PATHO TEST #2

True or false: malignant tumors are anaplasic while benign tumors are well differentiated

TRUE

___________________ regulates retention of sodium and water and excretion of potassium.

aldosterone

Osteoporosis is a disease of the MSK caused by a problem with ______________________

bone density

Osteomalacia is a disease of the MSK caused by a problem with ______________________

bone mineralization

what organs play key roles in acid-base regulation?

bones, lungs and kidneys

name the 5 main mechanisms of blood buffering

carbonic acid, H+/K+, protein, respiratory, renal

what enzyme plays a key role in the blood buffer system?

carbonic anhydrase

Cl- and HCO3- concentrations are ____________ related

inversely

calcium and phosphate concentrations are ________________ related

inversely

Concentrations of _________ and __________ alter membrane excitability. Describe how:

potassium (resting membrane potential) & calcium (threshold potential)

BRCA genes are: ________________________

pro-breast cancer genes.

Six hallmarks of cancer

1. self-sufficiency in growth signals (autocrine stimulation) 2. insensitivity to antigrowth signals 3. evading apoptosis 4. angiogenesis 5. immortality (telomeres do not shorten with # of replications) 6. tissue invasion & metastasis

normal ranges for magnesium

1.8-2.4 mg/dL

Normal ranges for sodium

135-145 mEq/L

normal ranges for phosphate

2.5-4.5 mg/dL

normal ranges for HCO3- (bicarbonate)

22-26 mEq/L

normal ranges for potassium

3.5-4.5 mEq/L

normal pCO2 range

35-45 mmHg

normal pH

7.35-7.45 pH below 6.8 or above 7.8 = death

normal ranges for calcium

8.6-10.5 mg/dL

normal ranges for Cl-

98-106 mEq/L

which of the following are clinical manifestations of hypokalemia (select all that apply) a) carbohydrate metabolism is affected as a result of decreased insulin secretion b) renal function is impaired c) neuromuscular excitability is decreased d) skeletal muscle is affected with increased contractility

A, B & C Carbohydrate metabolism is affected by depressing insulin secretion and alters hepatic and skeletal muscle glycogen synthesis. Renal function may be impaired with a decreased ability to concentrate urine, and renal tubular atrophy and fibrosis may occur. Neuromuscular excitability is decreased causing skeletal muscle weakness, smooth muscle atony, and cardiac dysrhythmias. Hypokalemia causes the skeletal muscle to be weak.

which treatments are appropriate for hyperkalemia? select all that apply a) calcium gluconate b) treating the contributing cause c) administering glucagon d) sodium bicarbonate

A, B & D Calcium gluconate, treating the contributing cause, and sodium bicarbonate are all appropriate treatments. Calcium gluconate can be administered to restore normal neuromuscular irritability when serum potassium levels are dangerously high. Glucose, which readily stimulates insulin secretion, or the administration of glucose and insulin for those with diabetes, facilitates cellular entry of potassium. Sodium bicarbonate corrects metabolic acidosis and lowers serum potassium. Glucagon is administered to treat beta-blocker overdose or hypoglycemia.

Which of the following are classic complications of rhabdomyolysis? (Select all that apply.) a) Dark urine b) Paresthesia c) Muscle pain d) Paralysis e) Muscle weakness

A, C & E A classic triad of muscle pain, weakness, and dark urine is considered typical of rhabdomyolysis. The remaining symptoms are associated with classic compartment syndrome.

Which medications have been associated with secondary osteoporosis? a) Heparin b) Estrogen c) Lithium d) Methotrexate e) Cortisone

A, C, D & E Heparin, lithium, glucocorticoids, methotrexate, anticonvulsants, cyclophosphamide, and cyclosporine are associated with secondary osteoporosis. Estrogen-replacement therapy has not been associated with secondary osteoporosis.

a patient reports severe diarrhea for 2 days the nurse understands this stimulates an increase in _______________

ADH

Which statements are true regarding viral pneumonia? (Select all that apply.) a) Viral pneumonia requires treatment with antibiotics. b) Viral pneumonia is usually mild and self-limiting. c) Viral pneumonia can set the stage for a secondary bacterial infection. d) Viral pneumonia is not seasonal.

B & C Viral pneumonia can set the stage for a secondary bacterial infection, is seasonal, and is usually mild and self-limiting.

Which statement regarding tumors is true? A) all neoplasms are cancerous B) cancer refers to a malignant tumor C) benign growths are cancerous D) malignant tumors have slow growth

B) cancer refers to a malignant tumor The term cancer refers to a malignant tumor with rapid growth, a loss of differentiation, and the absence of normal tissue organization. Neoplasm generally refers to new growth and may be benign or cancerous. Benign growths, which are not referred to as cancers, may retain some normal tissue structure and do not invade the capsules surrounding them or spread to regional lymph nodes or distant locations.

Which statement is true regarding hypokalemia? A) hypokalemia occurs when the serum level is below 135 mEq/L B) one cause of hypokalemia is diabetic ketoacidosis C) dietary causes of hypokalemia are common D) diuretics do not cause hypokalemia

B) one cause of hypokalemia is diabetic ketoacidosis Hypokalemia is low potassium. Therefore hypokalemia is defined as a serum level less than 3.5 mEq/L. It is often caused by diuretics. Diabetic ketoacidosis does cause hypokalemia. Potassium is shifted out of the cell in exchange for hydrogen and then excreted. The serum level may remain within a normal range, but then when insulin is administered, potassium is shifted back into the cells and a deficit occurs. Potassium balance is especially significant in the treatment of conditions requiring insulin administration, such as insulin-dependent diabetes mellitus (type 1). Dietary causes are uncommon.

Which virus(es) is (are) linked to the development of cancer? select all that apply a) hepatitis A b) hepatitis B c) hepatitis C d) epstein-barr virus e) human papillomavirus

B, C, D & E Hepatitis B and C have been linked to the development of liver cancer, which is usually caused by chronic inflammation. Epstein-Barr virus can lead to B-cell lymphomas in those individuals who are immunosuppressed. Human papillomavirus has been linked to cervical, anogenital, and penile cancers. Hepatitis A has not been linked to the development of cancer.

common causes of edema formation (increased filtration of fluid from capillaries and lymph into surrounding tissues ) include which of the following? SELECT ALL THAT APPLY a) decreased HP b) decreased plasma oncotic pressure c) increased capillary membrane permeability d) lymphatic obstruction e) sodium retention

B, C, D & E The five common causes of increased edema are: (1) increased hydrostatic pressure, (2) decreased plasma oncotic pressure, (3) increased capillary membrane permeability, (4) lymphatic obstruction, and (5) sodium retention.

A nurse hears in a report that an individual has benign tumors. What does this mean? A. are poorly differentiated B. Are encapsulated C. May develop anaplasia D. May spread to a distant locatio

B. Are encapsulated

When considering water balance, which statement is the correct balance? A) isotonic fluids cause increased cellular swelling B) hypertonic fluid causes increased cellular swelling C) hypotonic fluid causes cellular swelling D) hypernatremia causes cellular swelling

C) hypotonic fluid causes cellular swelling Hypotonic extracellular fluid (ECF) causes intracellular water gain and swelling. When the ECF is hypotonic, water moves from the intravascular space to the interstitial space, across the cell membrane, and into the cell. This action causes the cell to swell. An isotonic solution is equal to the plasma in concentration of solute molecules. Therefore no net water will move because equilibrium exists. The cell size is unchanged. A hypertonic fluid has excessive solute; therefore water will leave the cell and move into the vascular space to help balance this excess. Water leaving the cell results in cell shrinkage. Hypernatremia can occur with an acute gain in sodium or a loss of water, but generally it does not cause cellular swelling.

Which of the following are characteristics of cachexia? select all that apply a) increased appetite b) weight gain c) anorexia d) altered metabolism e) considered a sign of cancer f) early satiety

C, D, E & F Cachexia includes anorexia, early satiety, weight loss, anemia, asthenia, taste alterations, and altered metabolism. Clinical manifestations of cancer include cachexia. Cachexia is due to interleukins and TNFs

_____________________ and _____________ are important PLASMA mediums / buffers between H+ and bicarbonate?

Carbonic Acid (H2CO3) and hemoglobin (erythrocytes - hemoglobin is a protein, has a negative charge)

The nurse is assessing a pervasive epithelial tumor that has not broken through the basement membrane or invited the surrounding stroma. The nurse knows this a _____________________. When educating the patient, the nurse explains that there are three possible prognoses: 1)___________________ 2)___________________ 3) __________________

Carcinoma in situ (CIS) 3 prognoses: 1) Can remain stable for a long time. 2) Can progress to invasive and metastatic cancers. 3) Can regress and disappear.

Which statement is true regarding potassium balance? A) potassium is the major extracellular electrolyte B) during acidosis, potassium shifts into cell C) Aldosterone is secreted when potassium is decreased D) Insulin causes the movement of potassium into the cell

D) Insulin causes the movement of potassium into the cell Insulin causes movement of potassium into the cell and is one of the treatments for hyperkalemia. Potassium balance is especially significant in the treatment of conditions requiring insulin administration, such as insulin-dependent diabetes mellitus (type 1). Potassium is the major intracellular electrolyte and maintains the osmotic balance of the intracellular fluid (ICF) space. During acidosis, potassium is shifted out of the cell in exchange for hydrogen ions. Aldosterone is secreted when potassium is elevated, resulting in the excretion of potassium by the kidneys.

It is true that hyponatremia: A) is commonly caused by inadequate sodium intake B) can occur with a decrease in TBW C) never occurs with burns, vomiting or diarrhea D) occurs when sodium drops below 135 mEq/L

D) occurs when sodium drops below 135 mEq/L Hyponatremia occurs when the serum sodium drops below 135 mEq/L. It is the most common electrolyte disorder in individuals who are hospitalized. Although inadequate sodium intake can cause hyponatremia, it is uncommon. It can also occur with an increase in TBW or as a result of burns, vomiting, diarrhea, or gastrointestinal suctioning.

It is true that hyperchloremia: A) occurs with deficient sodium B) occurs with excess of bicarbonate C) has specific symptoms such as thirst D) requires treatment of underlying disorder

D) requires treatment of underlying disorder Hyperchloremia (too much chloride) is usually related to an underlying disorder, and therefore treatment is centered on the underlying disorder. Because chloride usually follows sodium, this condition usually occurs with an increase in sodium and a deficit of bicarbonate. Normally, neither specific symptoms are observed nor treatments are available for chloride excess.

Causes of metabolic acidosis

DKA, sepsis, any condition that causes an extreme build up of lactic acid because too many cells are performing fermentation due to lack of sufficient O2 or glucose.

Osteomalacia (clinical manifestations & etiology)

Deficiency of vitamin D lowers the absorption of calcium from the intestines. Bone formation progresses to osteoid formation, but calcification does not occur; result is soft bones. Mineralization is inadequate or delayed. Clinical manifestations: Pain, bone fractures, vertebral collapse, bone malformation, waddling gait

S&S of respiratory alkalosis

Dizziness, confusion, tingling of extremities (paresthesias), convulsions, and coma with signs of hypocalcemia pH above 7.45 CO2 is decreased below 38 mm Hg

S&S of metabolic acidosis

Headache Lethargy Kussmaul respirations pH drops below 7.35 HCO3- drops: less than 24 mEq/L

S&S of respiratory acidosis

Headache, restlessness, blurred vision, apprehension, lethargy, muscle twitching, tremors, convulsions, coma pH is below 7.35. CO2 elevates from hypercapnia

To compensate for alkalosis or acidosis, cells exchange this cation for H+

K+

___________ regulates ICF osmolality and deposits glycogen in liver and skeletal muscle cells

K+

A person arrives in the ED after a loss of consciousness and the development of Kussmaul respirations. Has a history of Diabetes and 2 days of vomiting and diarrhea. The nurse suspects the person has:

Metabolic acidosis (Kussamal - acidosis / compensating with resp. = metabolic process)

The nurse receives lab work for her pancreatic cancer patient and notes hypercalcemia. The nurse knows that this may indicate a _________________.

Paraneoplastic syndrome Symptom complexes are triggered by a cancer but are not caused by direct local effects of the tumor mass. Tumor secretes biologic substances (like hormones) or immune response is triggered by the tumor, producing syndromes that are not directly related to the local effects of the tumor ex 1: tumor secreting clotting factors independent of your own cascade, hypercalcemia in pancreatic cancer patients ex 2: SMALL CELL CARCINOMA OF LUNG - Syndrome of inappropriate ADH because these hormones are not being produced by their normal sites, they are not responsive to negative feedback loops Can be life threatening.

Causes of metabolic alkalosis

Prolonged vomiting Gastric suctioning Excessive bicarbonate intake Hyperaldosteronism with hypokalemia Diuretic therapy

Describe the roles of RANKL, RANK and OPG in osteoporosis.

RANKL = cytokine expressed by osteoblast RANK= receptor expressed by osteoclast progenitor ------RANK/RANKL binding has an ANTI-apoptotic effect for osteoclasts OPG is a RANK antagonist (binds to RANKL blocking RANK/RANKL binding) ------Estrogen regulates OPG production ------This is why post-menapausal women are at risk for osteoporosis - reduced OPG action / lack of osteoclast suppression

The following note is made in the patient's chart. "T2, N1, M1" The oncoming nurse knows that this means: ____________________________________________________________________________________

T2: Primary tumor lesion is 2-5 cm N1: mobile lymph nodes involved M2: suspected metastases distantly **Per Brown: M0 = no metastases, M1 = local metastases, M2 = suspected distant metastases

S&S of metabolic alkalosis

Weakness, muscle cramps, and hyperactive reflexes with signs of hypocalcemia pH is elevated above 7.45. HCO3- is elevated above 26 mEq/L.

You have a patient with: pH of 7.2 pCO2 of 40 HCO of 20 What is going on with your patient?

Your patient has metabolic acidosis. pH is low = acidemia pCO2 is normal (not respiratory acidosis) HCO3 is low (metabolic acidosis) Compensation would be respiratory CO2 elimination via hyperventilation (Kussmal breathing) to drop PCO2 below 40mmHg)

Hypernatremia is defined as levels above: a) 147 mEq/L b) 5.5 mEq/L c) 105 mEq/L d) 8.5 mg/dl

a) 147 mEq/L Hypernatremia is defined as serum levels above 147 mEq/L. Hyperkalemia is defined as serum levels above 5.5 mEq/L, and hyperchloremia is defined as serum levels above 105 mEq/L. Hypocalcemia occurs when serum calcium concentrations are less than 8.5 mg/dl.

A person has respirations that are characterized by alternating periods of deep and shallow breathing and apnea. What is the appropriate term for this breathing? a) Cheyne-Stokes b) Hypoventilation c) Kussmaul d) Hyperpnea

a) Cheyne-Stokes

What type of fracture occurs when the cortex is perorated and the spongy bone is splintered? a) Greenstick b) Torus c) Bowing d) Spiral

a) Greenstick A greenstick fracture is one that perforates one cortex and splinters the spongy bone. In a torus fracture, the cortex buckles but does not break. Bowing fractures usually occur with longitudinal force; typically, this type of fracture occurs in paired bones—one is fractured and the other bows. A spiral fracture is one that encircles the bone.

Which statement is true regarding the pathophysiologic process of asthma? a) Inflammation results in airway hyperresponsiveness. b) Immunoglobulin A (IgA) is the major factor. c) The inflammatory process is due to the loss of bronchial smooth muscle spasm. d) Vascular permeability increases.

a) Inflammation results in airway hyperresponsiveness. Increased bronchial smooth muscle spasm and increased vascular permeability cause asthma. Asthma is an immunoglobulin E (IgE)-mediated response.

What is the appropriate term for the failure of the bone ends to grow together? a) Nonunion b) Delayed union c) Malunion d) Dislocation

a) Nonunion Nonunion is when bone ends do not grow together. A delayed union is the healing of bone that takes 8 to 9 months. A malunion is the healing of a bone in a nonanatomic position. A dislocation is the temporary displacement of bone from its normal position in a joint.

A person is experiencing inadequate and delayed mineralization of osteoid in mature compact bone. This description supports which diagnosis? a) Osteomalacia b) Osteoporosis c) Paget disease d) Osteomyelitis

a) Osteomalacia Osteomalacia is inadequate and delayed mineralization in mature compact bone. Osteoporosis is a disease in which bone tissue is normally mineralized but the mass density of the bone is decreased. Osteomyelitis is an infection of the bone. Paget disease is a state of increased metabolic activity in bone characterized by abnormal and excessive bone remodeling.

Which bone tumor is the most aggressive and demonstrates a moth-eaten pattern of bone destruction? a) Osteosarcoma b) Chondrosarcoma c) Endochondroma d) Fibrosarcoma

a) Osteosarcoma Osteosarcoma has a moth-eaten pattern and is the most aggressive type of bone tumor. Chrondrosarcoma is the second most common primary malignant bone tumor and infiltrates the trabeculae of spongy bone. A secondary chondrosarcoma is derived from an endochondroma. Fibrosarcoma is a solitary tumor that most frequently affects the metaphyseal region of the femur.

What term is used to identify a ligament tear? a) Sprain b) Strain c) Subluxation d) Avulsion

a) Sprain

which statement characterizes radiation therapy? a) radiation is used to kill cancer cells while minimizing damage to normal structures b) effective killing of cancer cells using radiation requires poor local delivery of oxygen c) radiation blocks normal growth pathways in cells d) radiation can cause reversible changes in normal tissues

a) radiation is used to kill cancer cells while minimizing damage to normal structures Radiation is used to kill cancer cells while minimizing damage to normal structures. Effective cell killing using radiation also requires good local delivery of oxygen. Radiation produces slow changes in most cancers and irreversible changes in normal tissues as well. Antimetabolite chemotherapy blocks normal growth pathways in cells.

What is the term for cancers originating in connective tissue? a) sarcoma b) leukemia c) lymphoma d) carcinoma

a) sarcoma Cancers arising from connective tissue usually have the suffix sarcoma. Cancers of lymphatic tissue are called lymphomas, whereas cancers of blood-forming cells are called leukemias. Carcinoma is a cancer of epithelial tissue.

which statement is true regarding metastasis? a) metastasis is a highly efficient process b) metastasis occurs through the vascular and lymphatic systems c) metastatic cancer suppresses proteases d) most cancer cells are ablate metastasize to new areas

b) metastasis occurs through the vascular and lymphatic systems

How is tuberculosis spread from person to person? a) Semen to blood contact b) Air droplet c) Direct contact d) Fecal-oral contact

b) Air droplet Tuberculosis is extremely contagious and is transmitted via airborne droplets

What is the appropriate term for a chronic inflammatory joint disease characterized by stiffening and fusion of the spine and sacroiliac joints? a) Gout b) Ankylosing spondylitis c) Rheumatoid arthritis d) Osteoarthritis

b) Ankylosing spondylitis Ankylosing spondylitis is a chronic, inflammatory joint disease characterized by stiffening and fusion of the spine and sacroiliac joints. Osteoarthritis is a common age-related disorder of synovial joints. Rheumatoid arthritis is a systemic inflammatory autoimmune disease associated with swelling and pain in multiple joints. Gout is a syndrome caused by an inflammatory response to uric acid production.

Which term describes a hypersecretion of mucus and chronic productive cough that continues for at least 3 months of the year for a minimum of 2 consecutive years? a) Asthma b) Chronic bronchitis c) Emphysema d) Acute respiratory distress syndrome

b) Chronic bronchitis The hypersecretion of mucus with a chronic productive cough that lasts for at least 3 months for a minimum of 2 consecutive years characterizes chronic bronchitis. The mucus is thicker and will adhere to embedded bacteria. This condition is increased up to 20 times in smokers.

Which term describes the temporary displacement of a bone from its normal position? a) Fracture b) Dislocation c) Subluxation d) Nonunion

b) Dislocation Dislocation is the temporary displacement of the bone from its normal position. If the contact is only partially lost between the two surfaces, then the displacement is called a subluxation. A fracture is a complete break in the bone, and nonunion is the failure of bone ends to grow together after a fracture.

Which is the most common cause of pulmonary edema? a) Inhalation of toxic gases b) Heart disease c) Pulmonary hypertension d) Acute respiratory distress syndrome (ARDS)

b) Heart disease the most common cause of pulmonary edema is heart disease. Toxic gas inhalation, pulmonary hypertension, and ARDS are also causes of pulmonary edema but are not as common as pulmonary edema from heart disease.t

What is the appropriate term for inadequate alveolar ventilation in relation to metabolic demands? a) Hyperpnea b) Hypoventilation c) Orthopnea d) Dyspnea

b) Hypoventilation Hypoventilation is inadequate ventilation in relation to metabolic demands. Hyperpnea is rapid breathing. Orthopnea is difficulty breathing when an individual is lying flat. Dyspnea is difficulty breathing.

Which organism is the most common cause of hematogenous osteomyelitis? a) Haemophilus influenzae b) Staphylococcus aureus c) Group B streptococci d) Salmonella

b) Staphylococcus aureus Staphylococcus aureus (including methicillin-resistant staphylococcus aureus [MRSA]) is the primary cause of hematogenous osteomyelitis. Other microorganisms include group B streptococci, Haemophilus influenzae, Salmonella, and gram-negative bacteria. Group B streptococci and H. influenzae tend to infect young children; Salmonella infection is associated with sickle cell anemia; and gram-negative infections are most common in older adults and individuals with impaired immunity.

Upon palpation of a tumor, the nurse notes that it is soft and movable. The nurse suspects that the tumor is: a) malignant b) benign

b) benign

Which statement describes acidemia? a) state in which pH of arterial blood is greater than 7.45 b) state in which the pH of arterial blood is less than 7.35 c) systemic decrease in H+ concentration d) systemic excess of base

b) state in which the pH of arterial blood is less than 7.35 Acidemia is a state in which the pH of arterial blood is less than 7.35. Alkalemia is a state in which the pH of arterial blood is greater than 7.45. A systemic increase in hydrogen ion concentration or loss of base is termed acidosis. A systemic decrease in hydrogen ion concentration or an excess of base is termed alkalosis.

when in its normal state, which gene negatively regulates proliferation? a) oncogenes b) tumor-supressor genes c) proto-oncogenes d) telomeres

b) tumor-supressor genes Tumor-suppressor genes encode proteins that, when in their normal state, negatively regulate proliferation. Oncogenes are mutant genes that, when in their normal nonmutant state, direct the synthesis of protein that positively accelerate proliferation. A proto-oncogene is an oncogene in its nonmutant state. Telemeres are protective ends or caps on each chromosome.

Which statement is true regarding acute respiratory distress syndrome (ARDS)? a) Infection rarely causes ARDS. b) Esophageal injury can cause ARDS . c) ARDS can trigger severe pulmonary edema. d) Macrophages are not involved in the response.

c) ARDS can trigger severe pulmonary edema. The most common cause of ARDS is either sepsis or multiple trauma, which damages the alveolar capillary membrane and results in severe pulmonary edema. Macrophages, neutrophils, complement, and endotoxins are important mediators.

Which statement is true regarding bronchiolitis? a) In adults, a virus usually causes bronchiolitis. b) Bronchiolitis is most common in adults. c) Bronchiolitis is an inflammatory obstruction of the small airways. d) Bronchiolitis is associated with a bacterial infection.

c) Bronchiolitis is an inflammatory obstruction of the small airways. Bronchiolitis is most common in children and is caused by a virus. It is an inflammatory obstruction of the small airways called the bronchioles. Bronchiolitis is observed in adults with chronic bronchitis.

Which term is used to identify a bone fracture that consists of two or more pieces? a) Complete b) Open c) Comminuted d) Oblique

c) Comminuted A comminuted fracture is one in which the bone breaks into two or more fragments. An oblique fracture is one in which the break is slanted in relation to the shaft of the bone. An open fracture is when the skin is broken. A complete fracture is one in which the bone is broken all the way through.

Which statement its true regarding the staging of cancer? a) localized cancer is considered a high stage b) benign tumors are a stage 4 c) cancers that have spread regionally are stage 3 d) stage 1 had the poorest prognosis

c) cancers that have spread regionally are stage 3 Cancer confined to the organ of origin is stage 1; cancer that is locally invasive is stage 2; cancer that has spread to regional structures, such as lymph nodes, is stage 3; and cancer that has spread to distant sites, such as a liver cancer spreading to the lung or prostate cancer spreading to bone, is stage 4. The prognosis generally worsens with increasing tumor size, lymph node involvement, and metastasis. Benign tumors do not spread to distant regions.

Which marker is used to evaluate a tumor of the adrenal gland? a) prostate-specific antigen (PSA) b) alpha-fetoprotein (AFP) c) catecholamines d) adrenocorticotropic hormone (ACTH)

c) catecholamines catecholamines are secreted by the adrenal medulla and are found in excess if a tumor exists. PSA levels are used to detect prostate cancer. AFP is used to detect liver and germ cell cancers. ACTH is the marker used to detect pituitary adenomas.

Which disease is associated with bulbous enlargement of the distal segments of the fingers? a) Acute pneumonia b) Acute myocardial infarction c) Sickle cell disease d) Cystic fibrosis

d) Cystic fibrosis Cystic fibrosis is the disease associated with the bulbous enlargement of the distal segments of the fingers (clubbing). The enlargement of the distal segments of the fingers is also associated with bronchiectasis, pulmonary fibrosis, lung abscess, and congenital heart disease. Cystic fibrosis is not associated with the other options.

Which inflammatory response is not associated with repetitive stress? a) Tendinosis b) Tendinitis c) Bursitis d) Dislocation

d) Dislocation Tendinosis, tendinitis, and bursitis are inflammatory responses that may be seen after trauma and repetitive stress. They cause degradation of collagen fibers (tendinosis), inflammation of tendons (tendinitis), and inflammation of the bursal sacs (bursitis).

What is the term used to describe a respiratory infection that results in pus in the pleural space? a) Abscess b) Consolidation d) Empyema d) Transudate

d) Empyema Empyema is term used to describe the presence of pus in the pleural space and is a complication of respiratory infection. Abscess is a circumscribed area of suppuration and destruction of lung parenchyma. A consolidation is inflamed lung tissue that causes the alveoli to fill with exudate. Transudate is the presence of fluid with low protein content residing in the pleural space.

Paget disease exhibits which clinical manifestation? a) Increased lacrimation b) Increased sympathetic nervous system discharge c) Decreased density of the skull bones d) Impaired motor function

d) Impaired motor function In Paget disease of the skull, bone remodeling occurs and is first evident in the frontal and occipital regions. The skull thickens. Cranial nerve dysfunction with impaired motor function may be evident. Deafness, atrophy of the optic nerve, and obstruction of the lacrimal duct may occur. The sympathetic nervous system is not directly affected.

Which pathogen is commonly associated with a pneumonia that is acquired while in the hospital? a) Streptococcus pneumoniae b) Mycoplasma pneumoniae c) Haemophilus influenzae d) Pseudomonas aeruginosa

d) Pseudomonas aeruginosa Pseudomonas aeruginosa is commonly acquired in hospitals or nursing homes. All of the other choices are community-acquired pneumonias.

Which of the following is a characteristic of a malignant tumor? a) it is encapsulated b) it does not invade local tissues c) it is well differentiated d) it is able to spread far from the tissue of origin

d) it is able to spread far from the tissue of origin Malignant tumors have no capsule, which allows them to spread readily. They have rapid growth rates and specific microscopic alterations. They are poorly differentiated and spread to distant tissues.

Which statement is true regarding magnesium? a) hypomagnesemia occurs with a concentration less than 2.5 mEq/L b) magnesium is major extracellular cation c) thirty percent is stored in the muscle / bone d) tussauds de point is a symptom of hypomagnesemia

d) tussauds de point is a symptom of hypomagnesemia tussauds de point (type of ventricular tachycardia = fatal cardiac rhythm) is a complication of hypomagnesemia. Magnesium level is normal when between 1.8 and 2.4 mEq/L and is a major intracellular cation. Thirty percent is stored in the cells, with 40% to 60% stored in the bones and muscle.

Cl- and Na+ concentrations are ______________ related

directly (Cl- follows Na+)

One third of the body's fluid is ___________

extracellular (ECF) two thirds of the body's water is intracellular; one third is extracellular. Two components of the extracellular compartment are interstitial and intravascular. TBW is approximately 60% of body weight.

causes of respiratory acidosis

hypercapnia hypoventilation COPD / retainers

Chvostek and Trousseau signs indicate ______________________

hypocalcemia

Causes of respiratory alkalosis

hypocapniea hyperventilation

A recently diagnosed oncology patient is complaining of pain. The nurse knows that this is a sign of _______________ cancer.

late stage Pressure, obstruction, invasion of sensitive structures, stretching, tissue destruction, and inflammation

the ________ excrete volatile acids while the _____ excrete nonvolatile acids

lungs / kidneys

Osteoporosis (clinical manifestations & etiology)

multifactorial disease - Decreased levels of estrogen and testosterone - Decreased activity level - Inadequate levels of vitamins D and calcium or magnesium - Alterations in the OPG/RANKL/RANK system - Postmenopausal osteoporosis - Increased osteoclast activity, changes in OPG, insulin-like growth factor (IGF), and family history - Glucocorticoids -Increase RANKL expression and inhibit OPG production by osteoblasts, leading to lower bone density Clinical manifestations Pain, bone deformity, fractures, kyphosis (hunchback), and diminished height

what is the basement acidity for urine? (how low can it go)?

pH of 4.5 - ammonia is a last ditch buffer. can bind to H+ allowing it to be excreted without increasing the acidity of the content. phosphate can work similarly

____________ & _____________ are the most important intracellular buffers

phosphate (pick up hydrogen in renal system and bind to it, making it easier to excrete) and protein (proteins have a negative charge)

malignant cancer cells secrete _____________________ that digest the extracellular matrix & basement membranes to create an escape route.

proteases

A person with history of chronic lung disease arrives in the clinic with a 1 week history of productive cough, hypoventilation, headache, and muscle twitching. The nurse suspects:

respiratory acidosis