NR 507-week-3-quiz-advanced-pathophysiology

Question 1 2 / 2 pts Question 2 2 / 2 pts Question 3 2 / 2 pts Advanced Pathophysiology Week 3 Quiz- Version 2 In some anemias, the erythrocytes are present in various sizes, which is referred to as anisocytosis. poikilocytosis. microcytosis. isocytosis. Additional descriptors of erythrocytes associated with some anemias include anisocytosis (assuming various sizes) or poikilocytosis (assuming various shapes) (Figure 26-1). What is the pathophysiologic process of aplastic anemia? Autoimmune disease against hematopoiesis by activated cytotoxic T cells Inherited genetic disorder with recessive X-linked transmission Malignancy of the bone marrow in which unregulated proliferation of erythrocytes crowd out other blood cells Autoimmune disease against hematopoiesis by activated immunoglobulins Most cases of AA result from an autoimmune disease directed against hematopoietic stem cells. Cytotoxic T cells (Tc cells) appear to be the main culprits. The body compensates for anemia by increasing rate and depth of breathing. capillary vasoconstriction. hemoglobin holds on to oxygen more firmly. kidneys release more erythropoietin. This study source was downloaded by from CourseH on :42:40 GMT -05:00 Question 4 2 / 2 pts Question 5 2 / 2 pts Question 6 0 / 2 pts Tissue hypoxia creates additional demands and compensatory actions on the pulmonary and hematologic systems. The rate and depth of breathing increase in an attempt to increase the availability of oxygen. A woman complains of chronic gastritis, fatigue, weight loss, and tingling in her fingers. Laboratory findings show low hemoglobin and hematocrit levels, and a high mean corpuscular volume. These findings are consistent with anemia. aplastic iron deficiency folate deficiency pernicious Gastric atrophy commonly occurs in the presence of type A chronic gastritis and may be autoimmune. Autoantibodies against gastric parietal cells are frequently observed. When the hemoglobin level in the blood has decreased significantly (7 to 8 g/dl), the individual experiences the classic symptoms of anemia—weakness, fatigue, paresthesias of the feet and fingers, difficulty in walking, loss of appetite, abdominal pains, and weight loss. Symptoms of polycythemia vera are mainly the result of increased blood viscosity. destruction of erythrocytes. a decreased erythrocyte count. neurologic involvement. As the disease progresses many of the symptoms are related to the increased blood cellularity and viscosity. Untreated pernicious anemia is fatal, usually because of brain hypoxia. liver hypoxia. This study source was downloaded by from CourseH on :42:40 GMT -05:00 S - The Marketplace to Buy and Sell your Study Material Question 7 2 / 2 pts Question 8 2 / 2 pts Question 9 0 / 2 pts renal failure. Correct Answer heart failure. Untreated PA is fatal, usually because of heart failure. What is the most common cause of vitamin K deficiency? Administration of warfarin (Coumadin) An IgG-mediated autoimmune disorder Liver failure Total parenteral nutrition (TPN) with antibiotic therapy The most common cause of vitamin K deficiency is parenteral nutrition in combination with broad-spectrum antibiotics that destroy normal gut flora. Which of the following is a description consistent with chronic lymphocytic leukemia (CLL)? There is failure of B cells to mature into plasma cells that synthesize immunoglobulins. The bone marrow and peripheral blood are characterized by leukocytosis and a predominance of blast cells. As the immature blasts increase, they replace normal myelocytic cells, megakaryocytes, and erythrocytes. The translocation of genetic material from genes 9 and 22 creates an abnormal, fused protein identified as BCR-ABL. There are defects in the ras oncogene, TP53 tumor-suppressor gene, and INK4A, the gene encoding a cell-cycle regulatory protein. Thus CLL is derived from transformation of a partially mature B cell that has not yet encountered antigen. Local signs and symptoms of Hodgkin disease–related lymphadenopathy are a result of Correct Answer pressure and obstruction. This study source was downloaded by from CourseH on :42:40 GMT -05:00 S - The Marketplace to Buy and Sell your Study Material Question 10 2 / 2 pts Question 11 2 / 2 pts Question 12 2 / 2 pts ischemia and pressure. inflammation and ischemia. obstruction and pressure. Local symptoms caused by pressure and obstruction of the lymph nodes are the result of lymphadenopathy. Heparin-induced thrombocytopenia (HIT) is described as a(n) IgE-mediated allergic drug reaction that reduces circulating platelets. IgG immune-mediated adverse drug reaction that reduces circulating platelets. cell-mediated drug reaction in which macrophages process the heparin and platelet complexes that are then destroyed by activated cytotoxic T cells. hematologic reaction to heparin in which the bone marrow is unable to produce sufficient platelets to meet the body’s needs. Heparin is a common cause of drug-induced thrombocytopenia. HIT is an immune- mediated, adverse drug reaction caused by IgG antibodies that leads to increased platelet consumption and a decrease in platelet counts. In a full-term infant, the normal erythrocyte life span is days, whereas the adult is days. 120 to 130; 150 90 to 110; 140 30 to 50; 80 60 to 80; 120 In full-term infants, normal erythrocyte life span is 60 to 80 days; in premature infants it may be as short as 20 to 30 days; and in children and adolescents, it is the same as that in adults—120 days. What is the name of the disorder in which levels of bilirubin remain excessively high in the newborn and are deposited in the brain? This study source was downloaded by from CourseH on :42:40 GMT -05:00 S - The Marketplace to Buy and Sell your Study Material Question 13 2 / 2 pts Question 14 2 / 2 pts Question 15 2 / 2 pts Jaundice Icterus neonatorum Icterus gravis neonatorum Kernicterus Without replacement transfusions, in which the child receives Rh-negative erythrocytes, the bilirubin is deposited in the brain, which is a condition called kernicterus. Hemophilia B is caused by clotting factor deficiency. V X VIII IX Hemophilia B (Christmas disease) is caused by factor IX deficiency. Erythroblastosis fetalis is defined as an autosomal dominant hereditary disease. allergic disease in which maternal blood and fetal blood are antigenically incompatible. alloimmune disease in which maternal blood and fetal blood are antigenically incompatible. autoimmune disease in immature nucleated cells that are released into the bloodstream. HDN is an alloimmune disease in which maternal blood and fetal blood are antigenically incompatible, causing the mother’s immune system to produce antibodies against fetal erythrocytes. The type of anemia that occurs as a result of thalassemia is macrocytic, normochromic. microcytic, normochromic. This study source was downloaded by from CourseH on :42:40 GMT -05:00 S - The Marketplace to Buy and Sell your Study Material Question 16 2 / 2 pts Question 17 0 / 2 pts macrocytic, hyperchromic. microcytic, hypochromic. The anemic manifestation of thalassemia is microcytic-hypochromic hemolytic anemia. The sickle cell trait differs from sickle cell disease in that the child with sickle cell trait has a milder form of the disease that is characterized by vaso-occlusive crises and is believed to result from higher hemoglobin values and viscosity. has the mildest form of the disease with normal hemoglobin and hemoglobin F, which prevents sickling. inherited normal hemoglobin A from one parent and Hb S from the other parent, whereas the child with sickle cell disease has Hb S from both parents. has a mild form of sickle cell disease that causes sickling during fever and infection, but not during acidosis or hypoxia, whereas the child with sickle cells disease develops sickling during each of these conditions. Sickle cell–thalassemia disease and sickle cell–Hb C disease are heterozygous forms in which the child simultaneously inherits another type of abnormal hemoglobin from one parent. Sickle cell trait, in which the child inherits Hb S from one parent and normal Hb A from the other, is a heterozygous carrier state that rarely has clinical manifestations (Table 28-3). Which of the following can trigger an immune response within the bloodstream that can result in an embolus? Fat Bacteria Air Correct Answer Amniotic fluid Amniotic fluid not only displaces blood, reducing oxygen, nutrient, and waste exchange, but also introduces antigens, cells, and protein aggregates that trigger inflammation, coagulation, and the immune response within the bloodstream. Question 18 This study source was downloaded by from CourseH on :42:40 GMT -05:00 S - The Marketplace to Buy and Sell your Study Material Question 19 0 / 2 pts Question 20 0 / 2 pts 2 / 2 pts Which disorder causes a transitory truncal rash that is nonpruritic and pink with erythematous macules that may fade in the center, making them appear as a ringworm? Fat emboli Bacterial endocarditis Rheumatic fever Myocarditis of acquired immunodeficiency syndrome Erythema marginatum is a distinctive truncal rash that often accompanies acute rheumatic fever. It consists of nonpruritic, pink erythematous macules that never occur on the face or hands. Which form of cardiomyopathy is characterized by ventricular dilation and grossly impaired systolic function, leading to dilated heart failure? Dystrophic Septal Hypertrophic Correct Answer Dilated Dilated cardiomyopathy (congestive cardiomyopathy) is characterized by ventricular dilation and grossly impaired systolic function, leading to dilated heart failure. Which of the following is manufactured by the liver and primarily contains cholesterol and protein? Triglycerides (TGs) High-density lipoproteins (HDLs) Correct Answer Low-density lipoproteins (LDLs) Very-low-density lipoproteins (VLDLs) This study source was downloaded by from CourseH on :42:40 GMT -05:00 S - The Marketplace to Buy and Sell your Study Material Question 21 2 / 2 pts Question 22 2 / 2 pts Question 23 0 / 2 pts A series of chemical reactions in the liver results in the production of several lipoproteins that vary in density and function. These include VLDLs, primarily TG and protein; LDLs, mostly cholesterol and protein; and HDLs, mainly phospholipids and protein. When does most cardiovascular development occur? Between the eighth and 10th weeks of gestation By the 28th day of gestation Between the fourth and seventh weeks of gestation Between the 12th and 14th weeks of gestation Cardiogenesis begins at approximately 3 weeks of gestation; however, most cardiovascular development occurs between the fourth and seventh weeks. When does systemic vascular resistance in infants begin to rise? Once the placenta is removed from circulation One hour after birth During the beginning stage of labor One month before birth Removal of the low-resistance placenta from circulation causes an immediate increase in systemic vascular resistance to about twice that before birth. Which heart defect produces a systolic ejection murmur at the right upper sternal border that transmits to the neck and left lower sternal border with an occasional ejection click? Hypoplastic left heart syndrome Pulmonic stenosis Correct Answer Aortic stenosis Coarctation of the aorta This study source was downloaded by from CourseH on :42:40 GMT -05:00 S - The Marketplace to Buy and Sell your Study Material Question 24 2 / 2 pts Question 25 2 / 2 pts A systolic ejection murmur at the right upper sternal border that transmits to the neck and left lower sternal border is produced by blood flow through the stenotic area. An ejection click may be heard with valvular arterial stenosis. Which congenital heart defects occur in trisomy 13, trisomy 18, and Down syndrome? Atrial septal defect and dextrocardia Coarctation of the aorta and pulmonary stenosis Tetralogy of Fallot and persistent truncus arteriosus Ventricular septal defect and patent ductus arteriosus Congenital heart defects that are related to dysfunction of trisomy 13, trisomy 18, and Down syndrome include ventricular septal defect and patient ductus arteriosus (see Table 31-2). What is the most important clinical manifestation of aortic coarctation in the neonate? Congestive heart failure (CHF) Pulmonary hypertension Cerebral hypertension Cor pulmonale The newborn usually presents with CHF symptoms. Once the ductus closes, these infants deteriorate rapidly from the development of hypotension, acidosis, and shock. This study source was downloaded by from CourseH on :42:40 GMT -05:00