Pathophysiology 1 Final - Exam 1

It is important to consider that due to diversity, what two factors are not necessarily identical in any two individuals?

Health structure and function

What are the four interrelated topics that correspond to pathophysiology?

• etiology

• pathogenesis

• clinical manifestations

• treatment implications

True or False: Most diseases are multifactorial

True

A patient presents with hair loss due to undergoing chemotherapy, is this an example of an iatrogenic cause?

Yes

Coronary heart disease is a multifactorial disease, what are some reasons as to what classifies a multifactorial disease?

Multifactorial disease may be caused by different risk factors, such as genetic predisposition, diet, smoking, high blood pressure, stress, etc

True or False: Pathogenesis can be defined as the evolution or development of disease, starting from the initial stimulus to the final result of manifestation of the disease

True

True or False: Signs can be defined as a subjective clinical manifestation

False

True or False: Symptoms can be defined as an objective clinical manifestation

False

Which of the following is an example of the clinical manifestation known as a symptom?

• vomiting

• observing enlarged lymph nodes

• headache

• bruise

headache

What is the difference between latent period vs a prodomal period?

Latent period is the time between exposure of tissue to injurious agents and first appearance of signs and/or symptoms. Prodomal period is a time during which first signs/symptoms appear indicating onset of a disease.

Which is the phase that refers to a period during an illness when the signs/symptoms temporarily become mild, silent, or disappear?

Latent period

True or False: Specificity is the probability that a test will be negative when applied to a person without a particular condition

True

Fill in the blank: Strep Throat Swab with a sensitivity of 80% means that 20% of people with the conditions will test negative making this a ______

False negative

Define Endemic

Native to a local region

Define Epidemic

Spread to many at the same time

Define Pandemic

Spread to large geographic areas

Which of the following is an example of secondary prevention?

• Maintaining routine immunizations

• Performing monthly breast examinations

• Screening for cancer

• Rehabilitating after a stroke

Performing monthly breast examination

What are three ways that cells respond to environmental changes and injury?

Withstand, adapt, cell death

Another word for oncosis is? And what is its definition?

Hydropic swelling, and it is cellular swelling because of accumulation of water

True or False: Intracellular accumulation is characterized by excessive amounts of normal intracellular substances

True

What is an example of physiologic and pathologic hypertrophy

Physiological: When there is an increase in skeletal muscle size in response to exercise
Pathological: When there is an enlargement in the heart muscle due to high blood pressure

What are the two categories of irreversible cell injury?

Necrosis and Apoptosis

What is the most common form of necrosis?

Coagulative

What is gangrene defined as? And what are the three types?

Cellular death in a large area of tissue usually due to the interruption of blood supply to that particular zone

Three types:

• dry, wet, and gas

Does apoptosis cause an inflammatory response?

No

What is ischemia and hypoxic injury?

Ischemia: Lack of blood supply
Hypoxia: Lack of oxygen

True or False: Restoration of ox

Nutritional deficiencies may result from?

Poor intake, altered absorption, impaired distribution by circulatory system, and inefficient cellular uptake

What are the five causes of cellular injury?

• ischemia/hypoxic injury

• nutritional injury

• infectious/immunologic injury

• chemical injury

• physical/mechanical injury

What is the cellular basis of aging?

It is a cumulative result of two factors that cause cellular and molecular damage. It is a progressive decline in proliferation and reparative capacity of cells and exposure to environmental factors

What is the programmed senescence theory?

Programmed senescence theory is aging being the result of an intrinsic genetic program

What are the four groups of genetic disorders?

Genetic disorders are divided into chromosomal abnormalities, mendelian single-gene disorders, non-mendelian single gene disorder, and polygenic/multifactorial disorder

Chromosomal abnormalities generally result from?

An abnormal number of chromosomes and alterations to the structure of one or more chromosomes

What does aneuploidy refer to

An abnormal number of chromosomes either less than or greater than 46 chromosomes (in a human)

What is an example of autosomal aneuploidy, and why?

Down Syndrome (Trisomy 21) which means there is an extra copy of chromosome 21. This is considered an autosomal aneuploidy because it happens due to nondisjunction which is the failure of pairs to separate properly during 1st or 2nd meiotic division

Trisomy 18 and Trisomy 13 are examples of which aneuploidy, and what is another name for each?

Autosomal aneuploidy

Trisomy 18 - Edwards Syndrome
Trisomy 13 - Patau Syndrome

What are two examples of a sex chromosome aneuploidy?

Klinefelter Syndrome and Turner Syndrome

What is Cri du Chat Syndrome?

Is the deletion of part of the short arm (p arm) of chromosome 5

Marfan Syndrome is traced to which mutation, and low levels of this causes _____?

Mutation in fibrillin 1 gene on chromosome 15, low levels of fibrillin leads to weakened connective tissue

An abnormal amount of this protein is produced in Huntington disease that causes nerve degeneration.

Huntington protein

True or False: Do males always express the disease for a sex-linked (X-linked) disorder?

Yes, males always express the disease because they only have one X chromosome

Between which weeks, is the embryo most susceptible to teratogenesis?

Between the 3rd and 9th week, but especially during the 4th and 5th weeks during organ development

The suffix oma typically indicates?

Benign tumor

What do proto-oncogenes code for?

They code for growth factors, receptors, cytoplasmic signaling molecules, and transcription factors

How can proto-oncogenes become activated?

Oncogenes introduced to host cells by viruses, proto-oncogenes within cell suffers mutagenic event, DNA sequence may be lost or damaged and allows proto-oncogene to become abnormally active, and errors in chromosome replication cases extra copies of proto-oncogene in the genome

What are two examples of tumor suppressor genes?

BCRA 1 and BRCA2

What are the three steps of carcinogenesis?

1. Initiation: DNA damage (mutation)

2. Promotion: proliferation (growth promoters)

3. Progression: development of cancerous phenotype

Tumor markers help identify parent tissues of cancer origin, what are the examples for prostate cancer and ovarian cancer?

Prostate specific antigen (PSA) for prostate cancer and CA-125 for ovarian cancer

True or False: Grading is the histologic characterization of tumor cells, whereas staging is the location and patterns of spread within the host

True -

Grading: appearance of cells

Staging: location of the cancer and where it has spread to

What is the difference between self and nonself antigens?

Self antigens are proteins located on the cells surface of the individuals and the immune system ignores self antigens. Nonself antigens, the immune system recognizes specific nonself antigens as foreign, which produces a response and memory cells respond quickly to that antigen

Where do monocytes originate from?

The bone marrow (myeloid lineage)

True or False: Inflammatory cytokines cause the release of more immature neutrophils called bands from the bone marrow which is seen often in bacterial infections.

True

Where do T cells originate from, and mature at?

Originate in the bone marrow and mature in the thymus gland

What examples of T cells that function in cell mediated immunity?

Cytotoxic T-killer cells, Helper T cells, and memory T cells

Where do B cells originate from, and further proceed to?

B cells originate and mature in the bone marrow, where they then proceed to the spleen and lymphoid tissue

What do monocytes mature into?

Macrophages

Which vasoactive chemicals do mast cells release?

Histamine, prostaglandins, and leukotrienes

True or False: Chronic inflammation may impair healing and result in an accumulation of macrophages, fibroblasts, and collagen called granuloma

True

What is exudate?

Fluid that leaks out of blood vessels, combined with neutrophils and debris from phagocytosis

True or False: All nucleated cells express MHC Class I proteins on their cell surfaces

True

True or False: Cytotoxic T cells recognize antigens on MHC Class II

False, they recognize on MHC Class I

True or False: Certain specialized cells, primarily dendritic cells, macrophages, and B cells express MHC Class II proteins

True

Activated cytotoxic T cells (CD8+) proliferate into

Memory and effector cells

Which protein is needed for MHC Class I binding?

CD8

Which protein is necessary to enable T helper cells to bind to MHC II proteins

CD4

T helper cells (CD4+) recognize foreign antigen in association with which MHC molecules?

MHC II

True or False: B cells require activation help from T helper cells (CD4+)

True

Out of which immunoglobulin is the most common?

IgG

Which immunoglobulin is responsible for initiating inflammatory and allergic reactions?

IgE

What is antibody class switching dependent on?

By the presence of specific cytokines

What are some examples of passive immunity?

Mother to fetus: IgG can cross placenta; Mother to infant: IgA from breast milk; Serotherapy: direct injection of antibodies (humans or animals)

True or False: Type I hypersensitivity is known as immediate hypersensitivity, so reaction occurs 15-30 minutes after exposure

True

What are the immunoglobulins that mediate type II hypersensitivity

IgG or IgM

True or False: Type III hypersensitivity results from failure of immune system to remove antigen-antibody immune complexes (ICs)

True

Type IV hypersensitivity is defined as rapid or delayed response?

Delayed

Persistent Asthma is an example of which type IV hypersensitivity?

IVb, where T cells produce and release inflammatory cytokines and initiate eosinphil involvement, and released in response to severe inflamed and asthma symptoms

The deletion of which chromosome causes DiGeorge Syndrome?

Deletion of a section of chromosome 22 (22q11)

Wiskott-Aldrich Syndrome is an X-linked immunodeficiency disorder that affects?

Both T cells and B cells

An acquired primary immunodeficiency, such as HIV/AIDS causes a decrease in the number of what?

CD4+ (T-Helper cells)