Module 2 Integrative Body Functions

Question 1

During your pediatric ICU rotation, you are taking care of a 12-year-old boy who has significant edema secondary to nephrotic syndrome. During rounds, the attending physician asks you to explain the forces at work regulating fluid in the patient’s body. You explain that one of the forces pushing fluid out of the vasculature is:

Answer 1

Intravascular hydrostatic pressure

Intravascular hydrostatic pressure is the main force that determines fluid egress from the vasculature. It is a force generated by the pressure of fluid on the capillary walls either by the blood plasma or interstitial fluid.

Question 2

You are explaining the different types of pain to a high school class interest in health professions. You describe somatic pain as that in which:

Answer 2

Pain stimulus is easy to identify

Question 3

One of your patients has recently been diagnosed with muscular dystrophy and wants to talk about the course of his disease. He describe the conditions that follow general weakening and decreased use of muscles, including:

Answer 3

Flexor muscles are stronger than extensors, leading to contractures

Question 4

Prior to an examination block, one of your instructors meets with you to discuss the effects of stress on the body and how to prevent it from adversely affecting your life. During it, she talks about a substance that is released that leads to both vasoconstriction and vasodilation, bronchodilation, CNS stimulation, and glycogenolysis, among other things. You recall that the substance she is referring to is:

Answer 4

Epinephrine

Question 5

You are asked to see a patient who was brought in by a friend after sustaining an injury to his left lower leg in a soccer game. You look at the affected area, which is swollen and painful to the touch. You recall that this is an example of:

Answer 5

Somatic pain

Question 6

You are asked to see a patient who is complaining of an acute unilateral headache, associated with numbness, paralysis, and visual disturbance. After a full assessment, you realize this as an example of a:

Answer 6

Complicated migraine

Question 7

Ketoacidosis is an example of what metabolic state?

Answer 7

Metabolic acidosis

Question 8

You are assessing an injured finger of a patient in your urgent care clinic. As you gently press on the injured area, the patient quickly pulls the finger away. The is a demonstration of:

Answer 8

Flexor-withdrawal reflex

Question 9

After a full assessment of a patient complaining of knee pain, you explain that the patient’s condition is actually located in his hip. You explain that this is an example of:

Answer 9

Referred pain

Question 10

As part of a fund raising program, you participate in a 5K run and find yourself very thirsty at the end of the race. You realize that, given the stress of the race, multiple factors are at work controlling your fluid balance, including a substance that determines the reabsorption of sodium ions and water from the kidney tubules. That substance is:

Answer 10

Aldosterone

Aldosterone is the main mineralocorticoid hormone steroid hormone produced by the zona glomerulosa of the adrenal cortex in the adrenal gland. It is essential for sodium conservation in the kidney, salivary glands, sweat glands and colon

Question 11

A 12-year-old girl is brought to the ER by her mother. The girl is complaining of significant abdominal pain since earlier in the morning, following a few days of increased fluid intake and urinary output. Her mother reports that her child is breathing very fast and has a fruity smell to her breath. You immediately suspect diabetic ketoacidosis. While you are completing your assessment and initial intervention, you review the forces in play regarding the patient’s acid-base status. You realize that her increased respiratory rate is attempting to compensate for the primary insult by causing which one of the following?

Answer 11

Compensatory respiratory alkalosis

Question 12

You are asked to urgently assess a patient brought into the ER who has been sick for the past few days and who has just developed numbness and tingling in his hands and feet. He is on a number of medications to regulate his fluid balance, due to a past history of congestive heart failure. You are concerned that, given his current illness, his regular medications may be adversely affecting his blood electrolyte levels. You order blood work and an electrocardiogram (ECG). The ECG shows a wide, flat QRS complex and peaked, tented T-waves consistent with the diagnosis of:

Answer 12

Hyperkalemia

Question 13

Prior to an examination block, one of your instructors meets with you to discuss the effects of stress on the body and how to prevent it from adversely affecting your life. During it, she talks about a substance that is released that leads to protein catabolism, increased gastric secretions, CNS stimulation, and decreased inflammatory response, among other things. You recall the substance she was referring to was:

Answer 13

Cortisol

Question 14

One of your patients has recently been diagnosed with muscular dystrophy and wants to talk about the course of his disease. He describes the conditions that follow general weakening and decreased use of muscles, including:

Answer 14

Fibrous tissue slowly replacing weakened muscles

Question 15

You are explaining the different types of pain to a high school class interest in health professions. You describe autonomic pain as that in which:

Answer 15

Pain stimulus is difficult to identify

Question 16

After a full assessment of a patient who is complaining of back pain after a physical altercation in a local bar. You explain that the pain emanates from his kidney that sustained damage from a punch. You explain that this type of pain is an example of:

Answer 16

Visceral pain

Question 17

While you are in the ER, a 24-year-old male is brought in by paramedics, who found him unconscious with a needle lying nearby and a small amount of heroin in a bag beside his body. You realize that the overdose of the opiate heroin has depressed his respiratory drive, and this may lead to:

Answer 17

Respiratory acidosis

Question 18

Prior to an examination block, one of your instructors meets with you to discuss the effects of stress on the body and how to prevent it from adversely affecting your life. She explains that the effects of the stress response include which one of the following?
Bronchodilation
Hypotension
Bradycardia
Decreased respiratory rate
Hypoglycemia

Answer 18

Bronchodilation

Question 19

A patient with a five-day history of diarrhea presents to your clinic, dehydrated. In addition to the need to rehydrate him, you are concerned that excessive losses of bicarbonate in the stool may have lead to:

Answer 19

Metabolic acidosis

Question 20

You are asked to see a patient who is complaining of an acute unilateral headache; you diagnose as a common migraine. Your patient is a first-year medical student and asks what causes it. Your explanation includes:

Answer 20

Serotonin mediated vasoconstriction

Serotonin is a chemical necessary for communication between nerve cells. It can cause narrowing of blood vessels throughout the body. When serotonin or estrogen levels change, the result for some is a migraine. Serotonin levels may affect both sexes, while fluctuating estrogen levels affect women only

Question 21

During your pediatric ICU rotation, you are taking care of a 12-year-old boy who has significant edema secondary to nephrotic syndrome. During your rounds, the attending physician asks you to explain the forces at work that are regulating fluid in the patient’s body. You explain that his condition is associated with increased loss of protein through his kidneys. This results in a decrease in which one of the following?

Answer 21

A decrease in: Intravascular osmotic pressure

Osmotic pressure is defined as the pressure that must be applied to the solution side to stop fluid movement when a semipermeable membrane separates a solution from pure water. As the protein is lost from the PT, blood plasma becomes more dilute, decreasing osmotic pressure.

Osmotic pressure is induced by proteins, notably albumin, in a blood vessel’s plasma (blood/liquid) that displaces water molecules, thus creating a relative water molecule deficit with water molecules moving back into the circulatory system within the lower venous pressure end of capillaries

Question 22

You notice that the magnesium blood levels in a patient with renal failure whom you just admitted are abnormally high. Which one of the following clinical features might you expect to find?

Answer 22

Decreased reflexes

Question 23

A patient who has just sustained an ankle injury in a basketball game asks you how pain relievers work. You explain that aspirin (ASA), acetaminophen, and non-steroidal anti-inflammatories act by:

Answer 23

Blocking prostaglandin production

High levels of prostaglandins are produced in response to injury or infection and cause inflammation, which is associated with the symptoms of redness, swelling, pain and fever.

Question 24

A 56-year-old woman presents with a painful rash over a well-defined area of her back. She reports that she had chicken pox (varicella zoster) as a child, and you suspect this rash represents shingles (herpes zoster) and note the usefulness of dermatomes, as:

Answer 24

They indicate the area of skin supplied with afferent fibres of a single posterior root

Question 25

A 62-year-old woman is brought to your urgent care clinic by her daughter, who says her mother lost consciousness while rising from the couch after a family movie. You check the patient’s blood pressure while she is lying down, sitting, and standing and see significant decreases with each position change, suggesting the diagnosis of:

Answer 25

Orthostatic hypotension

Question 26

A patient with a five-day history of vomiting presents to your clinic, dehydrated. In addition to the need to rehydrate him, you are concerned that excessive losses of gastric acid in the stool may have led to:

Answer 26

Metabolic alkalosis

Question 27

In the ER, you see a patient complaining of muscle twitching in her hands and contractions of her fingers, which you recognize as carpopedal spasms. She just got out of the hospital, following an operation to remove her thyroid gland due to cancer. Her surgeon was concerned about the functioning of her parathyroid glands following the surgery and asked her to return if she had any concerns. You order blood work, which confirms the diagnosis of:

Answer 27

Hypocalcemia

The nervous system requires calcium to function.
The thyroid gland is responsible for the regulation of multiple minerals in the body through the release of hormones, including calcium. The thyroid will release either calcitonin or parathyroid hormone to regulate calcium serum levels.
Parathyroid hormone stimulates the release of calcium from bones into the blood stream and calcitonin lowers calcium levels in the blood by suppressing osteoclast activity.

When the calcium level is high in the bloodstream, the thyroid gland releases calcitonin. Calcitonin slows down the activity of the osteoclasts found in bone. This decreases blood calcium levels. When calcium levels decrease, this stimulates the parathyroid gland to release parathyroid hormone.

Question 28

You are asked to see a patient, who was brought in by his friend. The patient is complaining of generalized pain in his abdomen, associated with some nausea. His abdomen is not particularly tender to touch, and there is no guarding or rigidity. You recall that this type of pain is an example of:

Answer 28

Autonomic pain

Question 29

You are assessing a patient who has an upper motor neuron lesion. You bring the end of a reflex hammer along the lateral edge of the sole of the patient’s foot. His great toe dorsiflexes, and the toes fan out. This is a demonstration of:

Answer 29

Babinski reflex

Question 30

As part of a fundraising program, you participate in a 5K run and find yourself very thirsty at the end of the race. During the race, a runner collapses. You assist in his care as the paramedics rush to the scene. He tells you he has a history of congestive heart failure and he chose to walk the 5K, despite his physician’s recommendations not to. You think of the forces trying to regulate his fluid volume, including a substance released by the atrial myocardial cells controlling sodium, potassium, and water levels. That substance is:

Answer 30

Atrial natriuretic peptide