NR 507 Mid term weeks 1-4 PATHOPHYSIOLOGY QUESTIONS AND ANSWERS 100%

What is the most abundant class of plasma protein? Globulin Albumin Clotting factors Complement proteins Albumin (approximately 60% of total plasma protein at a concentration of about 4 g/dl) is the most abundant plasma protein. Carcinoma in situ is characterized by which changes? Cells have broken through the local basement membrane. Cells have invaded immediate surrounding tissue. Cells remain localized in the glandular or squamous cells. Cellular and tissue alterations indicate dysplasia. Carcinoma in situ (CIS) refers to preinvasive epithelial malignant tumors of glandular or squamous cell origin. These early stage cancers are localized to the epithelium and have not broken through the local basement membrane or invaded the surrounding tissue. Dysplasia refers to changes in mature cell structure. Which laboratory test is considered adequate for an accurate and reliable diagnosis of gonococcal urethritis in a symptomatic man? Ligase chain reaction (LCR) Gram-stain technique Polymerase chain reaction (PCR) DNA testing Microscopic evaluation of Gram-stained slides of clinical specimens is deemed positive for Neisseria gonorrhoeae if gram-negative diplococci with the typical “kidney bean” morphologic appearance are found inside polymorphonuclear leukocytes. Such a finding is considered adequate for the diagnosis of gonococcal urethritis in a symptomatic man. The other options are not relevant to the diagnosis of this condition. The Papanicolaou (Pap) test is used to screen for which cancer? Ovarian Uterine Cervical Vaginal The Pap test, an examination of cervical epithelial scrapings, readily detects early oncogenic human papillomavirus (HPV)infection. The Pap test is not used for screening the other cancer sites listed. Causes of hyperkalemia include: Hyperparathyroidism and malnutrition Vomiting and diarrhea Renal failure and Addison disease Hyperaldosteronism and Cushing disease Hyperkalemia should be investigated when a history of renal disease, massive trauma, insulin deficiency, Addison disease, use of potassium salt substitutes, or metabolic acidosis exists. The other options are not known to be causes of hyperkalemia. What is the major concern regarding the treatment of gonococci infections? Development of antibiotic resistance Changes in virulence Changes in pathogenicity Mutations into different strains Several types of drug-resistant strains have been identified; they are penicillinase- producing Neisseria gonorrhoeae (PPNG), which is resistant to penicillin; tetracycline- resistant N. gonorrhoeae (TRNG), which is resistant to tetracycline; chromosomal control of mechanisms of resistance of N. gonorrhoeae (CMRNG), which is resistant to penicillin and tetracycline; and increasingly a fluoroquinolone-resistant N. gonorrhoeae (QRNG). The other options are not major concerns. Hypersensitivity is best defined as a(an): Disturbance in the immunologic tolerance of self-antigens Immunologic reaction of one person to the tissue of another person Altered immunologic response to an antigen that results in disease Undetectable immune response in the presence of antigens Hypersensitivity is an altered immunologic response to an antigen that results in disease or damage to the host. The other options are not accurate definitions of hypersensitivity. Which immunoglobulin (Ig) is present in childhood asthma? IgM IgG IgE IgA Included in the long list of asthma-associated genes are those that code for increased levels of immune and inflammatory mediators (e.g., interleukin [IL]–4, IgE, leukotrienes), nitric oxide, and transmembrane proteins in the endoplasmic reticulum. None of the other options are associated with childhood asthma. Which criterion is used to confirm a diagnosis of asthma in an 8-year-old child? Parental history of asthma Serum testing that confirms increased immunoglobulin E (IgE) and eosinophil levels Reduced expiratory flow rates confirmed by spirometry testing Improvement on a trial of asthma medication Confirmation of the diagnosis of asthma relies on pulmonary function testing using spirometry, which can be accomplished only after the child is 5 to 6 years of age. Reduced expiratory flow rates that are reversible in response to an inhaled bronchodilator would be characteristic abnormalities. For younger children, an empiric trial of asthma medications is commonly initiated. The remaining options are major historical and physical factors that contribute but do not confirm the diagnosis of asthma in children. Continuous increases in left ventricular filing pressures result in which disorder? Mitral regurgitation Mitral stenosis Pulmonary edema Jugular vein distention Pressure changes are important because increased left ventricular filling pressures back up into the pulmonary circulation, where they force plasma out through vessel walls, causing fluid to accumulate in lung tissues (pulmonary edema). This selection is the only option that accurately identifies the disorder described in the question. Question 11 Which statement best describes a Schilling test? Administration of radioactive cobalamin and the measurement of its excretion in the urine to test for vitamin B12 deficiency Measurement of antigen-antibody immune complexes in the blood to test for hemolytic anemia Measurement of serum ferritin and total iron-binding capacity in the blood to test for iron deficiency anemia Administration of folate and measurement in 2 hours of its level in a blood sample to test for folic acid deficiency anemia. The Schilling test indirectly evaluates vitamin B12 absorption by administering radioactive B12 and measuring excretion in the urine. This selection is the only option that accurately describes a Schilling test. How high does the plasma glucose have to be before the threshold for glucose is achieved? 126 mg/dl 150 mg/dl 180 mg/dl 200 mg/dl When the plasma glucose reaches 180 mg/dl, as occurs in the individual with uncontrolled diabetes mellitus, the threshold for glucose is achieved. What is the ratio of coronary capillaries to cardiac muscle cells? 1:1 (one capillary per one muscle cell) 1:2 (one capillary per two muscle cells) 1:4 (one capillary per four muscle cells) 1:10 (one capillary per ten muscle cells) The heart has an extensive capillary network, with approximately 3300 capillaries per square millimeter (ca/mm2) or approximately one capillary per one muscle cell (muscle fiber). Deficiencies in which element can produce depression of both B- and T-cell function? Iron Zinc Iodine Magnesium Of the options available, only deficient zinc intake can profoundly depress T- and B-cell function. Which congenital heart defects occur in trisomy 13, trisomy 18, and Down syndrome? Coarctation of the aorta (COA) and pulmonary stenosis (PS) Tetralogy of Fallot and persistent truncus arteriosus Atrial septal defect (ASD) and dextrocardia Ventricular septal defect (VSD) and patent ductus arteriosus (PDA) Congenital heart defects that are related to dysfunction of trisomy 13, trisomy 18, and Down syndrome include VSD and PDA (see Table 33-2). The other defects are not associated with dysfunction of trisomy 13, trisomy 18, and Down syndrome. Which of the following is classified as a megaloblastic anemia? Iron deficiency Pernicious Sideroblastic Hemolytic Pernicious anemia is the most common type of megaloblastic anemia. The remaining options are not classified as megaloblastic anemias. The lung is innervated by the parasympathetic nervous system via which nerve? Vagus Phrenic Brachial Pectoral Fibers of the parasympathetic division of the autonomic nervous system (ANS) travel only in the vagus nerve to the lung. Which organ is stimulated during the alarm phase of the general adaptation syndrome (GAS)? Adrenal cortex Hypothalamus Anterior pituitary Limbic system The alarm phase of the GAS begins when a stressor triggers the actions of the hypothalamus and the sympathetic nervous system (SNS) (see Figure 11-1). The other organs are not stimulated by the alarm phase of GAS.