Patho Block 1 Study Guide 2024.docx

**Introduction to Pathophysiology** **Block 1 -- The Cell, Cellular Environment, Cellular Communication, Mechanisms of Inheritance, and Cell Adaptation, Injury and Death** **Summer 2024** **The Cell Membrane, Transport and Cellular Adhesion** 1\. Define homeostasis and recognize its importance i...

**Introduction to Pathophysiology** **Block 1 -- The Cell, Cellular Environment, Cellular Communication, Mechanisms of Inheritance, and Cell Adaptation, Injury and Death** **Summer 2024** **The Cell Membrane, Transport and Cellular Adhesion** 1\. Define homeostasis and recognize its importance in the normal functioning of the human body. 2\. Recognize the composition and function of a cell membrane. State how the distribution of phospholipids and proteins influence the membrane permeability of ions, hydrophilic and hydrophobic compounds. 3\. Recognize the following transport mechanisms and classify them as active or passive: diffusion, passive-mediated transport (facilitated diffusion), phagocytosis, pinocytosis, active transport, osmosis. 4\. Using the sodium/potassium pump as an example, explain how energy from the Na+ and K+ electrochemical gradients across the plasma membrane can be used to drive the net "uphill" (against a gradient) movement of other solutes (e.g., Na+/glucose co-transport; Na+/Ca2+ exchange or counter-transport). 5\. Identify the mechanisms that bind cells together: extracellular matrix, basement membrane, cell adhesion molecules, and specialized cell junctions. **Mechanisms of Cellular Communication and Signal Transduction** 6\. Define chemical / cellular messenger. 7\. Recognize the general characteristics of cellular receptors and identify the role they play in cellular communication. 8\. Identify the three main ways in which cells communicate. 9\. Identify the following primary modes of intracellular signaling; contact-dependent, hormonal, paracrine, autocrine, neurohormonal and neurotransmitter. 10\. Recognize how the solubility of a chemical messenger influences how it is transported and the mechanism by which it communicates with a cell. 11\. Identify the three classes of plasma membrane receptors and their functions: channel linked, catalytic, and G-protein linked. 12\. Outline the basic steps of a signal transduction pathway for both water soluble and lipid soluble chemical messengers. 13\. Recognize the regulation of hormone secretion by positive-feedback and negative-feedback loops with attention to the short, long, and ultra-short loops. 14\. Define upregulation and downregulation and note how these terms relate to the ability of the body to adjust its sensitivity to the concentration of a signaling hormone. **Sodium, Chloride and Water Balance** 15\. Define the following components of total body water (TBW) and recognize their relative proportions: 16\. Recognize the relationship between TBW and age. 17\. Define osmosis, osmolarity, osmolality, tonicity, osmotic pressure, and oncotic pressure. 18\. Explain the movement of water driven by solute concentration; identify how this applies to movement across bodily fluid compartments (e.g., intracellular fluid) and recognize the implications to cell volume when a cell is placed in iso-tonic, hyper-tonic and hypo-tonic solutions. 19\. Recognize how the following four forces control the movement of fluid across the capillary wall: capillary hydrostatic pressure (blood pressure), interstitial oncotic pressure, capillary oncotic pressure (plasma), and interstitial hydrostatic pressure. 20\. Outline how the following events contribute to the development of edema: decreased capillary oncotic pressure, increased capillary permeability, increased capillary hydrostatic pressure, and lymphatic obstruction. 21\. Relate the distribution of electrolytes in the intracellular and extracellular fluid; identify the major intracellular and extracellular cations and anions. 22\. Recognize the very basic ways in which plasma osmolality and plasma volume influence water balance. 23\. Recognize the relationship of sodium, potassium, chloride, and bicarbonate in maintaining the osmotic balance of the extracellular environment. 24\. Identify the terminology associated with the deficit or excess of the following electrolytes: sodium, potassium, calcium, phosphate, and magnesium. **Acid-Base Balance** 25\. Identify the role of the physiologic buffering systems in maintaining pH homeostasis. 26\. Recognize Le Chatelier's principle and apply it to alterations within the carbonic acid-bicarbonate buffer. **Mechanisms of Inheritance** 27\. Define the following terms related to genetics and mechanisms of inheritance: 28\. Identify the following patterns of inheritance based on unique characteristics and/or a pedigree chart: 29\. Differentiate between penetrance and expressivity as it pertains to phenotypic variability. Provide an example of diseases in which these phenomena are present. 30\. List the cause and possible outcomes for the following DNA mutations: 31\. Define the following terms regarding to errors related to genetic inheritance: 32\. Define epigenetics, identify the three major types of epigenetic modifications, and recognize their significance. 33\. Recognize the role epigenetics has on the development of disease and its multigenerational persistence. 34\. Identify "red flags" that may indicate a genetic cause is underlying a particular disease process. 35\. Identify several reasons for referral of a patient to a genetic specialist. **Cellular Adaptation, Injury and Death** 36\. Define the following general types of cellular adaptation: 37\. Recognize the outcome of the following common mechanisms resulting in cell injury and cell death: ATP depletion, reactive oxygen species, calcium entry, mitochondrial damage, membrane damage, protein misfolding, and DNA damaging. 38\. Distinguish between reversible cell injury and irreversible cell injury. 39\. Outline the mechanisms of cell injury caused by 1) ischemia and hypoxia, 2) ischemia-reperfusion, and 3) free radicals and reactive oxygen species. 40\. Outline the mechanisms of cell injury caused by ischemia-reperfusion. 41\. Recognize and give examples of cellular injury due to the following chemicals, toxic substance, and physical agents: lead, ethanol, and ionizing radiation. 42\. Define the following terms associated with cellular injury caused by temperature extremes: 43\. Identify the systemic manifestations of cellular injury and their causes (Table 2.11). **Cellular Death** 44\. Recognize the mechanisms of necrosis and apoptosis. 45\. Identify the following types of tissue necrosis as their pathogenic mechanisms. 46\. Identify the common pathologic states that lead to apoptotic death. 47\. Recognize the features of cellular necrosis and apoptosis (Table 2.12). 48\. Identify the cellular hallmarks of aging. **Clinical Correlation** 49\. Begin to apply scientific concepts covered in this block to specific disease and general manifestations of disease: cystic fibrosis.