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Exam 1 Pathophysiology
Manchester University ABSN
Terms in this set (261)
energy releasing process of metabolism
energy using process of metabolism
1. created from the energy contained in organic molecules
2. fuel for cell survival
3. stores and transfers energy
4. used in the synthesis of organic molecules, muscle contraction, and active transport
When ATP is used.. what will it become?
What are the 4 stages of action potential in order?
2. Threshold potential
4. Refractory period
What are the two components of the threshold potential?
hyperpolarized and hypopolarized
When a resting cell is stimulated through voltage gated channels, the membranes become permeable to sodium, so a net movement of sodium into the cell occurs, the membrane potential decreases or moves forward, from a negative value.. what is this called?
In order to generate an action potential and the resulting depolarization, which must be reached?
When the membrane potential is more negative than normal.. what is this called?
When the membrane potential is more positive than normal.. what is this called?
During this stage, the negative polarity of the resting membrane potential is reestablished...
During most of the action potential, the plasma membrane cannot respond to an additional stimulus.. which is called?
absolute refractory period
ingestion of large particles
ingestion of fluids
1. replaces plasma membrane removed by endocytosis
2. releases synthesized molecules in the extracellular matrix
What are the 4 types of tissue?
Which tissue is highly specialized?
Which tissue is internal and external?
Which tissue binds to tissues and organs?
Which muscle promotes movement and includes myocytes?
What is a triplet of bases?
ex: AUG start codon
How many amino acids is DNA comprised of?
What is DNA polymerase?
It is an enzyme that joins individual nucleotides to produce a new strand of DNA
What is spontaneous mutation?
those occurring in the absence of exposure to known mutagens
What is a mutational hot spot?
where DNA sequences have particularly high mutation rates
What is a nucleotide?
comprised of deoxyribose, phosphate group, and one nitrogenous base
What is the main difference between RNA and DNA?
RNA has uracil and ribose
DNA has thymine and deoxyriobse
Where does transcription occur?
Where does translation occur?
What is RNA polymerase?
binds to a promoter site, a sequence of DNA that specifies the beginning of a gene
What is aneuploidy?
An abnormal number of chromosomes
Ex: trisomy 21 (down syndrome): risk increases with maternal age above 35; 1:800 live births
What is Klinefelter syndrome?
individuals with at least two X chromosomes and one y chromosome
ex: male appearance, small testes
What is Turner syndrome?
females with only 1 X
X is usually inherited from the mother
ex: short stature, webbing of the neck
How many chromosomes do humans have?
What is one cause of aneuploidy?
nondisjunction: failure of seperation of chromosomes
What is an example of autosomal recessive?
What is autosomal dominant?
one copy of an inherited gene from one parent can cause genetic conditions
What is autosomal recessive?
a genetic trait or condition that can be passed down from parent to child
What is X-linked recessive?
-female receives 2 X chromosomes, 1 from the father
-2 copies are required for females to be affected
-commonly in males
What is true about epigenetic modifications?
can be influenced by diet and lifestyle
Which is correct regarding Down syndrome?
results in a distinctive facial appearance
The appropriate term for an energy releasing process is?
Which statement regarding body fluid movement is accurate?
water moves freely across membranes
The term describing the DNA subunit of one deoxyribose molecule, one phosphate group, and one base is?
An accurate description of a type I reaction would be that it?
is generally allergic in nature
Which is a characteristic humor immunity?
antibodies are primarily responsible for protection
Which of the following is a true statement regarding stress and the immune system?
cardiovascular disease is one condition related to stress
The clotting system at the site of injury or inflammation includes the flowing functions: (Select all that apply)
1) keeping microorganisms at the site of the greatest inflammatory cell activity
2) providing a framework for future repair and healing
What is epigenetics?
-the study of how the environment affects which genes are expressed
-stably inheritable phenotype changes in a chromosome w/o alternation in DNA sequence
How does DNA methylation occur?
when a methyl group is attached to a cytosine
What does DNA methylation do?
renders gene inactivate
What is Prader-Willi syndrome?
-deletion of paternal gene
-mother is imprinted
ex: short stature and obesity
What is histone modification?
turns on a gene
What is Angelman syndrome?
-deletion of maternal gene
-father is imprinted
-severely mentally challenged
Which gene does FSHMDS delete?
What is fetal alcohol syndrome (FAS)?
-the presence of severe birth defects in babies born to mothers who drink alcohol during pregnancy
-alters fetal expression of DNA methyltransferase
-affecting skeletal and neural development
Fragile X Syndrome
-a disorder produced by injury to a gene on the X chromosome, producing mild to moderate mental retardation
Together fragile x syndrome and FSHMDS presents that both abnormal gain and abnormal loss of epigenetic modification can result in what?
What is an example of uni-parental disomy?
beckwith-wiedemann spectrum: which is result of over expression of a gene product
What is atrophy?
decrease in cell size
What is hypertrophy?
increase in cell size
What is hyperplasia?
increase in number of cells
What is metaplasia?
change in cell type
What is dysplasia?
abnormal changes in the size, shape, and organization of mature cells
What is apoptosis?
programmed cell death
What is autophagy?
self-destructive and survival mechanism
What is hypoxia?
lack of oxygen
What is hypoxic ischemia?
lack of oxygen in cells, ischemia is a lack of blood supply
What is ischemic-reperfusion?
injury caused by restoration of oxygen and blood
What is death of tissue from severe hypoxic injury?
What causes membrane alternations?
reduction of ATP results in Na-K pump failure
What is osmosis?
-diffusion of water
-moves water down a concentration gradient
-filtration movement of water and solutes thru a membrane cuz of greater pushing pressure on one side of a molecule than the other
What is diffusion?
movement of molecules from high to low concentration
Intracellular fluid in cells is comprised of..
2/3 body weight
In terms of ICF what goes in?
In terms of ECF what goes out?
Considering the sodium-potassium pump...
3 Na+ out; 2 K+ in
What is aldosterone?
-leads to sodium and water reabsorption back into the circulation and excretion of potassium
-causes sodium and water excretion
An imbalance in this hormone can result in the issues of sodium and water excretion and retention..
What is the most efficient regulator?
Hydrostatic pressure (caused by BP) pushes water out of capillaries.. which is?
Osmotic pressure pulls water into capillaries.. which is?
What is an example of an increase in capillary hydrostatic pressure?
edema (localized vs generalized)
What is a primary intracellular cation?
What is hypoventilation an example of?
-b/c you are not taking in O2, but you are not taking out CO2, hence the CO2 is higher
What is hyperventilation an example of?
-b/c you are taking in more O2 and CO2 and are releasing a lot of the CO2
What happens to your acid-base balance when you are vomiting?
-b/c you are vomiting out the acid, so your pH will be higher
What happens to your acid-base balance when you have diarrhea?
-b/c you are losing electrolytes, so your pH will be lower and it'll be more acidic
What has pH below 7?
What has pH above 7?
How can you differentiate between respiratory and metabolic?
respiratory involves CO2 (lungs)
metabolic involves Bicarb (kidneys)
What is the average pH of blood?
What influences serum potassium levels?
aldosterone, insulin, and epinephrine
Normal range for potassium?
What constitutes hypokalemia?
-poor kidney function (less potassium)
What constitutes hyperkalemia?
-kidneys regulate well (more potassium)
If there is too much of this electrolyte it can become hard, rigid, and lack of function..
What constitutes hypocalcemia?
-increases neuromuscular excitability
-need vitamin D to control
-can cause cardiac arrest
What constitutes hypercalcemia?
-decreases neuromuscular excitability
-can cause blood clots
What is the complement system made of?
1. classical pathway
2. lectin pathway
3. alternative pathway
What pathway is activated by infectious microorganisms ?
What pathway is activated by antibodies?
What pathway is activated by plasma proteins?
What system is made of fibrin and platelets?
What releases histamine?
What are interleukins comprised of?
macrophages and lymphocytes
This interleukin only has macrophages and induces fever in bacterial infections; bacterial..
This interleukin has macrophages, lymphocytes, and fibroblasts and induces liver cells to make inflammatory proteins; viral and bacterial..
What is the ingestion of microbes?
Who are the first responders in a phagocyte in early inflammation?
What is the most abundant of antibodies?
How can you measure your immunity to a bacterial virus by drawing a blood sample?
What is active immunity?
long-lived immunity develops after exposure to antigen
What is a measure of acute inflammation?
-esr; erythocyte sedimentation rate
-acute phase reactants
What is passive immunity?
ex: vaccine for Hep A and rabies
What is activated by vascular injury?
What is the main difference between acute and chronic inflammation?
acute: self-limiting; lasts 8-10 days
chronic: longer lived; lasts weeks to months
What is primary intention?
wounds that heal under conditions of minimal tissue loss
ex: scraped knee
What is secondary intention?
wounds that require a great deal more tissue replacement
What is dysfunctional wound healing?
may occur during any phase of wound healing
caused by: ischemia, excessive bleeding, and predisposing disorders
ex: diabetes, wound infection
What is humoral immunity comprised of?
B cells; antibodies
What is cellular immunity comprised of?
T cells in blood and tissues
What do antigens bind with?
What do immunogens bind to?
receptors and induce immune response
What is the most abundant antibodies (80-85%)?
What is the first antibody to be produced?
What is the low concentration mediator to common allergic responses and defense against parasites?
What are antigens?
molecules on surface of microbes, infected cells, or abnormal tissues
What are lymphocytes?
Describe effect of aging on the immune function?
decreased antibody response to antigens
What is a direct antibody function?
through action of antibody alone
What is indirect antibody function?
requiring activation of other components
What Type I hypersensitivity?
What is IgE responsible for?
-releases histamine from mast cells
ex: urticaria and asthma
What is anaphylaxis?
-a rapid, severe immediate hypersensitivity rxn
-occurs minutes of reeexposure to antigen
What is Type II hypersensitivity?
antibodies attack tissues
ex: transfusion rxn
What is a Type III hypersensitivity reaction?
immune complex mediated
ex: SLE (systemic lupus erythematous)
What is a Type IV hypersensitivity reaction?
Anaphylaxis is what kind of hypersensitivity reaction?
What is alloimmunity?
rxn against another individuals tissue
ex: transfusion rejection
What is autoimmunity?
immune system targeting self
What blood testing should be done prior to the administration of blood products?
rH antigens and blood type screen
When antigens are expressed only on RBCs.. this is?
Rh blood group
ex: Rh-positive and Rh negative
What is hemolytic disease of the newborn?
Rh-neg mothers who have been exposed to an Rh positive fetus the first time, and then have an Rh-pos fetus
What are examples of T-cell deficiencies?
-viral, fungal, yeast, and atypical microorganisms
What are examples of B-cell and phagocyte deficiencies?
microorganisms requiring tagging
What is secondary immune deficiencies also known as?
What is an example of an immunosuppressive tx?
What is the structure HIV?
genetic info in the form of RNA
ex: reverse transcriptase
What constitutes a dx for AIDS?
-when CD4 T cells falls right below 200
-creates a generalized immune deficiency
What is a common cause of disease?
What are examples of bacteria?
-aerobic or anaerobic
-motile or immotile
What are examples of virulence factors?
What is a medical dx example of bacterial infection?
What is an exotoxin?
-enzymes that can damage the plasma membranes
-can inactive enzymes critical to protein synthesis
What is an endotoxin?
activates the inflammatory response and produces fever
What can antibiotic-resistant infection result in?
What is the purpose of vaccines?
biological preparations of antigens that stimulate production of protective antibodies
What happens in Septicemia?
bacteria release large amounts of toxins which induce overproduction of pro-inflammatory cytokines
How do organisms transmit from animals to humans?
antigenic drift because mutations occur that lead to easier transmission from animals to humans
What is stress?
a perceived or anticipated threat that disrupts a person's well-being or homeostasis
Demands of stress can be...
physical or psychological
What does the hypothalamus secrete?
corticotropin-releasing hormone (CRH)
What does the pituitary gland secrete?
adrenocorticotropic hormone (ACTH)
What do adrenals secrete?
What is secreted during stress?
cortisol, which elevates the blood glucose level
What can chronic, abnormal elevations of cortisol cause?
obesity, emotional disorders, and gastric ulcers
What causes pancreas to increase glucagon?
Chronic stress may cause..
cardiovascular dz, chronic inflammatory processes, burnout
What is an effect of telomeres?
increases risk of early death
What is coping?
process of managing stressful challenges
When is exercise mindfulness therapy effective?
at all ages
What are catecholamines?
Norepinephrine, Dopamine, Epinephrine are all involved in the stress response
Which mechanism would describe how a WBC can ingest bacteria?
What is exocytosis?
a process for secreting molecules into the extracellular environment
What is pinocytosis?
invokes the ingestion of fluids, bits of the plasma membrane, and solute molecules through formation of small vesicles
What is leukocytosis?
increase in WBC
Which definition would describe the term diffusion?
movement of a solute from high to low concentration
What is the movement of water down a concentration gradient?
What is the technical force of water pushing against a cell membrane?
What is the movement of water and solute through a membrane because of greater pushing pressure on one side of the membrane than on the other?
Which cellular processes would be examples of catabolism?
glycolysis, digestion, oxidation, citric acid cycle
What would be an example of anabolism?
Which major electrolytes would be essential in maintaining the resting membrane potential? Select all that apply.
sodium and potassium
What affects gap junction intercellular communication and is relapsed from injured cells?
Which expiation about oxidative phosphorylation would be correct?
energy proceeded from food is transferred to ATP
The electron transport chain is used in oxidative phosphorylation, but is not the explanation for...
Where does oxidative phosphorylation occur?
Where does translation occur?
Where does transcription occur?
Which findings are likely to be seen in a newborn whose mother drank beer and wine regularly during pregnancy?
low birth weight and facial anomalies
What would you see in a child with FAS?
growth retardation, facial anomalies, cognitive impairment, and ocular malformations
What would be associated with small head circumference?
Which complication is expected after restoration of oxygen to an oxygen-deprived tissue?
What is caused by excessive physical forces?
In which order do the postmortem changes occur in somatic death of a client?
An individual with a history of atherosclerosis is in the emergency department w/ chest pain. Which is the highest priority for quickly restoring adequate blood blow to the heart?
to rescue the ischemic cells
Why is important to rescue ischemic cells during chest pain?
to prevent a myocardial infarction
What types of cell deaths are not reversible?
necrosis and apoptosis
Which term describes cellular death that leads to cellular dissolution and leaking of cellular contents?
What is a reversible, structural or functional response both to normal or physiologic conditions and to adverse or pathologic conditions?
Which term describe a reduced blood supply to the heart?
What is anoxia?
What is an embolus?
moving blood clot that causes ischemia
Which goal is the priority to prevent the most common cellular injury?
Which statement describes an important difference b/w necrosis and apoptosis?
inflammation results from necrosis, but not from apoptosis
What happens to cells in apoptosis?
What happens to cells in necrosis?
Which pathophysiolocial process causes normal columnar ciliated epithelial cells of the airway to replaced by newly formed stratified squamous cells?
The cell recycles its own organic material. Lysosome will surround it and eat it, allowing its building blocks to be something else.
Apoptosis can be either..
physiological or pathological
Which characterizes metaplasia?
it is a reversible replacement of one mature cell type by another less mature cell typ[e
When can dysplasia be reversible?
if the offending stimulus is removed (cancer)
If there is a problem w/ the citric acid cycle, which biophysical response would occur?
decreased ATP production
What is secreted by fibroblasts?
Which system compensates for a metabolic acid-base imbalance?
Which organ regulates bicarbonate reabsorption and regeneration?
Which cation does aldosterone regulate in a client's body?
Which body system needs urgent monitoring in hyperkalemia?
Which acid-base imbalance is associated w/ low arterial pH and bicarbonate levels?
Which statements about the actions of aldosterone in regulating water and electrolyte balance are correct? Select all that apply
it is secreted when bp is low
it promotes renal absorption of water to increase blood volume
it is secreted when serum potassium levels are increased
Which electrolyte imbalance should be monitored for an individual with oliguria from renal failure?
Which system regulates potassium levels?
Which conditions can lead to edema formation?
increased salt and water retention
decreased circulatory blood volume
When an individual is stressed, which part of the nervous system initiates the stress response?
What is part of the endocrine system?
When an individual is stressed and epinephrine is released, which clinical manifestation will be observed?
increased blood glucose
An individual is experiencing physiological stress. The health care provider monitors the client for increased blood glucose levels. What is the rationale for the health care provider's action?
cortisol is released
What regulates cardiovascular responses during the stress response?
What are some x-linked recessive disorders?
turner syndrome and klinefelter
Which statement describes the process of transcription?
this process occurs when mRNA is formed from DNA
Which statement indicates an accurate understanding of the function of an individual's DNA polymerase?
it performs base-pairing in repliacation
Which information is correct regarding the first line of defense against dz; select all that apply?
low skin temperature
An individual breaks the first line of defense against infection. Which mechanism should now follow?
A person is in the later stages of inflammation. The individual's mast cell release leukotrienes that perform which function?
increase vascular permability
Which substance act as opsonins?
How should the role of chemotaxis in inflammation be described?
it causes migration of leukocytes to the site of injury
When a person's complement system is stimulated, which processes will be activated? Select all that apply.
degranulation of mast cells
lysis of cells through membrane disruption
Which antibody is expected to be elevated in an allergic response?
After a type 1 hypersensitivity response, which lab test is typically elevated?
Which findings are associated w/ sle?
arthralgies, mouth ulcers, and facial rash
Which statement applies to an individual w/ acquired immunodeficiency syndrome who has a decreasing CD4+ count?
the number of t-helped cells is decreasing
What is an example of an alloimmune disorder?
Which history finding is typical of an individual w/ immune deficiency?
frequent, severe infections
Which transfusion would cause a possible fatal reaction?
giving type AB blood to a person w/ type O blood
Which of the four pregnant individuals requires administration of RhoGAM?
B negative (individuals blood group)
O positive (fetal blood group)
Which is the correct explanation as to why a previous year's flu vaccine does not provide full protection during the current flu year?
the flu virus undergoes a variation known as an antigenic drift
Which explains how vaccines work?
Stimulates production of antibodies against the pathogen
What disrupts the cell wall of bacteria?
A person injures the left leg. When would substantial numbers of neutrophils be expected to arrive at the site of injury?
within 6-12 hrs
An individual is experiencing acute inflammation and releases IL1. Which piece of equipment should be used to determine the effects of iL-1?
A person has activated the complaint system during an inflammatory response to an injury. Which substance activates the complement system?
What is a vasodilator?
Which immunoglobulin should be suspected in someone who is experiencing dust allergies?
When teaching about the molecular classes of immunoglobulins, which examples should be included in the teaching session? Select all that apply
Which statement about virus infections is correct?
replication of a virus depends on its ability to infect a permissive host cell
Lyme disease and rocky mountain are...
Which explains the action of bactericidal antibiotic on a microorganism?
kill the microorganism
What antibiotic inhibits the growth of microorganisms?
How to treat antibiotic-resistance microorganisms..
w/ a combo of "super" antibiotics
Which physiological condition is present during anaphylactic shock?
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