NSG530 / NSG 530 Exam 4 Study guide | Latest 2026/2027 Update | Advanced Pathophysiology | Wilkes | Practice Questions & Accurate Solutions

GRADED A++ NSG530 / NSG 530 Exam 4 Study guide | Latest 2026/2027 Update | Advanced Pathophysiology | Wilkes | Practice Questions & Accurate Solutions Q: Pyelonephritis Answer inflammation of the renal pelvis and the kidney Q: Chronic Pyelonephritis Answer Interstitial fibrosis and atrophy of tubules due to multiple bouts of acute pyelonephritis Can be associated with chronic UTI's, vesicoureteral reflux, or kidney stones Q: Cystitis Answer Inflammation of the bladder Common pathogens are E. Coli and staphylococcus saphrophyticus GRADED A++ Q: Symptoms of cystitis Answer Frequency, urgency, dysuria, lower back pain Q: Renal cell carcinoma Answer cancerous tumor that arises from kidney tubule cells Q: Renal adenoma Answer small, slow-growing glandular noncancerous tumor of the kidney Q: Renal transitional cell carcinoma Answer rare and primarily arises in the renal parenchyma and renal pelvis. GRADED A++ Q: Transitional cell carcinoma Answer a malignant tumor of the urinary tract that is often found within the urinary bladder or within the renal pelvis. Generally occurs in older men. Gross painless hematuria Q: Gomerulonephritis Answer inflammation of the glomeruli within the kidney Q: Primary glomerulonephritis Answer inflammation of the glomeruli of the kidneys that occurs independently of other chronic conditions; usually the result of an acute infectious process Q: secondary glomerulonephritis Answer inflammation of the glomeruli of the kidneys that results from other chronic conditions, such as lupus erythematosus or diabetes. GRADED A++ Q: Symptoms of glomerulonephritis Answer Hematuria with red blood cell casts, proteinuria with albumin, oliguria, HTN, edema, nephrotic sediment Q: Types of glomerulonephritis Answer - membranous nephropathy/ glomerulonephritis - rapidly progressing glomerulonephritis -Anti-glomerular basement membrane disease (goodpasture syndrome) - chronic glomerulonephritis -diabetic neuropathy Q: Nephrotic syndrome Answer loss of large amounts of plasma protein, usually albumin, through urine due to an increased permeability of the glomerular membrane GRADED A++ Q: Causes of nephrotic syndrome Answer Membranous glomerulonephritis Minimal change nephropathy Focal segmental glomerulosclerosis -systemic disease such as diabetes or lupus Q: Hypospadias Answer congenital abnormality in which the male urethral opening is on the undersurface of the penis, instead of at its tip Q: Epispadias Answer Opening of the urethra on the superior surface of the penis GRADED A++ Q: Chordee Answer a downward curvature of the penis, often associated with hypospadias Q: Nephroblastoma (Wilms tumor) Answer A rapidly developing malignancy of the kidneys, usually affecting children before age 5. Normally found by parents due to swelling. Q: PCOS diagnosis Have to have two of the following: Answer -Irregular ovulation -Elevated levels of androgen -Polycystic ovaries on ultrasound Q: PCOS (polycystic ovarian syndrome) Answer GRADED A++ An endocrine disorder associated with chronic anovulation, most common in young women (teens to twenties). High LH/FSH ratio in blood; A hormonal disorder causing enlarged ovaries with small cysts on the outer edges. Q: Chlamydia Answer A bacterial infection that affects the reproductive organs of both males and females. Can cause permanent damage to a woman's reproductive system. Can also cause ectopic pregnancy. Q: Symptoms of Chlamydia Answer urethritis; penile and vaginal discharges; abdominal, rectal, or testicular pain; painful intercourse; irregular menses Q: Syphilis Answer an STD that attacks many parts of the body and is caused by a small bacterium called a spirochete. 3 phases GRADED A++ Q: Primary stage of syphilis Answer the first few weeks of a syphilis infection during which the chancre is present and can be present on the mouth, penis, vagina, anus Q: secondary stage of syphilis Answer Skin rashes and/or sores in the mouth, vagina, or anus. A rash that appears on the soles of the feet or palms. Fever, swollen lymph nodes, sore throat, patchy hair loss, headaches, weight loss, muscle aches, fatigue Latent syphilis the third stage of syphilis, which may last for years, during which symptoms disappear although the person is still infected Tertiary syphilis Damages internal organs and can result in death if not treated Ghonnorea Infects the mucus membrane of the reproductive tract including the cervix, uterus, and fallopian tubes in women. The urethra can be affected in women and men GRADED A++ Ghonnorea symptoms Discharge, dysuria, unusual sores, or rash Trichomoniasis an STD caused by a microscopic protozoan that results in infections of the vagina, urethra, and bladder Trichomoniasis symptoms Itching, burning, redness, sores, dysuria, clear, white yellow, or green vaginal discharge with a fishy smell Vaginal candidiasis a vaginal infection caused by the yeast-like fungus Candida albicans; also known as a yeast infection. Vaginal Candidiasis symptoms Itching, soreness, dyspareunia, dysuria, abnormal vaginal discharge (thick, white) GRADED A++ Bacterial vaginosis An overgrowth of bacteria in the vagina; characterized by itching, burning, or pain, and possibly a "fishy" smelling discharge. Ovarian cysts collections of fluid within a sac (cyst) in the ovary Follicular cysts transient condition in which the dominant follicle fails to rupture corpus leutum cyst Highly vascularized cysts formed by the granulosa cells left behind after ovulation Can rupture and cause hemorrhage Dermoid cyst ovarian teratomas that contain elements of all three germ layers. Have malignant potential Cervical cancer Malignant cell growth in the cervix; can be caused by HPV virus. Normal cervical cells change to dysplasia to carcinoma in situ and eventually invasive cancer. Predominantly asymptomatic GRADED A++ Vulvar cancer -Usually squamous cell carcinoma -Associated with HPV, increasing age, previous cancer, autoimmune conditions, and immunosuppression Endometrial cancer malignant tumor of the endometrium (also called uterine cancer). Primary risk factor is unopposed estrogen exposure (without progesterone). Manifested by abnormal vaginal bleeding. Ovarian cancer malignant tumor of the ovary. Usually no early symptoms Paraphimosis condition in which a retracted foreskin cannot be pulled forward to cover the glans Phimosis Inability to retract foreskin. Frequently caused by poor hygiene GRADED A++ Peyronie's disease "Bent nail syndrome". Slow development of fibrous plaques in the erectile tissue of the corpus cavernosa, causing lateral curvature of the penis during erection Priapism Prolonged erection. Urologic emergency. Have to drain blood from the penis. Balantitis Inflammation of the glans penis. Accumulation under the foreskin can irritate the glans and lead to infection. Category 1 prostatitis -acute bacterial prostatitis -Ascending infection of the urinary tract -infection stimulates an inflammatory response in which the prostate becomes enlarged, tender, firm, or boggy Category 2 prostatitis chronic bacterial prostatitis. Recurrent urinary tract symptoms and persistence of pathogenic bacteria in urine or prostatic fluid. Prostate may be fibrotic from frequent infection. GRADED A++ Category 3 prostatitis chronic prostatitis/chronic pelvic pain. No pathogenic bacteria can be localized to the prostate. -category 3a- chronic pelvic pain syndrome with WBC count elevated and localized to prostate -category 3b- noninflammatory Category 4 prostatitis Asymptomatic inflammatory prostatitis. There is an increase in bacteria and WBC localized to the prostate. GERD Reflux of gastric contents into the esophagus GERD symptoms -Heartburn 30-60 minutes after meals with reclining -Relief with antacids -Regurgitation/reflux -Dysphagia -Asthma -Cough -Laryngitis GRADED A++ -Sore throat -Chest pain Hiatal hernia A condition in which a portion of the stomach protrudes upward into the chest, through an opening in the diaphragm. Peptic Ulcer Disease A break or ulceration in the protective mucosal lining of the lower esophagus, stomach, or duodenum. -superficial: Erosions Duodenal ulcers Ulcers of the small intestine caused by NSAIDs and Helicobacter pylori infection. Characterized by intermittent pain in the epigastric area -relieved rapidly by ingestion of foods or antacids Ulcerative colitis a chronic condition of unknown cause in which repeated episodes of inflammation in the rectum and large intestine cause ulcers and irritation. GRADED A++ Symptoms of ulcerative colitis hematochezia, diarrhea with mucus/pus, tenesmus, rectal urgency Chron's disease A chronic inflammatory bowel disease that affects the lining of the digestive tract. Skip lesions. Ulcerations that can cause fissures that extend into the lymphatics. Anemia may result from the malabsorption of B vitamins and folic acid. Celiac disease Gluten causes inflammation in the small intestine which leads to malabsorption and decreased functionality. Bloating, chronic diarrhea, constipation, gas, loose stools, nausea, vomiting, abdominal pain Pancreatitis Inflammation of the pancreas. Develops due to an obstruction of the outflow of pancreatic enzymes caused by bile and pancreatic duct obstruction Acute pancreatitis May result from drugs, cellular injury from alcohol, or viral infection -epigastric or midabdominal constant pain GRADED A++ Chronic pancreatitis Process of progressive fibrotic destruction of the pancreas Related to chronic alcohol abuse Continuous or intermittent abdominal pain and weight loss are common Risk factor for pancreatic cancer Cirrhosis irreversible, chronic, progressive degeneration of liver w/fibrosis. s/s: fatigue, hepatomegaly, RUQ pain, jaundice, steatorrhea, clay-colored stools, ascities, hepatic encephalopathy. Rx: steroids, vit B. Alcoholic liver disease A degenerative liver condition that occurs in three stages: (1) fatty liver, (2) alcoholic hepatitis, and (3) cirrhosis. Portal hypertension Elevation of blood pressure within the portal venous system. Esophageal varices GRADED A++ Enlarged and swollen veins at the lower end of the esophagus caused by portal hypertension. Rupture leads to hemorrhage. Vomiting leads to large amounts of blood, black or tarry stools, lightheadedness, loss of consciousness Hepatic encephalopathy Cells in the nervous system are vulnerable to neurotoxins absorbed by the GI tract that, because of liver dysfunction, circulate to the brain. s/s: change in LOC, memory loss, asterixis (flapping tremor) impaired handwriting, hyperventilation w/ resp alkalosis. Rx: lactulose, low protein, safety, rest Biliary atresia Congenital absence of the opening from the common bile duct into small intestine (duodenum). Plugging, inflammation, and fibrosis of the bile ducts and cholestasis. Jaundice is the primary symptom. Liver-transplant for long-term therapy. Pyloric stenosis Narrowing of the opening of the stomach to the duodenum. Forceful and nonbilious vomiting immediately after feeding. Vomiting causes weight loss, electrolyte imbalance, and dehydration. Hypertonic pylorus is palpable in RUQ. Intussusception Telescoping of a segment of the intestine into a distal segment, causing an obstruction. Causes bleeding, necrosis, and bowel perforation, if not treated. Abdominal pain, irritability, vomiting, and "current jelly-like stools". Reduction with enema and possible correction with surgery. GRADED A++ Diverticula A sac-like outpouching of the wall of the small intestine that is present in some children at birth. Painless rectal bleeding or the diverticulum becomes infected. Interphase cell feeds, metabolizes and grows while replicating DNA in preparation for mitosis Prophase first appearance of chromosomes (will be 92) Metaphase Centrioles pull chromosomes to opposite sides of cell (chromatid) - 46 each side Anaphase Centromeres split and sister chromatids are pulled apart Telophase GRADED A++ New nuclear membrane formed around each group of 46 chromosomes When it goes right, euploid cells are produced Nondisjunction Error in meiosis in which homologous chromosomes fail to separate. Polyploidy condition in which an organism has extra sets of chromosomes Triploidy when an organism has three copies of every chromsome instead of two Tetrapoloidy euploid has 92 chromosomes and fetus usually does not survive Huntington's disease Single gene disorder (trinucleotide repeat mutation) Autosomal dominant (50% chance of passing it on) Progressive neurologic disease with late onset (40s) Prevention- genetic testing for pregnancy planning GRADED A++ Cystic fibrosis Single gene disorder (CFTR gene mutation) Autosomal recessive Most common in white children Defective transport of chloride ions cause salt imbalance- thickened secretions, digestive issues, malnutrition. Males and females Must inherit two copies of gene (1 from each parent) Turner syndrome XO chromosomal disorder, monosomy of X-affects females Short stature, webbed neck, undeveloped breasts but female genitalia, usually sterile Down syndrome Chromosomal disorder, trisomy 21 Affects both sexes Intellectual disability, poor muscle tone, low nasal bridge, low set ears, protruding tongue, epicanthal fold Fragile X syndrome Chromosomal disorder (break in long arm of X) GRADED A++ Higher prevalence in males Intellectual disability Klinefelter syndrome (XXY) chromosomal disorder 1:1000 male births Male appearance, sparse body hair, mild intellectual disability Atrophy Decrease in cell size "When cast is removed from left calf, it is smaller than the right calf" Hypertrophy Increase in cell size "Captain of roller derby team has greater thigh diameter at the end of the season than at the beginning of the season" Hyperplasia Increase in cell number "Lining of uterus thickens after ovulation because of increased amounts of estrogen" "Liver regenerates after surgical removal of damaged portion" GRADED A++ Metaplasia Reversible replacement of one mature cell type by another, less mature cell type or change in cell phenotype "Columnar epithelium in bronchi of cigarette smoker is replaced by stratified squamous epithelium after smoking cessation" Dysplasia Deranged cellular growth, is not considered a true cellular adaption but rather atypical hyperplasia "Cells of the cervix can be classified on PAP as high grade or low grade depending on how abnormal the cells have become in size and shape" What is the difference between hypertrophy and hyperplasia? Hypertrophy (a form of anabolism) increases tissue mass by keeping the same number of cells and making each individual cell larger, but hyperplasia increases tissue mass by increasing the number of cells What is suffocation? Occurs when oxygen fails to reach the blood. It can be caused by lack of O2 in environment (such as with carbon monoxide poisoning) or a blockage of the airway (choking). GRADED A++ CO Poisoning CO has easier time binding to Hgb thus decreasing O2 binding causing sleepiness, headache, nausea, vomiting, weakness Dehydration Reduction in bodily fluids Symptoms- headache, thirst, fatigue, dry mucous membranes, lightheadedness Elderly and infants more susceptible to low total body water Why are geriatric patients susceptible to dehydration? Lower total body muscle and fat mass Why are infants susceptible to dehydration? Higher metabolic rate and greater body surface area Edema Contributes to intracellular dehydration as fluid collects in extracellular areas due to osmosis Osmosis GRADED A++ Where water moves from an area of higher concentration to an area of lower concentration due to a cell membrane becoming more permeable to water Strangulation Occurs when neck pressure collapses blood vessels, stopping blood flow to the brain Innate immunity First line of defense Skin, mucous membranes, gastric acid, microbiome Inflammatory response of innate immunity Second line of defense Neutrophils, macrophages, some nonphagocytic immune cells Adaptive immunity Third line of defense T and B lymphocytes, antibodies Natural killer cells Eliminate virus-infected cells GRADED A++ Macrophage Phagocytize microorganisms and cellular debris Secrete chemicals that promote tissue healing Activate adaptive immunity Eosinophil WBC Defend against parasites Degrade vasoactive substances released by mast cells Neutrophil Phagocytize microorganisms and cellular debris soon after injury Secrete chemicals that call in longer-acting phagocytes Mast cell Releases chemicals that initiate the inflammatory response Monocyte GRADED A++ Helps break down bacteria/virus/fungus/parasite Lymphocyte Create antibodies to fight against bacteria or virus Basophil Secrete chemicals (histamine) when infectious agents are noted to aid immune response` Acute inflammation Neutralizes and destroys microorganisms What type of immunity prevents a neonate from developing an infection because he has maternal antibodies that he received in breast milk? Passive What type of immunity prevents a child from developing an infection because they have been vaccinated for it? Active GRADED A++ What immunity prevents a man from developing an infection because he was infection with the same microorganism previously and recovered? Active What prevents a woman from developing an infection because she was given gamma globulin after being exposed to an infection person? Passive B Cells Attack invaders outside of the cell T Cells Attack invaders inside the cell IgG Most abundant immunoglobulin Transports across placenta IgD Low concentration in blood GRADED A++ Surface receptors on developing B lymphocytes IgE Active against parasites Important mediators of allergic response IgM Produced during primary response to antigen Largest immunoglobulins IgA Most abundant in body secretions CF Likelihood Both Parents Must Carry Gene 25 percent (1 in 4) the child will have CF 50 percent (1 in 2) the child will be a carrier but will not have CF 25 percent (1 in 4) the child will not be a carrier of the gene and will not have CF GRADED A++ Nucleus Contains all of our DNA!!!!; Controls cell activity; What does DNA contain? contains the codes for all of the structural proteins of the body Cytoplasm Site of metabolic activity; supports organelles What does cytoplasm contain? Cytoplasm contains water, electrolytes, suspended protein, neutral fats, and glycogen (the stored form of glucose) Mitochondria - The power plant! -Generates ATP through aerobic respiration - This is where glucose and oxygen combine to form ATP! Ribosomes Synthesize proteins GRADED A++ Rough Endoplasmic Reticulum Protein Production Smooth Endoplasmic reticulum - Synthesize lipids - participates in drug detoxification Golgi Apparatus Processes and Packages Proteins/Lipids. The UPS of the cell! Packages and sends stuff out! Lysosomes Break down cell products and foreign bodies to be used AGAIN Peroxisomes Break down toxins in the cells to protect the cells Cell Membrane GRADED A++ Semipermeable barrier; controls transport *has a phospholipid bilayer and protein receptors, so only fats or small things like oxygen can pass through the cell membrane! Cilia Helps move substances along, but also acts as a filter! ex: cilia in our respiratory tract! Flagellum Only found in sperm. Helps the sperm move forward Passive Transport Examples - Diffusion -Osmosis -Facilitated diffusion Diffusion the movement of solutes (particles dissolved in a solvent) from an area of HIGHER concentration to lower concentration Osmosis GRADED A++ The movement of water or another solvent across the cellular membrane from an area of low solute concentration to an area of high solute concentration Facilitated Diffusion The movement of substances from an area of LOWER concentration to an area of HIGHER concentration WITH the assistance of a carrier molecule What does active transport use? ATP!!! What are examples of active transport? - Sodium Potassium Pump -Endocytosis (ex: phagocytosis) -Exocytosis Sodium-Potassium pump -helps to re-establish the proper concentration of Na and K inside of and outside of the cell GRADED A++ What is endocytosis and what is an example? Endocytosis- The act of bringing a substance into a cell example: phagocytosis- Involves solid particles (cell eating) Exocytosis The release of materials from a cell, usually with the assistance of a vesicle. What two molecules have to combine to form ATP? Oxygen and Glucose! Where is ATP created? In the mitochondria! Explain how ATP is made When we ingest food (glucose) and breathe in oxygen, the mitochondria then creates tons of packets to make ATP! which helps give our cells energy that they need to function on a normal basis Anaerobic Respiration GRADED A++ the 1st step is glycolysis, in which a glucose molecule is broken down into two pyruvate molecules, releasing electrons in the process and producing two ATP molecules. Why is Anaerobic not as good as aerobic? The byproducts of Anaerobic respiration (ex: working out) is lactic acid build up, and it also does not make anywhere near as much ATP as Aerobic respirations do What can be caused by lactic acid build up? - Muscle pain -fatigue -Metabolic Acidosis -Kidney Failure -Respiratory Failure -Death What is needed for aerobic respiration? oxygen!!! Pathophysiology The study of changes to normal bodily function due to disease, illness, or injury GRADED A++ When does disease occur? When there is disruption in homeostasis or deviation from the normal Negative feedback Example: glucose regulation *Negative feedback will have an opposite response that will balance it Positive feedback Ex: Labor contraction! you perpetuate contractions during labor, making it positive feedback! What are factors that determine baseline normal for patients? * Age *Gender *Genetic & Ethnic background *Geographic area *Time of day *Environment: Altitude, temp *Remember, findings are only relevant to the individuals "normal" GRADED A++ Etiology Cause or reason for the event *May include agents, age, gender, health, nutritional status, genetics Ex: a vegetarian has low B12 and they aren't using B12 supplements Pathogenesis Development and evolution of a disease *genesis always means "the creation of"! Epidemiology Patterns of diseases in a group of people Ex: malaria found in a certain group because the area they live has lots of mosquitos In order to understand pathophysiology, we need a solid working knowledge of which of the following? A. The patients history B. Where the patient lives C. Epidemiology of the patients region D. Normal and diseased states E. All of the above E. All of the above! GRADED A++ True OR False? The cells semipermeable membrane allows it to maintain a proper shape TRUE! Where is there more Na & K in a resting cell? Sodium- more on the OUTSIDE Potassium-more on the INSIDE Active Transport includes which of the following? A. Diffusion B. Osmosis C. Sodium Potassium Pump D. Endocytosis E. Two of the above E. Two of the above! Atrophy state that occurs because of decreased work demands on a cell. When cellular work demands decrease, the cells decrease in size and number. GRADED A++ Atrophy example Someone who has had a cast on their limb. and they take it off weeks later, the limb is much smaller. It is because there has been a decreased work load on that extremity, which decreased the size of the organelles, they decreased energy usage, they shrink, and they get it back to normal Hypertrophy Condition in which cells increase in size in an attempt to meet the bodies increased work demand. This change may be a result of normal or abnormal changes. *Increase size of the CELL itself Normal and abnormal example of hypertrophy Normal: Increase in muscle size if we workout! Abnormal: The heart! when the heart undergoes abnormalities like atherosclerosis (hardening of the aorta), the heart has to work harder to push blood out. It will hypertrophy which makes it flabbier because it stretches out the cardiac cells and they cant contract as well as they would if they were a normal size Hyperplasia An increase in the number of cells in an organ or tissue. The increase occurs only in cells that can perform mitotic division, such as epithelial cells. GRADED A++ **Increase in the NUMBER of CELLS Example of hyperplasia Normal- liver regeneration and wound healing Abnormal- endometrial hyperplasia, which can result from an over secretion of estrogen and a subsequent progesterone imbalance **Pathologic hyperplasia is not necessarily cancerous, but it can create a supportive environment for cancerous proliferation Metaplasia - The process of one adult cell being replaced by another cell type. - NORMAL CELLS ARE REPLACED BY THE ABNORMAL CELLS! -This change is usually initiated by chronic irritation and inflammation, such that a more virulent cell line emerges Metaplasia example GRADED A++ - Barrett's esophagus (people with reflux, the acidity moves into the esophagus and you change the cells in the bottom of the esophagus to more of that columnar shape like it is in the stomach.) -Cig smoking can change cells that line the trachea and bronchi. the problem is that cilia then cant clean junk out of our lungs as well. Dysplasia The final cellular adaptation, in which cells mutate into cells of a different size, shape, and appearance **Dysplastic changes are often implicated as precancerous cells Examples of Dysplasia - Most common is precancerous changes in the cervix. Mutation of the cells to an abnormal shape and size. - The reproductive and respiratory tracts are common sites for this type of adaptation because of their increased exposure to carcinogens (Ex: human papillomavirus and cig smoke) Cell proliferation the regulated process by which cells divide and reproduce GRADED A++ How do cells replicate? Cells replicate through Mitosis! Meiosis sperm or oocytes (eggs in the female ovary) undergo Meiosis! this creates half the number of chromosomes! we do that so that way when they get together, they form 46 (23 pairs), to create a normal number! *** meiosis goes through several steps to create a haploid cell! sounds like HALF! this only has 23 chromosomes. So when the egg and sperm meet it will create a full compliment of 46 chromosomes - if we dont have a normal number of chromosomes we will have some sort of congenital issue or abnormality or it doesnt create a viable baby. Proper number of chromosomes is very important! Mitosis -Mitosis will create two daughter cells containing the 46 chromosomes *cells that have a full compliment of 46 chromosomes are known as DIPLOID cells. Differentiation - A process by which cells become specialized in terms of cell type, function, structure, and cell cycle. GRADED A++ -Fertilized cells become more specialized as they mature to organs -This process does not begin until approximately 15-60 days after the sperm and ova unite Cell injury - Most diseases start with cell injury. -Can be reversible to a point -In normal states it is balanced with cell renewal Why does cell injury occur? Cell injury can occur because of: 1. Physical Agents (mechanical forces and extreme temperature) 2. Chemical injury (pollution, lead, and drugs) 3. Radiation (Ionizing, ultraviolet, non-ionizing) 4. Biological agents (viruses, bacteria, and parasites) 5.Low oxygen levels (hypoxia or ischemia) GRADED A++ 6. Nutritional imbalances Physiological cell death this is the normal breakdown of cells when we're trying to replace them or if our body flags them as "abnormal". we want to get rid of them so they undergo apoptosis Apoptosis Mechanism of programmed cell death that occurs because of morphologic changes in cells - apoptosis is like a programmed suicide where we break those cells down. Ischemia the loss of blood supply to an area - if you undergo a stroke or throw a blood clot, any area beyond that would have a decrease in blood supply (ischemia). Which leads to a decrease in nutrients and oxygen supple and the tissue beyond it would die. Free radicals Injurious, unstable agents that can cause cell death. GRADED A++ How do we fight off free radicals? - we have free radicals in our body all the time that we are usually able to fight off with antioxidants. Good healthy foods provide nutrients and antioxidants that we need to fight off free radicals. What happens when free radicals become too much for our body? We cant fight them off and could cause cell damage Difference between apoptosis and cell death? Apoptosis- the body decides that for some reason the cell is damaged or not working properly, it dies off and all the components are engulfed by macrophages (large immune cells that bring in either dead cell components or viruses and bacteria's to clean up the body) Cell death (necrosis)- cells that have become damaged, keep getting damaged- the cell then swells, bursts, and it releases all its components into the body which causes an inflammatory response in that area which can lead to certain disease states (Necrosis) Differences between apoptosis and necrosis (pt 2) Apoptosis- *Programmed *No inflammation *requires ATP! GRADED A++ *key role- cell turnover and immune sculpting Necrosis- *Pathologic *Inflammation! *Passive process *key role- cell death due to injury Types of necrosis (cell death) - Coagulative -Liquefactive -Caseous -Fat -Gangrene Coagulative necrosis type of necrosis that usually results from an interruption in blood flow -pH drops (acidosis), denaturing the cells enzymes - most often occurs in the kidneys, heart, and adrenal glands GRADED A++ Liquefactive Necrosis Type of necrosis that occurs when caustic enzymes dissolve and liquefy necrotic cells -Walled off, liquid goo - most common site of this necrosis is the BRAIN! which contains a plentiful supply of these enzymes Caseous Necrosis occurs when the necrotic cells disintegrate, but the cellular debris remains in the area for months or years - Granulomatous Inflammation - cottage cheese like appearance - most commonly noted with pulmonary tuberculosis! Fat necrosis - Occurs when lipase enzymes breakdown intracellular triglycerides into free fatty acids, which then combine with magnesium, sodium, and calcium to form soaps. GRADED A++ -These soaps give fat necrosis an opaque, chalky appearance -Commonly associated with breast injury (surgery, radiation, or trauma). OR acute pancreatitis Gangrene necrosis -A form of coagulative necrosis that represents a combination of impaired blood flow and a bacterial invasion -Tissue death with infection - usually occurs in the legs because of arteriosclerosis (hardening of the arteries), OR in the gastrointestinal tract. -It most commonly takes one of three forms: Dry, Wet, pr gas. Dry gangrene - occurs when bacterial presence is minimal. - the skin has a dry, dark brown, or black appearance. Wet gangrene -Occurs with liquefaction necrosis GRADED A++ - In this condition, extensive damage from bacteria and white blood cells produce a liquid wound -can occur in the extremities, as well as internal organs. Gas Gangrene -Develops because of the presence of CLostridium! An anaerobic bacterium. -This type of Gangrene is the most serious, and has the greatest potential to be fatal -The bacterium releases toxins that destroy surrounding cells, so the infection spreads rapidly -the gas released from this process bubbles from the tissue, often underneath the skin When does gangrene occur? When necrosis progresses with bacterial invasion Neoplasm New, uncontrolled growth (benign or malignant) -lacks normal controls and regulation -Can originate in one organ or spread to another site. Carcinogenesis GRADED A++ The different stages in cancer Oncogenes -Oncogenes are genes that get turned on in cancer cells, they begin as protooncogenes which direct NORMAL cell growth and differentiation. Cancer causing agents cause them to convert to oncogenes which cause abnormal cell growth and cell differentiation Steps in carcinogenesis 1. Initiation 2. Promotion 3. Progression Initiation in carcinogenesis Introduction of the agent (could be genetic as well) Promotion (step 2 of carcinogenesis) - this is where it starts to grow into the surrounding tissue and/or lymphatics and blood stream. In cancer these cells lack contact inhibition (knowing when to stop growing), so they have uncontrolled growth GRADED A++ Progression (3rd step in carcinogenesis) - Permanent malignant changes. They change the cells around them and they start to spread Carcinogens - Environmental changes that lead to cancerous cells -could also be what we get from our parents. Tumor suppressor gene Normally inhibits growth; mutation removes the breaks True or False: Malignant cells tend to look like the original tissue? FALSE When cilia are lost in the respiratory tract, this is an example of what type of cell change? A. Metaplasia B. Dysplasia C. Hyperplasia D. Hypertrophy A. Metaplasia GRADED A++ Benign -Slow, progressive, localized, well defined, resembles host (more differentiated), grows by expansion , does not usually cause death **undifferentiated means unlike the original tissue! Malignant cancer Rapid growing, spreads, fatal, highly undifferentiated Clinical manifestations of cancers (CAUTION) -Change in bowel or bladder habits -A sore that doesn't heal -Unusual bleeding or discharge -Thickening or lump in the breast or elsewhere -Indigestion or difficulty swallowing -Obvious change in a wart or mole -Nagging cough or hoarseness GRADED A++ Complications of cancer - anemia - cachexia (wasting) -fatigue -infection -leukopenia (low WBC) -thrombocytopenia (low platelets) -Pain Staging cancer - TNM (Tumor Node Metastasis); based on spread of the disease -When your cancer is described by the TNM system, there will be numbers after each letter that give more details about the cancer—for example, T1N0MX or T3N1M0. The following explains what the letters and numbers mean. Grading cancer -According to histology - I, II, III, & IV: as it increases, the tumor is more invasive and prone to spreading via blood vessels and/or lymph vessels GRADED A++ Primary Tumor (T) -TX: Main tumor cannot be measured. -T0: Main tumor cannot be found. -T1, T2, T3, T4: Refers to the size and/or extent of the main tumor. The higher the number after the T, the larger the tumor or the more it has grown into nearby tissues. T's may be further divided to provide more detail, such as T3a and T3b. Regional lymph nodes (N) -NX: Cancer in nearby lymph nodes cannot be measured. -N0: There is no cancer in nearby lymph nodes. -N1, N2, N3: Refers to the number and location of lymph nodes that contain cancer. The higher the number after the N, the more lymph nodes that contain cancer. Distant metastasis (M) -MX: Metastasis cannot be measured. -M0: Cancer has not spread to other parts of the body. -M1: Cancer has spread to other parts of the body. Treatment options for cancer - Surgery -radiation -chemotherapy GRADED A++ -hormone and antihormone therapy -immunotherapy three goals for cancer treatment 1. curative 2. palliative 3. prophylactic Stage IV cancer most likely: A. Is encapsulated B. Has no node involvement C. Has spread beyond the initial area of cancer D. To cause no symptoms in a patient C. Has spread beyond the initial area of cancer Karyotype Chromosome count Phenotype Observable characteristics from genes GRADED A++ Homozygous Identical pairs of genes Heterozygous Different pairs of genes where are chromosomes located? Chromosomes are the genetic information inside the nucleus Genetic and congenital disorders - caused by a mutation somewhere along that karyotype of those chromosomes -800 disorders - characterized by patterns of transmission -practiced in Punnett square. Will show if dominant is present, and recessive will show if homozygous Autosomal dominant disorders -Transmitted from an affected parent to offspring regardless of gender •Examples: Marfan syndrome and neurofibromatosis GRADED A++ Marfan syndrome -Disorder of connective tissue -Mutation of chromosome 15!! -Affects eyes, skeleton, and cardiovascular system *aortic defects *lens displacement *increased height with long spiderlike fingers *Funnel chest (pectus excavatum) *scoliosis *valve defects such as regurgitation *joint issues *tend to move very slowly Neurofibromatosis type one - neurogenic tumors *Type 1 -defect on chromosome 17 - subcutaneous lesions - café-au-lait spots (at least 6 at birth) - freckles - scoliosis GRADED A++ - erosive bone defects - nervous system tumors Neurofibromatosis Type 2 - defect on chromosome 22 -tumors of the acoustic nerve (can cause deafness), and may be on the cranial and spinal nerves as well Treatment: removal of the superficial tumors Autosomal Recessive Disorders -RARE -affects both genders -one out of four will be affected -two out of four will be carriers -early onset -usually presents as a deficient enzyme Examples: PKU & TAY-SACHS PKU -mutation of chromosome 12, leads to an error in converting pheylalanine to TYROSINE (both are amino acids that create proteins) -appears normal at birth, then fails to meet milestones GRADED A++ -progressive neurological decline -if untreated, can lead to severe intellectual disability -need early testing and a diet low in phenylalanine *phenylalanine is high in some gum packets, dairy products, and different nuts * treatment is a diet low in phenylalanine Tay-Sachs •Progressive disorder due to mutation (chromosome 15) of (hexosaminidase A) Necessary to break down certain lipids •Lipids accumulate, destroying and demyelinating nerve cells •Nerve cell destruction leads to a progressive mental and motor deterioration •Most are of Jewish decent •Three forms: infantile, juvenile, adult (rare) Hexosaminidase A- -Hexosaminidase A- an enzyme used to break down certain lipids, so we don't have an excess amount accumulate. On many nerves we have myelin and myelin is a fatty encasement around nerves that's an important structure that helps to increase the speed and transmission of nervous signal transmission. If you accumulate the wrong type of fat, even though myelin is a fat, if you accumulate the wrong type of fat and don't break it down it can actually destroy that myelin, overtake it, and those nerves cant function as efficiently as they use to. And this can lead to all sorts of nervous system side effects such as mental deterioration, motor function decreased and sensory decrease. GRADED A++ Tay-Sachs part 2 •Appears normal at birth, then the infant begins to miss milestones •Progresses to seizures, muscular rigidity, and blindness •Usually fatal by 5 years of age •Diagnosis: history, physical examination, and low serum and amniotic hexosaminidase A levels •No cure •Genetic counseling suggested X-linked disorders •Sex-linked disorders are almost always X linked. •Example: Fragile X syndrome Fragile X Syndrome •Associated with the X chromosome •Manifestations: long face with large mandible, large ears, large testicles, mental retardation, learning disabilities, speech delays, connective tissue disorders, behavioral issues, and autism spectrum disorder •Diagnosis: history, physical examination, genetic testing •Treatment: supportive -Most often seen in males! can be seen in females, but mostly in males Multifactorial Inheritance Disorders GRADED A++ •Result from an interaction between environmental and genetic factors •Less predictable •Extremely common •May be expressed at birth or later Examples of Multifactorial Inheritance Disorders cleft lip/palate - clubfoot - congenital dislocation of hips - congenital heart defects - pyloric stenosis - urinary tract malformations - diabetes mellitus - hypertension - cancer - psychiatric disorders Cleft lip and palate •Improper formation of soft tissues of mouth and lips •Unilateral or bilateral deformities lead to feeding and nutritional issues •Maternal smoking, diabetes, and seizure medication use (first trimester) are important risk factors •Diagnosis: prenatal ultrasound GRADED A++ •Treatment: surgery, speech therapy Chromosomal disorders •May be related to abnormality in chromosomal number and/or duplication that occurs in meiosis •More than 60 syndromes Down Syndrome -Trisomy 21 •Risk increases with maternal age •Manifestations: small square head, upward slant of eyes, small low-set ears, fat pad on back of the neck, open mouth with protruding tongue, simian crease, varying degrees of mental retardation, and behavioral issues •Also associated with congenital heart defects, ocular issues, leukemia, respiratory complications, gastrointestinal complications, hypothyroidism. •50% of patients with Down's syndrome develop Alzheimer's disease by age 50. •Diagnosis: parental screening including amniocentesis, hormone levels, 4D ultrasound. •Treatment: symptomatic and supportive. Monosomy X (Turner's Syndrome) •Deletion of all or part of an X—occurs spontaneously -only in females! GRADED A++ •Specific gene(s) associated: not known •No Y chromosome, so female •Manifestations: gonadal streaks instead of ovaries, (infertility) short stature, increased weight, neck webbing, small lower jaw, drooping eyelids, small fingernails, and widely spaced nipples, No mental retardation present Trisomy X (Klinefelter's Syndrome) - This is in males! -You can also have supermale which is XYY and they tend to be more aggressive and many of them are found in Jail! •One or more extra X chromosomes with the presence of the Y •Male appearance •Often undetected •Manifestations: gynecomastia, small testes and penis, tall stature, increased weight, and sparse body hair •Also associated with learning disabilities, behavioral problems, sexual dysfunction, pulmonary disease, varicose veins, osteoporosis, and breast cancer •Treatment: testosterone A patient was diagnosed as HIV positive several years ago. Which of the following blood tests is most clinically useful for determining the stage and severity of her disease? CD4+ cell counts GRADED A++ When the maternal immune system becomes sensitized against antigens expressed by the fetus, what type of immune reaction occurs? (transfusions, transplant tissues, pregnancy) Alloimmune A 10-year-old male is stung by a bee while playing in the yard. He begins itching and develops pains, swelling, redness and respiratory difficulties. He is suffering from: anaphylaxis When a patient presents at the ED for an allergic reaction, the nurse recognized the most severe consequences of a type I hypersensitivity reaction is: anaphylaxis A nurse recalls that an example of an immune-complex-mediated disease is: serum sickness When a nurse cares for a patient with systemic lupus erythematosus (SLE), the nurse remembers this disease is an example of: autoimmunity (disturbance in immunologic tolerance of self-antigens) GRADED A++ A 30-year-old female c/o fatigue, arthritis, rash and changes in urine color. Laboratory testing reveals anemia, lymphopenia and kidney inflammation. Assuming a diagnosis of SLE, which of the following is also likely to be present? Autoantibodies A 40-year-old is diagnosed with SLE. Which of the following findings would be considered a symptom of this disease? Photosensitivity + facial rash confined to cheeks (malar rash) A person is given an attenuated antigen as a vaccine. When the person asks what was given in the vaccine, how should the nurse respond? The antigen is: alive, but less infectious. An immunologist is discussing endotoxin production. Which information should the immunologist include? Endotoxins are produced by: gram-negative bacteria. A 50-year-old female experiences decreased blood pressure, decreased oxygen delivery, cardiovascular shock and subsequent death. A complication of endotoxic shock is suspected. Which of the following is the most likely cause? Gram-negative bacteria GRADED A++ Which information indicates a correct understanding of viral vaccines? Most viral vaccines contain: attenuated viruses. A 22-year-old was recently diagnosed with acquired immunodeficiency syndrome (AIDS). Which decreased lab finding would be expect to accompany this virus? CD4+ T-helper A 30-year-old male was diagnosed with HIV. Which of the following treatments would be most effective? Antiretroviral therapy (ART) When the immunologist says that pathogens possess virulence, what does virulence mean? Causes disease. A patient has a tissue growth that was diagnosed as cancer. Which of the following terms best described this growth? Neoplasm GRADED A++ Which information indicates a nurse understands characteristics of malignant tumors? Has a high mitotic index A nurse is discussing preinvasive epithelial tumors of glandular or squamous cell origin. What is the nurse describing? Cancer in situ A 25-year-old male develops a tumor of the breast glandular tissue. What type of tumor will be documented on the chart? Adenocarcinoma A 30-year-old female is diagnosed with cancer. Testing reveals that the cancer cells have spread to local lymph nodes. A nurse realized this cancer would be documented as stage: 3 An oncologist is discussing when a cancer cell loses differentiation. Which of the following is the oncologist describing? Anaplasia Which of the following indicates a nurse understands a proto-oncogene? A proto-oncogene is best define as a(n) _____ gene. GRADED A++ normal Of the following genetic lesions that cause cancer, which is the most common? Point mutations A 45-year-old female was recently diagnosed with cervical cancer. She reports a sexual history that includes 43 partners. Which of the following is the most likely cause of her cancer? Human papillomavirus (HPV) A 30-year-old male with HIV is diagnosed with Epstein-Barr virus. After 2 months, the virus is still active. Based upon the EBV, which of the following cancers is most likely to develop in this patient? B cell lymphoma Which statement indicates the patient has a correct understanding of metastasis? The most common route of metastasis is through the blood vessels and: Lymphatics When a patient asks what types of cancers are associated with tobacco use, how should the nurse respond? Squamous and small cell adenocarcinomas GRADED A++ A 50-year-old female develops skin cancer on her head and neck following years of sunbathing. Which of the following cancers is the most likely? Basal cell carcinoma Which of the following compounds has been shown to increase the risk of cancer when used in combination with smoking? Alcohol A 25-year-old female was diagnosed with cervical cancer. History reveals she had many sexual partners, which she indicates is too many to count. Which of the following is most likely to have caused her cancer? HPV-16 A 50-year-old female confirms chronic alcohol intake. This practice places the patient at risk for cancer in which organs? Larynx, esophagus, liver and breast. A 13-year-old female took a weight loss drug that activated the sympathetic nervous system. Which of the following assessment findings would the nurse expect? Increased cardiac conduction, increased myocardial contractions, increased HR. GRADED A++ A 30-year-old Caucasian female was recently diagnosed w. primary HTN. She reports that she eats fairly well, usually having red meat and potatoes daily. She also reports that her father has HTN as well. A nurse determines which of the following risk factors is most likely associated with this diagnosis? Genes Most cases of combined systolic and diastolic HTN have no known cause and are documented on the chart as ____ HTN. Primary A 52-year-old male is diagnosed with primary HTN. He has no other health problems. Present tx would cause the nurse to anticipate administering which drug to the patient? A diuretic When a nurse checks the patient for orthostatic hypotension, what did the nurse have the patient do? Stand up A 50-year-old male is diagnosed with orthostatic hypotension. Which of the following symptoms would he most likely experience? GRADED A++ Syncope and fainting An 8-week-old infant presents to his pediatrician for a well-baby checkup. Physical exam reveals a murmur and an ECG confirms a ventricular septal defect. Which of the following genetic factors should the nurse assess for as it would most likely accompany this dx? Down syndrome When a staff member asks what coarctation of the aorta is, how should the nurse respond? Coarctation of the aorta is the local narrowing of the aorta near the: Ductus arteriosus A newborn is suspected of having coarctation of the aorta. Which of the following assessments would aid in dx? Weak or absent femoral pulses A 1-month-old infant visits his PCP for a well-baby check. Physical exam reveals decreased cardiac output, hypotension, tachycardia and a loud murmur suggestive or aortic stenosis. Which of the following would be expected with this dx? Ventricular hypertrophy GRADED A++ A 2-week-old infant presents with poor feeding, fatigue, dyspnea and a murmur. She is diagnosed w. a patent ductus arteriosus (PDA). A nurse recalls this conditions results in a(n): Left-to-right shunt Which is the most common type of congenital heart defect the nurse should assess for in infants? Ventricular septal defect (VSD) A newborn experiences frequent periods of cyanosis, usually occurring during crying or after feeding. Which of the following is the most likely diagnosis the nurse will observe on the chart? Tetralogy of Fallot (Tet spell: hypoxic spell) A 40-year-old pregnant woman is concerned about the health of her unborn child. She has phenylketonuria (PKU) and recently had a viral infection. If the child is born with a congenital heart defect, which of the following is the most likely based on the mother's history? Coarctation of aorta; Patent ductus arteriosus (PDA) A nurse is teaching staff about pulmonary edema. Which information should the nurse include? The most common cause of pulmonary edema is: Left heart failure GRADED A++ A 22-year-old female presents w. chronic bronchitis. Tests reveal closure of the airway during expiration. While planning care, a nurse recalls this condition is most likely caused by: Thick mucus from hypertrophied glands (hypersecretion) While reviewing lab results, to help confirm a diagnosis of CF in a 1-year-old child, which substance will be present in the child's sweat? Sodium chloride A nurse is teaching about sudden infant death syndrome (SIDS). Which information should the nurse include? SIDS peaks between __ and __ months of age. 3, 4 Where does the conversion of angiotensin I to angiotensin II take place? Pulmonary vessels, and to a lesser extent in endothelial and renal epithelial cells Describe the sequence in the renin-angiotensin-aldosterone system. Low blood volume/ low BP/ low Na+/ high K+ concentration - secretes renin from kidneys - liver released angiotensin into blood which is converted to angiotensin I - ACE released from lungs to convert angtiotensin I to II - vasoconstriction - elevated BP and restores renal perfusion GRADED A++ - angiotensin II stimulates secretion of aldosterone from adrenal cortex and ADH from post. pituitary - aldosterone promotes Na+ and water reabsorption + excretion of K+ within renal tubules - increase blood volume What type of microorganisms produce exotoxins? Bacterial pathogens An elderly patient has a BP reading of 176/68. What is the most likely cause of this type of elevation? Stage 2 HTN SBP 140 and/or DBP 90 What lab tests would help dx HF and provide insight into its severity? ECHO - shows decreased EF and cardiomegaly BNP: level of serum used to estimate severity of HF What are the anticipated complications of left ventricular failure along with decreased renal perfusion? Decreased contractility - decreased renal perfusion and increase in renin and angiotensin - increased afterload - HTN GRADED A++ Decreased contractility - decreased EF and increased left ventricular end diastolic volume (LVEVD) - increased preload - renal failure What is the most likely cause of rheumatic heart disease? Pharyngeal infection (sore throat) by the group A β-hemolytic streptococci Immune response cross-reacts w/ molecularly similar SELF-ANTIGENS in heart, muscle, joints and brain, causing autoimmune response - inflammatory lesions in these tissues What is the most common valve disease that is often seen in young women? Mitral valve prolapse You examine a patient and notice a widened pulse pressure and throbbing peripheral pulses. What is the cause of these findings? Aortic regurgitation Widened pulse pressure d/t increased stroke volume and diastolic backflow Large stroke volume causes prominent carotid pulsation + bounding peripheral pulses (Corrigan pulse) GRADED A++ What do elevated trop levels indicate for both diagnostic purposes and what is taking place at the cellular level to cause an increase in this lab value? Diagnostic: MI MI caused by prolonged, unrelieved ischemia that interrupts blood supply to the myocardium - after 20 min of MI - irreversible hypoxic injury - cellular death and tissue necrosis Myocyte injury: cardiac muscle cells contain trop in their cytoplasm - when damaged/ die - cell membranes rupture - trop released into bloodstream Cardiac injury/ cardiac muscle damage You are reviewing the pathology and autopsy report on a patient that died from MI. What would you expect to see? An aggregation of platelets w. atherosclerotic coronary artery As you examine a patient with a long hx of peripheral vascular disease, you see persistent edema in the lower extremities and hyperpigmentation. What is the cause of the hyperpigmentation? Chronic venous insufficiency A genetically determined hypersensitivity to common environmental allergens causes _______ reactions, such as: atopic; urticaria. GRADED A++ Leukemia is most common in? Children PVD includes: Buerger disease and Raynaud phenomenon Impairs blood flow from left ventricle to aorta: aortic stenosis Valve opening constricted and narrowed: stenosis. Blood moves backward into the chamber from where it came from: regurgitation A patient has a loud holosystolic murmur that radiates to the back and axilla. Which valvular abnormality is this describing? Mitral regurgitation GRADED A++ Which is the most common complication of an acute MI? Arrythmia Which valvular disorder is characterized by impaired blood flow from the left atrium to the left ventricle? Mitral stenosis Cellular injury of myocardium 1. Cardiac cells can withstand ischemic conditions for about 20 min. 2. ECG changes are visible after 30-60 seconds of hypoxia. 3. After 8-10 seconds of blood flow, the myocardial cells are already cooler. Dyslipidemia: VLDL: very low-density lipoproteins (triglycerides and proteins) Which enzymes are released by damaged myocardial muscle tissue? 1. CK-MB 2. LDH 3. Trop I GRADED A++ Symptoms of MI: 1. Unrelenting indigestion 2. Diaphoresis 3. Substernal pain 4. Cool, clammy skin An infant born w. a congeintal heart defect experiences sudden onset of dyspnea, cyanosis and restlessness. Which condition will most likely be considered the cause of these symptoms? "Tet" spell assoacited w. tetralogy of Fallot Neuroendocrine mediators of HF: SNS + RAAS Tx: diuretics, BB, ACE-I Emphysema barrel chest workup: thoracentesis + sputum culture GRADED A++ extra: antitrypsin deficiency; CXR: pus in pleural space CF bacterial infx w. pathogens, such as: pseudomonos aeruginosa + staph aerues CF: thick mucus, sputum Pneumonia in children is most commonly: Viral. Nosocomial pnuemonia (hospital acquired) pseudomonas Atypical pneumonia chalmydophia; group mycoplasma pneumonia Endocrine System GRADED A++ complex messaging/control system, uses hormones secreted by glands throughout the body, hormones are classified by action, source, or chemical structure 2 main categories of endocrine hormones steroids/lipids, protein or polypeptides What orgran metabolizes hormones? liver Pituitary Gland size of a pea, base of the brain, 2 parts What organ secretes hormones? Kidney Posterior pituitary secretes anti-diuretic hormone, oxytocin Anterior pituitary secrets several hormones GRADED A++ FSH, LH, ACTH, TSH, prolactin, endorphins, GH (FLAT PEG) Growth Hormone stimulates cell growth/fat break down. Targets muscles/bone-stimulates amino acid uptake & protein synthesis TSH stimulates release of thyroxine and triiodothyronine MSH stimulates milk produvtion by the breast, function is unknown in humans What does ADH stimulate in the kidneys? Water reabsorption by nephrons What effect does ADH have on the breasts? Stimulates release of milk What role does ADH play during birth? GRADED A++ Stimulates uterine contractions What gland is essential to hormonal function of the body? pituitary gland Where is the hypothalamus located? Below the thalamus What does the hypothalamus regulate? The pituitary gland What two systems does the hypothalamus connect? The nervous and endocrine systems What type of receptors does the hypothalamus contain? Receptors that stimulate the hypothalamus to secrete releasing and inhibiting hormones The hypthalmus signals what gland? GRADED A++ anterior pituitary the brain controls which pituitary gland? the posterior the pancreas has exocrine and endocrine functions where is the pancreas under the stomach between the 2 kidneys in the retroperitoneum Each islet of langerhans contains 2 types of cells. Which 2 are most relevant alpha cells and beta cells Alpha cells secrete glucagon when serum glucose levels fall- releases stored glucose- liver Beta cells GRADED A++ secrete insulin when serum glucose levels increase Where is the thyroid gland located? At the base of the neck below the larynx How many lobes does the thyroid gland consist of? Two lobes What type of gland is the thyroid gland? A vascular gland What hormone does the thyroid gland produce that is also known as T4? Thyroxine What hormone does the thyroid gland produce that is also known as T3? Triiodothyronine What hormone does the thyroid gland produce that helps regulate calcium levels? GRADED A++ Calcitonin what are t3 and t4 responsible for? regulating cellular metabolism as well as growth and development What is required to synthesize thyroid hormones iodine How does calcitoning regulate serum calcium levels by release calcium from the bones How many parathyroid glands are there usually 4 Where is the parathyroid located posterior surgace of the thyroid PTH GRADED A++ works opposite of calcitonin to regulate serum calcium levels PTH is secreted when calcium levels drop PTH increases serum calcium by increasing osteoclast activity as well as increasing absorption of calcium in the GI tract and kidneys Adrenal gland location on each kidney the medulla inner portion of adrenal gland that produces epinephrine and norepinephrine Adrenal gland cortex outer portion that produces steroids Mineralocorticoids GRADED A++ primarily aldosterone, acts to conserve sodium and water glucocorticoids primarily cortisol, increases serum glucose levels gonadocorticoids (sex hormones) male and female hormones are secreted in minimal amounts in both sexes, but hormones from teh testes and ovaries usually mask Disorders of the pituitary gland hypopituitarism, hyperpituitarism Disorders of the thyroid goiter, hypothyroidism, hyperthyroidism disorders of the parathyroid hypoparathyroidism, hyperparathyroidism disorders of the adrenal gland GRADED A++ pheochromocytoma, cushings syndrome, addisions disease Hypopituitarism rare, complex conditions in which the pituitary gland does not produce sufficient amounts of hormones Hypopituitarism is caused by congenital defects, cerebral or pitutary traums Hypopituitarism can cause drawfism, diabetes insipidus (ex essive fluid excretion from the kidneys caused by deficient antidiuretic hormone levels) Hyperpituitarism excessive amounts of of or all of the pituitary hormones Hyperpituitarism caused by most likely tumors that secrete homrones or hormone-like substances GRADED A++ Hyperpituitarism can cause gigantism, acromegaly (large bones), syndrome of inappropriate diuretic hormone Hyperpituitarism can cause hyperprolactinemia (excessive prolaction resulting in menstrual dysfunction and galactorrhea), cushing syndrome: excessive cortisol that results from the increased ACTH levels, hyperthyroidism hypermetabolism state caused by excessive thyroid hormones from increased TSH Interphase cell feeds, metabolizes and grows while replicating DNA in preparation for mitosis Prophase first appearance of chromosomes (will be 92) Metaphase Centrioles pull chromosomes to opposite sides of cell (chromatid) - 46 each side Anaphase Centromeres split and sister chromatids are pulled apart GRADED A++ Telophase New nuclear membrane formed around each group of 46 chromosomes When it goes right, euploid cells are produced Nondisjunction Error in meiosis in which homologous chromosomes fail to separate. Polyploidy condition in which an organism has extra sets of chromosomes Triploidy when an organism has three copies of every chromsome instead of two Tetrapoloidy euploid has 92 chromosomes and fetus usually does not survive Huntington's disease Single gene disorder (trinucleotide repeat mutation) GRADED A++ Autosomal dominant (50% chance of passing it on) Progressive neurologic disease with late onset (40s) Prevention- genetic testing for pregnancy planning Cystic fibrosis Single gene disorder (CFTR gene mutation) Autosomal recessive Most common in white children Defective transport of chloride ions cause salt imbalance- thickened secretions, digestive issues, malnutrition. Males and females Must inherit two copies of gene (1 from each parent) Turner syndrome XO chromosomal disorder, monosomy of X-affects females Short stature, webbed neck, undeveloped breasts but female genitalia, usually sterile Down syndrome Chromosomal disorder, trisomy 21 Affects both sexes Intellectual disability, poor muscle tone, low nasal bridge, low set ears, protruding tongue, epicanthal fold GRADED A++ Fragile X syndrome Chromosomal disorder (break in long arm of X) Higher prevalence in males Intellectual disability Klinefelter syndrome (XXY) chromosomal disorder 1:1000 male births Male appearance, sparse body hair, mild intellectual disability Atrophy Decrease in cell size "When cast is removed from left calf, it is smaller than the right calf" Hypertrophy Increase in cell size "Captain of roller derby team has greater thigh diameter at the end of the season t