Patho EXAM Flashcards
A patient has bitemporal hemianopsia where the left eye cannot see the left hemifield and the right eye cannot see the right hemifield. Where is the lesion located?
optic chiasm
A patient has lost crude touch perception of the foot. Where is the lesion most likely located?
spinothalamic pathway
Which of the following symptoms would you expect to see in a patient who suffered a stroke of the motor cortex 3 months ago?
A. fibrillations B. bradykinesia C. Resting tremor D. spacticity E. intension tremor
D. sapcticity
raitionale:
spacticity {!motor cortex damage!}
intension tremor {!cerebellar disease!}
fibrillations {!denervation of skeletal muscle!}
bradykinesia {!Parkinson's disease!}
resting tremor {!Parkinson's disease!}
What does a diagnosis of visual agnosia mean?
inability to interpret what you see {!Intact primary visual cortex allows patient to see object but damaged association visual cortex cannot identify object.!}
A patient constantly faints as he rises quickly out of bed. Which system is most likely affected?
A. sensory system B. motor system C. limbic system D. reticular activating system E. autonomic nervous system
E. autonomic nervous system
- The patient has orthostatic hypotension as he rises because the autonomic nervous system doesn’t properly increase blood pressure to perfuse the brain.
How are dermatomes used clinically?
can be used to identify site of dorsal root damage
- Dermatomes are a map of the body areas sending sensory fibers through the dorsal roots.
How do antidepressants work?
they prevent removal of neurotransmitter in synaptic cleft in order to compensate for biogenic amine deficit
A patient has partial loss of proprioception and touch sensation in the lower left leg but the stretch reflex (also called deep tendon reflex) and muscle strength are functional. Which one of the following sites is the most likely location of the partial lesion?
A. right somatosensory cortex B. right lower motoneurons C. left dorsal root D. right dorsal root E. left somatosensory cortex
A. right somatosensory cortex
- this would affect left side sensory!
patient has lost sensation in his right foot. What is the most direct cause of his symptom?
an abnormal decrease in neuron activity
-This would reduce sensory transmission for perception. The decreased neuron activity could be secondary to compression from edema, poor blood circulation, or other factors.
A patient’s major problem is that he can not properly repeat spoken words. His speech is fluid and he understands spoken words very well. Which cortical area is most likely damaged?
conduction pathway between Wernicke’s area and Broca’s area
A patient has difficulty finding his way home after leaving for a walk even though he has lived in the same area for 30 years. Which cortical area is most likely damaged?
right parietal cortex
- Contains a spatial map of body in relation to surroundings!
A patient has problems with memory consolidation. What does this mean?
he can not convert short-term memory into long-term memory
A patient treated with neuroleptics for schizophrenia could develop what secondary symptoms?
symptoms of Parkinson’s disease
- Neuroleptics include dopamine receptor antagonists which can reduce dopamine effects to the point of causing symptoms of Parkinson’s disease
Which finding regarding symptoms is consistent with dementia?
A. Abrupt onset
B. Worsening at night
C. Progressive deterioration
D. Disturbed consciousness
C. Progressive deterioration
Which is the principal neurotransmitter involved in Parkinson disease?
dopamine
Which is a risk factor for cerebral palsy?
prenatal infection
An infant is born with a protrusion of a saclike structure in the lower portion of his back. What best describes this condition?
Spina bifida cystic
- Spina bifida cystica is the condition in which there is an external protrusion of the saclike structure.
Which statement is true regarding amyotrophic lateral sclerosis?
A. Early symptoms include speech abnormalities and respiratory failure.
B. Most patients lose their sensory and cognitive functions.
C. Most patients die within 1 year from cardiac failure.
D. The hands or upper extremities are affected first.
D. The hands or upper extremities are affected first.
- The earliest symptoms include muscle twitching, cramping, and stiffness. The hands or upper extremities are affected first. The weakness is progressive and eventually affects the muscles that control speech, swallowing, and breathing. These symptoms occur later in the progression of this disease. Despite the marked physical disability, most patients maintain their sensory and cognitive functions. Most people die from respiratory failure within 3 to 5 years from the onset of symptoms.
Which finding is consistent with Guillain-Barré syndrome?
A. There is progressive descending paralysis.
B. The symptoms usually begin in the arms and face.
C. Sensory nerves are affected more than motor nerves.
D. Patients often experience paresthesia or dysesthesia.
D. Patients often experience paresthesia or dysesthesia.
Characteristics of a petit mal seizure include which of the following?
A. Rigid muscles B. Tongue biting C. Bladder incontinence D. Cessation of speaking E. Brief periods of staring
D. Cessation of speaking
E. Brief periods of staring
Which is a pathophysiologic change that is consistent with Alzheimer disease?
A. Amyloid plaques B. Epileptogenic focus C. Focal cerebral infarct D. Neurofibrillary tangles E. Abnormal serotonin system
A. Amyloid plaques
D. Neurofibrillary tangles
What are the early signs of Parkinson disease?
A. Drooling B. Small writing C. Monotone speech D. Minimal blinking E. Loss of facial expression
D. Minimal blinking
E. Loss of facial expression
Which statement is true regarding multiple sclerosis (MS)?
A. Genetics may play a role in MS.
B. The triggering process for MS is not completely understood.
C. The main pathophysiology is demyelination of the nerves.
D. MS is believed to be a result of a bacterial infection.
E. MS follows a predictable clinical course.
A. Genetics may play a role in MS.
B. The triggering process for MS is not completely understood.
C. The main pathophysiology is demyelination of the nerves.
A patient with a spinal cord injury at T4 diagnosed with autonomic dysreflexia is likely to develop which of the following?
A. Sudden hypertension B. Upper body flushing C. Tachycardia D. Diaphoresis E. Headache
A. Sudden hypertension
B. Upper body flushing
D. Diaphoresis
E. Headache
***Autonomic dysreflexia is characterized by a sudden episode of bradycardia, not tachycardia
Which is an approved treatment for children with thalassemia?
Blood transfusion
Which statement(s) are true regarding plasma proteins?
A. There are three types of plasma proteins.
B. Plasma protein β fraction transports iron.
C. These proteins are formed in the kidneys.
D. Plasma proteins function as regulatory factors.
E. Plasma proteins are responsible regulating blood pressure.
A. There are three types of plasma proteins.
B. Plasma protein β fraction transports iron.
D. Plasma proteins function as regulatory factors.
E. Plasma proteins are responsible regulating blood pressure.
- plasma proteins are formed in the liver
Which statement(s) are true regarding hemoglobin? (Select all that apply.)
A. Oxyhemoglobin is hemoglobin-carrying oxygen.
B. There are 100 hemoglobin molecules per red blood cell.
C. Hemoglobin makes up 90% of dry weight of the red cell.
D. Hemoglobin is composed of two pairs of polypeptide chains.
E. Polypeptide chains contain iron that makes up a heme molecule.
A. Oxyhemoglobin is hemoglobin-carrying oxygen.
C. Hemoglobin makes up 90% of dry weight of the red cell.
D. Hemoglobin is composed of two pairs of polypeptide chains.
E. Polypeptide chains contain iron that makes up a heme molecule.
- there are 300 hemoglobin molecules per RBC
What causes a shift of the oxyhemoglobin curve to the left? (Select all that apply.)
A. Increased pH B. Chronic disease C. Decreased H+ ions D. Decreased temperature E. Increased in 2,3-DPG
A. Increased pH
C. Decreased H+ ions
D. Decreased temperature
- The shift of the oxyhemoglobin curve to the right enhances oxygen release to the cell. The shift provides the increase in oxygen delivery that is needed during stress, chronic disease, and exercise. The shift of the curve to the left occurs with a decrease in 2,3-DPG, in some congenital hemoglobinopathies, and with carboxyhemoglobin.
Which statement(s) are true regarding aplastic anemia? (Select all that apply.)
A. It is caused by viral infections.
B. It is characterized by pancytopenia.
C. It can be either acquired or familiar in nature.
D. It is a result of radiant damage to bone marrow stem cells.
E. It is characterized by overproduction of hematopoietic tissue.
A. It is caused by viral infections.
B. It is characterized by pancytopenia.
C. It can be either acquired or familiar in nature.
D. It is a result of radiant damage to bone marrow stem cells.
Which form(s) of anemia will present with macrocytes?
folate deficiency
B12
Hemoglobin desaturates in which states? (Select all that apply.)
A. High PCO2 (hypercapnia) B. Low PCO2 (hypocapnia) C. High pH (alkalosis) D. Low pH (acidosis) E. Dehydration
A. High PCO2 (hypercapnia)
D. Low pH (acidosis)
Signs and symptoms of aplastic anemia include which of the following? (Select all that apply.)
A. Fever B. Pallor C. Dyspnea D. Petechiae E. Bradycardia
A. Fever
B. Pallor
C. Dyspnea
D. Petechiae
A skin assessment of the legs of a client diagnosed with chronic venous insufficiency would show which of the following? (Select all that apply.)
A. Reddish pigmented areas
B. Reports of legs “cramping”
C. Edema increasing as the day progresses
D. An ulcer on the ankle of the affected leg
E. Pain that decreases when legs are in the dependent position
A. Reddish pigmented areas
B. Reports of legs “cramping”
C. Edema increasing as the day progresses
D. An ulcer on the ankle of the affected leg
A client was admitted with iron deficiency anemia and blood-streaked emesis. Which question is most appropriate for the nurse to ask in determining the extent of the client’s activity intolerance?
“What activities were you able to do 6 months ago compared with the present?”
A client calls the nurse with a complaint of sudden deep throbbing leg pain. What is the appropriate FIRST action by the nurse?
The symptom suggests deep vein thrombosis. The client must be maintained on bed rest and the physician notified immediately.
A nurse caring for a client with acute disseminated intravascular coagulation (DIC) should monitor the client for which of the following clinical manifestations?
Dizziness
Oliguria
Bleeding from the nose and mouth
The nurse is caring for a client with a deep vein thrombosis. Which of the following symptoms would require the nurse’s IMMEDIATE attention?
Respiratory rate of 32
Temperature of 102 degrees Fahrenheit
Pulse rate of 98 beats per minute
Blood pressure of 90/50
Respiratory rate of 32
-Respiratory rate of 32 deserved an urgent attention. Clients with deep vein thrombosis are at risk for the development of pulmonary embolism. The most common symptoms are tachypnea, dyspnea, and chest pain.
The purpose of the upper respiratory system is which of the following? (Select all that apply.) Filtering of inspired gas Warming of inspired gas Exchange of inspired gas Humidification of inspired gas Conduction of air toward the alveoli
Filtering of inspired gas
Warming of inspired gas
Humidification of inspired gas
Conduction of air toward the alveoli
Which condition presents a problem with lung diffusion?
pneumonia
pulmonary edema
interstitial lung disease
The characteristics of bronchiolitis include
- thick, tenacious mucus
- wheezing
- crackles
- ear pain
Clinical Manifestations of epiglottitis
Assumes “sniffing dog” position
Throat is “cherry red”
Reports dysphagia
Sounds hoarse
Which restrictive disease is associated with the formation of an antigen-antibody complex, causing fibrosis of the lung?
Hypersensitivity pneumonitis
Tubercular bacilli are transmitted by contract with infected
airborne droplets.
Pulmonary function testing for restrictive diseases reveals which to be decreased?
Vital capacity
Total lung capacity
Residual volume
Which statement is true concerning incontinence? (Select all that apply.)
A. Functional incontinence is often the result of environmental limitations.
B. Stress incontinence is caused by increased intra-abdominal pressure.
C. Urge incontinence is a result of involuntary detrusor contractions.
D. Stress incontinence is affected by muscle laxity.
E. Urge incontinence a normal part of aging.
A. Functional incontinence is often the result of environmental limitations.
B. Stress incontinence is caused by increased intra-abdominal pressure.
C. Urge incontinence is a result of involuntary detrusor contractions.
D. Stress incontinence is affected by muscle laxity.
Which procedure is commonly used in the treatment of muscle-invasive malignant bladder tumors? (Select all that apply.) A. Cystectomy B. Endoscopy C. Nephrectomy D. Radiation therapy E. Transurethral resection
A. Cystectomy
D. Radiation therapy
Aging adults are more prone to dehydration as a result of lack of thirst triggers resulting from
increased osmolality of extracellular fluid.
Normally, the highest amount of daily fluid loss occurs via the
urinary tract
The main cause of extracellular fluid volume deficit is
a decrease in saline in the same concentration as the normal extracellular fluid or third spacing.
The hormone ADH (antidiuretic hormone) release is stimulated by which of the following? (Select all that apply.)
Fever
Pain
Anxiety
Hypovolemia
Hyper-osmolality of the extracellular fluid
Pain
Anxiety
Hypovolemia
Hyper-osmolality of the extracellular fluid
Which statements are true regarding serum potassium (K+) levels? (Select all that apply.)
A. Hypokalemia is capable of causing elevated diastolic pressure.
B. Hyperkalemia can result in weakness in the lower extremities.
C. Hyperkalemia can be characterized by intestinal cramping.
D. Hypokalemia can often cause muscle weakness.
E. Hypokalemia can result in a paralytic ileus.
B. Hyperkalemia can result in weakness in the lower extremities.
C. Hyperkalemia can be characterized by intestinal cramping.
D. Hypokalemia can often cause muscle weakness.
E. Hypokalemia can result in a paralytic ileus.
Clinical manifestations of hypocalcemia include which of the following? (Select all that apply.)
Positive Trousseau sign Positive Chvostek sign Hyperactive reflexes Muscle twitching Constipation Paresthesias
Positive Trousseau sign Positive Chvostek sign Hyperactive reflexes Muscle twitching Paresthesias
Which statement regarding serum magnesium (Mg++) is true? (Select all that apply.)
A. Alcohol-related diseases frequently cause low Mg+ levels.
B. Vomiting is not generally seen as a major cause of Mg+ loss.
C. Mg++ levels present similarly to calcium (Ca++) levels in the blood.
D. Mg+ deficiencies often result in low serum potassium (K+) levels.
E. Mg+ deficiencies must be treated before potassium (K+) deficiencies.
A. Alcohol-related diseases frequently cause low Mg+ levels.
C. Mg++ levels present similarly to calcium (Ca++) levels in the blood.
D. Mg+ deficiencies often result in low serum potassium (K+) levels.
E. Mg+ deficiencies must be treated before potassium (K+) deficiencies.
The kidneys excrete acids that include
Lactic
Metabolic
Phosphoric
Hydrochloric
Which statement regarding age related changes to acid-base homeostasis is true of the older adult? (Select all that apply.)
A. Chronic laxative overuse may contribute to metabolic acidosis. =
B. Ability to correct respiratory acidosis is delayed in the older adult.
C. Older adults are at increased risk of respiratory acidosis from barbiturate use.
D. Older adults experience an increased risk for metabolic acidosis from acid accumulation.
E. Ammonia production is decreased by normal aging and often results in metabolic acidosis.
A. Chronic laxative overuse may contribute to metabolic acidosis.
B. Ability to correct respiratory acidosis is delayed in the older adult.
C. Older adults are at increased risk of respiratory acidosis from barbiturate use.
D. Older adults experience an increased risk for metabolic acidosis from acid accumulation.
What are the main causes of edema?
When the adjacent lymphatic system develops an impaired lymphatic flow or when the capillaries themselves become more permeable and “leak” fluid into the cell
Contraction of vascular smooth muscle (referred to as vasomotor tone) is mostly accomplished via the extrinsic mechanism of the autonomic nervous system, resulting in which receptor response?
α-1
What is the specific terminology to describe the formation of a blood clot in a vein?
Thrombophlebitis
Thrombosis in the microcirculation throughout the body is called
disseminated intravascular coagulation (DIC).
What are the upper acceptable values for cholesterol within the blood?
Total cholesterol level of 200 mg/dL, HDL of 40 mg/dL, and LDL of 160 mg/dL
An accurate comparison of arterial and venal vessels would include which of the following? (Select all that apply.)
A. Vein walls are thinner than those of arteries.
B. Veins have two distinct layers, while arteries have three.
C. Venules are composed primarily of connective tissue.
D. The principle tissue found in arterioles is smooth muscle.
E. With increasing age, the intimal arterial wall loses elasticity.
A. Vein walls are thinner than those of arteries.
C. Venules are composed primarily of connective tissue.
D. The principle tissue found in arterioles is smooth muscle.
E. With increasing age, the intimal arterial wall loses elasticity.
- veins and arteries have 3 layers
Which statement(s) are true regarding circulatory hemodynamics? (Select all that apply.)
A. As blood flow increases, resistance decreases.
B. Resistance decreases as the radius of a vessel increases.
C. Decreased viscosity of the blood increases resistance.
D. Decreased systemic peripheral vascular resistance causes distributive shock.
E. As the pressure difference in the vessels increases, the blood flow increases.
A. As blood flow increases, resistance decreases.
B. Resistance decreases as the radius of a vessel increases.
E. As the pressure difference in the vessels increases, the blood flow increases.
Which clinical manifestation is characteristic of arterial thrombosis? (Select all that apply.)
A. Pain is increased with activity in the affected limb.
B. A positive Homans’ sign is seen in 10% of patients.
C. The limb is usually cool to the touch and cyanotic.
D. A late sign is an ulcer around the toe. Correct
Intermittent claudication and pain.
A. Pain is increased with activity in the affected limb.
C. The limb is usually cool to the touch and cyanotic.
D. A late sign is an ulcer around the toe. Correct
Intermittent claudication and pain.
A contributing factor to the formation of an embolus includes which of the following? (Select all that apply.)
A. A chronic blood disorder like anemia B. Dislodged fat after long-bone surgery C. Air bolus introduced by IV therapy D. Foreign object in the blood stream E. An infected blood vessel
B. Dislodged fat after long-bone surgery
C. Air bolus introduced by IV therapy
D. Foreign object in the blood stream
E. An infected blood vessel
Which condition can produce signs and symptoms of a stroke? (Select all that apply.)
A. Varicose veins B. Atherosclerosis C. Cerebral aneurysm D. Cerebral AV fistula E. Chronic venous insufficiency
B. Atherosclerosis
C. Cerebral aneurysm
D. Cerebral AV fistula
A true statement regarding atherosclerosis is which of the following? (Select all that apply.)
A. Atherosclerosis obliterans occurs when the peripheral system of upper extremities are affected.
B. Atherosclerosis usually affects the coronary, cerebral, carotid, femoral arteries and the aorta.
C. Atherosclerosis obliterans is used to describe atherosclerosis; the terms are interchangeable.
D. Atherosclerosis is a result of medium and large arteries being occluded.
E. Atherosclerosis is the dominant type of arteriosclerosis.
B. Atherosclerosis usually affects the coronary, cerebral, carotid, femoral arteries and the aorta.
D. Atherosclerosis is a result of medium and large arteries being occluded.
E. Atherosclerosis is the dominant type of arteriosclerosis.
A skin assessment of the legs of a client diagnosed with chronic venous insufficiency would show which of the following? (Select all that apply.)
A. Reddish pigmented areas
B. Reports of legs “cramping”
C. Edema increasing as the day progresses
D. An ulcer on the ankle of the affected leg
E. Pain that decreases when legs are in the dependent position
A. Reddish pigmented areas
B. Reports of legs “cramping”
C. Edema increasing as the day progresses
D. An ulcer on the ankle of the affected leg
Which structures are located within the larynx?
- cartilage
- epiglottis
- vocal cords
Which condition presents a problem with lung diffusion?
Pneumonia
Pulmonary edema
Interstitial lung disease
Which is a characteristic of intrinsic (non-allergic) asthma?
Attacks are often severe.
Destruction of bronchial walls from dilation of airway sacs is a result of
bronchiectasis
bronchiectasis is common in
cystic fibrosis
what are the major obstructive airway diseases?
Asthma
Bronchitis
Emphysema
Bronchiectasis
Which medication may be required for status asthmaticus?
Epinephrine
Terbutaline (Brethine)
Aminophylline (Phyllocontin)
Acute bronchitis can be caused by which of the following? (Select all that apply.)
Influenza A Adenovirus Coxsackie virus Pseudomonas aeruginosa Streptococcus pneumoniae
Influenza A
Adenovirus
Coxsackie virus
Streptococcus pneumoniae
Which pathogenetic change is associated with acute bronchitis?
Swelling from exudation of fluid
Loss of ciliary function
Inflamed airways
Tachycardia, decreased or absent breath sounds on the affected side, hyperresonance, and sudden chest pain on the affected side are clinical manifestations of
pneumothorax.
Pulmonary function testing for restrictive diseases reveals which of the following to be decreased?
Vital capacity
Total lung capacity
Residual volume
The pathogenesis of adult respiratory distress syndrome (ARDS) involves which of the following? (Select all that apply.)
Injury to the alveolar-capillary membrane
Increased alveolar-capillary permeability
Decreased lung compliance
Injury to the alveolar-capillary membrane
Increased alveolar-capillary permeability
Decreased lung compliance
Abnormal fluid accumulations in the pleural space affect the lung function by causing which of the following?
Dyspnea
Dry cough
Pleuritic pain
Localized diminished breath sounds
The pathogenesis of pneumonia includes the inhalation of microbial agents and the resulting of which of the following? (Select all that apply.)
Inflammation
Lung consolidation
Formation of exudates
Inflammation
Lung consolidation
Formation of exudates
The pathogenesis of tuberculosis includes the entrance of mycobacteria into the lungs and the resulting of which of the following? (Select all that apply.)
Calcification Ghon tubercles Formation of granulomas Activation of macrophages Antigen-antibody complexes
Calcification
Ghon tubercles
Formation of granulomas
Activation of macrophages
Clinical manifestations of extracellular fluid volume excess include which of the following?
Edema Crackles Weight gain Bounding pulse Distended neck veins
How do the kidneys work to neutralize metabolic acidosis or alkalosis?
If metabolic alkalosis exists, the kidneys slow their acid excretion.
