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NR 507 patho final examination.docx/ COMPLETE SOLUTION/ RATED A

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NR 507 patho final examination.docx What period follows depolarization of the myocardium and represents a period during which no new cardiac potential can be propagated? What is the sugg... ested mean blood pressure for an 8- to 9-year-old child? Which is an example of an endogenous antigen? An infant has a crescendo-decrescendo systolic ejection murmur located between the second and third intercostal spaces along the left sternal border. A wide fixed splitting of the second heart sound is also found. These clinical findings are consistent with which congenital heart defect? Chvostek and Trousseau signs indicate which electrolyte imbalance? How does chest wall compliance in an infant differ from that of an adult? What is the most commonly reported symptom of cancer treatment? At birth, which statement is true? What is the treatment of choice for pernicious anemia (PA)? Which disease is an example of a rickettsial infection? Which statement is true regarding maternal antibodies provided to the neonate? The antibodies enter into the fetal circulation by means of active transport. The antibodies are transferred to the fetus via the lymphatic system. The antibodies reach protective levels after approximately 6 months of age. The antibodies are directly related to the mother’s nutritional intake. To protect the child against infectious agents both in utero and during the first few postnatal months, a system of active transport facilitates the passage of maternal antibodies into the fetal circulation. The antibodies are transmitted via the placenta and are related to the mother’s immune system. The infant’s own IgG-related antibodies reach protective levels by 6 months of age. Which statement is true regarding pain and cancer? Pain is primarily a result of pressure caused by the tumor. Pain is generally associated with late-stage cancer. Pain indicates the metastasis of a cancer. Pain is usually the initial symptom of cancer. Pain is generally associated with the late stages of cancer. Pressure, obstruction, invasion of a structure sensitive to pain, stretching, tissue destruction, and inflammation can cause pain. Pain is not the initial symptom of cancer nor does it indication that the cancer has metastasized. During an infection, why do lymph nodes enlarge and become tender? The nodes fill with purulent exudate. B lymphocytes proliferate. The nodes are not properly functioning. The nodes are inflamed. The B lymphocyte proliferation in response to significant antigen (e.g., during infection) may result in lymph node enlargement and tenderness (reactive lymph node). This description is not accurate for the other options. What is a significant cause of morbidity and mortality worldwide? Starvation Cardiovascular disease Infectious disease Traumatic injury Despite the wide-scale implementation of progressive public health and immunization policies, infectious disease remains a significant cause of morbidity and mortality. The other options are not significant causes. Which renal change is found in older adults? Sharp decline in glomerular filtration rate Decrease in urine output Sharp decline in renal blood flow Decrease in the number of nephrons With aging, the number of nephrons decreases. The other options are not necessarily related to aging. After sexual transmission of HIV, a person can be infected yet seronegative for how many months? 24 to 36 18 to 20 6 to 14 1 to 2 Antibody appears rather rapidly after infection through blood products, usually within 4 to 7 weeks. After sexual transmission, however, the individual can be infected yet seronegative for 6 to 14 months or, in at least one case, for years. Which organism is responsible for the development of syphilis? Neisseria syphilis Treponema pallidum Chlamydia trachomatis Haemophilus ducreyi T. pallidum is the only cause of syphilis. The common hay fever allergy is expressed through a reaction that is mediated by which class of immunoglobulins? IgE IgG T cells IgM Type I reactions are mediated by antigen-specific IgE and the products of tissue mast cells (see Figure 9-1). The most common allergies (e.g., pollen allergies) are type I reactions. In addition, most type I reactions occur against environmental antigens and are therefore allergic. The other options do not accurately identify the mediation factor related to hay fever. Blood cells that differentiate into macrophages are known as: Neutrophils Basophils Eosinophils Monocytes Only monocytes migrate into a variety of tissues and fully mature into tissue macrophages and myeloid dendritic cells (see Table 27-3). In which structure does B lymphocytes mature and undergo changes that commit them to becoming B cells? Spleen Regional lymph nodes Thymus gland Bone marrow B lymphocytes mature and become B cells in specialized (primary) lymphoid organs— the thymus gland for T cells and the bone marrow for B cells. Neither regional lymph nodes nor the spleen are involved in changing B lymphocytes into B cells. Hemophilia B is caused by a deficiency of which clotting factor? V IX X VIII Only factor IX deficiency causes hemophilia B (Christmas disease). Which of the following causes condylomata acuminata or genital warts? Human papillomavirus (HPV) Herpes simplex virus 1 (HSV-1) Chlamydia Adenovirus Genital warts are quite contagious and are a result of only HPV. Exhaustion occurs if stress continues when which stage of the general adaptation syndrome is not successful? Alarm Adaptation Flight or fight Arousal Exhaustion occurs if stress continues and adaptation is not successful, ultimately causing impairment of the immune response, heart failure, and kidney failure, leading to death. The other stages occur before the adaptation stage. Which chamber of the heart endures the highest pressures? Left ventricle Left atrium Right ventricle Right atrium Pressure is greatest in the systemic circulation, driven by the left ventricle. Which glycoprotein protects against urolithiasis and is a ligand for lymphokines? Uromodulin Urodilatin Cystatin Nephrin Tamm-Horsfall glycoprotein, also known as uromodulin, is the most abundant urinary protein, protects against bacterial adhesion and urolithiasis, and is a ligand for lymphokines. This statement is not true of the other options. Having ejected a mature ovum, the ovarian follicle develops into a(n): Functional scar Thecal follicle Atretic follicle Corpus luteum Having ejected a mature ovum, the only resulting structure is the corpus luteum. The most critical aspect in correctly diagnosing a seizure disorder and establishing its cause is: Health history Computed tomographic (CT) scan Skull x-ray studies Cerebrospinal fluid analysis Although the history may be supplemented with the remaining options, it remains the pivotal tool for establishing the cause of a seizure disorder. Which serum laboratory test is elevated in all forms of osteogenesis imperfecta? Alkaline phosphatase Calcium Total protein Phosphorus Of the available options, serum alkaline phosphatase is elevated in all forms of the disease. How does the release (increase) of epinephrine raise body temperature? It increases and strengthens the heart rate. The release of epinephrine causes shivering. It raises the metabolic rate. It affects muscle tone. Epinephrine and norepinephrine produce a rapid transient increase in heat production by raising the body’s basal metabolic rate. The other options are not correct descriptions of the effects of epinephrine on body heat. Clinical manifestations that include irregular or heavy bleeding, the passage of large clots, and the depletion of iron stores support which diagnosis? Premenstrual syndrome Dysfunctional uterine bleeding Primary dysmenorrhea Polycystic ovary syndrome Unpredictable and variable bleeding, in terms of amount and duration, characterize dysfunctional uterine bleeding. Especially during perimenopause, dysfunctional bleeding also may involve flooding and the passage of large clots, which often indicate excessive blood loss. Excessive bleeding can lead to iron-deficiency anemia. This option is the only answer that demonstrates the clinical manifestations described. What happens to the vagina’s lining at puberty? It becomes thinner. It becomes thicker. It assumes a neutral pH. It undergoes atrophy. Before puberty, vaginal pH is approximately 7 (neutral) and the vaginal epithelium is thin. At puberty, the pH becomes more acidic (4 to 5) and the squamous epithelial lining thickens. Cell atrophy is not associated with puberty. Why is prolonged diarrhea more severe in children than it is in adults? Children have diarrhea more often than adults. Less water is absorbed from the colon in children. Fluid reserves are smaller in children. Children have a higher fluid volume intake. Infants have low fluid reserves and relatively rapid peristalsis and metabolism. Therefore the danger of dehydration is great. This selection is the only option that correctly identifies the reason prolonged diarrhea is more severe in children. The two most important risk factors for type 2 diabetes are: Autoantibodies and human leukocyte antigen associations HLA associations and positive family history Autoantibodies and obesity Obesity and positive family history The two most important risk factors for type 2 diabetes are positive family history and obesity. The other options are not believed to be important risk factors for this form of diabetes. What is the leading cause of infertility in women? Polycystic ovary syndrome Endometriosis Pelvic inflammatory disease Salpingitis Polycystic ovary syndrome remains one of the most common endocrine disturbances affecting women, especially young women, and is a leading cause of infertility in the United States. Adoption studies have shown that the offspring of an alcoholic parent when raised by nonalcoholic parents have what amount of an increased risk of developing alcoholism? Tenfold Fourfold Threefold Twofold Adoption studies have shown that the offspring of an alcoholic parent, even when raised by nonalcoholic parents, have a fourfold increased risk of developing the disorder. Which structure attaches skeletal muscle to bone? Ligament Tendon Bursa Mesentery A tendon is fibrous connective tissue that attaches skeletal muscle to bone. None of the other options are associated with this function. Which term is used to describe an intestinal obstruction caused by the invagination of the ileum into the cecum and part of the ascending colon by collapsing through the ileocecal valve? Volvulus Intussusception Congenital aganglionic megacolon Malrotation Intussusception is the telescoping or invagination of one portion of the intestine into another section of intestine. Usually, the ileum invaginates the cecum and part of the ascending colon by collapsing through the ileocecal valve. The other terms are not used to describe this event. The tear in a ligament is referred to as a: Disunion Fracture Sprain Strain Ligament tears are commonly known as sprains. None of the other options are associated with this damage. Which dyskinesia involves involuntary movements of the face, trunk, and extremities? Hyperkinesia Paroxysmal Tardive Cardive Tardive dyskinesia is the involuntary movement of the face, trunk, and extremities. The other terms do not describe involuntary movements of the face, trunk, and extremities. Which of the following is a lipid-soluble hormone? Growth hormone Oxytocin Epinephrine Cortisol Cortisol and adrenal androgens are lipid-soluble hormones and are primarily bound to a carrier or transport protein in circulation. The other options are water-soluble hormones. Question 41 2 / 2 pts It is true that myasthenia gravis: Is an acute autoimmune disease. Causes muscle weakness. May result in adrenergic crisis. Affects the nerve roots. Exertional fatigue and weakness that worsens with activity, improves with rest, and recurs with resumption of activity characterizes myasthenia gravis. None of the other options are true of myasthenia gravis. What effect does hyperphosphatemia have on other electrolytes? Increases serum magnesium. Decreases serum calcium. Increases serum calcium. Decreases serum magnesium. Hyperphosphatemia leads to hypocalcemia; the other options are incorrect. An amniocentesis indicates a neural tube defect when an increase in which protein is evident? Embryonic Chorionic Alpha fetoprotein Amniotic Other disorders can be detected with this procedure. These include most neural tube defects, which cause an elevation of alpha fetoprotein in the amniotic fluid, and hundreds of diseases caused by mutations of single genes. The correct option is the only one that accurately identifies the protein responsible for a neural tube defect. Which pancreatic enzyme is responsible for the breakdown of carbohydrates? Chymotrypsin Trypsin Amylase Lipase Salivary and pancreatic amylases break down starches to oligosaccharides by splitting α-1,4-glucosidic linkages of long-chain molecules. None of the other options is relevant to this process. What part of the brain provides the emotional response to pain? Hypothalamus Thalamus Limbic system Parietal lobe The limbic and reticular tracts are involved in alerting the body to danger, initiating arousal of the organism, and emotionally processing the perceived afferent signals, not just as stimuli, but also as pain. The remaining options do not fulfill this objective. Which type of ion directly controls the contraction of muscles? Calcium Magnesium Potassium Sodium Contraction begins as the calcium ions combine with troponin, a reaction that overcomes the inhibitory function of the troponin-tropomyosin system. This selection is the only option that has such a direct association with muscle contraction. The secretion of adrenocorticotropic-stimulating hormone (ACTH) will result in the increased level of which hormone? Cortisol. Insulin Thyroxine Antidiuretic hormone Psychologic and physiologic stress (e.g., hypoxia, hypoglycemia, hyperthermia, exercise) increases ACTH secretion, leading to increased cortisol levels. Only cortisol describes the appropriate feedback loop. In 95% of children of delayed puberty, the problem is caused by: Disruption of the pituitary Physiologic hormonal delays Deficit in estrogen or testosterone Disruption in the hypothalamus In 95% of children with delayed puberty, the delay is physiologic; that is, hormonal levels are normal and the hypothalamic-pituitary-gonadal (HPG) axis is intact, but maturation is slowly happening. This option is the only answer that accurately describes the most common cause of delayed puberty. Bacteria gain access to the female urinary tract by which means? Systemic blood that is filtered through the kidney Bacteria ascending the urethra into the bladder Bacteria traveling from the lymph adjacent to the bladder and kidneys Colonization of the bladder when urine is static Urinary tract infections (UTIs) in girls occur as a result of perineal bacteria, especially Escherichia coli, ascending the urethra. None of the other options represent the means by which bacteria gain access to the female urinary tract. Neurofibrillary tangles characterize which neurologic disorder? Dementia syndrome Delirium Alzheimer disease Parkinson disease Amyloid plaques, neurofibrillary tangles, as well as neuronal and synaptic losses in the brain, characterize Alzheimer disease. Which change is a result of puberty and defends the vagina from infection? Estrogen levels are low. The pH stabilizes between 7 and 8. Vaginal pH becomes more acidic. A thin squamous epithelial lining develops. At puberty, the pH becomes more acidic (4 to 5) and the squamous epithelial lining thickens. These changes are maintained until menopause (cessation of menstruation), at which time the pH rises again to more alkaline levels and the epithelium thins out. Therefore protection from infection is greatest during the years when a woman is most likely to be sexually active. Estrogen does not play a role in infection protection. The data reporting that sickle cell disease affects approximately 1 in 600 American blacks is an example of which concept? Incidence Ratio Risk Prevalence Prevalence rate is the proportion of the population affected by a disease at a specific point in time. Thus both the incidence rate and the length of the survival period in affected individuals determine prevalence. The incidence rate is the number of new cases of a disease reported during a specific period (typically 1 year), divided by the number of individuals in the population. A numerical expression representing a part of a larger whole or proportion is considered a ratio. Any factor that increases the chance of disease or injury is considered a risk. Which clinical manifestations would be expected for a child who has complete trisomy of the twenty-first chromosome? Widely spaced nipples, reduced carrying angle at the elbow, and sparse body hair High-pitched voice, tall stature, gynecomastia, and an IQ of 60 to 90 Circumoral cyanosis, edema of the feet, short stature, and mental slowness An IQ of 25 to 70, low nasal bridge, protruding tongue, and flat, low-set ears Individuals with this disease are mentally retarded, with IQs usually ranging from 25 to 70. The facial appearance is distinctive and exhibits a low nasal bridge, epicanthal folds (which produce a superficially Asian appearance), protruding tongue, and flat, low-set ears. The correct option is the only one that accurately describes the clinical manifestations of the complete trisomy of the twenty-first chromosome. Which assessment finding characterizes Osgood-Schlatter disease? Tendinitis of the anterior patellar tendon Bursitis of the subscapular bursa in the glenohumeral joint Inflammation of the anterior cruciate ligament Lateral epicondylitis of the elbow Tendinitis of the anterior patellar tendon, within which the patella (kneecap) is embedded, and associated osteochondrosis of the tubercle of the tibia are characteristics of Osgood-Schlatter disease. This selection is the only option that is associated with Osgood-Schlatter disease. Dilation of the ipsilateral pupil, following uncal herniation, is the result of pressure on which cranial nerve (CN)? Abducens (CN VI) Trochlear (CN IV) Optic (CN I) Oculomotor (CN III) The oculomotor CN (III) is involved in this manifestation of pupil dilation. None of the other options would result in pupil dilation when subjected to pressure. What directly causes ovulation during the menstrual cycle? Gradual decrease in estrogen levels Gradual increase in estrogen levels Sudden increase of LH Sharp rise in progesterone levels Menstrual cyclicity and regular ovulation are dependent on (1) the activity of the gonadostat (GnRH pulse generator); (2) the pituitary secretion of gonadotropins; and (3) estrogen (estradiol)–positive feedback for the preovulatory LH and FSH surges, oocyte maturation, and corpus luteum formation. Which clinical manifestations are associated with fibromyalgia? Sensitivity at tender points and profound fatigue Hot, tender, and edematous muscle groups bilaterally Fasciculations of the upper and lower extremity muscles Exercise intolerance and painful muscle cramps Widespread joint and muscle pain, fatigue, and tender points are characteristics of fibromyalgia, a chronic musculoskeletal syndrome. Increased sensitivity to touch (i.e., tender points), the absence of systemic or localized inflammation, and fatigue and sleep disturbances are common. Fatigue is profound. The remaining options include symptoms not generally associated with fibromyalgia. Which would be considered a positive symptom of schizophrenia? Lack of social interaction Blunted affect Auditory hallucinations Poverty of speech Positive symptoms frequently occur during a psychotic episode, when an individual loses touch with reality and experiences something that should be absent (e.g., hallucinations). The remaining options are classified as negative symptoms. What anchors articular cartilage to the underlying bone? Collagen fibers Elastin fibers Sharpey fibers Glycoproteins Collagen fibers are important components of the cartilage matrix because they anchor the cartilage securely to underlying bone. This statement is not true of the other options. At 2 or 3 weeks of age, an infant who has been well fed and has gained weight begins to vomit for no apparent reason. The vomiting gradually becomes more forceful. These symptoms may be indicative of which disorder? Pyloric stenosis Galactosemia Congenital aganglionic megacolon Esophageal atresia Of the options available, only the clinical manifestations of pyloric stenosis—an infant who has been well fed and has gained weight begins to vomit without an apparent reason—can appear between 2 and 3 weeks after birth. The vomiting gradually becomes more forceful. Pinkeye is characterized by inflammation of which structure? Sebaceous glands Eyelids Meibomian glands Conjunctiva Acute bacterial conjunctivitis (pinkeye) is an inflammation of the conjunctiva (mucous membrane covering the front part of the eyeball). The other structures are not affected by this inflammation. The common property among the three types of medications used to treat depression is that they: Decrease neurotransmitter levels in the postsynapse. Increase neurotransmitter levels within the synapse. Decrease neurotransmitter levels within the synapse. Increase neurotransmitter levels in the presynapse. All available antidepressants share the common property, albeit through different mechanisms, that increasing monoamine neurotransmitter levels within the synapse is the basis for their antidepressant effects. The processes by which antidepressants affect depression make the remaining options untrue. What term is used to identify the calcium crystals that are associated with chronic gout? Spurs Stones Nodes Tophi With time, crystal deposition in subcutaneous tissues causes the formation of small white nodules, or tophi, that are visible through the skin. Crystal aggregates deposited in the kidneys can form urate renal stones and lead to renal failure. None of the other options are associated with the calcium crystals resulting from chronic gout. The presence of a zygote having one chromosome with the normal complement of genes and one with a missing gene is characteristic of which genetic disorder? Cri du chat Down syndrome Klinefelter syndrome Turner syndrome This description is only accurate for Cri du chat syndrome. Regarding type 2 diabetes, obesity is considered to be what type of risk? Relative Modifiable Empirical Genetic Obesity is a modifiable risk factor for many diseases including heart disease, stroke, hypertension, and type 2 diabetes. The other terms do not apply. Which hormone stimulates gonads to produce both male and female hormones? Estrogen Luteinizing hormone (LH) Follicle-stimulating hormone (FSH) Gonadotropin-releasing hormone (GnRH) Extrahypothalamic factors cause the hypothalamus to secrete GnRH, which stimulates the anterior pituitary to secrete gonadotropins—FSH and LH. These hormones, in turn, stimulate the gonads (ovaries or testes) to secrete female or male sex hormones. Which condition poses the highest risk for a cerebrovascular accident (CVA)? Smoking Hypertension Polycythemia Insulin-resistant diabetes mellitus Hypertension is the single greatest risk factor for stroke. The other options are recognized risk factors but do not carry the intensity of hypertension. When insulin binds its receptors on muscle cells, an increase in glucose uptake by the muscle cells is the result. This is an example of what type of effect by a hormone? Synergistic Direct Permissive Pharmacologic Direct effects are the obvious changes in cell function that specifically result from the stimulation by a particular hormone. The other options are not used to identify the described effect. Which four-step process correctly describes muscle contraction? Excitation, coupling, contraction, relaxation Coupling, contraction, relaxation, excitation Relaxation, excitation, coupling, contraction Contraction, relaxation, excitation, coupling Muscle contraction is a four-step process: excitation, coupling, contraction, and relaxation. Alterations in which part of the brain are linked to hallucinations, delusions, and thought disorders associated with schizophrenia? Hypothalamus Limbic system Temporal lobe Parietal lobe . Only temporal lobe alterations may be responsible for the production of positive schizophrenic symptoms, such as hallucinations, delusions, thought disorders, and bizarre behavior. Which person is at the greatest risk for developing delirium? A depressed Hispanic woman A man diagnosed with schizophrenia An individual with diabetes celebrating a 70th birthday Correct Answer An individual on the second day after hip replacement Delirium is associated with autonomic nervous system overactivity and typically develops in 2 to 3 days, most commonly in critical care units, postsurgically, or during withdrawal from CNS depressants (e.g., alcohol, narcotic agents). Age, gender, and chronic illnesses are not generally associated with delirium triggers. Aldosterone directly increases the reabsorption of: Calcium Water Sodium Magnesium In the kidney, aldosterone primarily acts on the epithelial cells of the nephron-collecting duct to increase sodium ion reabsorption. This action cannot be said of the other options. What term is used to identify the condition that exists when the urethral meatus is located on the undersurface of the penis? Hyperspadias Hypospadias Chordee Epispadias Hypospadias is a congenital condition in which the urethral meatus is located on the ventral side or undersurface of the penis. This is the only term used for this condition. Considering the mediating factors of premenstrual syndrome (PMS), which medication may be used either continually or only during the menstrual period as a treatment for the condition? SSRIs Estrogen NSAIDs Progesterone A selective serotonin reuptake inhibitors (SSRI) (an antidepressant) relieves symptoms in approximately 60% to 90% of women and may be continually administered or only prescribed during the premenstrual period. Oral contraceptive pills that contain estrogen and progesterone also can be continuously used for up to 3 months to decrease the frequency of menstrual periods, PMS, and premenstrual dysphoric disorder (PMDD). Nonsteriodal antiinflammatory drugs (NSAIDs) would not be continually administered. A criterion for a diagnosis of generalized anxiety disorder (GAD) is a period of excessive worrying that lasts for at least how many months? 12 3 9 6 GAD is diagnosed when an individual spends at least 6 months worrying excessively and exhibits at least three of the six symptoms. Although 3 months is not sufficient time, the remaining options are excessive. [Show More]

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