Patho Final Review
What is the most studied active transport system in the human body?
Sodium Potassium ATPase Pass
Define tertiary prevention and give an example:
Tertiary prevention occurs after a disease has been diagnosed and clinical intervention is needed to reduce complications or deterioration. One example is the use of certain medications one must take after a heart attack to help reduce the risk of a future event or death.
Each of the following statements is true regarding the organization of the nervous system except: The PNS has an afferent and efferent division The autonomic nervous system can be further divided into the sympathetic and parasympathetic divisions The CNS contains the cranial nerves The PNS contains the spinal nerves
The CNS contains the cranial nerves
The T cells that display the host's MHC antigens and T-cell receptors for a nonself-antigen are allowed to mature, a process termed negative selection.
False
The process of digestion begins in the stomach and finishes in the large intestine. True or False
False
A patient has a diagnosis of glomerular disease. Given what you know about the structural framework of the glomerular capillaries, what would be detected in this patient's urine, and explain why this would happen.
Blood and protein may be present in the urine. Spaces within the basement membrane of the glomerular capillaries, under normal circumstances prevent red blood cells and plasma proteins from passing through the glomerular membrane into the filtrate. The disease process would compromise this.
A paracrine hormone is a hormone that produces a biologic action on the cell that released them. True False
False
Activation of the peripheral nervous system decreases or stops the amplitude of the slow waves. True or False
False
Activation of the sympathetic nervous system increases amplitude of the slow waves. True or False
False
Anti-diarrheal medication can be used with all types of diarrhea. True or False
False
Anti-diarrheal medication can be used with all types of diarrhea. TRUE OR FALSE
False
Hemoglobin A1C measures glucose control over the previous 6 months. True False
False
Hypoventilation is associated with decreased PCO2. True False
False
Metaplastic cells are not better prepared to survive under stressful circumstances TRUE OR FALSE
False
Metaplastic cells are not better prepared to survive under stressful circumstances. True False
False
Passive immunity provides long lasting protection. True False
False
Name 2 types of medications that can cause constipation:
Nartcotics, anticholinergics, calcium channel blockers, diruetics, aluminum antacids
Tubular reabsorption is characterized by which of the following? The reabsorption of water and ions via passive means only Necessary solutes and fluids are reabsorbed into the tubular fluid Necessary solutes and fluids are reabsorbed into the peritubular capillaries
Necessary solutes and fluids are reabsorbed into the peritubular capillaries
A 9-year-old boy with a peanut allergy was exposed to peanuts. He presents to the emergency room with an anaphylactic reaction. (1) What symptoms might he present with? (2) Does the quantity of exposure mean he will have a more severe reaction? (3) What is the initial immediate treatment? (4) What are 2 things people with anaphylaxis should always carry?
(1) Any of the following reactions are accepted. Grade I: erythema and urticaria, with or without angioedema. Grade II: hypotension, tachycardia, dyspnea, and GI manifestations, like nausea, vomiting, diarrhea, and abdominal cramping from mucosal edema. Grade III: bronchospasm, cardiac dysrhythmias, and cardiac collapse. Grade IV: cardiac arrest (2) No (3) Epinephrine (4) identification about allergy, EpiPen
A 9-year-old boy with a peanut allergy was exposed to peanuts. He presents to the emergency room with an anaphylactic reaction. (1) What symptoms might he present with? (2) Does the quantity of exposure mean he will have a more severe reaction? (3) What is the initial immediate treatment? (4) What are 2 things people with anaphylaxis should always carry?
(1) Any of the following reactions are accepted. Grade I: erythema and urticaria, with or without angioedema. Grade II: hypotension, tachycardia, dyspnea, and GI manifestations, like nausea, vomiting, diarrhea, and abdominal cramping from mucosal edema. Grade III: bronchospasm, cardiac dysrhythmias, and cardiac collapse. Grade IV: cardiac arrest (2) No (3) Epinephrine (4) identification about allergy, EpiPen
A 45- year-old female presents with increased appetite, weight loss, and nervousness. Lab findings show a high serum T4 and low TSH. What diagnosis would her history and lab findings indicate? What is one treatment (not symptom treatment) you would suggest?
(1) Hyperthyroidism; (2) methimazole or propylthiouricil, radioactive iodine, or surgical removal.
Answer: Picture is of an atherosclerotic plaque. What risk factors mostly led to this disease state? 2. What is this person at risk for developing? 3. What lifestyle modifications would you suggest for them?
1) Smoking, poor diet, hyperlipidemia, obesity, diabetes, increased age 2) Coronary artery disease, myocardial infarction 3) Stop smoking, healthy diet, lose weight/exercise, take medications
Explain how the kidney can maintain a constant GFR despite variations in the arterial blood pressure of the rest of the body.
1) renal autoregulation 2) nervous system control 3) hormonal control
1. List two signs or symptoms a patient may present with that might indicate a cancer diagnosis: 2. What are two systemic manifestations of cancer exhibited by cancer patients?
1. Bleeding; sore that doesn't heal; fluid in the pleural, pericardial, or peritoneal spaces; chest pain, shortness of breath, cough, abdominal discomfort or swelling. Other possible answers can include a mass or lump, pain (need to be specific), fatigue, fevers, weight loss 2. Weight loss, wasting of body fat and muscle tissue, weakness, anorexia, and anemia, fatigue, sleep disturbances
A patient has a bilateral presentation of pain in the PIP joints of the hands. You believe this pain is due to arthritis but are unsure whether it is a result of RA or OA. What are 3 questions you could ask this patient to help you differentiate between RA and OA?
1. Do you experience stiffness in the morning? 2. If so, does it last less than or longer than 30 minutes? 3. Does prolonged movement aggravate or alleviate your symptoms? 4. Do you ever have periods of relief, or do you experience pain daily? 5. Did your pain start in both hands or did it start with one hand and develop in the other over time? 6. What is your profession? (occupations requiring repetitive movements often lead to OA) *Note - student only has to provide 3 questions.
1. Name 2 lifestyle changes to prevent further progression of atherosclerotic diseases: 2. Name 2 medications used to treat someone with coronary artery disease and their mechanisms of action:
1. Reduction in fat intake, quitting smoking, weight loss, exercise 2. Aspirin or other platelet inhibitors are used to prevent thrombosis formation. Beta-blockers and calcium channel blockers (CCB) - both decrease the heart rate and contractile force - can be initiated to decrease the heart's demand of oxygen. CCB also increase coronary vasodilatation and decrease coronary vasospasm. Nitrates are used to quickly dilate the coronary vessels. Nitrates also dilate veins, decreasing the heart's work by decreasing preload and afterload.
1. ______ is a systemic treatment that enables drugs to reach the site of the tumor as well as other distant sites. 2. The profound weight loss and wasting of fat and tissue that accompany cancer is known as _______.
1. chemotherapy 2. cancer anorexia-cachexia syndrome
A patient is said to be in stage 4 kidney disease. What would you expect their GFR to be? A. 25 mL/min/1.73m2 B. 42 mL/min/1.73m2 C. 70 mL/min/1.73m2 D. 14 mL/min/1.73m2
A
A 25-year-old female has noticed a lower pitch to her voice and coarsening of her hair, weight gain, menorrhagia, and intolerance to cold. Which of the following laboratory abnormalities are expected if the patient has primary disease? A. Decreased serum T3, T4 B. Increased serum T3, T4 C. Decreased serum TSH D. Increased serum TSH E. A & D F. B & C
A & D
Which of the following are necessary components of nutritional management for a patient with CKD? (mark all that apply) A decrease in dietary protein Adequate caloric intake in the form of carbohydrates and fats Fluid restrictions
A decrease in dietary protein Adequate caloric intake in the form of carbohydrates and fats Fluid restrictions
Explain 3 mechanisms in which neurotransmitters are removed from the synaptic cleft.
A neurotransmitter can be broken down by enzymatic activity into inactive substances. A neurotransmitter can be drawn back into the presynaptic neuron by a process known as reuptake. A neurotransmitter can diffuse into the intercellular fluid until its concentration is too low to elicit a postsynaptic response.
Which of the following is/are true regarding acid-base disorders? (mark all that apply) A. Metabolic disorders are a result of a change in plasma HCO3- levels B. Respiratory disorders are a result of a change in plasma CO2 levels C. Normal HCO3- = 35-45 mm D. Normal blood pH = 7.35-7.45
A, B and D
Gastric ulcers are worsened by _____. Duodenal ulcers are worsened by _____. A. Eating; not eating B. Not eating; eating C. Both a & b D. None of the above
A. Eating; not eating
Each of the following are treatments of Addison's disease EXCEPT? Hormone therapy for life Regular mealtimes ACE inhibitors Higher dose of hormones during stress
ACE Inhibitors
A patient presents with right upper quadrant pain, that worsens after eating a fatty meal. What would be the best imaging modality to evaluate their complaint? Abdominal CT scan HIDA scan Abdominal x-ray Abdominal ultrasound
Abdominal Ultrasound
_____ is the process of moving nutrients and other materials from the external environment of the GI tract into the internal environment.
Absorption
What is the term to describe when cells use energy to move ions against an electrical or chemical gradient?
Active transport
Which of the following types of immunity is/are true concerning vaccines? Select all that apply. Innate Adaptive Humoral Active Immunity Passive Immunity
Adaptive Correct Answer Humoral Correct! Active Immunity
Which of the following statements is false regarding ADH? Elevated levels of ADH will lead to a small volume of concentrated urine. Decreased levels of ADH will lead to dilute urine. Alcohol increases ADH levels.
Alcohol Increases ADH level
A 45-year-old woman presents with fatigue, weight gain, and cold intolerance. Lab findings show a low serum T4 and elevated TSH. 1. What diagnosis would her history and lab findings indicate? 2. What type of treatment should be given?
Answer: (1) Hypothyroidism; (2) synthetic T4 thyroid hormone, thyroxine
Oligodendrocytes produce myelin in the PNS.
Answer: False, oligodendrocytes produce myelin in the CNS.
A 75-year-old male is brought to the emergency department via ambulance at 5 pm. The patient's spouse reports that when they woke up (approximately at 6 am) he reported to her that he was having some blurred vision but decided to go about his day. As the day progressed, he started experiencing tingling and feelings of weakness on the entire left side of his body. He has a past medical history of diabetes. Based upon these symptoms and past medical history, what do you suspect this patient is experiencing? How would you confirm this diagnosis? What treatment should be administered? Explain why you chose that treatment.
Answer: This patient is more than likely experiencing an ischemic stroke. A CT scan and MRI would be needed to determine if a clot was blocking blood flow to the brain tissue and to rule out a hemorrhagic stroke. If a clot is found, this patient would need to be reperfused through catheter-base methods as they are outside of the 3-4.5 treatment window for the use of tPA drugs.
Risk factors for the development of peptic ulcer include which of the following? Select all that apply. Aspirin therapy Eating acidic foods Pylori infection Stress NSAID use
Aspirin Therapy Pylori Infection NSAID Use
Acute postinfectious glomerulonephritis is characterized by the following except: Typically caused by a streptococcal infection Associated with a poor prognosis as it often leads to CKD the prognosis is good when underlying cause is treated Accompanied by glomerular enlargement and hypercellularity Oliguria is often the first symptom
Associated with a poor prognosis as it often leads to CKD the prognosis is good when underlying cause is treated
Which is NOT a type of type II hypersensitivity reaction? Rh incompatibility Vascular rejection of organ grafts Graves' disease Blood transfusion reactions Atopy
Atopy
What symptoms of irritable bowel syndrome would require further investigation? Select all that apply. Blood in stool Weight loss Nausea and anorexia Bloating Anemia
Blood in Stool Weight Loss Anemia
What symptoms of irritable bowel syndrome would require further investigation? Select all that apply. Blood in stool Weight loss Nausea and anorexia Bloating Anemia
Blood in stool Weight loss Anemia
Clinical presentation of irritable bowel syndrome can include each of the following EXCEPT: Abdominal pain or discomfort for at least 12 weeks duration Pain may be relieved with defecation Constipation or diarrhea may be present Blood in the stool
Blood in the Stool
Each of the following are characteristics of Crohn disease EXCEPT: Fistulas and strictures Abscesses Skip lesions Cancer development is rare Bloody diarrhea
Bloody Diarrhea
A patient complains of chest pain and an elevated blood pressure. What are these examples of? Signs Symptoms Both A & B
Both A & B
Symptoms of diabetic ketoacidosis (DKA) include each of the following EXCEPT: Polydipsia Dehydration Fruity smell on the breath Bradycardia
Bradycardia
A patient is said to be in stage 2 kidney disease. What would you expect their GFR to be? A. 97 mL/min/1.73m2 B. 42 mL/min/1.73m2 C. 70 mL/min/1.73m2 D. 14 mL/min/1.73m2
C
Primary insomnia is characterized by each of the following except: Difficulty initiating sleep Difficulty maintaining sleep Waking up too early Can also be called comorbid insomnia
Can also be called comorbid insomnia
Which cell does NOT play an important role in type I hypersensitivity reactions? Mast cell Basophils CD4 T cells Eosinophils
CD4 T cells
Which cell is the master regulator of the immune system? CD4 T cells CD8 T cells Macrophages Neutrophils
CD4 T cells
A patient is having difficulty tracking their eye laterally. Which cranial nerve is affected? CN II. CN III. CN IV. CN VI.
CN VI.
Treatments for gastroesophageal reflux include each of the following EXCEPT: Losing weight Sleeping with head elevated Caffeinated beverages Proton pump inhibitors
Caffeinated Beverages
2. The profound weight loss and wasting of fat and tissue that accompany cancer is known as _______.
Cancer anorexia-cachexia syndrome
Which of the following does NOT affect the heart's ability to increase its output? Preload Afterload Cardiac contractility Cardiac reserve Heart rate
Cardiac Reserve
People with diabetes should be followed closely by their health care provider to monitor glycemic control and be screened regularly for complications. List 5 ways they should be screened:
Checking weight, blood pressure, fasting blood glucose and hemoglobin A1C, lipid profile, serum creatinine, microalbumin, foot exam, dilated eye exams, and dental exam.
The ___________ react within seconds to minimize changes in pH by binding free H+ or free OH-.
Chemical Buffer System
The breathing rate is determined by input from ______ that monitor oxygen, carbon dioxide, and pH levels in the blood. chemoreceptors
Chemoreceptors
1. ______ is a systemic treatment that enables drugs to reach the site of the tumor as well as other distant sites.
Chemotherapy
Clinical manifestations of cirrhosis include each of the following EXCEPT: Splenomegaly// Choledocholithiasis Portal hypertension Coagulation factor deficiencies Encephalopathy
Choledocholithiasis
Specialized ependymal cells that project into the ventricles and produce CSF are called the ______.
Choroid plexus
Consistently ignoring the urge to defecate can result in _____.
Constipation
Each of the following are characteristics of Crohn disease EXCEPT: Cobblestone appearance Primarily submucosal Continuous extent of involvement Affects primarily ileum Perianal abscesses
Continuous extent of involvement
All of the following viral agents are correctly paired with the associated lesion except: Human papillomavirus (HPV): genital warts Epstein-Barr virus: carcinoma of the cervix Hepatitis B virus: hepatocellular carcinoma Human herpes virus-8: Kaposi sarcoma
Correct! Epstein-Barr virus: carcinoma of the cervix Epstein Barr is linked to Burkitt lymphoma and nasopharyngeal cancer. Cervical carcinoma is linked to HPV.
Compare and contrast the blood supply of cortical bone and cancellous bone.
Cortical bone has a direct blood supply. Nutrient and Perforating arteries form an anastomosis (collateral circulation) that circulates through the bone through the Haversian and Volkmann canals. Cancellous bone does not have a direct blood supply. It receives its blood supply through diffusion from the endosteal bone surface extending outward through the canaliculi.
Redistribution of body fat with round moon face, dorsal "buffalo hump," and relatively thin extremities suggests which of the following:
Cushing Syndrome
Which of the following contribute to joint destruction associated with OA? (mark all that apply) Damaged chondrocytes Interleukin -1beta Tumor Necrosis Factor-Alpha An imbalance of protease and protease inhibitors
Damaged chondrocytes Interleukin -1beta Tumor Necrosis Factor-Alpha An imbalance of protease and protease inhibitors
Hemolytic anemias are characterized by each of the following except: Premature destruction of red cells Decrease in erythropoiesis Sickle cell disease and thalassemias are included Bone marrow is hyperactive
Decrease in erythropoiesis
Which of the following defects is associated with hemophilia A? Deficiency of hemoglobin S Deficiency of hemoglobin A Defective gene in the X chromosome Defective gene in the Y chromosome
Defective gene in the X chromosome
A loss of water from the plasma and interstitial compartments causing an osmotic flow of water from the intracellular compartment is characteristic of which of the following fluid imbalances? Dehydration Water intoxication Edema
Dehydration
What is angiogenesis? Why do tumors need it?
Development of new blood vessels within the tumor. They need it to continue to grow.
____ ____ is the leading cause of blindness and vision loss in the US.
Diabetic Retinopathy
Each of the following factors are associated with increased incidence of peptic ulcer EXCEPT: Dietary history Corticosteroid use H. Pylori infection Aspirin therapy Cigarette smoking
Dietary History
_____ is the transfer of gases between the alveoli and the pulmonary capillaries.
Diffusion
Cortical bone receives its blood supply through the following means except? Diffusion through the endosteal surface of the bone and the canaliculi Arteries branching inward from the periosteal arteries Arteries branching from the medullary cavity
Diffusion through the endosteal surface of the bone and the canaliculi
Which pharmacologic treatment of heart failure has a mechanism of action characterized by excretion of fluid, reducing preload: ACE inhibitor Beta-blocker Diuretic Vasodilators
Diuretic
What is it called when there is abnormally fast emptying of hyperosmotic gastric secretions?
Dumping Syndrome
Alpha-1 antitrypsin deficiency is most likely seen in which disease process? Bronchial asthma Chronic bronchitis Emphysema Bronchiectasis
Emphysema
The amplitude and frequency of the slow waves is regulated by ______?
Enteric Nervous System
Which of the following cells contribute to airway inflammation in asthma? Select all that apply.
Eosinophils Mast cells Neutrophils Leukotrienes Lymphocytes
Which of the following are most likely to have arisen from an adult stem cell? Muscle Bone Epithelial Neural
Epithelial cells like the skin are constantly being replaced.
Endometrial hyperplasia is a normal physiologic occurrence. True False
False It is pathologic.
Lamellae house osteocytes.
False, Lacunae house osteocytes.
Secondary gout is characterized by the overproduction or the underexcretion of uric acid.
False, Primary gout is characterized by the overproduction or the underexcretion of uric acid.
Studies have implicated that an increase in serotonin and norepinephrine is the underlying cause for certain types of depression.
False, a decrease in serotonin and norepinephrine is the underlying cause of certain types of depression.
A patient experiences a seizure that manifests with motor weakness on the right side, a tingling sensation on the right side, and flushing. They have experienced which type of seizure? Focal seizure without impairment of consciousness or awareness Focal seizure with impairment of consciousness or awareness Generalized tonic/clonic seizure
Focal seizure without impairment of consciousness or awareness
The most common complication of peptic ulcers is _____.
Gastrointestinal bleeding
You witness a seizure in which the person first exhibits a full body muscular contraction followed by a loss of consciousness and convulsions. Is this a generalized or focal seizure? Based upon this description, what specific type of seizure did this individual experience?
Generalized, Tonic-clonic seizure
What are the 2 factors that play a role in the development of autoimmune diseases?
Genetics and environmental Factors
Which GI hormone has strong growth hormone-releasing activity and stimulates food intake and digestive function?
Ghrelin
Which of the following do NOT move across the cell membrane via diffusion? Select all that apply. Oxygen Glucose Alcohol Carbon dioxide
Glucose
Type 1 diabetes mellitus is associated with each of the following characteristics EXCEPT: Markedly reduced beta cell mass Markedly reduced circulating insulin level Gradual, subtle onset Usually normal body weight
Gradual, subtle Onset
Each of the following are characteristics of ulcerative colitis EXCEPT: Granulomatous lesions Bloody diarrhea Pseudopolyps Risk of toxic megacolon Crypt abscess formation
Granulomatous Lesions
Each of the following are characteristics of ulcerative colitis EXCEPT: Granulomatous lesions Bloody diarrhea Pseudopolyps Risk of toxic megacolon Crypt abscess formation
Granulomatous lesions
Which of the following is true regarding tubular secretion? K+ is secreted in the intercalated cells H+ is secreted in the intercalated cells H+ along with organic acids and bases are secreted from the distal tubule
H+ is secreted in the intercalated cells
Which of the following are risk factors for developing cancer? Select all that apply. HBV Alcohol High intake of smoked meats Deodorant
HBV alcohol High Intake of Smoked Meats
Risk factors for coronary heart disease include each of the following except: HDL > 60 Smoking Hypertension Family history of heart disease
HDL > 60
The liver is responsible for each of the following EXCEPT: Can store 500-1000 mL of blood Can store glucose as glycogen Converts ammonia to urea Helps with digestion of lipids
Helps with digestion of lipids
Which of the following is NOT a hypercoagulable state? Select all that apply. Oral contraceptive use Mutation of prothrombin gene Hemophilia A Hemophilia B Immobility
Hemophilia A Hemophilia B
A 22-year-old competitive gymnast has experienced amenorrhea for the past 5 years. Her PCP is suspecting that she may have premature osteoporosis. Would you expect her OPG levels to be high, normal, or low? Explain why her levels would be at this level.
Her OPG levels would be low. Amenorrhea results in lower estrogen levels. Estrogen increases the production of OPG in turn decreasing osteoclast activity. If estrogen levels are low, OPG levels would also be low resulting in increased osteoclast activity.
List 4 of the 7 risk factors linked to cancer as stated in the module.
Heredity, hormonal factors, obesity, immunologic mechanisms, environmental agents such as chemicals, radiation, and cancer-causing viruses.
Predisposing factors that may lead to gastroesophageal reflux include each of the following EXCEPT: Hiatal hernia Pernicious anemia Pregnancy Incompetent esophageal sphincter
Hiatel Hernia
Signs and symptoms of Addison's disease include each of the following EXCEPT: Hyperpigmentation Weight loss Muscle weakness Hyperglycemia
Hyperglycemia
A person who has a blood Mg2+ concentration of 3.3 mg/dL. Is considered to have _______.
Hypermagnesemia
Which cardiomyopathy is the most common cause of sudden cardiac death in young athletes due to ventricular arrhythmias? Dilated Restrictive Inflammatory Hypertrophic
Hypertrophic
Asthma exhibits each of the following characteristics except: Bronchial swelling Mucus secretion Airway remodeling Hypertrophy of the submucosal glands
Hypertrophy of the submucosal glands
A patient has a diagnosis of acute pancreatitis and a subsequent electrolyte imbalance. Which electrolyte imbalance may they experience given this condition? Explain why pancreatitis would lead to this imbalance.
Hypocalcemia. Acute pancreatitis causes the release of proteolytic and lipolytic enzymes. Free fatty acids are released during lipolysis in the pancreas. Ca2+ binds to these fatty acids removing them from the blood.
The following are common signs and symptoms of Cushing syndrome EXCEPT: Hypoglycemia Mood changes Muscle weakness Amenorrhea
Hypoglycemia
______ is defined as a blood glucose of <60 mg/dL, with associated cognitive impairment.
Hypoglycemia
Which of the following will promote wound healing? Malnutrition Increased blood flow Infection Foreign bodies
Increased Blood Flow
Which is NOT a finding consistent with Graves' disease? Exophthalmos Hypothyroidism Goiter Corneal ulceration
Hypothyroidism (its actually hyperthyroidism)
A reduction in blood O2 levels is known as ______.
Hypoxemia
Which of the following is true of a test's sensitivity? It is how likely the same result will occur if repeated If negative, it can safely be assumed that the person does not have a disease It is considered a true-negative result It can only be calculated from people without the disease
If negative, it can safely be assumed that the person does not have a disease
Which immunoglobulin provides local immunity on mucosal surfaces? IgA IgM IgG IgD IgE
IgA
Type I hypersensitivity reactions are _____ mediated reactions.
IgE
The _____ prevents feces from going back into the ileum.
Ileocecal Valve
Number of new cases in a population at risk during a specified time
Incidence
Someone with COPD would exhibit each of the following characteristics except:
Increased D-dimer levels
Each of the following are characteristics of Crohn disease EXCEPT: Affects any part of the GI tract Increased risk of malignancy Skip lesions Cobblestone appearance Granulomatous inflammation
Increased Risk of Malignancy
Liver damage from cirrhosis, hepatitis, or cancer would cause what type of jaundice?
Intrahepatic Jaundice
Which of the following is characteristic of chronic transplant rejection? Involves humoral immunity It responds well to immunosuppressive therapy Involves increased T lymphocytes
Involved humoral immunity
Each of the following are characteristics of ulcerative colitis EXCEPT: Bleeding being the most frequent clinical presentation Crypt abscess formation Increased risk of adenocarcinoma Inflammatory changes limited to the mucosa and submucosa Involvement of any portion of the GI tract
Involvement of any portion of the GI tract
Explain how the skin's physical barrier makes it inhospitable to microorganisms.
It has closely packed cells in multiple layers that are continuously being shed. Keratin covers the skin, which creates a salty, acidic environment inhospitable to microbes. It also contains antimicrobial proteins and lysozymes that inhibit microorganisms and help to destroy them.
Which is NOT true of the cytoskeleton? It controls shape and movement Cilia and flagella are microtubule-filled cellular extensions It includes peroxisomes and proteasomes
It includes peroxisomes and proteasomes Peroxisomes and proteasomes are not part of the cytoskeleton.
Which are true of the mitochondria? Select all that apply. It is involved in cellular respiration They are found far from the site of energy consumption They play a role in apoptosis They control free radicals
It is involved in cellular respiration They play a role in apoptosis
Which of the following is true of 25-hydroxycholecalciferol? It is the inactive form of vitamin D taken in through the skin via UV rays It is the inactive form of synthetic vitamin D It is the active form of vitamin D, converted in the liver It is the active form of vitamin D, converted in the kidney
It is the active form of vitamin D, converted in the liver
The following are each diagnostic of hyperosmolar hyperglycemic state (HHS) EXCEPT: Hyperglycemia Ketoacidosis Hyperosmolarity Dehydration All of the above are correct
Ketoacidosis
What are molecular and cellular mechanisms in genes that increase susceptibility to cancer? Select all that apply. Lack of cellular senescence Angiogenesis Ability to undergo apoptosis Mutations in growth factor signaling pathways Intact DNA repair genes
Lack of cellular senescence Angiogenesis Mutations in growth factor signaling pathways
What is one example of osmotic diarrhea?
Lactase Deficieny
Damage to the synovial membrane resulting in non-specific inflammation occurs in which stage of OA? Early stages Mid stages Late stages
Late Stages
_______ is the precursor for ______ that crosses the blood brain barrier making it the drug of choice for treatment of Parkinson's disease.
Levadopa, dopamine
Left ventricular failure is commonly characterized by each of the following except: Decreased cardiac output Liver congestion Orthopnea Paroxysmal nocturnal dyspnea Pulmonary edema
Liver Congestion
Which lab value will typically be increased in a viral infection? Neutrophils Eosinophils Basophils Lymphocytes
Lymphocytes
Which of the following is NOT true of vitamin B12 deficiency anemia? Dietary deficiencies are not common Peripheral neuropathy can be a result of deficiency Vitamin B12 is bound to intrinsic factor MCV is decreased
MCV is decreased
The coagulation cascade involves each of the following except: Make thrombocytes Activate the intrinsic and extrinsic pathways Convert fibrinogen to fibrin Convert prothrombin to thrombin
Make Thrombocytes
Risk factors for gallstone formation include each of the following EXCEPT: Obesity Male gender Age (40's) Pregnancy
Male Gender
Risk factors for gallstone formation include each of the following EXCEPT: Obesity Male gender Age (40's) Pregnancy
Male gender
A person reports feelings of anhedonia, guilt, and worthlessness that seem to be worse in the morning. They also exhibit excessive weight loss and experience insomnia. What type of depression are they experiencing? Melancholic depression Atypical depression Depression with psychotic features Depression with catatonic features
Melancholic depression
A ______ test to assess sensation, vascular status, and skin integrity, should be administered annually on all diabetic patients.
Monofilament
The effect of an illness on one's life
Morbidity
Which of the following is the effect of an illness on one's life? Incidence Morbidity Prevalence Mortality
Morbidity
Deals with the cause of death in a population
Mortality
Efferent neurons deliver _______ input from the CNS to the periphery.
Motor
Parkinson's disease is characterized by each of the following except: A loss of dopaminergic neurons Lewy bodies Neurofibrillary tangles Abnormal movement patterns
Neurofibrillary tangles
Which of the following are true regarding cell communication? Select all that apply. Paracrine signaling depends on hormones Neurotransmitters act through synapses Enzyme linked receptors act through an on-off switch Autocrine signaling releases a chemical into the extracellular fluid that affects its own activity
Neurotransmitters act through synapses Autocrine signaling releases a chemical into the extracellular fluid that affects its own activity
A decrease in this type of cell can lead to an increased risk of bacterial infections: Red blood cell Neutrophil Platelets Monocyte
Neutrophil
Which cell type is an early responder and the most abundant in the body? Lymphocytes Eosinophils Basophils Neutrophils
Neutrophils
Which of the following does NOT lead to an increased risk for DVT? Select all that apply. Factor V Leiden mutation Obesity Non-smoker Sepsis
Non-smoker
What is now the most common cause of chronic liver disease in the Western world?
Nonalcoholic fatty liver disease (NAFLD)
Each of the following are modifiable factors related to stroke except: Hypertension Diabetes Cardiac disease Obesity
Obesity
What is nonalcoholic fatty liver disease (NAFLD) associated with?
Obesity and metabolic syndrome (type 2 diabetes, hyperlipidemia)
List one example of screening for each method: observation, palpation, and lab test/procedure:
Observation: skin, mouth, external genitalia Palpation: breast, thyroid, rectum and anus, prostate, lymph nodes Laboratory tests and procedures: Pap smear, colonoscopy, mammography
What is one cause of gastric Retention
Obstruction, gastric atony, surgery
Premature Osteoporosis is characterized by which of the following? (mark all that apply) Often a result of chronic corticosteroid use Premature birth An increase in intestinal calcium absorption
Often a result of chronic corticosteroid use Premature birth
The double-layered fold of peritoneum that hangs down from the stomach to adjacent organs is called what Answer: omentum
Omentum
The formation of erythropoietin is preceded by low levels of _______.
Oxygen
These are cells of the same lineage that have not yet differentiated to the extent that they have lost their ability to divide:
Parent Cells
Chronic reflux esophagitis can develop each of the following except Peptic ulcers Esophageal strictures Barrett esophagus Esophageal adenocarcinoma
Peptic Ulcers
What are rhythmic movements designed to propel the chyme along the small intestine toward the large intestine?
Peristaltic Movements
What are rhythmic movements designed to propel the chyme along the small intestine toward the large intestine?
Peristaltic mvmts
While labile and stable cells can regenerate themselves, _______ cells are unable to undergo mitotic division.
Permanent Cells
Approximately 55% of blood volume consists of _____.
Plasma
Cholelithiasis would be an example of what type of jaundice?
Posthepatic jaundice
Excessive red blood cell destruction would cause what type of jaundice?
Prehepatic jaundice
A drastic decrease in urine output accompanied by a disproportionate increase of blood urea nitrogen (BUN) in comparison to serum creatinine levels is characteristic of _______ failure.
Prerenal
Number of people with the disease in a population in a given time
Prevalence
A deficiency in which of the following would lead to a hypercoagulable state? Select all that apply. Protein C Protein S Factor II Factor VII Factor IX Factor X Antithrombin III
Protein C Protein S Antithrombin III
What are normal genes called that become cancer-causing if mutated?
Protononcogenes
Right ventricular failure is commonly characterized by each of the following changes except: Distended neck veins Hepatomegaly Ankle edema Sodium and water retention Pulmonary edema
Pulmonary Edema
The ______ controls the rate of stomach contents into the small intestine.
Pyloric Sphincter
A 10-year-old boy who is having an acute asthma attack is brought to the ER. He is observed to be sitting up and struggling to breathe. His breathing is accompanied by use of accessory muscles, a weak cough, and audible wheezing sounds. His pulse is rapid and weak, and both heart and breath sounds are distant on auscultation. His parents relate that his asthma began to worsen after he developed a "cold," and now he doesn't get relief from his albuterol inhaler. Explain the changes in physiologic function underlying his signs and symptoms.
Recruitment of inflammatory cells from the bloodstream into the bronchial wall, where they directly attack the invading organisms and secrete inflammatory chemicals that are toxic to the organisms causes airway inflammation. Swelling of the bronchial wall, mucus secretion, constriction of the airway; bronchial hyper-responsiveness to stimuli causes airway obstruction or narrowing. They may discuss on a cellular level as well: Upon a trigger, the cascade of neutrophils, eosinophils, lymphocytes, and mast cells cause epithelial injury. This causes airway inflammation, which further increases hyperresponsiveness and decreased airflow. Mast cells release histamine and leukotrienes. These cause major bronchoconstriction, inflammation, and mucus secretion. Mast cells can trigger multiple cytokine release, which causes more airway inflammation. The contraction of the airways and subsequent swelling leads to further airway obstruction.
The liver is responsible for each of the following EXCEPT: Producing bile Stores vitamins and minerals Releases insulin Synthesizes protein
Releases Insulin
In the nephron, the mass of capillaries surrounded by an epithelial capsule that opens into a tubule is collectively referred to as the _______.
Renal Corpuscle
Which GI hormone inhibits gastric acid secretion?
Secretin
The body's ability to distinguish self from nonself is termed what? Autoantibodies Positive selection Self-tolerance Anergy
Self-Tolerance
A 23-year-old African-American man with a history of severe lifelong anemia requiring many transfusions has nonhealing leg ulcers and recurrent periods of abdominal and chest pain. These signs and symptoms are most likely to be associated with which one of the following laboratory abnormalities? Sickle cells on peripheral blood smear Loss of intrinsic factor Decreased erythropoietin Decreased ferritin
Sickle Cells on peripheral blood smear
A 23-year-old African-American man with a history of severe lifelong anemia requiring many transfusions has nonhealing leg ulcers and recurrent periods of abdominal and chest pain. These signs and symptoms are most likely to be associated with which one of the following laboratory abnormalities? Sickle cells on peripheral blood smear Loss of intrinsic factor Decreased erythropoietin Decreased ferritin
Sickle cells on peripheral blood smear
Lung volumes can be measured using a ______.
Spirometer
Hypnic myoclonia occurs in which stage of sleep? Stage 1 Stage 2 Stage 3 Stage 4
Stage 1
Which of the following would a patient likely report if you suspect they have OA? Pain in their MCP joint Stiffness in the morning that resolves in less than 30 minutes Pain that would be described as "acute" They feel "looser" after they move around
Stiffness in the morning that resolves in less than 30 minutes
Which of the following would a patient likely report if you suspect they have OA? Pain in their MCP joint Stiffness in the morning that resolves in less than 30 minutes You Answered Pain that would be described as "acute" They feel "looser" after they move around
Stiffness in the morning that resolves in less than 30 minutes
The liver is responsible for each of the following EXCEPT: Making clotting factors Storing bile Drug metabolism Stores glucose
Storing Bile
Risk factors for the development of peptic ulcer include each of the following EXCEPT: pylori infection Family history of PUD NSAID use Alcohol use Stress
Stress
_____ lies between the mucosal and muscle layers of the intestinal wall, and is involved with controlling secretions, absorption, and contraction of each segment of the intestinal tract.
Submucoasl (Meissner) Plexus
Explain the TNM system:
T is the size and local spread of the primary tumor. N is the involvement of the regional lymph nodes. M is the extent of the metastatic involvement.
Hypertrophy can occur under normal and pathological conditions. TRUE OR FALSE
TRUE
Which of the following statements is true regarding nephrons? It is divided into an outer medulla and an inner cortex It has 1 source of blood supply The glomerulus filters the blood while the tubule reabsorbs needed nutrients
The glomerulus filters the blood while the tubule reabsorbs needed nutrients
A patient presents to the emergency department with complaints of sharp pain that comes in waves in the upper lateral quadrant of the abdomen. Their skin is clammy, and they have been experiencing nausea and vomiting all day long. They have a past medical history of hyperparathyroidism. Urinalysis reveals calcium in their urine. A CT scan is ordered, and it reveals a stone 6 mm in diameter. What type of renal calculi do you suspect? What treatment is needed? Explain your reasoning for both answers.
The patient has a calcium stone given their past medical history and the findings of calcium in their urine. The stone will be unable to pass on its own given the diameter greater than 5 mm. It can be removed through ureteroscopic removal or extracorporeal shockwave lithotripsy. The patient may also be put on medication for pain management.
A patient presents in the emergency department with severe dehydration secondary to vomiting. The following are the results of their blood work: pH = 8.2, PCO2 = 39 mm, and HCO3 - = 33 mEq/L. Based upon these results, what type of acid-base disorder are they experiencing? Is compensation occurring? Describe a treatment intervention for this disorder. Normal values are as follows: pH = 7.35-7.45, PCO2 = 35-45 mm, HCO3 - = 22-26 mEq/L.
The patient is in metabolic alkalosis. The respiratory system is not compensating as PCO2 compensation falls within normal limits. Fluids are replaced with normal saline solution.
A patient is admitted to the hospital with pneumonia. The following are the results of their blood work: pH = 6.9, PCO2 = 52 mm, and HCO3- = 30 mEq/L. Based upon these results, what type of acid-base disorder are they experiencing? Is compensation occurring? Describe a treatment intervention for this disorder. Normal values are as follows: pH = 7.35-7.45, PCO2 = 35-45 mm, HCO3- = 22-26 mEq/L.
The patient is in respiratory acidosis. The renal system is attempting to compensate as HCO3- concentration is elevated above normal limits. The goal of treatment for respiratory acidosis is improving ventilation. Supplemental O2 can be administered; in severe cases mechanical ventilation may be indicated. Supplemental O2 is needed.
Which of the following are false of the cell? Proteins carry out the functions of the cell membrane. Lysosomes are the digestive system of the cell. The rough ER is the site for lipid synthesis. Microfilaments are thin, threadlike cytoplasmic structures.
The rough ER is the site for lipid synthesis.
If someone loses their balance when walking on uneven terrain, explain how tendons and ligaments work to protect the joint and structures within it.
The tendons and ligaments of joints serve in proprioception (the awareness of ones' position in space or movement of the body). When these structures undergo stretch or torsional strain, these proprioceptive nerve fibers will cause a reflexive response to adjust the tension on the muscles (to maintain balance and not fall over) that support the joint protecting the capsule and other joint structures.
The time between HIV infection and seroconversion is called what?
The window Period
What is the purpose of haustral churning?
Then ensuring fecal mass is exposed to the intestinal surface
A patient is in the ICU following open heart surgery. The patient was feeling well earlier in the day, but suddenly began to demonstrate signs of confusion and disorientation. Blood results reveal Na+ = 100 mEq/L. Based upon these symptoms and results of blood work, what electrolyte imbalance is this patient experiencing? What treatment is indicated for this imbalance?
This patient is experiencing euvolemic hypotonic hyponatremia. The administration of intravenous saline solution would be indicated to correct the sodium deficiency.
Each of the following can lead to atelectasis except: Pleural effusion Tumor mass Thrombus Mucous plug
Thrombus
A unique feature of the liver is that it has a dual blood supply. True or False
True
Activation of the peripheral nervous system decreases or stops the amplitude of the slow waves. TRUE OR FALSE
True
An autocrine action occurs when a hormone exerts an action on the cells that released them. True or False
True
An endocrine hormone is released into circulation to act on a target organ. True False
True
Angiotensin II stimulates the release of aldosterone. True or False
True
Asthma is considered reversible airway bronchoconstriction. True False
True
Both carbon dioxide and oxygen are able to bind with hemoglobin. True False
True
Cervical intraepithelial neoplasia is a type of dysplasia. True False
True
Complete dependence for activities of daily living is characteristic of severe Alzheimer's disease.
True
Type 2 diabetics can improve hyperglycemia with weight loss. True False
True
What is a tumor suppressor gene? Give one example.
Tumor suppressor genes are associated with gene underactivity. These genes slow down cell division, repair DNA mistakes, or tell cells when to die. BRCA1 or 2, TP53
Explain why a patient with chronic kidney disease may develop anemia.
Under normal circumstances, erythropoietin is synthesized in the kidneys and regulates the differentiation of red blood cells within the bone marrow. The formation of erythropoietin is hindered in chronic kidney disease.
With increasing occlusion of the coronary vessel(s), the demands of the resting heart may become too great. When the patient experiences angina without exertion, or when the level of exertion necessary to cause anginal symptoms decreases, this is called what? Stable angina Unstable angina Myocardial infarction
Unstable Angina
Each of the following are true of gout except: Uric acid dissolves readily in synovial fluid Typically occurs at the first metatarsophalangeal joint Anyone can get gout Uric acid is a byproduct of purine metabolism
Uric acid dissolves readily in synovial fluid
What nerve controls parasympathetic innervation to the stomach, small intestine, cecum, ascending colon, and transverse colon?
Vagus Nerve
Malignant tumors have which of the following characteristics? Select all that apply. Variable rate of growth Spreads by metastasis Well-differentiated cells Fibrous capsule
Variable rate of growth Spreads by metastasis
Explain the differences in the pathophysiology, symptoms, and whether nitroglycerin and/or rest will relieve symptoms in stable angina, unstable angina, and myocardial infarction.
With atherosclerotic disease, the coronary vessel lumens are narrowed and blood supply to the heart is diminished. With exertion, the vessels cannot adequately vasodilate. This can manifest as chest pain or tightness and/or shortness of breath. Stable angina- The heart is stable at rest but cannot keep up with the demand of exertion. Stable angina typically has a >70% stenosis of the coronary arteries. It is relieved by rest or nitroglycerin (vasodilator). Unstable angina- With increasing occlusion of the coronary vessel(s), the demands of the resting heart may become too great. When the patient experiences angina without exertion, or when the level of exertion necessary to cause anginal symptoms decreases, this is called unstable angina. It can be relieved by nitroglycerin, but not rest. Unstable angina means one or more coronary vessels is nearly totally occluded. Myocardial infarction- If a plaque ruptures, coronary thrombosis can cause complete occlusion. If collateral flow is inadequate, the tissue supplied becomes ischemic. Without oxygen, a portion of the muscle can die. MI can present as chest pain unrelieved by rest, sometimes radiating down the left ram or into the jaw or neck, dyspnea, nausea/vomiting, sweating, and/or other signs of distress. Other symptoms include a crushing pain or like "something is sitting on my chest." Women may present with weakness, fatigue, shortness of breath, or GI complaints. Symptoms are not relieved by nitroglycerin.
T lymphocytes produce what type of immunity?
cell-medidated
Shallow or abnormally slow breathing is referred to as _______.
hyponea
SRIs ________ the reuptake of serotonin at the presynaptic space.
inhibit
What is the purpose of propulsive mass movements? Y
it's part of the larger segment of the colon that helps move fecal matter and triggers the need for bowel movement. A large segment of the colon contracts as a unit, moving the fecal contents forward. These mass movements last about 30 seconds, followed by a 2-3-minute period of relaxation, then another contraction. This is what triggers the need for a bowel movement.
Which of the following cells are stimulated by PTH? Osteocytes Osteoclasts Osteoblasts Osteoprogenitor cells
osteoclasts
Which drugs are contraindicated in heart failure patients due to exacerbation of CHF by fluid accumulation.
thiazolidinediones (TZDs or glitazones)
What is the most important procedure in diagnosing the correct cancer and histology?
tissue biopsy
Which of the following are true regarding synovial joints? (mark all that apply) Ball and socket joints are characterized by limited range of motion Condyloid joints allow gliding of irregular joint surfaces They are freely moving The synovium lines articulating surfaces of the joint The synovium surrounds the joint margins
Condyloid joints allow gliding of irregular joint surfaces They are freely moving The synovium surrounds the joint margins
Which type of immunity is characterized by the development of a specific response to an antigen? Innate immunity Adaptive immunity Autoimmunity Active immunity
Adaptive Immunity
What is the source of the hormone that affects nutrient metabolism, regulates blood glucose levels, and has anti-inflammatory actions? Adrenal cortex Adrenal medulla Thyroid Anterior pituitary
Adrenal Cortex
Which are true of the cell membrane: Controls the transport of materials from the outside fluids to within The main structural component is made of proteins Helps with conduction of electrical currents in nerve and muscle cells Aids in the regulation of cell growth and proliferation
Aids in the regulation of cell growth and proliferation Controls the transport of materials from the outside fluids to within Helps with conduction of electrial currents in nerve and muscle cells
Na+ reabsorption, through the excretion of H+ ions, is achieved through the action of which of the following? Cardiovascular baroreceptors Aldosterone You Answered Diuretics
Aldosterone
Which of the following drugs is most commonly prescribed to treat osteoporosis? Raloxifene Alendronate Calcitonin
Alendronate
A patient is being seen in your office with a primary complaint of daytime fatigue that has lasted for the past 2 months. They go on to tell you that they are having difficulty with work performance and are constantly on edge. You suspect they have chronic insomnia. What are the 4 primary symptoms of insomnia? Describe a nonpharmacologic treatment plan that you can prescribe for this patient.
Answer: The 4 primary symptoms of insomnia are: Difficulty initiating sleep Difficulty maintaining sleep Waking up too early Chronic nonrestorative or poor sleep You would educate the patient on proper sleep hygiene and encourage them to evaluate possible stressors that may need to be removed from their daily routine. Sleep hygiene involves the establishment of consistent sleep patterns (going to bed at the same time each night and only sleeping as long as one needs to feel refreshed during the day), creating a comfortable sleeping environment (optimal room temperature), avoidance of screens and excessive light right before bed, and finally, avoidance of stimulants (caffeine) several hours prior to normal bedtime.
Each of the following disorders are correctly paired with related characteristics except: Pneumothorax - decreased breath sounds Atelectasis - worsening pain on inspiration Asthma - wheezing on expiration Pneumothorax - subcutaneous emphysema
Atelectasis - worsening pain on inspiration
_____ disorders occur when the immune system fails to differentiate self from non-self.
Auto Immune
Type 2 diabetes mellitus is associated with each of the following characteristics EXCEPT: Normal or increased insulin synthesis Autoimmune origin Onset in adults Obesity Rare ketoacidosis
Autoimmune origin
Each of the following are risk factors for secondary hyperlipidemia except? Obesity Diabetes mellitus High cholesterol diet Autosomal dominant disorder of LDL receptor
Autosomal dominant disorder of LDL receptor
Which of the following is FALSE regarding sickle cell disease? Abnormality of HbS gene Blood vessel occlusion is a complication Average red cell lifespan is 60 days Can lead to encapsulated infections
Average red cell lifespan is 60 days
ARDS is caused by each of the following conditions except: Shock Sepsis Inhalation of toxic irritants Bronchial obstruction by foreign body You Answered Head injury
Bronchial obstruction by foreign body
Food is converted in the stomach into a creamy mixture called
Chyme
Complications of gallstones include each of the following EXCEPT: Cirrhosis Biliary obstruction Pancreatitis Cholecystitis
Cirrhosis
You are seeing a patient with Parkinson's disease in your office. You feel a catch as you passively take their arm through flexion and extension. This is an example of what physical manifestation of the disease? Tremor Bradykinesia Cogwheeling Pill-rolling
Cogwheeling
Which of following medication is used to treat an acute gout attack? (mark all that apply). Colchicine NSAIDS Allopurinol
Colchicine NSAIDS
A 40-year-old man presents with cough and shortness of breath. After an H&P and chest films, it is determined he has pneumocystis carinii pneumonia (PCP). The provider does an HIV test, which is positive. Upon further testing, the man's CD4+ cell count is 100 cells/µL and his viral load is 250,000 copies/mL. (1) Why did the provider do an HIV test after the man was diagnosed with PCP? (2) What classification does this man fall into based on his CD4+ count and symptomatology, and why?
(1) Opportunistic infections are those common organisms that do not produce infection without impaired immune function. (2) The last phase, or AIDS illness, occurs when the CD4+ cell count falls to less than 200 cells/µL or exhibits an AIDS-defining illness. The risk of opportunistic infections and death increases significantly when the CD4+ cell count falls below 200 cells/µL.
1. When would surgery be appropriate in the treatment of cancer? 2. Most chemotherapeutic drugs cause pancytopenia due to bone marrow suppression. What are the 3 possible adverse outcomes of this?
1. Surgery is often the first treatment for solid tumors. If the tumor is small with well-defined margins, it can be removed completely. It is also used for oncologic emergencies and prophylactic surgery in high risk patients. 2. Neutropenia- risk for infections Anemia- causing fatigue Thrombocytopenia- risk for bleeding
List the 4 types of tissue found in the body. Pick 2 and give a description and example of each.
Epithelial tissue covers the body's outer surface, lines the inner surfaces, and forms glandular tissue. Epithelial tissue has three distinct surfaces and the basal surface is attached to an underlying basement membrane. It is avascular, meaning without blood vessels. It receives oxygen and nutrients from the capillaries of the connective tissue on which it rests. Connective or supportive tissue is the most abundant tissue in the body. It connects and binds or supports the various tissues. Its cells produce the extracellular matrix that support and hold tissues together. Connective tissue is divided into two types: connective tissue proper and specialized connective tissue (cartilage, bone, and blood cells). The four types of connective tissue proper are loose (areolar), adipose, reticular, and dense connective tissue. The function of muscle tissue is to move the skeletal structures, pump blood through the heart, and contract the blood vessels and visceral organs. Muscle tissue can accomplish this by contraction. The two types of fibers that contract are called thin and thick filaments. Thin filaments are called actin, and the thick filaments are myosin. The three types of muscles tissue are skeletal, cardiac, and smooth. Nervous tissue is distributed throughout the body for communication. It provides the means for controlling body function and for sensing and moving about the environment. The two types of cells are neuron and glial cells. Neurons function is communication. Glial (meaning glue) cells support the neurons.
What is the term that best describes the following process? A transport protein aiding a lipid insoluble or large molecule across the cell membrane that would otherwise not be able to pass through on its own.
Facilitated Diffusion
COPD is reversible airway bronchoconstriction. True False
False
During inflammation, blood vessels constrict to minimize tissue damage. True False
False
Glycogenesis means glucose formation. True False
False
Passive immunity is achieved through immunization. True False
False, active immunity
Cell proliferation is the process in which proliferating cells become more specialized cell types. True False
False, cell differentation
Cell differentiation is the process of increasing cell numbers by mitotic cell division. True False
False, cell proliferation
Corticosteroids can be used as needed for the management of pain associated with OA.
False, corticosteroids are to be used sparingly in the management of pain associated with OA as they contribute to the destruction of the joint.
Someone in the early stages of Alzheimer's disease requires assistance for their activities of daily living. TRUE OR FALSE
False, early stages they can live alone.
Hyperkalemia can be caused by movement of K+ from the ECF to the ICF compartment.
False, hyperkalemia can be cause by the movement of K+ from the ICF to the ECF compartment.
Oligodendrocytes produce myelin in the PNS.
False, oligodendrocytes produce myelin in the CNS.
Blood tests for tumor markers can make a diagnosis of cancer. Why or why not?
False, only tissue can diagnose. Tumor markers are helpful to assess response to therapy or reoccurrence.
Vital signs increase during stage 1 of NREM sleep.
False, vital signs decrease during stage 1 of NREM sleep.
Cell proliferation is the process in which proliferating cells become more specialized cell types.
False. Cell Differentiation
Risk factors for atherosclerosis include each of the following except: Increasing age Female gender (pre-menopause) Elevated CRP levels Cigarette smoking
Female Gender (per-menopause)
What is the most specific test for diagnosing iron deficiency anemia? Ferritin RBC Total iron binding capacity Hematocrit
Ferritin
The laboratory test that measures the volume of red cells in 100 mL of blood is _____.
Hematocrit
A 40-year-old patient sustains an incomplete spinal cord injury affecting their ability to walk. They primarily use a wheel chair to complete daily activities. Explain why this patient is at increased risk for developing OA in their lower extremities.
Immobilization can compromise lubrication of the joint which comes with range of motion and weight bearing. The decreased nourishment of the articular cartilage will eventually lead to the structural joint changes associated with OA.
Compare and contrast the two types of gangrenous necrosis
In dry gangrene the affected tissue becomes dry and shrinks, the skin wrinkles, and its color changes to dark brown or black. The spread of dry gangrene is slow. It results from a cut off in arterial blood supply and is a form of coagulation necrosis. In wet gangrene, the affected area is cold, swollen, and pulseless. The skin is moist, black, and under tension. Blebs form on the surface, liquefaction occurs, and a foul odor is caused by bacterial action. The spread of tissue damage is rapid.
Compare and contrast the two types of gangrenous necrosis.
In dry gangrene the affected tissue becomes dry and shrinks, the skin wrinkles, and its color changes to dark brown or black. The spread of dry gangrene is slow. It results from a cut off in arterial blood supply and is a form of coagulation necrosis. In wet gangrene, the affected area is cold, swollen, and pulseless. The skin is moist, black, and under tension. Blebs form on the surface, liquefaction occurs, and a foul odor is caused by bacterial action. The spread of tissue damage is rapid.
Compare and Contrast breathing patterns between NREM and REM sleep (include a discussion on the specific stages of NREM sleep.)
In stages 1 and 2 NREM sleep as well as in REM sleep, breathing is irregular, and brief periods of apnea are often observed (approximately 5-15 seconds.) During stages 3 and 4 of deep sleep, breathing becomes regular.
In which of the following ways is blood flow NOT negatively affected? Blood viscosity Diameter of the vessel Low hematocrit Compliance
Low Hematocrit Compliance
Which of the following lab values would you expect to see in a patient who has Addison's disease? Low Na, Low K High Na, High K Low Na, High K High Na, Low K
Low Na, High K
Electrical potentials that exist in the cell membrane are called what?
Membrane potentials
The double layer of peritoneum that holds the organs in place and stores fat is called what?
Mesentery
The double layer of peritoneum that holds the organs in place and stores fat is called what? Answer: mesentery
Mesentery
Explain what necrosis is and give an example and description of one type of necrosis.
Necrosis refers to cell death in an organ or tissues that is still part of a living person. It often interferes with cell replacement and tissue regeneration. Coagulative necrosis results most often from a sudden cutoff of blood supply to an organ (ischemia), particularly the heart and kidney. Liquefactive necrosis occurs when some of the cells die but their catalytic enzymes are not destroyed. It is commonly seen with brain infarcts or abscesses. Caseous necrosis occurs as part of granulomatous inflammation and is most often associated with tuberculosis. Gangrenous necrosis most often affects the lower extremities or bowel and is secondary to vascular occlusion. The term gangrene is applied when a considerable mass of tissue undergoes necrosis. In dry gangrene the affected tissue becomes dry and shrinks, the skin wrinkles, and its color changes to dark brown or black. The spread of dry gangrene is slow. It results from a cut off in arterial blood supply and is a form of coagulation necrosis. In wet gangrene, the affected area is cold, swollen, and pulseless. The skin is moist, black, and under tension. Blebs form on the surface, liquefaction occurs, and a foul odor is caused by bacterial action. The spread of tissue damage is rapid.
A patient has low serum calcium levels. Which of the following is true given this scenario? The thyroid gland will secrete PTH to return serum calcium levels to normal The thyroid gland will secrete calcitonin to return serum calcium levels to normal PTH will increase renal reabsorption of calcium while simultaneously increasing renal excretion of phosphate PTH will increase blood phosphate levels
PTH will increase renal reabsorption of calcium while simultaneously increasing renal excretion of phosphate
Which of the following is NOT a regulator of blood pressure? Baroreceptors Renin-angiotensin-aldosterone system Vasopressin Parasympathetic nervous system activation
Parasympathetic Nervous System Activation
What type of cell secretes hydrochloric acid in the stomach?
Parietal Cells
High blood pressure is an example of which of the following? Pathology Pathophysiology Physiology No answer text provided.
Pathophysiology is the study of disease
Which of the following patients is at greater risk for developing osteoporosis and sustaining a fracture? Explain how you came to your conclusion. Patient A. is a 75-year-old white Caucasian male who has a history of a distal radius fractures at age 65. Patient B. is a 60- year-old African American female who is postmenopausal. She is active and does not have a history of fractures.
Patient A is at higher risk. Even though he is a male, he is advanced in age, white Caucasian, and sustained a fracture after the age of 50. Patient B is a postmenopausal female; however, she is active and of African American decent which is associated with high BMD and low rates of fracture.
A 72-year-old male is said to be in phase 2 of gout. He is obese and has a history of alcohol abuse. Develop a treatment plan including specific pharmacologic intervention and a non-pharmacologic recommendation to manage his disease.
Phase 2 of gout is acute gout arthritis. The goal of treatment in this phase is to control inflammation and pain. Colchicine is a prescription drug that could be used to treat his acute inflammation. NSAIDS can also be used to treat inflammation and manage pain. This patient should be encouraged to lose weight and decrease his alcohol consumption. He should also avoid purine rich foods such as fish, bacon, and liver. (*Note - the student has to provide 1 pharmacologic intervention and 1 non-pharmacologic recommendation.)
A 72-year-old male is said to be in phase 3 of gout. He is obese and has a history of alcohol abuse. Develop a treatment plan including specific pharmacologic intervention and a nonpharmacologic recommendation to manage his disease.
Phase three gout is called inter-critical phase. The goal is to prevent future attacks by maintaining normal uric acid levels, hence prevent disease progression. Allopurinol is used to reduce uric acid levels. Lifestyle changes, such as weight loss, reduction in alcohol consumption, and avoid foods high in purines (fish, bacon, shellfish). Phase 3 of gout is called inter-critical gout
What are two important properties that stem cells possess?
Potency and Self Renewal
Narcolepsy appears to be linked to an abnormal regulation of which stage of sleep? stage 1 stage 2 stage 4 REM
REM
A 10-year-old boy who is having an acute asthma attack is brought to the ER. He is observed to be sitting up and struggling to breathe. His breathing is accompanied by use of accessory muscles, a weak cough, and audible wheezing sounds. His pulse is rapid and weak, and both heart and breath sounds are distant on auscultation. His parents relate that his asthma began to worsen after he developed a "cold," and now he doesn't get relief from his albuterol inhaler.
Recruitment of inflammatory cells from the bloodstream into the bronchial wall, where they directly attack the invading organisms and secrete inflammatory chemicals that are toxic to the organisms causes airway inflammation. Swelling of the bronchial wall, mucus secretion, constriction of the airway; bronchial hyper-responsiveness to stimuli causes airway obstruction or narrowing. They may discuss on a cellular level as well: Upon a trigger, the cascade of neutrophils, eosinophils, lymphocytes, and mast cells cause epithelial injury. This causes airway inflammation, which further increases hyperresponsiveness and decreased airflow. Mast cells release histamine and leukotrienes. These cause major bronchoconstriction, inflammation, and mucus secretion. Mast cells can trigger multiple cytokine release, which causes more airway inflammation. The contraction of the airways and subsequent swelling leads to further airway obstruction.
What are the intermittent contractions that help to mix and move food along?
Rhythmic Movements
Which of the following is a way in which HIV is NOT spread? Saliva Sexual transmission Drug injection paraphernalia Breastfeeding
Saliva
Explain how the kidney can maintain a constant GFR despite variations in the arterial blood pressure of the rest of the body.
The renal autoregulatory system causes the efferent arteriole to constrict leading to an increased resistance to outflow from the glomeruli with a subsequent increase in glomerular pressure and the GFR. When the afferent arteriole constricts there is a reduction in renal blood flow, glomerular pressure, and the GFR.
When is the risk for obstructive atelectasis the greatest? What are strategies to decrease the chance for developing atelectasis?
The risk of obstructive atelectasis is increased following surgery. Anesthesia, pain and pain medications, and immobility promote retention of bronchial secretions. Patients are encouraged to frequently cough, deep breath, change positions, hydrate adequately, and ambulate early to prevent atelectasis.
A 50-year-old woman was diagnosed with breast cancer from tissue biopsy following her diagnostic mammography. They are determining if it has spread to the lymph nodes. (1) Explain what the sentinel node is. (2) How will they determine if it has spread to the lymph system? (3) Would a detailed family history of disease be important to obtain?
The sentinel node is the first lymph node to which the primary tumor drains. The extent of disease may be determined through lymphatic mapping and sentinel lymph node biopsy. A radioactive tracer and/or blue dye is injected into the tumor to determine the first lymph node. This lymph node is examined for the presence of cancer cells. Yes, heredity can be a strong risk factor for cancer in some families.
Each of the following statements are true regarding control over the GFR except: The kidney can maintain a constant GFR despite variations in the arterial blood pressure of the rest of the body. The sympathetic nervous system cannot supersede the renal autoregulatory system. The sympathetic nervous system can supersede the renal autoregulatory system. The RAA responds when blood pressure drops below normal limits.
The sympathetic nervous system cannot supersede the renal autoregulatory system.
Which of the following is false regarding the synovium? The inner membrane of the joint capsule is referred to as the synovium The synovium surrounds the margins of articulation and lines the articulating surfaces of the joint The synovium secretes fluid that facilitates movement between articulating surfaces
The synovium surrounds the margins of articulation and lines the articulating surfaces of the joint
If someone loses their balance when walking on uneven terrain, explain how tendons and ligaments work to protect the joint and structures within it.
The tendons and ligaments of joints serve in proprioception (the awareness of ones' position in space or movement of the body). When these structures undergo stretch or torsional strain, these proprioceptive nerve fibers will cause a reflexive response to adjust the tension on the muscles (to maintain balance and not fall over) that support the joint protecting the capsule and other joint structures.
Explain the challenges of diagnosing autoimmune disorders.
There are over 80 identified, many with overlapping presentations. Many manifestations are nonspecific and are seen in other non-autoimmune diseases. Blood testing isn't perfect either, as some tests are more generic and can be elevated in the presence of other diseases.
A 68-year-old, white Caucasian female has a DEXA scan at the recommendation of her PCP. Her scan yielded a T-score of -0.9. Interpret the results of her DEXA scan. Develop a treatment plan giving a pharmacologic recommendation if applicable (be specific with name of supplement and/or class of drug), and a non-pharmacologic recommendation.
This T-score indicates normal bone density; however, because of this patient's age, race, and gender, she should take a Calcium supplement as well as a Vitamin D supplement. She should also be participating in regular weight bearing activities such as walking or even resistance exercise.
A patient reports to the emergency department where you are working at 10 pm. They report that earlier in the day beginning at approximately 9 am they began to experience tingling in their right arm. They decided to ignore it thinking it was probably a result of all the gardening they did the day before. As the day went on, the tingling sensation got worse, and they started to have difficulty speaking. The patient's spouse reported that they were slurring their words. Past medical history includes a diagnosis of diabetes and hypercholesteremia. By the time they are evaluated, their symptoms start to subside. The tingling disappears and their speech returns to normal. What do you suspect this patient has experienced? What evidence is there to support that diagnosis?
This patient has experienced a TIA. They have experienced symptoms consistent with oxygen deprivation to the brain, however their symptoms subsided within 24 hours of their onset.
A patient presents with serum uric acid levels of 7.2 mg/dL. They have no active inflammation or complaints of pain. Which phase of gout are they in? Explain how you came to this conclusion.
This patient is in phase 1 of gout or asymptomatic hyperuricemia. They have elevated serum uric acid levels, but they do not exhibit symptoms of an acute attack.
A 75-year-old male is brought to the emergency department via ambulance at 5 pm. The patient's spouse reports that when they woke up (approximately at 6 am) he reported to her that he was having some blurred vision but decided to go about his day. As the day progressed, he started experiencing tingling and feelings of weakness on the entire left side of his body. He has a past medical history of diabetes. Based upon these symptoms and past medical history, what do you suspect this patient is experiencing? How would you confirm this diagnosis? What treatment should be administered? Explain why you chose that treatment.
This patient is more than likely experiencing an ischemic stroke. A CT scan and MRI would be needed to determine if a clot was blocking blood flow to the brain tissue and to rule out a hemorrhagic stroke. If a clot is found, this patient would need to be re-perfused through catheter-base methods as they are outside of the 3-4.5 treatment window for the use of tPA drugs. He is outside the window of tPA so catheter based methods are necessary to re-perfuse the brain
Clinical manifestations of cirrhosis include each of the following EXCEPT: Hemorrhoids Asterixis Esophageal varices Thrombocytosis Ascites
Thrombocytosis
What hormone plays a major role in the maintenance of body metabolism and growth and development in children? Epinephrine Cortisol Parathyroid Thyroid
Thryoid
There are ways to prevent and/or control progression of diabetic kidney disease (nephropathy). Name 4 of them:
Tight glycemic control; blood pressure control (<130/80); hyperlipidemia treatment; smoking cessation; and limiting proteinuria through ACE inhibitors or ARBs, or protein restriction.
What type of seizure occurs in 2 phases, involves a loss of consciousness, and lasts approximately 60-90 seconds? Tonic-clonic seizure Myoclonic seizure Absence seizure Atonic seizure
Tonic-clonic seizure
The movement of leukocytes from the vascular space to the extravascular tissue during acute inflammation is termed what? Adhesion Transmigration Chemotaxis Margination
Transmigration
Excess surface tension makes lung inflation harder. True False
True
Following a heart attack, the area of heart muscle that has undergone necrosis because of lack of blood supply will heal by scar tissue replacement. True False
True
Hormones work through receptors, and the speed of this action varies. True False
True
Insulin promotes glycogenesis and glycolysis. True False
True
Most hormones are controlled through negative feedback. True False
True
Nutritional deprivation can cause tissue to atrophy. True False
True
The Dowager hump is a result of collapsed vertebrae.
True
The GI tract produces both enzymes and hormones. True False
True
The T cells that display the host's MHC antigens and T-cell receptors for a nonself-antigen are allowed to mature, a process termed positive selection. True False
True
The diaphragm is the primary muscle of inspiration. True False
True
The production and release of hormones by the pituitary gland requires stimulation by the hypothalamus. True False
True
Blood circulates through bone by what means? (mark all that apply) Via the central Haversian and Volkmann canals An anastomosis between perforating and nutrient arteries Diffusion through the endosteal surface of the bone and the canaliculi
Via the central Haversian and Volkmann canals An anastomosis between perforating and nutrient arteries Diffusion through the endosteal surface of the bone and the canaliculi