final review Flashcards
- All these cellular responses are potentially reversible except
True: atrophy, hypertrophy, hyperplasia, metaplasia
- Allostasis is best defined as
the overall process of adaptive change necessary to maintain survival and well-being.
- Malignant neoplasms of epithelial origin are known as
carcinomas
- In regards to the Multistep Nature of Carcinogenesis, which is false about the Progression stage
TRUE:
-Mutant, proliferating cells begin to exhibit malignant behavior.
-Cells whose phenotype gives them a growth advantage proliferate more readily.
-Evolved tumor cells differ significantly from the normal tissue.
-Progress to malignant characteristics
Laminin receptors
Lytic enzymes
Anchorage independent
Bizarre karyotype
- The ________ are peptides produced and secreted by white blood cells.
Defensins
- What virus is associated with adult T-cell leukemia/lymphoma?
Retrovirus
- Which of the following is NOT abnormal behavior of cancer cells?
Cancer cells undergo apoptosis. Apoptosis is the death of cells with damaged DNA. When the immune system recognizes abnormal cells, it activates apoptosis, which prevents tumor growth. Even though cancer cells are abnormal, they do not undergo apoptosis.
- Which is false about the stages of Hemostasis?
TRUE: Vasoconstriction ,Platelet plug formation ,Coagulation (clot formation),Clot retraction/repair ,Fibrinolysis (clot dissolution)
- Which will not belong to the category of Myeloid neoplasms?
-Acute Lymphoblastic Leukemia (ALL)
-Chronic Lymphocytic Leukemia (CLL)
-Lymphomas
- Which is false about Hereditary Spherocytosis?
False: Hereditary Spherocytosis has a decreased osmotic fragility test
True:
-Hereditary Spherocytosis is an Inherited, Autosomal Dominant disease.
-Hereditary Spherocytosis is caused by a Deficiency in Spectrin which comprises the Red Cell Membrane, resulting in a Spherocyte shape.
-Hereditary Spherocytosis results in Extravascular Hemolysis in the Spleen.
-Hereditary Spherocytosis affects Northern Europeans through Autosomal Dominant inheritance.
- Childhood will exhibit Anemia, Splenomegaly, and Jaundice.
- Adulthood may exhibit Gallstones
- Cardiogenic shock is characterized by
reduced cardiac output.
- Hypotension, distended neck veins, and muffled heart sounds are classic manifestations of
Cardiac Tamponade
- Sepsis has been recently redefined as
a systemic inflammatory response to infection.
- What is false about Acute Renal Failure?
ARF is always irreversible and leads to chronic kidney disease, does not affect urine output, in prerenal ARF, dilute urine is formed, ATN can be treated with immunosuppression.
- What is false about Renin-angiotensin-aldosterone system?
Angiotensin converting enzyme changes angiotensinogen into angiotensin I
- In regards of Multiple Organ Dysfunction Syndrome (MODS), what is false?
TRUE:
-When 2 or more systems are affected
-Most common causes of secondary MODS: sepsis and septic shock
-Initiated by immune mechanisms that are overactive and destructive
-Cytokines affect endothelium, recruit neutrophils, and activate inflammation in vascular beds leading to tissue destruction and organ dysfunction.
- Which is CORRECT about Neurogenic Shock?
Neurogenic shock is sometimes caused by spinal injuries.
- In compensated respiratory acidosis, we can observe all of the following except;
TRUE:
Increased PaCO2 (primary imbalance)
Increased bicarbonate concentration (compensation)
Decreased (somewhat low) or even normal pH, depending on degree of compensation
- Which is false about Nephroblastoma (Wilms’ tumor)?
true:
Nephroblastoma (Wilms’ tumor)
* Most common kidney cancer in children
* Clinical manifestations: identified by palpable abdominal mass; may also have abdominal pain, hypertension, and/or hematuria
* Treatment: nephrectomy, radiation therapy, and chemotherapy
* Excellent cure rate
- Which is false about Minimal change disease (MCD)?
TRUE
-Previously called lipoid nephrosis
-Alteration in glomerular podocytes
-Sudden onset of edema, nephrotic levels of protein loss, and hypoalbuminemia
-Responds well to corticosteroids
- Which is incorrect about Peritoneal dyalisis?
TRUE: A procedure performed to
correct an imbalance of fluid or electrolytes in
the blood or to remove toxins by intermittent
infusion and removal of dialysis fluid through a
catheter in the peritoneal cavity.
- The Clinical manifestations of Urethral Valve Abnormalities include all the following except ;
TRUE:
Intrauterine renal failure causing:
* Oligohydramnios (decreased amniotic fluid)
* Pulmonary hypoplasia (incomplete lung development)
* Stillbirth or extreme distress at the time of birth
Inability to void (normally void within 24 hours of birth)
Abdominal masses, such as palpable bladder or hydronephrotic kidneys
Varying degrees of azotemia or renal failure
Urinary ascites (extravasated urine in the peritoneum)
Floating bowel on x-ray
- Which false about the etiology of neoplasms of the Penis?
- Pathophysiologically, esophageal varices can be attributed to
portal hypertension
- Which of the following is not an Insulin action?
TRUE:
-Enhance protein synthesis and prevent muscle breakdown
-Inhibit gluconeogenesis
-Enhance fat deposition by preventing fat breakdown (lipolysis) and inducing lipid formation
-Stimulate growth by enhancing secretion of IGF-1 (somatomedin)
- In contrast to osteoarthritis, rheumatoid arthritis may be associated with
- Cerebral aneurysm is most frequently the result of
subarachnoid hemorrhage.
- Characteristics of scoliosis include ( Select all that apply.)
-involvement of lateral curvature of the spine,
-increase during periods of rapid growth,
-identifiable by uneven shoulders or scapular prominence,
-possibility of leading to respiratory complications
- Common characteristics of sarcoidosis include (Select all that apply.)
-Presence of CD4+ T cells
-a non-productive cough
-granulomas in multiple body systems
-fatigue, weight loss, and fever
- Clinical manifestations of pleural effusion include (Select all that apply.)
-dyspnea,
-sharp pain on expiration,
-diminished breath sounds,
-a tracheal shift, if large
- Dysfunctional uterine bleeding (DUB) is caused by
Abnormal endometrial bleeding not associated with tumor, inflammation, pregnancy, trauma, or hormonal effects
- The major buffer in the extracellular fluid is
bicarbonate buffer system.
- Causes of hypomagnesemia include
-Serum magnesium concentration below the lower limit of normal (1.5 mEq/L)
Decreased magnesium intake or absorption: chronic alcoholism, malnutrition, ileal resection
Decreased physiologic availability of magnesium: elevated plasma free fatty acids
Increased magnesium excretion: usually renal
Loss of magnesium by an abnormal route: emesis
Increased neuromuscular excitability from excessive amount of acetylcholine
Insomnia
Hyperactive reflexes
Muscle cramps
Muscle twitching, grimacing
Positive Chvostek sign
Positive Trousseau sign
Clinical manifestations
Increased neuromuscular excitability from excessive amounts of acetylcholine
Nystagmus
Dysphagia
Ataxia
Tetany
Seizures
Cardiac dysrhythmias
- Signs and symptoms of clinical dehydration include
-Sudden weight loss
-Postural blood pressure decrease with concurrent increased heart rate
-Lightheadedness, dizziness, or syncope upon standing
-Flat neck veins when supine or neck veins that collapse during inspiration
(older children and adults)
-Sunken fontanel (infants)
-Rapid, thready pulse
-Prolonged small-vein filling time
-Prolonged capillary refill time
-Oliguria
-Decreased skin turgor
-Dryness of oral mucous membranes
-Absence of sweat and tears
-Hard stools
-Soft, sunken eyeballs
-Longitudinal furrows in the tongue
-Thirst
-Increased serum sodium concentration
-Confusion, lethargy
-Coma
-Hypovolemic shock
- Which causes vasoconstriction?
A decrease in the diameter of a blood vessel, usually referring to an arteriole, caused by contraction of vascular smooth muscle.
- Which is a cause of thrombocytopenia?
Decreased Platelet Production
Folate/B12 deficiency
Radiation therapy
Chemotherapy
Drugs (e.g., alcohol, thiazides, phenytoin)
Aplastic anemia
Cancer in bone marrow
Decreased Platelet Survival
Drugs (e.g., thiazides, digoxin, heparin, furosemide, certain antibiotics)
Mechanical prosthetic heart valves
Viral and bacterial infections
Circulating immune complexes
Increased destruction in the spleen
Disseminated intravascular coagulation
Splenic Sequestration (Pooling)
Splenomegaly
Hypothermia
Platelet Dilution
Massive transfusions with blood stored for more than 24 h
- Subarachnoid hemorrhage is usually managed with volume expansion and blood pressure support to enhance cerebral perfusion. This is necessary because subarachnoid hemorrhage predisposes to
cerebral vasospasm
- Which condition enhances lymphatic flow?
Increasing interstitial fluid colloid osmotic pressure
- When a patient is struck in the eye by a baseball, the result is redness and swelling. This increase in blood flow to a localized area is called
hyperemia
- The direct cause of stress incontinence is
-Decreased pelvic muscle support of the bladder and urethra or intrinsic urethral sphincter deficiency results
- Loss of bladder control caused by increased intraabdominal pressure (e.g., from coughing) combined with pelvic muscle laxity.
- The organism most commonly associated with acute pyelonephritis is
E. Coli
- Detrusor muscle overactivity can be improved by administration of
botulinum toxin.
- A person is unaware that his bladder is full of urine, but complains that he is leaking urine almost constantly. The most accurate term for this type of incontinence is
overflow.
- A progressive decrease in the force of the urinary stream, dribbling of urine, and difficulty initiating the urinary stream are characteristic of
prostatic enlargement.
- Activation of parasympathetic nerves to the bladder will cause
bladder contraction
- Findings that should prompt an evaluation for renal cancer include
hematuria
- What problem is a patient likely to experience in end-stage renal disease?
Uremia
- The urinalysis finding most indicative of cystitis include the presence of
nitrites.
- Which is false about Peroxisomes? Select all that apply
TRUE:
-are membrane-boundbags of enzymes that perform degradative functions.
-They are particularly important in liver and kidney cells, where they detoxify various substances, such as alcohol.
- contain oxidative enzymes
- oxidize fatty acids (βoxidation) to produce acetyl coenzyme A (acetyl CoA) that is used incellular metabolism
- Hyperlipidemia occurs in nephrotic syndrome because
hepatocytes synthesize excessive lipids.
- The condition characterized by oliguria and hematuria is
acute glomerulonephritis.
- Which is false about Oxidative Phosphorylation?
Protons are moved across the outer mitochondrial membrane in order to produce potential energy
- All is correct about Homeostasis, except;
TRUE:
Remaining stable while staying the same
A state in which all systems are in balance
A state of equilibrium
An ideal “set point” despite alterations within the body
- Which is false about the action potential?
TRUE: a rapid change in voltage across a cell membrane, which is a nerve impulse that allows cells to communicate with each other
- This law represents driving pressure and resistance variables and their effect on blood flow.
Poiseuille’s Law
- If an embolus leaves the Right ventricle, which consequence is correct?
More often, an embolism leaving the right ventricle lodges in the pulmonary vasculature. This PE may be asymptomatic or present with various signs and symptoms, many of which are vague and nonspecific. Most common is the sudden onset of shortness of breath (dyspnea), increased respiratory rate, and chest pain. It may be a cause of sudden death.
- Which is false about Raynaud Syndrome?
TRUE:
-Extreme vasoconstriction producing cessation of flow to fingers and toes
Color changes: white, blue (cyanosis), red (hyperemia); pain, numbness; cold triggers attacks
-Intrinsic structural factors, extrinsic neuroregulation, and locally produced mediators involved
-Treatment: enhancing circulation through biofeedback, relaxation, calcium-channel blockers, sympatholytic drugs, prostaglandins
- Which is false about Legionnaires disease, that causes Pneumonia?
true:
legionnaires disease is a severe systemic illness characterized by fever, diarrhea, abdominal pain, liver and kidney failure, and pulmonary infiltrates. The causative organism for legionnaires disease lives in water and is transmitted by means of potable water, condensers, and cooling towers. The current treatment of choice is administration of macrolide antibiotic. Patients whose immune systems have been compromised by disease or by drug therapy may be susceptible to the development of opportunistic pneumonia.
- The following are early clinical manifestations of IRDS (infant respiratory distress syndrome), except;
TRUE:
Shallow respirations, diminished breath sounds
Intercostal, subcostal, or sternal retractions
Flaring of nares
Hypotension, bradycardia
Peripheral edema
Low body temperature
Oliguria
Tachypnea (60 to 120 breaths/min)
- In this type of Enuresis, the child has nocturnal incontinence but no other signs of lower urinary tract syndrome (LUTS).
monosymptomatic enuresis (MSE)
- Which is false about Ureteral ectopy?
TRUE:
-Single ureter implanted in an abnormal location or a duplicate ureter
-Can increase risk of infection and reduce renal function
-Typically found with other genitourinary pathologies
-Surgical interventions usually required
- Which is false about Urethritis?
TRUE:
-Inflammation of the urethra
-Caused by infection from the bladder, STD-related or from external factors, like frequent catheterization, poor hygiene
-STDs confined to the urethra; infection of other etiologies may ascend to the bladder before symptoms present
-Pain (dysuria), burning, incontinence
-Treatment depends on the cause
- Which is false about Fibromyalgia Syndrome?
TRUE:
-Etiology unknown, but many risk factors have been identified (trauma, sexual abuse, stress)
-Women affected more than men
-Disordered pain mechanisms in the CNS
-Characterized by chronic widespread pain affecting all four extremities; hyperalgesia; trigger or tender points
-Many associated symptoms, such as sleep disturbance/insomnia, difficulty concentrating, fatigue, irritable bowel syndrome, allodynia
-Treatment: restoring sleep patterns, participating in regular exercise, and alleviating depression
-Pregabalin used to target pain pathways
- Respiratory acidosis may be caused by
hypoventilation.
- Lack of alpha 1-antitrypsin in emphysema causes
destruction of alveolar septa and loss of elastic recoil.
- Which disorder is associated with a type III hypersensitivity mechanism of injury?
Grave Disease
- Acceleration-deceleration movements of the head often result in polar injuries in which
Focal injuries occur in two places at opposite poles.
- Which inflammatory disorders can alter endothelial cell function? (Select all that apply.)
- Lupus erythematosus
- Kawasaki syndrome
- Rheumatoid arthritis
- Polyarteritis nodosa
- The complication which is not likely to result from a compound, transverse fracture of the tibia and fibula is
avascular necrosis of the femoral head
- A malignant bone-forming tumor is referred to as a(n)
osteosarcoma
- Patients with acute pancreatitis are generally made NPO and may require continuous gastric suctioning in order to
remove the usual stimuli for pancreatic secretion.
- Proton pump inhibitors may be used in the management of peptic ulcer disease to
decrease hydrochloric acid (HCl) secretion.
- What laboratory data would support a diagnosis of hemochromatosis?
Hypokalemia
- Brain injury secondary to high serum bilirubin is called
kernicterus.
- It is true that biliary cancer
tends to be asymptomatic and progress insidiously
- Congenital adrenal hyperplasia (adrenogenital syndrome) results from
blocked cortisol production.
- A change occurring in a pregnant woman that is indicative of a potential disorder is
increased urinary protein.
- The oliguric phase of acute tubular necrosis is characterized by
fluid excess and electrolyte imbalance
- Sexual impotence is rarely due to
primary causes
- Gastrointestinal drainage, perioperative and postoperative hypotension, and hemorrhage may all contribute to renal failure by causing
reduced renal perfusion
- From the time of fertilization until the end of the eighth week, the developing organism is referred to as the
embryo
- Which condition is caused by a genetic defect?
Anemia
- The type of glomerulonephritis which is most likely to result in a swift decline in renal function that then progresses to acute kidney injury is
Crescentic glomerulonephritis
- What information about INR does the nurse understand?
- The urea-splitting bacteria ( Proteus, Klebsiella, and Pseudomonas) contribute to the formation of ________ kidney stones.
struvite
- A patient is diagnosed with a tortuous blood vessel of the right hand that bleeds spontaneously. This patient presents with
Telagiectasia
- Polymyositis leads to ( Select all that apply.)
- What is involved in the release of plasminogen activators? (Select all that apply.)
Factor XII
Kallikrein
Thrombin
- A male patient involved in a motor vehicle accident is brought to the emergency department with acute flank pain. What additional signs of bleeding may the patient exhibit? (Select all that apply.)
Hematuria
Melena
Menorrhagia
Hemoptysis
- The __________ is decreased oxygen at cellular level
Hypoxia
- Crohn disease is associated with what complications? (Select all that apply.)
perianal fissures
fistulas
abscesses
rectal pain
- Autoimmune diseases result from (Select all that apply.)
- Overactive immune function
- Failure of the immune system to differentiate self and nonself molecules
- Environmental toxin exposure
- Signs/symptoms of Lyme disease include ( Select all that apply.)
fatigue, headache, chills, fever, sore throat, stiff neck, nausea, myalgias, and arthralgias
* Fever and chills
* Migratory rash
* Arthritic pain
* Headache
* Myalgia
- Modulation of pain signals is thought to be mediated by the release of
endorphins
- Which is not considered to be a risk factor for thrombus formation?
Thrombocytopenia
- A patient is diagnosed with stage IIA Hodgkin disease. This patient’s clinical stage was most likely determined by (Select all that apply.)
- Patient history
- Lymph node biopsy
- CT scan
- Physical examination
- Two of the most serious oncology emergencies associated with non-Hodgkin lymphoma are obstruction of the superior vena cava and compression of the _________.
Spinal cord
- Which is false about Giant Cell Tumor?
TRUE:
-Also called osteoclastoma
-Aggressive but benign tumor with richly vascularized tissue consisting of plump spindle-shaped cells and numerous giant cells; painful
-Can undergo transformation to sarcomas
-Located in distal end of the femur, proximal end of the tibia, distal part of the radius, and proximal end of the humerus
- Two mechanisms can cause brain cell death and they are________________ and ______________
ischemia and necrosis
- Which is false about Psoriatic Arthritis?
TRUE:
-Inflammatory arthritis associated with psoriasis; peak age of onset 30 to 55 years
-Genetic factors; T lymphocytes and macrophages infiltrate skin and joint tissue, producing inflammatory cytokines
-Asymmetric oligoarthritis; combined soft-tissue and peripheral joint disease with enthesitis and dactylitis
-Treatment: NSAIDs, corticosteroids, emollients, keratolytic agents, light therapy, or immunosuppressive therapy
