Midterm

Question 1

What information is contained within the nucleolus?

Answer 1

RNA, DNA, binding proteins (Histones)

Question 2

The function of proteins?

Answer 2

Act as receptors, transport channels, drive active pumps, cell surface markers, cell adhesion markers (CAMs), catalysts of chemical reactions, role in ATP

Question 3

Why are water-soluble molecules unable to center cells?

Answer 3

Phospholipid bilayer

Question 4

Refractory period?

Answer 4

No stimulus can evoke another response at that time?

Question 5

when normal columnar ciliated epithelial cells of the bronchial lining are replaced by stratified squamous epithelial cells due to chronic irritation

Answer 5

Metaplasia

Question 6

During pregnancy, mammary glands enlarge. What type of hormonal process causes this?

Answer 6

Hyperplasia - increase in cell amount, does not affect shape/size of cells

Question 7

A consequence of multiple blood transfusions for the patient.

Answer 7

Hemosiderosis - excess iron stored as hemosiderin in tissues/organs

Question 8

What is the physiological effect of hypernatremia?

Answer 8

High Na in blood vessels pulls H2O out of cells (ex brain) and into the blood vessels causing cells to shrink.

Question 9

What condition consists of an absent homologous X chromosome with a single X chromosome and physical features of the following: Short stature, widely spaced nipples, webbed neck?

Answer 9

Turners syndrome

Question 10

which blood type is that of a heterozygous having A & B alleles as a codominant?

Answer 10

Blood type AB

Question 11

Of the genetic processes, which can cause asthma in only one pair of identical twins

Answer 11

epigenetic modifications

Question 12

Which cell is the primary defense against parasites

Answer 12

Eosinophils

Question 13

Why do complement and chemotaxis deficiencies occur in neonates?

Answer 13

Transient depressed inflammatory response - born in sterile environment, neutrophils/monocytes not yet capable of effective chemotaxis making them prone to infection

Question 14

Why are some vaccines administered orally vs injected?

Answer 14

Each route stimulates a different lymphocyte containing tissues resulting in a different type of cellular and humoral immunity

Question 15

If a patient is having an IgE-mediated hypersensitivity reaction, what is the best intervention?

Answer 15

Antihistamines

Question 16

Mechanisms of type II hypersensitivity reaction

Answer 16

• Tissue-specific
• Antibodies (IgG/IgM) coat mast cells by binding to receptors that signal its degranulation, followed by a discharge of preformed mediators

Question 17

Rh- Mom delivers a Rh+ baby, what would you tell mom about RHO(D) immunoglobulin

Answer 17

prevents alloimmunity and hemolytic anemia of the newborns

Question 18

Neutrophils attack, engulf, and destroy which microorganism using phagocytosis?

Answer 18

Bacteria

Question 19

What are exotoxins

Answer 19

Released by bacteria during bacterial growth and affect surround tissues

Question 20

Immunity decreases during stress. The helper T cell response to stress is suppressed by which hormone makes them prone to infection?

Answer 20

Cortisol

Question 21

Which neurotransmitter causes a patient that is severely stressed to develop cold clammy skin.

Answer 21

Norepinephrine - causes vasoconstriction

Question 22

What percentage of intravascular volume needs to be decreased before hypovolemic shock occurs?

Answer 22

15%

Question 23

what is the hallmark of neurogenic shock due to overstimulation of the parasympathetic nervous system?

Answer 23

Vasodilation d/t low SVR

Question 24

Which of the following shock states has the highest priority to treat?

a. septic
b. hypovolemia
c. anaphylactic
d. neurogenic

Answer 24

Anaphylactic - concern for airway

Question 25

During septic shock which clinical finding confirms the elevation of the immune response?

Answer 25

Leukocytosis - Increased WBCs

Question 26

periorbital edema and hepatomegaly occur in pediatric cardiogenic shock due to?

Answer 26

Increased systemic venous congestion from high SVR

Question 27

true or false: Capillary refill greater than 4 seconds is normal in a child

Answer 27

False - sign of shock

Question 28

The primary goal of shock in a child?

Answer 28

Maximize O2 delivery, decrease demand.

Question 29

Limited glycogen storage of a child that has been seriously burned results in what outcome?

Answer 29

Increased morbidity - limited glycogen makes it hard to meet the increased energy demands of the burn leading to metabolic dysfunction and loss of lean body mass

Question 30

Which of these behaviors would be observed in a newborn suffering shock? SATA: a. Decreased heart variability b. hyperalertness c. hypoglycemia d. temperature instability e. increased muscle tone

Answer 30

A. decreased heart variability C. hypoglycemia D. temperature instability

Question 31

How does a child physiologically compensate for cardiogenic shock?

Answer 31

- splanchnic arteries are constricted to divert blood from the skin, kidneys, and gut to the heart and brain - Peripheral blood vessels are constricted to raise blood pressure - Adrenergic responses produce tachycardia to increase CO - The RAAS system is stimulated when renal function decreases

Question 32

what tissue does carcinoma originate?

Answer 32

Epithelial

Question 33

When a cell loses cellular differentiation, it is referred to as?

Answer 33

Anaplasia - hallmark of CA

Question 34

A pts in your office with a known diagnosis of CA and their labs show hgb of 7.9. what factors will you assess for? SATA: a. chronic bleeding b. malabsorption of iron c. malnutrition d. recent blood transfusion e. current infection

Answer 34

a. chronic bleeding b. malabsorption of iron c. malnutiriton

Question 35

You are tasked with developing a series of community discussions related to CA prevention strategies. Which of these topics do you choose? SATA: a. healthy eating b. tobacco avoidance c. importance of early diagnosis d. impact of obesity on one's health e. age-appropriate exercise

Answer 35

a. healthy eating b. tobacco avoidance d. impact of obesity on health e. age appropriate exercise

Question 36

Which form of CA is linked to congenital malformation syndrome?

Answer 36

Wilms tumor (nephroblastoma)

Question 37

a child that is diagnosed with aids, has an increased risk of developing ...?

Answer 37

Non-Hodgkin's lymphoma

Question 38

which cells can destroy some types of tumor cells and some viruses infected cells without having been exposed to them before?

Answer 38

Natural killer cells

Question 39

why do lymph nodes enlarge and become tender during an infection?

Answer 39

Increased antigens cause the proliferation of more B-lymphocytes which causes lymph nodes to become swollen and tender.

Question 40

What condition would cause hepatomegaly, cardiac dysfunction and bronze skin?

Answer 40

Hereditary hemochromatosis Tx: therapeutic phlebotomy

Question 41

What is the cause of neurological symptoms in a polycythemia pt?

Answer 41

Viscous blood

Question 42

Which of the following pts would be a priority to assess for DIC? a. heat stroke b. pancreatitis c. term delivery d. HELLP e. snake bite

Answer 42

a. heat stroke b. pancreatitis d. HELLP e. snake bite

Question 43

What is the role of collagen in the clotting process?

Answer 43

Activates platelets

Question 44

How would you describe acute lymphoblastic anemia (ALL) to a pt?

Answer 44

progressive neoplasm defined by the presence of greater than 30% lymphoblasts in the bone marrow or blood

Question 45

Burkitt's lymphoma in African children associated with which virus?

Answer 45

Epstein barr virus

Question 46

early symptoms of acute leukemia include: SATA: a. dizziness b. paresthesia c. anorexia d. bruising e. bone pain

Answer 46

c. anorexia d. bruising e. bone pain

Question 47

common causes of erythropoiesis in children

Answer 47

Iron deficiency

Question 48

G6PD deficiency is what form of inherited disorder

Answer 48

X-linked recessive disorder

Question 49

a potential cure for microcytic hypochromic anemia?

Answer 49

cord blood transplant

Question 50

Which disease is autosomal dominant inherited hemorrhagic disease?

Answer 50

Von Willebrand disease

Question 51

Pediatric pt presents with the following: pallor, fatigue, fever, petechiae, and purpura. What tests would you order? SATA: a. CBC b. renal function studies c. bone marrow biopsy d. CXR e. joint fluid sampling

Answer 51

a. cbc b. renal function studies c. bone marrow biopsy d. CXR

Question 52

is cortisol a lipid or water-soluble hormone?

Answer 52

Lipid

Question 53

Thyroid-stimulating hormone is released to stimulate thyroid hormones and is inhibited when plasma levels of TH are adequate. what type of feedback is this?

Answer 53

Negative feedback

Question 54

If a diabetic pt did not take their insulin in days, and no is in the ED w/ high blood glucose, which electrolyte is a priority

Answer 54

K+

Question 55

target tissue for prolactin-releasing factor

Answer 55

Anterior pituitary

Question 56

growth hormone is inhibited by which hormone?

Answer 56

Somatostatin

Question 57

The adrenal medulla excretes which hormone?

Answer 57

Epinephrine

Question 58

if a pt is diagnosed w/ SIADH, which lab values would you expect to see?

Answer 58

hyponatremia (120) | hypoosmolality (260)

Question 59

when a pt is suffering from DI, which form will result in the target cells for ADH in the renal collecting tubules demonstrating insensitivity?

Answer 59

Nephrogenic

Question 60

What are the signs of thyrotoxic crisis?

Answer 60

Tachycardia, hyperthermia "speed up mode"

Question 61

what is the pathophysiology of a pt with the following labs: ph 7.20, glucose 500, positive urine glucose, serum K 2.0, Na 130?

Answer 61

Decreased glucose causes fatty acid use (ketogenesis) resulting in metabolic acidosis & metabolic alkalosis

Question 62

What is the action of calcitonin?

Answer 62

Decreases serum Calcium

Question 63

In an acromegaly pt, what lifestyle patterns would you want to assess?

Answer 63

Sleep patterns

Question 64

Type 1 DM has episodes of hunger, lightheadedness, tachycardia, pallor, headache, and confusion. What causes these symptoms?

Answer 64

Hypoglycemia caused by increased exercise

Question 65

what is the Somogyi effect?

Answer 65

Hypoglycemia with rebound hyperglycemia

Question 66

your diabetic pt has a routine UA, which demonstrates proteinuria. Which therapy would you prescribe? a. ACE inhibitor b. Frequent BG monitor c. repeat UA

Answer 66

ACE inhibitor - protects kidneys and keeps them from spilling out proteins?

Question 67

Chronic microvascular complications for diabetes: SATA: a. eyes, b. peripheral, c. vascular, d. nerves, e. renal

Answer 67

a. eyes d. nerves e. renal

Question 68

which complication is a result of a reduction in parathyroid hormone? SATA: a. asphyxiation b. tonic clinic seizures c. muscle spasms d. laryngeal spasms e. hyporeflexia

Answer 68

a. asphyxiation b. tonic-clonic seizures c. muscle spasms d. laryngeal spasms

Question 69

A pt with abnormally severe tooth decay and erosion, what should a health care professional assess for?

Answer 69

Bulimia

Question 70

A health care professional speaking to a weight loss support group encourages participants for regular screening for medical conditions related to obesity: SATA: a. cancer b. cardiovascular disease c. cirrhosis d. diabetes e. dementia

Answer 70

a. cancer b. cardiovascular d. diabetes

Question 71

Head injury and pt can sense heat/cold or dull/pain comes from what part of the brain?

Answer 71

Pons

Question 72

Microinfarcts resulting in pure motor or pure sensory deficit result from which stroke?

Answer 72

Lacunar Stroke

Question 73

Pt with spinal cord damage to UPPER motor neurons what assessment finding would the healthcare provider associate with this injury

Answer 73

Initial paralysis, gradual partial recovery later

Question 74

Where is CSF produced

Answer 74

Choroid plexus

Question 75

Pt who sustained cervical spinal cord injury 2 days ago develops a sudden headache and blurred vision. What should be done?

Answer 75

Take BP/ pulse for hyperreflexia?

Question 76

Cognitive operations cannot occur w/o effective functioning of what part of the brain?

Answer 76

Reticular activating system

Question 77

Which midbrain dysfunction causes pinpoint pupils fixed in position?

Answer 77

pontine dysfuction

Question 78

The event most likely to occur when a person experiences a closed head injury

Answer 78

Brief instability of ones vital signs

Question 79

Pt w/ spinal cord injury C4, what should health care professional assess as a priority

Answer 79

Breathing. "C5 stay alive, C4 breathe no more"

Question 80

The neural group closes dorsally during which week of gestational life

Answer 80

4th week

Question 81

Health care professional advises pregnant women to add which supplement to prevent birth defects?

Answer 81

Folic acid

Question 82

Result of Arnold-Chiari type 2 malformation associated with myelomeningocele?

Answer 82

Downward displacement of cerebellum, brainstem, and 4th ventricle

Question 83

Pt cleaning litter box with HIV/AIDS develops fever, clumsy, trouble speaking. what medicine to give

Answer 83

pyrimethamine (pt has toxoplasmosis)

Question 84

Type of vascular malformation that most often results in hemorrhage

Answer 84

Arterial venous malformation

Question 85

Which cerebral vascular hemorrhage causes photophobia, positive kernig's & brudzinskis, & meningeal irritation?

Answer 85

Sub arachnoid hemorrhage (SAH)

Question 86

Vascular malformation is characterized by arteries that feed directly into veins through a vascular tangle of abnormal vessels?

Answer 86

AVM - arterial venous malformation

Question 87

Which neurotransmitter is reduced in schizophrenia?

Answer 87

GABA

Question 88

Hypothalamic pituitary-adrenal system abnormalities are present in which psychiatric disorder

Answer 88

Depression

Question 89

antipsychotic drugs causes tardive dyskinesia, which mimics the effects of an increase of which neurotransmitter?

Answer 89

Dopamine

Question 90

What is the link between depression and cortisol secretion?

Answer 90

Persistently increased cortisol increases depression risk

Question 91

Decrease in receptor binding for which neurotransmitter is found in depression

Answer 91

serotonin

Question 92

Which electrolyte imbalance is associated with lithium toxicity?

Answer 92

Hyponatremia

Question 93

Nerve fiber that transmits pain impuse?

Answer 93

A-delta fibers

Question 94

endogenous opioid located in the hypothalamus and pituitary and is a strong receptor agonist?

Answer 94

Endorphins

Question 95

A pregnant pt with severe depression has been taking venlafaxine (Effexor) and asks the health care professional what options are available. what would be recommended?

Answer 95

ECT - elctroconvulsion therapy