Medical Concepts and Terminology, Exams of Nursing

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NURS 231 PATHOPHYS FINAL ACTUAL EXAM

QUESTIONS AND ANSWERS

Lack of nerve stimulation can cause cells to atrophy - ✔✔ANSWER✔✔-

True proportion of people with a disease who are positive for the disease - ✔✔ANSWER✔✔->>>>>>>>sensitivity how likely the same result will occur if repeated - ✔✔ANSWER✔✔- reliability how a tool measures what it is intended to measure - ✔✔ANSWER✔✔- validity people without the disease who are negative on a given test - ✔✔ANSWER✔✔- specificity

Which is NOT true of the cytoskeleton? - ✔✔ANSWER✔✔->>>>>>>>it includes peroxisomes and proteasomes Which of the following are true of the cell? Select all that apply. - ✔✔ANSWER✔✔->>>>>>>>1: Proteins carry out the functions of the cell membrane 2:Lysosomes are the digestive system of the cell 3:Microfilaments are thin, threadlike cytoplasmic structures A bodybuilder's muscles will display hyperplasia. - ✔✔ANSWER✔✔-

False Barrett esophagus is an example of dysplasia - ✔✔ANSWER✔✔->>>>>>>>false hypertrophy is an increase in the size of an organ or tissue caused by an increase in the number of cells - ✔✔ANSWER✔✔->>>>>>>>True Which are true of the cell membrane? Select all that apply. - ✔✔ANSWER✔✔- 1: Controls the transport of materials from the outside fluids to within 2:Helps with the conduction of electrical currents in nerve and muscle cells 3: Aids in the regulation of cell growth and proliferation Which are false of the mitochondria? Select all that apply. - ✔✔ANSWER✔✔- 1: They are found far from the site of energy consumption. 2:They control free radicals.

High blood pressure is an example of which of the following? - ✔✔ANSWER✔✔->>>>>>>>pathophysiology A patient complains of chest pain and an elevated blood pressure. What are these examples of? - ✔✔ANSWER✔✔->>>>>>>>signs and symptoms Which of the following is true of a test's sensitivity? - ✔✔ANSWER✔✔-

If negative, it can safely be assumed that the person does not have a disease Chemical agents (poison, alcohol) are examples of which of the following? - ✔✔ANSWER✔✔->>>>>>>>Etiologic factors Define tertiary prevention and give an example: - ✔✔ANSWER✔✔- Tertiary prevention occurs after a disease has been diagnosed and clinical intervention is needed to reduce complications or deterioration. One example is the use of certain medications one must take after a heart attack to help reduce the risk of a future event or death. Compare and contrast the two types of gangrenous necrosis. - ✔✔ANSWER✔✔->>>>>>>>In dry gangrene the affected tissue becomes dry and shrinks, the skin wrinkles, and its color changes to dark brown or black. The spread of dry gangrene is slow. It results from a cut off in arterial blood supply and is a form of coagulation necrosis. In wet gangrene, the affected area is cold, swollen, and pulseless. The skin is moist, black, and under tension. Blebs form on the surface, liquefaction occurs, and a foul odor is caused by bacterial action. The spread of tissue damage is rapid.

Explain what necrosis is and give an example and description of one type of necrosis. - ✔✔ANSWER✔✔->>>>>>>>necrosis is cell death to an organ or tissue with still being apart of a living person. An example of this would be luiquefactive necrosis. this is when the cells die and the catalytic enzymes do not get destroyed after the cells death. This could cause necrosis sunburn - ✔✔ANSWER✔✔->>>>>>>>radiation injury obesity - ✔✔ANSWER✔✔->>>>>>>>nutritional imbalances reactive oxygen species - ✔✔ANSWER✔✔->>>>>>>>free radical injury low oxygen to tissues - ✔✔ANSWER✔✔->>>>>>>>hypoxic cell injury fractures - ✔✔ANSWER✔✔->>>>>>>>physical agents OTC drugs - ✔✔ANSWER✔✔->>>>>>>>Chemical injury hypothermia - ✔✔ANSWER✔✔->>>>>>>>physical agents radiation treatment - ✔✔ANSWER✔✔->>>>>>>>radiation injury lead toxicity - ✔✔ANSWER✔✔->>>>>>>>chemical injury bacteria - ✔✔ANSWER✔✔->>>>>>>>biologic agents

List the 4 types of tissue found in the body. Pick 2 and give a description and example of each. - ✔✔ANSWER✔✔->>>>>>>>Epithelial tissue- covers the body's outer surface, it is avascular and gets its o2 from the capillaries found in the neighboring connective tissues, and example of this is simple squamous tissue which means one layer of thin cells. Muscular tissue Nervous tissue- is found all throughout the body, helps with communication between tissues and the central nervous system. it aids in the functions of the body due to internal and external stimuli, helps with movement, and electrical signaling. neurons are an example of this, they aid in communicating to other cells in the body, they are held and supported by glial cells. Connective tissue What term means "cell eating" and engulfs and then kills microorganisms or other particulate matter? - ✔✔ANSWER✔✔->>>>>>>>Phagocytosis What is the term to describe when cells use energy to move ions against an electrical or chemical gradient? - ✔✔ANSWER✔✔->>>>>>>>Active transport Give one function of a membrane potential: - ✔✔ANSWER✔✔-

Generate nerve impulse, muscle contractions, or cause hormone secretion What is the term that best describes the following process? A transport protein aiding a lipid insoluble or large molecule across the cell biologic agents List the 4 types of tissue found in the body. Pick 2 and give a description and example of each. - ✔✔ANSWER✔✔->>>>>>>>Epithelial tissue- covers the body's outer surface, it is avascular and gets its o2 from the capillaries found in the neighboring connective tissues, and example of this is simple squamous tissue which means one layer of thin cells. Muscular tissue Nervous tissue- is found all throughout the body, helps with communication between tissues and the central nervous system. it aids in the functions of the body due to internal and external stimuli, helps with movement, and electrical signaling. neurons are an example of this, they aid in communicating to other cells in the body, they are held and supported by glial cells. Connective tissue What term means "cell eating" and engulfs and then kills microorganisms or other particulate matter? - ✔✔ANSWER✔✔->>>>>>>>Phagocytosis What is the term to describe when cells use energy to move ions against an electrical or chemical gradient? - ✔✔ANSWER✔✔->>>>>>>>Active transport Give one function of a membrane potential: - ✔✔ANSWER✔✔- >>>>>>>>Generate nerve impulse, muscle contractions, or cause hormone secretion What is the term that best describes the following process? A transport protein aiding a lipid insoluble or large molecule across the cell membrane that would otherwise not be able to pass through on its own. - ✔✔ANSWER✔✔->>>>>>>>facilitated diffusion

Blood tests for tumor markers can make a diagnosis of cancer. Why or why not?

• ✔✔ANSWER✔✔->>>>>>>>False, only tissue can diagnose. Tumor markers are helpful to assess response to therapy or reoccurrence. Tissue biopsy is of critical importance in what role? - ✔✔ANSWER✔✔-

Diagnosing the correct cancer and histology. Explain the TNM system: - ✔✔ANSWER✔✔->>>>>>>>T is the size and local spread of the primary tumor. N is the involvement of the regional lymph nodes. M is the extent of the metastatic involvement. List two signs or symptoms a patient may present with that might indicate a cancer diagnosis: - ✔✔ANSWER✔✔->>>>>>>>fatigue, anemia What are two systemic manifestations of cancer exhibited by cancer patients? - ✔✔ANSWER✔✔->>>>>>>>Weight loss, wasting of body fat and muscle tissue, weakness, anorexia, and anemia, fatigue, sleep disturbances When would surgery be appropriate in the treatment of cancer? - ✔✔ANSWER✔✔->>>>>>>>if it is a solid tumor and has clear margins Most chemotherapeutic drugs cause pancytopenia due to bone marrow suppression. What are the 3 possible adverse outcomes of this? - ✔✔ANSWER✔✔->>>>>>>>loss of RBCs, WBCs, and platelets, anemia, and hemolysis

Cell proliferation is the process in which proliferating cells become more specialized cell types. - ✔✔ANSWER✔✔->>>>>>>>false Cell differentiation is the process in which proliferating cells become more specialized cell types. Correct! - ✔✔ANSWER✔✔->>>>>>>>True What are two important properties that stem cells possess? - ✔✔ANSWER✔✔-

Potency and self-renewal Which of the following are most likely to have arisen from an adult stem cell? - ✔✔ANSWER✔✔->>>>>>>>Epithelial Define polyp. Are they benign or malignant? - ✔✔ANSWER✔✔->>>>>>>>A polyp is a growth that projects from a mucosal surface, such as the intestine. A polyp can be benign or malignant What are normal genes called that become cancer-causing if mutated? - ✔✔ANSWER✔✔->>>>>>>>protooncogenes What type of gene is involved in repairing damaged DNA? - ✔✔ANSWER✔✔- Tumor suppressor gene A 40 - year-old woman has experienced heavy menstrual bleeding. She was told she has a uterine tumor called a leiomyoma. She is worried she has cancer. What do you tell her? Explain at least 2 differences between a benign and malignant

tumor - ✔✔ANSWER✔✔->>>>>>>>i would explain to her that it is a benign tumor, and that there is nothing to worry about 1 benign tumors grow by expansion and are usually encapsulated; while malignant tumors grow by invading and taking over tissue 2: benign tissue is well differentiated and looks like the tissue of origin, while malignant cells are undifferentiated and are atypical and do not look like the tissues of origin. A 50-year-old woman was diagnosed with breast cancer from tissue biopsy following her diagnostic mammography. They are determining if it has spread to the lymph nodes. (1) Explain what the sentinel node is. (2) How will they determine if it has spread to the lymph system? (3) Would a detailed family history of disease be important to obtain? - ✔✔ANSWER✔✔->>>>>>>>The sentinel node is the first lymph node to which the primary tumor drains. The extent of disease may be determined through lymphatic mapping and sentinel lymph node biopsy. A radioactive tracer and/or blue dye is injected into the tumor to determine the first lymph node. This lymph node is examined for the presence of cancer cells. Yes, heredity can be a strong risk factor for cancer in some families. Malignant tumors have which of the following characteristics? Select all that apply - ✔✔ANSWER✔✔->>>>>>>>Variable rate of growth & Spreads by metastasis What are molecular and cellular mechanisms in genes that increase susceptibility to cancer? Select all that apply. - ✔✔ANSWER✔✔->>>>>>>>1:Lack of cellular senescence 2:Angiogenesis 3:Mutations in growth factor signaling pathways

List 4 of the 7 risk factors linked to cancer as stated in the module. - ✔✔ANSWER✔✔->>>>>>>>hereditary, obesity, environmental agents, immunological mechanisms

1. is a systemic treatment that enables drugs to reach the site of the tumor as well as other distant sites. - ✔✔ANSWER✔✔->>>>>>>>chemotherapy The profound weight loss and wasting of fat and tissue that accompany cancer is known as. - ✔✔ANSWER✔✔->>>>>>>>wasting or Cancer anorexia cachexia syndrome Which of the following is not a risk factor for developing cancer? - ✔✔ANSWER✔✔->>>>>>>>Sunscreen All of the following viral agents are correctly paired with the associated lesion except: - ✔✔ANSWER✔✔->>>>>>>>Epstein-Barr virus: carcinoma of the cervix List one example of screening for each method: observation, palpation, and lab test/procedure: - ✔✔ANSWER✔✔->>>>>>>>observation: looking at the skin palpation: palpating breast for abnormal masses Lab: pap smear swabbing for cervical cancer Explain the challenges of diagnosing autoimmune disorders. - ✔✔ANSWER✔✔-

There are over 80 identified, many with overlapping presentations. Many manifestations are nonspecific and are seen in other non-autoimmune diseases. Blood testing isn't perfect either, as some tests are more generic and can be elevated in the presence of other diseases.

Which cell is the first responder to phagocytose a foreign invader? - ✔✔ANSWER✔✔->>>>>>>>monocyte What allows the lymphocyte to differentiate between self and foreign molecules? - ✔✔ANSWER✔✔->>>>>>>>Major histocompatibility complex (MHC) molecule T lymphocytes produce what type of immunity? - ✔✔ANSWER✔✔-

Cell-mediated Which immunoglobulin passes immune factors from the mother to the fetus? - ✔✔ANSWER✔✔->>>>>>>>IgG Which cell type is an early responder and the most abundant in the body? - ✔✔ANSWER✔✔->>>>>>>>Neutrophils Which feature is NOT of adaptive immunity? - ✔✔ANSWER✔✔- Epithelium is a defense mechanism 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? - ✔✔ANSWER✔✔-

1. Mast cells, basophils, and eosinophils play an important role in the development of type I reactions because they contain the chemical mediator histamine. A primary or initial-phase response is vasodilation, vascular leakage, and smooth muscle contraction. A secondary or late-phase response is

characterized by more intense infiltration of tissues with eosinophils and other acute and chronic inflammatory cells, as well as tissue damage. (2) Antihistamines and intranasal corticosteroids are the mainstay of treatment. A narrow, surgical-type wound is likely to heal by secondary intention. - ✔✔ANSWER✔✔->>>>>>>>false Which of the following is an incorrect pairing of a classic manifestation of acute inflammation with its corresponding cause? - ✔✔ANSWER✔✔->>>>>>>>Dolor - inflammatory cells infiltrating sensory nerves B cells are primarily associated with humoral immunity. - ✔✔ANSWER✔✔-

true T cells mature in the thymus and are active in cellular immunity. - ✔✔ANSWER✔✔->>>>>>>>true B lymphocytes normally produce antibodies against host tissues. - ✔✔ANSWER✔✔->>>>>>>>false Antibodies are also known as? - ✔✔ANSWER✔✔- immunoglobulin Which of the following hypersensitivity reactions can be treated with the administration of epinephrine - ✔✔ANSWER✔✔->>>>>>>>type 1

Which cell is NOT part of the adaptive immune response? - ✔✔ANSWER✔✔-

monocytes Features of systemic lupus erythematosus include all of the following except - ✔✔ANSWER✔✔->>>>>>>>Exophthalmos What are the 2 factors that play a role in the development of autoimmune diseases? - ✔✔ANSWER✔✔->>>>>>>>genetics and environmental factors A 40 - year-old man presents with cough and shortness of breath. After an H&P and chest films, it is determined he has pneumocystis carinii pneumonia (PCP). The provider does an HIV test, which is positive. Upon further testing, the man's CD4+ cell count is 100 cells/μL and his viral load is 250,000 copies/mL. (1) Why did the provider do an HIV test after the man was diagnosed with PCP? (2) What classification does this man fall into based on his CD4+ count and symptomatology, and why - ✔✔ANSWER✔✔->>>>>>>>(1) Opportunistic infections are those common organisms that do not produce infection without true T cells mature in the thymus and are active in cellular immunity. - ✔✔ANSWER✔✔->>>>>>>>true B lymphocytes normally produce antibodies against host tissues. - ✔✔ANSWER✔✔->>>>>>>>false Antibodies are also known as? - ✔✔ANSWER✔✔- >>>>>>>>immunoglobulin Which of the following hypersensitivity reactions can be treated with the administration of epinephrine - ✔✔ANSWER✔✔->>>>>>>>type 1 Which cell is NOT part of the adaptive immune response? - ✔✔ANSWER✔✔- >>>>>>>>monocytes Features of systemic lupus erythematosus include all of the following except - ✔✔ANSWER✔✔->>>>>>>>Exophthalmos What are the 2 factors that play a role in the development of autoimmune diseases? - ✔✔ANSWER✔✔->>>>>>>>genetics and environmental factors A 40 - year-old man presents with cough and shortness of breath. After an H&P and chest films, it is determined he has pneumocystis carinii pneumonia (PCP). The provider does an HIV test, which is positive. Upon further testing, the man's CD4+ cell count is 100 cells/μL and his viral load is 250,000 copies/mL. (1) Why did the provider do an HIV test after the man was diagnosed with PCP? (2) What classification does this man fall into based on his CD4+ count and symptomatology, and why - ✔✔ANSWER✔✔->>>>>>>>(1) Opportunistic infections are those common organisms that do not produce infection without impaired immune function. (2) The last phase, or AIDS illness, occurs when the CD4+ cell count falls to less than 200 cells/μL or exhibits an AIDS-defining illness. The risk of opportunistic infections and death increases significantly when the CD4+ cell count falls below 200 cells/μL. Which process is NOT included in wound healing? - ✔✔ANSWER✔✔- Acute-phase response type 1 Which cell is NOT part of the adaptive immune response? - ✔✔ANSWER✔✔- >>>>>>>>monocytes Features of systemic lupus erythematosus include all of the following except - ✔✔ANSWER✔✔->>>>>>>>Exophthalmos What are the 2 factors that play a role in the development of autoimmune diseases? - ✔✔ANSWER✔✔->>>>>>>>genetics and environmental factors A 40 - year-old man presents with cough and shortness of breath. After an H&P and chest films, it is determined he has pneumocystis carinii pneumonia (PCP). The provider does an HIV test, which is positive. Upon further testing, the man's CD4+ cell count is 100 cells/μL and his viral load is 250,000 copies/mL. (1) Why did the provider do an HIV test after the man was diagnosed with PCP? (2) What classification does this man fall into based on his CD4+ count and symptomatology, and why - ✔✔ANSWER✔✔->>>>>>>>(1) Opportunistic infections are those common organisms that do not produce infection without impaired immune function. (2) The last phase, or AIDS illness, occurs when the CD4+ cell count falls to less than 200 cells/μL or exhibits an AIDS-defining illness. The risk of opportunistic infections and death increases significantly when the CD4+ cell count falls below 200 cells/μL. Which process is NOT included in wound healing? - ✔✔ANSWER✔✔- >>>>>>>>Acute-phase response While labile and stable cells can regenerate themselves, cells are unable to undergo mitotic division. - ✔✔ANSWER✔✔->>>>>>>>Permanent cells

disorders occur when the immune system fails to differentiate self from non-self. - ✔✔ANSWER✔✔->>>>>>>>autoimmune The time between HIV infection and seroconversion is called what? - ✔✔ANSWER✔✔->>>>>>>>the window period A person with HIV is not infectious when they are asymptomatic. - ✔✔ANSWER✔✔->>>>>>>>False The T cells that display the host's MHC antigens and T-cell receptors for a nonself-antigen are allowed to mature, a process termed negative selection. - ✔✔ANSWER✔✔->>>>>>>>False What cell mediator is the primary cause of vasodilation seen in acute inflammation? - ✔✔ANSWER✔✔->>>>>>>>Histamine The three stages of hemostasis include each of the following except: - ✔✔ANSWER✔✔->>>>>>>>Vascular dilation Which cell in the blood provides primary hemostasis - ✔✔ANSWER✔✔-

Platelets Which of the following medications would decrease a person's risk for clotting? Select all that apply. - ✔✔ANSWER✔✔->>>>>>>>1: Heparin 2: warfarin 3: lovenox

Which of the following is a hypercoagulable state? Select all that apply. - ✔✔ANSWER✔✔->>>>>>>>congestive heart failure, smoking, and post-surgical state Which of the following are TRUE of hemophilia A? Select all that apply. - ✔✔ANSWER✔✔->>>>>>>>Spontaneous joint bleeding can occur, The PTT is increased Which is NOT included in the three principles of blood flow? - ✔✔ANSWER✔✔-

Compliance Which of the following does NOT affect the heart's ability to increase its

autoimmune The time between HIV infection and seroconversion is called what? - ✔✔ANSWER✔✔->>>>>>>>the window period A person with HIV is not infectious when they are asymptomatic. - ✔✔ANSWER✔✔->>>>>>>>False The T cells that display the host's MHC antigens and T-cell receptors for a nonself-antigen are allowed to mature, a process termed negative selection. - ✔✔ANSWER✔✔->>>>>>>>False What cell mediator is the primary cause of vasodilation seen in acute inflammation? - ✔✔ANSWER✔✔->>>>>>>>Histamine The three stages of hemostasis include each of the following except: - ✔✔ANSWER✔✔->>>>>>>>Vascular dilation Which cell in the blood provides primary hemostasis - ✔✔ANSWER✔✔- >>>>>>>>Platelets Which of the following medications would decrease a person's risk for clotting? Select all that apply. - ✔✔ANSWER✔✔->>>>>>>>1: Heparin 2: warfarin 3: lovenox Which of the following is a hypercoagulable state? Select all that apply. - ✔✔ANSWER✔✔->>>>>>>>congestive heart failure, smoking, and post-surgical state Which of the following are TRUE of hemophilia A? Select all that apply. - ✔✔ANSWER✔✔->>>>>>>>Spontaneous joint bleeding can occur, The PTT is increased Which is NOT included in the three principles of blood flow? - ✔✔ANSWER✔✔- >>>>>>>>Compliance Which of the following does NOT affect the heart's ability to increase its output? - ✔✔ANSWER✔✔->>>>>>>>Cardiac reserve Which of the following is true of the renin-angiotensin-aldosterone system? - ✔✔ANSWER✔✔->>>>>>>>Angiotensin II increases sodium reabsorption in the kidney by stimulating the secretion of aldosterone Which of the following does NOT lead to an increased risk for DVT? Select all that apply. - ✔✔ANSWER✔✔->>>>>>>>Non-smoker Which of the following is NOT associated with iron deficiency anemia? - ✔✔ANSWER✔✔->>>>>>>>Normocytic What are the two major causes of microcytic anemias? - ✔✔ANSWER✔✔- Iron deficiency anemia, Thalassemias

Which of the following are potential causes of a sickle crisis in sickle cell anemia? Select all that apply. - ✔✔ANSWER✔✔->>>>>>>>1: dehydration 2: cold exposure 3: physical exertion The patient is found to be a severely malnourished alcoholic. The most likely cause of his anemia is: - ✔✔ANSWER✔✔->>>>>>>>Folate deficiency Which of the following is NOT true of vitamin B12 deficiency anemia? - ✔✔ANSWER✔✔->>>>>>>>Dietary deficiencies are common Each of the following are risk factors for secondary hyperlipidemia except? - ✔✔ANSWER✔✔->>>>>>>>Autosomal dominant disorder of LDL receptor Lifestyle changes to treat hyperlipidemia include each of the following except: - ✔✔ANSWER✔✔->>>>>>>>Increase red meat consumption Risk factors for atherosclerosis include each of the following except: - ✔✔ANSWER✔✔->>>>>>>>Female gender (pre-menopause)

1. The three major determinants of myocardial oxygen demand (MVO2) include each of the following except: - ✔✔ANSWER✔✔->>>>>>>>a. Diastolic pressure
2. is the most important factor in myocardial oxygen demand. As this increases, myocardial oxygen consumption or demand also increases. - ✔✔ANSWER✔✔->>>>>>>>heart rate

3. What is the most common cause of cardiogenic shock? - ✔✔ANSWER✔✔-

myocardial infarction

4. Which does NOT occur during cardiogenic shock? - ✔✔ANSWER✔✔-

decreased systemic vascular resistance Explain the differences in the pathophysiology, symptoms, and whether nitroglycerin and/or rest will relieve symptoms in stable angina, unstable angina, and myocardial infarction. - ✔✔ANSWER✔✔->>>>>>>>stable angina is when you have angina with exertion, usually will go away with nitro or rest unstable angia is wen you have angina without exetion and it will not go away with rest, its not very constant and very unstable, may ease woth nitro Myocardial infarction is a heart attack, may include SOB, nausea, chest pain, numbness, or an abnormal EKG. this can easy with nitro but most likely the pt will be sent to the cath lab for catherization. Increase red meat consumption Risk factors for atherosclerosis include each of the following except: - ✔✔ANSWER✔✔->>>>>>>>Female gender (pre-menopause) 1. The three major determinants of myocardial oxygen demand (MVO2) include each of the following except: - ✔✔ANSWER✔✔->>>>>>>>a. Diastolic pressure 2. is the most important factor in myocardial oxygen demand. As this increases, myocardial oxygen consumption or demand also increases. - ✔✔ANSWER✔✔->>>>>>>>heart rate 3. What is the most common cause of cardiogenic shock? - ✔✔ANSWER✔✔- >>>>>>>>myocardial infarction 4. Which does NOT occur during cardiogenic shock? - ✔✔ANSWER✔✔- >>>>>>>>decreased systemic vascular resistance Explain the differences in the pathophysiology, symptoms, and whether nitroglycerin and/or rest will relieve symptoms in stable angina, unstable angina, and myocardial infarction. - ✔✔ANSWER✔✔->>>>>>>>stable angina is when you have angina with exertion, usually will go away with nitro or rest unstable angia is wen you have angina without exetion and it will not go away with rest, its not very constant and very unstable, may ease woth nitro Myocardial infarction is a heart attack, may include SOB, nausea, chest pain, numbness, or an abnormal EKG. this can easy with nitro but most likely the pt will be sent to the cath lab for catherization. Hypertension is often called "the silent killer." By the time symptoms of hypertension occur, the complications can affect the kidneys, heart, eyes, and blood vessels. What is this term called? - ✔✔ANSWER✔✔->>>>>>>>target organ damage . Left ventricular hypertrophy is a major risk factor for what other diseases? Name at least 2. - ✔✔ANSWER✔✔->>>>>>>>coronary heart disease, cardiac dysrhythmias, congestive heart failure, and sudden death. With increasing occlusion of the coronary vessel(s), the demands of the resting heart may become too great. When the patient experiences angina without exertion, or when the level of exertion necessary to cause anginal symptoms decreases, this is called what? - ✔✔ANSWER✔✔->>>>>>>>Unstable angina

A 40 - year-old woman is hospitalized with a chronic illness characterized by hepatomegaly, distended neck veins, and peripheral edema. Which of the following disorders is the most likely cause of these findings? - ✔✔ANSWER✔✔-

Right heart failure Right ventricular failure is commonly characterized by each of the following changes except: - ✔✔ANSWER✔✔->>>>>>>>Pulmonary edema Left ventricular failure is commonly characterized by each of the following except: - ✔✔ANSWER✔✔->>>>>>>>Liver congestion Which pharmacologic treatment of heart failure has a mechanism of action characterized by excretion of fluid, reducing preload: - ✔✔ANSWER✔✔- diuretic The laboratory test that measures the volume of red cells in 100 mL of blood is

. - ✔✔ANSWER✔✔->>>>>>>>hematocrit are a group of inherited disorders of hemoglobin synthesis common among Mediterranean populations. - ✔✔ANSWER✔✔->>>>>>>>Thalassemias The drug most commonly associated with inhibition of platelet aggregation is . - ✔✔ANSWER✔✔->>>>>>>>aspirin According to JNC 8 guidelines, what category does this patient's blood pressure fall into?

What is hypertension a risk factor for? What lifestyle modifications would you suggest for them? Name one medication therapy for hypertension and its mechanism of action. - ✔✔ANSWER✔✔->>>>>>>>Hypertension stage 2 Atherosclerosis, CAD (MI), heart failure, stroke, peripheral artery disease Lose weight, exercise, decrease salt intake, decrease alcohol intake Diuretics, like thiazides, lower blood pressure by decreasing vascular volume; Even after forced expiration, a significant amount of air remains in the lungs. - ✔✔ANSWER✔✔->>>>>>>>TRUE Nearly all pulmonary emboli are thrombi arising from deep vein thrombosis in the upper and lower extremities. - ✔✔ANSWER✔✔->>>>>>>>true measures expiratory volume in a given time. - ✔✔ANSWER✔✔-

Forced expiratory volume (FEV) The are the actual sites of gas exchange between the air and blood. - ✔✔ANSWER✔✔->>>>>>>>alveoli diuretic The laboratory test that measures the volume of red cells in 100 mL of blood is . - ✔✔ANSWER✔✔->>>>>>>>hematocrit are a group of inherited disorders of hemoglobin synthesis common among Mediterranean populations. - ✔✔ANSWER✔✔->>>>>>>>Thalassemias The drug most commonly associated with inhibition of platelet aggregation is . - ✔✔ANSWER✔✔->>>>>>>>aspirin According to JNC 8 guidelines, what category does this patient's blood pressure fall into? What is hypertension a risk factor for? What lifestyle modifications would you suggest for them? Name one medication therapy for hypertension and its mechanism of action. - ✔✔ANSWER✔✔->>>>>>>>Hypertension stage 2 Atherosclerosis, CAD (MI), heart failure, stroke, peripheral artery disease Lose weight, exercise, decrease salt intake, decrease alcohol intake Diuretics, like thiazides, lower blood pressure by decreasing vascular volume; Even after forced expiration, a significant amount of air remains in the lungs. - ✔✔ANSWER✔✔->>>>>>>>TRUE Nearly all pulmonary emboli are thrombi arising from deep vein thrombosis in the upper and lower extremities. - ✔✔ANSWER✔✔->>>>>>>>true measures expiratory volume in a given time. - ✔✔ANSWER✔✔- >>>>>>>>Forced expiratory volume (FEV) The are the actual sites of gas exchange between the air and blood. - ✔✔ANSWER✔✔->>>>>>>>alveoli Intrapleural pressure is always negative in relation to alveolar pressure in a normal inflated lung. - ✔✔ANSWER✔✔->>>>>>>>true During inspiration, air is drawn into the lungs and the chest cavity is decreased.

• ✔✔ANSWER✔✔->>>>>>>>false

The diaphragm is the primary muscle of inspiration - ✔✔ANSWER✔✔-

true Excess surface tension makes lung inflation harder. - ✔✔ANSWER✔✔- True Lung volumes can be measured using a. - ✔✔ANSWER✔✔- spirometer is the flow of gases into and out of the alveoli of the lungs. - ✔✔ANSWER✔✔->>>>>>>>Ventilation Which of the following cells contribute to airway inflammation in asthma? Select all that apply. - ✔✔ANSWER✔✔->>>>>>>>Eosinophils, mast cells, neutrophils, Leukotrienes, and lymphocytes Alpha- 1 antitrypsin deficiency is most likely seen in which disease process? - ✔✔ANSWER✔✔->>>>>>>>Emphysema Histologically, chronic bronchitis would exhibit each of the following except: - ✔✔ANSWER✔✔->>>>>>>>Enlargement of the airspaces Each of the following are TRUE of ARDS except: - ✔✔ANSWER✔✔- Presents with decreased respiratory rate A 30 - year-old man is brought to the ER with a knife wound to the chest. On visual inspection, asymmetry of chest movement during inspiration, displacement

of the trachea, and absence of breath sounds on the side of the wound are noted. His neck veins are distended, and his pulse is rapid and thready. What is your initial diagnosis? What type of emergent treatment is necessary? - ✔✔ANSWER✔✔->>>>>>>>1) tension pneumothorax

2. chest tube When is the risk for obstructive atelectasis the greatest? What are strategies to decrease the chance for developing atelectasis? - ✔✔ANSWER✔✔->>>>>>>>The risk of obstructive atelectasis is increased following surgery. Anesthesia, pain and pain medications, and immobility promote retention of bronchial secretions. Patients are encouraged to frequently cough, deep breath, change positions, hydrate adequately, and ambulate early to prevent atelectasis. Explain why the oxygen flow rate for people with COPD is normally titrated to maintain the arterial PO2 between 60 and 65 mm Hg. - ✔✔ANSWER✔✔-

Their medullary respiratory center has adapted to the elevated CO levels and no longer responds to increases in PCO2. Therefore, a decrease in PO Enlargement of the airspaces Each of the following are TRUE of ARDS except: - ✔✔ANSWER✔✔- >>>>>>>>Presents with decreased respiratory rate A 30 - year-old man is brought to the ER with a knife wound to the chest. On visual inspection, asymmetry of chest movement during inspiration, displacement of the trachea, and absence of breath sounds on the side of the wound are noted. His neck veins are distended, and his pulse is rapid and thready. What is your initial diagnosis? What type of emergent treatment is necessary? - ✔✔ANSWER✔✔->>>>>>>>1) tension pneumothorax 2) chest tube When is the risk for obstructive atelectasis the greatest? What are strategies to decrease the chance for developing atelectasis? - ✔✔ANSWER✔✔->>>>>>>>The risk of obstructive atelectasis is increased following surgery. Anesthesia, pain and pain medications, and immobility promote retention of bronchial secretions. Patients are encouraged to frequently cough, deep breath, change positions, hydrate adequately, and ambulate early to prevent atelectasis. Explain why the oxygen flow rate for people with COPD is normally titrated to maintain the arterial PO2 between 60 and 65 mm Hg. - ✔✔ANSWER✔✔- >>>>>>>>Their medullary respiratory center has adapted to the elevated CO levels and no longer responds to increases in PCO2. Therefore, a decrease in PO becomes the stimulus for respiration. If oxygen is given at too high of a rate, it suppresses the stimulus and the respiratory drive. Each of the following can lead to atelectasis except: - ✔✔ANSWER✔✔- Thrombus Someone with COPD would exhibit each of the following characteristics except:

• ✔✔ANSWER✔✔->>>>>>>>Increased D-dimer levels

Ventilation - ✔✔ANSWER✔✔->>>>>>>>The flow of gases into and out of the alveoli of the lungs Perfusion - ✔✔ANSWER✔✔->>>>>>>>The flow of blood in the adjacent pulmonary capillaries Diffusion - ✔✔ANSWER✔✔->>>>>>>>The transfer of gases between the alveoli and the pulmonary capillaries Each of the following disorders are correctly paired with related characteristics except: - ✔✔ANSWER✔✔->>>>>>>>Atelectasis - decreased respiratory rate 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? - ✔✔ANSWER✔✔->>>>>>>>Focal seizure with impairment of consciousness or awareness Voluntary tongue movements are controlled by which cranial nerve? - ✔✔ANSWER✔✔->>>>>>>>CN XII. You are seeing a patient with Parkinson's disease in your office. You feel a catch as you passively take their arm through flexion and extension. This is an example of what physical manifestation of the disease? - ✔✔ANSWER✔✔-

Cogwheeling Sleep spindles are characteristic of which stage of sleep? - ✔✔ANSWER✔✔- Stage 2

A person reports a generalized depressed mood, changes in appetite, and irritability that gets worse as the day goes on. They also report that they sleep more than 8 hours which is affecting their productivity. What type of depression are they experiencing? - ✔✔ANSWER✔✔->>>>>>>>Atypical depression Each of the following statements is true regarding the organization of the nervous system except: - ✔✔ANSWER✔✔->>>>>>>>The CNS has an afferent and efferent division Each of the following statements is true regarding Alzheimer's disease except: - ✔✔ANSWER✔✔->>>>>>>>Neurofibrillary tangles are composed of deteriorating nerve pieces that arrange themselves around a sticky protein core called amyloid beta (Aβ) Each of the following are modifiable behaviors related to stroke except: - ✔✔ANSWER✔✔->>>>>>>>Hypercholesteremia Primary insomnia is characterized by each of the following except: - ✔✔ANSWER✔✔->>>>>>>>Can also be called comorbid insomnia What type of seizure occurs in 2 phases, involves a loss of consciousness, and lasts approximately 60-90 seconds? - ✔✔ANSWER✔✔->>>>>>>>Tonic-clonic seizure Sleep disturbances associated with narcolepsy include each of the following except: - ✔✔ANSWER✔✔->>>>>>>>sleep apnea

Each of the following statements is true of Parkinson's disease except: - ✔✔ANSWER✔✔->>>>>>>>It is characterized by an increase of dopaminergic neurons Efferent neurons deliver input from the CNS to the periphery. - ✔✔ANSWER✔✔->>>>>>>>Motor SRIs the reuptake of serotonin at the presynaptic space. - ✔✔ANSWER✔✔->>>>>>>>inhibit is sleep disordered breathing due to the brain not properly signaling the respiratory muscles. - ✔✔ANSWER✔✔->>>>>>>>Central sleep apnea utilizes electric impulses to inhibit or stop the abnormal nerve activity that causes tremor and other unwanted movement patterns associated with Parkinson's disease. - ✔✔ANSWER✔✔->>>>>>>>Deep brain stimulation Specialized ependymal cells that project into the ventricles and produce CSF are called the. - ✔✔ANSWER✔✔->>>>>>>>Choroid plexus Schwann cells produce myelin in the CNS. - ✔✔ANSWER✔✔->>>>>>>>False, Schwann cells produce myelin in the PNS. Alterations in the HPA axis have been linked to PTSD. - ✔✔ANSWER✔✔-

True

Vital signs increase during stage 1 of NREM sleep. - ✔✔ANSWER✔✔-

False, vital signs decrease during stage 1 of NREM sleep. Someone in the early stages of Alzheimer's disease requires assistance for their activities of daily living. - ✔✔ANSWER✔✔->>>>>>>>False, in the early stages of Alzheimer's disease, individuals are still independent with their ADLs. Explain how a chemical synapse produces an excitatory or inhibitory signal. - ✔✔ANSWER✔✔->>>>>>>>The presynaptic neuron will secrete neurotransmitters which diffuse into the synaptic cleft and bind to excitatory or inhibitory receptors on the postsynaptic membrane eliciting an excitatory or inhibitory signal in one direction. You are babysitting a 7 - year-old child with a known history of seizure activity. You notice they appear flushed and seem unresponsive. You ask if they are feeling alright and they stare at you blankly. After a few seconds they act as if nothing happened and return to play. Is this a generalized or focal seizure? Based upon this description, what specific type of seizure did this individual experience? - ✔✔ANSWER✔✔->>>>>>>>Generalized, Absence seizure Compare and Contrast breathing patterns between NREM and REM sleep (include a discussion on the specific stages of NREM sleep.) - ✔✔ANSWER✔✔- In stages 1 and 2 NREM sleep as well as in REM sleep, breathing is irregular, and brief periods of apnea are often observed (approximately 5 - 15 seconds.) During stages 3 and 4 of deep sleep, breathing becomes regular. A patient reports to the emergency department where you are working at 10 False, in the early stages of Alzheimer's disease, individuals are still independent with their ADLs. Explain how a chemical synapse produces an excitatory or inhibitory signal. - ✔✔ANSWER✔✔->>>>>>>>The presynaptic neuron will secrete neurotransmitters which diffuse into the synaptic cleft and bind to excitatory or inhibitory receptors on the postsynaptic membrane eliciting an excitatory or inhibitory signal in one direction. You are babysitting a 7 - year-old child with a known history of seizure activity. You notice they appear flushed and seem unresponsive. You ask if they are feeling alright and they stare at you blankly. After a few seconds they act as if nothing happened and return to play. Is this a generalized or focal seizure? Based upon this description, what specific type of seizure did this individual experience? - ✔✔ANSWER✔✔->>>>>>>>Generalized, Absence seizure Compare and Contrast breathing patterns between NREM and REM sleep (include a discussion on the specific stages of NREM sleep.) - ✔✔ANSWER✔✔- >>>>>>>>In stages 1 and 2 NREM sleep as well as in REM sleep, breathing is irregular, and brief periods of apnea are often observed (approximately 5 - 15 seconds.) During stages 3 and 4 of deep sleep, breathing becomes regular. A patient reports to the emergency department where you are working at 10 pm. They report that earlier in the day beginning at approximately 9 am they began to experience tingling in their right arm. They decided to ignore it thinking it was probably a result of all the gardening they did the day before. As the day

went on, the tingling sensation got worse, and they started to have difficulty speaking. The patient's spouse reported that they were slurring their words. Past medical history includes a diagnosis of diabetes and hypercholesteremia. By the time they are evaluated, their symptoms start to subside. The tingling disappears and their speech returns to normal. What do you suspect this patient has experienced? What evidence is there to support that diagnosis? - ✔✔ANSWER✔✔->>>>>>>>This patient has experienced a TIA. They have experienced symptoms consistent with oxygen deprivation to the brain, however their symptoms subsided within 24 hours of their onset. A 75 - year-old male is brought to the emergency department by their spouse at 8 pm. The spouse reports that they were cleaning up after dinner at approximately 6:30 pm, and she noticed that her husband's speech was very unclear. When she asked him what was going on, he said that he didn't know and that the entire right side of his face felt numb. She reports that he is very active, but he has a past medical history of atrial fibrillation. Based upon these symptoms and past medical history, what do you suspect this patient is experiencing? How would you confirm this diagnosis? What treatment should be administered? Explain why you chose that treatment. - ✔✔ANSWER✔✔->>>>>>>>This patient is more than likely experiencing an ischemic stroke. A CT scan and MRI would be needed to determine if a clot was blocking blood flow to the brain tissue and to rule out a hemorrhagic stroke. If a clot is found, this patient should receive tPA drugs as they are within the 3 - 4.5 hour treatment window. You are seeing a patient in your office with a primary complaint of excessive daytime sleepiness. Their spouse reports that they snore loudly and often wake up gasping for air. What type of sleep disorder do you suspect they are experiencing (be specific)? What type of diagnostic work up needs to be done? Name one treatment option to address this patient's symptoms. - ✔✔ANSWER✔✔-

This pt is experiencing Moderate/ borderline severe Obstructive Sleep apnea, we need to see if he has any of the potential risk factors like large neck girth, obseity, male, etc. the pt needs to go under extensive sleep studies to confirm their OSA diagnosis. depending on the severity, life style changes can help