Patho Midterm 1

Inflammation is triggered by: a. physical injuryb. chemical injuryc. microorganisms
The mast cell activates the inflammatory response through? a. degranulation of preformed histamine and chemotactic factorsb. synthesis of leukotrienes, prostaglandins, and platelet-activatingfactor
Which block the synthesis of prostaglandins, thereby inhibiting some aspects of the acute inflammatory response? nonsteroidal anti-inflammatory drugs (NSAIDs) e.g. aspirin,ibuprofen
In comparison to acute inflammation, chronic inflammation involves a. much less or no exudateb. fewer PMNs and proportionally more aggregation of macrophages.c. more activity of fibroblasts, leading to more scarring.d. granuloma.e. less pain.
Neutrophils (PMNs) and macrophages differ in a. factors that attract themb. arrival time at the site of inflammationc. length of time they remain actived. importance to acute versus chronic inflammatione. importance to healing
Macrophages, which are essential for wound healing, aid healing by a. summoning and activating fibroblastsb. stimulating vascular endothelial cells to form new blood vesselsc. stimulating epithelial cells to grow into and seal the wound
Redness, warmth, swelling, and pain are classic signs of vascular phase of acute inflammation
In acute inflammation, the white cell count in the blood usually drops. True or False False
A wounded tissue which can not regenerate a. can not undergo resolution.b. can undergo connective tissue repair.
Formation of granulation tissue is part of reconstruction
Maturation includes a. continuing differentiation of cellsc. scar formationd. contraction of wounde. remodeling of the scarf. epithelialization
Disruption of a wound leads to better healing with less scar tissue. True or False False
Which is LEAST essential to healing? saturated fats
Which vitamin is critical to the synthesis of proper collagen? C
Hemorrhage, ischemia, infection, and glucocorticoids (cortisol family) all slow or block healing
Which is characteristic of hay fever and animal fur reactions? a. Type I hypersensitivity b. IgE c. histamine
Which of the following is NOT a characteristic of anaphylaxis? a. laryngeal edema b. erythema and itching c. rapid onset d. endocytosis of histamine by mast cells endocytosis of histamine by mast cells
Type III hypersensitivity a. involves immune complexes. b. may be autoimmune or allergic. c. involves inflammation. d. is immediate.
Tuberculin reaction, reactions to poison ivy, and allergic contact dermatitis with lesions only at site of contact are examples of type ____ hypersensitivity. IV
Which is the hypersensitivity which does NOT involve antibodies? IV
Autoimmunity may be caused by a. exposure of the immune system to antigens which normally are sequestered b. complications of infectious disease (e.g. cross-reaction) c. neoantigens (e.g. antigens created by binding of haptens to proteins inside the body)
Autoimmune disorders include a. SLE (Systemic Lupus Erythematosus) b. rheumatoid arthritis c. multiple sclerosis d. rheumatic fever
Which is NOT an antigen on the red cell membrane? a. O b. A c. B d. Rh a. O
A person with blood type AB would have antibodies against: a. type O b. type A c. type B d. None of the above None of the above
If a person’s resistance to an organism does not depend on the immune system, the person is said to have ___________ immunity to the organism. natural or innate
Acquired immunity is gained: a. after birth b. via injection of specific antibodies c. by deliberate exposure to antigens through vaccination d. by accidental exposure to antigens
Regarding humoral and cellular immunity: a. B cell immunity is called humoral because antibodies are produced only by B cells. b. Both B cells and T cells are involved with fighting viruses
Regarding humoral and cellular immunity: a. T cell immunity is called cell-mediated because T cells can react only with cells, not isolated molecules.b. Both B and T cell lines produce memory cells.
The immunoglobulin which crosses the placenta confers _________________ immunity on the fetus. Passive
Which is the term for a molecule that can, by itself, induce the formation of antibodies and the maturation of B and T cells? Immunogen
The most important determinant of immunogenicity is: Foreignness
The cell-mediated immune response includes: a. cytotoxicity b. memory c. control
The primary immune response involves: a latent period followed by moderate antibody production
Generally, in comparison to a primary immune response, a secondary immune response occurs sooner after the person’s exposure to the antigen and is much stronger. T or F True
When an antibody binds to an antigen, which may occur? a. agglutination b. neutralization c. enhancement of phagocytosis d. inflammation
Natural Killer cells are part of the specific immune response. T or F False
Which is LEAST developed at time of birth? a. cell-mediated immune capability b. ability to produce primary response c. ability to produce IgG d. ability to produce IgM ability to produce IgG
Increased age is associated with: Increased production of antibodies against self-antigens. And lowered T-cell function.
Infections can be contracted from animal reservoirs through direct or indirect . T or F True
Which of the following statements correctly describes the incubation period a) The time period from initial exposure to the infectious agent and the onset of the first symptomsb) the time period during which the microorganism is multiplying but does not have enough numbers to cause symptomsc) it can last from hours to years
Virulence is defined as ____________. the capacity of a pathogen to cause severe disease.
Which of the following diseases are caused by protozoa?a) Amebiasisb) Trichomoniasisc) Malariad) Ascariasis a) Amebiasisb) Trichomoniasisc) Malaria
Which of the following correctly describe viruses? They are obligatory parasites. And they consist of nucleic acid protected by a protein shell.
Viruses rarely mutate (T or F) False
HIV is present in which body fluids? a) breast milkb) bloodc) semend) vaginal fluid
Which of the following statements correctly describe the prevalence of HIV-1 and HIV-2? HIV-1 is more common in North America. HIV-2 is more common in western Africa
Which of the following statements correctly describe the latent period of HIV infection? a) it can last up to 10 years b) it ends when opportunistic infections develop
Vaccines are a type of passive immunotherapy. T or F False
The concept of the general adaptation syndrome is based on the finding that __________. many very different types of stressors produce a similar
Which part of the nervous system is LEAST involved in the stress response?a. limbic systemb. sympathetic nervous systemc. hypothalamusd. thalamus thalamus
Corticotropin releasing factor (CRF) is produced and secreted by the ___________. hypothalamus
The increase in blood glucose during the stress response is produced by a. sympathetic nervous systemb. cortisolc.. growth hormone
Of the several pituitary hormones which increase during the stress response, which exerts the important influence on immune function? ACTH
Under stress, local increases in proinflammatory cytokines may lead to a variety of diseases even though systemically a T2 shift has occurred. (T or F) True
All attempts at coping with stress are beneficial during stressful experiences. (T or F) False
Sodium is most important for: ECF osmotic balance
Calcium is the most abundant cation in extracellular fluid. (T or F) False
Edema is the accumulation of fluid within the interstitial space
Which would NOT produce edema? decreased interstitial oncotic pressure
Accumulation of water inside the cell is called hypertrophy. (T or F) True
Aldosterone influences ECF volume: a. by directly increasing re-absorption of sodiumb. directly by re-absorption of potassium
Hypotension may be associated with both hypernatremia and hyponatremia. (T or F) True
Hypocalcemia decreases neuromuscular excitability. (T or F) False
Both hypokalemia and hyperkalemia result in muscular weakness and cardiac dysrhythmias. T or F True
Which would shift the blood pH toward alkalosis? a. secretion of hydrogen ions into the urineb. hyperventilationc. prolonged vomiting
Respiratory acidosis occurs with increased CO2
Metabolic acidosis occurs with decreased bicarbonate rather than increased CO2. T or F True
The lungs, kidneys, and blood each use several buffers including the carbonic acid – bicarbonate buffer system and proteins. T or F False
• sodium = 110 mEq/L• chloride = 100mEq/L• potassium = 4.8 mEq/L• calcium = 9 mEq/L• bicarbonate = 26 mEq/L What is the most likely alteration? Hyponatremia
young woman became agitated and apprehensive and eventually lost consciouslness. Lab values: • plasma sodium = 137 mEq/L• plasma potassium = 5.0 mEq/L• blood pH = 7.53• serum CO2 = 22 mm Hg• plasma bicarbonate = 24 mEq/L immediate diagnosis: respiratory alkalosis
Water intoxication and hyponatremia are consequences and important features of syndrome of inappropriate antidiuretic hormone secretion (SIADH): T or F True
Which is NOT a manifestation of hyperthyroidism? myxedema coma
Graves disease is characterized by hypersecretion of thyroid hormone
Which is FALSE regarding (thyroid storm)?a. is often fatal without early interventionb. involves increases in beta-adrenergic receptors and catecholaminesc. Is associated with Hashimoto’sd. occurs in severe hyperthyroidism under increased stress Is associated with Hashimoto’s thyroiditis
Systemic symptoms of thyroid storm include a. nausea, vomiting, or diarrheab. hyperthermiac. tachycardia, especially atriald. heart failuree. agitation or delirium
If a person has hypothyroidism secondary to iodine deficiency, the levels of thyroid releasing hormone are likely to be High
Which is NOT associated with severe hypothyroidism? Graves
Myxedema coma is associated with hypothyroidism
Signs and symptoms of myxedema coma include all of the following EXCEPTa. hypothermia without shiveringb. hyperventilationc. hypotensiond. hypoglycemiae. lactic acidosis b. hyperventilation
Polyuria and polydipsia are symptoms of all of the following EXCEPTa. Type 1 diabetes b. Type 2 diabetes c. SIADHd. HHNKS c. SIADH
A 12 year old boy is admitted with Type 1 diabetes. Which of the following pathophysiologic changes has occurred? destruction of the beta cells of the pancreas
Type 1 diabetes is usually due to: an interaction between genes and environment
13. A 24-year old woman with a history of type 1 diabetes is found in a stuporous state. She is hypotensive and has cold clammy skin. What is the likely etiology of her condition? insulin reaction
During gym class a male with Type 1 diabetes develops hunger, lightheadedness, tachycardia, pallor, headache and confusion. The most probable cause of these symptoms is hypoglycemia resulting from decreased insulin requirement due to increased exercise
Which is indicated by vomiting, abdominal pain, dehydration, and an acetone odor on the breath? diabetic ketoacidosis (DKA)
Which is FALSE regarding hyperosmolar hyperglycemic nonketotic syndrome (HHNKS) and DKA? Glucose levels are lower in HHNKS than in DKA.
Hypoxia and ischemia occur as a complication of chronic diabetes. This happens because: capillary basement membranes thicken
Diabetic neuropathy most commonly affects the extremities
An individual with diabetes is more prone to all of the following : a. stroke and coronary artery diseaseb. kidney failurec. infectiond. retinopathy
In syndromes of hypersecretion of steroids by the adrenal cortex, a. Cushing's is caused by excessive secretion of ACTH by the anterior pituitary.b. Cushing syndrome refers to chronically excessive levels of circulating cortisol.c. In some cases, the excess ACTH and/or CRH may be secreted by nonpituitary tumors.
Which is TRUE regarding symptoms of hypercortisolism? a. Glucose intolerance and diabetes result from insulin resistance and increased gluconeogenesis.b. Weight gain is most common of hypercortisolism.c. Truncal obesity, moon face, and buffalo hump are patterns of fat deposition.
Which is TRUE regarding symptoms of hypercortisolism? a. Muscles waste, bones become brittle, and skin thins because of catabolic effects on protein.b. Immune function is depressed.
Which is FALSE regarding Addison disease?a. It is called secondary hypocortisolism.b. ACTH levels are elevated.c. Synthesis and output of cortical steroids are inadequate.d. The adrenal cortex itself is defective. a. It is called secondary hypocortisolism.
Which condition usually does NOT occur in early malignant disease?a. fatigueb. painc. infection all of the above
Which condition associated with advanced cancer and metastasis includes symptoms of early satiety, weight loss, alterations in taste, and altered metabolism of nutrients? cachexia
Tumor staging involves a. size of tumorb. locationc. how much it has locally invadedd. how much it has metastasized
Expanding tumors require additional blood supply to feed their growth. Thegrowth of new blood vessels is called: angiogenesis
The three biochemical steps of local tumor invasion include all of the following a. anchoring of tumor cell to basement membrane ofneighboring cellb. secretion of proteolytic enzymes to degrade the matrixd. locomotion of the tumor cell into the weaken
Local invasion can occur due to mechanical invasion
Cancer can spread to a distant, separate site by a. entry of cancer cells into the body cavitiesb. entry of cancer cells into the bloodstreamc. entry of cancer cells into the lymph fluid in the lymphatics
Higher exposures to _______ are risks for cancer. a. ultraviolet or ionizing radiationb. gonadal steroidsc. carcinogensd. alcohole. inhalation of tobacco smokef. obesity
Which of the following is NOT a common feature of cancerous tissue? a. normal gene structureb. presence of a well-defined capsule surrounding it
Cancers of epithelial tissue are called carcinoma
Cancers of various types of connective tissue include a. leukemiab. lymphomac. sarcoma
Sarcomas include cancers of a. boneb. cartilagec. fatd. fibrous tissuee. muscle
A mutation which confers _______ is NOT likely to lead to cancer. inactivation of enzymes that drive the cell cycle
Loss, inactivation, or mutation of tumor suppressor genes protects the personagainst cancer. T or F False
Chronic inflammation __________ cancer. promotes the development of
Hepatitis B and C viruses lead to liver cancer (hepatocellular carcinoma) via producing chronic inflammation (chronic viral hepatitis)
Inflammation is triggered by:a. physical injuryb. chemical injuryc. microorganismsd. parasympathetic stimulation physical injurychemical injurymicroorganisms
The mast cell activates the inflammatory response througha. degranulation of preformed histamine and chemotactic factorsb. synthesis of leukotrienes, prostaglandins, and platelet-activatingfactorc. synthesis of serotonind. hemolysis The mast cell activates the inflammatory response throughDegranulation of preformed histamine and chemotactic factors.Synthesis of leukotrienes, prostaglandins, and platelet-activatingfactor.
Which block the synthesis of prostaglandins, thereby inhibiting some aspects of the acute inflammatory response?a. nonsteroidal anti-inflammatory drugs (NSAIDs) e.g. aspirin,ibuprofenb. leukotrienesc. bradykinind. alcohol Nonsteroidal anti-inflammatory drugs (NSAIDs) e.g. aspirin,ibuprofen
In comparison to acute inflammation, chronic inflammation involvesa. much less or no exudate.b. fewer PMNs and proportionally more aggregation of macrophages.c. more activity of fibroblasts, leading to more scarring.d. granuloma.e. less pain. a. much less or no exudate.b. fewer PMNs and proportionally more aggregation of macrophages.c. more activity of fibroblasts, leading to more scarring.d. granuloma.e. less pain.
Neutrophils (PMNs) and macrophages differ in: -Factors that attract them-Arrival time at the site of inflammation-Length of time they remain active-Importance to acute versus chronic inflammation-Importance to healing
Macrophages, are essential for wound healing, aid healing bya. summoning PMNsb. summoning & activating fibroblastsc. stimulating vascular endothelial cells to form new blood vesselsd. stimulating epithelial cells to grow into and seal wound -Summoning and activating fibroblasts-Stimulating vascular endothelial cells to form new blood vessels-Stimulating epithelial cells to grow into and seal the wound
A wounded tissue which can not regeneratea. can not undergo resolution.b. can undergo connective tissue repair.c. will not require fibroblasts in its reconstructive phase. -Can not undergo resolution.-Can undergo connective tissue repair.
Formation of granulation tissue is part of -Reconstruction
Maturation includes: -Continuing differentiation of cells-Scar formation
Maturation includes: – Contraction of wound- Remodeling of the scar-Epithelialization
Which is LEAST essential to healing?a. glucoseb. oxygenc. proteind. saturated fats Saturated Fats
All somatic cells within a given animal or person have the same:a. gene contentb. gene expressionc. type of enzymes producedd. replication rate gene content
Ribosome synthesizes protein by interpreting thegenetic code and assemblingpolypeptides.
Nucleus Directs activities of cell via its DNA,which codes for protein production.
Cell membrane Controls passage of materials into andout of cell; is involved in intercellularcommunication and recognition.
Mitochondrion is site for aerobic respiration. Most ATP production occurs here.
Rough endoplasmic reticulum synthesizes proteins for lysosomes andsecretion (exocytosis).
Smooth endoplasmic reticulum ) inactivates steroids and toxic chemicals;is involved in lipid synthesis.
Golgi apparatus modifies and packages proteins. Itsvesicles become secretory vesicles,carrying cell products to cell surface forexocytosis, or become lysosomes.
Cilium moves particles along surface of cell.
Lysosome digests unwanted organelles(autophagy) and invaders; can carry out apoptosis (cell suicide)
Na+/K+ pump maintains potential across cellmembrane.
Glycocalyx ) is fuzzy coat on surface of all cells(external side of membrane); viacarbohydrate groups is involved in cellrecognition, adhesion, etc.
_______ represents an increase in cell size dueto addition of water, without addition of functional components. swelling
_________ involves an increase in the number ofcells in an organ with no functional reason, i.e. in the absence ofincreased demand or stimulation. neoplasia
_________ represents the conversion from oneadult cell type to another (e.g. columnar ciliated epithelium tosquamous epithelium). metaplasia
________ is characterized by deranged cell growthof a specific tissue, producing cells that vary in size, shape, andappearance. It is NEVER a normal form of adaptation. dysplasia
Both metaplasia and dysplasia are ________ whenthe source of perturbation disappears. reversible
_______ is strongly implicated as a precursor ofcancer (e.g. cervical and lung). dysplasia
Chronic ______ can produce both metaplasiaand dysplasia. irritation
Which is NOT a common theme in injury and death of cells?a. free radicals, whose primary source within the body is oxygenb. depletion of ATPc. lack of oxygend. loss of selective membrane permeabilitye. depletion of intracellular calcium depletion of intracellular calcium
Which is NOT a mechanism of cell injury?a. hypoxiab. hyperoxiac. anti-oxidantsd. ischemia anti-oxidants
.Which statements is TRUE regarding free radicals?increase in free radicals. -Oxygen's the most common source of free radicals in the body.-The body has intracellular enzyme systems for getting rid of freeradicals.-Tissue hypoxia or ischemia followed by reperfusion can result in
Which is NOT considered to be a chemical agent of injury?a. leadb. bacterial toxinsc. carbon tetrachlorided. street drugs and ethanole. toxic asphyxiants bacterial toxins
Which is NOT a toxic asphyxiant?a. carbon monoxideb. hydrogen cyanidec. carbon tetrachlorided. hydrogen sulfide carbon tetrachloride
Nutritional imbalances are considered to be a physical agent of injury. False
Which substance is NEVER dangerous when it accumulates in cells?a. calciumb. fatc. bilirubind. watere. melanin Melanin
Which ALWAYS involves cellular death? apoptosisnecrosis
Which involves death of scattered, single cells? necrosisapoptosis
Of the following types of necrosis, which is NOT a distinctive type of celldeath?a. gangrenousb. coagulativec. caseousd. fate. liquefactive gangrenous

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