Patho Chapters 1-12
Familial retinoblastoma involves the transmission of what from parent to offspring?
Mutant tumor suppressor gene
An increase in organ size and function due to increased workload is termed
hypertrophy.
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
All these cellular responses are potentially reversible except
necrosis.( answer ) b. metaplasia. c. atrophy. d. hyperplasia.
Huntington disease primarily affects the _____ system.
neurologic
Somatic death refers to death
of the entire organism.
Persistence of the alarm stage will ultimately result in
permanent damage and death.
The risk period for maternal rubella infection leading to congenital problems begins
prior to conception
Children with PKU must avoid phenylalanine in the diet. Phenylalanine is most likely to be a component of
protein.
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.
HIV infection causes immunodeficiency because it
causes the destruction of T-helper cells.
Cancer grading is based on
cell differentiation.
Immune function is likely to be most effective in a
30-year-old.
Cleaning dirty needles prior to use helps prevent the spread of HIV. When using bleach, the user must rinse out all the blood first and then fill the needle and syringe with full-strength bleach three times for ____ to ____ seconds.
30; 60 After rinsing all the blood first, the user fills the needle and syringe with full-strength bleach at least three times for 30 to 60 seconds.
The immune system disorder associated with HIV is
deficiency of T-helper lymphocytes.
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.
The primary role of genes is to
direct the synthesis of proteins.
The primary adaptive purpose of the substances produced in the alarm stage is
energy and repair.
Socioeconomic factors influence disease development due to (Select all that apply.)
environmental toxins. overcrowding. nutrition. hygiene.
The differences in structure and function of cells in different body tissues is due to
expression of tissue-specific genes.
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
An HIV-positive patient is hospitalized for evaluation of symptoms of progressive weakness, dyspnea, weight loss, and low-grade fever. A biopsy of lung tissue reveals Pneumocystis carinii pneumonia. This diagnosis means that the patient
has AIDS.
The cardiac drug digitalis enhances myocardial contraction, because it
increases intracellular calcium level in cardiac cells.
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
Activation of the complement cascade results in (Select all that apply.)
inflammation. chemotaxis
Reperfusion injury to cells
involves formation of free radicals.
After bronchoscopy and histologic examination of a suspected tumor, your patient is diagnosed with primary bronchial carcinoma. Thus, the tumor
is malignant
The primary function of eosinophils is to
kill parasitic helminths (worms).
Necrotic death of brain tissue usually produces _____ necrosis.
liquefactive
Dramatic hypotension sometimes accompanies type I hypersensitivity reactions, because
massive histamine release from mast cells leads to vasodilation.
Drug resistance of microbes occurs secondary to
mutation of the microbe.
The term used to describe fungal infections is
mycoses.
Renal insufficiency is a common complication of which disease?
myeloma
RhoGAM (an Rh antibody) would be appropriate in an Rh-_____ woman with an _____ Rh-_____ antibody titer carrying an Rh-_____ fetus.
negative; negative; positive
Many of the responses to stress are attributed to activation of the sympathetic nervous system and are mediated by
norepinephrine.
Breast cancer in women who have the breast cancer gene
occurs at an earlier age
The membrane attack complex formed by complement is similar in function to
perforin
A 17-year-old college-bound student receives a vaccine against an organism that causes meningitis. This is an example of
primary prevention
Transfusion reactions involve RBC destruction caused by
recipient antibodies.
Carbon monoxide injures cells by
reducing oxygen level on hemoglobin.
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.
The clinical latency period after HIV infection is a time when no
significant symptoms of immunodeficiency occur.
Autologous stem cell transplantation is a procedure in which
stem cells are harvested from the patient and then returned to the same patient.
The stage during which the patient functions normally, although the disease processes are well established, is referred to as
subclinical
Functions of B cells include
synthesizing antibodies.
Ribosomes are very important organelles within the cell that have the function of
synthesizing proteins
The resting membrane potential in nerve and skeletal muscle is determined primarily by
the ratio of intracellular to extracellular potassium ions.
A patient receiving zidovudine and a protease inhibitor to manage HIV infection is found to have an undetectable viral load. This means that the
therapy is effective.
The primary function of kinins is
vasodilation to enhance inflammation.
All the following stress-induced hormones increase blood glucose except
A. aldosterone. ( answer ) b. cortisol. c. norepinephrine. d. epinephrine.
Selye's three phases of the stress response include all the following except
A. allostasis. ( answer) b. resistance. c. alarm. d. exhaustion.
Which statement best describes the etiologic development and transmission of AIDS?
AIDS is caused by a retrovirus and transmitted through body fluids.
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 due to pain. The child's most likely diagnosis is
ALL (acute lymphoid leukemia)
HIV infection of T-helper cells is facilitated by attachment of the viral envelope protein gp120 to
CD4 proteins on helper cells.
Which form of leukemia demonstrates the presence of the Philadelphia chromosome?
CML (chronic myeloid leukemia)
What is the correct definition of complete remission (CR) of leukemia?
CR is less than 5% blasts in marrow and normal CBC values.
The cellular component that is most susceptible to radiation injury is the
DNA
Which statement about HIV testing is correct?
Significant exposure to infected blood or body fluids requires HIV testing.
Which viruses have been implicated as cancer-causing agents? (Select all that apply.)
a. Epstein-Barr b. Human T-cell leukemia c. Human immunodeficiency
A patient is diagnosed with CML (chronic myeloid leukemia). The patient may experience which of these symptoms? (Select all that apply.)
a. Fatigue b. Weight loss c. Abdominal discomfort .e. Sweats
Characteristics of immunization include which of the following? (Select all that apply.)
a. Giving injections of preformed antibodies provides immediate immunity d. Herd immunity controls disease without immunizing everyone in the population e. Lack of immunization may lead to an epidemic
The CDC defines three CD4+ T cell categories of T cell ranges. Which values are correct? (Select all that apply.)
a. In category 1, the CD4+ T cell count is greater than or equal to 500/ml. c. In category 2, the CD4+ T cell counts range from 200 to 499/ml. d. In category 3, the CD4+ T cell count is less than 200/ml.
Which drugs are used for the management of HIV? (Select all that apply.)
a. Nucleoside reverse transcriptase inhibitors c. Protease inhibitors d. Nonnucleoside reverse transcriptase inhibitors
A patient is diagnosed with stage III non-Hodgkin lymphoma and is preparing to undergo treatment. Which treatments may be used to treat this patient's cancer? (Select all that apply.)
a. Radiation b. Bone marrow transplant c. Chemotherapy e. Monoclonal antibody therapy
Which modes of transmission occur with HIV infection? (Select all that apply.)
a. Sexual transmission b. Parenteral transmission d. Perinatal transmission to fetus
Characteristics of stem cells include that they (Select all that apply.)
a. may differentiate into any type of cell. c. have greater capacity to proliferate than more differentiated cells. d. are dependent upon environmental cues for proliferation. e. can die in the absence of an appropriate environment.
The mononuclear phagocyte system consists of (Select all that apply.)
a. monocytes and tissue macrophages. b. dendritic cells.
Passive immunity is provided by (Select all that apply.)
a. transfer of preformed human antibodies. b. injection of human immune globulin. c. injection with preformed animal antibodies.
10. Risk of infection is increased in (Select all that apply.)
a. use of corticosteroids. b. diabetes mellitus. c. spleen removal. e. stress
In general, the best prognosis for long-term disease-free survival occurs with
ALL (acute lymphoid leukemia).
Which type of leukemia primarily affects children?
ALL (acute lymphoid leukemia).
Burkitt lymphoma is most closely associated with
Epstein-Barr virus.
Which type of HIV virus causes most infections in the United States and Europe?
HIV type 1
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
Seasonal allergic rhinitis is most involved in type ____ hypersensitivity reactions.
I Seasonal allergic rhinitis is most involved in type I hypersensitivity reactions.
Anaphylaxis may occur in certain hypersensitivity reactions, including type (Select all that apply.)
I. II.
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
Characteristics of cellular differentiation include which of the following? (Select all that apply.)
a. Specialization for different functions c. Influenced by memory of developmental events d. Dependent on cell-to-cell coordination e. Generally not reversible
In which type of cells is the CD4 found? (Select all that apply.)
a. T cells b. Microglial cells c. Retinal cells d. Cervical cells
The patient is a 12-year-old boy with acute lymphoblastic leukemia (ALL). Manifestations of the patient's leukemia prior to treatment may include (Select all that apply.)
a. anemia. b. leukocytosis. d. thrombocytopenia.
Side effects of chemotherapy include (Select all that apply.)
a. anemia. b. nausea. d. bleeding. e. infections.
Functions of antibodies include (Select all that apply.)
a. antigen agglutination. b. antigen precipitation. c. opsonization. e. complement activation.
A patient is diagnosed with hairy cell leukemia. The patient's lab results would most likely indicate a decrease in (Select all that apply.)
a. granulocytes. b. platelets. c. RBC
The HIV nurse educator teaches a newly diagnosed patient about HIV. The nurse educator tells the patient that in the United States, those at greatest risk of HIV infection include (Select all that apply.)
b. heterosexual women. c. homosexual men.
Functions of T cells include (Select all that apply.)
b. secreting cytokines. c. killing antigen-presenting cells. d. stimulating of B cells. e. killing virally infected cells.
The Philadelphia chromosome is a balanced chromosome translocation that forms a new gene called
bcr-abl.
Active immunity involves (Select all that apply.)
d. vaccines with dead or altered organisms. e. active infections.
Leukocytosis with a "shift to the left" refers to
elevated immature neutrophils.
An infectious disease that is common in a community is termed
endemic.
An important mediator of a type I hypersensitivity reaction is
histamine
Myasthenia gravis is a type II hypersensitivity disorder that involves
impaired muscle function
Which clinical finding is most indicative of an acute bacterial infection?
increased (band) neutrophils.
The effects of histamine release include
increased vascular permeability.
The term infectivity is defined as the ability to
invade and multiply
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
a. is an enzyme deficiency resulting in the inability to metabolize phenylalanine. b. is an inborn error of metabolism. c. results from a chromosome abnormality called nondisjunction. (answer) d. is transmitted as an autosomal recessive disorder.
The cellular change that is considered preneoplastic is
dysplasia.
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.
In DNA replication DNA polymerase functions to (Select all that apply.)
d. match appropriate bases to the template base. e. proofread the newly developed DNA for errors in base pairing.
In general, with aging, organ size and function
decrease
Aldosterone may increase during stress, leading to (Select all that apply.)
decreased urinary output. increased sodium retention. decreased blood pressure.
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.
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.
Repolarization of a neuron after a depolarizing action potential is due to
efflux of potassium.
A disease that is native to a particular region is called
endemic
Cell-to-cell communication through secretion of chemical signals into the bloodstream to target cells throughout the body is called _____ signaling.
endocrine
An increase in extracellular potassium ion from 4.0 to 6.0 mEq/L would
hypopolarize the resting membrane potential.
When the cause is unknown, a condition is said to be ________.
idiopathic Many diseases are idiopathic in nature.
The effects of excessive cortisol production include
immune suppression.
The cellular response indicative of injury due to faulty metabolism is
intracellular accumulations.
After surgery to remove a lung tumor, your patient is scheduled for chemotherapy, which will
kill rapidly dividing cells.
During conditions of prolonged insufficient oxygen availability (e.g., respiratory or cardiovascular disease) anaerobic glycolysis accumulated pyruvate can lead to _____ acidosis.
lactic Pyruvate is converted to lactate and released into the blood stream, resulting in lactic acidosis.
Cystic fibrosis is a single gene disorder that primarily affects
lungs and pancreas.
The primary factor associated with risk of Down syndrome is
maternal age
The effect of stress on the immune system
may involve enhancement or impairment the immune system.
The organelle that contains enzymes necessary for oxidative phosphorylation to produce ATP is the
mitochondria.
Ion channels open and close in response to all the following except
temperature changes.
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.
Allostasis is best defined as
the overall process of adaptive change necessary to maintain survival and well-being.
Which is not normally secreted in response to stress?
Insulin
An important difference between skeletal and cardiac muscle is that
cardiac muscle has calcium channels on the cell surface for calcium entry.
The phase of cellular metabolism in which energy is released during breakdown of nutrient sources is ________.
catabolism Catabolism involves energy release via breakdown of nutrient sources such as glucose to provide ATP to the cell. In contrast, anabolism refers to energy-using processes that result in complex molecules such as fats.
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."
Approximately what percentage of the human DNA chromosomes code for proteins?
1%
A point mutation
Males are more likely than females to be affected by ________ disorders.
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.
GTP-binding proteins (G proteins) function to
activate intracellular enzyme systems.
Malignant neoplasms of epithelial origin are known as
carcinomas
The primary effect of aging on all body systems is
decreased functional reserve.
Some individuals inherit a gene that results in dangerously high blood cholesterol due to impaired ________ of low-density lipoproteins (LDLs).
endocytosis The defective gene inhibits the synthesis of LDL protein receptors on the cell membrane. This impairs endocytosis of LDL. High levels of LDL in the blood predispose to atherosclerosis.
The benefit of glycolysis is that this phase supplies
pyruvate to the citric acid cycle.
Gap junctions are connecting channels that allow passage of small molecules from one cell to the next and are especially important for
tissues requiring synchronized function.
The hypermetabolic state leading to cachexia in terminal cancer is thought to be due to
tumor necrosis factor.
HIV replicates very quickly from the onset of infection. What is the major site of HIV replication?
GI tract
An effective HIV vaccine is difficult to produce, primarily because
HIV mutates frequently.
The principle Ig mediator of type I hypersensitivity reactions is
IgE.
Which HIV-positive patient should be given a diagnosis of AID
One who has Mycobacterium tuberculosis
The most common tumor suppressor gene defect identified in cancer cells
P53
Which group of clinical findings describes the typical presentation of ALL (acute lymphoid leukemia)?
Pain in long bones, infection, fever, bruising
Which disorder is associated with a type III hypersensitivity mechanism of injury?
Systemic lupus erythematosus
Your patient's red blood cell is slightly elevated today. This might be explained by (Select all that apply.)
a.gender difference. b.situational factors. c.normal variation. e.illness
A characteristic of some bacteria is
contains cell wall endotoxin
The "classical pathway" for activation of the complement cascade is triggered by
d. antigen-antibody complexes.
A nurse who works in an assisted living facility is preparing to teach the residents about safe sex practices. What resident criteria should the nurse take into consideration when creating a teaching plan? (Select all that apply.)
Age b. Ethnicity c. Culture d. Sexual preference
A diagnostic laboratory finding in myeloma is
Bence Jones proteins in the urine.
A patient is diagnosed with myeloma. The nurse teaches the patient about the multiple tumor sites that can develop with this cancer. The possible tumor sites in myeloma include the (Select all that apply.)
a. liver. b. spleen. e. kidneys.
A patient presents to the clinic with flu-like symptoms and a rash. The nurse knows that the type of rash associated with HIV may include (Select all that apply.)
a. maculopapular. b. vesicular. d. urticarial.
Dietary zinc is an important defense against infection, because it maintains (Select all that apply.)
a. natural killer cell function. b. lymphocyte activity. d. neutrophil activity. e. complement activity.
A patient is diagnosed with stage IIA Hodgkin disease. This patient's clinical stage was most likely determined by (Select all that apply.) d. CT scan.
a. patient history. d. CT scan. e. physical examination.
Characteristics of telomerase include (Select all that apply.)
a. repairs the end caps of chromosomes. b. contributes to cancer cell immortality. d. activity allows a cell to replicate indefinitely.
Characteristics of complement include (Select all that apply.)
a. stimulating chemotaxis. b. lysing target cells. c. having multiple plasma proteins. e. enhancing phagocytosis.
Secondary immune deficiency problems may be caused by (Select all that apply.)
a. surgery. b. high blood sugar. c. corticosteroids. e. low protein level.
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.
Proteins that are increased in the bloodstream during acute inflammation are called
acute phase proteins
The only known curative treatment for CML is _____ bone marrow transplantation from a suitable donor.
allogeneic Allogeneic bone marrow transplantation from a suitable donor is the only curative treatment for CML.
Immunity to a specific organism can be determined by
antibody titer.
Opportunistic infections are a hallmark of HIV and AIDS. Which infections are considered opportunistic? (Select all that apply.)
b. Cytomegalovirus c. Candida albicans d. Pneumocystis carinii e. Clostridium difficile
Tumor markers (Select all that apply.)
b. are produced by normal cells. c. help determine cancer origin. d. help identify progression of cancer. e. include prostatic-specific antigen.
A patient is infected with the retrovirus HIV. The patient may have contracted HIV as it was transmitted via (Select all that apply.)
c. semen. d. cervical secretions.
Apoptosis is a process that results in cellular
death
Antigen-presenting cells function to
display foreign antigen on their cell surfaces bound to MHC.
The most common method of disease transmission is
droplet
In general, a cancer cell that is more tissue-specific differentiated is ____ (more/less) likely to be aggressive.
less 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.
Interleukin-1, interleukin-6, and tumor necrosis factor-α are inflammatory cytokines secreted by
macrophages
A primary effector cell of the type I hypersensitivity response is
mast cells
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
As of 2010, _____ individuals worldwide have been infected with HIV infection.
nearly 35 million
Autoimmune diseases result from (Select all that apply.)
overactive immune function. failure of the immune system to differentiate self and nonself molecules.
two of the most serious oncology emergencies associated with non-Hodgkin lymphoma are obstruction of the superior vena cava and compression of the
spinal cord Compression of the spinal cord is one of the two most serious oncology emergencies associated with non-Hodgkin lymphoma.
Retroviruses are associated with human cancers, including
Burkitt lymphoma.
Metaplasia is
the replacement of one differentiated cell type with another.
Coagulative necrosis is caused by
interrupted blood supply.
Glycolysis is the metabolic process of breaking down a glucose molecule to form
2 ATP and 2 pyruvate.
Which tissue type is categorized as epithelial?
Blood vessel endothelium
Calcium channel blocker drugs are often used to treat conditions associated with (Select all that apply.)
a. cardiac muscle. b. smooth muscle.
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.
Deficits in immune system function occur in cancer due to (Select all that apply.)
a. chemotherapy. b. cancer cells. c. cancer metastasis to bone marrow. e. malnutrition.
Protein synthesis involves (Select all that apply.)
a. direction from mRNA. c. nucleotide triplets. d. RNA polymerase. e. removal of introns from the DNA template.
Viruses differ from most bacteria in that they (Select all that apply.)
a. enter the host cell. c. use the host's metabolic processes to survive and replicate. e. do not produce toxins.
Infectious injury often results from (Select all that apply.)
a. exotoxins. b. endotoxins. c. self-destruction of cells. e. enzymes from white blood cells.
Characteristics of Marfan syndrome include that it (Select all that apply)
a. is a single-gene disorder. b. involves alterations in connective tissue. c. leads to skeletal and joint deformities. e. results in dangerous cardiovascular disorders.
Extreme cold injures cells by all the following except
a. ischemic injury from vasoconstriction. b. peripheral nerve damage from rebound vasodilation. c. decreased blood viscosity. ( answer) d. crystallization of cellular components.
Bacteria cause injury to cells by (Select all that apply.)
a. producing exotoxins. b. producing endotoxins. c. producing destructive enzymes e. evoking an immune reaction.
Chronic activation of stress hormones can lead to (Select all that apply.)
a. cardiovascular disease. b. depression. c. impaired cognitive function. d. autoimmune disease.
Indicators that an individual is experiencing high stress include all the following except
achycardia. b. diaphoresis. c. increased peripheral resistance. D. pupil constriction. ( Answer)
Characteristics of X-linked (sex-linked) recessive disorders include
all daughters of affected fathers' being carriers.
Phospholipids spontaneously form lipid bilayers, because they are
amphipathic.
Proto-oncogenes
are normal cellular genes that promote growth.
Characteristics of smooth muscle include
being found in blood vessels.
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
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 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.
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 a 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.
Excitable cells are able to conduct action potentials because they have
voltage-gated channels.