PATHO MIDTERM CH. 10, 11, 13, 14, 15
Which forms of leukemia demonstrates the presence of the Philadelphia chromosome?
CML (chronic myeloid leukemia)
What is the correct definition of complete remission (CR) of leukemia?
CR is less than 5% blasts in marrow and normal CBC values.
Widespread activation of the clotting cascade secondary to massive trauma is called
Disseminated intravascular coagulation (DIC)
A laboratory test finding helpful in confirming the diagnosis of iron-deficiency anemia is
Elevated total iron-binding capacity
The prothrombin time (PT) & international normalized ration (INR) measure the integrity of
Extrinsic pathway
Treatment for hemophilia A includes
Factor VIII replacement
True or False: Vaccination for pneumococcal pneumonia should be performed before 1 year of age in patients with sickle cell anemia.
False
True or False: seasonal allergic rhinitis is most involved in type II hypersensitivity reactions.
False
Dysfunction of which organ would lead to clotting factor deficiency?
Liver
Thalassemia may be confused with iron-deficiency anemia, because they are both
microcytic
Anemia related to vitamin B12 or folate deficiency is characterized by what laboratory features? (Select all that apply) A. RBC counts of 775,000 to 900,000 cells/mm3 B. RBC counts of 500,000 to 750,000 cells/mm3 C. WBC counts of 3000 to 4000 cells/mm3 D. WBC counts of 4000 to 5000 cells/mm3 E. Platelet counts of 60,000 cells/mm3
B, D
The most common primary immune deficiency that affects only B cells is
Selective IgA
Which disorder is associated with a type II hypersensitivity mechanism of injury?
Systemic lupus erythematosus
The hypersensitivity reaction that does not involve antibody production is type II (2)
type II
Which vessel normally demonstrates the most rapid blood flow?
vena cava
A commonly ingested substance associated with prolongation of the bleeding time is
aspirin
Red blood cells differ from other cell types in the body, because they
have no cytoplasmic organelles
A 3 year old boy who exhibits prolonged bleeding after minor trauma and a prolonged aPTT, but a normal platelet count, is likely to be diagnosed with
hemophilia
An important mediator of a type I hypersensitivity reaction is
histamine
The major cause of death from leukemic disease is
infection
The patient is a 12-year-old boy diagnosed with acute lymphoid leukemia (ALL). As part of treatment, the patient must undergo several weeks of chemotherapy. The most serious complication of chemotherapy is
infection
Pernicious anemia is caused by a lack of
intrinsic factor
What is necessary for red blood cell production?
iron
Dramatic hypotension sometimes accompanies type I hypersensitivity reactions, because
massive histamine release from mast cells leads to vasodilation
RhoGAM (an Rh antibody) would be appropriate in an Rh-_____ woman with an _____ Rh-_____ antibody titer carrying an Rh-_____ fetus.
negative, negative, positive
A diagnostic laboratory finding in myeloma is
Bence Jones proteins in the urine
Red blood cells obtain nearly all their energy from metabolism of
Glucose
A patient presents to the physician's office with pinpoint hemorrhages on the skin. The patient is most likely between the ages of _________ years.
4 and 7
Secondary immune deficiency problems may be caused by (select all that apply) A. Surgery B. High blood sugar C. Corticosteroids D. Genetic disorders E. Low protein level
A, B, C, E
Which condition is associated with an elevated reticulocyte count ?
hemolytic anemia
Myasthenia gravis is a type II hypersensitivity disorder that involves
impaired muscle function
The effects of histamine release include
increased vascular permeability
Which diseases may be associated with a bleeding problem? (Select all that apply) A. Urinary retention B. Renal failure C. Cirrhosis D. Systemic lupus erythematosus E. Ovarian cancer
B, C, D, E
A patient is diagnosed with CML (chronic myeloid leukemia). The patient may experience which of these symptoms? (select all that apply) A. Fatigue B. Weight loss C. Abdominal discomfort D. Joint pain E. Sweats
A, B, C, E
A patient is diagnosed with stage III non-Hodgkin lymphoma and is preparing to undergo treatment. Which treatments may be used to treat this patient's cancer (select all that apply) A. Radiation B. Bone marrow transplant C. Chemotherapy D. Lymph node transplant E. Monoclonal antibody therapy
A, B, C, E
A newborn has melena, bleeding from the umbilicus, and hematuria. The newborn most likely experiencing
vitamin K deficiency bleeding
Patients who experience anemic episodes when exposed to certain drugs most likely have
glucose-6-phosphate dehydrogenase deficiency
The nurse is educating a patient diagnosed with anemia of chronic renal failure about the disease. Which statements made by the nurse are correct regarding the patient's treatment? (Select all that apply) A. "Since your glomerular filtration is 13mL/min, you'll be started on dialysis" B. "Your hematocrit is 29%, so you're going to start on erythropoietin therapy" C. "Your hemoglobin is 9g/dL, so you'll need erythropoietin therapy" D. "We need to get your hemoglobin up to at least 15 g/dL" E. "You're going to need iron, folate & B12 therapy to help improve your blood
A, B, C, E
A patient is diagnosed with hairy cell leukemia. The patient's laboratory results would most likely indicate a decrease in (select all that apply) A. Granulocytes B. Platelets C. WBC D. RBC E. Melanocytes
A, B, D
The patient is a 12-year-old boy diagnosed with acute lymphoid leukemia (ALL). Manifestations of the patient's leukemia prior to treatment may include (select all that apply) A. Anemia B. Leukocytosis C. Leukopenia D. Thrombocytopenia E. Anuria
A, B, D
In general, the best prognosis for long-term disease-free survival occurs with
ALL (acute lymphoid leukemia)
Which type of leukemia primarily affects children?
ALL (acute lymphoid leukemia)
What is involved in the release of plasminogen activators? (Select all that apply) A. Factor X B. Factor XII C. HMWK D. Kallikren E. Thrombin
B, C, D, E
While I'm the hospital for management of acute lymphoid leukemia (ALL), a patient develops severe thrombocytopenia. The most appropriate action for this condition is
Activity restriction
Certain autoimmune diseases are associated with the presence of specific proteins on a person's cells. These proteins are called ________ proteins.
HLA or MHC
The principle Ig mediator of type I hypersensitivity reactions is
IgE
Disseminated Intravascular Coagulation (DIC) may be treated with heparin therapy to
Inhibit clotting factor consumption
The activated partial thromboplastin (aPTT) is a measure of the integrity of
Intrinsic pathway
The most appropriate treatment for secondary polycythemia is
Measured to improve oxygenation
A 58 year old women is seen in the clinic for reports of severe back pain. Her chest x-ray demonstrates generalized bone demineralization and compression fracture. Blood studies demonstrate elevated calcium levels. The most likely diagnosis is
Myeloma
Renal insufficiency is a common complication of which disease?
Myeloma.
Which group of clinical findings describes the typical presentation of ALL (acute lymphoid leukemia)?
Pain in long bones, infection, fever, bruising
A deficiency of von Willebrand factor impairs
Platelet adhesion to injured tissue
A patient is diagnosed with a tortuous blood vessel of the right hand that bleeds spontaneously. This patient presents with
Telangiectasia
Activation of the extrinsic pathway of coagulation is is initiated by
Tissue thromboplastin
True or False: Hemophilia B is also known as Christmas disease
True
True or False: The anemia resulting from a deficiency of either vitamin B12 (cobalamin) or folate is caused by a disruption in DNA synthesis of the blast cells in the bone marrow that produces very large abnormal bone marrow cells called megaloblasts.
True
True or False: The liver is responsible for the synthesis of coagulation factors, within the exception of part of VIII
True
True or False: The only known curative treatment for CML is allogeneic bone marrow transplantation from a suitable donor
True
True or False: Two of the most serious oncology emergencies associated with non-Hodgkin lymphoma are obstruction of the superior vena cava and compression of the spinal cord
True
A child with a history of recent strep throat infection develops glomerulonephritis. This is most likely a type _____ hypersensitivity reaction.
Type III
The Philadelphia chromosome is a balanced chromosome translocation that forms a new gene called
bcr-abl.
Most carbon dioxide is transported in the bloodstream as
bicarbonate ion
A cause of thrombocytopenia includes
chemotherapy
The final step in clot formation is __________.
clot retraction
Patients with immunodeficiency disorders are usually first identified because they
develop recurrent infections
The most effective therapy for anemia associated with kidney failure is
erythropoietin administration
The conversion of plasminogen to plasmin results in
fibrinolysis
The strength of the bond between oxygen and hemoglobin is known as the
oxygen-hemoglobin affinity
What laboratory finding is usually found in aplastic anemia?
pancytopenia
The megakaryocyte is a precursor to
platelets
Transfusion reactions involve RBC destruction caused by
recipient antibodies
The movement of blood through the vascular system is opposed by the force of
resistance
An increase in hemoglobin affinity for oxygen occurs with
shift to the left
Autologous stem cell transplantation is procedure in which
stem cells are harvested from the patient and then returned to the same patient
The cause of the most common form of anemia is
iron deficiency
The arterial oxygen content (CaO2) for a patient with PaO2 100mm HG, SaO2 95%, and hemoglobin 15g/dL is ____________ mL oxygen/dL.
19.4
Anaphylaxis may occur in certain hypersensitivity reactions, including type (Select all that apply.) A. I. B. II. C. III. D. IV.
A, B
A patient is diagnosed with aplastic anemia. The nurse expects to find what patient symptoms upon assessment? (Select all that apply) A. Lethargy B. Heart palpitations C. Transient murmurs D. Bradycardia E. Orthopnea
A, B, C
Regarding iron deficiency anemia, what laboratory features are typically decreased? (Select all that apply.) A. MCV B. MCH C. MCHC D. WBC E. Thrombocytes
A, B, C
Which involved bleeding associated with vascular or platelet defects? (Select all that apply) A. Bleeding that occurs immediately after trauma B. Bleeding that involves skin or mucus membranes C. Bleeding that is brief in duration D. Bleeding that is delayed E. Bleeding into muscles or joints
A, B, C
Which viruses have been implicated as cancer-causing agents? (select all that apply) A. Epstein-Barr B. Human T-cell leukemia C. Human immunodeficiency D. Herpes E. Shingles
A, B, C
A new born patient is diagnosed with hemolytic disease. The nurse may expect to find what signs and symptoms (select all that apply) A. Petechial hemorrhages B. Hepatomegaly C. Splenomegaly D. Kernicterus E. Erythema
A, B, C, D
One of the cardinal features of sickle cell anemia includes acute and chronic dysfunction of which organs? (Select all that apply.) A. Spleen B. Bones C. Brain D. Lungs E. Stomach
A, B, C, D
A male patient involved in a motor vechicle accident is brought to the emergency department with acute flank pain. What additional signs of bleeding may the patient exhibit? (Select all that apply) A. Hematuria B. Melena C. Hematemesis D. Menor hago a E. Hemoptysis
A, B, C, E
A patient is diagnosed with myeloma. The nurse teaches the patient about the multiple tumor sites that can develop with this cancer. The possible tumor sites in myeloma include the (select all that apply) A. Liver B. Spleen C. Stomach D. Pancreas E. Kidneys
A, B, E
Autoimmune diseases results from (select all that apply) A. Overactive immune function B. Increase in self-tolerance C. Failure of the immune system to differentiate self & no self molecules D. Communicable infections
A, C
A patient is diagnosed with stage II Hodgkin disease. This patient's clinical stage was most likely determined by (select all that apply) A. Patient history B. Lymph node biopsy C. Laparotomy results D. CT scan E. Physical examination
A, D, E
A 5 year old patient parents report loss of appetite and fatigue in their child. The parents also state that the child refuses to walk as a result of pain. The child's most likely diagnosis is
ALL (acute lymphoid leukemia)
Excessive red cells lysis can be detected by measuring the serum
Bilirubin
Hapten mechanisms are found in which medications? (Select all that apply.) A. Ibuprofen B. Narcotics C. Penicillin D. Cephalosporins E. Tetracycline
C, D, E
Severe combined immunodeficiency (SCID) syndrome is an example of a (n)
Deficient immune response
Burkitt's lymphoma is most closely associated with
Epstein-Barr virus
Which disorder is considered a primary immunodeficiency disease?
HIV/AIDS
A primary effector cell of type I hypersensitivity response is
Mast cells
A normal bleeding time in association with normal platelet count & increased prothrombin time (PT) and INR, is indicative of
Vitamin K deficiency
A low mean corpuscular hemoglobin concentration (MCHC) and mean corpuscular volume (MCV) are characteristic of which type of anemia?
iron deficiency
Which characteristic is indicative of hemolytic anemia?
jaundice
The primary source of erythropoietin is provided by
kidney
Which causes vasoconstriction?
norepinephrine
