Douglas College, Biology BIOL 2200

Pathophysiology

Biology 2200 - Objectives

Module 1: Cellular adaptation, inflammation & healing

1) Define the following initial concepts: Pathophysiology, signs and symptoms, diagnosis, hypoxia,
ischemia, thrombus, thrombosis, embolus, thromboembolism, atherosclerosis, hypoxemia.

2) Describe the five main tissue responses to stress: Atrophy, hypertrophy, hyperplasia,
metaplasia and dysplasia.

3) List some of the common causes of cell injury by physical, biological, chemical agents and
nutritional imbalances.

4) Explain the causes and cellular effects of three common mechanisms of cellular injury:
a) Hypoxia.
b) Free radical formation.
c) Failure of calcium homeostasis.

5) Describe the development and pathophysiological effects of hypoxia on cell function and the
corresponding changes in cell appearance observed.

6) Describe key differences between the two types of cell death: necrosis and apoptosis.

7) Describe the causes, locations and appearance of the following types of necrosis: coagulative,
liquefactive, caseous, gangrene and fat necrosis.

8) Outline two main categories of theory for the aging process (not required in depth).

9) Describe the cellular and chemical interactions that produce acute inflammation and be able to:
a) List the inflammatory cells involved.
b) List key chemical mediators.
c) Describe the sequence of cellular-chemical interactions that produce the:
i) Vascular response.
ii) Cellular response.
d) Describe observable tissue changes and explain the underlying causes, i.e.,
i) Redness.
ii) Heat.
iii) Swelling.
iv) Pain.

10) Describe the following four types of exudate and explain how these relate to the severity of
inflammation, the presence of infection and the state of wound healing.
1. Serous exudate.

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2. Fibrinous exudate.
3. Purulent exudate.
4. Hemorrhagic exudate.

11) Define chronic inflammation and outline its main causes and characteristics.

12) Describe the two main patterns of chronic inflammation, general (non-granulomatous) and
granulomatous.

13) Describe the sequence of cellular and chemical events in the three phases of wound healing:
1. Inflammatory.
2. Proliferative.
3. Contraction and remodeling.
14) Describe what meant by open and closed types of wounds and explain the terms clean incision,
healing by primary intension and by secondary intension.
15) Describe local problems of healing due to ischemia, blood clots, excessive fibrin, excessive
collagen, excessive wound contraction and wound disruption.
16) Describe common systemic problems of healing resulting from in particular inadequate
nutrition, diabetes mellitus, medications and age.
17) A “starting list” of more terms useful to know in pathophysiology and medicine (see module 1
slides for definitions): syndrome, local, systemic, acute, chronic, remission, exacerbation,
etiology, pathogenesis, prognosis, communicable disease, degenerative disease, idiopathic,
congenital, genetic.

Module 2: Disorders of the Immune system

1) Define the following terms: hypersensitivity, allergy, allergen, immediate hypersensitivity

reaction, anaphylaxis, delayed hypersensitivity reaction, autoimmune response, alloimmune
response, urticaria, immunotolerance.
2) Describe the mechanism of a Type I hypersensitivity response and give examples.
3) Describe the mechanism of a Type II hypersensitivity response and give examples.
4) Describe the mechanism of a Type III hypersensitivity response and give examples.
5) Describe the mechanism of a Type IV hypersensitivity response and give examples.
6) Describe 3 actions of histamine
7) Describe the general signs and symptoms of IgE (Type I) mediated responses.
8) Outline the signs, symptoms and treatment of allergic Rhinitis (hay fever).
9) Describe the mechanism, causes, signs, symptoms and treatment of anaphylaxis.
10) Describe the mechanism, causes, signs, symptoms and treatment of bronchial asthma.

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11) Define immunotolerance.

12) Define autoimmune disease and give two possible mechanisms for its occurrence.
13) Describe the mechanism, clinical manifestations and treatment of SLE (systemic lupus
erythematosus.
14) Describe the influence of HLA’s/MHCI’s on tissue transplantation.
15) Describe 3 types of tissue rejection.
16) Describe immunodeficiency and differentiate between primary and secondary.
17) Outline the five main types of primary immunodeficiency (PID).
18) Outline the clinical warning criteria of immunodeficiency in infants.
19) Outline current strategies used in the treatment of immunodeficiency.
20) Define secondary immune deficiencies and give at least one example.
21) Describe the causative agent of AIDS, and how HIV affects the immune system.
22) Describe is HIV transmitted.
23) Outline common diagnostic features of AIDS, including include atypical infections and cancers.
24) What are 3 reasons for the poor antigenic response of the elderly?

Module 3: Neoplasms

1) Describe the two main characteristics of tissue growth and repair.

2) Compare and contrast the characteristics of benign tumours with malignant tumours.
3) Define metastasis.
4) Describe the changes in cancer cell function compared to normal cells that enable them to
proliferate and metastasize.
5) Describe typical changes in cancer cell appearance as a result of their genetic instability.
6) Describe the four main characteristics of malignant tumours.
7) Describe how a primary malignant tumour is able to invade and metastasize to other organs and
tissues in the body.
8) Define the terms: carcinoma, adenocarcinoma, sarcoma, lymphoma and leukemia.
9) Describe common local manifestations of cancer, regarding:
• local tissue invasion
• The damaging effects of tumours to surrounding tissues
o compression
o obstruction
o ulceration hemorrhage

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o rupture
o infarction
10) Describe common general and systemic manifestations of cancer, regarding:
• Pain
• Fatigue and cachexia
• Anemia
• Leukopenia and thrombocytopenia
• Infection
• Gastrointestinal symptoms
• Skin reactions and hair loss
• Para-neoplastic syndromes
11) Outline commonly used diagnostic measures - such as lab tests, imaging techniques and staging-
grading tumours - in cancer detection and evaluation, including why and when a particular test
is carried out and its significance regarding potential outcomes and treatment.
12) Define tumour markers and describe their value in the diagnosis and evaluation of cancer.
13) Define carcinoma in-situ.
14) Describe the genetic and molecular basis for cancer, regarding:
• Gene mutations
• Proto-oncogenes and tumour suppressor genes
• The multistep hypothesis of carcinogenesis
• Defects in damaged repair genes
• Epigenetic silencing
15) Describe the stages of carcinogenesis
16) Outline the causative factors of cancer, including:
• Demography
• Heredity
• Immunological mechanisms
• Age
• Chemical carcinogens
• Low strength (solar) radiation high strength (nuclear) radiation
• Viral and bacterial infections
• Inflammation
17) Describe and outline the rationale of commonly used cancer treatments: chemotherapy,
radiation therapy and surgery.

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Module 4: Blood Disorders

1) Define anemia and outline 4 of its main causes:

a. Iron deficiency
b. Pernicious
c. Folate
d. Red bone marrow disorders
2) Describe the general signs and symptoms of anemia including effects of anemia on the CNS,
heart rate and stroke volume, breathing and the underlying causes of each.
3) Identify 3 other clinical manifestations of anemia.
4) Describe iron deficiency anemia and how this relates to the microcytic, hypochromic
appearance of erythrocytes. Include its main causes and pathogenesis.
5) Describe pernicious anemia and how this relates to the macrocytic, normochromic
appearance of erythrocytes. Include the involvement of intrinsic factor, underlying causes
and etiology, risk factors and clinical manifestations.

6) Describe folate anemia and how this relates to the macrocytic, normochromic appearance
of erythrocytes. Include the underlying causes, individuals at risk and clinical manifestations,
and why this is a serious risk factor in pregnancy.

7) Define polycythemia and differentiate the two etiologies: relative and absolute. Describe
two causes of absolute polycythemia.

8) Outline the clinical manifestations of polycythemia.

9) Define leukocytosis and leucopenia, and outline common causes for each.

10) Define neutrophilia, neutropenia and agranulocytosis and outline common causes for each.

11) Define lymphocytosis and lymphocytopenia and outline common causes.

12) Describe the infective agent, transmission, pathophysiology and clinical manifestations of
infectious mononucleosis.

13) Describe leukemia and leukemic cells in general.

14) Describe the common pathological feature of all leukemias.

15) Identify typical risk factors for leukemia.

16) Define the type of cells that have become malignant in ALL, AML, CLL, CML.

17) Describe the characteristics (clinical manifestations), the evaluation and treatment of acute
leukemias, in general.

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18) Describe the characteristics (clinical manifestations), evaluation and treatment of chronic
leukemias, in general.

19) Determine:
a. which of the leukemias tend to be manifested in children / older individuals.
b. which of the leukemias can be sufficiently slow such that an individual may die of an
unrelated disease.
20) Explain the significance of the Philadelphia chromosome.

21) Define thrombocytopenia and describe its clinical manifestations and common causes.

22) Define petechiae, purpura

23) Define primary and secondary thrombocytosis, their causes and clinical manifestations.

24) Define impaired platelet function: Outline three important causes for the acquired variety
and one type of inherited disorder.

25) Differentiate between inherited and acquired disorders of coagulation and give an example
of each.

26) Describe two causes of inappropriate coagulation and explain why this may lead to
uncontrolled bleeding.

27) Define and describe DIC and two major problems that it can cause.

28) Describe the etiology and underlying pathophysiology of DIC and circumstances that can
precipitate it.

29) Outline the main clinical manifestations of DIC and how can it be treated?

Module 5: Cardiovascular Disorders

1) Describe the pathophysiology of atherosclerosis, including:

a) the blood vessels principally affected.
b) the changes to the blood vessel wall thickness.
c) the resultant effects on blood flow.
d) the etiology underlying these changes.
e)the significance of low density lipoproteins in this disease.
f) predisposing risk factors.

2) Describe the pathophysiology of coronary artery disease (CAD), including:

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a) the relationship between CAD and ischemic heart disease.

b) which regions of the heart muscle are effected by ischemia when there is
obstruction to the:

• Right Coronary Artery.

• Left Anterior Descending Coronary Artery.
• Left Circumflex Coronary Artery.
c) the mechanisms that regulate myocardial blood flow.
d) why the subendocardial region of cardiac muscle is most sensitive to ischemia.
e)why myocardial collateral circulation may be life saving during acute ischemia.
f) the pathogenesis of CAD; that is the gradual series changes within the wall of the
coronary artery that can lead to angina pectoris or myocardial infarction.

3) Define angina pectoris and differentiate between stable angina and unstable angina,
including:
a) the differences in underlying pathology of each condition
b) the distinctive diagnostic clinical features of each condition regarding:

• the nature, pattern and duration of pain.

• the effect of exercise and emotional stress on the signs symptoms.
• the effect of short acting vasodilators such as glycerol trinitrate (GTN) on the signs
and symptoms.
4) Define Acute Coronary Syndrome and be able to describe:
a) differences in underlying pathology regarding:
• Unstable angina,

• Non-ST segment elevation Myocardial Infarction (Non-STEMI)

• ST-segment elevation Myocardial Infarction (STEMI)
b) the distinctive diagnostic clinical features for each above condition regarding:

• the nature, pattern and duration of pain.

• the effect of exercise and emotional stress on the signs symptoms.

• the effect of short acting vasodilators such as glycerol trinitrate (GTN) on the signs
and symptoms.

5) Describe the ECG changes related to myocardial infarction and be able to distinguish
between STEMI and Non-STEMI ECG traces.

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6) Describe the changes in serum cardiac biomarkers in relation to myocardial infarction and
how these are used to differentiate MI from unstable angina from less severe forms of ACS
(i.e., unstable angina).
7) Describe the more general manifestations of ACS [in addition to 4 .II] and explain the
meaning of the term “silent MI”.
8) Define the following normal types of ECG: Sinus rhythm, tachycardia, bradycardia, sinus
arrhythmia.
9) Define the following types of ECG arrhythmias: Atrial fibrillation, heart block, ventricular
fibrillation, ST segment elevation, T-wave inversion, asystole.
10) Describe the purpose of cardio-pulmonary resuscitation (CPR) and defibrillation and identify
the context in which is appropriate to use each in regards to the ECG trace.
11) Identify the three main causes of death through myocardial infarction.
12) Describe the key aspects of care and their rationale during the immediate management of
ACS.
13) Define heart failure and list its main causes and common risk factors.
14) Describe the immediate compensatory effects of moderate heart failure, as in the case of a
myocardial infarction, including:

• the sympathetic nervous system response to a sudden fall in cardiac output.

• the importance of the Frank-Starling mechanism in maintaining cardiac output.

• consequent changes in preload, afterload and blood pressure.

• the mechanism by which these effects can produce peripheral edema.
15) Describe how the renin-angiotensin system as well as angiotensin (ADH) respond to
compensate for the fall in blood pressure (humoral blood pressure control) due to heart
failure.
16) Explain how compensation by sympathetic and humoral mechanisms in response to heart
failure may increase both preload and afterload, further reducing the heart’s pumping
ability – i.e., systolic heart failure.
17) Explain the phrase “decompensated heart failure” and why this may lead to death.
18) Differentiate between systolic vs. diastolic heart failure.
19) Differentiate between left heart failure and right heart failure and describe the clinical
manifestations of each.
20) List the principal treatment interventions for heart failure and outline the rationale for each.
21) Briefly outline the following conditions regarding the underlying pathology, signs, symptoms
and treatment:

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• Pericarditis.

• Cardiomyopathy (dilated and hypertrophic).

• Valvular dysfunctions (regurgitant and stenosis).
• Rheumatic heart disease
22) Define hypertension and differentiate between primary and secondary hypertension.
23) Outline the risk factors, clinical manifestations and treatment of primary hypertension.
24) Define preeclampsia and eclampsia and describe their clinical manifestations and possible
underlying causes.
25) Describe the clinical manifestations and underlying causes of varicose veins.
26) Define chronic venous insufficiency, including its underlying causes and clinical
manifestations.
27) Define deep vein thrombosis and describe its pathogenesis, clinical manifestations and
potentially serious complications.

28) Describe circulatory shock, including:

a) The general definition of shock.
b) The underlying pathogenesis, physiological compensatory mechanisms and clinical
manifestations of the four types of shock:

• Cardiogenic
• Hypovolemic
• Obstructive

• Distributive types: neurogenic, anaphylactic and septic

29) Describe the cellular effects of shock:

• Explain how insufficient ATP and acidosis result in positive feedback loops that
exacerbate shock itself.

30) Outline the specific and general principles in the treatment of shock.

Module 6: Respiratory Disorders

1) Define Chronic Obstructive Pulmonary Disease (COPD) and name the two main underlying
pathological conditions: chronic bronchitis and emphysema.
2) Describe the development and underlying pathophysiology of chronic bronchitis.
3) Describe the development and underlying pathophysiology of emphysema.

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4) Describe the clinical manifestations of chronic bronchitis and emphysema and how to
differentiate the two conditions in diagnosis.
5) Outline principal modes of treatment for COPD.
6) Define or describe common signs and symptoms associated with respiratory disorders,
including: dyspnea, cough, abnormal sputum, hemoptysis, hyperventilation,
hypoventilation, cyanosis, pain, clubbing.
7) Explain why hypercapnia is usually an indication of hypoventilation rather than decreased
pulmonary perfusion.
8) Define hypoxemia and describe three defective mechanisms of oxygenation from which it
may result.
9) Explain what is meant by a “V/Q mismatch” and how low V/Q and high V/Q differ in terms
of their physiological causation.
10) Explain the concept “physiologic right to left shunt” in the context of V/Q mismatch..
11) Explain the concept of anatomical right to left shunting and describe one possible etiology
for this condition.
12) Define acute respiratory failure.
13) Outline common causes of acute respiratory failure.
14) Describe the ways in which a failure of ventilation differs from a failure in gas exchange
across the respiratory membrane, in terms of alterations of blood gasses and the type of
clinical intervention (treatment) required.
15) Define the following disorders of the chest wall and pleura: Flail chest, pneumothorax,
pleural effusion, empyema.
16) Define the following restrictive lung disorders: Atelectasis, bronchiectasis, pulmonary
edema.
17) Describe how the underlying pathophysiology of pulmonary edema can lead to a reduction
in the rate of oxygen diffusion into the blood resulting in hypoxemia.
18) Define acute respiratory distress syndrome (ARDS) and list its common causes.
19) Describe the pathogenesis of ARDS and how this results in damage to alveoli leading to
hypoxemia, including:

• the role of inflammatory cells and chemical mediators in the early stages
• fibrosis of the alveoli as inflammation progresses
20) Describe the effect ARDS has on lung function and treatment goals in its early stage
management.
21) Define pulmonary embolism (PE) and outline the origin and progress of a thrombolytic
embolism from a deep vein.

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22) List and explain the clinical manifestations of PE.

23) Define pulmonary hypertension, its causes and its possible pathological outcomes.
24) Define cor pulmonale, its causes and possible pathological outcomes.
25) Define the childhood condition of croup, list its possible causes and outline its clinical signs
and symptoms.
26) Briefly define: bronchiolitis, epiglottitis and respiratory distress syndrome.
27) Define bronchial asthma and describe the following:

• The underlying type of hypersensitivity mechanism

• The sequence of pathological events in the early phase
• The sequence of pathological events in the late phase
28) Explain how airway obstruction in asthma may initially produce hypocapnia and respiratory
alkalosis, but that may progress to hypercapnia and respiratory acidosis.

Module 7: Gastrointestinal Disorders

1) Define gastroesophageal reflux disease (GERD) and describe its underlying causes, signs and
symptoms.
2) Describe peptic ulcer disease, outline its risk factors, and differentiate between gastric ulcer
and duodenal ulcer regarding location and clinical manifestations.
3) Describe the pathophysiology of peptic ulcers, including the two most common causes:
NSAIDs (non-steroidal anti-inflammatory drugs) and Helicobacter pylori infection.
4) Outline the main treatment options for peptic ulcer.
5) Define inflammatory bowel disease and describe and differentiate between the two forms:
Crohn’s Disease and ulcerative colitis, including:

• typical age range affected

• regions of the bowel affected and the nature of the inflammatory process
• the gross and histological appearance of the inflamed tissues

• associated risk factors:

• clinical manifestations
• possible complications
6) Define Celiac disease and describe its underlying pathophysiology.

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7) Describe the clinical manifestations of celiac disease and the consequences of

malabsorption of nutrients in childhood and adulthood.
8) Define acute hepatitis and outline some of its common causes and diagnostic features.
9) Outline the typical causative agents (microbes) of viral hepatitis, the routes of transmission
and means of diagnosis.
10) List the potential complications of viral hepatitis, the viral strains implicated and why co-
infection is more serious.
11) Describe the three stages of viral hepatitis and their clinical manifestations.
12) Define chronic viral hepatitis and list other liver diseases for which this is a risk factor.
13) Define liver cirrhosis and outline some of the underlying diseases that may produce it.
14) Explain why cirrhosis is a multiple system disease.
15) Describe the pathology of cirrhosis, in terms of hepatic structural changes at the gross and
cellular level, and their consequence to normal liver functions.
16) Define liver failure and describe its clinical manifestations.
17) Define cholelithiasis and cholesystitis and describe the two main types of gallstone.
18) Outline the clinical manifestations of cholelithiasis and the significance of the presence of
jaundice in the diagnosis.
19) Define and describe acute pancreatitis, its manifestation, associated diseases and
underlying pathophysiology.
20) Define and describe chronic pancreatitis, its clinical manifestations and its most common
cause.
21) Describe the underlying pathophysiology and clinical manifestations of the following
complications of liver disorders:
1. Portal hypertension
2. Ascites
3. Hepatic encephalopathy
4. Jaundice (icterus)
5. Splenomegaly

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Module 8: Endocrine Disorders

1) Define prediabetes and outline how insulin imbalances may arise that produce this
condition.
2) Define the three key clinical manifestations of diabetes mellitus – the “three Ps”.
3) Define type 1 diabetes and describe the pathogenesis of the disease.
4) Describe the clinical manifestations of type 1 diabetes, including laboratory tests used to
confirm the diagnosis.
5) Define type 2 diabetes, outline its risk factors and describe its pathogenesis.
6) Define insulin resistance, and explain the mechanisms related to obesity that underlie its
development.
7) Describe the clinical manifestations of type 2 diabetes, including diagnostic laboratory tests.
8) Define metabolic syndrome.
9) Describe the following five acute complications of diabetes mellitus, including underlying
causation, clinical manifestations and treatment (if appropriate).
• Hypoglycemia

• Diabetic ketoacidosis
• Somogii effect
• Dawn phenomenon
• Hyperosmolar hypoglycemic state
10) Describe the following chronic complications of diabetes mellitus, including the underlying
pathological effects of chronic hyperglycemia and its clinical manifestations:

• Diabetic retinopathy

• Diabetic nephropathy
• Diabetic neuropathy
• Infection

• Macrovascular disorders (e.g., atherosclerosis, coronary artery disease, stroke)

11) Outline the general causes of endocrine system disorders.
12) Describe the three categories of endocrine disorders.
13) Explain the two general causes of hypothalamic-pituitary system dysfunction.
14) Define diabetes insipidus and outline its causation and clinical manifestations.

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15) Define SIADH (syndrome of inappropriate antidiuretic hormone secretion) and outline its
most common causes and clinical manifestations.
16) Describe hypopituitarism of the anterior pituitary, its general causes and common
manifestations.
17) Define hypothyroidism and describe its common primary and secondary pathophysiological
causes and typical clinical manifestations.
18) Define hyperthyroidism and describe its common primary and secondary pathophysiological
causes and typical clinical manifestations.
19) Define Grave’s disease and Hashimoto’s disease.
20) Define adrenal cortical insufficiency and describe its common primary and secondary
pathophysiological causes and typical clinical manifestations.
21) Define Addison’s disease.
22) Define hyperthyroidism and describe its common primary and secondary pathophysiological
causes and typical clinical manifestations.
23) Describe the three main forms of glucocorticoid hormone excess, its clinical manifestations,
and differentiate between Cushing’s disease and Cushing syndrome.

Module 9: Neurological Disorders

1) List the three main mechanisms of cerebrovascular disease and define the term “stroke” or
“brain attack”.
2) What immediate important effects does a stoke have on brain tissue.
3) Describe and differentiate between an ischemic stroke, a cardiogenic stroke and a
hemorrhagic stroke including:
• underlying pathophysiology

• clinical manifestations
4) Explain why hemorrhagic stokes may be especially serious, including effects resulting from
large bleeds on the brain as a whole.
5) List the most frequent sites of arterial and cardiac abnormalities causing ischemic strokes
and differentiate between large vessel and small vessel ischemic strokes in terms of the
regions of the brain usually affected and the clinical manifestations produces.
6) List the common risk factors and long term deficits of stroke.
7) Describe transient ischemic attack (TIA), including its typical diagnostic signs and symptoms
and what it may be a risk factor for.

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8) Describe the two main stages of traumatic brain injury.

9) Outline the two forms of primary traumatic brain injury and what factor of injury
distinguishes an open from a closed head injury.
10) Describe the two types of primary brain damage that either open or closed head injuries
can produce.
11) Define and explain the coup-contrecoup pattern of primary focal brain injury.
12) Describe the immediate clinical manifestation of a primary brain contusion.
13) Define hematoma and differentiate the probable bleeding pattern of epidural from
subdural hematomas.
14) Define increased intracranial pressure (ICP) and explain why it is the most serious (short
term) secondary effect of primary head injury (e.g., contusions, hematoma, diffuse axonal
injury) and explain why post-trauma clinical observations are important even though a
patient may initially be conscious and lucid.
15) List the three main tissues that are displaced in response to increased ICP.
16) Describe the four stages of increased ICP, including:

• how changes in ICP affects cerebral perfusion (blood flow in the brain)
• what is meant by “compensatory mechanisms”
• mental status: i.e., behavior and levels of consciousness
• blood pressure, heart rate, respiration and body temperature
• pupil size and response to light
• brain herniation

• the point at which cerebral blood flow ceases (and why)

17) Define cerebral edema, list its major causes and describe its pathogenesis.
18) Define hydrocephalus and outline its three main causes.
19) Define diffuse axonal injury (DAI) and describe its primary causes and underlying pathology.
20) Describe the five varying grades of severity of DAI, including its short-term clinical
manifestations and possible long-term outcomes for brain function.
21) Describe the five main modalities used to assess levels of arousal, the means by which this
may be done and how these may indicate the extent or level of brain damage.
22) Define the following potential cognitive deficits that may result from brain injury: agnosia,
dysphasia, Broca’s aphasia, Wernike’s aphasia.
23) List the specific clinical criteria required to determine brain death.
24) Differentiate brain death from persistent vegetative state.

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25) Describe the three characteristics alterations in motor function that may arise from
disruptions in the nervous system:

• alterations in muscle tone

• alterations in movement

• alterations in complex movement (posture, gait and expression)

26) Describe and contrast upper motor neuron with lower motor neuron lesions and the type of
paralysis that may manifest in each.
27) Describe and contrast decorticate posture with decerebrate posture in terms of their clinical
presentation and the type of lesions with which they are associated.
28) Define seizure and describe how they may present clinically.
29) Describe Parkinson’s disease, including its underlying pathophysiology and three cardinal
symptoms.
30) Describe Altzheimer’s disease, including its underlying pathophysiology and three cardinal
symptoms.

Module 10: Excretory and Electrolyte Disorders

1) Define urinary tract obstructions and outline the common causes and sites of obstruction.
2) State the two most damaging effects of urinary tract obstruction and outline their
pathogenesis.
3) Describe renal calculi, including the risk factors or conditions that may predispose to their
formation, their clinical manifestations, diagnosis and treatment.
4) Describe how lower urinary tract obstructions - neurogenic bladder, enlarged prostrate and
urethral scaring - may alter the storage and emptying of urine.
5) Define glomerulonephritis and describe the pathophysiology of two of its common causes:
acute post-infectious glomerulonephritis and Goodpasture syndrome.
6) Describe and contrast nephritic syndrome with nephrotic syndrome.
7) Describe the pathophysiology of nephrotic syndrome, in particular the reasons why this
typically manifests in systemic edema and hyperlipidemia.
8) Define acute renal failure (a.k.a. acute kidney failure) and how this may manifest clinically.
9) Explain the RIFLE classification of acute renal failure and be able to estimate the GFR and
urine output for risk or injury categories in a patient of known body weight.
10) Define plasma creatinine concentration and blood urea nitrogen (BUN) and how these
reflect alterations in kidney function.

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11) Define and describe the three categories of causes of acute renal failure, their common
causes and treatment goals.
12) Define chronic kidney disease (CKD) and what this represents in terms of kidney function
and the risk factors associated with its development.
13) Define the intact nephron hypothesis and explain why symptoms for CKD are not apparent
until only 25% or less functional nephrons remain.
14) Describe potential clinical manifestations of CKD and how each relates to alterations in
kidney function.
15) Describe the pathophysiological effects CKD has on the following body systems:
hematologic, cardiovascular, pulmonary, immune, neurologic, gastrointestinal, endocrine
and reproductive.
16) Outline the evaluation and treatment of CKD.
17) Describe the importance and regulation of sodium balance in the body.
18) Define hypernatremia and describe its causes, pathophysiological effects and clinical
manifestations.
19) Define hyponatremia and describe its causes, pathophysiological effects and clinical
manifestations.
20) Define hyperkalemia and describe its causes, pathophysiological effects and clinical
manifestations.
21) Describe the underlying mechanism where by metabolic acidosis may produce
hyperkalemia.
22) Define hypokalemia and describe its causes, pathophysiological effects and clinical
manifestations.
23) Define hypercalcemia and describe its pathophysiological effects and clinical manifestations.
24) Define hypocalcaemia and describe its pathophysiological effects and clinical
manifestations.
25) Explain the mechanism by which hypocalcaemia increases excitability in muscle and nerve.
26) Define hypermagnesemia and describe its pathophysiological effects and clinical
manifestations.
27) Define hypomagnesemia and describe its pathophysiological effects and clinical
manifestations.
28) Describe how the three compensatory mechanisms – chemical buffers, the pulmonary and
renal systems - manage changes in arterial blood pH in order to maintain homeostatic
equilibrium.

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29) Describe the four categories of acid-base disturbances, including their common causes and
clinical manifestations.
30) List the normal range values for arterial blood pH, PaCO2, HCO3-, PaO2 and O2 saturation.
31) Define the terms compensation, partial compensation, and fully compensated in relation to
acid-base disturbances.
32) Explain the concept of primary acid-base disturbance and how this is reflected by changes in
bicarbonate and carbon dioxide for metabolic vs. respiratory acidosis and alkalosis.
33) List the primary acid-base disturbances in terms of changes in PCO2 and bicarbonate.
34) Be able to interpret from arterial pH and blood gas results (PaCO2, HCO3-, PaO2) whether a
primary acid-base disturbance is: metabolic acidosis, metabolic alkalosis, respiratory
acidosis or respiratory alkalosis.
35) Explain how the concept of anion gap in metabolic acidosis is used determine the
underlying cause of the disturbance, i.e., increased metabolic acids vs. a pathological loss of
bicarbonate ions.

Module 11a: Musculoskeletal System Disorders

1) Define the following classification of fractures:

• Complete: Comminuted, spiral, transverse, oblique, linear.
• Incomplete: Greenstick, torus, bowing.
• Open, closed.
2) Describe the three causal classifications of fractures.
3) Outline the six stages of fracture healing.
4) Define dislocation and subluxation and where these are most likely to occur.
5) Define kyphosis, lordosis and scoliosis and name one cause for each.
6) Define sprain, avulsion and strain and where these are most likely to occur.
7) Define osteoporosis, and the general process that leads to this condition.
8) Name four hormones that can affect bone density and how their influence is possible.
9) Describe differences in male and female bone density and the age at which peak bone
density occurs.
10) Name the hormone linked to post-menopausal osteoporosis and describe how this
hormone affects bone density?
11) Describe two differences between men and women that result in men developing
osteoporosis later in life.

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12) What are four risk factors associated with osteoporosis?

13) Name three clinical manifestations of osteoporosis
14) Define osteomyelitis and describe the etiology and pathogenesis of each:

• Exogenous osteomyelitis
• Hematogenous osteomyelitis
15) What is the primary causative organism for osteomyelitis?
16) Describe the pathogenesis of hematogenous osteomyelitis in children and how this
condition differs in adults.
17) Outline the clinical manifestations of osteomyelitis.
18) Define osteoarthritis, outline its primary and secondary causes, and describe where the
condition usually occurs in the body.
19) Describe the pathological changes that occur to joints during the development of
osteoarthritis.
20) Describe the clinical manifestations of osteoarthritis, including the causes of joint
enlargement and how this affects joint function.
21) Define rheumatoid arthritis and outline how it differs in etiology from osteoarthritis.
22) Describe the underlying pathogenesis of rheumatoid arthritis, the role played by the
immune system and the significance of rheumatoid factor.
23) Describe the pathogenesis of joint destruction in rheumatoid arthritis, including the
inflammatory processes involved.
24) Define pannus and describe its role in the process of joint destruction of rheumatoid
arthritis.
25) Outline the clinical manifestations of rheumatoid arthritis, and compare and contrast the
condition with that of osteoarthritis.
26) Define ankylosing spondylitis, including how it is manifested and probable underlying
pathogenesis.
27) Define equinovarus, including how it is manifested and probable causation.
28) Define dysplasia of the hip, including how it is manifested and probable causation.

Module 11b: Reproductive System Disorders

1) Define the terms primary and secondary dysmenorrhea and amenorrhea.

2) Define anovulatory cycle

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3) Define dysfunctional uttering bleeding (DUB) and describe its underlying causation and
manifestations in relation to anovulatory cycles.
4) Define retrograde mensuration.
5) Define endometriosis, including its possible etiology and manifestations.
6) Describe cervical cancer, including its cause, associated risk factors and detection.
7) Describe endometrial cancer, including its incidence and associated risk factors.
8) Describe ovarian cancer, including its incidence and prognosis, associated risk factors and
detection.
9) Define the following terms in relation to breast disorders: galactorrhoea, mastitis, ductal
disorders, intraductal papillomas.
10) Regarding benign breast tumours, outline the terms fibrodenoma and “fibrocystic changes”,
including appearance, age occurrence, and manifestation.
11) Outline the incidence, pathogenesis and initial manifestation breast cancer.
12) Describe six risk factors associated with breast cancer.
13) Regarding disorders of the male reproductive system, define the following terms:
cryptorchidism, hydrocele, varicocele.
14) Describe torsion of the testis, including its common causes, manifestation and treatment.
15) Describe “benign prostatic hyperplasia” (BPH) including its incidence and manifestation.
16) Describe cancer of the prostate gland, including risk factors, detection, location and
manifestations.

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