Advanced Pathophysiology - Wilkes
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Multiple-Choice (A–D), For Each Question.
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,### 1. A 57-year-old male presents to his primary care provider for a red face, hands,
feet, ears, and headache and drowsiness. A blood smear reveals an increased number
of erythrocytes. This indicates:
- A) Leukemia
- B) Polycythemia vera (PV)
- C) Hemolytic anemia
- D) Thrombocytopenia
Answer: B) Polycythemia vera (PV)
- Explanation: Polycythemia vera is a myeloproliferative disorder characterized by an
increased number of erythrocytes (red blood cells). Symptoms such as facial flushing
and headaches can occur due to increased blood viscosity and hypervolemia.
### 2. A 67-year-old female is admitted to the emergency department with a diagnosis
of polycythemia vera. Upon taking the history, the patient will most likely report:
- A) Abdominal pain
- B) Chest pain
- C) Joint pain
- D) Blurred vision
Answer: B) Chest pain
- Explanation: Patients with polycythemia vera often experience chest pain as a
result of increased blood viscosity, which can lead to altered hemodynamics and
ischemia.
### 3. Alpha and beta thalassemias are inherited disorders. They are considered:
- A) X-linked recessive
- B) Autosomal dominant
- C) Autosomal recessive
- D) Mitochondrial
, Answer: C) Autosomal recessive
- Explanation: Both alpha and beta thalassemias are passed on through an
autosomal recessive inheritance pattern, requiring both parents to be carriers for a child
to express the disease.
### 4. What nutrient should the nurse encourage a woman in the early stages of
pregnancy to consume to prevent neural tube defects?
- A) Vitamin B12
- B) Folic acid
- C) Iron
- D) Calcium
Answer: B) Folic acid
- Explanation: Folic acid supplementation before and during early pregnancy is
essential to reduce the risk of neural tube defects, as it is critical for proper neural
development.
### 5. Sickle cell disease is characterized by the presence of Hb S. A nurse is trying to
differentiate between Hb S and normal Hb. Which of the following amino acids is
present in Hb S and not present in normal Hb?
- A) Glutamic acid
- B) Valine
- C) Lysine
- D) Alanine
Answer: B) Valine
- Explanation: In sickle cell disease, the amino acid glutamic acid in the beta-
globulin chain is replaced by valine, which leads to abnormal hemoglobin structure and
function.
, ### 6. High blood glucose levels damage blood vessels in the kidneys, which over time
causes kidneys to become inefficient at filtering blood. The damage caused then leads
to a high level of what (upon testing)?
- A) Creatinine
- B) Urea
- C) Microalbuminuria in urine
- D) Glucose
Answer: C) Microalbuminuria in urine
- Explanation: Diabetic nephropathy is characterized by leakage of albumin into
urine, indicated by microalbuminuria, reflecting kidney damage caused by prolonged
high glucose levels.
### 7. One of the most important factors leading to insulin resistance and diabetes is
obesity. What are several important mechanisms that correlate with obesity that cause
these conditions?
- A) Increase in leptin and decrease in ghrelin
- B) Alterations in insulin receptors, glucagon, adipokines, amylin, incretins, and
ghrelin
- C) Increase in thyroid hormones
- D) Decreased physical activity
Answer: B) Alterations in insulin receptors, glucagon, adipokines, amylin, incretins,
and ghrelin
- Explanation: Obesity leads to complex metabolic changes, including altered
secretion and action of hormones such as insulin and glucagon, which play critical roles
in glucose metabolism and insulin resistance.