patho midterm practice questions

Atopic dermatitis (eczema) is due to • parasitic infestation of the skin. • superficial staphylococcal infection. • superficial fungal infection. • contact with skin allergens.

contact with skin allergens.

Which of the following is an effective treatment of pneumonia, atelectasis, and cystic fibrosis? a. Deep breathing b. Oxygen c. Inhalers d. Chest physiotherapy

d. Chest physiotherapy

Aldosterone may increase during stress, leading to (Select all that apply.) A. decreased urinary output. B. increased blood potassium. C. increased sodium retention. D. increased blood volume. E. decreased blood pressure.

A. decreased urinary output. C. increased sodium retention. D. increased blood volume.

Which finding is characteristic of oral candidiasis? • Silvery plaques on the skin • Itching, oozing rash • Thickened, discolored nails • Whitish coating on the tongue

Whitish coating on the tongue

Impetigo is usually caused by a • virus. • fungus. • protozoan. • bacteria.

bacteria.

Nephrotic syndrome does not usually cause • hyperlipidemia. • proteinuria. • hematuria. • generalized edema.

hematuria.

Hyperlipidemia occurs in nephrotic syndrome because • hepatocytes synthesize excessive lipids. • lipids are not excreted in the urine. • body fats are catabolized. • muscles stop burning triglycerides for energy.

hepatocytes synthesize excessive lipids.

Which is not normally secreted in response to stress? • Norepinephrine • Cortisol • Epinephrine • Insulin

insulin

Serum creatinine may be increased by • carbohydrate intake. • fat intake. • muscle breakdown. • fluid intake.

muscle breakdown

Which disorder is associated with a type III hypersensitivity mechanism of injury? • Systemic lupus erythematosus • Graves disease • Erythroblastosis fetalis • Seasonal allergic rhinitis

Systemic lupus erythematosus

At puberty when sebaceous gland secretion increases, follicle obstruction and infection may occur, resulting in • psoriasis. • eczema. • acne vulgaris. • pemphigus.

acne vulgaris.

The pathophysiologic basis of acute glomerulonephritis is • renal ischemia. • bacterial invasion of the glomerulus. • an anaphylactic reaction. • an immune complex reaction.

an immune complex reaction.

Findings most consistent with iron def anemia

B. low MCH, low MCV

The blood urea nitrogen (BUN) level is affected by (Select all that apply.) A. protein intake. B. fat intake. C. fluid intake. D. catabolism. E. renal function.

A. protein intake. C. fluid intake. D. catabolism. E. renal function.

Every springtime, a young healthy man is bothered by episodes of nasal congestion accompanied by sneezing and watery eyes. He has no cough. On physical examination he is afebrile. There is swelling of his nasal passageways, but no other findings. His condition improves with use of loratadine. His problems are most likely produced by release of chemical mediators from which of the following cell types? A Neutrophil B Mast cell C CD4+ cell D NK cell E Macrophage

B Mast cell

A 21-year-old man with serum IgA of 22 mg/dL, IgG of 175 mg/dL, and IgM of 40 mg/dL has had a high fever with cough productive of yellowish sputum for the past two days. Auscultation of his chest reveals a few crackles in both lung bases. A chest radiograph shows bilateral patchy pulmonary infiltrates. Which of the following inflammatory cell types will most likely be seen in greatly increased numbers in his sputum specimen? A Macrophage B Neutrophil C Mast cell D Lymphocyte E Langhans giant cell

B Neutrophil

Sarah, aged 82 years, choked on a piece of meat and was unable to breathe for several minutes. A Heimlich Maneuver was performed and her ABGs are: pH 7.39, PaCO2 48, PaO2 92, and HCO3 24. What do you suspect? A. Resp alk B. Resp acid C. Met alk D. Met acid

B. Resp acid

When evaluating pulmonary function tests in clients with asthma, chronic severe bronchitis, or emphysema, would would expect to see: A. a decreased PCO2 in clients with asthma and an increased PCO2 in with severe, chronic bronchitis B. a decreased PO2 in clients with asthma and an increased PO2 in clients with emphysema C. a positive response to the bronchodilators in all 3 conditions D. a decrease in total lung capacity in all 3 conditions

C. a positive response to the bronchodilators in all 3 conditions

Acute urticaria is frequently an allergic reaction. The most common allergens that precipitate this specific response include A. insect stings, shellfish, parasites B. PCN, morphine, aspirin C. insect stings, infection, exercise D. drugs, exercise, cigarette smoke

C. insect stings, infection, exercise

A 30-year-old man has the sudden onset of fever, cough, and dyspnea. He has lost about 10% of his normal body weight over the past 6 months, along with a chronic, watery diarrhea. A bronchoalveolar lavage is performed, and cysts of Pneumocystis jiroveci are seen in the fluid. He is treated with clotrimoxazole and recovers. He develops pain and decreased vision on the right, and funduscopic examination reveals a cytomegalovirus retinitis; this improves with ganciclovir therapy. He develops tan-yellow plaques on his tongue with Candida albicans. Which of the following laboratory test findings is most likely to be present in this man? A ANA titer of 1:1024 B Platelet count of 15,000/microliter C Serum IgA of 10 mg/dL D CD4 lymphocyte count of 100/microliter E cANCA titer of 1:25

D CD4 lymphocyte count of 100/microliter

A 28-year-old woman is given intravenous penicillin to treat infective endocarditis. Within minutes of starting this therapy, she begins to have severe difficulty breathing with respiratory stridor and tachypnea. She suddenly develops an erythematous skin rash over most of her body. Her symptoms are most likely to be produced by release of which of the following chemical mediators? A Interleukin 1 B Bradykinin C Complement C5a D Histamine E Thromboxane

D Histamine

Twelve hours after going on a hike through dense foliage, a 40-year-old man notices a slightly raised and tender irregular reddish rash on one forearm that was not covered by clothing. This rash gradually increases in intensity for 2 days and then fades away after two weeks. Which of the following forms of immunologic hypersensitivity is most likely demonstrated in this patient? A Type I hypersensitivity B Type II hypersensitivity C Type III hypersensitivity D Type IV hypersensitivity

D Type IV hypersensitivity

What is the most common type of anemia worldwide? A. PA B. folate def C. anemia of chronic disease D. iron def

D. iron def

A hypersensitivity response of the immune system is noted to be stimulated by release of IL-4 and IL-5. This is accompanied by eosinophilia. This response is most likely be directed against which of the following? A Amyloid protein B Spirochetes C Neoplasms D Poison Ivy E Liver flukes

E Liver flukes

A patient with renal disease is at risk for developing uremia as the nephrons progressively deteriorate, because • the basement membrane becomes increasingly permeable. • filtration exceeds secretory and reabsorptive capacity. • excessive solute and water are lost in the urine. • GFR declines.

GFR declines.

A child with a history of recent strep throat infection develops glomerulonephritis. This is most likely a type _____ hypersensitivity reaction. • I • II • III • IV

III

MCV

Mean corpuscular volume (MCV) is the average volume of red cells.

Which skin disorder is thought to be caused by an autoimmune reaction and is characterized by bullous eruptions? • Pemphigus • Psoriasis • Pityriasis rosea • Lichen planus

Pemphigus

MCH

The mean corpuscular hemoglobin (MCH), or "mean cell hemoglobin" (MCH), is the average mass of hemoglobin per red blood cell in a sample of blood. It is reported as part of a standard complete blood count. MCH value is diminished in hypochromic anemias.

A patient who reported a very painful sore throat 3 weeks ago is now diagnosed with acute post-streptococcal glomerulonephritis. When asked, "Why is my urine the color of coffee?", the nurse responds • "Normally, red blood cells that enter the urine are taken back into the blood, but in glomerulonephritis, the kidney disease you have, they stay in the urine and make it coffee-colored." • "Your immune system was activated by your sore throat and has caused some damage in your kidneys that allows red blood cells to leak into the fluid that becomes urine and make it coffee-colored." • "The bacteria that caused your sore throat have traveled to your kidneys and are causing a little damage there that allows some red blood cells to leak into your urine and make it orange-colored." • "When parts of your kidneys stopped working, your blood kept flowing and broke some of your little blood vessels, so red blood cells are flowing into your urine and making it coffee-colored."

Your immune system was activated by your sore throat and has caused some damage in your kidneys that allows red blood cells to leak into the fluid that becomes urine and make it coffee-colored."

Which history is commonly found in clients with glomerularnephritis? a. Beta-hemolytic strep infection b. Frequent urinary tract infections c. Kidney stones d. Hypotension

a. Beta-hemolytic strep infection

A pulmonary function test, such as spirometry, is helpful in the diagnosis of a. Chronic bronchitis b. Lung cancer c. Pneumonia d. Tuberculosis

a. Chronic bronchitis

In clients receiving dialysis, which is the most common cause of end-stage renal disease in the United States? a. Diabetic nephropathy b. Chronic renal failure secondary to vascular disorders c. Acute tubular necrosis d. Kidney trauma

a. Diabetic nephropathy

Maury has renal failure and his arterial blood gas reading shows a decreased pH, normal PCO2, and decreased HCO3. What do you suspect? a. Respiratory acidosis b. Respiratory alkalosis c. Metabolic acidosis d. Metabolic alkalosis

c. Metabolic acidosis

The presence of a widely distributed pruritic maculopapular rash and erythema is commonly associated with • psoriasis. • drug reaction. • scleroderma. • bedbug bites.

drug reaction.

Appropriate therapy for prerenal kidney injury includes • fluid administration. • potassium supplementation. • fluid restriction. • protein restriction.

fluid administration.

Acute, painful inflammation with vesicles along the distribution of a spinal nerve (dermatome) is characteristic of • herpes zoster. • herpes simplex. • human papillomavirus. • tinea.

herpes zoster.

The body compensates for metabolic alkalosis by • hypoventilation. • decreasing arterial carbon dioxide. • increasing bicarbonate ion excretion. • hyperventilation.

hypoventilation

The major cause of glomerulonephritis is • infection of the glomerular capsule secondary to a urinary tract infection. • immune system damage to the glomeruli. • hydronephrosis resulting from kidney stones. • Streptococcus infection that migrates from the bloodstream to the glomerulus.

immune system damage to the glomeruli.

Respiratory acidosis is associated with • increased carbonic acid. • hypokalemia. • increased neuromuscular excitability. • increased pH.

increased carbonic acid.

The most likely cause of anemia in a patient with end-stage renal disease is • insufficient erythropoietin. • blood loss secondary to hematuria. • vitamin B12 deficiency secondary to deficient intrinsic factor. • iron deficiency.

insufficient erythropoietin.

Dramatic hypotension sometimes accompanies type I hypersensitivity reactions, because • massive histamine release from mast cells leads to vasodilation. • toxins released into the blood interfere with cardiac function. • anaphylaxis results in large volume losses secondary to sweating. • hypoxia due to bronchoconstriction impairs cardiac function.

massive histamine release from mast cells leads to vasodilation.

Two primary acid-base disorders that are present independently are referred to as • metabolic acidosis. • metabolic alkalosis. • respiratory alkalosis. • mixed acid-base imbalance.

mixed acid-base imbalance.

Fully compensated respiratory acidosis is demonstrated by • pH 7.36, PaCO2 55, HCO3 - 36. • pH 7.45, PaCO2 40, HCO3 - 28. • pH 7.26, PaCO2 60, HCO3 - 26. • pH 7.40, PaCO2 40, HCO3 - 24.

pH 7.36, PaCO2 55, HCO3 - 36.

The arterial blood gas pH = 7.52, PaCO2 = 30 mm Hg, HCO3- = 24 mEq/L demonstrates • metabolic acidosis. • respiratory acidosis. • respiratory alkalosis. • mixed alkalosis.

respiratory alkalosis.

Deep pressure ulcers usually • appear first as reddened areas that do not blanch. • begin in the dermal and epidermal skin layers. • result from thrombosis of deep vessels. • are an unavoidable consequence of immobility.

result from thrombosis of deep vessels.

A post-infective painful neuralgia can occur as a complication of • shingles. • herpes simplex. • impetigo. • verrucae.

shingles.