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NURS 364 - Final Exam Study Guide.

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NURS 364
Final Exam Study Guide


Cell Adaptation, Injury, and Death
-Be able to define and know examples of: Atrophy, Hyperplasia, Hypertrophy, Metaplasia, and Dysplasia
Atrophy
o A decrease in cell size and a more efficient level of
function Examples
Disuse: Reduced skeletal muscle use -> Broken Arm
Denervation: More extreme disuse in paralyzed limbs or muscle
groups with decreased innervation
Loss of endocrine stimulation: Reduced activity from reduced
stimulation e.g. estrogen in menopause
Inadequate nutrition: Triggers decreased activity as means of survival
Ischemia/Decreased blood flow: Decreases nutrient and oxygen availability
Hyperplasia
o Increase in the number of
cells Examples
Physiologic
o Hormonal: Breast and uterine enlargement in pregnancy
o Compensatory: Liver
regeneration Non-Physiologic
o BPH: Linked to changes in testosterone
o Endometrial hyperplasia: Estrogen
o Warts: Growth factor from viruses (sometimes dysplastic)
Hypertrophy
o Increased cell size and ultimately tissue
mass Examples
Normal Physiologic
o Weight-baring exercise: Depletes ATP and stretches
muscle fibers, triggers hypertrophy for additional actin and
myosin filaments and increased ATP synthesis
o Organ/Tissue removal (Kidney
removal) Abnormal Pathologic
o Long-standing hypertension
Increased workload required to pump blood against
elevated arterial pressure
Progressive concentric increase in left ventricular
muscle mass
Increased oxygen demand
Perpetuated by decreased end diastolic
volume/decreased stroke volume
Metaplasia
o One mature cell (epithelial or mesenchymal) type is replaced by another
cell type Example

, Patients with chronic GERD: normal squamous epithelium of
lower esophagus are replaced with columnar epithelium




o
s o Barrett’s Esophagus
o Gastric reflux
Dysplasia
o Cell growth in a tissue that varies in cell size, shape, and organization
Examples
Cervical cell dysplasia
o Pap smear
o Infection with human papilloma virus
-What occurs to a cell during a hypoxic injury? Why does cell swelling occur?
Causes: Ischemia, decreased oxygen in the air, decreased production of RBCs,
Cardiovascular diseases, and Respiratory Diseases
Swelling: Lacking ATP the sodium-potassium pump shuts down which causes swelling
due to the excess sodium because sodium follows water
-What is the difference between apoptosis and necrosis?
Apoptosis Necrosis
Cell Size Reduced (Shrinkage) Enlarges (Swelling)
Cell Nucleus Fragmentation Nuclear Dissolution
(Karyolysis)
Plasma Membrane Intact Disrupted
Cell Content Intact or Apoptotic bodies May leak out of cell
Presence of adjacent No Frequent
inflammation

, Physiologic or Pathologic Role Often Physiologic Pathologic



-What is the difference between expressivity and penetrance? What are some examples
of each? Expressivity is the degree to which a gene is expressed in the phenotype
o Marfan Syndrome
Penetrance is the ability of a gene to express its
function o Huntington’s disease
-What is trisomy? Monosomy? What are examples of each? What is the risk of trisomy
(i.e. Down syndrome) related to?
Trisomy
o More than 2 chromosomes in a pair
Ex. Down Syndrome (Trisomy
21) Risks
o Intellectual Disability
o Congenital Heart Defects
o Increased Risk of Alzheimer’s disease
o Characteristic Physical features
Monosomy
o Only one chromosome present in a chromosome pair
Ex. Turner Syndrome
-Autosomal Dominant Disorders: What are the chances of inheritance?
50% chance of inheritance

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