Pathophysiology-1 Exam 1 Study Guide (1).pdf

HSC 4555 Professor: Dr. Abdelli Pathophysiology 1 Exam #1 Study Guide (Ch’s.1,4,6,7,9,10) Chapter 1: Introduction to Pathophysiology 1 1. Fill in the blank: - ----------------------------- can be defined as the study of abnorma...

HSC 4555 Professor: Dr. Abdelli Pathophysiology 1 Exam #1 Study Guide (Ch’s.1,4,6,7,9,10) Chapter 1: Introduction to Pathophysiology 1 1. Fill in the blank: - ----------------------------- can be defined as the study of abnormalities in physiologic functioning of living beings, therefore it is about revealing the body’s responses to disruptions in its internal or external environment. 2. It is important to consider that due to diversity, what two factors are not necessarily identical in any two individuals? 3. What are the four interrelated topics that correspond to pathophysiology? 4. True or False: Most diseases are multifactorial. 5. A patient presents with hair loss due to undergoing chemotherapy, is this an example of an iatrogenic cause? 6. Coronary heart disease is a multifactorial disease, what are some reasons as to what classifies a multifactorial disease? 7. True or False: Every individual exposed in a population will contract the disease. 8. Which system is an example of an intercellular communication network? 9. 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. 10. The definition of etiology is, and what are its classifications? 11. The four interrelated topic definitions are: Etiology: Pathogenesis: Clinical manifestations: Treatment Implications: 12. True or False: Signs can be defined as a subjective clinical manifestation. 13. True or False: Symptoms can be defined as an objective clinical manifestation. 14. Which of the following is an example of the clinical manifestation known as a symptom? a) Vomiting b) Observing enlarged lymph nodes c) Headache d) Bruise 15. True or False: Syndrome is the etiology of signs and symptoms that have not been determined. 16. What is the difference between latent period vs a prodromal period? 17. Is the acute phase when the disease has reached its full intensity? 18. Which is the phase that refers to a period a during an illness when the signs/symptoms temporarily become mild, silent, or disappear? 19. Definitions for: Exacerbation: Remission: Convalescence: Sequela: 20. True or False: Specific treatment recommendations are beyond the scope of this text. 21. Fill in the blank: To determine whether a certain finding is indicative of a disease or “abnormal”, it must be compared with what is. 22. What is the difference between positive and negative predictive value? 23. True or False: Specificity is the probability that a test will be negative when applied to a person without a particular condition. 24. Fill in the blank: Strep Throat Swab with a sensitivity of 80% means that 20% of people with the condition will test negative making this a. 25. Definitions for the Patterns of Disease a) Endemic: b) Epidemic: c) pandemic: 26. Which of the following is an example of secondary prevention? a) Maintaining routine immunizations b) Performing monthly breast examinations c) Screening for cancer d) Rehabilitating after a stroke Chapter 4: Cell Injury, Aging, Death 27. What are the three ways that cells respond to environmental changes and injury? 28. Which of those two are reversible, which is irreversible? 29. What does reversible cell injury cause? 30. Another word for oncosis is, and what is its definition? 31. True or False: Intracellular accumulation is characterized by excessive amounts of normal intracellular substances. 32. What are some examples of normal intracellular substances? 33. Define common adaptive responses: a. Atrophy: b. Hypertrophy c. Hyperplasia d. Metaplasia e. dysplasia 34. What is an example of physiologic and pathologic hypertrophy? 35. What are the two categories of irreversible cell injury? 36. What is the most common form of necrosis? 37. What is gangrene defined as, and what are the three types? 38. Does apoptosis cause an inflammatory response? 39. What is ischemia, and hypoxic injury? 40. What is the relationship between ischemia and hypoxia? 41. True or False: Restoration of oxygen can worsen cell injury rather than reversing it. 42. Nutritional deficiencies may result from? 43. What are the five causes of cellular injury? 44. Radiation is an example of physical and mechanical injury to a cell, what are the primary effects it may have on a cell? 45. Are the aging processes and disease processes different? 46. What is the cellular basis of aging? 47. What is the free radical theory? 48. What is the programmed senescence theory? Chapter 6: Genetic and Developmental Disorder 49. The human DNA is organized into how many chromosomes, composed of how many pairs? 50. How many pairs of chromosomes are autosomal? 51. Which pair of chromosomes is defined as the sex chromosome? 52. What are the four groups of genetic disorders? 53. Chromosomal abnormalities generally result from? 54. What does aneuploidy refer to? 55. What is an example of autosomal aneuploidy, and why? 56. Trisomy 18 and Trisomy 13 are examples of which aneuploidy, and what is another name for each? 57. What are two examples of a sex chromsome aneuploidy? 58. What are the differences in abnormal chromosome structure between meiosis and mitosis? 59. True or False: The long arm is labeled the q arm, and the short arm is labeled the p arm. 60. What is Cri du Chat Syndrome? 61. The location of the defective gene is found where, and the mode of transmission is defined as__________? 62. Marfan Syndrome is an example of an autosomal dominant disorder, falling under which type of tissue disorder? 63. What are some clinical manifestations for Marfan Syndrome? 64. Marfan Syndrome is traced to which mutation, and low levels of this causes_________? 65. What does Huntington Disease affect? 66. An abnormal amount of this protein is produced in Huntington disease that causes nerve degeneration. 67. What are some examples of autosomal recessive disorders? 68. True or False: Do males always express the disease for a sex-linked (X-linked) disorder? 69. What classifies polygenic traits, and what are some examples of these traits? 70. True or False: Multifactorial traits do follow clear cut modes but tend to “run in families”. 71. What do teratogenic agents do? 72. What are some examples of teratogenic agents? 73. Between which weeks, is the embryo most susceptible to teratogenesis? Chapter 7: Neoplasia 74. Neoplasia means “new growth”, which is categorized into malignant and benign growth. What is the difference between those two? 75. The suffix oma typically indicates? 76. What terms are used to indicate malignant tumors? 77. Following question 76, what are their origins? 78. True or False: Benign are differentiated cells, whereas malignant are undifferentiated/ non-functional cells. 79. Fill in the blank: Cancer is the ----------- leading cause of death in the U.S. 80. What is the pathophysiology of malignant tumors- cancer? 81. What are cancer causing agents? 82. What are the two groups that cancer-critical genes are grouped into, and define them? 83. What do proto-oncogenes code for? 84. How can proto-oncogenes become activated? 85. What are two examples of tumor suppressor genes? 86. What are the three steps of carcinogenesis? 87. Metastasis can spread to distant sites via what two ways? 88. Tumor markers help identify parent tissues of cancer origin, what are the examples for prostate cancer and ovarian cancer? 89. True or False: Grading is the histologic characterization of tumor cells, whereas staging is the location and patterns of spread within the host. 90. True or False: Early detection is the best prognosis for cure. Chapter 9: Inflammation and Immunity 91. The immune system is a complex network composed of what? 92. True or False: All components of the immune system are inhabited by different types of white blood cells (leukocytes) that mediate inflammation and immunity. 93. What is the difference between self and nonself antigens? 94. Where do monocytes originate from? 95. 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. 96. What classifies lymphocytes and their function? 97. Where do T cells originate from, and mature at? 98. What examples of T cells that function in cell mediated immunity? 99. What are B cells responsible for? 100. Where do B cells originate from, and further proceed to? 101. What are examples of B cells and their function? 102. What are innate defenses? 103. What do monocytes mature into? 104. Where do these phagocytic cells migrate to? (Alveolar, microglial, kupffer cells, histiocytes) 105. What are primary organs vs secondary organs of the lymphoid system? 106. What are the chemical mediators that have immune function? 107. True or False: Major complement proteins are C1 to C9. 108. What is inflammation? 109. What are the five cardinal signs of inflammation? 110. What are the three main events of inflammation? 111. Which vasoactive chemicals do mast cells release? 112. True or False: Chronic inflammation may impair healing and result in an accumulation of macrophages, fibroblasts, and collagen called granuloma. 113. What is exudate? 114. What is the difference between the different types of exudates? 115. What are systemic responses to inflammation? 116. What are the two types of adaptive immunity, and functions? 117. True or False: All nucleated cells express MHC class I proteins on their cell surfaces. 118. True or False: Cytotoxic T cells recognize antigens on MHC class II. 119. Where do T Helper cells recognize antigens? 120. True or False: Certain specialized cells, primarily dendritic cells, macrophages, and B cells express MHC class II proteins. 121. Activated cytotoxic T cells (CD8+) proliferate into? 122. Which protein is needed for MHC class I binding? 123. Which protein is necessary to enable T helper cells to bind to MHC II proteins? 124. T helper cells (CD4+) recognize foreign antigen in association with which MHC molecules? 125. True or False: B cells require activation help from T helper cells (CD4+) 126. What are the five classes of immunoglobulins? 127. Which immunoglobulin is the most common? 128. Which immunoglobulin is the first to be produced on exposure to antigens or after immunization? 129. True or False: IgD is primarily found in salvia, tears, tracheobronchial secretions, colostrum, breast milk, and GI/GU secretions. 130. Which immunoglobulin is responsible for initiating inflammatory and allergic reactions? 131. What is antibody class switching dependent on? 132. What is the order of class switching? 133. What is immunity? 134. What are some examples of passive immunity? Chapter 10: Alterations in Immune Function 135. What are two categories of inappropriate immune response? 136. True or False: Autoimmune disorders range from organ-specific disease to organ nonspecific diseases. 137. True or False: Gender is an issue where females are at higher risk of developing autoimmune diseases than males. 138. Is hypersensitivity a normal immune response? 139. Hypersensitivity is divided into________? 140. What are the hypersensitivity types mediated by? 141. True or False: Type I hypersensitivity is known as immediate hypersensitivity, so reaction occurs 15 go 30 mins after exposure. 142. What are the immunoglobulins that mediate type II hypersensitivity? 143. True or False: Type II hypersensitivity is also known as tissue specific. 144. What is an example of Type II hypersensitivity? 145. True or False: Type III hypersensitivity results from failure of immune system to remove antigen-antibody immune complexes (ICs) 146. Type IV hypersensitivity is defined as rapid or delayed response? 147. Persistent Asthma is an example of which type IV hypersensitivity? 148. What are primary disorders under deficient immune response? 149. True or False: Selective IgA deficiency is an example of T cell disorder. 150. The deletion of which chromosome causes DiGeorge Syndrome? 151. Wiskott-Aldrich Syndrome is an X linked immunodeficiency disorder that affects---? 152. An acquired primary immunodeficiency, such as HIV/AIDS causes a decrease in the number of what? 153. True or False: AIDS causes a T cell count of below 250/ul. Answers: 1. Pathophysiology 2. Health structure and function 3. Etiology, pathogenesis, clinical manifestations, treatment implications 4. True 5. Yes 6. Multifactorial disease may be caused by different risk factors, such as genetic predisposition, diet, smoking, high blood pressure, stress, etc. 7. False 8. The immune system 9. True 10. Etiology is the study of causes or reasons for a particular something, and the causes can be categorized as idiopathic (cause unknown) or iatrogenic (results from an unwanted medical treatment) 11. Etiology: causes or reasons of disease Pathogenesis: development of disease Clinical manifestations: signs, symptoms, stages, course Treatment implications: general treatment strategies 12. False 13. False 14. Headache 15. True 16. Latent period is the time between exposure of tissue to injurious agents and first appearance of signs and/ or symptoms. Prodromal period is a time during which first signs/ symptoms appear indicating onset of disease. 17. Yes 18. Latent Period 19. Exacerbation: a sudden increase in severity of disease or signs or symptoms Remission: decrease in severity of disease or signs or symptoms; may indicate disease is cured Convalescence: stage of recovery after a disease, injury, or surgical procedure Sequelae: subsequent pathologic condition resulting from an illness 20. True 21. Normal 22. Positive predictive value is the probability that a disease is present if the test is positive. The negative predictive value is the probability that the disease is absent if the test is negative. 23. True 24. False negative 25. Endemic: native to a local region Epidemic: spread to many at the same time Pandemic: spread to large geographic areas 26. Screening for cancer and performing monthly breast examinations 27. Withstand, adapt, cell death 28. Withstand and adapt are both reversible, whereas cell death is irreversible. 29. Reversible cell injury causes cell swelling and intracellular accumulation. 30. Hydropic swelling, and it is cellular swelling cause of accumulation of water. 31. True 32. Lipids, carbohydrates, proteins, inorganic pigments (bilirubin) 33. Atrophy: decreased cell size; hypertrophy: increased cell size; hyperplasia: increased cell number; metaplasia: the conversion of one cell type to another; dysplasia: disorderly growth 34. Physiological example is when there is an increase in skeletal muscle size in response to exercise, whereas a pathological example is when there is enlargement in the heart muscle due to high blood pressure. 35. Necrosis, apoptosis 36. Coagulative 37. Gangrene is cellular death in a large area of tissue usually due to the interruption of blood supply to that particular zone. There is dry, wet, and gas. 38. No 39. Ischemia is defined as the lack of blood supply, whereas hypoxia is defined as the lack of oxygen. 40. The relationship between ischemia and hypoxia is most often that they occur hand in hand. In other words, hypoxia is most often caused by ischemia which causes power failure within the cell. 41. True 42. Nutritional deficiencies may result from poor intake, altered absorption, impaired distribution by circulatory system, and inefficient cellular uptake. 43. The five causes of cellular injury are ischemia/hypoxic injury, nutritional injury, infectious/immunologic injury, chemical injury, physical/mechanical injury. 44. Radiation causes genetic damage and acute cell destruction. 45. Yes 46. 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. 47. The free radical theory is that aging results from cumulative and progressive damage to cell structures. 48. The programmed senescence theory is aging is the result of an intrinsic genetic program. 49. It is a total of 46 chromosomes, composed of 23 pairs from each (mother and father). 50. 22 are autosomal. 51. The 23rd pair are the sex chromosomes (X and Y) which help decide either male (XY) and female (XX). 52. Genetic disorders are divided into chromosomal abnormalities, mendelian single-gene disorders, non-mendelian single-gene disorder, and polygenic/multifactorial disorder. 53. Chromosomal abnormalities generally result from an abnormal number of chromosomes, and alterations to the structure of one or more chromosomes. 54. Aneuploidy is an abnormal number of chromosomes either less than or greater than 46 chromosomes (in humans). 55. Down Syndrome (Trisomy 21) which means there is an extra copy of chromosome 21. This is because autosomal aneuploidy generally happens due to nondisjunction which is the failure of pairs to separate properly during 1st or 2nd meiotic division. 56. Examples of autosomal aneuploidy, and Trisomy 18 is Edwards Syndrome and Trisomy 13 is Patau Syndrome. 57. Klinefelter Syndrome, and Turner Syndrome 58. Abnormal chromosome structure results from breakage and loss or rearrangement of chromosome pieces during meiosis or mitosis. Meiosis is due to crossing over errors where chromosome portions are lost, attached to the wrong chromosome or not attached correctly. Mitosis is where there are opportunities for chromosomal breakage and rearrangement. 59. True 60. Cri du Chat Syndrome is the deletion of part of the short arm (p arm) of chromosome 5. 61. The location of the defective gene is autosomal or sex chromosome, and the mode of transmission is dominant or recessive. 62. Connective tissue disorder 63. Patients typically present with tall, slender bodies, long/ thin arms, fingers, and the aorta tends to be weaker. 64. Marfan Syndrome is due to a mutation in fibrillin 1 gene on chromosome 15. Low levels of fibrillin leads to weakened connective tissue. 65. Huntington disease affects primarily neurologic function. 66. Huntingtin protein 67. Albinism, Phenylketonuria (PKU), and cystic fibrosis 68. Yes, males always express the disease because they only have one X chromosome. 69. Polygenic traits develop in response to more than one gene, and some examples are height, weight, intelligence. 70. False, they do not follow 71. Teratogenic agents interfere with cell proliferation, migration, or differentiation. 72. Chemical and drugs: thalidomide, alcohol; infectious agents: viruses, rubella, TORCH (toxoplasmosis, others, rubella, cytomegalovirus, herpes); radiation. 73. Between the 3rd and 9th week, but especially during the 4th and 5th weeks during organ development. 74. A malignant growth means cancer vs a benign growth is noncancerous and tends to be more easily curable. There are a lot of differences, make sure to get familiar! 75. The oma suffix typically indicates benign tumor 76. Carcinoma, sarcoma, and leukemia 77. Carcinoma is of epithelial origin. Sarcoma is connective tissue, mesenchymal (nerve, bone, muscle) origin. Leukemia is of white blood cell origin. 78. True 79. Second 80. A malignant tumor which is cancerous will compress the blood vessels. Then the tumor cells will secrete enzymes or hormones that leads to inflammation and a loss of normal cells. This results in angiogenesis which is when the tumor forms its own blood vessels in order to grow bigger. 81. Carcinogens 82. Gain of functions genes which are mutations causes overactivity of genes. In their normal state, these genes are called proto-oncogenes, however when proto-oncogenes undergo a mutation they become cancerous-causing oncogenes. Loss of function genes mutation causes underactivity of genes, which are called tumor suppressor genes. 83. They code for growth factors, receptors, cytoplasmic signaling molecules, and transcription factors. 84. Oncogenes introduced to host cells by viruses, proto-oncogene 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. 85. BRCA 1 and BRCA 2 86. 1. Initiation: DNA damage (mutation), 2. Promotion: proliferation (growth promoters), 3. Progression: development of cancerous phenotype 87. Blood and lymph 88. Prostate specific antigen (PSA), and CA-125 for ovarian cancer 89. True, so grading refers to the appearance of the cells, whereas staging refers to the location of the cancer and where it has spread to. 90. True 91. The immune system is a complex network of cells, tissues, proteins that work together to protect the body against foreign invaders. 92. True 93. 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. 94. Monocytes originate from the bone marrow (myeloid lineage). 95. True 96. Both T cells and B cells function in adaptive immunity, and have the capacity to proliferate into memory cells, therefore they can provide long-lasting immunity against specific antigen. Natural killer (NK) cells function in innate immunity, and are present in circulation. 97. T cells originate in the bone marrow stem cells, and mature in the thymus gland. 98. Cytotoxic T-killer cells, Helper T cells, and Memory T cells 99. B cells are responsible for the production of antibodies. 100. B cells originate and mature in the bone marrow, where they then proceed to the spleen and lymphoid tissue. 101. Plasma cells produce antibodies, and B-memory cells can quickly form clones of plasma cells following subjects' future exposure to the antigen(pathogen). 102. Innate defenses don’t require a previous exposure to effectively respond to an antigen. 103. Macrophages 104. Alveolar: lung, microglial: brain, Kupffer cells: liver, histiocytes: connective tissue 105. Primary: bone marrow, thymus gland. Secondary organs: lymph nodes, spleen, tonsils, peyer patches (contain B cells) 106. Complement, Kinins, clotting factors, cytokines, chemokines 107. True 108. Inflammation is an innate defense and happens after cells are injured regardless of the cause of injury. 109. Redness, swelling, heat, pain, loss of function 110. Increased vascular permeability, emigration of leukocytes (WBC), and phagocytosis 111. Mast cells release vasoactive chemicals such as histamine, prostaglandins, and leukotrienes. 112. True 113. Exudate is fluid that leaks out of blood vessels, combined with neutrophils and debris from phagocytosis. 114. A. Serous: watery and clear, low protein, occurs in mild inflammation B. Fibrinous: thick and sticky, high protein, occurs in greater in injuries C. Purulent(pus): occurs in severe injury, contains infective organisms, leukocytes D. Hemorrhagic: has RBC, occurs in most severe inflammation 115. Fever, neutrophilia, lethargy, muscle catabolism, suppressed appetite, induction of sleep 116. Humoral: antibodies are produced by B cells to protect against non-self antigens. Cell mediated immunity: T cells are programmed to directly attack non-self cells to protect the body. 117. True 118. False, they recognize on MHC class 1 119. MHC class II 120. True 121. Memory and effector cells 122. CD8 123. CD4 124. MHC II 125. True 126. IgG, IgM, IgA, IgD, IgE 127. IgG is the most common 128. IgM 129. False, IgA 130. IgE 131. Class switching is influenced by the presence of specific cytokines. 132. Class switching occurs from IgM and IgD, to IgG/IgE/IgA 133. Immunity is the state of resistance against infection from a particular pathogen. 134. Mother to fetus: IgG can cross placenta; Mother to infant: IgA from breast milk; Serothearpy: direct injection of antibodies (human or animals) 135. Excessive immune response: over-or-high functioning. Deficient immune response: inadequate functioning 136. True 137. True 138. Normal immune response that is either inappropriately triggered, excessive, and produces undesirable effects on the body. 139. Type I, Type II, TYpe III, Type IV 140. Types I,II,III are mediated by antibodies, and type IV is mediated by T cells 141. True 142. IgG or IgM 143. True 144. Transfusion reaction 145. True 146. Delayed 147. IVb, where T cells produce and release inflammatory cytokines and initiate eosinophil involvement, and released in response to severe airway inflamed and asthma symptoms. 148. B cell disorders, T cell disorders, and combined B and T disorders, which can be congenital or acquired. 149. False, B cell disorders 150. Deletion of a section of chromosome 22 (22q11) 151. Affects both T cells and B cells 152. Decrease in the number of CD4+ (T-Helper cells) 153. False, AIDS: T cell count of below 200/ul