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Mastering the Midterm: Your Comprehensive Guide to Conquering NR 507 Advanced Pathophysio, Exams of Nursing

Mastering the Midterm: Your Comprehensive Guide to Conquering NR 507 Advanced Pathophysiology. An Ultimate Guide to Exam Success with Grade A+ Score Latest Updated 2025/2026.

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Mastering the Midterm: Your Comprehensive Guide to
Conquering NR 507 Advanced Pathophysiology.
An Ultimate Guide to Exam Success with Grade A+
Score
Latest Updated 2025/2026.
Asthma - ansChronic disease due to bronchoconstriction and an excessive inflammatory
response in the bronchioles
What are 5 s/s of asthma - anscoughing
wheezing
shortness of breath
rapid breathing
chest tightness
Pathophysiology of asthma (5) - ans-airway inflammation, bronchial hyper-reactivity and
smooth muscle spasm
-excess mucus production and accumulation
-hypertrophy of bronchial smooth muscle
-airflow obstruction
-decreased alveolar ventilation
Bronchioles - anssmaller passageways that originate from the bronchi that become the alveoli
3 layers of the bronchioles - ansinnermost layer
middle layer - lamina propria
outermost layer
lamina propria - ansthe middle layer of the bronchioles
structure of the lamina propria - ansembedded with connective tissue cells and immune cells
purpose of the lamina propria - answhite blood cells are present to help protect the airways
How does the lamina propria effect the lungs in regards to asthma - ansthe WBCs protective
feature goes into overdrive causing an inflammatory response that damages host tissue
What does the innermost layer of the bronchioles contain - anscolumnar epithelial ells and
mucus producing goblet cells
What does the outermost layer of the bronchioles contain - anssmooth muscle cells
what does the outermost layer of the bronchioles do - anscontrol the airways ability to
constrict and dilate
alveolar hyperinflation - ansWhen air is unable to move out of the alveolar like it should due
to bronchial walls collapsing around possible mucus plug thus trapping air inside
how does hyperinflation occur? - ansthe ongoing inflammatory process of asthma produces
mucus and pus plug that the bronchial walls collapse around
Effect of hyperinflation of the alveolar - ans-expanded thorax and hypercapnia (retention of
CO2)
- respiratory acidosis
What are two anticholinergic drugs used for asthma - anstiotropium and ipratropium
What do anticholinergics do in the lungs? - ansThese drugs block the effects of the
parasympathetic nervous system
- increasing bronchodilation
MOA of anticholinergic drugs for asthma - ansthe parasympathetic system is stimulated by
the vagal nerve to release acetylcholine which binds to the cholinergic receptors of the
respiratory tract to cause bronchial constriction = decreased airflow
- blocking the cholinergic receptors prevents acetylcholine binding preventing the bronchial
constriction
bronchitis - ansinflammation of the bronchial tubes
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Conquering NR 507 Advanced Pathophysiology.

An Ultimate Guide to Exam Success with Grade A+

Score

Latest Updated 2025/2026.

Asthma - ansChronic disease due to bronchoconstriction and an excessive inflammatory response in the bronchioles What are 5 s/s of asthma - anscoughing wheezing shortness of breath rapid breathing chest tightness Pathophysiology of asthma (5) - ans-airway inflammation, bronchial hyper-reactivity and smooth muscle spasm

  • excess mucus production and accumulation
  • hypertrophy of bronchial smooth muscle
  • airflow obstruction
  • decreased alveolar ventilation Bronchioles - anssmaller passageways that originate from the bronchi that become the alveoli 3 layers of the bronchioles - ansinnermost layer middle layer - lamina propria outermost layer lamina propria - ansthe middle layer of the bronchioles structure of the lamina propria - ansembedded with connective tissue cells and immune cells purpose of the lamina propria - answhite blood cells are present to help protect the airways How does the lamina propria effect the lungs in regards to asthma - ansthe WBCs protective feature goes into overdrive causing an inflammatory response that damages host tissue What does the innermost layer of the bronchioles contain - anscolumnar epithelial ells and mucus producing goblet cells What does the outermost layer of the bronchioles contain - anssmooth muscle cells what does the outermost layer of the bronchioles do - anscontrol the airways ability to constrict and dilate alveolar hyperinflation - ansWhen air is unable to move out of the alveolar like it should due to bronchial walls collapsing around possible mucus plug thus trapping air inside how does hyperinflation occur? - ansthe ongoing inflammatory process of asthma produces mucus and pus plug that the bronchial walls collapse around Effect of hyperinflation of the alveolar - ans-expanded thorax and hypercapnia (retention of CO2)
  • respiratory acidosis What are two anticholinergic drugs used for asthma - anstiotropium and ipratropium What do anticholinergics do in the lungs? - ansThese drugs block the effects of the parasympathetic nervous system
  • increasing bronchodilation MOA of anticholinergic drugs for asthma - ansthe parasympathetic system is stimulated by the vagal nerve to release acetylcholine which binds to the cholinergic receptors of the respiratory tract to cause bronchial constriction = decreased airflow
  • blocking the cholinergic receptors prevents acetylcholine binding preventing the bronchial constriction bronchitis - ansinflammation of the bronchial tubes

Conquering NR 507 Advanced Pathophysiology.

An Ultimate Guide to Exam Success with Grade A+

Score

Latest Updated 2025/2026.

3 characteristics of bronchitis - ansbronchial inflammation hypersecretion of mucus chronic productive cough for at least 3 consecutive months for at least 2 successive years Perfusion - ansThe supply of oxygen to and removal of wastes from the cells and tissues of the body as a result of the flow of blood through the capillaries. results of chronic bronchitis/ low perfusion - anscyanosis right to left shunting chronic hypoxemia Why is there cyanosis with chronic bronchitis - ansthere is hypoxia due to unfavorable conditions for gas exchange Right to left shunting - answhen blood passes from the right ventricle through the lungs and to the left ventricle without perfusion Causes of bronchitis - ans-long term exposure to environmental irritants

  • repeated episodes of acute infection (RSV infection in early infancy)
  • Factors affecting gestational childhood lung development (preterm birth) Pathogenesis of bronchitis - ans-Exposure to airborne irritants
  • Irritant activates bronchial smooth muscle constriction and mucus secretion
  • Triggers release of inflammatory mediators from immune cells located in the lamina propria most common irritant with bronchitis is? - anstobacco product smoke what does long term exposure to irritants promote in bronchitis? (5) - ans- smooth muscle hypertrophy
  • hypertrophy and hyperplasia of goblet cells
  • epithelial cell metaplasia
  • migration of more WBC to site
  • thickening and rigidity of bronchial basement membrane What does smooth muscle hypertrophy do in lungs? - anscauses increased bronchoconstriction Hypertrophy and hyperplasia of goblet cells do what in the bronchials - anspromotes hypersecretion of mucus What are characteristics of epithelial cell metaplasia? - anssquamous cells become nonciliated and are less protective; allow passage of toxins and WBCs What does the migration of WBCs to the bronchials do? - ansincreases inflammation of the cite and causes fibrosis in the bronchial wall How does the thickening and rigidity of bronchial basement membranes effect the lungs? - ansleads to further narrowing of the bronchial passageways What acid-base disorder is seen in chronic bronchitis? - ansrespiratory acidosis how does chronic bronchitis lead to respiratory acidosis? - anshyperinflation of the alveoli causes CO2 retention Where does air enter the body? - ansnaso and oropharynx (mouth and nose) Where does air go after it passes through the nose and mouth? - ansit passes through the trachea After air passes through the trachea where does it go? - ansgoes into the left or right bronchi Where does air flow after the bronchi? - ansinto the smaller bronchioles Where does air flow after the bronchioles? - ansinto the alveoli

Conquering NR 507 Advanced Pathophysiology.

An Ultimate Guide to Exam Success with Grade A+

Score

Latest Updated 2025/2026.

what stimulates the parasympathetic system - ansthe vagus nerve What does the parasympathetic system do? - ansIt releases acetycholine which decreases heart rate and causes vasodilation What can extreme vagal response result in? - anslife threatening bradycardia What mediates the sympathetic system - ansepinephrine and norepinephrine What does the sympathetic system promote in the cardiac system - ansvasoconstriction and increased HR What can uncontrolled tachycardia lead to? - ansreduced stroke volume and fatigue What are the two parts of the cardiac cycle? - ansdiastole and systole What causes blood to move from the atria to the ventricles - ansgravity and atriole systole What causes the S1 heart sound? - ansBicuspid/Mitral and Tricuspid valves closing What are the atrioventricular valves? - anstricuspid and bicuspid (mitral) valves What are the semilunar valves? - anspulmonary and aortic valves What causes the semilunar valves to open? - ansAs ventricles contract and intraventricular pressure rises, blood is pushed up against the SL valves, forcing them to open ejection fraction - ansmeasurement of the volume percentage of left ventricular contents ejected with each contraction What causes the semilunar valves to close? - ansventricles relax and intraventricular pressure falls, blood flows back from the arteries, and fill the cusps of the semilunar valves What causes the S2 heart sound? - ansclosing of semilunar (aortic and pulmonary) valves What prevents the backflow into the ventricles - anssemilunar valves Stenosis of heart valve - ansA narrowing of the valve opening, causing turbulent flow and enlargement of the emptying chamber Stenosis of a heart valve, may result in what? - ansNarrowing of the heart valves means that blood moves with difficulty out of the heart. Results may include chest pain, edema in the feet or ankles, and irregular heartbeat. and hypertrophy heart failure - anscardiac dysfunction caused by the inability of the heart to provide adequate CO resulting in inadequate tissue perfusion Left sided heart failure characteristic - ansinability of the left ventricle to provide adequate blood flow into systemic circulation Causes of left sided heart failure - anssystemic hypertension left ventricle MI LV hypertrophy Aortic SL valve or bicuspid valve damage Secondary to right heart failure How does LV hypertrophy lead to left sided heart failure - ansThe hypertrophy is secondary to cardiac damage resulting in an enlarged by weaker structure that holds more blood How does Aortic SL valve or bicuspid valve damage lead to heart failure - ansdamage leads to back flow into the left atrium or ventricle after ejection Biventricular failure - ansunresolved left sided heart failure will increase pressure on the right side of the heart contributing to right sided heart failure as well How does heart failure progress from hypertension? - ans- high systemic vascular pressure causes high after load requires the left ventricle to increase contraction force to eject the blood

Conquering NR 507 Advanced Pathophysiology.

An Ultimate Guide to Exam Success with Grade A+

Score

Latest Updated 2025/2026.

  • damage causes reduced ejection fraction and left ventricle gets tired and becomes unable to eject normal amount of blood
  • increased amount of blood remaining in left ventricle and increased left ventricle preload causes the left atrium unable to eject the normal amount of blood into the left ventricle
  • blood volume and pressure backs up into the pulmonary veins
  • increased pressure will force fluid from the pulmonary capillaries into the pulmonary tissues What does fluid in the pulmonary tissue result in - ansthe areas are flooded and results in pulmonary edema and dyspnea cor pulmonale - ansright-sided heart failure right sided heart failure - ansinability of the right ventricle to provide adequate blood flow into the pulmonary circulation Causes of right sided heart failure - ans- pulmonary disease
  • pulmonary hypertension
  • RV MI
  • RV Hypertrophy
  • pulmonary SLV or tricuspid valve damage
  • secondary to left heart failure What is the most common cause of right sided heart failure - anspulmonary hypertension Progression of right sided heart failure - ans- damage causes the right ventricle to increase contraction force to eject/unload the blood
  • over time EF is reduced and right ventricle us unable to eject the normal amount of blood
  • the blood remaining in the RV increases and RA preload increases until the RA is unable to eject the normal amount of blood into the RA
  • the amount of blood remaining in the right atrium increases causing an increase in RA preload
  • blood volum enad pressure then backs up into the vena cava and systemic veins signs and symptoms of right sided heart failure - ansjugular vein distension hepatosplenomegaly peripheral edema Why does hepatosplenomegaly develop in right sided heart failure - ansthe large volume of blood flow through the liver and spleen causes these areas to be engorged why does peripheral edema occur in right sided heart failure - ansIncreased pressure forces fluid from the systemic capillaries into the peripheral tissues and flood those areas High output failure - ansinability of the heart to pump sufficient amounts of blood to meet the circulatory needs of the body despite normal blood volume and cardiac contractility causes of high output failure - ansSevere anemia Nutritional deficiencies Hyperthyroidism

Conquering NR 507 Advanced Pathophysiology.

An Ultimate Guide to Exam Success with Grade A+

Score

Latest Updated 2025/2026.

hemolytic disease of the newborn (Rh incompatibility) autoimmune reaction drug induced development of anemia due to gastrectomy - ansloss of intrinsic factor from surgery results in the loss of protein necessary for vitamin B12 absorption an can lead to anemia what kind of anemia can result from incorrect blood transfusion - anshemolytic anemia normocytic normochromic anemia - ansCharacterized by red cells that are relatively normal in size and hemoglobin content but insufficient in number hemolytic anemia is what kind of anemia - ansnormocytic normochromic anemia polycythemia vera - anscondition characterized by too many erythrocytes; blood becomes too thick to flow easily through blood vessels Kidney Anatomy - ansrenal artery renal vein cortex, medulla, renal pelvis ureter renal pyramid nephron Nephron Anatomy - ans1. glomerulus

  1. bowman's capsule
  2. collecting duct
  3. tubule
  4. capillary Bladder anatomy - ans- ureter
  • bladder
  • urethra reabsorption (kidney) - ansmovement of solutes from filtrate to blood things taken back that were secreted of filtered by the kidney what solutes are typically reabsorbed - ansglucose, ions, amino acids and urea Where is most of the solute reabsorbed? - ansproximal convoluted tubule What effects amount of water and solute reabsorption - ansADH and aldosterone secretion (kidney) - ansmovement of solutes from blood to filtrate anywhere besides bowman's capsule able to secrete salts, acids, bases and urea directly into the tubule via active or passive transport what is secreted into the tubule depends on what the body needs at that time ex. eating a lot of protein nitrogen waste is a product of protein metabolism (ammonia) liver converts ammonia to urea and the kidneys secreted urea into the tubule for secretion also possible to eliminate products that are in excess in the blood -- potassium, hydrogen, metabolites or medications can secrete things that were too larger to fit through the glomerulus's pore filtration (kidney) - ansmovement of solutes from blood to filtrate at bowman's capsule

Conquering NR 507 Advanced Pathophysiology.

An Ultimate Guide to Exam Success with Grade A+

Score

Latest Updated 2025/2026.

20% of the blood that goes through the glomerulus is passed as filtrate into the bowman's capsule depends on the hydrostatic and oncotic pressures/ starling forces between the glomerulus and bowman's capsule hydrostatic pressure: a lot higher in the glomerulus (move into the nephron/bowman's capsule) oncotic pressure: higher in the blood/glomerulus than in the bowman's capsule (move into the blood/glomerulus) hydrostatic pressure is greater so there will be movement into bowman's capsule usually favors the filtrate to go into the bowman's capsule each persons full body is filtered about every 40 minutes Conditions associated with renal failure - ans- congenital abnormalities in the urethral tract development

  • kidney and bladder cancer
  • infections
  • glomerulonephritis
  • acute/ tubular necrosis
  • AKI vesicoureteral reflux - ansAbnormal ureter-bladder connection allowing retrograde flow of urine from bladder to ureters and/or kidneys renal agenesis - ansunilatral or bilateral failure of the kidneys to develop in utero Potter syndrome - ansSyndrome characterized by bilateral renal agenesis and incompatibility of live birth Wilms tumor - ans- Embryonal kidney tumor associated with defective tumor (WT) genes
  • Tumors are typically not clinically diagnosable until age 1-5 even though they are present at birth polycystic kidney disease - ans- Mutant PKD genes cause fluid accumulation in kidney tubules "cysts"
  • The cysts can be the size of grapes or oranges and compress and destroy nephrons Why are kidneys and bladders at high risk for cancer - ans- UT is the route of excretion for many toxins and contains highly mitotic cells Descending infection - ansThe blood can carry bacteria from a focus of infection in another part of the body to the kidneys. The bacteria then pass with the urine down the ureters to the bladder. Ascending infection - ans- urethra to bladder, and then to kidney
  • due to: bacteria from residual fecal contamination glomerulonephritis - ansinflammation of the glomeruli of the kidney tubular necrosis - ansthe renal tubules cells are highly sensitive to low oxygen levels or presence of toxins and leads to tubular necrosis

Conquering NR 507 Advanced Pathophysiology.

An Ultimate Guide to Exam Success with Grade A+

Score

Latest Updated 2025/2026.

  • Open prostatectomy pathogenesis of primary glomerulonephritis - ans- infection triggers of immune response to cause formation of antibodies
  • antibodies form complexes with the pathogen that should be rapidly phagocytized by WBC
  • in glomerulonephritis the Ag-Ab complexes are not phagocytized in a timely manner and continue to circulate in the blood stream
  • the Ag-Ab complexes get trapped in the narrow vasculature of the glomerular capillaries
  • build up of the Ag-Ab complexes signals that immune system and the complement system and WBC infiltration of the site
  • Complement protein with enzymes released by phagocytic cells attack the complexes and cause collateral damage to the glomerular area
  • Damage weakens thee glomerular structure and plasma proteins with blood leak into the tubular system and pass out into the urine clinical indicators of glomerulonephritis - ans- proteinuria
  • hematuria
  • edema
  • azotemia
  • oliguria
  • coagulation cascade activation Why is there edema with glomerulonephritis - ansthe loss of albumin from the bloodstream reduces plasma oncotic pressure and results in edema Azoetmia - anspresence of elevated plasma creatinine Why is there azoetmia with renal failure? - ansDecreased GFR means waste is remains in the bloodstream and is not excreted Why is there oliguria with renal failure? - answhen the glomerual structure has sustained enough damage the nephron structure is no longer functional as a filtration unit What happens in renal failure when the coagulation cascade is activated - ansfibrin is deposited in the glomerular structure and decreases capillary perfusion by causing blockages and further decreases GFR further blood hydrostatic pressure - ansthe pressure produced by a fluid against a surface filtration (kidney) - ansmovement of solutes from blood to filtrate at bowman's capsule 20% of the blood that goes through the glomerulus is passed as filtrate into the bowman's capsule depends on the hydrostatic and oncotic pressures/ starling forces between the glomerulus and bowman's capsule hydrostatic pressure: a lot higher in the glomerulus (move into the nephron/bowman's capsule) oncotic pressure: higher in the blood/glomerulus than in the bowman's capsule (move into the blood/glomerulus) hydrostatic pressure is greater so there will be movement into bowman's capsule

Conquering NR 507 Advanced Pathophysiology.

An Ultimate Guide to Exam Success with Grade A+

Score

Latest Updated 2025/2026.

usually favors the filtrate to go into the bowman's capsule each persons full body is filtered about every 40 minutes angiotensin converting enzyme (ACE) - ansan enzyme that converts angiotensin I to angiotensin II What does angiotensin II do? - ansincreases blood pressure by vasoconstriction Role of macrophages - ans-In Innate:

  1. Phagocytosis PRR or opsonization w/ complement
  2. Secrete Cytokines: Recruit more cells, inflammation, fever, etc.
  • In Adaptive:
  1. Phagocytosis: opsonization with complement or Abs
  2. Secrete cytokines: recruit more cells etc.
  3. Antigen presentation: peptides from the broken down pathogen are displayed on surface of the cell.