PATHO FINAL PT 1

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

a. tertiary prevention.
b. disease treatment.
c. primary prevention.
d. secondary prevention.

c. primary prevention.

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

a. primary prevention.
b. disease treatment.
c. secondary prevention.
d. tertiary prevention.

c. secondary prevention.

A patient with high blood pressure who is otherwise healthy is counseled to restrict sodium intake. This is an example of

a. primary prevention.
b. disease treatment.
c. tertiary prevention.
d. secondary prevention.

d. secondary prevention.

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

a. disease treatment.
b. primary prevention.
c. secondary prevention.
d. tertiary prevention

d. tertiary prevention.

A disease that is native to a particular region is called

a. pandemic.
b. endemic.
c. epidemic.
d. ethnographic.

b. endemic.

the stage during which the patient functions normally, although the disease process are well established

Subclinical

A patient has been exposed to meningococcal meningitis, but is not yet demonstrating signs of this disease. This stage of illness is called the _____ stage.

a. sequela
b. latent
c. prodromal
d. convalescence

b. latent

time during which first signs and/or symptoms appear indicating onset of disease

Prodromal Stage

Indicators that an individual is experiencing high stress include all the following except

a. increased peripheral resistance.
b. pupil constriction.
c. tachycardia.
d. diaphoresis.

b. pupil constriction.

Which is not normally secreted in response to stress?

a. Norepinephrine
b. Insulin
c. Epinephrine
d. Cortisol

b. Insulin

Selye’s three phases of the stress response incloude all the following except

allostasis

resistance

alarm

exhaustion

allostasis

Many of the responses to stress are attributed to activation of the sympathetic nervous system and are mediated by

a. ACTH.
b. norepinephrine.
c. glucagon.
d. cortisol.

b. norepinephrine.

The effects of excessive cortisol production include

a. hypoglycemia.
b. anorexia.
c. inflammatory reactions.
d. immune suppression.

d. immune suppression.

All the following stress-induced hormones increase blood glucose except

a. epinephrine.
b. norepinephrine.
c. aldosterone.
d. cortisol.

c. aldosterone.

Allostasis is best defined as

a. a state of equilibrium, of balance within the organism.
b. the overall process of adaptive change necessary to maintain survival and well-being.
c. steady-state.
d. the process by which the body heals following disease.

b. the overall process of adaptive change necessary to maintain survival and well-being.

The cellular response indicative of injury because of faulty metabolism is

a. metaplasia.
b. lactate production.
c. hydropic swelling.
d. intracellular accumulations.

d. intracellular accumulations.

An increase in organ size and function caused by increased workload is termed

a. metaplasia
b. atrophy.
c. inflammation.
d. hypertrophy.

d. hypertrophy.

The cellular change that is considered preneoplastic is

a. metaplasia.
b. hyperplasia.
c. anaplasia.
d. dysplasia.

d. dysplasia.

Metaplasia is

a. the disorganization of cells into various sizes, shapes, and arrangements.
b. an irreversible cellular adaptation.
c. the transformation of a cell type to malignancy.
d. the replacement of one differentiated cell type with another.

d. the replacement of one differentiated cell type with another.

All these cellular responses are potentially reversible except

a. necrosis.
b. metaplasia.
c. atrophy.
d. hyperplasia.

a. necrosis.

Coagulative necrosis is caused by

a. trauma or pancreatitis.
b. lung tissue damage.
c. interrupted blood supply.
d. dissolving of dead cells and cyst formation.

c. interrupted blood supply.

Necrotic death of brain tissue usually produces _____ necrosis.

a. liquefactive
b. coagulative
c. fat
d. caseous

a. liquefactive

Apoptosis is a process that results in cellular

a. mutation.
b. death.
c. atrophy.
d. proliferation.

b. death.

Somatic death refers to death

a. of the entire organism.
b. secondary to brain damage.
c. of a body organ.
d. of nerve cells.

a. of the entire organism

Liquefactive Necrosis

brain

Coagulative Necrosis

heart

Caseous Necrosis

lung

Fat Necrosis

pancreas

After surgery to remove a lung tumor, your patient is scheduled for chemotherapy, which will

a. kill rapidly dividing cells.
b. have minimal side effects.
c. selectively kill tumor cells.
d. stimulate immune cells to fight the cancer.

a. kill rapidly dividing cells.

Chemo Side Effects

anemia, nausea, bleeding, infections

deficits in immune system by cancer

chemotherapy

cancer cells

cancer metastasis to bone marrow

malnutrition

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

a. is malignant.
b. is benign.
c. is secondary to cancer elsewhere in the body.
d. has spread

a. is malignant.

Malignant neoplasms of epithelial origin are known as

a. adenomas.
b. lymphoma.
c. sarcomas.
d. carcinomas.

d. carcinomas.

sarcoma

malignant; mesenchymal origin

-oma

benign

Cancer grading is based on

a. local invasion.
b. tumor size.
c. metastasis.
d. cell differentiation

d. cell differentiation.

Your patient is scheduled for a staging procedure. She wants to know what that means. The correct response is which of the following?

a. It is based on exploratory surgery.
b. It is biochemical testing of tumor cells to determine the genetic basis of the tumor.
c. It is a histologic examination of tissues to determine the degree of tumor differentiation.
d. It is a procedure for determining the extent of tumor spread.

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

Tumor Marker Functions

produced by normal cells

help determine cancer origin

help identify progression of cancer

include prostatic-specific antigen

our patient eats "lots of fat," leads a "stressful" life, and has smoked "about two packs a day for the last 40 years." Her chronic morning cough recently worsened, and she was diagnosed with a lung mass. The most likely contributing factor for development of lung cancer in this patient is

a. stressful lifestyle.
b. high-fat diet.
c. cigarette smoking.
d. urban pollutants.

c. cigarette smoking

Dramatic hypotension sometimes accompanies type I hypersensitivity reactions, because

 

massive histamine release from mast cells leads to vasodilation.

 

toxins released into the blood interfere with cardiac function.

 

anaphylaxis results in large volume losses secondary to sweating.

 

hypoxia resulting from bronchoconstriction impairs cardiac function.

massive histamine release from mast cells leads to vasodilation.

Which disorder is associated with a type III hypersensitivity mechanism of injury?

 

Systemic lupus erythematosus

 

Graves disease

 

Erythroblastosis fetalis

 

Seasonal allergic rhinitis

systemic lupus erythematosus

The principle Ig mediator of type I hypersensitivity reactions is

 

IgA.

 

IgG.

 

IgM.

 

IgE.

IgE.

A primary effector cell of the type I hypersensitivity response is

 

monocytes.

 

mast cells.

 

neutrophils.

 

cytotoxic cells.

Mast cells

An important mediator of a type I hypersensitivity reaction is

 

complement

 

antigen–antibody immune complexes

 

T cells

 

histamine

histamine

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

 

I

 

II

 

III

 

IV

III

The hypersensitivity reaction that does not involve antibody production is type

 

I.

 

II.

 

III.

 

IV.

IV

While in the hospital for management of acute lymphoid leukemia (ALL), a patient develops severe thrombocytopenia. The most appropriate action for this condition is

 

anticoagulant therapy.

 

chemotherapy.

 

activity restriction.

 

isolation.

activity restriction

A 5-year-old patient’s parents report loss of appetite and fatigue in their child. The parents also state that the child refuses to walk as a result of pain. The child’s most likely diagnosis is

 

ALL (acute lymphoid leukemia)

 

CLL (chronic lymphoid leukemia)

 

AML (acute myeloid leukemia)

 

CML (chronic myeloid leukemia)

ALL (acute lymphoid leukemia)

Which type of leukemia primarily affects children?

 

ALL (acute lymphoid leukemia)

 

CLL (chronic lymphoid leukemia)

 

AML (acute myeloid leukemia)

 

CML (chronic myeloid leukemia)

Acute Lymphoblastic Leukemia (ALL)

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

 

ALL (acute lymphoid leukemia).

 

CLL (chronic lymphoid leukemia).

 

AML (acute myeloid leukemia).

 

CML (chronic myeloid leukemia).

ALL (acute lymphoid leukemia).

ALL (acute lymphoid leukemia).

Which group of clinical findings describes the typical presentation of ALL (acute lymphoid leukemia)?

 

Pain in long bones, infection, fever, bruising

 

Vertebral fracture, hypercalcemia, bone pain

 

Elevated WBC count found on routine examination, asymptomatic

 

Painless enlarged cervical lymph node, fever, weight loss

Pain in long bones, infection, fever, bruising

The patient is a 12-year-old boy diagnosed with acute lymphoid leukemia (ALL). As part of treatment, the patient must undergo several weeks of chemotherapy. The most serious complication of chemotherapy is

 

vomiting.

 

anemia.

 

alopecia.

 

infection.

infection

Which form of leukemia demonstrates the presence of the Philadelphia chromosome?

 

ALL (acute lymphoid leukemia)

 

CLL (chronic lymphoid leukemia)

 

AML (acute myeloid leukemia)

 

CML (chronic myeloid leukemia)

CML (chronic myeloid leukemia)

The Philadelphia chromosome is a balanced chromosome translocation that forms a new gene called

 

bcr-abl.

 

Rb.

 

p53.

 

ARA-c.

bcr-abl

CML signs and symptoms

fatigue, weight loss, abdominal discomfort, sweats

Multiple Myeloma possible location

liver, spleen, kidneys

A diagnostic laboratory finding in myeloma is

 

Bence Jones proteins in the urine.

 

decreased platelet count.

 

increased IgM antibody titer.

 

elevated blood glucose levels.

Bence Jones proteins in the urine.

Renal insufficiency is a common complication of which disease?

 

Chronic myeloid leukemia (CML)

 

Chronic lymphoid leukemia (CLL)

 

Myeloma

 

Hodgkin disease

myeloma

Hairy Cell Leukemia

reduction of granulocytes, platelets, RBC

Autologous stem cell transplantation is a procedure in which

 

there is a high rejection rate.

 

stem cells are transferred to the patient from an HLA-matched donor.

 

stem cells are transferred to the patient from an identical twin.

 

stem cells are harvested from the patient and then returned to the same patient.

stem cells are harvested from the patient and then returned to the same patient

The only known curative treatment for CML is allogeneic bone marrow transplantation from a suitable donor.

 

True

 

False

True

Allogenic Bone Marrow Transplant

transferring bone marrow from a healthy donor to a patient, often used for treating certain cancers and blood disorders

Patients with immunodeficiency disorders are usually first identified because they

 

run high fevers.

 

have unusually high WBC counts.

 

develop brain infections.

 

develop recurrent infections.

develop recurrent infections.

the primary source of erythropoietin is provided by

bone marrow

kidney

lung

liver

kidney

What is necessary for red blood cell production?

 

Phosphate

 

Iron

 

Magnesium

 

Calcium

Iron

Which characteristic is indicative of hemolytic anemia?

 

Increased total iron-binding capacity

 

Increased heart rate

 

Hypovolemia

 

Jaundice

Jaundice

What laboratory finding is usually found in aplastic anemia?

 

Leukocytosis

 

Thrombocythemia

 

Neutrophilia

 

Pancytopenia

Pancytopenia

The most effective therapy for anemia associated with kidney failure is

 

iron administration.

 

high-protein diet.

 

erythropoietin administration.

 

vitamin B₁₂ and folate administration.

erythropoietin administration.

Pernicious anemia is caused by a lack of

iron.

intrinsic factor.

folate.

erythropoietin.

intrinsic factor.

The cause of the most common form of anemia is

 

acute bleeding.

 

iron deficiency.

 

protein malnutrition.

 

chronic disease.

iron deficiency.

Patients who experience anemic episodes when exposed to certain drugs most likely have

 

thalassemia.

 

spherocytosis.

 

sickle cell anemia.

 

glucose-6-phosphate dehydrogenase deficiency.

glucose-6-phosphate dehydrogenase deficiency.

Transfusion reactions involve RBC destruction caused by

 

donor antigens.

 

recipient antibodies.

 

donor T cells.

 

recipient T cells.

recipient anntibodies.

Red blood cells differ from other cell types in the body, because they

 

contain cytoplasmic proteins.

 

have no cytoplasmic organelles.

 

have a longer life span.

 

contain glycolytic enzymes.

have no cytoplasmic organelles.

Excessive red cell lysis can be detected by measuring the serum

 

hemoglobin.

 

methemoglobin.

 

bilirubin.

 

erythropoietin.

bilirubin.

A 3-year-old boy who exhibits prolonged bleeding after minor trauma and a prolonged aPTT, but a normal platelet count, is likely to be diagnosed with

 

hemophilia.

 

liver dysfunction.

 

disseminated intravascular coagulation.

 

thrombocytopenia.

hemophilia.

Treatment for hemophilia A includes

 

heparin administration.

 

factor IX replacement.

 

factor VIII replacement.

 

platelet transfusion.

factor VIII replacement.

A normal bleeding time in association with normal platelet count, and increased prothrombin time (PT) and INR, is indicative of

 

vitamin K deficiency.

 

hemophilia B.

 

hemophilia A.

 

idiopathic thrombocytopenia.

vitamin K deficiency.

A newborn has melena, bleeding from the umbilicus, and hematuria. The newborn most likely experiencing

 

vitamin K deficiency bleeding.

 

acquired vitamin K deficiency.

 

von Willebrand disease.

 

disseminated intravascular coagulation.

vitamin K deficiency bleeding

The prothrombin time (PT) and INR (international normalized ratio) measure the integrity of

 

platelet function.

 

extrinsic pathway.

 

intrinsic pathway.

 

fibrinolysis.

extrinsic pathway.

The activated partial thromboplastin time (aPTT) is a measure of the integrity of

 

the extrinsic pathway.

 

the intrinsic pathway.

 

factor VIII synthesis.

 

plasminogen.

the intrinsic pathway.

A commonly ingested substance associated with prolongation of the bleeding time

acetaminophen

tobacco

aspirin

caffeine

aspirin

A cause of thrombocytopenia includes

 

hypoxemia.

 

reduced erythropoietin.

 

chemotherapy.

 

secondary polycythemia.

chemotherapy

Widespread activation of the clotting cascade secondary to massive trauma is called

 

hemophilia B.

 

disseminated intravascular coagulation (DIC).

 

Hageman disease.

 

idiopathic thrombocytopenia purpura.

disseminated intravascular coagulation (DIC)

Dysfunction of which organ would lead to clotting factor deficiency?

 

Liver

 

Kidney

 

Spleen

 

Pancreas

Liver

The conversion of plasminogen to plasmin results in

 

clot retraction.

 

fibrinolysis.

 

platelet aggregation.

 

activation of thrombin.

fibrinolysis.

the final step in clot formation is

conversion of prothrombin to thrombin
platelet degranulation and adhesion

conversion of fibrinogen to fibrin

clot retraction

clot retraction

Activation of the extrinsic pathway of coagulation is initiated by

 

platelet factors.

 

collagen exposure.

 

tissue thromboplastin.

 

factor VII.

tissue thromboplastin.

The megakaryocyte is a precursor to

 

factor IX.

 

white blood cells.

 

red blood cells.

 

platelets.

platelets.

the movement of lood through the vascular system is opposed by the force of

viscosity

the vessel length

vessel radius

resistance

resistance

Which causes vasoconstriction?

 

Norepinephrine

 

Calcium channel blocker

 

α-Adrenergic antagonist

 

Acetylcholine

Norepinephrine

Peripheral edema is a result of

 

arterial insufficiency.

 

venous thrombosis.

 

hypertension.

 

atherosclerosis.

venous thrombosis

Risk factors for atherosclerosis include

 

female gender.

 

hyperlipidemia.

 

high-protein diet.

 

low-fiber diet

hyperlipidemia

The goal of long term heparin for the management of a deep vein thrombosis is to

 

relieve edema.

 

prevent clot dislodgement.

 

dissolve the thrombus.

 

prevent further clot formation.

prevent further clot formation.

Tissues are able to autoregulate their rate of blood flow by controlling

 

perfusion pressure.

 

arterial blood pressure.

 

vascular resistance.

 

venous return to the heart.

vascular resistance.

A serious complication of deep vein thrombosis is

 

stroke.

 

hypertensive crisis.

 

extremity necrosis.

 

pulmonary embolus.

pulmonary embolus.

What results when systemic blood pressure is increased?

 

Hypovolemia

 

Decreased cardiac output

 

Vasoconstriction

 

Decreased vascular resistance

Vasoconstriction

Angiotensin-converting enzyme (ACE) inhibitors block the

 

release of rennin.

 

conversion of angiotensin I to angiotensin II.

 

conversion of angiotensinogen to angiotensin I.

 

effect of aldosterone on the kidney.

conversion of angiotensin I to angiotensin II.

Which blood pressure reading is considered to be indicative of prehypertension according to the JNC-7 criteria?

 

118/78

 

128/82

 

140/88

 

138/94

128/82

Restriction of which electrolytes is recommended in the management of high blood pressure?

 

Calcium

 

Potassium

 

Sodium

 

Magnesium

Sodium

Hypertension with a specific, identifiable cause is known as _____ hypertension.

 

primary

 

orthostatic

 

secondary

 

malignant

secondary