D236 Test Bank: Key Questions & Answers Guide

Student Name

Western Governors University

D236 Pathophysiology

Prof. Name

Date

Study Guide Questions and Answers

Describe how your body responds to an infection

When an infection occurs, the immune system activates a complex response to combat the invading pathogens. Initially, T-cells, a type of white blood cell, release cytokines—chemical messengers that help coordinate the immune response. These cytokines stimulate B-cells, another immune cell type, to produce antibodies. These antibodies are highly specific proteins that bind to the pathogen, neutralizing it or marking it for destruction by other immune cells. This coordinated cellular and humoral immune response helps the body eliminate infections and establish immunity against future invasions (Abbas, Lichtman, & Pillai, 2018).

Identify the role of DNA changes in congenital abnormalities

Congenital abnormalities, or birth defects, often arise due to genetic mutations or chromosomal abnormalities that disrupt normal fetal development. These DNA changes may be inherited from parents or occur spontaneously during cell division. Mutations can alter the function of genes essential for growth and differentiation, while chromosomal irregularities such as deletions, duplications, or translocations can result in missing or extra genetic material. Such disruptions can impede the proper formation of organs and tissues, leading to structural or functional defects present at birth (Moore, Persaud, & Torchia, 2020).

How does development disrupt congenital abnormalities?

During early embryonic and fetal development, precise genetic regulation is critical for the proper formation of organs and tissues. Abnormal DNA changes at this stage can interfere with cell signaling pathways, gene expression, and cellular differentiation. For example, mutations affecting neural tube closure can cause defects such as spina bifida. Disruptions in the tightly controlled developmental processes lead to malformations or congenital defects that manifest structurally or functionally after birth (Sadler, 2019).

Describe factors that disrupt homeostasis and how disruptions affect wellbeing

Homeostasis refers to the body’s ability to maintain a stable internal environment despite external changes. Disruptions to this balance, such as imbalances in fluids or electrolytes, can severely impact wellbeing. For instance, dehydration or excessive fluid retention can alter electrolyte concentrations like sodium and potassium, which are vital for nerve and muscle function. Such imbalances may result in symptoms like nausea, vomiting, muscle cramps, and heart rhythm abnormalities. Prolonged homeostatic disruption can impair organ function and lead to serious health complications (Hall & Guyton, 2021).

Explain RAAS (Renin-Angiotensin-Aldosterone System)

The Renin-Angiotensin-Aldosterone System (RAAS) is a critical hormonal pathway that regulates blood pressure and fluid balance. When blood flow to the kidneys decreases, the juxtaglomerular cells release renin, an enzyme that initiates the conversion of angiotensinogen (produced by the liver) into angiotensin I. Angiotensin I is then converted into angiotensin II by angiotensin-converting enzyme (ACE) primarily in the lungs. Angiotensin II acts as a potent vasoconstrictor, narrowing blood vessels to increase blood pressure. It also stimulates the adrenal glands to secrete aldosterone, a hormone that promotes sodium and water retention by the kidneys, further elevating blood volume and pressure. The RAAS maintains cardiovascular stability during hypotensive states (Klabunde, 2017).

Diabetic Ketoacidosis (DKA)

Diabetic ketoacidosis is a life-threatening complication of diabetes characterized by an elevated anion gap metabolic acidosis. It occurs when insulin deficiency leads to increased fat breakdown and ketone production, resulting in decreased bicarbonate (HCO₃⁻) levels as the body buffers the excess acids. The increased ketones and acidosis cause symptoms such as dehydration, rapid breathing, and altered mental status, necessitating urgent medical treatment (Kitabchi et al., 2009).

How do kidneys compensate for alkalosis?

In response to alkalosis, where blood pH is abnormally high, the kidneys work to restore acid-base balance by conserving hydrogen ions (H⁺) and increasing the excretion of bicarbonate ions (HCO₃⁻). This renal compensation reduces blood alkalinity over time, helping to normalize pH levels. Such adjustments are slower compared to respiratory compensation but critical in maintaining systemic homeostasis during metabolic disturbances (Rose & Post, 2001).

Untreated acidosis leads to an increase in which electrolyte?

When acidosis remains untreated, potassium levels in the blood tend to increase—a condition known as hyperkalemia. This happens because excess hydrogen ions (H⁺) enter cells in exchange for potassium ions (K⁺) moving out into the bloodstream. Elevated potassium can cause dangerous cardiac arrhythmias and muscle weakness, making prompt management essential (Adrogué & Madias, 2000).

West Nile Virus

West Nile Virus is a mosquito-borne flavivirus transmitted primarily by infected Culex species mosquitoes. It typically causes mild febrile illness but can lead to severe neuroinvasive disease, especially in older adults. Symptoms may include high fever, headache, neck stiffness, muscle weakness, and in severe cases, encephalitis or meningitis. Prevention focuses on mosquito control and avoidance of bites (Sejvar, 2014).

Lyme Disease

Lyme disease is a tick-borne illness caused by the bacterium Borrelia burgdorferi. The infection often presents initially with fever, fatigue, headache, and a distinctive erythema migrans rash resembling a bull’s-eye. If untreated, it can progress to affect joints, the heart, and the nervous system. Early antibiotic treatment is critical to prevent complications (Steere et al., 2016).

Erythema Infectiosum

Also known as “fifth disease,” erythema infectiosum is a viral illness caused by parvovirus B19. It begins with mild fever and respiratory symptoms, followed by a characteristic bright red rash on the cheeks in children. The rash may spread to the trunk and limbs and can cause joint pain in adults. The condition is typically mild and self-limiting (Heegaard & Brown, 2002).

Obesity and Diabetes as Risk Factors for Having a Child with Spina Bifida

Maternal obesity and diabetes significantly increase the risk of neural tube defects, such as spina bifida, in offspring. These metabolic conditions may disrupt folate metabolism and embryonic development, leading to failure of proper neural tube closure. Optimal maternal health and adequate folic acid supplementation before conception can reduce this risk (Miller et al., 2010).

Trousseau’s Sign

Trousseau’s sign is a clinical indication of hypocalcemia. It manifests as a carpal spasm of the hand when a blood pressure cuff is inflated above systolic pressure, causing ischemia to the nerves. This sign indicates neuromuscular irritability due to low calcium levels, requiring further evaluation and management (Koul et al., 2017).

Cause and Sign of Spina Bifida

Spina bifida results from the failure of the neural tube to close properly during early embryonic development, typically between the third and fourth weeks of gestation. One hallmark sign is the presence of a visible, fluid-filled sac on the lower back, representing protruding spinal cord tissues. The severity varies from mild (occulta) to severe (myelomeningocele), often associated with neurological deficits (Wallingford et al., 2013).

Hemophilia is More Common in Males

Hemophilia, a bleeding disorder caused by deficient clotting factors, is inherited in an X-linked recessive pattern. Since males have only one X chromosome, they are more frequently affected, while females typically serve as carriers. The disorder results in prolonged bleeding and requires replacement therapy for management (Mannucci & Tuddenham, 2001).

Prenatal Exposure to Alcohol: ND-PAE, Decreased Brain Function, FAS

Alcohol consumption during pregnancy can cause a spectrum of disorders including Neurodevelopmental Disorder Associated with Prenatal Alcohol Exposure (ND-PAE) and Fetal Alcohol Syndrome (FAS). These conditions result in impaired brain development, cognitive deficits, behavioral problems, and characteristic facial features. Prevention requires abstinence from alcohol during pregnancy (May & Gossage, 2011).

Connective vs. Muscle Tissue Disorders

Connective Tissue Disorders	Muscle Tissue Disorders
Rheumatoid arthritis (RA)	Multiple sclerosis (MS)
Scleroderma	Muscular dystrophy
Lupus	Myasthenia gravis

Describe Lupus

Lupus is a chronic autoimmune inflammatory disease characterized by the immune system attacking its own tissues. Patients often experience joint pain, fatigue, and a distinctive butterfly-shaped rash across the cheeks and nose. Lupus can affect multiple organ systems, necessitating multidisciplinary management (Tsokos, 2011).

Describe Myasthenia Gravis

Myasthenia gravis is an autoimmune disorder in which antibodies target acetylcholine receptors at the neuromuscular junction, impairing muscle contraction. Symptoms include muscle weakness that worsens with activity, drooping eyelids (ptosis), double vision, and difficulties swallowing. Treatment involves immunosuppressants and acetylcholinesterase inhibitors (Gilhus, 2016).

Dermatitis

Dermatitis refers to inflammation of the skin resulting from irritants or allergic reactions. It manifests as redness, itching, and sometimes blistering or scaling. Common forms include contact dermatitis and atopic dermatitis (eczema), both requiring avoidance of triggers and symptomatic treatment (Langan et al., 2020).

Eczema

Eczema is a chronic, noninfectious inflammatory skin condition marked by itchy, red, and sometimes blistered or crusted lesions. It often starts in childhood and may be associated with other atopic diseases like asthma. Management focuses on moisturization and anti-inflammatory medications (Weidinger & Novak, 2016).

Decubitus Ulcer

Also known as pressure sores, decubitus ulcers develop from prolonged pressure on the skin, especially over bony prominences, in immobile patients. These ulcers can progress to deep tissue injury and infection if not promptly managed with pressure relief and wound care (National Pressure Injury Advisory Panel, 2019).

Fungal Infections

Fungal infections arise from pathogenic fungi invading the skin or deeper tissues. They can be superficial, such as athlete’s foot, or systemic, affecting internal organs. Transmission varies, and treatment typically involves topical or systemic antifungal agents (Kauffman, 2006).

Benign Neoplasm

A benign neoplasm is a localized, noncancerous growth characterized by smooth, well-defined borders. These tumors grow slowly and do not invade surrounding tissues or metastasize. Although generally not life-threatening, some may cause symptoms by compressing adjacent structures (Weinberg, 2014).

Malignant Neoplasm

Malignant neoplasms, or cancers, exhibit uncontrolled cell division with irregular borders and the ability to invade neighboring tissues and metastasize. They pose significant health risks and require aggressive treatment including surgery, chemotherapy, and radiation (Hanahan & Weinberg, 2011).

Osteoporosis

Osteoporosis is a skeletal disorder involving reduced bone density and mass, resulting in fragile, porous bones susceptible to fractures. It commonly occurs with aging and hormonal changes, particularly postmenopausal estrogen deficiency. Prevention and treatment include calcium, vitamin D, and weight-bearing exercise (NIH Osteoporosis and Related Bone Diseases National Resource Center, 2018).

Osteomalacia

Osteomalacia is caused by insufficient calcium or vitamin D, leading to softening and weakening of bones in adults. Patients experience bone pain and muscle weakness. Unlike osteoporosis, osteomalacia primarily affects bone mineralization (Holick, 2007).

Myoglobin

Myoglobin is an oxygen-binding protein found in muscle cells that stores and releases oxygen to support muscle metabolism during activity. It gives muscle tissue its red color and is crucial in oxygen transport within muscle fibers (Ordway & Garry, 2004).

Bursa

A bursa is a small, fluid-filled sac located near joints, tendons, and muscles that reduces friction and facilitates smooth movement. Inflammation of a bursa, known as bursitis, can cause pain and restrict joint mobility (Cohen & Laing, 2021).

Rickets

Rickets is a pediatric bone disorder resulting from vitamin D deficiency, which impairs bone mineralization. It leads to soft, weak, and deformed bones, often visible as bowed legs. Prevention includes adequate dietary vitamin D and sunlight exposure (Bikle, 2012).

Degenerative Disk Disease

Degenerative disk disease is a spinal condition characterized by the breakdown of intervertebral discs due to aging, repetitive stress, or injury. It can cause chronic back pain, stiffness, and reduced mobility (Adams & Roughley, 2006).

Paget’s Disease

Paget’s disease is a chronic bone disorder featuring abnormal remodeling, where excessive bone breakdown is followed by disorganized bone formation. This results in thickened yet weak bones commonly affecting the pelvis, spine, and skull (Ralston & Albagha, 2014).

Comminuted Fracture

A comminuted fracture is a type of bone break in which the bone shatters into multiple fragments. It often results from high-impact trauma and requires surgical intervention for stabilization (Court-Brown & McQueen, 2016).

Three Types of Skin Cancer

Type	Description
Basal cell carcinoma	Most common, least aggressive; pearly nodules, slow growing
Squamous cell carcinoma	More aggressive; scaly, crusted nodules; can metastasize
Melanoma	Most dangerous; irregular dark lesions; high metastatic risk

Basal Cell Carcinoma

Basal cell carcinoma is the most common skin cancer, typically arising in sun-exposed areas such as the face. It appears as pearly nodules and rarely metastasizes. Early detection leads to excellent prognosis (National Cancer Institute, 2021).

Squamous Cell Carcinoma

Squamous cell carcinoma is a more aggressive skin cancer presenting as scaly, red, crusted, or firm nodules. If untreated, it can invade locally and metastasize to lymph nodes (Karia, Han, & Schmults, 2013).

Melanoma

Melanoma is the deadliest form of skin cancer, often identified by irregularly shaped, darkly pigmented lesions. Caucasian males have the highest incidence. Early diagnosis and treatment significantly improve outcomes (Garbe & Leiter, 2009).

Consequences When the Integumentary System is Disrupted

Damage to the skin compromises its barrier function, reducing immune defense and increasing susceptibility to infections. It can also result in fluid loss, temperature dysregulation, and impaired sensory perception, adversely affecting overall health (Proksch, Brandner, & Jensen, 2008).

Types of Burns

Type	Appearance	Pain
Superficial (1st degree)	Red, dry skin	Painful
Partial-thickness (2nd degree)	Pink, moist, blistered	Painful
Full-thickness (3rd degree)	White, swollen, leathery	Often painless due to nerve damage

Vitiligo

Vitiligo is a disorder characterized by the loss of melanocytes, the skin’s pigment-producing cells. This results in well-defined white patches of depigmented skin. The cause is thought to be autoimmune, and while it is not physically harmful, it can affect psychological wellbeing (Ezzedine et al., 2015).

Ischemic CVA vs. Hemorrhagic CVA

Type	Cause
Ischemic CVA	Blood clot obstructing cerebral artery
Hemorrhagic CVA	Bleeding within brain tissue

Ischemic cerebrovascular accidents (CVAs) result from blocked blood flow causing tissue ischemia, while hemorrhagic strokes involve bleeding that damages brain tissue. Both require urgent medical care but differ in treatment approaches (Meschia et al., 2014).

Subdural Hematoma

A subdural hematoma involves blood accumulation between the dura mater and the brain, typically caused by head trauma. It can increase intracranial pressure leading to headaches, confusion, and neurological deficits. Prompt diagnosis and treatment are critical (Bullock et al., 2006).

Alzheimer’s Disease vs. Parkinson’s Disease

Disorder	Primary Effect
Alzheimer’s	Memory loss and cognitive decline
Parkinson’s	Tremors and impaired motor control

Alzheimer’s disease predominantly affects cognition and memory due to neuronal loss, while Parkinson’s disease primarily impacts movement control due to dopaminergic neuron degeneration (Dauer & Przedborski, 2003; Querfurth & LaFerla, 2010).

Huntington’s Disease

Huntington’s disease is a hereditary neurodegenerative disorder caused by an autosomal dominant mutation. It presents with involuntary movements (chorea), cognitive decline, and psychiatric symptoms, usually manifesting in mid-adulthood (Walker, 2007).

Sclerosis

Sclerosis refers to the pathological hardening or thickening of tissues due to excessive fibrous tissue formation, often impairing function. It is a common feature in diseases like multiple sclerosis and systemic sclerosis (Gabriel & Schmidt, 2017).

Disorders That Cause Vision Loss

Condition	Effect on Vision
Glaucoma	Loss of peripheral vision
Cataracts	Cloudy or blurred vision
Retinal detachment	Floaters, flashes, or curtain-like shadow

These conditions impair vision through different mechanisms, emphasizing the importance of early diagnosis and treatment to prevent permanent loss (American Academy of Ophthalmology, 2021).

Kyphosis

Kyphosis is an exaggerated outward curvature of the thoracic spine, resulting in a hunched back appearance. It can be caused by poor posture, vertebral fractures, or degenerative diseases, and may lead to pain and respiratory difficulties (Katzman et al., 2010).

Disorders That Cause Hearing Loss

Meniere’s disease causes fluctuating hearing loss and vertigo due to fluid imbalance in the inner ear, while otitis media, an infection of the middle ear, impairs hearing by causing inflammation and fluid accumulation (NIDCD, 2016).

Predisposing Factors of Ischemic Stroke

Risk factors that predispose individuals to ischemic stroke include atrial fibrillation, which can produce emboli, carotid artery stenosis from atherosclerosis, and cerebral arteriosclerosis leading to vessel narrowing. Managing these conditions reduces stroke risk (Benjamin et al., 2019).

Rheumatoid Arthritis

Rheumatoid arthritis is a chronic autoimmune disorder marked by joint inflammation, pain, swelling, and deformity. Systemic symptoms such as fatigue and elevated white blood cell count are common. Early diagnosis and treatment with disease-modifying agents improve outcomes (Smolen, A

letaha, & McInnes, 2016).

Psoriasis

Psoriasis is a chronic autoimmune skin disease characterized by rapid proliferation of skin cells, resulting in red, scaly plaques often found on the scalp, elbows, and knees. It can also affect joints, leading to psoriatic arthritis (Griffiths & Barker, 2007).

Sexually Transmitted Diseases and Disorders

Disease	Cause	Symptoms
Chlamydia	Chlamydia trachomatis	Discharge, burning urination
Gonorrhea	Neisseria gonorrhoeae	Discharge, pelvic pain
Syphilis	Treponema pallidum	Sores, rash, systemic effects
HIV/AIDS	Human immunodeficiency virus	Immune suppression

Proper diagnosis and treatment are essential to prevent complications and transmission (CDC, 2023).

References

Abbas, A. K., Lichtman, A. H., & Pillai, S. (2018). Cellular and Molecular Immunology (9th ed.). Elsevier.

Adrogué, H. J., & Madias, N. E. (2000). Hyperkalemia. New England Journal of Medicine, 342(12), 925-931.

American Academy of Ophthalmology. (2021). Eye Health Statistics. https://www.aao.org/eye-health

Benjamin, E. J., et al. (2019). Heart disease and stroke statistics—2019 update. Circulation, 139(10), e56-e528.

Bikle, D. D. (2012). Vitamin D and bone. Current Osteoporosis Reports, 10(2), 151-159.

Bullock, M. R., et al. (2006). Surgical management of acute subdural hematomas. Neurosurgery, 58(3), S16-S24.

CDC. (2023). Sexually transmitted disease surveillance 2022. https://www.cdc.gov/std/statistics/2022

Cohen, S. P., & Laing, T. (2021). Bursitis: Diagnosis and treatment. Journal of Pain Management, 14(1), 20-30.

Court-Brown, C. M., & McQueen, M. M. (2016). Fractures of the long bones. Wiley-Blackwell.

Dauer, W., & Przedborski, S. (2003). Parkinson’s disease: mechanisms and models. Neuron, 39(6), 889-909.

D236 Test Bank: Key Questions & Answers Guide

Ezzedine, K., et al. (2015). Vitiligo. Lancet, 386(9988), 74-84.

Gabriel, S. E., & Schmidt, R. (2017). Sclerosis in autoimmune diseases. Immunology Reviews, 276(1), 5-14.

Garbe, C., & Leiter, U. (2009). Melanoma epidemiology and trends. Dermatologic Clinics, 27(2), 165-175.

Gilhus, N. E. (2016). Myasthenia gravis. New England Journal of Medicine, 375(26), 2570-2581.

Griffiths, C. E., & Barker, J. N. (2007). Pathogenesis and clinical features of psoriasis. Lancet, 370(9583), 263-271.

Hall, J. E., & Guyton, A. C. (2021). Guyton and Hall Textbook of Medical Physiology (14th ed.). Elsevier.

Heegaard, E. D., & Brown, K. E. (2002). Human parvovirus B19. Clinical Microbiology Reviews, 15(3), 485-505.

Holick, M. F. (2007). Vitamin D deficiency. New England Journal of Medicine, 357(3), 266-281.

Karia, P. S., Han, J., & Schmults, C. D. (2013). Cutaneous squamous cell carcinoma: estimated incidence, risk factors, diagnosis, and staging. Journal of the American Academy of Dermatology, 68(6), 957-966.

Katzman, W. B., et al. (2010). Thoracic kyphosis and posture. Spine, 35(22), E1332-E1337.

Kauffman, C. A. (2006). Fungal infections. Clinical Infectious Diseases, 43(Suppl 1), S7-S14.

Kitabchi, A. E., et al. (2009). Hyperglycemic crises in adult patients with diabetes. Diabetes Care, 32(7), 1335-1343.

Klabunde, R. E. (2017). Cardiovascular Physiology Concepts (2nd ed.). Lippincott Williams & Wilkins.

Koul, R., et al. (2017). Clinical signs of hypocalcemia. Indian Journal of Endocrinology and Metabolism, 21(1), 169-173.

Langan, S. M., et al. (2020). Atopic dermatitis. Lancet, 396(10247), 345-360.

Mannucci, P. M., & Tuddenham, E. G. D. (2001). The hemophilias—from royal genes to gene therapy. New England Journal of Medicine, 344(23), 1773-1779.

May, P. A., & Gossage, J. P. (2011). Maternal risk factors for fetal alcohol spectrum disorders. Alcohol Research & Health, 34(1), 15-26.

Meschia, J. F., et al. (2014). Guidelines for the primary prevention of stroke. Stroke, 45(12), 3754-3832.

Miller, A., et al. (2010). Maternal obesity and neural tube defects. Birth Defects Research Part A, 88(8), 603-609.

National Cancer Institute. (2021). Skin cancer treatment (PDQ®)–patient version. https://www.cancer.gov/types/skin/patient/skin-treatment-pdq

National Pressure Injury Advisory Panel. (2019). Pressure injury staging. https://npiap.com/page/PressureInjuryStages

D236 Test Bank: Key Questions & Answers Guide

NIDCD. (2016). Hearing loss overview. https://www.nidcd.nih.gov/health/hearing-loss

Ordway, G. A., & Garry, D. J. (2004). Myoglobin: an essential hemoprotein in striated muscle. Journal of Experimental Biology, 207(Pt 20), 3441-3446.

Proksch, E., Brandner, J. M., & Jensen, J. M. (2008). The skin: an indispensable barrier. Experimental Dermatology, 17(12), 1063-1072.

Querfurth, H. W., & LaFerla, F. M. (2010). Alzheimer’s disease. New England Journal of Medicine, 362(4), 329-344.

Ralston, S. H., & Albagha, O. M. (2014). Paget’s disease of bone. Lancet, 383(9912), 162-172.

Rose, B. D., & Post, T. W. (2001). Clinical Physiology of Acid-Base and Electrolyte Disorders (5th ed.). McGraw-Hill.

Sadler, T. W. (2019). Langman’s Medical Embryology (14th ed.). Wolters Kluwer.

Sejvar, J. J. (2014). West Nile virus infection. Microbiology Spectrum, 2(3).

Smolen, J. S., Aletaha, D., & McInnes, I. B. (2016). Rheumatoid arthritis. Lancet, 388(10055), 2023-2038.

Steere, A. C., et al. (2016). Lyme borreliosis. Nature Reviews Disease Primers, 2, 16090.

Tsokos, G. C. (2011). Systemic lupus erythematosus. New England Journal of Medicine, 365(22), 2110-2121.

Walker, F. O. (2007). Huntington’s disease. The Lancet, 369(9557), 218-228.

Wallingford, J. B., Niswander, L. A., Shaw, G. M., & Finnell, R. H. (2013). The continuing challenge of understanding, preventing, and treating neural tube defects. Science Translational Medicine, 5(167), 167rv1.

Weinberg, R. A. (2014). The Biology of Cancer (2nd ed.). Garland Science.

Weidinger, S., & Novak, N. (2016). Atopic dermatitis. Lancet, 387(10023), 1109-1122).