PATHO MIDTERM CH. 10, 11, 13, 14, 15

Which forms 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.

Widespread activation of the clotting cascade secondary to massive trauma is called

Disseminated intravascular coagulation (DIC)

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

Elevated total iron-binding capacity

The prothrombin time (PT) & international normalized ration (INR) measure the integrity of

Extrinsic pathway

Treatment for hemophilia A includes

Factor VIII replacement

True or False: Vaccination for pneumococcal pneumonia should be performed before 1 year of age in patients with sickle cell anemia.

False

True or False: seasonal allergic rhinitis is most involved in type II hypersensitivity reactions.

False

Dysfunction of which organ would lead to clotting factor deficiency?

Liver

Thalassemia may be confused with iron-deficiency anemia, because they are both

microcytic

Anemia related to vitamin B12 or folate deficiency is characterized by what laboratory features? (Select all that apply) A. RBC counts of 775,000 to 900,000 cells/mm3 B. RBC counts of 500,000 to 750,000 cells/mm3 C. WBC counts of 3000 to 4000 cells/mm3 D. WBC counts of 4000 to 5000 cells/mm3 E. Platelet counts of 60,000 cells/mm3

B, D

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

Selective IgA

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

Systemic lupus erythematosus

The hypersensitivity reaction that does not involve antibody production is type II (2)

type II

Which vessel normally demonstrates the most rapid blood flow?

vena cava

A commonly ingested substance associated with prolongation of the bleeding time is

aspirin

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

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

Pernicious anemia is caused by a lack of

intrinsic factor

What is necessary for red blood cell production?

iron

Dramatic hypotension sometimes accompanies type I hypersensitivity reactions, because

massive histamine release from mast cells leads to vasodilation

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

negative, negative, positive

A diagnostic laboratory finding in myeloma is

Bence Jones proteins in the urine

Red blood cells obtain nearly all their energy from metabolism of

Glucose

A patient presents to the physician's office with pinpoint hemorrhages on the skin. The patient is most likely between the ages of _________ years.

4 and 7

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

Which condition is associated with an elevated reticulocyte count ?

hemolytic anemia

Myasthenia gravis is a type II hypersensitivity disorder that involves

impaired muscle function

The effects of histamine release include

increased vascular permeability

Which diseases may be associated with a bleeding problem? (Select all that apply) A. Urinary retention B. Renal failure C. Cirrhosis D. Systemic lupus erythematosus E. Ovarian cancer

B, C, D, E

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

A newborn has melena, bleeding from the umbilicus, and hematuria. The newborn most likely experiencing

vitamin K deficiency bleeding

Patients who experience anemic episodes when exposed to certain drugs most likely have

glucose-6-phosphate dehydrogenase deficiency

The nurse is educating a patient diagnosed with anemia of chronic renal failure about the disease. Which statements made by the nurse are correct regarding the patient's treatment? (Select all that apply) A. "Since your glomerular filtration is 13mL/min, you'll be started on dialysis" B. "Your hematocrit is 29%, so you're going to start on erythropoietin therapy" C. "Your hemoglobin is 9g/dL, so you'll need erythropoietin therapy" D. "We need to get your hemoglobin up to at least 15 g/dL" E. "You're going to need iron, folate & B12 therapy to help improve your blood

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. WBC D. RBC E. Melanocytes

A, B, D

The patient is a 12-year-old boy diagnosed with acute lymphoid 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

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)

What is involved in the release of plasminogen activators? (Select all that apply) A. Factor X B. Factor XII C. HMWK D. Kallikren E. Thrombin

B, C, D, E

While I'm the hospital for management of acute lymphoid leukemia (ALL), a patient develops severe thrombocytopenia. The most appropriate action for this condition is

Activity restriction

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

HLA or MHC

The principle Ig mediator of type I hypersensitivity reactions is

IgE

Disseminated Intravascular Coagulation (DIC) may be treated with heparin therapy to

Inhibit clotting factor consumption

The activated partial thromboplastin (aPTT) is a measure of the integrity of

Intrinsic pathway

The most appropriate treatment for secondary polycythemia is

Measured to improve oxygenation

A 58 year old women 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.

Which group of clinical findings describes the typical presentation of ALL (acute lymphoid leukemia)?

Pain in long bones, infection, fever, bruising

A deficiency of von Willebrand factor impairs

Platelet adhesion to injured tissue

A patient is diagnosed with a tortuous blood vessel of the right hand that bleeds spontaneously. This patient presents with

Telangiectasia

Activation of the extrinsic pathway of coagulation is is initiated by

Tissue thromboplastin

True or False: Hemophilia B is also known as Christmas disease

True

True or False: The anemia resulting from a deficiency of either vitamin B12 (cobalamin) or folate is caused by a disruption in DNA synthesis of the blast cells in the bone marrow that produces very large abnormal bone marrow cells called megaloblasts.

True

True or False: The liver is responsible for the synthesis of coagulation factors, within the exception of part of VIII

True

True or False: The only known curative treatment for CML is allogeneic bone marrow transplantation from a suitable donor

True

True or 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

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

Type III

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

A cause of thrombocytopenia includes

chemotherapy

The final step in clot formation is __________.

clot retraction

Patients with immunodeficiency disorders are usually first identified because they

develop recurrent infections

The most effective therapy for anemia associated with kidney failure is

erythropoietin administration

The conversion of plasminogen to plasmin results in

fibrinolysis

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

oxygen-hemoglobin affinity

What laboratory finding is usually found in aplastic anemia?

pancytopenia

The megakaryocyte is a precursor to

platelets

Transfusion reactions involve RBC destruction caused by

recipient antibodies

The movement of blood through the vascular system is opposed by the force of

resistance

An increase in hemoglobin affinity for oxygen occurs with

shift to the left

Autologous stem cell transplantation is procedure in which

stem cells are harvested from the patient and then returned to the same patient

The cause of the most common form of anemia is

iron deficiency

The arterial oxygen content (CaO2) for a patient with PaO2 100mm HG, SaO2 95%, and hemoglobin 15g/dL is ____________ mL oxygen/dL.

19.4

Anaphylaxis may occur in certain hypersensitivity reactions, including type (Select all that apply.) A. I. B. II. C. III. D. IV.

A, B

A patient is diagnosed with aplastic anemia. The nurse expects to find what patient symptoms upon assessment? (Select all that apply) A. Lethargy B. Heart palpitations C. Transient murmurs D. Bradycardia E. Orthopnea

A, B, C

Regarding iron deficiency anemia, what laboratory features are typically decreased? (Select all that apply.) A. MCV B. MCH C. MCHC D. WBC E. Thrombocytes

A, B, C

Which involved bleeding associated with vascular or platelet defects? (Select all that apply) A. Bleeding that occurs immediately after trauma B. Bleeding that involves skin or mucus membranes C. Bleeding that is brief in duration D. Bleeding that is delayed E. Bleeding into muscles or joints

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 new born patient is diagnosed with hemolytic disease. The nurse may expect to find what signs and symptoms (select all that apply) A. Petechial hemorrhages B. Hepatomegaly C. Splenomegaly D. Kernicterus E. Erythema

A, B, C, D

One of the cardinal features of sickle cell anemia includes acute and chronic dysfunction of which organs? (Select all that apply.) A. Spleen B. Bones C. Brain D. Lungs E. Stomach

A, B, C, D

A male patient involved in a motor vechicle accident is brought to the emergency department with acute flank pain. What additional signs of bleeding may the patient exhibit? (Select all that apply) A. Hematuria B. Melena C. Hematemesis D. Menor hago a E. Hemoptysis

A, B, C, 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

Autoimmune diseases results from (select all that apply) A. Overactive immune function B. Increase in self-tolerance C. Failure of the immune system to differentiate self & no self molecules D. Communicable infections

A, C

A patient is diagnosed with stage II 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 5 year old patient 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)

Excessive red cells lysis can be detected by measuring the serum

Bilirubin

Hapten mechanisms are found in which medications? (Select all that apply.) A. Ibuprofen B. Narcotics C. Penicillin D. Cephalosporins E. Tetracycline

C, D, E

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

Deficient immune response

Burkitt's lymphoma is most closely associated with

Epstein-Barr virus

Which disorder is considered a primary immunodeficiency disease?

HIV/AIDS

A primary effector cell of type I hypersensitivity response is

Mast cells

A normal bleeding time in association with normal platelet count & increased prothrombin time (PT) and INR, is indicative of

Vitamin K deficiency

A low mean corpuscular hemoglobin concentration (MCHC) and mean corpuscular volume (MCV) are characteristic of which type of anemia?

iron deficiency

Which characteristic is indicative of hemolytic anemia?

jaundice

The primary source of erythropoietin is provided by

kidney

Which causes vasoconstriction?

norepinephrine