Download NUR 3125 Pathophysiology FINAL EXAM LATEST 2024.2025 100% ACCURATE FALL-SPRING (GUARANTEED and more Exams Nursing in PDF only on Docsity!
NUR 3125 Pathophysiology FINAL EXAM LATEST 2024.2025 100%
ACCURATE FALL-SPRING (GUARANTEED PASS)
What is cancer caused by? Gene mutations or epigenetic changes that control cell reproduction, growth, differentiation, and/or death leading to uncontrollable cancer growth. What are the stages of carcinogenesis? Initiation Promotion Progression What is initiation? First stage of carcinogenesis. A cell undergoes an irreversible mutation causing it to become abnormal. Cell may then become cancerous. What is promotion? Second stage of carcinogenesis. Exposure to a "promotor" causes an increase in the mutated cell's ability to replicate/grow What is progression? Third stage of carcinogenesis. Extension of the promotion phase where the cell no longer relies on a "promotor" to grow/reproduce. What gene mutations can cause cancer?
Point mutation Gene amplification Chromosomal translocation What epigenetic changes can cause cancer? DNA methylation Histone modifications What are labile cells? Epithelial and blood cells that rapidly divide and are prone to cancer What are proto oncogenes? "Good genes" that regulate cell growth
- can become "bad" oncogenes How do proto oncogenes become oncogenes?
- Gene amplification
- Chromosomal translocation
- Point mutations What are oncogenes? Mutated proto oncogenes that can cause cancer What do tumor suppressor genes do? They suppress cell growth and promote apoptosis. What happens if tumor suppressor genes are disabled? Uncontrollable cell growth How do tumors make new blood vessels?
What is the primary target of hypomethylation? Oncogenes & repetitive sequences What is the result of hypomethylation? Gene activation & genomic instability What is the consequence of hypomethylation? Increased risk of mutations and oncogene activation What are examples of hypomethylation? c-MYC Transposable elements What do histone modifications cause? Change how tightly DNA is packed, affecting gene expression (Histone ~ "He's toned") What are two types of histone modification? Acetylation Methylation What occurs during histone acetylation? Addition of acetyl groups to histones. Causes loosening of chromatin, making genes more active What occurs during histone methylation? Addition of methyl groups to histones.
Can either activate or silence genes depending on location. How many stages of cancer are there (in this class)? Five:
- 0, 1, 2, 3, 4 What is stage 0 cancer? "Cancer in situ" Tiny cellular abnormality that hasn't spread or broken through original location What is stage 1 cancer? Cancer is small/localized within original organ. Hasn't spread to other parts of the body. What is stage 2 cancer? Cancer begins to spread throughout original organ. Still hasn't spread to other parts of the body. Angiogenesis also occurs What is angiogenesis? Occurs during stage 2 cancer. Tumor cells release VEGF (vascular endothelial growth factor) to make new blood vessels. What is stage 3 cancer? Cancer has spread to nearby regions AND lymph nodes. What is stage 4 cancer? Cancer has spread to other organ systems (often through lymph nodes) What are the key biomarkers of breast cancer (for this exam)?
What are the key biomarkers of non-Hodgkin's lymphoma? Lactate dehydrogenase What is the main function of sodium in the body? Maintains fluid balance and nerve function What is the main function of potassium in the body? Muscle contraction and heart function What is the main function of calcium in the body? Bone health, muscle function, blood clotting What is the main function of magnesium in the body? Nerve/muscle function and enzyme reactions What are S&S of hyponatremia? Confusion, seizures, edema What can cause hyponatremia? Too much antidiuretic hormone (ADH) or Syndrome of Inappropriate ADH (SIADH) causes fluid buildup, pulling sodium out of the blood (osmosis) What are S&S of hypernatremia? Thirst, dehydration, restlessness What can cause hypernatremia? Diabetes Insipidus (DI=dry inside) or low ADH causes polyuria or polydipsia, raising sodium levels
What is polyuria? Excessive urination What is polydipsia? Excessive thirst from water loss Sodium is inversely related to which electrolyte? Potassium What are S&S of hypokalemia? Weakness, arrhythmias, cramping, flat T waves (the waves are kalm [calm]) What can cause hypokalemia? Loss from vomiting, diarrhea, high urine output What are S&S of hyperkalemia? Muscle paralysis, peaked T waves What can cause hyperkalemia? Faulty kidneys not properly excreting potassium What are S&S of hypocalcemia? Tetany, Trousseau's sign, and Chvostek's sign What is Trousseau's sign? Sign of hypocalcemia. BP cuff induces arm spasms
What would you see in metabolic alkalosis? High pH + high HCO What can cause metabolic alkalosis? Excessive vomiting or diuretics What would you see in respiratory acidosis? Low pH + high PaCO What can cause respiratory acidosis? Hypoventilation (COPD or overdose) What would you see in respiratory alkalosis? High pH + low PaCO What can cause respiratory alkalosis? Hyperventilation (anxiety or sepsis) What are B cells? B-lymphocytes; they release antibodies into blood. (humoral immunity) What is humoral immunity? Antibody-mediated immunity (B cells produce antibodies) What are T cells? T-lymphocytes; they directly kill infected cells.
What is type 1 hypersensitivity? An immediate reaction due to: IgE mediated mast cell degranulation releasing histamines that cause bronchoconstriction and vasodilation What are some examples of type 1 hypersensitivity? Anaphylaxis Asthma What is type 2 hypersensitivity? Cytotoxic antibody mediated reaction due to: Cytotoxic antibodies (IgG/IgM) attack host cells What cytotoxic antibodies are involved in type 2 hypersensitivity? IgG IgM What is an example of type 2 hypersensitivity? Blood Transfusion causes Hemolytic Reaction What is type 3 hypersensitivity? Immune complex mediated reaction where immune complexes deposit in tissues, activating inflammation and complement systems (can be an on/off flare-up reaction) What are examples of type 3 hypersensitivity? Lupus Rheumatoid arthritis What is type 4 hypersensitivity?
What makes mycobacterium tuberculosis (TB) so "invasive"? it resists phagocytosis and forms granulomas What makes influenza so "invasive"? Undergoes frequent antigenic variation to evade immunity What makes UTIs so "invasive"? Bad GU (genitourinary) tract introduces bacteria (e. coli) to UT (urinary tract) What makes hepatitis (HBC, HCV) so "invasive"? Persists by inhibiting immune signaling What makes pyelonephritis so "invasive"? Bacteria spread to kidneys, causing inflammation (ascending UTIs) What makes bacterial meningitis (N. meningitidis, S. pneumoniae) so "invasive"? Protective capsule of bacteria resists phagocytosis What makes malaria (plasmodium) so "invasive"? Alters surface proteins to evade immune recognition What is spina bifida occulta? Neural tube defect; A small section of the spine doesn't close properly, but the spinal cord/nerves are unaffected. How does spina bifida occulta affect neural function? The spinal cord and nerves are unaffected. It is usually asymptomatic and discovered incidentally.
What are some methods of preventing spina bifida occulta? Folates, reduction in teen pregnancies, early detection of defects What are some foods that are high in folate? Leafy greens Fortified cereals Avocados Liver Beans What is meningocele? Neural tube defect; A form of spina bifida where the meninges herniate through an opening in the spine. Spinal cord stays in place. What are the meninges? Protective membranes that cover the brain and spinal cord (dura mater, arachnoid mater, pia mater) How does meningocele affect neural function? It doesn't involve the spinal cord, so it typically has no affect on neural function What is myelomeningocele? Neural tube defect; Severe form of spina bifida where the spinal cord and meninges protrude through an opening in the vertebrae What is the affect of myelomeningocele on neural function? Involves the spinal cord and meninges. Results in significant neurological deficits and even paralysis. What is Arnold-Chiari malformation?
- Legs extended
- Feet turned inward What is decorticate posturing? (not signs) Flexor posturing due to an injury ABOVE brainstem. Involves: cerebral cortex, thalamus, or internal capsule What are signs of decerebrate posturing?
- Arms extended by the sides
- Flexed wrists (out)
- Legs extended
- Feet turned inward What is decerebrate posturing? (not signs) Extensor posturing due to brain compression going downward to midbrain/brainstem. What is the basic pathophysiology of seizures? Increased glutamate excretion (excitability neurotransmitter) What is the basic pathophysiology of neurogenic shock? Disruption of the ANS due to SC injury (above T6), brain injury, or severe nerve damage What are the clinical manifestations of neurogenic shock? Bradycardia and hypotension due to loss of sympathetic tone What is the basic pathophysiology of autonomic dysreflexia? Exaggerated noxious stimuli below the level of injury (T6 and up) puts the brain into overdrive. What are the clinical manifestations of autonomic dysreflexia?
HTN
Sweating What are examples of "noxious stimuli" that may cause autonomic dysreflexia? Bladder distention, tight clothing, rumpled sheets... How do you treat autonomic dysreflexia? Removal of "noxious stimuli" What is the basic pathophysiology of cerebral palsy? Non-progressive neurological disorder caused by damage to areas of motor control before, during, or shortly after birth. (motor cortex, basal ganglia, or cerebellum) What are some causes of cerebral palsy? Hypoxia Meningitis Genetics What are some clinical manifestations of cerebral palsy? Spastic CP = stiff muscles, hypertonia, contractures (most common) Dyskinetic CP = uncontrolled or involuntary movements (aka chorea or dystonia) What is the basic pathophysiology of multiple sclerosis (MS)? Progressive autoimmune demyelination disorder that prompts the SNS to attack myelin sheaths What are clinical manifestations of multiple sclerosis (MS)? Death from infection (respiratory or UTI) because of muscle weakness What is the basic pathophysiology of amyotrophic lateral sclerosis (ALS)?
Double vision (gravis = grave = Zombie-face) What is the basic pathophysiology of Addison's disease? Adrenal glands do not produce enough aldosterone/cortisol. (ADDison = ADDrenal glands) What are some clinical manifestations of Addison's disease? Hyponatremia due to low aldosterone Hyperkalemia due to low aldosterone Hypotension due to dehydration and hyponatremia (ADDison = ADD salt) What is the basic pathophysiology of Parkinson's disease? Progressive loss of dopamine-producing neurons in the substantia nigra What are some clinical manifestations of Parkinson's disease? Tremor in hands ("pill-rolling") Cogwheel rigidity What is the basic pathophysiology of Alzheimers? Progressive neurodegenerative disorder primarily affecting hippocampus and cerebral cortex. Caused by amyloid plaques and neurofibrillary tangles What are some clinical manifestations of Alzheimers? Memory loss/Cognitive decline What are amyloid plaques?
Cause of Alzheimers: Extracellular deposits that disrupt cell communication and trigger inflammation. What are neurofibrillary tangles? Cause of Alzheimers: Intracellular tangles that damage neuron structure. Also known as Tau proteins What is the Monro-Kellie hypothesis? Theory that since the skull is a closed system, changes in any of the three "components" of the skull (brain, blood, CSF) will require a compensation in the others to maintain a stable intracranial pressure What is the value of normal intracranial pressure (ICP) in adults? 5 - 15 mmHg What are three mechanisms to regulate intracranial pressure (ICP)?
- CSF regulation
- Cerebral blood flow (CBF) adjustment
- Brain tissue shift How does cerebrospinal fluid (CSF) regulation compensate to regulate intracranial pressure (ICP)? The brain can decrease CSF production or increases CSF drainage via arachnoid villi to reduce ICP How does cerebral blood flow (CBF) adjustment regulate intracranial pressure (ICP)? Blood vessels can constrict/dilate to control blood volume and oxygen delivery while preventing excessive pressure How do brain tissue shifts help regulate intracranial pressure (ICP)?
