HLTH module 4 questions Flashcards
A 32-year-old man presents to the ER with a fever, malaise, weight loss, and night sweats. On examination, you identify hepatosplenomegaly and palpable lymph nodes in the axillary and supraclavicular regions. A chest X-ray reveals enlarged mediastinal lymph nodes and a biopsy of the axillary nodes reveals Reed-Sternberg cells. The most likely diagnosis in this patient is:
hodgkin’s lymphoma
In your hematology rotation, you see a patient with a clotting disorder. She is 14 years old and has had multiple episodes of bruising and bleeding in her joints following minor traumas. More recently, she has had excessive bleeding with her periods (menorrhagia). After you learn more about her past history, you are able to rule out Hemophilia A, based on:
gender
A 7-year-old male patient presents to your office with his mother. She is concerned that he is pale and more tired than usual. She reports that he is a picky eater and drinks a lot of cow’s milk. He will eat meat and potatoes but refuses almost all types of vegetables. Vital signs reveal a blood pressure of 87/55 mm Hg and a heart rate of 105 beats/min. On examination, you notice significant pallor, and palmar creases in his hands. As part of your workup, you get a complete blood count. Which one of the following findings on the CBC could help explain this patient’s condition?
microcytic anemia
You are describing basic pharmacokinetics to a student and explain that the bioavailability of a drug is determined by many factors, including the route of administration. You tell this student that the lowest drug availability is provided by a particular route of administration. Which one of the following routes of administration is it?
oral
As you prepare for your final exams, you review the varying duration of action of medications based on their application. You remember that the following administration method leads to the longest duration of action:
transdermal patch
A patient of yours presents to your office one week after getting a prescription for an antibiotic, following a diagnosis of pneumonia. He complains that his cough has gotten worse and his fever has persisted. You ask him about the medication, and he tells you he has cut down from taking it three times to just once a day, as it makes him nauseated. The most likely reason for this patient’s persisting symptoms is:
poor compliance
You have prescribed a medication that helps prevent the reuptake of a neurotransmitter in the synaptic space, thus increasing the stimulation of the distal neuron. You consider this type of drug:
agonist
Multiple opportunistic infections develop with acute leukemia primarily because:
many circulating leukocytes are immature
You are asked to see a 10-year-old patient in the ER, who is continuing to bleed from his nose after falling during a basketball game at school. You take a thorough history and perform a physical examination and are concerned that the child may have a coagulopathy. In particular, you are concerned about von Willebrand disease. This disease is a problem with which one of the following?
An abnormality in the clotting pathway
Predisposing factors to leukemia commonly include:
exposure to radiation
A patient of yours has terminal cancer and is receiving oral morphine for palliation of bone pain. Over a period of weeks, you have had to increase the dose of the morphine to get the same level of pain relief. Having to increase the dose is due to which one of the following characteristics of pharmacology?
tolerance
What are the common early signs of aplastic anemia?
Excessive bleeding and recurrent infections
Petechiae and purpura are common signs of:
increased bleeding
The spleen has a number of important functions, which include:
Hematopoiesis, destruction of old erythrocytes, blood reservoir.
A patient presents with an adverse drug reaction that is unusual and cannot be explained based on its pharmacodynamics. The dose, frequency, and patient characteristics are all appropriate. You classify this reaction as which one of the following?
Idiosyncratic
What is the cause of sickle cell anemia?
a defective gene inherited from both parents
Dry mouth and drowsiness after the administration of an antihistamine is considered to be:
side effect
Which of the following substances acts as an anticoagulant?
heparin
While on your ICU rotation, the team you are working with is called to the bedside of a 46-year-old man with overwhelming sepsis. He is on many medications to control the infection and his blood pressure, but the most recent concern is that he has begun to bleed excessively. All his clotting tests are abnormal. The most likely diagnosis for this man’s condition is:
Disseminated intravascular coagulation (DIC)
You are asked to see a 10-year-old patient in the ER, who presents with a purpuric rash on his lower extremities and part of his abdomen. After you do a careful history and physical examination, you order blood work. The blood work suggests he may have idiopathic thrombocytopenic purpura, a condition characterized by:
Decreased number of platelets
What term is used to describe a deficit of all types of blood cells?
Pancytopenia
A general term for the inflammation or infection of the lymph nodes is:
Lymphadenopathy
What is the reaction called when two drugs interact to produce a result much greater than the sum of individual effects?
Synergism
You are giving a talk on anemia to a high school class. After you describe the basic types, you give them case-based quizzes to test their understanding of the information presented. The first case you describe is one that includes a pancytopenia, in which all blood cell lines are abnormally low. The type of anemia this represents is
Aplastic anemia
A 75-year-old male patient presents to your office, with his daughter. She insisted that he come in, as he has had a series of falls over the past six months. He has also complained of generalized weakness, malaise, light-headedness, and tingling in his extremities. His daughter is concerned about his memory, as he has been more forgetful than usual. Vital signs reveal a blood pressure of 97/56 mm Hg and a heart rate of 105 beats/min. On examination, you notice a thick, beefy tongue, general pallor, and decreased vibratory sensation in his lower extremities. As part of your workup, you get a complete blood count. Which one of the following findings on the CBC could help explain his condition?
Megaloblastic anemia
You are describing basic pharmacokinetics to a student and explain that the bioavailability of a drug is determined by many factors, including the route of administration. You tell him that the highest drug availability is provided by a certain route of administration. Of the following, which one is it?
intravenous
During your neonatology rotation, you assess a newborn who has birth defects attributed to the medication his mother was taking during critical portions of the pregnancy. You would classify this condition as which one of the following?
Teratogenic
A 65-year-old man presents, with his wife, to your office. She has encouraged him to come in because of his fatigue and unplanned weight loss. On physical examination, you identify painless lymphadenopathy and hepatosplenomegaly. Blood work reveals lymphocytosis. You arrange for a bone marrow biopsy, which shows an increased number of lymphocytes. The most likely diagnosis for this patient is:
Chronic lymphocytic leukemia
A patient of yours presents to your office one week after getting a prescription for an antibiotic, following a diagnosis of pneumonia. He complains that his cough has gotten worse and his fever has persisted. You ask him about the medication, and he tells you he has cut down from taking it three times to just once a day, as it makes him nauseated. You realize that the frequency of a medication is an important part of maintaining adequate blood levels. This is based on and determined by which one of the following?
the drug half life
As you prepare for your final exams, you review the varying duration of action of medications based on their application. You remember that the following administration method leads to the shortest duration of action:
intravenous
After they are metabolized, most drugs are excreted through the:
kidneys
The atypical cell that serves as a marker for diagnosing Hodgkin’s lymphoma is the:
Reed-Sternberg cell.
You have prescribed a medication that blocks the receptor cells on distal neurons, thus decreasing their stimulation. You consider this type of drug to be:
Antagonist
Individuals with type O blood are considered to be universal donors because their blood:
lacks A and B antigens
You have just diagnosed one of your patients with chronic lymphocytic leukemia. After the initial shock, she has many questions about her blood work. She wants to start with the basics and to know what the hematocrit measures. You tell her it represents:
the proportion of cells in the blood
Vitamin K is required by the liver to synthesize:
prothrombin
During a talk to high school students about hematology, one student asks what hemoptysis means. Which one of the following should be included in your explanation?
coughing up blood
In your hematology rotation, you see a patient with a clotting disorder. He is an 8-year-old boy who smiles when he tells you that he is special because he has Christmas disease. You smile back, and recall that this condition, also called Hemophilia B, results from the deficiency of which one of the following?
factor IX
During a talk to high school students about hematology, one student asks what ecchymosis means. Which one of the following should be included in your explanation?
large areas of bruising
In the ER, you are asked to see a 7-year-old boy who has a history of frequent infections. He presents this time with a high fever, but no obvious source is determined by the history or physical examination. You order blood work that reveals decreased levels of red blood cells, white blood cells, and platelets. A peripheral smear identifies multiple large lymphoblasts. The most likely diagnosis is:
acute lymphatic leukaemia
During anesthesia for a surgical procedure, a patient’s blood pressure drops. The anesthesiologist gives the patient an intravenous dose of an indirect-acting pressor, which brings the blood pressure back to normal. Forty-five minutes later, the patient’s blood pressure drops again, and the same dose of the pressor is repeated. This time, however, the patient’s blood pressure does not increase as much as it did previously. This is due to which one of the following characteristics of pharmacology?
Tachyphylaxis
You are giving a talk on anemia to a high school class. After you describe the basic types, you give them case-based quizzes to test their understanding of the information presented. The second case you describe is one that includes a microcytic, hypochromic red blood cells. The type of anemia this represents is:
iron deficiency anemia
You are reviewing a karyotype of a 38-year-old female patient of yours who presented with increasing fatigue, weight loss, and night sweats. On examination, her spleen was enlarged, and blood tests revealed an elevated white blood cell count. The peripheral smear identified granulocytes in multiple stages of differentiation. The karyotype you are reviewing shows the presence of the Philadelphia chromosome, (9,22)(q34;q11). The most likely diagnosis for this patient is:
chronic myelocytic leukemia
What are the typical early general signs and symptoms of anemia?
pallor, dyspnea, and fatigue
A 62-year-old man comes into your clinic, concerned that he no longer has the energy he needs to exercise regularly. He is increasingly tired and has developed muscle and joints aches. Recently, his back has been particularly painful. When questioned, he confirms that he has been constipated for some time and is urinating more frequently than usual. After a complete history and physical examination, you obtain blood work, which reveals that the levels of red blood cells, hemoglobin, and hematocrit are all slightly below normal and that his calcium is elevated. Urinalysis reveals slight proteinuria. Which one of the following is the most likely diagnosis?
multiple myeloma
A patient presents with a medical condition that was caused by a medication he is taking for a separate medical condition. You would classify this reaction as which of the following?
iatrogenic
One of the reasons non-Hodgkin’s lymphomas are harder to treat than Hodgkin’s lymphomas
is that they:
involve multiple nodes and widespread metastases
Multiple myeloma is a neoplastic disease of unknown etiology occurring in older adults and
involving:
plasma cells
Elephantiasis, caused by the obstruction of lymphatic vessels by parasitic worms, is an
example of the condition known as:
lymphedema
A rare illness that involves the overgrowth of lymphoid tissue, although not itself considered a
cancer is:
castleman’s disease
Non-Hodgkin’s lymphomas are increasing in incidence, partly due to the numbers associated
with:
an increase in HIV infections
The function of the hormones secreted by the thymus gland is to:
enable lymphocytes to develop into mature T cells
Malignant neoplasms involving lymphocyte proliferation in the lymph nodes are called:
lymphomas
The staging system typically used in determining the stage of the Hodgkin’s lymphoma is the:
ann arbor system
Which of the following would result from a reduced number of erythrocytes in the blood?
decreased hematocrit
Chronic blood loss causes anemia because of the:
smaller amounts of recycled iron available
Which of the following best describes the characteristic erythrocyte associated with pernicious
anemia?
Megaloblastic or macrocytic nucleated cells
hat causes numbness and tingling in the fingers of individuals with untreated pernicious anemia?
Vitamin B12 deficit causing peripheral nerve demyelination
Jaundice is one typical sign of:
sickle cell anemia
What is the cause of oral ulcerations and delayed healing occurring with any severe anemia?
Deficit of oxygen for epithelial cell mitosis and metabolism
Which of the following is present with pernicious anemia?
Hypochlorhydria
Why is pernicious anemia treated with injections of vitamin B12?
The ingested vitamin would not be absorbed into the blood.
Why do abnormally low hemoglobin values develop with pernicious anemia?
shorter lifespan of RBCs
Why do vascular occlusions and infarcts occur frequently with sickle cell anemia?
Erythrocytes change to sickle shape when hypoxia occurs.
Which of the following applies to sickle cell trait?
Sickling of erythrocytes occurs with severe hypoxia.
What is the basic abnormality in thalassemia?
There is failure to synthesize either the alpha or beta chains in the hemoglobin molecule.
Which of the following can result from a malabsorption problem?
Pernicious anemia
In individuals with pernicious anemia, antibodies form to:
intrinsic factor or parietal cells
In cases of polycythemia vera, blood pressure is elevated as a result of:
increased BV
Which statement applies to the disorder hemophilia A?
Hematomas and hemarthroses are common.
Which of the following occurs when disseminated intravascular coagulation develops?
Multiple thrombi and deficit of clotting factors
In individuals with acute leukemia, the increased number of malignant leukocytes leads to:
- decreased hemoglobin.
- thrombocytopenia.
- splenomegaly.
Why is excessive bleeding a common occurrence with acute leukemia?
decreased platelets
Von Willebrand disease is caused by:
absence of a clotting factor that helps platelets clump and stick.
Thrombophilia can result in conditions such as:
peripheral vascular disease
Multiple myeloma is a malignant tumor involving:
plasma cells
What is the primary treatment for the leukemias?
chemo
Which of the following statements applies to hemochromatosis. It is:
a metabolic error that leads to excess amounts of hemosiderin, causing damage to organs.
Thalassemia is caused by
a defect in one or more genes for hemoglobin.
Secondary polycythemia may be associated with:
severe chronic bronchitis
All of the following apply to vitamin K EXCEPT:
it is used as an antidote for warfarin (Coumadin).
Leukemia is sometimes linked to chromosome abnormalities, as evidenced by
the presence of Philadelphia chromosome translocation in cases of acute myelogenous leukemia (AML).
. Iron deficiency anemia frequently results from any of the following EXCEPT:
diabetes
Which of the following applies to the leukemias?
chronic leukemias are more common in older people
A high percentage of blast cells in the leukocyte population indicates a poor prognosis for an
individual with
acute myelogenous leukemia (AML).
Which of the following applies to erythropoietin?
it stimulates the production of RBCs
Which of the following diagnostic tests would be within the normal range for an individual with
hemophilia A?
bleeding time
Which of the following applies to the condition disseminated intravascular coagulation (DIC)?
it is usually a secondary condition
In which blood dyscrasia does pancytopenia develop?
aplastic anemia
Which of the following applies to the etiology of aplastic anemia? It is:
idiopathic and predisposed by exposure to mycotoxins.
Documenting drug-induced responses of physiologic and biochemical systems is part of
pharmacodynamics
The study of the body’s response to drugs, harmful effects, mechanisms of actions, symptoms,
treatment, and identification is the role of
pharmacotherapeutics
