NUR 529 Exam 1: Pathophysiology

83 Questions

What are examples of secondary prevention measures?

Pap smear, asking about smoking, blood pressure measurement, cholesterol levels, colonoscopy

Which infectious agents are included in the TORCH group?

Rubella

Folic acid deficiency has no association with neural tube defects.

False

Marfan syndrome is an autosomal __________ disorder.

dominant

Match the following components with their roles in acid-base regulation:

Respiratory system = Controls extracellular CO2 levels Kidneys = Excrete H+ and produce new HCO3

What are the general intervention methods used in the treatment of infectious diseases?

Antimicrobial agents, immunotherapy, surgical intervention

Which is considered the most formidable physical barrier to infection?

Intact skin

What are the primary functions of the tightly packed epithelial cells lining the gastrointestinal, respiratory, and urogenital tracts?

Line and protect the tracts, physically prevent microorganisms from entering the body, and secrete antimicrobial enzymes, proteins, and peptides.

What initiates the innate immune response when pathogens breach the epithelial defenses?

Leukocytes

Pathogens are microorganisms that are not capable of causing disease.

False

______ are smaller extrachromosomal pieces of circular DNA that bacteria often harbor.

Plasmids

Match the following terms with their definitions:

Colonization = Act of establishing a presence Mutualism = Interaction in which both microorganism and host benefit Parasitic relationship = Only the infecting organism benefits Virulence = Disease producing potential

What are the main mechanisms of stroke subtypes and their frequency?

20% large artery thrombosis, 25% small penetrating artery thrombosis, 20% cardiogenic embolism, 30% cryptogenic stroke, 5% other

What clinical manifestations are typical of a stroke based on the affected cerebral artery?

All of the above

A diagnosis of Alzheimer's disease can be confirmed by neuroimaging alone.

False

What is the main cause of Guillain-Barre Syndrome?

acute immune-mediated polyneuropathy

What pathogenic mechanisms are suggested to underlie schizophrenia?

All of the above

What explains how the disease process evolves?

Pathogenesis

Morphology refers to the gross anatomic and microscopic changes that are characteristic of a disease.

True

____ refers to the study of the cells and extracellular matrix of body tissues.

Histology

Define Clinical Manifestations.

Clinical Manifestations are signs or symptoms that indicate the presence of a disease or condition.

What type of hyperplasia includes regeneration of the liver after partial hepatectomy?

Compensatory hyperplasia

Match the type of necrosis with its description:

Liquefaction Necrosis = Occurs when some cells die but their catalytic enzymes are not destroyed. Coagulation Necrosis = Characterized by hypoxic injury and seen in infarcted areas. Caseous Necrosis = Form of coagulation necrosis most commonly found in TB granulomas.

What characterizes Ischemia?

Impaired oxygen delivery

What does Metastatic calcification result from?

Increased serum calcium levels

Describe Lead poisoning and its clinical manifestations.

Lead poisoning is characterized by its toxicity, involving inactivation of enzymes, competing with calcium for incorporation into bone, affecting nerve transmission, and brain development. Clinical manifestations include anemia, demyelination, and acute encephalopathy.

What is evidence-based practice based on?

Both individual clinical expertise and best external clinical evidence

What is the purpose of Screening in healthcare?

Screening represents a secondary prevention measure for the early recognition of cancer in an asymptomatic population through various methods like observation, palpation, and laboratory tests.

What is the most common cause of acute, flaccid nontraumatic paralysis?

Guillain-Barre syndrome

Which type of stroke is caused by cerebrovascular obstruction by thrombosis or emboli?

Ischemic

Amblyopia is also known as lazy eye.

True

Otitis media may occur in any age group, but is more frequently diagnosed in children between the ages of 3 months and 3 years. Smoking in the house is a significant ______ factor.

risk

What is the most significant factor contributing to the risk of developing otitis media in children?

Smoking in the house

What is the function of Sheets of tightly packed epithelial cells in the body?

Line and protect the gastrointestinal, respiratory, and urogenital tracts and physically prevent microorganisms from entering the body

Which type of immunity is acquired through the process of vaccination or from environmental exposure?

Active Immunity

Cytoplasm contains ______________, which is the reproductive and metabolic machinery of the cell.

reproductive and metabolic machinery

Chronic pain tends to resolve quickly once the underlying cause is resolved.

False

Match the pain type with its description:

Acute Pain = Short duration, resolves when underlying pathologic process is resolved Chronic Pain = Persists longer than expected after an inciting event Visceral Pain = Originates in visceral organs due to contractions, distention, or ischemia Referred Pain = Perceived at a site different from its point of origin but innervated by the same spinal segment

What is the definition of evidence-based practice?

Making decisions in health care based on scientific data that has shown a specific way of managing a disease, patient symptoms, and complaints. Integration of clinical expertise with external clinical evidence.

Describe the process of pathogenesis.

Pathogenesis explains how the disease process evolves, involving cellular and tissue events from initial contact with an etiologic agent to the ultimate expression of a disease.

Hyperplasia refers to an increase in the number of cells in an organ or tissue. It occurs in tissues with cells capable of mitotic division, such as the epidermis, intestinal epithelium, and glandular tissue. Name two common types of physiologic hyperplasia: hormonal and __________.

compensatory

Dysplasia is strongly implicated as a precursor of cancer.

True

What type of necrosis occurs when some cells die but their catalytic enzymes are not destroyed?

Liquefaction necrosis

What is the major target of lead toxicity in the body?

Red blood cells

Match the following diagnostic methods with their descriptions:

Papanicalaou Test = Cytologic method for detecting cancer cells Tissue Biopsy = Removal of tissue specimen for microscopic study Immunohistochemistry = Use of antibodies to identify cell products or surface markers Microarray Technology = Simultaneous detection and quantification of gene expression

What substance is often recommended to prevent neural tube defects during prenatal care?

Folic Acid

Provide examples of secondary prevention measures.

Examples include observation, palpation, laboratory tests such as pap smears or mammography.

What is an example of a secondary prevention measure?

Pap smear for early detection of cervical cancer

Which infectious agents are included in the TORCH group? (Select all that apply)

H – Herpes

Folic acid deficiency has been linked to the development of neural tube defects.

True

Marfan syndrome is an ________ dominant disorder.

autosomal

Which organ system is most commonly affected by Marfan syndrome?

Cardiovascular system

What is edema?

Palpable swelling produced by expansion of the interstitial fluid volume

What is the function of the lungs in acid-base regulation?

Control of extracellular CO2

Match the general intervention methods used in the treatment of infectious diseases with their categories:

Antimicrobial Agents = Antibacterial agents Immunotherapy = Supplementing or stimulating the hosts immune response Surgical Intervention = Surgical removal of infected tissues, organs, or limbs

The intact skin is not a significant physical barrier to infections.

False

Which type of immunity is acquired when the host mounts an immune response to an antigen through vaccination or environmental exposure?

Adaptive Immunity

Define 'Virulence'

Disease producing potential

Acute pain tends to resolve when the underlying pathologic process has resolved.

True

Match the type of pain with its description:

Acute Pain = Elicited by injury and short duration Chronic Pain = Persists longer than expected after an inciting event Visceral Pain = Originates in visceral organs and caused by certain conditions Referred Pain = Perceived at a site different from the point of origin

What are the five main mechanisms of stroke subtypes and their frequency?

20% large artery thrombosis, 25% small penetrating artery thrombosis, 20% cardiogenic embolism, 30% cryptogenic stroke, 5% other

What are common predisposing factors of hemorrhagic strokes?

Advancing age and hypertension

Is there a curative treatment for Alzheimer's Disease?

False

Guillain-Barre Syndrome is characterized by rapidly progressive ascending symmetrical limb weakness and loss of __________ reflexes.

tendon

Match the following mood disorders' neurophysiology with symptoms:

Inflammation, HPA axis hyperactivity, low levels of neurotrophic growth factor = Depressive disorder development Dopamine = Role in depression Changes in dysregulation of dopamine and serotonergic system = Symptoms in schizophrenia

What is an example of a secondary prevention measure for detecting disease early?

pap smear

Which of the following infectious agents is included in the TORCH group?

Rubella

Folic acid deficiency has been linked to the development of neural tube defects.

True

Marfan syndrome is an ___________ dominant disorder.

autosomal

Match these infectious disease diagnosis methods with their descriptions:

Culture = Growth of microorganisms outside the body for identification Serology = Identification through serum antibodies DNA and RNA sequencing = Using DNA probes or PCR for detection Antimicrobial Agents = Categorized by mechanism of action and target pathogen

Define Pathogenesis.

Pathogenesis explains how the disease process evolves.

What is Morphology?

Refers to the fundamental structure or form of cells or tissues.

Clinical Manifestations are manifestations that make it evident that the person is ______.

sick

Disease is either an acute or chronic illness that one acquires.

True

What is Metaplasia?

Metaplasia represents a reversible change in which one adult cell type is replaced by another.

Which type of necrosis occurs when some cells die but their catalytic enzymes are not destroyed?

Liquefaction Necrosis

What does dysplasia involve?

Variable size, shape, and organization of cells.

Fatty necrosis is a result of intracellular accumulation of ____________.

substances

Match the types of Pathologic Calcifications:

Dystrophic Calcifications = Macroscopic deposition of calcium salts in injured tissue Metastatic Calcifications = Occurs in normal tissues due to increased serum calcium levels

What is Lead poisoning?

Lead poisoning is toxicity related to lead's multiple biochemical effects.

What is evidence-based practice?

Evidence-based practice is making decisions based on scientific data and clinical expertise.

Describe Secondary Prevention.

Secondary prevention involves early recognition or cancer in asymptomatic populations.

What nutrient is recommended to prevent neural tube defects?

Folic Acid

Study Notes

Unit 1: Chapters 1-3

Concepts of Health and Disease

Pathogenesis: explains how a disease process evolves from initial contact with an etiologic agent to the ultimate expression of disease
Morphology: refers to the fundamental structure or form of cells or tissues
Histology: deals with the study of cells and extracellular matrix of body tissues
Clinical manifestations: symptoms that make it evident that a person is sick
Diagnosis: designation as to the nature or cause of a health problem
Clinical course: describes the evolution of a disease (acute, subacute, or chronic)

Disease

An acute or chronic illness that one acquires or is born with, causing physiologic dysfunction in one or more body systems
Each disease has specific signs and symptoms that characterize its pathology and identifiable etiology

Unit 2: Chapters 2-6

Cellular Adaptation: Hyperplasia

Refers to an increase in the number of cells in an organ or tissue
Occurs in tissues with cells capable of mitotic division (e.g., epidermis, intestinal epithelium, glandular tissue)
Types: physiologic (hormonal and compensatory) and non-physiologic (excessive hormonal stimulation or growth factors)

Cellular Adaptation: Metaplasia

Reversible change in which one adult cell type is replaced by another
Occurs in response to chronic irritation and inflammation
Examples: substitution of stratified squamous epithelial cells for ciliated columnar epithelial cells in the trachea and large airways of a habitual cigarette smoker

Cellular Adaptation: Dysplasia

Characterized by deranged cell growth of a specific tissue, resulting in cells that vary in size, shape, and organization
Associated with chronic irritation or inflammation
Examples: cervical dysplasia, precursor to cancer of the uterine cervix

Cell Injury and Death

Necrosis: cell death in an organ or tissue that is still part of a living organism
Types: liquefaction necrosis, coagulation necrosis, caseous necrosis
Ischemia: impaired oxygen delivery and removal of metabolic end-products; affects local tissue injury
Infarction: occurs when an artery supplying an organ or part of the body becomes occluded, with no other source of blood supply

Unit 3: Chapters 7-8

Stress and Adaptation

Acute stress: associated with the autonomic nervous system (ANS) and the fight-or-flight response
Chronic stress: can lead to pathological changes and long-term health problems

Compartmental Distribution of Body Fluids

Edema: palpable swelling produced by expansion of the interstitial fluid volume
Assessment: daily weight, visual assessment, measurement of affected part, application of finger pressure to assess for pitting edema
Treatment: directed towards maintaining life, correcting or controlling the cause, and preventing tissue injury

Unit 4: Chapters 10-12

Infectious Diseases

Diagnosis: requires recovery of a probable pathogen or evidence of its presence from infected sites, accompanied by accurate documentation of clinical signs and symptoms
Detection methods: culture, serology, and other techniques### Infectious Diseases
A tentative diagnosis of an infectious disease can be made if the antibody level (titer) against a specific pathogen rises during the acute phase and falls during convalescence.
Serologic identification of an infectious agent is not as accurate as a culture, but may be a useful adjunct.
IgM specific antibodies generally rise and fall during the acute phase of the disease, whereas IgG synthesis increases during the acute phase and remains elevated until or beyond resolution.
IgM antibodies do not cross the placenta, so if IgM is elevated in a neonate, it did not come from the mother.

Antimicrobial Agents

Antibacterial agents (antibiotics) are effective only against other prokaryotic organisms.
Antibiotics can be bactericidal (causing irreversible and lethal damage to the bacterial pathogen) or bacteriostatic (inhibiting bacterial growth, with effects reversed when the agent is eliminated).
Antiviral agents interrupt viral replication, often by interfering with host cell enzymes.
Antifungal agents target the cytoplasmic membranes of yeasts or molds.
Antiparasitic agents target essential components of the parasite's metabolism or cellular anatomy that are not shared by the host.

Immunotherapy

Involves supplementing or stimulating the host's immune response to limit or reverse the spread of a pathogen.
Examples include IVIG and cytokines.

Surgical Intervention

Involves surgical removal of infected tissues, organs, or limbs.
May be necessary when the infective agent is resistant to all treatments.

Innate and Adaptive Immunity

Epithelial barriers, including the skin and mucous membranes, provide a physical barrier to infection.
Innate immune responses involve the recognition of common surface receptors on invading microorganisms by leukocytes.
Adaptive immunity involves the development of an immune response to a specific antigen, either through vaccination or environmental exposure.

Immunoglobulins

Classified into five categories based on their role in the humoral defense mechanism.
Each Ig consists of four-polypeptide chains with at least two identical antigen-binding sites.

Anaphylaxis

A catastrophic, systemic, life-threatening IgE-mediated hypersensitivity reaction.
Clinical manifestations include vasodilation, hypotension, arterial hypoxia, and airway edema.
Grades of anaphylaxis range from I (cutaneous and mucosal) to IV (cardiac arrest).

Innate Immunity Barriers

The lungs have natural barriers to protect against pulmonary infections, including the presence of surfactant and the cough reflex.

Metabolic Requirements of Nervous Tissue

Nervous tissue has a high rate of metabolism and requires a constant supply of oxygen and glucose.
Interruption of the blood or oxygen supply to the brain can lead to clinically observable signs and symptoms.

Somatosensory Function, Pain, Headache, and Temperature Regulation

Acute pain is elicited by injury to body tissues and activation of nociceptive stimuli.
Chronic pain persists longer than expected after an inciting event.
Types of pain include cutaneous, deep somatic, visceral, and referred pain.

Disorders of the Motor Unit

Myasthenia gravis is a disorder of transmission at the neuromuscular junction, characterized by antibody-mediated attack on the nicotinic AChR or muscle-specific tyrosine kinase.

Disorders of Motor Function

Multiple sclerosis is characterized by inflammation and destruction of the CNS myelin, leading to a range of symptoms including parathesias, optic neuritis, and diplopia.
Parkinson's disease is a degenerative disorder of basal ganglia function, characterized by tremor, rigidity, akinesia/bradykinesia, and postural changes.

Mechanisms of Brain Injury

Primary brain injuries are caused by impact, including focal or diffuse injuries.
Secondary brain injuries result from subsequent brain swelling, infection, or cerebral hypoxia.

Brain Injury

Hematomas are collections of blood that can occur in the brain, including epidural, subdural, and traumatic intracerebral hematomas.
Stroke is a cerebrovascular accident, either ischemic or hemorrhagic.

Neurocognitive Disorders

Alzheimer's disease is a degenerative disorder characterized by cognitive decline, memory loss, and personality changes.
Guillain-Barré syndrome is an acute immune-mediated polyneuropathy, characterized by rapidly progressive ascending symmetrical limb weakness and loss of tendon reflexes.
Schizophrenia is a neurocognitive disorder characterized by changes in the dysregulation of the dopamine and serotonergic system, leading to symptoms such as impaired cognition and hallucinations.### Neurocognitive Disorders: Mood Disorders
Loss of cortical gray matter
Abnormal cortical thinning
Reduced numbers of synaptic structures on neurons
Reduced dendritic spine density of pyramidal neurons in the prefrontal cortex
Arrested migration of hippocampal neurons
Interactions between biologic and psychosocial factors over time explain the risk of developing MDD
Biologic theories for MDD development: inflammation, HPA axis hyperactivity, low levels of neurotrophic growth factor, and low levels of vitamin D
Depression may be linked to ongoing inflammation in the body
Neuroimaging: smaller hippocampal volumes and hippocampal hypertrophy in people who have depression and experienced early abuse
Neurologic disorders of the limbic system and basal ganglia are involved in the development of mood disorders
Dopamine plays a role in depression

Disorders of Eye Movement

Strabismus (squint): any abnormality of eye coordination or alignment that results in loss of binocular vision
Diplopia (double vision) occurs when images from the same spots in the visual space do not fall on corresponding points of the two retinas
Forms of strabismus: nonparalytic (concomitant) and paralytic (nonconcomitant)
Amblyopia (lazy eye): decrease in visual acuity resulting from abnormal visual development in infancy or early childhood
Vision loss ranges from mild (worse than 20/25) to severe (legal blindness, 20/200 or worse)

Disorders of the Conjunctiva

Allergic conjunctivitis: itching, bilateral tearing, and redness of the eye
Treatment: allergen avoidance, cold compresses, eye washes with tear substitute, and oral antihistamines
Viral conjunctivitis: generalized conjunctival hyperemia, copious tearing, and minimal exudate
Treatment: cool compresses and artificial tears
Bacterial conjunctivitis: burning, tearing, mucopurulent or purulent discharge
Treatment: antibiotic drops or ointments
N.gonorrhoeae is the most serious form of conjunctivitis

Disorders of Hearing and Vestibular Function: Otitis Media

Clinical manifestations: acute onset of otalgia, fever, irritability, otorrhea, hearing loss, and evidence of middle ear inflammation
Children older than 3 may have rhinorrhea, vomiting, and diarrhea
Ear pain usually increases as the effusion accumulates behind the tympanic membrane
Perforation of the tympanic membrane may occur acutely, allowing purulent material from the eustachian tube to drain into the external auditory canal
Otitis media with effusion symptoms: intermittent ear pain, sensation of fullness in ear, complaint of hearing loss, dizziness, and decreased tympanic membrane mobility

Disorders of Hearing and Vestibular Function: Otitis Media-Risk Factors

Risk factors: smoking in the house, prematurity, daycare attendance, having an unimmunized status, bottle-feeding, feeding in the supine position, being overweight or obese, family history of otitis media, being male, and sharing a bedroom
More frequent in children with craniofacial anomalies or congenital syndromes associated with craniofacial abnormalities
Strucutural immaturity contributes to the increased risk because the eustachian tube is shorter and more horizontal
To reduce the risk of contracting otitis media: routine childhood vaccinations, elimination of household smoking, exclusive breast-feeding, avoiding feeding while lying down, and selecting daycare facilities with small staff-to-child ratio

Unit 1: Chapters 1-3

Concepts of Health and Disease

Pathogenesis: explains how a disease process evolves from initial contact with an etiologic agent to the ultimate expression of disease
Morphology: refers to the fundamental structure or form of cells or tissues
Histology: deals with the study of cells and extracellular matrix of body tissues
Clinical manifestations: symptoms that make it evident that a person is sick
Diagnosis: designation as to the nature or cause of a health problem
Clinical course: describes the evolution of a disease (acute, subacute, or chronic)

Disease

An acute or chronic illness that one acquires or is born with, causing physiologic dysfunction in one or more body systems
Each disease has specific signs and symptoms that characterize its pathology and identifiable etiology

Unit 2: Chapters 2-6

Cellular Adaptation: Hyperplasia

Refers to an increase in the number of cells in an organ or tissue
Occurs in tissues with cells capable of mitotic division (e.g., epidermis, intestinal epithelium, glandular tissue)
Types: physiologic (hormonal and compensatory) and non-physiologic (excessive hormonal stimulation or growth factors)

Cellular Adaptation: Metaplasia

Reversible change in which one adult cell type is replaced by another
Occurs in response to chronic irritation and inflammation
Examples: substitution of stratified squamous epithelial cells for ciliated columnar epithelial cells in the trachea and large airways of a habitual cigarette smoker

Cellular Adaptation: Dysplasia

Characterized by deranged cell growth of a specific tissue, resulting in cells that vary in size, shape, and organization
Associated with chronic irritation or inflammation
Examples: cervical dysplasia, precursor to cancer of the uterine cervix

Cell Injury and Death

Necrosis: cell death in an organ or tissue that is still part of a living organism
Types: liquefaction necrosis, coagulation necrosis, caseous necrosis
Ischemia: impaired oxygen delivery and removal of metabolic end-products; affects local tissue injury
Infarction: occurs when an artery supplying an organ or part of the body becomes occluded, with no other source of blood supply

Unit 3: Chapters 7-8

Stress and Adaptation

Acute stress: associated with the autonomic nervous system (ANS) and the fight-or-flight response
Chronic stress: can lead to pathological changes and long-term health problems

Compartmental Distribution of Body Fluids

Edema: palpable swelling produced by expansion of the interstitial fluid volume
Assessment: daily weight, visual assessment, measurement of affected part, application of finger pressure to assess for pitting edema
Treatment: directed towards maintaining life, correcting or controlling the cause, and preventing tissue injury

Unit 4: Chapters 10-12

Infectious Diseases

Diagnosis: requires recovery of a probable pathogen or evidence of its presence from infected sites, accompanied by accurate documentation of clinical signs and symptoms
Detection methods: culture, serology, and other techniques### Infectious Diseases
A tentative diagnosis of an infectious disease can be made if the antibody level (titer) against a specific pathogen rises during the acute phase and falls during convalescence.
Serologic identification of an infectious agent is not as accurate as a culture, but may be a useful adjunct.
IgM specific antibodies generally rise and fall during the acute phase of the disease, whereas IgG synthesis increases during the acute phase and remains elevated until or beyond resolution.
IgM antibodies do not cross the placenta, so if IgM is elevated in a neonate, it did not come from the mother.

Antimicrobial Agents

Antibacterial agents (antibiotics) are effective only against other prokaryotic organisms.
Antibiotics can be bactericidal (causing irreversible and lethal damage to the bacterial pathogen) or bacteriostatic (inhibiting bacterial growth, with effects reversed when the agent is eliminated).
Antiviral agents interrupt viral replication, often by interfering with host cell enzymes.
Antifungal agents target the cytoplasmic membranes of yeasts or molds.
Antiparasitic agents target essential components of the parasite's metabolism or cellular anatomy that are not shared by the host.

Immunotherapy

Involves supplementing or stimulating the host's immune response to limit or reverse the spread of a pathogen.
Examples include IVIG and cytokines.

Surgical Intervention

Involves surgical removal of infected tissues, organs, or limbs.
May be necessary when the infective agent is resistant to all treatments.

Innate and Adaptive Immunity

Epithelial barriers, including the skin and mucous membranes, provide a physical barrier to infection.
Innate immune responses involve the recognition of common surface receptors on invading microorganisms by leukocytes.
Adaptive immunity involves the development of an immune response to a specific antigen, either through vaccination or environmental exposure.

Immunoglobulins

Classified into five categories based on their role in the humoral defense mechanism.
Each Ig consists of four-polypeptide chains with at least two identical antigen-binding sites.

Anaphylaxis

A catastrophic, systemic, life-threatening IgE-mediated hypersensitivity reaction.
Clinical manifestations include vasodilation, hypotension, arterial hypoxia, and airway edema.
Grades of anaphylaxis range from I (cutaneous and mucosal) to IV (cardiac arrest).

Innate Immunity Barriers

The lungs have natural barriers to protect against pulmonary infections, including the presence of surfactant and the cough reflex.

Metabolic Requirements of Nervous Tissue

Nervous tissue has a high rate of metabolism and requires a constant supply of oxygen and glucose.
Interruption of the blood or oxygen supply to the brain can lead to clinically observable signs and symptoms.

Somatosensory Function, Pain, Headache, and Temperature Regulation

Acute pain is elicited by injury to body tissues and activation of nociceptive stimuli.
Chronic pain persists longer than expected after an inciting event.
Types of pain include cutaneous, deep somatic, visceral, and referred pain.

Disorders of the Motor Unit

Myasthenia gravis is a disorder of transmission at the neuromuscular junction, characterized by antibody-mediated attack on the nicotinic AChR or muscle-specific tyrosine kinase.

Disorders of Motor Function

Multiple sclerosis is characterized by inflammation and destruction of the CNS myelin, leading to a range of symptoms including parathesias, optic neuritis, and diplopia.
Parkinson's disease is a degenerative disorder of basal ganglia function, characterized by tremor, rigidity, akinesia/bradykinesia, and postural changes.

Mechanisms of Brain Injury

Primary brain injuries are caused by impact, including focal or diffuse injuries.
Secondary brain injuries result from subsequent brain swelling, infection, or cerebral hypoxia.

Brain Injury

Hematomas are collections of blood that can occur in the brain, including epidural, subdural, and traumatic intracerebral hematomas.
Stroke is a cerebrovascular accident, either ischemic or hemorrhagic.

Neurocognitive Disorders

Alzheimer's disease is a degenerative disorder characterized by cognitive decline, memory loss, and personality changes.
Guillain-Barré syndrome is an acute immune-mediated polyneuropathy, characterized by rapidly progressive ascending symmetrical limb weakness and loss of tendon reflexes.
Schizophrenia is a neurocognitive disorder characterized by changes in the dysregulation of the dopamine and serotonergic system, leading to symptoms such as impaired cognition and hallucinations.### Neurocognitive Disorders: Mood Disorders
Loss of cortical gray matter
Abnormal cortical thinning
Reduced numbers of synaptic structures on neurons
Reduced dendritic spine density of pyramidal neurons in the prefrontal cortex
Arrested migration of hippocampal neurons
Interactions between biologic and psychosocial factors over time explain the risk of developing MDD
Biologic theories for MDD development: inflammation, HPA axis hyperactivity, low levels of neurotrophic growth factor, and low levels of vitamin D
Depression may be linked to ongoing inflammation in the body
Neuroimaging: smaller hippocampal volumes and hippocampal hypertrophy in people who have depression and experienced early abuse
Neurologic disorders of the limbic system and basal ganglia are involved in the development of mood disorders
Dopamine plays a role in depression

Disorders of Eye Movement

Strabismus (squint): any abnormality of eye coordination or alignment that results in loss of binocular vision
Diplopia (double vision) occurs when images from the same spots in the visual space do not fall on corresponding points of the two retinas
Forms of strabismus: nonparalytic (concomitant) and paralytic (nonconcomitant)
Amblyopia (lazy eye): decrease in visual acuity resulting from abnormal visual development in infancy or early childhood
Vision loss ranges from mild (worse than 20/25) to severe (legal blindness, 20/200 or worse)

Disorders of the Conjunctiva

Allergic conjunctivitis: itching, bilateral tearing, and redness of the eye
Treatment: allergen avoidance, cold compresses, eye washes with tear substitute, and oral antihistamines
Viral conjunctivitis: generalized conjunctival hyperemia, copious tearing, and minimal exudate
Treatment: cool compresses and artificial tears
Bacterial conjunctivitis: burning, tearing, mucopurulent or purulent discharge
Treatment: antibiotic drops or ointments
N.gonorrhoeae is the most serious form of conjunctivitis

Disorders of Hearing and Vestibular Function: Otitis Media

Clinical manifestations: acute onset of otalgia, fever, irritability, otorrhea, hearing loss, and evidence of middle ear inflammation
Children older than 3 may have rhinorrhea, vomiting, and diarrhea
Ear pain usually increases as the effusion accumulates behind the tympanic membrane
Perforation of the tympanic membrane may occur acutely, allowing purulent material from the eustachian tube to drain into the external auditory canal
Otitis media with effusion symptoms: intermittent ear pain, sensation of fullness in ear, complaint of hearing loss, dizziness, and decreased tympanic membrane mobility

Disorders of Hearing and Vestibular Function: Otitis Media-Risk Factors

Risk factors: smoking in the house, prematurity, daycare attendance, having an unimmunized status, bottle-feeding, feeding in the supine position, being overweight or obese, family history of otitis media, being male, and sharing a bedroom
More frequent in children with craniofacial anomalies or congenital syndromes associated with craniofacial abnormalities
Strucutural immaturity contributes to the increased risk because the eustachian tube is shorter and more horizontal
To reduce the risk of contracting otitis media: routine childhood vaccinations, elimination of household smoking, exclusive breast-feeding, avoiding feeding while lying down, and selecting daycare facilities with small staff-to-child ratio

Unit 1: Chapters 1-3

Concepts of Health and Disease

Pathogenesis: explains how a disease process evolves from initial contact with an etiologic agent to the ultimate expression of disease
Morphology: refers to the fundamental structure or form of cells or tissues
Histology: deals with the study of cells and extracellular matrix of body tissues
Clinical manifestations: symptoms that make it evident that a person is sick
Diagnosis: designation as to the nature or cause of a health problem
Clinical course: describes the evolution of a disease (acute, subacute, or chronic)

Disease

An acute or chronic illness that one acquires or is born with, causing physiologic dysfunction in one or more body systems
Each disease has specific signs and symptoms that characterize its pathology and identifiable etiology

Unit 2: Chapters 2-6

Cellular Adaptation: Hyperplasia

Refers to an increase in the number of cells in an organ or tissue
Occurs in tissues with cells capable of mitotic division (e.g., epidermis, intestinal epithelium, glandular tissue)
Types: physiologic (hormonal and compensatory) and non-physiologic (excessive hormonal stimulation or growth factors)

Cellular Adaptation: Metaplasia

Reversible change in which one adult cell type is replaced by another
Occurs in response to chronic irritation and inflammation
Examples: substitution of stratified squamous epithelial cells for ciliated columnar epithelial cells in the trachea and large airways of a habitual cigarette smoker

Cellular Adaptation: Dysplasia

Characterized by deranged cell growth of a specific tissue, resulting in cells that vary in size, shape, and organization
Associated with chronic irritation or inflammation
Examples: cervical dysplasia, precursor to cancer of the uterine cervix

Cell Injury and Death

Necrosis: cell death in an organ or tissue that is still part of a living organism
Types: liquefaction necrosis, coagulation necrosis, caseous necrosis
Ischemia: impaired oxygen delivery and removal of metabolic end-products; affects local tissue injury
Infarction: occurs when an artery supplying an organ or part of the body becomes occluded, with no other source of blood supply

Unit 3: Chapters 7-8

Stress and Adaptation

Acute stress: associated with the autonomic nervous system (ANS) and the fight-or-flight response
Chronic stress: can lead to pathological changes and long-term health problems

Compartmental Distribution of Body Fluids

Edema: palpable swelling produced by expansion of the interstitial fluid volume
Assessment: daily weight, visual assessment, measurement of affected part, application of finger pressure to assess for pitting edema
Treatment: directed towards maintaining life, correcting or controlling the cause, and preventing tissue injury

Unit 4: Chapters 10-12

Infectious Diseases

Diagnosis: requires recovery of a probable pathogen or evidence of its presence from infected sites, accompanied by accurate documentation of clinical signs and symptoms
Detection methods: culture, serology, and other techniques### Infectious Diseases
A tentative diagnosis of an infectious disease can be made if the antibody level (titer) against a specific pathogen rises during the acute phase and falls during convalescence.
Serologic identification of an infectious agent is not as accurate as a culture, but may be a useful adjunct.
IgM specific antibodies generally rise and fall during the acute phase of the disease, whereas IgG synthesis increases during the acute phase and remains elevated until or beyond resolution.
IgM antibodies do not cross the placenta, so if IgM is elevated in a neonate, it did not come from the mother.

Antimicrobial Agents

Antibacterial agents (antibiotics) are effective only against other prokaryotic organisms.
Antibiotics can be bactericidal (causing irreversible and lethal damage to the bacterial pathogen) or bacteriostatic (inhibiting bacterial growth, with effects reversed when the agent is eliminated).
Antiviral agents interrupt viral replication, often by interfering with host cell enzymes.
Antifungal agents target the cytoplasmic membranes of yeasts or molds.
Antiparasitic agents target essential components of the parasite's metabolism or cellular anatomy that are not shared by the host.

Immunotherapy

Involves supplementing or stimulating the host's immune response to limit or reverse the spread of a pathogen.
Examples include IVIG and cytokines.

Surgical Intervention

Involves surgical removal of infected tissues, organs, or limbs.
May be necessary when the infective agent is resistant to all treatments.

Innate and Adaptive Immunity

Epithelial barriers, including the skin and mucous membranes, provide a physical barrier to infection.
Innate immune responses involve the recognition of common surface receptors on invading microorganisms by leukocytes.
Adaptive immunity involves the development of an immune response to a specific antigen, either through vaccination or environmental exposure.

Immunoglobulins

Classified into five categories based on their role in the humoral defense mechanism.
Each Ig consists of four-polypeptide chains with at least two identical antigen-binding sites.

Anaphylaxis

A catastrophic, systemic, life-threatening IgE-mediated hypersensitivity reaction.
Clinical manifestations include vasodilation, hypotension, arterial hypoxia, and airway edema.
Grades of anaphylaxis range from I (cutaneous and mucosal) to IV (cardiac arrest).

Innate Immunity Barriers

The lungs have natural barriers to protect against pulmonary infections, including the presence of surfactant and the cough reflex.

Metabolic Requirements of Nervous Tissue

Nervous tissue has a high rate of metabolism and requires a constant supply of oxygen and glucose.
Interruption of the blood or oxygen supply to the brain can lead to clinically observable signs and symptoms.

Somatosensory Function, Pain, Headache, and Temperature Regulation

Acute pain is elicited by injury to body tissues and activation of nociceptive stimuli.
Chronic pain persists longer than expected after an inciting event.
Types of pain include cutaneous, deep somatic, visceral, and referred pain.

Disorders of the Motor Unit

Myasthenia gravis is a disorder of transmission at the neuromuscular junction, characterized by antibody-mediated attack on the nicotinic AChR or muscle-specific tyrosine kinase.

Disorders of Motor Function

Multiple sclerosis is characterized by inflammation and destruction of the CNS myelin, leading to a range of symptoms including parathesias, optic neuritis, and diplopia.
Parkinson's disease is a degenerative disorder of basal ganglia function, characterized by tremor, rigidity, akinesia/bradykinesia, and postural changes.

Mechanisms of Brain Injury

Primary brain injuries are caused by impact, including focal or diffuse injuries.
Secondary brain injuries result from subsequent brain swelling, infection, or cerebral hypoxia.

Brain Injury

Hematomas are collections of blood that can occur in the brain, including epidural, subdural, and traumatic intracerebral hematomas.
Stroke is a cerebrovascular accident, either ischemic or hemorrhagic.

Neurocognitive Disorders

Alzheimer's disease is a degenerative disorder characterized by cognitive decline, memory loss, and personality changes.
Guillain-Barré syndrome is an acute immune-mediated polyneuropathy, characterized by rapidly progressive ascending symmetrical limb weakness and loss of tendon reflexes.
Schizophrenia is a neurocognitive disorder characterized by changes in the dysregulation of the dopamine and serotonergic system, leading to symptoms such as impaired cognition and hallucinations.### Neurocognitive Disorders: Mood Disorders
Loss of cortical gray matter
Abnormal cortical thinning
Reduced numbers of synaptic structures on neurons
Reduced dendritic spine density of pyramidal neurons in the prefrontal cortex
Arrested migration of hippocampal neurons
Interactions between biologic and psychosocial factors over time explain the risk of developing MDD
Biologic theories for MDD development: inflammation, HPA axis hyperactivity, low levels of neurotrophic growth factor, and low levels of vitamin D
Depression may be linked to ongoing inflammation in the body
Neuroimaging: smaller hippocampal volumes and hippocampal hypertrophy in people who have depression and experienced early abuse
Neurologic disorders of the limbic system and basal ganglia are involved in the development of mood disorders
Dopamine plays a role in depression

Disorders of Eye Movement

Strabismus (squint): any abnormality of eye coordination or alignment that results in loss of binocular vision
Diplopia (double vision) occurs when images from the same spots in the visual space do not fall on corresponding points of the two retinas
Forms of strabismus: nonparalytic (concomitant) and paralytic (nonconcomitant)
Amblyopia (lazy eye): decrease in visual acuity resulting from abnormal visual development in infancy or early childhood
Vision loss ranges from mild (worse than 20/25) to severe (legal blindness, 20/200 or worse)

Disorders of the Conjunctiva

Allergic conjunctivitis: itching, bilateral tearing, and redness of the eye
Treatment: allergen avoidance, cold compresses, eye washes with tear substitute, and oral antihistamines
Viral conjunctivitis: generalized conjunctival hyperemia, copious tearing, and minimal exudate
Treatment: cool compresses and artificial tears
Bacterial conjunctivitis: burning, tearing, mucopurulent or purulent discharge
Treatment: antibiotic drops or ointments
N.gonorrhoeae is the most serious form of conjunctivitis

Disorders of Hearing and Vestibular Function: Otitis Media

Clinical manifestations: acute onset of otalgia, fever, irritability, otorrhea, hearing loss, and evidence of middle ear inflammation
Children older than 3 may have rhinorrhea, vomiting, and diarrhea
Ear pain usually increases as the effusion accumulates behind the tympanic membrane
Perforation of the tympanic membrane may occur acutely, allowing purulent material from the eustachian tube to drain into the external auditory canal
Otitis media with effusion symptoms: intermittent ear pain, sensation of fullness in ear, complaint of hearing loss, dizziness, and decreased tympanic membrane mobility

Disorders of Hearing and Vestibular Function: Otitis Media-Risk Factors

Risk factors: smoking in the house, prematurity, daycare attendance, having an unimmunized status, bottle-feeding, feeding in the supine position, being overweight or obese, family history of otitis media, being male, and sharing a bedroom
More frequent in children with craniofacial anomalies or congenital syndromes associated with craniofacial abnormalities
Strucutural immaturity contributes to the increased risk because the eustachian tube is shorter and more horizontal
To reduce the risk of contracting otitis media: routine childhood vaccinations, elimination of household smoking, exclusive breast-feeding, avoiding feeding while lying down, and selecting daycare facilities with small staff-to-child ratio

This quiz is based on Porth's Pathophysiology, 10th edition, and covers key concepts in altered states. It is designed for NUR 529 students at the University of Alabama's Capstone College of Nursing.

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