NURS-340: Pathophysiology 1 (Exam 1)

How is health defined according to the World Health Organization (WHO)?

A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity

What factors influence health status?

Age, genetics, gender, environment, and social factors

How is disease defined?

A condition in which the body no longer functions normally and varies in severity and duration

What is the difference between acute and chronic diseases?

Acute diseases occur and resolve quickly; chronic diseases last longer and may never fully resolve but can be managed

What is homeostasis?

The body’s ability to maintain a stable internal environment despite external changes

What are the two main mechanisms of cellular adaptation?

Proliferation (cell division) and differentiation (cells specializing in structure and function)

When is cellular adaptation considered abnormal?

When it persists after the stimulus is removed or contributes to disease

What is atrophy?

Decrease in cell size

What is hypertrophy?

Increase in cell size

What is hyperplasia?

Increase in the number of cells

What is metaplasia?

Replacement of one mature cell type with another

What is dysplasia?

Abnormal cell growth that is often precancerous

What causes cellular injury?

Physical, chemical, biologic agents, nutritional deficiencies, and free radicals

What is hypoxia?

Insufficient oxygen in the blood to sustain cellular function

What is ischemia?

Decreased blood supply to an organ

What is apoptosis?

Normal, programmed cell death

What is necrosis?

Premature, abnormal cell death due to injury that triggers inflammation

What is the difference between genetics and genomics?

Genetics studies individual genes; genomics studies the entire genome and gene-environment interactions

What are genes?

Segments of DNA on chromosomes that code for protein production and inherited traits

What is the difference between genotype and phenotype?

Genotype is genetic makeup; phenotype is observable traits

What is penetrance?

The percentage of individuals with a gene mutation who express the associated phenotype

What is expressivity?

The degree to which a gene is expressed in an individual

What is the difference between generic and brand names?

Generic names are official, lowercase, and standardized; brand names are capitalized and manufacturer-specific

Are generic and brand drugs interchangeable?

Yes, if FDA approved as bioequivalent

What is onset of action?

The time it takes for a drug to begin producing an effect

What is peak of action?

The time when the drug reaches its highest concentration and strongest effect

What is duration of action?

The length of time the drug maintains a therapeutic effect

What is a therapeutic effect?

The intended, desired effect of a medication

What is an adverse effect?

An unintended, potentially harmful effect of a medication

What is pharmacokinetics?

How the body processes a drug through absorption, distribution, metabolism, and elimination

What is absorption?

Movement of a drug from the administration site into the bloodstream

What is distribution?

Transport of the drug throughout the body via the bloodstream

What is metabolism?

Chemical alteration of a drug, primarily by the liver

What is elimination?

Removal of the drug from the body via kidneys, bile, lungs, skin, or feces

What is a peak level?

The highest concentration of a drug in the bloodstream after administration

What is a trough level?

The lowest concentration of a drug in the bloodstream, measured just before the next dose

What is pharmacodynamics?

The biochemical and physiological effects of drugs on the body

What is an agonist?

A drug that enhances or activates cellular activity

What is an antagonist?

A drug that blocks or reduces cellular activity

What is tolerance?

A decreased response to a drug over time, requiring higher doses

What is dependence?

Physical or psychological reliance on a drug

What is addiction?

Compulsive drug use despite harmful consequences

What is drug toxicity?

Drug accumulation in the body to harmful or life-threatening levels

What is a cumulative effect?

Drug buildup due to impaired metabolism or elimination

Why are drug-food interactions important?

Certain foods (e.g., grapefruit juice, calcium-rich foods) can alter absorption or metabolism and increase toxicity

Why do pharmacokinetics differ across the lifespan?

Differences in liver function, kidney function, body composition, and metabolism in infants, children, and older adults

What is the immune response?

The collective, coordinated response of immune cells and molecules that protect the body from foreign invaders

What are the body’s three lines of defense?

1. Physical and chemical barriers

2. Innate immune response

3. Adaptive immune response

What structures make up the first line of defense?

Skin, mucous membranes, mucus, cilia, tears, saliva, and stomach acid

What is innate (nonspecific) immunity?

A rapid, immediate defense that responds the same way to all pathogens and has no memory

What is adaptive (specific) immunity?

A slower but more precise immune response that targets specific antigens and has memory

What are key characteristics of innate immunity?

Immediate response, no memory, and limited specificity

What are key characteristics of adaptive immunity?

Specificity, diversity, memory, and stronger response on re-exposure

Which WBCs develop into macrophages?

Monocytes

Which WBCs are the first responders to infection?

Neutrophils

Which cells ingest bacteria and release enzymes?

Phagocytes (macrophages, neutrophils)

Which cells release histamine in allergic reactions?

Basophils and mast cells

Which cells recognize and destroy abnormal cells and release cytokines?

Natural killer (NK) cells

What is the role of B cells?

Produce antibodies

What is the role of cytotoxic (CD8+) T cells?

Directly destroy infected or abnormal cells

What do helper T cells do?

Coordinate and activate other immune cells

What is the function of antigen-presenting cells (APCs)?

Present antigens to T cells to initiate adaptive immunity

What is the complement system?

A cascade of plasma proteins that enhance inflammation and destroy pathogens

What are cytokines?

Immune signaling molecules that stimulate, inhibit, or regulate immune responses

What is inflammation?

An innate, automatic response to injury or infection that neutralizes harmful agents, removes damaged tissue, and promotes healing

What are the two stages of acute inflammation?

Vascular stage and cellular stage

What occurs during the vascular stage of inflammation?

Vasodilation and increased capillary permeability

Which mediators cause vasodilation?

Histamine and nitric oxide

What occurs during the cellular stage of inflammation?

WBCs migrate to tissue, destroy pathogens, remove debris, and release mediators

What are the five cardinal signs of inflammation?

Redness (rubor), swelling (tumor), heat (calor), pain (dolor), and loss of function (functio laesa)

What is histamine’s primary role in inflammation?

Increases vascular permeability

What do prostaglandins and leukotrienes do?

Potentiate inflammation; prostaglandins increase platelet aggregation, leukotrienes prolong permeability

What is the role of cytokines like TNF-α and IL-1?

Produce fever, hypotension, tachycardia, anorexia, and neutrophil release

What does bradykinin cause?

Pain, vasodilation, and increased permeability

What is hypersensitivity?

An exaggerated immune response that damages healthy tissue

What is Type I hypersensitivity?

IgE-mediated; causes allergies and anaphylaxis

What is Type II hypersensitivity?

Tissue-specific antibody reaction causing cell lysis (e.g., transfusion reactions)

What is Type III hypersensitivity?

Immune complex deposition causing inflammation (e.g., autoimmune disorders)

What is Type IV hypersensitivity?

Delayed, T-cell mediated response (e.g., TB skin test, transplant rejection)

What defines an infectious disease?

Microbial invasion that causes pathologic damage to the host

What is the difference between colonization and infection?

Colonization is presence without disease; infection involves tissue damage and symptoms

What are opportunistic infections?

Infections caused by normal flora or low-virulence organisms in immunocompromised hosts

What are the six links in the chain of infection?

Agent → Reservoir → Portal of exit → Mode of transmission → Portal of entry → Susceptible host

What is virulence?

A pathogen’s ability to cause disease

What are exotoxins?

Proteins secreted by bacteria that damage host cells

What are endotoxins?

Lipids from gram-negative bacterial cell walls causing fever, hypotension, and inflammation

What is the stress response?

A coordinated physiologic response designed to restore homeostasis during threats

Which systems regulate the stress response?

Nervous, endocrine, and immune systems

What is the HPA axis?

Hypothalamic-pituitary-adrenal axis regulating cortisol release

What is cortisol’s role in stress?

It increases blood glucose, suppresses immune function, and conserves energy

How does chronic stress affect immunity?

Prolonged cortisol suppresses immune responses and increases infection risk

What factors influence stress response effectiveness?

Age, health, nutrition, sleep, genetics, psychosocial factors, and duration of stress

How do vaccines work?

They introduce antigens that stimulate antibody production and immune memory

What is active immunity?

Immunity developed after infection or vaccination; memory present

What is passive immunity?

Temporary immunity from transferred antibodies; no memory

What is the purpose of booster vaccines?

To reinforce immune memory as immunity wanes over time

How do opioids relieve pain?

By binding to opioid receptors in the CNS to alter pain perception

How do NSAIDs reduce inflammation?

By inhibiting prostaglandin synthesis

How does acetaminophen differ from NSAIDs?

It provides analgesia and antipyresis but minimal anti-inflammatory effect

What is aspirin’s unique effect among NSAIDs?

Irreversible platelet inhibition