NUR 2063 Essentials of Pathophysiology – Exam 1 Review Sheet (Modules 1,2 & 3)

Essentials of Pathophysiology – Exam 1 Review Sheet Covers Modules 1, 2, and 3 – Chapters 1, 2, 3, 7, 8, 9, 10, 24, 51, 52, 53 1. Define pathophysiology. What does the study of pathophysiology include? • PATHOPHYSIOLOGY: The study of all the abnormalities in physiologic function of living beings. o Derives from 2 disciplines:  Patho meaning Dx of diseases through exam of organs, tissues, and cells.  Physiology meaning Mechanical, physical, and biochemical functions. o There are FOUR parts of pathophysiology: 1- Etiology: causes/reasons of disease. This ID’s causal factors for Dz 2- Pathogenesis: Evolution of Dz from the initial stimulus to ultimate manifestations of the Dz. (GENESIS = CREATE) 2. Review terms such as signs, symptoms, acute, chronic, exacerbation, remission, convalescence, and sequela • Signs: objective/observed manifestations o Ex: rash, change in temperature • Symptoms: Subjective o Ex: pain, nausea • Acute: short-lived. • Chronic: lasts for months/years • Exacerbation: increase in severity • Remission: decrease in severity • Remission: decrease in severity • Convalescence: Stage of recovery • Sequela: subsequent pathological condition resulting from an illness o Ex: renal failure 2/2 HTN o 3. What is epidemiology? Review the different levels of disease prevention such as primary, secondary, and tertiary as well as examples for each. • Epidemiology is the study of study and analysis of the distribution, patterns and determinants of health and conditions in defined populations. o Primary level: altering susceptibility a. Ex: Immunizations o Secondary level” early detections/screenings a. Ex: Pap smears, breast exams, cancer screenings o Tertiary level: Rehabilitation (reduce disabilities) a. Ex: PT/OT after a stroke • Florence Nightingale was the first practicing epidemiologist. 4. Review the difference between homeostasis and allostasis. • Homeostasis: The process by which a state of internal, physiological equilibrium is maintained. o Ex: pH, concentration of ions in ECF, glucose levels, osmolality of ECF • Allostasis: Steps the body takes to re-establish homeostasis. Adaptation to a changing internal and external environment o Ex: HR, body core temperature, BP 5. Review the three different stages of the General Adaptation Syndrome (GAS) including the alarm stage, adaptation/resistance, and exhaustion stage. What hormones are released during the alarm stage and what effects do they have on the body? • Three stages of GAS: 1: Alarm Stage: Fight/Flight response. 2: Resistance/Adaptation: Activity of nervous/endocrine systems to return to homeostasis 3: Exhaustion: If stressor is not removed the body cannot return to homeostasis. The body will go into allostatic overload and organs tissues give out. o Ex: renal failure 2/2 HTN Stressor Excites receptors Hypothalamus relases CRH + ACH This activates the SNS Providing a surge of energy Adrenal Medulla releases catecholamines (epinepherine and Norepinepherine) Increased cardiac output, increased respirations, enhanced blood coag. increased BP, dialated pupils, increadd BG (energy), GI/GU supressed. Adrenal Medulla releases cortisol due to ACTH. Corticosteroids stabilize vascular reactivitiy, inhibit glucose uptake, suppress protein sysnthesis *inhibit release of CRH+ACH fron the hypothalamus 6. Review the differences between the sympathetic vs the parasympathetic nervous systems. What happens to the body during “fight-or-flight” response? 7. Review the functions of the various organelles of the cell such as the nucleus, mitochondria, ribosome, lysosome, endoplasmic reticulum, peroxisome, golgi apparatus • Nucleus • Control center or “brain” of the cell • DNA and genes stored here • Production of messenger RNA • Contains the instructions needed to build nearly all the body’s proteins  Most cells contain only one nucleus • Some cells like liver and skeletal muscle cells contain more • Red blood cells contain no nucleus • Mitochondria - “Power house” of the cell • Provide energy to the cell in the form of ATP • More metabolically active cells have more mitochondria • Mitochondria are enclosed by two membranes • Outer membrane • Inner membrane has folds called cristae • Mitochondria are a unique organelle because they contain their own set of DNA • Ribosomes • Site of protein production - RNA produced in nucleus sent to ribosomes • RNA  Protein = Translation • Found either floating in the cytoplasm (free) or attached to the endoplasmic reticulum (bound) • Endoplasmic Reticulum (ER) • Series of folded membranes that move proteins around the cell • Continuous with nuclear membrane of nucleus • Rough ER – ribosomes attached to ER • Site of protein synthesis • Production of integral proteins and phospholipids found in cellular membranes • Smooth ER – ribosomes not attached to smooth ER • Functions include: • Detoxification • Lipid metabolism • Synthesis of hormones • Calcium storage • Golgi Bodies (Golgi Apparatus) • Organelle made up of stacked, flattened membranes • Sorts and packages proteins produced in ER • Protein “packaging plant” – cell post office • Move materials within cell and out of the cell • Lysosomes • Lysosomes are spherical membranous organelles containing digestive enzymes • Lysis = breakdown • Digests particles taken in by endocytosis • Including bacteria, viruses, and toxins • Degrades worn-out or nonfunctional organelles and tissues • Peroxisomes • membranous sacs containing a variety of powerful enzymes such as oxidase and catalase • Oxidases use molecular oxygen (O2) to detoxify harmful substances such as alcohol and f formaldehyde • Neutralize dangerous free radicals into hydrogen peroxide (H2O2) ▪ Free radicals - highly reactive chemicals with unpaired electrons that can damage biological molecules • Catalase breaks down hydrogen peroxide (H2O2) into H2O and O2 • Numerous peroxisomes found in liver and kidney cells 8. Review the differences between extracellular fluid and intracellular fluid. Which electrolytes are found in high concentration outside the cell versus inside the cell? • Water accounts for ½ body mass o Males: 60% o Females 50 % o Infants: 73% • Water occupies 2 main fluid compartments o ICF (75%): fluid within the cells o ICF has increased concentrations of K+, Magnesium, and HPO4. Has less NA and Cl. o ECF (25%): Fluid in-between cells (interstitial fluid) o Ex: blood plasma, CSF, lymph fluid, synovial fluid, GI secretions o The ECF has increased concentrations of Na+, Cl, and HCO3 o Also contains plasma therefore has higher concentrations of proteins. 9. Review how fluid is transported across the plasma membrane of the cell. What forces drive the movement of water across the membrane? 1. Passive: Moves down a concentration gradient (HIGH - LOW) 2. Active: Requires ATP (LOW - HIGH) 3. Osmosis: movement of water between ICF and ECF. o Know osmolality: concentration of solutes o Water moves from area of low osmolality to an area of higher osmolality. o Ex: if ECF osmolality is decreased, water will move from the ECF into the cells o ICF volume is determined by ECF solute concentration. • Increase in plasma osmolality triggers: o Release of antidiuretic hormone (ADH) o Kidneys conserve water and excrete concentrated urine o Thirst - causing us to drink water • Decreased osmolality of plasma inhibits both thirst and ADH release o Results in output of large volumes of dilute urine 10. Review ways that fluids enter the human body (intake) versus ways fluid is excreted (output) out of the body. • Intake: Ingested Liquids/food, cellular metabolism • Output: Urine, sweat, feces, exhaled air 11. Review conditions that result in ECF volume deficit (dehydration) versus ECF volume excess (hypotonic hydration). What are signs, symptoms, and causes for each? Dehydration: H20 output exceed intake. H20 from ECF is LOST  Osmolality of ECF increased and H20 moves from ICF to the ECF o Common after N/V/D, hemorrhage, burns, sweating o Due to DM/Diabetes insipidus • S/S of Dehydration: o Dry mouth, thirst, decreased urine output o If prolonged: weight loss, hypovolemic shock, fever, confusion Hypotonic Hydration: Over Hydration. o Occurs with rapid water intake OR decreased renal activity. o Concentration of water in ECF is increased and osmolality of ECF is decreased • S/S of Hypotonic Hydration: N/V, muscular Cramps o N/V, Muscular cramps, cerebral edema. o Treatment: IV hypertonic saline solution (pulls water out of the cells) 12. What is edema? Review the various factors that can contribute to edema. • Edema: The accumulation of fluid in the interstitial space due to the increase in forces that move fluid from capillaries to interstitial compartment. OR decreased forces that move fluid from interstitial compartment to capillaries. Factors Contributing to Edema: o Inflammation, CHF, HTN,