Advanced Pathophysiology Exam 3 2024
1. A 2000 ml blood loss will produce which assessment finding? (Select all that apply.) a. Air hunger
b. Normal blood pressure in the supine position
c. Rapid thready pulse
d. Cold clammy skin
e. lactic acidosis - ANSWER>>A, C, D. With a 2000 ml loss of blood, central venous pressure, cardiac
output, and arterial blood pressure are below normal, even when at rest and in the supine position. The
person commonly has air hunger; a rapid, thready pulse; and cold, clammy skin. With a 1500 ml loss of
blood, supine blood pressure and pulse can still be normal. Lactic acidosis is observed with a blood loss of
2500 ml or more.
1. Which conditions are generally included in the symptoms of pernicious anemia (PA)? (Select all that
apply.)
a. Weakness
b. Weight gain
c. Low hemoglobin
d. Paresthesias
e. Low hematocrit - ANSWER>>A, C, D, E. When the hemoglobin and hematocrit levels in the blood
have significantly decreased, the individual experiences the classic symptoms of PA— weakness, fatigue,
paresthesias of the feet and fingers, difficulty in walking, loss of appetite, abdominal pains, and weight
loss.
1. What are the clinical manifestations of folate deficiency anemia? (Select all that apply.) a. Constipation
b. Flatulence
c. Dysphagia
d. Stomatitis
e. Cheilosis - ANSWER>>B, C, D, E. Specific symptoms of folate deficiency anemia include severe
cheilosis (scales and fissures of the lips and corners of the mouth), stomatitis (inflammation of the
mouth), and painful ulcerations of the buccal mucosa and tongue. Gastrointestinal symptoms may be
present and include dysphagia (difficulty swallowing), flatulence, and watery diarrhea.
1. Which diseases are commonly associated with anemia of chronic disease? (Select all that apply.)
a. Rheumatoid arthritis
,b. Acquired immunodeficiency syndrome (AIDS)
c. Polycythemia vera
d. Systemic lupus erythematosus
e. Chronic hepatitis - ANSWER>>A, B, D, E. AIDS, rheumatoid arthritis, systemic lupus
erythematosus, malaria, acute and chronic hepatitis, and chronic renal failure are commonly associated
with anemias of chronic disease.
1. Which type of anemia is characterized by fatigue, weakness, and dyspnea, as well as conjunctiva of the
eyes and brittle, concave nails?
a. Pernicious
b. Aplastic
c. Iron deficiency
d. Hemolytic - ANSWER>>Iron deficiency. Early symptoms of iron deficiency anemia (IDA) include
fatigue, weakness, and shortness of breath. Pale earlobes, palms, and conjunctivae (see Figure 28-4) are
also common signs. Progressive IDA causes more severe alterations, with structural and functional
changes apparent in epithelial tissue (see Figure 28-4). The nails become brittle, thin, coarsely ridged, and
spoon-shaped or concave (koilonychia) as a result of impaired capillary circulation. The tongue becomes
red, sore, and painful.
1. Which statement concerning erythrocytes is true?
a. Erythrocytes contain a nucleus, mitochondria, and ribosomes.
b. Erythrocytes synthesize proteins.
c. Erythrocytes have the ability to change shape to squeeze through microcirculation.
d. Erythrocyte colony-stimulating factor (E-CSF) stimulates erythrocytes. - ANSWER>>C. Reversible
deformity enables the erythrocyte to assume a more compact torpedo-like shape, squeeze through the
microcirculation, and return to normal.
1. Which of the following are formed elements of the blood that are not cells but are diskshaped
cytoplasmic fragments essential for blood clotting?
a. Monocytes
b. Macrophages
c. Platelets
d. Erythrocytes - ANSWER>>Platelets (thrombocytes) are not true cells but are disk-shaped
cytoplasmic fragments that are essential for blood coagulation and control of bleeding.
,1. What is the life span of platelets (in days)?
a. 10
b. 90
c. 30
d. 120 - ANSWER>>A platelet circulates for approximately 10 days and ages. Macrophages of the
mononuclear phagocyte system, mostly in the spleen, remove platelets.
1. Which blood cells are the chief phagocytes involved in the early inflammation process? a. Neutrophils
b. Eosinophils
c. Monocytes
d. Erythrocytes - ANSWER>>Neutrophils are the chief phagocytes of early inflammation.
1. Which blood cells are biconcave in shape and have the capacity to be reversibly deformed? a.
Neutrophils
b. Eosinophils
c. Monocytes
d. Erythrocytes - ANSWER>>The erythrocyte's size and shape are ideally suited to its function as a
gas carrier. A red blood cell (RBC) is a small disk with two unique properties: (1) a biconcave shape and (2)
the capacity to be reversibly deformed.
1. What is the life span of an erythrocyte (in days)?
a. 20 to 30
b. 100 to 120
c. 60 to 90
d. 200 to 240 - ANSWER>>Because it cannot undergo mitotic division, the erythrocyte has a limited
life span of approximately 120 days.
1. Local signs and symptoms of Hodgkin disease-related lymphadenopathy are a result of which of the
following?
a. Pressure and ischemia
, b. Inflammation and ischemia
c. Pressure and obstruction
d. Inflammation and pressure - ANSWER>>Pressure and obstruction. Local symptoms caused by
pressure and obstruction of the lymph nodes are the result of lymphadenopathy.
1. Which statement best describes heparin-induced thrombocytopenia (HIT)?
a. Immunoglobulin G immune-mediated adverse drug reaction that reduces circulating platelets
b. Hematologic reaction to heparin in which the bone marrow is unable to produce sufficient
platelets to meet the body's needs
c. Immunoglobulin E-mediated allergic drug reaction that reduces circulating platelets
d. Cell-mediated drug reaction in which macrophages process the heparin and platelet complexes
that are then destroyed by activated cytotoxic T cells. - ANSWER>>Answer is A. Heparin is a common
cause of drug-induced thrombocytopenia. HIT is an immune-mediated, adverse drug reaction caused by
immunoglobulin G antibodies that leads to increased platelet consumption and a decrease in platelet
counts.
1. Vitamin _____ is required for normal clotting factor synthesis by the________? a. K; kidneys
b. K; liver
c. D; kidneys
d. D; liver - ANSWER>>K; liver. Vitamin K, a fat-soluble vitamin, is necessary for the synthesis and
regulation of prothrombin, procoagulant factors (VII, IX, X), and anticoagulant regulators (proteins C and
S) in the liver.
1. Which disorder is described as an unregulated release of thrombin with subsequent fibrin formation
and accelerated fibrinolysis?
a. Disseminated intravascular coagulation (DIC)
b. Immune thrombocytopenic purpura (ITP)
c. Heparin-induced thrombocytopenia (HIT)
d. Essential thrombocythemia (ET) - ANSWER>>DIC is an acquired clinical syndrome characterized
by widespread activation of coagulation resulting in the formation of fibrin clots in medium and small
vessels throughout the body.
1. In disseminated intravascular coagulation (DIC), what activates the coagulation cascade?
1. A 2000 ml blood loss will produce which assessment finding? (Select all that apply.) a. Air hunger
b. Normal blood pressure in the supine position
c. Rapid thready pulse
d. Cold clammy skin
e. lactic acidosis - ANSWER>>A, C, D. With a 2000 ml loss of blood, central venous pressure, cardiac
output, and arterial blood pressure are below normal, even when at rest and in the supine position. The
person commonly has air hunger; a rapid, thready pulse; and cold, clammy skin. With a 1500 ml loss of
blood, supine blood pressure and pulse can still be normal. Lactic acidosis is observed with a blood loss of
2500 ml or more.
1. Which conditions are generally included in the symptoms of pernicious anemia (PA)? (Select all that
apply.)
a. Weakness
b. Weight gain
c. Low hemoglobin
d. Paresthesias
e. Low hematocrit - ANSWER>>A, C, D, E. When the hemoglobin and hematocrit levels in the blood
have significantly decreased, the individual experiences the classic symptoms of PA— weakness, fatigue,
paresthesias of the feet and fingers, difficulty in walking, loss of appetite, abdominal pains, and weight
loss.
1. What are the clinical manifestations of folate deficiency anemia? (Select all that apply.) a. Constipation
b. Flatulence
c. Dysphagia
d. Stomatitis
e. Cheilosis - ANSWER>>B, C, D, E. Specific symptoms of folate deficiency anemia include severe
cheilosis (scales and fissures of the lips and corners of the mouth), stomatitis (inflammation of the
mouth), and painful ulcerations of the buccal mucosa and tongue. Gastrointestinal symptoms may be
present and include dysphagia (difficulty swallowing), flatulence, and watery diarrhea.
1. Which diseases are commonly associated with anemia of chronic disease? (Select all that apply.)
a. Rheumatoid arthritis
,b. Acquired immunodeficiency syndrome (AIDS)
c. Polycythemia vera
d. Systemic lupus erythematosus
e. Chronic hepatitis - ANSWER>>A, B, D, E. AIDS, rheumatoid arthritis, systemic lupus
erythematosus, malaria, acute and chronic hepatitis, and chronic renal failure are commonly associated
with anemias of chronic disease.
1. Which type of anemia is characterized by fatigue, weakness, and dyspnea, as well as conjunctiva of the
eyes and brittle, concave nails?
a. Pernicious
b. Aplastic
c. Iron deficiency
d. Hemolytic - ANSWER>>Iron deficiency. Early symptoms of iron deficiency anemia (IDA) include
fatigue, weakness, and shortness of breath. Pale earlobes, palms, and conjunctivae (see Figure 28-4) are
also common signs. Progressive IDA causes more severe alterations, with structural and functional
changes apparent in epithelial tissue (see Figure 28-4). The nails become brittle, thin, coarsely ridged, and
spoon-shaped or concave (koilonychia) as a result of impaired capillary circulation. The tongue becomes
red, sore, and painful.
1. Which statement concerning erythrocytes is true?
a. Erythrocytes contain a nucleus, mitochondria, and ribosomes.
b. Erythrocytes synthesize proteins.
c. Erythrocytes have the ability to change shape to squeeze through microcirculation.
d. Erythrocyte colony-stimulating factor (E-CSF) stimulates erythrocytes. - ANSWER>>C. Reversible
deformity enables the erythrocyte to assume a more compact torpedo-like shape, squeeze through the
microcirculation, and return to normal.
1. Which of the following are formed elements of the blood that are not cells but are diskshaped
cytoplasmic fragments essential for blood clotting?
a. Monocytes
b. Macrophages
c. Platelets
d. Erythrocytes - ANSWER>>Platelets (thrombocytes) are not true cells but are disk-shaped
cytoplasmic fragments that are essential for blood coagulation and control of bleeding.
,1. What is the life span of platelets (in days)?
a. 10
b. 90
c. 30
d. 120 - ANSWER>>A platelet circulates for approximately 10 days and ages. Macrophages of the
mononuclear phagocyte system, mostly in the spleen, remove platelets.
1. Which blood cells are the chief phagocytes involved in the early inflammation process? a. Neutrophils
b. Eosinophils
c. Monocytes
d. Erythrocytes - ANSWER>>Neutrophils are the chief phagocytes of early inflammation.
1. Which blood cells are biconcave in shape and have the capacity to be reversibly deformed? a.
Neutrophils
b. Eosinophils
c. Monocytes
d. Erythrocytes - ANSWER>>The erythrocyte's size and shape are ideally suited to its function as a
gas carrier. A red blood cell (RBC) is a small disk with two unique properties: (1) a biconcave shape and (2)
the capacity to be reversibly deformed.
1. What is the life span of an erythrocyte (in days)?
a. 20 to 30
b. 100 to 120
c. 60 to 90
d. 200 to 240 - ANSWER>>Because it cannot undergo mitotic division, the erythrocyte has a limited
life span of approximately 120 days.
1. Local signs and symptoms of Hodgkin disease-related lymphadenopathy are a result of which of the
following?
a. Pressure and ischemia
, b. Inflammation and ischemia
c. Pressure and obstruction
d. Inflammation and pressure - ANSWER>>Pressure and obstruction. Local symptoms caused by
pressure and obstruction of the lymph nodes are the result of lymphadenopathy.
1. Which statement best describes heparin-induced thrombocytopenia (HIT)?
a. Immunoglobulin G immune-mediated adverse drug reaction that reduces circulating platelets
b. Hematologic reaction to heparin in which the bone marrow is unable to produce sufficient
platelets to meet the body's needs
c. Immunoglobulin E-mediated allergic drug reaction that reduces circulating platelets
d. Cell-mediated drug reaction in which macrophages process the heparin and platelet complexes
that are then destroyed by activated cytotoxic T cells. - ANSWER>>Answer is A. Heparin is a common
cause of drug-induced thrombocytopenia. HIT is an immune-mediated, adverse drug reaction caused by
immunoglobulin G antibodies that leads to increased platelet consumption and a decrease in platelet
counts.
1. Vitamin _____ is required for normal clotting factor synthesis by the________? a. K; kidneys
b. K; liver
c. D; kidneys
d. D; liver - ANSWER>>K; liver. Vitamin K, a fat-soluble vitamin, is necessary for the synthesis and
regulation of prothrombin, procoagulant factors (VII, IX, X), and anticoagulant regulators (proteins C and
S) in the liver.
1. Which disorder is described as an unregulated release of thrombin with subsequent fibrin formation
and accelerated fibrinolysis?
a. Disseminated intravascular coagulation (DIC)
b. Immune thrombocytopenic purpura (ITP)
c. Heparin-induced thrombocytopenia (HIT)
d. Essential thrombocythemia (ET) - ANSWER>>DIC is an acquired clinical syndrome characterized
by widespread activation of coagulation resulting in the formation of fibrin clots in medium and small
vessels throughout the body.
1. In disseminated intravascular coagulation (DIC), what activates the coagulation cascade?
