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WCU PATHOPHYSIOLOGY (MIDTERM)
EXAM QUESTIONS AND ANSWERS
"Which disease has the presence of Reed-Sternberg cells on histologic examination? - CORRECT
ANSWER Hodgkin lymphoma"
"Which type of cellular adaptation would create the greatest concern if found on a biopsy report? -
CORRECT ANSWER Dysplasia"
"What is the primary cause of airway obstruction in patients with chronic bronchitis? - CORRECT
ANSWER Mucous plugs"
"Which describes a pathologic manifestation of neurogenic shock? - CORRECT ANSWER Loss of
sympathetic activation of arteriolar smooth muscle" "A heart that has to pump harder in order to effectively circulate blood is likely to undergo which type of
cellular adaptation? - CORRECT ANSWER Hypertrophy"
"Which pathogenetic change is associated with acute bronchitis? (Select all that apply.) - CORRECT
ANSWER -Swelling from exudation of fluid
-Loss of ciliary function -Inflamed airways"
"Which is true regarding hemophilia A? - CORRECT ANSWER It is caused by factor VII deficiency."
"Which is a malignant disorder of mature antibody-secreting B lymphocytes or plasma cells? - CORRECT
ANSWER Multiple myeloma"
"The pathogenesis of tuberculosis includes the entrance of mycobacteria into the lungs and the resulting
of which of the following? (Select all that apply.) - CORRECT ANSWER -Calcification
-Ghon tubercles -Formation of granulomas -Activation of macrophages" "Atherosclerosis predisposes to a number of processes that are factors in myocardial ischemia. These
processes include - CORRECT ANSWER Thrombus Formation"
"Which offers the best prognosis for the cure of cancer? - CORRECT ANSWER Early Detection"
"The role of the circulatory system is to do which of the following? (Select all that apply.) - CORRECT
ANSWER -Transport O2 and nutrients throughout the body
-Remove waste products found within the body"
"What stage is defined by "fight or flight"? - CORRECT ANSWER Alarm"
"Respiratory acidosis is associated with? - CORRECT ANSWER Increase carbonic acid"
"Neuromuscular disorder impair lung function primarily because of - CORRECT ANSWER Weak muscles
of respiration"
"Which statement is true regarding thalassemia? - CORRECT ANSWER It is a deficiency of one or more
polypeptide chains."
"Which is required for red blood cell production? (Select all that apply.) - CORRECT ANSWER -Iron
-Folate -Vitamin B12"
"Abnormal new cellular growth is referred to as - CORRECT ANSWER Neoplasia"
"How many liters of blood are circulating in the human body at any one time? - CORRECT ANSWER 4-
6l"
"What is the marker of choice for detecting a myocardial infarction? - CORRECT ANSWER Elevated
serum levels of cardiac troponin"
"Which is a risk factor associated with hypertension? (Select all that apply.) - CORRECT ANSWER -Age
-African American race -History of tobacco smoking" "Which component of the blood is responsible for protecting the body by phagocytosis of
microorganisms and other debris? - CORRECT ANSWER Leukocytes"
"Which term is used to identify hypertension that has a specific disease as its cause? - CORRECT
ANSWER Secondary"
"Restoration of effective function is the goal of which level of prevention? - CORRECT ANSWER
Teritary" "Which restrictive disease is associated with the formation of an antigen-antibody complex, causing
fibrosis of the lung? - CORRECT ANSWER Hypersensitivity pneumonitis"
"Which type of hypersensitivity response is mediated by T cells? - CORRECT ANSWER Hypersensitivity
type IV"
"Which type of cellular adaptation is most likely to occur as the result of chronic ischemia to a region? -
CORRECT ANSWER Atrophy"
"Which statement is true regarding asthma? - CORRECT ANSWER Airway inflammation"
"Which clinical manifestation differentiates myocardial infarction (MI) from angina pectoris? (Select all
that apply.) - CORRECT ANSWER -Radiating chest pain
-ST-segment changes on the ECG -Elevated serum levels of troponin"
"Which cell is from myeloid lineage? (Select all that apply.) - CORRECT ANSWER -Platelets
-Monocytes -Granulocytes"
"Signs and symptoms of a disease first occur during the - CORRECT ANSWER Prodromal period"
"Which condition occurs in the presence of cellular damage? - CORRECT ANSWER Sodium and water
move into the cell."
"Which statement is true about disseminated intravascular coagulation (DIC)? - CORRECT ANSWER It is
both a bleeding and clotting disorder."
"It is true that acute lymphoid leukemia (ALL) is - CORRECT ANSWER Primarily diagnosed in children"
"Which term means the cause of the disease? - CORRECT ANSWER Etiology"
"Which condition may result in chronic pulmonary hypertension, right ventricular hypertrophy, and
right-sided heart failure? - CORRECT ANSWER Mitral Valve Stenosis"
"In muscle hypertrophy, the hypertrophied cells increase in - CORRECT ANSWER Size"
"Which statement is true regarding cystic fibrosis? - CORRECT ANSWER It is the most common genetic
disease in the United States." "A patient with heart failure reports awakening intermittently with shortness of breath. Which terms
appropriately describe this clinical manifestation? - CORRECT ANSWER Paroxysmal nocturnal"
"The condition associated with hypoxemia as a result of lung disease or living at high altitudes is called -
CORRECT ANSWER Secondary polycythemia"
"Risk factors for the development of high blood pressure are which of the following? (Select all that
apply.) - CORRECT ANSWER -Age
-Race -Diet -Weight"
"Which term is used to describe the histologic characterization of tumor cells? - CORRECT ANSWER
Grading"
"Which statement regarding chronic myeloid leukemia (CML) is a true statement? - CORRECT ANSWER
Affected persons carry philadelphia chromosome"
"Chronic myeloid leukemia (CML) is characterized by which of the following? (Select all that apply.) -
CORRECT ANSWER -Elevated granulocyte count
-Abdominal discomfort -Weight loss"
“A common cause of heart failure is which of the following? (Select all that apply. - CORRECT ANSWER
-Coronary artery disease -Cardiomyopathy -Hypertension" "When the cause of a disease is due to unintended or unwanted medical treatment, the term to
describe this is - CORRECT ANSWER latrogenic"
"COPD type A is referred to as: - CORRECT ANSWER Emphysema"
"Which term best describes a condition that presents with the symptoms of petechiae, easy bruising,
bleeding gums, occult hematuria, or retinal hemorrhages? - CORRECT ANSWER Thrombocytopenia"
"What gene is associated with chronic myeloid leukemia (CML)? - CORRECT ANSWER BCR/ABL"
"Clinical manifestations of hypocalcemia include which of the following? (Select all that apply.) -
CORRECT ANSWER -Positive trousseau sign
-Positive chvostek sign -Hyperactive reflexes -Muscle twitching -Paresthesias"
"If an individual has a fully compensated metabolic acidosis, the blood pH is: - CORRECT ANSWER
Normal Range"
"The final step in clot formation is - CORRECT ANSWER Clot retraction"
"A disease is native to a particular region is called? - CORRECT ANSWER Endemic"
"A patient has a history of falls, syncope,dizziness, and blurred vision. The patient's symptomatology is
most likely related to - CORRECT ANSWER Hypotension"
"Patients who experience anemic episodes when exposed to certain drugs? - CORRECT ANSWER
Glucose 6 phosphate dehydrogenase deficiency" "A patient presents to the physician's office with pinpoint hemorrhages on the skin. The patient is most
likely between the ages of _____ years? - CORRECT ANSWER 4-7 yrs"
"Hypertension with a specific identifiable cause is known____hypertension? - CORRECT ANSWER
Secondary"
"The hallmark manifestation of acute respiratory distress syndrome? - CORRECT ANSWER Hypoxemia"
"In which stage of shock is a patient who has lost 1200 ml of blood who has normal blood pressure when
supine but who experiences orthostatic hypotension upon standing? - CORRECT ANSWER Class II
compensated stage"
"A person who has hyperthyroidism is likely to develop? - CORRECT ANSWER Hypercalcemia"
"A nurse swabbing a patient's throat to test for streptococcal pharyngitis. The nurse must understand that tests such as this differ in the probability that they will be positive for a condition when applied to a
person with the conditions this probability is termed sensitivity? - CORRECT ANSWER True"
"Patients with structural evidence of heart failure who exhibit no signs or symptoms are classified into
which New York Heart Association heart failure class? - CORRECT ANSWER Class I"
"The major buffer in the extracellular fluid is? - CORRECT ANSWER Bicarbonate"
"An abnormality wide (more than 0.10 second) QRS complex is a characteristic of - CORRECT ANSWER
Premature ventricular complexes" "Lactated ringer solution and normal saline are commonly used crystalloid solutions that contain
electrolytes - CORRECT ANSWER True"
"High blood pressure increases the workload of the left ventricle because it increases - CORRECT
ANSWER Afterload"
"Obstructive sleep apnea would most likely be found in a patient diagnosed with - CORRECT ANSWER
Pickwickian Syndrome"
"Decreased neuromuscular excitability is often the result of - CORRECT ANSWER Hypercalcemia and
hypermagnesemia"
"Somatic death refers to death of an - CORRECT ANSWER entire organism"
"Patients presenting with symptoms of unstable angina and no ST-segment elevation are treated with -
CORRECT ANSWER Antiplatelet drugs"
"The progressive stage of hypovolemic shock is characterized by - CORRECT ANSWER Tachycardia"
"A patient with flail chest will demonstrate - CORRECT ANSWER Outward chest movement on
expiration" "Which blood pressure reading is considered to be indicative of prehypertension according to the JNC-
criteria? - CORRECT ANSWER 128/82"
"The electrolyte that has a higher concentration in the extracellular fluid than in the intracellular fluid is?
- CORRECT ANSWER Sodium ion"
"Tachycardia is an early sign of low cardiac output that occurs because of - CORRECT ANSWER
Baroreceptor activity"
"Carbon monoxide injures cells by - CORRECT ANSWER Reducing oxygen level on hemoglobin"
"A patient with cold and edematous extremities, low carbonic output, and profound hypotension is
likely to be experiencing a progressive stage of - CORRECT ANSWER SEPTIC shock"
"A person who overuses magnesium-aluminum antacids for a long period of time is likely to develop -
CORRECT ANSWER Hypophosphatemia"
"Severe combined immunodeficiency syndrome is an example of an - CORRECT ANSWER Deficient
immune response"
"Clinical manifestation of hyponatremia include - CORRECT ANSWER Confusion, lethargy, coma, and
seizures"
"What age group has a larger volume of extracellular fluid than intracellular fluid? - CORRECT ANSWER
Infants"
"A common characteristic of viral pneumonia is - CORRECT ANSWER Dry cough"
"Which disorder is considered a primary immunodeficiency disease? - CORRECT ANSWER HIV/AIDS"
"Renal insufficiency is a common complication of which disease? - CORRECT ANSWER Myeloma"
"The prothrombin time (PT) and INR measure the integrity of? - CORRECT ANSWER Extrinsic pathway"
"The relationship of blood flow (Q), resistance ®, and pressure (P) in a vessel can be expressed by which
equation? - CORRECT ANSWER Q-P/R"
"Two primary acid-base disorder that are present independently are referred to as - CORRECT
ANSWER Mixed acid/base imbalance"
"Which condition is associated with an elevated reticulocyte count? - CORRECT ANSWER Hemolytic
anemia"
"First degree heart block is characterized by - CORRECT ANSWER Prolonged PR interval"
"What results when systemic blood pressure is increased? - CORRECT ANSWER Vasoconstriction"
"Vaccination for pneumococcal pneumonia should be performed before 1 year of age in patient with
sickle cell anemia? - CORRECT ANSWER False"
"The most effective therapy for anemia associated with kidney failure - CORRECT ANSWER
Erythropoietin Administration"
"Tissues are able to autoregulate their rate of blood flow by controlling - CORRECT ANSWER Vascular
Resistance"
"Which is indicative of a left tension pneumothorax - CORRECT ANSWER Absent breaths sound on the
left."
"Activations of the extrinsic pathway of coagulation is initiated by - CORRECT ANSWER Tissue
thromboplastin"
"The philadelphia chromosome is a balanced chromosome translocation that forms a new gene called -
CORRECT ANSWER bcr/abl"
"Croup is characterized by - CORRECT ANSWER Barking cough"
"Proto-oncogenes - CORRECT ANSWER Are normal cellular genes that promote growth"
"Necrotic death of brain tissue usually produces__necoris - CORRECT ANSWER Liquefactive"
"Clinical manifestation of chronic arterial obstruction include - CORRECT ANSWER Intermittent
claudication"
"Metaplasia is - CORRECT ANSWER The replacement of one differentiated cell type with another"
"Renal compensation for respiratory acidosis is evidenced by - CORRECT ANSWER Elevated
bicarbonate ion concentration"
"Lack of a-antitrypsin in emphysema causes - CORRECT ANSWER A destruction of alveolar tissue"
"Which alterations can lead to edema? - CORRECT ANSWER Decreased lymphatic flow"
"A person with acute hypoxemia may hyperventilate and develop - CORRECT ANSWER Respiratory
alkalosis" "A patient with a productive cough and parenchymal infiltrates on x-ray is demonstrating symptomology
of - CORRECT ANSWER Bacterial pneumonia"
"The ingestion of certain drugs, foods, or chemicals can lead to secondary hypotension? - CORRECT
ANSWER True"
"Velocity of blood flow is measured in - CORRECT ANSWER Centimeters per second"
"Critically ill patients may have parenterally administered vasoactive drugs that are adjusted according
to their ____pressure - CORRECT ANSWER Mean Arterial"
"Total body water in older adults is - CORRECT ANSWER Decreased because of increased adipose
tissue and decreased muscle mass"
"Breast cancer in women who have the breast cancer gene - CORRECT ANSWER Occur at an earlier
age"
"Glucose-6-phosphate dehydrogenase deficiency anemia occurs when - CORRECT ANSWER Exposed to
certain drugs"
"Hemophilia - CORRECT ANSWER -Prolonged bleeding time
-Prolonged aPTT -Normal platelet count"
"Vitamin K deficiency in newborns presents with - CORRECT ANSWER Melena, bleeding from the
umbilicus, and hematuria"
"Blood coagulation assessment - CORRECT ANSWER PT/INR, aPTT, Bleeding time"
"Asprin can - CORRECT ANSWER Prolong bleeding time"
"Chemotherpay can cause - CORRECT ANSWER Thrombocytopenia"
"Dysfunction of the liver can lead to - CORRECT ANSWER clotting factor deficiency"
"Function of the circulatory system - CORRECT ANSWER -Transport
-Protection -Regulation -Delivers O2 and nutrients to cells and takes waste away"
"Disseminated Intravascular Coagulations - CORRECT ANSWER Abnormal blood clotting in small
vessels throughout the body that cuts off the supply of oxygen to distal tissues, resulting in damage to body organs"
"Venous vs. Arterial Occlusion - CORRECT ANSWER Venous- often the result of thrombosis (when
blood clot forms inside a blood vessel) "The anemia resulting from deficiency of either vitamin B12 or folate is caused by disruption in DNA synthesis of the blast cells in the bone marrow that produces very large abdominal bone marrow called
megaloblastic? - CORRECT ANSWER True"
"A low mean corpuscular hemoglobin concentration (MCHC) and mean corpuscular volume (MCV) are
characteristics of which type of anemia? - CORRECT ANSWER Iron deficiency"
"The person at highest risk for developing hypernatremia is a person who - CORRECT ANSWER
Receives tube feedings because he or she is comatose after a stroke" "After suffering a heart attack, a middle aged man is counseled to take cholesterol lowering medication.
This is an example of - CORRECT ANSWER Teritary prevention"
"A 58 year old woman is seen in the clinic for a report 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 - CORRECT ANSWER Myeloma"
Arterial- most commonly caused by artherosclerosis (accumulation of fatty deposits inside a blood vessel)"
"Thrombosis vs. Embolism - CORRECT ANSWER Thrombosis- formation of a blood clot, known as
thrombus, within a blood vessel. Embolism- obstruction of an artery, typically by a clot of blood or an air bubble."
"Peripheral edema is a result of - CORRECT ANSWER Venous thrombosis"
"Atheroscelrosis - CORRECT ANSWER Hardening and narrowing of the arteries due to buildup of
cholesterol plaques on their inner walls."
"DVT (deep vein thrombosis) vs Varicose veins - CORRECT ANSWER Deep vein thrombosis- occurs
when a blood clot forms in a vein deep inside your body. Varicose vein- swollen, twisted veins that lie just under the skin and usually occur in the legs."
"Primary hypertension - CORRECT ANSWER Also called "essential". When we do not know the cause of
the HTN. 3 types: Isolated systolic hypertension (systolic BP is greater or equal to 140mmHg while diastolic pressure remains under 90 mmHg), Isolated diastolic hypertension (diastolic pressure is greater or equal to 90mmHg while systolic pressure remains under 140mmHg), and combined systolic and diastolic hypertension (most common diagnosis, both systolic and diastolic exceed prehypertension levels)."
"Secondary hypertension - CORRECT ANSWER Hypertension attributed to a specific identifiable
pathology or condition. Usually in infants and children - renal disease and coarctation of the aorta (aortic narrowing). Also can be from obstructive sleep apnea (snoring)."
"Hypertensive Urgency - CORRECT ANSWER Sudden increase in either or both systolic or diastolic
BP WITHOUT evidence of end-organ damage"
"Hypertensive Emergency - CORRECT ANSWER Sudden increase in either or both systolic or diastolic
BP WITH evidence of end-organ damage."
"Hypotension - CORRECT ANSWER Commonly orthostatic hypotension (decrease in systolic BP of
20mmHg or more or a decrease in diastolic pressure that is 10mmHg or more within 3 minutes of moving to an upright position)
"Complications of Acute coronary syndrome - CORRECT ANSWER Heart failure- your heart isn't able to
pump enough blood for the rest of our body. Abnormal heartbeat Chest pain Heart attack Related arterial diseases"
"Diagnostic tests and findings to detect Myocardial Infarction (MI) - CORRECT ANSWER
Electrocardiogram(ECG) Blood tests Chest X-ray Echocardiogram Coronary catheterization (angiogram) Cardia CT or MRI"
"Rheumatic heart disease (RHD) - CORRECT ANSWER Serious pathological condition resulting from
rheumatic fever, commonly causing permanent scarring of the heart valves, especially the mitral valve."
"Describe different congenital heart defects - CORRECT ANSWER Aortic stenosis- Aortic stenosis is
when the aortic valve (the valve between the left ventricle and the aorta) is too small, narrow, or stiff. Coarctation of the aorta (COA)- is a narrowing of the aorta, the major blood vessel that carries blood away from the heart to the body. This narrowing causes the left side of the heart to work harder to pump blood through the aorta. Ebstein anomaly- a rare heart defect that affects the tricuspid valve (one of the heart's four valves). It happens because of a problem with how the valve forms before a baby's birth. Patent ductus arteriosus (PDA)- an extra blood vessel found in babies before birth and just after birth. Patent foramen ovale (PFO)- a normal opening between the upper two chambers (the right atrium and left atrium) of an unborn baby's heart. The foramen ovale usually closes 6 months to a year after the baby's birth.
Tetralogy of Fallot (TOF)- a congenital (present at birth) heart defect. In tetralogy of Fallot (TOF), four related heart defects change the way blood flows to the lungs and through the heart. Truncus arteriosus- a heart defect that happens when a child is born with one large artery carrying blood to the lungs and body instead of two separate arteries. Ventricular septal defect (VSD)- sometimes referred to as a hole in the heart — is a type of congenital heart defect. In a VSD, there is an abnormal opening in the wall between the main pumping chambers of the heart (the ventricles). Atrial septal defect (ASD)- sometimes called a hole in the heart — is a type of congenital heart defect in which there is an abnormal opening in the dividing wall between the upper filling chambers of the heart (the a"
"Symptoms of right sided heart failure - CORRECT ANSWER -Awakening at night with shortness of
breath -Shortness of breath during exercise or when lying flat -Coughing -Wheezing -Difficulty concentrating -Dizziness -Fatigue -Fluid retention causing swelling in the ankles, legs, feet and/or abdomen -Increased urge to urinate -Lack of appetite and nausea -Difficulty exercising -Sudden weight gain"
"Symptoms of left sided heart failure - CORRECT ANSWER Exertional pulmonary vascular congestion
Exertional dyspnea Cough Fatigue Othopnea Paroxysmal nocturnal dyspnea Basilar rales Gallops
"Signs/symptoms of bacterial pneumonia - CORRECT ANSWER Productive cough and parenchymal
infiltrates on x-ray"
"Ghon tubercle - CORRECT ANSWER X-ray finding in Tuberculosis"
"IgE - CORRECT ANSWER Associated with inhaled allergencs in asthma"
"What is associated with allergic form of asthma? - CORRECT ANSWER Inflammation, mucosal edema,
and bronchoconstriction"
"Lack of alpha anti-trypsin in emphysema can lead to - CORRECT ANSWER Alveolar destruction"
"Hypersecretion of mucus in chronic bronchitis is a result of - CORRECT ANSWER Recurrent secretions"
"All obstructive pulmonary disorders are characterized by - CORRECT ANSWER Resistance to airflow"
"Extrinsic vs. Intrinsic asthma - CORRECT ANSWER Intrinsic asthma tends to start later in life, is more
common in females, and is typically more severe. In extrinsic asthma, symptoms are triggered by an allergen (such as dust mites, pet dander, pollen, or mold)."
"COPD leads to barrel chest due to - CORRECT ANSWER Air trapping"
"Emphysema - CORRECT ANSWER Has a destruction to the aveolar walls dues to the release of
proteolytic enzymes from immune cells"
"Chronic bronchitis - CORRECT ANSWER Leads to cor pulmonale due to increased pulmonary vascular
resistance"
"Acute Asthma attack is associated with - CORRECT ANSWER Bronchoconstriction, bronchial mucosal
edema, hypersecretion of mucus, and hypoxemia."
"Characteristics of asthma - CORRECT ANSWER Chronic inflammatory disorder, airway responsiveness,
genetic susceptibility, and airway remodeling"
"Acute asthma episode - CORRECT ANSWER Use of accessory muscles, expiratory wheezing, coughing,
and feeling of chest tightness"
"Status asthmaticus - CORRECT ANSWER Life-threatening complication of asthma"
"Airway obstruction in chronic bronchitis - CORRECT ANSWER Thick mucus, fibrosis, and smooth
muscle hypertrophy"
"Productive cough is seen in patients - CORRECT ANSWER Chronic bronchitis"
"Hypoxemia is the hallmark for - CORRECT ANSWER Acute respiratory distress syndrome"
"Tracheal shift and respiratory distress are a sign for - CORRECT ANSWER Pneumothorax"
"Inhalation of organic substances are a cause of - CORRECT ANSWER Hypersensitivity pneumonitis"
"Pneumothorax and ARDS are types of - CORRECT ANSWER Restrictive respiratory disorders"
"Air that enters the pleural space during inspiration but is unable to exit during expiration leads to -
CORRECT ANSWER Tension Pneumothorax"
"Loss of alveolar walls, immunological in nature, and "honeycomb" appearance on x-ray are all part of -
CORRECT ANSWER Interstitial lung disease"
"Presence of CD4+ cells, non-productive cough, granulomas, fatigue, weight loss, and fever are all
common characteristics of - CORRECT ANSWER Sarcoidosis"
"Dyspnea, diminished breath sounds, and tracheal shift are clinical manifestations of - CORRECT
ANSWER Pleural effusion"
"Antacids being a risk factor for - CORRECT ANSWER Hypophosphatemia"
"Hyperparathyroidism is a risk factor for - CORRECT ANSWER Hypercalcemia"
"Hypocalcemia and hypomagnesemia both - CORRECT ANSWER Increase neuromuscular excitability."
"Diarrhea can cause - CORRECT ANSWER Metabolic acidosis"
"Confusion is a sign of - CORRECT ANSWER Hypernatremia"
"Muscle weakness and cardiac dysrhythmias are manifestations of - CORRECT ANSWER Moderate to
severe hypokalemia"
"Chronic alcoholism is a cause for - CORRECT ANSWER Hypomagnesemia"
"Decreased urine output is a symptom of - CORRECT ANSWER Clinical dehydration"
"Decreased antidiuretic hormone can cause - CORRECT ANSWER Hypernatremia"
