from the body in urine  Condition often results in hyponatremia  Low ECF concentration of Na+  Water moves from ECF to ICF – causing cells to swell with water Hypotonic hydration leads to severe metabolic disturbances resulting in:  Nausea and vomiting  Muscular cramping  Cerebral edema  convulsions, coma and death Can be treated by intravenous administration of hypertonic saline solution  Reverses the osmotic gradient and “pulls” water out of the cells 13. What is edema? Edema - accumulation of fluid in the interstitial space - leading to tissue swelling Review the various factors that can contribute to edema. u Factors that contribute to edema include: u Increases in capillary hydrostatic pressure (blood vessel blockage, incompetent venous valves) u Increased capillary permeability (inflammation) u Congestive heart failure u High blood volume or HTN 3/28/24, 7:51 PM Essentials of Pathophysiology - Exam 1 review sheet updated about:blank 6/11 Blurred content of page 6 3/28/24, 7:51 PM Essentials of Pathophysiology - Exam 1 review sheet updated about:blank 7/11 MODULE 2 3/28/24, 7:51 PM Essentials of Pathophysiology - Exam 1 review sheet updated about:blank 8/11 MODULE 2 3/28/24, 7:51 PM Essentials of Pathophysiology - Exam 1 review sheet updated about:blank 9/11 Blurred content of page 9 3/28/24, 7:51 PM Essentials of Pathophysiology - Exam 1 review sheet updated about:blank 10/11 MODULE 2 Passive Immunity a. Transfer of preformed antibodies against specific antigen from a protected or immunized individual an unprotected or nonimmunized individual b. Provides immediate but temporary protection c. Short lasting, individual does not produce memory cells from transfer Examples include: Mother to fetus – antibodies cross placenta Mother to infant – antibodies from breast milk Serotherapy - direct injection/infusion of antibodies (human or animal) 20. What is a hypersensitivity? an immunological state in which the immune system “over-reacts” to foreign antigen such that the immune response itself is more harmful than the antigen. All types of hypersensitivity involve: • the adaptive immune response. • i.e., highly specific reactions via T or B cells. Review the four different types of hypersensitivities: Type I (Anaphylactic) - reaction mediated by IgE antibodies Type II (Cytotoxic) - cytotoxic reaction mediated by IgG or IgM antibodies Type III (Immune complex)- reaction mediated by immune complexes Type IV (Delayed cell-mediated)- delayed reaction mediated by cellular response Know examples and mediating factors for each type. 21. Review the differences between benign and malignant tumors. 22. What are the steps of carcinogenesis? Initiation (Conversion) – events which result in changes (mutations) to chromosomes or DNA Initiators include radiation, UV, carcinogens Promotion (Development) – Stage during which mutated cell proliferates Example – hormones such as estrogen Progression - Mutant, proliferating cells begin to exhibit malignant behavior, permanent changes 23. Review the effects of cancer on the body including terms: Cachexia - overall weight loss and generalized weakness- Loss of appetite (anorexia), Increased metabolic rate , Nausea/vomiting Anemia - deficiency in circulating red blood cells Leukopenia - deficiency in circulating white blood cells Thrombocytopenia - deficiency in circulating platelet 3/28/24, 7:51 PM Essentials of Pathophysiology - Exam 1 review sheet updated about:blank 11/11 MODULE 1 24. Review the various infections of the skin discussed in class including: warts, herpes simplex virus, herpes zoster, fungal infections, impetigo 25. Review the various inflammatory conditions of the skin discussed in class including: lupus, psoriasis, atopic dermatitis, and contact dermatitis. 26. Review parasitic infections of the skin/hair including: lice, scabies, and ticks 27. Review signs of skin cancer. What is the ABCDE rule? 28. Review the differences between first degree, second degree and third degree burns 29. What is compartment syndrome? Why does it occur and what are the signs? Remember the 5 P’s 30. Review diseases of the bone including: osteomyelitis, osteosarcoma, osteomalacia, rickets, and osteoporosis 31. Review disorders of the muscle including: myasthenia gravis, fibromyalgia, muscular dystrophy. Know causes and signs/symptoms for each. 32. Review disorders of the joints including: rheumatoid arthritis, osteoarthritis, psoriatic arthritis, and gout. Know causes and signs/symptoms for each.