Pathophysiology Final

Front 1

Of the 60% of the body weight made up of water, about two thirds is:

Back 1

Intracellular water

Front 2

What is the probable cause of cellular swelling in the early stages of cell injury?

Back 2

Na-K pump fails to remove intracellular Na+

Front 3

Which are characteristics of Down Syndrome?

Back 3

- It is an autosomal aneuploidy
- Mental retardation is consistently expressed
- Clinical diagnosis can be suggested by facial appearance
---
NOT - It is a genetic error of metabolism

Front 4

Identify the characteristics of X-linked recessive inherited disorders.

Back 4

Sons of affected female carries have a 50% risk of being affected.

Front 5

When environmental influences cause varied phenotypic expressions of genotypes, the result is:

Back 5

A multifactorial trait

Front 6

Which particle can penetrate cell membranes most easily?

Back 6

Lipid soluble, small.

Front 7

Which can transport substances uphill against the concentration gradient?

Back 7

Active transport

Front 8

Identify the correct sequences of events for initiation and conduction of a nerve impulse.

Back 8

1. Sodium permeability changes
2. Sodium moves inside
3. Potassium permeability changes
4. Potassium leaves cell
5. Resting potential is reestablished.

Front 9

There is one-way conduction at a synapse because:

Back 9

Only the presynaptic neuron contains neurotransmitters

Front 10

Which contains the precentral motor cortex and postcentral sensory cortex?

Back 10

Cerebrum

Front 11

The sympathetic division of the autonomic nervous system:

Back 11

- Mobilizes energy in times of need
- Is innervated by cell bodies from T1 through L2

Front 12

In cerebral vasogenic edema:

Back 12

Plasma proteins leak into extracellular spaces

Front 13

Which statement is true regarding increasing intracranial pressures?

Back 13

The brain volume increase
---
NOTE: excess of CO2 causes vasodilation

Front 14

An individual extension in upper extremities and extension in lower extremities. This is:

Back 14

Decerebrate posturing (damage to upper brainstem)
---
Decorticate posturing is the upper extremities flexed and lower extremities extended. Damage to corticospinal tract

Front 15

Precipitating causes of seizures include all of the following:

Back 15

- Meningitis
- Stroke
- Hypoglycemia
- Hyperthermia

Front 16

An individual with increased intracranial pressure from a head injury shows dilated and fixed pupils, falling pulse pressure, and irregular breathing. Which stage of ICP exists?

Back 16

Stage 4 - irregular breathing, dilation of pupils
---
Stage 3 - hyperventilation, dilation of one pupil
Stage 1 and 2 - blood pressure compensation

Front 17

Transient ischemic attacks (TIA) are:

Back 17

Focal neurologica deficits that develop suddenly, last for several minutes, and clear in 24 hours.
---
Warning sign for stroke (CVA)

Front 18

Osteoporosis pathogenesis involves:

Back 18

Alteration in the OPG/RANKL/RANK system.

Front 19

The ion necessary for coupling of contractile proteins is:

Back 19

Calcium

Front 20

Identify the bone cells which cooperate to maintain normal bone homeostasis and are coupled during bone remodeling.

Back 20

- Osteoblasts
- Osteoclasts

Front 21

In a complete fracture:

Back 21

The fracture crosses or involves the entire width or thickness of the bone.

Front 22

Which is a definite sign of a fracture?

Back 22

Unnatural alignment

Front 23

Identify the sequence of bone healing in fractures and surgical injuries.

Back 23

1. Hematoma formation
2. Procallus formation
3. Callus formation
4. Callus replacement with lamellar or trabecular
5. Periosteum and endosteum remodeling

Front 24

A function of the epiphyseal plates that is a function of the articular cartilage is to:

Back 24

- Enable articulation of bones
- Repair damage bone tissue
- Provide sensory nerves to bone
---
NOT - Enable bone to increase in length

Front 25

Postmenopausal osteoporosis can occur due to.

Back 25

- Low estrogen levels
- Insufficient dietary calcium
- Insufficient dietary magnesium

Front 26

The causes of osteoarthritis include all of the following:

Back 26

- Enzymatic breakdown of articular cartilage
- Proteoglycan breakdown
- Reduction in collagen
---
NOT - Rheumatoid factor

Front 27

A chronic musculoskeletal syndrome characterized by sensitive to touch, by absence of localized inflammation, sleep disturbance and fatigue is

Back 27

Fibromyalgia

Front 28

The most common cause of osteomyelitis is

Back 28

Direct contamination by an open fracture

Front 29

Which protein is found in the thick myofilament of skeletal and cardiac muscle

Back 29

Myosin

Front 30

Select the hormone which controls blood volume, but does NOT directly produce vasoconstriction of the arterioles.

Back 30

Aldosterone
---
Direct Vasoconstrictors - Antidiuretic hormones, Angiotensin II, Adrenalin

Front 31

Hemostasis involves all of the following:

Back 31

- Vasoconstriction
- Platelet plug formation
- Intrinsic pathway activités
- Clot formation
---
NOT - Prostacyclin I

Front 32

Which is the correct sequence in coagulation?

Back 32

Tissue Thromboplastin, VII, prothrombin

Front 33

Identify the correct sequence in the differentiation of erythrocytes.

Back 33

1. Proerythroblast
2. Normoblast
3. Reticulocyte

Front 34

The purpose of erythropoietin is to:

Back 34

Control erythrocyte production

Front 35

Which are the most effective phagocytes?

Back 35

Neutrophils and macrophages

Front 36

A thrombocytopenia with a platelet count below 10,000/mm likely will cause:

Back 36

Spontaneous bleeding

Front 37

DIC is associated with:

Back 37

- Endothelial damage
- Release of tissue thromboplastin

Front 38

Leukocytosis is found in all of the following

Back 38

- Inflammatory responses
- Allergic responses
- Bacterial infections
---
NOT - Bone marrow depression

Front 39

What is the most notable characteristic of infectious mononucleosis?

Back 39

The presence of heterophil antibody is diagnostically helpful.

Front 40

CML is characterized by its:

Back 40

Presence of the Philadelphia chromosome

Front 41

APCs are

Back 41

Memory cells or Macrophages
---
APC = antigen presenting cells

Front 42

Antibodies are produced by:

Back 42

Plasma cells

Front 43

Which of the following conditions could occur in an immobilized patient on antidepressants who is taken from a reclined to a standing position?

Back 43

Orthostatic hypotension
---
Decrease in blood pressure

Front 44

Which is correct regarding AIDS?

Back 44

- Antibody usually appears within 4 to 7 weeks after infection
- The patient will be anti-HIV
- The patient will likely develop opportunistic infections and cancer.
---
NOT - The patient will have increased numbers of CD4 cells or helper T cells.

Front 45

Rejection of kidney transplant occurred after 2 weeks. The reaction was because of

Back 45

- Immune response against donor HLA antigen
- A type IV hypersensitivity

Front 46

Chronic inflammation is characterized by

Back 46

Lymphocytic and macrophagic infiltration

Front 47

Which is synthesized by mast cells?

Back 47

Leukotrienes or histamines

Front 48

Interleukins:

Back 48

- Provide messages between leukocytes
- Are produced in response to tissue injury
- Stimulate cells to produce antiviral substances
- Increase antibody production and populations of T cells

Front 49

Diapedesis is a process in which:

Back 49

Neutrophils migrate from the bloodstream to an injured tissue site

Front 50

Events the development of atherosclerotic plaque include all of the following

Back 50

- Accumulation of LDL (low-density lipoprotein)
- Smooth muscle proliferation
- Calcification
- Decreased elasticity
---
NOT - Complement activation

Front 51

Primary hypertension

Back 51

Is essentially idiopathic

Front 52

A 76-year-old man came to the emergency room after experiencing chest pain while shoveling snow. Laboratory tests revealed essentially normal blood levels of SGOT, CPK, and LDH enzymes. The chest pain was relieved following rest and nitroglycerin therapy. The most probable diagnosis is:

Back 52

Angina Pectoris

Front 53

Which statement is correct concerning hypertension:

Back 53

- Malignant hypertension is characterized by a diastolic pressure higher than 140mm Hg.
- More than 90% of cases are the essential or primary type
- When it is left untreated, the major risks include CVAs and cardiac hypertrophy
---
NOT - Headache is the most reliable symptoms

Front 54

The QRS complex of the ECG represents

Back 54

Ventricular depolarization

Front 55

During atrial systole, the:

Back 55

Atrioventricular valves are open

Front 56

If the sympathetic nervous system stimulation of the heart predominates over parasympathetic nervous system stimulation, the heart will:

Back 56

Increase its rate

Front 57

Glucocorticoids would be highest during the stage of :

Back 57

Resistance

Front 58

Identify two hormones that increase metabolic rate and heat production.

Back 58

Thyroxine, Epinephrine

Front 59

Corticotrophin release factor (CRF) is released by the:

Back 59

Hypothalamus

Front 60

Endorphins

Back 60

Decrease pain sensation

Front 61

Many NSAIDS are antipyretic because they reduce fever by

Back 61

Block PGE2 synthesis

Front 62

These events occur associated with REM sleep except:

Back 62

80% of adult sleeping time occurs this stage

Front 63

Which is a modulator of pain?

Back 63

- Lymphokines
- Substance P
- Endorphins
---
NOT - Heparin

Front 64

Which of the following category of acute pain is poorly localized and often referred?

Back 64

Visceral pain

Front 65

What is the proposed role of the brain metabolite, adenosine, to sleep?

Back 65

Promotes sleep and suppress arousal

Front 66

A skateboard injury to a teenager results in a compound fracture of the thigh and excessive bleeding into the peritoneal cavity. This stressor elicits the secretion of CRH and the synthesis and release all of the following:

Back 66

- Cortisol
- Antidiuretic hormone
- Epinephrine
---
NOT - Luteinizing hormone

Front 67

Severe stress results in all of the following

Back 67

- Increased heart rate
- Increase in norepinephrine
- Alteration in respiratory minute volume
---
NOT - Overactive immune system

Front 68

The role of oxytocin in stress during parturition is:

Back 68

Antistress properties

Front 69

Autonomic and hormonal control are involved in gastrointestinal motility and:

Back 69

Digestive enzyme secretion

Front 70

A 15 year old female begins to take a new weight - loss during. The drug inhibits the smooth muscle action of the stomach and likely acts by increasing:

Back 70

Sympathetic stimulation

Front 71

Mucus production to form a mucosal barrier in the stomach is stimulated by the release of:

Back 71

Prostaglandins

Front 72

During the cephalic and gastric phase of digestion, gallbladder contraction is mediated branches of the:

Back 72

Vagus nerve

Front 73

The duct cells of the pancreas produces ___ which buffers HCl acid released into the duodenum.

Back 73

Bicarbonate

Front 74

All of the following are symptoms of Gluten-sensitive enteropathy and infants:

Back 74

- Diarrhea
- Excessive fat in stools
- Malabsorption of nutrients
---
NOT - Lack of pancreatic enzymes

Front 75

Osmotic diarrhea is caused by

Back 75

Lactase deficiency

Front 76

Infections of Helicobacter pylori are major etiologic factors associated with all of the following ulcers

Back 76

- Gastric
- Duodenal
- Peptic
---
NOT - Stress

Front 77

Hepatic encephalopathy is manifested by:

Back 77

Cerebral dysfunction

Front 78

Which type of viral hepatitis is associated with a chronic state or a carrier state?

Back 78

- Hepatitis C
- Hepatits B
---
NOT - Hepatitis A

Front 79

Which does cause constipation?

Back 79

- Opiates
- Sedentary lifestyle
- Emotional depression
---
NOT - Hyperthyroidism

Front 80

Polycystic ovary syndrome is:

Back 80

- The most common cause of infertility in the US
- Associated with hyperinsulinemia
- Sometimes a precursor of endometrial cancer

Front 81

Painful menstruation association with excessive release of PGE2 just before menses is called

Back 81

- Primary dysmenorrhea

Front 82

All are associated with benign prostate hyperplasia:

Back 82

- Difficult voiding
- Urine retention in bladder
- Elevated prostate specific antigen
---
NOT - Polyuria

Front 83

The most common cause of gingival ulceration in the U.S is

Back 83

Genital Herpes

Front 84

Select the organ essential for synthesis of 250H VitD to "active Vit D3"

Back 84

Thyroid
---
NOT - Liver, Skin or Parathyroid

Front 85

An elevation in plasma Ca++ stimulates the secretion of ___ from the thyroid C cells

Back 85

Calcitonin

Front 86

The pathogenesis of osteoporosis involves

Back 86

Alteration in the OPG/RANK/RANKL system

Front 87

Inadequate levels of thyroxine at birth may cause

Back 87

Mental retardation

Front 88

Hypersecretion of the adrenal cortical hormones produce all of the symptoms in an adult.

Back 88

- Protein catabolism
- Susceptible to infections
- Excessive deposition of fat in face and shoulders
---
NOT - Hypotension

Front 89

Acromegaly is a hormonal disorder due to

Back 89

Excessive secretion of growth hormone in an adult

Front 90

An older patient falls and is unable to get up, 18 hours later, the patient is found and hospitalized, which of the following hormonal changes did occur in this patient before medical care

Back 90

- Increase plasma ADH
- Increase in plasma glucagon
- Decrease in plasma insulin
---
NOT - Decrease in aldosterone secretion

Front 91

Common complications of diabetes mellitus include all of the following:

Back 91

- Nephropathy
- Retinopathy
- Susceptible to infections
---
NOT - Pancreatitis

Front 92

Which electrolyte alteration occurs in Addison's disease (hypoadrenalism)

Back 92

Hyponatremia

Front 93

Which ordinarily brings about the greatest increase in the rate of respiration

Back 93

Increase in arterial CO2

Front 94

Which statement is correct regarding normal adult hemoglobin and O2 transport?

Back 94

HbA is 75% saturated when resting tissue ppO2 is 40mmHg

Front 95

In bronchial asthma

Back 95

- Bronchia muscles contract
- Mucous secretions increase

Front 96

In ARDS, increased alveolocapillary permeability is caused by:

Back 96

- Platelet activating factor
- Tumor necrosis factor
- O2-free radicals

Front 97

Pulmonary emboli usually:

Back 97

Obstruct blood supply to the lung parenchyma

Front 98

Cor pulmonale

Back 98

- Occurs in response to long standing pulmonary hypertension
- Results in right heart failure
- Produces cyanosis

Front 99

Which renal condition usually has a history of recent infection with Beta-hemolytic streptococci?

Back 99

Glomerulonephritis

Front 100

An individual has an elevated BUN and creatinine because of calculi blockage of one ureter. This is referred to as:

Back 100

Postrenal disease

Front 101

Nephrotoxins such as antibiotics, may be responsible for:

Back 101

Acute tubular necrosis

Front 102

Nephrotic syndrome is associated with ___ to plasma ___.

Back 102

Increased glomerular permeability, protein

Front 103

All of the following occur in the plasma of a patient in acute renal failure:

Back 103

- Hyperkalemia
- Elevated BUN
- Acidosis
---
NOT - Increase HCO3-

Front 104

Filtered K+ is reabsorbed by the___ and secreted by the ___

Back 104

Proximal convoluted tubules, distal convoluted tubules.

Front 105

ADH causes water to

Back 105

Diffuse into the ascending limb of the vasa recta

Front 106

All of the following hormones are vasoconstrictors

Back 106

- Angiotensin II
- Epinephrine
- Antidiuretic hormone
---
NOT- Aldosterone

Front 107

Glycogenesis

Back 107

Insulin only

Front 108

Glycolysis

Back 108

Epinephrine & glucagon

Front 109

Chondrogenesis

Back 109

Growth hormone and insulin-like growth factor

Front 110

Lipolysis

Back 110

Cortisol & glucagon

Front 111

Lipogenesis

Back 111

Growth hormone & insulin

Front 112

Ascites

Back 112

Abdominal distension

Front 113

Intrahepatic Jaundice

Back 113

Icteric phase of Viral Hepatitis B

Front 114

Obstructive Jaundice

Back 114

Icteric phase due to gallstones

Front 115

Portal Hypertension

Back 115

Esophageal and stomach varices (vomiting blood)

Front 116

Hepatomegaly

Back 116

Liver enlarged and tender

Front 117

___ Produces pain in response to acute inflammation

Back 117

Bradykinin

Front 118

___ A phospholipid derivative that aggregates platelets

Back 118

Thromboxane A2

Front 119

___ A large hemostatic protein factor (exposed by injury to endothelium) that interacts with platelets to produce adherence to collagen and to fibrinogen

Back 119

vW Factor

Front 120

___ This hemostatic cofactor is released from injured endothelium to initiate extrinsic pathway

Back 120

Tissue Thromboplastin

Front 121

___ Vasodilation and increased in permeability of capillaries due to inflammation

Back 121

Histamine

Front 122

___ This enzyme acts on blood clot to produce fibrinolysis

Back 122

Plasmin