Chapter 30 Flashcards
What change is observed in leukocytes during an allergic disorder (type I hypersensitivity) often caused by asthma, hay fever, and drug reactions?
a. Neutrophilia
b. Basophilia
c. Eosinophilia
d. Monocytosis
c. Eosinophilia
Eosinophilia is an absolute increase (more than 450/μL) in the total numbers of circulating eosinophils. 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
In infectious mononucleosis (IM), what does the Monospot test detect?
a. Immunoglobulin E (IgE)
b. Immunoglobulin M (IgM)
c. Immunoglobulin G (IgG)
d. Immunoglobulin A (IgA)
b. Immunoglobulin M (IgM)
Heterophile antibodies are a heterogeneous group of IgM antibodies that are agglutinins against nonhuman red blood cells (e.g., sheep, horse) and are detected by qualitative (monospot) or quantitative (heterophile antibody) test methods.
Which description is consistent with acute lymphocytic leukemia (ALL)?
a. ALL is a progressive neoplasm defined by the presence of greater than 30% lymphoblasts in the bone marrow or blood.
b. Leukocytosis and a predominance of blast cells characterize the bone marrow and peripheral blood. As the immature blasts increase, they replace normal myelocytic
cells, megakaryocytes, and erythrocytes.
c. B cells fail to mature into plasma cells that synthesize immunoglobulins.
d. The translocation of genetic material from genes 9 and 22 create an abnormal, fused gene identified as BCR-ABL.
a. ALL is a progressive neoplasm defined by the presence of greater than 30% lymphoblasts in the bone marrow or blood.
Which description is consistent with chronic myelogenous leukemia (CML)?
a. Defects exist in the ras oncogene, TP53 tumor-suppressor gene, and INK4A, the gene encoding a cell-cycle regulatory protein.
b. Leukocytosis and a predominance of blast cells characterize the bone marrow and peripheral blood. As the immature blasts increase, they replace normal myelocytic
cells, megakaryocytes, and erythrocytes.
c. B cells fail to mature into plasma cells that synthesize immunoglobulins.
d. The translocation of genetic material from genes 9 and 22 creates an abnormal, fused protein identified as BCR-ABL1.
d. The translocation of genetic material from genes 9 and 22 creates an abnormal, fused protein identified as BCR-ABL1.
The Philadelphia chromosome is present in more than 95% of those with CML, and the presence of the BCR-ABL1 protein is responsible for the initiation of CML
Which electrolyte imbalance accompanies multiple myeloma (MM)?
a. Hyperkalemia
b. Hypercalcemia
c. Hyperphosphatemia
d. Hypernatremia
b. Hypercalcemia
Elevated levels of calcium in the blood (hypercalcemia) characterize the common presentation of MM
Reed-Sternberg (RS) cells represent malignant transformation and proliferation of which of the following?
a. Interleukin (IL)-1, IL-2, IL-5, and IL-6
b. Tumor necrosis factor-beta
c. B cells
d. T cells
c. B cells
Although the molecular events that cause malignant transformation remain controversial, RS cells are apparently from B-cell lineage.
Local signs and symptoms of Hodgkin disease-related lymphadenopathy are a result of which of the following?
a. Pressure and ischemia
b. Pressure and obstruction
c. Inflammation and ischemia
d. Inflammation and pressure
b. Pressure and obstruction
Local symptoms caused by pressure and obstruction of the lymph nodes are the result of lymphadenopathy
Which virus is associated with Burkitt lymphoma in African children?
a. Cytomegalovirus
b. Adenovirus
c. Human papillomavirus
d. Epstein-Barr virus
d. Epstein-Barr virus
Epstein-Barr virus, found in nasopharyngeal secretions, is associated with Burkitt lymphoma in African children.
Which term is used to describe a red-purple discoloration caused by diffuse hemorrhage into the skin tissue?
a. Petechiae
b. Hematoma
c. Ecchymosis
d. Purpura
d. Purpura
Diffuse hemorrhage into skin tissues that is visible through the skin causes a red-purple discoloration identified as a purpura
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.
a. Immunoglobulin G immune-mediated adverse 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 immunoglobulin G antibodies that leads to increased platelet consumption and a decrease in platelet counts
Immune thrombocytopenia (ITP) is a(n) _____ condition in adults and a(n) _____ condition in children.
a. Acute; acute
b. Chronic; chronic
c. Acute; chronic
d. Chronic; acute
d. Chronic; acute
ITP may be acute or chronic. The acute form is frequently observed in children. Chronic ITP is more commonly observed in adults, with the highest prevalence in women between 20 and 40 years of age.
Vitamin _____ is required for normal clotting factor synthesis by the _____.
a. K; kidneys
b. D; kidneys
c. K; liver
d. D; liver
c. 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.
What is the most common cause of vitamin K deficiency?
a. Administration of warfarin (Coumadin)
b. Total parenteral nutrition with antibiotic therapy
c. An immunoglobulin G-mediated autoimmune disorder
d. Liver failure
b. Total parenteral nutrition with antibiotic therapy.
The most common cause of vitamin K deficiency is parenteral nutrition in combination with broad-spectrum antibiotics that destroy normal gut flora.
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)
a. Disseminated intravascular coagulation (DIC)
In disseminated intravascular coagulation (DIC), what activates the coagulation cascade?
a. Cytokines, such as platelet-activating factor (PAF), and tumor necrosis factor- alpha (TNF-)
b. Thromboxane A, causing platelets to aggregate and consume clotting factors
c. Tissue factor (TF) located in the endothelial layer of blood vessels and subcutaneous tissue
d. Endotoxins from gram-negative and gram-positive bacteria circulating in the bloodstream.
c. Tissue factor (TF) located in the endothelial layer of blood vessels and subcutaneous tissue.
Direct tissue damage (ischemia and necrosis, surgical manipulation, crushing injury) causes the endothelium to release TF. The common pathway for DIC appears to be excessive and widespread exposure of TF.
