Pathology CH 9,10, & 11 WK 2

Which symptom is commonly observed in infants with severe combined immunodeficiency disease?

Susceptibility to infection

Which of the following is NOT an example of our innate immunity? -T and B lymphocytes -Alveolar macrophages -Acute inflammation -Anatomical barriers

T and B lymphocytes

The DTaP vaccine protects against:

Tetanus, pertussis, and tetanus

What is the most common means of transmission of infectious diseases?

respiratory

Although John's medication reduces swelling and inflammation, he is complaining that it is hurting his stomach. Which enzyme is involved with the production of protective prostaglandins that help maintain the health of the gastric mucosa? -Lipooxygenase -Cyclooxygenase-1 -Cyclooxygebase-2 -Arachidonase

-Cyclooxygenase-1

Which organism releases a toxin that causes muscle paralysis?

Clostridium botulinum

A 50 year old female presents to the ER with profuse diarrhea. She was just in the hospital for an atypical pneumonia where she was given CIPRO or ciprofloxacin for an antibiotic. Since being home, she has had an uncontrollable diarrhea that is watery and foul smelling along with abdominal pain and swelling. What is the most likely cause of this diarrheal illness based on her history? -Clostridium difficile -Mycoplasma pneumonia -Pseudomonas aeruginosa -E. coli 0157: H7

Clostridium difficile

A nurse practitioner works in a college infirmary. Which reason does the NP identify for the incidences of Neisseria meningitides within the college population?

College living exists in close, crowded quarters

______________are inflexible shrinkages of wound tissue as the body closes the wound. -Keloids -Transudates -Contractures -Adhesions

Contractures

You believe John is suffering from poor wound healing and inflammation due to infection of the surgical wound site. This does not appear to be a long-term, or chronic, inflammatory response, but rather an acute response to an infectious agent. Thus, anti-microbial medications, rather than long-term anti-inflammatory agents such ______________as are prescribed. -opioids -corticosteroids -beta blockers -analgesics

Corticosteroids

You have a 75 year old cachectic female patient as a patient in the nursing home you are working at. She has a stage 4 pressure ulcer along with hypertension, dementia and urinary incontinence. What is the BEST of the following orders to help in the healing and prevention of further pressure ulcers? -Keep systolic blood pressure below 90 mmg -A strict low calorie diet -Good control of blood sugar -Frequent repositioning of the patient

Frequent repositioning of the patient

Candida albicans -fungi or bacteria

Fungi: causes most opportunistic fungal infections. In mouth, "thrush", in vagina, "yeast infection".

Histoplasma capsulatum -Fungi or Protozoa

Fungi: endemic to Ohio valley. Most show no symptoms.

Pneumocystic jiroveci -Protozoa or Fungi

Fungi: opportunistic fungi affecting pulmonary system.

A 5 year old child is on your hospital ward with a fever of 102 degrees Fahrenheit, what is the BEST way to break the fever for this patient? -Give aspirin -Use an ice pack -Give acetaminophen or Tylenol(NSAIDS) -Place a cold wash cloth around child's neck

Give acetaminophen or Tylenol(NSAIDS)

Which of the following is NOT one of the 3 main stages of acute inflammation? -Vascular permeability -Systemic responses -Granulomatous changes -Cellular chemotaxis

Granulomatous changes

Which of the following statements about HIV is TRUE? -HIV is preventable by vaccination -We perform the Western blot analysis first then confirm with an ELISA test to diagnose HIV infection -HIV infection is called AIDS when the CD4 count is below 200 -Viral load testing is the first test used for screening a patient for HIV

HIV infection is called AIDS when the CD4 count is below 200

A 55 year old female wants to know her risk for having an MI in the next five years, what lab test would help to assess this patient's risk for coronary artery disease and atherosclerosis? -CBC or complete blood count -C-peptide -ESR or everything sedimentation rate -HS-CRP or high sensitivity C reactive protein

HS-CRP or high sensitivity C reactive protein

Which of the following cells is able to proliferate or undergo mitosis?

Hepatocytes (main function cell of liver and can regenerate)

Allergies and anaphylactic shock are two types of ___________disorders?

Hypersensitivity

Most infections are viral as they are the most common pathogen and are usually self-limiting, but sometimes this can lead to a bacterial infection as it weakens the immune system just enough for a bacteria to slip in. A patient presents with an infection, when should you NOT initiate antibiotic therapy or any treatment for this patient and still should wait?

If the patients natural barriers or innate immunity failed

Which immunoglobulin is found most abundant in sweat and tears? -IgA -IgG -IgE -IgM

IgA

Which is the most common primary immunodeficiency?

IgA deficiency

A 27-year-old patient is pregnant. The blood group of the patient and the fetus are incompatible. Which antibodies produced by the mother against the fetus's blood cells do not affect the fetus as they are too large to cross the blood-brain barrier?

IgM or immunoglobulin M

The first stage of an infectious disease in which the microbe is present but symptoms have not appeared.

Incubation

You inform John that you are not surprised his wound is healing slowly. Which of the following is the most important cause of delayed healing? • Poor surgical technique • Infections • Too much protein in the diet • Adequate oxygen delivery to the injury area

Infections

A nurse practitioner is assessing four patients who are suspected of having systemic lupus erythematosus. Which patient does the NP recognize as having developed the disease?

Patient 1

The Tap vaccination helps to immunize against all of the following pathogens EXCEPT: •Pertussis •Diphtheria •Polio •Tetanus

Polio

One of John's reasons for visiting the clinic today is that he has begun dating someone who is HIV negative. He and his partner are interested in learning more about pre-exposure prophylactic mediations. Which medication is John asking about?

PrEP: pre-exposure prophylaxis antiretroviral medication.

Primary immunodeficiencies are ____________?

Present at birth

Which of the following microorganisms causes bovine spongiform encephalopathy and variant Crutzfeldt-Jakob disease also known as "mad cow disease"?

Prions

Giardia lamblia -virus or Protozoa

Protozoa: affects humans and mammals like cattle, sheep and beavers. Occurs from drinking water contaminated with cysts.

Entamoeba histolytica -Protozoa or bacteria

Protozoa: infection of intestines. Severe damage of intestinal wall may occur.

Plasmodium falciparum -virus or Protozoa

Protozoa: responsible for devastating protozoal disease; malaria.

Which of the following is NOT a classic sign of inflammation? -Loss of function -Redness -Purulence -Heat

Purulence

Question 3 of 5 Which chemical resets the hypothalamic thermostat, causing fever? • chemotaxis • histamine • platelet-activating factor • pyrogen

Pyrogen

John's body temperature is slightly elevated. You know that fevers are a common sign of infection caused by _____________ chemical signals that reset the hypothalamic thermostat. -Chemotaxis -Leukotrienes -Pyrogens -Histamine

Pyrogens

Which autoimmune condition causes the appearance of shiny, stretched skin on the hands and face?

Scleroderma

A patient has a systemic (all over the body) bacterial infection of unknown origin with no specific area of infection identified by imaging studies. You need to know what bacteria is causing this sepsis, what would be the BEST method to determining the bacterial cause?

Serological testing

You have a severely septic patient in the ICU and cannot find the source of infection. Which of the following labs would be most helpful to identify the specific pathogen if all cultures have been negative thus far? -CBC with diff -Serology testing -ESR or erythrocyte sedimentation rate -Random cultures

Serology testing

Where would you find labile cells or cells that constantly regenerate?

Skin

John states he heard somewhere that some individuals cannot get the HIV infection. What would you tell him as the clinician?

Some individuals lack a receptor, CCR5, which prevents HIV from infecting their CD4 cells. These people are known as "HIV resistors."

Which statement is BEST regarding nutrients needed for wound healing? -"Adding zinc to the diet will help prevent wound infection." -"Consuming adequate amounts of protein will improve wound healing." -"Taking vitamin K will reduce the risk of decubitus ulcers." -"Consuming dairy products will encourage rapid wound healing."

"Consuming adequate amounts of protein will improve wound healing." (The most essential to wound healing and patient may require supplements)

Which statement below is NOT CORRECT or INCORRECT about C-reactive protein or CRP? O "It stimulates gastric mucus production." O "It prevents white blood cell (WBC) adhesion to endothelium." O "It stimulates other inflammatory cytokines." O "It identifies the presence of foreign material in the immune system."

"It identifies the presence of foreign material in the immune system." CRP is produced by the liver in response to inflammation, infection or tissue damage.

A registered nurse is teaching nursing students about passive acquired adaptive immunity. She shows the students, a patient who received convalescent plasma therapy for COVID-19 infection and is now doing better in the ICU. Which statement is NOT CORRECT or INCORRECT about passive acquired adaptive immunity? O "It provides immediate immunity." O "It is the same as receiving a vaccine." O "It is a short-term immunity." O "It is not associated with immunologic memory."

"It is the same as receiving a vaccine."

Which of the following statements is TRUE regarding medications that delay wound healing? -"Amitriptyline, an antidepressant, delays the healing process." -"Acetaminophen, an anti-inflammatory, delays the healing process." -"The injected corticosteroid delays the healing process." -"Naproxen, an NSAID, delays the healing process."

"The injected corticosteroid delays the healing process.

Poor wound healing would occur in all the following EXCEPT: -A young child or infant -A person using corticosteroids -A person with nutritional deficiencies -A person with poor circulation

-A young child or infant

Which data below is an example of serological testing? -Detecting the microorganism's genetic material using PC -Antibody titers and levels of immunoglobulin from a blood sample -Analyzing for cell changes using a microscope -Identifying for the presence of an antigen using a bacterial culture

-Antibody titers and levels of immunoglobulin from a blood sample

Which is a predisposing factor that can cause and infection with Pseudomonas aeruginosa while as a patient in the hospital? -Chronic urinary tract catheterization by Foley catheter -Hospital food -Hospital linens and towels -Nebulizer use

-Chronic urinary tract catheterization by Foley catheter

To reduce pain and swelling, John had been taking an anti-prostaglandin medication. Which enzyme is involved in the formation of prostaglandins associated with pain and swelling? -Lipooxygenase -Cyclooxygenase-1 -Cyclooxygebase-2 -Arachidonase

-Cyclooxygebase-2

John is a 34-year-old homosexual man diagnosed with HIV 2 years ago. He has come to your office for a follow-up appointment and has several concerns he would like addressed.Before his current appointment, you requested John have blood drawn to assess how the current regimen of medications has been working. What factors are you checking? Select all that apply. •HIV viral load •HIV antibody levels •Antibodies for CD4 cells •CD4 number •CD4:CD8 rat

-HIV Viral load(measure how much virus is in the blood) -HIV antibody levels(produced in response to infection) -CD4 numbers(infected by virus so levels are crucial) -CD4:CD8 ratio(due to inversion)

You want to speak to John about behaviors that may increase the risk of transmission of HIV to others. Which of the following are behaviors that increase the risk of transmission of HIV? Select all that apply.

-Intravenous (IV) drug use with needle sharing -Unprotected sexual activity -Male-to-male sex -Anal intercourse

Inflammation does all of the following EXCEPT: -lowers pH -Dilutes toxins -warms the area -decreases rubor or redness

-decreases rubor or redness

John wants to know how long after unprotected sex someone needs to wait before being sure he has not been infected with HIV. What is the normal time frame for seroconversion for HIV?

2 weeks to 6 months: amount of time to show seroconversion or appearance antibodies in blood in response to HIV. After formation the person is considered seropositive.

While assessing the vital signs of an adult patient, the nurse records a blood pressure of 130/85 mm Hg and body temperature as 103°F. Given the treatments below, which one is the BEST for reducing fever?

Administer aspirin (no danger of Reye's syndrome in adults)

Coccidiomycosis is an airborne disease known as valley fever. How is this disease transmitted?

Airborne spores from soil

Which component enables the blood vessels to dilate and become more permeable during the vascular phase of inflammation (increase vascular permeability)? •Platelet activating factor •Kinins •Histamine

All

Which of the following are associated with inflammation? Select all that apply. -Swelling -Increased blood flow -Increased vascular permeability -Redness -Warmth

All of the above

Which of the following cells are not created in the thymus? -CD8 cells -CD4 cells -B cells -T cells

B cells (made in bone marrow)

Lyme disease presents with a bullseye rash after being bitten by an infected tick. What type of pathogen is transmitted?

Bacteria called borrelia burgdorferi

Haemophilis influenzae -Bacteria or Virus

Bacteria: H. Influenza is a bacterium, not causative of seasonal flu. Causes ear infections and meningitis.

MSRA (methicillin-resistant staphylococcus aureus) -Virus or Bacteria

Bacteria: bacterial infection. Resistant to several antibiotics

Streptococcus pyogenes -virus or bacteria

Bacteria: causes bacterial infection referred to as "step throat". May progress into scarlet fever or cause rheumatic heart disease(inflammation of heart, blood vessels and joints) and glomerulonephritis(inflammation of tiny filters in kidneys)

Vibrio cholerae -Bacteria or virus

Bacteria: causes cholera marked by "rice water" stools. These patients may lose up to 1 liter of fluid per hour from disrupted intestinal absorption.

Clostridium botulinum -Bacteria or fungi

Bacteria: neurotoxin release from this bacteria causes botulism. Causes muscle flaccidity and paralysis. Toxin is also used to manage some medical conditions.

A patient reports fever and shortness of breath and is diagnosed with pneumonia. A complete blood count with differential shows a white blood count of 16,000 cells/mL with 90% neutrophils, 1% eosinophils, and 1% basophils. Which specific condition has the patient developed?

Bacterial pneumonia

Which WBC is primarily responsible for the release of histamines?

Basophils

Severe combined immunodeficiency affects ________?

Both B and T cells.

Which cell type does the human immunodeficiency virus infect?

CD4 Cells: it's binds to and replicates within cell. May lay dormant until replication occurs.

The main reason John has come to the clinic today is he is fearful he may have AIDS. What criteria make the diagnosis of AIDS?

CD4 less than 200

A patient with scleroderma has painful hard deposits on their fingers, what is the diagnosis? -Esophageal dysmotility -Raynaud's disease -Calcinosis -Telangiectasia

Calcinosis

Which term refers to the release of chemicals that dispatch white blood cells and platelets to areas of injury? -Stricture -Contracture -Chemotaxis -Phagocytosis

Chemotaxis

In addition, mediators of inflammation, including C-reactive protein (CRP) and _____________were shown to be elevated. -PT -ALT -ESR -AST

ESR

Which virus is a severe hemorrhagic virus, spread by person to person blood or body fluid contact, a member of the family of filoviruses, and has high virulence with mortality rates up to 90%?

Ebola

Which lab result would be most likely TRUE if a patient has SLE or systemic lupus erythematous? -Elevated CRP or C-reactive protein -Negative ANA or antinuclear antibody -Decreased ESR or erythrocyte sedimentation rate -Urinalysis with positive ketones

Elevated CRP or C-reactive protein

When you examine the wound, you note the appearance of redness and warmth. Fluid appearing to contain cells and proteins, known as ____________ , is seeping from the edges of the wound. -Eschar -Abscess -Exudate -Transudate

Exudate

T/F: All patients with HIV have AIDS

False

T/F: Patients with suspected hypogammaglobulinemia can be tested for this disease immediately after birth.

False

What pathogen caused the Spanish flu of 1918?

Influenza virus

Which of the following statements about Fifth disease is CORRECT? -It is caused from giving children aspirin -It is the leading cause of renal failure in children -It is deadly and has a high mortality -It is caused by Parvovirus B-19

It is caused by Parvovirus B-19

Increased epithelial formation may result in scars or -fever -acute inflammation -purulent exudate -keloid formatation

Keloid formation

Laboratory analysis of John's blood reveals an elevated white blood cell count of 12,000 cells per microliter, known as ____________ -Leukemoud reaction -Neutropenia -Leukocytosis -Leukopenia

Leukocytosis

Which of the following inflammatory mediators is NOT a pyrogen (causes fever)? -Interleukins -Leukotrienes -Prostaglandins -TNF-alpha

Leukotrienes

Which is the most devastating protozoal disease worldwide?

Malaria

Which of these cells contain cytoplasmic granules, but are not considered typical granulocytes and are the first-line of defense and are considered part of the innate immune system, they also can kill tumor cells and viral infected cells without any previous exposure?

Natural killer cells

If John's partner were to be interested in pre-exposure medication, what is the means by which this medicine is taken?

Once daily in pill form.

You are the attending physician on the ward and are speaking to four medical students about the use of COVID-19 monoclonal antibody therapy IV infusions for COVID-19 patients. Which of the students below is CORRECT in their statement about this therapy? -This therapy exposes the patient to an antigen so they can make their own antibodies actively -This therapy is an example of passive immunity -This therapy is like getting the COVID vaccine and lasts a very long time -This therapy is an example of active immunity

This therapy is an example of passive immunity

John is wondering which diseases he may get if he does have AIDS. Which of the following are opportunistic infections associated with AIDS? Select all that apply.

Toxoplasmosis, pneumocystis pneumonia and tuberculosis.

A patient comes to the urgent care center with a very pruritic rash on their legs. They had just been hiking in a forest three days ago and it appeared recently. Which type of hypersensitivity reaction does this BEST describe? -Type 4 -Type 3 -Type 1 -Type 2

Type 4

A 45 year old male presents with symptoms of pneumonia and on CBC, the differential of the WBCs show mostly lymphocytes known as lymphocytosis, what is the likely cause of this man's pneumonia? -Virus -Parasite -Bacteria -Fungus

Virus

Which of the following organisms CANNOT replicate on their own without a host cell? -Fungus -Bacteria -Virus -Candida

Virus

Varicella Zoster -Virus or Protozoa

Virus (herpesvirus that causes chickenpox and shingles)

Rubella -Virus or bacteria

Virus: German measles, can be transmitted to developing fetus resulting in birth defects. MMR vaccine provided as protection.

Herpes simplex -Virus or fungi

Virus: has two forms; type 1 (HSV-1) and type 2 (HSV-2). Estimated 75 to 95% if worlds population is infected with either HSV-1 or HSV-2.

Influenza -virus or bacteria

Virus: seasonal flu. Also present in birds and swine.

Which component of the blood performs phagocytosis with surrounding and consuming foreign material?

White blood cells

Streptococcus pneumonia is BEST described as? -Gram negative diplococci -Gram negative rods in clusters -Gram positive diplococci -Gram negative cocci in chains

• Gram positive diplococci

Cholera is a bacterial infection that causes profuse, watery diarrhea. What is the primary vector of disease transmission?

• Ingesting food/water contaminated by the feces of an infected person

Which of the following statements is NOT TRUE about chronic mucocutaneous candidiasis (CMCC)? •CMCC is a disease in which patients develop persistent, non-invasive Candida infections of the skin, mucous membranes, and nails as well as autoimmune endocrine disorders. •The only definitive laboratory test for the diagnosis of CMCC is the genetic analysis of relevant genes. •Only a C-reactive protein test is used to diagnose chronic mucocutaneous candidiasis. •80% of CMCC cases present in children younger than 3 years of age and usually with oral thrush or Candida dermatitis as well as autoimmune endocrine disorders.

• Only a C-reactive protein test is used to diagnose chronic mucocutaneous candidiasis.

An older female patient presents with a simple UTI and is given an antibiotic and gets better, but then represents to your clinic a few days later, this time with symptoms of vaginal candidiasis or infection of the vagina with candida, a fungus. She is now given an antifungal medication and this improves her symptoms. Why did this happen?

• The antibiotic for the UTI killed off Lactobacillus in the vagina which was a normal flora and allowed the candida to colonize new areas.