Pathophysiology Hesi . Revision Questions and answers. Rationale provided. Graded A+ An initial disturbance in a system sets off a chain of events that
... [Show More] does not favor stability and often abruptly displaces a system from its steady state: what is that?
A. positive feedback
B. negative feedback
C. disease
D. homeostasis - A. Positive feedback
Positive Feedback - -less common
- Snowball Effect (some pain/ pressure gets worse and worse)
- examples: clots, sneezing, childbirth
- when childbirth starts there is an increase in hormone production which progressively gets worse
- May use many means to correct one imbalance(NOT stable)
- Moves away from equilibrium
amplifies change
more of a product = more contractions, more clotting factors
Negative Feedback - - more common
- self regulating system that helps keep the balance (increase or decrease of output/production)
- If there is not enough it makes more, if there is enough it stops making it
- resist any changes from normal (example = glucose and temp regulation)
-example: thermoregulation- body temp decreases, heating mechanisms activated (shivering), body temp increases , cooling mechanisms activated (sweating)
reduces change
Disease - - the disruption in homeostasis or deviation from normal
- body is no longer functioning normally
- cellular process leads to disease
Homeostasis - - dynamic process that is always shifting/changing (give and take system)
- the body likes things just so (temp, pH, dilution, shape)
- equilibrium is necessary for all cells
- stable process, self regulating
- can affect proteins to be in proper function/ form, release of oxygen in the muscles
What organ shrinks with age?
A. Prostate
B. Gums
C. Heart
D. All of the above - B. Gums
Prostate Gland (increase/decrease) - - Chestnut-shaped gland at the base of the urethra in men
- produces fluid that mixes with sperm and secretions of the seminal vesicles
- prostate fluid further decreases acidity, increases sperm motility, and prolongs sperm life
- gets larger in size as men increase in age and can cause urethral problems
Gums (increase/decrease) - - around 40 gums start to recede and decrease in size
- inflammatory processes destroy gum tissue overtime and can cause pockets between the tooth, which can trap bacteria
Heart (increase/decrease) - - can increase in size slightly as you age
- depends one one's heart wall muscles (can strengthen heart wall muscle through exercise)
Which of the following is true?
A. an infant will have a slower heart rate than an adult
B. the elderly have better temperature sensations
C. there are more sweat glands in an elderly person
D. there is less thirst perception in the elderly - D. there is less thirst perception in the elderly
There is less thirst perception in the elderly (T/F) - True
- the aging process alters the psychological control systems with thirst
- the elderly also can take medications that can lead to dehydration
- the elderly have less physical activity that does not stimulate the thirst perception
An infant will have a slower heart rate than an adult (T/F) - False
- an infant/child's heart rate is normally slightly faster than an adult's heart rate
The elderly have better temperature sensations (T/F) - False
- elderly's senses are weaker as opposed to children and adults
There are more sweat glands in an elderly person (T/F) - False
- no correlation
Which of the following is true?
A. women snore more than men
B. men have higher calcium levels
C. women have a lower hemoglobin than men.
D. men have a lower creatinine level than women - C. Woman have a lower hemoglobin than men
Woman snore more than men (T/F) - False
-No correlation
Men have higher calcium levels (T/F) - False
- men and women have the same "normal" levels (8.8-10.6 mg/dl)
- calcium intake (ages 19-50): 1,000 mg per day
-older women over age 50 and older, men over age 70 should increase their calcium intake to 1,200 mg per day
Women have a lower hemoglobin than men. (T/F) - True
- Oxygen carrying proteins of erythrocytes
- Females (12-18 = 12 to 16 g/dl) (Older than 18 = 12.1 to 15.1 g/dl)
- Males (12-18 = 13 to 16 g/dl) (Older than 18= 13.6 to 17.7
Men have a lower creatinine level than women (T/F) - False
- creatinine levels between men and women usually have no correlation
- usually depends on how active a person is
- creatinine = from the metabolism of creatine, which is involved in the supply of energy for muscle contraction
An increase in normal adaptive response to the decreased availability of oxygen at high altitude is termed which?
A. circadian
B. acclimatization
C. population
D. diurnal - B. acclimatization
- see the word climate in the word
- climate= oxygen levels/availability changes accordingly
-higher altitudes/colder climates are low in oxygen availability/ levels
Circadian - circadian rhythms are associated with sleep cycle
Population - has no correlation to the availability of oxygen
Dinural - daily; during the day
What does it mean when the cause of disease is unwanted medical treatment?
A. idiopathic
B. ecogenetic
C. genotypical
D. Iatrogenic - D. Iatrogenic
unintended effect of medical treatment
Idiopathic - unknown cause
why/how did you get the disease
Ecogenetic - genetic traits related to the response to environmental substances
Genotypic - refers to the genetic material of a person and a singular trait, multiple traits, or a complex of traits
Which term is used for the first two months of life?
A. infancy
B. childhood
C. prenatal
D. neonatal - D. Neonatal
0-2 months
Infancy - birth- 2 years
Childhood - early: 3-8 years
middle: 9-11 years
adolescence 12-18 years
Prenatal - during pregnancy
Which is an objectively identifiable aberration of the disease?
A. symptom
B. syndrome
C. stage
D. sign - D. Sign
objectively identifiable of the disease
clinical manifestations that can be seen or measured
Symptom - clinical manifestation that are described by the patient
Syndrome - a group of signs and symptoms that occur together
stage - phase or severity of a disease
Which of the following is true regarding catecholamines?
A. they are from the parasympathetic nervous system
B. they cross the blood brain barrier
C. they include epinephrine and norepinephrine
D. they cause of decrease in heart rate - C. They include epinephrine and norepinephrine
- catecholamines= hormones made by the adrenal glands; adrenal glands send catecholamines into the blood when the body is physically or emotionally stressed
-epinephrine, norepinephrine, dopamine
-epinephrine and norepinephrine (produced in the medulla) mediate the fight or flight response of the sympathetic nervous system
Which of the following is a true statement?
A. antidiuretic hormone is not important for blood volume regulation
B. endorphins increase with stress, resulting in a decrease in pain perception
C. epinephrine and cortisol act very differently
D. cortisol negates epinephrine's activity - B. endorphins increase with stress, resulting in a decrease in pain perception
-factors such as pain and stress, help stimulate the release of endorphins
- the brain is able to reduce the ability to perceive pain (through opiate receptors)
antidiuretic hormone is not important for blood volume regulation (T/F) - False
Antidiuretic hormone tells the kidneys how much water to conserve and constantly regulates and balances the amount of water in the blood
epinephrine and cortisol act very differently (T/F)
cortisol negates epinephrine's activity(T/F) - False
- epinephrine and cortisol act similarly (help maintain blood sugar levels with the help of the growth hormone and both epinephrine and cortisol are secreted from the adrenal gland)
- epinephrine is essentially adrenaline
-cortisol helps decrease inflammation
By what mechanism do lipid molecules cross cell membranes?
A. they use channel proteins as a membrane transport system
B. they are transported across the plasma membrane by endocytosis and exocytosis
C. they use voltage-gated ion channels
D. they cross by diffusion. - D. They cross by diffusion.
-diffusion: the movement of solutes (particles that dissolve in a solvent) from a higher concentration gradient to a lower concentration gradient
Which of the following metabolic processes is a component of anabolic metabolism?
A. protein synthesis.
B. glycolysis
C. citric acid cycle
D. Oxidative phosphorylation - A. Protein Synthesis
-anabolic metabolism= builds larger molecules from smaller molecules, requires energy and energy is expended
- protein synthesis= process of making a protein (through the steps such as transcription)
-synthesis of proteins and amino acids is anabolism and further the breakdown of proteins is catabolism
Glycolysis - the breakdown of glucose by enzymes, releasing energy and pyruvic acid
citric acid cycle (krebs cycle) - the sequence of reactions by which most living cells generate energy during the process of aerobic respiration
- glucose and other molecules are broken down in the presence of oxygen
Which of the following electrochemical mechanism is responsible for maintaining cell volume?
A. the calcium pump
B. Glucose transporters
C. the sodium-potassium pump.
D. ATP-binding cassette(ABC) transporters - C. The sodium-potassium pump
- important for maintaining cell volume/osmolarity of a cell
- a low concentration of sodium ions and a high concentration of potassium ions inside the cell
- involves atp
Cellular hypoxia results in:
A. enhanced ATP activity
B. loss of intracellular calcium
C. increased pH
D. failure of the sodium-potassium pump - D. Failure of the sodium-potassium pump
-hypoxia = tissue gets blood and there is o2 in the blood, but the o2 is not getting deposited in the tissue
- when a cell is hypoxic, the sodium potassium pump fails resulting in an increase of sodium ions in the cell and a low concentration of potassium ions inside the cell (increase outside the cell) ---> opposite of how the sodium potassium pump works
A 75 yo woman develops weakness in her lower extremities after a prolonged period of bed rest. This is most likely caused by:
A. atrophy of her leg muscles
B. dysplasia of her leg muscles
C. hypertrophy of her leg muscles
D. hyperplasia of the leg muscles - A. atrophy of her leg muscles
Atrophy - weak cells
less work demands
usually due to disuse, paralysis, or neuromuscular diseases
dysplasia - bad cells/ mutation
precancerous
new cells are poorly differentiated
Hypertrophy - increase in cell size
big cells
happens when the cells are overworked and grow larger to meet the demand (or disease state)
excessive size may impair function
hypertrophic myocardium -> smaller chambers, less efficiency
Hyperplasia - more cells
Metaplasia - process whereby a normal cell under stress (inflammation, irritation) is replaced with a stronger kind of cell
Which of the following types of cellular adaption is most likely to occur from chronic ischemia?
A. hypertrophy
B. metaplasia
C. atrophy
D. hyperplasia - C. Atrophy
-chronic ischemia = no blood or O2 getting to the tissues; due to thrombi or emboli; leads to necrosis --> atrophy (WEAK cells)
What is the mechanism of cellular injury that occurs when deep sea divers get 'the bends'?
A. free radicals form abnormal chemical bonds which destroy the cellular membranes
B. carbon monoxide binds tightly to hemoglobin, preventing the RBCs from carrying O2
C. intracellular calcium accumulation create muscle tetany
D. gas bubbles form in the blood, blocking circulation and resulting in ischemia - D. Gas bubbles form in the blood, blocking circulation and resulting in ischemia
-decompression sickness (DCS) or caisson disease
- occurs in scuba divers, high altitude, or aerospace events when dissolved gases (mainly nitrogen) come out of solution in bubbles
-can affect just about any body are including joints, lungs, heart, skin and brain
-gas bubbles form in blood, blocking circulation, and resulting in ischemia
Which type of cellular adaption would create the greatest concern if found on a biopsy report?
A. dysplasia
B. metaplasia
C. hyperplasia
D. atrophy - A. dysplasia
bad cells, mutated cells, cancerous
Which of the following is the process by which mRNA is synthesized from single stranded DNA?
A. sense stranding
B. replication
C. translation
D. transcription. - D. Transcription
- the process of making an RNA copy of a gene sequence
DNA to RNA (transcription)
RNA to protein (translation)
Transcription - information in a strand of DNA is copied into a new molecule, mRNA
Replication - DNA makes a copy of itself during cell division
Translation - ribosomes in the cytoplasm or ER synthesize proteins after transcription
Which of the following is not one of the 4 cell types found in adult humans?
A. epithelium
B. connective tissue
C. hematopoietic tissue.
D. nervous tissue - C. Hematopoietic
-development of blood cells
If a patient has a recessive trait, which of the following is the genotype of this patient?
A. aa
B. AA
C. Aa
D. aA - A. aa
Which of the following chromosomal abnormalities has been linked with Down syndrome?
A. translocation
B. inversion
C. deletion
D duplication - D. Duplication
Translocation - a chromosome breaks and a portion of it reattaches to a different chromosome
Inversion - a chromosome rearrangement in which a segment of a chromosome is reversed end to end
Which of the following refers to a deficiency of factor VII that causes a bleeding disorder?
a.Marfan syndrome b.Phenylketonuria
c. Hemophilia
d. Huntington - C. Hemophilia
-hemophilia A
x linked recessive bleeding disorder
deficiency or abnormality of clotting factor VIII
Which of the following is a retrovirus that causes cancer?
A. rhinovirus
B. parvovirus
C. Epstein- Barr virus
D. poxvirus - C. Epstein Barr virus
people who have had this virus are more likely to develop nasopharyngeal cancer (cancer of the back of the nose) due to fast growing lymphomas
Which of the following genes contributes specifically to some breast cancer?
A. Rb
B. BRCA1
C. P53
D. VHL - B. BRCA1
explanation: involved in breast cancer and helps repair mutation of DNA
Which is used to describe the histologic characteristics of tumor cells?
A. staging
B. cachexia
C. grading.
D. angiogenesis - C. Grading
I,II,III (I- more differentiated, good) (III-less differentiated -bad)
Which of the following offers the best prognosis for the cure of cancer?
A. early detection
B. aggressive chemotherapy
C. adjunct radiation
D. Gene therapy - A. Early Detection
Which of the following is true about cancer?
A. most deaths occur in those over 75 years old
B. men have a 1 in 3 lifetime risk of cancer
C. the combined 5 year survival rate for cancer is 62%
D. it is the leading cause of death - C. The combines 5 year survival rate for cancer is 62%
What is the purpose of the TNM classification system?
A. it provides information for ongoing research efforts to develop a cure for cancer
B. it tracks the progress of the disease and the effectiveness of treatment
c. It enables the MD to determine the underlying cause of the malignancy
D. it provides tumor data for the Centers for Disease Control and Prevention - B. it tracks the progress of the disease and the effectiveness of treatment
- Tumor Node Metastasis
-based on the spread of the disease
-asses the tumor size, metastatic progress/how extensive, and nodal involvement/how many lymph nodes
Why do patients with advanced cancer develop cachexia?
A. cancer cells produce an enzyme that robs normal cells of nutrients.
B. they lack an adequate number of normal cells to support metabolism [Show Less]