Download ADVANCED PATHOPHYSIOLOGY EXAM 1 2024- 2025/ACTUAL EXAM WITH CORRECT DETAILED ANSWERS /100 and more Exams Pathophysiology in PDF only on Docsity!
ADVANCED PATHOPHYSIOLOGY EXAM 1 2024-
2025 /ACTUAL EXAM WITH CORRECT DETAILED
ANSWERS /100% VERIFIED AND GRADED A+
A certain disease is currently found in 1 of every 10 people in the country and 1, people contract the disease yearly. The population of the country is 4,500,000. Which of the following statements is correct? a. The prevalence of the disease is 10% and the incidence is .02%. b. The prevalence of the disease is .02% and the incidence is 10%. c. Neither is correct. d. There is insufficient data - Correct Answer-A In relation to disease development, the term "etiology" refers to which of the following? a. number of people with the disease b. cause of the disease c. definition of the disease d. outcome of the disease - Correct Answer-B Which of the following is(are) true about "symptoms"? a. objective and measurable b. the same as "signs" c. both of the above d. neither of the above - Correct Answer-D In 1992, there were 980 deaths in a Midwestern city with a population of 1,000,000. At
the beginning of that year, 900 cases of AIDS existed in this population. During the year, 250 new cases of AIDS were diagnosed, and 75 people died of the disease in 1992. Using the data given above, what was the incidence rate (per 100,000 population) at the end of 1992 for AIDS? a. 6 b. 25 c. 88 d. 116 - Correct Answer-B What level of prevention is a blood pressure screening program for high school students who are pregnant? a. primary b. secondary c. tertiary - Correct Answer-B Mr. Forbes complains of "indigestion" and becomes sweaty and pale. His wife takes him to the Emergency Department at Northwestern Memorial Hospital. A cardiac catheterization 2 days later shows partial blockage of his right coronary artery (RCA). Blockage of the right coronary artery can lead to myocardial cell injury because it results in which of the following? a. bilirubin accumulation in myocardial cells b. alteration in the genetic material of myocardial cells c. reduced energy production in myocardial cells d. activation of the complement system - Correct Answer-C When myocardial cells are injured, the function of the Na-K membrane pump may be
b. increased anaerobic metabolism c. decreased metabolic rate d. increased oxidative phosphorylation - Correct Answer-B A mountain climber is stranded at 23,000 feet in the Swiss Alps and has lost all his equipment and supplies in an avalanche. Subsequently, he suffers cell injury due to impaired ATP production. The reason for the decrease in ATP is which of the following? a. enzyme inhibition b. uncoupling c. hypoxia d. none of the above - Correct Answer-C An elderly patient develops an obstruction in his left middle cerebral artery. The brain tissue supplied by this artery becomes hypoxic. The best explanation for this is which of the following? a. the obstruction results in decreased blood flow b. the obstruction results in decreased hemoglobin in the blood c. while blood flow stays the same, the obstruction reduces oxygen content in the blood d. none of the above explain the reason for the hypoxia - Correct Answer-A Increased mobilization and delivery of free fatty acids to liver cells can result in fat accumulation. Which of the following problems results in increased mobilization of free fatty acids? a. anemia b. hepatic toxins c. starvation d. hypoxia - Correct Answer-C
Generalized hypoxia results in a switch to anaerobic metabolism in cells. Anaerobic metabolism results in which of the following? a. decreased lactic acid inside cells b. decreased arterial pH c. more effective ATP production d. increased pH inside cells - Correct Answer-B There is a disease of the spleen, which results in an excessive destruction of RBCs. This increase in RBC destruction can lead to which of the following? a. hypoxia b. hypobilirubinemia c. an increase in platelets d. all of the above - Correct Answer-A Your body has developed an increased demand for thyroid hormones. This will lead to of the thyroid gland. a. atrophy b. hypertrophy c. dysplasia d. metaplasia - Correct Answer-B You palpate a gangrenous leg and note the presence of crepitus. Crepitus is associated with which of the following? a. wet gangrene b. dry gangrene
Which of the following changes is indicative of irreversible cell injury? a. sodium influx into the cytoplasm b. glycolysis (anaerobic metabolism) c. detachment of ribosomes from rough endoplasmic reticulum d. release of lysosomal enzymes - Correct Answer-D Which of the following best describes reperfusion injury? a. The increased blood pressure in the area of reperfusion causes rupture of small arterioles and release of free radicals. b. The return of blood flow to the area results in a burst of free radical production from neutrophils that accumulated in the area. c. Reperfusion injury results from restoration of the function of the sodium-potassium pump. d. Reperfusion of the area results in apoptosis of the previously ischemic cells. - Correct Answer-B Which of the following best describes free radicals? a. stable molecules not normally found in the body, but introduced exogenously during ischemia b. unstable molecules that are normal products of oxidative metabolism and are removed by endogenous antioxidants c. stable molecules that have an affinity for iron in the cytoplasm of the cell d. none of the above - Correct Answer-B The usual fate of apoptotic cells is which of the following? a. metaplastic transformation b. calcification
c. hypertrophy d. phagocytosis e. neoplastic transformation - Correct Answer-D Which of the following statements is true regarding the difference between cell necrosis and apoptosis? a. Apoptosis is a more rapid process. b. Apoptosis is usually initiated by ischemia-induced cell injury. c. Apoptosis is genetically controlled. d. Apoptosis characteristically involves rupture of the cell membrane. - Correct Answer- C You are a nurse practitioner working in an outpatient clinic. Your patient's echocardiogram shows moderate aortic stenosis (narrowing of the aortic valve). You know that the stenotic valve creates an increased resistance against which the left ventricle contracts. The cellular adaptation most likely to occur in the left ventricle is which of the following? a. atrophy b. hypertrophy c. hyperplasia d. metaplasia - Correct Answer-B Select the condition that is an example of physiologic hyperplasia. a. breast enlargement during puberty b. endometrial hyperplasia from excessive estrogen stimulation c. prostatic hyperplasia occurring as men age
b. hyperplasia of the thyroid gland c. atrophy of the thyroid gland d. hypertrophy and hyperplasia of the thyroid gland - Correct Answer-B Chronic alcoholism can result in the development of a fatty liver because it results in which of the following? a. increased production of free fatty acids b. increased conversion of free fatty acids to triglycerides c. decreased oxidation of cholesterol, triglycerides, and phospholipids d. decreased binding of cholesterol, triglycerides, and phospholipids to apoproteins - Correct Answer-A Which of the following is the primary difference between wet and dry gangrene? a. Infection and inflammation are present in wet gangrene. b. Wet gangrene results from arterial occlusion and dry gangrene from venous stasis. c. Dry gangrene involves the presence of Clostridium perfringens. d. Wet gangrene occurs only in internal organs. - Correct Answer-E Which of the following components is not involved in apoptosis? a. Bcl- 2 b. apaf- 1 c. caspase 9 d. cytochrome c e. HLA 2 - Correct Answer-E Some cancer-causing viruses are able to protect the cells that they transform from
undergoing apoptosis by interfering with the action of the apoptosis promoter called: a. TNF-alpha. b. Fas. c. p53. d. IL-2. e. INF-beta. - Correct Answer-C Which of the following diseases is thought to be related to free radical damage? a. osteoarthritis b. detached retina c. cerebral aneurysm d. cancer - Correct Answer-D Which of the following enzymes, released from dying cells, may indicate problems in the liver? a. alanine aminotransferase b. aspartate aminotransferase c. alkaline phosphatase d. all of the above e. none of the above - Correct Answer-D Researchers hypothesize that the disappearance of dopamine-generating cells in the midbrain in Parkinson's Disease may be related to oxidative stress due to a decrease in the amount of glutathione in the midbrain. The best explanation for this theory is which of the following? a. DNA synthesis requires glutathione for optimal development. b. Dopamine synthesis requires glutathione to prevent free radical production. c. Free radicals produced via dopamine synthesis are neutralized by glutathione.
how are symptoms and signs different - Correct Answer-symptoms are what the patient reports signs are objective or measurable outcomes - Correct Answer-cure, remission, chronicity, or death primary prevention - Correct Answer-Efforts to prevent an injury or illness from ever occurring. secondary prevention - Correct Answer--focuses on early identification of individuals or communities experiencing illness, providing treatment, and conducting activities that are geared to prevent worsening health status
- examples: communicable disease screening and case finding; early detection and treatment of diabetes; exercise programs for older adult clients who are frail Tertiary prevention - Correct Answer--aims to prevent the long-term consequences of a chronic illness or disability and to support optimal functioning
- examples: prevention of pressure ulcers as complication of a spinal cord injury; promoting independence for the client who has traumatic brain injury Atrophy - Correct Answer-Decrease or shrinkage in cellular size.Most common in skeletal muscle, heart, secondary sex organs, and brain. Physiologic atrophy - Correct Answer-occurs with early development. Ex. Thymus gland gets physiologic atrophy during childhood. pathologic atrophy - Correct Answer-occurs as a result of decreases in workload,
pressure, use, blood supply, nutrition, hormonal stimulation, and nervous stimulation hypertrophy - Correct Answer-Increase in the size of the cells that increase the size of the affected organ. Heart and kidneys (responsive to enlargement) and skeletal muscle. physiologic hypertrophy - Correct Answer-occurs with increased demand, stimulation of hormones, and growth factors. Ex. Pregnancy causes hormone induced hypertrophy of the uterus, in skeletal muscle occurs as a response to heavy workload. pathologic hypertrophy - Correct Answer-results from chronic hemodynamic overload. Ex. Hypertension or heart valve dysfunction. Hypertrophic cells have increased accumulation of ER, plasma membrane, myofilaments, mitochondria (not cellular fluid). Nucleus is also hypertrophic with increased DNA synthesis. Triggers for cardiac hypertrophy include mechanical signals (stretch) and trophic signals (growth factors and vasoactive agents). Hyperplasia - Correct Answer-increase in number of cells in an organ/tissue as a response to injury that results from an increased rate of cellular division compensatory Physiologic hyperplasia - Correct Answer-is an adaptive mechanism that enables certain organs to regenerate. Occurs in skin, intestines, hepatocytes, bone marrow, and fibroblasts. Ex. Is when skin gets callus in response to mechanical stimulus. Hormonal physiologic hyperplasia - Correct Answer-Hormonal occurs mainly from estrogen dependent organs such as uterus and breasts.Ex- after ovulation estrogen
mature cells. mostly found in epithelia Significance of dysplasia - Correct Answer-can be reversed if it does not involve the entire epithelium. When dysplastic changes penetrate the basement membrane it is considered a preinvasive neoplasm (carcinoma in situ) mechanisms of cell injury - Correct Answer-ATP depletion, mitochondrial damage, accumulation of oxygen and oxygen-derived free radicals membrane damage protein folding defects DNA damage defects calcium level alterations reperfusion injury - Correct Answer-injury to tissue that occurs after blood flow is restored restoration of needed oxygen is accompanied by oxidative stress with the generation of toxic oxygen radicals which damage cellular membranes and mitochndria What helps reperfusion injury? - Correct Answer-antioxidants and anti-inflammatory drugs examples of cell injury - Correct Answer-ischemic and hypoxic injury ischemia-reperfusion injury oxidative stress or accumulation of oxygen-derived free radicals induced injury chemical injury Cell injury: ATP depletion - Correct Answer-loss of mitochondrial ATP and decreased
ATP synthesis results include: cellular swelling decreased protein synthesis decreased membrane transport lipogenesis all changes that contribute to loss of integrity of the plasma membrane Cell injury: Oxygen and oxygen-derived free radicals - Correct Answer-lack of oxygen is key in progression of cell injury in ischemia (reduced blood supply) activated oxygen species (free radicals) cause destruction of cell membranes and cell structure Cell Injury: Intracellular calcium and loss of calcium steady state - Correct Answer- Normally intracellular cytosolic calcium concentrations are very low; ischemia and certain chemicals can cause an increase in cytosolic Ca concentrations sustained levels of Ca continue to increase with damage to plasma membrane Ca causes intracellular damage by activating enzymes Cellular events that occur with ischemia-hypoxic injury - Correct Answer--Decrease in oxygen reaching the cell
- decrease in ATP production within mitochondria
- failed NA+/K pump
- Na, Ca enter cell, K leaves
- organelle swelling
- protein synthesis stops
Deleterious effects of free radicals on cells - Correct Answer--unstable compounds with an unpaired electron in outer ring
- anxious to "mate" with other substances affinity for lipid substances (there is a phospholipid bilayer membrane around cell)
- combine avidly with cell and organelle membranes
- lipid peroxidation - dissolution of the membrane
- "drills a hole" examples o diseases linked to oxygen-derived free radicals - Correct Answer-aging atherosclerosis brain disorders Cancer Cardiac myopathy Diabetes Eye disorders inflammatory disorders iron overload emphysema radiation injury reperfusion injury rheumatoid arthritis sleep apnea Burns
Most types of cellular accumulations occur as a result of what 4 mechanisms - Correct Answer- 1 - insufficient removal of normal substance because of altered packaging/transport 2 - abnormal substance (result of mutated gene) accumulated because of deficits in protein folding, transport, or abnormal degredation 3 - endogenous substance not effectively catabolized because of lack of vital lysosomal enzyme 4 - harmful exogenous materials such as heavy metals, dusts, microorganisms that accumulate because of inhalation, ingestion, or infection normal substances that cause cell accumulation - Correct Answer-water protein lipid carbs abnormal substances that cause cell accumulation - Correct Answer--endogenous: product of abnormal metabolism synthesis
- exogenous: infectious agent or material pathophysiology of reperfusion injury - Correct Answer--generation of highly reactive oxygen intermediates (oxidative stress)
- these radicals cause further membrane damage and mitochondrial calcium overload what does reperfusion cause - Correct Answer--causes creation of free radicals, pH alterations, inflammatory signaling, osmotic changes, gap junction changes, calcium overload, apoptosis
