Patho Exam 2

It is accurate to state that

Allergy means deleterious effects of hypersensitivity

An accurate description of a type I reaction would be that it

Is generally allergic in nature

Atopic individuals

Tend to produce higher quantities of IgE

Serum sickness is

Caused by the formation of immune complexes

A type IV allergic reaction will

Be transferred by cells

A patient who presents with systemic lupus erythematosus (SLE) is likely to

Report symptoms of arthritis

Which of the following is true regarding organ transplant rejection

It is a type IV hypersensitivity

Which is true for a patient who is transfused with a unit of unmatched packed RBCs? The unit

Is type O blood and will have neither A nor B antigens

A patient who is a type AB+ blood will

Produce no anti-D antibodies

Hypersensitivity reactions include,

Type I IgE allergic reactions.
Type II tissue-specific reactions.
Type III immune complex reactions.
Type IV cell mediated reactions

The action of histamine results in the

Increase of vascular permeability.
Formation of edema.
Increase of blood flow into the affected area.
Bronchoconstriction

Urticarial is also known as

Hives.
Wheal/flare.
Dermal skin reaction

The mechanism by which a type II hypersensitivity reaction affects cells includes which of the following.

The cell is destroyed by antibody and complement
o Antibody may cause phagocytosis
o Components of neutrophils will release their granules
o Antibody-dependent cell-mediated cytotoxicity

An example of type IV sensitivity reactions would include
o Graft rejection
o Skin test for tuberculosis
o Autoimmune processes
o Poison ivy blebs

...

� A characteristic of a malignant tumor includes that is

Can spread far from the tissue of origin

Cancer of the connective tissue is referred to as a

Sarcoma

A cancerous tumor that is very poorly differentiated is referred to as being

Anaplastic

The serum marker used to evaluate a tumor of the adrenal gland is

Catecholamines

Which gene in its normal state negatively regulates cell proliferation?

Tumor suppressor genes

A mutation that occurs due to changes in nucleotide base-pairs is described as a

Point mutation

The name for the process whereby tumor cells generate their own blood supply is referred to as

Angiogenesis

When a patient is diagnosed with a benign tumor

it can be assumed that the tumor is, Well encapsulated. Well differentiated

Research has shown a connection between the development of cancer and the

Epstein-Barr virus or Hepatitis B virus or Hepatitis C virus or Human papillomavirus

It is true that tobacco smoking is

Associated with both small and squamous cell carcinomas

It is true that ultraviolet light

Induces the tumor necrosis factor

When a patient has been diagnose with a basal cell carcinoma

it is correct to assume that the, Lesion is most likely found on the arms and legs

It is accurate to assume that a patient diagnosed with melanoma is most likely

Experiencing a lesion on the back of the legs

Long-term exposure to asbestos is most likely to resort in development of cancer of the

Lung

Which is a characteristic of cachexia?

Early satiety

Which best describes the term therapeutic index

The relative effective dose needed to kill cancer without harming normal cells

Excessive alcohol consumption is connected with cancer of the

Oral cavity or Larynx or Liver or Esophagus

Regarding the body's defense mechanisms against cell damage it is true that

The phase I activation enzyme is represented by cytochroms P450

The enzymes that protect against damage are found predominantly in the liver

Most xenobiotics are transported in the blood by lipoproteins

Which cancers are linked to obesity and a higher risk of death?

Esophageal or Stomach or Colorectal

Radiation-induced damage is affected by factors that include

Dose response or? Repair mechanisms or? Antioxidants or? Protraction

It is true that the specificity theory of pain

Relates the amount of pain to the amount of soft tissue injury

Which pair of structures regulates the complex emotional responses to pain?

Limbic and reticular system

Which activity has been documented to increase the levels of circulating endogenous endorphins?

Stress

The appropriate definition of perceptual dominance is

Pain at one location that may cause an increase in threshold at another location

The appropriate term for pain that is present in an area distant from its point of origin is

Referred pain

A mechanism that does not result in heat loss is

Vasoconstriction

A benefit of fever to human blood includes

A switch to lipolysis and proteolysis

A patient who was outside on a summer day and is now experiencing increased sweating and thirst weakness and dizziness is exhibiting signs of

Heat exhaustion

A 55-year-old obese male presents to a sleep clinic complaining of difficulty sleeping. He reports that he wakes gasping for air and his wife is ready to divorce him because his snoring keeps her up at night. Which is the most likely diagnosis for this pa

Obstructive sleep apnea

Involuntary unilateral or bilateral rhythmic movements of the eyes is referred to as

Nystagmus

A young child presents with redness of the eyes. The parents indicate that this condition seems to be 'going around' the daycare. Which is the most likely diagnosis?

Conjunctivitis

Which type of hearing loss is a result of foreign body obstruction of the inner ear?

Conductive

A patient who reports that 'everything tastes unpleasant' is exhibiting symptoms of

Dysgeusia

Endogenous opioids include

Enkephalins and Endorphins And Dynorphins And Endomorphins

The classification of acute pain includes

Acute visceral And Referred And Acute somatic And Cutaneous

It is correct to assume that Cheyne-Stokes respirations (CSR)

Involve a pathologically increased ventilator response

A patient experiences no nausea but significant vomiting with a CNS injury when the trauma

Involves the vestibular nuclei

Pinhole-sized pupils can be a result of an overdose of

Opiates

A patient has sustained a traumatic brain injury but is able to follow simple commands and can manipulate objects. The term used to describe this state is

Minimally conscious

A patient experiencing the tonic phase of a seizure exhibits

Muscle contraction with increased muscle tone

A patient who reports a loss of childhood memories is describing a characteristic of

Retrograde amnesia

A patient who is experiencing difficulty in recognizing a pattern's form and the nature of objects is exhibiting characteristics of

Aphasia

A patient who is experiencing a loss of comprehension or the production of language is described as having

Dysphasia

A patient who fell and hit his head 2 days ago is now restless and irritable. This scenario is characteristic of

Delirium

It is true that Alzheimer disease is

A result of neuronal proteins becoming distorted and tangled

The term used to describe a patient who sustains a cerebrovascular accident and is paralyzed on the left side is

Hemiplegia

A patient who exhibits involuntary twisting movements caused by slow muscle contraction on the right side of the body is experiencing

Hemidystonia

A patient is diagnosed with Huntington disease. Which of the following is a true statement? Huntington's disease is

Also known as chorea

A patient diagnosed with Parkinson disease initially experiences

Fine tremors

A patient presents with a wide-based gait in which the feet were turned outward. She staggers when walking and holds her pelvis stiff. These characteristics are representative of

Cerebellar gait

A basic neural system to cognitive function would include

Attentional systems or Memory systems or (Affective or emotive systems) or Language systems

Abnormal findings in which of the following evaluations would indicate possible neurological dysfunction

Level of consciousness or Pattern of breathing or Eye position or Skeletal muscle motor responses

Criteria for determining brain death include

Unresponsive coma or No spontaneous respiration or Isoelectric EEG

A means of classifying a seizure includes

Clinical manifestations or Site of origin or Response to therapy or EEG correlates

A characteristic of Alzheimer disease includes

Short-term memory loss or Increased irritability and agitation or Anxiety and depression

The person at highest risk for traumatic brain injury (TBI) is

African American and economically disadvantaged

The most common cause of TBI is

Motor vehicle accidents

A trauma patient diagnosed with a brain contusion experiences changes in attention memory affect and emotion. In which region of the brain is the contusion most likely located?

Frontal

An elderly alcoholic man falls and experiences a hematoma that is on the top of his brain. The hematoma is most likely a

Subdural

A 23-year-old patient is hit in the temporal portion of his skull during an altercation. Although he initially loses consciousness he soon awakens and is conversant. Three hours later he is experiencing vomiting drowsiness and confusion. These symptoms ar

Epidural

A patient experiences a vertebral fracture in which the C1 vertebra is fractures into several fragments. This type of fracture can be described as

Comminuted

It is true that spinal shock

Involves all skeletal muscles

A patient is experiencing pain that courses over the buttocks and into the calf and ankle. This is suggestive of a herniated disc at which vertebral level?

Lumbar

It is true that an acute cerebrovascular accident (CVA) is

The leading cause of disability in the United States

It is true that hemorrhagic stroke

Is commonly caused by hypertension

It is correct to assume that a saccular aneurysm

Can be due to a combination of congenital and degenerative changes

It is correct to assume that a subarachnoid hemorrhage is

A risk for individuals with an intracranial aneurysm

Which of the following statements is true regarding grading of the astrocytoma?

Grades III and IV are treated with surgery

it is correct to assume that Grade III and Grade IV astrocytomas are

Commonly found in the frontal lobe and cerebral hemisphere

It is true that an oligodendroglioma

Rarely includes cysts or calcifications

Which is true regarding metastatic tumors that are located in the brain?

Carcinomas are disseminated to the brain from the circulation

Which is true regarding meningitis?

Tubercular meningitis has a 90% recovery rate if diagnosed early

A patient has a brain abscess with a decreased necrotic center and mature collagen. This is most consistent with which stage?

Early capsule formation

It is true that encephalitis is

A result of arthropod borne viruses

A patient experiences demyelination of the peripheral nerves with sparing of the axons. This is characteristic of

Guillain-Barre

A patient is brought to the emergency room following a motor vehicle accident in which he sustained diffuse brain injury. Which of the following symptoms would be expected to accompany his injury?

Memory deficits or Swallowing disorders or Agitation or Short attention span

Risk factors for a CVA includes

Smoking or Diabetes or Arterial hypertension or Atrial fibrillation

A patient is diagnosed with a meningioma. The most likely site of the tumor is the

Sella turcica or Olfactory groove or Tuberculum sellae or Sphenoidal wing or Cerebellopontine angle

A cause of cerebral aneurysm includes

Arteriosclerosis or Congenital anomaly or Trauma or Cocaine abuse

Abnormalities in endocrine function may be caused by an

Absence of antibodies against specific receptors

A symptom of SIADH is

Hyponatremia

It is true that DI:

Occurs with organic lesion of the hypothalamus or pituitary

A patient experiences nausea vomiting loss of body hair fatigue weakness and hypoglycemia. The hormone deficiency the patient is most likely experiencing is that of

ACTH

It is correct to assume that pituitary adenomas

Arise from the anterior pituitary

A patient with visual changes that begin in one eye then progress to the second eye is likely experiencing

Pituitary adenoma

It is correct to assume that acromegaly

Is the result of a GH-secreting pituitary adenoma

A symptom of prolactinoma would include

Galactorrhea

Symptoms of Graves disease includes

Goiter

Medication used to treat thyrotoxic crisis includes

Iodine

Two siblings are diagnosed with a thyroid disorder due to destruction of thyroid tissue by lymphocytes and circulating thyroid autoantibodies. This pathology is likely the result of

Hashimoto disease

Myxedema coma is generally associated with

Lactic acidosis

It is correct to assume that primary hypothyroidism

Is the result of absent thyroid tissue

When a patient is diagnosed with thyroid carcinoma patient education concerning the disease should include the information that

Thyroid carcinoma is the most common endocrine malignancy

Diabetic ketoacidosis (DKA) is a result of

Increased fat metabolism

A patient develops severe dehydration and hyperglycemia in the absence of ketosis. Which of the following conditions does this patient have?

Hyperosmolar hyperglycemic nonketotic syndrome (HHNKS)

A patient experiences retinopathy due to diabetes. There is venous dilation microaneurysm formation and blot hemorrhages. Which stage of retinopathy is this person experiencing?

Stage I

Which symptom would a patient diagnosed with pheochromocytoma also experience?

Headaches

Syndrome of inappropriate antidiuretic hormone hypersecretion (SIADH) may result from

Ectopic production of ADH by tumors or Pulmonary disorders like asthma or Central nervous system disorders such as encephalitis or (Psychiatric disease treated with antidepressants or antipsychotics)

A newly diagnosed diabetic patient will exhibit symptoms of

Polydipsia and Polyphagia and Weight loss

Risk factors for insulin resistance include

Obesity and Inactivity and Age and Medications

Complications experienced by patients with chronic uncontrolled type 2 diabetes are

Peripheral vascular disease or Orthostatic hypotension or Thickened capillary membranes or Visual difficulties

Which form of anemia is caused by altered heme synthesis in erythroid cells?

Sideroblastic

Which term refers to an abnormally high production of red blood cells?

Polycythemia

Which statement regarding infectious mononucleosis (IM) is true?

Commonly caused by Epstein-Barr virus (EBV)

Which form of leukemia is the most common in children?

Acute lymphoblastic leukemia (ALL)

Which statement regarding lymphoma is true?

Palpable tender lymph nodes are present

Which statement regarding Hodgkin lymphoma is true?

Peak incidence ovvurs in the early 20s through the 30s and then later in life

Which statement regarding Burkitt lymphoma is true?

A fast-growing tumor of the jaw and facial bones

Spontaneous bleeding without trauma is possible when the platelet count is

Less than 10,000

The most common source of drug-induced thrombocytopenia is

Heparin

Which statement regarding immune thrombocytopenic purpura (ITP) is true?

It is more common in females

Which statement regarding iron deficiency anemia is true?

It is common in children due to their extremely high need for iron for normal growth

Which statement regarding iron deficiency is true?

Hemoglobin of 7 g/dl to 8 g/dl may be accompanied by pallor

Microcytic-hypochromic anemia is known to be a result of disorders involving

Iron metabolism and Porphyrin synthesis and Globin synthesis and Heme production

Neutropenia

a condition invoving the blood's neutrophil count, is believed to be caused by its, Decreased production or? Increased turnover or? Abnormal distribution or? Reaction to an overwhelming infection

Which condition is a known cause of eosinophilia

Asthma or Atopic dermatitis or Eczema

The known causes of lymphadenopathy include

Neoplastic disease and Inflammatory condition and Lipid storage disease and Immunologic disorders

Which condition is one of the current criteria for presence of an overactive spleen?

Anemia or Cellular bone marrow or Splenomegaly or Thrombocytopenia

Which statement regarding thrombotic thrombocytopenic purpura (TTP) is true?

Caused by platelet aggregates or More common in females or Occurring more frequently

Which factors involved in blood clotting are regulated by vitamin K?

II or VII or IX or X

Which situation is a characteristic of the triad of Virchow?

Injury to endothelium or Abnormalities of blood flow or Hypercoagulability of the blood

cell membrane

Target cell receptors for water-soluble hormones are located in the___________

posterior pituitary

Which gland secretes ADH and oxytocin?

high serum osmolarity

ADH release from the posterior pituitary is stimulated by the__________

oxytocin

If a patient had a problem with the hypothalamus, what hormone would be affected?

uterus

Target cells for oxytocin are located in the ________

inhibit calcium reabsorption from bones

A 70-year-old female has brittle bones secondary to osteoporosis. Her doctor provides calcitonin to:

iodine

Which nutrient would the nurse encourage the patient to consume for thyroid hormone synthesis?

increased serum calcium levels

A nurse is reviewing lab results. Which of the following lab results would slow down the rate of parathyroid hormone secretion

serum glucose levels

Insulin is primarily regulated by

cortisol

the post potent naturally occurring gulcocorticoid

afferent pathway

begins in the peripheral nervous system, travels to the spinal gate in the dorsal horn and the ascend to higher centers in the central nervous system

interpretive centers

located in the brain stem, midbrain, diencephalon, and cerebral cortex

efferent pathway

descend from the CNS back to the dorsal horn of the spinal cord

nociception

the processing of potentially harmful stimuli through a normally functioning nervous system; pain perception

noxious

harmful stimuli

A-delta fibers

medium sized thinly myelinated fibers that transmit sharp, localized pain

C fibers

small unmyelinated fibers that transmit slow dull aching, or burning sensations that are poorly localized

A-beta fibers

large myelinated fibers that transmit touch and vibration sensation but usually do not transmit pain

inhibition

promotes pain and opens pain gate; negative

excitation

blocks pain and closes pain gate; positive

transduction

activation of nociceptors when tissue is damaged

transmission

conduction to dorsal horn and up spinal cord to thalamus, brains seem, and cerebral cortex

perception

the conscious awareness of pain in the reticular and limbic systems and the cerebral cortex

modulation

the increase or decrease of the transmission of pain before during or after the pain is perceived

excitatory neuromodulators

substance P, glutamate, and somatostatin

inhibitory neuromodulators

GABA, glycine, serotonin norepinephrine, and endorphins

endogenous opioids

a family of morphine-like neuropeptides that block transmission of pain impulses in the spaniel cord, brain, and periphery by binding with specific receptors. May be responsible for feeling of well being

pain threshold

the point where pain is first perceived

perceptual dominance

pain at one location may cause an increase in the threshold at another

pain tolerance

the greatest intensity of pain that a person can endure

acute pain

a protective mechanism that alerts the individual to a condition or experience that is immediately harmful to the body and mobilizes the individual to take prompt action to relieve it

acute somatic

pain that is superficial, arising from the skin muscle or bone

acute visceral

pain in the internal organs and abdomen; less localized because of less nociceptors

referred pain

pain that is felt in a place distant from its point of origin; shares the same spinal segment as point of origin

chromic

refer to hemoglobin content

cytic

refer to RBC size

anisocytosis

RBC assuming various sizes

poikilocytosis

RBC assuming various shape

leukocytosis

leukocyte count is high; normal protective response to stressors

leukopenia

leukocyte count is low; not normal

shift-to-the-left

premature release of immature cells

lymphocytosis

rare in acute bacterial infections; mostly in acute viral infections; EBV

lymphocytopenia

abnormalities of lymphocytes because of immune deficiencies, destruction by drugs, viruses, or radiation

acute leukemia

presence of immature blast cells

chronic leukemia

presence of mature mature cells that don't function correctly

thrombocytopenia

not enough platelets

thrombocythemia

to many platelets >400,000; increased risk for clotting

chronic pain

pain lasting longer than the normal healing time

neuropathic pain

result of trauma or disease of nerves

peripheral neuropathic pain

problems with the nerves such as painful diabetic neuropathy

central neuropathic pain

problems with the brain or spinal chord such as phantom limb

hypothalamus

primarily regulates temperature

exogenous pyrogens

endotoxins produced by pathogens

endogenous pyrogens

excretions from phagocytic cells in response to exogenous pyrogens which increases temperature

hyperthermia

elevation of body temperature not caused by pyrogens

seizure

a syndrome where there are suddenly explosive, disorderly discharge of cerebral neurons and is characterized by a sudden transient alteration in brain function

tonic-clonic

happens in convulsions; contract relax movement

epilepsy

seizure activity for which no underlying correctable cause for the seizure can be found

aura

partial seizure that immediately precedes the onset of a generalized tonic-clonic seizure

prodrama

early manifestations occurring hours to days before seizure

tonic phase

associated with consciousness; muscle contraction

clonic phase

relaxation of muscles in seizure

postical phase

time period immediately following seizure activity

dementia

a progressive failure of many cerebral functions that often includes a decrease in orienting, memory, language, judgement and decision making

hydrocephalus

various conditions characterized by excess fluid in the cerebral ventricles, subarachnoid space, or both

noncommunicating hydrocephalus

obstruction within the ventricular system; seen mostly in children

communication hydrocephalus

defective resorption of CSF from the cerebral subarachnoid space

normal-pressure hydrocephalus

dilation of the ventricles without increased pressure

Parkinson's disease

degeneration of the basal ganglia causing a disorder of movement

secondary parkinsonism

caused by disorders other than parkinson disease, such as drugs, infection, or head trauma, that create the symptoms of parkinsons

spinal stenosis

narrowing of the spinal canal that puts pressure on the spinal nerves or cord and can be congenital or is usually acquired

spondylolisthesis

occurs when a vertebra slides forward and onto the vertebra below it

spondylolysis

a structural defect of the spine

thrombotic stroke

arterial occlusions caused by thrombi formation in the arteries supplying the brain or intracranial vessels

embolic stroke

fragments that break from a thrombus formed outside the brain

saccular aneurysms

occur frequently and likely result from congenital abnormalities in the arterial wall

fusiform aneurysms

occur as a result of diffuse arteriosclerotic changes and are found most commonly in the basilar arteries

adh

retains water

microcytic-hypochromic anemia

abnormally small RBC that contain reduced amounts of hemoglobin

macrocytic anemia

unusually large stem cells in the marrow that mature into RBC that are unusually large

normochromic

sufficient hemoglobin

pernicious anemia

caused by vitamin b12 deficiency; spleen enlargement, yellow skin

normocytic-normochromic anemia

normal sized RBC, sufficient hemoglobin, but not enough RBC's

posthemorrhagic anemia

caused by sudden blood loss with normal iron stores

polycythemia

overproduction of RBC

relative polycythemia

results from dehydration; to much RBC for the amount of water

granulocytosis

increase in granulocytes