Patho Exam 1

Atrophy is a type of cellular adaptation where there is a _____ in cell size due to ____ synthesis or increased _____ _____, or both.

a decrease in cell size due to protein synthesis or increased protein catabolism or both.

Hypertrophy is cellular adaption where there is an _____ in _____ of cell due to _____ work demands or _____ _____.

**increase** in size of cell due to **increased** work demands or **hormonal** **stimulation**.

Example of physiologic cellular adaption (normal stressors)

enlargement of skeletal muscles with exercise.

Example of pathologic cellular adaption (abnormal stressors)

enlargement of the heart due to CHF (congenital heart failure)

Hyperplasia is a cellular adaptation where the ___ of cells ___.

**amount** of cells **increases**.

Metaplasia is a cellular adaption with the ____ of one ____ ____ to another.

the conversion of one cell type to another.

Dysplasia (cellular adaptation) is ____ cell ____.

**disorderly** cell **growth**.

What term describes varying degrees of a disease?

expressivity

This term describes how to define a child’s parents who are siblings.

consanguinity

Another name for Down Syndrome is

Trisomy 21

What is the genetic term for an allele with observable effects?

dominance

What is the most important risk factor for Down Syndrome?

increased maternal age

What aneuploidy (cell containing abnormal # of chromosomes) occurs in females only?

Turner’s syndrome

In Klinefelter’s disease, this a variant:

abnormal # of X chromosomes with at least one Y chromosome.

What can you conclude if a couple has 2 children and only 1 has CF (cystic fibrosis) and the other does not?

both parents of the children are carriers.

What autosomal recessive disorder is characterized by defective chloride and thick mucous?

cystic fibrosis

What is the most common genetic disorder that is not a X-linked disorder?

Down syndrome

What is the definition of metaplasia?

the conversion of one cell type to another

What is the type of cellular change expected with a lung cancer diagnosis?

dysplasia

To confirm somatic death, you should look for

cessation of respiratory and circulatory function.

What is the term is used to describe cellular destruction through programmed death?

apoptosis

What is the cause of warmth and swelling during inflammation?

increased vascular permeability

A provider notes that a group of institutionalized people develop similar respiratory symptoms due to what type of necrosis?

caseous necrosis

What type of tissue includes skeletal and smooth?

muscular tissue

What term describes a steady decline in body temperature to match ambient temperature?

algomortus (when you die your body temperature matches the temperature of the room)

Liquefactive necrosis occurs in the brain, why?

the cells are digested by self hydrolase because the brain is rich in hydrolytic enzymes and lipids.

Irreversible cell injury involves an increase in intracellular what?

massive calcium influx

What term describes the outward manifestation of a disease?

phenotype

What type of pathologic atrophy occurs with prolonged bedrest?

decreased muscle size atrophy

If the skin is breached, the second line of defense is activated, known as:

inflammatory response

The bacteria that make up normal flora prevents two things:

colonization and multiplication

What type of cells responds to parasitic infection?

eosinophils

____ is a protein synthesized by the liver, as are all ___ ____ except for immunoglobulins, and is catabolized by all ____ active tissues.

albumin, liver, plasma proteins except for immunoglobulins, and catabolized by all metabolically active tissues.

Oncotic/ osmotic pressure is induced by ____, notably ____.

proteins, albumin

_____ fluid is the fluid that lies within tissues, outside of and in between the ____.

**interstitial** fluid, the **cell**

Intracellular fluid is ____ the cell while extracellular fluid lies ____ of the cell.

within, outside

____ is a process by which molecules of a ____ (water) tend to pass through a ____ membrane from a ____ concentrated solution into a ____ concentrated one, thus ____ the concentrations on each side of the ____.

**osmosis, solvent, semipermeable, less, more, equalizing, membrane**

Osmosis equalizes ____ and happens only in a ____ medium.

**concentration, liquid**

____ is the tendency of the ____ of a ____ (gas/ liquid/ solid) to move from a region of ____ to ____ concentration.

**diffusion, molecules, substance, high, low**

Diffusion moves molecules from

a high to low concentration

Osmosis moves molecules from

a low to high concentration

True of false: diffusion can happen only through solid or gas.

false, diffusion can happen through solid, liquid, or gas.

In the body, oxygen and carbon dioxide move by ____.

**diffusion**

Water is __% of body weight in adults.

**60**%

Water is __% to __% of body weight in children.

**75**%-**80**%

Aging adults experience ____ free fat and ____ mass, and renal decline.

decreased free fat and muscle mass, and renal decline

____ pressure pushes water out of capillaries (____).

Hydrostatic, (filtration).

Hydrostatic pressure is higher during ____.

filtration

____ / ____ pressure puts water into capillaries (____). It holds onto ____ molecules.

**osmotic/ oncotic** (**reabsorption**).

**water** molecules

Oncotic pressure is higher during ____.

**reabsorption**

____ (osm) is the concentration of salt in the ____ / blood.

**osmolality, plasma**

The range for serum/ plasma osmolality is ___- ___ mOsm/kg.

**280-295** mOsm/kg

____ is the protein responsible for **oncotic** pressure.

**albumin**

Forces favoring filtration:

• _____ hydrostatic pressure ( ____ pressure)

• _____ (in between capillaries, space between cells) oncotic pressure (water- pulling)

• capillary hydrostatic pressure (blood pressure)

• interstitial (space between cells) oncotic pressure

Forces favoring reabsorption:

* capillary ____ pressure (water- pulling)
* interstitial ____ pressure

* capillary **oncotic** pressure
* interstitial **hydrostatic** pressure

_____ hormone (ADH) helps retain/ reabsorb the amount of ____ in your body.

**antidiuretic** hormone, **water**

ADH works to control the amount of ____ that the ____ reabsorb as they filter out ____ from your ____ (urination).

**water, kidneys, waste, blood**

A high ADH level causes the body to produce ____ urine.

A low level of ADH results in ____ urine production.

**less**, **greater**

The higher the ____ (concentration), the ____ the ADH level.

**osmolality**, **higher**

Acid in the body is called

carbon dioxide (CO2)

Alkaline in the body is referred to as

bicarbonate (HCO3)

What is the normal body pH range?

7\.35- 7.45

The normal CO2 range in the body is

35-45 mmHg (millimeters of mercury)

The normal partial pressure range of oxygen in the body is __- 100mmHg.

**80**-100 mmHg

The normal bicarbonate range in the body is 22-__mmHg.

22-**26** mmHg

The normal oxygen saturation range is

**95-100%**

____ - ____ system (RAS) is triggered by a drop in ____ ____ and a drop in ____ volume.

renin- angiotensin system (RAS), drop in blood pressure, fluid

The first step in the RAS system is ____ release from kidneys (increase in ____ volume by ____ fluids).

____ also releases ____.

**renin** (**fluid** volume by **reabsorbing** fluids)

**liver**, **angiotensinogen**

2nd step in RAS system:

____ then acts on angiotensinogen to form ____ I.

**renin**, **angiotensin** I.

3rd step in RAS system:

ACE (angiotensin- ____ ____) release from ____.

angiotensin- **converting** **enzyme**, **lungs**

4th step in RAS system:

ACE acts on angiotensin to form ____ II.

____ II also acts directly on blood ____ stimulating ____ (narrowing).

**angiotensin** II.

**angiotensin** II, blood **vessels** stimulating **vasoconstriction**

5th step in RAS system:

Angiotensin II acts on the ____ gland to stimulate the release of ____.

**adrenal**, **aldosterone**

(RAS system)

Aldosterone acts on the kidneys to stimulate reabsorption of ____ and ____.

salt and water

The goal of renin- angiotensin system is to raise ____ ____ and ____ ____.

**blood pressure** and **fluid volume**

Infarction is

a complete loss of blood supply.

Ischemia is ____ / inadequate blood supply.

**reduced**

ANP (atrial natriuretic hormone) BNP (brain natriuretic peptide) system counteracts the ___ system.

**RAS**

ANP increases _____ excretion.

**sodium**

BNP increases _____ excretion.

fluid

ANP BNP system works by increasing ____ (which decreases ____ volume), performing ____ (which decreases ____ ____), and decreasing ____.

GFR- glomerular filtration rate, blood, vasodilation, blood pressure, renin

The solution with the higher solute concentration is _____.

The solution with the lower concentration is _____.

The solution with the same concentration is _____.

hypertonic, hypotonic, isotonic

Edema is the accumulation of _____ within the _____ spaces.

Edema is caused by an increase in _____ _____ pressure, a decrease in plasma ____ pressure, an increase in ____ permeability, and ____ channel obstruction (lymphedema).

fluid, interstitial

capillary hydrostatic pressure, plasma oncotic pressure, capillary permeability, and lymph channel obstruction.

What is the normal sodium range?

135-145 mEq/L

The normal potassium range is 3.5-_ mEq/L.

3\.5-**5** mEq/L

The normal ____ range is 8.5-10.5 mEq/L.

**calcium**

Hyperkalemia (high potassium) is categorized by (think tight and contracted):

in the heart: peaked _ waves, _fib or ____ standstill, hypotension, ___cardia.

in the GI tract: diarrhea and ____ bowel sounds.

neuromuscular: paralysis in ____ extremities, increased ____, profound muscle ____.

**T** waves, **V**fib or **cardiac** standstill, hypotension, **brady**cardia.

diarrhea and **hyperactive** bowel sounds

paralysis in **lower** extremities, increased **DTR** (deep tendon reflex), profound muscle **weakness**

Hypokalemia (low potassium) is categorized by (think low and slow):

in the heart: flat _ waves, __ depression, and prominent _ wave.

muscular: decreased ___, muscle ____, and flaccid ____ (paralyzed limbs).

GI tract: decreased _____, _____ to absent bowel sounds, _____, abdominal _____, paralytic ileus, paralyzed intestines.

flat T waves, ST depression, prominent U wave.

decreased DTR, muscle cramping, and flaccid paralysis.

decreased motility, hypoactive to bowel sounds, constipation, abdominal distention (enlargement) paralytic ileus, paralyzed intestines.

Hypernatremia (high sodium) is categorized by (think big and bloated):

____ “red and rosy”

____ “waterbed skin”

___ ___ fever

____ (hyper thirst)

**flush**, **edema**, **low grade** fever, **polydipsia**

Hyponatremia is categorized by (think depressed and deflated):

neuro: ____ & ____

**seizures** & **coma**

Hypercalcemia is categorized by

swollen & slow

moans, groans and stones

Hypocalcemia is categorized by

Trousseau’s sign, Chvostek’s sign

Trousseau’s sign is a sign of _____ and demonstrates

_____ of the thumb, flexion of the _____ joints, extension of the _____ joints, and flexion of the _____.

**hypocalcemia, adduction, metacarpophalangeal, interphalangeal joints, wrist**

Chvostek’s sign is a sign of _____ and demonstrates _____ of the lip to _____ of all facial muscles.

**hypocalcemia, twitching, spasm**

Hypovolemia is isotonic fluid _____.

**loss**

Isotonic fluid excess is known as _____.

**hypervolemia**

Glomerular filtration rate is the amount of _____ passing through the _____ per _____.

**blood, glomeruli, minute**

Creatinine is a chemical waste product made as a by-product of normal _____ _____, excreted by the _____.

**muscle contractions, kidneys**

Blood urea nitrogen is a waste product in the _____ from _____ metabolism.

**blood, protein**

24- hour urine osmolality range is ___-___ mOsm/kg of water.

500-800 mOsm/kg of water

Random urine osmolality range is ___-900 mOsm/kg of water.

300-900 mOsm/kg of water