Patho exam 1
Males are more likely than females to be affected by ________ disorders. a. X-linked b. autosomal-dominant c. autosomal-recessive d. chromosomal nondisjunction
A
The risk period for maternal rubella infection leading to congenital problems begins a. prior to conception. b. during the last trimester. c. at birth. d. all through pregnancy.
A
An obese but otherwise healthy teen is given a prescription for a low-calorie diet and exercise program. This is an example of a. primary prevention. b. secondary prevention. c. tertiary prevention. d. disease treatment.
B
An important mediator of a type I hypersensitivity reaction is a. complement. b. antigen-antibody immune complexes. c. T cells. d. histamine.
D
The Philadelphia chromosome is a balanced chromosome translocation that forms a new gene called a. bcr-abl. b. Rb. c. p53. d. ARA-c.
A
The primary function of eosinophils is to a. kill parasitic helminths (worms). b. kill bacteria. c. stop viral replication. d. phagocytize fungi.
A
A 17-year-old college-bound student receives a vaccine against an organism that causes meningitis. This is an example of a. primary prevention. b. secondary prevention. c. tertiary prevention. d. disease treatment.
A
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 a. ALL (acute lymphoid leukemia) b. CLL (chronic lymphoid leukemia) c. AML (acute myeloid leukemia) d. CML (chronic myeloid leukemia)
A
A diagnostic laboratory finding in myeloma is a. Bence Jones proteins in the urine. b. decreased platelet count. c. increased IgM antibody titer. d. elevated blood glucose levels.
A
Which type of leukemia primarily affects children? a. ALL (acute lymphoid leukemia) b. CLL (chronic lymphoid leukemia) c. AML (acute myeloid leukemia) d. CML (chronic myeloid leukemia)
A
Anaphylaxis may occur in certain hypersensitivity reactions, including type (Select all that apply.) a. I. b. II. c. III. d. IV.
A, B
The mononuclear phagocyte system consists of (Select all that apply.) a. monocytes and tissue macrophages. b. dendritic cells. c. bone marrow stem cells. d. antibody-secreting plasma cells. e. basophils.
A,B
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. d. vaccines with dead or altered organisms. e. active infections.
A,B,C
Which viruses have been implicated as cancer-causing agents? (Select all that apply.) a. Epstein-Barr b. Human T-cell leukemia c. Human immunodeficiency d. Herpes e. Shingles
A,B,C
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 d. Joint pain e. Sweats
A,B,C,E
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 d. Lymph node transplant e. Monoclonal antibody therapy
A,B,C,E
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. c. leukopenia. d. thrombocytopenia. e. anuria.
A,B,D
Side effects of chemotherapy include (Select all that apply.) a. anemia. b. nausea. c. leukocytosis. d. bleeding. e. infections.
A,B,D,E
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. c. stomach. d. pancreas. e. kidneys.
A,B,E
A patient is diagnosed with stage IIA Hodgkin disease. This patient's clinical stage was most likely determined by (Select all that apply.) a. patient history. b. lymph node biopsy. c. laparotomy results. d. CT scan. e. physical examination.
A,D,E
A child with a history of recent strep throat infection develops glomerulonephritis. This is most likely a type _____ hypersensitivity reaction. a. I b. II c. III d. IV
C
Carbon monoxide injures cells by a. destruction of cellular membranes. b. reducing oxygen level on hemoglobin. c. promotion of free radicals. d. crystallization of cellular organelles.
B
Huntington disease is often transferred to offspring before a parent knows of the genetic possibility of this disease, because a. symptoms are so mild that they are not recognized. b. symptoms often do not occur until approximately 40 years of age. c. genetic testing for the disease is not possible. d. the genetic alteration is rarely expressed.
B
Immunity to a specific organism can be determined by a. active phase protein count. b. antibody titer. c. erythrocyte sedimentation rate. d. WBC count.
B
Proto-oncogenes a. are the same as oncogenes. b. are normal cellular genes that promote growth. c. lead to abnormal tumor-suppressor genes. d. result from severe mutational events.
B
Somatic death refers to death a. of a body organ. b. of the entire organism. c. of nerve cells. d. secondary to brain damage.
B
The cellular change that is considered preneoplastic is a. anaplasia. b. dysplasia. c. metaplasia. d. hyperplasia.
B
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 a. leukemia. b. myeloma. c. Hodgkin disease. d. back trauma.
B
A disease that is native to a particular region is called a. epidemic. b. endemic. c. pandemic. d. ethnographic.
B
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. sequelad d. convalescence
B
In general, with aging, organ size and function a. increase. b. decrease. c. remain the same. d. are unknown.
B
Children with PKU must avoid phenylalanine in the diet. Phenylalanine is most likely to be a component of a. fat. b. sugar. c. protein. d. carbohydrate.
C
Cystic fibrosis is a single-gene disorder that primarily affects a. brain and heart. b. kidney and adrenals. c. lungs and pancreas. d. liver and intestine.
C
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. d. crystallization of cellular components.
C
Information parents should be given about the consequences of PKU includes a. high dietary phenylalanine may help induce enzyme production. b. PKU is commonly associated with other congenital anomalies. c. failure to avoid phenylalanine results in progressive mental retardation. d. mental retardation is inevitable.
C
Malignant neoplasms of epithelial origin are known as a. lymphoma. b. sarcomas. c. carcinomas. d. adenomas.
C
Necrotic death of brain tissue usually produces _____ necrosis. a. coagulative b. caseous c. liquefactive d. fat
C
Of the statements below, the accurate statement regarding nutrition and cellular health is a. the body can generally produce elements essential for nutritional balance. b. obese individuals are generally nutritionally healthy. c. deficient cellular uptake by one cell type may contribute to excess nutrient delivery to other cell types. d. a normal BMI indicates nutritional health.
C
Proteins that are increased in the bloodstream during acute inflammation are called a. membrane attack complexes. b. selectin receptors. c. acute phase proteins. d. major histocompatibility complexes.
C
Renal insufficiency is a common complication of which disease? a. Chronic myeloid leukemia (CML) b. Chronic lymphoid leukemia (CLL) c. Myeloma d. Hodgkin disease
C
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. d. is transmitted as an autosomal-recessive disorder.
C
While in the hospital for management of acute lymphoid leukemia (ALL), a patient develops severe thrombocytopenia. The most appropriate action for this condition is a. anticoagulant therapy. b. chemotherapy. c. activity restriction. d. isolation.
C
Paraneoplastic syndromes in cancer involve excessive production of substances by multiple means. A common substance found in excessive amounts resulting from cancer paraneoplastic syndromes is a. insulin. b. tumor necrosis factor. c. potassium. d. calcium.
D
Patients with immunodeficiency disorders are usually first identified because they a. run high fevers. b. have unusually high WBC counts. c. develop brain infections. d. develop recurrent infections.
D
Reperfusion injury to cells a. results in very little cellular damage. b. results from calcium deficiency in cells. c. occurs following nutritional injury. d. involves formation of free radicals.
D
The "classical pathway" for activation of the complement cascade is triggered by a. activation of C3. b. inflammation. c. first recognition of an antigen. d. antigen-antibody complexes.
D
The cellular response indicative of injury because of faulty metabolism is a. hydropic swelling. b. lactate production. c. metaplasia. d. intracellular accumulations.
D
TRUE/FALSE In general, a cancer cell that is more tissue-specific differentiated is more likely to be aggressive.
FALSE
TRUE/FALSE Seasonal allergic rhinitis is most involved in type II hypersensitivity reactions.
FALSE
True/False 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
RhoGAM (an Rh antibody) would be appropriate in an Rh-_____ woman with an _____ Rh-_____ antibody titer carrying an Rh-_____ fetus. a. negative; positive; positive b. positive; negative; negative c. negative; negative; positive d. negative; negative; negative
C
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 a procedure for determining the extent of tumor spread. b. It is a histologic examination of tissues to determine the degree of tumor differentiation. c. It is based on exploratory surgery. d. It is biochemical testing of tumor cells to determine the genetic basis of the tumor.
A
Deficits in immune system function occur in cancer as a result of (Select all that apply.) a. chemotherapy. b. cancer cells. c. cancer metastasis to bone marrow. d. immunotherapy. e. malnutrition.
A,B,C,E
The effects of histamine release include a. vasoconstriction. b. bronchodilation. c. increased vascular permeability. d. decreased gut permeability.
C
All these cellular responses are potentially reversible except a. necrosis. b. metaplasia. c. atrophy. d. hyperplasia.
A
Antigen-presenting cells function to a. display foreign antigen on their cell surfaces bound to MHC. b. stimulate cytokine production by macrophages. c. phagocytose and degrade foreign antigens. d. initiate the complement cascade by way of the alternative pathway.
A
Breast cancer in women who have the breast cancer gene a. occurs at an earlier age. b. is more likely to be unilateral. c. is more common than non-inherited breast cancer. d. is more responsive to treatment.
A
Burkitt lymphoma is most closely associated with a. Epstein-Barr virus. b. radiation exposure. c. immunodeficiency syndromes. d. history of cigarette smoking.
A
Characteristics of X-linked (sex-linked) recessive disorders include a. all daughters of affected fathers' being carriers. b. boys' and girls' being equally affected. c. the son of a carrier female's having a 25% chance of being affected. d. affected fathers' transmitting the gene to all their sons.
A
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
Familial retinoblastoma involves the transmission of what from parent to offspring? a. Mutant tumor-suppressor gene b. Cancer-causing virus c. Oncogene d. Extra chromosome
A
Functions of B cells include a. synthesizing antibodies. b. secreting cytokines. c. killing antigen-presenting cells. d. stimulating B cells. e. killing virally infected cells.
A
Huntington disease primarily affects the _____ system. a. neurologic b. muscular c. gastrointestinal d. endocrine
A
In general, the best prognosis for long-term disease-free survival occurs with a. ALL (acute lymphoid leukemia). b. CLL (chronic lymphoid leukemia). c. AML (acute myeloid leukemia). d. CML (chronic myeloid leukemia).
A
Metaplasia is a. the replacement of one differentiated cell type with another. b. the transformation of a cell type to malignancy. c. an irreversible cellular adaptation. d. the disorganization of cells into various sizes, shapes, and arrangements.
A
Myasthenia gravis is a type II hypersensitivity disorder that involves a. impaired muscle function. b. symptoms of hyperthyroidism. c. symptoms of arthritis or polyarthralgia. d. symptoms of glomerular disease.
A
Retroviruses are associated with human cancers, including a. Burkitt lymphoma. b. Hodgkin's lymphoma. c. pancreatic cancer. d. hepatic cancer.
A
Severe combined immunodeficiency (SCID) syndrome is an example of a(n) a. deficient immune response. b. excessive immune response. c. primary acquired immunodeficiency. d. hypersensitivity reaction.
A
The hypermetabolic state leading to cachexia in terminal cancer is thought to be because of a. tumor necrosis factor. b. angiogenesis. c. loss of ATP production. d. pain medications.
A
The major cause of death from leukemic disease is a. infection. b. malnutrition. c. hypovolemic shock. d. kidney failure.
A
The primary effect of aging on all body systems is a. decreased functional reserve. b. diseased function. c. programmed senescence. d. senility.
A
Which clinical finding is most indicative of an acute bacterial infection? a. Increased (band) neutrophils b. Elevated temperature c. Elevated erythrocyte sedimentation rate d. Elevated WBC count
A
Which disorder is associated with a type III hypersensitivity mechanism of injury? a. Systemic lupus erythematosus b. Graves disease c. Erythroblastosis fetalis d. Seasonal allergic rhinitis
A
Which disorder is considered a primary immunodeficiency disease? a. HIV/AIDS b. Malnutrition immunodeficiency c. Cancer immunodeficiency d. Radiation immunodeficiency
A
Which group of clinical findings describes the typical presentation of ALL (acute lymphoid leukemia)? a. Pain in long bones, infection, fever, bruising b. Vertebral fracture, hypercalcemia, bone pain c. Elevated WBC count found on routine examination, asymptomatic d. Painless enlarged cervical lymph node, fever, weight loss
A
Bacteria cause injury to cells by (Select all that apply.) a. producing exotoxins. b. producing endotoxins. c. producing destructive enzymes. d. reproducing inside of host cells altering cellular function. e. evoking an immune reaction.
A,B,C,E
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. d. leads to short stocky build. e. results in dangerous cardiovascular disorders.
A,B,C,E
Characteristics of complement include (Select all that apply.) a. stimulating chemotaxis. b. lysing target cells. c. having multiple plasma proteins. d. being synthesized in the bone marrow. e. enhancing phagocytosis.
A,B,C,E
Functions of antibodies include (Select all that apply.) a. antigen agglutination. b. antigen precipitation. c. opsonization. d. phagocytosis. e. complement activation.
A,B,C,E
Infectious injury often results from (Select all that apply.) a. exotoxins. b. endotoxins. c. self-destruction of cells. d. anti-inflammatory reactions. e. enzymes from white blood cells.
A,B,C,E
Secondary immune deficiency problems may be caused by (Select all that apply.) a. surgery. b. high blood sugar. c. corticosteroids. d. genetic disorders. e. low protein level.
A,B,C,E
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. d. cultural variation. e. illness.
A,B,C,E
A patient is diagnosed with hairy cell leukemia. The patient's laboratory results would most likely indicate a decrease in (Select all that apply.) a. granulocytes. b. platelets. c. white blood cells. d. red blood cells. e. melanocytes.
A,B,D
Characteristics of telomerase include (Select all that apply.) a. repairs the end caps of chromosomes. b. contributes to cancer cell immortality. c. is deficient in cancer cells. d. activity allows a cell to replicate indefinitely.
A,B,D
Autoimmune diseases result from (Select all that apply.) a. overactive immune function. b. increase in self-tolerance. c. failure of the immune system to differentiate self and nonself molecules. d. communicable infections.
A,C
Viruses differ from most bacteria in that they (Select all that apply.) a. enter the host cell. b. directly produce free radicals. c. use the host's metabolic processes to survive and replicate. d. do not induce an immune response. e. do not produce toxins.
A,C,E
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
A patient with metastatic lung cancer wants to know her chances for survival. Which response is correct? a. "Lung cancer is always fatal." b. "Lung cancer has about a 15% survival rate." c. "Lung cancer is highly curable when diagnosed early." d. "Lung cancer death rate has decreased significantly, as with all other cancers."
B
A primary effector cell of the type I hypersensitivity response is a. monocytes. b. mast cells. c. neutrophils. d. cytotoxic cells.
B
After bronchoscopy and histologic examination of a suspected tumor, your patient is diagnosed with primary bronchial carcinoma. Thus, the tumor a. is benign. b. is malignant. c. is secondary to cancer elsewhere in the body. d. has spread.
B
An increase in organ size and function caused by increased workload is termed a. atrophy. b. hypertrophy. c. metaplasiad. d. inflammation.
B
Apoptosis is a process that results in cellular a. atrophy. b. death. c. proliferation. d. mutation.
B
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. a sore throat. B. streptococcal infection. C. genetic susceptibility. D. pharyngitis.
B
Leukocytosis with a "shift to the left" refers to a. elevated segmented neutrophils. b. elevated immature neutrophils. c. decreased monocytes. d. decreased immature neutrophils
B
The cellular component that is most susceptible to radiation injury is the a. membrane. b. DNA. c. RNA. d. ribosomes.
B
The most common tumor-suppressor gene defect identified in cancer cells is a. Rb. b. P53. c. DCC. d. APC.
B
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 a. each child has a 25% chance of being a carrier. b. each child has a 25% chance of being affected. c. since one child is already affected, the next three children will be unaffected. d. one cannot predict the risk for future pregnancies.
B
The stage during which the patient functions normally, although the disease processes are well established, is referred to as a. latent. b. subclinical. c. prodromal. d. convalescence.
B
Transfusion reactions involve RBC destruction caused by a. donor antigens. b. recipient antibodies. c. donor T cells. d. recipient T cells.
B
What is the correct definition of complete remission (CR) of leukemia? a. CR is the absence of leukemic cells in the blood. b. CR is less than 5% blasts in marrow and normal CBC values. c. CR is absence of leukemic cells regardless of CBC values. d. CR is less than 5% leukemic cells in the blood.
B
Functions of T cells include (Select all that apply.) a. synthesizing antibodies. b. secreting cytokines. c. killing antigen-presenting cells. d. stimulating of B cells. e. killing virally infected cells.
B,C,D,E
Socioeconomic factors influence disease development because of (Select all that apply.) a. genetics. b. environmental toxins. c. overcrowding. d. nutrition. e. hygiene.
B,C,D,E
Tumor markers (Select all that apply.) are found only in the blood. a. are produced by normal cells. b. help determine cancer origin. c. help identify progression of cancer. d. include prostatic-specific antigen.
B,C,D,E
Activation of the complement cascade results in (Select all that apply.) a. antibody production. b. inflammation. c. immunosuppression. d. autoimmunity. e. chemotaxis.
B,E
Certain autoimmune diseases are associated with the presence of specific proteins on a person's cells. These proteins are called ________ proteins. a. complement b. antibody receptor c. HLA or MHC d. TCR or BCR
C
A fetus is most vulnerable to environmental teratogens during a. birth. b. conception. c. the first trimester. d. the last trimester.
C
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
Cancer grading is based on a. tumor size. b. local invasion. c. cell differentiation. d. metastasis.
C
A point mutationa. a. results from the addition or loss of one or more bases. b. is because of the translocation of a chromosomal segment. c. always produces significant dysfunction. d. involves the substitution of a single base pair.
D
After surgery to remove a lung tumor, your patient is scheduled for chemotherapy, which will a. selectively kill tumor cells. b. stimulate immune cells to fight the cancer. c. have minimal side effects. d. kill rapidly dividing cells.
D
Autologous stem cell transplantation is a procedure in which a. there is a high rejection rate. b. stem cells are transferred to the patient from an HLA-matched donor. c. stem cells are transferred to the patient from an identical twin. d. stem cells are harvested from the patient and then returned to the same patient.
D
Coagulative necrosis is caused by a. dissolving of dead cells and cyst formation. b. trauma or pancreatitis. c. lung tissue damage. d. interrupted blood supply.
D
Interleukin-1, interleukin-6, and tumor necrosis factor-α are inflammatory cytokines secreted by a. plasma cells. b. neutrophils. c. lymphocytes. d. macrophages.
D
The hypersensitivity reaction that does not involve antibody production is type a. I. b. II. c. III. d. IV.
D
The membrane attack complex formed by complement is similar in function to a. CD4+. b. granzymes. c. CD8. d. perforin.
D
The most common primary immune deficiency that affects only B cells is a. DiGeorge. b. Bruton agammaglobulinemia. c. Wiskott-Aldrich. d. selective IgA.
D
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 a. vomiting. b. anemia. c. alopecia. d. infection.
D
The primary factor associated with the risk of Down syndrome is a. family history of heritable diseases. b. exposure to TORCH syndrome organisms. c. maternal alcohol intake. d. maternal age.
D
The primary function of kinins is a. phagocytosis of antigens. b. production of antibodies. c. to limit immune reactions. d. vasodilation to enhance inflammation.
D
The principle Ig mediator of type I hypersensitivity reactions is a. IgA. b. IgG. c. IgM. d. IgE.
D
The spleen is an important defense against infection, because it a. activates the complement cascade. b. initiates inflammation. c. controls phagocytosis. d. filters the blood.
D
Which form of leukemia demonstrates the presence of the Philadelphia chromosome? a. ALL (acute lymphoid leukemia) b. CLL (chronic lymphoid leukemia) c. AML (acute myeloid leukemia) d. CML (chronic myeloid leukemia)
D
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. high-fat diet. b. urban pollutants. c. stressful lifestyle. d. cigarette smoking.
D
Active immunity involves (Select all that apply.) a. injection of preformed human antibodies. b. injection of human immune globulin. c. injection with preformed animal antibodies. d. vaccines with dead or altered organisms. e. active infections.
D,E
TRUE/FALSE The only known curative treatment for CML is allogeneic bone marrow transplantation from a suitable donor.
TRUE
TRUE/FALSE 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.
TRUE
TRUE/FALSE When the cause is unknown, a condition is said to be idiopathic
TRUE
