Patho Exam I Review (7, 9, 10, 11)

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

c. HLA or MHC

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

c. Myeloma

Passive immunity is provided by (Select all that apply.) a. transfer of preformed human antibodies. b. injection of human immune globulin. c. injection with preformed animal antibodies. d. vaccines with dead or altered organisms. e. active

infections.ANS: A, B, C

In general, a cancer cell that is more tissue-specific differentiated is ____ (more/less) likely to be aggressive.

less

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

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.

ANS: A, B, C, E

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. anticoagulant therapy. b. chemotherapy. c. activity restriction. d. isolation.

c. activity restriction.

Malignant neoplasms of epithelial origin are known as a. lymphoma. b. sarcomas. c. carcinomas. d. adenomas.

c. carcinomas.

Cancer grading is based on a. tumor size. b. local invasion. c. cell differentiation. d. metastasis.

c. cell differentiation.

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

c. increased vascular permeability.

The patient is a 12-year-old boy with acute lymphoblastic 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.

ANS: A, B, D

Side effects of chemotherapy include (Select all that apply.) a. anemia. b. nausea. c. leukocytosis. d. bleeding. e. infections.

ANS: A, B, D, 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.

ANS: A, B, E

Anaphylaxis may occur in certain hypersensitivity reactions, including type (Select all that apply.) a. I. b. II. c. III. d. IV.

ANS: A,B

The mononuclear phagocyte system consists of (Select all that apply.) a. monocytes and tissue macrophages. b. dendritic cells. c. bone marrow stem cells. d. antibody-secreting plasma cells. e. basophils.

ANS: A,B

Autoimmune diseases result from (Select all that apply.) a. overactive immune function. b. increase in self-tolerance. c. failure of the immune system to differentiate self and nonself molecules. d. communicable infections.

ANS: A,C

A patient is diagnosed with stage IIA 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.

ANS: A,D,E

Which clinical finding is most indicative of an acute bacterial infection? a. Increased (band) neutrophils. b. Elevated temperature. c. Elevated erythrocyte sedimentation rate. d. Elevated WBC count.

a. Increased (band) neutrophils.

Your patient is scheduled for a staging procedure. She wants to know what that means. The correct response is which of the following? a. It is a procedure for determining the extent of tumor spread. b. It is a histologic examination of tissues to determine the degree of tumor differentiation. c. Is based on exploratory surgery. d. It is biochemical testing of tumor cells to determine the genetic basis of the tumor.

a. It is a procedure for determining the extent of tumor spread.

Familial retinoblastoma involves the transmission of what from parent to offspring? a. Mutant tumor suppressor gene b. Cancer-causing virus c. Oncogene d. Extra chromosome

a. Mutant tumor suppressor gene

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

d. CML (chronic myeloid leukemia)

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

d. IV.

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

d. IgE.

The "classical pathway" for activation of the complement cascade is triggered by a. activation of C3. b. inflammation. c. first recognition of an antigen. d. antigen-antibody complexes.

d. antigen-antibody complexes.

Paraneoplastic syndromes in cancer involve excessive production of substances by multiple means. A common substance found in excessive amounts due to cancer paraneoplastic syndromes is a. insulin. b. tumor necrosis factor. c. potassium. d. calcium.

d. calcium.

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

a. HIV/AIDS

A patient is diagnosed with hairy cell leukemia. The patient's lab results would most likely indicate a decrease in (Select all that apply.) a. granulocytes. b. platelets. c. white blood cells. d. red blood cells. e. melanocytes.

ANS: A, B, D

Characteristics of telomerase include (Select all that apply.) a. repairs the end caps of chromosomes. b. contributes to cancer cell immortality. c. is deficient in cancer cells. d. activity allows a cell to replicate indefinitely.

ANS: A, B, D

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

ANS: A, B, C

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

ANS: 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

ANS: A, B, C, E

Characteristics of complement include (Select all that apply.) a. stimulating chemotaxis. b. lysing target cells. c. having multiple plasma proteins. d. being synthesized in the bone marrow. e. enhancing phagocytosis.

ANS: A, B, C, E

Deficits in immune system function occur in cancer due to (Select all that apply.) a. chemotherapy. b. cancer cells. c. cancer metastasis to bone marrow. d. immunotherapy. e. malnutrition.

ANS: A, B, C, E

Functions of antibodies include (Select all that apply.) a. antigen agglutination. b. antigen precipitation. c. opsonization. d. phagocytosis. e. complement activation.

ANS: A, B, C, E

Functions of T cells include (Select all that apply.) a. synthesizing antibodies. b. secreting cytokines. c. killing antigen-presenting cells. d. stimulating of B cells. e. killing virally infected cells.

ANS: B, C, D, E

Tumor markers (Select all that apply.) a. are found only in the blood. b. are produced by normal cells. c. help determine cancer origin. d. help identify progression of cancer. e. include prostatic-specific antigen.

ANS: B, C, D, E

Activation of the complement cascade results in (Select all that apply.) a. antibody production. b. inflammation. c. immunosuppression. d. autoimmunity. e. chemotaxis.

ANS: B,E

Active immunity involves (Select all that apply.) a. injection of preformed human antibodies. b. injection of human immune globulin. c. injection with preformed animal antibodies. d. vaccines with dead or altered organisms. e. active infections.

ANS: D,E

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 due to pain. The child's most likely diagnosis is a. ALL (acute lymphoid leukemia) b. CLL (chronic lymphoid leukemia) c. AML (acute myeloid leukemia) d. CML (chronic myeloid leukemia)

a. ALL (acute lymphoid leukemia)

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

a. ALL (acute lymphoid leukemia)

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

a. ALL (acute lymphoid leukemia).

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

a. Bence Jones proteins in the urine.

Retroviruses are associated with human cancers, including a. Burkitt lymphoma. b. Hodgkin's lymphoma. c. pancreatic cancer. d. hepatic cancer.

a. Burkitt lymphoma.

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

a. Epstein-Barr virus.

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

a. Pain in long bones, infection, fever, bruising

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

a. Systemic lupus erythematosus

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

a. bcr-abl.

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

a. deficient immune response.

Antigen-presenting cells function to a. display foreign antigen on their cell surfaces bound to MHC. b. stimulate cytokine production by macrophages. c. phagocytose and degrade foreign antigens. d. initiate the complement cascade by way of the alternative pathway.

a. display foreign antigen on their cell surfaces bound to MHC.

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

a. impaired muscle function.

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

a. infection.

The primary function of eosinophils is to a. kill parasitic helminths (worms). b. kill bacteria. c. stop viral replication. d. phagocytize fungi.

a. kill parasitic helminths (worms).

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 due to bronchoconstriction impairs cardiac function.

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

Breast cancer in women who have the breast cancer gene a. occurs at an earlier age. b. is more likely to be unilateral. c. is more common than non-inherited breast cancer. d. is more responsive to treatment.

a. occurs at an earlier age.

Functions of B cells include a. synthesizing antibodies. b. secreting cytokines. c. killing antigen-presenting cells. d. stimulating B cells. e. killing virally infected cells.

a. synthesizing antibodies.

The hypermetabolic state leading to cachexia in terminal cancer is thought to be due to a. tumor necrosis factor. b. angiogenesis. c. loss of A TP production. d. pain medications.

a. tumor necrosis factor.

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

allogenic

A patient with metastatic lung cancer wants to know her chances for survival. Which response is correct? a. "Lung cancer is always fatal." b. "Lung cancer has about a 15% survival rate." c. "Lung cancer is highly curable when diagnosed early." d. "Lung cancer death rate has decreased significantly, as with all other cancers."

b. "Lung cancer has about a 15% survival rate."

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

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

The most common tumor suppressor gene defect identified in cancer cells is a. Rb.b. P53. c. DCC. d. APC.

b. P53.

Immunity to a specific organism can be determined by a. active phase protein count. b. antibody titer. c. erythrocyte sedimentation rate. d. WBC count.

b. antibody titer.

Proto-oncogenes a. are the same as oncogenes. b. are normal cellular genes that promote growth. c. lead to abnormal tumor suppressor genes d. result from severe mutational events.

b. are normal cellular genes that promote growth.

Leukocytosis with a "shift to the left" refers to a. elevated segmented neutrophils. b. elevated immature neutrophils. c. decreased monocytes. d. decreased immature neutrophils.

b. elevated immature neutrophils.

After bronchoscopy and histologic examination of a suspected tumor, your patient is diagnosed with primary bronchial carcinoma. Thus, the tumor a. is benign. b. is malignant. c. is secondary to cancer elsewhere in the body. d. has spread.

b. is malignant.

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

b. mast cells.

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.

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

b. recipient antibodies.

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

c. III

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

c. negative; negative; positive

Your patient eats "lots of fat," leads a "stressful" life, and has smoked "about two packs a day for the last 40 years." Her chronic morning cough recently worsened, and she was diagnosed with a lung mass. The most likely contributing factor for development of lung cancer in this patient is a. high-fat diet. b. urban pollutants. c. stressful lifestyle. d. cigarette smoking.

d. cigarette smoking.

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

d. develop recurrent infections.

The spleen is an important defense against infection, because it a. activates the complement cascade. b. initiates inflammation. c. controls phagocytosis. d. filters the blood.

d. filters the blood.

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

d. histamine.

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 a. vomiting. b. anemia. c. alopecia. d. infection.

d. infection.

After surgery to remove a lung tumor, your patient is scheduled for chemotherapy, which will a. selectively kill tumor cells. b. stimulate immune cells to fight the cancer. c. have minimal side effects. d. kill rapidly dividing cells.

d. kill rapidly dividing cells.

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

d. selective IgA.

Autologous stem cell transplantation is a procedure in which a. there is a high rejection rate. 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. stem cells are harvested from the patient and then returned to the same patient.

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

The primary function of kinins is a. phagocytosis of antigens. b. production of antibodies. c. to limit immune reactions. d. vasodilation to enhance inflammation.

d. vasodilation to enhance inflammation.