patho review
Match the following types of trajectories of dying. A. A rapid, unexpected death in a person of any state of health. B. A long period of living with a life-limiting condition, followed by a short period of decline and death. C. A long, steady period of gradual decline, disability, and loss of function, with a transition to death that is hard to pin-point. D. A long period of living with a chronic condition with a gradual decline interspersed with episodes of severe decline and some recovery, ending with by a short, rapid period of decline to death. 1. Sudden 2. Terminal illness 3. Organ failure 4. Frailty
A 1. Sudden B 2. Terminal illness D 3. Organ failure C 4. Frailty
What is the life span of an erythrocyte (in days)? A. 200-230 B. 100-120 C. 50-70 D. 5-10
B. 100-120
A 3 year old is brought in by his parents who report a history of recurrent bruising. Which of the following is NOT on the list of possible diagnoses? A. Leukemia B. Factor V Leiden C. Child abuse D. Idiopathic thrombocytopenia also known as Immune thrombocytopenia purpura (ITP)
B. Factor V Leiden
Which of the following are associated with innate immunity? (select all that apply) A. Immune memory B. Fast response C. Epithelial interface D. General response E. Antibody
B. Fast response C. Epithelial interface D. General response
A 64 year old diabetic presents to your clinic with complaints of increased thirst, nausea, abdominal pain. The patient is breathing at a rate of 40 breaths per minute. You note that the patient's breath smells fruity. The patients blood sugar is 780. ABG results are: pH= 7.33 PaCO2= 25 HCO3=12 PaO2= 89 The patient PaCO2 is low, which could suggest an alkalosis, but based on this patient's history and blood sugar, you know that this patient is compensating for: A. Respiratory alkalosis B. Metabolic acidosis C. Respiratory acidosis D. Metabolic alkalosis
B. Metabolic acidosis
DNA formation occurs in which of the cell's structures? A. Membrane B. Nucleus C. Cytoplasm D. Histone
B. Nucleus
Which statement regarding total body water (TBW) is true? A. Progesterone plays a role in female TBW. B. Older adults experience a decrease in TBW as a result of decreased muscle mass. C. Men tend to have lower TBW as a result of their muscle mass. D. Gender has no influence on TBW until old age.
B. Older adults experience a decrease in TBW as a result of decreased muscle mass.
Which of the following lists describe the antigen presenting cells? A. CD4+ T cells and CD8+ T cells B. B cells and plasma cells C. Macrophages, neutrophils and basophils D. Macrophages, Dendritic Cells and B cells
D
Which is an example of an endogenous antigen? A. Bacteria B. Viruses C. Yeast D. Cancer Cells
D. Cancer Cells
Which of the following antibody isotypes is correctly matched with its principal function? A. IgG - defense against helminthes (worms) B. IgD - activation of complement C. IgE - B cell antigen receptor D. IgM - neonatal immunity E. IgA - neutralization of microbes and toxins
E. IgA - neutralization of microbes and toxins
Differentiated effector T cells work to eliminate antigens by a variety of mechanisms. Which of the following statements concerning these mechanisms is correct? A. Th-1 cells secrete mediators (interferon and IL-2) that activate macrophages and stimulate T cytotoxic cells that can attack the infected cells, including APCs. B. Th-2 cells directly kill infected cells by releasing enzymes that enter target cells and activate the apoptotic death pathway of the infected cell C. Th-17 cells secrete mediators that stimulate IgE production and activate eosinophils D. cytotoxic T cells secrete mediators (IL14) that stimulate IgE production and activate eosinophils
A. Th-1 cells secrete mediators (interferon and IL-2) that activate macrophages and stimulate T cytotoxic cells that can attack the infected cells, including APCs.
In the patient described in the previous question, what are his risk factors for hypothermia? (select all that apply) A. Alcohol intoxication B. Probable malnutrition C. Inadequate shelter on a cold night. D. Age E. Head injury
A. Alcohol intoxication C. Inadequate shelter on a
The body is constantly managing blood glucose levels depending on a person's nutritional intake and glucose demands. This is an example of: A. Allostasis B. Synthesis C. Cellular respiration D. Homeostasis
A. Allostasis
What is the role of angiogenesis in cancer? A. Angiogenesis allows for more nutrients to be delivered to a growing tumor. B. Angiogenesis restricts cancer cells access to the bloodstream thus inhibiting metastasis. C. Angiogenesis refers to the process by which cancer cells inhibit blood vessel growth. D. Angiogenesis facilitates hypermethylation of the proto-oncogenes.
A. Angiogenesis allows for more nutrients to be delivered to a growing tumor.
Humoral immunity is a type of acquired or adaptive immunity that results in the circulation of which of the following throughout the blood? A. Antibodies B. Antigens C. Antigen presenting cells D. Phagocytes
A. Antibodies
Blood cells are programed to eventually die to make room for new ones that are continually produced in the bone marrow. This is an example of: A. Apoptosis B. Allostasis C. Meiosis D. Hyperplasia
A. Apoptosis
A patient is diagnoses with a benign thyroid adenoma. What is the correct statement to make to your patient? A. Benign tumors do not invade other tissues. B. The tumor is benign and therefore does not have the potential to become malignant. C. Benign tumors are usually caused by genetic mutations. D. Benign tumors are not harmful to the patient.
A. Benign tumors do not invade other tissues.
A common pathway of irreversible cell injury involves increased intracellular: A. Calcium B. Sodium C. Phosphorus D. Potassium
A. Calcium
What is the most common cause of iron deficiency anemia (IDA)? A. Chronic blood loss B. pregnancy C. autoimmune disease D. poor dietary intake of iron
A. Chronic blood loss
Which of the following are types of epigenetic modification? (Select all that apply) A. DNA methylation B. Genetic recombination C. MicroRNAs D. Histone modifications
A. DNA methylation C. MicroRNAs
A patient is in hypovolemic shock and is already in renal failure and cardiac failure, his GI system also starts to fail, as evidenced by which of the following: A. Decreased peristalsis due to reduced blood flow. B. Increased peristalsis leads to diarrhea. C. Liver enzymes falling precipitously. D. Ulcers due to the buildup of ammonia in the GI tract.
A. Decreased peristalsis due to reduced blood flow.
A woman's PAP smear indicates changes in the shape and organization of cervical cells. This type of change is _____. A. Dysplasia. B. Hypertrophy. C. Hyperplasia. D. Atrophy.
A. Dysplasia.
A child fell off a swing and scraped his right knee. The injured area becomes painful. What else will the nurse observe upon assessment? A. Edema at the sight of injury. B. Vasoconstriction at the site of injury. C. Decreased RBC concentration at the site of injury. D. Pale skin at the sight of injury.
A. Edema at the sight of injury. B. Vasoconstriction at the site
Which of the following best describes the role of a natural killer (NK) cells? A. Elimination of malignant cells B. Binding tightly to antigens C. Initiation of the complement cascade D. Proliferation after immunization with antigen
A. Elimination of malignant cells
Are cancers more frequent in epidermal mucosa or in nerve tissue? A. Epidermal mucosa B. Nerve tissue
A. Epidermal mucosa
Which of the following statements about Exons are true? A. Exons are protein-coding sequences of DNA/RNA strands. B. Exons are nucleotide sequences in DNA that are removed by DNA splicing in the final RNA product. C. Exons always end with phosphate groups. D. Exons are known as "non-coding" sequences.
A. Exons are protein-coding sequences of DNA/RNA strands.
Which of the following mutations have the most significant effect on protein synthesis? A. Frameshift mutations B. Silent mutations C. Missense mutations D. Intron mutations
A. Frameshift mutations
Which of the following hepatitis panel results indicates that the person has not been infected or vaccinated with Hepatitis and is susceptible to infection if exposed to the Hepatitis B virus? The following abbreviations are used: Hepatitis B surface antigen (HBsAg) Hepatitis B surface antibody (anti-HBs) Total hepatitis B core antibody (anti-HBc) IgM antibody to hepatitis B core antigen (IgM anti-HBc) A. HBsAg negative anti-HBc negative anti-HBs negative IgM anti-HBc negative B. HBsAg negative anti-HBc positive anti-HBs positive C. HBsAg positive anti-HBc positive IgM anti-HBc negative anti-HBs negative D. HBsAg positive anti-HBc positive IgM anti-HBc positive anti-HBs negative
A. HBsAg negative anti-HBc negative anti-HBs negative
A fever indicates a problem with temperature regulation due to an underlying illness that has resulted in the loss of: A. Homeostasis B. Synthesis C. Allostasis D. Cellular respiration
A. Homeostasis
Which electrolyte imbalance accompanies multiple myeloma (MM)? A. Hypercalcemia B. Hypernatremia C. Hyperphosphatemia D. Hyperkalemia
A. Hypercalcemia
Coagulopathies include all of the following disorders EXCEPT: A. Inherited Familial ecchymosis B. Drug-induced platelet adhesion defects from too much ibuprofen. C. Thrombotic Thrombocytopenic Purpura [TTP] D. von Willebrand's syndrome
A. Inherited Familial ecchymosis
A common phenomenon in hypothermia is the Lewis phenomenon, which is a maladaptive response to exposure to the cold. What is the characteristic feature of Lewis Phenomenon? A. Intermittent reperfusion of the extremities to preserve oxygenation. B. A decrease in heart rate and respiratory rate to preserve energy. C. The hypothalamus inducing shivering to induce heat production. D. Peripheral constriction to shunt blood to the core and decrease heat loss.
A. Intermittent reperfusion of the extremities to preserve oxygenation.
Which cell component is capable of cellular autodigestion when it is released during cell injury? A. Lysosomes B. Smooth endoplasmic reticulum C. Ribosome D. Golgi complex
A. Lysosomes
Some cancer drugs work during the cell cycle phase where nuclear and cytoplasmic divisions occur. What is this cell cycle phase called? A. M B. G2 C. S D. G1
A. M
Which cell is the "garbage collector" of the immune system? A. Macrophages B. Eosinophils C. Neutrophils D. Fibroblasts
A. Macrophages
To result in cancer developing due to a mutation on a tumor suppressor gene, a person must inherit a copy of this gene. However, the same is not true for mutations on oncogenes. Why is this? A. Mutations on tumor suppressor genes are recessive, while mutations on oncogenes are dominant. B. Mutations on inherited oncogenes are dominate and will activate a mutation on the tumor suppressor gene. C. Mutations on both tumor suppressor genes and oncogenes are dominant, so inheritance does not matter. D. Mutations on tumor suppressor genes are dominant, while mutations on proto-oncogenes are recessive.
A. Mutations on tumor suppressor genes are recessive, while mutations on oncogenes are dominant.
A patient suffered a heart attack that leads to cell injury and subsequent cellular death with severe cell swelling and breakdown of organelles. This process is best described as: A. Necrosis B. Apoptosis C. Hypoxia D. Autophagy
A. Necrosis
Which of the following inflammatory mediators is most identified with systemic vasodilation and resulting hypotension in the cascade of events that can lead to Multiple Organ Dysfunction Syndrome (MODS) A. Nitric Oxide B. Lactic Acid C. Tumor Necrosis Factor D. Prostaglandins
A. Nitric Oxide
Water movement between the intracellular fluid (ICF) compartment and the extracellular fluid (ECF) compartment is primarily a function of: A. Osmotic forces B. Hydrostatic forces C. Plasma oncotic pressure D. Antidiuretic hormone
A. Osmotic forces
Which component of the cell produces hydrogen peroxide (H2O2) by using oxygen to remove hydrogen atoms from specific substrates in an oxidative reaction? A. Peroxisomes B. Oxyhydrosomes C. Ribosomes D. Lysosomes
A. Peroxisomes
Early identification of sepsis is determined by the presence of two or more of the following (choose all that apply): A. Respiratory rate >= 22/minute B. WBC < 4000 C. Temperature > 38C D. Altered mentation E. SBP < 100
A. Respiratory rate >= 22/minute D. Altered mentation E. SBP < 100
You have a patient who has been vomiting all night. Vomiting-induced metabolic alkalosis, resulting in the loss of chloride, causes: A. Retention of bicarbonate to maintain the anion balance B. Retained sodium to bind with the chloride C. Hydrogen to move into the cell and exchange with potassium to maintain cation balance D. Hypoventilation to compensate for the metabolic alkalosis
A. Retention of bicarbonate to maintain the anion balance
A homeless man is brought into the ER on a cold night. His temperature is 34.8 C, heart rate 53, respiratory rate 7, blood pressure is 82/45, and is positive for elevate serum alcohol. What stage of hypothermia is he in? [Note: remember these data for the next question] A. Severe B. Moderate C. None of the above D. Mild
A. Severe
Free radicals cause cell damage by: A. Stealing an electron from the cell, which causes injury to the chemical bonds of the cell membrane B. Transferring one of its charged, stabilized atoms to the cell membrane, which causes lysis C. Stealing the cell's oxygen to stabilize the electron, thus causing hypoxia D. Stimulating the release of lysosomal enzymes that digest the cell membranes
A. Stealing an electron from the cell, which causes injury to the chemical bonds of the cell membrane
A DNA strand has a region with the sequence ATCGGAT. Which of the following would be a complementary strand? A. TAGCCTAG B. UAGCCUAG C. TUGCCTUG D. CGATACGT
A. TAGCCTAG
You are caring for a patient with adenocarcinoma of the lung. You read the chart and see the patient's cancer is classified Stage IV (T4N3M1b). What does this tell you? (Select all that apply) A. The characteristics that can be used to determine prognosis and treatment. B. The primary tumor is 4 mm in size. C. Three lymph nodes are involved. D. There is at least one distant metastasis. E. The cancer involves the lymph nodes.
A. The characteristics that can be used to determine prognosis and treatment. D. There is at least one distant metastasis. E. The cancer involves the lymph nodes.
When a nurse cares for a patient with systemic lupus erythematosus (SLE), the nurse remembers this disease is an example of: A. autoimmunity B. allergy C. homoimmunity D. alloimmunity
A. autoimmunity
Sending a signal through the cell membrane can lead to the production of second messengers inside the cell. Which of the following can serve as second messengers? A. cAMP B. Pyruvate C. Antigen D. Glucose
A. cAMP
The foundation of non-pharmacologic management of acute inflammation involves: A. rest, ice, compression, elevation B. heat, exercise, alternating cold, diet C. elevation, acupuncture, tension, slings D. stretching, heat, orthopedic braces, TENS
A. rest, ice, compression, elevation
Many major pathologies, such as congestive heart failure, liver failure, renal failure, and pneumonia, may be associated with hyponatremia. Which of the following is true regarding hyponatremia? A. The reference range for serum sodium is 145-155 mEq/L and is considered severe when the serum level is <135 mEq/L. B. Hyponatremia is defined as a serum sodium level <135 mEq/L and is considered severe when the serum level is <125 mEq/L. C. Hyponatremia is more common among men. D. Chronic hyponatremia can be safely corrected more quickly than acute hyponatremia.
B. Hyponatremia is defined as a serum sodium level <135 mEq/L and is considered severe when the serum level is <125 mEq/L.
What might cause someone to go into anaphylactic shock the first time they are ever exposed to a bee sting? A. This would not actually happen, ever. Anaphylaxis is a hypersensitivity response that would only occur upon repeated exposure to an antigen/allergen. B. If the person had been previously exposed to a very similar antigen, molecular mimicry could account for the severe primary response. C. Maternally acquired IgG waiting on Mast cells could cause this type of primary response. D. Having unprotected sex with someone who is severely allergic could result in transfer of IgE, thus facilitating a primary exposure anaphylaxis
B. If the person had been previously exposed to a very similar antigen, molecular mimicry could account for the severe primary response.
An 86 year old with a long-standing history of worsening congestive heart failure, has for the past month, experienced increasing cognitive decline (not having the right words, falling asleep mid-sentence, confused when he awakens). He has had a more difficult time feeding himself, and spends more and more time sleeping. Today he tells you that he does not have the strength to walk anymore; his legs simply don't work. In discussing this situation with his family, which of the following is the best counsel? A. People with Congestive Heart failure or other organ failure sometimes have these symptoms when they develop a urinary tract infections; I am sure that antibiotics will help; does he have any allergies? B. Often when people this age and with this kind of medical history begin having trouble using their hands and then their legs, it can be an indicators that death is getting closer. C. Encourage the doctor to order physical therapy and occupational therapy to help get his strength back. D. Let's see if feeding him more protein will increase his strength. Can you bring some of his favorite foods for us to tempt him to eat more?
B. Often when people this age and with this kind of medical history begin having trouble using their hands and then their legs, it can be an indicators that death is getting closer.
You are caring for an HIV+ person who has been taking antiretroviral therapy (ART) to manage the infection. This month the person has an undetectable viral load. Which is the best interpretation of this finding? A. Additional testing is needed to determine whether the patient is being affected by the HIV virus. B. Since the medications have been effective in decreasing viral load, this medication regime is working and should be continued. C. Since the medications have been effective in decreasing viral load, they can be discontinued for three months. D. HIV has been eliminated from the patient's blood and is considered cured.
B. Since the medications have been effective in decreasing viral load, this medication regime is working and should be continued.
The base components of DNA are: A. XY, XX, XXX and YX B. A, G, C, and T C. A, G, C, and U. D. X, XY, XX, and YY
B. A, G, C, and T
A runner has depleted all the oxygen available for muscle energy. Which of the following will facilitate her continued muscle performance? A. Electron-transport chain B. Anaerobic glycolysis C. Aerobic glycolysis D. Oxidative phosphorylation
B. Anaerobic glycolysis
In which of the following groups of cell types would you expect to find MHC II molecules? A. B cells, natural killer (NK) cells and T cells B. B cells, dendritic cells, macrophages C. basophils, dendritic cells, T cells, D. macrophages, T cells, basophils E. B cells, macrophages, natural killer (NK) cells
B. B cells, dendritic cells, macrophages
A malfunction in DNA methylation can lead to: A. Autophagy B. Cancer C. Chemical poisoning that causes cell injury. D. Stalled cell cycle in G1 phase.
B. Cancer
An imbalance of potassium can produce which dysfunction? A. Strengthened skeletal muscles B. Cardiac dysrhythmias C. All of the above D. Smooth muscle tetany E. Visual impairment
B. Cardiac dysrhythmias
Cytokines are vital to a cell's ability to do which function? A. Replicate B. Communicate C. Excrete D. Metabolize
B. Communicate
Systemic lupus erythematosus (SLE) primarily attacks which of the following tissues? A. Lung B. Connective C. Heart D. Neural
B. Connective
The phases of catabolism include which of the following? (select all that apply) A. Respiration B. Glycolysis C. Excretion D. Digestion E. Citric Acid (Kreb's) Cycle F. Oxidation
B. Glycolysis D. Digestion E. Citric Acid (Kreb's) Cycle
A patient is admitted to the emergency department after sustaining abdominal injuries and a broken femur from a motor vehicle accident. The patient is pale, diaphoretic, and is not talking coherently. Vital signs upon admission are temperature 37 C, BP 65/40, HR 135, RR 32. What kind of shock do you suspect this patient is experiencing? A. Distributive B. Hypovolemic C. Neurogenic D. Anaphylactic E. Cardiogenic
B. Hypovolemic
Which of the following does NOT contribute to uncontrolled cell growth? A. Increased amounts of MYC being produced B. Increased amounts of p53 being produced C. Increased amounts of RAS being produced D. The presence of too many epidermal growth factor receptors (EGFRs)
B. Increased amounts of p53 being produced
Which of the following describes how the body first compensates for anemia? A. Decreasing capillary vasoconstriction B. Increasing rate and depth of breathing C. Kidneys releasing more erythropoietin D. Hemoglobin holding more firmly onto oxygen
B. Increasing rate and depth of breathing
A 75 year-old patient has suffered from a myocardial infarction (heart attack). She asks why there is so much pain when she exerts herself. The nurse explains this is due to: A. Atrophy. B. Ischemia. C. Vasodilation. D. Necrosis.
B. Ischemia.
Signaling between cells usually results in the activation of protein _______. A. Lipases. B. Kinases. C. Nucleases. D. Proteases.
B. Kinases.
Vaccinations are able to provide protection against certain microorganisms because of the: A. Memory cells for IgE B. Level of protection provided by IgG C. Strong response from IgM D. Rapid response from IgA
B. Level of protection provided by IgG
A cell secretes growth factors that have a slow diffusion rate and interact only with other cells in the immediate area. This is an example of which type of cell signaling? A. Endocrine B. Paracrine C. Autocrine D. Synaptic
B. Paracrine
What type of immunity is produced when an immunoglobulin crosses the placenta? A. Active-innate immunity B. Passive-acquired immunity C. Passive-innate immunity D. Active-acquired immunity
B. Passive-acquired immunity
A 15 year-old male is in a bicycle accident, sustaining a fracture to his femur and significant soft tissue injury. What is causing the pain he experiences? A. Neutrophils B. Prostaglandins C. Mast cells D. C5 complement
B. Prostaglandins
Cell membrane lipid rafts are thought to perform many functions, including: A. Protecting cells from viruses and toxins. B. Providing organization of signaling traffic. C. Maintaining cell structure. D. Initiating mitosis.
B. Providing organization of signaling traffic.
When discussing DNA transcription, which enzyme is most important? A. Transfer RNA B. RNA polymerase C. Messenger RNA D. DNA polymerase E. Transfer DNA
B. RNA polymerase
A 45 year old presents to the emergency room, with shortness of breath. She has cyanosis of the lips. She has had a productive cough for 2 weeks. Her temperature is 102.2, blood pressure 110/76, heart rate 108, respiration rate 40, rapid and shallow. Breath sounds are diminished in both bases, with coarse rhonchi in the upper lobes. Chest X-ray indicates bilateral pneumonia. She is most likely in: Arterial blood gas (ABG) results are: pH= 7.49 PaCO2= 28 HCO3= 24 PaO2= 54 What can you say about her acid-base status. A. Metabolic acidosis B. Respiratory alkalosis C. Metabolic alkalosis D. Respiratory acidosis
B. Respiratory alkalosis
39 y.o. F w/ 6-mo. history of (h.o.) malaise, extremely fatigued; paresthesias in both hands, & vague pain in both hands & wrists worse in a.m. She is beginning to notice pain & swelling in both knees. Normal family history. No current meds. No Known Drug Allergies (NKDA). PE: sense of "bogginess" & slight swelling in both hands, in both wrists, in the small bones of hands; & both knees. no other abnormalities, & rest of PE WNL. What is the most likely diagnosis in this patient? A. Osteoarthritis B. Rheumatoid arthritis C. Scleroderma D. Ankylosing Spondylitis
B. Rheumatoid arthritis
Direct cellular connections such as gap junctions in human cells permit: A. The rapid exchange of genetic information between adjacent cells. B. Second messengers to produced in one cell to rapidly diffuse into and stimulate events in surrounding cells. C. Adjacent cells to adhere strongly to each other. D. Protein kinases to flow between cells, coordinating cellular responses in tissues.
B. Second messengers to produced in one cell to rapidly diffuse into and stimulate events in surrounding cells.
The nurse is caring for a patient with pneumonia and notes the patient is sleeping a lot and gives short answers to questions. This is likely an example of: A. Clinical depression B. Sickness behavior C. Asocial behavior D. Stress response
B. Sickness behavior
The loss of the adenosine triphosphate (ATP) during ischemia causes cells to: A. Swell because of the influx of nitric oxide (NO). B. Swell because of the influx of sodium chloride (NaCl). C. Shrink because of the influx of potassium chloride (KCl). D. Shrink because of the influx of calcium (Ca).
B. Swell because of the influx of sodium chloride (NaCl).
A patient who is in hypovolemic shock has the following clinical signs: Heart rate 120 beats/minute, blood pressure, 80/55mmHg RR 55, and urine output 20mL/hr. After administering an IV fluid bolus, which of these signs if noted by the healthcare provider is the best indication of improved perfusion? A. Heart rate drops to 100 bpm B. Urine output increases to 30mL/hour C. Systolic blood pressure increases to 85 mmHg D. Right atrial pressure increases
B. Urine output increases to 30mL/hour
As death approaches, notable respiratory changes are observed, such as Cheyne-Stokes and Kussmaul respirations. When asked about this by the loved ones, you explain that this is normal at this time. What is the best additional response you can provide? A. the muscles used for breathing have become weak, so fluids build up in the lungs. The changing respirations are an attempt to push the fluid out. B. The changing respirations indicate their loved one is in pain and discomfort, so you will get an order for morphine. C. As a person dies, lung and kidney function decline, leading to a build up of CO2 in the blood stream. The changing respirations are an unsuccessful attempt to remove the excess CO2. D. The changing respirations are an indication of acidosis, which occurs because the liver is not able to filter waste products from the lungs.
C. As a person dies, lung and kidney function decline, leading to a build up of CO2 in the blood stream. The changing respirations are an unsuccessful attempt to remove the excess CO2.
If you experience a needle-stick injury from a known HIV+ patient, which of the following is likely to happen? A. I will panic and pray and not tell anyone what happened. B. I'll use condoms and/or other appropriate barriers when engaging in sexual activity until cleared by occupational health. I'll go to occupational health to be tested in 3 months to see if I contracted the virus. C. I will go to occupational/employer health or the Emergency Room, have blood drawn on myself, and then start Post-Exposure Prophylaxis PEP with a 2 or 3 drug regimen for 28 days. I'll use condoms and/or other appropriate barriers when engaging in sexual activity until cleared by occupational health. D. I will have one of my colleagues
C. I will go to occupational/employer health or the Emergency Room, have blood drawn on myself, and then start Post-Exposure Prophylaxis PEP with a 2 or 3 drug regimen for 28 days. I'll use condoms and/or other appropriate barriers when engaging in sexual activity until cleared by occupational health.
The vast majority of people who contract the HIV virus are classified as which phenotype? A. Elite Controllers- people who have positive antibody tests and have been infected for more than 12 months but have at least three longitudinal undetectable HIV RNA determinations (viral loads all have to be less than 1000 copies/μl) B. Long Term Nonprogressors who remain asymptomatic for a long time even off of medications, their CD4 cell count remains high (normal). C. Intermediate progressors whose immune systems are not immediately defeated, but, if not treated with medications will progress to AIDS within 3-10 years. D. Rapid Progressors whose immune systems cannot control the virus and develop AIDS within three years of infection
C. Intermediate progressors whose immune systems are not immediately defeated, but, if not treated with medications will progress to AIDS within 3-10 years.
Which of the following statements about Macrophages is true? A. Macrophages are sentinel cells that do not have any function beyond alerting the rest of the immune system that there is an injury or invasion. B. Macrophages are activated by changes in the sodium-calcium exchange pump when they encounter a pathogen. C. Macrophages are phagocytic cells that destroy pathogens and secrete cytokines to initiate inflammatory responses and promote healing. D. Macrophages arise from stem cells and circulate in the vascular system, then differentiate into monocytes in the tissues when needed.
C. Macrophages are phagocytic cells that destroy pathogens and secrete cytokines to initiate inflammatory responses and promote healing.
Epigenetics as it relates to cancer includes the process by which: A. tumor suppressor genes can become hypomethylated and protooncogenes can become hypermethylated B. histone modification of tumor suppressor genes occurs C. tumor suppressor genes can become hypermethylated and protooncogenes can become hypomethylated D. tumor oppressor genes undergo apoptosis
C. tumor suppressor genes can become hypermethylated and protooncogenes can become hypomethylated
1.Tumor Necrosis factor affects cardiac contractility 2.Peripheral vasodilation 3.Bacteria stimulate Toll-like receptors on Macrophages 4.Hypotension A. 2,4,3,1 B. 4,2,3,1 C. 3,2,4,1 D. 1,2,3,4
C. 3,2,4,1
Which of the following statements is TRUE? A. DNA is replicated in the cytoplasm of a cell. B. RNA contains the same bases as DNA C. A mutation is an inherited alteration of DNA D. RNA is double stranded.
C. A mutation is an inherited alteration of DNA
When the maternal immune system becomes sensitized against antigens expressed by the fetus, what type of immune reaction occurs? A. Autoimmune B. Homoimmune C. Alloimmune D. Allergy
C. Alloimmune
Neurotransmitter receptors are present on immune system cells, resulting in a neural-immune connection. This is an example of: A. Sickness behavior. B. Bottom-up immune response. C. Bi-directionality. D. Top-down immune response.
C. Bi-directionality.
In which structure do B lymphocytes mature and undergo changes that commit them to becoming B cells? A. Spleen B. Basement membranes C. Bone Marrow D. Thymus E. Blood
C. Bone Marrow
HIV is a retrovirus with single stranded RNA contained within an envelope and capsid, carrying several enzymes. Which of the following is NOT an enzyme related to HIV? A. Retroviral integrase B. Reverse transcriptase C. Capsid D. HIV protease
C. Capsid
It is true that natriuretic peptides: A. Decrease heart rate and increase potassium excretion. B. Increase blood pressure and decrease sodium and water excretion. C. Decrease blood pressure and increase sodium and water excretion. D. Increase heart rate and decrease potassium excretion.
C. Decrease blood pressure and increase sodium and water excretion.
Chemotaxis affects the inflammatory process by: A. Producing edema around the inflamed area B. Stimulating smooth muscle contraction in the inflamed area C. Directing leukocytes to the inflamed area D. Causing vasodilation around the inflamed area
C. Directing leukocytes to the inflamed area
When considering abnormal epigenetic modifications, what factor is currently being viewed as strongly associated with the development of some cancers? A. Emotional coping skills B. Family genetic history C. Environmental stressors D. Lifestyle choices
C. Environmental stressors
Which of the following statements regarding epigenetic inheritance is TRUE? A. Epigenetic inheritance occurs more commonly on maternally inherited alleles. B. Epigenetic inheritance cannot be reset during gametogenesis. C. Epigenetic inheritance does not involve a change in DNA sequence. D. Epigenetic inheritance ensures a homogeneous phenotype in heterozygotes.
C. Epigenetic inheritance does not involve a change in DNA sequence
The nurse is developing a care plan for a client diagnosed with systemic lupus erythematosus (SLE). Which goal is priority for this client? A. He/She will maintain reproductive ability. B. He/She will verbalize feelings of body-image changes. C. He/She will have no deterioration of organ function. D. The person's skin will remain intact and have no irritation.
C. He/She will have no deterioration of organ function.
What is a consequence of plasma membrane damage to the mitochondria? A. Edema from an influx of sodium causes a reduction in ATP production. B. Enzymatic digestion halts DNA synthesis. C. Influx of calcium ions halts ATP production. D. Potassium shifts out of the mitochondria, which destroys the infrastructure.
C. Influx of calcium ions halts ATP production.
Prader-Willi syndrome causes a chromosomal defect that is: A. Transferred from mother to child B. Initiated by postnatal exposure to a virus C. Inherited from the father D. Related to maternal alcohol abuse
C. Inherited from the father
Which anemia produces small, pale erythrocytes? A. Pernicious B. Folic acid C. Iron deficiency D. Hemolytic
C. Iron deficiency
What is an outcome of the complement cascade? A. Inactivation of chemical mediators such as histamine B. Prevention of the spread of infection to adjacent tissues C. Lysis of bacterial cell membranes D. Activation of the clotting cascade
C. Lysis of bacterial cell membranes
Non-Hodgkin's lymphoma involves which kind of cells? A. Precursor B-lymphocytes B. Precursor myelocytes. C. Matures T-lymphocytes D. Mature Neutrophils.
C. Matures T-lymphocytes
The focus of treatment for rheumatoid arthritis is related directly to joint damage that is caused by: A. Antiphospholipid downregulation B. Vasculitis C. Pannus formation D. Upregulated T regulatory cells
C. Pannus formation
If you want to evaluate the intrinsic clotting pathway, which is the best test result to consider? A. International Normalized Ratio (INR) B. d-dimer C. Partial thromboplastin time (PTT) D. Prothrombin time (PT) E. Fibrin degradation products (FDP)
C. Partial thromboplastin time (PTT)
In a normal, nonmutant state, an oncogene is referred to as a: A. Basal cell B. Target cell C. Proto-oncogene D. Caretaker gene
C. Proto-oncogene
A 36 year-old male complains of severe pain and bluish-red discoloration in his fingers while at work. He reports he recently started a job working in a refrigerated environment. What is he likely to be experiencing? A. Arthur's reaction B. Heparin-induced thrombocytopenia (HIT) C. Raynaud's phenomenon D. Rheumatic fever
C. Raynaud's phenomenon
Toll-like receptors are a type of enzyme-linked receptor that: A. Are responsible for transport of ions. B. Use multi-pass transmembrane proteins. C. Signal the immune system to an abnormality. D. Activate our senses of taste, smell, and sight.
C. Signal the immune system to an abnormality.
What is the very first step in the initial management of a patient who presents with lethargy, hypotension, low oxygen saturation, tachycardia and fever? A. Antibiotic therapy B. Vasopressor therapy C. Supplemental oxygen and airway management D. Intravenous (IV) fluid resuscitation
C. Supplemental oxygen and airway management
You attended the delivery of an infant to a mother with a diagnosis of chorioamnionitis. When examining the infant 4 hours later in the nursery, you note that the infant is lethargic, tachypneic, and has an axillary temperature of 36.0C. You suspect septic shock. Which of these assessments is an indication that this infant is compensating by increasing cardiac output? A. Warm, flushed skin B. Bounding pulses C. Tachycardia D. Active precordium
C. Tachycardia
Which statement is believed to be true concerning Th2 cells? A. Th2 cells produce IL-2, TNF-ß, and IFN-gamma B. They are induced by antigens derived from cancer cells. C. Th2 cells are induced by antigens derived from allergens. D. They assist in the development of cell-mediated immunity.
C. Th2 cells are induced by antigens derived from allergens.
When reviewing the laboratory results of a child with leukemia, you note that the child is also anemic. Which statement provides the best rationale for this problem? A. The increased number of lymphocytes is destroying the red blood cells at a rapid rate B. Chemotherapy-induced osteoporosis has caused decreased erythropoiesis C. The overproduction of immature white blood cells occurs at the expense of other cells D. The child has a poor appetite and has not been consuming adequate dietary iron
C. The overproduction of immature white blood cells occurs at the expense of other cells D. The child has a po
A patient who has tested positive for the human immunodeficiency virus (HIV) arrives at the clinic with a report of rapid weight loss, night sweats, and fatigue. The patient's CD4 count is 161 cells/mcL. How should the healthcare provider interpret these findings? A. The patient is a rapid progressor now in the latent stages of HIV infection. B. The patient needs an HIV antibody test immediately. C. The patient is diagnosed with acquired immunodeficiency syndrome (AIDS). D. These findings provide evidence that the patient has seroconverted.
C. The patient is diagnosed with acquired immunodeficiency syndrome (AIDS).
Disseminated intravascular coagulation is most often a rapid onset condition. This results from: A. Drug overdose with heparin B. Von Willebrand's factor coming into contact with blood C. Tissue factor (Factor III) coming into contact with blood D. Drug overdose with NSAIDS
C. Tissue factor (Factor III) coming into contact with blood
Type I Diabetes occurs when beta cells are destroyed, resulting in loss of insulin production. This is caused by which type of hypersensitivity response? (choose all that apply) A. Type II B. Type II & III C. Type IV D. Type III & IV E. Type I & II F. Type II & IV
C. Type IV
Which of the following is associated with an increased risk of developing Rheumatoid Arthritis (RA)? A. Use of oral contraceptive pills (OCPs) B. Pregnancy C. Use of tobacco products D. Excessive exercise
C. Use of tobacco products
The basic components of DNA are: A. pentose sugars and four phosphate bases. B. codons, oxygen, and cytosine. C. a phosphate molecule, deoxyribose, and four nitrogenous bases. D. adenine, guanine, and purine.
C. a phosphate molecule, deoxyribose, and four nitrogenous bases.
The family is present while you are performing post-mortem care for a patient and note that the patient's limbs are stiff and her back is blue. They ask if something happened to her before she died. You explain that these are normal changes after death called: (Select all that apply) A. pallor mortis B. algor mortis C. rigor mortis D. livor mortis E. ruber mortis
C. rigor mortis D. livor mortis
You are caring for a pregnant woman who has been HIV positive for 6 years. She is 8 weeks pregnant and worried that her HIV 3 drug medication regimen will harm her fetus. What do you tell her about remaining on HAART? A. You are right to be worried about your baby beiong harmed by things in your body. Which is worse, getting HIV from you or having birth defects? B. Any medication can harm a developing fetus, you should probably stop taking all medications until after the birth. C. Your concerns are reasonable and we will support your decision to stop medications now, but we really think you should plan on having a Cesarean section and not breast-feeding. D. Since we can reduce perinatal HIV transmission to less than 1% with appropriate therapy, you should stay on your current regimen.
D. Since we can reduce perinatal HIV transmission to less than 1% with appropriate therapy, you should stay on your current regimen.
An athlete runs a marathon, after which his muscles feel fatigued and unable to contract. The athlete asks the nurse why this happens. The nurse's response is based on the knowledge that the problem results from a deficiency of: A. AMP B. GTP C. GMP D. ATP
D. ATP
A 90 year-old woman is admitted to the medical unit with a urinary tract infection. She is given IV ceftazidine, a broad spectrum antibiotic. Two days later, she develops severe diarrhea and tests positive for Clostridium difficile (C. diff). C. diff was able to take hold because: A. And inadequate immune response resulted in an under-expression of cytokines B. Age-related decline in immunity made her more susceptible. C. There was a disruption of the epithelial barrier that was undetected. D. Ceftazidine interfered with her microbiome.
D. Ceftazidine interfered with her microbiome.
Arachidonic acid initiates a pathway that produces all of the following except: A. Thromboxane A2 that initiates vasoconstriction, bronchoconstriction, and platelet aggregation. B. Leukotrienes that attract eosinophils and neutrophils and cause bronchoconstriction. C. Prostaglandins that cause vasodiation, pain, vascular permeability and more pain. D. Complement to initiate opsonization, destruction of cells, increased vascular permeability and chemotaxis
D. Complement to initiate opsonization, destruction of cells, increased vascular permeability and chemotaxis
Granulomas form when: A. Excessive IgE are activated by B cells that cause a hypersensitivity response in the tissue. B. Autoantibodies are formed in response to IgM and IgG that are called up due to the pathogen. C. Excessive neutrophils respond to immune complexes form in response to the pathogen. D. Cytotoxic (Tc) cells and macrophages mediate a response to a pathogen.
D. Cytotoxic (Tc) cells and macrophages mediate a response to a pathogen.
Which term best describes an allele with an observable effect? A. Homozygous B. Recessive C. Carrier D. Dominant
D. Dominant
The human body's main defense against the HIV virus is: A. Phagocytosis of the virus by Macrophages and neutrophils. B. Clonal deletion of all infected T-cells at the direction of T-regulator cells C. An antibody response calling in complement to opsonize and cause cell lysis of infected cells. D. Effective cytotoxic killing of infected CD4+ T helper cells by CD8+ cytotoxic T cells.
D. Effective cytotoxic killing of infected CD4+ T helper cells by CD8+ cytotoxic T cells.
A patient with diabetic ketoacidosis has a dangerously high level of serum glucose related to the failure of the insulin-glucagon feedback loop. This indicates a failure in which type of cell signaling? A. Autocrine B. Paracrine C. Synaptic D. Endocrine
D. Endocrine
A ligand binds to a cell receptor and activates a change within the cell. The cell receptor is a _____. A. Gap junction. B. G-protein-coupled receptor. C. Gated ion channel. D. Enzyme-linked receptor.
D. Enzyme-linked receptor.
What genetic process is likely responsible for the occurrence of asthma in only one of a pair of identical twins? A. Methylation B. Transgenerational inheritance C. Genomic imprinting D. Epigenetic modifications
D. Epigenetic modifications
The difference between DNA sequence mutations and epigenetic modifications is: A. DNA sequence mutations can be directly altered. B. Leukemia is a result of only DNA sequence mutation. C. No known drug therapies are available for epigenetic modifications. D. Epigenetic modifications can be reversed.
D. Epigenetic modifications can be reversed.
You are caring for a patient with acute myelogenous leukemia (AML). Which of the following best describes the characteristics of this type of leukemia? A. Leukocytes undergo increased differentiation B. Mature leukocytes are transformed into immature cells C. The function of T-cells and B-cells is adversely affected D. Examination of peripheral blood will show excessive myeloblasts
D. Examination of peripheral blood will show excessive myeloblasts
Which is the preferred first-line test for HIV screening? A. RNA viral load B. Western Blot C. Enzyme linked Immunoassay (ELISA) D. Fourth Generation Combination Immunoassay
D. Fourth Generation Combination Immunoassay
What mechanism can cause hypernatremia? A. Syndrome of inappropriate antidiuretic hormone B. Brief bouts of vomiting or diarrhea C. Excessive diuretic therapy D. Hypersecretion of aldosterone
D. Hypersecretion of aldosterone
During which stage of human development does the role of epigenetics have the greatest impact on the development of epigenetic abnormalities? A. Infancy B. Puberty C. Middle Age D. In utero
D. In utero
When a B cell or plasma cell stops making IgM and starts making another kind of antibody, this is called: A. Light chain alteration B. Antibody reversal. C. Isometric switching. D. Isotope switching.
D. Isotope switching.
What principle should the nurse remember when trying to distinguish aging from diseases? A. Aging is defined as exceeding life expectancy, but not maximal life span. B. It is easy to tell normal processes from abnormal processes. C. Disease, unlike aging, has a genetic component. D. It is often difficult to tell the difference because both processes are believed to result form cell injury.
D. It is often difficult to tell the difference because both processes are believed to result form cell injury.
A person's immune system responds to a small viral antigen in the cytoplasm of liver cells. Which of the following would most likely recognize the antigen? A. Membrane bound antibody receptor on a CD4+ helper T cell B. Membrane bound antibody receptor on a B cell C. MHC II molecule on a CD4+ helper T cell D. MHC I molecule on a CD8+ T cell
D. MHC I molecule on a CD8+ T cell
What compounds attach to genes to direct their expression as certain types of cells? A. Secondary messenger RNA B. DNA riders C. Introns D. Methyl groups
D. Methyl groups
Symptoms of hyperkalemia include: A. Muscle spasms, tachycardia, low voice, substernal chest pain B. Tremors, diaphoresis, constipation C. Bone pain D. Muscle weakness, bradycardia, diarrhea, parasthesia of the hands, feet, tongue and face. E. All of the above
D. Muscle weakness, bradycardia, diarrhea, parasthesia of the hands, feet, tongue and face.
An 80-y.o. F c/o 6-mo. h.o. stiffness in hands bilaterally, which worsens in p.m. & subsides thereafter; increased (but not severe) pain in lower back, both hips, & both knees. PE: obese pt. w/ significant swelling of both PIP & DIP joints; deformity of both knees; & rest of her PE is WNL. What is the most likely diagnosis in this patient? A. Bone cancer B. Multiple myeloma C. Rheumatoid arthritis D. Osteoarthritis
D. Osteoarthritis
A patient suffered a heart attack with subsequent myocardial ischemia. Once blood flow is restored to the heart, reperfusion injury occurs as a result of: A. Ca-binding proteins B. Decreased ATP production. C. Apoptosis D. Oxidative stress
D. Oxidative stress
During acidosis, the body compensates for the increase in serum hydrogen ions by shifting hydrogen ions into the cell in exchange for which electrolyte? A. Oxygen B. Sodium C. Magnesium D. Potassium E. Chloride
D. Potassium
The two major forms of leukemia, acute and chronic, are classified by which criteria? A. Age of individual when cell differentiation occurs and rate of progression B. Predominant cell type and serum level of leukocytes C. Serum level of leukocytes and rate of progression D. Predominant cell type and rate of progression
D. Predominant cell type and rate of progression
A patient is diagnosed Hodgkin's lymphoma. A defining characteristic would be: A. Being 43 years old. B. Rash and puritis. C. Multiple, painless enlarged lymph nodes. D. Presence of Reed-Sternberg cells.
D. Presence of Reed-Sternberg cells
The adaptive advantage of meiosis includes: A. Limiting diversity in the population, making the species more resistant to threats. B. Producing chromosomes with identical kentochores at each replication. C. Preventing apoptosis from occurring early. D. Provide a means for double-stranded DNA damage to be repaired through recombination.
D. Provide a means for double stranded DNA damage to be repaired through recombination.
Which of the following is most commonly an early sign of Systemic Lupus Erythematosus (SLE)? A. Hallux vargus B. Intermittent flaring of metacarpal phalangeal joints C. Night sweats D. Raynaud's Phenomenon
D. Raynaud's Phenomenon
A ligand fails to bind to a cell receptor. This is an failure of what stage of cell signaling? A. Transduction B. Response C. Feedback D. Reception
D. Reception
A 70-year-old man presents to the emergency department with a 2-day history of fever, chills, cough, and right sided pleuritic chest pain. On the day of admission, the patient's family noted that he was more lethargic and dizzy and was falling frequently. The patient's vital signs are: temperature, 101.5 F; heart rate, 120 bpm; respiratory rate, 30 breaths/min; blood pressure, 70/35mm hg; and oxygen saturation as measured by pulse oximetry, 80% without oxygen. A chest x-ray shows a righth lower lobe infiltrate.The patient's condition can be best defined as which of the following? A. Multiorgan Dysfunction Syndrome (MODS) B. Acute Renal Failure C. Metabolic acidosis D. Septic Shock
D. Septic Shock
The generation of clonal diversity includes a process that: A. Allows the differentiation of cells into antibody-secreting plasma cells or mature T cells. B. Involves antigens that select those lymphocytes with compatible receptors. C. Causes antigens to expand and diversify their populations. D. Takes place in the primary (central) lymphoid organs.
D. Takes place in the primary (central) lymphoid organs.
Which of the following describes a "left shift" in the CBC? A. There are relatively more immature erythrocytes than usual in relation to the mature erythrocytes. B. There are relatively fewer mature neutrophils than usual and the immature neutrophils are also reduced. C. There are relatively fewer immature erythrocytes than usual relation to the mature erythrocytes D. There are relatively more immature neutrophils than usual in relation to the mature neutrophils
D. There are relatively more immature neutrophils than usual in relation to the mature neutrophils
Which of the following statements is FALSE regarding Class 1 viruses, which contain double-stranded DNA? A. These viruses may be able to push the cell into replicating itself in order to use the cells' polymerases. B. These viruses require entering the host cells' nucleus in order to replicate. C. Examples of Class I viruses include Herpes viruses, and human papilloma virus. D. These viruses supply their own polymerase to replicate, and do not require host polymerase.
D. These viruses supply their own polymerase to replicate, and do not require host polymerase.
Housekeeping genes are vital to the function and maintenance of all the body's cells. What characteristic is associated with these genes? A. Epigenetic silencing has occurred. B. They lack encoding histones. C. Ribosomal RNA genes are absent. D. They are transcriptionally active.
D. They are transcriptionally active.
Allergic contact dermatitis is cell mediated and does not involve antibodies. This is which type of hypersensitivity response? A. Type III B. Type II C. Type I D. Type IV
D. Type IV
All of the following are risk factors for developing sepsis EXCEPT: A. Current antibiotic use B. Alcoholic C. Elderly D. Walking barefoot in the mud E. Immunocompromised
D. Walking barefoot in the mud
Studies in the field of behavioral epigenetics are showing that: A. past traumas can make brain fluid more acidic. B. DNA is extremely vulnerable to re-coding molecules. C. childhood suffering can change the DNA code. D. past traumas can be recorded on genes and passed on.
D. past traumas can be recorded on genes and passed on.
Which term refers to the silenced gene of a gene pair? A. Altered B. Snipped C. Mutated D. Activated E. Imprinted
E. Imprinted
Which of the following is a nurse least likely to provide in his or her practice in regard to clinical genomics? A. An understanding of how molecular diagnosis can help us identify the mechanisms of particular diseases. B. The ability to take an accurate and comprehensive family health history. C. Using clinical genomics to help predict a person's response to drugs, and their likelihood of having an adverse drug reaction. D. An understanding of how gene expression is influenced by our environment and our behavior E. The ability to interpret the results of a whole genome sequencing array at a glance.
E. The ability to interpret the results of a whole genome sequencing array at a glance.
The steps in metastasis include: A. invasion of surrounding tissues and angiogenesis B. intravasation of cancer cells into the blood stream C. cancer cells combining with blood elements that adhere to vessel walls (clot) D. extravasation of cancer cells into other tissues or organs E. all of the above
E. all of the above
Which one of the following statements about the platelet phase of hemostasis is TRUE ? A. Platelets secrete factors that promote primary hemostasis. B. Platelets are called to the site of injury by collagen. C. Most clotting factors circulate as inactive precursors. D. Von Willebrand Factor is necessary for proper adhesion of the platelets to subendothelial structures. E. A & C F. All of the above
F. All of the above
The Rheumatoid Arthritis phenotype featuring the presence of Anti-Citrullinated Protein Antibodies (ACPA) are associated with more severe disease, faster disease progression and responds better than the ACPA negative phenotype to disease-modifying antirheumatic drugs (DMARDs). True False
True
Question 1 of 58 1.0/ 1.0 Points Match the type of hypersensitivity response to one of its characteristics. A. Immune complexes attach to tissues, activating complement. B. Excessive production of IgE in reaction to an antigen. C. Delayed immune response due to the loss of tolerance to an antigen. D. Antibodies attacking platelets due to the formation of an auto antigen. 1. Type I 2. Type II 3. Type III 4. Type IV
Type 1: B. Excessive production of IgE in reaction to an antigen. Type 2: D Antibodies attacking platelets due to the formation of an auto antigen. Type 3: A Immune complexes attach to tissues, activating complement. Type 4: C. Delayed immune response due to the loss of tolerance to an antigen.
