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470 terms

Patho Midterm

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Active acquired immunity is gained:
After birth
If a person has innate resistance to a disease, the person has _____ immunity.
Natural
A 20-year-old male received a knife wound to the arm during an altercation. Which of the following types of immunity was compromised?
Natural Immunity
Which of the following is an example of biochemical secretions that trap and kill microorganisms?
Earwax
A 25-year-old female presents to her physician complaining of vaginal discharge of a white, viscous, and foul-smelling substance. She reports that she has been taking antibiotics for the past 6 months. Which of the following is the most likely reason for her discharge?
Decreased Lactobacillus
What is a purpose of the inflammatory process?
To prevent infection of the injured tissue
A child fell off the swing and scraped her knee. The injured area becomes red and painful. Which of the following would also occur?
Edema at injured site
The mast cell, a major activator of inflammation, initiates the inflammatory response through the process of:
degranulation.
A 13-year-old female fell on her knee while skating. The area became inflamed and sore to touch. Which of the following would result from activation of the plasma system secondary to her injury?
Cellular infiltration
The directional movement of cells along a chemical gradient is termed:
chemotaxis
A 20-year-old male shoots his hand with a nail gun while replacing roofing shingles. Which of the following cell types would be the first to aid in killing bacteria to prevent infection in his hand?
Neutrophils
The predominant phagocyte of early inflammation is the:
Neutrophils
A 25-year-old female experiences a headache and takes aspirin for relief. Which of the following effects will relieve the headache?
Decrease prostaglandin production
Leukotrienes differ from histamine in which of the following ways?
Time of release
A 25-year-old male is in a car accident and sustains a fracture to his left femur with extensive soft tissue injury. The pain associated with the injury is related to:
kinins and prostaglandins
The complement system, clotting system, and kinin system share which of the following characteristics?
Activation of a series of proenzymes
The classic pathway of the complement system is activated by:
antigen-antibody complexes
The primary actions of the complement cascade include:
increased vascular permeability and vasodilation, chemotaxis, opsonization, and cell killing
Bradykinin is involved in:
increasing vascular permeability
The end product of the clotting system is:
Fibrin
A 5-year-old male is diagnosed with a bacterial infection. Cultures of the bacteria revealed lipopolysaccharides on the bacterial cell surface. Which of the complement pathways would be activated in this case?
Alternate Pathway
A 2-year-old female presents with difficulty breathing and an edematous appearance. Her mother reports that the condition is recurrent and seems to occur more often during stressful situations. The child is diagnosed with angioneurotic edema. Which of the following is deficient in this child?
C1 esterase inhibitor
Opsonins are molecules that:
enhance phagocytosis
A 10-year-old male is diagnosed with a large tapeworm. Which of the following cells would be produced in response to this worm?
Eosinophils
A 65-year-old female is diagnosed with metastatic breast cancer. Which of the following cells would be produced in large quantities to eliminate the tumor cells?
Natural killer cells
The phagocyte's role begins when the inflammatory response causes it to stick avidly to capillary walls in a process called:
margination
An infant develops a fever secondary to a bacterial infection. Which of the following most likely triggered the fever?
Interleukin-1
A 54-year-old male IV drug user is diagnosed with chronic hepatitis C. Testing revealed that he is a candidate for treatment. Which of the following could be used to treat his condition?
Interferon
A 35-year-old male is diagnosed with lobar pneumonia (lung infection). Which of the following exudates would be present in highest concentration at the site of this advanced inflammatory response?
Fibrinous
During inflammation, the liver is stimulated to release plasma proteins, collectively known as:
acute phase reactants
A 30-year-old female develops chronic inflammation after accidentally ingesting cat feces that were contaminated with toxoplasmosis. Which of the following would most likely also be present?
Granuloma formation
The cleanup of a lesion involving the dissolution of fibrin clots by fibrinolytic enzymes is a process called:
Debridement
A 12-year-old male is fighting with another child when he receives a puncture wound from a pencil. The school nurse cleans and bandages the wound. After about 1 week, the wound would be in which phase of healing?
Reconstruction
The macrophage secretion that stimulates procollagen synthesis and secretion is:
transforming growth factor-beta
A patient with scurvy generally expresses impaired wound healing caused by a lack of:
ascorbic acid
A 30-year-old male was involved in a motor vehicle accident. The glass from the shattered window cut his face and neck. The scar, however, was raised and extended beyond the original boundaries of the wound. This pattern of scarring is caused by:
impaired collagen synthesis
Which of the following cells is responsible for presenting the antigen to the immune cells during clonal selection?
Antigen-processing cells
Both B and T cells are originally derived from cells of the:
Bone marrow
A 3-year-old male is diagnosed with autoimmune-induced type 1 diabetes. Which of the following therapies may help prevent worsening of the disease?
Oral administration of self-antigens
A 6-year-old female is diagnosed with a bacterial infection of the respiratory system. Which of the following will most likely try to fight the antigen?
Antibodies
The immunoglobulin that crosses the placenta confers _____ immunity to the fetus.
passive acquired
A 16-year-old male is bitten by a rabid dog while jogging in the park. Upon admission to the ER, he is given _____ to prevent infection.
immunoglobulins
A molecule is isolated from the human body and studied. It is found to react with antibodies on B cells. Further testing reveals that the molecule is large and chemically diverse. Which of the following would best describe the molecule?
Antigen
Which of the following characteristics increases an antigen's ability to be immunogenic?
Combining with carrier molecules
If a person is given antigen X and is later given antigen Y, a(n)_____ response to antigen Y will result.
determinant
The most abundant class of antibody in the serum is:
IgG
The predominant antibody of a typical primary immune response is:
IgM
The primary role of secretory IgA is to prevent infections in:
Mucous Membranes
A 23-year-old pregnant female visits her physician for her final prenatal checkup. The physician determines that the fetus has developed an infection in utero. Which of the following would be increased in the fetus at birth?
IgM
Which portion of the antibody is responsible for activating the inflammatory systems?
Fc portion
An experiment is carried out to characterize newly discovered immunoglobulins. Specificity of the immunoglobulin could be determined by studying the:
Complementary-determining region
A 20-year-old female is applying for nursing school and is required to be tested for immunity against several illnesses. Testing that looks at which of the following would be the best to determine immunity?
Titer
A 10-year-old male is stung by a bee while playing in the yard. He experiences a severe allergic reaction and has to go to the ER. This reaction is the result of:
IgE
A 25-year-old female has sexual relations with her boyfriend. Later she is told that the boyfriend is infected with Neisseria gonorrhoeae. Testing reveals that she does not have the disease. How is it possible that she did not contract the disease?
Antibodies covered sites of attachment
Which of the following characteristics is shared by both the secretory and systemic immune systems?
Neutralization following antigen-antibody binding
At a 12-month well-baby visit, the mother reports that the child has never been ill. She proudly reports that the baby was breastfed since birth. The nurse tells her that breastfeeding is beneficial because the dominant antibody in breast milk acts by functioning as an antigen receptor:
in mucosal membranes
Pure monoclonal antibodies are produced by:
laboratories
An experiment is designed to determine specific cell types involved in cell-mediated immune response. The experimenter is interested in finding cells that attack cells that have specific antigens. Which cells should be isolated?
Cytotoxic T cells
Histocompatibility antigens help the immune system:
distinguish self from nonself
A 20-year-old female has been diagnosed with AIDS. Laboratory testing would reveal diminished levels of:
helper T cells
Which of the following is not a secondary lymph organ?
Liver
After exposure to a specific antigen, B cells differentiate into:
plasma cells
A macrophage was isolated and analyzed for major histocompatibility complex. Which of the following would be expected?
MHC I and II
A cell that is produced in the thymus and interacts with MHC II molecules would have which of the following surface proteins?
CD4
A patient is diagnosed with cancer. Which of the following cells would be produced in the greatest number?
Th1
A young male patient becomes severely ill following lunch at the local hamburger stand. He experiences fever, vomiting, and diarrhea. Testing at the restaurant reveals that he ate food contaminated by Streptococcus pyogenes. Which of the following would be expected to accompany his illness?
Binding without antigen recognition
A 6-month-old infant is brought to the pediatrician for recurrent colds. The child is fed formula, and the other family members have not been ill. The physician tells the mother that the child's immune system is not yet competent but will be about 60% of an adult system around age:
12 Months
Increased age is associated with:
increased hypersensitivity responses
A 5-month-old child is admitted to the hospital with recurring respiratory infections. A possible cause of this condition is:
immune insufficiency
Hypersensitivity is best defined as:
an excessive or inappropriate response of the immune system to a sensitizing antigen
A 5-year-old female takes a hike through the woods during a school field trip. Upon returning home, she hugs her father and he later develops poison ivy. Which of the following immune reactions is he experiencing?
Cell-mediated
When the maternal immune system becomes sensitized against antigens expressed by the fetus, what type of immune reaction occurs?
Alloimmune
Seasonal allergic rhinitis is expressed through:
IgE-mediated reactions
A patient presents with poison ivy on extremities, face, and buttocks. This disease is an example of:
delayed hypersensitivity
A 10-year-old male is stung by a bee while playing in the yard. He begins itching and develops pain, swelling, redness, and respiratory difficulties. He is suffering from:
anaphylaxis
The most severe consequence of a type I hypersensitivity reaction is:
anaphylaxis
A 25-year-old female is suffering from hay fever. Which of the following would be an expected symptom?
Edema
Which of the following hypersensitivity reactions does not involve an antibody response?
Type IV
A 10-year-old male presents to his physician complaining of wheezing and difficulty breathing. History reveals that both of the child's parents suffer from allergies. Which of the following terms would be used to classify the child?
Atopic
A 30-year-old female presents to her physician complaining of fatigue, excessive sweating, and increased appetite. Physical examination reveals protruding eyes, and laboratory testing reveals hyperthyroidism secondary to autoantibody production. This disorder falls into which of the following categories?
Type II hypersensitivity
A 30-year-old male is having difficulty breathing and has been spitting blood. He reports that he began experiencing this reaction after cleaning his pigeons' cages. Testing reveals he is suffering from allergic alveolitis. Which of the following is he experiencing?
Arthus reaction
An example of an immune-complex-mediated disease is:
serum sickness
Several prisoners are experiencing symptoms of tuberculosis. A tuberculin reaction test was ordered. This test is an example of type _____ hypersensitivity.
IV
Systemic lupus erythematosus (SLE) is an example of:
autoimmunity
A 30-year-old female complains of fatigue, arthritis, rash, and changes in urine color. Laboratory testing reveals anemia, lymphopenia, and kidney inflammation. Assuming a diagnosis of systemic lupus erythematosus (SLE), which of the following is also likely to be present?
Antinuclear antibodies
A 40-year-old female is diagnosed with systemic lupus erythematosus (SLE). Which of the following symptoms would be considered a symptom of this disease?
Photosensitivity
What is the chance that two siblings share both HLA haplotypes, making them a good match for an organ transplant from one to the other?
25%
If a person has type O blood, she is likely to have high titers (levels) of anti-_____ antibodies.
A and B
In addition to matching ABO antigens, a blood transfusion must also be matched for:
Rh antigen
A 15-year-old male suffers from severe hemorrhage following a motor vehicle accident. He is given a blood transfusion, but shortly afterward the red blood cells are destroyed by agglutination and lysis. Which of the following blood type-transfusion type matches would cause this?
A-AB
Which relationship benefits the organism but causes no harm to the host?
Commensalism
The microorganisms that make up the normal human flora are important for:
preventing the attachment and multiplication of pathogens
Bacterial pathogens can defend themselves from an immune response by:
producing capsules
When a person is given an attenuated antigen as a vaccine, the antigen is:
alive, but less infectious
Endotoxins are produced by:
gram-negative bacteria
A 5-year-old male becomes ill with a severe cough. Histologic examination reveals a bacterial infection and further laboratory testing reveals cell membrane damage and decreased protein synthesis. Which of the following is the most likely cause of this illness?
Exotoxin
A 50-year-old female experiences decreased blood pressure, decreased oxygen delivery, cardiovascular shock, and subsequent death. Which of the following is the most likely cause?
Gram-negative bacteria
Viruses:
replicate their genetic material inside host cells
Varicella, the virus that causes chicken pox, replicates:
in the cytoplasm
A 25-year-old female reports having unprotected sexual intercourse with several men. Blood tests reveal that she is positive for human papilloma virus. Which of the following may occur because of the infection?
Warts
Fungi causing deep or systemic infections:
are commonly opportunistic
The hallmark symptom of most infectious diseases is:
fever
Most viral vaccines contain:
attenuated viruses
Most bacterial vaccines contain:
dead bacteria
Bacteria become resistant to antimicrobials by:
mutation
A common symptom of individuals with immunodeficiency is:
recurrent infections
A 5-year-old male presents with low-set ears, a fish-shaped mouth, and involuntary rapid muscular contraction. Laboratory testing reveals decreased calcium levels. Which of the following diagnosis is most likely?
T lymphocyte deficiency
A 22-year-old prostitute was recently diagnosed with acquired immunodeficiency syndrome (AIDS). A decrease in which of the following cell types would be expected to accompany this virus?
CD4 T-helper
Which of the following is a characteristic of the human immunodeficiency virus (HIV), which causes acquired immunodeficiency syndrome (AIDS)?
HIV is a retrovirus
A 30-year-old male was diagnosed with HIV. Which of the following treatments would be most effective?
Highly active antiretroviral therapy
Which of the following is true regarding stress?
It can be viewed as transactional
Selye reported several structural changes in rats exposed to repeated stressors. These included:
ulceration in the gastrointestinal system
A student is driving to school when another driver nearly hits her. Her heart begins beating harder and faster as she becomes aroused and scared. Which of the following stages of the general adaptation syndrome is she experiencing?
Alarm stage
Exhaustion occurs if stress continues and _____ is not successful
adaptation
A student arrives at school to find that he has an exam for which he is unprepared. Which of the following would be expected?
Increased glucagon release
A 10-year-old female is arriving at a national spelling bee contest. Her heart starts beating faster and harder and she begins to sweat. Which of the following is she experiencing?
Anticipatory response
Which of the following hormones activates both alpha- and beta-adrenergic receptors?
Epinephrine
A 35-year-old male is diagnosed with a hormone-secreting tumor of the adrenal medulla. He experiences elevated blood pressure, pupil dilation, "goose bumps," and excessive sweating of the armpits and hands. Which of the following hormones is the predominant one released by the tumor?
Norepinephrine
Stress induces sympathetic stimulation of the adrenal medulla. This causes the secretion of catecholamines, which include:
epinephrine and norepinephrine
Stress-induced stimulation of the adrenal cortex causes it to secrete:
cortisol
Stress-induced catecholamine release from the adrenal medulla may result in:
elevated blood pressure
A 50-year-old female is diagnosed with a hormone-secreting tumor of the adrenal cortex. Which of the following would be expected?
Increased lipogenesis of face and trunk
A 30-year-old male develops poison ivy after mowing the lawn near the woods. His physician prescribes a synthetic cortisol. How will the cortisol relieve his symptoms?
Suppressing Th1 cell activity
Effects of elevated -endorphins include:
pain inhibition
A 10-year-old male was physically abused for the previous 4 years. He reports feeling stressed all the time and frequently gets ill. Which of the following hormones is most likely suppressed in this child?
Growth hormone
Coping is best defined as the process of:
managing stressful challenges
The stress-age syndrome includes which of the following?
Immunodepression
A patient has a tissue growth that was diagnosed as cancer. Which of the following growth types could it be?
Neoplasm
Which feature is characteristic of malignant tumor?
Has a high mitotic index
The process by which a cell acquires specific new observable characteristics is:
differentiation
Preinvasive epithelial tumors of glandular or squamous cell origin are referred to as:
cancer in situ
A 25-year-old male develops a tumor of the breast glandular tissue. This type of tumor is classified as a(n):
adenocarcinoma
A 30-year-old female is diagnosed with cancer. Testing reveals that the cancer cells have spread to local lymph nodes. This cancer would be stage:
3
When a cancer cell loses differentiation, _____ has occurred
Anaplasia
A physician is attempting to diagnose cancer and is looking for a tumor marker. Which of the following could be a possible marker?
Enzymes
A 52-year-old male with hepatitis C recently developed hepatic cancer. Which of the following markers should be increased?
Alpha-fetoprotein
The best explanation for higher rates of cancer in older populations is:
the development of cancer requires several mutations over time
In cancer, angiogenic factors stimulate:
new blood vessel growth
Presence of telomere caps gives cancer cells:
immortality
A proto-oncogene is best defined as:
a normal gene
Of the following genetic lesions that cause cancer, which is the most common?
Point mutations
A child develops retinoblastoma. Which of the following must have occurred?
Mutations in the rb gene occurred in both copies of the gene
A 50-year-old female develops skin cancer. One potential reason for development of this condition is:
mutation of caretaker genes
A 45-year-old female was recently diagnosed with cervical cancer. She reports a sexual history that includes 43 partners. Which of the following is the most likely cause of her cancer?
Human papilloma virus
A 30-year-old American male with HIV is diagnosed with Epstein-Barr virus. After 2 months, the virus is still active. What is the concern for this patient?
Development of B cell lymphoma
A 45-year-old male presents with persistent, severe stomach pain. Testing reveals a peptic ulcer. Further laboratory tests reveal the presence of Helicobacter pylori. Which of the following is of concern for this patient?
Gastric cancer
A 40-year-old female was diagnosed with colorectal cancer, for which she refused treatment. Four years later she returned to her physician. Testing revealed that the cancer had metastasized to the:
liver
Which of the following factors is necessary for local tumor spread?
Increased cellular motility
The most common route of metastasis is through the:
lymphatics
The most important environmental risk factor for cancer is exposure to:
cigarette smoke
Chromosome aberrations and mutations in cells not directly irradiated are referred to as:
bystander effects
A 50-year-old female develops skin cancer on her head and neck following years of sunbathing. Which of the following cancers is the most likely?
Basal cell carcinoma
A 50-year-old female develops breast and colorectal cancers. Which of the following dietary factors most likely would have increased her risk for developing these cancers?
ETOH
A 25-year-old nursing student recently learned how diet can alter the chances of developing cancer. He tries to minimize his risks of developing the disease by ordering his steak:
rare
Which of the following compounds has been shown to increase the risk of cancer when used in combination with smoking?
ETOH
A 25-year-old female was diagnosed with cervical cancer. History reveals she had many sexual partners, which she indicates is "too many to count." Which of the following is most likely to have caused her cancer?
HPV-16
Physical activity was shown to reduce the risk of which of the following types of cancer?
Colon
A 65-year-old male was recently diagnosed with cancer. He is retired from construction work. Which of the following cancers is he likely to develop secondary to occupational hazards?
Mesothelioma
Indoor pollution is considered worse than outdoor pollution because of cigarette smoke and:
radon
A water test recently revealed arsenic levels above 200 ug/L. Which of the following cancers would be most likely to develop in those who consistently drank the water?
Skin
The most frequently reported symptom of cancer and cancer treatment is:
fatigue
A 50-year-old female is suffering from anorexia, anemia, asthenia, weight loss, and altered metabolism resulting in malnutrition. She was previously diagnosed with cancer. Which of the following describes her symptoms?
Cachexia
Alterations in carbohydrate metabolism in people with cancer cause:
a diabetes-like syndrome
Individuals with cancer are often at risk for infections because of:
leukopenia
Which of the following is the most significant cause of complications and death in cancer patients?
Infection
A 75-year-old male was recently diagnosed with prostate cancer. The cancer had not metastasized upon diagnosis. Which of the following factors would most predispose this patient to infection?
Age
To be curative, chemotherapy must eradicate:
enough cancer cells so that the body's own defenses can kill any remaining cells
A 15-year-old female is diagnosed with melanoma. Which of the following treatments would most likely be used first?
Immunotherapy
Adjuvant chemotherapy treatment is used:
after surgical removal of a tumor
Biologic response modifiers are a form of:
immunotherapy
All of the following represent goals of radiation therapy except:
to replace chemotherapy
A 50-year-old male discovers a mass growing in his mouth. A biopsy reveals that the mass is benign. Which of the following treatments would most likely be recommended?
Surgical removal
Gastrointestinal alterations, such as nausea and mucosal erosions, are common side effects of chemotherapy treatment because:
chemotherapy agents target rapidly dividing cells in the oral and intestinal linings
A 30-year-old female is diagnosed with cancer and put on chemotherapy treatment. Which of the following would help to relieve some of the side effects?
Red cell transfusion
Most childhood cancers originate from the:
mesodermal germ layer
A 4-year-old male was recently diagnosed with leukemia. Which of the following characterizes this type of cancer?
Embryonic tumor
The most common malignancy in children is:
leukemia
A 3-year-old female was diagnosed with Wilms tumor. This disease is a tumor of the:
kidney
A couple brings their child to his physician for a checkup. The child has Down syndrome, and the couple is concerned about other diseases that could afflict the child. The physician explains that young children with Down syndrome are at higher risk for developing:
leukemia
A newborn male is born with heart failure. Three weeks later he receives a heart transplant. Which of the following is he at the highest risk for developing?
Leukemia
A 40-year-old female developed adenocarcinoma of the vagina. Which of the following is the most likely cause of her cancer?
Prenatal exposure to DES
A 16-year-old male with aspirations of becoming a bodybuilder spends 3 hours a day in the gym. Five years later he develops hepatocellular carcinoma. Which of the following is the most likely cause of the cancer?
Anabolic steroids
Plasma proteins synthesized by lymphocytes in the lymph nodes are:
globulins
The most abundant cells in the blood are
erythrocytes
All of the following properties allow erythrocytes to function as gas carriers except:
presence of many mitochondria
A blood sample is analyzed in a laboratory. Assuming a normal sample, which type of white blood cell accounts for the highest percentage?
Neutrophils
A group of cells is isolated in the laboratory. The cells have membrane-bound granules in their cytoplasm, and they show phagocytic activity. Which of the following cells is most similar?
Eosinophils
The predominant phagocyte of early inflammation is the:
neutrophil.
Which of the following types of white blood cells contain preformed granules of vasoactive amines?
Basophil
Monocytes are blood cells that mature (differentiate) into:
macrophages
In addition to playing a role in hemostasis, platelets have the ability to:
release biochemical mediators of inflammation
The main site of hematopoiesis in the fetus is the:
spleen
A 45-year-old female undergoes splenectomy to remove a tumor. Which of the following is most likely to occur following surgery?
Leukocytosis
During an infection, lymph nodes enlarge and become tender because:
macrophages are rapidly dividing.
After birth, red blood cells are normally made only in the:
bone marrow
A cell that can differentiate into any tissue type is referred to as:
pluripotent
Which of the following participate in hematopoiesis?
Colony-stimulating factors
Hemoglobin contains heme groups that allow it to carry oxygen. How many oxygen molecules can one molecule of hemoglobin carry?
4
_____ is an unstable type of hemoglobin that cannot bind with oxygen.
Methemoglobin
The greatest proportion of total body iron is located in the:
erythrocytes
Recycled iron from macrophages is delivered to the bone marrow bound to:
transferrin
Erythropoietin is produced in the:
Kidneys
Secretion of erythropoietin is stimulated by:
Hypoxia
After erythrocytes have circulated for about 120 days, they are removed by macrophages, which are mainly in the:
spleen
Which electrolyte is necessary for normal platelet function?
Calcium
Which of the following nutritional components is needed for erythropoiesis?
Cobalamin
A newborn baby is diagnosed with a blood disorder in which her platelet count is low. Which of the following could be the reason?
Decreased thrombopoietin
Which of the following molecules is the insoluble end product of the clotting cascade?
Fibrin
Fibrinolysis is mediated by:
Plasmin
A newborn baby has a clotting disorder that results in her body being unable to produce thrombin. Which of the following phases of platelet degranulation would be impossible?
A. Subendothelial exposure
Aggregation
In some anemias, the erythrocytes are present in various sizes; this is referred to as:
anisocytosis
A newborn is diagnosed with congenital intrinsic factor deficiency. From which of the following types of anemia does he suffer?
Pernicious anemia
Erythrocytes that are _____ contain an abnormally low concentration of hemoglobin.
hypochromic
A 5-year-old male was diagnosed with normocytic-normochromic anemia. Which of the following anemias falls into this category?
Hemolytic anemia
What hemodynamic change occurs after initial compensation for a reduction in the number of circulating erythrocytes?
Hyperdynamic blood flow
A 25-year-old female has a heavy menses during which she loses a profuse amount of blood. Which of the following adaptations could be expected?
Blood vessel dilation
A 60-year-old female emphysema patient experiences a rapid and pounding heart, dizziness, and fatigue with exertion. How would the respiratory system compensate for the increased oxygen demand?
Increased rate and depth of breathing
A 2-year-old malnourished child has vitamin B12 and folate deficiencies. A blood smear would reveal _____ amounts of hemoglobin.
normal
A 45-year-old male is diagnosed with pernicious anemia. The most likely cause of this condition is:
defective DNA synthesis
Which of the following statements explains why vitamin B12 and folate deficiencies cause anemia?
Red blood cells have a shorter life span.
A 20-year-old female undergoes lab testing for anemia. Results show high iron, bilirubin, and transferrin and low hemoglobin and hematocrit. Which of the following is the most likely diagnosis?
Sideroblastic anemia
A 35-year-old female is diagnosed with vitamin B12 deficiency anemia. A decrease in which of the following is the most likely cause?
Intrinsic Factor
Which of the following individuals is at highest risk for developing a vitamin B12 deficiency anemia?
47-year-old male who had a gastrectomy procedure (removal of the stomach)
A 50-year-old male experienced loss of appetite, weight loss, and beefy red tongue shortly before his death. Autopsy would most likely reveal:
HF
A 40-year-old male vegetarian is diagnosed with folate deficiency anemia. He reports that he is an alcoholic. Which of the following factors put him at greatest risk for developing his disease?
Being alcoholic
The Schilling test for pernicious anemia involves:
the administration of radioactive cobalamin and the measurement of its excretion in the urine.
A 67-year-old female has chronic gastrointestinal bleeding. The primary cause of her anemia is:
iron deficiency.
A 34-year-old male presents in the emergency room with extreme fatigue and shortness of breath. His skin and sclera appear to have a yellowish discoloration. These findings are consistent with which type of anemia?
Hemolytic anemia
A 58-year-old female presents in the clinic with complaints of fatigue, weight loss, and tingling in her fingers. Laboratory findings show a low hemoglobin and hematocrit, a high mean corpuscular volume, and normal plasma iron. These findings are consistent with which type of anemia?
Pernicious Anemia
Which of the following tests directly measures iron stores?
Bone marrow bx
A 21-year-old female was recently diagnosed with iron deficiency anemia. In addition to fatigue and weakness, which of the following clinical signs and symptoms would she most likely exhibit?
Red, sore tongue
A 21-year-old woman was recently diagnosed with iron deficiency anemia. Her hematocrit is 32%. Which of the following treatments would you expect to be prescribed for her?
Iron replacement and change of diet
A 45-year-old male is diagnosed with sideroblastic anemia. Which of the following is the most likely cause of this disease?
Ineffective iron uptake and hemoglobin production
A 50-year-old female was diagnosed with sideroblastic anemia. Which of the following would most likely occur?
Pale skin
Aplastic anemia is caused by:
stem cell deficiency
All of the following pathogenic mechanisms cause anemia in chronic inflammation except:
increased basal metabolic rate
Posthemorrhagic anemia can result in death when blood loss is in excess of
40% to 50%
A 57-year-old male presents to his physician for red face, hands, feet, ears, and headache and drowsiness. A blood smear reveals an increased number of erythrocytes, indicating:
polycythemia vera
A 67-year-old female is admitted to the emergency room with a diagnosis of polycythemia vera. She will most likely complain of:
chest pain
A 68-year-old female is admitted to the emergency room with a diagnosis of polycythemia vera. Her symptoms are mainly the result of:
increased blood viscosity
A 67-year-old female is admitted to the emergency room with a diagnosis of polycythemia vera. Treatment for her condition might involve:
therapeutic phlebotomy
A 70-year-old male is brought to the emergency room, where he dies shortly thereafter. Autopsy reveals polycythemia vera. His death was most likely the result of:
cerebral thrombosis
A 67-year-old male was diagnosed with polycythemia vera but refused treatment. His condition is at risk for converting to:
acute myeloid leukemia
Leukocytosis can be defined as:
A high leukocyte count
A 35-year-old male was diagnosed with hepatitis B. Further tests revealed neutropenia characterized by a neutrophil count less than _____ per milliliter.
2000
A 20-year-old female has an increase in eosinophils. Which of the following is the most likely cause?
Parasitic invasion and allergic reactions
A 15-year-old female presents with splenomegaly, hepatomegaly, and lymph node enlargement. She is diagnosed with infectious mononucleosis. Further testing would indicate an acute infection of:
macrophages
A 35-year-old male with hyperthyroidism begins treatment to decrease thyroid activity. Which of the following could result secondary to the treatment?
Basophilia
A 15-year-old male is diagnosed with infectious mononucleosis. The most likely cause is:
Epstein-Barr virus (EBV).
A 15-year-old male with infectious mononucleosis is being given instructions on how to prevent the spread of this infection to others. Which statement represents a correct instruction?
Do not share drinking glasses or eating utensils
A 15-year-old male is diagnosed with infectious mononucleosis. He most likely presented with the classic triad of symptoms: fever, sore throat, and:
lymph node enlargement
Known causes of acute leukemia include:
chemotherapy treatment for other cancers
A 10-year-old male is diagnosed with leukemia. Which of the following could be associated with his disease?
Down syndrome
A 5-year-old female is diagnosed with acute leukemia. She will most likely be treated with:
Chemotherapy
Multiple myeloma can be defined as a neoplasm of:
B cells
A 65-year-old male is diagnosed with multiple myeloma. He complains of severe pain. This pain can be attributed to:
destruction of bone tissue
A 35-year-old female is diagnosed with lymphadenopathy. The most likely finding leading to this diagnosis is:
enlarged lymph nodes
A 35-year-old male has enlarged lymph nodes in the neck and a mediastinal mass. He was diagnosed with Hodgkin lymphoma. Which of the following abnormal cells would be expected with this disease?
Reed-Sternberg cell
The country with the lowest rate of Hodgkin lymphoma is:
Japan
A 62-year-old female tells her health care provider she has been experiencing regular night sweats that cause her to wake up drenched. She also remarks that she has been unintentionally losing weight. Physical exam reveals enlarged lymph nodes on her neck that do not appear to be painful. She should be screened for which of the following cancers?
Hodgkin lymphoma
A 10-year-old male presents with abdominal swelling, night sweats, fever, and weight loss. He is diagnosed with Burkitt lymphoma. Which of the following is the most likely cause?
Epstein-Barr virus (EBV)
Under the conditions of hypersplenism, erythrocytes are:
sequestered
Thrombocytopenia may be:
congenital or acquired
Thrombocytopenia is described as a platelet count below _____ platelets per cubic millimeter.
150,000
A 30-year-old female presents with hematuria, menorrhagia, and bleeding gums. She is diagnosed with immune thrombocytic purpura (ITP). The most likely cause is:
antibody destruction of platelets
A 50-year-old female is diagnosed with primary thrombocythemia. A blood smear reveals _____ platelets
overproduced
A 52-year-old male IV drug user was diagnosed with hepatitis C 5 years ago. He is now experiencing impaired blood clotting. A decrease in which of the following could be the cause?
K
Individuals with liver disease often suffer from coagulation disorders because:
clotting factors are produced in the liver
A 40-year-old female develops disseminated intravascular coagulation (DIC). The most likely cause of this condition is:
sepsis
The sequence of events in disseminated intravascular coagulation (DIC) is initiated by the release of:
tissue factor
In DIC, active bleeding occurs after intravascular clotting because:
clotting factors are depleted
A 22-year-old female just delivered a healthy baby girl. She suffered from eclampsia during her pregnancy, and on the second postpartum day she complained of bleeding gums and bruising on her arms and legs. Hematology lab tests indicate that she had DIC. Further testing revealed an increase in:
fibrin degradation products (FDPs).
A common, life-threatening complication of a thrombus in a deep vein is:
pulmonary embolus
A 1-year-old female is diagnosed with anemia secondary to insufficient erythropoiesis. The most likely cause is:
an iron deficiency
Iron deficiency anemia:
may be related to socioeconomic factors
A 12-month-old toddler weighing 18 pounds is brought to the clinic because of weakness, slow physical growth, and developmental delays. His mother reports that the only food he will consume is cow's milk. Considering this information, the nurse decides that the child probably has:
iron deficiency anemia
A 16-month-old female presents with tachycardia, pallor, anorexia, and systolic murmur. Hemoglobin determination indicates a content below _____ g/dl.
5
Maternal-fetal blood incompatibility may exist in which of the following conditions?
Mother is Rh-negative, and fetus is Rh-positive
A 22-year-old female gives birth at 20 weeks' gestation to a stillborn fetus. Physical exam reveals gross edema of the entire body and anemia. This condition is referred to as:
hydrops fetalis
Sickle cell disease is characterized by the presence of Hb S. Which of the following amino acids is present in Hb S and not present in normal Hb?
Valine
A 10-year-old male is diagnosed with sickle cell anemia. He most likely inherited it from:
Both his mother and father
In the United States, sickle cell disease most commonly occurs in:
African Americans
A 25-year-old female has a child that is diagnosed with sickle cell anemia. She does not have the disease. Which of the following characterizes the genetic makeup of the parents with regard to this trait?
HbS and HbA
The erythrocytes of a person with sickle cell anemia may become sickled if:
oxygen tension is low
A 12-year-old male is diagnosed with sickle cell anemia. A blood smear reveals severely sickled cells. The sickled cells will be removed from circulation mostly by the:
spleen
A major symptom of vaso-occlusive crisis in sickle cell anemia is:
peripheral edema
The type of sickle cell crisis seen only in young children is
sequestration
A 6-year-old male presents with fatigue, jaundice, and irritability. A blood smear shows the presence of sickled cells. Erythropoiesis is compromised in this child, resulting in a(n):
aplastic crisis
A 5-year-old female dies from sickle cell disease. The most likely cause of death is:
Infection
The alpha and beta thalassemias are inherited in an _____ fashion.
autosomal recessive
A 2-year-old male presented with growth and maturation retardation and splenomegaly. He died shortly after arriving at the ER. Autopsy revealed thalassemia secondary to defective:
HgB synthesis
A 38-year-old female gives birth to a stillborn fetus. Autopsy reveals cardiomegaly, hepatomegaly, edema, and ascites. The most likely cause is:
alpha-thalassemia major.
Hydrops fetalis may result from which type of thalassemia?
Alpha Major
The mother of a 3-year-old child speaks to the pediatrician because the child took several hours to stop bleeding following a minor scrape. Testing reveals that the child has hemophilia A resulting from a deficiency in:
Factor VIII
Hemophilia B is also known as:
Christmas Dz
A 3-year-old child presents with bruising on the legs and trunk and a petechial rash. The mother also reports frequent nosebleeds. Lab tests reveal a decreased platelet count. The most likely diagnosis is:
idiopathic thrombocytopenic purpura
A 5-year-old male is diagnosed with idiopathic thrombocytic purpura (ITP). This condition is caused by:
virally induced antibody destruction of platelets.
Which of the following clusters of symptoms would lead you to suspect a child has idiopathic thrombocytopenic purpura (ITP)?
Spontaneous nosebleeds; bruising; petechiae
A 1-year-old is diagnosed with idiopathic thrombocytopenic purpura (ITP). The most serious concern is development of:
intracranial bleeding
The most common childhood cancer is:
acute lymphoblastic leukemia
A 5-year-old male is diagnosed with leukemia. Which of the following symptoms would be expected?
Fatigue
A 10-year-old male with Down syndrome undergoes chemotherapy for cancer. Following treatment, he is most susceptible to:
acute myelogenous leukemia
A 10-year-old female is diagnosed with a malignancy in the brain and lung. DNA analysis reveals translocation at chromosome 7 and 14. The most likely diagnosis is:
lymphoblastic non-Hodgkin lymphoma
Which condition increases the risk of developing malignant lymphoma?
AIDS
The most common cx of elevated levels of ADH?
Cancer
A 54-year-old pt with pulmonary tuberculsosis is evaluated for SIADH. Which of the following CM would be expect in this pt?
Concentrated urine
A 54-year-old pt with pulmonary tuberculosis is evaluated for SIADH. Which of the following electrolyte imbalances would be expected in this pt?
Hyponatremia
A severe consequence of SIADH is:
Neurologic damage
A 22- year old male is admitted to the ICU with a closed head injury sustained in a motorcycle accident The injury has cxed severe damage to the posterior pituitary. Which of the following complications should be anticipated?
Dehydration from polyuria
A side effect of some general anesthetic agents is _____DI.
Nephrogenic
DI, DM, and SIADH share which of the following CM:
Thirst
A 50-year old male pt presents with polyuria and extreme thirst. He was given exogenous ADH. For which of the following would this be effective
Neurogenic DI
A 25-year old male presents with fatigue, constipation, and sexual dysfunction. Tests reveal all pituitary hormones are normal and no masses are appreciated. The most likely cx of his sx is a dysfunction in the:
hypothalamus
Common neurologic disturbances seen with pituitary adenomas are?
Visual disturbances
A 35 year old female with graves dz is admitted to a med-surg unit. Lab tests would most likely reveal:
High levels of circulating Thyroid-stimulating antibodies
The level of T3 in graves dz is usually abnormally:
High
A 35 year old female with graves dz is admitted to a med-surg unit. Which of the following sx would be expected before tx?
Skin hot and moist, rapid heart rate
Visual disturbances are a common occurrence in pts with untreated graves dz. The main cx of this complication:
orbital edema and extraocular muscle paralysis
A 22 year old female has a low level of TSH. This condition would cx ______hypothyroidism.
Secondary
The basal metabolic rate is unusually_____ with hypothyroidism
Low
A 3 year old male is dx with congenital hypothyroidism. If left untx, the child would have:
mental retardation and stunted growth
A 30 year female was dx with thyroid carcinoma. Lab tests would most likely indicate _________T3 and T4 levels.
Normal
A problem associated with chronic hyperparathyroidism is:
Osteoprosis and pathologic fractures
A 45 year old with graves dz under went surgical removal of her thyroid gland. During the post op period, her serum calcium was low. The most probable reason for her low serum calcium is :
hypoparathyroidism cxed by surgical injury to the parathyroid glands
Hypoparathyroidism is most commonly cxed by:
Parathyroid gland injury
A 25 year old male presents to his physician complaining of changes in facial features. CT scans reveals a mass on the anterior pituitary, and the lab tests reveal severely elevated growth hormone. Which of the following would be expected?
Sexual dysfunction
A 30 year old male presents to his physician complaining of visual disturbances. CT reveals a pituitary tumor and lab tests reveal elevated prolactin. Which of the following would aslo be expected?
Increased Dopamine
A 12 year old female is newly dxed with type 1 DM. Which of the following is the most likely cx of her dz?
Immune destruction of the pancreas
A 12 year old male is newly dxed type 1 DM. Which of the following is most beneficial in confirming the dx?
Fasting plasma glucose levels and glucose tolerance test
Management of DM involves glycosylated hemoglobin(HgB A1C) levels. The purpose of this test is to?
Monitor long-term serum glucose control
Hyperglycemia in type 2 DM is a result of:
Hyperinsulinemia and insulin resistance
A 19 year old female with type 1 DM was admitted to the hospital with the following lab values: serum glucose: 500mg/dL(high), urine glucose and ketones +4(high); arterial pH7.20(low); Her parents state she has been sick with the "flu" for a week. Which of the following statements bets explains her acidotic state?
Insulin deficiency promotes lipid metabolism and ketone formation
A 55 year old female is admitted to the medical unit for complications of long-term, poorly controlled type 2 DM. Which of the following would be expected in addition to elevated glucose?
Elevated serum lipids
Chronic complications of DM such as microvascular and macrovascular dz are primarily r/t?
hyperglycemia
Both cushings syndrome and addison dz can manifest with elevated levels of:
ACTH
Which of the following alterations would you expect to find in a pt with untreated cushings dz or syndrome?
HTN
Characteristic physical features of individuals with cushings syndrome include:
truncal obesity and thin skin
A 35 year old female took corticosteriod therapy for several months. Which of the following would be expected?
Type 2 DM
The most common cx of addison's dz is:
An autoimmune reaction
A 50 year old female presents with light-headedness and overall abnormal feelings.CT scabs reveals an adrenal coritical tumor. Lab tests reveal that the tumor is hormone secreting. Which of the following would be expected?
Hypokalemia
Mental status changes and muscle weakness in people with addisons dz are primarily cxed by:
hypoglycemia
What is the cx of the hyperpigmentation seen in people with cushings syndrome and addisons dz?
Elevated levels of ATCH
A 30 year old female presents with HTN, HA, Tachycardia, impiared glucose tolerance, and weight loss. Which of the following is the most likely dx?
Pheochromocytoma
A 60 year old male presents to his physician complaining of chest pain. He is dx with atherosclerosis. The dz is cx by?
abnormal thickening and hardening of vessel walls
In general, atherosclerosis is cxed by?
endothelial injury and inflammation
Foam cells in a fatty steak are?
macrophages that engulf LDL
Normal blood pressure of adults age 18 or older is:
systolic pressure less than 120mm Hg and diastolic pressure less than 80 mm Hg
Most cases of combined systolic and diastolic HTN have no known cx and are dx as ____________HTN
Primary
A 30 year old Caucasian female was recently dx with primary HTN. She reports that she eats fairly well, usually having red meats and potatoes daily. She also reports that her father has HTN as well. Which of the following risk factors is most likely associated with this dx?
Genes
A 65 year old male presents for a routine checkup. A BP check reveals a systolic pressure of 160mm Hg and a diastolic pressure of 70 mm Hg. Which of the following is the most likely cx of this type of pressure elevation?
Rigidity of the aorta
A 55 year old has undiagnosed HTN. She presents to her physician complaining of impaired vision and chronic edema. Lab tests reveal that she also has renal insufficiency. The most likely cx for these findings?
end organ damage
The rapid onset of malignant HTN resullts in:
encepahlopathy
Orthostatic hypotension refers to a drop in BP when with:
Standing up
A 50 year old male is dx with orthostatic hypotension. Which of the following would he most likely experience?
Syncope and fainting
A 65 y/o female presents to ther ER c/o difficulty swallowing and SOB. A CT scan would most likely show an aneurysm in the:
aorta
A 60 y/o male is dx with cerebral aneurysm. The most likely area for it to occur is the:
circle of willis
A detached blood clot is called a:
thromboembolus
A 32 y/o female presents with lower leg pain and redness. An ultrasound reveals venous thrombus. Which of the following could have cx her condition?
Vascular injury and inflammation
A 28 y/o female presents with severe chest pain and SOB. She is dx with a PE, which most likely originated from the:
deep veins of the legs
Individuals with Raynauds dz have severe sx under which of the following conditions?
Cold exposure
A 75 y/o obese female presents to her physician c/o edema in the lower extremities Physical exam reveals that she has varicose veins. Which of the following is a possible cx?
Long periods of standing
A 52 y/o males presents with pooling of blood in the veins of the lower extremities and edema. The most likely manifestation of this disorder is?
skin depigmentation
Superior vena cava syndrome is a progressive ______ of the superior vena cava that leads
to venous distention of the upper extremities and head.
obstruction
A 50 y/o male with a 30 yr hx of smoking was dx with bronchogenic ca. He developed edema and venous distension in the upper extremities and face. Which of the following is the most likely dx?
Superior vena cava syndrome
A 52 y/o female is dx with coronary artery dz. She would be expected suffer from myocardial:
ischemia
A 50 y/o obese male with HTN and CAD visits a nutrionalist for food conseling. He is told that ___ fats raise LDL and lower HDL levels and should be avoided.
Trans-fats
The most common cx of myocardial ischemia?
atherosclerosis
A 53 y/o male presents with recurrent chest pain on exertion. He is dx with angina pectoris. The pain he experiences occurs when:
the myocardial oxygen supply has fallen below demand
A 51 y/o male is at his health clinic for an annual physical exam. After walking from the car to the clinic, he developed a substernal pain. He also reported discomfort in his left shoulder and jaw, lasting 2 to 3 mins and then subsiding with rest. He indicates that this has occurred frequently over the past few months with similar exertion. He is most likely experiencing:
stable angina
A 49 y/o male presents to his physician c/o chest pain. EKG reveals ST elevation. He is dx with myocardial ischemia. Which of the following interventions would be most beneficial?
Increase myocardial oxygen supply
A 68 y/o male presents to the ER c/o chest pain. He has a hx of stable angina that now appears to be unstable. He most likely has:
impending myocardial infarction
A 55 y/o male died of myocardial infarction. Autopsy would most likely reveal:
platelet aggregation within the atherosclerotic coronary artery
Cardiac cells can withstand ischemic conditions for ____before irreversible cell injury occurs
20 mins
A 60 y/o female had a myocardial infarction. She was brought to the hospital 30 mins later. She survived but now has impaied ventricular function because:
the resulting ischemia leads to hypoxic injury and myocardial cell death
A 75 y/o male has severe chest pain and dials 911. Lab tests at the hospital reveal elevated levels of creatinine phosphate and lactic dehydrogenase. These elevated levels indicate :
MI
A 28 y/o female presents to the ER complaining of severe chest pain that worsens with
respiration or lying down. She has a fever, tachycardia, and a friction rub. The most likely cx of these sx is:
acute pericarditis
A 56 y/o male presents to his physician for a checkup. Physical exam reveals edema, hepatomegaly, and muffled heart sounds. Which of the following is a concern?
Tamponade
A 42 y/o female is dx with constrictive pericarditis. She would also have a decreased cardiac output because of:
fibrosis and calcification of the pericardial layers
Many valvular stenosis and regurgitation disorders in adults have a common etiology. Which of the following can result in both types of what valvular dz?
Rheumatic fever or heart dz.
In valvular _____, the valve opening is constricted and narrow because the valve leaflets, or cusps, fail to open completely.
Stenosis
A 67 y/o female was previously dx with rheumatic heart dz. Tests reveal lipoprotein deposition with chronic inflammation that impairs blood flow from the left ventricle into the aorta. Which of the following is the most likely dx?
Aortic stenosis
A 60 y/o female was dx with mitral stenosis. As a result, she has incomplete emptying of the:
left atrium
A 72 y/o female has a hx of HTN and atherosclerosis. An echo reveals backflow of blood into the left ventricle. Which of the following is most likely the dx?
Aortic regurgitation
A 35 y/o male presents with pulmonary HTN. Testing reveals he is in heart failure. Which of the following is the most likely dx?
Tricuspid regurgitation
The most common cardiac valve dz in the united states, which tends to be the most prevalent in young women is:
Mitral valve prolapse
A 10 y/o male presents with fever, lymphadenopathy, arthalgia, and nose bleeds. He is dx rheumatic heart dz. The most likely cx of this dz is:
Group B-hemolytic streptococcus infections
A 10 y/o male presents with fever, lymphadenopathy, arthalgia, and nose bleeds. He is dx with rheumatic heart dz. This dz is usually characterized by:
antigens that bind to the valvular lining, triggering an autoimmune response.
A 30 y/o female presents to her physician with fever, cardiac murmur, and petechial skin lesions. She is dx with infective endocarditis. The most likely cx of her dz is:
bacteria
Inflammatory cells have difficultly limiting the colonization of microorganisms in infective endocarditis because:
the microorganisms are sequestered in a fibrin clot
A 50 y/o male visits the cardiologist for an EKG. Results indicate he has no PR interval and a variable rate QRS with rhythm irregularity. Which of the following is the most likely dx?
A fib
A 65 y/o male with a hx of untreated HTN is now experiencing left heart failure. The mist likely reason is:
Myocardial hypertrophy and ventricular remodeling
A 59 y/o female is dx with left ventricular failure. The decrease in kidney perfusion would ultimately cx:
Increased systemic vascular resistance
A 68 y/o female is experiencing left heart failure. Physical exam reveals elevated blood pressure most likely cx by:
sympathetic nervous system compensated for decreased cardiac output
A 65 y/o male is dx with chronic pulmonary dz and elevated pumonary vascular resistance. Which of the following heart failures generally results from this condition?
R HF
A 72 y/o female has a hx of right HF cx by right ventricular myocardial infarction. Which of the following sx are specifically r/t her Right HF:
Significant edema to both lower legs and feet
High output failure occurs with:
anemia
When a person is in shock, impairment in cellular metabolism is cx by:
inadequate tissue perfusion
One consequence of switching from aerobic to anaerobic cellular metabolism during shock state is:
Decreased ATP production
During shock status, glucose uptake is usually:
impaired
A 50 y/o male was admitted to the intesnive care unit with a dx of acute myocardial infarction. He is being tx for shock. His cardiopulmonary sx include low BP, tachycardia and tachypnea. His skin is pale and cool. The primary cx of his shock is most likely:
decreased cardiac contractility
An 82 y/o female was admitted to the hospital with confusion and severe hypotension. Her body's compensatory mechanisms are increased heart rate, vasoconstriction, and movement of large volumes of interstitial fluid to the vascular compartment. What kind of shock do you suspect?
Hypovolemic
A 27 y/o male is admitted to a neurologic unit with a complete C-5 spinal cord transection. On inital assessment, he is bradycardic, hypotensive, and hyperventilating. He appears to be going into shock. The most likely mechanism of his shock is:
vasodilation cx by decrease in sympathetic stimulation
Neurogenic shock can be cx by any factor that inhibits the:
sympathetic nervous system
A 15 y/o male who is allergic to peanuts eats a peanut butter cup. He then goes into anaphylatic shock and develops:
bronchoconstriction, hives or edema, and hypotension
For an infection to progress to septic shock, which of the following must occur?
bacteria must enter the bloodstream
A 20 y/o female is being admitted to the hospital with fever and septic shock. Which set of clinical manifestations would you expect her to exhibit?
Low BP, Tachycardia, generalized edema
The hypotensive state seen in septic shock can cx:
gut lining disruption and the translocation of bacteria into the bloodstream
The most common cx of multiple organ dysfucntion syndrome (MODS) is:
septic shock
A 75 y/o female has been critically ill with MODS for longer than a week and has developed a severe oxygen supply and demand imbalance. The statement that best describes this imbalance is:
The reserve has been exhausted, and the amount of oxygen consumed depends on the amount the circulation is able to deliver
Which organ of the body is often the first to fail in pts with MODS?
Lungs
An 8-week old infant presents to his pediatrician for a well-baby check up. Physical exam reveals a murmur and an ECG confirms a ventricular septum defect. Which of the following genetic factors would most likely accompany this dx?
Down syndrome
A newborn child experiences hypoxia and cyanosis. The most likely dx is congenital heart defect cx a ____ stunt
Right-to-left
A newborn is dx with pulmonary stenosis. Which of the following intrauterine factors could have
cx this defect?
Infection
A 40 y/o pregnant women is concerned about the health of her unborn child. She has phenylketonuria (PKU) and recently had a viral infection. The child is born with a congenital heart defect, which of the following is the most likely based on the mother's hx?
Patent ductus arteriosus
Coarctation of the aorta is the local narrowing of the aorta near the:
ductus arteriosus
A newborn is suspected of having coarctation of the aorta. Which of the following assessments would aid in dx?
weak or absent femerol pulses
A newborn child s dx with trisomy 18. Which og the following congenital heart defects will she most likely have?
Ventricular deptal defect
A 1-month old infant visits her physician for a well baby check. Physical exam reveals decreased cardiac output, hypotension, tachycardia, and loud murmur suggestive of aortic stenosis. Which of the following would be expected with this dx?
ventricular hypertrophy
A newborn develops a murmur and cyanosis shortly after birth. She is dx with pulmonary stenosis after an ECG revealed narrowing of the:
pulmonary valve orifice
The patent opening between the aorta and pulmonary artery in a fetus is called the:
ductus arteriosus
A 2 wk old infant presents with poor feeding, fatigue, dyspnea, and a murmur. She is dx with a patent ductus arteriosus. This condition results in a:
left to right shunt
An infant under goes an Echo for a suspected heart defect. Tests reveal an opening in the middle of the atrial septum. This defect is referred to as:
ostium secundum atrial septal defect
The most common type of congenital heart defect is:
ventricular septal defect
A newborn experiences frequent periods of cyanosis. An echo reveals that the tricuspid valve failed to develop and no blood flows between the right atrium and right ventricle. This condition is referred to as triscuspid:
atresia
Which of the following statements best describes total anomalous pulmonary venous connection?
Pulmonary venous return into the right atrium
A newborn baby is severely cyanotic. An echo reveals transportation of the great arteries. Which of the following occurs with this defect?
The aorta leaves the right ventricle
A 1 month old infant was dx with trucus arteriosus with a ventricular septal defect. Which of the following would also be expected?
Blood from both ventricles mixing in a common vessel
A 22 y/o pregnant female presents for a fetal echo. Tests reveal small left atrium and mitral valve and ab absent left ventricle and aortic valve. This defect is:
an indication for neonatal heart transplant
A 1 y/o female with a ventricular septal defect is experiencing CHF. Which of the following will most likely occur?
Failure to thrive and periorbital edema
A 3 y/o Japanese male is dx with Kawasaki dz. Which of the followig is most likely the cx:
Systemic vasculitis of unknown etiology
A 5 y/o female is found to have HTN during three seperate visits to her physician. Lab tests reveal
that the HTN is secondary to :
Renal dz
A 55 y/o male presents c/o incontinence. Tests reveal that he has a lower urinary tract obstruction. Which of the following is of concern?
Formation of renal calculi
The most common type of renal stone is composed of:
Calcium
The most important factor in renal calculus formation is:
urine pH
A 24 y/o female is dx with renal calculus that is cx obstruction. Which of the following sx would she most likely experience?
Flank pain
A 25 y/o female presents with burning urination. She was dx with a UTI. Which of the following organisms ia moat likely infecting her urinary tract?
E. Coli
A 35 y/o male received a traumatic brain injury in a MVA. CT scan revealed a lesion above the pontine micturition center. Which of the following would be expected:
Detrusor hyperflexia
A 19 y/o female is involved in a MVA during which she sustained a closed head injury. She is now experiencing detrusor sphincter dyssynergia. Which of the following is the most beneficial tx?
Alpha 1-blockers
A complicated UTI:
occurs in individuals with other health problems
Mechanisms for defense against urinary pathogens in women include:
secretion of mucus that traps bacteria
A 28 y/o female presents with fever, chills, and flank pain. She is dx with pylonephritis. Her infection is located in the:
renal pelvis
A 25 y/o male was dx with good pasture syndrome. Which of the following mechanisms would cx tissue injury?
Production of antibodies against the glomerular basement membrane
A 15 y/o male is dx pharyngitis. Eight days later he developed acute glomerulonephritis. Which of
the following is most likely the cx of this dz?
Group A b-hemolytic streptococcus
Acute poststreptococcal glomerulonephritis is primarily cx by:
antigen-antibody complex deposition in the glomeular capillaries and inflammatory damage
A 30 y/o male is demonstrating hematuria with RBC casts and proteinuria exceeding 3-5 g/day, with albumin being the major protein. The most probable dx is:
acute glomerulonephritis
A 54 y/o female is dx with nephrotic syndrome. Which of the following is a common sx of the dz?
Proteinuria
A 35 y/o female was severely burned and is hospitalized She is now suffering from acute tubular necrosis. Which of the following is most likely the dx?
Intrarenal
A 56 y/o male presents with flank pain and polyuria. Tests reveal that he has an enlarged prostate. Which of the types of RF are most likely to occur?
Postrenal
A 60 y/o male is dx with RF. Which of the lab values would be most consistent with the dx?
Elevated plasma creatinine level
A 45 y/o female presents with HTN, anorexia, N/V, and anemia. She is dx with chronic RF. Anemia in this pt is cx by:
inadequate production of erythropoietin
A 42 y/o female is dx with chronic RF. Tx including restricting:
Proteins
Bone fractures are at risk in chronic RF because:
the kidneys fail to activate vitamin D
Anemia accompanies chronic RF because of :
inadequate production of erythropoietin
Pruitus, seen in pts with end-stage renal dz, is cx by high levels of:
calcium
Upon examination of a male infant, it is determined that the urethral meatus is located on the undersurface of the penis. This condition is called:
renal aplasia
A newborn male dies shortly afterbirth. Physical examination reveals wide-set eyes, parrot-beak nose low set ears and receding chin. The most likely dx is:
bilateral renal agenesis
A 15 y/o female presents with flank pain, irritability, malaise, and fever. Tests reveal glomerularnephritis. Which of the following is most likely dx?
poststreptococcal glomerulonephritis
If nephrotic syndrome is not cx initially by kindey dz, it is termed_____nephrotic syndrome.
Secondary
A 4 y/o male is dx with nephrotic syndrome. Which of the following accompanies this condition?
Proteinuria
A 7 y/o female is dx with nephrotic syndrome. Which of the following results from this condition?
Frothy urine
Which of the following clusters of sx would make a clinician suspect a child has developed glomerulonephritis:
Gross hematuria, flank pain, and HTN
A 5 y/o male was dx with glomerulonephritis. Hx reveals that he had an infection 3 weeks before the onset of this condition. The infection was most likely located in the:
Pharynx
In children, the most common cx of acute RF is:
hemolytic uremic syndrome
A 10 y/o male is dx with glomerulonephritis. Tests reveal the deposition of immunoglobulin IgA in the glomerular capillaries He would most likely have recurrent:
Hematuria
UTI's are common in newborns, and when they do occur, they are usually:
blood-borne infections
A 3 y/o female presents with recurrent UTI, fever, poor growth and development, and feeding problems. Tests reveal retrograde flow of urine from the urinary bladder into the ureters. This condition is known as:
vesicoureteral reflux
Wilms tumors are found in the:
kidneys
A 6 y/o male is experiencing urine reflux from the urinary bladder into a grossly dilated ureter and calyces. He was dx with vesicoureteral reflux. This condition would be graded:
IV
A 20 y/o male is dx with wilms tumor. Which of the following if often associated with this dz?
Aniridia (lack of the iris in the eye)
A 7 y/o male presents to his physician for incontinence. His mother indicates that he has never been continent. Which of the following is most likely the dx?
Primary enuresis