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Final Exam Advanced Pathophysiology,
Pathophysiology Finals
physiologic jaundice - A 3-day old infant is noted to have a mildly elevated unconjugated bilirubin level and icterus. Your concern is that this child may have: a. physiologic jaundice b. kernicterus c. glucose- 6 - phosphate dehydrogenase deficiency d. pathologic jaundice Lysosomes - Which cell component is capable of cellular autodigestion when it is released during cell injury? a. lysosomes b. ribosomesc. smooth endoplasmi c reticulum d. golgi complex Which component of the cell produces hydrogen peroxide (H2O2) by using oxygen to remove hydrogen atoms from specific substrates in an oxidative reaction? A) lysosomes B) peroxisomes C) ribosomes D) oxyhydrosomes - Ans: B- peroxisomes Contain organelles and complex internal membranes - The difference between eukaryotes and prokaryotes is that eukaryotes: a. all of these answers are correct b. are smaller in size c. contain organelles d. have no nuclear membrane What is a consequence of plasma membrane damage to the mitochondria? A) enzymatic digestion halts deoxyribonucleic acid (DNA) synthese B) influx of calcium ions halts adenosine triphosphate (ATP) production C) edema from an influx in sodium causes a reduction in ATP production D) potassium shifts out of the mitochondria, which destroys the infrastructure - Ans: B- influx of calcium ions halts adenosine triphosphate (ATP) production Packages protein for secretion to the outside of the cell - Which of the following is function of Golgi?
a. Packages protein for secretion to the outside of the cell b. Produces ATP for cell function c. Contains hydrolytic enzymes d. Is the site of protein synthesis in a cell Which statement is a description of one of the characteristics of apoptosis? A) apoptosis involves programmed cell death of scattered singel cells B) apoptosis is characterized by the swelling of the nucleus and the cytoplasm C) apoptosis involves unpredictable patterns of cell death D) apoptosis results in benign malignancies - Ans: A- apoptosis involves programmed cell death of scattered singel cells During cell injury caused by hypoxia, sodium and water move into the cell because: A) during cell injury cause by hypoxia, sodium and water move into the cell because: B) the pump that transports sodium out of the cell cannot function because of a decrease in adenosine triphosphate (ATP) levels C) the osmotic pressure is increased, which pulls additional sodium across the cell membrane D) oxygen is not available to bind with sodium to maintain it outside of the cell - Ans: C- the osmotic pressure is increased, which pulls additional sodium across the cell membrane Is the site of protein synthesis in a cell - Which of the following is function of the rough endoplasmic reticulum? a. Contains hydrolytic enzymes b. Is the site of protein synthesis in a cell c. Packages protein for secretion to the outside of the cell d. Produces ATP for cell function Obesity creates a greater risk for dehydration in people because: A) adipose cells contain little water because fat is water repelling B) the metabolic rates of obese adults are slower than those of lean adults C) the rates of urine output of obese adults are higher than thos of lean adults D) the thirst receptors of the hypothalamus do not function effectively - Ans: A- adipose cells contain little water because fat is water repelling Epigenetic modifications - What genetic process is likely responsible for the occurrence of asthma in only one of a pair of identical twins? a. genomic imprinting b. epigenetic modifications c. methylation d. transgenerational inheritance RNA is synthesized from a DNA template - Transcription is best defined as a process by which a. A base pair substitution results in a mutation of the amino acid sequence
a. apoptosis b. necrosis c. metastatic calcification d. gangrene Histones - The nucleolus is a small dense structure composed mainly of RNA and cellular DNA. What causes the DNA to bind and fold into chromosomes? a. amino acid sequences b. histones c. polymerase d. miRNA x-linked recessive disease - Duchenne's Muscular Dystrophy is never transmitted from father to son. It is a good example of a. sex-linked recessive disease b. autosomal dominant disease c. x-linked recessive disease d. chromosome structure abnormality disease Eosinophils - Which cell is the body's primary defense against parasite invasion? a. t lymphocytes b. neutrophils c. eosinophils d. b lymphocytes classic - Which pathway in the complement system is activated by an antigen-antibody response? a. lectin b. classic c. alternative d. none of the above severe loss of CD4 Th cells - The hallmark of AIDS profound immunosuppression, results from: a. proper function of helper t cells b. infection of b cells c. severe loss of CD4 Th cells d. none of the above exotoxins - These are proteins released by bacteria during growth. a. endotoxins b. TNF c. exotoxins d. pili
True - Activation of the complement cascade may destroy pathogens directly and can activate with virtually every other component of the inflammatory response. True/False Considering the hypothalamus, a fever is produced by: A) endogenous pyrogen acting directly on the hypothalamus B) exogenous pyrogens acting directly on the hypothalamus C) immune complexes acting indirectly on the hypothalamus D) cytokines acting indirectly on the hypothalamus - Ans: A- endogenous pyrogen acting directly on the hypothalamus gram-negative bacteria - One of the leading causes of death in the intensive care unit is the release of sufficient amounts of endotoxin resulting in endotoxic (septic) shock. The most common cause is: a. cachectin b. fungi c. gram-positive bacteria d. gram-negative bacteria candida albicans - The most common cause of fungal infections in humans are a. staphylococcus b. candida albicans c. gram-negative bacteria d. salmonella wilms tumor - Which one of the childhood cancers is associated with the tumor suppressor genes? a. wilms tumor b. acute leukemia c. cerebellar hemagioblastoma d. testicular tumor blood-forming cells - Leukemia refers to abnormal cell proliferation originating from which tissue origin? a. connective tissue b. epithelial cells c. glandular tissue d. blood-forming cells Two "hits" are required to inactivate tumor-suppressor genes because: A) each allele must be altered and each person has two copies, or alleles, of each gene, one from each parent B) the first hit stops tissue growth and the second hit is needed to cause abnormal tissue growth C) tumor-suppressor genes are larger than proto-oncogenes, requiring two hits to effect carcinogenesis D) the first hit is insufficient to cause enough damage to cause a mutation -
b. Switch on the telomerase so that cells can divide indefintely c. Switch off the telomerase so that cells can divide indefintely d. Use it as an intracellular signaling chemical to stimulate cell division human papillomavirus - The major virus involved in cervical cancer is a. human papillomavirus b. human cervical endogenous virus c. herpes simplex virus d. human immunodeficiency virus What term is used to describe the complication that can result from a spinal cord injury above T6 that is producing paroxysmal hypertension, as well as piloerection ans sweating above the spinal cord lesion? A) craniosacral dysreflexia B) parasympathetic dysreflexia C) autonomic hyperreflexia D) retrograde hyperreflexia - Ans: C- autonomic hyperreflexia anti-oncogenes - umor suppressor genes encode proteins that in their normal state negatively regulate proliferation. They are also called a. anti-oncogenes b. proto-oncogenes c. mutation of RAS gene d. oncogenes Multiple sclerosis is best described as: A) a CNS demyelination, possibly from an immunogenetic virus B) inadequate supply of acetylcholine at the neurotransmitter junction as a result of an autoimmune disorder C) the depletion of dopamine in the CNS as a result of a virus D) a degenerative disorder of lower and upper motor neurons caused by viral-immune factors - Ans: A- a CNS demyelination, possibly from an immunogenetic virus deep venous thrombosis - What is the usual source of this condition in the lung from an obese smoker who had sudden death? a. valvular disease b. left heart failure c. endocartitis d. deep venous thrombosis Graves disease develops from: A) a viral infection of the thyroid gland that causes overproduction of thyroid hormone B) an autoimmune process during which lymphocytes and fibrous tissue replace thyroid tissue
C) thyroid-stimulating immunoglobulin, which causes overproduction of thyroid hormones D) ingestion of goitrogenes, which inhibits the synthesis of the thyroid hormones, causing goiter - Ans: D- ingestion of goitrogenes, which inhibits the synthesis of the thyroid hormones, causing goiter a. diabetes mellitus b. hypertension c. obesity - The risk of developing coronary artery disease is increased in patients with: (Select 3) a. diabetes mellitus b. hypertension c. obesity d. liver disease e. congenital heart defects f. high alcohol consumption Pathologic changes associated with Graves disease include: A) high levels of circulating thyroid-stimulating immunoglobulins B) diminished levels of TRH C) high levels of TSH D) diminished levels of thyroid-binding globulin - Ans: A- high levels of circulating thyroid-stimulating immunoglobulins A patient diagnosed with diabetic ketoacidosis (DKA) has the following laboratory values: arterial pH 7.20, serum glucose 500 mg/dl, positive urine glucose and ketones, serum postassium (K+) 2 mEq/L, and serum sodium (Na+) 130 mEq/L. The patient reports that he has been sick with the "flu" for a week. What relationship do these values have to his insulin deficiency? A) increased glucose use causes the shift of fluid from the intravascular to the intracellular space B) decreased glucose use causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresis C) increased glucose and fatty acids stimulate renal diuresis, electrolyte loss, and metabolic alkalosis D) decreased glucose use results in protein catabolism, tissue wasting, respiratory acidosis, and electrolyte loss - Ans: B- decreased glucose use causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresis Restrictive - Which form of cardiomyopathy is usually caused by an infiltrative disease of the myocardium, such as amyloidosis, hemochromacytosis, or glycogen storage disease? a. hypertrophic b. infiltrative c. restrictive d. septal acute pericarditis - A patient complains of sudden onset of severe chest pain that radiates to the back and worsens with respiratory movement and when lying down. These clinical manifestations describe a(n): a. acute pericarditis
c. right heart failure d. left heart failure Which structure is lined with columnar epithelial cells? A) perimetrium B) endocervical canal C) myometrium D) vagina - Ans: B- endocervical canal there is shift in gas exchange from the placenta to the lungs - At birth which of the following statements is true? a. systemic resistance falls and pulmonary resistance rises b. there is shift in gas exchange from the placenta to the lungs c. systemic resistance and pulmonary resistance rise d. systemic resistance and pulmonary resistance fall Where is the usual site of cervical dysplasia or cancer in situ? A) wher the squamos epithelium of the cervix meets the cuboidal epithelium of the vagina B) where the columnar epithelium fo the cervix meets the squamous epithelium of the uterus C) where the squamous epithelium of the cervix meets the columnar epithelium of the uterus D) where the columnar epithelium of the cervix meets the squamous epithelium of the vagina - Ans: D- where the columnar epithelium of the cervix meets the squamous epithelium of the vagina atrial septal defect (ASD) - An infant has a crescendo-decrescendo systolic ejection murmur located between the second and third intercostal spaces along the left sternal border. There is also wide fixed splitting of the second heart sound. These clinical findings are consistent with which congenital heart defect? a. ventricular septal defect (VSD) b. atrial septal defect (ASD) c. atrioventricular canal (AVC) defect d. patent ductus arteriosus (PDA) patent ductus arteriosus (PDA) - An infant has a continuous-machine type of murmur best heard at the left upper sternal border throughout systole and diastole. The infant has a bounding pulse and a thrill on palpation. These clinical findings are consistent with which congenital heart defect? a. atrioventricular canal (AVC) defect b. atrial septal defect (ASD) c. patent ductus arteriosus (PDA) d. ventricular septal defect (VSD) Which statement best describes a Schilling test? A) administration of radioactive cbalamin and the measurement of its excretion in the urine to test for vitamin B12 deficiency
B) measurement of anigen-antibody immune complexes in the blood to test for hemolytic anemia C) measurement of serum ferritin and total iron-binding capacity in the blood to test for iron deficiency anemia D) administration of folate and measurement in two hours of its level in a blood sample to test for folic acid deficiency - Ans: A- administration of radioactive cbalamin and the measurement of its excretion in the urine to test for vitamin B12 deficiency In aplastic anemis (AA), pancytopenia develops as a result of which of the following? A) suppression of erythropoietin to produce adequate amounts of erythrocytes B) suppression of the bone marrow to produce adequte amounts of erythrocytes, leukocytes, and thrombocytes C) lack of deoxyribonucleic acid (DNA) to form sufficient quantitites of erythrocytes, leukocytes, and thrombocytes D) lact of stem cells toform sufficient quantities of leukocytes - Ans: B- suppression of the bone marrow to produce adequate amounts of erythrocytes, leukocytes, and thrombocytes left to right shunts - Congenital heart defects that cause acyanotic congestive heart failure usually involve: a. obstructive lesions b. left to right shunts c. right to left shunts d. mixed lesions Which statement is true regarding warm autoimmune hemotlytic anemia? A) warm autimmune hemolytic anemia occurs primarily in men B) it is self-limiting and rarely produces hemolysis C) erythrocytes are bound to macrophages and sequestered in the spleen D) immunoglobulin M (IgM) coats erythrocytes and binds them to receptors on monocytes - Ans: C- erythrocytes are bound to macrophages and sequestered in the spleen impairing alveolocapillary membrane diffusion - Pulmonary edema and pulmonary fibrosis cause hypoxemia by: a. creating alveolar dead space b. impairing alveolocapillary membrane diffusion c. creating a right to left shunt d. decreasing the oxygen in inspired gas Hemolytic disease of the newborn (HDN) can occur if the mother: A) is Rh-positive and the fetus is Rh-negative B) is Rh-negative and the fetus is Rh-positive C) has type A blood and the fetus has type O blood D) has type AB blood and the fetus has type O blood - Ans: B- is Rh-negative and the fetus is Rh-positive
A) blood flow through the pulmonary capillary bed increases in regular increments B) alveolar pressure is greater than venouse pressure, but not greater than arterial pressure C) the capillary bed collapses and normal blood flow ceases D) blood flows through Zone I, but it is ipeded to a certain extent by alveolar pressure - Ans: C- capillary bed collapses and normal blood flow ceases What factor associated with gluten-sensitive enteropathy (celiac sprue) causes an infant to bruise and bleed easily? A) vitamin K deficiency from fat malabsorption B) bone marrow function depression C) iron, folate, and B12 deficiency anemias D) prescrbed daily warfarin (Coumadin) - Ans: A- vitamin K deficiency from fat malabsorption vasospasm of one or more coronary arteries - Prinzmetal angina pain is caused by: a. abnormal stretching of the ischemic myocardium b. buildup of lactic acid that irritates myocardial nerve fibers c. coronary embolus d. vasospasm of one or more coronary arteries classical, lectin, alternative - 3 pathways of the complement system aortic stenosis - ___________________ is the most common valvular abnormality affecting nearly 2% of adults older than 65 years of age. a. mitral stenosis b. aortic stenosis c. mitral regurgitation d. aortic regurgitation Telomeres - DNA at the tips of chromosomes, act as caps that protect internal regions of the chromosomes asthma - This is classified as a chronic inflammatory disorder of the bronchial mucosa that causes bronchial hyperresponsiveness, constriction of the airways and variable airflow obstruction that is reversible. a. pneumonia b. asthma c. COPD d. upper respiratory infection Strains of Hepatitis - A,B,C,D,E
hepatitis a - A 45-yo female is informed that she has hepatitis. She has been traveling recently and was told that the form that she has is self-limiting and is transferred via the fecal-oral route. Which of the following types of hepatitis is she most likely to have contracted? a. hepatitis c b. hepatitis a c. hepatitis b d. hepatitis d nephroblastoma - A Wilms tumor is also known by the histologic name: a. neuroblastoma b. blastomycosis c. glioblastoma d. nephroblastoma Examples of toxins - Endotoxins, exotoxins hepatitis C - A 35yo female with a hx of IV drug abuse was recently diagnosed with HIV. She is called back to your clinic as she was noted to have elevated aminotransferase (ALT and AST) levels on routine blood work. A hepatitis panel was ordered. Which strain of hepatitis will MOST LIKELY come back positive? a. hepatitis D b. hepatitis B c. hepatitis C d. hepatitis A Aneuploidy of Sex Chromosomes -
- Nondisjunction of sex chromosomes produces a variety of aneuploid conditions
- Klinefelter syndrome is the result of an extra chromosome in a male, producing XXY individuals
- Monosomy X, called Turner syndrome, produces X0 females, who are sterile; it is the only known viable monosomy in humans phases of ovarian cycle - follicular phase, ovulation, luteal phase primary nephrotic syndrome - A 3yo male presents to the clinic for a routine well child visit. His mother states that he has had some mild swelling in his extremities. A urinalysis and lab work are sent and he is noted to have proteinuria, hypoalbuminemia and hyperlipidemia. His MOST LIKELY diagnosis is: a. acute glomerulonephritis b. hemolytic uremis syndromw c. henoch-schonlein purpura nephritis d. primary nephrotic syndrome Factors that contribute to edema in nephrotic syndrome -
Well demarcation in benign all of the above - GERD causes inflammatory responses in the esophageal wall resulting in: a. erosion and ulcerations b. tissue fragility c. hyperemia d. all of the above sarcoma - Cancers arising from the mesenchymal tissue usually have the suffix Factors that suppress ovulation increase or decrease risk of ovarian cancer - Decrease acute gastritis - A 45 yo female presents to the ED with abdominal discomfort, epigastric tenderness and upper GI bleeding. She has a hx of a recent H-pylori infection. Her most likely diagnosis would be: a. illeus b. hiatal hernia c. acute gastritis d. GERD What are the important environmental and lifestyle factors correlated with breast cancer - Radiation, diet, synthetic chemicals, physical activity ulcerative colitis - The primary lesions in which disease are continuous with no skip lesions, are limited to the mucosa and are not transmural? a. diverticulitis b. crohns disease c. irritable bowel syndrome d. ulcerative colitis IBS - ______ is characterized by lower abdominal pain, diarrhea-predominant, constipation - predominant, alternating diarrhea/constipation, gas, bloating and nausea. a. diverticulitis b. IBS c. ulcerative colitis d. crohns disease What are several disorders collectively known as chronic myeloproliferative disorder - Essential theombocytosis, polycythemia Vera, chronic idiopathic myelofibrosis, chronic myeloid leukemia, chronic neutrophilic leukemia, chronic eosinophilia leukemia Most common risk factors for endocardial damage - Trauma, CHD, valvular heart disease, prosthetic valve
Symptomatic changes in chronic kidney disease including increased creatinine, urea and potassium levels do not become apparant until renal function declines to: a. 30% b. < 25% c. 25% d. 50% Types of Angina - stable, unstable, variant/printzmetal, silent prerenal - On POD #1, your patient is noted to have an elevated creatinine. The most likely cause would be__________? a. non-oliguric b. intrarenal c. prerenal d. postrenal Graves disease - the most common form of hyperthyroidism; caused by an autoimmune defect that creates antibodies that stimulate the overproduction of thyroid hormones; exophthalmos is a featured characteristic hypernatremia - The features of nephrotic syndrome include all EXCEPT? a. hyperlipidemia b. infection c. orbital edema d. hypernatremia pericarditis - inflammation of the pericardium myasthenia gravis - Functional dysphagia can be seen in a patient with: a. myasthenia gravis b. tumor c. GERD d. esophageal stricture Disorders of the posterior pituitary - SIADH and DI alcohol abuse - The most common cause of chronic pancreatitis isa. coagulative necrosisb. obstructionc. vascular damaged. alcohol abuse Right heart failure most often results from: -
- Cyanosis Ex: aspiration, atelectasis, bronchiectasis, bronchiolitis, pulmonary fibrosis, inhalation disorders, pneumoconiosis, allergic alveolitis, pulmonary edema, ARDS kaussmaul respirations - A compensatory breathing pattern frequently seen with DKA is called: a. cheyne stokes respirations b. apnea c. kaussmaul respirations d. hypoventilation Occlusion or partial occlusion of pulmonary artery or it's branches by an embolus - Pulmonary embolism ADH - With diabetes insipidus, insufficient levels of _________ lead to polyuria and polydipsia? a. GH b. ADP c. IGF- 1 d. ADH infected pleural effusion - empyema type I DM - DKA is most commonly associated with: a. type I DM b. HHNKS c. diabetes insipidus d. type II DM cushing disease - Weight gain and accumulation of adipose tissue in the trunk, face and cervical areas is seen with: a. hypothyroidism b. metabolic syndrome c. graves disease d. cushing disease Emphysema/Chronic Bronchitis - Results from destruction of elastin in alveolar septa and loss of passive elastic recoil Disorders of the Adrenal Cortex - Cushing, congenital adrenal hyperplasia, hyperaldosteronism, hypersecretion of adrenal androgens and estrogens, adrenocortical hypodunction negative feedback system - The most common type of monitoring and control system for our hormones is: a. positive feedback system
b. down regulation c. negative feedback system d. up regulation Acute complications of diabetes - Hypoglycemia, DKA, HHNKS, Somogyi effect, dawn phenomenon Prolatin - The most common hormonally active pituitary tumor in both men and women is: a. prolactin b. ACTH c. TSH d. FSH e. oxytocin Two common types of IBD - Crohn's disease, ulcerative colitis gonorrhea and chlamydia - Pelvic inflammatory disease (PID) is most often caused by a. HIV b. E. coli c. H. influenze d. gonorrhea and chlamydia Vesicollobullous disorders - Pemphigus, bulbous pemphigoid, erythema multiforme, SJS, TEN increased - The use of oral contraceptives, nulliparity, and 30 years or older at first birth are associated with ___________ risk of breast cancer. increased/decreased adenocarcinomas - Most cancers of the prostate are _________ that develop in the periphery of the gland. a. myeloma b. squamous cell carcinoma c. adenocarcinomas d. sarcomas pheochromocytoma - Your patient presents with HTN, palpitations, tachycardia, glucose intolerance, excessive sweating & constipation. Your most likely diagnosis is: a. pheochromocytoma b. cushing syndrome c. hypoparathyroidism d. hypocortisolism e. hyperpituitarism
