Mid term path 370

tumor markers

- are produced by normal cells - help determine cancer origin - help identify progression of cancer - include prostatic-specific antigen

dysrhythmias are significant since they

-can indicate an underlying disorder -can impair cardiac output

Which blood pressure is considered to be indicative of prehypertension according to the JNC-7 criteria?

128/82 Normal BP in adults

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

iron deficiency

After surgery to remove a lung tumor, your patient is scheduled for chemotherapy, which will

kill rapidly dividing cells

Necrotic death of brain tissue usually produces _____ necrosis.

liquefactive

Clinical manifestations of moderate to severe hypokalemia include

muscle weakness and cardiac dysrhythmias

All these cellular responses are potentially reversible except Necrosis Metaplasia Atrophy Hyperplasia

necrosis

What laboratory finding is usually found in aplastic anemia?

pancytopenia

Common characteristics of sarcoidosis include

presence of CD4+ T cells. a non-productive cough. granulomas in multiple body systems. fatigue, weight loss, and fever.

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

primary prevention

A patient with pure left-sided heart failure is likely to exhibit

pulmonary congestion with dyspnea

Hypertrophy of the right ventricle is a compensatory response to

pulmonary stenosis

cardiogenic shock is characterized by

reduced cardiac output

Emphysema results from destruction of alveolar walls and capillaries, which is because of

release of proteolytic enzymes from immune cells

Metaplasia is

replacement of one differentiated cell type with another

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

secondary prevention

orthostatic hypotension is a risk factor for

stroke, cognitive impairment, and death

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

subclinical

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

tertiary prevention

acute coronary syndrome in the presence of thrombosis may present as

unstable angina MI sudden cardiac arrest

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

vitamin K deficiency bleeding

The prothrombin time (PT) and INR (international normalized Ratio) measures the integrity of

Extrinsic pathway The PT and INR asses the extrinsic pathway of coagulation Platelet function is measured through a CBC. aPPT asses intrinsic pathway of coagulation D-dimer assay reflects fibrinolysis

Which is not normally secreted in response to stress?

Insulin Insulin secretion is impaired during stress to promote energy from increased blood glucose. Norepinephrine is secreted during stress as a mediator of stress and adaptation. Cortisol is secreted during stress as a mediator of stress and adaptation and stimulates gluconeogenesis in the liver to supply the body with glucose. Epinephrine is secreted during stress as a mediator of stress and adaptation and increases glycogenolysis and the release of glucose from the liver.

Coagulative necrosis is caused by

Interrupted blood supply

pernicious anemia is caused by lack of

Intrinsic factor

After bronchoscopy and histologic examination of a suspected tumor, your patient is diagnosed with primary bronchial carcinoma. Thus, the tumor

Is malignant

Your patient is scheduled for a staging procedure. She wants to know what that means. The correct response is which of the following

It is a procedure for determining the extent of tumor spread.

The primary source or erythropoietin is provided by

Kidney erythropoietin is a hormone secreted into the bloodstream by the kidney.

It is true that diffuse interstitial lung disease

Leads to loss of alveolar wall. May be immunologic in nature. Shows on x-ray as a "honeycomb lung"

Dysfunction of which organ would lead to clotting factor deficiency?

Liver The liver is responsible for the synthesis of coagulation factors. A clotting factor deficiency is the result of liver dysfunction. Coagulation does not occur in the kidneys. About 25% of the total number of platelets can be found in the spleen. The pancreas is not a location where coagulation occurs.

Regarding iron deficiency anemia, what laboratory features are typically decreased? (Select all that apply.) a. MCV b. MCH c. MCHC d. WBC e. Thrombocytes

MCV MHC MCHC

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

Norepinephrine

Always obstruction in chronic bronchitis is due to

Thick mucus, fibrosis, and smooth muscle hypertrophy

The primary functions of the circulatory systems are

Transport oxygen Transport nutrients Remove metabolic waste

Individuals who have chronic bronchitis most often have

a productive cough Productive cough for 3 months. Abnormal lung sounds.

Sepsis has been recently redefined as

a systemic inflammatory repose to infection

Side effects of chemotherapy include

anemia, nausea, bleeding, and infections

A disease that is native to a particular region is called

endemic. A disease that is native to a particular region is called endemic. An epidemic is a disease that spreads to many individuals at the same time. Pandemics are epidemics that affect large geographic regions, perhaps spreading worldwide.

A person who overuses magnesium-aluminum antacids for a long period of time is likely to develop

hyperphosphatemia

A patient presents to the emergency department with a diastolic blood pressure of 132 mm Hg, retinopathy, and symptoms of an ischemic stroke. This symptomology is likely the result of

hypertensive crisis. Hypertensive crisis is characterized by a diastolic blood pressure of greater than 120 mm Hg, and symptoms of end-organ damage such as retinopathy and ischemic stroke. Blood pressure is not an indication of arthrosclerosis. Angina may accompany hypertensive crisis, but the question stem relates directly to hypertensive crisis. The patient may be having a myocardial infarction, but the addition of end-organ damage symptoms points to hypertensive crisis.

Which electrolyte imbalance increases the risk for digoxin/digitalis/digibind toxicity?

hypokalemia

metabolic alkalosis is often accompanied by

hypokalemia. Note: Hypokalemia often accompanies metabolic alkalosis because it can cause metabolic alkalosis or be caused by it. Metabolic alkalosis and hypernatremia, hyponatremia, and hyperkalemia are not often associated with each other.

Respiratory acidosis may be caused by

hypoventilation

The body compensates for metabolic alkalosis by

hypoventilation In metabolic alkalosis, the lungs compensate by hypoventilation to conserve CO2 in the body. Decreasing arterial carbon dioxide would worsen metabolic alkalosis. The respiratory system compensates for metabolic acid and base disturbances; the lungs do not increase bicarbonate ion excretion. Hyperventilation would blow off CO2 and cause respiratory alkalosis.

Dramatic hypotension sometimes accompanies type I hypersensitivity reactions, because

massive histamine release from mast cells lead to vasodilation.

The primary effector cell of the type I hypersensitivity response is

mast cells

Left sides heart failure is characterized by

Pulmonary congestion

Massive release of histamine with consequent vasodilation and hypotension occurs with what type of shock?

Anaphylactic

rheumatic heart disease is most often a consequence of

B-hemolytic streptococcal infection

A middle-aged patient has a follow up visit for a recorded blood pressure of 162/96 mm Hg taken 3 weeks ago. The patient has no significant past medical history and takes no medications, but smokes 1 1/2 packs of cigarettes per day, drinks alcohol regularly, and exercises infrequently. The patient is about 40 lbs. overweight and admits to a high-fat, high-calorie diet. At the office visit today, the patient's blood pressure is 150/92 mm Hg. What is the least appropriate intervention for this patient at this time?

Begin antihypertensive drug therapy. Antihypertensive drug therapy is not the first intervention in a person with modifiable risk factors. Therefore, lifestyle alterations are attempted first. Lifestyle alterations include exercise, smoking cessation, and weight loss. Blood pressure should be rechecked in 4 to 6 weeks. Smoking cessation counseling is an appropriate lifestyle alteration.

A diagnostic laboratory finding in myeloma is

Bence Jones proteins in the urine Bence Jones protein in the urine is a common clinical manifestation of plasma cell myeloma.

malignant neoplasm of epithelial origin are known as

Carcinomas

A patient is diagnosed with hairy cell leukemia. The patient's lab results would most likely indicate a decrease in

Granulocytes Platelets Red blood cell

An increase in organ size and function due to increased workload is termed

Hypertrophy

Which electrolyte imbalances cause increase neuromuscular excitability

Hypocalcemia and HYPOmagnesemia

A patient experiences anaphylactic shock. The nurse expects to observe which signs and symptoms in the patient?

Hypotension Urticaria Angioedema Wheezing

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

III Immune complex glomerulonephritis (an inflammatory renal disorder) is an example of a type III hypersensitivity reaction. The circulating immune complex is then deposited in the glomerular capillary wall and mesangium. Glomerulonephritis secondary to strep throat is not a type I, II, or IV sensitivity reaction.

The hypersensitivity reaction that does not involve antibody production is type

IV Type IV hypersensitivity reactions do not involve antibody production. The principal mediators are lymphocytes, including T helper cells (Th) that mediate the reaction by releasing lymphokines (cytokines) and/or antigen-sensitized cytotoxic T cells (Tc) that can directly kill cells. The other types involve antibody production. Type I involves IgE; type II involves IgM or IgG; type III involves IgG.

Allergic (extrinsic) asthma is associated with

IgE-mediated airway inflammation Involves hyperresponsiveness of the airways Antigens are precipitating factors Airway obstruction is reversible

A patient with forward effects of heart failure may present which symptoms?

Impaired memory Mental fatigue Confusion Other symptoms: Restlessness. Anxiety. Generalized fatigue. Activity intolerance. Lethargy

While hospitalized, an elderly patient with a history of myocardial infarction was noted to have high levels of low-density lipoproteins (LDLs). What is the significance of this finding?

Increased LDL levels are associated with an increased risk of coronary artery disease

What is necessary for red blood cell production

Iron Immature red blood cells produce hemoglobin, which is composed of two pairs of polypeptide chains, the globins. Each globin has an attached heme molecule that contains iron. Dietary iron is transported through the plasma on the RBC membrane. Phosphates are not a necessary component of red blood cell production. Magnesium is not a part of the production of red blood cells. Calcium is not involved in red blood cell production.

restrictive respiratory disorders include

Pneumothorax ARDS

After sitting in a chair for an hour, an elderly patient develops moderate lower extremity edema. His edema is most likely a consequence of

Right-sided heart failure The backward effects of right-sided heart failure are due to congestion in the systemic venous system and lead to lower extremity edema. Arterial obstruction is not associated with dependent edema of the lower extremities. Left-sided heart failure is associated with pulmonary symptoms. Edema may be associated with peripheral vascular disease, but dependent edema over a 1-hour period is related to right-sided heart failure.

A patient with a productive cough and parenchymal infiltrates on x-ray is demonstrating symptomology of

bacterial pneumonia

Hypotension, distended neck veins, and muffled heart sounds are classic manifestations of

cardiac tamponade

patent ductus arteriosus is accurately described as a(n)

communication between the aorta and the pulmonary artery

A common characteristic of viral pneumonia is

dry cough

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

glucose-6-phosphate dehydrogenase deficiency Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a RBC intracellular defect. Usually this anemia is first recognized during or after an infectious illness or exposure to certain drugs. Thalassemia does not carry a manifestation associated with pharmacologic agents. Spherocytosis is a hereditary anemia with manifestations of jaundice. Episodes of sickle cell anemia are associated with recurrent painful episodes related to organ dysfunction.

Red blood cells differ from other cell types in the body, because they

have no cytoplasmic organelles RBC have no cytoplasmic organelles, nucleus, mitochondria, or ribosome. Cannot synthesize proteins or carry out oxidative reaction, because of their lack of organelles. Live up to 80-120 days. Do not contains glycolytic enzymes.

early manifestations of a developing metabolic acidosis include

headache Coma is a late symptom Deep rapid respiration are compensatory mechanisms

A person who has hyperparathyroidism is likely to develop

hypercalcemia

respiratory alkalosis is caused by

hyperventilation

Which type of leukemia primarily affects children?

ALL (acute lymphoid leukemia) ALL is primarily a disorder of children. The peak incidence occurs between the ages of 3 and 7 years. The average age of patients with CLL is about 65 to 70 years. The median age of presentation of AML is 64 years. Average onset of CML is between 40 and 50 years.

Deficit in immune system function occur in cancer due to

Chemotherapy Cancer cells Cancer metastasis to bone marrow Malnutrition

After being diagnosed with hypertension, a patient returns to the clinic 6 weeks later. The patient reports "moderate" adherence to the recommended lifestyle changes and has experienced a decreased from 165/96 to 148/90 mm Hg in blood pressure. What is the most appropriate intervention for this patient at this time?

Continue lifestyle modifications only. The patient should be encouraged to continue compliance with lifestyle changes since the patient has exhibited some positive response to his changes. Diuretics are not needed at this time. ACE inhibitors should not be added to the therapy yet. β-blockers are not required at this time.

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

Pain in long bones, infection, fever, bruising The onset of symptoms of ALL is abrupt and may begin when a child refuses to walk or begins to exhibit loss of appetite, fatigue, or abdominal pain. Bruising, fever, and infection are also common early findings. Vertebral fractures, elevated calcium levels, and bone pain are more frequently associated with plasma cell myeloma. Asymptomatic onset is generally found with CLL and is often found by accident on a routine blood count. Enlarged cervical lymph nodes are seen more commonly in Hodgkin disease.

In individuals exhibiting respiratory distress as well as tracheal shift should be evaluated for

Pneumothorax

Selve's Three Phases of Stress Response include

Resistance, alarm, exhaustion