Pathophysiology for Advanced Practice Nursing Study Guide

Selye's three phases of the stress response include all of the following except:

Allostasis

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

Microcytic

The organelle that contains enzymes necessary for oxidative phosphorylation to produce ATP is the

Mitochondria

Which of the following correctly match intracellular organelles to their functions?

Mitochondria produce cellular energy in the form of ATP

Which is true about blood flow from the atria?

occurs primarily during ventricular diastole

A vessel that normally contains desaturated venous blood is the

pulmonary artery

In lead II of a normal ECG, the Q wave is a downward deflection resulting from __________ depolarization

septal

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

systemic lupus erythematosus

Allostasis is best defined as

the overall process of adaptive change necessary to maintain survival and well-being

The primary function of kinins is

vasodilation to enhance inflammation

A patient has been exposed to meningococcal meningitis, but is not yet demonstrating signs of this disease. This stage of illness is called the ____________________ stage.

Latent

Active immunity involves

*Active infections *Vaccines with dead or altered organisms

Which diseases are due to Type IV hypersensitivity?

*Brucellosis *TB *Leprosy

Which of the following are characteristics of stem cells?

*Can differentiate into any type of cell *Can die in absence of appropriate environment *Have greater capacity to proliferate than more differentiated cells *Are dependent upon environmental cues for proliferation

Calcium channel blocker drugs are often used to treat conditions associated with which types of muscle or tissue?

*Cardiac muscle *Smooth muscle

Secondary immune deficiency problems may be caused by which of the following?

*High blood glucose *Low protein level *Corticosteroids *Surgery

Which changes in the circulatory system occur in the older adult?

*Increased systemic vascular resistance *Decreased elasticity of vessel walls *Increased afterload *Decreased baroreceptor function

Dietary zinc is an important defense against infection because it maintains

*Lymphocyte activity *Natural killer cell function *Neutrophil activity *Complement activity

In DNA replication, DNA polymerase functions to do which of the following? Select all that apply.

*Proofread the newly developed DNA for errors in base pairing *Match appropriate bases to the template bases

The pain characteristics of chronic venous insufficiency include which of the following?

*Relief with elevation *Aching and cramping *Relief with ambulation

Which of the following statements are accurate when considering diagnostic testing for an individual with a possible medical condition? Select all that apply.

*Specificity shows that a test will be negative if the person does not have the disease. *Sensitivity is the chance the test will be positive if the hypothesized disease is present.

Events which occur during the alarm stage of the stress response include secretion of (select all that apply):

*catecholamines *immune cytokines *glucocorticoids *ACTH

What roles does inflammation play in cancer development?

*causes direct DNA damage *contributes to angiogenesis *initiates carcinogenesis *limits apoptosis

Aldosterone may increase during stress, leading to (select all that apply):

*decreased urinary output *increased sodium retention *increased blood volume

Your patient's red blood cell count is slightly elevated today. This might be explained by: (Select all that apply)

*gender differences *situational factors *illness *normal variation

Passive immunity is provided by

*injection of human immune globulin *transfer of preformed human antibodies *injection of preformed animal antibodies

Necrotic death of brain tissue usually produces ____________________ necrosis

Liquefactive

List 5 physical, behavioral, or emotional indicators of high stress.

1. Elevated blood pressure 2. Sweaty palms 3. Restlessness 4. Anxiety 5. Mental exhaustion

Match the body organ or system with the effect of allostatic overload

1. nervous system-overeating 2. genitourinary system-diuresis 3. integumentary system-hair loss 4. musculoskeletal system-tension headaches

The cellular component most susceptible to radiation injury is the

DNA

Glycolysis is the metabolic process of breaking down a glucose molecule to form

2 ATP and 2 pyruvate

Laboratory findings associated with aplastic anemia

Low MCV & MCHC

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

Tertiary prevention

What are the CD4 T tell count ranges for the 3 stages of HIV?

6yrs and greater 1: greater than or equal to 500 2: 200-499 3: less than 200 Child less than one year 1: greater than or equal to 1500 2: 750-1499 3. less than 750 Child 1-5 1. greater than or equal to 1000 2. 500-999 3. less than 500 Child 1-5

What is true about the mitral valve?

allows blood to flow from left atrium to left ventricle

In general, the best prognosis for long-term disease-free survival occurs with:

ALL

Which type of leukemia primarily affects children?

ALL

Characteristics of X-linked recessive disorders include

All daughters of affected fathers being carriers

In general, with aging, organ size and function

Decrease

While hospitalized for management of ALL, a patient develops severe thrombocytopenia. The most appropriate intervention is:

Activity Restriction

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

Acute phase proteins

All the following stress-induced hormones increase blood glucose except:

Aldosterone

A middle aged patient follows up today for a BP 156/94 3 weeks ago. They have no significant past medical history, take no meds, but smoke 1.5 PPD, drink alcohol regularly, and exercise infrequently. They are about 40# overweight and eat a high-fat high-calorie diet. Today's BP is 150/92. What is the LEAST appropriate intervention for this patient at this time?

Begin antihypertensive drug therapy

Characteristics of smooth muscle include

Being found in blood vessels

A diagnostic laboratory finding in myeloma is:

Bence Jones proteins in urine

How is most carbon dioxide transported in the blood?

Bicarbonate ions

HIV infection of T-helper cells is facilitated by attachment of the viral envelope protein gp120 to:

CD4 proteins on helper cells

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:

Calcium

Malignant neoplasms of epithelial origin are known as

Carcinomas

The primary role of genes is to

Direct the synthesis of proteins

The cellular change that is considered preneoplastic is

Dysplasia

What lab test is helpful in diagnosing iron deficiency anemia?

Elevated TIBC (total iron binding capacity)

A disease that is native to a particular region is called

Endemic

Cell-to-cell communication through the secretion of chemical signals into the bloodstream to target cells throughout the body is called ____________________ signaling

Endocrine

The primary adaptive purpose of the substances produced in the alarm stage is

Energy and repair

PT & INR measure which pathway?

Extrinsic

RBC obtain nearly all their energy from metabolism of?

Glucose

Which disorder is considered a primary immunodeficiency disease?

HIV/AIDS

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

HLA or MHC

What happens to the staging of of HIV if opportunistic infections are found?

It will automatically move the diagnosis to stage 3, despite what the CD4 count is

Which electrolyte imbalance may lead to clotting disorders?

Hypocalcemia

An increase in extracellular potassium ion from 4.0 to 6.0 mEq/L would

Hypopolarize the resting membrane potential

Anaphylaxis may occur in which types of hypersensitivity reactions?

I & II

The principle Ig mediator of Type I hypersensitivity reactions is

IgE

The effects of excessive cortisol production include:

Immune suppression

What is not normally secreted in response to stress?

Insulin

The cellular response indicative of injury because of faulty metabolsm is

Intracellular accumulations

aPTT measures which pathway?

Intrinsic

Drug resistance of microbes occurs secondary to

Mutation of a microbe

A patient 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

Many of the responses to stress are attributed to activation of the sympathetic nervous system and are mediated by:

Norepinephrine

What lab value is usually associated with aplastic anemia?

Pancytopenia

Persistence of the alarm stage will ultimately result in

Permanent damage and death

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

Primary prevention

Indicators that an individual is experiencing high stress include all the following except

Pupil constriction

The relationship of blood flow (Q), resistance (R), and pressure (P) in a vessel can be expressed by which equation?

Q=P/R

Transfusion reactions involve RBC destruction caused by

Recipient antibodies

When determining additional data to gather before making a diagnosis, what factors need to be considered? Select all that apply.

Reliability and validity

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

Secondary prevention

An obese but otherwise healthy teen is given a prescription for a low-calorie diet and exercise program. This is an example of:

Secondary prevention

Brad was recently exposed to group A hemolytic Streptococcus and subsequently developed a pharyngeal infection. His clinical examination reveals an oral temperature of 102.3F, 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 Brad's disease is:

Streptococcal infection

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

Subclinical

Pulse pressure is defined as

Systolic pressure-diastolic pressure

When educating a patient about their newly diagnosed non-Hodgkin lymphoma, you should include that:

There may be GI involvement

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

Tumor necrosis factor

Excitable cells are able to conduct action potentials because they have

Voltage gated channels

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

X-linked

Chronic activation of stress hormones can lead to (Select all that apply.) a. cardiovascular disease. b. depression. c. impaired cognitive function. d. autoimmune disease. e. overactive immune function.

a. cardiovascular disease b. depression c. impaired cognitive function d. autoimmune disease

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. chemotherapy b. cancer cells c. metastasis d. malnutrition

Characteristics of telomerase include (select all that apply):

a. contributing to cancer cell immortality b. allowing indefinite replication c. promoting synthesis of telomere ends

Viruses differ from most bacteria in that they act in which of the following ways? (Select all that apply):

a. enter the host cell b. do not produce toxins c. use the host's metabolic processes to survive and replicate

Bacteria cause injury to cells by which mechanism (Select all that apply).

a. evoking an immune response b. producing exotoxins c. producing destructive enzymes d. producing endotoxins

Functions of T cells include

a. killing virally infected cells b. secreting cytokines c. stimulating b cells d. killing antigen presenting cells

Risk of infection is increased in (select all that apply):

a. use of corticosteroids b. diabetes mellitus c. splenectomy stress

An important difference between skeletal and cardiac muscle is that

cardiac muscle has calcium channels on the cell surface for calcium entry

HIV infection causes immunodeficiency because it:

causes destruction of T-helper cells

The effect of stress on the immune system

may involve enhancement or impairment the immune system

Antigen-presenting cells function to

display foreign antigen on their cell surfaces bound to MHC

Leukocytosis with a "shift to the left" refers to

elevated immature neutrophils

Reperfusion injury to cells

involves formation of free radicals