NSG 533 Pathophysiology Exam Questions Graded A+
2025/2026
5 forms of direct cell membrane damage/injury - 1. The effect of free radicals (reactive oxygen species)
2. Activation of the complement system
3. Lysis by enzymes
4. Lysis by viruses
5. Physical and chemical stressors
2 forms of endogenous accumulations (metabolic derangements) - 1. Fat
2. Bilirubin
4 effects of free cytosolic calcium - 1. Activation of protein kinases
2. Activation of phospholipases with phospholipid degradation and loss
3. Activation of proteases
4. Activation of endonuclease
Pyknosis - Clumping of nuclear material
Karyorrhexis - Fragmentation of the nuclear material
Karyolysis - Dissolution of the nuclear material
3 mechanisms involved in apoptosis - 1. Apoptosis triggered by internal signals: the intrinsic or
mitochondrial pathway
2. Apoptosis triggered by external signals: the extrinsic or death receptor pathway
3. Apoptosis-inducing factor (AIF)
Current TBW for water deficit - weight in kg x (0.4 for women, 0.5 for men, 0.6 for infants)
,Ideal TBW - (current Na X TBW) / 140
Water deficit - (Current Na X TBW) / 140 - TBW
Current TBW for water excess - weight in kg (0.5 for women, 0.6 for men, 0.7 for infants)
Water excess - weight (kg) X (0.5 for women, 0.6 for men, 0.7 for infants) x (1 - [Na/125])
Serum osmolality - OSM (calc) = 2 X [sodium concentration] + [glucose concentration/18] + [BUN/2.8]
Corrected serum sodium - Corrected sodium = 1.6 mEq/L X (every increase of 100 mg/dl in glucose
concentration over 100)
5 mechanisms of edema formation - 1. Increased capillary venous hydrostatic pressure
2. Decreased capillary oncotic pressure
3. Lymphatic obstruction/dysfunction
4. Increased capillary permeability
5. Sodium and water retention
Metabolic acidosis and an elevated anion gap ... - "Abnormal" numbers and types of anions present
Metabolic acidosis and a normal anion gap ... - A loss of bicarb
Typically either GI or renal (RTA - type 1, type 2, or type 4)
"Hyperchloremic metabolic acidosis"
Type 1 or distal RTA - Decrease in the ability of the distal nephron to produce new HCO3 (or secrete H+)
Results in hypokalemia
, Type 2 or proximal RTA - Involves a decrease in the ability of the proximal tubule to reabsorb filtered
HCO3
Type 4 or hyperkalemic RTA - Involves a lack of aldosterone activity at the distal nephron
Hallmark is hyperkalemia
Metabolic acidosis and an elevated anion gap ... - Addition or retention of acid due to derangements in
metabolism or exogenous ingestions (PLUMSEEDS)
Retention of acid usually occurs due to: - Renal defects (uremia), decrease in number of functional
nephrons and a decrease in ammonium secretion, usually occurs when GFR <25%
(Metabolic acidosis) 2 derangements in metabolism - 1. Ketoacidosis
2. Lactic acidosis
Type A lactic acidosis - Results from tissue hypoxia, leading to anaerobic metabolism
Type B lactic acidosis - Results from a mitochondrial defect in oxygen utilization
PLUMSEEDS - Paraldehyde
Lactic acidosis
Uremia
Methanol
Salicylates
Ethanol
Ethylene glycol
DKA
Starvation
Anion gap - (Na) - (Cl + HCO3)
2025/2026
5 forms of direct cell membrane damage/injury - 1. The effect of free radicals (reactive oxygen species)
2. Activation of the complement system
3. Lysis by enzymes
4. Lysis by viruses
5. Physical and chemical stressors
2 forms of endogenous accumulations (metabolic derangements) - 1. Fat
2. Bilirubin
4 effects of free cytosolic calcium - 1. Activation of protein kinases
2. Activation of phospholipases with phospholipid degradation and loss
3. Activation of proteases
4. Activation of endonuclease
Pyknosis - Clumping of nuclear material
Karyorrhexis - Fragmentation of the nuclear material
Karyolysis - Dissolution of the nuclear material
3 mechanisms involved in apoptosis - 1. Apoptosis triggered by internal signals: the intrinsic or
mitochondrial pathway
2. Apoptosis triggered by external signals: the extrinsic or death receptor pathway
3. Apoptosis-inducing factor (AIF)
Current TBW for water deficit - weight in kg x (0.4 for women, 0.5 for men, 0.6 for infants)
,Ideal TBW - (current Na X TBW) / 140
Water deficit - (Current Na X TBW) / 140 - TBW
Current TBW for water excess - weight in kg (0.5 for women, 0.6 for men, 0.7 for infants)
Water excess - weight (kg) X (0.5 for women, 0.6 for men, 0.7 for infants) x (1 - [Na/125])
Serum osmolality - OSM (calc) = 2 X [sodium concentration] + [glucose concentration/18] + [BUN/2.8]
Corrected serum sodium - Corrected sodium = 1.6 mEq/L X (every increase of 100 mg/dl in glucose
concentration over 100)
5 mechanisms of edema formation - 1. Increased capillary venous hydrostatic pressure
2. Decreased capillary oncotic pressure
3. Lymphatic obstruction/dysfunction
4. Increased capillary permeability
5. Sodium and water retention
Metabolic acidosis and an elevated anion gap ... - "Abnormal" numbers and types of anions present
Metabolic acidosis and a normal anion gap ... - A loss of bicarb
Typically either GI or renal (RTA - type 1, type 2, or type 4)
"Hyperchloremic metabolic acidosis"
Type 1 or distal RTA - Decrease in the ability of the distal nephron to produce new HCO3 (or secrete H+)
Results in hypokalemia
, Type 2 or proximal RTA - Involves a decrease in the ability of the proximal tubule to reabsorb filtered
HCO3
Type 4 or hyperkalemic RTA - Involves a lack of aldosterone activity at the distal nephron
Hallmark is hyperkalemia
Metabolic acidosis and an elevated anion gap ... - Addition or retention of acid due to derangements in
metabolism or exogenous ingestions (PLUMSEEDS)
Retention of acid usually occurs due to: - Renal defects (uremia), decrease in number of functional
nephrons and a decrease in ammonium secretion, usually occurs when GFR <25%
(Metabolic acidosis) 2 derangements in metabolism - 1. Ketoacidosis
2. Lactic acidosis
Type A lactic acidosis - Results from tissue hypoxia, leading to anaerobic metabolism
Type B lactic acidosis - Results from a mitochondrial defect in oxygen utilization
PLUMSEEDS - Paraldehyde
Lactic acidosis
Uremia
Methanol
Salicylates
Ethanol
Ethylene glycol
DKA
Starvation
Anion gap - (Na) - (Cl + HCO3)
