Pathophysiology: Week 2 Check Your Understanding

which disorder is considered a primary immunodeficiency disease?

- hiv/aids

- malnutrition immunodeficiency

- cancer immunodeficiency

- radiation immunodeficiency

hiv/aids

The relationship of blood flow (Q), resistance (R), and pressure (P) in a vessel can be expressed by which equation?

- q = p/r

- q = r/p

- r = pq

- p = q/r

q = p/r

the principle Ig mediator of type i hypersensitivity reaction is

- IgA

- IgG

- IgM

- IgE

IgE

an important mediator of a type i hypersensitivity reaction is

- complement

- antigen-antibody immune complexes

- t cells

- histamine

histamine

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

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

venous obstruction leads to edema because it __________ pressure.

- increases capillary oncotic

- increases arterial blood

- decreases tissue

- increases capillary hydrostatic

increases capillary hydrostatic

a primary effector cell of the type i hypersensitivity response is

- monocytes

- mast cells

- neutrophils

- cytotoxic cells

mast cells

the effects of histamine release include

- vasoconstriction

- bronchodilation

- increased vascular permeability

- decreased gut permeability

increased vascular permeability

a serious complication of deep vein thrombosis is

- stroke

- hypertensive crisis

- extremity necrosis

- pulmonary embolus

pulmonary embolus

a 58-year-old woman is seen in the clinic for reports of severe back pain. her chest x-ray demonstrates generalized bone demineralization and compression fracture. blood studies demonstrate elevated calcium levels. the most likely diagnosis is

- leukemia

- myeloma

- hodgkin disease

- back trauma

myeloma

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

which is not a manifestation of acute arterial obstruction?

- pain

- purpura

- pallor

- pulselessness

purpura

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 clinical finding is indicative of compartment syndrome?

- peripheral edema

- absent peripheral pulses

- redness and swelling

- atrophy of distal tissues

absent peripheral pulses

what is the effect on resistance if the radius of a vessel is halved?

- resistance doubles

- resistance decreases by a factor of 16

- resistance decreases by half

- resistance increases by a factor of 16

resistance increases by a factor of 16

the most common primary immune deficiency that affects only B cells is

- digeorge

- bruton agammaglobulinemia

- wiskott-aldrich

- selective IgA

selective IgA

renal insufficiency is a common complication of which disease?

- chronic myeloid leukemia (CML)

- chronic lymphoid leukemia (CLL)

- myeloma

- hodgkin disease

myeloma

clinical manifestations of chronic arterial obstruction include

- edema

- intermittent claudication

- decreased pressure proximal to the obstruction

- distal hyperemia

intermittent claudication

transfusion reactions involve rbc destruction caused by

- donor antigens

- recipient antibodies

- donor t cells

- recipient t cells

recipient antibodies

which vessel normally demonstrates the most rapid blood flow?

- an arteriole

- a capillary

- a venule

- the vena cava

the vena cava

which characteristic is indicative of hemolytic anemia?

- increased total iron-binding capacity

- increased heart rate

- hypovolemia

- jaundice

jaundice

the anemia resulting from a deficiency of either vitamin B12 (cobalamin) or folate is caused by a disruption in DNA synthesis of the blast cells in the bone marrow that produces very large abnormal bone marrow cells called megaloblasts

- true

- false

true

the arterial oxygen content (CaO2) for a patient with PaO2 100 mm Hg, SaO2 95%, and hemoglobin 15 g/dL is __________ mL oxygen/dL

- 19.4

- 1909.8

- 210

- 21.05

19.4

when systemic vascular resistance is decreased, blood flow

- increases

- decreases

- stays the same

- moves to the extremities

decreases

a newborn has melena, bleeding form 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

pernicious anemia is caused by a lack of

- iron

- intrinsic factor

- folate

- erythropoietin

intrinsic factor

a deficiency of von willebrand factor impairs

- activation of the coagulation cascade

- platelet aggregation

- platelet adhesion to injured tissue

- platelet production

platelet adhesion to injured tissue

the cause of the most common form of anemia is

- acute bleeding

- iron deficiency

- protein malnutrition

- chronic disease

iron deficiency

which causes vasoconstriction?

- norepinephrine

- calcium channel blockers

- a-adrenergic antagonist

- acetylcholine

norepinephrine

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

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

what laboratory finding is usually found in aplastic anemia?

- leukocytosis

- thrombocythemia

- neutrophilia

- pancytopenia

pancytopenia

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)

a cause of thrombocytopenia includes

- hypoxemia

- reduced erythropoietin

- chemotherapy

- secondary polycythemia

chemotherapy

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

- viscosity

- the vessel length

- the vessel radius

- resistance

resistance

a patient presents to the physician's office with pinpoint hemorrhages on the skin. the patient is most likely between the ages of __________ years.

- 6 months and 2

- 4 and 7

- 15 and 18

- 25 and 45

4 and 7

the most appropriate treatment for secondary polycythemia is

- volume expansion with saline

- measured to improve oxygenation

- phlebotomy

- chemotherapy

measured to improve oxygenation

treatment for hemophilia a includes

- heparin administration

- factor ix replacement

- factor viii replacement

- platelet transfusion

factor viii replacement

which condition is associated with an elevated reticulocyte count?

- renal disease

- aplastic anemia

- hypertension

- hemolytic anemia

hemolytic anemia

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

- bcr-abl

- Rb

- p53

- ARA-c

bcr-abl

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)

severe combined immunodeficiency (SCID) syndrome is an example of a(n)

- deficient immune response

- excessive immune response

- primary acquired immunodeficiency

- hypersensitivity reaction

deficient immune response

the hypersensitivity reaction that does not involve antibody production is type

- I

- II

- III

- IV

IV

which is not considered to be a risk factor for thrombus formation?

- thrombocytopenia

- vascular trauma

- stasis of blood flow

- circulatory shock

thrombocytopenia

peripheral edema is a result of

- arterial insufficiency

- venous thrombosis

- hypertension

- atherosclerosis

venous thrombosis

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)

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

RhoGAM (an Rh antibody) would be appropriate in an Rh- _____ woman with an _____ Rh- _____ antibody titer carrying an Rh- _____ fetus

- negative; positive; positive

- positive; negative; negative

- negative; negative; positive

- negative; negative; negative

negative; negative; positive

myasthenia gravis is a type ii hypersensitivity disorder that involves

- impaired muscle function

- symptoms of hyperthyroidism

- symptoms of arthritis or polyarthralgia

- symptoms of glomerular disease

impaired muscle function

the only known curative treatment for CML is allogenic bone marrow transplantation from a suitable donor

- true

- false

true

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

thalassemia may be confused with iron-deficiency anemia, because they are both

- hyperchromic

- microcytic

- genetic

- responsive to iron therapy

microcytic

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

two of the most serious oncology emergencies associated with non-hodgkin lymphoma are obstruction of the superior vena cava and compression of the spinal cord

- true

- false

true

blood flow is slow through capillaries because capillaries

- are so far away from the heart

- have the largest total cross-sectional area

- are so narrow

- have no smooth muscle

have the largest total cross-sectional area

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

- platelet function

- extrinsic pathway

- intrinsic pathway

- fibrinolysis

extrinsic pathway

excessive red cell lysis can be detected by measuring the serum

- hemoglobin

- methemoglobin

- bilirubin

- erythropoietin

bilirubin

disseminated intravascular coagulation may be treated with heparin therapy to

- enhance fibrinolysis

- inhibit clotting factor consumption

- activate platelets

- enhance liver synthesis of clotting factors

inhibit clotting factor consumption

a commonly ingested substance associated with prolongation of the bleeding time is

- acetaminophen

- tobacco

- caffeine

- aspirin

aspirin

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

what is the correct definition of complete remission (CR) of leukemia?

- cr is the absence of leukemic cells in the blood

- cr is less than 5% blasts in marrow and normal cbc values

- cr is absence of leukemic cells regardless of cbc values

- cr is less than 5% leukemic cells in the blood

cr is less than 5% blasts in marrow and normal cbc values

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 type of leukemia primarily affects children?

- ALL (acute lymphoid leukemia)

- CLL (chronic lymphoid leukemia)

- AML (acute myeloid leukemia)

- CML (chronic myeloid leukemia)

ALL (acute lymphoid leukemia)

blood flow throughout the periphery is regulated by

- cardiac output

- the autonomic nervous system

- velocity

- hemodynamics

the autonomic nervous system

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

burkitt lymphoma is most closely associated with

- epstein-barr virus

- radiation exposure

- immunodeficiency syndromes

- history of cigarette smoking

epstein-barr virus

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

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

a laboratory test finding helpful in confirming the diagnosis of iron-deficiency anemia is

- elevated total iron-binding capacity

- elevated MCHC and MCV

- elevated total and indirect bilirubin

- positive direct or indirect coombs test

elevated total iron-binding capacity

most carbon dioxide is transported in the bloodstream as

- carboxyhemoglobin

- bicarbonate ion

- dissolved carbon dioxide

- carbonic acid

bicarbonate ion

an increase in hemoglobin affinity for oxygen occurs with

- hyperthermia

- shift to the right

- elevated PCO2

- shift to the left

shift to the left

activation of the extrinsic pathway of coagulation is initiated by

- platelet factors

- collagen exposure

- tissue thromboplastin

- factor vii

tissue thromboplastin

vaccination for pneumococcal pneumonia should be performed before 1 year of age in patients with sickle cell anemia

- true

- false

false

the primary source of erythropoietin is provided by the

- bone marrow

- kidney

- lung

- liver

kidney

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

what is necessary for red blood cell production?

- phosphate

- iron

- magnesium

- calcium

iron