NURS 5315 ADVANCED PATHOPHYSIOLOGY UTA EXAM 1 (LATEST 2025 / 2026 UPDATE) REAL QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT | ALREADY GRADED A+.

NURS 5315 ADVANCED PATHOPHYSIOLOGY UTA EXAM 1 (LATEST 2025 / 2026 UPDATE) REAL QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT | ALREADY GRADED A+. “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" "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*" "Hypoxic injury clinical manifestations - CORRECT ANSWER 1. Increased CK (muscle and heart) 2. Increased LDH (muscle, liver, lung, heart, RBC, brain) 3. Increased ALT and AST (liver) 4. Increased troponin (heart)" "What lab values are elevated as we age? - CORRECT ANSWER Interleukin 1, tumor necrosis factor-alpha, and C-reactive protein" "Role of hepatocytes - CORRECT ANSWER Acetyl CoA is processed by hepatocytes and transforms to 3 ketone bodies: 1. Acetoacetate 2. Acetone 3. B-hydroxybutyrate" "Role of mitochondria - CORRECT ANSWER Ketogenesis: occurs mostly in the hepatocytes" "What triggers ketogenesis? - CORRECT ANSWER Unavailability of glucose. Keto diet = no sugar. Starvation and Type 2 DM can lead to this." "Role of Acetyl-CoA - CORRECT ANSWER Returns to citric acid cycle and combines with oxaloacetate to form citrate. Also transforms into ketone bodies by hepatocytes" "Oxaloacetate - CORRECT ANSWER Used in gluconeogenesis (process of getting sugars from carbs). During starvation or uncontrolled diabetes, oxaloacetate levels are insufficient because it has been completely used by gluconeogenesis. Depletion of oxaloacetate increases amount of Acetyl CoA." "Breast cancer site of metastasis? - CORRECT ANSWER Bones, lung, liver, brain" "Head and neck cancer site of metastasis? - CORRECT ANSWER Lymphatics, liver, bones" "Sarcoma site of metastasis? - CORRECT ANSWER Lungs" "Melanoma site of metastasis? - CORRECT ANSWER Lymphatics, lung, liver, brain, GI" "Origin of cancer from adeno? - CORRECT ANSWER Glandular Epithelial" "TNM Staging System - CORRECT ANSWER T= tumor spread TX= main tumor not measured T0= tumor cannot be found T1=T4=size or extent of main tumor. Higher the number, larger it is N= node involvement NX= cannot be measured N0=no cancer in lymph nodes N1-N3= number of lymph nodes. Higher the number, the more lymph nodes that contain cancer M= presence of metastasis MX=cannot be measured M0=cancer has not spread to other parts of body M1=Cancer has spread to other parts of body" "BRCA gene - CORRECT ANSWER Increases risk for developing ovarian, breast, and prostate cancer" "Paraneoplastic syndromes - CORRECT ANSWER Triggered by cancer but aren't caused directly from a tumor/mass. Commonly caused by hormones released by a tumor or an immune response triggered by a tumor. *May be earliest S/S of unknown cancer*" "Cachexia - CORRECT ANSWER Imbalance between amount of energy intake vs. energy used. Wasting syndrome = catabolic process. Increase in apoptosis and impaired ability to regenerate cells." "Necrosis - CORRECT ANSWER Cell death, irreversible cell injury. Clinical implications: fever, increased heart rate, increase number of leukocytes, pain, presence of cellular enzymes (LDH, CK, AST, ALT, ALT, Amylase, aldolase)" "AST and ALT are related to which organ? - CORRECT ANSWER Liver" "Valve malfunction can cause what? - CORRECT ANSWER Ventricular hypertrophy" "Metabolic alkalosis can cause what? - CORRECT ANSWER Hypoglycemia" "Osmolality - CORRECT ANSWER Measure of a solute concentration in a solution. Higher number of solutes in a compartment = higher concentration and less water" "Osmosis - CORRECT ANSWER Movement of water from low concentration to high concentration" "Osmotic pressure - CORRECT ANSWER Amount of pressure or force that is exerted by solute molecules of a given compartment. PULLS water into a higher concentration. HIGHER osmolality = HIGHER osmotic pressure" "Hydrostatic pressure - CORRECT ANSWER Force within a fluid compartment. PUSHES fluid outside of compartment (OPPOSES OSMOSIS). Ex. blood pressure" "Fluid volume excess (fluid retention) clinical manifestations - CORRECT ANSWER Edema, tight skin, puffiness of eyes, rales or wet breath sounds" "Edema is an accumulation of fluid where? - CORRECT ANSWER Interstitial space" "Edema pathophysiology - CORRECT ANSWER 1. Increased hydrostatic pressure 2. Decreased oncotic pressure 3. Increased capillary membrane permeability 4. Lymphatic channel obstruction" "Hyperkalemia clinical manifestations - CORRECT ANSWER Syncope, weakness, paresthesia, paralysis, cardiac arrest" "Relationship between calcium and phosphorous? - CORRECT ANSWER React OPPOSITELY. When calcium rises, phosphate falls, and vice versa. Regulated by PTH, vitamin D, and calcitonin." "Hypercalcemia effect on action potential - CORRECT ANSWER Hypercalcemia decreases cell permeability to Na+ --> threshold potential farther from RMP --> LESS EXCITABLE." "Hypocalcemia effect on action potential - CORRECT ANSWER Hypocalcemia increases cell permeability to Na+ --> threshold potential closer to RMP --> MORE EXCITABLE" "Hypocalcemia clinical manifestations - CORRECT ANSWER Tetany, hyperreflexia, paresthesia, seizures, dysrhythmias" "Hypercalcemia clinical manifestations - CORRECT ANSWER Polyuria, renal stones, nausea, vomiting, constipation, weakness, fatigue, confusion, coma" "Huntingtons disease - CORRECT ANSWER Diseased dominant allele" "Cystic fibrosis - CORRECT ANSWER Autosomal recessive" "Phenylkenonuria - CORRECT ANSWER Homozygous recessive" "Clastogens - CORRECT ANSWER Harmful agents which damage chromosomes. Ex: radiation" "Hypoxic injury pathophysiology - CORRECT ANSWER Lack of O2 --> decrease in mitochondrial function --> decreased ATP --> increases anaerobic metabolism. Also causes cessation of protein synthesis." Atrophy - CORRECT ANSWER E. Cells decrease in size P. Still functional Physiologic: thymus gland in early childhood Pathological: disuse" "Hypertrophy - CORRECT ANSWER E. Increase in cell size P. Increased workload Physiologic: weightlifting Pathologic: cardiomegaly from HTN" "Hyperplasia - CORRECT ANSWER E. Increase in cell number P. Increased cellular division Physiologic: liver regeneration Pathologic: endometrial- usually r/t hormones" "Dysplasia - CORRECT ANSWER E. Cells change in size, shape, organization P. AKA atypical hyperplasia, a disorderly proliferation Physiologic: N/A Pathologic: squamous dysplasia of cervix from HPV" "Metaplasia - CORRECT ANSWER E. one cell type replaced with another P. reprogramming of stem cells, reversible Physiologic: N/A Pathologic: stratified squamous cells in bronchial lining r/t cigarette smoke" "Hypoxia injury - CORRECT ANSWER E. inadequate oxygenation of tissues P. decrease in mitochondrial function, decreased production of ATP increases anaerobic metabolism. eventual cell death. C.M. hypoxia, cyanosis, cognitive impairment, lethargy" "Free radical and ROS - CORRECT ANSWER E. normal byproduct of ATP production, will overwhelm the mitochondria- exhaust intracellular antioxidants P. lipid peroxidation, damage proteins, fragment DNA C.M. development in Alzheimer's, heart disease, Parkinson's disease, Amyotrophic Lateral Sclerosis" "Ethanol - CORRECT ANSWER E. mood altering drug, long term effects on liver and nutritional status P. metabolized by liver, generates free radicals C.M. CNS depression, nutrient deficiencies-Mag, Vit B6, thiamine, PO4, inflammation and fatty infiltration of liver, hepatomegaly, leads to liver failure irreversible" "Oncosis - CORRECT ANSWER Na and H2O enter cell and cause swelling. Organ increases in weight, becomes distended and pale. Associated with high fever, hypocalcemia, certain infections" "Fatty Infiltration - CORRECT ANSWER intracellular accumulation of lipids in the liver liver fails to metabolize lipids. usually from ETOH or high fat diet. can lead to cirrhosis" "dystrophic calcification - CORRECT ANSWER accumulation of Ca in dead or dying tissues calcium salt clump and harden- interfere with cellular structure and function r/t pulmonary TB, atherosclerosis, injured heart valves, chronic pancreatitis" "metastatic calcification - CORRECT ANSWER accumulation of Ca in normal tissue result of hypercalcemia r/t hyperparathyroidism, hyperthyroidism, toxic levels of Vit D. Can also r/t hyperphosphatemia in renal failure" "urate accumulation - CORRECT ANSWER sodium urate crystals are deposited in tissues- group of disorders collectively called gout- acute arthritis, chronic gouty arthritis, tophus, nephritis" "Coagulative Necrosis - CORRECT ANSWER kidneys, heart, adrenals- secondary to hypoxia" "Liquefactive Necrosis - CORRECT ANSWER nerve cells- brain- accumulation of pus" "Caseous Necrosis - CORRECT ANSWER lung disease- usually TB- tissue looks like clumped cheese" "Fat Necrosis - CORRECT ANSWER breast, pancreas, abdominal structures- creates soaps" "Gangrenous Necrosis - CORRECT ANSWER Dry- dark shriveled skin Wet- internal organs- can lead to death Gas- from clostridium- antitoxins and hyperbaric therapy" "Gout - CORRECT ANSWER E. disturbances in serum urate levels. uncommon for < 30 years old. P. uric acid is deposited in the tissues of kidney, heart, earlobes, and joints. C.M. inflammation, painful joints. result of diuretic use or diet high in cream sauces, red wine, or red meat" "Rhabdomyolysis - CORRECT ANSWER E. cell hypoxia caused by severe muscle trauma, hyperthermia, crush injuries, or severe dehydration P. hypoxia leads to cell death, cellular contents are released in bloodstream. C.M. CK is 5x upper normal limit, muscle pain, weakness, dark, reddish-brown urine, hypercalcemia, renal failure" "Alpha Fetoprotein Origin - CORRECT ANSWER Liver and germ cell tumors" "Carcinoembryonic Antigen - CORRECT ANSWER GI, pancreas, lung, breast tumors" "Beta Human Chorionic gonadotropin origin - CORRECT ANSWER germ cell tumors" "Prostate Specific Antigen - CORRECT ANSWER prostate tumors" "Carcino- - CORRECT ANSWER from epithelial tissue- renal cell carcinoma" "Sarco- - CORRECT ANSWER from connective tissue- chondrosarcoma" "-oma - CORRECT ANSWER benign tumor- lipoma" "Carcinoma in situ - CORRECT ANSWER preinvasive epithelial malignant tumors of glandular or squamous cells- cervix" "-blastoma - CORRECT ANSWER from blasts or immature cells- neuroblastoma" "Lung ca metastasis - CORRECT ANSWER Multiple organs including brain" "Colorectal ca metastasis - CORRECT ANSWER Liver, lungs" "Testicular ca metastasis - CORRECT ANSWER Liver, lungs, brain" "Prostate ca metastasis - CORRECT ANSWER Bones (especially lumbar spine), liver" "Breast ca metastasis - CORRECT ANSWER Liver, lungs, brain, bones" "Head and neck ca metastasis - CORRECT ANSWER Liver, bones, lymphatics" "Ovarian ca metastasis - CORRECT ANSWER Peritoneal surfaces, diaphragm, omentum, liver" "Sarcoma metastasis - CORRECT ANSWER Lungs" "Melanoma metastasis - CORRECT ANSWER In transit lymphatics, lung, liver, brain, GI tract" "Mechanisms of ca metastasis - CORRECT ANSWER Local invasion, followed by invasion of surrounding tissues. Cells then may invade blood and lymphatic vessels. They must survive in circulation, then enter and survive in a new location. Then the cells can multiply and form a new tumor." "TNM staging system - CORRECT ANSWER T= tumor size >/= correlates with metastatic ability N= whether lymph nodes are involved M= extra nodal involvement (liver, lungs)" "Intravascular fluid compartment - CORRECT ANSWER In venous system- 20%" "Osmolality - CORRECT ANSWER The measure of solute concentration in a fluid. 280-295 mOsm" "Interstitial fluid compartment - CORRECT ANSWER Surrounds the cells and bathes them in nutrients- 20%" "Intracellular fluid compartment - CORRECT ANSWER Within the cells- 40% uk" "Osmosis - CORRECT ANSWER Passive- the movement of water from an area of low concentration of solute to one of higher concentration" "Osmotic pressure - CORRECT ANSWER Pulling- the amount of pressure or force that is exerted by solute molecules of a given compartment" "Hydrostatic pressure - CORRECT ANSWER Blood pressure- pushes fluid outside of the vessels, the force of fluid against the walls of a compartment- venous obstruction, Na and water retention" "Oncotic pressure - CORRECT ANSWER Colloid pressure keeps water inside the compartment, attracts water from interstitial space back into the capillary- losses or diminished albumin" "Effective arterial blood volume - CORRECT ANSWER The amount of blood within the arterial space- ECF changes will cause changes in the EABV in the same direction" "Antidiuretic hormone - CORRECT ANSWER Secreted by pituitary gland in response to water deficit, Na excess, or hypotension. Causes kidneys to reabsorb water, increasing plasma volume" "Renin Angiotensin Aldosterone System - CORRECT ANSWER Activated by low blood volume, triggers release of renin which converts angiotensinogen to angiotensin 1. ACE converts angiotensin 1 to angiotensin which causes arterial vasoconstriction and stimulates release of aldosterone. Aldosterone stimulates renal Na reabsorption and K+ excretion. Water is retained, less urine is produced, blood volume increases." "Natriuretic hormones - CORRECT ANSWER ANP and BNP- released by heart- works opposite RAAS to decrease blood volume, promotes urinary excretion of Na and water" "Fluid volume deficit - CORRECT ANSWER Dehydration- intake is not enough for body's needs C.M. Poor skin turgor, dry mucous membranes, sunken eyes, sunken fontanelles, decreased urine output, fatigue" "Fluid volume excess - CORRECT ANSWER Fluid intake exceeds body's needs C.M. Edema, rales, HTN, weight gain, bounding pulses, intake> output, JVD, restlessness or anxiety" "Edema - CORRECT ANSWER Accumulation of fluid within the interstitial space- venous obstruction, Na and water retention C.M. can be localized or dependent, tightness of skin, facial swelling, rales, decreased wound healing, increased risk of pressure sores, weight gain" "Euvolemic Hypernatremia - CORRECT ANSWER total body water loss, usually from DI C.M. severe polyuria and mild hypernatremia, weight loss, weak pulses, tachycardia, postural hypotension, fever, restless" "hypovolemic hypernatremia - CORRECT ANSWER from GI losses or diuretics C.M. Volume depletion, orthostatic hypotension, tachycardia, lack of organ perfusion" "hypervolemic hypernatremia - CORRECT ANSWER administration of hypertonic saline C.M. volume overload, edema, chf, htn, pulmonary edema" "mild hyponatremia - CORRECT ANSWER Na 125-135 C.M. anorexia, apathy, restless, nausea, lethargy, muscle cramps" "moderate hyponatremia - CORRECT ANSWER Na 120-125 C.M. agitation, disorientation, headache" "severe hyponatremia - CORRECT ANSWER Na <120 C.M. seizures, coma, areflexia, incontinence, death" "isotonic hyponatremia - CORRECT ANSWER mOsm 280-295- not true hypovolemia- from elevated triglycerides or serum proteins" "hypertonic hyponatremia - CORRECT ANSWER mOsm >295- from solutes other than Na- osmotic pressure leads to fluid shift from intracellular to extracellular" "hypotonic hyponatremia - CORRECT ANSWER mOsm <280 and urine Na >100- fluid excess r/t intake or renal impairment" "insulin effect on K+ - CORRECT ANSWER K+ enters cell with glucose transport. Monitor Type II DM for hypokalemia" "acid base balance effect on K+ - CORRECT ANSWER hydrogen enters cell, allowing potassium to escape during acidosis, visa versa for alkalosis" "Adrenergic agents effect on K+ - CORRECT ANSWER albuterol, beta blockers, and alpha adrenergic antagonists cause K+ movement into the cell. Alpha adrenergic receptors shift K+ out of the cell" "Osmolality effect on K+ - CORRECT ANSWER hyperosmolality causes water to shift out of cell via osmosis. K+ will also shift out, causing hyperkalemia." "Cell lysis effect on K+ - CORRECT ANSWER intracellular K+ is released into bloodstream" "Exercise effect on K+ - CORRECT ANSWER cellular ATP is diminished, opening K+ channels and allowing K+ to leave cell" "Kidneys effect on K+ - CORRECT ANSWER excretion and absorption of K+ is regulated by tubule system" "calcium and phosphorus relationship - CORRECT ANSWER inverse relationship- if one increases= other one decreases, rehulated by PTH, Vit D, calcitonin" "magnesium and potassium - CORRECT ANSWER mag inhibits the potassium channels, keeping balance. when mag is low, more K+ exits the call, and is excreted via the kidneys." "calcium and ionized calcium - CORRECT ANSWER acidosis increases ionized Ca+ alkalosis decreases ionized Ca+ and may cause symptoms of hypocalcemia" "calcium and albumin - CORRECT ANSWER When blood levels of albumin are low, serum calcium levels will also be low as there is less protein available for binding" "metabolic acidosis - CORRECT ANSWER E. increased acid production, loss of bicarb, diminished renal excretion of hydrogen C.M hyperventilation (compensatory), h/a, n/v/d, dehydration, hypotension pH <7.4 HCO3 <22" "metabolic alkalosis - CORRECT ANSWER E. GI loss, diuretic use C.M. slow, shallow respirations, irritability, twitching, s/s of hypokalemia pH >7.4 HCO3 >26" "respiratory acidosis - CORRECT ANSWER E. cns depression, airway abnormalities C.M. restless, confused, seizures, tachycardia pH <7.4 PaCO2 >44" "respiratory alkalosis - CORRECT ANSWER E. usually anxiety, PE, chf, salicylate OD, illegal drugs C.M. light-headed, confused, tetany pH >7.4 PaCO2 <38" "pH normal HCO3 normal PaCO2 normal - CORRECT ANSWER 7.35-7.45 22-26 38-44" "Allele - CORRECT ANSWER Paired genes on autosomal chromosomes" "Locus - CORRECT ANSWER Position in which a gene occupies on a chromosome" "Phenotype - CORRECT ANSWER Outward appearance of an individual" "Genotype - CORRECT ANSWER A map of ones specific genes" "Polymorphic - CORRECT ANSWER Two or more alleles which occur with an appreciable frequency in a population" "Homozygous - CORRECT ANSWER Two dominant or recessive alleles" "Heterozygous - CORRECT ANSWER When both a dominant and a recessive allele are present" "Dominant - CORRECT ANSWER Trait seen in phenotype" "Recessive - CORRECT ANSWER Trait not seen in phenotype" "Codominance - CORRECT ANSWER Both alleles exhibit (blood type AB)" "Carrier - CORRECT ANSWER Person who has a diseased gene but is phenotypically normal" "Autosomal chromosomes - CORRECT ANSWER first 22 of 23 chromosomes" "sex-linked chromosomes - CORRECT ANSWER 23rd pair of chromosomes" "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." "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) 3. Decrease in production of red blood cells (anemia or leukemia) 4. Diseases of cardiopulmonary systems (ischemia, blood supply loss, arteriosclerosis)" "Reperfusion injury - CORRECT ANSWER Oxygen supply is restored to ischemic tissues. Triggers oxygen intermediates which causes cell membrane damage and mitochondrial calcium overload. Xanthine dehydrogenase --> xanthine oxidate. This makes large amounts of free radicals, superoxide, and hydrogen peroxide. Causes cell membrane damage and *mitochondrial calcium overload*" "Reperfusion injury clinical manifestations - CORRECT ANSWER White blood cell count is impaired. Seen in tissue transplantation, ischemic syndromes of the heart, liver, intestines, kidneys, and cerebrum." "Free Radical - CORRECT ANSWER Molecules that have an unpaired electron on its outer shell. This makes the molecule unstable. Cause cellular injury, aging, and disease to occur." "Reactive Oxygen Species (ROS) - CORRECT ANSWER Produced as a normal byproduct of ATP production in mitochondria. ROS can overwhelm the mitochondria and exhaust intracellular antioxidants. Also produced by absorption of high energy sources like radiation or UV light." "Ethanol - CORRECT ANSWER Acute affects in the liver include inflammation, fatty infiltration, hepatomegaly, acute liver necrosis, suppressed fatty acid oxidation. Chronic ethanol use is mainly seen in the stomach and liver, and is caused by free radicals. *Elevated anion gap and osmolar gap >10 is diagnostic*" "Infarct - CORRECT ANSWER Form of necrosis that is a SUDDEN insufficiency of arterial blood flow. (ie: heart attack, cold leg, MI)" "Apoptosis - CORRECT ANSWER Programmed cell death (normal). Needed to prevent cellular proliferation that would result in a large body. Clinical implications: neurodegenerative disease, ischemic injury, death of virus infected cells" "Autophagy - CORRECT ANSWER Autodigestion of the cell. When cells lack nutrition, autophagy is triggered. During times of metabolic stress, autophagy provides ATP and other macromolecules for energy and cell survival. When stress progresses, it leads to cell death" "Aging - CORRECT ANSWER Body released more cytokines and proinflammatory substances which results in chronic inflammation" "Normal cells - CORRECT ANSWER Will not grow unless attached to a firm surface. Normal cells have a limited life span and divide 10-50 times. Uniform in size and shape." "Cancer cells - CORRECT ANSWER Cells continue to crowd and eventually pile over. Immortal and divide for years. Divide rapidly and are parasites. Must grow in a hypoxic or acidic environment." "Which cancer produces alpha fetoprotein? - CORRECT ANSWER Liver and germ cell tumors secrete this into the blood. Found in liver, testicles, or ovaries." "Which cancer produces carcinoembryonic antigen? - CORRECT ANSWER GI, pancreas, lung, breast, large intestine, colon, rectal" "Which cancer produces beta human chorionic gonadotropin? - CORRECT ANSWER Germ cell (reproductive)" "Which cancer produces prostate specific antigen? - CORRECT ANSWER Prostate" "Origin of cancer from carcino-? - CORRECT ANSWER Carcinoma = cancer from the epithelial tissue" "Origin of cancer from sarco-? - CORRECT ANSWER Cancer arising from the connective tissue" "Origin of cancer from -oma? - CORRECT ANSWER Benign tumor" "Origin of cancer -blastoma? - CORRECT ANSWER Nervous tissue" "Lung cancer site of metastasis? - CORRECT ANSWER Multiple organs, including brain" "Colorectal cancer site of metastasis? - CORRECT ANSWER Liver, lungs" "Testicular cancer site of metastasis? - CORRECT ANSWER Lungs, liver, brain" "Prostate cancer site of metastasis? - CORRECT ANSWER Bones (especially lumbar spine), liver" "Coagulative necrosis - CORRECT ANSWER Occurs primarily in the kidneys, heart, and adrenal glands. Commonly results from hypoxia caused by severe ischemia or hypoxia from chemical injury (especially ingestion of mercuric chloride)" "Liquefactive necrosis - CORRECT ANSWER Commonly results from ischemic injury to neurons and glial cells in the brain" "What does T3N2M0 in cancer staging mean? - CORRECT ANSWER large, with local nodes but no evidence of metastasis" "What kind of genetics does a person with cystic fibrosis have? - CORRECT ANSWER Autosomal recessive" "Which type of cellular injury can cause Alzheimers? - CORRECT ANSWER Free radical/ROS" "Well differentiated vs undifferentiated cancer cells - CORRECT ANSWER Well-differentiated cancer cells look more like normal cells and tend to grow and spread more slowly than poorly differentiated or undifferentiated cancer cells." "What is the main plasma protein? - CORRECT ANSWER Albumin (negative charge). Buffers H+ (positive charge). Binds calcium (about 40%)." "What does a decreased plasma oncotic pressure mean? - CORRECT ANSWER Results from losses or diminished production of plasma albumin. Causes fluid to move into the interstitial space, resulting in EDEMA." "Oncotic pressure - CORRECT ANSWER Force that KEEPS water/fluid within a compartment. PULLS." "Antidiuretic hormone - CORRECT ANSWER VASOPRESSIN. Secreted by pituitary gland in response to water deficit, sodium excess, or low BP. Causes kidneys to reabsorb water thus increasing intervascular/plasma fluid." "Renin Angiotensin Aldosterone System (RAAS) - CORRECT ANSWER Activated by low blood volume. Low blood volume --> renin --> angiotensinogen --> angiotensin 1 --> ACE (angiotensin converting enzyme) converts angiotensin 1 to angiotensin 2 -->causes arterial vasoconstriction --> release of aldosterone --> renal Na+ and H2O reabsorption and K+ excretion. Produces LESS urine and blood volume INCREASES. Manages BP - when body constricts, BP increases" "Normal plasma osmolality - CORRECT ANSWER 280-295 mOsm/kg" "Natriuretic hormones - CORRECT ANSWER ANP and BNP. Hormones released from the heart to decrease blood volume by promoting urinary excretion of Na+ and H2O. Decreases blood volume. Opposite of RAAS." "How does a hypertonic solution alter osmolality? - CORRECT ANSWER Increases solute concentration, causing INCREASED osmolality. Causes cells to SHRINK." "How does a hypotonic solution alter osmolality? - CORRECT ANSWER Intravascular space to become more dilute, causes cells to SWELL." "Fluid volume deficit (dehydration) clinical manifestations - CORRECT ANSWER Poor skin turgor, dry mucous membranes, sunken eyes, sunken fontanels (in babies), decreased urine output, fatigue" "Edema clinical manifestations - CORRECT ANSWER Pitting, swelling, puffiness, limited movement in affected area" "Liver disease and protein malnutrition can result in what? - CORRECT ANSWER Decreased oncotic pressure" "Glomerular disease, trauma victims, hemorrhage, burns, and cirrhosis of the liver can result in what? - CORRECT ANSWER Decreased oncotic pressure" "How does edema cause increased hydrostatic pressure? - CORRECT ANSWER Venous obstruction --> increased hydrostatic pressure --> fluid is pushed out of the vascular space into the interstitial space" "How does edema cause decreased oncotic pressure? - CORRECT ANSWER Decreased plasma protein production --> decreased oncotic pressure and osmotic pressure --> fluid moves into the interstitium" "How does edema cause increased capillary permeability? - CORRECT ANSWER Results from times of inflammation (trauma, crushing injuries, burns, neoplastic diseases, allergic reactions, infections). Increased capillary permeability allows large amounts of fluid to escape and enter the interstitial space." "How does edema cause lymphatic channel obstruction? - CORRECT ANSWER Lymphatic channels are blocked because of infection or tumor. Proteins and fluids are not reabsorbed and accumulate in the interstitial space, causing lymphedema." "Hypovolemic hypernatremia - CORRECT ANSWER Occurs as a result of sodium and water loss. Clinical manifestations: volume depletion, orthostatic hypotension, hypotension, tachycardia, lack of organ perfusion" "Hypervolemic hypernatremia - CORRECT ANSWER Uncommon, but most common cause is administration of hypertonic sodium salts. Infants: erroneous preparation of dietary formula Outpatient adults: ingestion of salts Inpatient adults: iatrogenic (hypertonic IV solutions)" "Clinical manifestations of mild, moderate, and severe hyponatremia? - CORRECT ANSWER Mild: anorexia, apathy, restlessness, nausea, lethargy, muscle cramps Moderate: agitation, disorientation, headache Severe: seizures, coma, incontinence, death" "Insulin effects on potassium - CORRECT ANSWER Shifts K+ intracellularly" "Acid base balance effects on potassium - CORRECT ANSWER Alkalosis shifts K+ into cells --> hypokalemia Acidosis shifts K+ out of cells --> hyperkalemia" "Osmolality and effects on potassium - CORRECT ANSWER Hyperosmolar state causes K+ to shift out of cells --> hyperkalemia. Hypoosmolar state causes K+ to shift into cells --> hypokalemia." "Exercise and effects on potassium - CORRECT ANSWER Depletes ATP --> opens K+ channels --> K+ shifts into ECF --> hyperkalemia" "What causes hypokalemia? - CORRECT ANSWER Diuretics, nephrotoxic drugs, diarrhea, laxative abuse, hyperglycemia, increased levels of aldosterone, alkalosis" "Hypokalemia clinical manifestations - CORRECT ANSWER Dysrhythmias, weakness, numbness, tingling, confusion, respiratory difficulty, constipation, depression, muscle cramps" "What causes hyperkalemia? - CORRECT ANSWER ESRD, medications (ACE inhibitors, NSAIDS), tissue injury, adrenal insufficiency, hypoxia, digitalis overdose, insulin deficits, acidosis" "Metabolic acidosis - CORRECT ANSWER Causes: Excess H+ ions (renal disease), bicarb deficiency (diarrhea, renal tubular acidosis), increased acid production (ketoacidosis, lactic acidosis). Clinical Manifestations: myocardial contractility, decreased cardiac output, hyperkalemia, headache, lethargy, coma Patho: Body will compensate by hyperventilation or Kussmaul respirations, increased ionized calcium" "Metabolic alkalosis - CORRECT ANSWER Causes: Excess of bicarbonate, deficiency of H+ (gastric suctioning, excessive vomiting, diuretic use) Clinical Manifestations: Hypokalemia, cardiac arrhythmias, hyperactive reflexes, hypocalcemia weakness, slow shallow respirations Patho: Hypokalemia, decreased ionized calcium" "Respiratory Acidosis - CORRECT ANSWER Causes: Hypoventilation, respiratory depression, impaired respiratory musculature from Guillian Barre or multiple sclerosis, OSA, asthma, ARDS, COPD, PNA Clinical Manifestations: Headache, restlessness, blurred vision, apprehension, lethargy, muscle twitching, tremors, convulsions Patho: Hypoventilation (mechanical ventilation may be required)" "Respiratory Alkalosis - CORRECT ANSWER Causes: Hyperventilation, hypoxemia, PE, CHF, high altitudes, fever, sepsis, anemia, anxiety, hepatic failure, salicylate overdose Clinical Manifestations: dizziness, confusion, paresthesias, convulsions, seizures, coma" "Chronic metabolic acidosis will enhance resorption of what? - CORRECT ANSWER Ammonium" "What are the 4 nitrogenous bases of DNA? How do they pair up? - CORRECT ANSWER Adenine, cytosine, guanine, thymine Thymine <--> adenine Guanine <--> cytosine" "How does DNA replication occur? - CORRECT ANSWER Consists of breaking the weak hydrogen bond between the bases, leaving a single strand with each base unpaired. The consistent pairing of TA and GC is key to accurate replication. DNA polymerase travels along a single DNA strand, adding the correct nucleotides to the free end of each new strand." "What is RNA? - CORRECT ANSWER Responsible for transcription, translation, protein formation from DNA. Uracil <--> adenine Guanine <--> cytosine" "Transcription - CORRECT ANSWER RNA is synthesized from DNA resulting in creating of mRNA" "Translation - CORRECT ANSWER RNA directs synthesis of polypeptides. mRNA interacts with tRNA and ribosomes to create amino acids" "Gamete cell - CORRECT ANSWER Mature sperm or egg cell. Haploid, contain 23 chromosomes. Reproduce through meiosis. When the sperm and egg join, the two sets of 23 chromosomes form a complete set of 46 chromosomes." "Somatic cells - CORRECT ANSWER All other cells in the body. Diploid, 46 chromosomes or 23 pairs of chromosomes. Reproduce through mitosis. 23 pairs of chromosomes or 46 chromosomes total." "Polyploidy and its clinical manifestations - CORRECT ANSWER When a cell has more than 46 chromosomes Ex: Liver, bronchial and epithelial tissues are normally polyploid. A zygote having 3 or 4 copies of each chromosome, rather than 2 has triploidy or tetraploidy which almost always results in spontaneous abortion/stillborn." "Aneuploidy and its clinical manifestations - CORRECT ANSWER Cells that do not contain multiple of 23 chromosomes (can contain more or less, like 45 or 47). Caused by nondisjunction (failure for the chromosomes to divide properly). Ex: Spontaneous abortion, still born, birth defects" "Autosomal aneuploidy and its clinical manifestations - CORRECT ANSWER Autosomal chromosomes are all chromosomes which do not have any relation to gender. Ex: Trisomy 13, 18, 21 (can survive, others don't survive). Trisomy 21 causes down syndrome (low IQ, low nasal bridge, poor muscle tone, short stature, lower life expectancy)" "Sex chromosome aneuploidy and its clinical manifestations - CORRECT ANSWER Less serious than autosomal aneuploidy. Atypical number of X or Y. Ex: Trisomy X, Turner syndrome, Klinefelter" "Turner syndrome - CORRECT ANSWER Sex-linked monosomy" "Klinefelter's syndrome - CORRECT ANSWER Sex linked trisomy" "Down syndrome - CORRECT ANSWER Autosomal trisomy" "Chromosomal deletion and examples - CORRECT ANSWER Broken chromosomes and loss of DNA. Ex: Cri de chat "cry of the cat" syndrome" "Chromosomal duplications - CORRECT ANSWER Duplication of chromosomes. Less severe disease than deletion" "Chromosomal inversions and examples - CORRECT ANSWER Two breaks of a chromosome, followed by reinsertion of the fragment its original site. ABCDEFG ends up looking like ABCDFEG. Ex: No apparent physical affect, but can cause serious problems in offspring." "Chromosomal translocation and examples - CORRECT ANSWER Interchanging of genetic material between non-homolygous chromosomes. Ex: Usually no serious problems, but can cause serious problems in offspring."