patho midterm

true or false: ischemia is the most common cause of cell injury

true

a 75-year old male presents with chest pain on exertion. the chest pain is most likely due to hypoxic injury secondary to:

ischemia

a 52 year old male suffered a myocardial infarction secondary to atherosclerosis and ischemia. once blood flow is returned to the damaged heart, reperfusion injury occurs as a result of

calcium overload and formation of free radicals

a patient has a heart attack that leads to progressive cell injury that causes cell death with severe cell swelling and breakdown of cell membrane and organelles. what term would the nurse use to define this process?

necrosis

true or false: sodium and water accumulation in an injured cell are result of hydropic swelling

true

what cellular adaptation describes an increase in the number of cells?

hyperplasia

describes the replacement of one adult cell with another

metaplasia

a report comes back indicating that muscular atrophy has occurred. a nurse recalls that muscular atrophy involves a decrease in ___ of muscle cell

size

a 40 year old female’s pap smear indicates abnormal changes in the shape and organization of cervical cells. which term would be used to identify this change?

dysplasia

true or false: dysplasia describes a reduction in cell size

false

liquefactive necrosis occurs in the brain because

it is rich in hydrolytic enzymes

a group of prison inmates developed tuberculosis following exposure to an infected inmate. on examination, tissues were soft and granular (like clumped cheese). what is the most likely cause?

caseous necrosis

true or false: intracellular accumulations of fatty acid and pigment is a reversible cell injury

true

a 50 year old female became infected with clostridium bacteria and died a week later. examination of her red blood cells revealed lysis of membranes. what was the most likely cause of her death?

gas gangrene

a 50 year old male intravenous drug user is diagnosed with hepatitis C. examination of the liver reveals cell death secondary to what?

infection induced apoptosis

coagulative necrosis___

is reversible if promptly and aggressively managed

true or false: ubiquitin is a protein that attaches to cellular proteins and targets them to the lysosomes

false

all the following are potentially reversible cellular responses except

necrosis

metaplasia

atrophy

hyperplasia

necrosis

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

cellular hypoxia

which of the following cellular changes is considered to be preneoplastic

hypertophy

dysplasia

metaplasia

hyperplasia

dysplasia

the enzymes responsible for degrading key intracellular structures during apoptosis are called

caspases

true or false: cancer is a condition that develops due to excessive and uncontrollable cell growth

true

the majority of solid cancerous tumors arise from

glandular tissue

skin tissue

nervous tissue

epithelial tissue

epithelial tissue

a biopsy from a patient with tissue growth showed anaplastic with abnormal cell size and shape. what best describes this growth?

malignant tumor

a 25 year old female develops a tumor of the breast glandular tissue. what type of tumor will be documented on the chart?

adenocarcinoma

a 30 year old female is diagnosed with cancer. testing reveals that the cancer cells have spread to local lymph nodes. a nurse realizes this cancer would be documented as stage

3

an oncologist is discussing when a cancer cell loses differentiation. what is the oncologist describing?

anaplasia

a nurse is referring to angiogenesis. what is the nurse describing?

new blood vessel growth

a nurse is explaining a proto-oncogene. a proto-oncogene is best defined as a ___ gene

normal

which of the following will trigger conversion of a protooncogene to oncogene

HIV

epstein barr virus

human t lymphocyte virus type 1

all of the above

all of the above

true or false: the suffix “oma” is always used to designate tissues as benign

false

true or false: the Rb and p53 proteins are examples of tumor suppressor gene products

true

the most common route of metastasis is through the blood vessels and ___

lymphatics

the normal function of tumor suppressor protein Rb is

blocks cell division by binding to transcription factors

all of the following are functions of the p53 protein except

triggers apoptosis when cells are critically damaged

inhibits the Rb protein

mediates cell growth induced by radiation and chemotherapy

stalls the cell cycle to allow time for cellular repair

inhibits the Rb protein

G.P.’s tumor is determined to have metastasized, which means that

tumor cells have spread to distant sites

after surgery to remove a lung tumor, mr. jones is scheduled for chemotherapy, which will

kill rapidly dividing cells

which of the following is a side effect of chemotherapy

anemia

leukopenia

thrombocytopenia

all of the above

all of the above

true or false: in general, a cancer cell that is more tissue-specific differentiated is more likely to be more aggressive

false

the cellular damage that is considered preneoplastic is

dysplasia

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

kill rapidly dividing cells

retroviruses are associated with human cancers, including

burkitt lymphoma

the hypermetabolic state leading to cachexia in terminal cancer is thought to be because of

tumor necrosis factor

malignant neoplasms of epithelial origin are known as

carcinomas

the primary effect of aging on all body systems is

decreased functional reserve

breast cancer in women who have the breast cancer gene

occurs at an earlier age

the most common tumor-suppressor gene defect identified in cancer cells is

p53

a patient with metastatic lung cancer wants to know her chances for survival. which response is correct:

“Lung cancer is always fatal.”

“Lung cancer has about a 15% survival rate.” 

“Lung cancer is highly curable when diagnosed early.”

“Lung cancer death rate has decreased significantly, as with all other cancers.”

“Lung cancer has about a 15% survival rate.” 

necrotic death of brain tissue usually produces what

liquefactive necrosis

metaplasia is

the replacement of one differentiated cell type with another

another bronchoscopy and histologic examination of a suspected tumor, your patient is diagnosed with primary bronchial carcinoma. thus, the tumor is what?

malignant

proto-oncogenes__

are normal cellular genes that promote growth

your patient is scheduled for a staging procedure. she wants to know what that means. the correct response is?

it is a procedure for determining the extent of tumor spread

familial retinoblastoma involves the transmission of what from parent to offspring?

mutant tumor suppressor gene

carbon monoxide injures cells by

reducing oxygen level on hemoglobin

paraneoplastic syndromes in cancer involve excessive production of substances by multiple means. a common substance found in excessive amounts resulting from cancer paraneoplastic syndromes is

calcium

of the statements below, which is the accurate statement regarding nutrition and cellular health

the body can generally produce elements essential for nutritional balance.

obese individuals are generally nutritionally healthy.

deficient cellular uptake by one cell type may contribute to excess nutrient delivery to other cell types.

a normal BMI indicates nutritional health.

deficient cellular uptake by one cell type may contribute to excess nutrient delivery to other cell types.

the cellualr response indicative of injury because of faulty metabolism is

intracellular accumulations

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

latent

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

norepinephrine

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

primary prevention

all of these cellular responses are potentially reversible except

necrosis 

metaplasia

atrophy

hyperplasia

necrosis

reperfusion injury to cells __

involves formation of free radicals

extreme cold injures cell by all the following except

ischemic injury from vasoconstriction

peripheral nerve damage from rebound vasodilation 

decreased blood viscosity

crystallization of cellular components

decreased blood viscosity

apoptosis is a process that results in cellular __

death

the primary adaptive purpose of the substances produced in the alarm stage is __

energy and repair

after suffering a heart attack, a middle aged man is counseled to take a cholesterol lowering medication. this is an example of

tertiary prevention

in general, with age, organ size and function __

decrease

the effects of excessive cortisol production include

immune suppression

persistence of the alarm stage will ultimately result in

permanent damage and death

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

hypertrophy

allostasis is best defined as

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

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

tachycardia

diaphoresis

increased peripheral resistance

pupil constriction

pupil constriction

the stage during which the patient functions normally, although disease processes are well established, is referred to as

subclinical

C.Q was recently exposed to group A hemolytic streptococcus and subsequently developed a pharyngeal infection. his clinic examination reveals an oral temperature of 102.3°F, skin rash, dysphagia, and reddened throat mucosa with multiple pustules. he complains of sore throat, malaise, and joint stiffness. a throat culture is positive for streptococcus, and antibiotics have been prescribed. the etiology of C.Q.’s disease is

streptococcal infection

somatic death refers to death __

of the entire organism

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

secondary prevention

true or false: when the cause is unknown, a condition is said to be idiopathic

true

what is the main characteristic of excessive immune responses?

autoimmunity

what is a key characteristic of type I hypersensitivity

IgE binds to mast cells, leading to degranulation and histamine release

which of the following is NOT common example of type III hypersensitivity?

urticaria (hives)

rheumatoid arthritis (RA)

systemic lupus erythematosus (SLE)

post-streptococcal glomerulonephritis (PSGN)

urticaria (hives)

an example of neoplasms from the myeloid lineage include alterations in

granulocytes

B cells

T cells

natural killer cells

granulocytes

which of the following leukemia presentations is primarily found in children?

acute myeloid leukemia (AML)

acute lymphoblastic leukemia (ALL)

chronic myeloid leukemia (CML)

chronic lymphoid leukemia (CLL)

acute lymphoblastic leukemia (ALL)

what finding is associated with hodgkin disease?

reed sternberg cells

when a patient asks the nurse what hypersensitivity is, how should the nurse respond? hypersensitivity is best defined as:

an excessive or inappropriate response of the immune system to a sensitizing agent

a patient presents with poison ivy on the extremities, face, and buttocks after an initial exposure 48 hours ago. this condition is an example of:

hypersensitivity type IV - contact dermatitis

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

type __ hypersensitivity reactions does NOT involve an antibody response

IV - involved with T cells

a nurse recalls that an example of an immune-complex mediated disease is:

hypersensitivity type III

which immunoglobulin class is found on the surface of mast cells?

IgE

which hypersensitivity reaction is associated with glomerulonephritis?

type III: immune complex

which hypersensitivity reaction is associated with hemolytic disease of the newborn?

type II: cytotoxic - everything with blood is type II

true or false: enlarged, contender lymph nodes (lymphadenopathy) are found with lymphoma and some leukemias

true

true or false: chronic lymphoid leukemia (CLL) is the most common type of leukemia in the U.S.

true

the philadelphia chromosome is a balanced chromosome translocation that forms a new gene called

bcr-abl

a diagnostic laboratory finding in plasma cell myeloma is

bence jones protein in the urine

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 the nurse expect to find with this disease?

reed-sternberg cell

a 62 year old reports experiencing regular night sweats and unintentionally losing weight. physical exam reveals enlarged neck lymph nodes that do not appear do be painful. these findings support a diagnosis of which type of cancer?

hodgkin lymphoma

a patient diagnosed with multiple myeloma reports severe pain. this pain can be attributed to:

destruction of bone tissue

what is the most common form of childhood leukemia?

acute lymphoblastic leukemia (ALL)