Check Your Understanding Quiz 2

In general, the best prognosis for long-term disease-free survival occurs with a. ALL (acute lymphoid leukemia). b. CML (chronic myeloid leukemia). c. AML (acute myeloid leukemia). d. CLL (chronic lymphoid leukemia).

a. ALL (acute lymphoid leukemia).

Which form of leukemia demonstrates the presence of the Philadelphia chromosome? a. CML (chronic myeloid leukemia) b. CLL (chronic lymphoid leukemia) c. ALL (acute lymphoid leukemia) d. AML (acute myeloid leukemia)

a. CML (chronic myeloid leukemia)

What is the correct definition of complete remission (CR) of leukemia? a. CR is less than 5% blasts in marrow and normal CBC values. b. CR is less than 5% leukemic cells in the blood. c. CR is absence of leukemic cells regardless of CBC values. d. CR is the absence of leukemic cells in the blood.

a. CR is less than 5% blasts in marrow and normal CBC values.

Vaccination for pneumococcal pneumonia should be performed before 1 year of age in patients with sickle cell anemia. a. False b. True

a. False

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

a. III

Renal insufficiency is a common complication of which disease? a. Myeloma b. Chronic myeloid leukemia (CML) c. Chronic lymphoid leukemia (CLL) d. Hodgkin disease

a. Myeloma

Most carbon dioxide is transported in the bloodstream as a. bicarbonate ion. b. dissolved carbon dioxide. c. carboxyhemoglobin. d. carbonic acid.

a. bicarbonate ion.

Patient who experiences anemic episodes when exposed to certain drugs most likely have a. glucose-6 phosphate dehydrogenase deficiency b. spherocytosis c. thalassemia d. sickle cell anemia

a. glucose-6 phosphate dehydrogenase deficiency

Red blood cells obtain nearly all their energy from metabolism of a. glucose. b. acetyl coenzyme A. c. fats. d. proteins.

a. glucose.

Red blood cells differ from other cell types in the body, because they a. have no cytoplasmic organelles b. contain cytoplasmic proteins. c. contain glycolytic enzymes. d. have a longer life span..

a. have no cytoplasmic organelles

Transfusion reactions involve RBC destruction caused by a. recipient antibodies b. donor antigens c. donor T cells d. Recipient T cells

a. recipient antibodies

The arterial oxygen content (CaO2) for a patient with PaO2 100 mm Hg, SaO2 95%, and hemoglobin 15 g/dL is _____ mL oxygen/dL. a. 210 b. 19.4 c. 21.05 d. 1909.8

b. 19.4

A 5-year-old patient's 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 a. CLL (chronic lymphoid leukemia) b. ALL (acute lymphoid leukemia) c. AML (acute myeloid leukemia) d. CML (chronic myeloid leukemia)

b. ALL (acute lymphoid leukemia)

Seasonal allergic rhinitis is most involved in type II hypersensitivity reactions. a. True b. False

b. False

Which disorder is considered a primary immunodeficiency disease? a. Radiation immunodeficiency b. HIV/AIDS c. Malnutrition immunodeficiency d. cancer immunodeficiency

b. HIV/AIDS

Hemophilia B is also known as Christmas disease. a. False b. True

b. True

The prothrombin time (PT) and INR (international normalized ratio) measured the integrity of a. fibrinolysis b. extrinsic pathway c. intrinsic pathway d. platelet function

b. extrinsic pathway

Which clinical finding is indicative of compartment syndrome? a. Redness and swelling b. Peripheral edema c. Absent peripheral pulses d. Atrophy of distal tissues

c. Absent peripheral pulses

Blood flow is slow through capillaries because capillaries a. are so far away from the heart. b. are so narrow .c. have the largest total cross-sectional area. d. have no smooth muscle.

c. have the largest total cross-sectional area.

The effects of histamine release include a. decreased gut permeability. b. bronchodilation. c. increased vascular permeability. d. vasoconstriction.

c. increased vascular permeability.

Which type of leukemia primarily affects children? a. CML (chronic myeloid leukemia) b. AML (acute myeloid leukemia) c. CLL (chronic lymphoid leukemia) d. ALL (acute lymphoid leukemia)

d. ALL (acute lymphoid leukemia)

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

d. Systemic lupus erythematosus

Myasthenia graves is a type II hypersensitivity disorder that involves a. symptoms of glomerular disease b. symptoms of arthritis or polyarthralgia c. symptoms of hyperthyroidism d. impaired muscle function

d. impaired muscle function

The major cause of death from leukemic disease is a. malnutrition b. hypovolemic shock c. kidney failure d. infection

d. infection

Which is necessary for red blood cell production? a. phosphate b. calcium c. magnesium d. iron

d. iron

The activated partial thromboplastin time (aPTT) is measure of integrity of a. the extrinsic pathway b. plasminogen c. factor VII synthesis d. the intrinsic pathway

d. the intrinsic pathway

Which is not considered to be a risk factor for thrombus formation? a. vascular trauma b. circulatory shock c. stasis of blood flow d. thrombocytopenia

d. thrombocytopenia

The primary source of erythropoietin is provided by the

kidney

The principle Ig mediator of type I hypersensitivity reactions is a. IgA. b. IgE. c. IgG. d. IgM.

b. IgE

The relationship of blood flow (Q), resistance (R), and pressure (P) in a vessel can be expressed by which equation? a. Q = R/P b. Q = P/R c. P = Q/R d. R = PQ

b. Q = P/R

Certain autoimmune diseases are associated with the presence of specific proteins on a person's cells. These proteins are called ________ proteins. a. TCR or BCR b. HLA or MHC c. antibody receptor d. complement

b. HLA or MHC

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. a. False b. True

b. True

A deficiency of von Willebrand factor impairs a. platelet aggregation. b. platelet adhesion to injured tissue. c. platelet production. d. activation of the coagulation cascade.

b. platelet adhesion to injured tissue.

The megakaryocyte is a precursor to a. white blood cells. b. platelets. c. red blood cells. d. factor IX.

b. platelets.

Which causes vasoconstriction? a. Acetylcholine b. a-Adrenergic antagonist c. Norepinephrine d. Calcium channel blocker

c. Norepinephrine

Which is not a manifestation of acute arterial obstruction? a. Pulselessness b. Pallor c. Purpura d. Pain

c. Purpura

Which condition is associated with an elevated reticulocyte count? a. Renal disease b. Aplastic anemia c. Hypertension d. Hemolytic anemia

d. Hemolytic anemia

The hypersensitivity reaction that does not involve antibody production is type a. II. b. III. c. I. d. IV.

d. IV.

The final step in clot formation is a. conversion of prothrombin to thrombin b. conversion of fibrinogen to fibrin c. platelet degranulation and adhesion d. clot retraction

d. clot retraction

The movement of blood through the vascular system is opposed by the force of a. viscosity b. the vessel radius c. the vessel length d. resistance

d. resistance

A low mean corpuscular hemoglobin concentration (MCHC) and mean corpuscular volume (MCV) are characteristic of which type of anemia? a. Folate deficiency b. Erythropoietin deficiency c. Vitamin B12 deficiency d. Iron deficiency

d. Iron deficiency

While in the hospital for management of acute lymphoid leukemia (ALL), a patient develops severe thrombocytopenia. The most appropriate action for this condition is a. chemotherapy. b. isolation. c. anticoagulant therapy. d. activity restriction.

d. activity restriction.

A laboratory test finding helpful in confirming the diagnosis of iron-deficiency anemia is a. elevated total and indirect bilirubin. b. elevated MCHC and MCV. c. positive direct or indirect Coombs test. d. elevated total iron-binding capacity.

d. elevated total iron-binding capacity.

The most effective therapy for anemia associated with kidney failure is a. iron administration. b. vitamin B12 and folate administration c. high-protein diet d. erythropoietin administration.

d. erythropoietin administration.

Disseminated intravascular coagulation may be treated with heparin therapy to a. enhance fibrinolysis b. enhance liver synthesis of clotting factors. c. activate platelets. d. inhibit clotting factor consumption.

d. inhibit clotting factor consumption.

Dysfunction of which organ would lead to clotting factors deficiency? a. spleen b. pancreas c. kidney d. liver

d. liver

Thalassemia may be confused with iron-deficiency anemia, because they are both a. hyperchromic. b. genetic. c. responsive to iron therapy. d. microcytic.

d. microcytic.

Which group of clinical findings described the typical presentation of ALL (acute lymphoid leukemia)? a. vertebral fracture, hypercalcemia, bone pain b. painless enlarged cevical lymph node, fever, weight loss c. elevated WBC count found in on routine examination, asymptotic d. pain in long bones, infection, fever, bruising

d. pain in long bones, infection, fever, bruising

Which laboratory finding is usually found in aplastic anemia?

Pancytopenia

Autologous stem cells transplantation is a procedure in which a. stem cells are harvested from the patient and then returned to the same patient b. stem cells are transferred to the patient from an HLA-matched donor c. stem cells are transferred to the patient from an identical twin d. there is a high rejection rate.

a. stem cells are harvested from the patient and then returned to the same patient

Risk factors for atherosclerosis include a. hyperlipidemia b. female gender c. low-fiber diet d. high-protein diet

a. hyperlipidemia Hyperlipidemia is a modifiable risk factor associated with atherosclerosis. Men have a higher incidence of atherosclerosis earlier in life than women. A high-protein diet is not associated with atherosclerosis. Dietary fats do play a role as a modifiable risk factor. A low-fiber diet is not a risk factor for atherosclerosis.

Which condition enhances lymphatic flow? a. increased interstitial fluid colloid osmotic pressure b. increased capillary oncotic pressure c. increased tissue hydrostatic pressure d. decreased capillary hydrostatic pressure

a. increased interstitial fluid colloid osmotic pressure

Velocity of blood flow is measures in a. yards per hour b. centimeters per second c. kilometeres per second d. millimeters per minute

b. centimeters per second

A cause of thrombocytopenia includes a. secondary polycythemia. b. chemotherapy. c. reduced erythropoietin. d. hypoxemia.

b. chemotherapy.

When systemic vascular resistance is decreased, blood flow a. stays the same. b. decreases. c. moves to the extremities. d. increases.

b. decreases.

Venous obstruction leads to edema because it ________ pressure. a. increases arterial blood b. increases capillary hydrostatic c. decreases tissue d. increases capillary oncotic

b. increases capillary hydrostatic

The patient is a 12-year-old diagnosed with acute leukemia (ALL). As part of treatment, the patient must undergo several weeks of chemotherapy. The most serious complication of chemotherapy is a. anemia b. infection c. vomiting d. alopecia

b. infection

A patient presents to the physician's office with pinpoint hemorrhages on the skin. The patient is most likely between the ages of _____ years. a. 6 months and 2 b. 25 and 45 c. 4 and 7 d. 15 and 18

c. 4 and 7

A diagnostic laboratory finding in myeloma is a. elevated blood glucose levels b. increased IgM antibody titer c. Bence Jones proteins in the urine d. decreased platelet count

c. Bence Jones proteins in the urine

The Philadelphia chromosome is a balanced translocation that forms a new gene called a. ARA-c b. Rb c. bcr-abl d. p53

c. bcr-abl

Excessive red cell lysis can be detected by measuring the serum a. methemoglobin. b. hemoglobin. c. bilirubin. d. erythropoietin.

c. bilirubin

Treatment for hemophilia A includes a. heparin administration b. platelet transfusion c. factor VIII replacement. d. factor IX replacement.

c. factor VIII replacement.

The conversion of plasminogen to plasmin results in a. clot retraction. b. platelet aggregation. c. fibrinolysis. d. activation of thrombin.

c. fibrinolysis.

The major cause of death from leukemic disease is a. kidney failure. b. hypovolemic shock. c. infection d. malnutrition.

c. infection

Tissues are able to autoregulate their rate of blood flow by controlling a. perfusion pressure. b. arterial blood pressure. c. vascular resistance. d. venous return to the heart.

c. vascular resistance.

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 a. thrombocytopenia. b. liver dysfunction. c. disseminated intravascular coagulation. d. hemophilia.

d. hemophilia.

An important mediator of a type I hypersensitivity reaction is a. complement b. T cells c. antigen-antibody immune complexes d. histamine

d. histamine Histamine mediates type I hypersensitivity reactions. Complement mediates type II hypersensitivity reactions. Antigen-antibody immune complexes mediate type III hypersensitivity reactions. T cells mediate type IV hypersensitivity reactions.

Patients with immunodeficiency disorders are usually first identified because they

develop recurrent infections

The most appropriate treatment for secondary polycythemia is a. volume expansion with saline b. measured to improve oxygenation c. chemotherapy d. phlebotomy

b. measured to improve oxygenation

Pernicious anemia is caused by a lack of a. intrinsic factor. b. erythropoietin. c. iron. d. folate.

a. intrinsic factor.

The cause of the most common form of anemia is a. iron deficiency b. acute bleeding c. chronic disease d. protein malnutrition

a. iron deficiency

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

a. massive histamine release from mast cells leads to vasodilation.

A primary effector cell of the type I hypersensitivity response is a. mast cells. b. cytotoxic cells. c. neutrophils. d. monocytes.

a. mast cells.

RhoGAM (an Rh antibody) would be appropriate in an Rh-_______woman with an Rh-________ antibody titer carrying Rh-_______fetus. a. negative; negative; postive b. positive; negative; negative c. negative; negative; positive d. negative; positive; positive

a. negative; negative; postive

An increase in hemoglobin affinity for oxygen occurs with a. shift to the left. b. elevated PCO2. c. hyperthermia. d. shift to the right.

a. shift to the left.

Which vessel normally demonstrates the most rapid blood flow? a. the vena cava b. a venue c. a capillary d. an arteriole

a. the vena cava

The liver is responsible for the synthesis of coagulation factors, with the exception of part VIII. a. true b. false

a. true

The only known curative treatment for CML is allogeneic bone marrow transplantation from a suitable donor a. true b. false

a. true

Peripheral edema is a result of a. venous thrombosis. b. atherosclerosis. c. hypertension. d. arterial insufficiency.

a. venous thrombosis.

A normal bleeding time in association with normal platelet count, and increased prothrombin time (PT) and INR, is indicative of a. vitamin K deficiency. b. hemophilia B. c. idiopathic thrombocytopenia. d. hemophilia A.

a. vitamin K deficiency.

A commonly ingested substance associated with prolongation of the bleeding time is a. acetaminophen. b. aspirin. c. caffeine. d. tobacco.

b. aspirin. Many drugs are associated with prolonged bleeding times. Aspirin is known to alter normal platelet function. Acetaminophen is not associated with prolongation of bleeding time. Tobacco does not interfere with bleeding times. Caffeine does not interfere with bleeding times.

Severe combined immunodeficiency (SCID) syndrome is an example of a(n) a. excessive immune response b. deficient immune response. c. hypersensitivity reaction. d. primary acquired immunodeficiency.

b. deficient immune response.

Widespread activation of the clotting cascade secondary to massive trauma is called a. idiopathic thrombocytopenia purpura. b. disseminated intravascular coagulation (DIC). c. Hageman disease. d. hemophilia B.

b. disseminated intravascular coagulation (DIC).

Clinical manifestations of chronic arterial obstruction include a. decreased pressure proximal to the obstruction. b. intermittent claudication. c. distal hyperemia. d. edema.

b. intermittent claudication.

Which characteristic is indicative of hemolytic anemia? a. increased heart rate b. jaundice c. increased total iron-binding capacity d. hypovolemia

b. jaundice

A 58-year-old woman 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 a. leukemia b. myeloma c. hodgkin disease d. back trauma

b. myeloma

What is the effect on resistance if the radium of a vessel is halved? a. resistance doubles b. resistance increases by a factor of 16 c. resistance decreases by a factor of 16 resistance decreases by half

b. resistance increases by a factor of 16

The most common primary immune deficiency that affects only B cells is a. Bruton agammaglobulinemia. b. selective IgA. c. Wiskott-Aldrich. d. DiGeorge.

b. selective IgA.

A patient is diagnosed with a tortuous blood vessel of the right hand that bleeds spontaneously. This patient presents with a. petechiae b. telangiectasia c. purpura d. thrombocytosis

b. telangiectasia

Blood flow throughout the periphery is regulated by a. cardiac output b. the autonomic nervous system c. hemodynamic d. velocity

b. the autonomic nervous system

A newborn has melena, bleeding from the umbilicus, and hematuria. The newborn most likely experiencing a. disseminated intravascular coagulation. b. vitamin K deficiency bleeding. c. acquired vitamin K deficiency. d. von Willebrand disease.

b. vitamin K deficiency bleeding.

Burkitt lymphoma is most closely associated with a. immunodeficiency syndromes b. radiation exposure c. Epstein-barr virus d. history of cigarette smoking

c. Epstein-barr virus

When a patient is struck in the eye by a baseball, the result is redness and swelling. This increases in blood flow to a localized are is called a. auto regulation b. edema c. hyperemia d. hypoxia

c. hyperemia Hyperemia is a local increase in blood flow. Autoregulation is the ability of blood vessels within organs to maintain a constant blood flow. Edema is the swelling that results from hyperemia. Hypoxia is an insufficient supply of oxygen.

The goal of long term heparin for the management of a deep vein thrombosis is to a. relieve edema b. dissolve the thrombus c. prevent further clot formation d. prevent clot dislodgment

c. prevent further clot formation

Activation of the extrinsic pathway of coagulation is initiated by a. factor VII b. collagen exposure c. tissue thromboplastin d. platelet factors

c. tissue thromboplastin