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A concise review of key concepts in advanced pathophysiology, focusing on cellular injury, adaptation, and disease mechanisms. It covers topics such as hypoxia, free radicals, ethanol metabolism, oncotic pressure, and acid-base imbalances. The material is presented in a question-and-answer format, making it useful for exam preparation and quick review. It also includes information on tumor markers, metastasis, and fluid compartments, offering a comprehensive overview of essential pathophysiology principles for nursing students and healthcare professionals. Designed to help students quickly review and understand complex topics in pathophysiology, making it an excellent resource for exam preparation and clinical practice.
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"E. inadequate oxygenation of tissues P. decrease in mitochondrial function, decreased production of ATP increases anaerobic metabolism. eventual cell death.
injury" "E. normal byproduct of ATP production, will overwhelm the mitochondria- exhaust intracellular antioxidants P. lipid peroxidation, damage proteins, fragment DNA C.M. development in Alzheimer's, heart disease, Parkinson's disease, Amyotrophic Lateral
"E. mood altering drug, long term effects on liver and nutritional status P. metabolized by liver, generates free radicals C.M. CNS depression, nutrient deficiencies-Mag, Vit B6, thiamine, PO4, inflammation and fatty
Ethanol" "Na and H2O enter cell and cause swelling. Organ increases in weight, becomes distended and
Oncosis"
metastasis"
effect on K+" "mag inhibits the potassium channels, keeping balance. when mag is low, more K+ exits the call,
"E. increased acid production, loss of bicarb, diminished renal excretion of hydrogen C.M hyperventilation (compensatory), h/a, n/v/d, dehydration, hypotension
"E. GI loss, diuretic use C.M. slow, shallow respirations, irritability, twitching, s/s of hypokalemia
"E. cns depression, airway abnormalities C.M. restless, confused, seizures, tachycardia
"E. usually anxiety, PE, chf, salicylate OD, illegal drugs C.M. light-headed, confused, tetany
Infarct" "liver cell, ketogenesis occurs in the mitochondria of the hepatocyte
"Ketogenesis is the formation of ketone bodies and occurs mostly in the mitochondria of the
"lack of glucose -occur from the depletion of carbohydrate stores or may occur bc the cell is not able to use glucose
ketogenesis" "processed by hepatocytes and undergoes transformation to 3 ketone bodies: Acetoacetate, Acetone and B-hydroxybutyrate (basis of ketoacidosis) -States of starvation or uncontrolled DM, cells do not receive enough glucose to produce energy, resulting in acceleration of the B-oxidation cycle and increasing oxidation of fatty acids or
Acetyl-CoA"
"regional lymph node metastasis present; (at some sites: tumor spread to closest or small number
"Apprehension, confusion, decreased DTR, diaphoretsis, headache,n/v, restless,tachy, tremors,
alk causes"
"Anxiety, diaphoresis, dyspraxia, ECG changes, hyper reflexes, parasthesias, restlessness, tachy,
"pH <7. Paco2 >
Uncompensated"
"-Water moves between plasma and interstitial space by osmosis and hydrostatic pressure, occur across the capillary membrane
pattern of fluid shift" "hydrostatic pressure promotes the movement of about 10% of fluid along with small amount of
Interstitial pattern of fluid shift" "- Fluid inside the cell
Intracellular pattern of fluid shift"
"- The measure of solute concentration in a solution (basically the concentration of plasma) aka
"amount of pressure of force that is exerted by solute molecules of a given compartment
"Movement of water b/w compartments from an area of low concentration of solutes to an area
Excess"
"S/S Swelling or puffiness of tissue, shiny skin, increased abdominal size, dyspnea, SOB, chest
"It facilitates the outward movement of water from the vascular space to the interstitial space. It is determined by blood pressure and blood volume - in Edema, hydrostatic pressure is increased
"It osmotically attracts water from the interstitial space back into the capillary - in Edema,
"most common electrolyte imbalance in hospital 3 types: isotonic, hypertonic, hypotonic (euvolemic, hypovolemic, hypervolemic) Mild (126-130): anorexia, apathy, restlessness, nausea, lethargy, muscle cramps Moderate (120-125): agitation, disorientation, headache
Hyponatremia"
"- regulated by 3 hormones: parathyroid (PTH), vit D, and calcitonin
"<8.5mg/dl E: Causes increased cell permeability to Na+ causing a progressive depolarization. The threshold potential becomes more negative and closer to the resting membrane potential, requiring a smaller stimulus for an action potential. The cells are more likely to initiate an action potential; they are excitable. Causes: Hypoparathyroidism, renal failure, acute pancreatitis, vitamin D deficiency, CM: Tetany (cont. muscle spasm), hyperreflexia, circumoral paresthesia, seizures, dysrhythmias Chvostek's sign - tap facial nerve just below temple leads to twitching of nose or lip Trousseau's sign - contraction of hand and fingers when arterial blood flow in arm occluded for 5
"Hyperparathyroidism, cancers of the bone originating from breast cancer, myeloma or lymphoma Polyuria, renal stones, nausea, vomiting, constipation, weakness, fatigue, confusion,
"Measured should be slightly greater than calculated If >10, then other solutes present
"ph < 7.4 and HCO3 < 21 E: Increased H+ load - Decreased H+ excretion - Uremia, distal renal tubule acidosis; Concentration of non-carbonic acids increases or bicarbonate is lost from ECF or cannot be regenerated by the kidneys.
Causes: ketoacidosis (DM, starvation), Lactic acidosis (shock-hypoxemia), ingestions ((high osmolar gaps) (ammonium Cl-, ethylene glycol, methanol, salicylates, paraldehyde); HCO3 loss - Diarrhea, renal failure, proximal renal tubule acidosis CM: Decreased myocardial contractility, decreased cardiac output, catecholamine resistant
"Etiology:Free Radical- have unpaired electron in its outer shell, making molecule unstable and highly reactive. aka being oxidized ROS-byproduct of ATP production in the mitochondria Clinical Manif: FR- to stabilize self, it will steal an electron from another molecule or give up an electron. The free radical will often steal an electron from another molecule, making that molecule a free radical ROS- can overwhelm mitochondria and exhaust intracellular antioxidants, causing cell injury/disease Patho: ROS are produced by absorption of high energy sources such as radiation or UV light, have role in development of Alzheimer's, Parkinson's, Amyotrophic Lateral Sclerosis (ALS). ROS cause lipid peroxidation, damage proteins which maintain ion pumps and cellular transport, fragment DNA and causes less protein synthesis, cause chromatin destruction, and damage mitochondria. Antioxidants are our body's defense
"Etiology: ETOH is metabolized to acetaldehyde in the cytoplasm of the cell, enzyme alcohol dehydrogenase (ADH) helps with conversion Clinical Manifestation: adverse effects on liver and causes nutritional disorders. acute effects in the liver include inflammation, fatty infiltration, hepatomegaly, acute liver necrosis and suppressed fatty acid oxidation. liver failure is irreversible effect of chronic abuse Patho: Conversion oxidized niacin (NAD+) is reduced to NADH. In the mitochondrial acetaldehyde is further converted by ADH to acetate and further oxidized niacin (NAD+) is reduced to NADH. the increased NADH/NAD+ ratio in the liver causes the following Pyruvate change to lactic acid causing lactic acidosis Oxaloacetate converted to malate, preventing gluconeogenesis leading to fasting hypoglycemia Glyceraldehyde to glycerol
"Cellular Effect:- the sum of cellular changes after local cell death and the process of cellular self- digestion (autolysis)- rapid loss of plasma membrane, organelle swelling, mitochondrial dysfunction, lack typical features of apoptosis Clinical Implications:- induced by nonspecific trauma or injury- necroptosis - programmed necrosis- associated with development, tissue damage during acute pancreatitis, and retinal detachment; and provides an innate immune response to viral infection- this challenges the historic view of necrosis as passive cell death
damage:Alcoholic Hepatitis" "Cirrhosis is a late stage of serious liver disease marked by inflammation (swelling), fibrosis (cellular hardening) and damaged membranes preventing detoxification of chemicals in the body, ending in scarring and necrosis (cell death). Acetaldehyde may be responsible for alcohol- induced fibrosis by stimulating collagen deposition by hepatic stellate cells.[2] The production of oxidants derived from NADPH oxi- dase and/or cytochrome P-450 2E1 and the formation of acetaldehyde-protein adducts damage the cell membrane.[2] Symptoms include jaundice(yellowing), liver enlargement, and pain and tenderness from the structural changes in damaged liver architecture. Without total abstinence from alcohol use, cirrhosis will eventually lead to liver failure. Late complications of cirrhosis or liver failure include portal hypertension (high blood pressure in the portal vein due to the increased flow resistance through the damaged
- CORRECT ANSWER Hepatocellular damage:Cirrhosis" "Role: liver cell, ketogenesis occurs in the mitochondria of the hepatocyte Clinical Implications:
"Role: Ketogenesis is the formation of ketone bodies and occurs mostly in the mitochondria of the hepatocytes (liver cells) Clinical Implications:- level of ketone bodies too high, pH drops =
of the mitochondria" "Role:lack of glucose Clinical Implications:occur from the depletion of carbohydrate stores or
"Role:processed by hepatocytes and undergoes transformation to 3 ketone bodies: Acetoacetate, Acetone and B-hydroxybutyrate (basis of ketoacidosis) Clinical Implications:States of starvation or uncontrolled DM, cells do not receive enough glucose to produce energy, resulting in acceleration of the B-oxidation cycle and increasing oxidation of fatty acids or energy. B-
"Role:Oxaloacetate is also used in gluconeogenesis, during starvation & uncontrolled DM oxaloacetate levels are insufficient due to gluconeogenesis... this depletion furthers the amount of acetyl-CoA which activates ketogenesis Clinical Implications:Oxaloacetate (an intermediate) is involved in: Citric acid cyclegluconeogenesisurea cycleamino acid synthesisfatty acid
Marker:Alpha Fetoprotein"
Marker:Carcinoembryonic Antigen"
gonadotropin"
"Definition:arise from epithelial tissue Ex:Adenocarcinoma: arising from ductal/glandular
"Definition:connective tissue Ex:malignant cancers of the skeletal muscle are known as
"Benign tumors generally named according to the tissue from which they arise Ex:- benign tumor
(suffix)" "Definition:-preinvasive epithelial malignant tumors of glandular or squamous cell origin- localized to the epithelium- not yet malignant- 3 fates: can remain stable for long time, progress to invasive/met CA, or regress and disappear Ex:- # of sites including cervix, skin, oral cavity, esophagus and bronchus- in breast, ductal carcinoma in situ (DCIS) fills the mammary ducts but
Testicular" "bones (especially lumbar spine), liver - regional lymph and veins which drain to batson plexus
"The measure of solute concentration in a solution, in humans it is basically the concentration of
"The movement of water "down" a concentration gradient, that is, across a semipermeable membrane from a region of higher water concentration to a region of lower water concentration.
- CORRECT ANSWER Osmosis" "The amount of pressure or force that is exerted by solute molecules of a given compartment. The higher the osmolality the higher the osmotic pressure. This is a pulling force and will pull water into a compartment. This is the force that must be overcome by hydrostatic pressure to oppose
"The force within a fluid compartment- the mechanical force of fluid against the walls of the compartment, i.e. blood pressure. This is a pushing force and pushes fluid outside the
"The force which helps to keep water/fluid within a compartment. It contributes to osmotic
"The amount of blood within the arterial space which effectively perfuses the organs and tissues.
"Secreted by the pituitary gland in response to a water deficit, Na excess or a low BP. It causes the kidneys to reabsorb H2O thus increasing plasma volume. With fluid loss (vomiting, diarrhea or excessive sweating) a decrease in blood volume and blood pressure occurs. Baroreceptors (located in Right and Left atria, large veins, aorta, pulmonary arteries and carotid sinus), signal
Renin Angiotensin Aldosterone System" "Released from the atria or ventricle of the heart. Works opposite of the RAAS to decrease blood
Volume Deficit"
"Poor skin turgor, dry mucous membranes, sunken eyes, sunken fontanels, decreased urine
manifestations of edema" "Increased capillary hydrostatic pressure caused by thrombophlebitis, hepatic obstruction, right heart failure, tight clothing, prolonged standing, CHF and renal failure, liver disease, protein malnutrition (from decreased production of plasma proteins), glomerular disease, trauma,
"Generalized edema (uniform distribution of fluid throughout the body), dependent edema (fluid accumulation in gravity dependent areas of body), localized edema (limited to site of injury) Edema is identified by swelling and puffiness,weight gain, dehydration from sequestering of
Serum Na level: 125-135 mEq/L clinical manifestations"
clinical manifestations"
120mEq/L clinical manifestations" "1.reduced intake of potassium 2.increased entry of K+ into cells
"Increase in ECF K+ concentration > 5.5 mEq/L.
end of capillary membranes into the interstitial fluid surrounding the capillary is an example of which fluid movement process? a. Hydrostatic pressure b. Osmosis c. Diffusion d. Active transport" “E. Cells decrease in size P. Still functional; imbalance between protein synthesis and degradation. Essentially there is an increase in the catabolism of intracellular organelles, reducing structural components of cell Physiologic: thymus gland in early childhood Pathological: disuse (muscle atrophy d/ decrease workload, pressure, use, blood supply,
"E: cells increase in number, mitosis (cell division) must occur, size of cell does not change Phys: increased rate of division, increase in tissue mass after damage or partial resection; may be compensatory, hormonal, or pathologic Patho: abnormal proliferation of normal cells usually caused by increased hormonal stimulation (endometrial). increase of production of local growth factors Ex: removal of part of the liver lead to hyperplasia of hepatocytes. uterine or mammary gland
"E. Not true adaptation; Cells abnormal change in size, shape, organization (classified as mild, moderate, severe) P. caused by cell injury/irritation, characterized by disordered cell growth. aka atypical hyperplasia or pre-cancer, a disorderly proliferation Physiologic: N/A Pathologic: squamous dysplasia of cervix from HPV shows up on pap smear, breast cancer development; pap smears often show dysplastic cells of the cervix that must undergo
"E: reversible change, one type of cell changes to another type for survival P: reversible; results from exposure of the cells to chronic stressors, injury, or irritation; Cancer can arise from this area, stimulus induces a reprogramming of stem cells under the influence of cytokines and growth factors Ex: Patho: Columnar cells change to squamous cells in lungs of smoker or normal ciliated epithelial cells of the bronchial linings are replaced by stratified squamous epithelial cells.; Phys:
Barrett Esophagus- normal squamous cells change to columnar epithelial cells in response to
metastasis" "Local invasion, followed by invasion of surrounding tissues. Cells then may invade blood and lymphatic vessels. They must survive in circulation, then enter and survive in a new location.
metastasis" "T= tumor size >/= correlates with metastatic ability N= whether lymph nodes are involved
"The measure of solute concentration in a fluid.
fluid compartment"
"Passive- the movement of water from an area of low concentration of solute to one of higher
"Pulling- the amount of pressure or force that is exerted by solute molecules of a given
"Blood pressure- pushes fluid outside of the vessels, the force of fluid against the walls of a
pressure" "Colloid pressure keeps water inside the compartment, attracts water from interstitial space back
"The amount of blood within the arterial space- ECF changes will cause changes in the EABV in