Patho Exam 3

Improvement in a patient with septic shock is indicated by an increase in

systemic vascular resistance

Atherosclerosis predisposes to a number of processes that are factors in myocardial ischemia. These processes include

thrombus formation.

The effect of nitric oxide on systemic arterioles is

vasodilation

A loud pansystolic murmur that radiates to the axilla is most likely a result of

mitral regurgitation.

Hypotension associated with neurogenic and anaphylactic shock is because of

peripheral pooling of blood.

Atherosclerotic plaques with large lipid cores are prone to

rupture

The uncontrolled hormone production in acromegaly and gigantism is most often the result of

benign somatotropic tumor in the pituitary gland

Copious amounts of foul-smelling sputum are generally associated with

bronchiectasis

In extrinsic asthma the immune system responds to the presence of allergens by causing

bronchoconstriction

Growth hormone-deficient infants would display

normal birth length and weight

Activation of the renin-angiotensin system in shock causes

fluid retention.

Myocardial cells are connected by gap junctions enabling them to

function as a coordinated syncytium

In primary thyroid hormone deficiency, the TSH levels are

high

In contrast to all other types of shock, the hyperdynamic phase of septic shock is associated with

high cardiac output.

The major wave complexes of an ECG include the (Select all that apply.)

A. P wave. D. QRS complex. E. T wave.

Positive inotropic drugs work by increasing (Select all that apply.)

A. contractility. B. cardiac output. C. tissue perfusion. D. myocardial oxygen demand.

Cardiac myosin has a high affinity for actin when the myosin has what molecule(s) bound to it?

ADP and phosphate

Which pathogenetic change is associated with acute bronchitis? (Select all that apply.)

B. Swelling from exudation of fluid D. Loss of ciliary function E. Inflamed airways

Which is a normal excitation pathway? (Select all that apply.)

A. AV node B. SA node D. Bundle of HIS E. Purkinje Fibers

Insulin resistance during pregnancy is precipitated by which hormone? (Select all that apply.)

A. Human chorionic somatomammotropin D. Estrogen E. Cortisol

Ketoacidosis results in which of the following? (Select all that apply.)

A. Increase in hormonal levels of cortisol B. Continued insulin deficiency C. Accumulation of fatty acids

Acute bronchitis can be caused by which of the following? (Select all that apply.)

A. Influenza A B. Adenovirus C. Coxsackie virus E. Streptococcus pneumoniae

Which is true about epiglottitis? (Select all that apply.)

A. Is usually caused by H. influenzae type B B. Can be caused by bacterial infection C. Usually occurs in children D. Is characterized by pain with swallowing

Which are clinical findings usually associated with type 1 diabetes mellitus? (Select all that apply.)

A. Polyuria B. Polydipsia C. Polyphagia

Electrical currents that travel through the heart are called vectors because they include (Select all that apply.)

A. direction. C. magnitude.

Diagnostic tests used to diagnose or confirm MI include (Select all that apply.)

A. electrocardiogram. B. cardiac catheterization. C. echocardiography. D. radionuclide scintigraphy.

Echocardiograms are used to help diagnose (Select all that apply.)

A. heart enlargement. B. valvular disorders. C. cardiac tumors. D. left ventricular motion abnormalities.

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 increased risk of coronary artery disease

Which physiologic change increases cardiac work but does not enhance cardiac output?

Increased afterload

Which is a true statement about the affect of the Frank-Starling law on the heart?

Increased diastolic stretching of myocardial fibers produces increased stroke volume

A patient with cold and edematous extremities, low cardiac output, and profound hypotension is likely to be experiencing a progressive stage of ________ shock.

Septic

Tachycardia is an early sign of low cardiac output that occurs because of

baroreceptor activity.

Diabetic neuropathy is thought to result from

decreased myoinositol transport

At very high heart rates, cardiac output

decreases.

Primary treatment for myocardial infarction (MI) is directed at

decreasing myocardial oxygen demands.

Oversecretion of ACTH occurs in

Cushing disease

When it is necessary for another substance to be produced through intermediate processes to serve as a catalyst for intracellular responses, the new substance is referred to as a

second messenger.

What is a major determinant of stroke volume? (Select all that apply.)

A. Preload B. Afterload D. Contractility

What portion(s) of the heart does the left anterior descending branch supply? (Select all that apply.)

A. Septal B. Apical C. Anterior

Which type of shock is characterized by generalized vasodilation and peripheral pooling of blood? (Select all that apply.)

A. Septic B. Neurogenic D. Anaphylactic

Individuals with diabetes mellitus are particularly susceptible to infections of which of the following? (Select all that apply.)

A. Skin B. Vagina D. Urinary tract

Syndrome of inappropriate antidiuretic hormone (SIAHD) secretion can be attributed to which of the following? (Select all that apply.)

B. Malignant lung disorders CD. Nonmalignant lung disorders

Which are complications of diabetes mellitus that are microvascular? (Select all that apply.)

B. Retinopathy C. Nephropathy

A standard ECG has 13 leads.

False

Which is a true statement regarding the mechanics of breathing?

Functional residual capacity is the air remaining in alveoli

What indicator is most helpful in evaluating long-term blood glucose management in patients with diabetes mellitus?

Glycosylated hemoglobin levels (HbA1c)

Which describes a pathologic manifestation of neurogenic shock?

Loss of sympathetic activation of arteriolar smooth muscle

What effect would adrenocortical insufficiency have on an individual's response to surgical stress?

More prone to hypotension

Which is an upper airway structure?

Oropharynx

Cortisol is produced in the zona ________ of the adrenal cortex.

Fasciculata

The therapies that would be appropriate for a patient with type 1 diabetes mellitus include (Select all that apply.)

A. carbohydrate counting. C. daily exercise. D. insulin.

Characteristics of asthma include (Select all that apply.)

A. chronic inflammatory disorder. B. airway hyperresponsiveness D. genetic susceptibility. E. airway remodeling

Acute coronary syndrome in the presence of thrombosis may present as (Select all that apply.)

A. unstable angina. B. MI. C. sudden cardiac arrest.

The v wave of an atrial pressure tracing corresponds to

atrial filling

The anatomic center of coordination and communication between nervous system and endocrine system is the

hypothalamus

Hypoventilation causes

hypoxemia

Constrictive pericarditis is associated with

impaired cardiac filling.

Macrovascular complications of diabetes mellitus include

ischemic cerebrovascular accidents

Abnormal vascular regulation by endothelial cells in small vessels of the heart contributes to

ischemic heart disease.

Changes in urine osmolality seen in syndrome of inappropriate antidiuretic hormone (SIADH) secretion cause

increased water retention without sodium.

Obstructive disorders are associated with

low expiratory flow rates

A thyroid gland that grows larger than normal is known as

goiter

A requirement for rhythmicity is that the cell membrane has channels that automatically open in phase 3.

False

A type of shock that includes brain trauma that results in depression of the vasomotor center is cardiogenic.

False

Disseminated intravascular coagulation is a serious complication of septic shock characterized by abnormal clot formation in the microvasculature throughout the body.

False

Lactated Ringer solution and normal saline are commonly used crystalloid solutions that contain electrolytes.

False

A patient reporting vision changes, photophobia, and lid lag may be exhibiting signs of

Graves disease

The signs and symptoms of adrenocortical hormone excess may occur from either a primary or secondary disorder.

Hyperglycemia

Some hormones are secreted in cyclic patterns. In these cases, which statement is true?

Immediate systemic needs can override cyclic patterns and modify hormone secretion.

Which complication of asthma is life threatening?

Status asthmaticus

Aldosterone secretion is regulated by the presence of ________ in the circulation.

angiotensin II

The origin of congenital adrenal hyperplasia occurs when circulating cortisol levels

are insufficient to provide negative feedback to the anterior pituitary gland

Steroids dissolve poorly in blood and require a transport protein (globulin) to convey them through the circulation because they

are lipid-soluble molecules.

It is true that Graves disease is

associated with autoantibodies to TSH receptors

After evaluation, a child's asthma is characterized as "extrinsic." This means that the asthma is

associated with specific allergic triggers

A clinical finding that is consistent with a diagnosis of adrenocortical insufficiency is

hypoglycemia

A laboratory finding that would help confirm the diagnosis of hyperaldosteronism is

hypokalemia

A clinical finding consistent with a diagnosis of syndrome of inappropriate ADH secretion (SIADH) is

hyponatremia

The pathology of syndrome of inappropriate antidiuretic hormone (SIADH) secretion, leading to dilution of serum and an excess of water relative to solute, produces

hyponatremia and swelling of cells and neural compression

A patient presenting with muscle cramps, fatigue, anxiety, depression, and prolonged Q-T intervals on EKG may be showing symptoms of

hypoparathyroidism

Surgical removal of a gland may result in

hyposecretion

To best prevent emphysema, a patient is instructed to stop smoking since cigarette smoke

impairs α1-antitrypsin, allowing elastase to predominate

Circulatory shock is best defined as

inadequate tissue perfusion.

An increase in serum osmolality would be expected to ________ secretion.

increase vasopressin

An increase in filtration of fluid from the pulmonary capillaries into the interstitium occurs with ________ pressure.

increased capillary hydrostatic

Insulin binding to its receptor on target cells results in

increased facilitated cellular diffusion of glucose

The shift to anaerobic metabolism in shock results in

increased lactate production.

Chronic bronchitis often leads to cor pulmonale because of

increased pulmonary vascular resistance

Secondary pulmonary hypertension is most often caused by

increased pulmonary vascular resistance.

The increased anterior-posterior chest diameter associated with obstructive lung disease is caused by

increased residual lung volumes

Up-regulation of target cell receptors results in

increased target cell responsiveness to hormone

Growth hormone has several effects on the body, including

increasing lean body mass

Propylthiouracil may be used to treat hyperthyroidism, because it

inhibits thyroid hormone synthesis.

The underlying pathogenic mechanism for type 2 diabetes is

insulin resistance and β-cell dysfunction

The formation of active vitamin D

is impaired in renal failure

It is true that the synthesis of thyroid hormones

is inhibited by iodine deficiency

An enlarged thyroid gland produces a colloid goiter when

lack of iodine prevents T4 and T3 but without stopping thyroglobulin formation

Radioactive iodine treatment is the therapy of choice in patients with Graves disease. The patient should be expected to

need lifelong thyroid replacement therapy

The most common mechanism regulating hormone production and secretion is

negative feedback

A description of the feedback mechanism implemented by the thyroid gland would state that

negative feedback occurs when low levels of circulating T3 and T4 trigger thyrotropin-releasing hormone to stimulate release of pituitary thyroid-stimulating hormone that then stimulates thyroid secretion of T3 and T4, resulting in rising levels that inhibit thyroid-stimulating hormone release.

The most significant regulator of antidiuretic hormone (ADH) release is

osmotic pressure of plasma

Calcitonin is produced by thyroid parafollicular cells and increases bone formation by

osteoblasts

What value is consistent with acute respiratory failure?

pH less than 7.3

The underlying pathogenic mechanism for type 1 diabetes is

pancreatic β-cell destruction

If annual development assessment shows a child to have growth hormone deficiencies, treatment alternatives include

pharmacologic agents that affect growth hormone secretion

A tumor which results in excessive production and release of catecholamines is

pheochromocytoma

An example of a secondary endocrine disorder is

pituitary hyposecretion of TSH

Blood is transported from the right ventricle to the lungs by the

pulmonary artery

Virchow's triad can result in

pulmonary embolus

When preparing for the admission of a client diagnosed with bronchiectasis, the nurse will

put a sputum cup and a box of tissues on the bedside table

Primary pulmonary hypertension is

rapidly progressive

The hypersecretion of mucus resulting for chronic bronchitis is the result of

recurrent infection

Early compensation for hypovolemic shock includes

release of epinephrine from adrenal glands.

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

release of proteolytic enzymes from immune cells

The amount of gas remaining in the lungs after a maximal expiration is called the

residual volume.

In type I diabetes, respiratory compensation may occur through a process of

respiratory alkalosis

The central chemoreceptors for respiratory control are

responsive primarily to changes in pH and CO2.

Clinical manifestations of hypoparathyroidism

result from decreased serum ionized calcium.

Diabetes insipidus is a condition that

results from inadequate ADH secretion

It is true that growth hormone excess in adults

results in the condition of acromegaly.

Microvascular complications of diabetes mellitus are seen in

retinopathy and nephropathy

The most common cause of chronic bronchitis is

smoking

Autonomic nervous system stimulation effects on the respiratory system include

sympathetic stimulation relaxes bronchial smooth muscle

Most of the carbon dioxide in blood is

transported as bicarbonate.

A clinical finding consistent with a hypoglycemic reaction is

tremors

The pathophysiology of gestational diabetes mellitus most closely resembles that of

type 2 diabetes

Current views about the target group and frequency of screening for diabetes are based on concern for the high prevalence in the adult population of

undiagnosed type 2 diabetes mellitus

Cells can increase their number of receptors in response to chronically low hormone concentrations, so that they are more sensitive to the hormone despite a lower than normal hormone concentration. This phenomenon is called

up-regulation

The vasoactive mediators released in septic shock contribute to increase

vascular permeability.

Areas of the lung that have little ventilation and thus little oxygen will cause the blood vessels of that area to

vasoconstrict

The R wave is responsible for apical depolarization.

False

An elderly patient's blood pressure is measured at 160/98. How would the patient's left ventricular function be affected by this level of blood pressure?

Left ventricular workload is increased with high afterload.

The majority of cardiac cells that die after myocardial infarction do so because of

apoptosis.

A vessel that normally contains desaturated (venous) blood is the

pulmonary artery

Which proteins are associated with the thin filament in the cardiac muscle? (Select all that apply.)

A. Actin C. Nebulin D. Troponin

Clinical manifestations of Graves disease may include

tremor

A patient with significant aortic stenosis is likely to experience

syncope.

The pulmonary structure that has the least pulmonary blood flow is

lung apex

During which phase of the cardiac cycle is the mitral valve normally open?

Atrial systole

Administration of which therapy is most appropriate for hypovolemic shock?

Crystalloids

What valve directs blood flow from the left atrium to the left ventricle?

Mitral

_________ is the hormone which causes uterine and milk duct contractions.

Oxytocin

A severely hypertensive patient presents with the classic triad of headache, tachycardia, and diaphoresis, and laboratory tests show excessive circulating catecholamine levels. Which rare, but treatable, disorder is suspected?

Pheochromocytoma

Which wave on the ECG is representative of depolarization of the lateral walls?

S wave

What compensatory sign would be expected during periods of physical exertion in a patient with limited ventricular stroke volume?

Tachycardia

Patients presenting with symptoms of unstable angina and no ST segment elevation are treated with

antiplatelet drugs.

Tetralogy of Fallot is characterized by which of the following? (Select all that apply.)

A. A ventricular septal defect B. Right ventricular hypertrophy D. Obstructed right ventricular outflow E. An aorta positioned above the ventricular septal opening

Mitral stenosis is associated with

a pressure gradient across the mitral valve

The echocardiogram is especially useful in the measurement of the

heart motion within the chest.

Septic shock is commonly associated with Gram-negative infections and Gram-positive organisms that enter the body through the (Select all that apply.)

B. genitourinary tract. C. gastrointestinal tract. D. respiratory tract. E. skin.

Inflammatory disorders that may alter endothelial cell function include (Select all that apply.)

B. lupus erythematosus. C. Kawasaki syndrome. E. polyarteritis nodosa.

The urinary signs and symptoms of acute renal failure associated with the progressive stage of shock are (Select all that apply.)

B. oliguria. D. increased serum creatinine.

The major factors that influence stroke volume are (Select all that apply.)

B. preload. D. contractility. E. afterload.

The American Diabetes Association recommends a postprandial blood glucose level of ________ mg/dL for adults with diabetes

less than 180

Allergic (extrinsic) asthma is associated with

IgE-mediated airway inflammation

When a client diagnosed with COPD type A asks, "Why is my chest so big and round?", the nurse responds that

"Loss of elastic tissue in your lungs allows your airways to close and trap air, which makes your chest round."

Which electrolyte is necessary for muscle contraction?

Ca2 + (calcium)

The tightness of the hormone-receptor bond is known as

affinity

Congenital adrenal hyperplasia (adrenogenital syndrome) results from

blocked cortisol production

Myxedema coma is a severe condition associated with

hypothyroidism.

All obstructive pulmonary disorders are characterized by

resistance to airflow

The progressive stage of hypovolemic shock is characterized by

tachycardia.

Compliance of the lung is the measure of

the lungs ability to be inflated

An example of a lipid-soluble hormone is

thyroid hormone

An increase in ADH secretion occurs in response to

dehydration

Creatine phosphate is

synthesized when ATP levels are high

The primary cause of sudden cardiac death is usually because of

ventricular dysrhythmia.

An example of an acyanotic heart defect is

ventricular septal defect.

Antidiuretic hormone (ADH) increases

water reabsorption in the collecting tubule of the kidney

Oral antidiabetic agents have been used with success

with dietary planning for type 2 diabetes

Rheumatic heart disease is most often a consequence of

β-hemolytic streptococcal infection.

Which is true about the mitral valve?

Allows blood to flow from the left atrium to the left ventricle

Gas exchange occurs in which of the respiratory system's structures?

Alveoli

Which is a true statement regarding the airways?

Cough receptors lie at the carina

Uncontrolled massive bleeding causes what type of shock?

Hypovolemic

What is the name of the structure of long hairs that filter air?

Vibrissae

Which lung zone has continuous perfusion throughout the cardiac cycle?

Zone 3

Hormones are synthesized within an endocrine organ's cell organelles with

hormone synthesis sometimes taking place in other organs or cell types

Cushing syndrome differs from Cushing disease in that the term Cushing syndrome is used only to describe

hypercortisolism manifestations, regardless of cause

An increase in intracellular calcium ion results in myocardial contraction, because calcium

binds troponin, causing actin-binding sites to be exposed

Shifts in the oxyhemoglobin dissociation curve represent the

changes in hemoglobin affinity for oxygen.

The major risk factor for the development of lung cancer is

cigarette smoking

Patent ductus arteriosus is accurately described as a(n)

communication between the aorta and the pulmonary artery.

Right-sided heart failure secondary to pulmonary hypertension is also called

cor pulmonale

A primary endocrine disorder occurs when

the target gland is unresponsive to pituitary regulation

Thyroid hormones are derived from

tyrosine amino acids

In the United States, nearly ________ people have diabetes mellitus.

29.1 million

The lungs are normally fully developed by what year of age?

8

Which person is at greatest risk for developing a pulmonary embolism?

A 67-year-old man with a deep vein thrombosis in the femoral vein

Dead space includes which of the following dimensions? (Select all that apply.)

A. Anatomic B. Alveolar C. Physiologic

Which clinical manifestation suggests epiglottitis? (Select all that apply.)

A. Assumes "sniffing dog" position C. Throat is "cherry red" D. Reports dysphagia E. Sounds hoarse

Which are major obstructive airway diseases? (Select all that apply.)

A. Asthma B. Bronchitis D. Emphysema E. Bronchiectasis

The purpose of the upper respiratory system is which of the following? (Select all that apply.)

A. Filtering of inspired gas B. Warming of inspired gas D. Humidification of inspired gas E. Conduction of air toward the alveoli

Which datum supports a diagnosis of compensatory metabolic alkalosis? (Select all that apply.)

A. History of diabetes C. Presence of an infection D. Deep, labored respirations

The portion of the brain that is responsible for neural control of the respiratory system is which of the following? (Select all that apply.)

A. Medulla oblongata E. Pons

A patient diagnosed with hormonal resistance can present with which assessment datum? (Select all that apply.)

A. No response to exogenous hormone replacement B. Lack of normal hormonal action C. Normal hormone levels D. Elevated hormone levels

The role of iodine in proper thyroid gland function relates to which of the following? (Select all that apply.)

A. Oxidation to iodide B. Coupling to molecular tyrosine D. Trapping of dietary iodine in thyroid cells

The secretion of the appropriate amount of free thyroid hormones in circulating body fluid is regulated by the feedback interaction between which hormone sources? (Select all that apply.)

A. Pituitary B. Hypothalamus D. Thyroid

Which condition presents a problem with lung diffusion? (Select all that apply.)

A. Pneumonia B. Pulmonary edema C. Interstitial lung disease

Which clinical manifestation differentiates myocardial infarction (MI) from angina pectoris? (Select all that apply.)

A. Radiating chest pain C. ST-segment changes on the ECG D. Elevated serum levels of troponin

The characteristics of bronchiolitis include which of the following? (Select all that apply.)

A. Thick, tenacious mucus B. Wheezing C. Crackles E. Ear pain

Hormonal cell receptors that influence intracellular activity are specific to hormone types and are located on which of the following parts of the cell? (Select all that apply.)

A. Walls B. Nuclei C. Cytoplasm

An acute asthma attack is associated with (Select all that apply.)

A. bronchoconstriction B. bronchial mucosal edema C. hypersecretion of mucus E. hypoxemia

Hormones that are released from the anterior pituitary gland include (Select all that apply.)

A. luteinizing hormone C. prolactin. E. follicle-stimulating hormone.

Structure(s) that engage in exchange of respiratory gases include(s) the (Select all that apply.)

A. trachea. B. bronchi. D. pulmonary capillaries. E. alveoli.

When assessing an individual during an acute asthma episode, you should expect to find (Select all that apply.)

A. use of accessory breathing muscles. B. expiratory wheezing D. coughing E. feeling of chest tightness

Which hormone is regulated by releasing and inhibiting factors from the hypothalamus?

Adrenocorticotropic hormone (ACTH)

A patient is diagnosed with cardiogenic shock. The patient is hyperventilating and is therefore at risk for the respiratory complication of respiratory acidosis.

False

Which characteristic uniquely belongs to type 2 diabetes mellitus?

An absent first-phase insulin response and diminished second-phase response

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

Anaphylactic

Which is a characteristic of intrinsic (non-allergic) asthma?

Attacks are often severe.

Which insulin types are most commonly used in the rapid-acting category? (Select all that apply.)

B. Aspart D. Lispro

Which structures are located within the larynx? (Select all that apply.)

B. Cartilage C. Epiglottis D. Vocal cords

When emphysema is a result of a α1-antitrypsin disorder, assessment data is likely to include which of the following? (Select all that apply.)

B. Client age younger D. History of cigarette smoking E. Enzyme levels that are below normal

Which are major classifications of deficiencies in growth hormone secretion? (Select all that apply.)

B. Decreased GH secretion C. Defective GH action E. Defective IGF-1 generation

Which medication may be required for status asthmaticus? (Select all that apply.

B. Epinephrine D. Terbutaline (Brethine) E. Aminophylline (Phyllocontin)

Which are hormones that increase serum glucose level? (Select all that apply.)

B. Glucagon C. Growth hormone D. Catecholamine

A patient experiences anaphylactic shock. The nurse expects to observe which signs and symptoms in the patient? (Select all that apply.)

B. Hypotension C. Urticaria D. Angioedema E. Wheezing

For the individual with type 2 diabetes, the immediate problems brought about by hyperglycemia can lead to which of the following? (Select all that apply.)

B. Insulin resistance D. Polydipsia and polyuria E. Further diminished insulin secretion

Which causes of shock are considered to be obstructive? (Select all that apply.)

B. Pulmonary embolus C. Cardiac tamponade D. Tension pneumothorax

Non-ketotic hyperglycemic hyperosmolar coma in type 2 diabetes is characterized by which of the following? (Select all that apply.)

B. Striking dehydration C. Mortality rate of 11% D. With no or slight ketosis

What likelihood is there that gestational diabetes will persist or recur after pregnancy?

Between 30% to 84%of women with a history of gestational diabetes mellitus will have a recurrence in subsequent pregnancies

Which wave corresponds with the AV valve bulging during ventricular contraction?

C wave

A patient experiencing shock may exhibit which signs and symptoms? (Select all that apply.)

C. Pulse of more than 100 beats/minute E. Fast and deep respirations

The pathologic changes that occur in the development of coronary atherosclerotic lesions include cell damage resulting from which of the following? (Select all that apply.)

C. The effects of oxidized lipids D. An inflammatory response E. The formation of plaques

Which statement regarding oxygen and carbon dioxide is true?

Carbon dioxide is carried in three forms in the blood

Which statement is true regarding muscle contraction?

Cardiac myocytes are terminally differentiated.

Low cardiac output in association with high preload is characteristic of ________ shock.

Cardiogenic

In which stage of shock is a patient who has lost 1200 mL of blood, who has normal blood pressure when supine, but who experiences orthostatic hypotension upon standing?

Class II, Compensated Stage

What is the pathophysiologic phenomenon underlying disseminated intravascular coagulation (DIC)?

Clotting that leads to bleeding

The most reliable indicator that a person is experiencing an acute myocardial infarction (MI) is

ST-segment elevation.

Which hormone is responsible for regulation of immune and inflammatory reactions?

Cortisol

What describes an asthma that is common in children and adolescents, with bronchospasm occurring within 3 minutes of physical exertion?

Exercise-induced

When damage occurs to the antidiuretic hormone (ADH)-producing cells in the hypothalamus from head trauma, intracranial tumors, or neurosurgery, what disorder is suggested by a large diuresis of very dilute urine?

Diabetes insipidus

What is the marker of choice for detecting a myocardial infarction?

Elevated serum levels of cardiac troponin

Which results in an increase in lung compliance?

Emphysema

The layer of squamous cells that lines the cardiac chambers and valves is called the

Endocardium.

Growth hormone stimulates the liver to release

IGF-1

When exposed to inhaled allergens, a patient with asthma produces large quantities of

IgE

Which condition may result in chronic pulmonary hypertension, right ventricular hypertrophy, and rightsided heart failure?

Mitral valve stenosis

What is the primary cause of airway obstruction in patients with chronic bronchitis?

Mucous plugs

The endocrine system closely resembles the ________ system because many of their actions are coordinated at the level of the hypothalamus.

Nervous

Which pulmonary function test result is consistent with a diagnosis of asthma?

Reduced forced expiratory volume in 1 second (FEV1)

Chronic pulmonary hypertension can eventually cause which complication?

Right heart failure

Diabetes mellitus is the ________ leading cause of death and a major cause of disability in the United States.

Seventh

What suppresses the normal secretion of growth hormone?

Somatostatin

What type of cells make up the alveoli and are involved in gas exchange?

Type I pneumocytes

If the cause of hypercortisolism is an adrenal tumor, which option is indicated?

Unilateral removal of the affected gland

Croup is characterized by

a barking cough

Individuals who have chronic bronchitis most often have

a productive cough

Sepsis has been recently redefined as

a systemic inflammatory response to infection.

COPD leads to a barrel chest, because it causes

air trapping

One role of ATP in cardiac muscle contraction is

altering myosin affinity for actin-binding sites.

Surfactant is a phospholipid that reduces

alveolar surface tension.

In adrenocortical insufficiency, such as Addison disease, the most severe manifestations are the result of

an insufficient amount of circulating cortisol

Cystic fibrosis is associated with

bronchiectasis

Destruction of bronchial walls from dilation of airway sacs is a result of

bronchiectasis

Hypoxic pulmonary vasoconstriction

can lead to secondary pulmonary hypertension.

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

cardiac tamponade.

COPD type A is referred to as

emphysema

Asthma is categorized as a(n)

obstructive pulmonary disorder

Cardiogenic shock is characterized by

reduced cardiac output.

A type of insulin that would be most appropriate for acute management of hyperglycemia is

regular

The peripheral chemoreceptors

respond to the arterial oxygen level.

Diabetes mellitus is most accurately defined as a disorder that affects

the utilization of all energy nutrients

Airway obstruction in chronic bronchitis is because of

thick mucus, fibrosis, and smooth muscle hypertrophy

The biological activity of a particular hormone is based in part on its rate of which of the following? (Select all that apply.)

A. Release C. Synthesis D. Excretion E. Metabolism

Which is true about lung compliance? (Select all that apply.)

A. Represents lung expandability B. Decreases in the elderly C. Can be decreased by obesity, abdominal distention, pregnancy E. Is affected by body position

What occurs during an acute asthma attack? (Select all that apply.)

A. Sputum is often thick, tenacious, scant, and viscid. B. Bronchoconstriction occurs. C. Residual lung volume increases. E. Forced expiratory volumes decrease.

What is the underlying problem common among all types of shock?

Inadequate cellular oxygenation

Aldosterone secretion would be expected to produce which change?

Increase blood pressure

Which cellular change is seen with chronic bronchitis?

Increased eosinophils

"My doctor said I have cor pul-something, which is a heart problem," says Mr. Garabedian. "I thought I just had these bad lungs that can't be fixed. How can that make my heart go bad?" Which mechanism leads to the development of cor pulmonale, which should serve as the basis for your response to Mr. Garabedian?

Increased resistance to pulmonary arterial flow leads to compensatory right ventricular hypertrophy

In individuals who have asthma, exposure to an allergen to which they are sensitized leads to which pathophysiologic event?

Inflammation, mucosal edema, and bronchoconstriction

Which statement is true regarding asthma?

It is characterized by airway inflammation

Which statement regarding bronchiectasis is true?

It is common in cystic fibrosis

Which statement is true regarding cystic fibrosis?

It is the most common genetic disease in the United States

Which response to an injection of ACTH indicates a primary adrenal insufficiency?

No change in serum glucocorticoid level

Type 2 diabetes mellitus is often associated with

Non-ketotic hyperosmolality

Which assessment would support a diagnosis of type A COPD rather than type B COPD

Normal PaCO2, scant sputum, accessory muscle use, barrel chest

________ is the most powerful predictor of developing type 2 diabetes mellitus.

Obesity

What situation occurs with hypoventilation?

The PaCO2 exceeds 45 mm Hg

The assessment findings of a 5-year-old with a history of asthma include extreme shortness of breath, nasal flaring, coughing, pulsus paradoxus, and use of accessory respiratory muscles. There is no wheezing and the chest is silent in many areas. How should you interpret your assessment?

The child may be having such a severe asthma episode that the airways are closed, so start oxygen and get the doctor immediately

For the patient in hypovolemic shock, what compensatory mechanism will help preserve adequate circulation?

The renin-angiotensin-aldosterone cascade

A patient experiencing an acute myocardial infarction (MI) is given a drug to lyse the clot in the coronary artery. What is the best explanation for the sudden development of a serious arrhythmia once circulation is restored?

The return of oxygen perfusion resulted in reperfusion injury.

Which statement is true regarding the function of hormones?

They may act to target and influence either the secreting cell or cells at other locations

Which hormone is known for its ability to be stored and synthesized but is bound until it is needed for systemic use?

Thyroid

Which major cartilage structure is often referred to as the Adam's apple?

Thyroid cartilage

Which hormone is highly bound to carrier proteins in the bloodstream?

Thyroid hormones

Low serum levels of which hormone is helpful in differentiating between primary or secondary causes of hypothyroidism?

Thyroid-stimulating hormone (TSH)

Intracellular activation of hormones by secondary signal amplification refers to which process?

Tiny amounts of circulating hormones cause a cascade effect of progressively larger number of chemical reactions at each step

What physiologic abnormality is characteristic of emphysema?

Trapping of air in the distal air sacs

Lack of α-antitrypsin in emphysema causes

destruction of alveolar tissue

It is true that lipid-soluble hormones are

diffused through cell membranes to activate intracellular receptors

The release of prolactin is normally inhibited by

dopamine

The phenomenon that occurs when cells decrease their number of receptors when exposed to prolonged periods of high concentrations of a hormone is called

down-regulation

Elevated glucose levels in individuals with diabetes mellitus greatly influence fluid balance and hydration because

fluids are lost as the kidneys clear excessive glucose during hyperglycemia

Most endocrine hormones are water-soluble and exert their effects on target cells by

generating second messengers

The breakdown of stored glycogen in the liver and muscles is called

glycogenolysis

Children who have midline craniocerebral defects, nystagmus, retinal abnormalities, and other midline or midfacial abnormalities (e.g., cleft lip or palate) should be evaluated for deficiencies in

growth hormone

The conditions of pituitary gigantism in children and acromegaly in adults are produced by excessive levels of

growth hormone

The pituitary gland produces a hormone that is a potent anabolic agent that causes the development of all tissues of the body that are capable of responding to it. This hormone is called

growth hormone (GH)

A patient who was involved in a fall from a tree becomes short of breath. The lung sounds are absent on one side. This patient is experiencing ________ shock.

Obstructive

Which is true about blood flow from the atria?

Occurs primarily during ventricular diastole

Which statement is true regarding the vagus nerves?

Parasympathetic nerve stimulation reduces the heart rate.

Myocytes leak the enzyme creatine kinase (CK) into the bloodstream in response to cell

ischemia.

Which phase of cardiac action potential is caused by closure of the fast sodium channels?

Phase 1

Myocarditis should be suspected in a patient who presents with

acute onset of left ventricular dysfunction.

The majority of cases of anaphylactic shock occur when a sensitized individual comes in contact with

antibiotics

Blood flows in the human body move from which of the following? (Select all that apply.)

A. Right atrium to the right ventricle B. Right ventricle to the lungs C. Left ventricle to the body D. Lungs to the left atrium

Which terms refers to an increased speed of conduction?

Dromotropic

Which serum biomarker(s) are indicative of irreversible damage to myocardial cells?

Elevated CK-MB, troponin I, and troponin T

Angina caused by coronary artery spasm is called _____ angina.

Prinzmetal variant

Which refers to intermittent, spontaneous generation of action potentials?

Rhythmicity

What factor causes a congenital heart disease to produce cyanosis?

Right-to-left shunting of blood

In lead II of a normal electrocardiogram (ECG), the Q wave is a downward deflection resulting from ________ depolarization.

Septal

A patient presenting with fever, hypotension, and lactic acidosis is most likely to be experiencing what type of shock?

Septic

Overproduction of nitric oxide is an important aspect of the pathophysiologic process of what type of shock?

Septic

What is the name for the arrangement in which separate cells of the myocardium can function together?

Syncytium

Administration of a vasodilator to a patient in shock would be expected to

decrease left ventricular afterload

While caring for a geriatric patient, the changes in the heart that may be expected include

decreased response to an elevated heart rate

The part of the cardiac cycle in which the cardiac muscle obtains oxygen and rids itself of waste products is

diastole.

Aortic regurgitation is associated with

diastolic murmur.

Automatic pacemaker cells spontaneously depolarize, because

leak channels (If) allow calcium and sodium ions into the cell

In a patient with mitral stenosis, cardiac catheterization findings would indicate increased pressure in the

left atria

The structure that is composed of six polypeptide chains, two heavy chains, and four light chains is called

myosin.

Tumor necrosis factor α and interleukin-1 contribute to shock states because they induce production of

nitric oxide.

Phase 0 of the cardiac muscle cell action potential is associated with ________ channels

opening of fast sodium ion

Parasympathetic stimulation of the heart generally leads to a decrease in heart rate, because acetylcholine

opens potassium channels allowing potassium ion efflux.

A patient with a history of myocardial infarction continues to complain of intermittent chest pain brought on by exertion and relieved by rest. The likely cause of this pain is

stable angina.