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Internal Med > Assignments/Quizzes Exam 4 > Flashcards

Assignments/Quizzes Exam 4 Flashcards

1
Q

Skin is the largest body organ, constituting ________ of the body weight.
5% to 10%
15% to 20%
25% to 30%
35% to 40%

A

15-20%

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2
Q

What is the primary function of fibroblasts in the dermis?

Collagen synthesis for skin strength and wound healing
Synthesis of keratin
Perception of heat, cold, pain, itching
Production of apocrine sweat

A

Collagen Synthesis for skin strength and wound healing

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3
Q

Which of the following is true about skin lesions?

Ulcer and scaly skin are considered primary lesions.

Wheal and vesicle are considered secondary lesions.

Skin lesions can result from the reaction to radiotherapy or medication.

Most birthmarks require treatment.

A

Skin lesions can result from the reaction to radiotherapy or medication

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4
Q

Which of the following lab values are the most relevant to skin lesions and wound healing?

AST and ALT
Prealbumin and hematocrit
Albumin and bilirubin
TSH and ACTH

A

Prealbumin and hematocrit

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5
Q

Which of the following is true about aging and the integumentary system?

  • For women, excessive facial hair may occur along the upper lip and around the chin.
  • Gray hair and balding are visible indications of skin changes associated with aging.
  • With aging, blood vessels within the dermis are reduced in number, and the walls are thinned.
  • All the above
A

All of the above

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6
Q

Which of the following is true about skin infection?

Herpes zoster is bacterial infection. !
Athlete’s foot (Tinea Pedis) is fungal infection.
Cellulitis is a viral infection.
Warts (Verrucae) are parasitic infections.

A

Athletes foot is a fungal infection

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7
Q

Which of the following is true for first-degree burn?

  • Normally with little or no pain.
    • Ultraviolet exposure can be the cause.
  • Large thick-walled blisters covering extensive area.
  • Superficial partial-thickness burn heals in 14-21 days.
A

Ultraviolet exposure can be the cause

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8
Q

You are working in an ICU and treating a 34-year-old female patient who has sustained second- and third-degree burns over her front chest, abdomen, and front left upper extremity. Using the Wallace rule of nines, total body surface area (TBSA) is

9%
18%
22.5%
Over 36%

A

22.5

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9
Q

______ account for approximately 75% (43% flame or fire; 34% scalding) of all burn center admissions

Chemical burns
Electrical burns
Thermal burns
Radiation burns

A

Thermal burns

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10
Q

Extensive burns result in generalized body ______ in both burned and nonburned tissues and a ______ in circulating intravascular blood volume

inflammation; decrease
erythema; increase
edema; decrease
pain; increase

A

edema; decrease

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11
Q

___ is the most common and life-threatening complication of burn injuries.

Abscess
Gangrene
Infection
Hypertrophic scarring

A

Infection

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12
Q

Which of the following is true on skin transplantation for person with burn?

Autograft are usually cadaver skin.
Allografts are typically pigskin.
Biosynthetic grafts are a combination of collagen and synthetics.
Xenografts are the person’s own skin.

A

Biosynthetic grafts are a combination of collagen and synthetics

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13
Q

What are the three classic determinants of burn mortality?

TBSA, age, and inhalation injury
Location, depth, and age
Temperature, source of energy, and duration
Family history, degree-burn, and sec

A

TBSA, age, inhalation injury

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14
Q

Which of the following are the common medical complications of gastrointestinal system on a person with burn?

Paralytic ileus
Appendicitis​
Diverticulosis
Peptic ulcer

A

Paralytic ileus

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15
Q

Which of the following body parts would get pressure injuries the most easily?

Clavicle and sternum
Scapula and elbow
ASIS and pubic tubercles
Medial epicondyle and medial malleolus

A

Scapula and elbow

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16
Q

Partial-thickness skin loss with exposed dermis is considered ______ pressure injury.

stage 1
stage 2
stage 3
stage 4

A

stage 2

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17
Q

Which of the following patient populations may have higher risk of infection if they develop pressure injuries on the skin, because they are unable to mount a sufficient inflammatory response to start the healing?

Type 2 diabetes
Eczema
Squamous Cell Carcinoma
Low back pain

A

Type 2 diabetes

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18
Q

Which of the following is appropriate medical management for a patient with pressure injuries?

Negative pressure wound therapy
Adequately redistribute the pressure
Electrical stimulation
All of the above

A

All of the above

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19
Q

Which of the following is the common cardiovascular sign or symptom in integumentary system?

Cyanosis
Intermittent claudication
Syncope
Myalgias

A

Cyanosis

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20
Q

Which of the following is true about aging and the cardiovascular system?

The hearts of older persons pump more blood to peripheral organs than that of a younger person.

Vascular aging involves epithelial dysfunction and increase in arterial wall thickness and stiffness.

Age-related decline in steroid hormones triggers a feedback loop to elevate cholesterol concentrations.

Aerobic capacity, measured as peak oxygen uptake (VO2), is increased in aging.

A

Age-related decline in steroid hormones triggers a feedback loop to elevate cholesterol concentrations.

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21
Q

Which of the following lab results can be mostly identified on a person with metabolic syndrome?

Blood pressure 115/75 mm Hg
Fasting blood glucose 95 mg/dL
Triglyceride 200 mg/dL
HDL (high-density lipoprotein) 55 mg/dL

A

Triglyceride 200

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22
Q

When athero mas (plaques of fatty deposits) form in the inner layer (intima) of the arteries, it is called _____.

Mönckeberg arteriosclerosis
Atherosclerosis
Arteriolosclerosis
Arteriolar sclerosis

A

Atherosclerosis

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23
Q

Which of the following surgical management is primarily for atherosclerosis of the coronary arteries?

Ambulatory electrocardiography
Coronary Artery Bypass Graft (CABG)
Implantable cardioverter-defibrillator
Echocardiogram (Echo)​

A

CABG

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24
Q

Which of the following medications can treat hypertension?

α-Adrenergic Receptor Antagonists and Direct Renin Inhibitors

Calcium Channel Blockers and Angiotensin-
Converting Enzyme (ACE) Inhibitors

Diuretics and β-Adrenergic Receptor Antagonists (β Blockers)​

All of the above

A

All

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25
Q

What is true for angina pectoris?

Any condition that decrease the blood (oxygen) supply or increase blood (oxygen) demand of the myocardium can cause myocardial ischemia.

Pain that spreads to the throat, neck, back, jaw, shoulder or arms is one of the most common warning signs of heart attack.

Anemia can cause myocardial ischemia.

All of the above

A

All of the above

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26
Q

Which of the following is modifiable risk factors of primary hypertension?

Personality traits (hostility, sense of hopelessness)​
Age (>55 years)​
Family history
Ethnicity

A

Personality traits

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27
Q

_________ is a disturbance of heart rate or rhythm caused by an abnormal rate of electrical impulse generation by the sinoatrial (SA) node or the abnormal conduction of impulses​.

Myocardial infarction
Heart failure
Arrhythmia (dysrhythmia)
Pericarditis​

A

Arrhythmia

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28
Q

Which of the following is the risk factor for deep venous thrombosis?

Neurologic disorder (e.g., spinal cord injury, stroke)
Prolonged air travel
Childbirth and delivery
All of the above

A

All of the above

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29
Q

Which of the following is true about lymphatic system?

The thoracic duct carries far less lymph than the left lymphatic duct, draining mainly the right arm and head, the heart and lungs, and the anterior chest wall.

It is designed to absorb macromolecules (protein and fatty acids); help maintain fluid balance in the tissues; fight infection; and assist in the removal of cellular debris and waste products from the extracellular spaces.

Superficial vessels generally parallel the venous system.

Deep vessels generally parallel the nervous system.

A

It is designed to absorb macromolecules (protein and fatty acids); help maintain fluid balance in the tissues; fight infection; and assist in the removal of cellular debris and waste products from the extracellular spaces.

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30
Q

Which of the following body region contain more lymph nodes?

Anterior knee
Axillary
Calcaneus
Scalp

A

Axillary

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31
Q

What is true about lymph nodes?

As lymph flows from the periphery to the root of the limbs and on to the central circulation, it passes through many lymph nodes, which act as filters to cleanse the lymph of waste products and cellular debris.

Lymph nodes produce lymphocytes and macrophages.

Lymph nodes offer 100 times the normal resistance to flow of lymph within the lymphatic vessels themselves, which explains why they are often the sites of obstruction in lymphatic dysfunction.

All of the above

A

All of the above

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32
Q

What is lymphadenopathy?

Enlargement of the lymph nodes
Inflammation of a lymphatic vessel
An increased amount of lymph fluid in the soft tissues
Inflammation of one or more lymph nodes

A

Enlargement of the lymph nodes

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33
Q

What is true for lymphedema?

Most commonly seen in the axillary and inguinal areas.

In advanced cases of lymphedema, loss of skin integrity allows portals of entry for bacteria to invade the skin and cause recurrent infection​

The most common cause of secondary lymphedema in the US is ​filariasis.

Stage I (one) lymphedema is referred to as lymphostatic elephantiasis.

A

In advanced cases of lymphedema, loss of skin integrity allows portals of entry for bacteria to invade the skin and cause recurrent infection​

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34
Q

In what type of anemia would one see red blood cells of various SIZES?

Microcytic
Anisocytosis
Poikilocytosis
Macrocytic

A

Anisocytosis

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35
Q

Pernicious anemia is caused by autoantibodies that block the formation of the _____.

sodium
B12-intrinsic factor complex
folate
iron

A

B12-intrinsic factor complex

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36
Q

Lack of clotting factor _____ causes hemophilia A.
I
IX
V
VIII

A

VIII

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37
Q

Which of the following could be the cause of hemolytic (destruction of erythrocytes) anemia?

Excessive menstruation
Bone marrow failure
Hemoglobinopathies (e.g., sickle cell diseases)
Nutritional deficiency

A

Hemoglobinopathies

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38
Q

Which of the following is true for complete blood count (CBC)?

Decreased hematocrit (Hct) may indicate there is an anemia caused by blood loss.

Increased erythrocyte (rec cell count) may indicate there is a dietary insufficiency of iron and vitamins.

Hemoglobin (Hb) measures the percentage of whole blood occupied by red blood cells (RBCs).

A patient with thrombocytopenia may have platelets count above 400,000 / mm3

A

Decreased hematocrit (Hct) may indicate there is an anemia caused by blood loss.

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39
Q

Which of the following is true on skin transplantation for person with burn?

A

Autograft are the persons own skin

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40
Q

The two primary causative factors for the development of pressure injuries are ___

depth and duration
interface pressure (externally) and pressure with shearing forces
location and moisture
activity levels and of consiciousness

A

interface pressure (externally) and pressure with shearing forces

41
Q

Which of the following is true about clinical manifestations for pressure injuries?

proteolytic enzymes from bacteria an macrophages dissolve necrotic tissues, which can result in foul-smelling discharge

pressure injuries usually occur over bony prominences

pressure injuries often manifest with a circular pattern shaped like an inverted volcano, with the greatest tissue ischemia at the apex next to the bone

all of the above

A

all of the above

42
Q

Which of the following are intrinsic factors most associated with pressure injury development?

Hemoglobin, hematocrit, prealbumin, total protein, and lymphocytes

impaired mobility, incontinence, diaphoresis, impaired nutritional status

pressure, shear, friction, moisture

all of the above

A

impaired mobility, incontinence, diaphoresis, impaired nutritional status

43
Q

Which of the following is true about treatment for pressure injuries?

therapeutic modalities such as ultrasound and electrical stimulation can be used

Eliminating or limiting associated risk factors as much as possible is the first step in preventing the occurrence of pressure injuries

in stage 3 pressure injuries, undamaged tissue near the wound can be rotated to cover the ulcer

all of the above

A

all of the above

44
Q

What is the primary function of mast cells in the dermis?

Provide histamine for vasodilation and chemotactic factors

Antigen presentation

production of apocrine sweat

energy storage and balance

A

Provide histamine for vasodilation and chemotactic factors

45
Q

Which of the following lab values are the most relevant to skin lesions and wound healing?

Hemoglobin and total-protein

Calcium and Vitmain D

Triiodthyonin and thyroxnie

triglycerides and glucocorticords

A

Hemoglobin and total-protein

46
Q

Which of the following is true about integumentary system?

Hormonal abnormalities may result in excessive facial and body hair in woman and male-pattern baldness in men

Wrinkling signifies loss of elastin fibers, weakened collagen and decreased subcutaneous fat

The epidermis is one of the body’s principle suppliers of vitamin D

all of the above

A

all of the above

47
Q

Which of the following is true about skin infection?

impetigo is a bacterial infection

athletes foot is a viral infection

Pediculosis is fungal infection

Ringwork is parasitic infection

A

impetigo is a bacterial infection

48
Q

Which of the following is true for partial-thickness burn?

also called third-degree burn

painful

desquamation in 3-7 days

no blisters

A

painful

49
Q

a male has full thickness burns on his bilateral lower extremities, using the wallace rule of nines TBSA is

9%
18%
27%
over 30%

A

over 30%

50
Q

Why do children have a higher risk of burns

inadequate supervision and abuse with scald injuries

diminished pain perception

weakened inflammatory response

all of the above

A

inadequate supervision and abuse with scald injuries

51
Q

Obscured full-thickness skin and tissue loss is considered ___ pressure injury

stage 4
stage 3
stage 2
unstageable

A

unstageable

52
Q

Which of the following tools can be used for risk assessment evaluating both sensation and physiologic risk of pressure injuries?

lund and browder
wallace rules of nines
braden scale
wagner scale

A

braden scale

53
Q

Which of the following are the common medical complications in a burn-injured adult?

stressed-induced gastric ulcer

stasis dermatitis

herpes zoster

actinic keratosis

A

stressed induced gastric ulcer

54
Q

Which of the following lab results on lipid panel might be a concern in an adult patient at high risk for heart disease?

total cholesterol 250

LDL 50

HDL 85

Triglycerides 100

A

total cholesterol 250

55
Q

What is true for lymphedema?

physical impairments can lead to functional limitations and disability along with potential for psychosocial morbidity

stage IV lymphedema is the most sever type and referred to as lymphostatic elephantiasis

most seen in cervical areas

most common cause of primary lymphedema worldwide is filariasis

A

physical impairments can lead to functional limitations and disability along with potential for psychosocial morbidity

56
Q

Which of the following is true about aging and the cardiovascular system?

the max HR or the highest HR during exercise declines with age

the hearts of older persons pump more blood to peripheral organs than that of a younger person

vascular aging involves epithelial dysfunction increase in arterial wall thickness and stiffness

the hearts of older persons have higher capillary density than that of a younger person

A

the max HR or the highest HR during exercise declines with age

57
Q

Which of the following could be the cause of anemia associated with decreased production of erythrocytes?

diverticulosis

bleeding peptic ulcer

bone marrow failure

autoimmune hemolytic anemia

A

bone marrow failure

58
Q

Which of the following are non-modifiable risk factors of primary hypertension?

obesity and diabetes
high sodium intake
white coat hypertension
age and sex

A

age and sex

59
Q

What is lymphadenitis?

Enlargement of the lymph nodes

inflammation of the lymphatic vessel

an increased amount of lymph fluid in the soft tissue

inflammation of one or more lymph nodes

A

inflammation of one or more lymph nodes

60
Q

Which of the following is a disorder of hemostasis?

von WIllebrane disease

anermias

lyme disease

arrhythmias

A

von WIllebrane disease

61
Q

Which of the following is a localized region of necrosis caused reduction of arterial perfusion?

infarction
thrombus
edema
emolus

A

infarction

62
Q

Pernicious anemia is caused by loss of ____

potassium
vitamin B6
iron
B12-intrinsic factor complex

A

B12-intrinsic factor complex

63
Q

Which of the following medical technologies can be used to evaluate your heart valves are working correctly?

electrocardiogram

external cardiac monitoring

echocardiogram

electromyography

A

echocardiogram

64
Q

The right lymphatic duct drains lymph from the ____

right subscapular axillary nodes

right-deep inguinal nodes

right deep popliteal nodes

lumbar nodes

A

right subscapular axillary nodes

65
Q

Hemophilia A results from a lack of clotting factor _ and constitutes 80% of all cases of hemophilia

A

VIII

66
Q

In what type of anemia would one see red blood cells of various SHAPES

hyperchronic

poikilocytosis

anisocytosis

macrocytic

A

poikilocytosis

67
Q

Which of the following medications can be primarily used to treat angina?

hemostatic

antiarrhythmics

B-adrenergic receptor antagonists (B blockers)

antibiotics

A

B-adrenergic receptor antagonists (B blockers)

68
Q

Which of the following clincal magnifications can be seen on a person with orthostatic hypotension?

fall
organ ischemia
syncope
all of the above

A

all of the above

69
Q

What is the most common renal cell carcinoma?

Adenocarcinoma
Chondrosarcoma
Papillary carcinoma
Clear cell cancer

A

Clear Cell cancer

70
Q

Pain in the _____ during the early days of dialysis is referred to as “first use syndrome.”

pelvis and hip
shoulder and back
chest and back
pelvis and chest

A

chest and back

71
Q

A urinary tract infection (UTI) that has spread to the kidneys is referred to as _____.

pyelonephritis
nephritis
uncomplicated UTI
kidney-dominated UTI

A

pyelonephritis

72
Q

What bacterium is most often responsible for urinary tract infection (UTI)?

Escherichia coli
Staphylococcus saprophyticus
Klebsiella
Enterococcus

A

E coli

73
Q

Pyuria is evidenced by what type of cell in the urine?

T cells
B cells
Leukocytes
Red blood cells

A

Leukocytes

74
Q

What type of kidney stones are common in people with gout?

Cystine stones
Uric acid stones
Calcium stones
Struvite stones

A

Uric acid stones

75
Q

Which of the following is the least common cause of chronic kidney disease?

Hypertension
Glomerulonephritis
Cystic kidney disease
Diabetes

A

Cystic kidney disease

76
Q

In what stage of chronic kidney disease does uremia develop?
Stage 2
Stage 3
Stage 4
Stage 5

A

stage 5

77
Q

With impairment of the glomerular filtration rate, the body is unable to excrete _____ or synthesize _____.

calcium; vitamin B
phosphate; vitamin B
phosphate; calcitriol
sodium; calcitriol

A

phosphate; calcitrol

78
Q

Which of the following is not a common site for extraskeletal calcification associated with chronic kidney disease?

Bladder
Skin
Peripheral arteries
Lungs

A

Bladder

79
Q

What type of prostatitis is diagnosed when a man does not complain of pain or discomfort but has white blood cells in his semen?

Chronic bacterial prostatitis
Asymptomatic inflammatory prostatitis
Acute bacterial prostatitis
Chronic prostatitis/chronic pelvic pain syndrome

A

Asymptomatic inflammatory prostatitis

80
Q

Which of the following pathogens is associated with acute prostatitis?

Proteus mirabilis
Escherichia coli
Klebsiella pneumoniae
Pseudomonas aeruginosa

A

E coli

81
Q

Why does the prostate increase in weight as a man ages?
It fills with old red blood cells
It fills with urine
It begins to fibrose
Cells die at a slower rate

A

Cells die at a slower rate

82
Q

What does a prostate-specific antigen (PSA) test measure?

Protein in the bloodstream secreted by cells in the prostate gland

Protein in the urine secreted by cells of the prostate gland

Flow rate of urine

The weight of the prostate gland

A

Protein in the bloodstream secreted by cells in the prostate gland

83
Q

urinary incontinence is often related to detrusor instability, a condition in which the bladder contracts at small volumes, often in response to triggers such as running water or arriving home.
Functional
Stress
Urgency
Overflow

A

Urgency

84
Q

What is the primary indication for dalteparin?

Anticoagulants
Antiseizure
Antianxiety
Antiarrhythmics

A

Anticoagulants

85
Q

_____ nerves originate in the spinal cord at the level of S2, S3, and S4, and innervate the bladder wall via the ___ nerve.

Parasympathetic; pelvic
Sympathetic; hypogastric
Somatic; pudendal
Sensory; pelvic

A

Parasympathetic; pelvic

86
Q

Urination is initiated with voluntary relaxation of the followed by relaxation of the and contraction of the to squeeze the urine out of the bladder.

detrusor muscle; external urethral sphincter; pelvic floor muscle

abdominal muscle; pelvic floor muscle; internal urethral sphincter

pelvic floor muscle; internal urethral sphincter; detrusor muscle

detrusor muscle; abdominal muscle; pelvic floor muscle

A

pelvic floor muscle; internal urethral sphincter; detrusor muscle

87
Q

There are three layers of the pelvic floor muscles from superficial to deep. The levator ani muscle (the deepest layer) is made up of

external anal sphincter, the sexual muscle (bulbocavernous and ischiocavernous), and the transverse perineal muscles

sphincter urethra and urethrovaginal sphincter

puborectalis, pubococcygeus, coccygeus, and ischiococcygeus muscles

All of above

A

puborectalis, pubococcygeus, coccygeus, and ischiococcygeus muscles

88
Q

Which of the following is the symptom when the pelvic floor muscles are over activity?

Obstructive voiding
Urinary incontinence
Fecal incontinence
Pelvic organ prolapse

A

obstructive voiding

89
Q

What is true about UTI?

the symptoms may include pain at the shoulder

men have higher incidence than women

virus accounts for most of pathogens

exposure to asbestos and/or cadnium have been linked to an increased risk of developing a UTI

A

the symptoms may include pain at the shoulder

90
Q

What is true about bladder function?

the pontine micturition is located in the spinal cord

parasympathetic nerves originate in the spinal cord at the level S2 S3 S4 and innervate the bladder wall via the pudendal nerve

normal voiding interval is a minimum of 2 hours (often in the elderly) and usually 2-3 hours between voids for others

the internal urethral sphincter is a voluntary skeletal muscle

A

normal voiding interval is a minimum of 2 hours (often in the elderly) and usually 2-3 hours between voids for others

91
Q

What type of kidney stones is the most common

cystine stones
uric acid stones
calcium stones
struvite stones

A

calcium stones

92
Q

Which of the following is considered part of the lower urinary tract?

Kidney
Renal pelvis
Ureter
Bladder

A

Bladder

93
Q

Which of the following types of urinary incontinence occurs during activities that increase intrabdominal pressure?

A

stress

94
Q

Which of the following is a risk factor for urinary incontinence?

taking diuretics or narcotic analgesics

diabetes mellitus and depression

cystocele or uterine prolapse

all of the above

A

all of the above

95
Q

What is the primary indication for lidocaine?

anticoagulants

local anesthetic

antianxiety

sedative-hypnotic

A

local anesthetic

96
Q

There are three layers to the pelvic floor muscles from superifical to deep, The most superficial layer of the PFMs includes

obturator internus, externus, superioir gemellus, inferior gemeullus, piubrecticalis, pubococcygeus, and ischiococcygeus muscles

external anal sphincter, the sexual muscle (bulbocavernous and ischiocavernous) and the transverse perineal muscles

sphincter urethra and urethrovaginal

puborectalis, pubococcygeus, coccygeus, ischiococcygeus muscles

A

external anal sphincter, the sexual muscle (bulbocavernous and ischiocavernous) and the transverse perineal muscles

97
Q

In chronic kidney disease, proteinuria is the hallmark of

stage 2
stage 3
stage 4
stage 5

A

stage 4

98
Q

What type of prostatitis is the most commonly seen in the PT clinic?

A

chronic prostatitis/chronic pelvic pain syndrome

99
Q

What are the metastases of prostate tumors most located?

femur
spine
humerus
tibia

A

spine

Internal Med (26 decks)

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