PATH 370: Ch 1,2,4,7

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

pupil constriction Pupils dilate during stress from the effects of catecholamines. Tachycardia, diaphoresis, and increased peripheral resistance are indicators of stress and also occur because of catecholamine release.

Carbon monoxide injures cells by?

reducing oxygen level on hemoglobin Carbon monoxide binds tightly to hemoglobin preventing the red blood cell from carrying adequate oxygen, leading to hypoxic injury. Other chemicals such as carbon tetrachloride promote free radicals, which injure cells and destroy cellular membranes. Crystallization of cellular organelles is caused by hypothermia.

A patient with metastatic lung cancer wants to know her chances for survival. Which response is correct?

"Lung cancer has about a 15% survival rate." Lung cancer has a 15% survival rate. Lung cancer is not always fatal, but is not highly curable at any stage of diagnosis. The death rate from lung cancer has increased dramatically.

In general, a cancer cell that is more tissue-specific differentiated is more likely to be aggressive. T/F

False The degree of tissue-specific differentiation predicts malignant potential. A lack of differentiated features in a cancer cell is called anaplasia, and a greater degree of anaplasia is correlated with a more aggressively malignant tumor.

Apoptosis is a process that results in cellular?

death Apoptosis results in death of a cell when it is no longer needed. Atrophy refers to reduction in size of an organ because of cellular shrinkage. Proliferation refers to growth of new cells. Mutation refers to alteration in the genetic structure of cellular DNA.

In general, with aging, organ size and function

decrease

The effects of excessive cortisol production include

immune suppression Cortisol suppresses immune function and inflammation and stimulates appetite. Cortisol leads to hyperglycemia by stimulating gluconeogenesis in the liver.

The effect of stress on the immune system?

may involve enhancement or impairment the immune system. Many studies demonstrate that long-term stress impairs the immune system, but many researchers identify that short-term stress may enhance the immune system.

Retroviruses are associated with human cancers, including

Burkitt lymphoma At least three retroviruses are thought to be causative factors in some human cancers: HIV Kaposi sarcoma, Epstein-Barr in Burkitt lymphoma, and human T-lymphocyte type I in T-cell leukemia-lymphoma. The other answer options are not associated with a retrovirus.

The cellular component that is most susceptible to radiation injury is the?

DNA Cellular DNA is particularly susceptible to damage from radiation via breakage of the bonds holding the linear DNA together. Cell membranes, RNA, and ribosomes are not the most susceptible to radiation injury.

Which is not normally secreted in response to stress?

Insulin Insulin secretion is impaired during stress to promote energy from increased blood glucose. Norepinephrine is secreted during stress as a mediator of stress and adaptation. Cortisol is secreted during stress as a mediator of stress and adaptation and stimulates gluconeogenesis in the liver to supply the body with glucose. Epinephrine is secreted during stress as a mediator of stress and adaptation and increases glycogenolysis and the release of glucose from the liver.

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

It is a procedure for determining the extent of tumor spread. Staging describes the location and pattern of spread of a tumor. Staging does not involve biochemical testing of tumor cells, or the histologic examination of tissues, which is done with cancer grading. CT, MRI, and PET imaging techniques have allowed for noninvasive cancer detection.

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

Mutant tumor-suppressor gene Familial retinoblastoma involves transmission of a mutant tumor-suppressor gene from parent to child. Familial retinoblastoma is not caused by a virus and does not involve an extra chromosome, but rather a single gene. Familial retinoblastoma is caused by a mutant tumor-suppressor gene, not an oncogene, which is a mutated proto-oncogene.

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

P53 The most common tumor-suppressor gene defect identified in cancer cells involves P53. More than half of all types of human tumors lack functional P53, which inhibits cell cycling. Rb, DC, and APC are not the most common tumor-suppressor gene defects identified in cancer cells.

Selye's three phases of the stress response include all the following except?

allostasis Allostasis is defined as the ability to successfully adapt to challenges. Allostasis may/may not occur in response to stress. Alarm, resistance, and exhaustion are the three phases of the stress response as described by Selye in the general adaptation syndrome.

The nurse is swabbing a patient's throat to test for streptococcal pharyngitis. The nurse must understand that tests such as this differ in the probability that they will be positive for a condition when applied to a person with the condition; this probability is termed sensitivity. T/F

True The sensitivity of any test refers to the probability that the test will be positive when applied to a person with the condition and will not provide a false negative result. In contrast, specificity is the probability that a test will be negative when applied to a person who does not have a given condition.

All the following stress-induced hormones increase blood glucose except?

aldosterone Aldosterone results in water and sodium retention and potassium loss in the urine. It does not affect blood glucose. Cortisol is a glucocorticoid secreted by the adrenal cortex. Cortisol stimulates gluconeogenesis in the liver, thus increasing blood glucose. Norepinephrine inhibits insulin secretion, thus increasing blood sugar. Epinephrine increases glucose release from the liver and inhibits insulin secretion, thus increasing blood glucose.

Proto-oncogenes

are normal cellular genes that promote growth. Proto-oncogenes are normal cellular genes that promote growth. Proto-oncogenes are not the same as oncogenes, which are mutant proto-oncogenes. They are different from tumor-suppressor genes and do not alter tumor-suppressor genes. Mutational events lead to oncogenes, a mutated proto-oncogene.

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 Common paraneoplastic syndromes include hypercalcemia associated with abnormal production of parathyroid hormone-related protein by tumor cells. Insulin is a general growth factor for a number of tissues and may be implicated in development of some cancers, but it is not a cause of paraneoplastic syndromes. Tumor necrosis factor is associated with cachexia in cancer, but it is not associated with paraneoplastic disorders of cancer. Potassium is not found in excess amounts in cancer.

Malignant neoplasms of epithelial origin are known as?

carcinomas Carcinoma refers to malignant tumors of epithelial origin. Lymphoma refers to cancer of the lymphatic tissue. Sarcoma refers to malignant tumors of mesenchymal (nerve, bone, muscle) origin. Adenoma is a benign tumor of glandular tissue.

Cancer grading is based on

cell differentiation Grading refers to the histologic characterization of tumor cells and is basically a determination of the degree of anaplasia (lack of differentiation). The other answer options are associated with tumor staging.

Your 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?

cigarette smoking The most likely contributing factor for the development of lung cancer is cigarette smoking. Tobacco smoke contains hundreds of compounds, many of which have known genotoxicity and probably serve as initiators. Tobacco smoke also contains promoters, which spur the mutant cells to proliferate. Although a high-fat diet, urban pollutants, and a stressful lifestyle have been implicated in some types of cancer, they are not the likely contributing factor in your patient's lung cancer.

Extreme cold injures cells by all the following except?

decreased blood viscosity Hypothermia causes increased blood viscosity, which can result in ischemic injury. Initial vasoconstriction causes ischemic injury. Rebound vasodilation leads to intense swelling which damages peripheral nerves. Crystallization of cellular components leads to rupture of these components.

The primary effect of aging on all body systems is?

decreased functional reserve All body systems show age-related changes that can be generally described as a decrease in functional reserve; aging leads to inability to adapt to (internal and external) environmental changes. Not all effects of aging are considered disease; some are considered a normal part of aging. Programmed senescence is currently only a theory of aging that states cells have a preprogrammed number of cell divisions before they will die. Senility is an outdated term used to describe the cognitive changes associated with dementia; dementia is a disease and is not a normal part of aging.

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

deficient cellular uptake by one cell type may contribute to excess nutrient delivery to other cell types. Deficient cellular uptake by one cell type may contribute to excess nutrient delivery to other cell types such as in diabetes mellitus. Most of these essential nutrients must be obtained from external sources, because the cell is unable to manufacture them. Obesity involves an excess of caloric intake. The BMI is a measure for obesity, but does not indicate if a nutritional imbalance is present.

The cellular change that is considered preneoplastic is?

dysplasia Dysplastic cells have the potential to become cancerous and are therefore referred to as preneoplastic. Anaplasia, metaplasia, and hyperplasia are not considered preneoplastic.

A disease that is native to a particular region is called

endemic A disease that is native to a particular region is called endemic. An epidemic is a disease that spreads to many individuals at the same time. Pandemics are epidemics that affect large geographic regions, perhaps spreading worldwide.

The primary adaptive purpose of the substances produced in the alarm stage is?

energy and repair These resources are used for energy and as building blocks, especially the amino acids, for the later growth and repair of the organism. The substances do not produce a resting state. The substances can produce exhaustion if they continue, but that is not the adaptive purpose of these. Although a new baseline steady-state may result from the stress response that is not the adaptive purpose of the substances produced during the alarm stage.

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

hypertrophy Increased function of an organ such as the heart or skeletal muscle results in organ hypertrophy because of cellular enlargement. Atrophy refers to reduction in size of an organ because of cellular shrinkage. Metaplasia refers to replacement of one differentiated cell type with another. Inflammation results from immune response rather than workload.

Coagulative necrosis is caused by?

interrupted blood supply. Coagulative necrosis results from interrupted blood supply leading to ischemic cell injury. Liquefactive necrosis results from dissolving of dead cells and cyst formation. Fat necrosis is caused by trauma or pancreatitis. Caseous necrosis is caused by lung tissue damage such as that caused by tuberculosis.

The cellular response indicative of injury because of faulty metabolism is?

intracellular accumulations Intracellular accumulations result from faulty metabolism of lipids, carbohydrates, glycogen, and proteins. Hydropic swelling results from malfunction of the sodium-potassium pump. Lactate production results from anaerobic glycolytic pathway. Metaplasia occurs from persistent cell injury.

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

is malignant Bronchial carcinoma is a malignant cancer of the epithelial lining of the bronchi. Carcinoma refers to a malignant tumor. Primary indicates that the cancer began in the lungs and did not metastasize from another site. A staging procedure must be done before knowing if the lung cancer has spread.

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

kill rapidly dividing cells Chemotherapy kills rapidly dividing cells. Chemotherapy does not selectively kill tumor cells, but affects all rapidly dividing cells. Chemotherapy has many damaging side effects. Immunotherapy uses the power of the immune system and has the potential for targeting cancer cells.

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 Incubation refers to the interval between exposure of a tissue to an injurious agent and the first appearance of signs and symptoms. In infectious diseases, this period is often called the incubation (latent) period. Prodromal refers to the appearance of the first signs and symptoms indicating the onset of a disease. These are often nonspecific, such as headache, malaise, anorexia, and nausea, which are associated with a number of different diseases. Sequela refers to subsequent pathologic condition resulting from a disease. Convalescence is the stage of recovery after a disease, injury, or surgical operation.

Necrotic death of brain tissue usually produces _____ necrosis?

liquefactive Liquefactive necrosis is produced when brain tissue dies, as it is rich in enzymes and has little connective tissue. Coagulative necrosis occurs from ischemic injury in any tissue. Caseous necrosis occurs in lung tissue damaged by tuberculosis. Fat necrosis occurs in adipose (fat) tissue.

All these cellular responses are potentially reversible except?

necrosis Necrosis refers to death of cells/tissue and is not reversible. Metaplasia refers to the replacement of one differentiated cell type with another from persistent injury and is reversible when the injury stops. Atrophy occurs because of lack of use of an organ and is reversible. Hyperplasia is an increase in the number of cells from increased physiologic demands or hormonal stimulation and is reversible.

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

norepinephrine Norepinephrine is secreted in response to activation of the sympathetic nervous system during stress by the adrenal medulla. Cortisol is secreted by the adrenal cortex. Glucagon is secreted by the pancreas. ACTH is secreted by the pituitary gland.

Breast cancer in women who have the breast cancer gene

occurs at an earlier age The age of onset of inherited breast cancer is earlier than the onset of non-inherited forms and the prevalence of bilateral breast cancer is higher. Breast cancer in women who have the breast cancer gene is less common (only 5% to 10% of all cases) than non-inherited breast cancer and is more likely to be bilateral. Response to treatment is not affected by whether the cancer gene is present.

Somatic death refers to death

of the entire organism. Somatic death refers to death of an entire organism. Somatic death is not simply death of one body organ. Somatic death involves death of all cells in the body. Brain death refers to death of the brain only, but organ systems can remain living with mechanical assistance.

Persistence of the alarm stage will ultimately result in

permanent damage and death If the alarm stage were to persist, the body would soon suffer undue wear and tear and become subject to permanent damage and even death. Actions taken by the individual during the resistance stage lead to stress reduction. The resistance stage may or may not occur following the alarm stage, based on resource availability. The sympathetic nervous system will continue to function, resulting in continued release of stress hormones.

Persistence of the alarm stage will ultimately result in?

permanent damage and death If the alarm stage were to persist, the body would soon suffer undue wear and tear and become subject to permanent damage and even death. Actions taken by the individual during the resistance stage lead to stress reduction. The resistance stage may or may not occur following the alarm stage, based on resource availability. The sympathetic nervous system will continue to function, resulting in continued release of stress hormones.

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

primary prevention Primary prevention is prevention of disease by altering susceptibility or reducing exposure for susceptible individuals by providing vaccination. Secondary prevention is the early detection, screening, and management of the disease. Tertiary prevention includes rehabilitative and supportive care and attempts to alleviate disability and restore effective functioning. Disease treatment involves management of the disease once it has developed.

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 Secondary prevention is the early detection, screening, and management of the disease such as prescribing diet and exercise for an individual who has already developed obesity. Primary prevention is prevention of disease by altering susceptibility or reducing exposure for susceptible individuals. Tertiary prevention includes rehabilitative and supportive care and attempts to alleviate disability and restore effective functioning. Disease treatment involves management of the disease once it has developed.

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

secondary prevention Secondary prevention is the early detection, screening, and management of the disease, such as by prescribing sodium restriction for high blood pressure. Primary prevention is prevention of disease by altering susceptibility or reducing exposure for susceptible individuals. Tertiary prevention includes rehabilitative and supportive care and attempts to alleviate disability and restore effective functioning. Disease treatment involves management of the disease once it has developed.

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 Etiology refers to the proposed cause or causes of a particular disease process. A sore throat is the manifestation of the disease process. Genetic susceptibility refers to inherited tendency to develop a disease. Pharyngitis refers to inflammation of the throat and is also a clinical manifestation of the disease process.

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

subclinical The stage during which the patient functions normally, although the disease processes are well established, is called the subclinical stage. The interval between exposure of a tissue to an injurious agent and the first appearance of signs and symptoms may be called a latent period or, in the case of infectious diseases, an incubation period. The prodromal period, or prodrome, refers to the appearance of the first signs and symptoms indicating the onset of a disease. Convalescence is the stage of recovery after a disease, injury, or surgical operation.

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

tertiary prevention Tertiary prevention includes rehabilitative and supportive care and attempts to alleviate disability and restore effective functioning such as prescribing a cholesterol-lowering medication following a heart attack. Primary prevention is prevention of disease by altering susceptibility or reducing exposure for susceptible individuals. Secondary prevention is the early detection, screening, and management of the disease. Disease treatment involves management of the disease once it has developed.

Allostasis is best defined as

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

Metaplasia is

the replacement of one differentiated cell type with another. Metaplasia is the replacement of one differentiated cell type with another secondary to persistent damage. Dysplasia transforms cells to preneoplastic lesions, which may become malignant. Metaplasia is reversible when the damage is stopped. Disorganization of cells into various sizes, shapes, and arrangements occurs in dysplasia.

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

tumor necrosis factor. Production of tumor necrosis factor (TNF) and other immune cytokines is thought to be important in producing the hypermetabolic state leading to cachexia in cancer. Angiogenesis is the development of new blood vessels to feed the tumor; it is not a cause of the hypermetabolic state leading to cachexia in terminal cancer. Loss of ATP production and pain medications is not causes of the hypermetabolic state leading to cachexia in terminal cancer.