PORTAGE LEARNING NURS 231 PATHOPHYSIOLOGY MODULE 1 - MODULE 10 EXAMS {LATEST UPDATE} GRADED A

PATHOPHYS Module Module 1 Exam Question 1 2.5 / 2.5 pts True/False: A bodybuilder’s muscles will display hyperplasia. True Correct! False It will display hypertrophy. Question 2 2.5 / 2.5 pts True/False: Barrett esophagus is an example of dysplasia. True Correct! False It’s metaplasia. Question 3 0 / 2.5 pts True/False: Hypertrophy is an increase in the size of an organ or tissue caused by an increase in the number of cells You Answered True Correct Answer False Question 4 2.5 / 2.5 pts True/False: Hypertrophy can occur under normal and pathological conditions. Correct! True 2 2 False Question 5 10 / 10 pts Match the following: Deals with the cause of death in a population a. Incidence Number of new cases in a population at risk during a specified time b. Prevalence Number of people with the disease in a population in a given time c. Morbidity The effect of an illness on one’s life d. Mortality Question 6 2.5 / 2.5 pts Multiple Choice Which is NOT true of the cytoskeleton? It controls shape and movement Cilia and flagella are microtubule-filled cellular extensions Correct! It includes peroxisomes and proteasomes Peroxisomes and proteasomes are not part of the cytoskeleton. 3 Question 7 1.67 / 2.5 pts Which of the following move across the cell membrane via diffusion? Select all that apply. Correct! 4 Oxygen Glucose Correct Answer Water Correct! Carbon dioxide Question 8 2.5 / 2.5 pts Multiple Choice Which of the following are false regarding cell communication? Endocrine signaling depends on hormones Neurotransmitters act through synapses G-protein linked receptors act through an on-off switch Correct! Paracrine signaling releases a chemical into the extracellular fluid that affects its own activity Question 9 2.5 / 2.5 pts Which is true of the cytoskeleton? Select all that apply. Correct! It controls shape and movement Correct! Cilia and flagella are microtubule-filled cellular extensions It includes peroxisomes and proteasomes Question 10 0 / 2.5 pts Multiple Choice High blood pressure is an example of which of the following? Pathology Correct Answer 5 Pathophysiology Physiology You Answered No answer text provided. Question 11 2.5 / 2.5 pts Multiple Choice A patient has a fever and rash. What are these examples of? Correct! Signs Symptoms Both A & B Question 12 2.5 / 2.5 pts Multiple Choice Which of the following is true of a test’s sensitivity? It is how likely the same result will occur if repeated Correct! If negative, it can safely be assumed that the person does not have a disease It is considered a true-negative result It can only be calculated from people without the disease Question 13 2.5 / 2.5 pts Multiple Choice Which of the following is the effect of an illness on one’s life? Incidence Correct! Morbidity 6 Prevalence Mortality Question 14 10 / 10 pts Define secondary prevention and give an example: Your Answer: It is one of three categories in disease prevention. It aims to detect and treat disease early, while the disease is asymptomatic and curable. An example is an annual Pap smear. Secondary prevention aims to detect and treat disease early, usually while the disease is asymptomatic and curable. Some examples include annual Pap smears to detect early cervical cancer, encouraging smoking cessation, checking blood pressure and cholesterol, and colonoscopy screening. Question 15 10 / 10 pts Compare and contrast the two types of gangrenous necrosis. Your Answer: 2 types are dry and moist. In dry gangrenous, the affected tissue is dehydrated, shrinks back and becomes dark brown or black in color. THe spread of dry is slow. In wet, the affected area is cold, swollen, with no pulse. The skin is moist, black, and distended. Small blisters form and as liquefaction occurs, foul ordor emerges. The spread of wet gangrenous is rapid. In dry gangrene the affected tissue becomes dry and shrinks, the skin wrinkles, and its color changes to dark brown or black. The spread of dry gangrene is slow. It results from a cut off in arterial blood supply and is a form of coagulation necrosis. In wet gangrene, the affected area is cold, swollen, and pulseless. The skin is moist, black, and under tension. Blebs form on the surface, liquefaction occurs, and a foul odor is caused by bacterial action. The spread of tissue damage is rapid. Question 16 10 / 10 pts Explain what necrosis is and give an example and description of one type of necrosis. Your Answer: Necrosis is cell death in tissue or organ that is still part of a living person. An example of a type of necrosis is coagulative necrosis. This results from a sudden cutoff of the blood supply to an organ, such as the heart. Necrosis refers to cell death in an organ or tissues that is still part of a living person. It often interferes with cell replacement and tissue regeneration. Coagulative necrosis results most often from a sudden cutoff of blood supply to an organ (ischemia), particularly the heart and kidney. Liquefactive necrosis occurs when some of the cells die but their catalytic enzymes are not destroyed. It is commonly seen with brain infarcts or abscesses. Caseous necrosis occurs as part of granulomatous inflammation and is most often associated with tuberculosis. Gangrenous necrosis most often affects the lower extremities or bowel and is secondary to vascular occlusion. The term gangrene is applied when a considerable mass of tissue undergoes necrosis. In dry gangrene the affected tissue becomes dry and shrinks, the skin wrinkles, and its color changes to dark brown or black. The spread of dry gangrene is slow. It results from a cut off in arterial blood supply and is a form of coagulation necrosis. In wet gangrene, the affected area is cold, 7 swollen, and pulseless. The skin is moist, black, and under tension. Blebs form on the surface, 8 liquefaction occurs, and a foul odor is caused by bacterial action. The spread of tissue damage is rapid. Question 17 10 / 10 pts Match the type of cell injury to the cause. Some answers may be used more than once. (1 point each) Sunburn a. Physical agents Obesity b. Radiation injury Reactive oxygen species c. Chemical injury Low oxygen to tissues d. Biologic agents Fractures e. Nutritional imbalances OTC drugs f. Free radical injury Hypothermia g. Hypoxic cell injury Radiation treatment Lead toxicity Bacteria Question 18 10 / 10 pts List the 4 types of tissue found in the body. Pick 2 and give a description and example of each. Your Answer: Epithelial, Connective, Muscle, and Nervous Epithelial tissue covers the body's outer surface, lines inner surfaces, forms glandular tissue. It is avascular and can be squamous, cuboidal, and columnar. An example of this type of tissue is our skin. Muscle tissue functions to move our bones, pump blood through the heart, as well as contract blood vessels. Cardiac muscle tissue is an example of muscle tissue. 9 Epithelial tissue covers the body’s outer surface, lines the inner surfaces, and forms glandular tissue. Epithelial tissue has three distinct surfaces and the basal surface is attached to an underlying 10 basement membrane. It is avascular, meaning without blood vessels. It receives oxygen and nutrients from the capillaries of the connective tissue on which it rests. Connective or supportive tissue is the most abundant tissue in the body. It connects and binds or supports the various tissues. Its cells produce the extracellular matrix that support and hold tissues together. Connective tissue is divided into two types: connective tissue proper and specialized connective tissue (cartilage, bone, and blood cells). The four types of connective tissue proper are loose (areolar), adipose, reticular, and dense connective tissue. The function of muscle tissue is to move the skeletal structures, pump blood through the heart, and contract the blood vessels and visceral organs. Muscle tissue can accomplish this by contraction. The two types of fibers that contract are called thin and thick filaments. Thin filaments are called actin, and the thick filaments are myosin. The three types of muscles tissue are skeletal, cardiac, and smooth. Nervous tissue is distributed throughout the body for communication. It provides the means for controlling body function and for sensing and moving about the environment. The two types of cells are neuron and glial cells. Neurons function is communication. Glial (meaning glue) cells support the neurons. Question 19 2.5 / 2.5 pts What is the most studied active transport system in the human body? Your Answer: The most studied active transport system is the sodium-potassium-ATPase pump. This pumo moves sodium from inside the cell to outside region, returning potassium to the inside of the cell. If this did not occur, sodium would remain in the cell, water would follow resulting in the cell to swell. Sodium-potassium (Na+/K+)-ATPase pump Question 20 2.5 / 2.5 pts What is the term to describe when cells use energy to move ions against an electrical or chemical gradient? Your Answer: Active transport Active transport Question 21 2.5 / 2.5 pts Give one function of a membrane potential: Your Answer: Generate nerve impulses Generate nerve impulse, muscle contractions, or cause hormone secretion Question 22 2.5 / 2.5 pts What is the term that describes a transport protein to help lipid soluble or large molecules pass through the membrane, that otherwise would not be able to get through? Your Answer: Facilitated diffusion facilitated diffusion 11 Module 2 Exam- 12 Question 1 3 / 3 pts True/False: Blood tests for tumor markers are the single best screening tool for cancer. Why or why not? Your Answer: False. Tumor markers, which can be used for establishig prognosis, monitoring treatment and detecting recurrent disease, have limitiations. Under benign situations, tumor markers can still be elevated. Whereas in early stages of malignancy, not elevated. They have a lack of specificity and are then limited in their ability to screen or diagnose accuratley. False, they are elevated in benign conditions, most are not elevated in the early stages of malignancy. Question 2 3 / 3 pts Tissue biopsy is of critical importance in what role? Your Answer: Play a critical role in histologic and cytologic studies for diagnosis of cancers. Diagnosing the correct cancer and histology. Question 3 4 / 4 pts 1. List two signs or symptoms a patient may present with that might indicate a cancer diagnosis: 2. What are two side effects commonly experienced by cancer patients? Your Answer: 1) Bleeding and/or weight loss 2) Anorexia, hair loss 1. Bleeding; sore that doesn’t heal; fluid in the pleural, pericardial, or peritoneal spaces; chest pain, shortness of breath, cough, abdominal discomfort or swelling. Other possible answers can include a mass or lump, pain (need to be specific), fatigue, fevers, weight loss 2. Weight loss, wasting of body fat and muscle tissue, weakness, anorexia, and anemia, fatigue, sleep disturbances Question 4 10 / 10 pts Explain the TNM system: Your Answer: TNM system is a detailed staging system, created by AJCC, is used by cancer facilites. It classifies cancers into stages using 3 tumor components; Tumor, Nodes, Metastasis. T is size and spread of the primary tumor. N is how involved the lymph nodes. M is the extent of metastatic involvement. Classification: Tx, T0, Tis, T1-4 Nx, N0, N1-3 Mx, M0, M1 T is the size and local spread of the primary tumor. N is the involvement of the regional lymph nodes. 13 M is the extent of the metastatic involvement. 14 Question 5 10 / 10 pts 1. When would surgery be appropriate in the treatment of cancer? 2. Most chemotherapeutic drugs cause pancytopenia due to bone marrow suppression. What are the 3 possible adverse outcomes of this? Your Answer: 1. Surgery can be used if the tumor is solid and small with well-defines margins. Also can be used to treat oncologic emergencies and be used as prophylactic measures. 2. 3 possible adverse outcomes are neutropenia, anemia, thrombocytopenia. 1. Surgery is often the first treatment for solid tumors. If the tumor is small with well-defined margins, it can be removed completely. It is also used for oncologic emergencies and prophylactic surgery in high risk patients. 2. Neutropenia- risk for infections Anemia- causing fatigue Thrombocytopenia- risk for bleeding Question 6 2.5 / 2.5 pts True/False: Cell proliferation is the process in which proliferating cells become more specialized cell types. True Correct! False False, cell differentiation Question 7 2.5 / 2.5 pts True/False: Cell differentiation is the process of increasing cell numbers by mitotic cell division. True Correct! False False, cell proliferation Question 8 2.5 / 2.5 pts What are two important properties that stem cells possess? Your Answer: 15 Stem cells possess self-renewal and potency. Self renewal means that they can undergo mitotic divisions while maintaining undifferentiated state. Potency is the differentiation potential of stem cells. Potency and self-renewal 16 Question 9 0 / 2.5 pts Which of the following are most likely to have arisen from an adult stem cell? You Answered Muscle Bone Correct Answer Epithelial Neural Question 10 4 / 4 pts What is angiogenesis? Why do tumors need it? Your Answer: Angiogenesis is the development of new blood vessels within the tumor. In order to continue growing, it must establish blood vessels and growth factors. development of new blood vessels within the tumor. They need it to continue to grow. Question 11 3 / 3 pts What are normal genes called that become cancer-causing if mutated? Your Answer: Proto-oncogenes and Tumor suppressor genes protooncogenes Question 12 1 / 3 pts What is a tumor suppressor gene? Give one example. Your Answer: It is a gene that codes for a protein that inhibits cell growth and signals apoptosis. An example is p53. Tumor suppressor genes are associated with gene underactivity. These genes slow down cell division, repair DNA mistakes, or tell cells when to die. BRCA1 or 2, TP53 Question 13 10 / 10 pts Determine if the tumor is benign or malignant based on the nomenclature: Papilloma Lipoma Leiomyosarcoma Hemangioma Adenocarcinoma Neuroblastoma 17 Adenoma Melanoma 18 Lymphoma Glioma Question 14 10 / 10 pts A 62-year-old man with a 30-pack year smoking history is diagnosed with small cell lung cancer with metastasis to the bone. (1) Explain the process of how cancer spreads metastatically. (2) What symptoms might he have presented with? (3) Which screening test would he have benefited from? Your Answer: 1. Metastasis is a multi-step process. Cancer cells breaks loose from the primary tumor and enters circulation via a blood vessel or lymp system. It finds a new favorable location to invade, grow, and establish blood supply. 2. Patient might have presented with shortness of breath, chest pain, and cough. 3. Patient would have benefited from a chest CT scan. (1) Metastasis- a cancer cell must break loose from the primary tumor, invade the surrounding extracellular matrix, gain access to a blood vessel, survive its passage in the bloodstream, emerge at a favorable location, invade the surrounding tissue, begin to grow, and establish a blood supply. (2) Chest pain, shortness of breath, cough, bone pain. (3) Yearly low-dose chest CT. Question 15 3 / 3 pts Benign tumors have which of the following characteristics? Select all that apply. Undifferentiated cells 19 Correct! 20 Grows by expansion Gains access to blood and lymph channels Correct! Growth may stop or regress Question 16 3 / 3 pts What are the genetic events that can lead to cancer? Select all that apply. Correct! Gene amplification Pleomorphism Correct! Point mutation Seeding Correct! Chromosomal translocation Question 17 4 / 4 pts List 4 of the 7 risk factors linked to cancer as stated in the module. Your Answer: 1. heredity 2. environmental agents 3. radiation 4. cancer-causing viruses Heredity, hormonal factors, obesity, immunologic mechanisms, environmental agents such as chemicals, radiation, and cancer-causing viruses. Question 18 5 / 10 pts 1. is a systemic treatment that enables drugs to reach the site of the tumor as well as other distant sites. 2. The profound weight loss and wasting of fat and tissue that accompany cancer is known as . Your Answer: 1. Chemotherapy Portage Learning / NURS 231 Patho All Module 2. Wasting 1. chemotherapy 2. cancer anorexia-cachexia syndrome 24 Portage Learning / NURS 231 Patho All Module Exams Question 19 3. 5 / 3.5 pts Which of the following are risk factors for developing cancer? Select all that apply. Correct! HBV Correct! Alcohol Correct! High intake of smoked meats Deodorant Question 20 3.5 / 3.5 pts All of the following viral agents are correctly paired with the associated lesion except: Human papillomavirus (HPV): genital warts Correct! Epstein-Barr virus: carcinoma of the cervix Epstein Barr is linked to Burkitt lymphoma and nasopharyngeal cancer. Cervical carcinoma is linked to HPV. Hepatitis B virus: hepatocellular carcinoma Human herpes virus-8: Kaposi sarcoma Question 21 3 / 3 pts List one example of screening for each method: observation, palpation, and lab test/procedure: Your Answer: Observation: skin Palpation: breast Lab test: Pap smear Observation: skin, mouth, external genitalia Palpation: breast, thyroid, rectum and anus, prostate, lymph nodes Laboratory tests and procedures: Pap smear, colonoscopy, mammography MODULE 3 Question 1 5 / 5 pts Short answer Explain the challenges of diagnosing autoimmune disorders. Your Answer: Diagnosing is made by history, physical, and serological findings. Since some blood tests are more generic, results can be imprecise. Markers can be elevated in the presence of other diseases.Criteria for diagnosis: Evidence of an autoimmune reaction, immunological findings are not second to other conditions, and no other causes are found. There are over 80 identified, many with overlapping presentations. Many manifestations are nonspecific and are seen in other non-autoimmune diseases. Blood testing isn’t perfect either, as some tests are more generic and can be elevated in the presence of other diseases. Question 2 2.5 / 2.5 pts Multiple Choice: Which type of immunity is characterized by the development of a specific response to an antigen? Innate immunity Correct! Adaptive immunity Autoimmunity Active immunity Question 3 2.5 / 2.5 pts Multiple Choice: What allows the lymphocyte to differentiate between self and foreign molecules? Antigen presenting cells Regulatory cells Correct! Major histocompatibility complex (MHC) molecule Effector cells Question 4 0 / 3 pts T lymphocytes produce what type of immunity? Your Answer: 25 Portage Learning / NURS 231 Patho All Module Adaptive immunity Cell-mediated Question 5 26 Portage Learning / NURS 231 Patho All Module Exams 2 / 2 pts Multiple Choice: Which immunoglobulin passes immune factors from the mother to the fetus? IgM IgA Correct! IgG IgD IgE Question 6 2 / 2 pts Multiple Choice: Which cell type is an early responder and the most abundant in the body? Lymphocytes Eosinophils Basophils Correct! Neutrophils Question 7 3.5 / 3.5 pts Multiple Choice: Which is NOT a finding consistent with Graves’ disease? Exophthalmos Correct! Portage Learning / NURS 231 Patho All Module Hypothyroidism hyperthyroidism Goiter 28 Portage Learning / NURS 231 Patho All Module Corneal ulceration Question 8 10 / 10 pts A 9-year-old boy with a peanut allergy was exposed to peanuts. He presents to the emergency room with an anaphylactic reaction. (1) What symptoms might he present with? (2) Does the quantity of exposure mean he will have a more severe reaction? (3) What is the initial immediate treatment? (4) What are 2 things people with anaphylaxis should always carry? Your Answer: 1) shortness of breath, skin redness/hives , abdominal cramping 2) quantity of the exposure does NOT play role on how severe the reaction can be 3) elimination of the food and EpiPen (epiniphereine) 4) carry 2 EpiPens (1) Any of the following reactions are accepted. Grade I: erythema and urticaria, with or without angioedema. Grade II: hypotension, tachycardia, dyspnea, and GI manifestations, like nausea, vomiting, diarrhea, and abdominal cramping from mucosal edema. Grade III: bronchospasm, cardiac dysrhythmias, and cardiac collapse. Grade IV: cardiac arrest (2) No (3) Epinephrine (4) identification about allergy, EpiPen Question 9 3.5 / 3.5 pts True/False: Following a heart attack, the area of heart muscle that has undergone necrosis because of lack of blood supply will heal by scar tissue replacement. Correct! True False Question 10 3 / 3 pts Multiple Choice: Which of the following is an incorrect pairing of a classic manifestation of acute inflammation with its corresponding cause? Rubor – vasodilation Correct! Dolor – inflammatory cells infiltrating sensory nerves 29 30 In acute inflammation, dolor (pain) is caused by increased hydrostatic pressure in tissues and by chemical mediators. Calor – increased blood flow 31 Tumor – exudation of fluid and cells into extravascular tissues Question 11 3.5 / 3.5 pts True/False: Lymphocytes are categorized as either granulocytes or agranulocytes. True Correct! False false, leukocytes Question 12 3 / 3 pts True/False: Passive immunity is achieved through immunization. True Correct! False false, active immunity Question 13 2.5 / 2.5 pts True/False: B lymphocytes normally produce antibodies against host tissues. True Correct! False Question 14 3.5 / 3.5 pts Antibodies are also known as ? Your Answer: immunoglobulins immunoglobulins 32 Question 15 3.5 / 3.5 pts Multiple Choice: Which of the following hypersensitivity reactions can be treated with the administration of epinephrine? 33 Correct! Type I Type II Type III Type IV Question 16 3.5 / 3.5 pts Multiple Choice: Which cell is NOT part of the adaptive immune response? Correct! Monocytes Lymphocytes Antigen presenting cells Effector cells Question 17 3.5 / 3.5 pts Multiple Choice: The body’s ability to distinguish self from nonself is termed what? Autoantibodies Positive selection Correct! Self-tolerance Anergy Question 18 5 / 5 pts 34 Short answer: What are autoantibodies? Your Answer: 35 In autoimmune diseases, the immune sustem loses its ability to recognize self and produces autoantibodies, which act against host tissues Answer: In many autoimmune diseases, the immune system loses its ability to recognize self and produces what is called autoantibodies, which act against host tissues. Question 19 10 / 10 pts Short answer A 40-year-old man presents with cough and shortness of breath. After an H&P and chest films, it is determined he has pneumocystis carinii pneumonia (PCP). The provider does an HIV test, which is positive. Upon further testing, the man’s CD4+ cell count is 100 cells/μL and his viral load is 250,000 copies/mL. (1) Why did the provider do an HIV test after the man was diagnosed with PCP? (2) What classification does this man fall into based on his CD4+ count and symptomatology, and why? Your Answer: 1) PCP is a lung infection that affects people with weakened immune systems, such as those infected with HIV. It is listed as an opportunistic infection. 2) Overt AIDS. Patient's CD4+ cell count is below 200 cells/uL. Patient also presented with an AIDS- defining illness, such as PCP. (1) Opportunistic infections are those common organisms that do not produce infection without impaired immune function. (2) The last phase, or AIDS illness, occurs when the CD4+ cell count falls to less than 200 cells/μL or exhibits an AIDS-defining illness. The risk of opportunistic infections and death increases significantly when the CD4+ cell count falls below 200 cells/μL. Question 20 3.5 / 3.5 pts Multiple Choice: Which process is NOT included in wound healing? Inflammatory Proliferative Correct! Acute-phase response Remodeling Question 21 3.5 / 3.5 pts Multiple Choice: 36 Which of the following cells is a permanent cell? Epidermal cell 37 Hepatocyte Intestinal mucosal cell Correct! Neuron Renal tubular cell Question 22 3.5 / 3.5 pts Fill in the blank As the CD4 T cell count decreases, the body becomes susceptible to . Your Answer: opportunistic infections Answer: opportunistic infections Question 23 3.5 / 3.5 pts The term to describe the time when an infected person’s blood converts from being negative for HIV antibodies to being positive is called what? Your Answer: Seroconversion Answer: seroconversion Question 24 3.5 / 3.5 pts True/False: A person with HIV is not infectious when they are asymptomatic. True Correct! False Question 25 2.5 / 2.5 pts True/False: The T cells that display the host’s MHC antigens and T-cell receptors for a nonself-antigen are allowed to mature, a process termed positive selection. Correct! Portage Learning / NURS 231 Patho All Module True False 38 Portage Learning / NURS 231 Patho All Module Exams Question 26 0 / 2.5 pts Multiple Choice: The process of leukocyte accumulation in the cellular phase of acute inflammation is called what? You Answered Adhesion Transmigration Chemotaxis Correct Answer Margination Question 27 2.5 / 2.5 pts Multiple Choice: Which lab value will typically be increased in a viral infection? Neutrophils Eosinophils Basophils Correct! Lymphocytes MODULE 4 Question 1 2.5 / 2.5 pts Which of the following increases the chance of clotting? Select all that apply. Vitamin K deficiency Von Willebrand factor deficiency Correct! Protein C deficiency Thrombocytopenia Portage Learning / NURS 231 Patho All Module Exams Question 2 2.5 / 2.5 pts A deficiency in which of the following would lead to a hypercoagulable state? Select all that apply. Correct! Protein C Correct! Protein S Factor II Factor VII Factor IX Factor X Correct! Antithrombin III Question 3 2.5 / 2.5 pts Which of the following is a hypercoagulable state? Select all that apply. Hemophilia A Correct! Congestive heart failure Correct! Smoking Thrombocytopenia Correct! Postsurgical state Question 4 0 / 2.5 pts 41 Which of the following is FALSE of disseminated intravascular coagulation (DIC)? Select all that apply. Microthrombi cause vessel occlusion and tissue ischemia You Answered 42 It can cause multiple organ failure Severe hemorrhage results Obstetric disorders are the main cause of DIC Correct! Lab results show a decreased PT, PTT Question 5 2.5 / 2.5 pts Well-known causes of disseminated intravascular coagulation (DIC) include each of the following conditions except: Retained dead fetus Carcinoma Gram-negative sepsis Correct! Heparin administration Question 6 2.5 / 2.5 pts Which of the following does NOT affect the heart’s ability to increase its output? Preload Afterload Cardiac contractility Correct! Cardiac reserve Heart rate Question 7 2.5 / 2.5 pts Which of the following is NOT a regulator of blood pressure? Baroreceptors 43 Renin-angiotensin-aldosterone system Vasopressin Correct! Parasympathetic nervous system activation Question 8 2.5 / 2.5 pts Antiphospholipid syndrome is NOT associated with which of the following? Select all that apply. Correct! Bleeding risk Thrombus risk Recurrent fetal loss Thrombocytopenia Can be seen with SLE Question 9 2.5 / 2.5 pts Multiple Choice What is the most specific test for diagnosing iron deficiency anemia? Correct! Ferritin RBC Total iron binding capacity Hematocrit Question 10 2.5 / 2.5 pts Multiple Choice Hemolytic anemias are characterized by each of the following except: 44 Premature destruction of red cells Correct! 45 Decrease in erythropoiesis Sickle cell disease and thalassemias are included Bone marrow is hyperactive Question 11 2.5 / 2.5 pts Which of the following are potential causes of a sickle crisis in sickle cell anemia? Select all that apply. Alkalosis Correct! Dehydration Correct! Cold exposure Correct! Physical exertion Question 12 0 / 2.5 pts Multiple Choice: A 23-year-old African-American man with a history of severe lifelong anemia requiring many transfusions has nonhealing leg ulcers and recurrent periods of abdominal and chest pain. These signs and symptoms are most likely to be associated with which one of the following laboratory abnormalities? Correct Answer Sickle cells on peripheral blood smear Loss of intrinsic factor You Answered Decreased erythropoietin Decreased ferritin Question 13 2.5 / 2.5 pts Multiple Choice: Portage Learning / NURS 231 Patho All Module Which of the following is NOT true of vitamin B12 deficiency anemia? 46 Dietary deficiencies are not common Peripheral neuropathy can be a result of deficiency Vitamin B12 is bound to intrinsic factor Correct! MCV is decreased Question 14 2.5 / 2.5 pts Multiple Choice: Each of the following are risk factors for secondary hyperlipidemia except? Obesity Diabetes mellitus High cholesterol diet Correct! Autosomal dominant disorder of LDL receptor Question 15 2.5 / 2.5 pts Multiple Choice: Risk factors for coronary heart disease include each of the following except: Correct! HDL > 60 Smoking Hypertension Family history of heart disease Question 16 2.5 / 2.5 pts Multiple Choice: Risk factors for atherosclerosis include each of the following except: Increasing age 47 48 Correct! Female gender (pre- menopause) Elevated CRP levels Cigarette smoking Question 17 8 / 10 pts Matching: Match the cardiac procedures to their description and what they are best used for. 2 answers per question (1 from Set 1, and 1 from Set 2). 1. Cardiac catheterization 2. Exercise stress testing 3. Electrocardiography 4. Echocardiography Set 1: a. Records electrical potential differences during the cardiac cycle b. Observes cardiac function under stress c. Checks for structure and function of the heart d. Catheter is inserted into the great vessels and chambers of the heart Set 2: a. Best to assess ventricular function and heart failure b. Best to assess for arrhythmias and myocardial infarction c. Best to assess need for coronary artery bypass graft and stenting d. Best to assess suspected ischemic heart disease Your Answer: 1. D, C 2. B, D 3. A, A 4. C, B 1. Set 1: d, Set 2: c 2. Set 1: b, Set 2: d 3. Set 1: a, Set 2: b 4. Set 1: c, Set 2: a Question 18 10 / 10 pts Explain the differences in the pathophysiology, symptoms, and whether nitroglycerin and/or rest will relieve symptoms in stable angina, unstable angina, and myocardial infarction. Your Answer: 49 In stable angina, with exertion, the vessels cannot properly vasodilate. This can cause chest pain, tightness or shortness of breath. Heart is stable at rest, but cannot keep up with the exertion demand. It is relieved with rest and/or use of nitroglycerin. With increasing occlusion of the coronary vessel, the demands of the resting heart may become too great. Unstable agina is when patient has angina without exertion. Rest is insuffient, but can be releived with nitroglycerin. If the plaque ruptures, complete occulsion can occur. This can lead to lack of oxygen to tissues in the heart and muscle can die. This is myocardial infarction. Chest pain unrelieved by rest, sharp pain down left arm, vomitting are signs of distress. Emergency/hospital interventions are needed. With atherosclerotic disease, the coronary vessel lumens are narrowed and blood supply to the heart is diminished. With exertion, the vessels cannot adequately vasodilate. This can manifest as chest pain or tightness and/or shortness of breath. Stable angina- The heart is stable at rest but cannot keep up with the demand of exertion. Stable angina typically has a >70% stenosis of the coronary arteries. It is relieved by rest or nitroglycerin (vasodilator). Unstable angina- With increasing occlusion of the coronary vessel(s), the demands of the resting heart may become too great. When the patient experiences angina without exertion, or when the level of exertion necessary to cause anginal symptoms decreases, this is called unstable angina. It can be relieved by nitroglycerin, but not rest. Unstable angina means one or more coronary vessels is nearly totally occluded. Myocardial infarction- If a plaque ruptures, coronary thrombosis can cause complete occlusion. If collateral flow is inadequate, the tissue supplied becomes ischemic. Without oxygen, a portion of the muscle can die. MI can present as chest pain unrelieved by rest, sometimes radiating down the left ram or into the jaw or neck, dyspnea, nausea/vomiting, sweating, and/or other signs of distress. Other symptoms include a crushing pain or like “something is sitting on my chest.” Women may present with weakness, fatigue, shortness of breath, or GI complaints. Symptoms are not relieved by nitroglycerin. Question 19 10 / 10 pts 1. Name 2 lifestyle changes to prevent further progression of atherosclerotic diseases: 2. Name 2 medications used to treat someone with coronary artery disease and their mechanisms of action: Your Answer: 1. Stop smoking and frequent exercise 2. ACE inhibitors prevent conversion of angiotensin I to angiotensin II, which decreases vasocontriction, aldosterone production, sodium and water retiention by the kidneys. Diuretics promote the excretion of fluids, reducing preload. 1. Reduction in fat intake, quitting smoking, weight loss, exercise 2. Aspirin or other platelet inhibitors are used to prevent thrombosis formation. Beta-blockers and calcium channel blockers (CCB) – both decrease the heart rate and contractile force – can be initiated to decrease the heart’s demand of oxygen. CCB also increase coronary vasodilatation and decrease coronary vasospasm. Nitrates are used to quickly dilate the coronary vessels. Nitrates also dilate veins, decreasing the heart’s work by decreasing preload and afterload. Question 20 2.5 / 2.5 pts Multiple Choice: 50 With increasing occlusion of the coronary vessel(s), the demands of the resting heart may become too great. When the patient experiences angina without exertion, or when the level of exertion necessary to cause anginal symptoms decreases, this is called what? Stable angina Correct! Unstable angina Myocardial infarction Question 21 2.5 / 2.5 pts Multiple Choice: Which of the following is NOT a risk factor for hypertension? Correct! Increased potassium intake Increased salt intake Increased alcohol intake Increased caloric intake Question 22 2.5 / 2.5 pts Multiple Choice: Each of the following lifestyle modifications will help to decrease blood pressure except: Losing weight Increase fruits and vegetables Correct! 3 drinks or more of alcohol Limiting salt intake Question 23 2.5 / 2.5 pts 51 Multiple Choice: 52 With atherosclerotic disease, the coronary vessel lumens are narrowed and blood supply to the heart is diminished. With exertion, the vessels cannot adequately vasodilate. This can manifest as chest pain or tightness and/or shortness of breath. What is this referred to as? Correct! Stable angina Unstable angina Myocardial infarction Question 24 2.5 / 2.5 pts Multiple Choice: Which arrhythmia is the most common chronic arrhythmia and incidence increases with age? Sinus bradycardia Sinus tachycardia Correct! Atrial fibrillation Atrial flutter Question 25 2.5 / 2.5 pts Fill in the blank: The laboratory test that measures the volume of red cells in 100 mL of blood is . Your Answer: hematocrit hematocrit Question 26 2.5 / 2.5 pts Fill in the blank: are a group of inherited disorders of hemoglobin synthesis common among Mediterranean populations. Your Answer: thalassemias 53 Thalassemias Question 27 2.5 / 2.5 pts