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365 terms

Pathophysiology

STUDY
PLAY
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
If an individual with normal fluid balance is given 2 L of normal saline, how will this fluid distribute in the body (assuming no excretion)?
all extracellular
A person who chronically hypoventilates will have a higher than normal concentration of bicarbonate in the blood.
true
Loss of upper GI contents (e.g., vomiting) may lead to metabolic acid excess, whereas loss of lower GI contents (e.g., diarrhea) may lead to metabolic acid deficit.
false
In response to a chronically elevated PaCO2, the kidneys would be expected to compensate by:
...
In which of the following cases would administration of bicarbonate be most appropriate?
...
The kidneys are able to convert CO2 and water to bicarbonate and hydrogen ions.
true
In which of the following acid-base disturbances would compensation occur most quickly?
...
Joe is a 24 year old who is brought to the emergency department by a friend. The friend reports that Joe was on the lake all day in a boat and then developed severe headache and vomiting in the evening. He has been unable to keep down any fluids, and he is warm and flushed with a temperature of 102 degrees F. He has not urinated in the last 16 hours. For which acid-base disorder is Joe at risk if his vomiting continues for a prolonged period of time?
...
Metabolic acidosis is evident on an arterial blood gas sample when both pH and bicarbonate ion are lower than normal.
true
Which of the following arterial blood gases indicates a compensated respiratory acidosis?
pH 7.36, PaCO2 55, HCO3- 30
Copious, foul-smelling respiratory secretions are generally associated with
bronchiectasis.
Chronic bronchitis is defined as a chronic productive cough for at least 6 months for three or more consecutive years.
false
Emphysema decreases the surface area available for gas exchange.
true
Asthma is caused by airway inflammation.
true
Obstructive disorders are associated with which pulmonary function test result?
low expiratory flow rates
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)
Patients with chronic bronchitis usually maintain a normal PaO2 and PaCO2 until late in the course of the disease.
false
Chronic bronchitis occurs most commonly in association with long-term cigarette smoking.
true
Emphysema results from destruction of alveolar walls and capillaries, which is due to
release of proteolytic enzymes from immune cells.
Hyperresponsiveness of airway mast cells to inhaled antigens occurs with extrinsic asthma.
true
Early emphysema is characterized by a chronic productive cough and increased PaCO2.
false
Viral pneumonia is characterized by
a dry cough.
The presence of a Ghon tubercle in a patient's lung is indicative of acute respiratory distress syndrome.
false
Infants born prematurely may develop infant respiratory distress syndrome because their production of surfactant is insufficient.
true
Occupational lung diseases are also called pneumoconioses.
true
Restrictive diseases are characterized by small tidal volumes and faster respiratory rates.
true
The characteristic x-ray findings in tuberculosis include
Ghon tubules
A lack of surfactant as occurs with acute respiratory distress syndrome causes airway collapse and hyperinflation of alveoli.
false
A pleural effusion may develop when a patient with liver disease is unable to synthesize adequate amounts of albumin. This would result in fluid movement from the vascular bed into the pleural space because of:
decreased pleural capillary oncotic pressure
A patient with a productive cough and a localized area of infiltrate or atelectasis on x-ray probably has
bacterial pneumonia.
Which of the following would be indicative of a left tension pneumothorax?
Absent breath sounds on the left
The hypoxia associated with acute respiratory distress syndrome responds well to supplemental oxygen.
false
Noncardiogenic pulmonary edema occurs when inflammatory exudate leaks into the alveoli.
true
Deposition of antigen-antibody complexes in the lung after inhalation of organic particles occurs with hypersensitivity pneumonitis.
true
Manifestations of magnesium imbalance are attributed to:
altered release of neurotransmitter at the neuromuscular junction
Abnormalities in intracellular regulation of enzyme activity and cellular production of ATP are associated with
hypophosphatemia.
Patients with pure saline deficit have normal serum sodium concentrations.
true
A 14-month-old girl is brought to urgent care by her parents for persistent fever, vomiting, and diarrhea. Upon questioning, the parents report that the child has had only one to two wet diapers per day for the last 2 days. The child's weight is noted to be 2 pounds less than her normal weight. This is equivalent to approximately how much fluid loss?
one liter
Which of the following is likely to lead to hyponatremia?
Frequent nasogastric tube irrigation with water
After a patient has received fluid therapy for several hours, her supine and standing heart rate and blood pressure are recorded. Which of the following results indicates a need for further therapy?
Supine HR 88, BP 100/80; standing HR 110, BP 98/78
One liter of fluid weighs about one pound.
false
Causes of calcium imbalance do NOT include
chronic alcoholism
Saline deficit is defined as:
a deficit of extracellular volume
Orthostatic hypotension is a manifestation of saline deficit.
true
The primary force promoting fluid movement from the capillary to the interstitium is capillary oncotic pressure.
false
A person who chronically hypoventilates will have a higher than normal concentration of bicarbonate in the blood.
true
Joe is a 24 year old who is brought to the emergency department by a friend. The friend reports that Joe was on the lake all day in a boat and then developed severe headache and vomiting in the evening. He has been unable to keep down any fluids, and he is warm and flushed with a temperature of 102 degrees F. He has not urinated in the last 16 hours. For which acid-base disorder is Joe at risk if his vomiting continues for a prolonged period of time?
metabolic alkalosis
Administration of sodium bicarbonate to a patient with acidosis will
increase formation of carbon dioxide in the blood.
The kidneys are able to convert CO2 and water to bicarbonate and hydrogen ions.
true
The role of the lungs in maintaining acid-base balance includes:
elimination of carbonic acid
Diarrhea and other lower intestinal fluid losses will contribute to
metabolic acidosis
A person who experiences a panic attack and develops hyperventilation symptoms may experience
numbness and tingling in the extremeties
A person with respiratory acidosis can compensate for the disorder by hyperventilating.
false
Which of the following arterial blood gases indicates a compensated respiratory acidosis?
pH 7.36, PaCO2 55, HCO3- 30
Evaluate the following laboratory value, PaCO2 30 mm Hg:
low
The body compensates for metabolic alkalosis by
hypoventilation
A person can have acidosis but not exhibit acidemia.
true
Asthma is categorized as
a reversible obstructive pulmonary disorder.
Chronic bronchitis patients will typically have a slight cough that is most noticeable in the evenings.
false
After evaluation, a child's asthma is characterized as "extrinsic." This means that the asthma is
associated with specific allergies
Acute and chronic bronchitis differ in which of the following ways?
chronic bronchitis results in airway changes that are irreversible
A child is taken to the emergency department with severe dyspnea. A blood gas reveals the following values: pH = 7.45; PaCO2 = 35; HCO3- = 23; PaO2 = 63; SaO2 = 90%. What is the most appropriate initial therapy?
...
Early emphysema is characterized by a chronic productive cough and increased PaCO2.
false
Cystic fibrosis is
an autosomal recessive disorder affecting exocrine glands.
All of the following changes occur during an acute asthma episode except
alveolar collapse.
Croup is characterized by
a barking cough
Obstructive pulmonary disorders are characterized by
...
The hypoxia associated with acute respiratory distress syndrome responds well to supplemental oxygen.
false
A reduced peak expiratory flow rate is a common finding in restrictive disorders.
false
The characteristic x-ray findings in tuberculosis include
Ghon tubercles
A lack of surfactant as occurs with acute respiratory distress syndrome causes airway collapse and hyperinflation of alveoli.
false
An empyema is a collection of lymphatic fluid within the pleural space.
false
A major difference between restrictive and obstructive pulmonary diseases is that in restrictive diseases:
airway resistance is not increased
Restrictive diseases are characterized by small tidal volumes and faster respiratory rates.
true
A patient exhibiting respiratory distress who has a tracheal shift should be evaluated for
pneumothorax.
Infants born prematurely may develop infant respiratory distress syndrome because their production of surfactant is insufficient.
true
Orthostatic hypotension is a manifestation of saline deficit.
true
Osmoreceptors located in the hypothalamus control the release of
vasopressin (antidiuretic hormone, ADH).
A serum sodium level is obtained and shows a level of 142 mEq/L. Which of the following is a correct interpretation of this value?
normal value
Tube feeding is a common cause of hypernatremia.
tube
Hypernatremia causes cells to accumulate sodium and water so that they swell.
false
Saline deficit is defined as:
a deficit of extracellular volume
A buffer can reversibly bind protons.
true
Acidosis is commonly associated with
...
A person with respiratory acidosis can compensate for the disorder by hyperventilating.
false
Peripheral chemoreceptors located in the aorta and carotid arteries are responsive to changes in arterial pH, PO2, and PCO2.
true
Vomiting of stomach contents or continuous nasogastric suctioning may predispose to development of
metabolic acid deficit.
Classify the following arterial blood gas: pH = 7.19, PaCO2 = 49 mm Hg, HCO3- = 18 mEq/L.
mixed acidosis
A person with acute hypoxemia may hyperventilate and develop
respiratory alkalosis
The body compensates for metabolic alkalosis by
hypoventilation.
Chronic bronchitis is defined as a chronic productive cough for at least 6 months for three or more consecutive years.
false
Widespread atelectasis, noncardiogenic pulmonary edema, and fibrosis are characteristic of
acute respiratory distress syndrome.
The organism that causes pulmonary tuberculosis is
Mycobacterium tuberculosis.
Noncardiogenic pulmonary edema occurs when inflammatory exudate leaks into the alveoli.
true
The classic features of acute respiratory distress syndrome include
large pulmonary shunt fraction
Occupational lung diseases like pneumoconiosis:
result from chronic inhalation of particles of inert materials like coal and asbestos dust
The primary force promoting fluid movement from the capillary to the interstitium is capillary oncotic pressure.
false
Two thirds of body fluids are within the intracellular fluid compartments.
true
Patients with pure saline deficit have normal serum sodium concentrations.
true
A patient's serum sodium level upon admission was 148 mEq/L, her heart rate was 110 lying supine, and her blood pressure was 88/60. What is the most appropriate fluid therapy?
Administer IV normal saline (0.9%).
An electrolyte disorder that frequently accompanies ketoacidosis is
hyperkalemia.
Which fluid will be most effective in restoring volume?
Normal saline (0.9%)
All of the following changes occur during an acute asthma episode except
alveolar collapse.
A child's physician prescribes a bronchodilating agent for her. Which of the following drugs would be in this category?
Beta-2-Adrenergic agonist
The major reason for air trapping in emphysema is
...
Which of the following clinical manifestations is not likely in the patient with tuberculosis infection?
Cyanosis
The hypoxia associated with acute respiratory distress syndrome responds well to supplemental oxygen.
false
A collection of air in the pleural space that develops a positive pressure is called _____ pneumothorax.
tension
The most appropriate therapy for an individual with hypernatremia is
hypotonic fluids.
An increase in the resting membrane potential (hyperpolarized) is associated with
hypokalemia
Abnormalities in intracellular regulation of enzyme activity and cellular production of ATP are associated with
hypophosphatemia.
Because of continuing decreased urine output, the function of a patient's kidneys is evaluated with urine electrolytes. The urine Na+ is found to be quite low. This is most likely due to
aldosterone effect on kidney tubules
The role of the lungs in maintaining acid-base balance includes:
elimination of carbonic acid
Administration of sodium bicarbonate to a person with respiratory alkalosis is an effective therapy to correct the acidosis.
false
Which of the following statements about acids is true?
carbonic acid is classified as a volatile acid because exhalation can eliminate it
The finding of ketones in the urine suggests that a person may have which of the following acid-base disorders?
Metabolic acidosis
Chronic bronchitis often leads to cor pulmonale because of
increased pulmonary vascular resistance.
Noncardiogenic pulmonary edema occurs when inflammatory exudate leaks into the alveoli.
true
Restrictive pulmonary diseases are associated with which of the following pulmonary function test results?
decreased vital capacity
Which hormone is released from the posterior pituitary gland to cause reabsorption of water in the kidneys and decrease urine volume?
antidiuretic hormone (ADH)
Two important renal buffers are
NH3 and HPO42+.
The normal ratio of bicarbonate to carbonic acid in blood is 20:1.
true
Filtered bicarbonate (HCO3-) is converted to carbon dioxide (CO2) before it is reabsorbed across the kidney tubular epithelium.
true
Antidiuretic hormone enhances the passive reabsorption of water from the collecting tubules.
true
Which of the following describes the correct flow of blood in the kidney?
afferent arteriole to the glomerular capillaries to the efferent arteriole
Renin is released from
juxtaglomerular cells.
Which of the following hormones is associated with an increase in hypotonic fluid reabsorption from the tubular fluid?
Aldosterone
Which of the following findings on urinalysis should prompt further evaluation?
nitrites
The functional unit of the kidney is the:
nephron
Which of the following is NOT a function of the kidney?
production of albumin
The glucose transporter in the proximal tubule
may be saturated at high filtered glucose loads.
A patient with a serum glucose of 150 mg/dl and a GFR of 50 ml/min would have a tubular glucose load equal to _____ mg/min.
75
The organism most commonly associated with acute pyelonephritis is
Escherichia coli.
A person with acute pyelonephritis would most typically have
fever
Wilms tumor is a renal cancer that primarily affects children.
true
Uric acid stones are radiopaque and therefore detectable by x-ray imaging.
false
The presence of white blood cell casts in the urine is indicative of pyelonephritis.
true
Most renal calculi are composed of calcium crystals.
true
The pathophysiologic basis of acute glomerulonephritis is
an immune complex reaction
Which of the following signs is consistent with a diagnosis of glomerulonephritis?
proteinuria
Colicky, spasmodic pains in the flank area are likely to occur with ureteral irritation.
true
The nerves that carry pain sensations from the kidney enter the cord at T10 to L1.
true
Renal artery stenosis, hypertension, and nephrosclerosis may all contribute to renal failure by causing
renal ischemia
Which type of acute renal failure (ARF) is associated with prostatic hyperplasia?
post renal
Patients with acute renal failure commonly develop metabolic acidosis because of impaired kidney secretion of H+.
true
Prerenal oliguria is a reversible stage of acute renal failure.
true
Acute renal failure produces all of the following characteristic alterations in laboratory values except:
decreased serum potassium
At his most recent clinic visit, a patient with end-stage renal disease is noted to have edema, congestive signs in the pulmonary system, and a pericardial friction rub. Appropriate therapy at this time would include
initiation of dialysis
The most helpful laboratory value in monitoring the progression of declining renal function is
serum creatinine
A patient with renal disease is at risk for developing uremia as his nephrons progressively deteriorate because
GFR declines
The best indicator of renal function is the glomerular filtration rate (GFR).
true
Which type of acute renal failure (ARF) is associated with shock?
prerenal
T.G. comes to the nurse practitioner clinic complaining of burning when she urinates, as well as feeling as though she needs to go to the bathroom more often than usual. She is a 25 year old graduate student and has recently returned from her honeymoon. The nurse orders a urinalysis to confirm the diagnosis of cystitis. What results would support the preliminary diagnosis?
bacteria in urine
Urinary casts are typically present in patients with Cystitis?
false
Which of the following is not a clinical manifestation of uremic syndrome?
azotemis
The primary cause of stress incontinence is
pelvic muscle weakness
Innervation of the bladder is supplied by the pelvic nerves.
true
Approximately 20% of 5-year-old children have enuresis.
true
Congenital malformations of the ureters primarily produce signs and symptoms related to:
obstructed flow of urine
Vesicoureteral reflux, a congenital malformation, is usually diagnosed by:
incidence of recurrent urinary tract infection
Detrusor muscle overactivity can be improved by administration of
anticholinergic agents
Activation of sympathetic neurons in the bladder sphincter causes it to relax.
true
Constriction of the afferent arteriole increases GFR.
true
The normal GFR for a young adult is about 125 ml/min.
true
The primary function of the vasa recta is to
reabsorb interstitial water.
Constriction of the efferent arteriole decreases GFR.
false
Which of the following is NOT a function of the kidney?
production of albumin
From the following, choose the substance likely to appear in the urine when the glomerulus is inflamed.
albumin
Filtered bicarbonate (HCO3-) is converted to carbon dioxide (CO2) before it is reabsorbed across the kidney tubular epithelium.
true
A patient with gouty arthritis develops renal calculi. The composition of these calculi is most likely to be
uric acid crystals
Which of the following is not usually associated with nephrosis?
hematuria
Which of the following findings should prompt an evaluation for renal cancer?
painless hematuria
Pyelonephritis is an infection of the kidney that commonly follows group A Streptococcus pharyngitis.
false
Z.C. is a 49-year-old man with autosomal dominant polycystic kidney disease (ADPKD). His kidneys are enlarged with multiple urine-filled cystic lesions. Z.C. is currently in a stage of renal insufficiency with a GFR of about 20% of normal. He suffers from recurrent urinary tract infections and chronic anemia. In counseling Z.C. about the risk of transmitting the disorder to his offspring, which of the following statements would be correct?
Each offspring has a 50% chance of developing the disease.
The adult form of polycystic kidney disease is transmitted as an autosomal recessive disorder.
false
Osteodystrophy commonly occurs in patients with end-stage renal disease because of
insufficient active vitamin D.
The primary risk factor for the development of chronic kidney disease is hypertension.
true
Patients with end-stage renal disease are at a high risk of developing hypocalcemia.
true
Which of the following interventions has been found to retard the advancement of chronic kidney disease?
ACE inhibitors or A-II receptor blockers
What problem(s) is a patient likely to experience in end-stage renal disease?
uremia
Normal BUN for adults is 100-200 mg/dL.
false
The primary cause of enuresis is psychological disturbances.
false
A tumor in the bladder could produce postrenal failure.
true
Bladder cancer is the third most common cause of cancer diagnosed in the United States among both men and women.
false
stones forming in the urinary bladder are usually composed of calcium.
false
Which of the following groups is at the highest risk for urinary tract infection?
sexually active women
Infectious cystitis is usually a consequence of bacterial invasion from the urethra.
true
Activation of sympathetic neurons in the bladder sphincter causes it to relax.
true
The incidence of vesicoureteral reflux is increased in children with urinary tract infections.
true
Atrial natriuretic peptide increases urine output.
true
The transport maximum for glucose in normal kidneys is about 150 mg/min.
false
Which of the following describes the flow of filtrate in the kidney?
Bowman's capsule to the proximal convoluted tubule to the loop of Henle
If normal GFR is maintained but tubular reabsorption is completely blocked, how long does it take to lose 5 L of fluid?
6 hours
The pain that accompanies kidney disorders is called
nephralgia.
Unilateral renal agenesis is not compatible with life.
false
Prerenal oliguria is characterized by low urine osmolality and high urine sodium concentration.
false
A patient who develops acute renal failure after receiving nephrotoxic antibiotics most likely has postrenal acute renal failure.
false
The most likely cause of anemia in a patient with end-stage renal disease is
insufficient erythropoietin.
Appropriate management of end-stage renal disease includes
erythropoietin administration.
he most common cause of bladder calculi is:
urinary retention
The musculature of the bladder is composed of striated muscle called detrusor muscle.
false
Urinary retention with consistent or intermittent dribbling of urine is called
overflow incontinence.
Which of the following conditions would result in increased GFR?
Increased glomerular hydrostatic pressure
The primary selectivity barrier for glomerular filtration is the
glomerular basement membrane
The presence of red blood cell casts in the urine is indicative of glomerulonephritis.
true
Prerenal acute renal failure occurs when kidney perfusion is impaired.
true
Which type of acute renal failure (ARF) is associated with nephrotoxic antibiotics?
intrarenal
In patients with polycystic kidney disease, renal failure is expected to progress over time as the cystic process destroys more nephrons. At what point will a patient reach end-stage renal disease?
greater than 90% nephron loss
Infectious cystitis is usually a consequence of bacterial invasion from the urethra.
true
The macula densa in the distal convoluted tubule regulates the glomerular filtration rate (GFR) by monitoring the tubular Na+ concentration.
true
Which of the following structures is most likely to be located in the renal medulla?
loop of henle
The usual presenting manifestation of bladder cancer is hematuria.
true
Activation of parasympathetic nerves to the bladder will causes
sphincter relaxation
Principal selectivity barrier for glomerular filtration is the tight junctions between capillary endothelial cells
false
Polycystic kidney disease is
genetically transmitted
The stage of "renal insufficiency of chronic kidney disease is associated with
Polyuria and nocturia