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Which of the following is considered a systemic sign of disease?

fever

Pathophysiology involves the study of:

functional or structural changes resulting from disease processes

A 17-year-old college-bound student receives a vaccine against an organism that causes meningitis. This is an example of

primary prevention

Which term describes an abatement or decline in disease manifestations:

Remission

Most homeostatic mechanisms function via positive feedback loops.

false

Which of the following is a statement about disease pathogenesis?

Streptococcal infection activates immune cells, leading to inflammation.

After suffering a heart attack, a middle-aged man is counseled to take a cholesterol-lowering medication. This is an example of

tertiary prevention

In addition to disease or illness, which of the following factors may cause variations in physiologic parameters?

all of the above

Which of the following would be the most likely cause of an iatrogenic disease?

an unwanted effect of a prescribed drug

Which of the following is the best definition of epidemiology?

the science of tracking the occurrence and distribution of diseases

Chaperone proteins (heat-shock proteins) help misfolded proteins refold correctly.

True

Necrotic death of brain tissue usually produces _____ necrosis.

liquefactive

In general, aging tissues are less capable of

...

A high serum lactate level (lactic acidosis) usually indicates the presence of

cellular hypoxia

The mechanism of radiation-induced injury includes all of the following except

...

Injury that occurs when blood flow is restored to previously ischemic tissues is called _____ injury.

reperfusion

Which of the following cellular responses is indicative of injury due to faulty metabolism?

Intracellular accumulations

A change in a tissue marked by cells that vary in size and shape and show increased mitotic figures would be called:

dysplasia

Metaplasia is an irreversible process.

false

Down syndrome is an example of a/an:

chromosomal disorder

What information should parents be given about the consequences of PKU?

Failure to avoid phenylalanine results in progressive mental retardation.

Trisomy 18 is also called Down syndrome.

false

Genotype refers to the specific set of gene alleles an individual possesses.

true

A fetus is most vulnerable to environmental teratogens during

the first trimester

A frameshift mutation usually causes a single base pair substitution.

false

Characteristics of Autosomal recessive disorders include all of the following EXCEPT:

The mating of a carrier and an affected individual results in a 25% chance of producing an affected offspring

All of the following characteristics are true about Autosomal Dominant disorders EXCEPT:

The mating of a normal and an affected individual results in a 25% chance of producing an affected offspring

A spontaneous alteration in genetic material that may result from exposure to harmful substances is termed:

mutation

Recessive gene traits are expressed when an individual is homozygous for the gene.

true

After surgery to remove a lung tumor, G.P. is scheduled for chemotherapy, which will

kill rapidly dividing cells.

Inactivation of tumor suppressor genes occurs in most types of cancer.

true

G.P. is diagnosed with primary bronchial carcinoma and she is scheduled for a staging procedure. She wants to know what that means. Which response is correct?

It is a procedure for determining the extent of tumor spread.

A classification process that applies to a specific malignant tumor and describes the extent of the disease at a given time is called:

staging

Which of the following is a characteristic of a benign tumor?

Cells appear relatively normal.

What is a benign neoplasm originating from adipose tissue called?

Lipoma

The warning signs for cancer include:

all of the above

Generally the higher a tumor's grade, the higher its malignant potential.

true

High risk factors for cancer include: 1. human papilloma virus. 2. chronic irritation and inflammation. 3. repeated sun exposure. 4. high family incidence.

1,2,3,4

Familial retinoblastoma involves the transmission of which of the following from parent to offspring?

Mutant tumor suppressor gene

Chemical mediators released during the inflammatory response include:

histamine and prostaglandins

The inflammatory response is a nonspecific response to:

any tissue injury

In a primary immune response, activated B cells produce mostly

IgM

What is the correct sequence involved with the inflammatory response? (1) increased vascular permeability, (2) phagocytosis, (3) emigration of leukocytes

1,3,2

Activation of the complement cascade results in

inflammation.

Each B lymphocyte is able to bind to and produce antibody against only one specific antigen.

true

Clonal expansion of B lymphocytes upon first exposure to antigen requires T helper stimulation.

true

Which of the following immune reactions does not require participation by specific immune cells (lymphocytes)?

Phagocytosis of antigen by macrophage

Inflammation is said to be nonspecific because

the inflammatory reaction is similar regardless of cause.

Antigen-presenting cells function to

display foreign antigen on their cell surfaces bound to MHC.

Which of the following hypersensitivity type reactions is NOT mediated by antibodies?

Type IV

J.B. developed an opportunistic infection that is to be managed with an antibiotic. J.B. has received this antibiotic once previously with no adverse reactions. Which of the following statements should guide administration of the drug this time?

Anaphylaxis is antibody mediated and may occur on second exposure.

Delayed-type hypersensitivity reactions require participation by T lymphocytes.

true

Type II hypersensitivity reactions are also called immune complex reactions.

false

Dramatic hypotension sometimes accompanies type I hypersensitivity reactions because

massive histamine release from mast cells leads to vasodilation.

Distinguishing clinical features of systemic lupus erythematosus include:

inflammation in multiple organs

A woman, aged 23, has developed a skin rash as well as nausea and vomiting, after taking an antimicrobial drug for a short time. The skin rash is red and quite itchy and is spreading over her entire body. The physician stops the medication because of this allergic reaction. The patient has also had hay fever during the summer and fall for the past few years and recently has demonstrated a severe reaction on several occasions to insect bites. What kind of hypersensitivity are these allergic reactions?

type 1

Which of the following disorders is associated with a type III hypersensitivity mechanism of injury?

Systemic lupus erythematosus

Mast cells bind to the Fc portion of IgE antibodies.

true

In which of the following patients would administration of RhoGAM (an Rh antibody) be appropriate?

...

Predisposing factors to leukemia commonly include:

exposure to radiation

Spontaneous conversion to acute myeloid leukemia (AML) may occur with polycythemia vera, chronic myeloid leukemia, and essential thrombocythemia.

true

Polycythemia vera is a myeloid neoplasm.

true

Which of the following is typical of Hodgkin's disease?

initial tumor is single, painless, enlarged lymph node, often cervical

Which of the following applies to the leukemias?

Chronic leukemias are more common in older people.

Non-Hodgkin lymphoma tends to spread in a predictable pattern.

false

Multiple myeloma is a malignant tumor involving:

plasma cells

While in the hospital for management of ALL, J.B. developed severe thrombocytopenia. The most appropriate action for this condition would be

...

Plasma cell myeloma is a myeloid neoplasm.

true

Fluid and diuretic therapy are used in the management of plasma cell myeloma to

...

A factor associated with risk of Down syndrome is

maternal age

A spontaneous alteration in genetic material that may result from exposure to harmful substances is termed:

mutation

What is characteristic of a congenital disorder?

Usually manifested in the neonatal period.

DNA mutation is a rare event because of DNA repair mechanisms.

true

Which of the following statements regarding Down syndrome is TRUE?

The typical physical characteristics are present at birth.

Which of the following types of inherited disorders can have carriers of the defective trait? (1) Autosomal Dominant; (2) Autosomal Recessive; (3) X linked; (4) Y linked

2,3

Which of the following is the most common chromosomal disorder that is the leading cause of mental retardation in newborns and is associated with an increased risk due to maternal age?

Trisomy 21

Turner syndrome and Klinefelter syndrome are examples of sex chromosome disorders.

true

A point mutation

involves the substitution of a single base pair.

Characteristics of X-linked recessive disorders include which of the following?

All daughters of affected fathers are carriers.

Remission for cancer is generally defined as a period in which:

signs and symptoms are absent

Cancer cells have a higher mutation rate than normal cells.

true

G.P. is diagnosed with primary bronchial carcinoma and she is scheduled for a staging procedure. She wants to know what that means. Which response is correct?

It is a procedure for determining the extent of tumor spread.

What is a benign neoplasm originating from adipose tissue called?

Lipoma

Cancers arise from stem cells present in tissues.

true

The most critical adverse effects of chemotherapy and radiation therapy are:

thrombocytopenia and leucopenia

One reason for staging a malignant tumor at the time of diagnosis is to:

determine the best treatment and the prognosis

Proto-oncogenes are normal cellular genes.

true

Why is excessive bleeding a common occurrence with acute leukemia?

decreased platelets

J.B. is a 12-year-old boy with ALL. As part of J.B.'s treatment, he must undergo several weeks of chemotherapy. The most serious complication of chemotherapy is

nausea and vomiting.

A diagnostic laboratory finding in plasma cell myeloma is

Bence Jones proteins in the urine.

In general, the best prognosis for long-term disease-free survival occurs with

ALL

The difference between leukemia and lymphoma is that of disease stage.

true

Nearly all cases of which form of leukemia demonstrate the presence of the Philadelphia chromosome?

CML

J.B. is a 12-year-old boy with acute lymphoblastic leukemia (ALL). Manifestations of J.B.'s leukemia prior to treatment would include all of the following except

leukopenia

The major cause of death from leukemic disease is

infection

Which of the following types of leukemia primarily affects children?

ALL

Etiology is defined as the study of the:

causes of a disease

Individuals experiencing the same disease process exhibit the same clinical manifestations.

False

An obese but otherwise healthy teen is given a prescription for a low-calorie diet and exercise program. This is an example of

...

Ubiquitin is a protein that attaches to cellular proteins and targets them to the lysosomes.

false

To which of the following does the term apoptosis refer?

preprogrammed cell self-destruction

Cellular accumulation of water occurs with Na+- K+ pump dysfunction.

true

Gangrene is a term applied to large areas of necrotic tissue.

true

Apoptosis is a process that results in cellular

death

Which of the following are common manifestations of Down syndrome? 1. congenital heart defect. 2. cleft lip and palate. 3. large protruding tongue.4. limited intellectual development.

1,3,4

An affected male with Cystic Fibrosis is concerned about having a child with a carrier female. What is the probability that their child will be affected?

50%

A father affected with hemophilia A, whose wife is unaffected, will pass on the defective gene to:

all his daughters, who will be carriers

Children with PKU must avoid phenylalanine in the diet. Phenylalanine is most likely to be a component of

protein

Side effects of chemotherapy include all the following except

leukocytosis.

What would be an external source of ionizing radiation?

gamma rays delivered by a cobalt machine

The process of carcinogenesis usually begins with:

...

After bronchoscopy and histologic examination of a suspected tumor, G.P. is diagnosed with primary bronchial carcinoma. Thus, the tumor

malignant

Cancer is a multistep process usually occurring over many years. The first step in the initiation process is thought to be caused by

genetic mutations in growth regulatory genes.

Radiation therapy destroys:

primarily rapidly dividing cells

Which of the following white blood cells is characterized by the presence of a CD8 receptor on it's surface?

Cytotoxic T cell

The classical pathway for activation of the complement cascade requires

antibodies

What is the correct order of the following events in the inflammatory response immediately after tissue injury? 1. increased permeability of blood vessels. 2. dilation of blood vessels. 3. transient vasoconstriction. 4. migration of leukocytes to the area. 5. hyperemia.

3,2,5,1,4

Clonal deletion refers to

destruction of self-reacting B and T lymphocytes.

For T helper cells to bind to a foreign antigen, the antigen must first be processed by an antigen-presenting cell.

true

T lymphocytes are activated primarily by free viruses.

false

Macrophages develop from monocytes in various tissues contained within the mononuclear phagocyte system. Macrophages found in the joints of the body are called:

Synovial A cells

Which of the following immunodeficiency diseases is attributed to a genetic defect in enzyme function?

Severe combined immunodeficiency (SCID)

Certain autoimmune diseases are associated with the presence of specific proteins on a person's cells. These proteins are called _____ proteins.

HLA MHC

Excessive production of which T-helper cytokine has been implicated in the development of type I hypersensitivity.

IL-4

Which of the following disorders is considered a primary immunodeficiency disease?

HIV/AIDS

A child with a history of recent strep throat infection develops glomerulonephritis. This is most likely to be a type _____ hypersensitivity reaction.

III

Immunoglobulins produced by malignant plasma cells are monoclonal.

true

Which of the following is a correct definition of complete remission (CR) of leukemia?

CR is less than 5% blasts in marrow and normal CBC values.

What is the primary treatment for the leukemias?

Chemotherapy

Chronic bronchitis patients will typically have a slight cough that is most noticeable in the evenings.

false

Widespread pulmonary hypoxemia increases right ventricular workload and may lead to cor pulmonale.

true

Susie is a 6 year old girl brought into the clinic by her mother for episodes of difficulty breathing. The mother reports that Susie has had a hard time exercising at school because she gets so short of breath. There is a family history of allergies. Auscultation of Susie's lungs reveal expiratory wheezing. Susie's eyes are red and itchy, and she has swollen nasal mucosa. A preliminary diagnosis of asthma is made. Asthma is characterized as:

a reversible obstructive pulmonary disorder

Patients with emphysema should not be given supplemental oxygen.

false

Acute and chronic bronchitis differ in which of the following ways?

chronic bronchitis results in airway changes that are irreversible

To further evaluate the diagnosis of asthma, a child has pulmonary function tests. Which test result is consistent with a diagnosis of asthma?

Reduced forced expiratory volume in 1 second (FEV1)

After evaluation, a child's asthma is characterized as "extrinsic." This means that the asthma is`

associated with specific allergic triggers.

Patients with chronic bronchitis usually maintain a normal PaO2 and PaCO2 until late in the course of the disease.

false

Asthma is categorized as

a reversible obstructive pulmonary disorder

Obstructive disorders are associated with which pulmonary function test result?

Low expiratory flow rates

Patients with restrictive chest wall disorders usually exhibit

tachypnea

Which of the following serum electrolyte values is abnormal?

Calcium 10.0 mEq/L

The best indicator of extracellular (saline) volume status would be

weight change

Which of the following statements best describes the pathophysiologic process of hypernatremia?

Increased extracellular osmolality leads to cellular shriveling.

Manifestations of magnesium imbalance are attributed to:

altered release of neurotransmitter at the neuromuscular junction

Decreased neuromuscular excitability can be seen in which two electrolyte disorders?

Hypercalcemia and hypermagnesemia

Filtration and diffusion are passive mechanisms of capillary transport.

true

Orthostatic hypotension is a manifestation of saline deficit.

true

Muscle weakness may be a symptom of all of the following electrolyte disturbances except:

hyperphosphatemia

C.G. is a 42-year-old patient with type 1 diabetes that is normally well controlled with insulin. Three days ago, she developed a viral infection with high fever and has not been checking her blood glucose regularly. She is now in the emergency department complaining of abdominal pain and flu symptoms. C.G.'s urine is positive for glucose and ketones, and serum glucose and blood gases are obtained. What fluid balance problem is C.G. at risk for secondary to glycosuria?

water deficit or saline excess

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