Module 6: Infection, Inflam., and Tissue Healing

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Which of the following cells are strong phagocytes? - Macrophages - T lymphocytes - Plasma cells - Natural killer cells

macrophages

A malignant bone-forming tumor is referred to as a(n) - rhabdosarcoma. - liposarcoma. - osteosarcoma. - chondrosarcoma.

osteosarcoma. An osteosarcoma is a malignant bone-forming tumor. Rhabdo- refers to skeletal muscle. Lipo- refers to fat. Chondro- refers to cartilage.

Bone healing may be impaired by - excessive vitamin C - nicotine use - a high-protein diet - immobilization

nicotine use Nicotine can delay bone healing. Vitamin C, protein, and immobilization are necessary for bone healing.

The most common source of osteomyelitis is - an infection that migrates via the bloodstream. - direct invasion from a fracture. - surgical contamination. - a joint prosthesis.

an infection that migrates via the bloodstream. Hematogenous osteomyelitis (via the blood stream) is the most common type of osteomyelitis. Direct invasion of infection from a fracture, infection of a bone resulting from surgical contamination, and a joint prosthesis are not the most common sources of osteomyelitis.

The process of programmed cellular self-destruction is called: - necrosis - gangrene - somatic death - apoptosis

apoptosis

A bone disorder that results from insufficient vitamin D is referred to as - rickets - osteoporosis. - osteomalacia - subluxation

osteomalacia Osteomalacia is caused by vitamin D deficiency in adults. Rickets is caused by vitamin D deficiency in children. Osteoporosis is related to decreased estrogen. Subluxation refers to a bone displacement.

The disorders characterized by softening and then enlargement of bones is referred to as - osteomyelitis. - osteoporosis. - Paget disease. - rickets.

Paget disease. Paget disease is characterized by excessive bone resorption and formation, causing fractures and deformities. Osteomyelitis, osteoporosis, and rickets do not involve softening and then enlargement of bones.

People who have osteoporosis are at risk for - rhabdomyolysis. - osteomyelitis. - osteomalacia. - bone fractures.

bone fractures Osteoporosis weakens the bone structure and increases the risk of bone fractures. Rhabdomyolysis, osteomyelitis, and osteomalacia are completely different conditions.

The most common symptom of multiple myeloma is - pathologic fracture. - fever. - bone pain. - osteomyelitis.

bone pain The most common symptom of multiple myeloma is bone pain. Although pathologic fractures occur in multiple myeloma, bone pain is the most common symptom. Fever and osteomyelitis are not common in multiple myeloma.

A compound, transverse fracture is best described as a bone that is - broken in two or more pieces. - cracked but not completely separated. - broken along the long axis. - broken and protruding through the skin.

broken and protruding through the skin. The type of fracture described is broken and protruding through the skin. A comminuted fracture is one that is broken in two or more pieces. An incomplete fracture is cracked but not completely separated. A longitudinal fracture is broken along the long axis.

Free radicals are unstable molecules that cause cellular injury by: - antioxidant activity - hypoxia - cell membrane damage - phagocytosis

cell membrane damage

Pain in fibromyalgia involves - muscle inflammation. - autoimmune destruction of muscle tissue. - nerve inflammation. - changes in pain transmission in the spinal cord.

changes in pain transmission in the spinal cord. Pain in fibromyalgia involves changes in pain transmission in the spinal cord that are called central sensitization. Muscle inflammation, nerve inflammation, and autoimmune destruction of muscle tissue do not cause the pain in fibromyalgia.

Following a bone fracture, the most likely event to occur is - development of a blood clot beneath the periosteum. - leukocyte infiltration into bone tissue. - blood vessel growth at the fracture site. - migration of osteoblasts to the fracture site.

development of a blood clot beneath the periosteum. The first step in bone healing is hematoma formation. Leukocyte infiltration into bone tissue, blood vessel growth at the fracture site, and migration of osteoblasts to the fracture site are not the first steps in bone healing.

The most common method of disease transmission is - airborne. - droplet. - vector. - inoculant.

droplet The most common transmission occurs through the exchange of body fluids (droplet) from kissing or sexual intercourse. Airborne transmission is not the most common method of disease transmission. Vector is not the most common method of disease transmission. Inoculant transmission is not the most common method of disease transmission.

A risk factor for osteoporosis is - endometriosis - early menopause - late menopause - ovarian cysts

early menopause Early menopause and late menarche are risk factors for osteoporosis. Endometriosis, late menopause, and ovarian cysts are not risk factors for osteoporosis.

An infectious disease that is common in a community is termed - endemic. - epidemic. - pandemic. - partdemic.

endemic An infectious disease that has a fairly constant presence in a community and changes little from year to year is classified as endemic. An epidemic is a significant increase in new infections in a certain population. A pandemic is an epidemic that has spread to a large geographic area, even worldwide. Partdemic is not a term that pertains to infectious diseases.

The disease that is similar to osteomalacia and occurs in growing children is - rickets. - osteosarcoma. - Paget disease. - osteopenia.

rickets Rickets is similar to osteomalacia in that it is caused by vitamin D deficiency and leads to soft, deformable bones. Rickets occurs in growing children. Osteosarcoma, Paget disease, and osteopenia are not similar to osteomalacia.

Rickets is characterized by soft, weak bones resulting from a deficiency of - calcium. - estrogen. - phosphate. - vitamin D.

vitamin D. Rickets is characterized by soft, weak bones resulting from vitamin D deficiency. Rickets is not caused by poor calcium intake or phosphate deficiency. Estrogen deficiency is related to osteoporosis, not rickets.

Immune function is likely to be most effective in a - newborn - 7 month old infant - 30 year old - 70 year old

30 year old Immune function is most effective in middle life. Newborns have an immature immune system. In older infants, maternal IgG that crossed the placenta at birth begins to fade over the first 6 months of life, and these babies are at greater risk for serious infection. Immunity tends to decline in the elderly resulting in reduced antibody responses to new antigens. The very young and the very old are more susceptible to infection because of immature or degenerating immune functions.

The person at highest risk of a greenstick fracture from falling off a tall ladder is age - 68. - 44. - 8. - 23.

8. Greenstick fractures occur primarily in children. The adults are not at high risk for greenstick fracture.

What is a lysosome? - A cell that has ruptured - A degradative enzyme inside a cell - A substance that has been ingested by a phagocytic cell - A membrane-bound bag of degradative enzymes within a cell

A membrane-bound bag of degradative enzymes within a cell

Where are neutrophils produced and stored in the body? - Bone marrow - Kidney - Thymus - Lymph nodes

Bone marrow Neutrophils are produced and stored in the bone marrow, from which they are released as needed.

Which of the following terms indicates cell death that occurs by severe cell swelling and the breakdown of organelles? - Gangrene - Metastasis - Necrosis - Adaptation

Necrosis

Which of the following terms indicates cell death that occurs by severe cell swelling and the breakdown of organelles? - Gangrene - Metastasis - Necrosis - Adaptation

Necrosis

What are polymorphonucleocytes? - Neutrophils - Mast cells - Cytotoxic T cells - Macrophages

Neutrophils Polymorphonucleocytes are neutrophils. The term describes their multilobed nuclei.

Which disorder usually causes skeletal pain and involves significant bone demineralization from vitamin D deficiency? - Osteomalacia - Osteopenia - Osteomyelitis - Osteoporosis

Osteomalacia Osteomalacia is inadequate mineralization of bone tissue, most commonly caused by vitamin D deficiency, and it usually causes skeletal pain. Osteopenia, osteomyelitis, and osteoporosis are not caused by vitamin D deficiency.

Which disorder usually causes skeletal pain and involves significant bone demineralization from vitamin D deficiency? - Osteomalacia - Osteopenia - Osteomyelitis - Osteoporosis

Osteomalacia Osteomalacia is inadequate mineralization of bone tissue, most commonly caused by vitamin D deficiency, and it usually causes skeletal pain. Osteopenia, osteomyelitis, and osteoporosis are not caused by vitamin D deficiency.

Which of the following cells produce antibodies? - T cells - Mast cells - Plasma cells - Macrophages

Plasma cells Plasma cells are mature B lymphocytes that have developed the capacity to produce antibodies.

Most muscle strains are caused by - a tear in an adjoining tendon. - abnormal muscle contraction. - muscle asymmetry. - bleeding into the muscle.

abnormal muscle contraction. Most muscle strains are caused by abnormal muscle contraction. A muscle strain can be caused by a tear in the muscle. A tendon strain can be as a result of a tear in the tendon. Muscle asymmetry is not the cause of muscle strains. Muscle strains are not caused by bleeding into the muscle.

Inflammation of the sacs that overlie bony prominences is called - epicondylitis. - arthritis. - tendinitis. - bursitis.

bursitis. Bursitis is inflammation of the bursal sacs that protect the skin over bony protuberances. Epicondylitis is inflammation of an epicondyle. Arthritis is inflammation of one or more joints. Tendinitis is inflammation of a tendon.

Muscular dystrophy includes a number of muscle disorders that are - genetically transmitted. - easily prevented and managed. - autoimmune in nature. - demyelinating focused.

genetically transmitted. Muscular dystrophy includes a number of muscle disorders that are genetically transmitted. Muscular dystrophy is not easily prevented or managed. It is not an autoimmune disease or a demyelinating disease.

What type of fracture generally occurs in children? - greenstick - stress - nightstick - colles

greenstick Greenstick fractures occur most often in the growing bones of children. Stress fractures can occur at any age. Nightstick and Colles fractures occur most often in adults.

The pathophysiology of osteomalacia involves - increased osteoclast activity. - collagen breakdown in the bone matrix. - crowding of cells in the osteoid. - inadequate mineralization in the osteoid.

inadequate mineralization in the osteoid. Osteomalacia is characterized by inadequate or delayed mineralization in the osteoid. Osteomalacia does not involve increased osteoclast activity, collagen breakdown in the bone matrix, or crowding of cells in the osteoid.

Healing of a fractured bone with a poor alignment is called - malunion. - nonunion. - disunion. - delayed union.

malunion Malunion is a complication that occurs when the bone fails to align correctly during the healing process. Nonunion and delayed union are different complications of bone healing. Disunion is not the term used for fracture healing with poor alignment.

The precursor cell to the macrophage is the: - neutrophil. - eosinophil. - fibroblast. - monocyte.

monocyte Monocytes produced by the bone marrow circulate in the blood, from which they enter tissue and mature into macrophages.

Drug resistance of microbes occurs secondary to - patient allergy to a drug - mutation of the microbe - enhance pathogenicity of the microbe - using high doses of drugs

mutation of the microbe Drug resistance develops secondary to chance mutations of microbes in response to a change in the host's environment. Patient allergy to a drug does not cause drug resistance. Although drug resistance may lead to enhanced pathogenicity of a microbe, pathogenicity does not lead to drug resistance. Using low doses of a drug to treat infection leads to drug resistance.

Compartment syndrome occurs secondary to - bone infarction. - soft-tissue damage. - muscle necrosis. - breakdown of RBCs.

soft-tissue damage Compartment syndrome occurs because of severe soft-tissue damage. Bone infarction and the breakdown of RBCs do not cause compartment syndrome. Muscle necrosis does not cause compartment syndrome, but can result from it.

What are cytokines? - Regulatory chemicals secreted by endocrine glands - Inflammatory chemicals that are released from necrotic cells - Chemical messengers secreted by immune and other cells - Destructive enzymes contained in lysosomes

Chemical messengers secreted by immune and other cells

Complete healing of a bone fracture occurs when - no movement of the break is detectable. - the callus has been completely replaced with mature bone. - the fracture site and surrounding soft tissue are pain free. - a cast is no longer required to stabilize the break.

the callus has been completely replaced with mature bone Complete healing of a bone fracture occurs when the callus has been completely replaced with mature bone. A lack of detectable movement of the break does not indicate that the fracture is healed. Even when a bone fracture is healed, pain at the fracture site and surrounding soft tissue may be present. The patient may progress from a cast to a splint, sling, or brace as the bone fracture continues to heal.

Characteristics of immunization include which of the following? (Select all that apply.) - Giving injections of preformed antibodies provides immediate immunity. - Immunization provides life-long immunity. - Immunization with killed vaccines may lead to infection from the agent. - Herd immunity controls disease without immunizing everyone in the population. - Lack of immunization may lead to an epidemic.

- Giving injections of preformed antibodies provides immediate immunity. - Herd immunity controls disease without immunizing everyone in the population. - Lack of immunization may lead to an epidemic. Injections of preformed antibodies to an organism provide immediate immunity to disease caused by that organism. Herd immunity controls disease, because a certain percentage of the population is no longer susceptible to the disease. Lack of immunization may lead to an epidemic. Immunization does not provide lifelong immunity. For example, immunization with preformed antibodies is temporary. The CDC monitors disease outbreaks and recommends additional boosters for some infectious diseases. Immunization with killed vaccines does not lead to infection from the agent, as the organism is no longer living.

Manifestations of fibromyalgia often include (Select all that apply.) - generalized pain. - sensitivity to heat. - headaches. - fatigue. - sleep disturbance.

- generalized pain. - headaches. - fatigue. - sleep disturbance. Common manifestations of fibromyalgia include generalized pain, headaches, fatigue, and difficulty sleeping. Sensitivity to cold (not heat) is common.

Characteristics of scoliosis include (Select all that apply.) - involvement of lateral curvature of the spine. - increase during periods of rapid growth. - more common in boys. - identifiable by uneven shoulders or scapular prominence. - possibility of leading to respiratory complications.

- involvement of lateral curvature of the spine. - increase during periods of rapid growth. - identifiable by uneven shoulders or scapular prominence. - possibility of leading to respiratory complications. Scoliosis involves a lateral curvature of the spine that increases during times of rapid growth. It is evidenced by uneven shoulders or scapular prominence. If severe and untreated, it can lead to respiratory and other complications in later age. Scoliosis is more common in girls.

Dietary zinc is an important defense against infection, because it maintains (Select all that apply.) - natural killer cell function. - lymphocyte activity. - antioxidant activity. - neutrophil activity. - complement activity.

- natural killer cell function. - lymphocyte activity. - neutrophil activity. - complement activity. Decreased availability of zinc results in a reduction in natural killer cell function, lymphocyte activity, neutrophil function, and complement activity. Zinc does not maintain antioxidant activity.

Risk of infection is increased in (Select all that apply.) - use of corticosteroids. - diabetes mellitus. - spleen removal. - stomach removal. - stress

- use of corticosteroids. - diabetes mellitus. - spleen removal. - stress Use of corticosteroids depresses immune function and increases risk of infection. Diabetes mellitus increases risk of infection resulting from high blood sugar, decreased resistance to infection, and inability to sense pain secondary to neuropathies. Spleen removal increases susceptibility to infection as one of its functions was phagocytosis of encapsulated bacteria. Stress increases hormones that affect immune responsiveness. The stomach is not an organ that affects immune function; therefore, removal of the stomach does not increase the risk for infection.

Myasthenia gravis is an autoimmune disease in which - neuronal demyelination disrupts nerve transmission. - muscles become increasingly bulky but weakened. - acetylcholine receptors are destroyed or dysfunctional. - acetylcholine release from motor neurons is disrupted.

acetylcholine receptors are destroyed or dysfunctional. Myasthenia gravis is an autoimmune disease in which acetylcholine receptors are destroyed or dysfunctional. Multiple sclerosis is an autoimmune disease in which neuronal demyelination disrupts nerve transmission. Muscles become weak, but not bulky, in myasthenia gravis. Acetylcholine receptors are destroyed or dysfunction in myasthenia gravis.

A fracture in which bone breaks into two or more fragments is referred to as - comminuted. - open. - greenstick. - stress.

comminuted. A fracture in which the bone breaks into two or more fragments is called a comminuted fracture. Open fractures, greenstick fractures, and stress fractures do not involve two or more bone fragments.

A characteristic of some bacteria - is intracellular parasite - is composed of RNA or DNA - contains cell wall endotoxin - cannot replicate extracellularly

contains cell wall endotoxin Some bacteria contain endotoxin in the cell wall. Viruses are intracellular parasites using host cell components to replicate; bacteria do not use host cell components to replicate. Viruses are composed of RNA or DNA, as opposed to bacteria. Bacteria can replicate extracellularly.

A patient diagnosed with diabetes, smokes a pack of cigarettes daily and eats very few green leafy vegetables. After experiencing a fractured toe, this patient is at risk for - delayed healing - malunion - nonunion - dysunion

delayed healing Fracture healing that does occur but takes longer than expected is called delayed healing. The situation is not an example of malunion or nonunion. Dysunion is not a term used to describe healing complications.

In older women, osteoporosis is thought to be primarily because of - dietary inadequacies. - estrogen deficiency. - malabsorption syndrome. - inactivity.

estrogen deficiency In older women, osteoporosis is thought to be primarily because of estrogen deficiency. Although dietary inadequacies and inactivity play roles, the primary cause of osteoporosis in older women is thought to be because of estrogen deficiency. Malabsorption is not the primary cause of osteoporosis in older women.

Paget's disease is characterized by - overactivity of osteoblasts leading to multiple bone tumors - excessive bone resorption followed by excessive formation of fragile bone. - inflammatory disorder resulting in fusion of spine joints. - failure of resorption by osteoclasts resulting in hard bones.

excessive bone resorption followed by excessive formation of fragile bone. Paget's disease is characterized by excessive bone resorption followed by excessive formation of fragile bone. Overactivity of osteoblasts that lead to multiple bone tumors is not the cause of Paget's disease. Paget's disease is not characterized by the fusion of spine joints. Fragile bone, not hard bone, is a characteristic of Paget's disease.

The most common type of osteomyelitis is - hematogenous. - contiguous focus. - Brodie abscess. - direct invasion.

hematogenous. Hematogenous osteomyelitis is the most common type of osteomyelitis. Contiguous focus osteomyelitis is not the most common type. Brodie abscess is when an infection becomes enclosed by fibrotic tissue. Osteomyelitis may be caused by a direct invasion of organisms into the bone, but this is not the most common cause.

When mast cells degranulate, they release: - perforins and other toxins. - histamine and other inflammatory mediators. - complement. - antibodies.

histamine and other inflammatory mediators.

Assessment of an extremity six hours after surgical alignment and casting demonstrates pulselessness and pallor. The priority action to take is to - increase the administration his pain medication. - initiate action to have the cast split or removed. - note the increase in pain in his chart, and recheck the extremity in 30 minutes. - elevate the extremity to relieve swelling

initiate action to have the cast split or removed. The priority action is to have the cast split or removed because these are signs of compartment syndrome and emergent decompression is needed. While increasing pain medication may be appropriate, it is not the priority action. It is not the priority action to note pain increases in the chart. In compartment syndrome, extremity is not to be elevated above the heart, as that may lower venous pressure and slow arterial perfusion.

The most common site affected in Paget's disease is the - lower spine - skull - pelvis - joints

lower spine The lower spine is the most common site affected in Paget's disease. The skull and pelvis are affected, but are not the most common sites. Joints are not affected in Paget's disease.

Anticholinesterase inhibitors may be used to manage - muscular dystrophy. - myasthenia gravis. - fibromyalgia. - rheumatoid arthritis.

myasthenia gravis. Anticholinesterase inhibitors may be used to manage myasthenia gravis. Anticholinesterase agents are not used to manage muscular dystrophy, fibromyalgia, or rheumatoid arthritis.

The term used to describe fungal infections is - sepsis. - mycoses. - amebiasis. - Chlamydia.

mycoses Infections caused by fungi are called mycoses. Sepsis means an overwhelming infection that may lead to shock, multiple organ failure, and death. Sepsis can be caused by any organism. Amebiasis is an infection caused by a protozoan parasite. Chlamydia is a bacterial infection.

Pain with passive stretching of a muscle is indicative of - noncontractile tissue injury. - contractile tissue injury. - vascular insufficiency. - skeletal muscle damage.

noncontractile tissue injury. Pain with passive stretching of a muscle is indicative of noncontractile tissue injury. Pain with passive stretching of a muscle is not an indication of a contractile tissue injury, vascular insufficiency, or skeletal muscle damage.

The process of covering bacteria with antibodies to promote phagocytosis of the microorganisms is called: - neutralization. - precipitation. - margination. - opsonization.

opsonization The Fc portions of the antibodies that cover an opsonized microorganism attract phagocytes.

The displacement of two bones in which the articular surfaces partially lose contact with each other is called - subluxation - subjugation - sublimation - dislocation

subluxation Subluxation is partial dislocation of a joint. Subjugation, sublimation, and dislocation are not the terms for partial loss of contact of articular surfaces.

A unique characteristic feature of fibromyalgia is the presence of - tender joint pain - head pain - contractures - muscle atrophy

tender joint pain Tender point pain is a unique characteristic feature of fibromyalgia. Headache, contractures, and muscle atrophy are not unique characteristic features of fibromyalgia.


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