Pathophysiology Exam 1
Clinical indicators of inflammation include all of the following:
1) Heat 2) Redness 3) Tenderness 4) Swelling 5) Pain
adaptation
A reversable, structural, or functional response both to normal (physiologic) conditions and to adverse (pathologic) conditions in order to maintain homeostasis.
Mechanisms of Cellular Injury
hypoxia chemical infectious immunologic & inflammatory nutritional imbalances physical agents
hypertrophy
increase in the SIZE of cells and consequently in the size of the affected organ
Klinefelter Syndrome
individuals with XXY karyotype, may have moderate mental impairment, male appearance but may have hypogonadism and sterility, high pitched voice and mosaicism (duel XXY & XY karyotypes).
asphyxial injury
injury caused by failure of cells to receive or use oxygen
What is the most common cause of hypoxia?
ischemia: reduction of blood flow caused by arteriosclerosis (narrowing of arteries/harden arteries) or thrombosis (blockage by blood clots)
hypoxia
lack of sufficient oxygen; most common cause of cell injury
Examples of hypertrophy
loss of kidney: other kidney enlarges utreus in pregnancy heart secondary to hypertension or diseased heart valves
What is dysplasia associated with?
malignancy neoplastic growths strong indicator of development of breast cancer often found adjacent to cancerous cells
blunt force injury
mechanical injury to body resulting in tearing, shearing, or crushing; most common injury seen in healthcare, caused by blows or impact, MVA, and falls
metastatic calcification
mineral deposits that occur in undamaged tissues due to hypercalcemia
Turner Syndrome
monoploidy of sex chromosome (karyotype 45, X); may cause learning diabilities, short stature, coarctation of aorta and sterility.
Triploidy
mutation that causes cells to have 3 copies of each chromosome, resulting in 69 chromosomes; incompatible with life
hormonal hyperplasia
occurs chiefly in estrogen-dependent organs such as the uterus and breast; enables buildup of endometrium in preparation of pregnancy
oxidative stress
occurs when free radicals overwhelm endogenous antioxidant systems
algor mortis
postmortem reduction in body temp
albumin
protein in plasma that protects cells by binding with unconjugated bilirubin
ischemia
reduced blood supply; often caused by ateriosclerosis or thombosis
How does metaplasia differ from atrophy, hypertrophy, and hyperplasia?
reversible replacement of one mature cell by another cell allows for replacement with cells that are better able to tolerate environmental stresses
Examples of atrophy
skeletal muscle: person with cast, spinal cord injury, bed rest patient heart atrophy: no blood supply to part of heart, chamber of heart can atrophy
When does metaplasia occur?
smoking replacement of normal columnar ciliated epithelial cells of the bronchial (airway) lining by stratified squamous epithelial cells replacement of ciliated epithelial cells in trachea with non-ciliated cells, airway not protected
pathologic hyperplasia
the abnormal proliferation of normal cells, usually in response to excessive hormonal stimulation or growth factors on target cells
Expressivity
the extent of variation in a phenotype associated with a particular genotype
metaplasia
the reversible replacement of one mature cell type by another, sometimes less differentiated, cell type
rigor mortis
the stiffening of muscles that occurs after death due to depletion of ATP, causing detachment of myosin from actin in muscle cells
necrosis
the sum of cellular changes after local cell death, characterized by the rapid loss of the plasma membrane, organelle swelling, mitochrondrial dysfunction, and lack of typical features of apoptosis.
Down syndrome
trisomy-21; most well known aneuploidy, occurs in about 1:800 live births; characterized by mental retardation, sterility, poor muscle tone, congenital heart defects, characteristic facial features and lowered life expectancy (about 60 years).
Metastasis
Spread of cancer cells to distant sites by the blood or lymphatics; secondary malignant tumor
Angiogenesis
The development of new capillaries
A couple has three offspring: one child with an autosomal dominant disease trait and two who are normal. The father is affected by the autosomal dominant disease, but the mother does not have the disease gene. What is the recurrence risk of this autosomal dominant disease for their next child? A) 50% B) 33% C) 25% D) Impossible to determine
a
A somatic cell that does not contain a multiple of 23 chromosomes is called: A) an aneuploid cell. B) a euploid cell. C) a polyploidy cell. D) a haploid cell.
a
Edema can result from all of the following alterations except: A) decreased capillary hydrostatic pressure. B) decreased capillary oncotic pressure. C) lymphatic obstruction. D) increased capillary membrane permeability.
a
Free radical injury can be caused by all of the following factors except: A) tissue damage by antioxidants. B) radiation injury. C) tissue reperfusion following ischemia. D) enzymatic metabolism of chemicals.
a
In addition to phagocytosis, which of the following functions are also performed by macrophages? A) Release of growth factors and stimulating new blood vessel growth B) Destroying circulating antibodies C) Inhibiting inflammation D) Promotion of blood clotting
a
In compensatory hyperplasia, growth factors stimulate cell division in response to: A) tissue loss. B) decreased hormonal stimulation. C) ischemia. D) puberty.
a
Metaplasia involves the replacement of normal cells by: A) another type of cell. B) abnormal cells of the same tissue type. C) scar tissue. D) cancer cells.
a
Symptoms of dehydration include: A) decreased urine output. B) increased skin turgor. C) increased blood pressure. D) edema.
a
The population group most vulnerable to lead poisoning is: A) children. B) pregnant women. C) male adolescents. D) the elderly.
a
What are the primary factors contributing to oncosis from hypoxic injury? A) Decrease in ATP production and sodium movement into the cell B) Injury to the endoplasmic reticulum and Golgi apparatus C) Increase in ATP production and potassium movement out of the cell D) Accumulation of lipids and pigments in the cell
a
Which of the following is an accurate characterization of an X-linked recessive pedigree? A) Disease is seen more often in males than females. B) A pattern of skipped generations is rare. C) Males are gene carriers. D) Mothers usually transmit the disease to their daughters.
a
Why is carbon monoxide exposure a life-threatening condition? A) Carbon monoxide binds to hemoglobin and prevents normal oxygen transport to tissues. B) Inhalation of carbon monoxide interferes with oxygen diffusion in the lungs. C) Carbon monoxide causes the release of toxic amounts of iron from the tissues. D) Carbon dioxide removal from the tissues is inhibited.
a
livor mortis
a purple discoloration that occurs postmortem as gravity causes blood to pool in the lowest tissues
dysplasia
abnormal changes in the size, shape, and organization of mature cels
What are causes of hypertrophy?
adaptation for loss (kidney) physiological (skeletal muscle) hormone induced (uterus)
What are causes of atrophy?
aging disuse (skeletal tissue) ischemia [restriction in blood supply to tissue] (heart, brain) inadequate nutrition decrease in work load, use, blood supply, hormones, and nervous stimulation
compensatory hyperplasia
an adaptive mechanism that enables certain organs to regenerate; occurs significantly in epidermal and intestinal epithelia, hepatocytes, bone marrow cells, fibroblasts, and some bone, cartilage, and smooth muscle.
hyperplasia
an increase in the NUMBER of cells, resulting from an increased rate of cellular division
pathologic atrophy
atrophy that occurs as a result of decreases in workload, pressure, use, blood supply, nutrition, hormonal or nervous stimulation.
physiologic atrophy
atrophy that occurs early in development, like with the thymus gland
disuse atrophy
atrophy that occurs in skeletal muscles with prolonged periods of non use
A monocyte is a circulating white blood cell that transforms into which of the following cells once it enters the tissue during an inflammatory response? A) Neutrophil B) Macrophage C) Mast cell D) Fibroblast
b
Adaptive cellular mechanisms function to: A) treat disease. B) protect cells from injury. C) prevent cellular aging. D) speed up cellular death.
b
An error in which homologous chromosomes fail to separate during meiosis is termed: A) aneuploidy. B) nondisjunction. C) polyploidy. D) anaplasia.
b
Cellular atrophy involves: A) an increase in cell size. B) a decrease in cell size. C) an increase in the number of cells. D) a decrease in the number of cells.
b
If a person is a chromosomal mosaic, the person may: A) be a carrier of the genetic disease. B) have a mild form of the genetic disease. C) have two genetic diseases. D) be sterile as a result of the genetic disease.
b
In response to an increased workload, such as that caused by high blood pressure (hypertension), myocardial cells in the left ventricle will adapt through the process of: A) atrophy. B) hypertrophy. C) hyperplasia. D) dsyplasia.
b
Lead poisoning affects nervous system function by which of the following mechanisms? A) Lead blocks oxygen delivery to the brain by binding with hemoglobin. B) Lead interferes with neurotransmitter release. C) Lead causes nervous tissue necrosis. D) Lead inhibits fatty acid oxidation in the brainstem.
b
People who have neurofibromatosis will show varying degrees of the disease; this is because of the genetic principle of: A) penetrance. B) expressivity. C) dominance. D) recessiveness.
b
The condition in which the immune cells attack the individual's own tissues as if they were invaders is called: A) alloimmunity. B) autoimmunity. C) hypersensitivity. D) graft rejection.
b
The gradual increase in height among the human population over the past 100 years is an example of: A) polygenic trait. B) multifactorial trait. C) crossing over. D) recombination.
b
The process by which cells program themselves to die is called: A) karyolysis. B) apoptosis. C) pyknosis. D) necrosis.
b
The process of a phagocyte squeezing through retracted endothelial cells to enter into the tissues is called: A) fusion. B) diapedesis. C) phagocytosis. D) margination.
b
Tissue ischemia and a decrease in mitochondrial oxygenation result in: A) cellular dehydration. B) decreased ATP production. C) calcium accumulation outside the cell. D) increased protein synthesis.
b
To express a polygenic trait: A) genes must interact with the environment. B) several genes must act together. C) multiple mutations must occur in the same family. D) in situ cloning must occur.
b
A 13-year-old girl has a karyotype that reveals an absent homologous X chromosome with only a single X chromosome present. Her condition is called: A) Down syndrome. B) Cri du chat syndrome. C) Turner syndrome. D) Edward syndrome
c
A 20-year-old pregnant female gives birth to a stillborn child. Autopsy reveals that the fetus has 92 chromosomes. Which of the following describes this condition? A) Euploidy B) Triploidy C) Tetraploidy D) Aneuploidy
c
An ordered photographic display of a set of chromosomes from a single cell is a(n): A) metaphase spread. B) autosomal spread. C) karyotype. D) anaphase spread.
c
Capillary oncotic pressure is primarily determined by which of the following molecules? A) Glucose B) Sodium C) Albumin D) Water
c
In contrast with the inflammatory response, the immune response: A) is more effective at fighting microorganisms. B) is faster. C) recognizes specific invaders. D) has no memory.
c
Osmosis describes the movement of: A) electrolytes. B) glucose. C) water. D) blood.
c
Prior to engulfment of a bacterium during phagocytosis, which of the following events must occur? A) Release of lysosomal enzymes B) Fusion C) Recognition and adherence D) Formation of a phagolysosome
c
The most common cause of Down syndrome is: A) paternal nondisjunction. B) maternal translocations. C) maternal nondisjunction. D) paternal translocations.
c
The outward manifestation of a disease, often influenced by both genes and the environment, is called the disease: A) genotype. B) allele. C) phenotype. D) dominance.
c
The process of muscle hypertrophy involves an increase in: A) cell division. B) water accumulation. C) protein synthesis. D) plasma membrane thickness.
c
Which of the following is an accurate characteristic of an autosomal recessive pedigree? A) On average, 50% of the children will have the autosomal recessive disease if one parent has the disease. B) Males are affected more than females. C) On average, 25% of the children are affected by the autosomal recessive disease if both parents are carriers. D) There is a decreased risk of disease with consanguinity.
c
Which of the following organs is most frequently affected by ethanol injury? A) Heart B) Kidneys C) Liver D) Stomach
c
dystrophic calcification
calcification of dying and dead tissues that occurs as a reaction to tissue injury; necrosis is one example
fetal alcohol syndrome
caused by prenatal alcohol exposure; causes growth retardation, facial anomalies, cognitive impairment and occular malformation
Euploid
cells with a normal number of chromosomes (diploid = 46, haploid = 23)
Where does dysplasia occur?
cervix respiratory tract epithelia tissue of cervix
frailty
clinical syndrome in older adults involving negative energy balance, sarcopenia, and diminished strength and tolerance for exertion, which leaves a person vulnerable to falls, functional decline, disability, disease, and death.
A 12-year-old male is diagnosed with Klinefelter syndrome. His karyotype would reveal which of the following? A) XY B) XX C) XYY D) XXY
d
A 50-year-old male was recently diagnosed with Huntington disease. Transmission of this disease is associated with: A) penetrance. B) recurrence risk. C) expressivity. D) delayed age of onset.
d
A child fell off the swing and scraped her knee. The injured area becomes red and painful. Which of the following would also occur? A) Vasoconstriction B) Decreased RBC concentration at injured site C) Fluid movement from tissue to vessels D) Edema at injured site
d
Cystic fibrosis is caused by an _____ gene. A) X-linked dominant B) X-linked recessive C) autosomal dominant D) autosomal recessive
d
Fetal exposure to alcohol during pregnancy can result in: A) low birth weight. B) mental retardation. C) death. D) all of the above.
d
Lysosomal rupture during hypoxic injury leads to: A) cellular acidosis. B) sodium influx. C) cellular adaptation. D) autodigestion of cells.
d
Pathologic hyperplasia can lead to: A) neoplasia (cancer). B) dysplasia. C) metaplasia. D) all of the above.
d
Risk factors for Down syndrome include: A) fetal exposure to mutagens in the uterus. B) increased paternal age. C) family history of Down syndrome. D) pregnancy in women over age 35.
d
The most common cause of hypoxic injury is: A) free radicals. B) malnutrition. C) chemical toxicity. D) ischemia.
d
The primary cell of immunity is the: A) mast cell. B) macrophage. C) neutrophil. D) lymphocyte.
d
The process by which RNA directs the synthesis of protein is called: A) termination. B) transcription. C) promotion. D) translation.
d
The process of cellular atrophy is accomplished through which of the following processes? A) Loss of fluid B) Decreased cell division C) Inhibition of enzyme formation D) Formation of autophagic vacuoles
d
Warmth and redness of the skin are indicators of inflammation. Which of the following processes is responsible for this clinical manifestation? A) Increased vascular permeability B) Phagocytosis C) Vasoconstriction D) Vasodilation
d
What is the purpose of vasodilatation and increased vascular permeability during inflammation? A) To bring white blood cells to the area of injury B) To transport inflammatory chemicals to the area of injury C) To dilute toxins D) All of the above
d
Which of the following electrolytes is found in the highest concentrations in the intracellular fluid (ICF)? A) Sodium B) Calcium C) Magnesium D) Potassium
d
Which of the following genetic diseases manifests with progressive dementia in middle to later adulthood? A) Duchenne muscular dystrophy B) Cystic fibrosis C) Achondroplasia D) Huntington disease
d
Which of the following types of genetic disorders is the most common cause of miscarriage? A) Autosomal dominant B) Autosomal recessive C) X-linked recessive D) Chromosomal
d
gangrenous necrosis
death of tissue from hypoxia, commonly from arteiosclerosis and affecting lower leg; may be be classified as dry, where the skin appears brown and wrinkled, or wet, where the skin appears cold, swollen and black as a result of liquefactive necrosis occurring at the site
