Pathophysiology Flashcards
A man diagnosed with hypertension has thickening of his left ventricle wall. This adaptive change of his left ventricle is best described as:
- Atrophy
- Hypertrophy
- Hyperplasia
- Metaplasia
-Hypertrophy
A cardiac panel helps in the diagnosis of a myocardial infarction and the timing and relative levels of various substances that make up the cardiac panel indicate the severity and duration of an MI.
- True
- False
-True
Although adaptation can help strengthen the heart initially to help overcome afterload, eventually if hypertension continues there may be an excess demand on the heart muscle to contract that cannot be met by the available blood supply, causing the heart to fail.
- True
- False
-True
Chest pain in Myocardial Infarction is caused by the build-up of the following substance that is formed under anaerobic respiration:
- Oxygen
- Lactic acid
- Glucose
- Carbon dioxide
-Lactic acid
Reperfusion injury involves which of the following processes:
- Host inflammatory responses
- Oxygen free radicals attack cellular lipids and proteins
- Damage to cell membranes that may release more free radicals
- Any of the above processes may occur during reperfusion injury
-Any of the above processes may occur during reperfusion injury
In myocardial infarction, blood samples contain a variety of substances that have leaked from dead and dying cardiomyocytes, including:
- Troponin 1
- CK-MB
- Myoglobin
- All of the above
-All of the above
Chronic ulcerative processes have been attributed to reperfusion injury as a consequence of alternating occlusion of blood flow then return of blood flow that sets off both inflammatory and oxidative stress responses that can cause tissue damage.
- True
- False
-True
Reperfusion injury is caused by the formation of:
- Reactive oxygen species
- Oxygen
- Lactic acid
- Calcium
-Reactive oxygen species
The most important change related to atherosclerosis that contributes to hypertension would be a(n):
- Decreased radius of the blood vessel
- Decreased viscosity of the blood
- Increased length of the blood vessel
- Increased radius of the blood vessel
-Decreased radius of the blood vessel
The heart undergoes which type of adaptation in response to hypertension:
- Atrophy
- Hypertrophy
- Hyperplasia
- Metaplasia
-Hypertrophy
Infection with Clostridium perfringens and the release of exotoxins is most likely associated with which type of gangrene?
- Dry gangrene
- Wet gangrene
- Gas gangrene
- Fournier’s gangrene
-Gas gangrene
Which of the following treatment approaches for gangrene is best described as the surgical removal of dead and dying tissue?
- Debridement
- Hyperbaric Oxygen Therapy
- Antibiotic Therapy
- Anticoagulants
-Debridement
The basic pathological process that underpins gangrene is a lack of oxygen usually due to ischemia.
- True
- False
-True
During the reproductive cycle in the female, hormonal stimulation increases the thickness of the endometrial lining of the uterus by increasing the number of epithelial cells. This is an example of the following type of adaptation:
- Atrophy
- Hypertrophy
- Hyperplasia
- Metaplasia
-Hyperplasia
During a myocardial infarction, cardiac monocytes are deprived of oxygen and acidosis results in protein denaturation and the cellular outline is preserved. This type of necrosis is best described as:
- Coagulative
- Liquefactive
- Caseous
- Fat
-Coagulative
During a focal bacterial infection, destruction of bacteria and immune cells results in the formation of pus. This type of necrosis is best described as:
- Coagulative necrosis
- Liquefactive necrosis
- Caseous necrosis
- Fat necrosis
-Liquefactive necrosis
During cell injury:
- Use of anaerobic metabolism increases lactic acid production, which can lead to cellular damage
- Reactive oxygen species are formed and interact with cellular proteins and lipids, causing cellular damage
- Compromise to membrane integrity can allow ions such as calcium to enter the cells, causing cellular damage
- Any of the above can occur during cell injury
-Any of the above can occur during cell injury
Cells can die by necrosis or apoptosis. Which of the following characteristics is associated with apoptosis BUT NOT necrosis?
- Autodigestion
- Inflammatory response
- Pyknosis
- Fragmented DNA
-Fragmented DNA
**This was listed as the correct answer, but I thought autodigestion was right based on our midterm
Hemosiderin is a golden brown pigment formed from phospholipids and proteins that is observed when cellular membranes degenerate.
- True
- False
-False
Normally, the body has anti-oxidant systems to deal with reactive oxygen species. These anti-oxidant systems include superoxide dismutase, which is an enzyme that converts hydrogen peroxide into water.
- True
- False
-False
Although cellular injury is often reversible, the one characteristic that distinguishes reversible and irreversible cell injury is that irreversible injury is marked by the influx of calcium, which signals cell death.
- True
- False
-True
Caseous necrosis involves the release of lipases, which digests fats and forms a soap-like substance as the fats combine with minerals such as calcium and magnesium.
- True
- False
-False
Which of the following types of hereditary or familial colon cancer are associated with mutations in DNA repair genes?
- FAP
- HNPCC
-HNPCC
Screening tests that measure the presence of blood in the stool include:
- Colonoscopy
- FOBT
- CEA
- All of the above
-FOBT
Changes in both oncogenes and tumor suppressor genes are typically required for FAP to develop.
- True
- False
-True
The RB1 gene (pRB) is which kind of gene?
- Oncogene
- Tumor suppressor gene
- DNA repair gene
- Telomerase gene
-Tumor suppressor gene
Normally the RB1 gene (pARB):
- Activates DNA repair proteins, thus makes sure new mutations are not passed on to progeny cells
- Arrests the cell cycle to allow DNA repair to take place
- Governs the passage of the restriction point in the cell cycle, thus regulates cell proliferation
- Initiates apoptosis
-Governs the passage of the restriction point in the cell cycle, thus regulates cell proliferation
Germline mutations are inherited, whereas somatic mutations are acquired.
- True
- False
-True
Lung cancer is used to support the initiation, promotion, progression theory of carcinogenesis. According to this theory:
- Initiation is a reversible step caused by exposure to cigarette smoke
- Promotion is initially reversible, but must follow initiation for tumors to form
- Progression involves the mutation of DNA and is an irreversible step
- Promotion is associated with metastasis and genomic instability, among other cellular changes
-Promotion is initially reversible, but must follow initiation for tumors to form
The most common cause of lung cancer is:
- Asbestos exposure
- Radon gas
- Cigarette smoking
- Inherited genetic mutation
-Cigarette smoking
Small-cell lung cancer can present as diabetes insipidus since these cells can release aldosterone.
- True
- False
-False
Chronic Myeloid Leukemia (CML) is associated with expansion of which of the following cell populations:
- Erythrocytes only
- Lymphocytes only
- Granulocytes and Platelets only
- Granulocytes, Erythrocytes, and Platelets only
-Granulocytes, Erythrocytes, and Platelets only
The phase of CML associated with fewer than 10% of cells in the blood and bone marrow being of the blast form is referred to as:
- Chronic phase
- Accelerated phase
- Blast phase
- Remission
-Chronic phase
The formation of the Philadelphia chromosome occurs by a chromosomal translocation between chromosomes 9 and 22 and results in the activation of tyrosine kinase.
- True
- False
-True
Cancer cells are generally characterized by:
- Increased rates of proliferation
- The ability to produce telomerase
- Poor differentiation or immaturity
- Cancer cells are generally characterized by all of the above
-Cancer cells are generally characterized by all of the above
Cancer cells are associated with a number of mutations. One gene that is often mutated in cancer cells is the pRB gene. This gene is responsible for:
- Causing the cell to pause so that DNA repair can take place
- Allowing cells to pass the R point and become committed to completion of the cell cycle
- Adding new telomeres to the chromosomes of the cell
- Causing phosphorylation of cellular proteins that are responsible for cell division
-Allowing cells to pass the R point and become committed to completion of the cell cycle
Mutations in only one allele of these genes (listed below), which normally promote cell growth, is associated with changes associated with cancer.
- Tumor suppressor genes
- Protooncogenes
- DNA repair genes
- Genes encoding telomerase
-Protooncogenes
Mutations in which type of genes is most generally associated with Hereditary NonPolyposis Colon Cancer (HNPCC)?
- Tumor suppressor genes
- Protooncogenes
- DNA repair genes
- Genes encoding telomerase
-DNA repair genes
Advanced forms of cancer may involve the spread of the original tumor cells to distant sites within the body. This process is most accurately described as:
- Invasion
- Angiogenesis
- Metastasis
- Cachexia
-Metastasis
Which of the following tumors would be considered most advanced?
- T1N0M0
- T2N1M1
- T3N2M1
- T1N1M1
-T3N2M1
Cancer cells from Henrietta Lacks, who died in 1951, still grow in many laboratories in tissue culture. These cells, which essentially continue to divide, are immortalized.
- True
- False
-True
Most mutations associated with cancer are inherited rather than due to environmental exposures
- True
- False
-False
Cancer is genetic, but not necessarily inherited.
- True
- False
-True
In the initiation-promotion theory of cancer, initiation is thought to involve an irreversible mutation in the DNA of a cell.
- True
- False
-True
Cystic Fibrosis (CF) is which kind of genetic disorder?
- Autosomal dominant
- Autosomal recessive
- X-linked dominant
- X-linked recessive
-Autosomal Recessive
If two parents were each heterozygous for CF and they had a child, what is the chance that the child would have CF disease?
- 100%
- 50%
- 25%
- 10%
-25%
Newborn screening can detect the common mutation for CF and help provide early interventions to improve nutrition and growth.
- True
- False
-True
Sickle Cell Disease is caused by:
- A point mutation in the beta-globin gene
- A deletion of the beta-globin gene
- A point mutation in the alpha-globin gene
- A deletion of the alpha-globin gene
-A point mutation in the beta-globin gene
Sickle Cell Disease (SCD) is typically associated with:
- Occlusion of blood vessels as cells sickle under high oxygen tension
- Hemolysis that can result in elevated serum bilirubin
- Congestion of the liver and spleen due to inflammation
- Autoimmune destruction of the liver and spleen
-Hemolysis that can result in elevated serum bilirubin
Hydroxyurea may help reduce sickle cell crisis by increasing fetal hemoglobin production, thus help reduce the occurrence of sickling-related complications.
- True
- False
-True
Which type of genetic disorder typically causes Down Syndrome:
- Translocation
- Point mutation
- Trisomy
- Monosomy
-Trisomy
A child with Down Syndrome should be evaluated for:
- Congenital heart defects
- Hearing loss
- Polycythemia
- All of the above
-All of the above
Down syndrome is typically inherited as an autosomal recessive trait.
- True
- False
-False
The inheritance pattern of hemophilia A is:
- Autosomal dominant
- Autosomal recessive
- X-linked
- Mitochondrial
-X-linked
Based upon the pedigree for a patient who has an affected brother and maternal uncle with, which of the following statements is correct?
- His father has hemophilia
- His mother is a carrier of the hemophilia trait
- His paternal grandfather is a carrier of the hemophilia trait
- All of his sisters would be carriers of the hemophilia trait
-His mother is a carrier of the hemophilia trait
Depending upon the values for FVIII assays, a person with hemophilia will have different disease severity with more mild disease associated with higher levels of FVIII.
- True
- False
-True
Which of the following terms relates to the concept that as DNA is copied, one original and one newly formed copy of the DNA is inherited together in each of the progeny cells?
- Complement base pairing
- Semi-conservative replication
- Redundancy in the genetic code
- Central Dogma
-Semi-conservative replication
The kind of genetic mutation that results in the change of an amino acid sequence in the protein sequence is best described as a:
- Silent mutation
- Missense mutation
- Nonsense mutation
- Antisense mutation
-Missense mutation
Two parents are both carriers of cystic fibrosis have four children. How many would likely be carriers of cystic fibrosis?
- 1
- 2
- 3
- 4
-2
Which of the following statements is correct about Hemophilia A?
- Hemophilia A is an X-linked recessive disorder
- Hemophilia A is mitochondrially inherited from mother to child
- Hemophilia A is generally only found in males because it is carried on the Y chromosome
- Hemophilia A is only carried by females with two affected alleles
-Hemophilia A is an X-linked recessive disorder
Which of the following genetic disorders results in aneuploidy?
- Sickle Cell Disease
- Hemophilia A
- Down Syndrome
- Cystic Fibrosis
-Down Syndrome
Most genetic disorders of medical importance involve a combination of changes in a number of genes that are either inherited or acquired by environmental influences. Such genetic disorders are best described as:
- Single-gene disorders
- Chromosomal disorders
- Multifactorial disorders
- Mitochondrial disorders
-Multifactorial disorders
Crossing-over involves the exchange of genetic material between two homologous chromosomes during meiosis.
- True
- False
-True
Reduction of chromosome number from 46 to 23 occurs during meiosis.
- True
- False
-True
The principle of segregation means that genes governing distinct individual traits are separated and inherited independently of one another.
- True
- False
-False
Chromosomes other than the X and Y chromosome are referred to as autosomes.
- True
- False
-True
TSI represents:
- Another word for TSH
- Antibodies that act like TSH
- Antibodies that act like TH
- Antibodies that act like TRH
-Antibodies that act like TSH
Blood tests from a patient with Graves would reveal:
- Decreased levels of TSH
- Increased levels of TSI
- Increased levels of TH
- All of the above
-All of the above
TSI functions as an agonist for TSH, because it functions equal to or better than natural TSH in stimulating the release of TH from the thyroid gland.
- True
- False
-True
Type 1 Diabetes Mellitus is most likely caused by:
- Genetic changes
- Environmental trigger like viral infection
- A combination of genetic predisposition plus an environmental trigger like viral infection
- A bacterial infection
-A combination of genetic predisposition plus an environmental trigger like viral infection
Ketones:
- Are derived from carbohydrates and can be used to fuel the body
- Are formed when insulin levels are sufficient to allow glucose uptake by cells
- Are acidic and give rise to ketoacidosis in excess
- Are derived from proteins as the body tries to fuel itself during starvation
-Are acidic and give rise to ketoacidosis in excess
Polyuria results from the osmotic shift that occurs as excess blood glucose is retained in the filtrate, causing water to be retained in the tubule and increasing urine output.
- True
- False
-True
Loss of the mineralcorticoid aldosterone would most likely give rise to which of the following S/S of Addison’s Disease.
- Low blood pressure
- Hypoglycemia
- Hyperpigmentation
- Increased risk of infection
-Low blood pressure
Which of the following statements is correct about Addison’s Disease?
- Primary adrenal insufficiency is due to lack of ACTH
- Primary adrenal insufficiency may be due to autoimmune destruction of the adrenal gland
- Primary adrenal insufficiency may be caused by use of prednisone
- Secondary adrenal insufficiency is due to lack of cortisol
-Primary adrenal insufficiency may be due to autoimmune destruction of the adrenal gland
Elevated cortisol levels associated with Addison’s Disease give rise to the elevated ACTH observed in our patient.
- True
- False
-False
Exogenous causes of Cushings Syndrome include:
- Pituitary adenoma
- Adrenal tumor
- Non-pituitary ACTH-secreting tumor
- Prednisone use for an autoimmune disease
-Prednisone use for an autoimmune disease
The buffalo hump and moon face are most likely associated with which of the following normal functions of cortisol?
- Stimulation of gluconeogenesis
- Inhibition of anti-stress responses
- Activation of anti-inflammatory pathways
- Fluid retention
-Stimulation of gluconeogenesis
Most cases of endogenous Cushings Syndrome are caused by a pituitary adenoma. This form of Cushings Syndrome is referred to as Cushings Disease.
- True
- False
-True
Excessive growth hormone production in the adult is referred to as:
- Acromegaly
- Gigantism
- Adrenal Insufficiency
- Addison’s Disease
-Acromegaly
Which of the following adrenal cortex hormones is released during response to stress?
- Mineralcorticoids
- Glucocorticoids
- Steroidal Sex Hormones
- Epinephrine
-Glucocorticoids
Which of the following is an example of hyperthyroidism?
- Cretinism
- Myxedema
- Hashimotos Disease
- Graves Disease
-Graves Disease
Which of the following is most likely associated with excess production of parathyroid hormone (PTH)?
- Rickets
- Osteomalacia
- Renal Calculi (Stones)
- Autoimmune destruction of the parathyroid gland
-Renal Calculi (Stones)
The pancreas has a number of endocrine responsibilities including:
- Release of insulin, when glucose levels are low to help bring glucose into cells
- Release of glucagon, when glucose levels are high to help store glucose by the liver
- Release of insulin, when glucose levels are high to help recruit glucose transporters to the cells
- Release of glucose, when stores in the pancreas when insulin levels are slow
-Release of insulin, when glucose levels are high to help recruit glucose transporters to the cells
Which of the following conditions results from excess thyroid hormone?
- Cretinism
- Myxedema
- Hashimoto’s disease
- Thyrotoxicosis
-Thyrotoxicosis
Autoimmune destruction of the adrenal cortex is best described as secondary adrenal insufficiency.
- True
- False
-False
Individuals suffering from Addison’s disease may suffer from hyperpigmentation, since excess ACTH stimulates melanocytes.
- True
- False
-True
Goiter is associated with hypothyroidism, which is the excessive production of thyroid hormone.
- True
- False
-False
A child with growth hormone deficiency would likely be short of stature and overweight for age.
- True
- False
-True
Which of the following statements is correct about Benign Prostatic Hyperplasia (BPH)?
- BPH actually involves a hypertrophy process rather than hyperplasia
- BPH often includes urine storage symptoms including urinary frequency and urgency, and nocturia
- Incomplete voiding in BPH decreases the risk of a urinary tract infection
- BPH is caused by too little testosterone that stimulates the prostate
-BPH often includes urine storage symptoms including urinary frequency and urgency, and nocturia
Diagnosis of BPH includes:
- Presentation of clinical symptoms often related to urinary frequency or hesitancy
- A rectal examination to feel for an enlarged prostate gland
- Evaluation of blood for PSA levels, which are often elevated
- All of the above may be used to help diagnose BPH
-All of the above may be used to help diagnose BPH
Enlargement of the prostate gland compresses the urethral canal making it difficult for urine outflow in benign prostatic hyperplasia (BPH).
- True
- False
-True
Which of the following scenarios would most likely be associated with primary hypogonadism?
- Lack of GnRH production by the hypothalamus
- Lack of LH production by the anterior pituitary
- Lack of FSH production by the anterior pituitary
- Lack of testosterone production by the testes
-Lack of testosterone production by the testes
Testosterone is responsible for:
- Deepening the voice
- Muscular development
- Sperm production
- All of the above
-All of the above
Hypogonadism may be caused by an inherited (congenital) trait or something that happens later in life (acquired) such as injury or infection.
- True
- False
-True
Major symptoms of endometriosis include:
- Dysmenorrhea
- Chronic pelvic pain
- Dyspareunia (painful sexual intercourse)
- Any of the above
-Any of the above
The pathogenesis of endometriosis is believed to involve
- Hereditary factors
- Exposure to environmental toxins
- Compromised immune system
- Some combination of hereditary factors, exposure to environmental toxins, and compromise to the immune system
-Some combination of hereditary factors, exposure to environmental toxins, and compromise to the immune system
The theory of retrograde menstruation suggests that during menstruation some endometrial material exits the uterus through the fallopian tubes and attaches itself to the peritoneal surface setting up endometriosis.
- True
- False
-True
Typical symptoms of PCOS include:
- Excess weight
- Loss of menstruation’
- Facial hair
- All of the above
-All of the above
In PCOS, the relationship between insulin and obesity is best described by the phrase:
- Insulin resistance leads to excess blood glucose levels that are converted into fat by the liver
- Insulin helps glucose get into the adipose cells so that fat stores are increased
- Excess insulin leads to increase uptake of glucose
- Insulin levels and action are typically normal in a person with PCOS
-Insulin resistance leads to excess blood glucose levels that are converted into fat by the liver
Infertility is an important consequence of PCOS and many women with PCOS have difficulty becoming pregnant.
- True
- False
-True
Inflammation of the prostate is best described as:
- Enlarged Prostate
- Prostatitis
- Benign Prostate Hypertrophy
- Prostate Cancer
-Prostatitis
A man with low sperm count is found to have low testosterone levels. He is given GnRH, which does not change testosterone levels. He is given LH, which raises testosterone levels to normal levels. Based upon this information you can determine that the problem with this man is most likely that his:
- Hypothalamus is not releasing GnRH
- Anterior pituitary is not releasing LH
- Leydig cells cannot produce testosterone
- Sertoli cells cannot produce androgen binding proteins
-Anterior pituitary is not releasing LH
Painful menstruation is best described by the term.
- Amenorrhea
- Menopause
- Dysmenorrhea
- Leiomyoma
-Dysmenorrhea
During embryonic development, the nervous system is derived from which of the following primary germ layers?
- Ectoderm
- Mesoderm
- Endoderm
- Somatoderm
-Ectoderm
During pregnancy there are a number of hormones that help maintain the pregnancy and prepare for delivery and lactation. Which of the following hormones is responsible for increasing maternal metabolism during pregnancy?
- Relaxin
- Human placental lactogen
- Human chorionic thyrotropin
- Human chorionic gonadotropin
-Human chorionic thyrotropin
Infertility resulting from damage or blockage of the fallopian tubes would most likely be associated with which of the following:
- Uterine fibroids
- Disorders of the hypothalamus
- Endometriosis
- Polycystic ovary disease
-Endometriosis
Pelvic Inflammatory Disease can be caused by bacterial infections and give rise to infertility.
- True
- False
-True
Human Chorionic Gonadotropin (hCG) is produced by the corpus luteum after fertilization and until the placenta is formed.
- True
- False
-False
Colostrum is a nutrient rich substance secreted from breast tissue before breast milk is formed.
- True
- False
-True
A high sperm count is required for fertility, as many sperm release the contents of their acrosomes to help degrade the zona pellucida. This process best described as a block to polyspermy
- True
- False
-False
Information about touch and pressure that ascends the dorsal columns is carried by the:
- Fast myelinated fibers
- Fast unmyelinated fibers
- Slow Unmyelinated fibers
- Unmyelinated fibers
-Fast myelinated fibers
Slow pain information is carried on the slowest nerve fibers, called the:
- Fast myelinated fibers
- Fast unmyelinated fibers
- Slow myelinated fibers
- Unmyelinated fibers -C-fibers
-Unmyelinated fibers -C-fibers
Brown-Sequard results in the loss of pain and temperature sensation on the same side as the lesion along with loss of voluntary motor control on the opposite side of the lesion.
- True
- False
-False
Stroke is defined as:
- The rapidly developing loss of brain functions due to a disturbance in the blood vessels supplying blood to the brain
- An open head injury
- Sudden movement of the brain resulting in a diffuse but transient and reversible injury to the brain
- Bruising of the brain during blunt trauma in a closed head injury
-The rapidly developing loss of brain functions due to a disturbance in the blood vessels supplying blood to the brain
Stroke may be caused by:
- Thrombosis
- Embolism
- Hypoperfusion
- All of the above
-All of the above
Stroke is most commonly the result of a traumatic brain injury.
- True
- False
-False
Which statement about multiple sclerosis is true?
- Multiple sclerosis is associated with destruction of motor neurons in the peripheral nervous system
- Multiple sclerosis involves inflammation and possibly autoimmune destruction of the myelin sheaths of neurons
- Multiple sclerosis is inherited as an autosomal dominant trait
- Infection with cytomegalovirus in individuals with specific HLA markers has been shown to cause multiple sclerosis
-Multiple sclerosis involves inflammation and possibly autoimmune destruction of the myelin sheaths of neurons
Which of the following disease courses for Multiple Sclerosis is associated with episodes of acute worsening with recovery and a stable course between relapses?
- Relapsing-remitting
- Secondary progressive
- Primary progressive
- Progressive relapsing
-Relapsing-remitting
Diagnosis of Multiple Sclerosis includes presence of gamma globulin in the cerebral spinal fluid, magnetic resonance imaging (MRI) of CNS showing patch abnormalities in myelin.
- True
- False
-True
Which of the following statements is CORRECT about Alzheimer’s disease (AD)?
- AD is a rare form of dementia
- AD is highly curable but requires early detection
- AD is progressive and eventually leads to death
- AD has a rapid onset
-AD is progressive and eventually leads to death
Which of the following stages of Alzheimer’s disease would most likely be associated with mild forgetfulness, absent-mindedness and occasionally misplacing items?
- Pre-dementia
- Progressive
- Moderate
- Late
-Pre-dementia
Amyloid plaques and neurofibrillary tangles are clearly visible by microscopy in brain tissue from individuals afflicted with Alzheimer’s disease.
- True
- False
-True
The region of the brain that contains the hypothalamus is the:
- Cerebral hemispheres
- Diencephalon
- Brain stem
- Cerebellum
-Diencephalon
Head injuries are often characterized by problems with:
- Hypoxia
- Increased intracranial pressure
- Edema
- Any or all of the above
-Any or all of the above
Sharp, stabbing pain is relayed through which of the following sensory tracts:
- Fast myelinated fibers
- Slow myelinated fibers
- Fast unmyelinated fibers
- Slow unmyelinated fibers
-Slow myelinated fibers
The neurotransmitter receptor that is found at parasympathetic postganglionic synapses that can be blocked by atropine is the::
- Nicotinic receptor
- Muscarinic receptor
- Alpha-adrenergic receptor
- Beta-adrenergic receptor
-Muscarinic receptor
The neurological disease associated with autoimmune destruction of the myelin basic protein is:
- Multiple sclerosis
- Amyotrophic lateral sclerosis
- Huntington’s disease
- Parkinson’s disease
-Multiple sclerosis
A temporary and fully resolvable brain injury would best be described by the term:
- Stroke
- Cerebrovascular accident
- Transient ischemic attack
- Contusion
-Transient ischemic attack
Depression is associated with high levels of neurotransmitters, like serotonin, and may be alleviated by drugs such as selective serotonin reuptake inhibitors (SSRIs).
- True
- False
-False
An aneurysm is localized dilation of a blood vessel, that can rupture and lead to an intracranial bleed.
- True
- False
-True
The medulla is involved in governing both the respiratory and cardiovascular systems.
- True
- False
-True
A man experiences a stroke with left-sided hemiparesis. Based upon this information, you would expect his lesion to be on the left side.
- True
- False
-False
Which of the following statements about asthma is NOT CORRECT?
- Asthma is primarily a restrictive respiratory disorder
- Increased airway resistance is characteristic of asthma
- In asthma, the FEV1/FVC ratio may be decreased from normal
- Asthma may be characterized by a hyperinflation of the lungs, which is reflected as an increase in residual volume
- Asthma may be associated with symptoms such as coughing, wheezing, shortness of breath, or chest tightness
-Asthma is primarily a restrictive respiratory disorder
Which of the following statements about asthma is CORRECT?
- Increased airway resistance would result from an increase in airway radius
- A beta-agonist would promote bronchoconstriction thus would reduce airway resistance
- V/Q mismatching in asthma would generally be characterized as an increase in the shunt fraction
- Anti-inflammatory agents like a glucocorticoid would not be beneficial to a patient with asthma, since asthma is a disorder that is not associated with inflammation
-V/Q mismatching in asthma would generally be characterized as an increase in the shunt fraction
Hypocapnia occurs as a consequence of hypoventilation, which reduces CO2 levels.
- True
- False
-False
Which of the following statements about Pulmonary Fibrosis is CORRECT?
- Pulmonary fibrosis is an obstructive pulmonary disorder
- Pulmonary fibrosis is characterized by reduced or restricted airflow through the airways
- The parameter of Fick’s law of diffusion altered in a person with pulmonary fibrosis is “x”
- Persons with pulmonary fibrosis have an increased compliance
-The parameter of Fick’s law of diffusion altered in a person with pulmonary fibrosis is “x”
Which of the following statements about Pulmonary Fibrosis is NOT CORRECT?
- Persons with pulmonary fibrosis have an increased total lung capacity (TLC)
- Pulmonary fibrosis may be associated with an inflammatory process that leads to an increase in scar tissue
- Reduced PaO2 levels are due to impaired gas exchange
- Decreased PaCO2 levels may be a consequence of hyperventilation
-Persons with pulmonary fibrosis have an increased total lung capacity (TLC)
When a person with pulmonary fibrosis exercises, the ability to equilibrate oxygen may be compromised by an increased thickness of the respiratory membrane.
- True
- False
-True
A patient with COPD has a “prolonged expiratory phase” to his respirations. In the case of emphysema what is the most likely mechanism that underlies this slowing of forced expiration?
- Increased airway resistance due to mucus
- Loss of elastic recoil of the lungs
- Increased airway resistance due to inflammation
- Smooth muscle constriction of the airways
-Loss of elastic recoil of the lungs
A patient with COPD has an increased PaCO2 value at 69 mmHg and an increased bicarbonate value at 34 mEq/L. Based upon these values our patient most likely was in:
- Respiratory acidosis with renal compensation
- Respiratory alkalosis with renal compensation
- Metabolic acidosis with respiratory compensation
- Metabolic alkalosis with respiratory compensation
-Respiratory acidosis with renal compensation
The primary risk factor for COPD is tobacco smoking, but an inherited genetic condition is responsible for a minority of cases.
- True
- False
-True
Which of the following is NOT considered a specific risk factor or indication for pulmonary embolism?
- Female
- Birth control pill use
- Overweight
- Deep vein thrombosis (DVT)
-Female
Virchow’s triad includes all of the following EXCEPT:
- Change in vessel wall
- Decreased blood flow
- Decreased coagulability of the blood
- Increased coagulability of the blood
-Decreased coagulability of the blood
One of the most common sources of embolism in pulmonary embolism is deep vein thrombosis of the popliteal vein.
- True
- False
-True
Jason smoked a considerable amount in college. One day, he experienced sharp chest pain and could not catch his breath. His roommate took him to the emergency room where he was diagnosed with a collapsed lung. Based upon the above information, Jason’s condition would most likely be described as a:
- Tension pneumothorax
- Secondary pneumothorax
- Spontaneous pneumothorax
- Traumatic pneumothorax
-Spontaneous pneumothorax
Which of the following would most likely be associated with an increase in lung compliance?
- Pulmonary fibrosis
- Pulmonary edema
- Emphysema
- Pneumonia
-Emphysema
Jane had a chest infection and was feeling short of breath, experiencing a sharp pain in her chest. Her nurse practitioner detected diminished breath sounds and chest x-ray revealed that Jane was suffering from a pleural effusion. Thoracentesis (a pleural tap) was performed to remove a sample of the fluid causing the effusion, and lymph was detected. Based upon this information, Jane is most likely suffering from a(n):
- Hydrothorax
- Empyema
- Hemothorax
- Chylothorax
-Chylothorax
Which of the following conditions best describes primary atelectasis?
- A baby is born prematurely and lacks surfactant
- A man suffers from an airway obstruction caused by a mucus plug
- A woman suffers from a pneumothorax caused by a traumatic accident
- A man is in a car accident and suffers a vascular injury that results in a pleural effusion
-A baby is born prematurely and lacks surfactant
Which of the following scenarios best describes a condition where the amount of dead space is increased?
- A woman with pneumonia and mucous plugs
- A man with a blood clot that embolizes to the lungs
- A child suffering from bronchoconstriction
- An elderly man that has pulmonary edema
-A man with a blood clot that embolizes to the lungs
Which of the following best describes an obstructive lung disorder?
- Decreased compliance
- Pulmonary fibrosis
- Pulmonary edema
- Increased airway resistance
-Increased airway resistance
The most important variable governing airway resistance is the radius of the airway.
- True
- False
-True
The Forced Expiratory Volume in one second (FEV1) is often reduced in an obstructive lung disorder like asthma because of increased airway resistance to expiratory flow.
- True
- False
-True
A congenital heart defect that causes venous blood to directly join the arterial circulation (thus bypassing gas exchange in the lungs) would promote hypoxemia.
- True
- False
-True
Smoking is the most common cause of lung cancer.
- True
- False
-True
All of the characteristics below describe the structure of the glomerulus in renal failure EXCEPT one. Identify the characteristic that DOES NOT describe the glomerulus.
- Fenestrated capillary endothelium
- Incomplete basement membrane
- Positively charged basement membrane
- Podocytes and slit pores in the tubule epithelial cells
-Positively charged basement membrane
Patients with renal failure may:
- Suffer from anemia because they are unable to produce sufficient levels of renin
- Require calcium supplementation because the kidneys normally activate vitamin D, which is required for the absorption of calcium from dietary sources
- Experience both a decrease in hydrostatic pressure as well as an increase in osmotic pressure, which would account for the edema they experience
- Have an increased GFR that would account for the elevated creatinine and blood urea nitrogen (BUN) levels
-Require calcium supplementation because the kidneys normally activate vitamin D, which is required for the absorption of calcium from dietary sources
A patient with renal failure is likely to also have hyperalbuminemia
- True
- False
-False
Diabetes insipidus:
- Is due to a lack of insulin secretion by the pancreas
- May be caused by a lack of anti-diuretic hormone (ADH or vasopressin) secretion from the anterior pituitary
- May be caused by a decreased ability of the kidney to respond to available ADH
- Is characterized by an elevated fasting blood glucose level
-May be caused by a decreased ability of the kidney to respond to available ADH
Which of the following statements about diabetes insipidus is CORRECT?
- Central diabetes insipidus may be treated by dDAVP, which is a synthetic replacement for vasopressin (or ADH)
- Nephrogenic diabetes insipidus may be treated with dDAVP, which is a synthetic replacement for vasopressin (or ADH)
- A person with central diabetes insipidus would have a normal level of ADH
- Central diabetes insipidus is most often caused by chronic lithium ingestion
-Central diabetes insipidus may be treated by dDAVP, which is a synthetic replacement for vasopressin (or ADH)
Excessive urination associated with diabetes insipidus can cause dehydration and potassium losses.
- True
- False
-True
A person with a recent sore throat that subsequently develops glomerulonephritis (GN) would most likely have their GN attributed to:
- Bacterial endocarditis
- Streptococcal infection
- Lupus
- Goodpasture’s syndrome
-Streptococcal infection
Which of the following complications of glomerulonephritis is characterized by a massive loss of proteins?
- Acute kidney failure
- Chronic kidney failure
- High blood pressure
- Nephrotic syndrome
-Nephrotic syndrome
A kidney biopsy can be used to confirm the diagnosis of glomerulonephritis.
- True
- False
-True
Which of the following would most likely be considered to be an ischemic cause of acute tubular necrosis (ATN)?
- Rhabdomyolysis
- Heavy metal exposure
- Shock
- Cisplatin treatment for cancer
-Shock
A person with acute tubular necrosis (ATN) most likely would have:
- Decreased BUN and serum creatinine levels
- Hyperkalemia
- Increased urine output
- Alkalosis
-Hyperkalemia
Blood transfusion reaction can cause acute tubular necrosis (ATN).
- True
- False
-True
Which of the following statements about nephritic and/or nephrotic syndromes is correct?
- In nephrotic syndrome there is significant basement membrane damage that allows massive protein losses into the urine
- In nephrotic syndrome there is massive red blood cell loss without significant protein loss into the urine
- Nephrotic syndrome, but not nephritic syndrome, is characterized by hematuria
- Nephrotic syndrome, but not nephritic syndrome, is characterized by fluid retention and edema
-In nephrotic syndrome there is significant basement membrane damage that allows massive protein losses into the urine
Renal calculi would be best classified as which of the following types of renal disease?
- Pre Renal
- Intra Renal
- Renal
- Post Renal
-Post Renal
Which of the following statements about the renin-angiotension system is correct?
- The macula densa cells of the juxtaglomerular apparatus release renin
- Angiotensin I is a potent vasoactive substance
- Angiotensin Converting Enzyme converts angiotensin I into angiotensin II
- Aldosterone is released from the adrenal medulla
-Angiotensin Converting Enzyme converts angiotensin I into angiotensin II
Which of the following hormones would most likely cause a decrease in blood volume and decrease mean arterial pressure?
- Angiotensin II
- Aldosterone
- Atrial Naturetic Factor
- Antidiuretic hormone
-Atrial Naturetic Factor
Jaime is not secreting sufficient antidiuretic hormone (ADH) from her posterior pituitary. Likely she is suffering from:
- Syndrome of Inappropriate ADH (SIADH)
- Central (or neurogenic) Diabetes Insipidus
- Nephrogenic Diabetes Insipidus
- Renovascular hypertension
-Central (or neurogenic) Diabetes Insipidus
Bob is a 68-year-old male with a history of smoking, high cholesterol, and high blood pressure. On physical examination an abdominal bruit is heard. Likely Bob is suffering from:
- Diabetic Nephropathy
- Chronic Kidney Disease
- Renal Cell Carcinoma
- Renovascular Hypertension
-Renovascular Hypertension
Infection of the kidneys is called cystitis.
- True
- False
-False
Uremic syndrome describes elevated serum levels of nitrogen-containing substances including urea, creatinine, and uric acid.
- True
- False
-False
Spirinolactone acts as a diuretic by inhibiting aldosterone.
- True
- False
-True
Chronic renal failure is often associated with either anemia or calcium imbalances or both.
- True
- False
-True
In MI, death of tissue due to necrosis is best described as:
- Ischemia
- Infarction
- Hypoxemia
-Infarction
Vasodilation of coronary vessels to increase blood flow to the heart is best achieved by the use of:
- Supplemental oxygen
- Nitroglycerine
- Metoprolol
-Nitroglycerine
Ace inhibitors activate angiotensin II, thus use of an ace inhibitor would result in vasodilation.
- True
- False
-False
Which of the following conditions is a risk factor for hypertension?
- Smoking
- Diabetes
- Obesity
- All of the above are risk factors for hypertension
-All of the above are risk factors for hypertension
Which of the following substances would directly block the production of angiotension II?
- ACE inhibitor
- Oral diuretic
- Beta-blocker
- Calcium-channel blocker
-ACE inhibitor
Hypertension decreases the “afterload” or the force against which the heart must pump blood.
- True
- False
-False
Major signs or symptoms of mitral valve stenosis include:
- Dyspnea on exertion
- Jugular vein distension
- Portal hypertension
- None, it is usually asymptomatic
-Dyspnea on exertion
Treatment of mitral valve stenosis may include:
- Anticoagulants
- Diuretics
- Beta-blockers
- Any of the above may be used as part of the treatment of mitral valve stenosis
-Any of the above may be used as part of the treatment of mitral valve stenosis
The most common underlying cause of mitral valve stenosis is rheumatic fever or rheumatic heart disease.
- True
- False
-True
A person with anaphylactic reaction would most likely suffer from which type of shock:
- Cardiogenic
- Distributive
- Obstructive
- Hypovolemic
-Distributive
In hypovolemic shock, compensation for blood loss can explain a patient’s:
- Increased heart rate
- Decreased heart rate
- Decreased blood pressure
- Increased hematocrit
-Increased heart rate
Shock is any condition that results in a decreased perfusion of vital organs and tissues in the body and can be a life-threatening condition.
- True
- False
-True
Juanita has scar tissue between the pericardial layers around her heart. Juanita’s condition would be described as:
- Acute pericarditis
- Restrictive pericarditis
- Pericardial effusion
- Cardiac tamponade
-Restrictive pericarditis
Narrowing of the left atrioventricular valve would best be described as:
- Mitral valve regurgitation
- Mitral valve stenosis
- Aortic valve regurgitation
- Aortic valve stenosis
-Mitral valve stenosis
If conduction through the heart were initiated at a site other than the sinoatrial node, the resulting heartbeat would best be described as:
- Premature
- Inefficient
- Blocked
- Ectopic
-Ectopic
Joe is in a car accident and loses a lot of blood before going into shock. This type of shock would best be classified as:
- Hypovolemic shock
- Cardiogenic shock
- Obstructive shock
- Distributive shock
-Hypovolemic shock
Venous pathology associated with impaired blood flow including tissue congestion, edema, and impairment of tissue nutrition would best be described as:
- Varicose veins
- Chronic venous insufficiency
- Thromboangiitis obliterans
- Venous thrombosis
-Chronic venous insufficiency
Which of the following statements is correct regarding hypertension?
- Primary hypertension results from any disease condition that increases cardiac output or total peripheral resistance
- Secondary or essential hypertension accounts for most of the hypertension
- Hypertensive crisis involves a sudden elevation of blood pressure that can be life threatening
- Drugs used to treat hypertension are most typically directed at reducing cardiac output
-Hypertensive crisis involves a sudden elevation of blood pressure that can be life threatening
Cardiac drugs that block calcium channels primarily work by increasing the contractility of the heart and heart rate.
- True
- False
-False
Ejection fraction is calculated as the stroke volume divided by the end diastolic volume.
- True
- False
-True
Venous thromboses are enlarged tortuous veins.
- True
- False
-False
Vascular disease includes peripheral arterial disease, which typically results from direct injury or inflammation due to a viral infection.
- True
- False
-False
Which of the following factors would most likely contribute to hiatal hernia?
- Sedentary lifestyle
- Obesity
- Laxative use
- Being 30 years of age
-Obesity
Which of the following agents WOULD NOT likely be used for someone with a hiatal hernia?
- Histamine H2 receptor blockers
- Proton pump inhibitors
- Antacids
- Anticholinergic drugs
-Anticholinergic drugs
Hiatal hernia is often associated with acid reflux and may simulate angina.
- True
- False
-True
Which of the following tests would directly detect blood in the feces?
- Guaiac test
- Endoscopy
- Urease test
- Biopsy
-Guaiac test
Which of the following types of bacteria is believed to be the causative agent of peptic ulcer disease (PUD)?
- Staphylococcus aureus
- Streptococcus pyogenes
- Camplobacter jejuni
- Helicobacter pylori
-Helicobacter pylori
A patient with PUD may have anemia because of either blood loss or intrinsic factor.
- True
- False
-True
Individuals with irritable bowel syndrome (IBS) typically experience:
- Chronic abdominal pain
- Bloating
- Alteration of bowel habits
- Any of the above signs or symptoms may be experienced by someone with IBS
-Any of the above signs or symptoms may be experienced by someone with IBS
Which of the following classifications of IBS best describes the form of IBS that occurs after an infection?
- IBS-D
- IBS-C
- IBS-A
- IBS-PI
-IBS-PI
There is no evidence that stress is related to irritable bowel syndrome.
- True
- False
-False
Individuals diagnosed with celiac disease may suffer from which of the following disorders or conditions?
- Osteopenia
- Failure to thrive
- Anemia
- Any of the above may be experienced by an individual with celiac disease
-Any of the above may be experienced by an individual with celiac disease
Persons with celiac disease cannot tolerate:
- Lactose
- Gluten
- Peanuts
- Eggs
-Gluten
Celiac disease involves an autoimmune reaction.
- True
- False
-True
Willy is a 12-year-old with cystic fibrosis. He requires vitamin K supplementation by injection. Most likely James is deficient in vitamin K because:
- He lacks vitamin K in his diet
- His gut is “sterile”, thus he lacks sufficient bacteria to produce vitamin K
- He has decreased absorption of vitamin K because of insufficient lipase release from his pancreas
- He has a blood clotting condition that has consumed all or most of the vitamin K from his diet
-He has decreased absorption of vitamin K because of insufficient lipase release from his pancreas
A person suffering from an esophageal tear comes to the Emergency Department (ED) vomiting up blood. This scenario would best be described as:
- Hematemesis
- Hematochezia
- Melena
- Lower gastrointestinal bleed
-Hematemesis
Bob is an elderly man with chronic constipation who experiences an acute episode of lower abdominal pain, fever and increased white blood cell count. Radiological images reveal herniation of the colon and there was concern for peritonitis and possible sepsis. Based upon this information, bob is most likely suffering from:
- Inflammatory Bowel Disease
- Crohn’s Disease
- Irritable Bowel Syndrome
- Diverticulosis
-Diverticulosis
Bill is a smoker and obese. He experiences an episode of acute pain and goes to the ED. Radiologic analysis reveals that a small portion of his stomach is above his diaphragm. Likely Bill is suffering from:
- Hiatal hernia
- Gastritis
- Stomatitis
- Peptic ulcer disease
-Hiatal hernia
Jamie eats a large meal and experiences acute epigastric pain as a consequence of the return of gastric contents into the esophagus. This scenario could describe gastroesophageal reflux disease (GERD).
- True
- False
-True
James is diagnosed with an esophageal tumor that makes it very difficult to swallow food. His difficulty swallowing would be described as:
- Diarrhea
- Dysphagia
- Vomiting
- Constipation
-Dysphagia
Jane is suffering from a chronic infection with Hepatitis B virus. Most likely she is suffering from:
- Cirrhosis
- Peptic ulcer disease
- Pancreatitis
- Stomatitis
-Cirrhosis
Kate experiences significant pain as a consequence of a strangulated small bowel. You should be concerned that this is potentially a serious condition that may be life threatening as a consequence of shock and vascular collapse.
- True
- False
-True
Elderly individuals are at greatest risk of vitamin B12 deficiency. One reason is that the number of chief cells decrease as we age, thus less intrinsic factor is produced since the chief cells produce intrinsic factor.
- True
- False
-False
Use of tobacco and alcohol are associated with oral cancer.
- True
- False
-True
Which bone cells are responsive to parathyroid hormone, produce osteocalcin when stimulated by 1,24- dihydroxyvitamin D, and synthesize osteoid?
- Osteoblasts
- Osteocytes
- Fibrocytes
- Osteoclasts
-Osteoblasts
What causes the vasomotor instability (hot flashes) that are associated with declining ovarian function with age?
- Increased estrogen levels
- Decreased thyroxine levels
- Rapid changes in estrogen levels
- Increased progesterone levels
-Rapid changes in estrogen levels
Which of the following cells function to maintain bone matrix?
- Osteophytes
- Osteocytes
- Osteoclasts
- Osteoblasts
-Osteocytes
A patient presents with a history of heavy smoking and obesity and experiences acute pain. Radiologic studies reveal that a small portion of the stomach is above the diaphragm. This is most likely?
- Hiatal hernia
- Stomatitis
- Gastritis
- Peptic ulcer disease
-Hiatal hernia
Which of the following is most likely a sign or symptom of acromegaly?
- Hyperactivity
- Melena
- Aphasia
- Peripheral neuropathy
-Peripheral neuropathy
Hypovolemia that decreases mean arterial pressure normally results in activation of the sympathetic nervous system and the renin-angiotensin system.
- True
- False
-True
The renin-angiotensin-aldosterone system compensates for hypovolemic shock by stimulating:
- Movement of calcium into vascular smooth muscle, causing vasoconstriction and increasing systemic vascular resistance
- B1 adrenergic receptors to increase myocardial contractility, heart rate, and conduction through the atrioventricular node
- Aldosterone release, which retains sodium and hence water to increase the blood volume
- Antidiuretic hormone from the posterior pituitary to retain potassium and excrete sodium to improve myocardial contractility
-Aldosterone release, which retains sodium and hence water to increase the blood volume
Spermatogenesis occurs in the:
- Seminiferous tubules
- Epididymis
- Vas deferens
- Testes
-Seminiferous tubules
The final common pathway in all shock is:
- Impairment of cellular metabolism
- Cellular alterations in the vasculature and kidneys
- Impairment of urine excretion
- Cellular alterations in the heart and brain
-Impairment of cellular metabolism
A patient with renal failure is likely to have hypoalbuminemia
- True
- False
-True
Psoriasis may be considered a chronic, genetically determined disease of epidermal proliferation.
- True
- False
-True
***Sara’s test
?I’m not sure I like the genetically-determined wording.
Which joint disease is characterized by joint stiffness on movement and joint pain of weight-bearing joints that usually is relieved by rest?
- Rheumatoid arthritis
- Suppurative arthritis
- Osteoarthritis
- Gouty arthritis
- Osteoarthritis
* Sara’s test*
What is an appropriate treatment for sickle cell disease?
- Early spleen removal
- Dehydration to prevent vaso-occlusive crisis
- Acetaminophen for fever control
- Hydroxyurea for Streptococcus pneumoniae
- Hydroxyurea for Streptococcus pneumoniae
* Sara’s test*
Which of the following minerals are stored in the bones?
- Sodium, iron, and selenium
- Phosphate, carbonate, and magnesium
- Potassium, fluoride, and copper
- Zinc, sulfur, and chloride
- Phosphate, carbonate, and magnesium
* Sara’s & Annie’s test*
Rhabdomyolysis is characterized by:
- Paralysis of skeletal muscles resulting from impaired nerve supply
- Smooth muscle degeneration resulting from ischemia
- Lysis of skeletal muscle cells through the initiation of complement cascade
- Release of myoglobin from damaged striated muscle cells
- Release of myoglobin from damaged striated muscle cells
* Sara’s test*
Urticaria is a result of what type of reaction?
- Type I hypersensitivity
- Type IV hypersensitivity
- Type III hypersensitivity
- Type II hypersensitivity
-Type I hypersensitivity
What causes the microvascular complications of clients with diabetes mellitus?
- The capillary basement membranes thicken and there is endothelial cell hyperplasia
- Fibrous plaques form from the proliferation of subendothelial smooth muscle of arteries
- The capillaries contain plaques of lipids that obstruct blood flow
- There is increased pressure within capillaries as a result of the elevated glucose attracting water
- The capillary basement membranes thicken and there is endothelial cell hyperplasia
- Sara’s test*
During an IgE-mediated hypersensitivity reaction, which leukocyte is activated?
- Monocytes
- Eosinophils
- T lymphocytes
- Neutrophils
- Eosinophils
* Sara’s test*
The end product of protein metabolism excreted in the urine is:
- Glucose
- Ketones
- Bile
- Urea
- Urea
* **Annie’s Test
Which of the following is the proper histological cell type associated with hashimoto’s thyroiditis?
- Cells with Orphan-Annie Eye Nuclei
- Granulomatous inflammation
- Acinar Cells
- Hurthle Cells
- Hurthle Cells
* **Annie’s test
Which of the following is a lab value, neurotransmitter or hormone most likely identified with acromegaly?
- Increased T3
- Increased T4
- Excessive growth hormone
- Decreased growth hormone
-Excessive growth hormone
Removal of substances from the blood into the renal tubule at the peritubular capillaries is best described as which of the following processes?
- Reabsorption
- Filtration
- Excretion
- Secretion
- Secretion
* **Annie’s Test
Innervation of the bladder and internal urethral sphincter is supplied by which nerves?
- Tenth thoracic nerve roots
- Parasympathetic nervous system
- Peripheral nerves
- Sympathetic nervous system
The part of the nephron where antidiuretic hormone (ADH) primarily acts is the:
- Collecting tubule
- Proximal convoluted tubule
- Loop of Henle
- Cortex
- Collecting tubule
* **Annie’s test
Severe combined immunodeficiency is a disorder that results from the loss of B-cell function as well as T-cell function.
- True
- False
- True
* *Annie’s Test
When bone is “resorbed” during the process of growth and repair, the original bone:
- Hardens
- Is synthesized
- Is replaced
- Is removed
Which type of angina results from coronary artery vasospasm and occurs in atypical patterns A. Classic Angina B. Prinzmetal's Angina C. Unstable Angina D. Pleuritic chest pain
Prinzmetal’s Angina
The rhythm of the heart is generated by the: SA node AV node Atrium Ventricle
SA node (Sinoartrial node)
To increase oxygen saturation after exertion, a patient with Tetralogy of Fallot will: Lie down Stand up Squat Cough
Squat
Which of the following ECG changes is NOT specific to episodes of angina? ST segment elevation Premature ventricular contractions T-wave inversions Q waves
Premature Ventricular Contractions
How long after a myocardial infarction can the initial troponin level be detected? 1 hour 3 hours 6 hours 8 hours
3 hours
The bacteria responsible for rheumatic fever is: Klebsiella pneumoniae Group A Streptococcus Enterobacter species Escherichia coli
Group A Streptococcus
Which of the following assessment findings correlates with dynamic obstruction of the left ventricle? PVCs Lung hyperinflation Peripheral edema Systolic murmur
Systolic Murmur
Which of the following cardiac rhythms do not lead to a decrease in cardiac output?
Normal sinus rhythm
Bradycardia
Atrial Fibrillation
Atrioventricular block
Normal sinus rhythm
The acute inflammatory response in a myocardial infarction is associated with:
A decrease in serum cytokine concentrations
Depletion of nitric oxide, causing vasoconstriction
Vasodilation and increased systemic pressure
Cytokine activation and vasodilation with decreased perfusion pressure
Cytokine activation and vasodilation with decreased perfusion pressure
Which of the following cardiac rhythms is characterized by P waves that precede each QRS interval?
Sinus bradycardia
Atrial flutter
Ventricle tachycardia
Torsades de Pointes
Sinus bradycardia
Aortic stenosis may be identified by:
A low-intensity, high-pitched murmur
A crescendo-decrescendo systolic murmur
A high-pitched and blowing murmur with a decrescendo configuration
A murmur with a rumbling character
A crescendo-decrescendo systolic murmur
Hypertension is NOT caused by changes in:
Heart rate
Stroke volume
Cardiac output
Vascular relaxation
Vascular relaxation
The accumulation of fluid in the pericardial cavity is:
Endocarditis
Myocarditis
Pericardial effusion
Cardiomyopathy
Pericardial effusion
A pediatric patient with a ventricular septal defect would have which type of murmur?
Mid-diastolic
Holosystolic
Atypical systolic
Mid-systolic
Holosystolic
Which of the following may be seen in patients with acute coronary syndrome?
Resting angina lasting less than 10 minutes in duration
New onset angina that markedly limits physical activity
Intermittent pleuritic chest pain that occurs with movement
Chest pain that occurs at least once a week for 6 weeks
New onset angina that markedly limits physical activity
Hypercholesterolemia is one of the major risk factors contributing to the development of:
Coronary artery disease
Dilated cardiomyopathy
Type 1 diabetes
Acute renal insufficiency
Coronary artery disease
The systemic disease that occurs secondary to untreated Strep throat is:
Rheumatic fever
Meningitis
Mononucleosis
Tonsillitis
Rheumatic fever
A reduced risk of cardiovascular disease has been associated with aggressive control of:
Sodium
Potassium
Triglycerides
Low-density lipoproteins
Low-density lipoproteins
Which one of the following produces visible evidence of an underlying problem with reverse venous flow?
Cellulitis
Bruising
Stasis Dermatitis
Varicose Veins
Varicose Veins
Triglycerides are synthesized by the:
Pancreas
Liver
Kidneys
Stomach
Liver
In right heart failure due to right ventricular dysfunction:
Systemic venous pressure decreases
Systemic venous pressure is not affected
Systemic venous pressure increases
Systemic venous pressure can be increased or decreased
Systemic venous pressure increases
Cardiogenic shock in the presence of an acute myocardial infarction typically involves:
Decreased stroke volume and increased cardiac output
Decreased vascular resistance and decreased cardiac output
Increase in systemic vascular resistance and increase in stroke volume
Decrease in stroke volume and decrease in cardiac output
Decrease in stroke volume and decrease in cardiac output
Which lipoprotein plays a major role in reverse cholesterol transport away from the arteries and back to the liver?
HDL
LDL
Triglycerides
Total Cholesterol
HDL
In a patient with atrial-septal defect, split heart sounds are due to:
Left-to-right shunting of blood
Systolic overload of the left ventricle
Stenosis of the aortic valve
Decreased pulmonary blood flow
Left-to-right shunting of blood
Which one of the following causes reactive hyperemia?
Raynaud phenomenon
Peripheral neuropathy
Pulmonary edema
Hypotension
Raynaud phenomenon
The most common cause of left ventricular hypertrophy is:
Heredity
Hypertension
Pulmonary edema
Mitral regurgitation
Hypertension
Which one of the following is NOT present in tetralogy of Fallot?
Patent ductus arteriosus
Ventricular hypertrophy
Pulmonary stenosis
Ventricular septal defect
Patent ductus arteriosus
Which of the following is true about the normal heart function of an infant?
The left ventricle pumps oxygen-rich blood
The right ventricle pumps oxygen-rich blood
The ductus arteriosus closes in the two weeks of birth
The pulmonary artery carries oxygen-rich blood to the left ventricle
The left ventricle pumps oxygen-rich blood
Which one of the following is secreted by ventricular myocytes and assists in the diagnosis of heart failure?
Atrial natriuretic peptide
Brain natriuretic peptide
Endothelin
Nitric oxide
Brain natriuretic peptide
Atherosclerosis in the lower extremities commonly causes:
Venous insufficiency
Peripheral artery disease
Lymphadenopathy
Diabetic neuropathy
Peripheral artery disease
A congenital heart defect that warrants emergency medical and surgical intervention is:
An acyanotic defect that increases pulmonary blood flow
A cyanotic defect that decreases pulmonary blood flow
A stenotic lesion with poor blood flow from ventricles
A cyanotic mixed defect with increased pulmonary blood flow
A cyanotic defect that decreases pulmonary blood flow
Diastolic heart failure is a result of impairment in the:
Right atrium
Left ventricle
Right ventricle
Left atrium
Left ventricle
An elevation of which laboratory finding is indicative of a myocardial infarction?
Troponin
CK-MB
BNP
Potassium
Troponin
Cardiac preload is defined as the:
Amount of vascular resistance that must be overcome on ventricular contraction
Pressure exerted on the atria during filling
Volume of blood in the atria at the end of diastole
Decreased volume of blood in the ventricles during systole
Volume of blood in the atria at the end of diastole
Which one of the following conditions is an acute, febrile, immune-mediated disease characterized by vasculitis leading to coronary artery aneurysm?
Measles
Epstein Barr infection
Rocky Mountain spotted fever
Kawasaki syndrome
Kawasaki syndrome
A variant angina characterized by transient reduction in the luminal diameter within the coronary artery and consistent with ST elevation is:
Classic angina
Stable angina
Prinzmetal’s angina
Unstable angina
Prinzmetal’s angina
Which of the following types of angina involves nocturnal symptoms?
Classic angina
Stable angina
Prinzmetal’s angina
Unstable angina
Unstable angina
A patient who is in cardiogenic shock will present with:
A high cardiac index
Decreased vascular resistance
Increased ventricular ejection fraction
Mixed venous oxygen saturation
Mixed venous oxygen saturation
Which heart condition includes both a systolic and diastolic timed murmur?
Pulmonic stenosis
Aortic regurgitation
Mitral stenosis
Tricuspid regurgitation
Tricuspid regurgitation
Symptoms of mild heart failure include:
Nocturnal dyspnea
Hypotension
S3 gallop
Frothy sputum
S3 gallop
Mortality associated with Kawasaki syndrome is most likely related to:
Splenomegaly
Coronary artery aneurysm
Acute renal failure
Secondary pneumonia
Coronary artery aneurysm
Which of the following is most responsible for the buildup of cholesterol in the arteries, increasing the risk of heart disease and stroke?
High-density lipoproteins
Low-density lipoproteins
Triglycerides
Total cholesterol
Low-density lipoproteins
Unstable angina is characterized by:
Angina with prolonged activity
Angina symptoms lasting >6 months
Increasing crescendo angina
Angina with elevated cardiac markers
Increasing crescendo angina
Pediatric patients with tetralogy of Fallot have episodes of bluish skin during crying and feeding that are called:
Tachypnea
Dyspnea
Tet spells
Cheyne-Stokes breathing
Tet spells
What is the purpose of activation of the sympathetic nervous system, the renin-angiotensin-aldosterone system, and the antidiuretic system in the presence of impaired cardiac pumping and/or filling?
Promotion of venous relaxation
Production of arterial vasoconstriction
Decrease in venous pressure
Decrease in ventricular filling
Production of arterial vasoconstriction
A mother states that her young child has been squatting after exertion and is easily fatigued. The NP suspects:
Aortic stenosis
Tetralogy of Fallot
Atrial septal defect
Patent ductus arteriosus
Tetralogy of Fallot
Which condition is a direct acute cause of pulmonary hypertension, leading to right heart failure?
Obstructive sleep apnea
Chronic obstructive pulmonary disease
Pulmonary embolism
Pulmonary fibrosis
Pulmonary embolism
When atrial fibrillation terminates within 7 days of onset, it is classified as:
Longstanding persistent
Permanent
Paroxysmal
Nonvalvular
Paroxysmal
Elevated troponin levels are present in:
Unstable angina
NSTEMI
Uncontrolled hypertension
Heart failure
NSTEMI
Which congenital heart defect involves an abnormal opening between the atria that is expected to close without surgical intervention by 12 months of age?
Atrial septal defect
Ventricular septal defect
Patent ductus arteriosus
Tetralogy of Fallot
Atrial septal defect
Which one of the following is a clinical syndrome that results from any structural or functional cardiac disorder that impairs the ability of the ventricles to fill or eject blood?
Heart failure
Hypertension
Cardiomyopathy
Myocardial infarction
Heart failure
The formation of an atherosclerotic lesion in the arterial wall is related to high levels of:
Cholesterol
HDLs
LDLs
Triglycerides
LDLs
Which type of ECG changes may be produced by acute coronary syndrome?
ST elevation
QT prolongation
Dropped P waves
Diastolic murmur
ST elevation
Which cardiac condition involves thickening of the muscle wall of the right lower chamber of the heart?
Ventricular septal defect
Ventricular hypertrophy
Pulmonary stenosis
Patent ductus arteriosus
Ventricular hypertrophy
With each heart beat, blood within the left and right ventricle is ejected into the:
Left atrium only
Aorta and pulmonary artery
Anterior descending artery
Right coronary artery
Aorta and pulmonary artery
When alpha receptors are stimulated, what primary physiologic response is expected:
Blood pressure decreases
Blood pressure increases
Heart rate decreases
Heart rate increases
Blood pressure increases
In a patient with a ventricular septal defect, blood flows:
Through the left ventricle back to the heart
To the left atrium and into the lungs
To the right ventricle and into the lungs
Through the right atrium back to the heart
To the right ventricle and into the lungs
Which congenital heart defect is known to cause cyanotic episodes precipitated by crying, feeding, or other activities?
Atrial septal defect
Ventricular septal defect
Patent ductus arteriosus
Tetralogy of Fallot
Tetralogy of Fallot
Sick sinus syndrome is described as the:
Failure of the SA node to discharge
Junction fibers in the AV node joining with the bundle of His.
AV node pacing when the SA node fails to initiate impulse
Destruction of the SA node and changes in the nerves and ganglia
Destruction of the SA node and changes in the nerves and ganglia
Transposition of the great arteries (TGA) is described as:
Acyanotic deficits increasing pulmonary blood flow
Cyanotic defect that decreases pulmonary blood flow
Cyanotic mixed defects with increased pulmonary blood flow
Obstructive lesions with poor blood flow from ventricles
Cyanotic mixed defects with increased pulmonary blood flow
Which one of the following is NOT a true statement about left-sided heart failure?
The heart moves blood from high pulmonary pressure to low systemic circulation pressure
Left-sided heart failure causes a decrease in cardiac output and an increase in diastolic pressure
Left-sided heart failure results in an increase in left atrial pressure and congestion in pulmonary circulation
Capillary filtration pressure exceeds the capillary colloidal osmotic pressure
The heart moves blood from high pulmonary pressure to low systemic circulation pressure
A common symptom of a congenital heart defect is:
Jugular venous distension
Hypertension
Central cyanosis
Atrial fibrillation
Central cyanosis
The heart sound that is NOT auscultated in a patient with aortic stenosis is:
Narrowing split S2
Right sternal border thrill
Grade III harsh murmur
S3 gallop
S3 gallop
Patients with acute coronary syndrome typically have plaque erosion, which is characterized by:
Cellulose and eosinophils
Low-density lipoproteins and monocytes
Calcium and leukocytes
Hyaluronan and neutrophils
Hyaluronan and neutrophils
Which peptide hormone causes vasoconstriction and increases blood pressure?
Norepinephrine
Epinephrine
Angiotensin
Vasopressin
Angiotensin
The Trendelenburg test is used to assess for:
Peripheral neuritis
Deep vein thrombosis
Arterial insufficiency
Varicose veins
Varicose veins
A common cause of diastolic heart failure is:
Myocarditis
Myocardial infarction
Dilated cardiomyopathy
Hypertension
Hypertension
Diastole:
Occurs at the end of the cardiac cycle
Is the highest pressure in the aorta during relaxation
Is the minimum arterial pressure exerted during relaxation and dilation of the ventricles
Is the peak pressure that occurs when the ventricles contract
Is the minimum arterial pressure exerted during relaxation and dilation of the ventricles
Which one of the following congenital heart defects does NOT depend on left to right shunting through ductus arteriosus for pulmonary circulation?
Aortic stenosis
Pulmonary atresia
Pulmonary stenosis
Tetralogy of Fallot
Aortic stenosis
The amount of pressure that occurs when the ventricles contract is the:
Mean arterial pressure
Systolic pressure
Diastolic pressure
Pulse pressure
Systolic pressure
A progressive disease of heart muscle that is characterized by ventricular chamber enlargement and contractile dysfunction is:
Acute coronary syndrome
Cardiac tamponade
Dilated cardiomyopathy
Thyrotoxicosis
Dilated cardiomyopathy
Which one of the following is the cardiac rhythm described as prolongation of the QT interval?
Atrial flutter
Ventricular tachycardia
Torsades de pointes
Third-degree AV block
Torsades de pointes
The primary function of the heart is:
To maintain pressure throughout the cardiovascular system
To generate the flow of blood to the right ventricle
To pump blood through the body via the circulatory system
To excrete carbon monoxide from the blood
To pump blood through the body via the circulatory system
Patients with acute coronary syndrome may experience chest pain secondary to:
Arterial vasodilation
Oxygen demand
Potassium depletion
Elevated Creatine
Oxygen demand
Which of the following is NOT a Virchow’s triad risk factor for deep vein thrombosis?
Hypercoagulability
Endothelial injury
Stasis
Peripheral nervous system damage
Peripheral nervous system damage
Which of the following is not a deficit of tetralogy of Fallot?
A hole between the ventricles of the heart
A narrowing of the pulmonary valve and artery
An enlargement of the triscupid valves
A thickening of the ventricle chambers
An enlargement of the triscupid valves
The primary cause of cardiogenic shock in a patient with acute MI is:
Failure of the ventricle to pump blood adequately
Failure of the aortic valve to pump blood adequately
Regurgitation of the tricuspid valve
Regurgitation of the mitral valve
Failure of the ventricle to pump blood adequately
A birth defect characterized by a hole in the septum that separates the two upper chambers of the heart is:
Ventricular septal defect
Patent ductus arteriosus
Atrial septal defect
Tetralogy of Fallot
Atrial septal defect
Which of the following statements accurately describes a premature ventricular contraction (PVC)?
It is caused by a ventricular ectopic pacemaker
It is caused by failure of the AV node to fire
It is caused by bifurcation on the bundle of His
It is caused by prolongation of the QT interval
It is caused by a ventricular ectopic pacemaker
Which of the following conditions may predispose patients to an atypical presentation of myocardial ischemia?
Obesity
Lupus
Diabetes mellitus
Rheumatoid arthritis
Diabetes mellitus
