NURS 5315 Advanced Pathophysiology – Exam 2 (Set 1)

Nurs 5315AdvancedPathophysiology
Exam 2 Set1
1. First 5 stepsin theinflammatoryprocess:
1. mastcell degranulation
2. activationof coagulationcascade

3. activationof kinin cascade

4. release of chemotactic factors 5.Activation

of thecomplementcascade

2. Role/functionin theinflammatoryprocess:Complement:
I. Form themembraneattackcomplex
II. bacteriallysis
vasodilation
III. Increasedvascularpermeability
IV. triggersmastcell degranulation
V. chemotaxis
VI. opsonization- opsoninstagforeignpathogensfor eliminationby phagocytes

3. Role/function in the inflammatory process: kinin: turned into bradykinin which is
responsiblefor pain, chemotaxisand Increasedvascularpermeabilityand vasodilation

4. Role/function in the inflammatory process: Coagulation cascade:plays role in activating
the kinin system
FactorXII (Hagemonfactor)activateskinin and formsa fibrin meshto stop bleeding and trap
microorganisms

5. Role/functionin the inflammatoryprocess:chemotacticfactors:once released attract
neutrophils, eosinophils and monocytes for phagocytosis

6. Role/function in the inflammatory process: Neutrophils:
show up at thesite of injury in 6-
8 hours

,Neutrophils express and release cytokines, which in turn amplify inflammatory reactions
by sever
othercell types.In additionto recruitingand activatingother



, Nurs 5315AdvancedPathophysiology
Exam 2 Set1



cells of theimmunesystem,neutrophilsplay a key role in thefront-line defense against invading
pathogens.

7. Role/function in the inflammatory process: monocytes: Show up in 1-7 days become
macrophages
presentantigens totheCD4 cell which leadsto Tcell immunity which leadsto B cell immunity

ReleasesIL1, IL6, TNF and growthfactors

8. Role/functionin the inflammatoryprocess: Mast cell degranulation:
triggerstheactivationof theacutephasereactants
This leadsto thereleaseof histamine,cytokines,leukotrienes,plateletactivation factor and
prostaglandins

9. Role/function in the inflammatory process: Histamine 1 (H1):
promotesinflammation
smoothmuscles,i.e.bronchi- asthmacausesbronchoconstriction

10. Role/functionin the inflammatory process: Histamine 2 (H2): anti-
inflammatory properties gastric mucosa
11. Role/functionin the inflammatoryprocess:cytokines:IL4 early in theinflammation
IL 13 laterin inflammationTNF

12. Role/function in the inflammatory process: leukotrienes: released when mast cell
degranulates cause vasodilation attract neutrophils, monocytes
eosinophils

Singularimpactsleukotrienes

13. Role/function in the inflammatory process: prostaglandins:
released when the mast ce
degranulates produced by the arachidonic pathway




, Nurs 5315AdvancedPathophysiology
Exam 2 Set1



causevasodilation,plateletaggregation,pain and fever

14. Role/functionin the inflammatoryprocess: platelet-activating factor:
derivedfrom fattyacidsin theplasmamembrane
producedby neutrophils,monocytes,endothelialand platelets
causeendothelialcell retraction,increasesvascularpermeability,activates platelets, enhances
leukocyte adhesion to endothelial cell

15. Stepsin thearachidonicacidpathway:Linoleic acid plus phospholipaseA2 make
arachidonic acid (AA)

AA plus COX1 or COX 2 make Prostaglandins
Prostaglandins from COX1 maintain homeostasis
gastric
mucosaplateletaggregation fluid/electrolyte imbalance

Prostaglandinsfrom COX2 assistin theinflammatoryprocessvia pain, fever help
with homeostasis via renal function tissue repair

reproductiondevelopment

16. Function of arachidonicacid pathway:The arachidonic pathwayis the biochemical
processresponsiblefor thesynthesisof prostaglandins(See concept map).

It is madefrom linoleic acid which is partof thephospholipidcell membrane.

17. COX2 noteof caution:While COX2 inhibitorsblock theinflammatoryfunction of
prostaglandins, they can also impair renal function.

18. NSAIDS: inhibit both COX1 and COX2 prostaglandin synthesis Risk:
gastric

ulcerations,GI bleeds,bleeding,edema,renalimpairment