MIDTERM PATHO 370
A 5-year-old patient's parents report loss of appetite and fatigue in their child. The parents also state that the child refuses to walk as a result of pain. The child's most likely diagnosis is
ALL (acute lymphoid leukemia)
Which type of leukemia primarily affects children?
ALL (acute lymphoid leukemia)
what clinical course would you see SIGNS & SYMPTOMS?
PRODROMAL
Which group of clinical findings describes the typical presentation of ALL (acute lymphoid leukemia)?
Pain in long bones, infection, fever, bruising
Which blood pressure reading is considered to be indicative of prehypertension according to the JNC-7 criteria?
128/82
The most reliable indicator that a person is experiencing an acute myocardial infarction (MI) is
ST-segment elevation
Which disorder is associated with a type III hypersensitivity mechanism of injury?
Systemic lupus erythematosus
The primary functions of the circulatory system are (Select all that apply.) Select one or more a. transport oxygen. b. transport nutrients c. remove metabolic waste d. reabsorb leaking fluid. e. return leukocytes to the circulation.
a b c (transport oxygen, nutrients, remove metabolic waste)
Chronic activation of stress hormones can lead to (Select all that apply.) a. cardiovascular disease. b. depression. c. impaired cognitive function. d. autoimmune disease. e. overactive immune function.
a b c d (cardio disease, depression, impaired cognitive function, autoimmune disease)
Events which occur during the alarm stage of the stress response include secretion of (Select all that apply.) a. catecholamines b. ACTH c. glucocorticoids d. immune cytokines e. TSH
a b c d (catecholamines, ACTH, glucocorticoids, immune cytokines)
Atherosclerosis puts a patient at risk for (Select all that apply.) Select one or more a. ischemic stroke b. hemorrhagic stroke c. retinal injury d. renal impairment e. liver disease
a b d (ischemic stroke, hemorrhagic stroke, renal impairment)
Aldosterone may increase during stress, leading to (Select all that apply.) a. decreased urinary output. b. increased blood potassium. c. increased sodium retention. d. increased blood volume. e. decreased blood pressure.
a c d (decreased urinary output, increased sodium retention, increased blood volume)
Sepsis has been recently redefined as
a systemic inflammatory response to infection.
All the following stress-induced hormones increase blood glucose except? a. aldosterone. b. cortisol. c. norepinephrine. d. epinephrine.
a. Aldosterone
Selye's three phases of the stress response include all the following except? a. allostasis. b. resistance. c. alarm. d. exhaustion.
a. Allostasis
Proto-oncogenes a. are normal cellular genes that promote growth b. are irregular cellular genes that promote irregular growth
a. Are normal cellular genes that promote growth
The primary adaptive purpose of the substances produced in the alarm stage is a. energy and repair b. invoke resting state c. produce exhaustion d. set a new baseline steady-state
a. Energy and Repair
The effects of histamine release include a. increased vascular permeability b. decrease vascular permeability c. stays the same
a. Increased vascular permeability
Malignant neoplasms of epithelial origin are known as a. osteosarcoma b. carninoma
b. Carninoma
A disease that is native to a particular region is called a. epidemic b. endemic c. pandemic d. ethnographic
b. Endemic
Risk factors for atherosclerosis include Select one: a. female gender b. hyperlipidemia c. high-protein diet. d. low-fiber diet.
b. Hyperlipidemia
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. a. prodromal b. latent c. sequela d. convalescence
b. Latent
Persistence of the alarm stage will ultimately result in a. stress reduction. b. permanent damage and death. c. movement into the resistance stage. d. exhaustion of the sympathetic nervous system.
b. Permanent damage and death
A patient with high blood pressure who is otherwise healthy is counseled to restrict sodium intake. This is an example of a. primary prevention b. secondary prevention c. tertiary prevention d. disease treatment
b. Secondary Prevention
The stage during which the patient functions normally, although the disease processes are well established, is referred as a. latent b. subclinical c. prodromal d. convalescence
b. Subclinical
Apoptosis is a process that results in cellular a. atrophy. b. death. c. proliferation. d. mutation.
b. death
Widespread activation of the clotting cascade secondary to massive trauma is called a. hemophilia B b. disseminated intravascular coagulation (DIC). c. Hageman disease. d. idiopathic thrombocytopenia purpura.
b. disseminated intravascular coagulation (DIC).
Transfusion reactions involve RBC destruction caused by a. donor antigens b. recipient antibodies c. donor T-cells d. recipient T cells
b. recipient antibodies
A patient with a history of myocardial infarction continues to complain of intermittent chest pain brought on by exertion and relieved by rest. The likely cause of this pain is
stable angina
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 a. stressful lifestyle b. high-fat diet c. cigarette smoking d. urban pollutants
c. Cigarette Smoking
Restriction of which electrolytes is recommended in the management of high blood pressure? a. Calcium b. Potassium c. Sodium d. Magnesium
c. Sodium
A commonly ingested substance associated with prolongation of the bleeding time is a. acetaminophen b. tobacco c. caffeine d. aspirin
d. Aspirin
Patients with immunodeficiency disorders are usually first identified because they a. run high fevers b. have usually high WBC counts c. develop brain infections d. develop recurrent infections.
d. Develop recurrent infections
The cellular change that is considered preneoplastic is a. necrosis b. metaplasia c. atrophy d. dysplasia
d. Dysplasia
The hypersensitivity reaction that does not involve antibody production is type a. I b. II c. III d. IV
d. IV
Allostasis is best defined as a. steady-state b. a state of equilibrium, of balance within the organism c. the process by which the body heals following disease d. the overall process of adaptive change necessary to maintain survival andwell-being
d. the overall process of adaptive change necessary to maintain survival andwell-being
Seasonal allergic rhinitis is most involved in type II hypersensitivity reactions. true or false
false
Patients who experience anemic episodes when exposed to certain drugs most likely have
glucose-6-phosphate dehydrogenase deficiency
Red blood cells differ from other cell types in the body, because they
have no cytoplasmic organelles
A 3-year-old boy who exhibits prolonged bleeding after minor trauma and a prolonged aPTT, but a normal platelet count, is likely to be diagnosed with
hemophilia
An important mediator of a type I hypersensitivity reaction is
histamine
Risk factors for atherosclerosis include
hyperlipidemia.
A patient presents to the emergency department with a diastolic blood pressure of 132 mm Hg, retinopathy, and symptoms of an ischemic stroke. This symptomology is likely the result of
hypertensive crisis
A patient has a history of falls, syncope, dizziness, and blurred vision. The patient's symptomology is most likely related to
hypotension
A 58-year-old woman is seen in the clinic for reports of severe back pain. Her chest x-ray demonstrates generalized bone demineralization and compression fracture. Blood studies demonstrate elevated calcium levels. The most likely diagnosis is
myeloma
Renal insufficiency is a common complication of which disease?
myeloma
The goal of long term heparin for the management of a deep vein thrombosis is to
prevent further clot formation.
primary level of prevention
prevention before you ever have a disease; immunization
Left-sided heart failure is characterized by
pulmonary congestion
A patient with pure left-sided heart failure is likely to exhibit
pulmonary congestion with dyspnea
Low cardiac output to the kidneys stimulates the release of _____ from juxtaglomerular cells.
renin
Cor pulmonale refers to
right ventricular hypertrophy secondary to pulmonary hypertension.
The most common primary immune deficiency that affects only B cells is
selective IgA
A patient presenting with fever, hypotension, and lactic acidosis is most likely to be experiencing what type of shock?
septic
When systemic vascular resistance is decreased, blood flow
decrease
An increase in organ size and function caused by increased workload is termed a. atrophy b. hypertrophy c. metaplasia d. inflammation
B. Hypertrophy
A child with a history of recent strep throat infection develops glomerulonephritis. This is most likely a type _____ hypersensitivity reaction.
III
The principle Ig mediator of type I hypersensitivity reactions is
IgE
After surgery to remove a lung tumor, your patient is scheduled for chemotherapy, which will a. kill rapidly dividing cells. b. have minimal side effects. c. selectively kill tumor cells. d. stimulate immune cells to fight the cancer.
a. Kill rapidly diving cells
After bronchoscopy and histologic exam of a suspected tumor, your pt is diagnosed with primary bronchial carcinoma. This type of tumor? a. malignant b. beningn
a. Malignant
Dramatic hypotension sometimes accompanies type I hypersensitivity reactions, because a. massive histamine release from mast cells leads to vasodilation. b. toxins released into the blood interfere with cardiac function. c. anaphylaxis results in large volume losses secondary to sweating. d. hypoxia resulting from bronchoconstriction impairs cardiac function.
a. Massive histamine release from mast cells leads to vasodilation
All these cellular responses are potentially reversible except a. necrosis. b. metaplasia. c. atrophy. d. hyperplasia.
a. Necrosis
Many of the responses to stress are attributed to activation of the sympathetic nervous system and are mediated by? a. norepinephrine b. cortisol c. glucagon d. ACTH
a. Norepinephrine
The common denominator in all forms of heart failure is a. reduce cardiac output b. high cardiac output
a. Reduce cardiac output
When the cause is unknown, a condition is said to be idiopathic a. true b. false
a. True
The hyper metabolic state leading to cachexia in terminal cancer is thought to be because of a. tumor necrosis b. metaplasia
a. Tumor necrosis
The hypermetabolic state leading to cachexia in terminal cancer is thought to be because of a. tumor necrosis factor. b. pain medications. c. angiogenesis. d. loss of ATP production.
a. Tumor necrosis factor
produce by normal cells, help determine cancer organ help identify progression of cancer and include prostatic specific antigen a. tumor necrosis factor. b. pain medications. c. angiogenesis. d. loss of ATP production.
a. Tumor necrosis factor
In contrast to all other types of shock, the hyperdynamic phase of septic shock is associated with a. low cardiac output b. high cardiac output
b
While in the hospital for management of acute lymphoid leukemia (ALL), a patient develops severe thrombocytopenia. The most appropriate action for this condition is
activity restriction
what are side effects of chemotherapy include
anemia nausea bleeding infections
The majority of cases of anaphylactic shock occur when a sensitized individual comes in contact with
antibiotic
The Philadelphia chromosome is a balanced chromosome translocation that forms a new gene called
bcr-abl
Most carbon dioxide is transported in the bloodstream as
bicarbonate ion
Excessive red cell lysis can be detected by measuring the serum
bilirubin
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 a. genetic susceptibility b. pharyngitis c. streptococcal infection d. a sore throat
c. Streptococcal Infection
1 After suffering a heart attack, a middle-aged man is counseled to take a cholesterol-lowering medication. This is an example of a. primary prevention b. secondary prevention c. tertiary prevention d. disease treatment
c. Tertiary Prevention
What results when systemic blood pressure is increased? a. Hypovolemia b. Decreased cardiac output c. Vasoconstriction d. Decreased vascular resistance
c. Vasoconstriction
A cause of thrombocytopenia includes a. hypoxemia. b. reduced erythropoietin. c. chemotherapy. d. secondary polycythemia.
c. chemotherapy
Hypotension, distended neck veins, and muffled heart sounds are classic manifestations of
cardiac tamponade
Angiotensin-converting enzyme (ACE) inhibitors block the
conversion of angiotensin I to angiotensin II
Your patient is scheduled for a staging procedure. She wants to know what that means. The correct response is which of the following? a. It is based on exploratory surgery. b. It is biochemical testing of tumor cells to determine the genetic basis of the tumor. c. It is a histologic examination of tissues to determine the degree of tumor differentiation. d. It is a procedure for determining the extent of tumor spread.
d. It is a procedure for determining the extent of tumor spread.
A serious complication of deep vein thrombosis is a. stroke. b. hypertensive crisis. c. extremity necrosis. d. pulmonary embolus.
d. Pulmonary embolus
Cancer grading is based on a. local invasion. b. tumor size. c. metastasis. d. cell differentiation.
d. cell differentiation.
The cellular response indicative of injury because of faulty metabolism is a. hydropic swelling b. lactate production c. metaplasia d. intracellular accumulations
d. intracellular accumulations.
The effect of stress on the immune system a. is unknown. b. has been demonstrated to be non-existent in studies. c. most often involves enhancement of the immune system. d. may involve enhancement or impairment the immune system.
d. may involve enhancement or impairment the immune system.
The major cause of death from leukemic disease is
infection
The patient is a 12-year-old boy diagnosed with acute lymphoid leukemia (ALL). As part of treatment, the patient must undergo several weeks of chemotherapy. The most serious complication of chemotherapy is
infection
Disseminated intravascular coagulation may be treated with heparin therapy to
inhibit clotting factor consumption.
Pernicious anemia is caused by a lack of
intrinsic factor
A low mean corpuscular hemoglobin concentration (MCHC) and mean corpuscular volume (MCV) are characteristic of which type of anemia?
iron deficiency
The cause of the most common form of anemia is
iron deficiency
The primary source of erythropoietin is provided by the
kidney
Dysfunction of which organ would lead to clotting factor deficiency?
liver
The activated partial thromboplastin time (aPTT) is a measure of the integrity of
the intrinsic pathway
Activation of the extrinsic pathway of coagulation is initiated by
tissue thromboplastin
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. true or false?
true
The only known curative treatment for CML is allogeneic bone marrow transplantation from a suitable donor. true or false?
true
A newborn has melena, bleeding from the umbilicus, and hematuria. The newborn most likely experiencing
vitamin K deficiency bleeding.
Rheumatic heart disease is most often a consequence of
β-hemolytic streptococcal infection