NSG 533 Adv Pathophysiology Exam 1
What are the 4 common mechanisms of cell injury and death? - CORRECT ANSWER-
1. ATP depletion
2. O2 and oxygen-derived free radicals
3. Intracellular calcium and loss of steady state
4. Membrane permeability defect
What is ATP depletion? - CORRECT ANSWER-Inability of cell to produce adequate
ATP to fuel normal activities
-most common: hypoxia
How does hypoxia affect cellular energy production? - CORRECT ANSWER-Hypoxia
leads to the inability to perform oxidative phosphorylation (aerobic) and glycolysis
(anaerobic) kicks in
What are the consequences of ATP depletion in terms of ion regulation? - CORRECT
ANSWER-ATP depletion leads to the failure of the NaK pump, causing the leakage of
Na+ and Ca2+ into the cell, and the production of lactate
How does NaK pump failure impact the cell? - CORRECT ANSWER-Na normally
outside and K normally inside
Na+ leaks in and pump can't maintain balance
Water follows, cell and contents swells
What does a drop in pH do to the cell? - CORRECT ANSWER-Pyknosis, karyorrhexis,
and karyolysis
Disruption of cell membrane allowing calcium influx
Pyknosis - CORRECT ANSWER-Clumping of nuclear material as a result of a drop in
pH
Karyorrhexis - CORRECT ANSWER-Fragmentation of nuclear material
Karyolysis - CORRECT ANSWER-Dissolution of nuclear material
What are free radicals? - CORRECT ANSWER-Unstable compounds with an unpaired
electron and high affinity for lipids, normal byproduct of cellular metabolism
,What is lipid peroxidation? - CORRECT ANSWER-Binding of free radicals to
phospholipid bilayer membrane around the cell and its organelles causing dissolution or
a hole
What are reactive oxygen species (ROS) - CORRECT ANSWER-Chemically reactive
molecules formed as natural oxidant species in cells during mitochondrial respiration
and energy generation
How does the body handle free radicals and ROS to prevent tissue injury - CORRECT
ANSWER-Antioxidants remove
problems occur when free radicals are produced in amounts that overwhelm
antioxidants
How can membrane permeability defect? - CORRECT ANSWER-Inherited / genetic
acquired / exposure to mutagenic or carcinogenic environmental factors
lysis by enzymes, virus, or direct injury from stressors
What is bilirubin? - CORRECT ANSWER-Pigment released when RBC's breakdown
What is unconjugated bilirubin? - CORRECT ANSWER-Type of bilirubin that is fat-
soluble and can't be excreted
What are the five components of pathophysiology? - CORRECT ANSWER-etiology
pidemiology
pathogenesis
clinical manifestations
outcomes
Etiology - CORRECT ANSWER-Causative factor
-simple
-complex
-idiopathic
-iatrogenic
Epidemiology - CORRECT ANSWER-Patterns in populations of people and their
characteristics
-incidence
-prevalence
Incidence - CORRECT ANSWER-New
Prevalence - CORRECT ANSWER-Existing and new; total
, Pathogenesis - CORRECT ANSWER-Sequence of events from stimulus of disease and
manifestations
Clinical manifestations - CORRECT ANSWER-Signs (assessment, definitive)
Symptoms (experienced by pt, subjective)
Outcomes - CORRECT ANSWER-Cure, remission, chronicity, or death
-not specifically treatment
Primary prevention - CORRECT ANSWER-Preventing initial occurrence
Secondary prevention - CORRECT ANSWER-Detection and screening
Tertiary prevention - CORRECT ANSWER-Treating or reducing
relapse/disability/chronicity
What is conjugated bilirubin? - CORRECT ANSWER-Type of bilirubin that is water-
soluble and able to be excreted
What is the role of glucuronic acid in bilirubin metabolism? - CORRECT ANSWER-It is
required from liver cells to convert unconjugated bilirubin to conjugated bilirubin
What is hemolytic hyperbilirubinemia? - CORRECT ANSWER-Excessive hemoglobin
breakdown that the liver can't keep up with
What is hepatocellular hyperbilirubinemia? - CORRECT ANSWER-Liver cells are sick
and unable to uptake unconjugated bilirubin
What is obstructive hyperbilirubinemia? - CORRECT ANSWER-Blockage in
hepatic/common bile duct which prevents bilirubin from entering intestines; leads to clay
colored stool and very dark urine
What is kernicterus? - CORRECT ANSWER-Condition where prolonged
hyperbilirubinemia in infants (esp preterm) passes the BBB more easily, which is toxic
to nerve tissue
What is reperfusion injury? - CORRECT ANSWER-Results from the generation of highly
reactive O2 intermediates (oxidative stress) - these radicals can all cause further
membrane damage and mitochondrial calcium overload
WBCs especially affected
Antioxidant treatment can help, as well as blockage of inflammatory mediators and
inhibition of certain cell death pathways
What are the 4 common mechanisms of cell injury and death? - CORRECT ANSWER-
1. ATP depletion
2. O2 and oxygen-derived free radicals
3. Intracellular calcium and loss of steady state
4. Membrane permeability defect
What is ATP depletion? - CORRECT ANSWER-Inability of cell to produce adequate
ATP to fuel normal activities
-most common: hypoxia
How does hypoxia affect cellular energy production? - CORRECT ANSWER-Hypoxia
leads to the inability to perform oxidative phosphorylation (aerobic) and glycolysis
(anaerobic) kicks in
What are the consequences of ATP depletion in terms of ion regulation? - CORRECT
ANSWER-ATP depletion leads to the failure of the NaK pump, causing the leakage of
Na+ and Ca2+ into the cell, and the production of lactate
How does NaK pump failure impact the cell? - CORRECT ANSWER-Na normally
outside and K normally inside
Na+ leaks in and pump can't maintain balance
Water follows, cell and contents swells
What does a drop in pH do to the cell? - CORRECT ANSWER-Pyknosis, karyorrhexis,
and karyolysis
Disruption of cell membrane allowing calcium influx
Pyknosis - CORRECT ANSWER-Clumping of nuclear material as a result of a drop in
pH
Karyorrhexis - CORRECT ANSWER-Fragmentation of nuclear material
Karyolysis - CORRECT ANSWER-Dissolution of nuclear material
What are free radicals? - CORRECT ANSWER-Unstable compounds with an unpaired
electron and high affinity for lipids, normal byproduct of cellular metabolism
,What is lipid peroxidation? - CORRECT ANSWER-Binding of free radicals to
phospholipid bilayer membrane around the cell and its organelles causing dissolution or
a hole
What are reactive oxygen species (ROS) - CORRECT ANSWER-Chemically reactive
molecules formed as natural oxidant species in cells during mitochondrial respiration
and energy generation
How does the body handle free radicals and ROS to prevent tissue injury - CORRECT
ANSWER-Antioxidants remove
problems occur when free radicals are produced in amounts that overwhelm
antioxidants
How can membrane permeability defect? - CORRECT ANSWER-Inherited / genetic
acquired / exposure to mutagenic or carcinogenic environmental factors
lysis by enzymes, virus, or direct injury from stressors
What is bilirubin? - CORRECT ANSWER-Pigment released when RBC's breakdown
What is unconjugated bilirubin? - CORRECT ANSWER-Type of bilirubin that is fat-
soluble and can't be excreted
What are the five components of pathophysiology? - CORRECT ANSWER-etiology
pidemiology
pathogenesis
clinical manifestations
outcomes
Etiology - CORRECT ANSWER-Causative factor
-simple
-complex
-idiopathic
-iatrogenic
Epidemiology - CORRECT ANSWER-Patterns in populations of people and their
characteristics
-incidence
-prevalence
Incidence - CORRECT ANSWER-New
Prevalence - CORRECT ANSWER-Existing and new; total
, Pathogenesis - CORRECT ANSWER-Sequence of events from stimulus of disease and
manifestations
Clinical manifestations - CORRECT ANSWER-Signs (assessment, definitive)
Symptoms (experienced by pt, subjective)
Outcomes - CORRECT ANSWER-Cure, remission, chronicity, or death
-not specifically treatment
Primary prevention - CORRECT ANSWER-Preventing initial occurrence
Secondary prevention - CORRECT ANSWER-Detection and screening
Tertiary prevention - CORRECT ANSWER-Treating or reducing
relapse/disability/chronicity
What is conjugated bilirubin? - CORRECT ANSWER-Type of bilirubin that is water-
soluble and able to be excreted
What is the role of glucuronic acid in bilirubin metabolism? - CORRECT ANSWER-It is
required from liver cells to convert unconjugated bilirubin to conjugated bilirubin
What is hemolytic hyperbilirubinemia? - CORRECT ANSWER-Excessive hemoglobin
breakdown that the liver can't keep up with
What is hepatocellular hyperbilirubinemia? - CORRECT ANSWER-Liver cells are sick
and unable to uptake unconjugated bilirubin
What is obstructive hyperbilirubinemia? - CORRECT ANSWER-Blockage in
hepatic/common bile duct which prevents bilirubin from entering intestines; leads to clay
colored stool and very dark urine
What is kernicterus? - CORRECT ANSWER-Condition where prolonged
hyperbilirubinemia in infants (esp preterm) passes the BBB more easily, which is toxic
to nerve tissue
What is reperfusion injury? - CORRECT ANSWER-Results from the generation of highly
reactive O2 intermediates (oxidative stress) - these radicals can all cause further
membrane damage and mitochondrial calcium overload
WBCs especially affected
Antioxidant treatment can help, as well as blockage of inflammatory mediators and
inhibition of certain cell death pathways
