Advance patho test, study guide complete test

ADVANCED PATHOPHYSIOLOGY QUIZZES After sexual transmission of HIV, a person can be infected yet seronegative for months. 1 to 2 6 to 14 24 to 36 18 to 20 Antibody appears rather rapidly after infection through blood products, usually within 4 to 7 weeks. After sexual transmission, however, the individual can be infected yet seronegative for 6 to 14 months or, in at least one case, for years. Once they have penetrated the first line of defense, which microorganisms do neutrophils actively attack, engulf, and destroy by phagocytosis? Bacteria Viruses Mycoplasma Fungi Invasion results in direct confrontation with an individual’s primary defense mechanisms against bacteria, which include the complement system, antibodies, and phagocytes, such as neutrophils and macrophages. (See Chapters 6, 7, and 8). Which statement about vaccines is true? Vaccines require booster injections to maintain lifelong protection. Vaccines provide effective protection for all people against viruses, bacteria, and fungal infections. Most bacterial vaccines contain attenuated organisms. Most viral vaccines are made by using dead organisms. In general, vaccine-induced protection does not persist as long as infection-induced immunity, thus booster injections may be necessary to maintain protection throughout life. Cells in may act as a reservoir in which HIV can be relatively protected from antiviral drugs. the thymus gland the central nervous system the lungs bone marrow HIV may persist in regions where the antiviral drugs are not as effective, such as the CNS. Which statement is true about fungal infections? They result in release of endotoxins. They are controlled by phagocytes and T lymphocytes. They are prevented by vaccines. They occur only on skin, hair, and nails. The host defense against fungal infection includes the fungistatic properties of neutrophils and macrophages. T lymphocytes are crucial in limiting the extent of infection and producing cytokines to further activate macrophages. What of the following remains a significant cause of morbidity and mortality worldwide? Infectious disease Traumatic injury Cardiovascular disease Starvation Despite the wide scale implementation of progressive public health and immunization policies, infectious disease remains a significant cause of morbidity and mortality. In a type II hypersensitivity reaction, when soluble antigens from infectious agents enter circulation, tissue damage is a result of complement-mediated cell lysis. phagocytosis in the spleen. neutrophil granules and toxic oxygen products. phagocytosis by macrophages. The components of neutrophil granules, as well as the several toxic oxygen products produced by these cells, damage the tissue. Question 8 2 / 2 pts What is the mechanism in type III hypersensitivity reactions? Antibodies bind to the antigen on the cell surface. Cytotoxic T lymphocytes or lymphokine-producing Th1 cells attack and destroy cellular targets directly. Antibodies coat mast cells by binding to receptors that signal its degranulation followed by discharge of preformed mediators. Antibodies bind to soluble antigens that were released into body fluids and the immune complexes are deposited in the tissues. Most type III hypersensitivity diseases are caused by antigen-antibody (immune) complexes that are formed in the circulation and deposited later in vessel walls or extravascular tissues (Figure 8-3). Deficiencies in which element can produce depression of both B- and T-cell function? Iodine Zinc Magnesium Iron Deficient zinc intake can profoundly depress T- and B-cell function. A person with type O blood is likely to have high titers of anti- antibodies. A and B B A O Type O individuals, who have neither A or B antigen but have both anti-A and anti- B antibodies, cannot accept blood from any of the other three types. Hypersensitivity is best defined as a(n) altered immunologic response to an antigen that results in disease. immunologic reaction of one person to the tissue of another person. disturbance in the immunologic tolerance of self-antigens. 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. In which primary immune deficiency is there a partial to complete absence of T-cell immunity? Adenosine deaminase (ADA) deficiency Bruton disease Reticular dysgenesis DiGeorge syndrome The principal immunologic defect in DiGeorge syndrome is the partial or complete absence of T-cell immunity. What mechanism occurs in Raynaud phenomenon that classifies it as a type III hypersensitivity reaction? Immune complexes are deposited in capillary beds, blocking circulation. Antibodies detect the capillaries as foreign protein and destroy them using lysosomal enzymes and toxic oxygen species. Cytotoxic T lymphocytes attack and destroy the capillaries so that they are unable to perfuse local tissues. Mast cells bind to specific endothelial receptors that cause them to degranulate, creating a localized inflammatory reaction that occludes capillary circulation. A form of serum sickness is Raynaud phenomenon, a condition caused by the temperature-dependent deposition of immune complexes in the capillary beds of the peripheral circulation. The effect that low serum albumin has on the central stress response is to impair wound healing. diminish oncotic pressure. impair circulation of epinephrine and norepinephrine. lessen circulation of cortisol. Once released, catecholamines circulate bound to the plasma protein albumin. Low serum albumin would impair circulation of both epinephrine and norepinephrine. Which cytokines initiate the production of corticotropin-releasing hormone (CRH)? IL-2 and TNF-α TNF-ß and IL-4 IFN and IL-12 IL-1 and IL-6 A number of stress factors initiate CRH production, including high levels of IL-1 and IL- 6. Stress-age syndrome results in decreased ACTH. catecholamines. cortisol. Correct Answer immune system. Immunodepression is one of the characteristic changes seen in stress-age syndrome. Exhaustion occurs if stress continues and is not successful. arousal alarm adaptation flight or fight Exhaustion occurs if stress continues and adaptation is not successful, ultimately causing impairment of the immune response, heart failure, and kidney failure, leading to death. Inherited mutations that predispose to cancer are almost invariably what kind of gene? Oncogenes Proto-oncogenes Correct Answer Tumor-suppressor genes Growth-promoting genes These inherited mutations that predispose to cancer are almost invariably in tumor- suppressor genes. At present there are no data to support the other options as factors related to how inherited mutations cause cancer. Which of the viruses below are oncogenic DNA viruses? Papovaviruses, adenoviruses, and herpesviruses Retroviruses, papovaviruses, and adenoviruses Adenoviruses, herpesviruses, and retroviruses Herpesviruses, retroviruses, and papovaviruses Papovaviruses, adenoviruses, and herpesviruses are oncogenic DNA viruses; the remaining examples do not fall into this category. Which of the following represents the correct nomenclature for benign and malignant tumors of adipose tissue, respectively? Liposarcoma, lipoma Adisarcoma, adipoma Adipoma, adisarcoma Lipoma, liposarcoma In general, cancers are named according to the cell type from which they originate (e.g., lip), whereas benign tumors use the suffix ―-oma.‖ Cells from a muscle tumor show a reduced ability to form new muscle and appear highly disorganized. This is an example of dysplasia. hyperplasia. myoplasia. anaplasia. Anaplasia is defined as the loss of cellular differentiation, irregularities of the size and shape of the nucleus, and loss of normal tissue structure. In clinical specimens, anaplasia is recognized by a loss of organization and a marked increase in nuclear size with evidence of ongoing proliferation. The remaining options refer to very specific changes in the cell. What is the role of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), and transforming growth factor-alpha (TGF-α) in cell metastasis? To develop new blood vessels to feed cancer cells To prevent cancer cells from escaping apoptosis To act as a chemical gradient to guide cells to blood vessels The angiogenic factors, such as VEGF, platelet-derived growth factor (PDGF), transforming growth factor-alpha (TGF-α), and growth factor bFGF, by recruiting new vascular endothelial cells and initiating the proliferation of existing blood vessel cells, allow small cancers to become large cancers. Which of the following cancers originate from connective tissue? Adenocarcinoma Osteogenic sarcoma Basal cell carcinoma Multiple myeloma Cancers arising from connective tissue usually have the suffix "-sarcoma.‖ Which characteristic among women correlates with a high morbidity of cancer of the colon, liver, gallbladder, pancreas, breast, uterus, and kidney? Women older than 45 years of age Women who had a high body mass index Woman who smoked for more than 10 years A recent hypothesis states that the observed increased incidence of such cancers as breast, endometrium, colon, liver, kidney, and adenomas of the esophagus may be associated with obesity. There are no current data to support the remaining options. What percentage of children with cancer can be cured? 70% 60% 50% 40% Currently, more than 70% of children diagnosed with cancer are cured. Question 1 0 / 2 pts Symptoms of polycythemia vera are mainly the result of neurologic involvement. destruction of erythrocytes. Correct Answer increased blood viscosity. a decreased erythrocyte count. 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 renal failure. liver hypoxia. Correct Answer heart failure. brain hypoxia. Untreated PA is fatal, usually because of heart failure. What is the pathophysiologic process of aplastic anemia? Autoimmune disease against hematopoiesis by activated immunoglobulins Correct Answer 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 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. Pernicious anemia generally requires continued therapy lasting 6 to 8 weeks. the rest of one’s life. until the iron level is normal. 8 to 12 months. PA cannot be cured, so maintenance therapy is lifelong. The underlying disorder of anemia is defective secretion of intrinsic factor, which is essential for the absorption of vitamin B12. hypochromic microcytic pernicious hemolytic PA, the most common type of megaloblastic anemia, is caused by vitamin B12 deficiency. Which anemia produces small, pale erythrocytes? Folic acid Hemolytic Correct Answer Iron deficiency Pernicious characterized by erythrocytes that are abnormally small and contain abnormally reduced amounts of hemoglobin. What change is seen in leukocytes during an allergic disorder (type I) often caused by asthma, hay fever, and drug reactions? Monocytosis Basophilia Correct Answer Eosinophilia Neutrophilia Allergic disorders (type I hypersensitivity) associated with asthma, hay fever, and drug reactions, as well as parasitic infections (particularly with metazoal parasites) are often cited as causes. Which of the following is a description consistent with acute lymphocytic leukemia (ALL)? Correct Answer It is a progressive neoplasm defined by the presence of greater than 30% lymphoblasts in the bone marrow or blood. 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 create an abnormal, fused gene identified as BCR-ABL. There is failure of B cells to mature into plasma cells that synthesize immunoglobulins. lymphoblasts in the bone marrow or blood. Heparin-induced thrombocytopenia (HIT) is described as a(n) hematologic reaction to heparin in which the bone marrow is unable to produce sufficient platelets to meet the body’s needs. IgE-mediated allergic drug reaction that reduces circulating platelets. Correct Answer 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. 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. 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. There are defects in the ras oncogene, TP53 tumor-suppressor gene, and INK4A, the gene encoding a cell-cycle regulatory protein. 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. Thus CLL is derived from transformation of a partially mature B cell that has not yet encountered antigen. Erythroblastosis fetalis is defined as an alloimmune disease in which maternal blood and fetal blood are antigenically incompatible. allergic disease in which maternal blood and fetal blood are antigenically incompatible. autoimmune disease in immature nucleated cells that are released into the bloodstream. autosomal dominant hereditary disease. 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. In a full-term infant, the normal erythrocyte life span is days, whereas the adult is days. 120 to 130; 150 30 to 50; 80 60 to 80; 120 90 to 110; 140 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. 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. Correct Answer 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 the mildest form of the disease with normal hemoglobin and hemoglobin F, which prevents sickling. 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). Hemophilia B is caused by clotting factor deficiency. V Correct Answer IX VIII X Hemophilia B (Christmas disease) is caused by factor IX deficiency. Idiopathic thrombocytopenic purpura (ITP) is an autoimmune process involving antibodies against Correct Answer platelets. neutrophils. basophils. ITP is a disorder of platelet consumption. G6PD and sickle cell disease are inherited autosomal recessive disorders. inherited X-linked recessive disorders. diagnosed equally in men and women. Correct Answer disorders initiated by hypoxemia and acidosis. Sickling is an occasional, intermittent phenomenon that can be triggered or sustained by one or more of the following stressors: decreased oxygen tension (PO2) of the blood (i.e., hypoxemia), increased hydrogen ion concentration in the blood (decreased pH), increased plasma osmolality, decreased plasma volume, and low temperature (Figure 28-7). An individual who is demonstrating elevated levels of troponin, creatine kinase (CK), and lactic dehydrogenase (LDH) is exhibiting indicators associated with: myocardial infarction (MI). coronary artery disease. hypertension. Cardiac troponins (troponin I and troponin T) are the most specific indicators of MI. Other biomarkers released by myocardial cells include CK-MB (creatine kinase-MB) and LDH. Which of the following is manufactured by the liver and primarily contains cholesterol and protein? Very-low-density lipoproteins (VLDLs) High-density lipoproteins (HDLs) Triglycerides (TGs) Correct Answer Low-density lipoproteins (LDLs) 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. In systolic heart failure, what effect does angiotensin II have on stroke volume? Decreases preload and increases afterload Increases preload and increases afterload Increases preload and decreases afterload Decreases preload and decreases afterload Activation of the renin-angiotensin-aldosterone system (RAAS) causes not only increases in preload and afterload but also direct toxicity to the myocardium. Which of the following can trigger an immune response within the bloodstream that can result in an embolus? Correct Answer Amniotic fluid Fat Air Bacteria 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. When does most cardiovascular development occur? Between the eighth and 10th weeks of gestation Between the 12th and 14th weeks of gestation By the 28th day of gestation Correct Answer Between the fourth and seventh weeks of gestation Cardiogenesis begins at approximately 3 weeks of gestation; however, most cardiovascular development occurs between the fourth and seventh weeks. Question 22 2 / 2 pts 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? Coarctation of the aorta Hypoplastic left heart syndrome Pulmonic stenosis Aortic stenosis 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? Ventricular septal defect and patent ductus arteriosus Atrial septal defect and dextrocardia Coarctation of the aorta and pulmonary stenosis Tetralogy of Fallot and persistent truncus 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). An infant has a loud, harsh, holosystolic murmur and systolic thrill that can be detected at the left lower sternal border that radiates to the neck. These clinical findings are consistent with which congenital heart defect? Atrioventricular canal (AVC) defect Atrial septal defect (ASD) Correct Answer Ventricular septal defect (VSD) On physical examination a loud, harsh, holosystolic murmur and systolic thrill can be detected at the left lower sternal border. The intensity of the murmur reflects the pressure gradient across the VSD. An apical diastolic rumble may be present with a moderate to large defect, reflecting increased flow across the mitral valve. The foramen ovale is covered by a flap that creates a check valve allowing blood to flow unidirectionally from the to the . right ventricle; left ventricle right atrium; left atrium left atrium; left ventricle right atrium; right ventricle The nonfused septum secundum and ostium secundum result in the formation of a flapped orifice known as the foramen ovale, which allows the right (atrium)-to-left (atrium) shunting necessary for fetal circulation In hemolytic anemia, jaundice occurs only when the erythrocytes are coated with an immunoglobulin. the patient has elevations in aspartate transaminase (AST) and alanine transaminase (ALT). heme destruction exceeds the liver’s ability to conjugate and excrete bilirubin. Jaundice (icterus) is present when heme destruction exceeds the liver’s ability to conjugate and excrete bilirubin. Clinical manifestations of mild to moderate splenomegaly and hepatomegaly, bronze-colored skin, and cardiac dysrhythmias are indicative of which anemia? Iron deficiency Correct Answer Sideroblastic Aplastic Pernicious Mild to moderate enlargement of the spleen (splenomegaly) and liver (hepatomegaly) occurs. Occasionally, abnormal skin pigmentation (bronze colored) is seen. Heart rhythm disturbances, along with congestive heart failure, are major life-threatening complications related to cardiac iron overload. Which proinflammatory cytokines are responsible for the development and maintenance of DIC? Correct Answer TNF-α; IL-1, IL-6, and IL-8; and PAF Granulocyte colony-stimulating factor (G-CSF); IL-2, IL-4, and IL-10; and IFN-γ Macrophage colony-stimulating factor (M-CSF); IL-7, IL-11, and IL-14; and PAF Granulocyte-macrophage colony-stimulating factor (GM-CSF); IL-3, IL-5, and IL-9, and IFN-γ Endotoxin, in particular, triggers the release of multiple cytokines that play a significant role in the development and maintenance of DIC. Proinflammatory cytokines (TNF-α; IL-1, IL-6, IL-8; and PAF) are responsible for the clinical signs and symptoms associated with sepsis. Hemolytic disease of the newborn can occur if the mother is type AB blood and the fetus has type B. Rh-positive and the fetus is Rh-negative. type A blood and the fetus has type O. Rh-negative and the fetus is Rh-positive. Maternal-fetal incompatibility exists if mother and fetus differ in ABO blood type or if the fetus is Rh-positive and the mother is Rh-negative. The type of anemia that occurs as a result of thalassemia is macrocytic, hyperchromic. microcytic, normochromic. macrocytic, normochromic. Correct Answer microcytic, hypochromic. The anemic manifestation of thalassemia is microcytic-hypochromic hemolytic anemia. What is the name of the disorder in which levels of bilirubin remain excessively high in the newborn and are deposited in the brain? Correct Answer Kernicterus Jaundice Without replacement transfusions, in which the child receives Rh-negative erythrocytes, the bilirubin is deposited in the brain, which is a condition called kernicterus. The pulsus paradoxus that occurs as a result of pericardial effusion is significant because it reflects the impairment of the Correct Answer diastolic filling pressures of the left ventricle and reduction of blood volume in all four heart chambers. blood ejected from the left atria and reduction of blood volume in the left ventricle. diastolic filling pressures of the right ventricle and reduction of blood volume in both ventricles. blood ejected from the right atria and reduction of blood volume in the right ventricle. Pulsus paradoxus means that the arterial blood pressure during expiration exceeds arterial pressure during inspiration by more than 10 mmHg. This clinical finding reflects impairment of diastolic filling of the left ventricle plus reduction of blood volume within all four cardiac chambers. Atherosclerosis causes an aneurysm by Correct Answer eroding the vessel wall. obstructing the vessel. Atherosclerosis is a common cause of aneurysms because plaque formation erodes the vessel wall. What alteration occurs in injured endothelial cells that contributes to atherosclerosis? They release toxic oxygen radicals that oxidize low-density lipoproteins (LDLs). They develop a hypersensitivity to homocysteine and lipids. They produce an increased amount of antithrombotic cytokines. They are unable to make the normal amount of vasodilating cytokines. Injured endothelial cells become inflamed and cannot make normal amounts of antithrombotic and vasodilating cytokines. When does most cardiovascular development occur? Between the eighth and 10th weeks of gestation By the 28th day of gestation Between the 12th and 14th weeks of gestation Between the fourth and seventh 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? One month before birth During the beginning stage of labor One hour after birth Correct Answer Once the placenta is removed from circulation Removal of the low-resistance placenta from circulation causes an immediate increase in systemic vascular resistance to about twice that before birth. The body compensates for anemia by Correct Answer increasing rate and depth of breathing. kidneys release more erythropoietin. hemoglobin holds on to oxygen more firmly. capillary vasoconstriction. 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. In some anemias, the erythrocytes are present in various sizes, which is referred to as poikilocytosis. microcytosis. isocytosis. Correct Answer anisocytosis. Additional descriptors of erythrocytes associated with some anemias include anisocytosis (assuming various sizes) or poikilocytosis (assuming various shapes) (Figure 26-1). Local signs and symptoms of Hodgkin disease–related lymphadenopathy are a result of obstruction and pressure. Correct Answer pressure and obstruction. ischemia and pressure. inflammation and ischemia. 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) hematologic reaction to heparin in which the bone marrow is unable to produce sufficient platelets to meet the body’s needs. Correct Answer 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. IgE-mediated allergic drug reaction that reduces circulating platelets. 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.. Polycythemia occurs in a fetus because the fetus has a different hemoglobin structure of two α- and two γ-chains rather than two α-and two β- chains. fetal hemoglobin has a greater affinity for oxygen due to DPG. Correct Answer there is increased erythropoiesis in response to the hypoxic intrauterine environment. the lungs of the fetus are undeveloped and unable to adequately diffuse oxygen to the pulmonary capillaries. The hypoxic intrauterine environment stimulates erythropoietin production in the fetus. What is the most common cardiac disorder associated with acquired immunodeficiency syndrome (AIDS) resulting from myocarditis and infective endocarditis? Hypertrophic cardiomyopathy Restrictive cardiomyopathy Correct Answer Dilated cardiomyopathy Inflammatory cardiomyopathy Individuals infected with HIV and resultant acquired immunodeficiency syndrome (AIDS) are at risk for numerous cardiac complications. Pericardial effusion and left heart failure are the most common complications of HIV infection. Other conditions include cardiomyopathy, myocarditis, tuberculous pericarditis, infective and nonbacterial endocarditis, heart block, pulmonary hypertension, and non-antiretroviral drug-related cardiotoxicity. Cardiac cells can withstand ischemic conditions and still return to a viable state for how many minutes? 15 25 Correct Answer 20 10 Cardiac cells remain viable for approximately 20 minutes under ischemic conditions. If blood flow is restored, aerobic metabolism resumes, contractility is restored, and cellular repair begins. If the coronary artery occlusion persists beyond 20 minutes, myocardial infarction occurs. Which of the following can trigger an immune response within the bloodstream that can result in an embolus? Correct Answer Amniotic fluid Air Bacteria Fat 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. What is the most important clinical manifestation of aortic coarctation in the neonate? Cerebral hypertension Correct Answer Congestive heart failure (CHF) Pulmonary 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. When thirst is experienced, how are osmoreceptors activated? By an increase in the antidiuretic hormone secreted into the plasma Correct Answer By an increase in the osmotic pressure of the plasma By an increase in the hydrostatic pressure of the plasma By an increase in aldosterone secreted into the plasma Thirst is experienced when water loss equals 2% of an individual’s body weight or when there is an increase in osmolality. Dry mouth, hyperosmolality, and plasma volume depletion activate osmoreceptors (neurons located in the hypothalamus that are stimulated by increased osmolality). Question 2 2 / 2 pts How does the loss of chloride during vomiting cause metabolic alkalosis? Loss of chloride causes hypoventilation to compensate for the metabolic alkalosis. Loss of chloride causes retention of bicarbonate to maintain the anion balance. Loss of chloride causes hydrogen to move into the cell and exchange with potassium to maintain cation balance. Loss of chloride stimulates the release of aldosterone, which causes the retained sodium to bind with the chloride. When acid loss is caused by vomiting with depletion of ECF and chloride (hypochloremic metabolic alkalosis), renal compensation is not very effective because the volume depletion and loss of electrolytes (Na+, K+, H+, Cl-) stimulate a paradoxical response by the kidneys. The kidneys increase sodium and bicarbonate reabsorption with excretion of hydrogen. Bicarbonate is reabsorbed to maintain an anionic balance because the ECF chloride concentration is decreased. At the arterial end of capillaries, fluid moves from the intravascular space into the interstitial space because the capillary oncotic pressure is lower than the interstitial hydrostatic pressure. capillary hydrostatic pressure is higher than the capillary oncotic pressure. interstitial oncotic pressure is higher than the interstitial hydrostatic pressure. interstitial hydrostatic pressure is higher than the capillary hydrostatic pressure. At the arterial end of capillaries, fluid moves from the intravascular space into the interstitial, because capillary hydrostatic pressure is higher than the capillary oncotic pressure. What is a major determinant of the resting membrane potential necessary for transmission of nerve impulses? The ratio between intracellular Na+ and extracellular sodium The ratio between intracellular Na+ and extracellular K+ The ratio between intracellular K+ and extracellular Na+ The ratio of K+ in the ICF to K+ in the ECF is the major determinant of the resting membrane potential, which is necessary for the transmission and conduction of nerve impulses, maintenance of normal cardiac rhythms, and skeletal and smooth muscle contraction. Physiologic pH is maintained around 7.4 because bicarbonate (HCO3) and carbonic acid (H2CO3) exist in a ratio of 1:20. 10:5. 10:2. 20:1. The relationship between bicarbonate and carbonic acid is usually expressed as a ratio. When the pH is 7.40, this ratio is 20:1 (bicarbonate/carbonic acid). Water movement between the intracellular fluid compartment and the extracellular compartment is primarily a function of plasma oncotic pressure. antidiuretic hormone. hydrostatic forces. osmotic forces. The movement of water between ICF and ECF compartments is primarily a function of osmotic forces. (Osmosis and other mechanisms of passive transport are discussed in Chapter 1.) Which are indications of dehydration? Polyuria and hyperventilation Tachycardia and weight loss Muscle weakness and decreased deep tendon reflexes Decreased hemoglobin and hematocrit Marked water deficit is manifested by symptoms of dehydration: headache, thirst, dry skin and mucous membranes, elevated temperature, weight loss, and decreased or concentrated urine (with the exception of diabetes insipidus). Skin turgor may be normal or decreased. Symptoms of hypovolemia, including tachycardia, weak pulses, and postural hypotension, may be present. A(n) is a circumscribed area of suppuration and destruction of lung parenchyma. cavitation empyema consolidation abscess An abscess is a circumscribed area of suppuration and destruction of lung parenchyma. Which inflammatory mediators are produced in asthma? Neutrophil proteases, bradykinin, and histamine Bradykinin, serotonin, and neutrophil proteases Histamine, prostaglandins, and leukotrienes Lymphokines, serotonin, and prostaglandins A large number of inflammatory mediators, such as histamine, prostaglandins, and leukotrienes are produced by asthma. Clinical manifestations of pulmonary hypertension include productive cough and rhonchi bilaterally. dyspnea on exertion and paroxysmal nocturnal dyspnea. peripheral edema and jugular venous distention. systemic blood pressure greater than 130/90. Symptoms of fatigue, chest discomfort, tachypnea, and dyspnea on exertion, palpitations, and cough are common. Examination may reveal peripheral edema, jugular venous distention, a precordial heave, and accentuation of the pulmonary compartment of the second heart sound. Question 11 2 / 2 pts is a fulminant form of respiratory failure characterized by acute lung inflammation and diffuse alveolocapillary injury. Pulmonary emboli Pneumonia Acute respiratory distress syndrome (ARDS) Acute pulmonary edema ARDS is a fulminant form of respiratory failure characterized by acute lung inflammation and diffuse alveolocapillary injury. Clinical manifestations that include unexplained weight loss, dyspnea on exertion, use of accessory muscles, and tachypnea with prolonged expiration are indicative of emphysema. pneumonia. chronic bronchitis. asthma. Individuals with emphysema usually have dyspnea on exertion that later progresses to marked dyspnea, even at rest (Table 33-3). Little coughing and very little sputum are produced. The individual often is thin, has tachypnea with prolonged expiration, and must use accessory muscles for ventilation. The anteroposterior diameter of the chest is increased (barrel chest), and the chest has a hyperresonant sound with percussion. Which pleural abnormality involves a site of pleural rupture that act as a one-way valve, permitting air to enter on inspiration but preventing its escape by closing during expiration? Secondary pneumothorax Open pneumothorax Spontaneous pneumothorax In tension pneumothorax, the site of pleural rupture acts as a one-way valve, permitting air to enter on inspiration but preventing its escape by closing up during expiration. As more and more air enters the pleural space, air pressure in the pneumothorax begins to exceed barometric pressure. In ARDS, alveoli and respiratory bronchioles fill with fluid as a result of the increased capillary permeability, which causes alveoli and respiratory bronchioles to fill with fluid. compression on the pores of Kohn, thus preventing collateral ventilation. increased capillary hydrostatic pressure that forces fluid into the alveoli and respiratory bronchioles. inactivation of surfactant and the impairment of type II alveolar cells. Lung inflammation and injury damages the alveolar epithelium and the vascular endothelium. Surfactant is inactivated, and its production by type II alveolar cells is impaired as alveoli and respiratory bronchioles fill with fluid or collapse. Which of the following is a true statement? Hyperventilation results in an increased PaCO2. Hyperventilation causes hypocapnia. Hyperventilation causes hypercapnia. Hyperventilation is alveolar ventilation that exceeds metabolic demands. The lungs remove CO2 at a faster rate than it is produced by cellular metabolism, resulting in decreased PaCO2 or hypocapnia. In tuberculosis, the body walls off the bacilli in a tubercle by stimulating apoptotic infected macrophages that activate cytotoxic T cells. formation of immunoglobulin G to initiate the complement cascade. phagocytosis by neutrophils and eosinophils. macrophages that release TNF-α. In defense, macrophages and lymphocytes release interferon, which inhibits the replication of the microorganism and stimulates more macrophages to attack the bacterium. Apoptotic infected macrophages also can activate cytotoxic T cells (CD8). Pulmonary edema usually begins at a pulmonary capillary wedge pressure or left atrial pressure of mm Hg. 30 20 40 10 Pulmonary edema usually begins to develop at a pulmonary capillary wedge pressure or left atrial pressure of 20 mm Hg. Kussmaul respirations may be characterized as a respiratory pattern commonly observed in pulmonary fibrosis. with alternating periods of deep and shallow breathing. commonly observed in chronic obstructive pulmonary disease. with a slightly increased ventilatory rate, large tidal volumes, and no expiratory pause. Kussmaul respirations are characterized by a slightly increased ventilatory rate, very large tidal volume, and no expiratory pause. Which of the following statements about the advances in the treatment of RDS of the newborn is incorrect? Administering glucocorticoids to women in preterm labor accelerates the maturation of the fetus’s lungs. Treatment includes the instillation of exogenous surfactant down an endotracheal tube of infants weighing less than 1,000 g. Administering oxygen to mothers during preterm labor increases their arterial oxygen before birth of the fetus. Supporting the infant’s respiratory function by using continuous positive airway pressure (CPAP). An infant’s respiratory function is supported by using continuous pressure (CPAP). Administration of oxygen to the mother is not a valid treatment of RDS. Which of the following types of croup is most common? Viral Bacterial Autoimmune Fungal In 85% of cases, croup is caused by a virus, most commonly parainfluenza; however, other viruses such as influenza A or RSV also can cause croup. The release of fibroblast growth factors affects ARDS by causing pulmonary hypertension. pulmonary fibrosis. atelectasis and decreased lung compliance. disruption of alveolocapillary membrane. In the fibroproliferative phase, type II alveolar cells proliferate, and there is alveolar septal thickening and collagen deposition. Interstitial fibrosis can be evident as early as 10 days after the initial insult. Similarly, vascular changes may occur, including obliteration of the microcirculation and thickening of the walls of pulmonary arterioles and arteries, which can lead to chronic pulmonary hypertension in survivors. What is the primary cause of RDS of the newborn? An immature immune system Small alveoli Anemia A surfactant deficiency RDS is caused primarily by surfactant deficiency and secondarily by a deficiency in alveolar surface area for gas exchange. Chest wall compliance in infants is in adults. unlike that the same as higher than lower than Chest wall compliance is high in infants, particularly premature infants. Cystic fibrosis (CF) is caused by a(n) autosomal dominant inheritance. autosomal recessive inheritance. malignancy. infection. Cystic fibrosis is an autosomal recessive inherited disorder that is associated with defective epithelial ion transport. An accurate description of childhood asthma is that it is a(n) pulmonary disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray. obstructive airway disease characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency. pulmonary disorder involving an abnormal expression of a protein producing viscous mucus that lines the airways, pancreas, sweat ducts, and vas deferens. obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation. Asthma is an obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation. In hyperkalemia, cardiac rhythm changes are a direct result of cardiac cell hypopolarization. cardiac cell hyperexcitability. depression of the sinoatrial (SA) node. cardiac cell repolarization. If extracellular potassium concentration increases without a significant change in intracellular potassium, the resting membrane potential becomes more positive (i.e., changes from –90 to –80 mV) and the cell membrane is hypopolarized (the inside of the cell becomes less negative or partially depolarized [increase excitability]). (Electrical properties of cells are discussed in Chapter 1.) Why are infants susceptible to significant losses in total body water (TBW)? Because infants have a slow metabolic rate Because an infant’s kidneys are not mature enough to counter fluids losses Because they are unable communicate adequately when they are thirsty Because more than half of an infant’s body weight is water Infants are particularly susceptible to significant changes in TBW because of their high metabolic rate and the accelerated turnover of body fluids caused by their greater body surface area in proportion to total body size. Loss of fluids from diarrhea can represent a significant proportion of body weight. Renal mechanisms that regulate fluid and electrolyte conservation may not be mature enough to counter the losses, so dehydration may develop rapidly. Chvostek sign and Trousseau sign indicate hyperkalemia. hypercalcemia. hypocalcemia. hypokalemia. Two clinical signs are Chvostek sign and Trousseau sign. At the arterial end of capillaries, fluid moves from the intravascular space into the interstitial space because the interstitial hydrostatic pressure is higher than the capillary hydrostatic pressure. interstitial oncotic pressure is higher than the interstitial hydrostatic pressure. capillary hydrostatic pressure is higher than the capillary oncotic pressure. capillary oncotic pressure is lower than the interstitial hydrostatic pressure. At the arterial end of capillaries, fluid moves from the intravascular space into the interstitial, because capillary hydrostatic pressure is higher than the capillary oncotic pressure. Dyspnea is not a result of decreased pH, increased PaCO2, and decreased PaO2. stimulation of stretch or J-receptors. decreased blood flow to the medulla oblongata. fatigue of the intercostal muscles and diaphragm. There are no data to support the role of decreased blood flow to the medulla oblongata as being a cause of dyspnea. The most successful treatment for chronic asthma begins with elimination of the causative agent. drugs that reduce bronchospasm. broad-spectrum antibiotics. drugs that decrease airway inflammation. Chronic management of asthma begins with avoidance of allergens and other triggers. Clinical manifestations that include unexplained weight loss, dyspnea on exertion, use of accessory muscles, and tachypnea with prolonged expiration are indicative of pneumonia. chronic bronchitis. emphysema. asthma. Individuals with emphysema usually have dyspnea on exertion that later progresses to marked dyspnea, even at rest (Table 33-3). Little coughing and very little sputum are produced. The individual often is thin, has tachypnea with prolonged expiration, and must use accessory muscles for ventilation. The anteroposterior diameter of the chest is increased (barrel chest), and the chest has a hyperresonant sound with percussion. What is the primary cause of RDS of the newborn? A surfactant deficiency An immature immune system Small alveoli Anemia RDS is caused primarily by surfactant deficiency and secondarily by a deficiency in alveolar surface area for gas exchange. An accurate description of childhood asthma is that it is a(n) obstructive airway disease characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency. pulmonary disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray. pulmonary disorder involving an abnormal expression of a protein producing viscous mucus that lines the airways, pancreas, sweat ducts, and vas deferens. obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation. Asthma is an obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation. The release of fibroblast growth factors affects ARDS by causing pulmonary hypertension. atelectasis and decreased lung compliance. disruption of alveolocapillary membrane. pulmonary fibrosis. In the fibroproliferative phase, type II alveolar cells proliferate, and there is alveolar septal thickening and collagen deposition. Interstitial fibrosis can be evident as early as 10 days after the initial insult. Similarly, vascular changes may occur, including obliteration of the microcirculation and thickening of the walls of pulmonary arterioles and arteries, which can lead to chronic pulmonary hypertension in survivors. Which immunoglobulin is present in childhood asthma? IgG IgE IgM IgA Included in the long list of asthma-associated genes are those that code for increased levels of immune and inflammatory mediators (e.g., IL-4, IgE, and leukotrienes), nitric oxide, and transmembrane proteins in the endoplasmic reticulum. Cystic fibrosis (CF) is caused by a(n) malignancy. autosomal dominant inheritance. autosomal recessive inheritance. infection. Cystic fibrosis is an autosomal recessive inherited disorder that is associated with defective epithelial ion transport. Why are infants susceptible to significant losses in total body water (TBW)? Correct Answer Because an infant’s kidneys are not mature enough to counter fluids losses Because more than half of an infant’s body weight is water Because infants have a slow metabolic rate Because they are unable communicate adequately when they are thirsty Infants are particularly susceptible to significant changes in TBW because of their high metabolic rate and the accelerated turnover of body fluids caused by their greater body surface area in proportion to total body size. Loss of fluids from diarrhea can represent a significant proportion of body weight. Renal mechanisms that regulate fluid and electrolyte conservation may not be mature enough to counter the losses, so dehydration may develop rapidly. Which enzyme is secreted by the juxtaglomerular cells of the kidney when circulating blood volume is reduced? Angiotensin I Aldosterone Renin Angiotensin II When circulating blood volume or blood pressure is reduced, renin, an enzyme secreted by the juxtaglomerular cells of the kidney, is released in response to sympathetic nerve stimulation and decreased perfusion of the renal vasculature. Water movement between the intracellular fluid compartment and the extracellular compartment is primarily a function of antidiuretic hormone. hydrostatic forces. osmotic forces. plasma oncotic pressure. The movement of water between ICF and ECF compartments is primarily a function of osmotic forces. (Osmosis and other mechanisms of passive transport are discussed in Chapter 1.) In ARDS, alveoli and respiratory bronchioles fill with fluid as a result of the increased capillary permeability, which causes alveoli and respiratory bronchioles to fill with fluid. inactivation of surfactant and the impairment of type II alveolar cells. compression on the pores of Kohn, thus preventing collateral ventilation. increased capillary hydrostatic pressure that forces fluid into the alveoli and respiratory bronchioles. Lung inflammation and injury damages the alveolar epithelium and the vascular endothelium. Surfactant is inactivated, and its production by type II alveolar cells is impaired as alveoli and respiratory bronchioles fill with fluid or collapse. High altitudes may produce hypoxemia through hypoventilation. decreased inspired oxygen. diffusion abnormalities. shunting. The first factor is the presence of adequate oxygen content of the inspired air. Oxygen content is lessened at high altitudes. After sexual transmission of HIV, a person can be infected yet seronegative for months. 1 to 2 6 to 14 24 to 36 18 to 20 Antibody appears rather rapidly after infection through blood products, usually within 4 to 7 weeks. After sexual transmission, however, the individual can be infected yet seronegative for 6 to 14 months or, in at least one case, for years. Once they have penetrated the first line of defense, which microorganisms do neutrophils actively attack, engulf, and destroy by phagocytosis? Bacteria Viruses Mycoplasma Fungi Invasion results in direct confrontation with an individual’s primary defense mechanisms against bacteria, which include the complement system, antibodies, and phagocytes, such as neutrophils and macrophages. (See Chapters 6, 7, and 8). Which statement about vaccines is true? Vaccines require booster injections to maintain lifelong protection. Vaccines provide effective protection for all people against viruses, bacteria, and fungal infections. Most bacterial vaccines contain attenuated organisms. Most viral vaccines are made by using dead organisms. In general, vaccine-induced protection does not persist as long as infection-induced immunity, thus booster injections may be necessary to maintain protection throughout life. Cells in may act as a reservoir in which HIV can be relatively protected from antiviral drugs. the thymus gland the central nervous system the lungs bone marrow HIV may persist in regions where the antiviral drugs are not as effective, such as the CNS. Which statement is true about fungal infections? They result in release of endotoxins. They are controlled by phagocytes and T lymphocytes. They are prevented by vaccines. They occur only on skin, hair, and nails. The host defense against fungal infection includes the fungistatic properties of neutrophils and macrophages. T lymphocytes are crucial in limiting the extent of infection and producing cytokines to further activate macrophages. What of the following remains a significant cause of morbidity and mortality worldwide? Infectious disease Traumatic injury Cardiovascular disease Starvation Despite the wide scale implementation of progressive public health and immunization policies, infectious disease remains a significant cause of morbidity and mortality. In a type II hypersensitivity reaction, when soluble antigens from infectious agents enter circulation, tissue damage is a result of complement-mediated cell lysis. phagocytosis in the spleen. neutrophil granules and toxic oxygen products. phagocytosis by macrophages. The components of neutrophil granules, as well as the several toxic oxygen products produced by these cells, damage the tissue. What is the mechanism in type III hypersensitivity reactions? Antibodies bind to the antigen on the cell surface. Cytotoxic T lymphocytes or lymphokine-producing Th1 cells attack and destroy cellular targets directly. Antibodies coat mast cells by binding to receptors that signal its degranulation followed by discharge of preformed mediators. Antibodies bind to soluble antigens that were released into body fluids and the immune complexes are deposited in the tissues. Most type III hypersensitivity diseases are caused by antigen-antibody (immune) complexes that are formed in the circulation and deposited later in vessel walls or extravascular tissues (Figure 8-3). Deficiencies in which element can produce depression of both B- and T-cell function? Iodine Zinc Magnesium Iron Deficient zinc intake can profoundly depress T- and B-cell function. A person with type O blood is likely to have high titers of anti- antibodies. A and B B A O Type O individuals, who have neither A or B antigen but have both anti-A and anti- B antibodies, cannot accept blood from any of the other three types. Question 11 2 / 2 pts Hypersensitivity is best defined as a(n) altered immunologic response to an antigen that results in disease. immunologic reaction of one person to the tissue of another person. disturbance in the immunologic tolerance of self-antigens. 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. What mechanism occurs in Raynaud phenomenon that classifies it as a type III hypersensitivity reaction? Immune complexes are deposited in capillary beds, blocking circulation. Antibodies detect the capillaries as foreign protein and destroy them using lysosomal enzymes and toxic oxygen species. Cytotoxic T lymphocytes attack and destroy the capillaries so that they are unable to perfuse local tissues. Mast cells bind to specific endothelial receptors that cause them to degranulate, creating a localized inflammatory reaction that occludes capillary circulation. A form of serum sickness is Raynaud phenomenon, a condition caused by the temperature-dependent deposition of immune complexes in the capillary beds of the peripheral circulation. The effect that low serum albumin has on the central stress response is to impair wound healing. diminish oncotic pressure. impair circulation of epinephrine and norepinephrine. lessen circulation of cortisol. Once released, catecholamines circulate bound to the plasma protein albumin. Low serum albumin would impair circulation of both epinephrine and norepinephrine. Which cytokines initiate the production of corticotropin-releasing hormone (CRH)? IL-2 and TNF-α TNF-ß and IL-4 IFN and IL-12 IL-1 and IL-6 A number of stress factors initiate CRH production, including high levels of IL-1 and IL- 6. Stress-age syndrome results in decreased ACTH. catecholamines. cortisol. Correct Answer immune system. Immunodepression is one of the characteristic changes seen in stress-age syndrome. Exhaustion occurs if stress continues and is not successful. arousal alarm adaptation flight or fight Exhaustion occurs if stress continues and adaptation is not successful, ultimately causing impairment of the immune response, heart failure, and kidney failure, leading to death. Inherited mutations that predispose to cancer are almost invariably what kind of gene? Oncogenes Proto-oncogenes Correct Answer Tumor-suppressor genes Growth-promoting genes These inherited mutations that predispose to cancer are almost invariably in tumor- suppressor genes. At present there are no data to support the other options as factors related to how inherited mutations cause cancer. Which of the viruses below are oncogenic DNA viruses? Papovaviruses, adenoviruses, and herpesviruses Retroviruses, papovaviruses, and adenoviruses Adenoviruses, herpesviruses, and retroviruses Herpesviruses, retroviruses, and papovaviruses Papovaviruses, adenoviruses, and herpesviruses are oncogenic DNA viruses; the remaining examples do not fall into this category. Which of the following represents the correct nomenclature for benign and malignant tumors of adipose tissue, respectively? Liposarcoma, lipoma Adisarcoma, adipoma Adipoma, adisarcoma Lipoma, liposarcoma In general, cancers are named according to the cell type from which they originate (e.g., lip), whereas benign tumors use the suffix ―-oma.‖ Cells from a muscle tumor show a reduced ability to form new muscle and appear highly disorganized. This is an example of dysplasia. hyperplasia. myoplasia. anaplasia. Anaplasia is defined as the loss of cellular differentiation, irregularities of the size and shape of the nucleus, and loss of normal tissue structure. In clinical specimens, anaplasia is recognized by a loss of organization and a marked increase in nuclear size with evidence of ongoing proliferation. The remaining options refer to very specific changes in the cell. What is the role of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), and transforming growth factor-alpha (TGF-α) in cell metastasis? To stimulate growth of nearby tumor cells To develop new blood vessels to feed cancer cells To prevent cancer cells from escaping apoptosis To act as a chemical gradient to guide cells to blood vessels The angiogenic factors, such as VEGF, platelet-derived growth factor (PDGF), transforming growth factor-alpha (TGF-α), and growth factor bFGF, by recruiting new vascular endothelial cells and initiating the proliferation of existing blood vessel cells, allow small cancers to become large cancers. Which of the following cancers originate from connective tissue? Adenocarcinoma Osteogenic sarcoma Basal cell carcinoma Multiple myeloma Cancers arising from connective tissue usually have the suffix "-sarcoma.‖ Which characteristic among women correlates with a high morbidity of cancer of the colon, liver, gallbladder, pancreas, breast, uterus, and kidney? Women older than 45 years of age Women who had a high body mass index Women who never had children Woman who smoked for more than 10 years A recent hypothesis states that the observed increased incidence of such cancers as breast, endometrium, colon, liver, kidney, and adenomas of the esophagus may be associated with obesity. There are no current data to support the remaining options. What percentage of children with cancer can be cured? 70% 60% 50% 40% Currently, more than 70% of children diagnosed with cancer are cured. What of the following remains a significant cause of morbidity and mortality worldwide? Traumatic injury Starvation Cardiovascular disease Infectious disease Despite the wide scale implementation of progressive public health and immunization policies, infectious disease remains a significant cause of morbidity and mortality. Which statement is true about fungal infections? They result in release of endotoxins. They are controlled by phagocytes and T lymphocytes. They are prevented by vaccines. They occur only on skin, hair, and nails. The host defense against fungal infection includes the fungistatic properties of neutrophils and macrophages. T lymphocytes are crucial in limiting the extent of infection and producing cytokines to further activate macrophages. What is the role of reverse transcriptase in HIV infection? It is needed to produce integrase. It converts single DNA into double-stranded DNA. It transports the RNA into the cell nucleus. It converts RNA into double-stranded DNA. One particular family of viruses, retroviruses (e.g., HIV) carries an enzyme reverse transcriptase that creates a double-stranded DNA version of the virus. Deficiencies in which element can produce depression of both B- and T-cell function? Zinc Magnesium Iron Iodine Deficient zinc intake can profoundly depress T- and B-cell function. What is the mechanism in type III hypersensitivity reactions? Cytotoxic T lymphocytes or lymphokine-producing Th1 cells attack and destroy cellular targets directly. Antibodies bind to soluble antigens that were released into body fluids and the immune complexes are deposited in the tissues. Antibodies coat mast cells by binding to receptors that signal its degranulation followed by discharge of preformed mediators. Antibodies bind to the antigen on the cell surface. Most type III hypersensitivity diseases are caused by antigen-antibody (immune) complexes that are formed in the circulation and deposited later in vessel walls or extravascular tissues (Figure 8-3). During an IgE-mediated hypersensitivity reaction, what causes bronchospasm? Bronchial edema caused by chemotactic factor of anaphylaxis Bronchial edema caused by binding of the cytotropic antibody Smooth muscle contraction caused by histamine bound to H2 receptors Acting through the H1 receptors, histamine contracts bronchial smooth muscles, causing bronchial constriction; increases vascular permeability, causing edema; and causes vasodilation, increasing blood flow into the affected area (Figures 6-3 and 6-10). In a type II hypersensitivity reaction, when soluble antigens from infectious agents enter circulation, tissue damage is a result of phagocytosis in the spleen. Correct Answer neutrophil granules and toxic oxygen products. phagocytosis by macrophages. complement-mediated cell lysis. The components of neutrophil granules, as well as the several toxic oxygen products produced by these cells, damage the tissue. What mechanism occurs in Raynaud phenomenon that classifies it as a type III hypersensitivity reaction? Immune complexes are deposited in capillary beds, blocking circulation. Cytotoxic T lymphocytes attack and destroy the capillaries so that they are unable to perfuse local tissues. Mast cells bind to specific endothelial receptors that cause them to degranulate, creating a localized inflammatory reaction that occludes capillary circulation. Antibodies detect the capillaries as foreign protein and destroy them using lysosomal enzymes and toxic oxygen species. A form of serum sickness is Raynaud phenomenon, a condition caused by the temperature- dependent deposition of immune complexes in the capi