FINAL EXAM
GENERAL CONCEPTS
Modifiable Risk Factors
Definition: Risk factors that can be changed or controlled to reduce disease risk.
Why it happens: Lifestyle choices, environmental exposures, and behaviors can influence disease development or progression.
Example: Quitting smoking reduces the risk of lung cancer.
Non-Modifiable Risk Factors
Definition: Risk factors that cannot be changed.
Why it happens: Genetic makeup, age, or biological sex influences susceptibility.
Example: Having a family history of heart disease increases risk.
Signs
Definition: Objective evidence of disease observed by others.
Why it happens: Physiologic changes manifest visibly or can be measured.
Example: Fever during an infection.
Symptoms
Definition: Subjective experiences reported by the patient.
Why it happens: Disease affects body systems and causes sensations only the patient can perceive.
Example: Nausea in gastroenteritis.
Exacerbation
Definition: Worsening of a disease or symptoms.
Why it happens: Triggering factors like infection, stress, or noncompliance with treatment increase disease activity.
Example: Asthma attack after pollen exposure.
Remission
Definition: Period during which symptoms of a chronic disease decrease or disappear.
Why it happens: Disease activity slows or treatment is effective.
Example: Cancer showing no detectable tumor after chemotherapy.
Morbidity
Definition: Disease impact on function or quality of life.
Why it happens: Chronic disease can impair physical, mental, or social abilities.
Example: Disability after stroke.
Mortality
Definition: Rate of death associated with a disease.
Why it happens: Severe disease or complications can be fatal.
Example: Untreated sepsis can result in death.
Prognosis
Definition: Predicted outcome of a disease.
Why it happens: Based on disease type, severity, patient factors, and treatment response.
Example: Early-stage breast cancer has a good prognosis after surgery.
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CELLULAR CONCEPTS
Atrophy
Definition: Decrease in cell size.
Why it happens: Reduced workload, blood supply, nutrition, or aging.
Example: Muscle wasting after limb immobilization.
Hypertrophy
Definition: Increase in cell size.
Why it happens: Cells adapt to increased workload.
Example: Enlarged left ventricle from chronic high blood pressure.
Hyperplasia
Definition: Increase in cell number.
Why it happens: Hormonal or compensatory stimuli trigger cell proliferation.
Example: Thickened uterine lining during menstrual cycle.
Metaplasia
Definition: Replacement of one mature cell type with another.
Why it happens: Chronic irritation or inflammation triggers protective cell changes.
Example: Bronchial epithelium changes to squamous cells in smokers.
Dysplasia
Definition: Disorganized or abnormal cell growth, often precancerous.
Why it happens: Abnormal stimuli disrupt normal cellular development.
Example: Cervical dysplasia on a Pap smear.
Benign Tumors
Definition: Noncancerous growths that do not invade tissues.
Why it happens: Cells proliferate slowly and remain localized.
Example: Lipoma on the arm.
Malignant Tumors
Definition: Cancerous growths that invade tissues and can metastasize.
Why it happens: Uncontrolled cell division with ability to spread.
Example: Lung cancer spreading to liver.
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FLUID, ELECTROLYTE, AND ACID-BASE IMBALANCES
Intracellular Electrolytes
Definition: Electrolytes primarily located inside cells.
Why it happens: Maintains nerve, muscle, and metabolic function.
Example: Potassium inside muscle cells.
Extracellular Electrolytes
Definition: Electrolytes primarily outside cells.
Why it happens: Maintains fluid balance and nerve conduction.
Example: Sodium in blood plasma.
Calcium Imbalance
• Hypocalcemia: Low calcium; causes: hypoparathyroidism, vitamin D deficiency. Symptoms: muscle cramps, tetany.
• Hypercalcemia: High calcium; causes: hyperparathyroidism, cancer. Symptoms: fatigue, kidney stones.
Sodium Imbalance
• Hyponatremia: Low sodium; causes: excess water, vomiting, diarrhea. Symptoms: confusion, weakness.
• Hypernatremia: High sodium; causes: dehydration, high intake. Symptoms: thirst, confusion.
Edema
Definition: Excess fluid in tissues.
Why it happens: Increased capillary pressure, low albumin, or inflammation.
Example: Swollen ankles in heart failure.
Albumin
Definition: Blood protein maintaining fluid balance.
Why it happens: Low albumin reduces oncotic pressure, leading to edema.
Example: Swelling in liver disease.
Dehydration
Definition: Loss of body water and electrolytes.
Why it happens: Vomiting, diarrhea, sweating, or insufficient intake.
Example: Dry mucous membranes in a child with diarrhea.
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CONGENITAL AND GENETIC DISORDERS
Congenital Disorders
Definition: Present at birth.
Why it happens: Genetic mutation or prenatal environment.
Example: Congenital heart defect.
Inheritance Patterns
• Autosomal Recessive: Two defective genes needed. Example: Cystic fibrosis.
• Autosomal Dominant: One defective gene needed. Example: Huntington’s disease.
• X-Linked Dominant/Recessive: Gene on X chromosome; males often affected. Example: Hemophilia A.
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COMPLICATIONS DUE TO AGING
Skin: Thinning, dryness, decreased elasticity. Example: More skin tears in elderly.
Bones: Decreased density, increased fracture risk. Example: Hip fracture from fall.
Immunity: Slower response, higher infection risk. Example: Pneumonia in older adults.
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IMMOBILITY AND ASSOCIATED PROBLEMS
Benefits of Physical Activity
Definition: Maintains muscle, cardiovascular, and bone health.
Why it happens: Exercise stimulates circulation and metabolism.
Example: Walking prevents blood clots during hospitalization.
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STRESS AND ASSOCIATED PROBLEMS
Positive Stress: Motivates, improves performance. Example: Preparing for exam.
Negative Stress: Harmful, leads to illness. Example: Job burnout causing high blood pressure.
Technostress: Stress from technology overuse. Example: Anxiety from constant notifications.
Homeostasis: Internal balance maintained by feedback systems. Example: Blood sugar regulated by insulin.
Stages of Stress
• Alarm: Fight-or-flight; heart rate rises when startled.
• Resistance: Adaptation; elevated blood pressure during ongoing stress.
• Exhaustion: Depletion; chronic stress leading to ulcers or infection.
Chronic Stress Effects: Long-term negative impact on immune, cardiovascular, and metabolic systems. Example: Poor wound healing.
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INFLAMMATION AND HEALING
Acute Inflammatory Response: Local response to injury; redness, swelling, heat. Example: Cut finger becomes red and swollen.
Systemic Inflammation: Body-wide response; fever, malaise. Example: Sepsis.
Wound Exudate Types
• Serous: Clear, watery; mild injury.
• Purulent: Thick, yellow-green; infection.
• Sanguineous: Bloody; fresh injury.
• Serosanguineous: Blood and fluid mix; healing surgical wound.
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INFECTION
Agents of Disease: Bacteria, viruses, fungi, helminths. Example: Streptococcus causing strep throat.
Microorganisms
• Nonpathogenic: Normal flora, do not cause disease. Example: Skin bacteria.
• Flora: Protect the host. Example: Gut Lactobacillus.
• Pathogens: Cause disease. Example: Influenza virus.
Infection Patterns
• Sporadic: Occasional cases. Example: Tetanus.
• Endemic: Regularly present. Example: Malaria in some countries.
• Epidemic: Many cases in one area. Example: Measles outbreak.
• Pandemic: Worldwide. Example: COVID-19.
Chain of Infection: Agent → Reservoir → Portal of exit → Mode of transmission → Portal of entry → Susceptible host. Example: Influenza virus spreads via droplets.
Stages of Illness: Incubation → Prodromal → Acute → Convalescence → Recovery. Example: Chickenpox.
Viral Replication Requirement: Needs host cells to reproduce. Example: HIV infects T cells.
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IMMUNITY
Natural Active Immunity
Definition: Immunity developed after actual infection.
Why it happens: Exposure to pathogen triggers antibody production and memory cells.
Example: Recovering from chickenpox gives lifelong immunity.
Artificial Active Immunity
Definition: Immunity developed after vaccination.
Why it happens: Vaccine stimulates immune system without causing disease.
Example: Receiving measles vaccine.
Natural Passive Immunity
Definition: Immunity passed from mother to infant via placenta or breast milk.
Why it happens: Maternal antibodies provide temporary protection.
Example: Infant protected from measles for first months.
Artificial Passive Immunity
Definition: Immunity gained by injecting antibodies.
Why it happens: Provides immediate, short-term protection.
Example: Receiving rabies immunoglobulin after exposure.
Impact of Aging on Immunity
Definition: Decreased immune response in older adults.
Why it happens: T-cell and B-cell function decline with age.
Example: Elderly have higher risk of influenza complications.
Cells of Immunity
• Neutrophils: First responders; fight bacteria. Example: Acute bacterial infection.
• Eosinophils: Combat parasites and mediate allergic reactions. Example: Asthma attack.
• Basophils: Release histamine; involved in allergic reactions. Example: Anaphylaxis.
• Monocytes/Macrophages: Phagocytosis; present antigens. Example: Engulf bacteria in wound.
• Lymphocytes: B and T cells; specific immune response. Example: Produce antibodies after infection.
Immunoglobulins
• IgG: Most abundant; provides long-term immunity. Example: Protects against measles.
• IgA: Found in mucous, saliva, breast milk; protects surfaces. Example: Prevents respiratory infections.
• IgM: First antibody produced; indicates recent infection. Example: Detecting hepatitis infection.
• IgE: Mediates allergic reactions and parasite defense. Example: Triggers histamine release in allergies.
• IgD: Initiates B-cell activation. Example: Early immune response.
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SKIN DISORDERS
Burn Classification
• First-degree: Superficial; redness and pain. Example: Mild sunburn.
• Second-degree: Partial thickness; blisters. Example: Hot liquid scald.
• Third-degree: Full thickness; destroys skin layers. Example: Severe flame burn.
• Fourth-degree: Extends to muscle/bone. Example: Electrical burn.
ABCDs of Cancer Assessment
• Asymmetry: One half different from other.
• Border: Irregular edges.
• Color: Uneven pigmentation.
• Diameter: Larger than 6 mm.
Example: Early detection of melanoma.
Keloid
Definition: Overgrowth of scar tissue beyond wound.
Why it happens: Excess collagen deposition during healing.
Example: Raised scar after ear piercing.
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URINARY SYSTEM DISORDERS
Functions of Kidneys
Definition: Filter blood, remove waste, regulate electrolytes and blood pressure.
Why it happens: Nephrons filter plasma to maintain homeostasis.
Example: Kidney failure leads to fluid overload.
Hormones in Urinary System
• Erythropoietin: Stimulates red blood cell production. Example: Anemia in chronic kidney disease.
• Renin: Regulates blood pressure via angiotensin. Example: Low blood pressure triggers renin release.
• Antidiuretic Hormone (ADH): Promotes water reabsorption. Example: Low ADH causes excessive urination in diabetes insipidus.
Cystitis vs. Urethritis
• Cystitis: Bladder inflammation; causes: bacterial infection. Symptoms: frequent urination, burning.
• Urethritis: Urethra inflammation; causes: infection or trauma. Symptoms: burning with urination.
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BLOOD AND CIRCULATION
Leukemia
Definition: Cancer of white blood cells.
Why it happens: Uncontrolled proliferation of abnormal WBCs crowds bone marrow.
Example: Fatigue, anemia, infection risk.
Hemophilia A
Definition: X-linked recessive disorder; deficiency of clotting factor VIII.
Why it happens: Impaired coagulation leads to prolonged bleeding.
Example: Excessive bleeding after minor injury.
Anemias
• Iron-deficiency: Low iron; small, pale RBCs; fatigue.
• Pernicious: Lack of vitamin B12; neurological symptoms.
• Aplastic: Bone marrow failure; pancytopenia.
• Sickle Cell: Abnormal hemoglobin; vaso-occlusive crises.
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RESPIRATORY SYSTEM DISORDERS
Gas Exchange Terminology
• Hypoxia: Low oxygen in tissues. Example: COPD patient shortness of breath.
• Hypercapnia: High carbon dioxide in blood. Example: Respiratory failure.
Anatomic Functions
• Trachea: Airway passage to lungs.
• Diaphragm: Main muscle for breathing.
Obstructive Lung Disease Classification
Definition: Airflow obstruction, difficulty exhaling.
Example: Chronic bronchitis, emphysema, asthma.
Emphysema Pathophysiology
Definition: Destruction of alveolar walls; enlarged air spaces.
Why it happens: Smoking damages elastin; reduces gas exchange.
Example: Barrel chest, dyspnea.
Asthma Pathophysiology
Definition: Chronic airway inflammation and hyperreactivity.
Why it happens: Allergens trigger bronchoconstriction and mucus production.
Example: Wheezing during pollen season.
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DIGESTIVE/METABOLIC DISORDERS
Resident Flora
Definition: Normal microbes in GI tract.
Why it happens: Help digest food and prevent pathogen growth.
Example: Lactobacillus in intestines.
Stool Characteristics
• Color, consistency, presence of blood/fat.
Example: Steatorrhea indicates fat malabsorption.
Ulcerative Colitis
Definition: Chronic inflammation of colon mucosa.
Why it happens: Autoimmune attack on colon lining.
Example: Diarrhea with blood and mucus.
Appendicitis
Definition: Inflammation of appendix.
Why it happens: Obstruction leads to infection and swelling.
Example: Right lower quadrant abdominal pain.
Chronic Renal Failure
Definition: Progressive loss of kidney function.
Why it happens: Diabetes, hypertension damage nephrons.
Example: Fatigue, edema, electrolyte imbalance.
Liver Cirrhosis
Definition: Chronic liver scarring.
Why it happens: Alcohol, hepatitis, or fatty liver damages hepatocytes.
Example: Jaundice, ascites, portal hypertension causing esophageal varices.
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CARDIOVASCULAR SYSTEM DISORDERS
Diastole
Definition: Phase of the cardiac cycle when the heart relaxes and fills with blood.
Why it happens: Ventricular relaxation allows blood to flow from atria to ventricles.
Example: Blood fills left ventricle after contraction.
Systole
Definition: Phase when the heart contracts and pumps blood.
Why it happens: Ventricular contraction ejects blood into circulation.
Example: Left ventricle pumps blood into aorta.
Cardiac Output
Definition: Amount of blood the heart pumps per minute.
Why it happens: Stroke volume multiplied by heart rate determines perfusion.
Example: Reduced cardiac output in heart failure causes fatigue.
Stroke Volume
Definition: Amount of blood pumped by one ventricle per beat.
Why it happens: Determined by preload, afterload, and contractility.
Example: Reduced stroke volume in myocardial infarction.
Electrical Conduction of the Heart
Definition: System controlling heart rhythm.
Components:
• Sinoatrial (SA) node: Pacemaker; initiates heartbeat.
• Atrioventricular (AV) node: Delays impulse; allows atrial contraction.
• Bundle of His / Purkinje fibers: Conduct impulses to ventricles.
Example: Arrhythmia when conduction is disrupted.
Myocardial Infarction (MI)
Definition: Death of heart muscle due to ischemia.
Why it happens: Blocked coronary artery prevents oxygen delivery.
Example: Chest pain radiating to arm, shortness of breath.
Atrial Fibrillation
Definition: Irregular, rapid atrial contractions.
Why it happens: Abnormal electrical impulses cause uncoordinated contraction.
Example: Palpitations, risk of stroke due to clot formation.
Left Ventricular Hypertrophy (from untreated hypertension)
Definition: Thickening of left ventricular wall.
Why it happens: Heart works harder to pump against high blood pressure.
Example: Shortness of breath, risk of heart failure.
Heart Failure
• Left-sided: Pulmonary congestion, dyspnea, orthopnea.
• Right-sided: Peripheral edema, jugular vein distention, ascites.
Why it happens: Ventricles fail to pump effectively.
Example: Left-sided heart failure causing pulmonary edema.
Hypertension
Definition: Chronic high blood pressure.
Why it happens: Increased vascular resistance, fluid overload, hormonal factors.
Example: Risk factor for stroke, MI, kidney disease.
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NEUROLOGICAL SYSTEM DISORDERS
Decerebrate Posturing
Definition: Abnormal body posture with arms extended and legs straight.
Why it happens: Severe brainstem injury.
Example: Patient after traumatic brain injury.
Decorticate Posturing
Definition: Arms flexed, legs extended.
Why it happens: Lesion above brainstem; corticospinal tract damage.
Example: Intracranial hemorrhage patient.
Neuron Components
• Axon: Transmits impulses away from cell body.
• Dendrites: Receive signals from other neurons.
• Myelin: Insulates axons; speeds conduction.
• Soma: Cell body; metabolic center.
Example: Demyelination in multiple sclerosis slows nerve conduction.
Aneurysm
Definition: Weakness in blood vessel wall causing bulge.
Why it happens: Hypertension, atherosclerosis, or congenital defect.
Example: Cerebral aneurysm causing stroke risk.
Transient Ischemic Attack (TIA)
Definition: Temporary interruption of cerebral blood flow.
Why it happens: Small clot or narrowing in cerebral artery.
Example: Sudden weakness or speech difficulty lasting minutes.
Multiple Sclerosis (MS)
Definition: Chronic demyelinating disease of CNS.
Why it happens: Autoimmune attack on myelin sheaths.
Example: Weakness, visual disturbances, fatigue.
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ENDOCRINE SYSTEM DISORDERS
Negative Feedback Loops
Definition: Mechanism that maintains homeostasis by reversing a change.
Why it happens: Endocrine glands adjust hormone levels based on feedback.
Example: High blood glucose triggers insulin release.
Hypoparathyroidism
Definition: Low parathyroid hormone levels.
Why it happens: Surgical removal, autoimmune destruction.
Example: Low calcium causing muscle cramps and tetany.
Graves’ Disease
Definition: Autoimmune hyperthyroidism.
Why it happens: Antibodies stimulate thyroid hormone production.
Example: Exophthalmos, weight loss, heat intolerance.
Addison’s Disease
Definition: Adrenal insufficiency.
Why it happens: Autoimmune destruction of adrenal cortex.
Example: Weakness, hypotension, hyperpigmentation.
Diabetes Mellitus (DM)
• Polyuria: High glucose causes osmotic diuresis.
• Amputations: Poor circulation and neuropathy cause tissue death.
• Delayed wound healing: Hyperglycemia impairs immune response.
• Peripheral neuropathy: Nerve damage from chronic high glucose.
Type 1 DM
Definition: Autoimmune destruction of beta cells.
Why it happens: No insulin production.
Example: Childhood onset, requires insulin therapy.
Type 2 DM
Definition: Insulin resistance and relative insulin deficiency.
Why it happens: Obesity, sedentary lifestyle, genetics.
Example: Adult onset, may use oral medications or insulin.
Diabetes Insipidus
Definition: Deficiency of antidiuretic hormone.
Why it happens: Pituitary damage or renal insensitivity to ADH.
Example: Excessive urination and thirst.
Diabetic Ketoacidosis (DKA)
Definition: Life-threatening hyperglycemia with ketone buildup.
Why it happens: Lack of insulin leads to fat breakdown and ketone production.
Example: Fruity breath, dehydration, rapid breathing.
Acromegaly
Definition: Excess growth hormone in adults.
Why it happens: Pituitary adenoma.
Example: Enlarged hands, facial features, jaw.
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MUSCULOSKELETAL SYSTEM DISORDERS
Bone Health Cells
• Osteoblasts: Build bone.
• Osteoclasts: Resorb bone.
• Osteocytes: Mature bone cells, maintain matrix.
Electrolytes for Bone Health
Calcium and phosphorus; needed for mineralization.
Example: Deficiency leads to osteoporosis.
Gout
Definition: Uric acid crystal deposition in joints.
Why it happens: Purine metabolism imbalance.
Example: Painful big toe inflammation.
Joint Dislocation
Definition: Bones displaced from joint.
Why it happens: Trauma or ligament injury.
Example: Shoulder dislocation from fall.
Osteoporosis
Definition: Low bone density.
Why it happens: Imbalance between resorption and formation.
Example: Vertebral compression fracture in elderly.
Osteomyelitis
Definition: Bone infection.
Why it happens: Bacterial invasion, often from bloodstream or open fracture.
Example: Fever, bone pain, redness over affected bone.
Compartment Syndrome
Definition: Increased pressure in a muscle compartment.
Why it happens: Trauma or swelling compresses nerves/vessels.
Example: Severe leg pain after crush injury.
Rheumatoid Arthritis (RA)
Definition: Autoimmune joint inflammation.
Why it happens: Immune attack on synovium causes joint destruction.
Example: Morning stiffness, joint swelling.
Osteoarthritis (OA)
Definition: Degenerative joint disease.
Why it happens: Cartilage wears down over time or injury.
Example: Knee pain worsens with activity.
Fat Embolism
Definition: Fat particles in circulation after fracture.
Why it happens: Long bone fractures release marrow fat.
Example: Respiratory distress, confusion, petechiae.
Duchenne Muscular Dystrophy (DMD)
Definition: X-linked recessive muscular degeneration.
Why it happens: Lack of dystrophin causes muscle breakdown.
Example: Weakness, difficulty walking in childhood.
Fractures
• Communited: Bone shattered into pieces.
• Open: Bone breaks through skin.
• Simple/Closed: Bone breaks without skin breach.
Example: Falling from ladder causing open tibia fracture