Patho Chapters 1-12

Familial retinoblastoma involves the transmission of what from parent to offspring?

Mutant tumor suppressor gene

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

hypertrophy.

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

All these cellular responses are potentially reversible except

necrosis.( answer ) b. metaplasia. c. atrophy. d. hyperplasia.

Huntington disease primarily affects the _____ system.

neurologic

Somatic death refers to death

of the entire organism.

Persistence of the alarm stage will ultimately result in

permanent damage and death.

The risk period for maternal rubella infection leading to congenital problems begins

prior to conception

Children with PKU must avoid phenylalanine in the diet. Phenylalanine is most likely to be a component of

protein.

Huntington disease is often transferred to offspring before a parent knows of the genetic possibility of this disease, because

symptoms often do not occur until approximately 40 years of age.

HIV infection causes immunodeficiency because it

causes the destruction of T-helper cells.

Cancer grading is based on

cell differentiation.

Immune function is likely to be most effective in a

30-year-old.

Cleaning dirty needles prior to use helps prevent the spread of HIV. When using bleach, the user must rinse out all the blood first and then fill the needle and syringe with full-strength bleach three times for ____ to ____ seconds.

30; 60 After rinsing all the blood first, the user fills the needle and syringe with full-strength bleach at least three times for 30 to 60 seconds.

The immune system disorder associated with HIV is

deficiency of T-helper lymphocytes.

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

deficient immune response.

Patients with immunodeficiency disorders are usually first identified because they

develop recurrent infections.

The primary role of genes is to

direct the synthesis of proteins.

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

energy and repair.

Socioeconomic factors influence disease development due to (Select all that apply.)

environmental toxins. overcrowding. nutrition. hygiene.

The differences in structure and function of cells in different body tissues is due to

expression of tissue-specific genes.

Information parents should be given about the consequences of PKU includes

failure to avoid phenylalanine results in progressive mental retardation.

The spleen is an important defense against infection, because it

filters the blood

An HIV-positive patient is hospitalized for evaluation of symptoms of progressive weakness, dyspnea, weight loss, and low-grade fever. A biopsy of lung tissue reveals Pneumocystis carinii pneumonia. This diagnosis means that the patient

has AIDS.

The cardiac drug digitalis enhances myocardial contraction, because it

increases intracellular calcium level in cardiac cells.

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

Activation of the complement cascade results in (Select all that apply.)

inflammation. chemotaxis

Reperfusion injury to cells

involves formation of free radicals.

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

is malignant

The primary function of eosinophils is to

kill parasitic helminths (worms).

Necrotic death of brain tissue usually produces _____ necrosis.

liquefactive

Dramatic hypotension sometimes accompanies type I hypersensitivity reactions, because

massive histamine release from mast cells leads to vasodilation.

Drug resistance of microbes occurs secondary to

mutation of the microbe.

The term used to describe fungal infections is

mycoses.

Renal insufficiency is a common complication of which disease?

myeloma

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

negative; negative; positive

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

norepinephrine.

Breast cancer in women who have the breast cancer gene

occurs at an earlier age

The membrane attack complex formed by complement is similar in function to

perforin

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

primary prevention

Transfusion reactions involve RBC destruction caused by

recipient antibodies.

Carbon monoxide injures cells by

reducing oxygen level on hemoglobin.

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

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

selective IgA.

The clinical latency period after HIV infection is a time when no

significant symptoms of immunodeficiency occur.

Autologous stem cell transplantation is a procedure in which

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

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

subclinical

Functions of B cells include

synthesizing antibodies.

Ribosomes are very important organelles within the cell that have the function of

synthesizing proteins

The resting membrane potential in nerve and skeletal muscle is determined primarily by

the ratio of intracellular to extracellular potassium ions.

A patient receiving zidovudine and a protease inhibitor to manage HIV infection is found to have an undetectable viral load. This means that the

therapy is effective.

The primary function of kinins is

vasodilation to enhance inflammation.

All the following stress-induced hormones increase blood glucose except

A. aldosterone. ( answer ) b. cortisol. c. norepinephrine. d. epinephrine.

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

A. allostasis. ( answer) b. resistance. c. alarm. d. exhaustion.

Which statement best describes the etiologic development and transmission of AIDS?

AIDS is caused by a retrovirus and transmitted through body fluids.

A 5-year-old patient's parents report loss of appetite and fatigue in their child. The parents also state that the child refuses to walk due to pain. The child's most likely diagnosis is

ALL (acute lymphoid leukemia)

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

CD4 proteins on helper cells.

Which form 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.

The cellular component that is most susceptible to radiation injury is the

DNA

Which statement about HIV testing is correct?

Significant exposure to infected blood or body fluids requires HIV testing.

Which viruses have been implicated as cancer-causing agents? (Select all that apply.)

a. Epstein-Barr b. Human T-cell leukemia c. Human immunodeficiency

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 .e. Sweats

Characteristics of immunization include which of the following? (Select all that apply.)

a. Giving injections of preformed antibodies provides immediate immunity d. Herd immunity controls disease without immunizing everyone in the population e. Lack of immunization may lead to an epidemic

The CDC defines three CD4+ T cell categories of T cell ranges. Which values are correct? (Select all that apply.)

a. In category 1, the CD4+ T cell count is greater than or equal to 500/ml. c. In category 2, the CD4+ T cell counts range from 200 to 499/ml. d. In category 3, the CD4+ T cell count is less than 200/ml.

Which drugs are used for the management of HIV? (Select all that apply.)

a. Nucleoside reverse transcriptase inhibitors c. Protease inhibitors d. Nonnucleoside reverse transcriptase inhibitors

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 e. Monoclonal antibody therapy

Which modes of transmission occur with HIV infection? (Select all that apply.)

a. Sexual transmission b. Parenteral transmission d. Perinatal transmission to fetus

Characteristics of stem cells include that they (Select all that apply.)

a. may differentiate into any type of cell. c. have greater capacity to proliferate than more differentiated cells. d. are dependent upon environmental cues for proliferation. e. can die in the absence of an appropriate environment.

The mononuclear phagocyte system consists of (Select all that apply.)

a. monocytes and tissue macrophages. b. dendritic cells.

Passive immunity is provided by (Select all that apply.)

a. transfer of preformed human antibodies. b. injection of human immune globulin. c. injection with preformed animal antibodies.

10. Risk of infection is increased in (Select all that apply.)

a. use of corticosteroids. b. diabetes mellitus. c. spleen removal. e. stress

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).

Burkitt lymphoma is most closely associated with

Epstein-Barr virus.

Which type of HIV virus causes most infections in the United States and Europe?

HIV type 1

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

Seasonal allergic rhinitis is most involved in type ____ hypersensitivity reactions.

I Seasonal allergic rhinitis is most involved in type I hypersensitivity reactions.

Anaphylaxis may occur in certain hypersensitivity reactions, including type (Select all that apply.)

I. II.

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

III

The hypersensitivity reaction that does not involve antibody production is type

IV

Characteristics of cellular differentiation include which of the following? (Select all that apply.)

a. Specialization for different functions c. Influenced by memory of developmental events d. Dependent on cell-to-cell coordination e. Generally not reversible

In which type of cells is the CD4 found? (Select all that apply.)

a. T cells b. Microglial cells c. Retinal cells d. Cervical cells

The patient is a 12-year-old boy with acute lymphoblastic leukemia (ALL). Manifestations of the patient's leukemia prior to treatment may include (Select all that apply.)

a. anemia. b. leukocytosis. d. thrombocytopenia.

Side effects of chemotherapy include (Select all that apply.)

a. anemia. b. nausea. d. bleeding. e. infections.

Functions of antibodies include (Select all that apply.)

a. antigen agglutination. b. antigen precipitation. c. opsonization. e. complement activation.

A patient is diagnosed with hairy cell leukemia. The patient's lab results would most likely indicate a decrease in (Select all that apply.)

a. granulocytes. b. platelets. c. RBC

The HIV nurse educator teaches a newly diagnosed patient about HIV. The nurse educator tells the patient that in the United States, those at greatest risk of HIV infection include (Select all that apply.)

b. heterosexual women. c. homosexual men.

Functions of T cells include (Select all that apply.)

b. secreting cytokines. c. killing antigen-presenting cells. d. stimulating of B cells. e. killing virally infected cells.

The Philadelphia chromosome is a balanced chromosome translocation that forms a new gene called

bcr-abl.

Active immunity involves (Select all that apply.)

d. vaccines with dead or altered organisms. e. active infections.

Leukocytosis with a "shift to the left" refers to

elevated immature neutrophils.

An infectious disease that is common in a community is termed

endemic.

An important mediator of a type I hypersensitivity reaction is

histamine

Myasthenia gravis is a type II hypersensitivity disorder that involves

impaired muscle function

Which clinical finding is most indicative of an acute bacterial infection?

increased (band) neutrophils.

The effects of histamine release include

increased vascular permeability.

The term infectivity is defined as the ability to

invade and multiply

Results of biochemical tests indicate an infant has phenylketonuria (PKU). The parents ask what PKU means. Correct responses would include all the following except PKU

a. is an enzyme deficiency resulting in the inability to metabolize phenylalanine. b. is an inborn error of metabolism. c. results from a chromosome abnormality called nondisjunction. (answer) d. is transmitted as an autosomal recessive disorder.

The cellular change that is considered preneoplastic is

dysplasia.

Your patient eats "lots of fat," leads a "stressful" life, and has smoked "about two packs a day for the last 40 years." Her chronic morning cough recently worsened, and she was diagnosed with a lung mass. The most likely contributing factor for development of lung cancer in this patient is

cigarette smoking.

In DNA replication DNA polymerase functions to (Select all that apply.)

d. match appropriate bases to the template base. e. proofread the newly developed DNA for errors in base pairing.

In general, with aging, organ size and function

decrease

Aldosterone may increase during stress, leading to (Select all that apply.)

decreased urinary output. increased sodium retention. decreased blood pressure.

Of the statements below, the accurate statement regarding nutrition and cellular health is

deficient cellular uptake by one cell type may contribute to excess nutrient delivery to other cell types.

The parents of a child with PKU are concerned about the risk of transmitting the disorder in future pregnancies. The correct assessment of the risk is

each child has a 25% chance of being affected.

Repolarization of a neuron after a depolarizing action potential is due to

efflux of potassium.

A disease that is native to a particular region is called

endemic

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

endocrine

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

hypopolarize the resting membrane potential.

When the cause is unknown, a condition is said to be ________.

idiopathic Many diseases are idiopathic in nature.

The effects of excessive cortisol production include

immune suppression.

The cellular response indicative of injury due to faulty metabolism is

intracellular accumulations.

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

kill rapidly dividing cells.

During conditions of prolonged insufficient oxygen availability (e.g., respiratory or cardiovascular disease) anaerobic glycolysis accumulated pyruvate can lead to _____ acidosis.

lactic Pyruvate is converted to lactate and released into the blood stream, resulting in lactic acidosis.

Cystic fibrosis is a single gene disorder that primarily affects

lungs and pancreas.

The primary factor associated with risk of Down syndrome is

maternal age

The effect of stress on the immune system

may involve enhancement or impairment the immune system.

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

mitochondria.

Ion channels open and close in response to all the following except

temperature changes.

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

tertiary prevention

A fetus is most vulnerable to environmental teratogens during

the first trimester.

Allostasis is best defined as

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

Which is not normally secreted in response to stress?

Insulin

An important difference between skeletal and cardiac muscle is that

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

The phase of cellular metabolism in which energy is released during breakdown of nutrient sources is ________.

catabolism Catabolism involves energy release via breakdown of nutrient sources such as glucose to provide ATP to the cell. In contrast, anabolism refers to energy-using processes that result in complex molecules such as fats.

A patient with metastatic lung cancer wants to know her chances for survival. Which response is correct?

"Lung cancer has about a 15% survival rate."

Approximately what percentage of the human DNA chromosomes code for proteins?

1%

A point mutation

Males are more likely than females to be affected by ________ disorders.

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.

GTP-binding proteins (G proteins) function to

activate intracellular enzyme systems.

Malignant neoplasms of epithelial origin are known as

carcinomas

The primary effect of aging on all body systems is

decreased functional reserve.

Some individuals inherit a gene that results in dangerously high blood cholesterol due to impaired ________ of low-density lipoproteins (LDLs).

endocytosis The defective gene inhibits the synthesis of LDL protein receptors on the cell membrane. This impairs endocytosis of LDL. High levels of LDL in the blood predispose to atherosclerosis.

The benefit of glycolysis is that this phase supplies

pyruvate to the citric acid cycle.

Gap junctions are connecting channels that allow passage of small molecules from one cell to the next and are especially important for

tissues requiring synchronized function.

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

tumor necrosis factor.

HIV replicates very quickly from the onset of infection. What is the major site of HIV replication?

GI tract

An effective HIV vaccine is difficult to produce, primarily because

HIV mutates frequently.

The principle Ig mediator of type I hypersensitivity reactions is

IgE.

Which HIV-positive patient should be given a diagnosis of AID

One who has Mycobacterium tuberculosis

The most common tumor suppressor gene defect identified in cancer cells

P53

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

Pain in long bones, infection, fever, bruising

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

Systemic lupus erythematosus

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

a.gender difference. b.situational factors. c.normal variation. e.illness

A characteristic of some bacteria is

contains cell wall endotoxin

The "classical pathway" for activation of the complement cascade is triggered by

d. antigen-antibody complexes.

A nurse who works in an assisted living facility is preparing to teach the residents about safe sex practices. What resident criteria should the nurse take into consideration when creating a teaching plan? (Select all that apply.)

Age b. Ethnicity c. Culture d. Sexual preference

A diagnostic laboratory finding in myeloma is

Bence Jones proteins in the urine.

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. e. kidneys.

A patient presents to the clinic with flu-like symptoms and a rash. The nurse knows that the type of rash associated with HIV may include (Select all that apply.)

a. maculopapular. b. vesicular. d. urticarial.

Dietary zinc is an important defense against infection, because it maintains (Select all that apply.)

a. natural killer cell function. b. lymphocyte activity. d. neutrophil activity. e. complement activity.

A patient is diagnosed with stage IIA Hodgkin disease. This patient's clinical stage was most likely determined by (Select all that apply.) d. CT scan.

a. patient history. d. CT scan. e. physical examination.

Characteristics of telomerase include (Select all that apply.)

a. repairs the end caps of chromosomes. b. contributes to cancer cell immortality. d. activity allows a cell to replicate indefinitely.

Characteristics of complement include (Select all that apply.)

a. stimulating chemotaxis. b. lysing target cells. c. having multiple plasma proteins. e. enhancing phagocytosis.

Secondary immune deficiency problems may be caused by (Select all that apply.)

a. surgery. b. high blood sugar. c. corticosteroids. e. low protein level.

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

activity restriction.

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

acute phase proteins

The only known curative treatment for CML is _____ bone marrow transplantation from a suitable donor.

allogeneic Allogeneic bone marrow transplantation from a suitable donor is the only curative treatment for CML.

Immunity to a specific organism can be determined by

antibody titer.

Opportunistic infections are a hallmark of HIV and AIDS. Which infections are considered opportunistic? (Select all that apply.)

b. Cytomegalovirus c. Candida albicans d. Pneumocystis carinii e. Clostridium difficile

Tumor markers (Select all that apply.)

b. are produced by normal cells. c. help determine cancer origin. d. help identify progression of cancer. e. include prostatic-specific antigen.

A patient is infected with the retrovirus HIV. The patient may have contracted HIV as it was transmitted via (Select all that apply.)

c. semen. d. cervical secretions.

Apoptosis is a process that results in cellular

death

Antigen-presenting cells function to

display foreign antigen on their cell surfaces bound to MHC.

The most common method of disease transmission is

droplet

In general, a cancer cell that is more tissue-specific differentiated is ____ (more/less) likely to be aggressive.

less The degree of tissue-specific differentiation predicts malignant potential. A lack of differentiated features in a cancer cell is called anaplasia, and a greater degree of anaplasia is correlated with a more aggressively malignant tumor.

Interleukin-1, interleukin-6, and tumor necrosis factor-α are inflammatory cytokines secreted by

macrophages

A primary effector cell of the type I hypersensitivity response is

mast cells

A 58-year-old woman is seen in the clinic for reports of severe back pain. Her chest X-ray demonstrates generalized bone demineralization and compression fracture. Blood studies demonstrate elevated calcium levels. The most likely diagnosis is

myeloma

As of 2010, _____ individuals worldwide have been infected with HIV infection.

nearly 35 million

Autoimmune diseases result from (Select all that apply.)

overactive immune function. failure of the immune system to differentiate self and nonself molecules.

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 Compression of the spinal cord is one of the two most serious oncology emergencies associated with non-Hodgkin lymphoma.

Retroviruses are associated with human cancers, including

Burkitt lymphoma.

Metaplasia is

the replacement of one differentiated cell type with another.

Coagulative necrosis is caused by

interrupted blood supply.

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

2 ATP and 2 pyruvate.

Which tissue type is categorized as epithelial?

Blood vessel endothelium

Calcium channel blocker drugs are often used to treat conditions associated with (Select all that apply.)

a. cardiac muscle. b. smooth muscle.

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

a. catecholamines. b. ACTH. c. glucocorticoids. d. immune cytokines.

Deficits in immune system function occur in cancer due to (Select all that apply.)

a. chemotherapy. b. cancer cells. c. cancer metastasis to bone marrow. e. malnutrition.

Protein synthesis involves (Select all that apply.)

a. direction from mRNA. c. nucleotide triplets. d. RNA polymerase. e. removal of introns from the DNA template.

Viruses differ from most bacteria in that they (Select all that apply.)

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

Infectious injury often results from (Select all that apply.)

a. exotoxins. b. endotoxins. c. self-destruction of cells. e. enzymes from white blood cells.

Characteristics of Marfan syndrome include that it (Select all that apply)

a. is a single-gene disorder. b. involves alterations in connective tissue. c. leads to skeletal and joint deformities. e. results in dangerous cardiovascular disorders.

Extreme cold injures cells by all the following except

a. ischemic injury from vasoconstriction. b. peripheral nerve damage from rebound vasodilation. c. decreased blood viscosity. ( answer) d. crystallization of cellular components.

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

a. producing exotoxins. b. producing endotoxins. c. producing destructive enzymes e. evoking an immune reaction.

Chronic activation of stress hormones can lead to (Select all that apply.)

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

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

achycardia. b. diaphoresis. c. increased peripheral resistance. D. pupil constriction. ( Answer)

Characteristics of X-linked (sex-linked) recessive disorders include

all daughters of affected fathers' being carriers.

Phospholipids spontaneously form lipid bilayers, because they are

amphipathic.

Proto-oncogenes

are normal cellular genes that promote growth.

Characteristics of smooth muscle include

being found in blood vessels.

Paraneoplastic syndromes in cancer involve excessive production of substances by multiple means. A common substance found in excessive amounts due to cancer paraneoplastic syndromes is

calcium

The nurse is swabbing a patient's throat to test for streptococcal pharyngitis. The nurse must understand that tests such as this differ in the probability that they will be positive for a condition when applied to a person with the condition; this probability is termed ________.

sensitivity The sensitivity of any test refers to the probability that the test will be positive when applied to a person with the condition and will not provide a false negative result. In contrast, specificity is the probability that a test will be negative when applied to a person who does not have a given condition.

C.Q. was recently exposed to group A hemolytic Streptococcus and subsequently developed a pharyngeal infection. His clinic examination reveals an oral temperature of 102.3° F, skin rash, dysphagia, and reddened throat mucosa with multiple pustules. He complains of a sore throat, malaise, and joint stiffness. A throat culture is positive for Streptococcus, and antibiotics have been prescribed. The etiology of C.Q.'s disease is

streptococcal infection.

Excitable cells are able to conduct action potentials because they have

voltage-gated channels.