Patho midterm review Flashcards
Pernicious anemia is caused by a lack of
intrinsic factor.
Treatment for hemophilia A includes
factor VIII replacement.
A patient diagnosed with chronic compensated heart failure reports that, “My feet swell if I eat salt but I don’t understand why” The nurse’s best response is
“Salt holds water in your blood and makes more pressure against your blood vessels, so fluid leaks out into your tissues and makes them swell.”
To best prevent emphysema, a patient is instructed to stop smoking since cigarette smoke
impairs α1-antitrypsin, allowing elastase to predominate.
Pneumocystitis is a term that refers to a
fungal pneumonia secondary to HIV.
New-organ damage is a function of both the stage of hypertension and its duration.
False
Which change in a patient’s assessment has the greatest urgency?
Serum potassium concentration is increasing; has developed cardiac dysrhythmias, but denies any difficulty breathing
Improvement in a patient with septic shock is indicated by an increase in
systemic vascular resistance.
A 5-year-old patient’s parents report loss of appetite and fatigue in their child. The parents also state that the child refuses to walk as a result of pain. The child’s most likely diagnosis is
ALL (acute lymphoid leukemia)
Mitral stenosis is associated with
a pressure gradient across the mitral valve.
In individuals who have asthma, exposure to an allergen to which they are sensitized leads to which pathophysiologic event?
Inflammation, mucosal edema, and bronchoconstriction
An increase in organ size and function caused by increased workload is termed
hypertrophy.
A person who experiences a panic attack and develops hyperventilation symptoms may experience
numbness and tingling in the extremities.
All these cellular responses are potentially reversible except
necrosis.
COPD leads to a barrel chest, because it causes
air trapping.
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.
A major cause of treatment failure in tuberculosis is
noncompliance
Selye’s three phases of the stress response include all the following except
allostasis.
Clinical manifestations of chronic arterial obstruction include
intermittent claudication.
The finding of ketones in the blood suggests that a person may have
metabolic acidosis.
The principle Ig mediator of type I hypersensitivity reactions is
IgE
Dramatic hypotension sometimes accompanies type I hypersensitivity reactions, because
massive histamine release from mast cells leads to vasodilation.
What is the most likely explanation for a diagnosis of hypernatremia in an elderly patient receiving tube feeding?
Inadequate water intake
Disseminated intravascular coagulation may be treated with heparin therapy to
inhibit clotting factor consumption.
Which pulmonary function test result is consistent with a diagnosis of asthma?
Reduced forced expiratory volume in 1 second (FEV1)
Blood flow is slow through capillaries because capillaries
have the largest total cross-sectional area.
The arterial oxygen content (CaO2) for a patient with PaO2 100 mm Hg, SaO2 95%, and hemoglobin 15 g/dL is _____ mL oxygen/dL.
19.4
After surgery to remove a lung tumor, your patient is scheduled for chemotherapy, which will
kill rapidly dividing cells.
Which disorder is associated with a type III hypersensitivity mechanism of injury?
Systemic lupus erythematosus
Extreme cold injures cells by all the following except
decreased blood viscosity.
The goal of long term heparin for the management of a deep vein thrombosis is to
prevent further clot formation.
Which is not considered to be a risk factor for thrombus formation?
Thrombocytopenia
High blood pressure increases the workload of the left ventricle, because it increases
afterload.
Lactated Ringer solution and normal saline are commonly used crystalloid solutions that contain electrolytes.
True
A patient is diagnosed with cardiogenic shock. The patient is hyperventilating and is therefore at risk for the respiratory complication of respiratory acidosis.
False
The majority of cases of anaphylactic shock occur when a sensitized individual comes in contact with
antibiotics.
A major risk factor for the development of active pulmonary tuberculosis (TB) disease is
immunosuppression.
Which condition enhances lymphatic flow?
Increased interstitial fluid colloid osmotic pressure
Two primary acid-base disorders that are present independently are referred to as
mixed acid-base imbalance.
What is the effect on resistance if the radius of a vessel is halved?
Resistance increases by a factor of 16.
A 58-year-old woman is seen in the clinic for reports of severe back pain. Her chest x-ray demonstrates generalized bone demineralization and compression fracture. Blood studies demonstrate elevated calcium levels. The most likely diagnosis is
myeloma.
The only known curative treatment for CML is allogeneic bone marrow transplantation from a suitable donor.
True
An example of an acyanotic heart defect is
ventricular septal defect.
Coagulative necrosis is caused by
interrupted blood supply.
Which acid are the kidneys unable to excrete?
Carbonic
The most definitive diagnostic method for active tuberculosis is acquired via
sputum culture.
Patients with immunodeficiency disorders are usually first identified because they
develop recurrent infections.
A patient presenting with fever, hypotension, and lactic acidosis is most likely to be experiencing what type of shock?
Septic
Which disorder is considered a primary immunodeficiency disease?
HIV/AIDS
A patient with significant aortic stenosis is likely to experience
syncope
The major buffer in the extracellular fluid is
bicarbonate.
An elderly patient’s blood pressure is measured at 160/98. How would the patient’s left ventricular function be affected by this level of blood pressure?
Left ventricular workload is increased with high afterload.
Left-sided heart failure is characterized by
pulmonary congestion.
Which condition is associated with an elevated reticulocyte count?
Hemolytic anemia
Restriction of which electrolytes is recommended in the management of high blood pressure?
Sodium
Reperfusion injury to cells
involves formation of free radicals.
The most reliable indicator that a person is experiencing an acute myocardial infarction (MI) is
ST-segment elevation.
Tachycardia is an early sign of low cardiac output that occurs because of
baroreceptor activity.
Decreased neuromuscular excitability is often the result of
hypercalcemia and hypermagnesemia.
The most common primary immune deficiency that affects only B cells is
selective IgA.
How do clinical conditions that increase vascular permeability cause edema?
By allowing plasma proteins to leak into the interstitial fluid, which draws in excess fluid by increasing the interstitial fluid osmotic pressure
Carbon monoxide injures cells by
reducing oxygen level on hemoglobin.
Total body water in older adults is
decreased because of increased adipose tissue and decreased muscle mass.
Osmoreceptors located in the hypothalamus control the release of
vasopressin (antidiuretic hormone, ADH).
A normal bleeding time in association with normal platelet count, and increased prothrombin time (PT) and INR, is indicative of
vitamin K deficiency.
What is the correct definition of complete remission (CR) of leukemia?
CR is less than 5% blasts in marrow and normal CBC values.
Severe combined immunodeficiency (SCID) syndrome is an example of a(n)
deficient immune response.
The primary cause of infant respiratory distress syndrome is
lack of surfactant.
Effects of hypernatremia on the central nervous system typically include
confusion.
A laboratory test that should be routinely monitored in patients receiving digitalis therapy is
serum potassium.
The common denominator in all forms of heart failure is
reduced cardiac output.
A 3-year-old is diagnosed with starvation ketoacidosis. What signs and symptoms should you anticipate in your assessment?
Rapid, deep breathing, lethargy, abdominal pain
Necrotic death of brain tissue usually produces _____ necrosis.
liquefactive
After sitting in a chair for an hour, an elderly patient develops moderate lower extremity edema. His edema is most likely a consequence of
right-sided heart failure.
Your patient is scheduled for a staging procedure. She wants to know what that means. The correct response is which of the following?
It is a procedure for determining the extent of tumor spread.
Atherosclerotic plaques with large lipid cores are prone to
rupture.
A patient with cold and edematous extremities, low cardiac output, and profound hypotension is likely to be experiencing a progressive stage of ________ shock.
septic
The ________ system compensates for metabolic acidosis and alkalosis.
respiratory
Many of the responses to stress are attributed to activation of the sympathetic nervous system and are mediated by
norepinephrine.
Which dysrhythmia is thought to be associated with reentrant mechanisms?
Preexcitation syndrome tachycardia (Wolf-Parkinson-White syndrome)
In contrast to all other types of shock, the hyperdynamic phase of septic shock is associated with
reduced contractility.
The conversion of plasminogen to plasmin results in
fibrinolysis.
A serious complication of deep vein thrombosis is
pulmonary embolus.
Which complication of asthma is life threatening?
Status asthmaticus
Patients presenting with symptoms of unstable angina and no ST segment elevation are treated with
antiplatelet drugs.
The Philadelphia chromosome is a balanced chromosome translocation that forms a new gene called
bcr-abl.
The most appropriate treatment for secondary polycythemia is
measured to improve oxygenation.
Familial retinoblastoma involves the transmission of what from parent to offspring?
Mutant tumor-suppressor gene
Overproduction of nitric oxide is an important aspect of the pathophysiologic process of what type of shock?
Septic
Which type of leukemia primarily affects children?
ALL (acute lymphoid leukemia)
The nurse is swabbing a patient’s throat to test for streptococcal pharyngitis. The nurse must understand that tests such as this differ in the probability that they will be positive for a condition when applied to a person with the condition; this probability is termed sensitivity.
True
The anemia resulting from a deficiency of either vitamin B12 (cobalamin) or folate is caused by a disruption in DNA synthesis of the blast cells in the bone marrow that produces very large abnormal bone marrow cells called megaloblasts.
True
Airway obstruction in chronic bronchitis is because of
thick mucus, fibrosis, and smooth muscle hypertrophy.
Neuromuscular disorders impair lung function primarily because of
weak muscles of respiration.
What compensatory sign would be expected during periods of physical exertion in a patient with limited ventricular stroke volume?
Tachycardia
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.
True
After evaluation, a child’s asthma is characterized as “extrinsic.” This means that the asthma is
associated with specific allergic triggers.
Fully compensated respiratory acidosis is demonstrated by
Correct!
pH 7.36, PaCO2 55, HCO3– 36.
Legionnaires disease is characterized by
presence of systemic illness.
Apoptosis is a process that results in cellular
death.
Massive release of histamine with consequent vasodilation and hypotension occurs with what type of shock?
Anaphylactic
In general, a cancer cell that is more tissue-specific differentiated is more likely to be aggressive.
False
Critically ill patients may have parenterally administered vasoactive drugs that are adjusted according to their _____ pressure.
mean arterial
A patient presents to the emergency department with a diastolic blood pressure of 132 mm Hg, retinopathy, and symptoms of an ischemic stroke. This symptomology is likely the result of
hypertensive crisis.
Angiotensin-converting enzyme (ACE) inhibitors block the
conversion of angiotensin I to angiotensin II.
A patient has a positive Chvostek sign. The nurse interprets this as a sign of
increased neuromuscular excitability.
The most definitive diagnostic method for active tuberculosis is acquired via
sputum culture.
Disseminated intravascular coagulation may be treated with heparin therapy to
inhibit clotting factor consumption.
After bronchoscopy and histologic examination of a suspected tumor, your patient is diagnosed with primary bronchial carcinoma. Thus, the tumor
is malignant.
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.
Diarrhea causes
metabolic acidosis.
Extreme cold injures cells by all the following except
decreased blood viscosity.
The assessment findings of a 5-year-old with a history of asthma include extreme shortness of breath, nasal flaring, coughing, pulsus paradoxus, and use of accessory respiratory muscles. There is no wheezing and the chest is silent in many areas. How should you interpret your assessment?
The child may be having such a severe asthma episode that the airways are closed, so start oxygen and get the doctor immediately.
A type of shock that includes brain trauma that results in depression of the vasomotor center is cardiogenic.
False
Disseminated intravascular coagulation is a serious complication of septic shock characterized by abnormal clot formation in the microvasculature throughout the body.
True
Which clinical manifestation is not likely the result of a tuberculosis infection?
Cyanosis
What laboratory finding is usually found in aplastic anemia?
Pancytopenia
Pernicious anemia is caused by a lack of
intrinsic factor.
Which disorder is caused by inhalation of organic substances?
Hypersensitivity pneumonitis
A patient with heart failure who reports intermittent shortness of breath during the night is experiencing
paroxysmal nocturnal dyspnea.
