NURS 5315: Advanced Pathophysiology Exam 1 Latest 2023

NURS 5315: Advanced Pathophysiology Exam 1 Latest 2023. cells increase in number, mitosis (cell division) must occur, size of cell does not change Phys: increased rate of division, increase in tissue mass after damage or partial resection; may be compensatory, hormonal, or pathologic Patho: abnormal proliferation of normal cells usually caused by increased hormonal stimulation (endometrial). increase of production of local growth factors Ex: removal of part of the liver lead to hyperplasia of hepatocytes. uterine or mammary gland enlargement during pregnancy - Hyperplasia E. Not true adaptation; Cells abnormal change in size, shape, organization (classified as mild, moderate, severe) P. caused by cell injury/irritation, characterized by disordered cell growth. aka atypical hyperplasia or pre-cancer, a disorderly proliferation Physiologic: N/A Pathologic: squamous dysplasia of cervix from HPV shows up on pap smear, breast cancer development; pap smears often show dysplastic cells of the cervix that must undergo laser/surgical tx - Dysplasia E: reversible change, one type of cell changes to another type for survival P: reversible; results from exposure of the cells to chronic stressors, injury, or irritation; Cancer can arise from this area, stimulus induces a reprogramming of stem cells under the influence of cytokines and growth factors Ex: Patho: Columnar cells change to squamous cells in lungs of smoker or normal ciliated epithelial cells of the bronchial linings are replaced by stratified squamous epithelial cells.; Phys: Barrett Esophagus- normal squamous cells change to columnar epithelial cells in response to reflux, aka intestinal metaplasia - Metaplasia E. inadequate oxygenation of tissues P. decrease in mitochondrial function, decreased production of ATP increases anaerobic metabolism. eventual cell death. C.M. hypoxia, cyanosis, cognitive impairment, lethargy - Hypoxia injury E. normal byproduct of ATP production, will overwhelm the mitochondria- exhaust intracellular antioxidants P. lipid peroxidation, damage proteins, fragment DNA C.M. development in Alzheimer's, heart disease, Parkinson's disease, Amyotrophic Lateral Sclerosis - Free radical and ROS E. mood altering drug, long term effects on liver and nutritional status P. metabolized by liver, generates free radicals C.M. CNS depression, nutrient deficiencies-Mag, Vit B6, thiamine, PO4, inflammation and fatty infiltration of liver, hepatomegaly, leads to liver failure irreversible - Ethanol Na and H2O enter cell and cause swelling. Organ increases in weight, becomes distended and pale. Associated with high fever, hypocalcemia, certain infections - Oncosis Liver and germ cell tumors - Alpha Fetoprotein Origin GI, pancreas, lung, breast tumors - Carcinoembryonic Antigen prostate tumors - Prostate Specific Antigen from epithelial tissue- renal cell carcinoma - Carcinofrom connective tissue- chondrosarcoma - Sarcopreinvasive epithelial malignant tumors of glandular or squamous cells- cervix - Carcinoma in situ Multiple organs including brain - Lung ca metastasis Liver, lungs - Colorectal ca metastasis Liver, lungs, brain - Testicular ca metastasis Bones (especially lumbar spine), liver - Prostate ca metastasis Liver, bones, lymphatics - Head and neck ca metastasis Peritoneal surfaces, diaphragm, omentum, liver - Ovarian ca metastasis Lungs - Sarcoma metastasis In transit lymphatics, lung, liver, brain, GI tract - Melanoma metastasis Local invasion, followed by invasion of surrounding tissues. Cells then may invade blood and lymphatic vessels. They must survive in circulation, then enter and survive in a new location. Then the cells can multiply and form a new tumor. - Mechanisms of ca metastasis T= tumor size /= correlates with metastatic ability N= whether lymph nodes are involved M= extra nodal involvement (liver, lungs) - TNM staging system In venous system- 20% - Intravascular fluid compartment The measure of solute concentration in a fluid. 280-295 mOsm - Osmolality Surrounds the cells and bathes them in nutrients- 20% - Interstitial fluid compartment Within the cells- 40% uk - Intracellular fluid compartment Passive- the movement of water from an area of low concentration of solute to one of higher concentration - Osmosis Pulling- the amount of pressure or force that is exerted by solute molecules of a given compartment - Osmotic pressure