Patho Final Exam

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."

The arterial oxygen content (CaO2) for a patient with PaO2 100 mm Hg, SaO2 95%, and hemoglobin 15 g/dl is _____ ml oxygen/dl

19.4

A loud pansystolic murmur that radiates to the axilla is most likely a result of

mitral regurgitation

All these cellular responses are potentially reversible except

necrosis

RhoGAM (an Rh antibody) would be appropriate in an Rh-_____ woman with an _____ Rh-_____ antibody titer carrying an Rh-_____ fetus.

negative; negative; positive

Huntington disease primarily affects the _____ system

neurologic

The prevalence of high blood pressure is higher in

non-Hispanic black adults

Hypertension is closely linked to

obstructive sleep apnea

Breast cancer in women who have the breast cancer gene

occurs at an earlier age

Somatic death refers to death

of the entire organism

Parasympathetic stimulation of the heart generally leads to a decrease in heart rate, because acetylcholine

opens potassium channels allowing potassium ion efflux

The strength of the bond between oxygen and hemoglobin is known as the

oxygen-hemoglobin affinity

A patient with heart failure who reports intermittent shortness of breath during the night is experiencing

paroxysmal nocturnal dyspnea

The membrane attack complex formed by complement is similar in function to

perforin

An erroneously low blood pressure measurement may be caused by

positioning the arm above the heart level

An abnormally wide (more than 0.10 second) QRS complex is characteristic of

premature ventricular complexes

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

primary prevention

The risk period for maternal rubella infection leading to congenital problems begins

prior to conception

First-degree heart block is characterized by

prolonged PR interval

Children with PKU must avoid phenylalanine in the diet. Phenylalanine is most likely to be a component of

protein

A vessel that normally contains desaturated (venous) blood is the

pulmonary artery

Blood is transported from the right ventricle to the lungs by the

pulmonary artery

In both Adult respiratory distress syndrome (ARDS)& infant respiratory distress syndrome (IRDS)

pulmonary compliance is decreased.

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

Hypertrophy of the right ventricle is a compensatory response to

pulmonary stenosis

Transfusion reactions involve RBC destruction caused by

recipient antibodies

Beta-blockers are advocated in the management of heart failure because they

reduce cardiac output

The common denominator in all forms of heart failure is

reduced cardiac output

Carbon monoxide injures cells by

reducing oxygen level on hemoglobin

The majority of tachydysrhythmias are believed to occur because of

reentry mechanisms

Low cardiac output to the kidneys stimulates the release of _____ from juxtaglomerular cells

renin

Results of biochemical tests indicate an infant has phenylketonuria (PKU). The parents ask what PKU means. Correct responses would include all the following except PKU

results from a chromosome abnormality called nondisjunction

After sitting in a chair for an hour, an elderly patient develops moderate lower extremity edema. His edema is most likely a consequence of

right-sided heart failure

Hypertension with a specific, identifiable cause is known as _____ hypertension.

secondary

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

secondary prevention

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

The most common primary immune deficiency that affects only B cells is

selective IgA

A laboratory test that should be routinely monitored in patients receiving digitalis therapy is

serum potassium

An increase in hemoglobin affinity for oxygen occurs with

shift to the left

The primary feature distinguishing bacterial from viral pneumonia is

A cough productive of purulent sputum

Which of the following situations would result in the release of erythropoietin?

A patient with lung disease and chronic hypoxia

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

DNA

Serum levels of cortisol fluctuate over 24-hour period, reflecting a

Diurnal variation and Circadian rhythm

Increased preload of the cardiac chambers may lead to which patient symptom?

Edema

Which disorder is considered a primary immunodeficiency disease?

HIV/AIDS

Certain autoimmune diseases are associated with the presence of specific proteins on a person's cells. These proteins are called ________ proteins.

HLA or MHC

Which condition is associated with an elevated reticulocyte count?

Hemolytic anemia

A patient has acute respiratory failure. Which lab findings will you expect to find?

Hypoxemia and hypercapnia

A child with a history of recent strep throat infection develops glomerulonephritis. This is most likely a type _____ hypersensitivity reaction

III

The hypersensitivity reaction that does not involve antibody production is type

IV

The principle Ig mediator of type I hypersensitivity reactions is

IgE

Which clinical finding is most indicative of an acute bacterial infection?

Increased (band) neutrophils

Which physiologic change increases cardiac work but does not enhance cardiac output?

Increased afterload

A patient has edema. What could have caused the edema?

Increased interstitial fluid osmotic pressure

Place the multi step nature of carcinogenesis in order

Initiation, promotion, and progression

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

Which characteristic is indicative of hemolytic anemia?

Jaundice

Amyotrophic Lateral Sclerosis (ALS)

Leads to death by respiratory failure

Water excess (Hyponatremia)is best detected by

Low serum sodium

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

Mutant tumor suppressor gene

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

P53

What compensatory sign would be expected during periods of physical exertion in a patient with limited ventricular stroke volume?

Tachycardia

What results when systemic blood pressure is increased?

Vasoconstriction

Males are more likely than females to be affected by ________ disorders

X-linked

Mitral stenosis is associated with

a pressure gradient across the mitral valve

A patient is exhibiting severe dyspnea and anxiety. The patient also has bubbly crackles in all lung fields with pink, frothy sputum. This patient is most likely experiencing

acute cardiogenic pulmonary edema

Myocarditis should be suspected in a patient who presents with

acute onset of left ventricular dysfunction

Proteins that are increased in the bloodstream during acute inflammation are called

acute phase proteins

The patient should be encouraged to continue compliance with lifestyle changes since the patient has exhibited some positive response to his changes. Diuretics are not needed at this time. ACE inhibitors should not be added to the therapy yet. Beta-blockers are not required at this time.

afterload

Characteristics of X-linked (sex-linked) recessive disorders include

all daughters of affected fathers' being carriers

One role of ATP in cardiac muscle contraction is

altering myosin affinity for actin-binding sites

Immunity to a specific organism can be determined by

antibody titer

The "classical pathway" for activation of the complement cascade is triggered by

antigen-antibody complexes

Patients presenting with symptoms of unstable angina and no ST segment elevation are treated with

antiplatelet drugs

The majority of cardiac cells that die after myocardial infarction do so because of

apoptosis

Proto-oncogenes

are normal cellular genes that promote growth

The v wave of an atrial pressure tracing corresponds to

atrial filling

Paraneoplastic syndromes in cancer involve excessive production of substances by multiple means. A common substance found in excessive amounts due to cancer paraneoplastic syndromes is

calcium

Malignant neoplasms of epithelial origin are known as

carcinomas

Hypotension, distended neck veins, and muffled heart sounds are classic manifestations of

cardiac tamponade

Cancer grading is based on

cell differentiation

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

Angiotensin-converting enzyme (ACE) inhibitors block the

conversion of angiotensin I to angiotensin II

Apoptosis is a process that results in cellular

death

In general, with aging, organ size and function______

decrease

Extreme cold injures cells by all the following except

decreased blood viscosity

The primary effect of aging on all body systems is

decreased functional reserve

While caring for a geriatric patient, the changes in the heart that may be expected include

decreased response to an elevated heart rate

At very high heart rates, cardiac output

decreases

Primary treatment for myocardial infarction (MI) is directed at

decreasing myocardial oxygen demands

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

Severe combined immunodeficiency (SCID) syndrome is an example of a(n)

deficient immune response

Patients with immunodeficiency disorders are usually first identified because they

develop recurrent infections

Aortic regurgitation is associated with

diastolic murmur

The therapy that most directly improves cardiac contractility in a patient with systolic heart failure is

digitalis

Antigen-presenting cells function to

display foreign antigen on their cell surfaces bound to MHC

The cellular change that is considered preneoplastic is

dysplasia

The parents of a child with PKU are concerned about the risk of transmitting the disorder in future pregnancies. The correct assessment of the risk is

each child has a 25% chance of being affected

Leukocytosis with a "shift to the left" refers to

elevated immature neutrophils

A laboratory test finding helpful in confirming the diagnosis of iron-deficiency anemia is

elevated total iron-binding capacity

A disease that is native to a particular region is called

endemic

The most effective therapy for anemia associated with kidney failure is

erythropoietin administration

Information parents should be given about the consequences of PKU includes

failure to avoid phenylalanine results in progressive mental retardation

The spleen is an important defense against infection, because it

filters the blood

Red blood cells obtain nearly all their energy from metabolism of

glucose

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

An important mediator of a type I hypersensitivity reaction is

histamine

An increase in organ size and function due to increased workload is termed

hypertrophy

A patient has a history of falls, syncope, dizziness, and blurred vision. The patient's symptomology is most likely related to

hypotension

When the cause is unknown, a condition is said to be...

idiopathic

Constrictive pericarditis is associated with

impaired cardiac filling

Lusitropic impairment refers to

impaired diastolic relaxation

Myasthenia gravis is a type II hypersensitivity disorder that involves

impaired muscle function

The effects of histamine release include

increased vascular permeability

Coagulative necrosis is caused by

interrupted blood supply

The cellular response indicative of injury due to faulty metabolism is

intracellular accumulations

Pernicious anemia is caused by a lack of

intrinsic factor

Reperfusion injury to cells

involves formation of free radicals

A point mutation

involves the substitution of a single base pair

The cause of the most common form of anemia is

iron deficiency

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

is malignant

The primary source of erythropoietin is provided by the

kidneys

The primary function of eosinophils is to

kill parasitic helminths (worms)

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

kill rapidly dividing 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

Second-degree heart block type I (Wenckebach) is characterized by

lengthening PR intervals and dropped P wave

Necrotic death of brain tissue usually produces _____ necrosis

liquefactive

Cystic fibrosis is a single gene disorder that primarily affects

lungs and pancreas

Interleukin-1, interleukin-6, and tumor necrosis factor-α are inflammatory cytokines secreted by

macrophages

Dramatic hypotension sometimes accompanies type I hypersensitivity reactions, because

massive histamine release from mast cells leads to vasodilation

A primary effector cell of the type I hypersensitivity response is

mast cells

The primary factor associated with risk of Down syndrome is

maternal age

Cardiac myosin has a high affinity for actin when the myosin has what molecule(s) bound to it?

ADP and phosphate

Term for describing the process of a tumor forming new blood vessels

Angiogenesis

Which disease has increased airway responsiveness to various stimuli?

Asthma

In which dysrhythmias should treatment be instituted immediately?

Atrial fibrillation with a ventricular rate of 220 beats/min

During which phase of the cardiac cycle is the mitral valve normally open?

Atrial systole

Retroviruses are associated with human cancers, including

Burkitt lymphoma

associated with metabolic acidosis?

Central nervous system depression

What laboratory finding is usually found in aplastic anemia?

Pancytopenia

Which dysrhythmia is thought to be associated with reentrant mechanisms?

Preexcitation syndrome tachycardia (Wolf-Parkinson-White syndrome)

Angina due to coronary artery spasm is called _____ angina.

Prinzmetal variant

The time during which early signs / symptoms begin to appear is called

Prodromal period

The most reliable indicator that a person is experiencing an acute myocardial infarction (MI) is

ST-segment elevation

Restriction of which electrolytes is recommended in the management of high blood pressure?

Sodium

Which disorder is associated with a type III hypersensitivity mechanism of injury?

Systemic lupus erythematosus

Most carbon dioxide is transported in the bloodstream as

bicarbonate ion

Excessive red cell lysis can be detected by measuring the serum

bilirubin

An increase in intracellular calcium ion results in myocardial contraction, because calcium

binds troponin, causing actin-binding sites to be exposed

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

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

subclinical

Huntington disease is often transferred to offspring before a parent knows of the genetic possibility of this disease, because

symptoms often do not occur until approximately 40 years of age

A patient with significant aortic stenosis is likely to experience

syncope

Creatine phosphate is

synthesized when ATP levels are high

Functions of B cells include

synthesizing antibodies

Pulse pressure is defined as

systolic pressure - diastolic pressure

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

tertiary prevention

A fetus is most vulnerable to environmental teratogens during

the first trimester

Metaplasia is_____

the replacement of one differentiated cell type with another

The hypermetabolic state leading to cachexia in terminal cancer is thought to be due to

tumor necrosis factor

The primary function of kinins is

vasodilation to enhance inflammation

An example of an acyanotic heart defect is

ventricular septal defect

Rheumatic heart disease is most often a consequence of

β-hemolytic streptococcal infection.