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Internal Medicine > Final Assignments, Quizzes, and Medications (The Big One) > Flashcards

Final Assignments, Quizzes, and Medications (The Big One) Flashcards

1
Q

Which of the following is true on skin transplantation for persons with burns?

A

Autografts are the person’s own skin

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2
Q

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

A

Interference pressure (externally) and pressure with shearing forces

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3
Q

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

A

All of the above
-Proteolytic enzymes from bacteria and macrophages dissolve necrotic tissues, which can result in a 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

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4
Q

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

A

Impaired mobility, incontinence, diaphoresis, impaired nutritional status

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5
Q

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

A

All of the above
-Therapeutic modalities such as ultrasound and electrical stimulation can be used.
-eliminating or limiting associating 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

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6
Q

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

A

Provide histamine for vasodilation and chemotactic factors for inflammatory responses

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7
Q

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

A

Hemoglobin and total protein

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8
Q

Which of the following is true about the integumentary system?

A

All of the above
-hormonal abnormalities may result in excessive facial and body hair in women (androgen-related) and male-pattern baldness (alopecia) in men
-wrinkling signifies the loss of elastin fibers, weakened collagen, and decreased subcutaneous fat
-The epidermis is one of the body’s principle suppliers of vitamin D

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9
Q

Which of the following is true about skin infection?

A

Impetigo is a bacterial infection

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10
Q

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

A

It is painful

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11
Q

A 42-year old male with a history of schizophrenia has full-thickness burns on his bilateral lower extremities. Using the Wallace Rule of Nines, the total body surface area (TBSA) is?

A

Over 30%

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12
Q

Why do children have a higher risk of burns?

A

Inadequate supervision and abuse with scald injuries

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13
Q

Obscured full-thickness skin and tissue loss is considered ______.

A

Unstageable

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14
Q

For bedbound and chairbound patients and patients with impaired ability to reposition themselves, which of the following tools can be used for risk assessment evaluating both sensation and physiologic risk of pressure injuries?

A

Braden scale

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15
Q

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

A

Stress-induced gastric ulcers

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16
Q

Skin is the largest body organ, constituting ________ of the body weight.

A

15-20%

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17
Q

What is the primary function of fibroblasts in the dermis?

A

Collagen synthesis for skin strength and wound healing

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18
Q

Which of the following is true about skin lesions?

A

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

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19
Q

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

A

Prealbumin and hematocrit

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20
Q

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

A

All of the above
-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.

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21
Q

Which of the following is true about skin infection?

A

Athlete’s foot (Tinea Pedis) is fungal infection.

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22
Q

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

A

Ultraviolet exposure can be the cause.

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23
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

A

22.5%

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24
Q

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

A

Thermal burns

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25
Q

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

A

Edema; decrease

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26
Q

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

A

Infection

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27
Q

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

A

Biosynthetic grafts are a combination of collagen and synthetics

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28
Q

What are the three classic determinants of burn mortality?

A

TBSA, age, and inhalation injury

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29
Q

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

A

Paralytic ileus

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30
Q

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

A

Scapula and elbow

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31
Q

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

A

Stage 2

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32
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?

A

Type 2 diabetes

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33
Q

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

A

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

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34
Q

Which of the following clinical manifestations is commonly seen in a person with diabetes?

A

All of the above
-Impaired cognitive function
-Infection
-Balance and gait abnormalities

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35
Q

When a person has hypoglycemia episode, what clinical manifestation he/she may have?

A

Tachycardia and shallow respirations

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36
Q

What is TRUE about insulin resistance?

A

The endogenous insulin levels can be high during the diagnosis, and it may become low as the diabetes progress

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37
Q

Which of the following is TRUE in a person with hyperglycemia?

A

High Ketones

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38
Q

What will be an ideal A1C target for a person with type 2 diabetes?

A

< 7.0%

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39
Q

Which of the following is TRUE on diabetes?

A

Type 2 diabetes can develop at any age.

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40
Q

Which of the following decreases blood glucose levels?

A

Insulin released by beta cells in the islet of Langerhans.

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41
Q

If an individual has a fasting plasma glucose of 80 mg/dL, what can physical therapist infer from this information?

A

Normal fasting plasma glucose level

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42
Q

The National Institutes of Health clinical guidelines and the WHO define overweight in adults as a BMI equal to or greater than _______.

A

25 kg/m^2

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43
Q

Prediabetes is diagnosed in people with an A1C greater than or equal to but less than or equal to ______.

A

5.7% ; 6.4%

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44
Q

In children, BMI greater than or equal to the ______ percentile signifies risk for being obese.

A

95th

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45
Q

What is metabolic syndrome?

A

All of the above
-Abdominal obesity and atherogenic dyslipidemia
-Elevated blood pressure and insulin resistance
-Prothrombotic and proinflammatory state of the blood

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46
Q

Which of the following is precipitating causes of diabetic ketoacidosis?

A

All of the above
-Trauma
-Medications i.e., Beta blockers
-Pregnancy
-Inadequate insulin under stressful conditions

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47
Q

In the United States, about _______ have been diagnosed with diabetes.

A

1 in every 10 people

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48
Q

In diabetes, ________ causes dehydration, which causes thirst. Excessive thirst is called _______.

A

polyuria; polydipsia

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49
Q

According to the natural history of type 2 diabetes, which of the following complications may already exist when people are diagnosed with diabetes?

A

Macrovascular

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50
Q

Hulk checked his blood glucose levels two hours after eating a Chinese buffet last night. The glucometer showed 299 mg/dL. What would be the clinical indication from this information?

A

Hulk may have developed hyperglycemia

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51
Q

Releasing a series of multiple-function mediators, ___________ is involved in a wide spectrum of diseases, including not only cardiovascular and metabolic complications, such as atherosclerosis and type 2 diabetes, but also inflammatory- and immune-related disorders, such as rheumatoid arthritis and osteoarthritis.

A

white fat

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52
Q

Which type of diabetes is an autoimmune type of diabetes that begins in middle to late adulthood, also referred to as latent autoimmune diabetes in adults (LADA)?

A

Type 1.5

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53
Q

Which of the following diseases is considered a microvascular complication for diabetes?

A

Retinopathy

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54
Q

Which region of the brain is the main integrative center for the endocrine and autonomic nervous systems, controls the function of endocrine organs by neural and hormonal pathways?

A

Hypothalamus

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55
Q

Which of the following tissues can be classified as an endocrine gland?

A

Adipose tissue

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56
Q

In response to the hypothalamus, the posterior pituitary secretes _____.

A

Oxytocin and ADH

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57
Q

What is the basic action of adrenocorticotropic hormone (ACTH)?

A

Stimulates secretory activity and synthesis of corticosteroids in adrenal cortex

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58
Q

The primary hormones produced by the thyroid are _______________.

A

thyroxine, triiodothyronine, and calcitonin

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59
Q

Which of the following hormone’s basic action is calcium and phosphorus metabolism, construct bone, and reduce serum calcium?

A

Calcitonin

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60
Q

Which of the following disorders creates a generalized elevation of body metabolism, the effects of which are manifested in almost every system?

A

Hyperthyroidism

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61
Q

Myxedema is the clinical manifestation of ____________.

A

Hypothyroidism

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62
Q

Hyperparathyroidism is a disorder caused by overactivity of one or more of the four parathyroid glands that _____________.

A

disrupts calcium, phosphate, and bone metabolism

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63
Q

Which of the following medical diagnosis occurs because of a disorder within the adrenal gland itself, with insufficient cortisol release from the adrenal glands causing a wide range of problems?

A

Addison disease

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64
Q

Hypercortisolism resulting from adrenal gland oversecretion or from hyperphysiologic doses of corticosteroid medications is called _________.

A

Cushing syndrome

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65
Q

Which of the following medical diagnosis occurs when an adrenal lesion results in hypersecretion of aldosterone, the most powerful of the mineralocorticoids?

A

Conn syndrome

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66
Q

Which of the following is the characteristic of hypoparathyroidism?

A

Decreased bone resorption

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67
Q

Which of the following hormones is essential to norepinephrine-induced vasoconstriction and other physiologic phenomena necessary for survival under stress?

A

Cortisol

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68
Q

What is the hallmark of Addison disease?

A

Decreased serum cortisol levels

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69
Q

-prazole

A

Proton pump inhibitor

Used for gastric ulcers

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70
Q

-idine

A

Histamine H2-receptor blockers

Used for gastric ulcers

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71
Q

-amide

A

Oral antidiabetics (sulfonylurea group)

Antidiabetic (Type 2 Diabetes)

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72
Q

-dronate

A

Bisphosphonates

Used for Osteoporosis

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73
Q

Omeprazole, lansoprazole

A

Proton pump inhibitor

Used for gastric ulcer

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74
Q

Cimetidine, ranitidine

A

Histamine H2-receptor blockers

Used for gastric ulcers

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75
Q

Chlorpropamide, tolbutamide

A

Oral antidiabetics (sulfonylurea group)

Antidiabetic (Type 2 Diabetes)

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76
Q

Alendronate, pamidronate

A

Bisphosphonates

Used for Osteoporosis

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77
Q

Which of the following is a characteristic of hyperthyroidism?

A

Increased bone resorption

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78
Q

What can be the medical diagnosis and symptoms of a patient with an enlarged neck?

A

Goiter; enlargement of the thyroid gland

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79
Q

This patient presents the signs and symptoms of Myxedema (nonpitting, boggy edema, especially around the eyes, hands, feet, and in the supraclavicular fossae). What can be her medical diagnosis?

A

Hypothyroidism

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80
Q

Which of the following can be a cause for Cushing disease?

A

An excess of corticosteroid medication

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81
Q

What is true for cortisol?

A

It is essential to norepinephrine-induced vasoconstriction and other physiologic phenomena necessary for survival under stress

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82
Q

Which of the following lab (blood) tests is relevant to diagnose hyperthyroidism?

A

Thyroid-stimulating hormone

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83
Q

Flexor tenosynovitis with stiffness can accompany carpal tunnel syndrome in persons with _______

A

Hypothyroidism

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84
Q

Hyperparathyroidism is a disorder caused by overactivity of one or more of the four parathyroid glands that ______

A

disrupts calcium, phosphate, and bone metabolism

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85
Q

Which of the following is true?

A

All of the above
-Hyposecretion of human growth hormone results in dwarfism
-Hypersecretion of human growth hormone causes gigantism in children
-Hypersecretion of human growth hormone causes acromegaly in adults

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86
Q

Decreased levels of thyroid hormone lead to an overall slowing of the basal metabolic rate. This slowing of the body processes leads to ______

A

All of the above
-Bradycardia
-Decreased GI tract motility
-Slowed neurologic functioning

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87
Q

What is true about insulin resistance?

A

commonly being seen in people w/ Type 2 Diabetes

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88
Q

Which of the following clinical manifestations is commonly seen in a person with diabetes?

A

Numbness of the limbs

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89
Q

What clinical manifestation may a patient have if their blood glucose is 62 mg/dL?

A

Convulsion / coma

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90
Q

What is the A1C recommendation for non-pregnant adults with diabetes?

A

Less than 7.0%

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91
Q

Fat accumulated in the lower body (subcutaneous fat) results in a _____ figure, whereas fat in the abdominal area (visceral fat) produces more of an ______.

A

Pear-shaped, apple shape

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92
Q

_______ is the branch of medicine concerned with the management of obesity.

A

Bariatrics

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93
Q

Which of the following Islet cells produce insulin in the Pancreas?

A

Beta cells

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94
Q

Prediabetes is diagnosed in people with a fasting plasma glucose greater than or equal to ____ but less than or equal to _____.

A

100 mg/dL ; 125 mg/dL

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95
Q

In diabetes, _____ causes dehydration, which causes thirst. Excessive thirst is called _____.

A

Polyuria, polydipsia.

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96
Q

How to manage diabetes?

A

All of the above
-work with a health professional
-Eat healthy
-Stay active

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97
Q

The term _______ was often applied to opioid compounds because when taken, they tend to have sedative or sleep-inducing side effects, and high doses can produce a state of unresponsiveness and stupor.

A

Narcotic

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98
Q

The source of the naturally occurring opioid (narcotic) analgesics is from

A

the opium poppy

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99
Q

Opioid drugs exert their analgesics effects by binding to the same receptors as

A

endogenous opioids (endorphins, enkephalins)

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100
Q

Morphine and many other powerful opioids exert their primary analgesic effects by binding to the ________

A

mu opioid receptor

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101
Q

Drugs such as butorphanol, nalbuphine, and pentazocine may stimulate certain opioid receptors while blocking or only partially activating other receptors. These drugs _____

A

all the above are true
-may have fewer addictive qualities than strong opioids such as morphine
-may produce adequate analgesia with less risk of side effects such as respiratory depression
-may produce more psychotropic effects (hallucinations, vivid dreams) than other opioids
-are known as mixed agonist-antagonists

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102
Q

By blocking all opioid receptors, opioid antagonists such as nalmefene and naloxone are used primarily to

A

treat opioid overdose

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103
Q

Opioid drugs exert their effects on afferent pain pathways by binding to neuronal receptors that in turn

A

decrease transmitter release from presynaptic terminals

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104
Q

Preliminary studies on animals suggest that opioids can exert analgesic effects when administered directly into peripheral tissues (e.g., injected into an inflamed joint) because

A

opioids may bind to receptors located on the distal (peripheral) ends of primary afferent (sensory) neurons.

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105
Q

When used to treat pain, opioids can be administered by all the following routes EXCEPT

A

inhalation

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106
Q

In addition to their use as analgesics, opioid drugs can also be administered

A

all the above are true
-to treat severe diarrhea
-as a preoperative medication
-as a general anesthetic
-as a cough suppressant

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107
Q

Which of the following side effects is NOT associated with opioid drugs?

A

increased respiration

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108
Q

Certain patients can develop “tolerance” to opioid analgesics, which is indicated by

A

the need to progressively increase the dosage of the drug to achieve a therapeutic effect when the drug is used for prolonged periods

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109
Q

Methadone is often used to treat opioid addiction because methadone

A

has mild withdrawal symptoms

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110
Q

The onset of withdrawal symptoms (body aches, shivering, sweating, and so forth) after sudden discontinuation of opioid analgesics is an example of

A

physical dependence

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111
Q

Certain patients may fail to respond to opioids or may report increased pain (hyperalgesia) when given opioid drugs. This opioid-induced hyperalgesia is likely due to _____ in nociceptive pathways in susceptible patients.

A

increased activity of glutamate

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112
Q

NSAIDs such as aspirin exhibit all of the following effects EXCEPT

A

the ability to increase bronchodilation in conditions such as asthma

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113
Q

Aspirin and other NSAIDs exert their primary therapeutic effects by interfering with the biosynthesis of

A

prostaglandins

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114
Q

Prostaglandins are

A

a group of lipidlike compounds that exhibit a wide range of physiological activities

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115
Q

NSAIDs exert their therapeutic effects by _____ the ______ enzyme.

A

inhibiting; cyclooxygenase

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116
Q

The _____ form of the cyclooxygenase enzyme seems to be responsible for producing beneficial prostaglandins that help maintain or protect function in specific tissues such as the stomach and kidneys.

A

COX-1

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117
Q

In addition to its analgesic and anti-inflammatory effects, it appears that regular use of low-dose aspirin may also help prevent

A

All the above are true
-colorectal cancer
-heart attacks
-ischemic strokes

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118
Q

In theory, a COX-2 selective drug such as celecoxib will be less likely to cause gastric irritation because

A

COX-2 drugs do not inhibit the production of beneficial prostaglandins in the stomach.

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119
Q

Aspirin ______ be used to treat fever in children because this drug may cause _____.

A

should not; Reye syndrome

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120
Q

It has been suggested that aspirin and other NSAIDs _______ be used to treat pain following surgeries such as spinal fusion because these drugs may ______.

A

should not; inhibit bone healing

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121
Q

Several COX-2 selective inhibitors such as rofecoxib (Vioxx) and valdecoxib (Bextra) have been taken off the market because these drugs can cause serious side effects such as

A

heart attack and stroke

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122
Q

Gastric irritation caused by aspirin and other NSAIDs can be treated with

A

All the above
-Gastric proton pump inhibitors (PPIs) such as omeprazole (Prilosec) and esomeprazole (Nexium)
-Drugs that mimic prostaglandins (PGs) such as PGE1 (e.g., misoprostol [Cytotec])
-Histamine type 2 (H2) blockers such as cimetidine (Tagamet) and ranitidine (Zantac)

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123
Q

Which of the following is a commonly encountered problem with the use of corticosteroids?

A

Hyperglycemia

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124
Q

The lower GI tract includes the ________.

A

small and large intestines

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125
Q

_______ occurs when nerve endings in the stomach and other parts of the body are irritated and usually precedes vomiting.

A

Nausea

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126
Q

Which of the following is a gastrointestinal sign or symptom associated with strenuous exercise?

A

Abdominal cramping

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127
Q

Which of the following is the most common neurogenic cause of diarrhea?

A

Hyperthyroidism

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128
Q

Which of the following medications is a common cause of constipation?

A

-Diuretics and opioids
-Hydrocodone (semi-synethetic opioid)

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129
Q

What drugs are the most common causes of reactive gastritis?

A

Aspirin and NSAID’s

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130
Q

Which of the following is a failure to relax the smooth muscle fibers of the gastrointestinal tract?

A

Achalasia

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131
Q

Which of the following is least likely to refer pain to the left shoulder?

A

Liver cancer

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132
Q

What type of hiatal hernia is the most common?

A

Sliding

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133
Q

What types of exercise would increase intraabdominal pressure?

A

All of the above
-lifting
-straining
-bending over

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134
Q

One of the most common symptoms of a hiatal hernia is ________.

A

heartburn or reflux

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135
Q

Which of the following exercises is contraindicated for an individual with a known hiatal hernia?

A

Any exercise that causes Valsalva in the supine position

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136
Q

What is the common cause of gastroesophageal reflux disease?

A

All of the above
-Nicotine or cigarette smoke
-Peppermint, fatty foods, citrus products (including tomatoes), spicy foods, garlic, onions
-Carbonated drinks, alcohol and coffee
-Caffeine
-Pregnancy (last trimester)
-Calcium channel blockers
-Central nervous system depressants
-Sclerodema
-Estrogen Therapy

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137
Q

What type of medication is used to treat gastroesophageal reflux disease, blocks acid pumps and prevent stomach acid production?

A

Proton pump inhibitor (PPI)

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138
Q

Which of the following is not considered an extraesophageal manifestation of gastroesophageal reflux disease?

A

Heartburn

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139
Q

_______ occurs when the peptic ulcer erodes into adjacent organs such as the small bowel, pancreas, or liver.

A

Penetration

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140
Q

_________ is a chronic inflammatory disorder of the mucosa of the colon, typically involving the rectum, which can then advance proximally in a continuous manner to involve the entire colon.

A

Ulcerative colitis

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141
Q

In ulcerative colitis, intestinal lesions are usually found in which locations?

A

Rectum and left colon

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142
Q

What is the most common extraintestinal finding in inflammatory bowel disease?

A

Arthritis

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143
Q

What is the primary indication or desired effect of Omeprazole?

A

To treat gastric ulcers

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144
Q

Which of the following is Bisphosphonates that can treat osteoporosis?

A

Alendronate

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145
Q

What is the primary indication of proton pump inhibitors?

A

Gastric Ulcers

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146
Q

Which of the following medications is a common cause of diarrhea?

A

Antibiotics

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147
Q

The most common presenting symptoms of acute appendicitis occur in a classic sequence of abdominal pain over ________.

A

right lower quadrant

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148
Q

Why is the stool normally brown?

A

Bile converted from bilirubin causes brown coloration of the stool

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149
Q

What do light-colored stools and urine the color of tea or cola most likely indicate?

A

Liver dysfunction

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150
Q

Which of the following is one of the most common signs and symptoms of hepatic disease?

A

Hepatic osteodystrophy

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151
Q

What is the cause of jaundice?

A

Defects in bilirubin metabolism (in uptake by the liver or conjugation)

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152
Q

Progressive loss of normal tissue that is replaced with fibrosis and nodular regeneration is a characteristic of ______.

A

Cirrhosis

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153
Q

Bile helps in alkalinizing the intestinal contents and plays a role in the emulsification, absorption, and digestion of _____.

A

Fat

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154
Q

What is the treatment of choice for tense ascites?

A

Paracentesis and diuretics

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155
Q

What is the 5-year survival rate for compensated cirrhosis?

A

Greater than 90%

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156
Q

Which of the following occur in association with jaundice?

A

Dark urine and light stools

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157
Q

The liver is the major site of production proteins that are associated with _____.

A

acute inflammatory reactions

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158
Q

Which of the following is associated with overproduction of bilirubin?

A

Autoimmune hemolytic anemia

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159
Q

What type of hepatitis virus currently has no vaccine available?

A

Hepatitis C virus (HCV)

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160
Q

What is the most common cause of fulminant hepatitis?

A

Acetaminophen toxicity

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161
Q

Which of the following laboratory tests are both for liver function?

A

Gamma-glutamyl transferase (GGT) and lactate dehydrogenase (LDH)

162
Q

In what stage of cancer is the cancer usually localized to the primary organ?

A

Stage 1

163
Q

A history of obesity or type 2 diabetes is a risk factor for which of the following cancers?

A

Colorectal, pancreatic, breast

164
Q

_____ can be generated by translocations in which part of one gene moves to a different chromosome and recombines with another gene.

A

Fusion proteins

165
Q

Approximately what percent of clients with newly diagnosed cancers have clinically detectable metastasis?

A

30%

166
Q

What is the first level of dysplasia?

A

Metaplasia

167
Q

What type of malignant tumor originates from adipose tissue?

A

Liposarcoma

168
Q

Using the TNM staging system, what would be the grade if the cancer has no distant metastasis?

A

M 0

169
Q

What gene appears to be the trigger of programmed cell death as a way of regulating uncontrolled cellular proliferation?

A

p53

170
Q

Which of the following organs is the most likely location of primary metastasis of bone cancer?

A

Lungs

171
Q

What are the most common of all metastatic tumors?

A

Lung

172
Q

What is the primary indication of theophylline?

A

Bronchodilation

173
Q

What is the drug class for albuterol?

A

Bronchodilators (adrenergic)

174
Q

If a patient has a tumor in the pancreas, what would be the most common site of pain referral for this tumor?

A

Shoulder, midthoracic, or low back

175
Q

Cells are most sensitive to radiation therapy in the _____ phase

A

G2

176
Q

What is the last step in the mitotic cycle before cell division?

A

G2

177
Q

Which chemotherapy agents bind to DNA and prevent DNA replication?

A

Alkylating agents

178
Q

Tamoxifen in an antiestrogen hormonal agent is used in _____ to block estrogen receptors in tumor cells that require estrogen to thrive.

A

Breast cancer

179
Q

Monoclonal antibodies may be especially effective in treating certain cancers because these drugs

A

bind to antigens on the surface of a particular type of cancer cells.

180
Q

A relatively new strategy for treating certain tumors is to prevent the formation of new blood vessels, thus impairing tumor growth by starving the tumor of oxygen and nutrients. Drugs that use this strategy are known as ________.

A

angiogenesis inhibitors

181
Q

Most cancer chemotherapy agents exert severe and potentially toxic side effects because

A

most of these drugs do not discriminate between healthy tissues and cancerous cells.

182
Q

Some of the newer cancer chemotherapy agents (e.g., cytokines) are called biological therapies or biological response modifiers because they

A

encourage the body’s immune system to fight cancerous cells.

183
Q

The drug subclass of cytarabine is antimetabolites. What is the mechanism of action of cytarabine?

A

Inhibit DNA and RNA synthesis

184
Q

Which of the following healthcare professionals determines the delivery method and dosage of radiation therapy to be provided to a patient?

A

Radiation oncologist

185
Q

Which of the following therapy options is considered as nonpharmacologic modality for cancer pain?

A

Relaxation training

186
Q

Which of the following concepts describe the theory that each round of chemotherapy will affect a certain percentage of cancerous cells and the chemotherapeutic regimen can never completely eliminate the tumor?

A

Cell kill hypothesis

187
Q

Tumor lysis syndrome (TLS) is a serious complication of chemotherapy that has significant adverse effects on the _______.

A

Kidney

188
Q

A 37-year-old female has breast cancer. She is receiving FAC chemotherapy: Fluorouracil, doxorubicin (Adriamycin), Cyclophosphamide (Cytoxan). (Please answer the following questions from 15-18) 15. What is the drug class of Fluorouracil?

A

Antimetabolites

189
Q

What is the trade name of doxorubicin?

A

Adriamycin

190
Q

What is the drug class of Cyclophosphamide (Cytoxan)?

A

Alkylating agents

191
Q

What are the common adverse effects of Cyclophosphamide (Cytoxan)?

A

All of the above
-Blood disorders (anemia, leukopenia, thrombocytopenia)
-GI distress (nausea, vomiting, loss of appetite)
-Bladder irritation; hair loss; cardiotoxicity; pulmonary toxicity

192
Q

A 68-year-old man presents with a history of chronic cough, weight loss, and hemoptysis. Chest X-ray reveals a mass in the right lung. A biopsy confirms the diagnosis of non-small cell lung cancer.
Question:
Given the patient’s diagnosis, which of the following imaging studies would be most appropriate to stage the tumor and assess for metastasis?

A

Positron emission tomography (PET) scan

193
Q

A patient receives chemotherapy, which includes a combination of agents such as doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD).
Question:
To help the patient recover from chemotherapy-induced neutropenia, which of the following medications might the physician consider?

A

Granulocyte colony-stimulating factor (G-CSF)

194
Q

Which of the following is a risk factor of cancer?

A

Advancing age, gender, occupation
(all of the above)

195
Q

What type of malignant tumor originates from cartilage?

A

Chondrosarcoma

196
Q

Which of the following organs is the most likely location of primary metastasis of colorectal cancer via blood?

A

Liver

197
Q

_______ also called cancer-causing genes, have the ability to transform normal cells into malignant cells, independently or incorporated with a virus and there are more than 100 of them that have been identified

A

Oncogenes

198
Q

Using the TNM staging system, what would be the grade if the cancer has increasing degrees of involvement of regional lymph nodes?

A

N1

199
Q

Which of the following medications is a bronchodilator?

A

Pirbuterol

200
Q

Which of the following cells can recognize different types of tumor antigens?

A

T cells

201
Q

Which of the following is a common tumor evasion strategy?

A

-Antigenic modulation
-Induction of immune suppression
-Loss of immunogenicity

(all of the above)

202
Q

In what stage of cancer is it described that there is an increased risk of spread because of tumor size?

A

Stage II

203
Q

Which of the following is a secondary prevention of cancer?

A

Pap test of cervix

204
Q

Which of the following tests are useful for early detection and staging of tumors?

A

-CT scan and MRI
-Tissue biopsy
-Laboratory values

(all of the above)

205
Q

In the mitotic phase, when are cells most susceptible to chemotherapy?

A

Synthesis and mitosis

206
Q

Which of the following is true for irradiation therapy (radiotherapy)?

A

It can be used preoperatively to shrink a tumor, making it operable, while preventing further spread of the disease

207
Q

Which class of chemotherapy agents disrupts cellular mitosis by inhibiting microtubule assembly or disassembly?

A

Microtubule targeting agents

208
Q

Bevacizumab (Avastin) is approved by the FDA to treat cancer. It binds and inhibits vascular endothelial growth factor (VEGF) to prevent the formation of new blood vessels, thus impairing cancer growth by starving the tissue of oxygen and nutrients. What drug class is Bevacizumab (Avastin)?

A

Angiogenesis inhibitor

209
Q

Which of the following is true for myelosuppression after chemotherapy?

A

Patient may easily get infected due to fewer white blood cells

210
Q

Which of the following is an adverse effect of chemotherapy?

A

-fatigue
-pulmonary toxicity
-renal toxicity (nephrotoxicity)

(all of the above)

211
Q

What can be the cause of cancer related fatigue?

A

Emotional distress

212
Q

When tumors produce signs + symptoms at a site distant from the tumor or its metastasized sites, these remote effects of malignancy are collectively referred to as _______.

A

Paraneoplastic syndromes

213
Q

Which of the following are large granular lymphocyte cells that do not express antigen-specific receptors?

A

Natural Killer cells

214
Q

Which of the following membrane proteins function to present antigenetic peptides for recognition by T cells?

A

Major histocompatibility complex molecules

215
Q

What type of immunity used by the body adapts to recognize, eliminate, and establish long-term memory against a threat?

A

Acquired immunity

216
Q

Which of the following is an example of active artificial acquired immunity?

A

Vaccination

217
Q

Which of the following cells live the longest?

A

Monocytes

218
Q

Which immunoglobulin is the predominant immunoglobulin on mucus membrane surfaces and is found in secretions such as saliva, breast milk, urine, and tears?

A

IgA

219
Q

What type of major histocompatibility complex (MHC) molecule combines fragments of proteins that have been phagocytized, pinocytosed, or endocytosed from the extracellular environment?

A

MHC class II

220
Q

Which of the following is not involved in the humoral immune response?

A

Urine

221
Q

Which of the following is TRUE for antibodies?

A

The fragment antigen-binding (Fab fragment) is the portion of an antibody that binds to antigens.

222
Q

Which of the following is called CD8+ T cells?

A

Cytotoxic T lymphocytes

223
Q

Which phase of the immune response is characterized by the removal of antigens by many different mechanisms?

A

Effector phase

224
Q

After intense exercise of long duration, the concentration of natural killer cells and natural cytolytic activity decline below preexercise values. Maximal reduction in natural killer cell concentrations and lower natural killer cell activity occur _____ hours after exercise.

A

2 to 4 hours

225
Q

When HIV enters the body, what cells serve as receptors for the HIV retrovirus, allowing direct passage of the infection into other target cells?

A

CD4 cells and macrophages

226
Q

At what stage will an individual with HIV disease develop Kaposi sarcoma?

A

Advanced HIV disease

227
Q

Which of the following is true when describing the factors affecting the immunocompromised person?

A

Reusable equipment can be one of the common reservoirs

228
Q

What type of hypersensitivity is characterized by a delayed response to the allergen?

A

Type IV (Cell-Mediated Immunity) Hypersensitivity

229
Q

What type of immunologic hypersensitivity would cause the symptoms of seasonal allergic rhinitis?

A

Type I (IgE-mediated or Immediate Type) Hypersensitivity

230
Q

Which of following is true for systemic lupus erythematosus (SLE)?

A

Mild symptoms can be managed with nonsteroidal antiinflammatory drugs to relieve muscle and joint pain while reducing tissue inflammation

231
Q

Which of the following is the avenue for HIV transmission?

A

-Sexual activity (anal, vaginal, very rarely oral)
-Maternal to child (either through pregnancy, during delivery, or breastfeeding)
-Contaminated blood
All the above

232
Q

CD4+ T cells produce different cytokines that modulate the immune system and help it to mount effective responses against foreign invaders. Which of the following is NOT the primary functions of CD4+ T cells?

A

Producing antibodies

233
Q

In human defense mechanisms, which of the following acts as the body’s first line of defense?

A

Neutrophils

234
Q

What type of cell development begins with a progenitor cell from the bone marrow and migrates to the thymus gland, which is a primary lymphoid organ?

A

T Cell

235
Q

Which phase of the immune response is characterized by generation of long-lived T and B lymphocytes?

A

Memory phase

236
Q

Which immunoglobulin is the first secreted antibody and is predominant in a primary or initial immune response?

A

IgM

237
Q

What type of immunologic hypersensitivity is characterized by releasing histamine?

A

Type I (IgE-mediated or Immediate Type) Hypersensitive

238
Q

What type of immunologic hypersensitivity would cause systemic lupus erythematosus?

A

Type III (Immune complex mediated) Hypersensitivity

239
Q

Which of the following is true when describing the factors affecting the immunocompromised person?

A

Invasive devices are reservoirs

240
Q

In immunology, the term _____ refers to a lack of recognition and responsiveness to one’s own tissue antigens

A

Self-tolerance

241
Q

Which of the following is called CD4+ T cells?

A

Helper T Lymphocytes

242
Q

Which of the following symptoms will be affected by HIV?

A

-Integumentary
-Cardiopulmonary
-Neuromuscular
(all of the above)

243
Q

Which of the following belongs to the second line of defense?

A

inflammatory response

244
Q

________ refers to the emergence of HIV antibodies in the bloodstream (i.e. the person becomes positive for HIV antibodies) and usually takes place 3 to 6 weeks after infection.

A

seroconversion

245
Q

-azole

A

Azole antifungals

Used for fungal infections

246
Q

-avir

A

HIV Protease inhibitors

Used for HIV infections

247
Q

-cillin

A

Penicillin antibiotics

Used for bacterial infections

248
Q

-cycline

A

Tetracycline antibiotics

Used for bacterial infection

249
Q

-micin or -mycin

A

Various other antibacterials

250
Q

What is the term for the period of time between when the pathogen enters the host and the appearance of clinical symptoms?

A

Incubation period

251
Q

____ are primarily animal pathogens that generally produce disease in humans through the bite of an insect vector

A

Rickettsiae

252
Q

Which of the following is an example of an airborne disease?

A

Measles

253
Q

______ are unusual self-replicating bacteria that have no cell wall components and very small genomes.

A

Mycoplasmas

254
Q

What size of disease-causing organism would be most likely to be transmitted through the air?

A

4 um (micrometers)

255
Q

Which of the following precautions do not require a patient to have a private room?

A

Standard precautions

256
Q

What vaccine is recommended for all adults with a booster every 10 years?

A

Tetanus and diphtheria

257
Q

What is the recommendation for work restrictions in an individual who has active measles?

A

Exclude from duty

258
Q

What is the duration of an uncomplicated case of influenza type A or B?

A

3 to 7 days

259
Q

Antibacterial drugs work by all of the following mechanisms except inhibition of _____

A

bacterial intracellular calcium release

260
Q

Penicillin, cephalosporins, and several other commonly used antibacterial drugs exert their antibacterial effects by inhibiting the function of ______, which results in impaired production of ______ that are essential for normal membrane structure and function.

A

penicillin-binding proteins; peptidoglycans

261
Q

Aminoglycosides, erythromycin, the tetracyclines, and several other antibacterial drugs affect the function of the bacterial _______, thereby impairing______ in the bacterial cell.

A

ribosome; messenger RNA translation

262
Q

Certain antibacterial drugs such as trimethoprim and the sulfonamide drugs (e.g., sulfadiazine, sulfamethoxazole) selectively inhibit the synthesis and function of nucleic acids and certain essential amino acids by impairing the production of ______ in bacterial cells.

A

folic acid

263
Q

Bacteria can become resistant to antibacterial drugs by ____

A

-developing enzymes that destroy the drug
-modifying or masking the site where the antibacterial drug typically binds on or within the bacterial cell
-modifying the bacterial enzymes normally targeted by the drug
-developing drug efflux pumps that expel the drug from the bacterial cell

(all the above are true)

264
Q

Viral infections are often more difficult to treat than other types of infections because ____

A

viruses penetrate into human cells, and cannot be easily killed without harming the human cell

265
Q

Certain anti-HIV drugs (e.g., zidovudine, didanosine, and zalcitabine) are known as reverse transcriptase inhibitors because they ______

A

inhibit transcription of viral RNA to viral DNA

266
Q

Reverse transcriptase inhibitors such as zidovudine, didanosine, and lamivudine are especially important for physical therapists because they may cause side effects such as ____

A

-peripheral neuropathy
-myopathy
-joint pain

(all the above are true)

267
Q

Interferons are small proteins that

A

-exert nonspecific antiviral activity
-control cell differentiation
-limit excessive cell proliferation
-modify certain immune processes

(all the above are true)

268
Q

Which of the following medications is an antibiotic?

A

Ampicillin

269
Q

What is the drug class of Doxycycline?

A

Tetracycline antibiotics

270
Q

Based on the case study 45 Parkinson Disease, which of the following facts belong to the component of body structures/functions on the ICF framework?

A

His tremors have become less pronounced during the last three weeks.

271
Q

Based on the case study 45 Parkinson Disease, which of the following facts belong to the personal factor on the ICF framework?

A

Relocated after his wife’s death and now living with family of four in Wyoming; mother/ wife of family is LPN and caregiver in the home.

272
Q

What is defined as the development of unhealthy conditions or disease?

A

Pathogenesis

273
Q

The World Health Organization (WHO) defines which of the following as “a state of complete physical, mental, and social well-being, and not merely as the absence of disease or infirmity”?

A

Health

274
Q

Which of the following is the correct term used to describe a medical condition that is substantiated by objective data such as elevated temperature or presence of infection?

A

Disease

275
Q

If an individual has experienced brain damage that leads to decreased executive function, what area of the brain is most likely injured?

A

Right hemisphere

276
Q

Who created the germ theory?

A

Louis Pasteur

277
Q

Who made a ground-breaking study of mitochondrial DNA in the beginning of the 21st century?

A

Douglas Wallace

278
Q

Which is not a primary prevention strategy?

A

Antibiotics

279
Q

When was the Human Genome Project started?

A

1990

280
Q

The number one cause of death in the U.S. adult population, heart disease, has been reduced by how much due to changes in diet and lifestyle.

A

52%

281
Q

Gender and sex differences are topics with constantly updating information. Recent research has indicated that steroid-induced epigenetic changes impact a single life span. Which of the following may exert a multigenerational effect?

A

Endocrine-disrupting compounds

282
Q

Which of the following is NOT an example of a damage-based explanation of aging?

A

Telomerase theory

283
Q

Adverse childhood experiences are linked to problems in adulthood including all except

A

Travel related disease

284
Q

Who are examples of successful aging?

A

Those in their 100s

285
Q

Past schools of thought indicated that race was the cause of health disparities, while current thinking indicates that epigenetics is more likely the cause and include interactions between all except the following:

A

The amount of melanin in skin

286
Q

Life expectancy in the 20th century has increased by 35 yrs. Healthcare improvements have created an additional how many years of that 35?

A

7 years

287
Q

What group has seen the most rapid population increase in the past decade?

A

Over age 85

288
Q

Supercenturians live to be over how many years past 100?

A

10 years

289
Q

Adverse childhood experiences are linked to problems in adulthood including all except

A

Travel related disease

290
Q

The use of specific drugs to prevent, treat, or diagnose disease is known as

A

pharmacotherapeutics

291
Q

Toxicology is

A

the study of the harmful effects of chemicals

292
Q

The generic name of a drug

A

All of the above are true
-is also known as the “official” or “nonproprietary” name
-is often derived from the chemical name -tends to be somewhat shorter than the drug’s chemical name

293
Q

The generic form of a drug is considered to be as safe and effective as the original, brand-name product if the generic form _________ as the brand-name drug.

A

All of the above are true
-has the same type and amount of the active ingredient(s)
-uses the same administration route
-has the same pharmacokinetic profile (drug absorption, plasma levels, and so forth)
-produces the same therapeutic effects

294
Q

Regarding drug development and approval, an “orphan drug” is a drug that is

A

given special funding for development because it is used in a small patient population with a relatively rare disease

295
Q

Prescription use of a drug to treat conditions other than those that the drug was originally approved to treat (off label prescribing)

A

is legal and quite common in the United States

296
Q

When two drugs are compared, the drug that requires a lower dosage to produce the same effect as a higher dose of the second drug is said to

A

be more potent

297
Q

The ______ effect occurs when drugs are transported initially to the liver where a significant amount of the drug may be metabolized and destroyed before the drug reaches its primary site of action.

A

first-pass

298
Q

The extent to which a drug reaches the systemic circulation is referred to as

A

bioavailability

299
Q

Osmosis refers to the special case of diffusion where the diffusing substance is

A

water

300
Q

A drug that has a volume of distribution of approximately 42 L in a healthy 70-kg man will typically be

A

distributed uniformly throughout all of the body fluids

301
Q

Drug developers are exploring nanotechnology (i.e., the use of very small particles with specific physical properties) as a way to

A

All of the above
-target and deliver drugs to specific tissues within the body
-facilitate drug absorption from the GI tract
-enable drugs to cross the blood brain barrier more easily

302
Q

Drug metabolism that occurs when a drug is changed chemically following administration is also known as

A

biotransformation

303
Q

Most drugs are metabolized by _____ to the drug molecule, and the enzymes that catalyze these reactions are typically located at the ____ of specific cells.

A

adding an oxygen or removing a hydrogen; smooth (agranular) endoplasmic reticulum

304
Q

Prolonged administration of therapeutic drugs and other substances (alcohol, nicotine) may enhance the liver’s ability to metabolize certain drugs, thus decreasing their therapeutic effect. This process is known as _______ .

A

enzyme induction

305
Q

Drugs and their metabolites are excreted from the body primarily by

A

kidneys

306
Q

To calculate drug elimination rates, blood flow to an organ and the fraction of drug removed from the plasma as it passes through the organ are measured to determine drug

A

clearence

307
Q

Drug metabolism by the liver and other organs typically creates a more ____ compound, thus enabling the compound to be ____ when it reaches the nephrons in the kidney.

A

polar; excreted

308
Q

The acetylcholine receptor located on the postsynaptic membrane of the skeletal neuromuscular junction is an example of a membrane receptor that

A

functions as an ion channel or pore

309
Q

Some drugs affect the function of the adenylate cyclase, an enzyme located on the inner surface of the cell membrane. This enzyme is responsible for hydrolyzing adenosine triphosphate (ATP) into _____, which acts as a second messenger that activates other enzymes (i.e., protein kinases) throughout the cell.

A

cyclic adenosine monophosphate (cAMP)

310
Q

A drug that binds readily to available receptors even if the concentration of drug is relatively low is said to have _______ for that receptor.

A

high affinity

311
Q

The ability of a drug to bind to its receptor can be influenced by local chemicals such as guanine nucleotides, ammonium ions, and divalent cations. These local regulators are commonly known as _____.

A

allosteric modulators

312
Q

In contrast to an agonist, a pharmacologic antagonist

A

All the above are true
-has affinity for the receptor, but lacks efficacy
-is also known as a “blocker”
-can be used prevent endogenous chemicals from overstimulating the receptor

313
Q

A drug that fails to evoke a maximal response even though it occupies all available receptors is known as

A

a partial agonist

314
Q

Overstimulation of postsynaptic receptors may lead to a decrease in responsiveness of the receptors. A fairly brief and transient decrease in receptor responsiveness is known as _____, whereas a more prolonged process in which the actual number of available receptors is diminished is known as _________.

A

desensitization; down-regulation

315
Q

What is the mechanism of action for Ozempic?

A

Activates glucagon-like-peptide-1 (GLP-1) receptor.

316
Q

One of the common adverse reactions to Oxycodone is ______.

A

Constipation

317
Q

What is the drug subclass of Tresiba?

A

Diabetes: Insulins

318
Q

Clostridium tetani releases an exotoxin that is preferentially absorbed by the alpha motor neurons and delivered into the central nervous system. What is the cause of injury to the neuron cell?

A

Infectious agent

319
Q

What happens when the immune system is compromised or if the number of invading microorganisms overwhelms the immune system?

A

Disease occurs

320
Q

Which of the following conditions is generally not thought to be caused by free radicals?

A

Rheumatoid arthritis

321
Q

What is the correct term for protein malnutrition?

A

Kwashiorkor

322
Q

During acute reversible cell injury, the concentrations of which two elements are increased?

A

Sodium and calcium

323
Q

Which of the following is a change in cell morphology and function resulting from the conversion of one adult cell type into another?

A

Metaplasia

324
Q

Pure hypertrophy occurs only where in the body?

A

Heart and striated muscles

325
Q

Hypertrophy of what chamber of the heart is a typical complication of hypertension?

A

Left ventricle

326
Q

Which of the following statements regarding necrosis of cells is true?

A

Cell size increases.

327
Q

The hallmark of chronic inflammation in a tissue is the accumulation of

A

All of the above
-Lymphocytes
-Macrophages
-Plasma cells

328
Q

What type of inflammatory exudate is bright red or bloody and signals the presence of red blood cells?

A

Sanguineous

329
Q

What is the first step in the migration of leukocytes from the vasculature to the interstitial tissues?

A

Binding of leukocytes to receptors on endothelial cells of venules

330
Q

What is the approximate life cycle of a neutrophil after extrusion from the circulation?

A

24 hours

331
Q

Which of the following cells store and release histamine?

A

Mast cells

332
Q

What is secreted by fibroblasts early during the tissue repair reaction?

A

Proteoglycans

333
Q

What type of collagen is the predominant component of growth plates in bones?

A

Type II

334
Q

What is true in phases of healing?

A

Hemostasis and degeneration –> Inflammation –> Proliferation and migration –> Remodeling and maturation

335
Q

Which of the followings about cell injury is true?

A

Apoptosis is a programmed cell death.

336
Q

Which of the following is the LEAST appropriate for a physical therapist to do during a patient’s healing process?

A

Suppress inflammatory process as soon as possible.

337
Q

What is the primary indication of prednisone?

A

Anti-inflammatory

338
Q

What is the drug class for celecoxib?

A

Cyclooxygenase type 2 (COX-2) inhibitors

339
Q

Which of the following factors would affect tissue healing?

A

All of the above
-Vascular sufficiency
-Caffeine
-Immobility

340
Q

The time for overall bone healing varies depending on

A

All of the above
-The bone involved and degree of soft tissue injury
-Treatment required (e.g., immobilization versus surgical repair, the need for bone grafting or use of bone graft substitutes)
-The fracture site and type

341
Q

Which of the following is true for tendon injury and healing?

A

Hemostasis begins immediately, followed by the inflammatory process, which begins during the first 72 hours (3 to 5 days) after injury or surgical intervention

342
Q

A 45-year-old patient presents with redness, swelling, and pain in her right knee following an injury. Laboratory tests reveal elevated levels of prostaglandins in the affected area. Based on these findings, which of the following is the most likely effect of prostaglandins in the context of this patient’s acute inflammation?

A

Pain and fever, along with modulation of vascular permeability.

343
Q

Which of the following sequences correctly describes the steps in leukocyte accumulation during an inflammatory response?

A

Margination → Adhesion → Diapedesis → Chemotaxis

344
Q

Which of the following best describes the role of diapedesis in the inflammatory response?

A

Diapedesis is the active migration of leukocytes out of the blood vessels and into the interstitial tissues, enabling them to reach the site of injury.

345
Q

Which of the following chemical mediators is primarily responsible for increasing vascular permeability and causing vasodilation during an acute inflammatory response?

A

Histamine

346
Q

Which statement best describes the role of fibronectin in tissue healing?

A

It provides a scaffold, tensile strength, and helps to “glue” other substances and cells together.

347
Q

Which collagen type is first deposited during wound healing, contributes to the elasticity of skin and blood vessels, and is eventually replaced by type I collagen as healing progresses?

A

Type III

348
Q

A 65-year-old patient with diabetes mellitus and chronic obstructive pulmonary disease (COPD) presents to the physical therapy clinic with a non-healing pressure ulcer on their sacrum. How should these comorbid conditions be managed to optimize the healing process of the pressure ulcer?

A

Address glycemic control through consultation with the patient’s endocrinologist and improve oxygenation by managing COPD symptoms, alongside regular wound care.

349
Q

Which of the following conditions is likely to experience delayed healing due to its decreased blood supply?

A

Achilles tendon tear

350
Q

What roles do myofibroblasts play during the remodeling and maturation phase of tissue healing?

A

They contribute to tissue contraction by containing contractile proteins that help shrink the healing tissue.

351
Q

Which of the following is an example of labile cells in the human body, known for their continuous division and high turnover rate?

A

Epithelial cells of the skin

352
Q

Which of the following statements about lung tissue repair after injury is TRUE?

A

After lethal injury to alveolar cells, regeneration can occur only when the basement membrane remains intact.

353
Q

Which of the following statements about peripheral nerve injury and repair is TRUE?

A

Within 24 hours of nerve section, new axonal sprouts from the central stump are observed.

354
Q

A 60-year-old patient presents with a fractured femur after a fall. X-rays show a soft callus formation around the fracture site. Based on the typical phases of bone healing, what is the most accurate description of the phase the patient is currently in?

A

The patient is in the reparative phase, as evidenced by the formation of a soft callus, which will eventually be replaced by a hard callus.

355
Q

A 23-year-old female athlete presents with a diagnosis of tendinopathy in the Achilles tendon. The condition is characterized by pain and pathologic changes in the tendon for more than one year. Which of the following statements accurately describes the type of tendinopathy and its underlying mechanism?

A

The condition is tendinosis, characterized by a degenerative process with little or no inflammation but histopathologic changes in the collagen matrix.

356
Q

A 45-year-old patient presents with a recent knee injury after a sports activity. The patient reports pain, swelling, and episodes of the knee locking. MRI results indicate a meniscal tear. Based on the location of the tear, which statement is most accurate regarding the potential for healing and management?

A

Tears in the outer one-third of the meniscus, which is vascular, are likely to heal more effectively due to better blood supply, and the management might include conservative measures such as physical therapy.

357
Q

A 55-year-old patient presents with chronic low back pain and MRI findings that reveal disc degeneration with significant dehydration and fissures in the annulus fibrosus. Which of the following statements most accurately describes the pathological changes occurring in the disc and their potential contribution to the patient’s symptoms?

A

The loss of water-binding capacity and formation of fissures in the annulus fibrosus lead to reduced shock absorption and increased compressive forces, contributing to the patient’s chronic low back pain.

358
Q

-erol (adrenergic)

A

Bronchodilators

Albuterol, pirbuterol

359
Q

-phylline

A

Bronchodilators (xanthine derivatives)

Theophylline, aminophylline

360
Q

-sone

A

Glucocorticoids

Anti-inflammatory, Immunosuppressants

361
Q

-olone

A

Glucocorticoids

Anti-inflammatory, Immunosuppressants

362
Q

-coxib

A

Cyclooxygenase type 2 (COX-2) inhibitors

Pain, inflammation

363
Q

-pril

A

Angiotensin-converting
enzyme (ACE) inhibitor

Antihypertensive, congestive heart failure

364
Q

-sartan

A

Angiotensin II - receptor blockers

Antihypertensive, congestive heart failure

365
Q

-olol

A

Beta blockers

Antihypertensive, antianginal, antiarrythmic, congestive heart failure

366
Q

-ipine

A

Calcium channel blocker

Antihypertensive, antianginal

367
Q

-statin

A

HMG-CoA reductase inhibitors (statins)

Hyperlipidemia

368
Q

The number one cause of death in the US adult population heart disease has been reduced by how much due to changes in diet and lifestyle

A

52%

369
Q

Past school of thought indicated that race was the cause of health disparities while current thinking indicated that epigenetics is more likely the cause and include interactions between all except the following

A

The amount of melanin in skin

370
Q

Life expectancy in the 20th century has increased by 35 yrs. Healthcare improvements have created an additional how many years of that 35?

A

7 years

371
Q

A pt is doing an initial evaluation on a knee patient. Which of the following facts told by a patient belongs to the component of body structures/functions on the ICF framework?

A

My knee feels really weak and sometimes it just gives way without warning

372
Q

Which of the following statements made by patients best represents a personal factor according to the ICF framework?

A

I have a strong support system from My family and close friends, which helps my manage my health better

373
Q

Which of the following actions taken by PT is an example of tertiary preventions in preventative medicine

A

Designing a fall prevention program for an elderly patient to reduce the risk of future falls, to prevent complications and further deterioration

374
Q

Which of the following is the set time frame to define a subacute condition

A

There is no set time frame

375
Q

Which of the following psychological defense mechanisms is illustrated by a patient who insists that their illness is not serious and continues to engage in activities that might worsen their condition?

A

Denial

376
Q

What is the process or condition of growing old that may be the result of continuous cellular metabolism, cellular damage, and inefficient repair systems throughout the entire lifespan

A

Senescence

377
Q

Based on behavioral trends in health care which of the following age groups is most likely to assume a passive role in their own healthcare?

A

Age 80 and older

378
Q

Recent epigentic studies have shown benefits to people with increased blood pressure high blood sugar excess body fat around the waist and abnormal cholesterol or triglycerides levels with interventions involving which interventions that physical therapist provide

A

Therapeutic activities and exercise

379
Q

Which if the following has been shown to control DNA accessibility and gene activation or inactivation

A

DNA methylation and histone acetylation

380
Q

Which of the following is the product of gene expression ?

A

Protein

381
Q

The______ effect occurs when drugs are transported initially to the liver where a significant amount of the drug may be metabolized and destroyed before the drug reaches its primary site of action

A

First pass

382
Q

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

A

Cyanosis

383
Q

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

A

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

384
Q

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

A

Triglyceride 200 mg/dL

385
Q

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

A

Atherosclerosis

386
Q

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

A

Coronary Artery Bypass Graft (CABG)

387
Q

Which of the following medications can treat hypertension?

A

All of the above
-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)​

388
Q

What is true for angina pectoris?

A

All of the above
-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.

389
Q

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

A

Personality traits (hostility, sense of hopelessness)​

390
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​.

A

Arrhythmia (dysrhythmia)

391
Q

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

A

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

392
Q

Which of the following is true about lymphatic 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.

393
Q

Which of the following body region contain more lymph nodes?

A

Axillary

394
Q

What is true about lymph nodes?

A

All of the above
-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.

395
Q

What is lymphadenopathy?

A

Enlargement of the lymph nodes

396
Q

What is true for lymphedema?

A

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

397
Q

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

A

Anisocytosis

398
Q

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

A

B12-intrinsic factor complex

399
Q

Lack of clotting factor _____ causes hemophilia A.

A

VIII

400
Q

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

A

Hemoglobinopathies (e.g., sickle cell diseases)

401
Q

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

A

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

Internal Medicine (3 decks)

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