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Patho Chapters 20-24
In the liver, amino acids are used to produce complex molecules by means of
anabolic processes
Which of the following cells in the gastric mucosa produce intrinsic factor and hydrochloric acid?
parietal cells
Which of the following is the primary site for absorption of nutrients?
ileum
When highly acidic chime enters the duodenum, which hormone stimulated the release of pancreatic secretions that contains very high bicarbonate ion content?
secretin
Which of the following breaks protein down into peptides?
trypsin
In which structure is oxygenated blood (arterial) mixed with unoxygenated blood (venous) so as to support the functions of the structure?
liver
Which of the following stimulates increased peristalsis and secretions in the digestive tract?
vagus nerve
Which of the following is contained in pancreatic exocrine secretions?
bicarbonate ion
An alkaline environment is required in the duodenum to
activate intestinal and pancreatic enzymes
Which of the following processes is likely to occur in the body immediately after a meal?
glycogenesis
What does the term gluconeogenesis refer to?
formation of glucose from protein and fat
The early stage of vomiting causes
metabolic alkalosis
Prolonged vomiting cause a state of acidosis due to
catabolism of proteins and lipids
What is the first change in arterial blood gases with diarrhea?
decreased bicarbonate ion
Dehydration causes acidosis because of increased
hypovolemia and lactic acid production
Following gastric resection, the onset of nausea, cramps, and dizziness immediately after meals indicates
a large volume of chime has entered the intestines, causing distention
Which of the following is/are (a) manifestation(s) of hemolytic jaundice?
increased unconjugated bilirubin in the blood
Why does mild hyperbilirubinemia occur in newborns?
the immature liver cannot process bilirubin quickly enough
What is the major effect when a gallstone obstructs the cystic duct?
severe colicky pain in upper right quadrant
Which of the following applies to hepatitis A infection?
it is transmitted by the fecal-oral route
What can be concluded if the hepatitis B antigen level remains high in the serum?
chronic infection has developed
What is the most common type of hepatitis transmitted by blood transfusion?
HCV
What causes elevated serum level of AST and ALT during the preicteric stage of hepatitis?
necrosis of liver cells
What indicates the presence of third-stage alcohol hepatitis?
accumulation of fat in the hepatocytes and hepatomegaly
A primary factor causing encephalopathy with cirrhosis is the elevated
serum ammonia
In patients with cirrhosis, serum ammonia may increase when
bleeding occurs in the digestive tract
What is the primary cause of esophageal varices?
portal hypertension
What is the primary cause of increased bleeding tendencies associated with cirrhosis?
deficit of vitamin K and prothrombin
Which of the following is NOT usually present during the icteric stage of viral hepatitis?
esophageal varices
Which type(s) of hepatitis increase(s) the risk of hepatocellular carcinoma?
HBV and HCV
Which of the following occurs with hepatitis B?
the liver is inflamed and enlarged
What is the initial pathological change in alcoholic liver disease?
accumulation of fat in hepatocytes with hepatomegaly
Which type of hepatitis virus requires the presence of hepatitis B virus so as to replicate?
HDV
Which of the following structures is most likely to be located in the renal medulla?
loop of Henle
Which of the following is NOT a function of the kidney?
production of albumin
Which of the following describes the correct flow of blood in the kidney?
afferent arteriole to the glomerular capillaries to the efferent arteriole
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
Which of the following describes the normal flow of urine?
collecting duct to the renal pelvis to the ureter to the bladder
Which statement about the bladder is TRUE?
Three openings from the urinary bladder form the trigone
Which of the following increases glomerular filtration rate?
increased hydrostatic pressure in the glomerular capillaries
Normally, which of the following is reabsorbed completely from the filtrate?
glucose
Which substance directly controls the reabsorption of water from the collecting ducts?
antidiuretic hormone
Under what circumstances do cells in the kidneys secrete renin?
blood flow in the afferent arteriole decreases
Which of the following should be present in the filtrate in the proximal convoluted tubule?
sodium and potassium ions
From the following, choose the substance likely to appear in the urine when the glomerulus is inflamed
albumin
Which of the following is a significant indicator of renal insufficiency?
increased serum urea and creatinine
Choose the basic cause of osteodystrophy associated with chronic renal failure
failure of the kidney to activate vitamin D
The normal pH of urine is
4.5-8.0
Which of the following functions would be impaired when tubular epithelial cells have been damaged?
adjusting the specific gravity of the urine
When a respiratory infection with high fever is present in the body, how would the kidney tubules maintain normal pH of body fluids?
secrete more acids and reabsorb more bicarbonate ions
When comparing normal kidney function with dialysis, which of the following mechanisms is not possible in dialysis?
active transport
What is the cause of most cases of pyelonephritis?
an ascending infection by E. coli
Which disease is manifested by dysuria and pyuria?
cystitis
Why may acute pyelonephritis and cystitis follow untreated prostatitis?
there is a continuous mucosa along these structures
Pyelonephritis may be distinguished from cystitis by the presence in pyelonephritis of
urinary casts and flank pain
In a case of acute pyelonephritis, what is the cause of flank pain?
inflammation, stretching the renal capsule
Which pathophysiologic process applies to acute poststreptococcal glomerulonephritis?
immune complexes deposit glomerular tissue, casing inflammation
What causes the dark urine associated with acute poststreptococcal glomerulonephritis?
increased glomerular permeability resulting in gross hematuria
Renal disease frequently causes hypertension because
congestion and ischemia stimulates release of renin
Urinary casts are present with acute poststreptococcal glomerulonephritis because of
inflamed tubules mold RBCs and protein into a typical mass
Which disease would cause an increased ASO titer and elevated serum ASK?
acute poststreptococcal glomerulonephritis
Why does metabolic acidosis develop with bilateral kidney disease?
tubule exchanges are impaired
What is the first indicator in the arterial blood gases of acidosis caused by kidney disease?
decreased bicarbonate ion
What would be the long-term effects of chronic infection or inflammation of the kidneys?
gradual necrosis, fibrosis, and development of uremia
What factors contribute to headache, anorexia and lethargy with kidney disease?
1,2,3,4
1.) increased blood pressure
2.) elevated serum urea
3.) anemia
4.) acidosis
1.) increased blood pressure
2.) elevated serum urea
3.) anemia
4.) acidosis
What are the significant signs of nephrotic syndrome?
hyperlipidemia and lipiduria
Why does blood pressure often remain near normal in patients with nephrotic syndrome?
Hypoproteinemia results in significant fluid shift to the interstitial compartment
Common causes of urolithiasis include all of the following EXCEPT
hyperlipidemia
Which of the following results from obstruction of the left ureter by a renal calculus?
an attack of renal colic
What does hydronephrosis lead to?
ischemia and fibrosis in the compressed area
Reduced urine output resulting from inflammation and necrosis of the tubules is called?
oliguria
Which of the following does NOT usually result from nephrosclerosis?
acute renal failure
Which of the following relates to polycystic kidney disease?
it results in gradual degeneration and chronic renal failure
Which of the following indicates the early stage of acute renal failure?
very low GFR and increased serum urea
What is a cause of acute tubule necrosis and acute renal failure?
all of the above
Which of the following would likely cause chronic renal failure?
persistent bilateral glomerulonephritis
What causes polyuria during the stage of renal insufficiency?
loss of tubule function
What is the primary reason for hypocalcemia developing during end-stage renal failure or uremia?
a deficit activated vitamin D and hyperphosphatemia
Cystitis is more common in females due to
the urethra is short, wide, and adjacent to areas with resident flora
Which of the following indicate a decreased GFR?
increased serum urea and decreased serum bicarbonate
Which of the following is NOT likely to lead to hydronephrosis?
nephrosclerosis
Which of the following congenital defects is a common cause of cystitis in young children?
vesicoureteral reflux
Which factor contributes to severe anemia in individuals with chronic renal failure?
limited protein intake
When acidosis becomes decompensated in renal failure, a key indicator is
serum pH dropping below 7.35
Which of the following causes acute renal failure?
bilateral acute glomerulonephritis
Uremic signs of renal failure include all of the following EXCEPT
congestive heart failure
Choose the basic cause of osteodystrophy associated with chronic renal failure
failure of the kidney to activate vitamin D
Agenesis is often not diagnosed because
one kidney provides more that adequate function
Which of the following results from decreased blood flow into the kidneys?
increased angiotensin and systemic vasoconstriction
In acute post-streptococcal glomerulonephritis, the glomerular inflammation results from
type III hypersensitivity reaction
In acute post-streptococcal glomerulonephritis, the inflammation causes
a,b
a.) increases permeability of the glomerular capillaries
b.) glomerular congestion and decreased GFR
a.) increases permeability of the glomerular capillaries
b.) glomerular congestion and decreased GFR
The reabsorption of water and electrolytes by the kidneys is directly controlled by
1,2
1.) atrial natriuretic hormone
2.) antidiuretic hormone
1.) atrial natriuretic hormone
2.) antidiuretic hormone
Uncontrolled essential hypertension may cause chronic renal failure because of
damage to afferent arterioles and renal ischemia
Autoregulation in the kidneys refers to
local minor reflex adjustments in the arterioles to maintain normal blood flow
The defective gene for Huntington's disease can be detected in carriers
True
The best description of a myelomeningocele is
herniation of the meninges, CSF, and spinal cord or nerves through a vertebral defect
What characteristics is common to all individuals with cerebral palsy?
a form of motor disability
Which of the following is characteristic of generalizes seizures?
the uncontrolled discharge of neurons in both hemispheres
What does the clonic stage of a seizure consist of?
alternating contractions and relaxation of skeletal muscles
Which type of seizure commonly occurs in children?
generalized absence
Which of the following is NOT a typical effect of advanced Parkinson's disease?
loss of vision
Which of the following classes of drugs may provide temporary improvement in cases of myasthenia gravis?
anticholinesterase agents
Which of the following is NOT considered to be a common contributing factor to AIDS dementia?
development of arteriosclerosis
Failure of the spinous processes to fuse but without herniation of the meninges is called
spina bifida occulta
Creutfeldt-Jakob disease is caused by
infection in the brain by a prion
In case of noncommunicating hydrocephalus, why does excess cerebrospinal fluid accumulate?
an obstruction is present in the aqueduct of Sylvius or other channel
All of the following are typical signs of hydrocephalus in the neonate EXCEPT
vomiting, headache, and paralysis
How is the presence of spina bifida diagnosed?
prenatally by ultrasound or detection of AFP in maternal blood or amniotic fluid
Which of the following applies to cerebral palsy?
nonprogressive brain damage to the fetus or neonate
From the following, choose the two events (in correct sequence) that immediately follow the aura during a tonic-clonic event
loss of consciousness, then the tonic stage
How would a seizure consisting of bizarre or inappropriate activity be classified?
a psychomotor seizure
Which of the following is characteristic of multiple sclerosis?
remissions and exacerbations
Which statement does NOT apply to the pathophysiology of multiple sclerosis?
progressive random degeneration of peripheral nerves
Which of the following are common early signs of multiple sclerosis?
tremors, weakness in the legs, visual problems
Which of the following applies to Parkinson's disease?
onset occurs in men and women over 60 years of age
What is the pathophysiologic change in Parkinson's disease?
degeneration of the basal nuclei with a deficit of dopamine
Which of the following are common early manifestations of Parkinson's disease?
tremors at rest in the hands and difficulty initiating voluntary movements
In which type of neuron is progressive degeneration occurring with amyotrophic lateral sclerosis (ALS)?
upper and lower motor neurons
Which of the following statements does NOT apply to myasthenia gravis?
dementia develops in the later stage
Which statement applies to Huntington's disease? It
presents with choreiform movements in the upper body and decreased ability to concentrate
What are the characteristic changes in the brain with Alzheimer's disease?
cortical atrophy with plaques and neurofibrillary tangles, impairing conduction
Which disease is associated with excessive dopamine secretion, decreased gray matter in the temporal lobes, and abnormal hippocampal cells in the brain?
schiophrenia
In which disorders do biochemical abnormalities involving the neurotransmitters in the brain occur?
1,2,3
1.) bipolar disorder
2.) schizophrenia
3.) Huntington's disease
1.) bipolar disorder
2.) schizophrenia
3.) Huntington's disease
Which of the following are typical characteristics associated with schizophrenia?
disorganized thought processes, short attention span, delusions
Which of the following is characteristic of generalized seizures?
the uncontrolled discharge of neurons in both hemispheres
What is the typical initial effects of a herniated intervertebral disc at the L4 to L5 level?
lower back pain radiating down the leg
What causes a herniated intervertebral disc?
a protrusion of the nucleus pulposus through the annulus fibrosis
Which of the following dietary supplements has reduced the incidence of spina bifida in recent years?
folic acid
Which of the following is the most common cause of brain damage in children with cerebral palsy?
hypoxia
The ataxic form of cerebral palsy results from damage to the
cerebellum
Which of the following is used both to confirm the diagnosis and classify seizures?
electroencephalogram
Which statement does NOT apply to status epilepticus?
this condition occurs only in idiopathic seizures
All of the following may precipitate a seizure EXCEPT
severe acidosis
Which of the following is a typical early sign of amyotrophic lateral sclerosis (ALS)?
weakness and muscle atrophy in upper limbs
Which of the following are typical early signs of Alzheimer's disease?
1,2
1.) behavioral changes
2.) reduced ability to reason and problem solve
1.) behavioral changes
2.) reduced ability to reason and problem solve
Communicating hydrocephalus causes increased intracranial pressure because of
failure of the subarachnoid to absorb CSF
Which statement is TRUE about amyotrophic lateral sclerosis (ALS)?
cognitive function remains normal
Which statement is TRUE about the condition depression?
a,c
a.) it is classified as a mood disorder
c.) it is marked by periods of sadness, hopelessness and inability to concentrate
a.) it is classified as a mood disorder
c.) it is marked by periods of sadness, hopelessness and inability to concentrate
What must happen for the pupil of the eye to dilate?
stimulation of the sympathetic nervous system is required
Which of the following indicates corneal trauma or infection?
severe pain and photophobia
Which disorder is manifested by loss of peripheral vision?
chronic (wide-angle) glaucoma
Which of the following is an example of conduction deafness?
adhesions reducing the movement of the ossicles
How does otosclerosis cause hearing loss?
fixation of the stapes to the oval window
Which is the early effect of age-related macular degeneration?
loss of central visual acuity
Which fluid is found surrounding the optic disc?
cerebrospinal fluid
Narrow-angle glaucoma develops when the angle is decreased between the
iris and cornea
Which term refers to near-sightedness?
myopia
What is the chemical transmitter released at the neuromuscular junction?
acetylcholine
Which of the following would identify an open or compound fracture?
the skin and soft tissue is expose at the fracture site
During the fracture healing process, the hematoma
is the structure into which granulation tissue grows
The inflammation surrounding a fracture site during the first few day may complicate healing by causing
sever ischemia and tissue necrosis
Which of the following does NOT usually develops as a complication of diabetes?
osteoporosis
Visual impairment may develop in diabetics, primarily because of
abnormal metabolism in the lens
Why is amputation frequently a necessity in diabetics?
necrosis and gangrene in the feet and legs
Which of the following hormonal imbalances causes myxedema?
deficit of T3 and T4
Which of the following may cause hypertension?
pheochromocytoma
Blood glucose levels are increased by
1,2,3
1.) glucocorticoids
2.) glucagon
3.) epinephrine
1.) glucocorticoids
2.) glucagon
3.) epinephrine