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BIOD331 Pathophysiology Final Exam UPDATED ACTUAL
Questions and CORRECT Answers
Taking your child to the pediatrician for their annual well check-up and keeping up with the recommended vaccination schedule would be an example of: Primary prevention You are seeing a patient in your clinic who recently suffered a TIA. Recent diagnostic tests revealed that he has atrial fibrillation. You decide to put him on a blood thinner to prevent a future neurologic event. This would be an example of: Tertiary prevention James is being seen for his first colonoscopy. He turned 50 this year, and his father recently passed away from colon cancer at age 85. This would be an example of: Secondary prevention True/False: Metaplastic cells are not better prepared to survive under stressful circumstances False Fill in the blank _____ propel chyme along the small intestine toward the large intestine in one direction. Peristaltic movements Fill in the blank _______ occlude small portions of the intestinal lumen to push digestive contents forward and backward Segmentation Waves
True or False: Peristaltic movements occur in two directions. False, one direction True/False: Hypertrophy can occur under normal and pathological conditions. True You are reading results from a recent blood panel for Fred, a 76 - year-old male. His hemoglobin levels are 15.5 g/dL. Would this be considered a normal or abnormal value? Normal You are reading results from a recent blood panel for Susan, a 48 - year-old female. Her hemoglobin levels are 7 g/dL. Would this be considered a normal or abnormal value? Abnormal. Normal Hemoglobin levels for a female is 12- 15 g/dL You are reading results from a recent blood panel for Jane, a 37 - year-old female. Her hemoglobin levels are 13 g/dL. Would this be considered a normal or abnormal value? Normal Which are true of the mitochondria? Select all that apply. It is involved in cellular respiration They play a role in apoptosis Which is NOT true of the cytoskeleton? It includes peroxisomes and proteasomes Which of the following is an active form of Vitamin D? 25 - hydroxycholecalciferol Which of the following is an inactive form of Vitamin D? Cholecalciferol Which of the following is synthesized in the kidney and regulates the differentiation of red blood cells within bone marrow? Erythropoietin Which are true of the cell membrane? Select all that apply. Controls the transport of materials from the outside fluids to within Helps with the conduction of electrical currents in nerve and muscle cells Aids in the regulation of cell growth and proliferation True or False. If false, explain why the statement is false. A benign neoplasm invades and destroys tissue and possesses a rapid rate of growth. False. A malignant neoplasm invades and destroys tissues and possesses a rapid rate of growth. OR A benign neoplasm resembles the cells of the tissues of origin and possesses a slow rate of growth.
True/False: Cell proliferation is the process in which proliferating cells become more specialized cell types. False, cell differentiation True/False: Cell differentiation is the process of increasing cell numbers by mitotic cell division. False, cell proliferation You are working in the Emergency Department, and a 17 - year-old male who is 6'2" is brought in via ambulance with complaints of chest pain on the left side and difficulty breathing. His parents report that he was playing basketball in their driveway and suddenly collapsed with complaints of the above symptoms. You order a CT scan of his chest and determine that he has experienced a large, spontaneous pneumothorax in his left lung. Describe the treatment required for this condition. In a large pneumothorax, the air must be removed by needle aspiration or a closed drainage system with or without suction. You are evaluating a patient in the Emergency Department who was brought in by ambulance after being involved in a serious motor vehicle accident. Their respiratory rate is increased; they are experiencing difficulty breathing, and breath sounds in their right lung are diminished. You order a CT scan and determine that they are experiencing a pneumothorax of their right lung. Pulse oximetry and arterial blood gases reveal that blood oxygenation is outside of normal limits. Describe the treatment required to reverse this condition. Emergency treatment of a tension pneumothorax requires the immediate insertion of a large- bore needle or chest tube into the affected side, along with one-way valve drainage or continuous chest suction to aid in re-inflating the affected lung. What are two important properties that stem cells possess? Potency and Self-renewal True or False. If false, explain why it is false. Humoral immunity is a form of innate immunity False, humoral immunity is a form of adaptive immunity. True/False: The innate immune response takes time to acquire and is developed over multiple exposures to foreign organisms. False, the adaptive immune response takes time to acquire and is developed over multiple exposures to foreign organisms. OR The innate immune response is immediate in nature.
True or False. If false, explain why it is false. An initial immune response that is generalized (non-specific) and unable to distinguish between various foreign agents is characteristic of adaptive immunity. False. An initial immune response that is generalized (non- specific) and unable to distinguish between various foreign agents is characteristic of innate immunity. OR Adaptive immunity serves not only to distinguish self from non-self but to recognize and destroy specific foreign agents based on their different antigenic properties. This type of cell remains incompletely differentiated throughout life: Stem cell These are cells of the same lineage that have not yet differentiated to the extent that they have lost their ability to divide. Progenitor or parent cells Which of the following are most likely to have arisen from an adult stem cell? Epithelial Each of the following is characteristic of Addison's Disease except? Emotional disturbances Signs and symptoms of Addison's disease include each of the following EXCEPT: Hyperglycemia Which of the following would you expect to find if someone has Addison's Disease? Select all that apply. Decreased cortisol levels Hyperpigmentation of the skin Which of the following would you expect to find if someone has Cushing's Disease? Select all that apply. Increased cortisol levels Buffalo hump 1 _______ is a systemic treatment that enables drugs to reach the site of the tumor as well as other distant sites
- The profound weight loss and wasting of fat and tissue that accompany cancer is known as __ _.
- Chemotherapy
- Cancer anorexia-cachexia syndrome What type of signaling occurs when a cell releases a chemical into the extracellular fluid that affects its own activity? Autocrine What type of signaling depends on hormones carried in the bloodstream to act on cells throughout the body? Endocrine What type of signaling occurs in the nervous system as neurotransmitters act on adjacent nerve cells? Synaptic
You are seeing Jenny, a 25 - year-old female in your office whose chief complaint is debilitating pain in the MCP joints of both hands. Jenny reports general feelings of fatigue, and you notice nodules over her MCP joints. She states that she experiences stiffness in her hands in the morning that lasts well over an hour. However, as she gets moving, this seems to subside. Would you suspect that Jenny has OA or RA? List TWO pieces of evidence that support your diagnosis. Jenny more than likely has RA. She is young. She has a bilateral presentation. Her MCP joints are affected, which is most common with RA. She is exhibiting systemic symptoms of fatigue. She has prolonged morning stiffness in her joints, but this is alleviated with movement. You are seeing Lynn, a 40 - year-old female in your office whose chief complaint is severe pain in the DIP joints of both of her hands. She is a medical transcriptionist and types all day long. She reports that her pain gets worse as the day goes on. Would you suspect that Lynn has OA or RA? List TWO pieces of evidence that support your diagnosis. Lynn more than likely has OA. Her age of onset is between 30 and 60. Her DIP joints are affected, which is common with OA but not for RA. She has a job that is repetitive in nature. Her symptoms get worse with activity/as the day goes on. (If the correct diagnosis is identified, 3 points should be awarded. Full credit should be given if the correct diagnosis is made with two pieces of supporting evidence.) You are seeing Tom, a 65 - year-old male in your office whose chief complaint is severe pain in his right knee. Tom reports that he experiences some stiffness when he first wakes up, but if he walks around for a little bit, the stiffness goes away. Tom likes to be active and is on his feet a lot throughout the day. He reports that by the end of the day he has to take a Tylenol because he cannot tolerate the pain. Would you suspect that Tom has OA or RA? List TWO pieces ofevidence that support your diagnosis. Tom more than likely has OA. His age of onset is higher. He has unilateral presentation. His stiffness in the morning is relieved quickly by moving around. His pain worsens the longer he is on his feet. (If the correct diagnosis is identified, 3 points should be awarded. Full credit should be given if the correct diagnosis is made with two pieces of supporting evidence.) Which lab value will typically be increased in a viral infection? Lymphocytes Which cell in the blood provides primary hemostasis? Platelets Your patient has serum uric acid levels of 7. mg/dL. They are not complaining of pain, and there are no signs of inflammation. What phase of gout would you place them? Asymptomatic hyperuricemia Your patient has serum uric acid levels of 7. mg/dL. They are complaining of severe pain in the affected joint that is painful to the touch. What phase of gout would you place them? Acute gout arthritis
Your patient has serum uric acid levels of 7. mg/dL. They have had multiple gout attacks in the past. They are currently not experiencing joint pain, but you notice visible tophi over their affected joints. What phase of gout would you place them? Chronic tophaceous gout (phase 4) A 9 - year-old boy with a peanut allergy was exposed to peanuts. He presents to the emergency room with an anaphylactic reaction. (1) What symptoms might he present with? (2) Does the quantity of exposure mean he will have a more severe reaction? (3) What is the initial immediate treatment? (4) What are 2 things people with anaphylaxis should always carry? (1) Any of the following reactions are accepted. Grade I: erythema and urticaria, with or without angioedema Grade II: hypotension, tachycardia, dyspnea, and GI manifestations, like nausea, vomiting, diarrhea, and abdominal cramping from mucosal edema Grade III: bronchospasm, cardiac dysrhythmias, and cardiac collapse. Grade IV: cardiac arrest (2) No (3) Epinephrine (4) Identification about allergy, EpiPen A 12 - year-old female presents with itchy eyes, nasal congestion and drainage, and sneezing every spring when the pollen count is high. (1) Explain the immunologic mechanisms that are responsible for her symptoms. (2) What type(s) of treatment might be used to relieve her symptoms? (1) Mast cells, basophils, and eosinophils play an important role with type I reactions because they contain histamines. Primary response is vasodilation, vascular leakage, and smooth muscle contraction. Late-phase response is more intense with eosinophils and other acute and chronic inflammatory cells, as well as tissue damage. (2) Antihistamines. Which of the following is/are characteristic of normal tissue function, renewal and repair? Select all that apply. Hypertrophy Apoptosis Which of the following is/are characteristic of neoplasia? Select all that apply. Unregulated growth An abnormal cellular growth, resulting in cells that vary in size, shape, and organization is called: Dysplasia True/False: Proliferation, differentiation, and apoptosis are essential for neoplasia. False, proliferation, differentiation, and apoptosis are essential for normal tissue renewal and repair A 23 - year-old African-American man with a history of severe lifelong anemia requiring many transfusions has nonhealing leg ulcers and recurrent periods of abdominal and chest pain. These signs and symptoms are most likely to be associated with which one of the following laboratory abnormalities? Sickle cells on peripheral blood smear
Diagnosis of an autoimmune disease is made by following patient history, physical evidence, and serological findings. Explain why blood tests alone are not enough to diagnose an autoimmune disorder. Blood testing can be imprecise, as some tests are more generic and can be elevated in the presence of other diseases. Briefly explain why autoimmune diseases are difficult to diagnose There are over 80 identified autoimmune disorders identified, many with overlapping and/or nonspecific presentations, making an accurate diagnosis can be quite challenging. Risk factors for coronary heart disease include each of the following except:
HDL > 60
YES --> smoking, HTN, family Hx A patient has experienced a seizure affecting the left temporal lobe. The family reports that the patient exhibited repetitive lip smacking and hand rubbing followed by a period of great fear and insecurity. They have experienced which type of seizure? Focal seizure with impairment of consciousness or awareness A patient experiences a seizure that manifests with motor weakness on the right side, a tingling sensation on the right side, and flushing. They have experienced which type of seizure? Focal seizure without impairment of consciousness or awareness A patient experiences a seizure that manifests with repetitive hand rubbing and reports of hallucinations right before the seizure occurred. They have experienced which type of seizure? Focal seizure with impairment of consciousness or awareness Patient is found to have the above:
- What risk factors mostly led to this disease state?
- What is this person at risk for developing?
- What lifestyle modifications would you suggest for them? Picture is of an atherosclerotic plaque
- Hyperlipidemia, cigarette smoking, obesity and visceral fat, hypertension, diabetes mellitus. Increasing age, family history of premature CHD, and male sex. May also include C-reactive protein (CRP) and serum lipoprotein (a)
- Coronary artery disease, angina, myocardial infarction, aneurysm, stroke (ischemia, thrombosis, emboli).
- Stop smoking, lose weight/exercise, healthy diet (low-fat, low-cholesterol), adhere to medication for blood pressure, hyperlipidemia, and/or diabetes. An increase in the size of an organ or tissue due to the increase in size of the cells that comprise it is called: Hypertrophy
A decrease in the size of an organ or tissue resulting from a decrease in the mass of pre-existing cells is called: Atrophy A patient is experiencing a severe reduction in GFR, and their GFR is 15- 29 mL/min/1.73m2. What stage of kidney disease are they in?
A patient is experiencing kidney damage with a mild decrease in GFR, and their GFR is 60 - 89 mL/min/1.73m². What stage of kidney disease are they in?
Steve is a 55 - year-old male who has atherosclerosis. Steve smokes 2 packs of cigarettes per day, and his lipid panel reveals that he has elevated LDL and low HDL levels. List one thing Steve can do to slow the progression of atherosclerosis or mitigate its effects. He could stop smoking and change his diet to decrease his LDL and increase his HDL levels. Steve is a 55 - year-old male who has atherosclerosis. Steve is obese, smokes 2 packs of cigarettes per day, and coronary artery disease runs in his family. Steve can make several lifestyle changes to mitigate the effects of atherosclerosis; however, there are things he cannot control. Name one of them. Steve is an older male, and CAD runs in his family. Give a specific example of how our diet can increase our risk for cancer. Any of the following are acceptable answers: While some dietary carcinogens occur naturally in plants (aflatoxins), others are used in the preparation or preservation of food. For instance, when foods are fried in fat that has been reused multiple times, due to the extreme heat, benzo[a] pyrene (and other polycyclic hydrocarbons) are converted to carcinogens. The polycyclic aromatic hydrocarbons are among the most potent and can be found in many common places. They are produced from animal fat when charcoal-broiling meats, are present in smoked meats and fish, and are also present in tobacco smoke. Nitrosamines are formed in foods that are smoked, salted, cured, or pickled using nitrites or nitrates as preservatives. The effects of nitrosamines, however, may be reduced by antioxidants such as vitamin C found in fruits and vegetables. Colon cancer is associated with high dietary fat and red meat intake and low dietary fiber intake, as well as obesity and low physical activity.
