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Nurs 5315: Adv Patho Exam 1 Questions and Answers Graded A+

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Atrophy - -E. Cells decrease in size P. Still functional; imbalance between protein synthesis and degradation. Essentially there is an increase in the catabolism of intracellular organelles, reducing structural components of cell Physiologic: thymus gland in early childhood Pathological: disuse (muscle atrophy d/ decrease workload, pressure, use, blood supply, nutrition, hormonal sti

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Nurs 5315: Adv Patho Exam 1 Questions and Answers
Graded A+
Atrophy - -E. Cells decrease in size P: reversible; results from exposure of the cells to
P. Still functional; imbalance between protein chronic stressors, injury, or irritation; Cancer can
synthesis and degradation. Essentially there is arise from this area, stimulus induces a
an increase in the catabolism of intracellular reprogramming of stem cells under the influence
organelles, reducing structural components of of cytokines and growth factors
cell Ex: Patho: Columnar cells change to squamous
Physiologic: thymus gland in early childhood cells in lungs of smoker or normal ciliated
Pathological: disuse (muscle atrophy d/ decrease epithelial cells of the bronchial linings are
workload, pressure, use, blood supply, nutrition, replaced by stratified squamous epithelial cells.;
hormonal stimulation, or nervous stimulation) Phys: Barrett Esophagus- normal squamous cells
change to columnar epithelial cells in response to
reflux, aka intestinal metaplasia
Hyperplasia - -E: cells increase in number,
mitosis (cell division) must occur, size of cell
does not change Hypoxia injury - -E. inadequate
Phys: increased rate of division, increase in oxygenation of tissues
tissue mass after damage or partial resection; P. decrease in mitochondrial function, decreased
may be compensatory, hormonal, or pathologic production of ATP increases anaerobic
Patho: abnormal proliferation of normal cells metabolism. eventual cell death.
usually caused by increased hormonal C.M. hypoxia, cyanosis, cognitive impairment,
stimulation (endometrial). increase of production lethargy
of local growth factors
Ex: removal of part of the liver lead to
hyperplasia of hepatocytes. uterine or mammary Free radical and ROS - -E. normal
gland enlargement during pregnancy byproduct of ATP production, will overwhelm the
mitochondria- exhaust intracellular antioxidants
P. lipid peroxidation, damage proteins, fragment
Dysplasia - -E. Not true adaptation; Cells DNA
abnormal change in size, shape, organization C.M. development in Alzheimer's, heart disease,
(classified as mild, moderate, severe) Parkinson's disease, Amyotrophic Lateral
P. caused by cell injury/irritation, characterized Sclerosis
by disordered cell growth. aka atypical
hyperplasia or pre-cancer, a disorderly
proliferation Ethanol - -E. mood altering drug, long term
Physiologic: N/A effects on liver and nutritional status
Pathologic: squamous dysplasia of cervix from P. metabolized by liver, generates free radicals
HPV shows up on pap smear, breast cancer C.M. CNS depression, nutrient deficiencies-Mag,
development; pap smears often show dysplastic Vit B6, thiamine, PO4, inflammation and fatty
cells of the cervix that must undergo infiltration of liver, hepatomegaly, leads to liver
laser/surgical tx failure irreversible


Metaplasia - -E: reversible change, one Oncosis - -Na and H2O enter cell and
type of cell changes to another type for survival cause swelling. Organ increases in weight,


,Nurs 5315: Adv Patho Exam 1 Questions and Answers
Graded A+
becomes distended and pale. Associated with Fat Necrosis - -breast, pancreas,
high fever, hypocalcemia, certain infections abdominal structures- creates soaps


Fatty Infiltration - -intracellular Gangrenous Necrosis - -Dry- dark
accumulation of lipids in the liver shriveled skin
liver fails to metabolize lipids. usually from ETOH Wet- internal organs- can lead to death
or high fat diet. can lead to cirrhosis Gas- from clostridium- antitoxins and hyperbaric
therapy

dystrophic calcification - -accumulation of
Ca in dead or dying tissues Gout - -E. disturbances in serum urate
calcium salt clump and harden- interfere with levels. uncommon for < 30 years old.
cellular structure and function P. uric acid is deposited in the tissues of kidney,
r/t pulmonary TB, atherosclerosis, injured heart heart, earlobes, and joints.
valves, chronic pancreatitis C.M. inflammation, painful joints. result of diuretic
use or diet high in cream sauces, red wine, or red
meat
metastatic calcification - -accumulation of
Ca in normal tissue
result of hypercalcemia r/t hyperparathyroidism, Rhabdomyolysis - -E. cell hypoxia caused
hyperthyroidism, toxic levels of Vit D. Can also r/t by severe muscle trauma, hyperthermia, crush
hyperphosphatemia in renal failure injuries, or severe dehydration
P. hypoxia to cell causes failure of the Na-K
pump, causing accumulation of intracellular
urate accumulation - -sodium urate sodium, oncosis, and eventual cell death. Cell
crystals are deposited in tissues- group of death releases enzymes such as CK, uric acid,
disorders collectively called gout- acute arthritis, LDH, AST, etc.
chronic gouty arthritis, tophus, nephritis C.M. Causes: trauma, hyperthermia, crush
injuries, severe dehydration; s/s: CK is 5x upper
normal limit, muscle pain, weakness, dark,
Coagulative Necrosis - -kidneys, heart, reddish-brown urine, hypercalcemia, renal failure
adrenals- secondary to hypoxia

Alpha Fetoprotein Origin - -Liver and germ
Liquefactive Necrosis - -nerve cells- brain- cell tumors
accumulation of pus

Carcinoembryonic Antigen - -GI, pancreas,
Caseous Necrosis - -lung disease- usually lung, breast tumors
TB- tissue looks like clumped cheese

Prostate Specific Antigen - -prostate


,Nurs 5315: Adv Patho Exam 1 Questions and Answers
Graded A+
tumors lymphatics, lung, liver, brain, GI tract


Carcino- - -from epithelial tissue- renal cell Mechanisms of ca metastasis - -Local
carcinoma invasion, followed by invasion of surrounding
tissues. Cells then may invade blood and
lymphatic vessels. They must survive in
Sarco- - -from connective tissue- circulation, then enter and survive in a new
chondrosarcoma location. Then the cells can multiply and form a
new tumor.

Carcinoma in situ - -preinvasive epithelial
malignant tumors of glandular or squamous cells- TNM staging system - -T= tumor size >/=
cervix correlates with metastatic ability
N= whether lymph nodes are involved
M= extra nodal involvement (liver, lungs)
Lung ca metastasis - -Multiple organs
including brain
Intravascular fluid compartment - -In
venous system- 20%
Colorectal ca metastasis - -Liver, lungs

Osmolality - -The measure of solute
Testicular ca metastasis - -Liver, lungs, concentration in a fluid.
brain 280-295 mOsm


Prostate ca metastasis - -Bones Interstitial fluid compartment - -Surrounds
(especially lumbar spine), liver the cells and bathes them in nutrients- 20%


Head and neck ca metastasis - -Liver, Intracellular fluid compartment - -Within the
bones, lymphatics cells- 40% uk


Ovarian ca metastasis - -Peritoneal Osmosis - -Passive- the movement of
surfaces, diaphragm, omentum, liver water from an area of low concentration of solute
to one of higher concentration

Sarcoma metastasis - -Lungs
Osmotic pressure - -Pulling- the amount of
pressure or force that is exerted by solute
molecules of a given compartment
Melanoma metastasis - -In transit


, Nurs 5315: Adv Patho Exam 1 Questions and Answers
Graded A+
Fluid volume excess - -Fluid intake
exceeds body's needs
Hydrostatic pressure - -Blood pressure- C.M. Edema, rales, HTN, weight gain, bounding
pushes fluid outside of the vessels, the force of pulses, intake> output, JVD, restlessness or
fluid against the walls of a compartment- venous anxiety
obstruction, Na and water retention

Edema - -Accumulation of fluid within the
Oncotic pressure - -Colloid pressure keeps interstitial space- venous obstruction, Na and
water inside the compartment, attracts water water retention
from interstitial space back into the capillary- C.M. can be localized or dependent, tightness of
losses or diminished albumin skin, facial swelling, rales, decreased wound
healing, increased risk of pressure sores, weight
gain
Effective arterial blood volume - -The
amount of blood within the arterial space- ECF
changes will cause changes in the EABV in the Euvolemic Hypernatremia - -total body
same direction water loss, usually from DI
C.M. severe polyuria and mild hypernatremia,
weight loss, weak pulses, tachycardia, postural
Renin Angiotensin Aldosterone System - - hypotension, fever, restless
Activated by low blood volume, triggers release
of renin which converts angiotensinogen to
angiotensin 1. ACE converts angiotensin 1 to hypovolemic hypernatremia - -from GI
angiotensin which causes arterial losses or diuretics
vasoconstriction and stimulates release of C.M. Volume depletion, orthostatic hypotension,
aldosterone. Aldosterone stimulates renal Na tachycardia, lack of organ perfusion
reabsorption and K+ excretion. Water is retained,
less urine is produced, blood volume increases.
hypervolemic hypernatremia - -
administration of hypertonic saline
Natriuretic hormones - -ANP and BNP- C.M. volume overload, edema, chf, htn,
released by heart- works opposite RAAS to pulmonary edema
decrease blood volume, promotes urinary
excretion of Na and water
mild hyponatremia - -Na 125-135
C.M. anorexia, apathy, restless, nausea,
Fluid volume deficit - -Dehydration- intake lethargy, muscle cramps
is not enough for body's needs
C.M. Poor skin turgor, dry mucous membranes,
sunken eyes, sunken fontanelles, decreased moderate hyponatremia - -Na 120-125
urine output, fatigue C.M. agitation, disorientation, headache

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