NUR 2030. PATHO. Final Exam
At what age is peak bone mass achieved? - ANS-30-35 yrs
\At what size is surgical repair indicated in an aneurysm? - ANS-6 cm
\Describe the different types of joints. - ANS---Synarthroidal: immovable (i.e. skull)
--Amphiarthroidal: slightly moveable (i.e. ribs attached to sternum)
--Diarthroidal or Synovial: freely moveable, lined with synovium, most comply affected by
joint disorders, "ball and socket", "hinge", "biaxial", bursa cushion to prevent friction on
tendon over the bone
\During relaxation or contraction of bladder is urine expelled? - ANS-CONTRACTION
\How common does Hepatitis B become a chronic infection? - ANS-only about 10-15%
develop chronic infection
\How common does Hepatitis C become a chronic infection? - ANS-75-85% develop chronic
infection
\How do patients with a stoke present? - ANS---HA
--slurred speech or aphasia
--loss of gag
--facial droop
--hemiparesis (one sided weakness)
\How many concussions increases the risk for future concussions? - ANS-one
\What are bile stones composed of? - ANS--bile
-cholesterol
-proteins
-bilirubin
\What are fascicles? - ANS-individual muscle fibers that are arranged in bundles
\What are Kupffer cells? - ANS-phagocytic cells of the liver
\What are Lewy bodies? What do they cause? - ANS-abnormal aggregation of proteins
(alpha-synuclein); accumulation of this protein causes neurodegeneration
\What are myofibrils? - ANS-muscle fibers that are arranged parallel to each other
\What are osteoblasts? Secrete? Able or unable to divide? - ANS---bone-forming cells
--secrete osteoid which forms bone matrix
--begin mineralization
--UNABLE to divide
\What are osteoclasts? - ANS---function in resorption and degradation of existing bone
\What are osteocytes? Able or unable to divide? - ANS---mature osteoblasts
--UNABLE to divide
\What are osteoprogenitor cells? Able or unable to divide? Where are they found? -
ANS---immature cells that differentiate into osteoblasts
--DIVDE!
--found in growth plates for linear growth
\What are sarcomeres? - ANS-the contractile unit of skeletal muscle (thin and thick filaments
that side over each other causing contraction)
\What are some complications of fractures? - ANS--neurovascular injury
-acute compartment syndrome
-infection
,-DVT
-fat embolism
-avascular necrosis
-arthritis
-delayed union (not heard after 8 weeks)
\What are the 3 calcium-regulating hormones and what do they do? - ANS-1. Parathyroid
Hormone (PTH): stimulates Ca to be released from bone (adds P to bone), stimulates
kidneys to retain Ca, stimulates vitamin D synthesis
2. Calcitriol: form of vitamin D which helps Ca absorption
3. Calcitonin: stimulated by hypercalcemia, enhances movement of Ca back into bone
blocking bone break down
\What are the 3 main parts of Virchow's triad? - ANS---Hypercoagulable state
--Endothelial injury
--Venous stasis
\What are the 3 phases of gastric digestion? - ANS-1. Cephalic phase: regulated by vagus
nerve, triggered by sight, smell and taste of food
2. Gastric phase: gastrin secreted which promotes secretion of HCL and pepsinogen, which
becomes pepsins need for protein digestion
3. Intestinal phase: chyme passes into the duodenum, acid production inhibited and gastric
motility slows
\What are the 3 types of femoral fractures? - ANS---Type 1: spiral or transverse
--Type 2: Comminuted
--Type 3: Open
\What are the 4 processes of pancreatitis? - ANS-1- Lipolysis: enzymatic fat necrosis in the
pancreas by lipase
2. Auto digestion of the parenchyma by the enzyme trypsin-->gangrene of the entire or part
of the pancreas
3. Elastase, activated by trypsin, dissolves blood vessels and ducts --> bleeding which can
be massive
4. Inflammation around the necrotic tissue can lead to abscess or pseudocyst formation
\What are the causes of hyperbilirubinemia? - ANS---hepatocellular (inability to secret
bilirubin
--obstructive (gallbladder disease)
--hemolytic
--hereditary
\What are the common neurotransmitters of the nervous system? - ANS--ACH
-NE
-Serotonin
-GABA
-glutamate
\What are the complications of Cirrhosis? - ANS---Portal HTN
, --Caput medusa
--Esophageal and rectal varices (hemorrhoids)
--Hyperbilirubinemia
--Portal-System Encephalopathy (PSE)
--Bleeding/Coagulopathies
\What are the difference is causes of stroke? - ANS---Ischemic: obstruction; atherosclerosis,
A. Fib, carotid stenosis
--Hemorrhagic: rupture of a cerebral artery w/ compression, ischemia and edema
\What are the differences between smooth muscle and skeletal muscle? - ANS---skeletal
muscle is striated voluntary muscle control under control of the CNS and PNS
\What are the differences betweens tendons, ligaments and joints? - ANS---Tendons: muscle
to bone (for motion)
--Ligaments: bone to bone (for stability)
--Joints: space in which bones come together to provide movement and flexibility
\What are the different grades of a sprain? - ANS---Grade 1: mild, no tearing, no lost of joint
function
--Grade 2: partial tear of ligament with obvious bruising, swelling, pain and reduced function
of joint
--Grade 3: complete tear of ligament (4-6 weeks to heal!)
\What are the different variations of spinal cord injuries? - ANS---Central cord: upper
extremities, sensory and bladder may be intact
--Brown-Seguard: penetrating, incomplete, GSW, hemisection, same side paralysis
--Cauda Equina: low back pain with leg numbness, loss of bowel or bladder control
\What are the different zones of injury with burns? - ANS---Zone of coagulation: inner most
layer, most damaged, deepest, irreversible
--Zone of stasis: middle layer, decreased perfusion, potentially reversible
--Zone of hyperemia: outer most layer, reddened, minimal injury
\What are the endocrine and exocrine functions of the pancreas? - ANS---Endocrine: Islets
of Langerhans (glucagon, insulin, somatostatin)
--Exocrine: (80% of pancreas), Acinar cells, trypsin and chymotrypsin, carboxypeptidase,
amylase, lipase
\What are the functions of the liver? - ANS---storage (vitamins and minerals)
--Digestion (bile salt secretion for fat digestion)
--Protection (phagocytes and detoxification)
--Metabolism (protein, carbs, fats, bilirubin)
--Synthesis (bile, thrombopoietin, angiotensinogen, clotting factors)
\What are the ligaments that surround and stabilize the knee? - ANS---2 collateral
--2 cruciate
\What are the physical findings of Cholelithiasis and Cholecystitis? Diagnostics? Treatment?
- ANS---Presentation: pain in RUQ on palpation, rebound tenderness, enlarged gallbladder,
jaundice, clay colored stool, dark urine, vitamin deficiencies
--Diagnostics: lab, US, x-ray ERCP
At what age is peak bone mass achieved? - ANS-30-35 yrs
\At what size is surgical repair indicated in an aneurysm? - ANS-6 cm
\Describe the different types of joints. - ANS---Synarthroidal: immovable (i.e. skull)
--Amphiarthroidal: slightly moveable (i.e. ribs attached to sternum)
--Diarthroidal or Synovial: freely moveable, lined with synovium, most comply affected by
joint disorders, "ball and socket", "hinge", "biaxial", bursa cushion to prevent friction on
tendon over the bone
\During relaxation or contraction of bladder is urine expelled? - ANS-CONTRACTION
\How common does Hepatitis B become a chronic infection? - ANS-only about 10-15%
develop chronic infection
\How common does Hepatitis C become a chronic infection? - ANS-75-85% develop chronic
infection
\How do patients with a stoke present? - ANS---HA
--slurred speech or aphasia
--loss of gag
--facial droop
--hemiparesis (one sided weakness)
\How many concussions increases the risk for future concussions? - ANS-one
\What are bile stones composed of? - ANS--bile
-cholesterol
-proteins
-bilirubin
\What are fascicles? - ANS-individual muscle fibers that are arranged in bundles
\What are Kupffer cells? - ANS-phagocytic cells of the liver
\What are Lewy bodies? What do they cause? - ANS-abnormal aggregation of proteins
(alpha-synuclein); accumulation of this protein causes neurodegeneration
\What are myofibrils? - ANS-muscle fibers that are arranged parallel to each other
\What are osteoblasts? Secrete? Able or unable to divide? - ANS---bone-forming cells
--secrete osteoid which forms bone matrix
--begin mineralization
--UNABLE to divide
\What are osteoclasts? - ANS---function in resorption and degradation of existing bone
\What are osteocytes? Able or unable to divide? - ANS---mature osteoblasts
--UNABLE to divide
\What are osteoprogenitor cells? Able or unable to divide? Where are they found? -
ANS---immature cells that differentiate into osteoblasts
--DIVDE!
--found in growth plates for linear growth
\What are sarcomeres? - ANS-the contractile unit of skeletal muscle (thin and thick filaments
that side over each other causing contraction)
\What are some complications of fractures? - ANS--neurovascular injury
-acute compartment syndrome
-infection
,-DVT
-fat embolism
-avascular necrosis
-arthritis
-delayed union (not heard after 8 weeks)
\What are the 3 calcium-regulating hormones and what do they do? - ANS-1. Parathyroid
Hormone (PTH): stimulates Ca to be released from bone (adds P to bone), stimulates
kidneys to retain Ca, stimulates vitamin D synthesis
2. Calcitriol: form of vitamin D which helps Ca absorption
3. Calcitonin: stimulated by hypercalcemia, enhances movement of Ca back into bone
blocking bone break down
\What are the 3 main parts of Virchow's triad? - ANS---Hypercoagulable state
--Endothelial injury
--Venous stasis
\What are the 3 phases of gastric digestion? - ANS-1. Cephalic phase: regulated by vagus
nerve, triggered by sight, smell and taste of food
2. Gastric phase: gastrin secreted which promotes secretion of HCL and pepsinogen, which
becomes pepsins need for protein digestion
3. Intestinal phase: chyme passes into the duodenum, acid production inhibited and gastric
motility slows
\What are the 3 types of femoral fractures? - ANS---Type 1: spiral or transverse
--Type 2: Comminuted
--Type 3: Open
\What are the 4 processes of pancreatitis? - ANS-1- Lipolysis: enzymatic fat necrosis in the
pancreas by lipase
2. Auto digestion of the parenchyma by the enzyme trypsin-->gangrene of the entire or part
of the pancreas
3. Elastase, activated by trypsin, dissolves blood vessels and ducts --> bleeding which can
be massive
4. Inflammation around the necrotic tissue can lead to abscess or pseudocyst formation
\What are the causes of hyperbilirubinemia? - ANS---hepatocellular (inability to secret
bilirubin
--obstructive (gallbladder disease)
--hemolytic
--hereditary
\What are the common neurotransmitters of the nervous system? - ANS--ACH
-NE
-Serotonin
-GABA
-glutamate
\What are the complications of Cirrhosis? - ANS---Portal HTN
, --Caput medusa
--Esophageal and rectal varices (hemorrhoids)
--Hyperbilirubinemia
--Portal-System Encephalopathy (PSE)
--Bleeding/Coagulopathies
\What are the difference is causes of stroke? - ANS---Ischemic: obstruction; atherosclerosis,
A. Fib, carotid stenosis
--Hemorrhagic: rupture of a cerebral artery w/ compression, ischemia and edema
\What are the differences between smooth muscle and skeletal muscle? - ANS---skeletal
muscle is striated voluntary muscle control under control of the CNS and PNS
\What are the differences betweens tendons, ligaments and joints? - ANS---Tendons: muscle
to bone (for motion)
--Ligaments: bone to bone (for stability)
--Joints: space in which bones come together to provide movement and flexibility
\What are the different grades of a sprain? - ANS---Grade 1: mild, no tearing, no lost of joint
function
--Grade 2: partial tear of ligament with obvious bruising, swelling, pain and reduced function
of joint
--Grade 3: complete tear of ligament (4-6 weeks to heal!)
\What are the different variations of spinal cord injuries? - ANS---Central cord: upper
extremities, sensory and bladder may be intact
--Brown-Seguard: penetrating, incomplete, GSW, hemisection, same side paralysis
--Cauda Equina: low back pain with leg numbness, loss of bowel or bladder control
\What are the different zones of injury with burns? - ANS---Zone of coagulation: inner most
layer, most damaged, deepest, irreversible
--Zone of stasis: middle layer, decreased perfusion, potentially reversible
--Zone of hyperemia: outer most layer, reddened, minimal injury
\What are the endocrine and exocrine functions of the pancreas? - ANS---Endocrine: Islets
of Langerhans (glucagon, insulin, somatostatin)
--Exocrine: (80% of pancreas), Acinar cells, trypsin and chymotrypsin, carboxypeptidase,
amylase, lipase
\What are the functions of the liver? - ANS---storage (vitamins and minerals)
--Digestion (bile salt secretion for fat digestion)
--Protection (phagocytes and detoxification)
--Metabolism (protein, carbs, fats, bilirubin)
--Synthesis (bile, thrombopoietin, angiotensinogen, clotting factors)
\What are the ligaments that surround and stabilize the knee? - ANS---2 collateral
--2 cruciate
\What are the physical findings of Cholelithiasis and Cholecystitis? Diagnostics? Treatment?
- ANS---Presentation: pain in RUQ on palpation, rebound tenderness, enlarged gallbladder,
jaundice, clay colored stool, dark urine, vitamin deficiencies
--Diagnostics: lab, US, x-ray ERCP
