Porth's Pathophysiology Ch.2, Cell & Tissue Characteristics

Which statement made by the student nurse demonstrates that teaching about the Krebs cycle has been affective?

"It provides the final common pathway for the metabolism of nutrients."

What are cyclins?

- family of proteins that control progression of cells through cell cycle - activate CDKs - CDKs phosphorylate specific proteins to activate or inhibit the cell cycle - there are a different arrangement of cyclin and CDKs at each stage - transition from G2 to M is the most important

Chromosomes

1 from mom, 1 from dad 46 single or 23 pairs 22 are autosomes, 1 sex male XY, female XX ***only 1 X in females control expression of traits but both XX activated in gametogenesis

How many strands are used in transcribing info? DNA replication?

1 strand for transcribing 2 strands for DNA rep

What balances cell population?

1. cell proliferation 2. new cells from differentiation 3. death by apoptosis

What are cyclin-CDK complexes regulated by?

1. synthesis and degradation of cyclin 2. binding of CDK inhibitors ***CDK inhibitors prevent CDKs from working and therefore stop the cell cycle

The Krebs cycle provides a common pathway for the metabolism of nutrients by the body. The Krebs cycle forms two pyruvate molecules. Each of the two pyruvate molecules formed in the cytoplasm from one molecule of glucose yields another molecule of:

ATP

Which cellular dysfunction is responsible for the manifestations of cystic fibrosis?

Abnormal chloride channel proteins allow increased sodium and water reabsorption.

When cells use energy to move ions against an electrical or chemical gradient, the process is called:

Active transport

The microbiologist is explaining cell communication. Which statement is accurate?

Autocrine signaling occurs when a cell releases a chemical into the extracellular fluid that affects its own activity.

How do growth factors initiate a response?

Bind to a R and trigger extracellular signals that are transmitted into cell - signal in the cell producing the GF = autocrine - signal in cells in immediate vicinity = paracrine - signal in distant cells (bloodstream) = endocrine

A 6-year-old child cuts her leg while playing outside. An inflammatory process begins the healing process by moving leukocytes and platelets through the endothelial lining of blood vessels. This process results in linking actin and structures with which extracellular component?

Cadherins

Dysplasia

Change in size, shape, and organization

The nurse is caring for a client receiving colchicine for treatment of gout. The nurse knows the drug is effective because it:

Correct response: stops microtubules from forming. Explanation: Colchicine works by interfering with formation of the mitotic spindles made from microtubules that are necessary for cell mitosis. It also prevents migration of neutrophils and lowers their response to urate crystals in the tissues. The axoneme is part of the cell that produces mobility for cilia and flagella. The proteasomes are cell mechanisms for regulating the protein quality.

Which statements are true about the cell nucleus? Select all that apply.

DNA contains information used for protein synthesis rRNA synthesizes proteins All eukaryotic cells have at least one nucleus

When does the body make the most lactic acid? Select all that apply.

During intense exercise During cardiac arrest

From which embryonic tissue do nerve cells develop?

Ectoderm

Tissues are composed primarily of cells in the M phase.

False

Scenario: A woman breaks her leg, 3 wks. later you find .. new calluses on the right foot

Hyperplasia

Hyperplasia

Increase in number of cells

infarction

Necrosis or death of tissues due to local ischemia resulting from obstruction of blood flow

Which type of epithelium is found in the lining of blood vessels, lymph nodes, and alveoli of the lungs?

Simple squamous epithelium

A nurse practitioner (NP) has been asked to speak with a local high school track team about health, wellness, and nutrition. One of the athletes asks about the differences in the physiology of the energy used in sprinting versus long-distance running. Which response is the best answer?

Sprinters utilize ATP generated via anaerobic glycolysis, and distance runners utilize ATP generated via aerobic metabolism.

A Jewish couple that is trying to conceive ask the nurse if they should receive genetic counseling. The nurse is aware that an autosomal recessive disorder that causes a deficiency in hexosamininidase A may be present. What disorder should the couple be tested for?

Tay-Sachs disease

The obstetrical nurse is caring for a client who is in the second stage of labor. What physiologic process would result from the action of smooth muscle?

The client experiences vasoconstriction as a result of physiologic stress.

Scenario: 2 boys suffer from hypoxia : one with a normal body temp and one who is very cold- Which one will have more cell swelling?

The one who is very cold due to vasoconstriction and an increased viscosity of blood

Each skeletal muscle is a discrete organ made up of hundreds or thousands of muscle fibers. Although muscle fibers predominate, substantial amounts of connective tissue, blood vessels, and nerve fibers are also present. What happens during muscle contraction?

The thick myosin and thin actin filaments slide over each other, causing shortening of the muscle fiber.

How does facilitated diffusion enable molecules to cross cell membranes?

Transport proteins carry molecules to areas of lower concentration

An example of a stressed cell filling up with pigment is

a tattoo, black lung, jondus

Multipotent cells

able to differentiate into a specific family of cells - ex. bone marrow, skin, hemopoietic

Allele

alternate form of a gene

Example of Hypertrophy

athletes muscles get bigger

A nurse is assessing a patient who is a body builder. The nurse documents the increased size of the patient's muscle as resulting from which of the following? a) Atrophy b) Hypertrophy c) Dysplasia d) Hyperplasia

b) Hypertrophy Explanation: Hypertrophy represents an increase in cell size and with it an increase in the amount of functioning tissue mass (Fig. 5.2). It results from an increased workload imposed on an organ or body part and is commonly seen in cardiac and skeletal muscle. tissue, which cannot adapt to an increase in workload through mitotic division and formation of more cells.1

A 68 year old male client with aortic stenosis secondary to calcification of the aortic valve is receiving care. Which of the following statements best captures an aspect of this client's condition? a) Paget's disease, cancer with metastases or excess vitamin D may have been contributors. b) The client has possibly undergone damage as a result of calcification following cellular injury. c) Increased calcium intake over time may have contributed to the problem. d) The client has possibly exhibited phosphate retention leading to calcium deposits.

b) The client has possibly undergone damage as a result of calcification following cellular injury. Explanation: Dystrophic calcification is a result of deposition of calcium following cellular injury, such as that which commonly occurs in heart valves. Answers A, B and D all refer to phenomenon associated with metastatic calcification and the associated increases in serum calcium levels.

Heat

burn and heatstroke; increase in cell metabolism, inactivate temperature sensitive enzymes, disrupt cell membrane

How are most human traits determined?

by multiple pairs of genes

Unipotent cells

can only differentiate into 1 cell type can only make itself retain properties of self renewal

Example of Dysplasia

cancer

Injurious agents

causes stress damage

The cell surface is surrounded by a cell coat (glycocalyx.). Select the most important function of the cell coat.

cell to cell recognition and adhesion

How does Necrosis work?

cells swell and rupture, inflammation results

Mitochondria

cellular respiration houses mtDNA (only from mom) has its own DNA and its self replicating

What kind of proteins do free ribosomes make?

cytosolic proteins will stay inside cell to be used

Which of the following statements would a nurse tell a patient that best describes a lab finding of metaplasia? a) "This is a decrease in the oxygen-carrying capacity of the cells." b) "This is a change in the number of cells as they adapt to change." c) "this is a decrease in the size of the cell." d) "This is a change in cell form as it adapts to increased work demands or threats to survival."

d) "This is a change in cell form as it adapts to increased work demands or threats to survival." Explanation: Metaplasiais a change in the cell's form as it adapts to increased work demands or threats to survival. Hyperplasia is the change in the number of cells, and atrophy and hypertrophy are changes in a cell's size. Hypoxia or hypoxemia are decreases in oxygen

A client's condition has resulted in a decrease in work demands of most cells in the body; the anticipated result would be: a) Decreased programmed cellular death b) Increased mitochondrial growth c) Increased oxygen consumption d) Decreased size of organelles

d) Decreased size of organelles Explanation: Cell atrophy results in a decreased number and size of cell organelles. With cell atrophy, the cell has decreased oxygen consumption and growth of the mitochondria. The cell decreases in size. When confronted with a decrease in work demands or adverse environmental conditions, most cells are able to revert to a smaller size and a lower and more efficient level of functioning that is compatible with survival. This decrease in cell size is called atrophy. Cellular death process is not affected.

Which of the following assessments supports the finding of lead toxicity? a) Heart rate 70 beats/min b) Hematocrit 40% c) Blood pressure 140/90 mm/Hg d) Hemoglobin 9 g/dL

d) Hemoglobin 9 g/dL Explanation: Anemia is a cardinal sign of lead toxicity. Lead competes with the enzymes required for hemoglobin synthesis and with the membrane-associated enzymes that prevent hemolysis of red blood cells. The other findings are not necessarily found in lead toxicity.

A pregnant client is attending a nutrition class for first-time moms. During the class, the instructor stressed that they should avoid consumption of which food that may cause brain damage from methyl mercury exposure? a) Fresh milk b) Beets c) Raw hamburger d) Tuna

d) Tuna Explanation: The main source of methyl mercury exposure is from consumption of long-lived fish, such as tuna and swordfish. Fish concentrate mercury from sediment in the water. Because the developing brain is more susceptible to mercury-induced damage, it is recommended that young children and pregnant and nursing women should avoid consumption of fish known to contain high mercury content. None of the other foods listed pose a threat of mercury toxicity.

Atrophy

decrease in size

What do lysosomes do?

digestive system of cell highly acidic molecules that break down unwanted and excess parts, and foreign substances

Chemical Agents

drugs, lead, mercury, caron monoxide, insecticides, tobacco smoke- liver damage , injure the cell membrane, block enzymatic pathways, coagulate cell proteins, disrupt the ionic and osmotic balance

Semiconservative replication

each daughter cell contains meaningful strand and complementary strand - 2 strands are separated - complementary molecule duplicated next to each original strand (2 becomes 4) - newly duplicated double stranded molecules separated and placed in daughter cells

When exercising outside on an extremely warm day, the client can feel his heart pounding very rapidly. Thinking in terms of the ability of the aorta to stretch to accommodate more blood circulating during exercise and the warm environment, this is an example of the function of which fibrous protein?

elastin

Mutations

errors in DNA inserting base pairs, taking them out, substituting them can be edited by DNA readers

Where do all cell types originate?

fertilized ovum

What are growth factors?

hormome-like proteins that trigger cell proliferation ***the same GF can have opposite effects on a cell = can cause some cells to proliferate and inhibit others

An example of a stressed cell filling up with calcium salts is

hyperparathyroid (hypercalcemia)

Reasons for Necrosis : Coagulation

hypoxic areas (Lack of oxygen)

Hypertrophy

increase in size

Smooth muscle contractions are typically characterized as:

involuntary

Dry gangrene

lack of arterial blood supply but can carry fluid out of the tissue, causes tissue to coagulate

Wet gangrene

lack of veneous flow so a bunch of fluid accumulates; organ is cold and swollen; foul odor

Calcium cascade

letting in more calcium to the cell

Function of activator and repressor sites

monitor protein product levels and regulate GE - product level down = increase transcription - product level up = decrease transcription

Free radical formation causes

oxidation

The cell membrane is also called what?

plasma membrane

What kind of proteins do RER ribosomes make?

proteins for export

2 subunits of ribosomes

rRNA and proteins held together by strand of mRNA

Gas gangrene

toxic bubbles, clostridium infection produces toxins and H2S bubbles

Necrosis

unregulated cell death caused by injury to the cell

Scenario: Mr.X had a stroke and blood flow is cut off to part of the brain- Why give him oxygen?

we want to hyperoxygenate so that cells can have as much oxygen as possible

A nurse is caring for four clients. Select the client at greatest risk for high blood levels of lead. a) A 62-year-old male with hypercalcemia who smokes b) A 30-year-old Caucasian female office worker with asthma c) A 17-year-old Hispanic male student who takes a wood working class d) A 2-year-old anemic child who lives in a turn-of-the-century home

d) A 2-year-old anemic child who lives in a turn-of-the-century home Explanation: The client at the highest risk of having higher blood levels would be a young child who is likely to puts small toys in his or her mouth or ingests lead dust form soil. Factors that increase the risk of lead toxicity include preschool age, low socioeconomic status, and living in older housing built primarily before 1960. A client with a deficiency in calcium (hypocalcemia), iron, or zinc increases his or her risk of lead absorption. Behaviors that include smoking and working around wood have no apparent affect on the development of lead poisoning.

Biologic agents differ from other injurious agents in that they are able to replicate and can continue to produce their injurious effects. How do Gram-negative bacteria cause harm to the cell? a) Gram-negative bacilli enter the cell and disrupt its ability to replicate. b) Gram-negative bacilli cannot cause harm to the cell; only Gram-positive bacilli can harm the cell. c) Gram-negative bacilli excrete elaborate exotoxins that interfere with cellular production of ATP. d) Gram-negative bacilli release endotoxins that cause cell injury and increased capillary permeability.

d) Gram-negative bacilli release endotoxins that cause cell injury and increased capillary permeability Explanation: Gram-negative bacilli release endotoxins that cause cell injury and increased capillary permeability. Certain bacteria excrete elaborate exotoxins that interfere with cellular production of ATP. Gram-negative bacilli do not disrupt a cell's ability to replicate. Many Gram-negative bacilli cause harm to cells

A patient asks why her breasts are enlarged during pregnancy. Which of the following is the best answer? a) Atrophy due to decreased workload b) Decreased workload of the glands c) Increased blood flow to the area d) Hyperplasia due to estrogen stimulation

d) Hyperplasia due to estrogen stimulation Explanation: Physiologic hyperplasia results from estrogen stimulation during pregnancy, causing the breasts and uterus to enlarge

Which of the following exemplifies physiologic hypertrophy? a) Heart size increase in hypertension b) Lung size increase in emphysema c) Cell size increase with hypoxia d) Muscle mass increase with exercise

d) Muscle mass increase with exercise Explanation: Hypertrophy that occurs as the result of normal physiologic conditions is seen as muscle mass increases with exercise. Heart size increase in hypertension is an example of pathologic increase, as is lung size increase in emphysema and cell increase with hypoxia

Which of the following should be included in the teaching plan of care for the parents of a child diagnosed with Tay-Sachs disease? a) The primary organ affected is the heart. b) The disorder involves tissue hyperplasia. c) Symptoms are often noted at birth. d) The disorder involves accumulation of abnormal lipids.

d) The disorder involves accumulation of abnormal lipids. Explanation: In Tay-Sachs disease, a genetic disorder, abnormal lipids accumulate in the brain and other tissues, causing motor and mental deterioration beginning at approximately 6 months of age, followed by death at 2 to 5 years of age

Increased intracellular calcium causes

damge to cell organelles

Reasons for Necrosis : Caseous Necrosis

dead cells persist indefinitely such as in tuberculosis

A client experiences compartment syndrome after a leg injury. Surgical intervention will focus on which type of connective tissue?

dense connective tissue

Hypoxia

deprives the cell of oxygen and interrupts ATP generation

Pluripotent cells

differentiate into 3 germ layers (mesoderm, endoderm, ectoderm)

The process responsible for generating and conducting membrane potentials is:

diffusion of current-carrying ions.

Which form of signal transduction resulting from ligand-receptor binding has the potential to produce effects in the entire body system?

endocrine

Nutritional imbalances

excess or deficiency of a nutrient- anemia

True or false? Cells usually maintain high intracellular calcium levels

false ; low

Electricity

lightning or high-voltage wires- extensive tissue injury or disruption of neural and cardiac impulses

Locus

location on chromosome

Select the organelle that is responsible for the breakdown of excess and worn-out cell parts as well as foreign substances that are taken into the cell.

lysosomes

Expressitivity

manner in which a gene is expressed in the phenotype; may be mild to severe

Example of Atrophy

menopause- decrease in hormones which causes a decrease in reproductive organ size.

At which part of the cell is the action by the vinca alkaloid drugs directed during cancer treatment?

microtubules in the cytoskeleton

Free radicals

molecules with an unpaired electron in the outer electron electron shell ; they are extremely unstable and reactive, can damage normal cell component and produce more.

Multifactorial inheritance

multiple genes and environmental factors contribute its less predictable

Polygenic inheritance

multiple genes at different loci have additive effect in determining trait

Function of cytoskeleton

network of thick filaments, intermediate filaments, microfilaments controls shape and movement

Reasons for Necrosis : Infarction

no blood supply

Scenario: 2 boys suffer from hypoxia : one with a normal body temp and one who is very cold - Which one will have a lower intracellular pH?

normal body temp because metabolism is the same with an increase in lactic acid

Antioxidants

normally remove free radicals from the body

Accumulated damage in aging cells

older cells have more DNA damage, more free radicals, and cells lose their ability to repair their telomeres.

Monogenic/Mendelian inheritance

only 1 pair of genes involved in transmission of info

While reviewing the basic information related to hemodialysis, the professor explains that water molecules move through adjacent phospholipid molecules in the cell membrane by:

osmosis

How do you reactivate the cell cycle for non-proliferative and quiescent cells?

remove the CDK inhibitor

When working with a client who has end-stage renal disease (ESRD) and is receiving peritoneal dialysis, the concept of diffusion can be explained by which statement?

"If your potassium level is high, then K+ particles will move from your peritoneal cavity into the dialysis solution, where the concentration of K+ is lower."

The nurse educated a client with a suspected myocardial infarction (MI) about the blood test to evaluate troponin levels. The nurse knows the education has been successful when the client says:

"This test is specific to components found in my heart muscle."

Apoptosis

"cell suicide" or programmed death

How is DNA packaged?

- DNA helices wrapped around histones and spiraled into chromatin (tightly packed) - all condensed in chromosomes

Actions of GFs

- assist in healing process - chemoattractants for neutrophils - stimulate angiogenesis - contribute to generation of ECM - promote cell proliferation - prevent apoptosis - enhance synthesis of cellular proteins in prep for mitosis

Progenitor cells

- come from stem cells - specialized in a certain type of cell, but not so specialized that they can't proliferate - ex. hemopoietic cells

Gene expression

- degree to which a particular gene or group of genes are expressed - induction = increases GE - repression = decreases or prevents GE

Permanent tissue

- do not proliferate - do not do mitosis past postnatal life - once destroyed, will be replaced with fibrous scar tissue but it lacks functional characteristic of cell

mtDNA

- from mom - 37 genes = 24 needed for mtDNA translation, 12 for oxidative metabolism - issues affect neuromuscular system

Functions of molecular chaperones

- functional conformation of new protein - prevent misfolding - protein relocation ***disruption of chaperones can lead to denaturation and instability and cause Parkinson's, Alzhemier's, Huntington's disease

Meisois

- germ cell production - only once in cell line - results in ovum and sperm - 4 daughter cells produced

Continually dividing tissue/labile tissue

- mature cells are terminally differentiated and short lived - can divide and replicate throughout life - can rapidly regenerate after injuries as long as stem cell pools are ready

Golgi body

- modifies and packages proteins - sends them off in vesicles to be exported - makes large CHO molecules - makes glycoproteins - can receive products coming into cell

Stable tissue

- normally stop dividing when growth ceases - capable of regenerating if needed - remain in G0 phase of cell cycle

Cell cycle checkpoints

- pauses at specific points to ensure correct DNA replication, each step is doing what its supposed to - can edit out defects, repair bad DNA - cyclins are the family of protein that do this

Totipotent cells

- produced by fertilized ovum - 1st few cells after fertilization - can differentiate into any kind of cell

Mitosis

- replication of non-germ cell - repair tissue, wound healing - increase tissue mass - duplicate chromosomes and divide in 2

What kind of cells are stable?

- smooth muscle - vascular endothelial cells

What kind of cells are continually dividing?

- surface epithelial cells of skin, mouth and vagina - bone marrow cells

Functions of ECM

- turgor to soft tissue - rigidity to bone - substratum for cell adhesion - growth of cells - movement of cells - differentiation of cells - storage of molecules during repair process - provides scaffolding for repair tissue

Cell cycle

- when cells duplicate their contents and divide into 2 cells - tissue repair, cancer, replacing cells - continuously dividing cells like stratified squamous will go from 1 cell to the next - some highly specialized cells cannot divide and stay in G0 - interphase = G1, GS, G2 - mitosis = division - cytokinesis = actual separation

Stresses damage cells by..

1) free radical formation 2) increased intracellular calcium 3) ATP depletion

Critical to the wound healing process are the transitions in the composition of the extraceullular matrix (ECM). Place the following steps in the proper order from the transitional process of the ECM to delivery to site of injury.

1. ECM components are degraded by proteases (enzymes) 2. Some of the proteases are highly specific and cleave particular proteins at a small number of sites. 3. Structural integrity of the ECM is retained while healing occurs. 4. Actions of proteases are tightly controlled by being produced in an inactive form. 5. Proteases are activated by certain chemicals present at the site of injury. 6. Chemicals are rapidly inactivated by tissue inhibitors once injury is healed.

What 4 factors regulate differentiation?

1. expression of specific genes 2. external stimuli provided by neighboring cells 3. ECM 4. variety of growth factors

Differentiation

= cells become more specialized - as you go down line, you get more differentiated but the variety of things you can do gets smaller - as cells become more specialized, the stimuli able to induce mitosis is more limited - more specialized cells will not be able to divide

A client has been diagnosed with a genetic disorder that affects his voltage-gated sodium channels, increasing his risk of sudden cardiac death. In a healthy individual, what role do ion channels perform in the body?

Allow for membrane potentials to be established in excitable cells for rapid ion movement

A client experiences burning muscle pain at the peak of high intensity physical training for an athletic competition. What is the best explanation for the cause of this occurrence?

Anaerobic glycolysis creates pyruvate, which converts to lactic acid.

Which of the following is true about a cell's cytoplasm?

Answer: The cell contains organelles. The cell is where protein is synthesized. The cell transports substances within the cell. The cell serves as its own digestive system. Explanation: Embedded in cytoplasm are various organelles, which function as the organs of the cell. These organelles include the ribosomes, endoplasmic reticulum, Golgi complex, mitochondria, and lysosomes. Ribosomes serve as sites for protein synthesis in the cell, whereas the endoplasmic reticulum functions as a tubular communication system that transports substances from one part of the cell to another. Lysosomes are viewed as the digestive system of the cell. The nucleus is the site for the synthesis of the three types of ribonucleic acid (mRNA, rRNA, and tRNA) that move to the cytoplasm and carry out the actual synthesis of proteins.

A client with end-stage renal disease has been on peritoneal dialysis at home. Based on the lab work, the client regulates the type of solution to infuse into the abdomen. When there is a high concentration of potassium inside the cell (hyperkalemia), the solution infused has a lower concentration so that the potassium ions will diffuse outward. At this point, the cellular membrane is said to be:

Answer: polarized because of the presence of a negative membrane potential. Explanation: Because of the large concentration gradient existing across the cell membrane, potassium ions tend to diffuse outward. As they do so, they carry their positive charges with them, causing the inside to become negative in relation to the outside. This new potential difference repels further outward movement of the positively charged potassium ion. The membrane is said to be polarized.

Which type of epithelium is found in the lining of blood vessels, lymph nodes, and alveoli of the lungs?

Answerr: Simple squamous epithelium Simple squamous epitheliumi s adapted for filtration, which works well on the blood vessels, lymph nodes, and alveoli of the lungs. Stratified squamous keratinized epithelium makes up the epidermis of the skin. A pseudostratified ciliated columnar epithelium with goblet cells forms the lining of most of the upper respiratory tract. Transitional epithelium is well adapted for the lining of organs that are constantly changing their volume, such as the urinary bladder.

Scenario: A woman breaks her leg, 3 wks. later you find .. The left leg is smaller than the right

Atrophy

The nurse is assigned to care for the client with primary ciliary dyskinesia. What effects does this syndrome have on the body that the nurse should be aware of? Select all that apply.

Bronchiolitis Sinus aplasia A reversal of the thorax and abdominal organs

Cadherins, selections, and some integrins, which are adhesion molecules, depend on which of the following to function in cell adhesion?

Calcium

Select all cell actions that are moderated by enzyme-linked receptors.

Calcium influx Sodium-potassium exchange Glucose uptake

Metaplasia

Change in the type of cell from one type to another

A client comes to the clinic complaining of severe pain in the left great toe and is diagnosed with gout. What medication that stops cell mitosis in the treatment of gout does the nurse anticipate educating the client about?

Colchicine

A client is having surgical removal of her gallbladder laparoscopically. While dissecting the gallbladder for removal, what type of epithelial tissue will be removed?

Columnar

Which type of cell in tissue produced the extracellular matrix that supports and holds the tissues together?

Connective tissue

The nurse is caring for a child newly diagnosed with a lysosomal storage disease. What instruction should the parents receive?

Consider genetic testing if you plan to have more children.

Which statements describe characteristics of the plasma membrane? Select all that apply.

Contains a bilayer of lipids with hydrophilic heads Provides receptors for hormones Participates in the electrical events of muscle cells Has a cell coat with immunoregulatory properties

When discussing the function of the cell membrane during pathophysiology class, which statement(s) by the faculty is accurate? Select all that apply.

Contains receptors for hormones and neurotransmitters Allow ions to cross the membrane during electrical signaling in cells Helps determine what can and cannot enter and exit cells

Which body process uses cell differentiation?

Correct response: A bone marrow transplant is successful. Oral mucosa repairs ulcers post-chemotherapy. Explanation: Stem cells in the bone marrow are undifferentiated enough that they can completely rebuild the hematopoietic and immune systems from a transplant. The stem cells lining the gastrointestinal tract can also differentiate as needed. Skeletal muscle cells and nerve cells are highly specialized. Nerve cells do not have enough undifferentiated stem cells to regenerate while neither skeletal nor cardiac muscle can undergo the mitotic activity needed to replace/regenerate injured cells.

The nurse is assigned to care for the client with primary ciliary dyskinesia. What effect does this syndrome have on the body that the nurse should be aware of?

Correct response: Bronchiolitis Sinus aplasia A reversal of the thorax and abdominal organs Explanation: Primary ciliary dyskinesia (formerly Kartagener syndrome) is an example of immotile cilia syndrome and involves diffuse bronchiolitis, sinus aplasia, and situs inversus totalis, which is a reversal of the thorax and abdominal organs.

A client is having surgical removal of her gallbladder laparoscopically. While dissecting the gallbladder for removal, what type of epithelial tissue will be removed?

Correct response: Columnar Explanation: Columnar epithelial tissue is found on the lining of the intestine and gallbladder.

Tissues are composed primarily of cells in the M phase.

Correct response: False Explanation: Tissues may be composed primarily of quiescent cells in the G0 phase. The M phase is the phase during which cell mitosis occurs.

The Golgi complex, or Golgi bodies, consists of stacks of thin, flattened vesicles or sacs within the cell. These Golgi bodies are found near the nucleus and function in association with the endoplasmic reticulum (ER). What is one purpose of the Golgi complex?

Correct response: Receive proteins and other substances from the cell surface by a retrograde transport mechanism Explanation: Recent data suggest that the Golgi apparatus has yet another function: it can receive proteins and other substances from the cell surface by a retrograde transport mechanism. Golgi bodies do not produce bile. They produce secretory, not excretory, granules, and they produce large carbohydrate molecules rather than small ones.

The student is studying membrane potentials. Which membrane potential is essentially a potassium equilibrium potential?

Correct response: Resting membrane potential Explanation: The resting membrane potential, which is necessary for electrical excitability, is present when the cell is not transmitting impulses. Because the resting membrane is permeable to potassium, it is essentially a potassium equilibrium potential.

How does facilitated diffusion enable molecules to cross cell membranes?

Correct response: Transport proteins carry molecules to areas of lower concentration. Explanation: Diffusion is movement of a substance across cell membranes in the direction of a lower concentration. Facilitated diffusion also moves substances to areas of lower concentration, but with the assistance of a carrier molecule. Ion channels are proteins that allow certain electrolyte ions to pass rapidly through the membrane. Active transport occurs when a transport protein carries substances across the cell membrane toward an area of higher concentration.

The process responsible for generating and conducting membrane potentials is:

Correct response: diffusion of current-carrying ions. Explanation: Membrane potentials rely on the permeability of the cell membrane and the diffusion of electrically charged ions. If voltage-gated channels remain closed, membrane potential cannot be generated. Ion channel neurotransmitters are involved with opening protein channels for purposes of cell-to-cell communication.

A teenager has experienced repeated bacterial infections throughout her life and has recently been diagnosed with leukocyte adhesion deficiency. The nurse explains that this is caused by the teenager's inability to:

Correct response: synthesize appropriate integrin molecules. Explanation: Persons affected with leukocyte adhesion deficiency are unable to synthesize appropriate integrin molecules. As a result, they experience repeated bacterial infections because their white blood cells are not able to transmigrate through vessel walls.

When does the body make the most lactic acid?

Correct response: During cardiac arrest During intense exercise Explanation: Lactic acid is produced from pyruvate during anaerobic metabolism, which occurs during intense physical exercise, cardiac arrest, and circulatory shock. Gluconeogenesis is the process by which the liver converts lactic acid back to glucose. Fat metabolism produces fatty acids that are broken down into acetyl CoA, which enters the citric acid cycle.

Which statement regarding cell metabolism is most accurate?

Correct response: Glycolysis also provides energy in situations when delivery of oxygen to the cells is delayed. Explanation: Glycolysis provides energy in situations when delivery of oxygen to the cells is delayed or impaired. Anabolism is a constructive process, in which more complex molecules are formed from simpler ones. Energy from foodstuffs is used to convert ADP to ATP. The aerobic pathway occurs in the mitochondria.

A nurse practitioner (NP) has been asked to address the local high school basketball team regarding health and nutrition. One player asks how the pizza he ate last night is converted to energy that he can use today when he goes to practice. Which response is the best answer?

Correct response: Nutrients are converted to ATP, and when ATP undergoes hydrolysis, it transfers energy to molecules in the cells for their use. Explanation: Cellular metabolism (catabolism) of carbohydrates via glycolysis, TCA cycle, and the mitochondrial electron transport chain converts the caloric energy into the chemical energy of ATP. ATP is hydrolyzed by enzymes in the cell to liberate the stored energy.

Which type of tissue forms the architecture of liver sinusoids and lymphoid tissues such as the spleen?

Correct response: Reticular connective tissue Explanation: Reticular connective tissue is characterized by a network of fibers interspersed with fibroblasts and macrophages. Reticular tissue forms the architecture of liver sinusoids, adipose tissue, bone marrow, and lymphoid tissues such as the spleen.

A nurse practitioner (NP) has been asked to speak with the local high school track team about health, wellness, and nutrition. One of the athletes asks about the differences in the physiology of the energy used in sprinting versus long-distance running. Which response is the best answer?

Correct response: Sprinters utilize ATP generated via anaerobic glycolysis, and distance runners utilize ATP generated via aerobic metabolism. Explanation: The use of anaerobic glycolysis by sprinters is due to the rapid demand for ATP, which outpaces the ability to produce it. Distance runners utilize ATP as it is synthesized; therefore, they may run for much longer. Diet does not affect muscle function on a cellular level. A reference to "explosive" or "slow, steady" energy does not explain the physiology of the matter.

In which parts of the body are smooth muscles found?

Correct response: Stomach Renal ureters Blood vessels Explanation: There are three types of muscle tissue. Cardiac and skeletal muscles are striated and a located in the heart and muscles that support the body. Smooth muscle is not striated and is found in the iris of the eye, stomach, urinary bladder, and hollow tubes such as blood vessels, ureters, and the common bile duct.

Which statements describe epithelial tissue cells? Select all that apply.

Correct response: They have no blood vessels. They require moisture. They are classed by shape. Explanation: Epithelial cells are closely joined together, have an underlying basement membrane, are avascular, and must be kept moist to survive. They have three surfaces: a free (apical) surface, a lateral surface, and a basal surface. Epithelial cells are classified by the number of layers and the shape of the cells.

Which statement made by the student nurse demonstrates that teaching about the Krebs cycle has been effective?

Correct response: "It provides the final common pathway for the metabolism of nutrients." Explanation: The Krebs cycle provides the final common pathway for the metabolism of nutrients. Glycolysis is the process by which energy is liberated from glucose.

A client has been diagnosed with a genetic disorder that affects his voltage-gated sodium channels, increasing his risk of sudden cardiac death. In a healthy individual, what role do ion channels perform in the body?

Correct response: Allow for membrane potentials to be established in excitable cells for rapid ion movement Explanation: Membrane potentials occur at the level of the cell membrane; ion channels allow for the passage of charged particles in and out of the excitable cell. Membrane potentials do result from the binding of sodium and potassium ions, both of which have a positive charge. Gated channels open and close in response to specific stimuil. Blood cells do not participate directly in the establishment of membrane potential in general, or the role of ion channels in particular. Ion channels do not respond to lipophilic or hydrophilic substances.

The cell surface is surrounded by a cell coat (glycocalyx.). Select the most important function of the cell coat.

Correct response: Cell-to-cell recognition and adhesion Explanation: The cell coat participates in cell-to-cell recognition and adhesion, and it contains tissue transplant antigens. Ribosomes serve as sites for protein synthesis in the cell; the Golgi apparatus modifies materials synthesized in the ER. DNA provides the information necessary for the synthesis of the various proteins.

What is an accurate explanation of why a client with iron deficiency anemia experiences fatigue?

Correct response: Cytochromes in skeletal muscle are less effective at transporting oxygen. Explanation: Clients with iron deficiency anemia frequently have reduced blood hemoglobin levels, but they also have less effective cytochromes in the muscles. Normally, cytochromes have a stronger affinity for oxygen than heme molecules, so they attract the oxygen molecules to enter the muscle cells. When iron is reduced, there is less transport of oxygen into the cells by the cytochromes.

A client experiences compartment syndrome after a leg injury. Surgical intervention will focus on which type of connective tissue?

Correct response: Dense connective tissue Explanation: Dense connective tissue such as muscle fascia forms the fibrous sheath around many organs and bone. Compartment syndrome is when the fascia fills with blood or fluid compressing the vascular and nervous connections to the extremity. Surgical release of the fascia is essential to restoring function of the extremity.

When discussing the various functions of the cellular parts, the pathophysiology professor asks a group of students, "Where are the primary sites of protein synthesis located in a cell?" Which student response is correct?

Correct response: Endoplasmic reticulum Explanation: The endoplasmic reticulum (with its associated ribosomes) and Golgi apparatus represent the primary sites of protein synthesis in the cell.

The nurse is caring for a client with liver failure. What process of conversion does the nurse know will be impaired due to the inability of the liver to remove lactic acid from the bloodstream?

Correct response: Gluconeogenesis Explanation: The liver removes lactic acid from the bloodstream and converts it to glucose in a process called gluconeogenesis. This glucose is released into the bloodstream to be used again by the muscles or by the central nervous system.

At which part of the cell is the action by the vinca alkaloid drugs directed during cancer treatment?

Correct response: Microtubules in the cytoskeleton Explanation: Microtubules are responsible for mitosis. The vinca alkaloid agents inhibit mitosis by binding to microtubules, which prevents formation of the mitotic bundle.

The nurse is performing an assessment with a client who presents with blisters on the skin and mucous membranes. What primary disorder of desmosomes does the nurse suspect the client may be suffering from?

Correct response: Pemphigus Explanation: A primary disease of desmosomes is pemphigus, which is caused by a buildup of antibodies to desmosome proteins. Affected people have skin and mucuous membrane blistering.

A nurse on the oncology ward in the hospital is doing some background research to better understand the molecular basis of cancer. She comes to the understanding that transformed cancer cells are very similar to a normal type of cell, with the exception of regulation of division. Which cell type found in the normal state is most similar to a cancer cell?

Correct response: Stem cells Explanation: Cancer cells and stem cells have very similar characteristics. They both are immortal and undifferentiated, unlike epithelial, muscle, and neural tissue. The primary difference between stem cells and cancer cells is the rate and regulation of division. Cancer cells have lost the ability to regulate the cell cycle.

A client with long QT syndrome has the gene that increases potassium channels. How will this affect membrane potentials? It will cause:

Correct response: delayed return to resting potential. Explanation: Action potentials involve rapid changes when the sodium channels open allowing sodium to enter the cell, quickly followed by the sodium channels closing and the potassium channels opening so potassium exits the cell. An increase of potassium channels means this will happen quickly. In long QT syndrome, the heart takes longer than usual to recharge between beats, causing a delay in reaching the resting potential. Equilibrium potential is the balance between the electrical potential and the diffusion potential.

While reviewing the basic information related to hemodialysis, the professor explains that water molecules move through adjacent phospholipid molecules in the cell membrane by:

Correct response: osmosis. Explanation: Water molecules move through adjacent phospholipid molecules in the cell membrane by osmosis without actually dissolving in the region occupied by the fatty acid side of the chains. Osmosis is regulated by the concentration of nondiffusible particles on either side of the membrane, with water moving from the side with the lower concentration of particles to the side with the higher concentration.

What is an accurate explanation of why a client with iron deficiency anemia experiences fatigue?

Cytochromes in skeletal muscle are less effective at transporting oxygen.

What is chromatin remodeling?

DNA in chromatin is not accessible in the tightly wound structure - acetylation uncoils chromatin so DNA can be accessed - methylation of histones = gene inactivation

Transcription and translation

DNA to mRNA in nucleus mRNA leaves nucleus to go to ribosome tRNA brings AA to ribosomes for translation rRNA forms ribosomes that "read" the mRNA

A client with long QT syndrome has the gene that increases potassium channels. How will this affect membrane potentials? It will cause:

Delayed return to resting potential

Endocrine glands are epithelial structures that have had their connection with the surface obliterated during development. How are these glands described?

Ductless and produce secretions

When exercising outside on an extremely warm day, the client can feel his heart pounding very rapidly. Thinking in terms of the ability of the aorta to stretch to accommodate more blood circulating during exercise and the warm environment, this is an example of the function of which fibrous protein?

Elastin Explanation: Three types of fibers are found in the extracellular space: collagen, elastin, and reticular fibers. Elastin acts like a rubber band; it can be stretched and then returns to its original form. Elastin fibers are abundant in structures subjected to frequent stretching, such as the aorta and some ligaments. Collagen is the most common protein in the body. It is a tough, nonliving, white fiber that serves as the structural framework for skin, ligaments, tendons, and many other structures. Reticular fibers are extremely thin fibers that create a flexible network in organs subjected to changes in form or volume, such as the spleen, liver, uterus, or intestinal muscle layer.

A client is admitted to the hospital with reports of severe fatigue, weight gain, and feeling cold all of the time. The client is suspected of having a diagnosis of hypothyroidism and will have several diagnostic tests performed. What type of glandular dysfunction does the nurse suspect this will be?

Endocrine gland

When discussing the various functions of the cellular pets, the pathophysiology professor asks a group of students, "Where are the primary sites of protein synthesis located in a cell?" Which student response is correct?

Endoplasmic reticulum

Which term describes the chemical processes involved in converting carbohydrates, fats, and proteins from the foods we eat into the energy to perform these tasks?

Energy metabolism

Which type of receptor binds with insulin?

Enzyme-linked

A child has been diagnosed with an autoimmune disease that predominantly affects epithelial tissue. Histologic examination should include which body parts as potential sites of involvement? Select all that apply.

Epidermis Bladder Blood vessel lining

A client's condition has resulted in a decrease in work demands of most cells in the body; the anticipated result would be: a) Decreased programmed cellular death b) Increased mitochondrial growth c) Decreased size of organelles d) Increased oxygen consumption

Explanation: Cell atrophy results in a decreased number and size of cell organelles. With cell atrophy, the cell has decreased oxygen consumption and growth of the mitochondria. The cell decreases in size. When confronted with a decrease in work demands or adverse environmental conditions, most cells are able to revert to a smaller size and a lower and more efficient level of functioning that is compatible with survival. This decrease in cell size is called atrophy. Cellular death process is not affected

How does cellular activity change when a client with hyperglycemia received insulin?

Facilitated diffusion transports glucose into cells.

An example of a stressed cell filling up with unused foods is

Fatty liver and Taysacs disease

The nurse is administering a beta-blocker that is a G-protein receptor blocker. What type of messenger is blocked by this medication?

First messenger

The nurse is caring for a client with liver failure. What process of conversion does the nurse know will be impaired due to the inability of the liver to remove lactic acid from the bloodstream?

Gluconeogenesis

Which statement regarding cell metabolism is most accurate?

Glycolysis also provides energy in situations when delivery of oxygen to the cells is delayed.

Choose the accurate statement about how smooth muscle differs from skeletal or cardiac muscle. Select all that apply. Smooth muscle:

Has dense bodies attached to actin filaments Has one centrally located nucleus

Scenario: A woman breaks her leg, 3 wks. later you find .. the circumferance of the right calf has increased by 2 cm

Hypertrophy

ATP depletion

If mitochondria is not getting enough oxygen = hypoxia

Cold

Increase viscosity of blood and vasoconstriction

Some messengers, such as thyroid hormone and steroid hormones, do not bind to membrane receptors but move directly across the lipid layer of the cell membrane and are carried to the cell nucleus. What do they do at the cell nucleus?

Influence DNA activity

The client asks the health care provider to explain phagocytosis. The provider will respond, "Phagocytosis:

Is a process where microorganisms are engulfed and subsequently degraded or killed."

An instructor is explaining to a group of students the way in which muscles and their associated tendons can be so strongly attached. The instructor makes references to the role of the basal lamina. Which statement most accurately captures an aspect of the basal lamina?

It is present where connective tissue contacts the tissue it supports.

What will happen to a cell that does not make adaptive changes as a result of stress?

It will die

Gangrene

Large area of necrotic tissue

The living part of the cell found both inside and outside of the nucleus is called protoplasm. In addition to proteins, carbohydrates, electrolytes, and water, what other substance is found in protoplasm?

Lipids

While lecturing about what happens to undigested materials that remain in the cytoplasm, the instructor will emphasize which materials as residual bodies? Select all that apply.

Lipofuscin granules in the heart muscle cells of an older adult client Tattoo pigments from a tattoo received during a teenage prank

The parents of a child newly diagnosed with Tay-Sachs disease asks what signs and symptoms they will see if the disease is progressing. Which response(s) by the nurse is most accurate? Select all that apply.

Loss of motor skills like turning over Vision loss

The cytoplasm surrounds the nucleus of the cell and contains organelles. Select the organelles found in the cytoplasm. Select all that apply.

Lysosomes Endoplasmic reticulum Mitochondria Golgi apparatus

Scenario: A woman breaks her leg, 3 wks. later you find .. a nodule of skin tissue has formed a fluid-filled cyst near her incision

Metaplasia

Which statement accurately explains function of cellular components?

Microtubules aid intracellular transport

Which cellular organelle transforms organic compounds into energy that is easily accessible to the cell?

Mitochondria

Which statements are accurate about mitochondria? Select all that apply.

Mitochondria in active skeletal muscles increase rapidly Mitochondria are self-replicating Mitochondria regulate apoptosis

In Tay-Sachs disease, an autosomal recessive disorder, hexosaminidase A, which is the lysosomal enzyme needed for degrading the GM2 ganglioside found in nerve cell membranes, is deficient. Although GM2 ganglioside accumulates in many tissues, where does it do the most harm?

Nervous system and retinas

Which nondividing cells in a human body have left the cell cycle and are not capable of mitotic division once an infant is born. Select all that apply.

Neurons Skeletal muscle cells Cardiac muscle cells

Cell signaling systems help with communication through a process that requires a variety of first messengers. Which are examples of first messengers? Select all that apply.

Neurotransmitters Steroids Growth Factors Protein Hormones

A school nurse is teaching a class on immunity. Which statement contains an accurate explanation about cellular defenses?

Neutrophils engulf invading organisms where lysosomes break them down.

What are the three main parts of a typical cell? Select all that apply.

Nucleus Cell membrane Cytoplasm

A nurse practitioner (NP) has been asked to address the local high school basketball team regarding health and nutrition. One player asks how the pizza he ate last night is converted to energy that he can use today when he goes to practice. Which response is the best answer?

Nutrients are converted to ATP, and when ATP undergoes hydrolysis, it transfers energy to molecules in the cells for their use.

A client with a history of ischemic heart disease has had a myocardial infarction and gone into cardiac arrest. As a result, the client will:

Obtain energy from glycolysis due to the sudden development of anaerobic conditions.

A client with pemphigus has multiple mouth sores. Which class of medication is most likely to produce disease remission?

Oral steroids

The nurse is performing an assessment with a client who presents with blisters on the skin and mucous membranes. What primary disorder of desmosomes does the nurse suspect the client may be suffering from?

Pemphigus

How does the body react to the injection of tattoo pigments?

Pigment is encapsulated into residual bodies

A client with end-stage renal disease has been on peritoneal dialysis at home. Based on the lab work, the client regulates the type of solution to infuse into the abdomen. When there is a high concentration of potassium inside the cell (hyperkalemia), the solution infused has a lower concentration so that the potassium ions will diffuse outward. At this point, the cellular membrane is said to be:

Polarized because of the presence of a negative membrane potential.

The mitochondria are literally the "power plants" of the cell because they transform organic compounds into energy hat is easily accessible to the cell. What do the mitochondria do?

Produce ATP from carbon sources

There are two forms of endoplasmic reticulum (ER) found in a cell. They are the rough and smooth ER. What does the rough ER do in a cell?

Produces proteins

ER

RER = has ribosomes, participates in protein synthesis - proteins made here will leave cell - digestive enzymes, insulin SER = no ribosomes and doesn't participate in protein synthesis - lipids, steroid hormones

The Golgi complex, or Golgi bodies, consist of stacks of thin, flattened vesicles or sacs within the cell. These Golgi bodies are found near the nucleus and function in association with the endoplasmic reticulum (ER). What is one purpose of the Golgi complex?

Receive proteins and other substances from the cell surface by a retrograde transport mechanism

The student is studying membrane potentials. Which membrane potential is essentially a potassium equilibrium potential?

Resting membrane potential

When describing the structures of the cell membrane, how does the pathophysiology instructor identify the various roles/functions this membrane is responsible for? Select all that apply.

Separates intracellular environment from extracellular environment Holds and binds receptors for hormones Participates in the conduction of electrical currents in muscle cells

A client has been diagnosed with systemic lupus erythematosus, a disease that affects the structure and function of collagen. The nurse should expect to asses this client for:

Signs of connective tissue weakness.

What statement is true concerning the use of ATP [adenosine triphosphate] by skeletal muscles?

Skeletal muscles use ATP at a rapid rate during exercise.

In which locations can epithelial tissue be found? Select all that apply.

Skin Sweat glands Mucous membranes

Example of Metaplasia

Smokers cells change from ciliated to stratified squamous which causes a chronic cough

While explaining cellular membrane potentials, the instructor states that during an action potential, the cell membrane becomes more permeable to which mineral/electrolyte?

Sodium

A nurse on the oncology ward in the hospital is doing some background research to better understand the molecular basis of cancer. She comes to the understanding that transformed cancer cells are very similar to a normal type of cell, with the exception of regulation of division. Which cell type found in the normal state is most similar to a cancer cell?

Stem cells

Some tissues, such as the mucosal surface of the gastrointestinal tract, have cells that are capable of cell division and serve as a reserve source for specialized cells. What term describes these specialized cells?

Stem cells

In which parts of the body are smooth muscles found? Select all that apply.

Stomach Renal ureters Blood vessels

A young, healthy adult helps lift a sofa to move it 25 feet. The nurse knows that which source of energy will the client most likely use in this process?

Stored ATP

A client has an elevated troponin level. Which conditions could this indicate? Select all that apply.

Strained flexor muscle Myocardial infarction

A teenager has experienced repeated bacterial infections throughout her life and has recently been diagnosed with leukocyte adhesion deficiency. The nurse explains that this is caused by the teenager's inability to:

Synthesize the appropriate integrin molecules.

Which of the following is true about a cell's cytoplasm? Select all that apply.

The cell contains organelles The cell is where protein is synthesized The cell transports substances within the cell The cell serves as its own digestive system

A forensic scientist examines a body that was discovered while still in a state of rigor Morris. In addition to environmental conditions when the body was found, what understanding will help determine approximate time of death? Select all that apply.

The muscles will stay rigid until arctic and myosin cross-bridges are destroyed. In the noncontracted state, troponin covers tropomyosin-binding sites on actin. T tubules help transmit the action potential to release calcium and start contraction.

Penetrance

The percentage of individuals with a particular genotype that actually displays the phenotype associated with the genotype

Which role does adipose tissue play in the body?

Thermal insulation

Which explanation identifies correctly how the G protein-linked receptors are similar?

They have a ligand-binding extracellular receptor component, which causes changes that activate the G protein on the cytoplasmic side of the cell membrane.

Which statements describe epithelial tissue cells? Select all that apply.

They have no blood vessels They require moisture They are classed by shape

Select the most important function of the Endoplasmic reticulum (ER):

Tubular communication system

Radiation

UV rays-disrupt intracellular bonds and cause sunburn which can lead to skin cancer

Example of Hyperplasia

Warts and prostate

The majority of the cell's protoplasm is:

Water

Scenario: Mr.X had a stroke and blood flow is cut off to part of the brain- Why give him a calcium channel blocker?

We want to block calcium to prevent damage of cells and ATP depletion

A patient with gastroesophageal reflux disease has metaplasia. Which of the following is the cause? a) Cells are replaced in response to chronic irritation. b) This represents cancerous cells. c) Cells are increased in size due to increased oxygenation. d) These are nonreversible cell changes.

a) Cells are replaced in response to chronic irritation. Explanation: Metaplasia represents a reversible change in which one adult cell type is replaced by another adult cell type in response to chronic irritation and inflammation.

Which of the following causes atrophy? Select all that apply. a) Decreased blood flow b) Disuse c) Denervation d) Increased endocrine stimulation e) Increased nutrition.

a) Decreased blood flow b) Disuse c) Denervation Explanation: Atrophy is caused by disuse, denervation, decreased blood flow, decreased endocrine stimulation, and decreased nutrition.

Mercury is a toxic substance, and the hazards of mercury-associated occupational and accidental exposures are well known. What is the primary source of mercury poisoning today? a) Fish such as tuna and swordfish b) Mercury from thermometers and blood pressure machines c) Amalgam fillings in the teeth d) Mercury found in paint that was made before 1990

a) Fish such as tuna and swordfish Explanation: The main source of methyl mercury exposure is from consumption of long-lived fish, such as tuna and swordfish. Although there is mercury in amalgam fillings, the amount of mercury vapor given off by the fillings is very small. Most thermometers today are made without mercury. The same holds true for most blood pressure machines. Lead in paint is a concern, not mercury

A 7 year old boy is admitted to the hospital with a suspected diagnosis of lead toxicity. Which of the following assessment findings is most congruent with the client's diagnosis? a) Hemoglobin 9.9 g/dL b) Diffuse muscle pain. c) White blood cells (WBC) 11,000/mm3 d) Decreased deep tendon reflexes.

a) Hemoglobin 9.9 g/dL Explanation: Anemia is the cardinal sign of lead toxicity. Neither muscle pain, decreased deep tendon reflexes nor changes in WBC levels is associated with lead toxicity

select the statement the best describes apoptosis. a) Highly selective in eliminating injured or aged cells b) The release of products of cell death is uncontrolled c) Unregulated by enzymatic digestion of cell components d) Responsible for initiating an inflammatory response

a) Highly selective in eliminating injured or aged cells Explanation: Apoptosis is a highly selective process that eliminates injured and aged cells in a manner that maintains the integrity of the plasma membrane and does not initiate inflammation. All the other options describe the occurrences of necrosis.

A client has developed heart failure. The doctor reviews the client's chest x-ray and notes that the heart has enlarged. The changes in the size and shape of the heart are the result of: a) Hypertrophy b) Hypoplasia c) Atrophy d) Hyperplasia

a) Hypertrophy Explanation: Cells adapt to changes in their environment and in their work demands by changing their size, number, and characteristics. An increase in work results in cells undergoing hypertrophy and increasing in size. Hyperplasia is an increase in the number of cells in an organ or tissue. A decrease in work demands or adverse environmental conditions results in cells atrophy, or reducing in size. Hypoplasia is underdevelopment or incomplete development of a tissue or an organ

A patient is admitted with an alteration in arterial blood gases. Cellular injury is most likely to result from which of the following aspects of this abnormality? a) Hypoxia b) Alkalemia c) Hypocapnea d) Hypercapnea

a) Hypoxia Explanation: Lack of oxygen or hypoxia is a common cause of cell injury. Hypocapnea, alkalemia, and hypercapnea are not typical mechanisms of injury. The other common major mechanisms of cell injury are free radical formation, adenosine triphosphate depletion and disruption of intracellular calcium homeostasis.

The radiologist is reviewing potential types of radiation therapy for a client. Select the type of radiation that directly breaks down chemical bonds in a cell. a) Ionizing radiation b) Sunlight radiation c) Ultraviolet radiation d) Nonionizing radiation

a) Ionizing radiation Explanation: Ionizing radiation affects cells by causing ionization of molecules and atoms in the cell by directly hitting the target molecules of the cell and/or by producing free radicals that interact with critical cell components. Nonionizing radiation exerts it effects on the cell by causing a vibration and rotation of atoms and molecules. Sunlight is a form of ultraviolet radiation that induces skin damage by reactive oxygen species and by damage to the melanin-producing processes in the skin.

Which of the following statements is true concerning hyperplasia? a) It is a response to a stimulus. b) It is an abnormal response to stimulation. c) It is an increase in the size of a cell. d) It is an uncontrolled process.

a) It is a response to a stimulus Explanation: Hyperplasia is an increase in the number of cells in an organ, not the size of cells, and is the response to a stimulus that is a controlled process that occurs in response to an appropriate stimulus.

A client with diabetes who is diagnosed with a gangrenous right heel ulcer presents with a wound that has no line of demarcation, is spreading rapidly, and has a foul odor. The health care worker recognizes these manifestations as: a) Moist gangrene b) Internal gangrene c) Gas gangrene d) Dry gangrene

a) Moist gangrene Explanation: In moist gangrene, there is no line of demarcation between the normal and diseased tissues, and the spread of tissue damage is rapid. Moist gangrene often results in a foul odor caused by bacterial action at the site. Dry gangrene has a clear demarcation and spreads slowly. Gas and internal gangrene do not apply to this client's symptoms.

The nurse is providing care for a 21 year old female client with gas gangrene secondary to her compound fracture in her arm. Which of the following assessment finding would the nurse most reasonably expect to find when caring for a client with a diagnosis of gas gangrene? a) Spreading edema b) Inflammation of the affected tissue. c) Impaired alveolar gas exchange d) A positive culture for Staphylococcus

a) Spreading edema Explanation: Spreading edema is a cardinal sign of gas gangrene. It is often caused by Clostridium bacteria, not Staphylococcus. Inflammation may exist at the interface between affected and unaffected tissue, but not in the dead, affected tissue. Impaired gas exchange would not be a sign

Hypertrophy may occur as the result of normal physiologic or abnormal pathologic conditions. The increase in muscle mass associated with exercise is an example of physiologic hypertrophy. Pathologic hypertrophy occurs as the result of disease conditions and may be adaptive or compensatory. Examples of adaptive hypertrophy are the thickening of the urinary bladder from long-continued obstruction of urinary outflow and the myocardial hypertrophy that results from valvular heart disease or hypertension. What is compensatory hypertrophy? a) When one kidney is removed, the remaining kidney enlarges to compensate for the loss. b) When the body controls myocardial growth by stimulating actin expression to enlarge the heart c) When the body stimulates gene expression to begin a progressive decrease in left ventricular muscle mass d) When the body increases its major organs during times of malnutrition

a) When one kidney is removed, the remaining kidney enlarges to compensate for the loss. Explanation: Compensatory hypertrophy is the enlargement of a remaining organ or tissue after a portion has been surgically removed or rendered inactive. The body does not enlarge its major organs during times of malnutrition. Gene expression, not actin expression, stimulates the body to increase the muscle mass of the heart. Hypertrophy is not a progressive decrease in the size of anything

What happens when calcium is released into the cell?

acts as a "second messenger system" , turns on intracellular enzymes, can open more calcium gates in cell membrane

Cellular Adaptation

allows the stressed tissue to survive or maintain function

What concept will the nurse need to explain about the purpose and action of chemotherapy to a client with cancer?

apoptosis

The student is reviewing the aging process. One group of theories of aging involves the shortening of telomeres until a critical minimal length is attained and then senescence ensues. These theories are known as which of the following? a) Systems-level theories b) Cellular theories c) Molecular theories d) Evolutionary theories

b) Cellular theories Explanation: There are a number of cellular theories of senescence that are under investigation, including those that focus on telomere shortening.

A patient is admitted with frostbite. Which of the following will the nurse tell the patient about the changes that have occurred due to cold exposure? a) Cold exposure results in hypertrophy of cells in the affected are b) Cold increases blood viscosity and thrombosis. c) Cold increases the speed of blood flow through vessel d) Cold causes vasodilation and redness.

b) Cold increases blood viscosity and thrombosis. Explanation: Cold temperature exposure causes increased blood viscosity and can cause clots to form. Vasoconstriction is induced, and the flow of blood is slowed due to this. Cells do not hypertrophy in response to temperature change.

The nurse is teaching a patient about genetic disorders. Which of the following contains the genetic code? a) mRNA b) DNA c) tRNA d) rRNA

b) DNA Explanation: DNA contains genetic code, and injury to DNA can cause a variety of genetic mutations.

A group of elderly residents were commenting on how many cell functions decline with age. One resident commented that many of his friends who lived under large electromagnetic towers seemed to experience aging at an accelerated rate in comparison with residents who lived nearby in lakefront housing. This observation is the basis for which theory on aging? a) Insufficient telomerase enzyme theory b) Error theory associated with DNA damage c) Theories of genetic influences d) Programmed cell receptor theories

b) Error theory associated with DNA damage Explanation: Error theory suggests that aging results from DNA mutation or faulty repair. Another group of theories of aging focuses on programmed cell changes with genetic influences that systematically cause cell senescence. Elimination of receptor sites is not part of aging theory. Telomerase enzyme is thought to reduce the shortening of the chromosomes and loss of telomere DNA with each cell replication

The nurse is conducting a physical assessment of a homeless man during a night when the windchill factor is -10 degrees Farenheit. When assessing the man's fingers and toes for frostbite, the nurse looks for which of the following types of cellular injury? a) Endogenous b) Hypoxic c) Mechanical d) Chemical

b) Hypoxic Explanation: Exposure to cold increases blood viscosity and induces vasoconstriction by direct action on blood vessels and through reflex activity of the sympathetic nervous system. The resultant decrease in blood flow may lead to hypoxic tissue injury, depending on the degree and duration of cold exposure.

Which of the following statements is true in relation to lead exposure? a) Lead is absorbed through the skin. b) Lead is absorbed through the gastrointestinal tract or the lungs. c) Increased calcium levels increases the risk of lead poisoning. d) Increased iron increases the risk of lead poisoning.

b) Lead is absorbed through the gastrointestinal tract or the lungs. Explanation: Lead is absorbed through the gastrointestinal tract and the lungs. It is not absorbed through the skin. Decreased calcium and iron increases the risk of lead poisoning.

When confronted with a decrease in work demands or adverse environmental conditions, most cells are able to revert to a smaller size and a lower, more efficient level of functioning that is compatible with survival. This decrease in cell size is known as: a) dysplasia b) atrophy c) hyperplasia d) hypertrophy e) metaplasia

b) atrophy Explanation: When confronted with a decrease in work demands or adverse environmental conditions, most cells are able to revert to a smaller size and a lower and more efficient level of functioning that is compatible with survival. This decrease in cell size is called atrophy. Hypertrophy, metaplasia, and hyperplasia are all cellular adaptations that result in greater number or size. Dysplasia is a loss of cellular organization.

Which of the following clients are at high risk for developing dilated cardiomyopathy? a) 17 year old with a diving injury resulting in paraplegia. b) 78 year old Alzheimer's patient who received a third degree burn following an oven fire. c) 44 year old noncompliant female who forgets to take her hypertensive medications. d) 4 year old child born with cerebral palsy and confined to a wheelchair.

c) 44 year old noncompliant female who forgets to take her hypertensive medications. Explanation: In hypertension, the increased workload required to pump blood against an elevated arterial pressure in the aorta results in a progressive increase in LV muscle mass and need for coronary blood flow. The pressure overload causes hypertrophied cells to have greater width and length. Paraplegia, cerebral palsy and Alzheimer's disease does not increase the workload of the cardiac muscle per se.

A client is experiencing muscle atrophy following two weeks in traction after a motor vehicle accident. Which of the following factors has most likely contributed to the atrophy of the client's muscle cells? a) Reduced oxygen consumption and cellular function that ensures muscle cell survival. b) Denervation of the affected muscles during the time of traction. c) A reduction of skeletal muscle use secondary to the traction treatment. d) High levels of insulin and IGF-1 in the client's blood during immobilization.

c) A reduction of skeletal muscle use secondary to the traction treatment. Explanation: Disuse atrophy results from the reduction in skeletal muscle use such as that following encasement in plaster casts or traction. Low levels of insulin and IGF-1 contribute to atrophy, and denervation only occurs in paralyzed limbs. Reduced oxygen consumption and cellular function are the mechanisms of cell atrophy but not the causes of the process.

Which of the following statements is true regarding drug therapy and its effects on the body? a) Drugs only have positive effects on cells. b) Drugs do not injure tissues or cells. c) Antineoplastic cells directly damage cells. d) Drugs only have bad effects when they have side effects.

c) Antineoplastic cells directly damage cells. Explanation: Antineoplastic drugs directly injure cells. Many drugs injure tissues and cells either through their direct mechanism of action, side effects, or adverse effects.

The obstetric nurse explains to the client that when she stops breast feeding, her breast tissue will reduce in size. The nurse understands that this regression is due to which of the following? a) Hypoxia b) Cell necrosis c) Apoptosis d) Atrophy

c) Apoptosis Explanation: Apoptosis is thought to be responsible for several normal physiologic processes, including hormone-dependent involution of tissues (e.g., the regression of breast tissue after weaning from breastfeeding).

A client has developed dystrophic calcification as a result of macroscopic deposition of calcium salts. The tissue that would be most affected would be: a) Dead tissue b) Normal tissue c) Injured tissue d) Regenerated tissue

c) Injured tissue Explanation: Pathologic dystrophic calcification occurs in injured tissue. The components of the calcium deposits are derived from the bodies of dead or dying cells as well as from the circulation and interstitial fluid. It also occurs when the tissues have smaller amounts of iron, magnesium, and other minerals. Metastatic calcification occurs in normal tissue

A mother rushes her 4-year-old child to the emergency department after she found an empty Tylenol (acetaminophen) bottle beside her child. The nurse is trying to explain why it is so important to give the child Ipecac to induce vomiting in order to prevent: a) Hemorrhage b) Seizures c) Liver failure d) Renal failure

c) Liver failure Explanation: Acetaminophen, a commonly used over-the-counter analgesic drug, is detoxified in the liver, where small amounts of the drug are converted to a highly toxic metabolite. This metabolite is detoxified by a metabolic pathway that uses a substance normally present in the liver. When large amounts of the drug are ingested, this pathway becomes overwhelmed and toxic metabolites accumulate, causing massive liver necrosis.

The provider explains to the client, who smokes, that cells in the trachea are substituted with cells that are better able to survive. This process is known as which of the following? a) Hyperplasia b) Atrophy c) Metaplasia d) Dysplasia

c) Metaplasia Explanation: Metaplasia represents a reversible change in which one adult cell type is replaced by another adult cell type. An example of metaplasia is the adaptive substitution of stratified epithelial cells for the ciliated columnar epithelial cells in the trachea and large airways of a habitual cigarette smoker.

A patient is admitted with an electrical burn and a fractured arm. Which of the following causes the fracture related to the burn? a) The client most likely fell after the electrical injury. b) The client had a predisposing condition. c) The client had violent muscle contractions during the electrical injury. d) The client may have fallen into the electrical cord.

c) The client had violent muscle contractions during the electrical injury Explanation: The most likely scenario is that the client had an injury with alternating current (AC) that is usually more dangerous than direct current as it causes violent muscle contractions that can result in fractures and dislocations.

Which of the following is an example of physiologic hyperplasia? a) Benign prostatic hyperplasia b) Skin warts c) Uterine enlargement in pregnancy d) Endometrial hyperplasia

c) Uterine enlargement in pregnancy Explanation: Two common types of physiologic hyperplasia are hormonal and compensatory. Breast and uterine enlargements during pregnancy are examples of a physiologic hyperplasia. The other examples are nonphysiologic hyperplasia

Which type of tissue forms the architecture of liver sinusoids and lymphoid tissues such as the spleen?

reticular connective tissue

ECM

secreted locally, surrounds tissue cells comprised of basement membrane and interstitial matrix includes: 1. fibrous structural proteins = collagen and elastin fibers 2. water hydrated gels = allow resilience and lubrication 3. adhesive glycoproteins = connects matrix to cells

Reasons for Apoptosis

signaling factor of cell damage receptors, mitochondrial damage, protein p53 activated by DNA damage

What do peroxisomes do?

smaller, membrane bound molecules have enzymes that degrade peroxides and free radicals like bile

Reasons for Necrosis : Liquefaction

some cells die, catylitic enzymes dont get destroyed and cause an absess

The nurse is caring for a client receiving colchicine for treatment of gout. The nurse knows the drug is effective because it:

stops microtubules from forming

The student is examining a tissue sample with a microscope. The student decides that it is squamous keratinized tissue. Which type of epithelial tissue is the student viewing?

stratified epithelium

What must happen for the cells in tissue capable of regeneration to be able to do restoration?

the ECM must be in tact ***the integrity of the basement membrane is most important if the epithelial cell is not bound to the basement membrane, it is not capable of regenerating

Polymorphism

the individual differences of form among the members of a species

Once a protein is made it goes to...

through the ER then to Golgi Golgi packages and modifies will "bud off" from Golgi in a vesicle to be sent elsewhere

true or false? Necrotic tissue cannot be reversed

true

How does apoptosis work?

turn their own enzymes on themselves, digest their own cell, proteins, and DNA, then are destroyed by white blood cells

Stem cells

undifferentiated, reserve cells 1. self-renewal while in undifferentiated state 2. asymmetric replication (some stay stem and others become progenitor) 3. have different potency potentials

Stressed cells may fill up with ..

unused foods, abnormal protein, pigmenet, calcium salts

Biological agents

viruses and bacteria- diverse array of mechanisms

Which of the following should a nurse stress when teaching patients to avoid exposure to lead in the environment? Select all that apply. a) Lead can contaminate soil. b) Avoid flaking paint. c) Not everyone has a reaction to lead. d) Root vegetables can contain more lead than other vegetables. e) Repeated exposure to small amounts of lead is not a problem.

• Avoid flaking paint. • Lead can contaminate soil. • Root vegetables can contain more lead than other vegetables Explanation: Lead is a very toxic metal and small amounts can accumulate to reach toxic levels. The nurse should teach patients to avoid flaking paint, especially in older homes, as older paint contains lead. Lead can contaminate soil, and root vegetables tend to contain more lead.

What happens as a cell's workload declines? Select all that apply. a) Cell size decreases. b) Insulin levels increase. c) Energy expenditure increases. d) Oxygen consumption decreases. e) Protein synthesis decreases

• Cell size decreases. • Oxygen consumption decreases. • Protein synthesis decreases. Explanation: As the cell's workload declines, oxygen consumption decreases, protein synthesis decreases, and cell size decreases. Insulin levels do not increase, and energy expenditure would decrease.

A client has developed acute encephalopathy from lead toxicity. The nurse is aware that the client may display: Select all that apply. a) Increase in alertness b) Increased appetite c) Seizures d) Vomiting e) Coma f) Papilledema g) Ataxia

• Vomiting • Ataxia • Seizures • Papilledema • Coma Explanation: The most serious manifestation of lead poisoning is acute encephalopathy. It is manifested by persistent vomiting, ataxia, seizures, papilledema, impaired consciousness, and coma. Acute encephalopathy may manifest suddenly, or it may be preceded by other signs of lead toxicity such as behavioral changes or abdominal complaints.