PATH 370 - W2 Check Your Understanding

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

19.4

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

4 and 7

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 ALL (acute lymphoid leukemia) CLL (chronic lymphoid leukemia) AML (acute myeloid leukemia) CML (chronic myeloid leukemia)

ALL (acute lymphoid leukemia)

Which type of leukemia primarily affects children? ALL (acute lymphoid leukemia) CLL (chronic lymphoid leukemia) AML (acute myeloid leukemia) CML (chronic myeloid leukemia)

ALL (acute lymphoid leukemia)

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

ALL (acute lymphoid leukemia).

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

Absent peripheral pulses

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

Bence Jones proteins in the urine.

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

CML (chronic myeloid leukemia)

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

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

Burkitt lymphoma is most closely associated with Epstein-Barr virus. radiation exposure. immunodeficiency syndromes. history of cigarette smoking.

Epstein-Barr virus.

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

False

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

False It's a type I hypersensitivity reaction

Which disorder is considered a primary immunodeficiency disease? HIV/AIDS Malnutrition immunodeficiency Cancer immunodeficiency Radiation immunodeficiency

HIV/AIDS

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

HLA or MHC HLA = human leukocyte antigen MHC = Major histocompatibility complex

Which condition is associated with an elevated reticulocyte count? Renal disease Aplastic anemia Hypertension Hemolytic anemia

Hemolytic anemia

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

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

IV.

The principle Ig mediator of type I hypersensitivity reactions is IgA. IgG. IgM. IgE.

IgE.

Which condition enhances lymphatic flow? Increased tissue hydrostatic pressure Increased interstitial fluid colloid osmotic pressure Decreased capillary hydrostatic pressure Increased capillary oncotic pressure

Increased interstitial fluid colloid osmotic pressure

What is necessary for red blood cell production? Phosphate Iron Magnesium Calcium

Iron

A low mean corpuscular hemoglobin concentration (MCHC) and mean corpuscular volume (MCV) are characteristic of which type of anemia? Vitamin B12 deficiency Folate deficiency Iron deficiency2 Erythropoietin deficiency

Iron deficiency

Which characteristic is indicative of hemolytic anemia? Increased total iron-binding capacity Increased heart rate Hypovolemia Jaundice

Jaundice

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

Myeloma

Which causes vasoconstriction? Norepinephrine Calcium channel blocker α-Adrenergic antagonist Acetylcholine

Norepinephrine

Which group of clinical findings describes the typical presentation of ALL (acute lymphoid leukemia)? Pain in long bones, infection, fever, bruising Vertebral fracture, hypercalcemia, bone pain Elevated WBC count found on routine examination, asymptomatic Painless enlarged cervical lymph node, fever, weight loss

Pain in long bones, infection, fever, bruising

What laboratory finding is usually found in aplastic anemia? Leukocytosis Thrombocythemia Neutrophilia Pancytopenia

Pancytopenia

Which is not a manifestation of acute arterial obstruction? Pain Purpura Pallor Pulselessness

Purpura

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

Q = P/R

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

Resistance increases by a factor of 16.

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

Which vessel normally demonstrates the most rapid blood flow? An arteriole A capillary A venule The vena cava

The vena cava

Which is not considered to be a risk factor for thrombus formation? Thrombocytopenia Vascular trauma Stasis of blood flow Circulatory shock

Thrombocytopenia

Hemophilia B is also known as Christmas disease. True False

True

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 False

True

The liver is responsible for the synthesis of coagulation factors, with the exception of part of VIII. True False

True

The only known curative treatment for CML is allogeneic bone marrow transplantation from a suitable donor. True False

True

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 False

True

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

activity restriction.

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

aspirin.

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

bcr-abl.

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

bicarbonate ion.

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

bilirubin.

Velocity of blood flow is measured in centimeters per second. millimeters per minute. yards per hour. kilometers per minute.

centimeters per second.

A cause of thrombocytopenia includes hypoxemia. reduced erythropoietin. chemotherapy. secondary polycythemia.

chemotherapy.

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

clot retraction.

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

decreases.

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

deficient immune response.

Patients with immunodeficiency disorders are usually first identified because they run high fevers. have unusually high WBC counts. develop brain infections. develop recurrent infections.

develop recurrent infections.

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

disseminated intravascular coagulation (DIC).

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

elevated total iron-binding capacity.

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

erythropoietin administration.

The prothrombin time (PT) and INR (international normalized ratio) measure the integrity of platelet function. extrinsic pathway. intrinsic pathway. fibrinolysis.

extrinsic pathway.

Treatment for hemophilia A includes heparin administration. factor IX replacement. factor VIII replacement. platelet transfusion.

factor VIII replacement.

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

fibrinolysis.

Patients who experience anemic episodes when exposed to certain drugs most likely have thalassemia. spherocytosis. sickle cell anemia. glucose-6-phosphate dehydrogenase deficiency.

glucose-6-phosphate dehydrogenase deficiency.

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

glucose.

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

have the largest total cross-sectional area.

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. liver dysfunction. disseminated intravascular coagulation. thrombocytopenia.

hemophilia.

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

histamine.

When a patient is struck in the eye by a baseball, the result is redness and swelling. This increase in blood flow to a localized area is called autoregulation. edema. hyperemia. hypoxia.

hyperemia.

Risk factors for atherosclerosis include female gender. hyperlipidemia. high-protein diet. low-fiber diet.

hyperlipidemia.

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

impaired muscle function.

The effects of histamine release include vasoconstriction. bronchodilation. increased vascular permeability. decreased gut permeability.

increased vascular permeability.

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

increases capillary hydrostatic

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

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 vomiting. anemia. alopecia. infection.

infection.

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

inhibit clotting factor consumption.

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

intermittent claudication.

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

intrinsic factor.

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

iron deficiency.

The primary source of erythropoietin is provided by the bone marrow. kidney. lung. liver.

kidney.

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 resulting from bronchoconstriction impairs cardiac function.

massive histamine release from mast cells leads to vasodilation.

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

mast cells.

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

measured to improve oxygenation.

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

measured to improve oxygenation.

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

microcytic.

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 leukemia. myeloma. Hodgkin disease. back trauma.

myeloma

RhoGAM (an Rh antibody) would be appropriate in an Rh-_____ woman with an _____ Rh-_____ antibody titer carrying an Rh-_____ fetus. negative; positive; positive positive; negative; negative negative; negative; positive negative; negative; negative

negative; negative; positive

The strength of the bond between oxygen and hemoglobin is known as the Bohr effect. oxygen-hemoglobin affinity. dissociation curve. hemoglobin synthesis.

oxygen-hemoglobin affinity.

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

platelet adhesion to injured tissue.

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

platelets.

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

prevent further clot formation.

A serious complication of deep vein thrombosis is stroke. hypertensive crisis. extremity necrosis. pulmonary embolus.

pulmonary embolus.

Transfusion reactions involve RBC destruction caused by donor antigens. recipient antibodies. donor T cells. recipient T cells.

recipient antibodies.

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

resistance.

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

selective IgA.

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

shift to the left. (on the dissociation curve) decrease in the oxygen affinity is associated with a shift to the right on the oxyhemoglobin dissociation curve.

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

telangiectasia.

Blood flow throughout the periphery is regulated by cardiac output. the autonomic nervous system. velocity. hemodynamics.

the autonomic nervous system.

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

the intrinsic pathway.

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

tissue thromboplastin.

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

vascular resistance.

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

venous thrombosis.

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

vitamin K deficiency bleeding.

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

vitamin K deficiency.