Maryville NURS 611 PATHOPHYSIOGY Exam 2025

Nurs 611 Maryville NURS 611 PATHOPHYSIOGY Exam 2025 Apoptosis - -A programmed cell death that is regulated or programmed. Cellular self destruction for elimination or unwanted cell populations Necrosis - -Rapid loss of the plasma membrane structure, organelle swelling, mitochondria dysfunction What is the #1 cause of cellular injury leading to necrosis (especially the kidney and heart) - -hypoxia What is the #1 cause of hypoxia? - -ischemia Main component of a cell - -nucleus What does the nucleus contain? - -nucleolus What is the nucleolus composed of? - -RNA, most of cellular DNA, DNA binding proteins, and histones Why are histone important? - -histones bind to DNA and fold it into chromosomes (chromatin) which is essential for cell division What are ribosomes? - -RNA-protein complexes (nucleoproteins) that are synthesized in the nucleolus and secreted into the cytoplasm through pores in the nuclear envelope called nuclear pore complexes (NPCs) Where can ribosomes be found? - -cytoplasm and rough ER what are ribosomes chief function? - -provides sits for cellular protein synthesis What is the Golgi apparatus (complex)? - -a network of flatten, smooth membranes and vesicles frequently located near the nucleus of the cell What does the Golgi apparatus do? - -takes proteins from the ER and processes/packages them into small membrane-bound vesicles called "secretory vesicles, and refines and directs traffic in the cell What are lysosomes and what do they do? - -maintain cellular health by removal of toxic cellular components, removal of useless organelles, termination of signal transduction, and signals cellular adaption Nurs 611 Nurs 611 How does aging affect lysosomes? - -leads to progressive loss of lysosomal efficiency which declines the regenerative capacity of organs and tissue What functions do lysosomal components integrate? - -nutrient abundance, energy levels, and cell stressors and will translate them into instructions that regulate cellular metabolism toward either proliferation or inactivity What is mitochondria responsible for? - -cellular respiration, cellular metabolism , and energy production What does the inner membrane of mitochondria contain? - -enzymes of the respiratory chain and are essential to the process of oxidative phosphorylation that generates most of the cell's ATP The mitochondrial matrix contains what kind of pathways (1), involve what two things (2), and metabolizes what three things (3)? - -1- metabolic 2- urea and heme synthesis 3- carbs, proteins, and lipids What can accumulate intracellularly caused by stresses form metabolic dearangements? - -carbs, proteins, and lipids What is physiologic atrophy? - -occurs in early development. ex: thymus glad during childhood What is pathologic atrophy? - -occurs as a result of decreases in workload, use, pressure, blood supply, nutrition, and hormonal stimulation. Ex: Shrinking of gonads in an adolescent pt in response to decreased hormonal stimulation. and an pt immobilized in bed for a prolonged time what is hypertrophy? - -increase in cell size Example of beneficial physiologic hypertrophy? - -hypertrophy of myocardial cells from endurance training example of pathologic hypertrophy - -cardiomegaly in a hypertensive patient What is hyperplasia? - -increase in the number of cells example of compensatory hyperplasia? - -regeneration of the liver example of pathological hyperplasia - -endometrial tissue example of hormonal hyperplasia - -enlargement of the uterus during pregnancy What is metaplasia? - -replacement of the cells Nurs 611 Nurs 611 example of metaplasia - -normal columnar ciliated epithelial cells of the bronchial lining being replaced by squamous cells. can be reversed if irritant stopped cellular metabolism- what molecule gives us energy? - -ATP functions as the energy transferring molecule During ischemia, what effect does the loss of ATP have on the cells? - -a reduction of ATP levels (ATP needs oxygen) that causes the Na+/K+ pump and Na+/Ca exchange to fail, leading to intracellular accumulation of Sodium and calcium and diffusion of K+ out of the cell . Sodium and water can enter cell freely causing cellular swelling What is a free radical? - -A molecule that is unstable and highly reactive because it contains unpaired electrons. To stabilize, it gives up or takes a electron making it capable of injurious chemical bond formations with proteins, lipids, or carbs what plays a major role in the initiation and progression of disease? - -free radicals what are the 5 major diseases that are affected by reactive oxygen species and are known to play a role in initiation and progression? - -hyperlipidemia, diabetes m., hypertension, CHF, and ischemic heart disease What is wrong with an unpair electron? - -causes a chemical imbalance of the cell membrane, making the molecule unstable What is a consequence of leakage of lysosomes during chemical injury? - -enzymatic digestion of cellular organelles, including the nucleus and nucleolus, ensues, halting synthesis of DNA and RNA What happens when liver enzymes metabolize ethanol into acetaldehyde? - -hepatic cellular dysfunction. Peroxisomes help detoxify the liver-if not functioning properly the ethanol is turned into fat in the liver, "fatty liver" What is ionizing radiation (IR)? - -any form of radiation capable of removing orbital electrons from atoms. What does ionizing radiation result in? - -the production of negatively charge free elections and positively charged ionized atoms What is ionizing radiation emitted from? - -x-rays, y-rays, alpha and beta particles, subatomic particles such as neutrons, deuterons, protons, and pions WEAR A LEAD APRON Nurs 611 Nurs 611 What is the main mechanism of damage to DNA by the ionizing radiation? - -from generation of reactive oxygen species from reactions with free radicals by radiolysis of water IT HURTS THE DNA THE MOST What happens with physiologic processes with aging? - -every physiologic process can be shown to function less effeciently What is sarcopenia? - -muscular atrophy: degenerative skeletal muscle loss how fast it happens depends on nature/nurture What happens when "stiffness" or "rigidity" of systems occur with aging? - -1-peripheral vascular resistance increases (HTN) 2- decreased production of hydrochloric acid (HCL) and delayed stomach emptying (decrease in appetite) 3- decreased immune response to T-dependent antigens What happens with fluid and electrolytes with aging? - -1- total body potassium concentration decreases because of decreased cellular mass 2- the decreased cellular mass is accompanied by an increased extracellular compartment leading to an increased sodium/potassium ratio What is an aneuploid cell? - -those that do not contain a multiple of 23 chromosomes What makes a trisomic cell? - -an aneuploid cell containing three copies of one chromosome (Trisomy 21, 18) What is a well known example of aneuploidy? - -trisomy 21 (down syndrome) What is trisomy 21 or down syndrome known for? - -IQ between 25-70 low nasal bridge protruding tongue flat, low set ears What is the definition of penetrance? - -The percentage of individuals with a specific genotype who also express the expected phenotype What is Imcomplete Penetrance? - -individuals who have a disease-causing allele may not exhibit that expected phenotype at all, even though the allele and the associated disease may be transmitted to the next generation What is Huntington's disease and what are the main features? - -1-A well-known autosomal dominant condition 2- progressive dementia and increasingly uncontrollable movements of the limbs Nurs 611 Nurs 611 When does Huntington's disease appear? - -not usually seen until 40 y/o or later due to this, Huntington's disease what is an example of a age-dependent penetrance? - -Huntington disease What do most genetic diseases exhibit? - -variable expressivity What is the definition of Expressivity? - -the extent of variation in the phenotype associated with a particular genotype If the expressivity of a disease is variable, how is penetrance affected? - -penetrance may be complete, but the severity of the disease can vary What is a well-known example of variable expressivity in an autosomal dominant disease? - -Type 1 neurofibromatosis or Von Recklinghausen disease How does the expression of Recklinghausen disease gene express itself? - -Can vary from a few harmless cafe-au-lait spots on the skin to malignant tumors, scoliosis, seizures, gliomas, hypertension, learning disabilities, and neuromas Cystic fibrosis is caused by what type of gene? - -autosomal recessive Who does cystic fibrosis affect most? - -white children-most lethal autosomal recessive disease How does someone get cystic fibrosis? - -the individual must be homozygous for a recessive allele to express the disease (both parents have to have the allele) What happens if a person is a carrier for cystic fibrosis? - -1- usually the carriers are phenotypically normal 2- most recessive alleles are maintained in normal carriers; they are able to survive in the populations from one generation to the next What form of gene accounts for approximately 5% of breast cancer? - -autosomal dominant form Which genes are responsible for this form of breast cancer? - -BRACA1 (chromosome 17) and BRACA2 (chromosome 13) What is the chance of a lifetime risk of developing breast cancer for women who inherit the BRACA1 or BRACA2 gene? - -50-80% What is the risk of developing breast cancer if a woman has 1 affected 1st degree relative? - -double the risk Nurs 611 Nurs 611 How common is a given disease in a population? - -well-established measures are used to answer this question What is the definition of incidence rate? - -number of new cases of a disease reported during a specific period (typically 1 year) divided by the number of individuals in the population What is the definition of relative risk? - -a common measure of the effect of a specific risk factor how is relative risk expressed? - -a ratio of the incidence rate of the disease among individuals exposed to a risk factor divided by the incidence of the disease among individuals not exposed to a risk factor Ex: the incidence of death from lung cancer was 1.66 (per 1000 person-years) in heavy smokers (25 cigs/day), but it was only 0.07 in the non smokers. The ratio of these two incidence rates is 1.66/0.07, which yields a relative risk of 23.7 deaths. Thus, the risk of dying from lung cancer is increased by 24-fold in heavy smokers vs nonsmokers What are the major characteristics of type 1 DM? - -1- T-cell infiltration of the pancreas 2-destruction of the insulin-producing beta cells 3-auto-antibodies are formed against pancreatic cells What does epigenetics do? - -bridges DNA info and function by modifying gene expression without any alteration in DNA sequence What can epigenetic modification cause individuals with the same DNA (twins) - -have different disease profiles Ex: the occurrence of asthma in only one pair of the identical twins What is demonstrated when twins age? what does this cause? - -1- they demonstrate increasing differences in methylation patterns of their DNA sequences causing increased numbers in phenotype differences What environmental factors can affect epigenetic modification? - -diet and exposure to certain chemicals What is the main difference between DNA mutation and epigenetic modification? - -DNA sequence mutations cannot be altered but epigenetic modifications can be reversed Ex: 5-azacytidin When messenger RNA (mRNA) is over-expressed what does it result in and why? - -1 results in metastasis of an already existing cancer 2- hypermethylation is in miRNA genes that bind to the ends of mRNAs, degrading them and preventing their translatio