Patho Final Exam
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."
The arterial oxygen content (CaO2) for a patient with PaO2 100 mm Hg, SaO2 95%, and hemoglobin 15 g/dl is _____ ml oxygen/dl
19.4
A loud pansystolic murmur that radiates to the axilla is most likely a result of
mitral regurgitation
All these cellular responses are potentially reversible except
necrosis
RhoGAM (an Rh antibody) would be appropriate in an Rh-_____ woman with an _____ Rh-_____ antibody titer carrying an Rh-_____ fetus.
negative; negative; positive
Huntington disease primarily affects the _____ system
neurologic
The prevalence of high blood pressure is higher in
non-Hispanic black adults
Hypertension is closely linked to
obstructive sleep apnea
Breast cancer in women who have the breast cancer gene
occurs at an earlier age
Somatic death refers to death
of the entire organism
Parasympathetic stimulation of the heart generally leads to a decrease in heart rate, because acetylcholine
opens potassium channels allowing potassium ion efflux
The strength of the bond between oxygen and hemoglobin is known as the
oxygen-hemoglobin affinity
A patient with heart failure who reports intermittent shortness of breath during the night is experiencing
paroxysmal nocturnal dyspnea
The membrane attack complex formed by complement is similar in function to
perforin
An erroneously low blood pressure measurement may be caused by
positioning the arm above the heart level
An abnormally wide (more than 0.10 second) QRS complex is characteristic of
premature ventricular complexes
A 17-year-old college-bound student receives a vaccine against an organism that causes meningitis. This is an example of
primary prevention
The risk period for maternal rubella infection leading to congenital problems begins
prior to conception
First-degree heart block is characterized by
prolonged PR interval
Children with PKU must avoid phenylalanine in the diet. Phenylalanine is most likely to be a component of
protein
A vessel that normally contains desaturated (venous) blood is the
pulmonary artery
Blood is transported from the right ventricle to the lungs by the
pulmonary artery
In both Adult respiratory distress syndrome (ARDS)& infant respiratory distress syndrome (IRDS)
pulmonary compliance is decreased.
Left-sided heart failure is characterized by
pulmonary congestion
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
Transfusion reactions involve RBC destruction caused by
recipient antibodies
Beta-blockers are advocated in the management of heart failure because they
reduce cardiac output
The common denominator in all forms of heart failure is
reduced cardiac output
Carbon monoxide injures cells by
reducing oxygen level on hemoglobin
The majority of tachydysrhythmias are believed to occur because of
reentry mechanisms
Low cardiac output to the kidneys stimulates the release of _____ from juxtaglomerular cells
renin
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
results from a chromosome abnormality called nondisjunction
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
Hypertension with a specific, identifiable cause is known as _____ hypertension.
secondary
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
A laboratory test that should be routinely monitored in patients receiving digitalis therapy is
serum potassium
An increase in hemoglobin affinity for oxygen occurs with
shift to the left
The primary feature distinguishing bacterial from viral pneumonia is
A cough productive of purulent sputum
Which of the following situations would result in the release of erythropoietin?
A patient with lung disease and chronic hypoxia
The cellular component that is most susceptible to radiation injury is the
DNA
Serum levels of cortisol fluctuate over 24-hour period, reflecting a
Diurnal variation and Circadian rhythm
Increased preload of the cardiac chambers may lead to which patient symptom?
Edema
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
Which condition is associated with an elevated reticulocyte count?
Hemolytic anemia
A patient has acute respiratory failure. Which lab findings will you expect to find?
Hypoxemia and hypercapnia
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
The principle Ig mediator of type I hypersensitivity reactions is
IgE
Which clinical finding is most indicative of an acute bacterial infection?
Increased (band) neutrophils
Which physiologic change increases cardiac work but does not enhance cardiac output?
Increased afterload
A patient has edema. What could have caused the edema?
Increased interstitial fluid osmotic pressure
Place the multi step nature of carcinogenesis in order
Initiation, promotion, and progression
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
Which characteristic is indicative of hemolytic anemia?
Jaundice
Amyotrophic Lateral Sclerosis (ALS)
Leads to death by respiratory failure
Water excess (Hyponatremia)is best detected by
Low serum sodium
Familial retinoblastoma involves the transmission of what from parent to offspring?
Mutant tumor suppressor gene
The most common tumor suppressor gene defect identified in cancer cells is
P53
What compensatory sign would be expected during periods of physical exertion in a patient with limited ventricular stroke volume?
Tachycardia
What results when systemic blood pressure is increased?
Vasoconstriction
Males are more likely than females to be affected by ________ disorders
X-linked
Mitral stenosis is associated with
a pressure gradient across the mitral valve
A patient is exhibiting severe dyspnea and anxiety. The patient also has bubbly crackles in all lung fields with pink, frothy sputum. This patient is most likely experiencing
acute cardiogenic pulmonary edema
Myocarditis should be suspected in a patient who presents with
acute onset of left ventricular dysfunction
Proteins that are increased in the bloodstream during acute inflammation are called
acute phase proteins
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. Beta-blockers are not required at this time.
afterload
Characteristics of X-linked (sex-linked) recessive disorders include
all daughters of affected fathers' being carriers
One role of ATP in cardiac muscle contraction is
altering myosin affinity for actin-binding sites
Immunity to a specific organism can be determined by
antibody titer
The "classical pathway" for activation of the complement cascade is triggered by
antigen-antibody complexes
Patients presenting with symptoms of unstable angina and no ST segment elevation are treated with
antiplatelet drugs
The majority of cardiac cells that die after myocardial infarction do so because of
apoptosis
Proto-oncogenes
are normal cellular genes that promote growth
The v wave of an atrial pressure tracing corresponds to
atrial filling
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
Malignant neoplasms of epithelial origin are known as
carcinomas
Hypotension, distended neck veins, and muffled heart sounds are classic manifestations of
cardiac tamponade
Cancer grading is based on
cell differentiation
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
Angiotensin-converting enzyme (ACE) inhibitors block the
conversion of angiotensin I to angiotensin II
Apoptosis is a process that results in cellular
death
In general, with aging, organ size and function______
decrease
Extreme cold injures cells by all the following except
decreased blood viscosity
The primary effect of aging on all body systems is
decreased functional reserve
While caring for a geriatric patient, the changes in the heart that may be expected include
decreased response to an elevated heart rate
At very high heart rates, cardiac output
decreases
Primary treatment for myocardial infarction (MI) is directed at
decreasing myocardial oxygen demands
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
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
Aortic regurgitation is associated with
diastolic murmur
The therapy that most directly improves cardiac contractility in a patient with systolic heart failure is
digitalis
Antigen-presenting cells function to
display foreign antigen on their cell surfaces bound to MHC
The cellular change that is considered preneoplastic is
dysplasia
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
Leukocytosis with a "shift to the left" refers to
elevated immature neutrophils
A laboratory test finding helpful in confirming the diagnosis of iron-deficiency anemia is
elevated total iron-binding capacity
A disease that is native to a particular region is called
endemic
The most effective therapy for anemia associated with kidney failure is
erythropoietin administration
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
Red blood cells obtain nearly all their energy from metabolism of
glucose
Patients who experience anemic episodes when exposed to certain drugs most likely have
glucose-6-phosphate dehydrogenase deficiency
Red blood cells differ from other cell types in the body, because they
have no cytoplasmic organelles
An important mediator of a type I hypersensitivity reaction is
histamine
An increase in organ size and function due to increased workload is termed
hypertrophy
A patient has a history of falls, syncope, dizziness, and blurred vision. The patient's symptomology is most likely related to
hypotension
When the cause is unknown, a condition is said to be...
idiopathic
Constrictive pericarditis is associated with
impaired cardiac filling
Lusitropic impairment refers to
impaired diastolic relaxation
Myasthenia gravis is a type II hypersensitivity disorder that involves
impaired muscle function
The effects of histamine release include
increased vascular permeability
Coagulative necrosis is caused by
interrupted blood supply
The cellular response indicative of injury due to faulty metabolism is
intracellular accumulations
Pernicious anemia is caused by a lack of
intrinsic factor
Reperfusion injury to cells
involves formation of free radicals
A point mutation
involves the substitution of a single base pair
The cause of the most common form of anemia is
iron deficiency
After bronchoscopy and histologic examination of a suspected tumor, your patient is diagnosed with primary bronchial carcinoma. Thus, the tumor
is malignant
The primary source of erythropoietin is provided by the
kidneys
The primary function of eosinophils is to
kill parasitic helminths (worms)
After surgery to remove a lung tumor, your patient is scheduled for chemotherapy, which will
kill rapidly dividing cells
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
Second-degree heart block type I (Wenckebach) is characterized by
lengthening PR intervals and dropped P wave
Necrotic death of brain tissue usually produces _____ necrosis
liquefactive
Cystic fibrosis is a single gene disorder that primarily affects
lungs and pancreas
Interleukin-1, interleukin-6, and tumor necrosis factor-α are inflammatory cytokines secreted by
macrophages
Dramatic hypotension sometimes accompanies type I hypersensitivity reactions, because
massive histamine release from mast cells leads to vasodilation
A primary effector cell of the type I hypersensitivity response is
mast cells
The primary factor associated with risk of Down syndrome is
maternal age
Cardiac myosin has a high affinity for actin when the myosin has what molecule(s) bound to it?
ADP and phosphate
Term for describing the process of a tumor forming new blood vessels
Angiogenesis
Which disease has increased airway responsiveness to various stimuli?
Asthma
In which dysrhythmias should treatment be instituted immediately?
Atrial fibrillation with a ventricular rate of 220 beats/min
During which phase of the cardiac cycle is the mitral valve normally open?
Atrial systole
Retroviruses are associated with human cancers, including
Burkitt lymphoma
associated with metabolic acidosis?
Central nervous system depression
What laboratory finding is usually found in aplastic anemia?
Pancytopenia
Which dysrhythmia is thought to be associated with reentrant mechanisms?
Preexcitation syndrome tachycardia (Wolf-Parkinson-White syndrome)
Angina due to coronary artery spasm is called _____ angina.
Prinzmetal variant
The time during which early signs / symptoms begin to appear is called
Prodromal period
The most reliable indicator that a person is experiencing an acute myocardial infarction (MI) is
ST-segment elevation
Restriction of which electrolytes is recommended in the management of high blood pressure?
Sodium
Which disorder is associated with a type III hypersensitivity mechanism of injury?
Systemic lupus erythematosus
Most carbon dioxide is transported in the bloodstream as
bicarbonate ion
Excessive red cell lysis can be detected by measuring the serum
bilirubin
An increase in intracellular calcium ion results in myocardial contraction, because calcium
binds troponin, causing actin-binding sites to be exposed
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 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
The stage during which the patient functions normally, although the disease processes are well established, is referred to as
subclinical
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
A patient with significant aortic stenosis is likely to experience
syncope
Creatine phosphate is
synthesized when ATP levels are high
Functions of B cells include
synthesizing antibodies
Pulse pressure is defined as
systolic pressure - diastolic pressure
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
Metaplasia is_____
the replacement of one differentiated cell type with another
The hypermetabolic state leading to cachexia in terminal cancer is thought to be due to
tumor necrosis factor
The primary function of kinins is
vasodilation to enhance inflammation
An example of an acyanotic heart defect is
ventricular septal defect
Rheumatic heart disease is most often a consequence of
β-hemolytic streptococcal infection.