NUR 631- Patho Final Exam 2022/ 2023

NUR 631- Patho Final Exam 1. What houses cellular genetic information?: Nucleus 2. What is cellular suicide?: Apoptosis 3. What happens with impaired cellular metabolism?: Accumulation of waste products, impaired ATP production 4. How does water move between inter and extracellular space?: Osmosis 5. What protein detects the presence of a neural tube defect in a fetus?: In- creased Alpha Fetoprotein (AFP) 6. What are common defects seen in Trisomy 21?: -Flat nose -Wide spaced eyes -No creases in palms -Heart defects -Low set ears -IQ 70 or less 7. What cells within wound healing and inflammation maintain the status of the cell?: Housekeeping 8. What happens if a newborn does not have enough collectin protein?: In- creased risk of respiratory infection 9. What is active acquired immunity?: Gathered through exposure to a virus or through vaccination. 10. Where do B lymphocytes mature?: Bone marrow 11. What is a type II hypersensitivity?: Allergic reaction 12. Why do we give Rhogram? And to who?: Prevents hemolytic anemia. Give to Rh- mom with Rh+ baby. 13. When are exotoxins released?: With bacterial growth 14. What type of cells control fungal infections?: -T lymphocytes -Phagocytes 15. What hormone is affected by stress?: Cortisol 16. How does stress affect blood glucose?: Increases due to cortisol release 17. When a patient develops MODS, what helps cells change to a proinflam- mation state?: Interleukins 18. How dehydrated does a child have to be to be hypotensive?: 10% 19. Why do we worry about urinary function in children with electrical burns?: Immature kidneys, damaged muscles release myoglobulin which cannot be processed by kidneys. 20. What kind of cancer can be avoided with exercise?: Colon cancer 21. Exposure to what virus has a carcinogenic effect on children?: Epstein Barre Virus 22. Exposure to what increases a child's risk of cancer?: Chemotherapy -EBV -Ionizing radiation -2nd hand cigarette smoke 23. What are granulocytes with vasoactive histamine?: Basophils 24. What is it called when you cannot absorb B12?: Pernicious anemia 25. What is aplastic anemia?: Pancytopenia, deficits in erythrocytes, lympho- cytes, and thrombocytes 26. What sex is hemophilia highest in?: Men 27. What gene is hemophilia dependent on?: X-linked recessive 28. What does B12 deficiency cause?: Degranulation of the myelin sheath 29. What genetic materials will translocate in CML?: Genes 9 & 22 abnormally fuse and make BCRABL1 30. What causes sickle cell disease?: Genetic mutation, valene replaces amino acid, glutamate 31. Where is oxytocin produced?: Posterior pituitary 32. What does desmopressin do?: Vasoconstrict 33. What regulates calcium absorption?: Parathyroid hormone 34. What do we look for in small cell carinoma of the stomach?: ADH 35. TBI patient has increased UOP of 5-7L/day. What medication should be administered?: DDAP 36. What would you see in the urine of a diabetic patient?: Glucose 37. Why do we see neurovascular injury with diabetes?: Thickened basement membrane, hyperplasia 38. Why do diabetic patients need frequent eye exams?: Vasoconstriction causes retinopathy 39. Signs of hypothyroidism?: -Dry skin -Lethargy -Hair loss -Bradycardia -Constipation 40. Why do older adults lose weight?: -Decreased sense of taste -Constipation -Polypharmacy -Poor dental hygiene -Social isolation 41. Inability to discern sharp from dull indicates and injury where in the brain?: The Pons 42. What part of the brain controls involuntary movement such as balance and posture?: Cerebellum 43. Which facial nerve controlsl facial expressions: Cranial nerve 7 44. You suspect cranial nerve 7 injury. What do you ask your patient to do?: Smile 45. How do you differentiate between upper and lower nerve injury?: Lower - permanent paralysis Upper - gradual recovery 46. What separates the cerebellum from the cerebrum: Tentorium cerebelli 47. If a patient has a defect in their arachnoid villi, what would you see at decreased levels?: CSF 48. What part of the brain allows you to focus/attention?: Pre-frontal 49. If a patient is experiencing a dream state seizure what type is this?: Com- plex focal seizure 50. What edema is caused by increased capillary permeability in the brain?- : Vasogenic cerebral edema 51. During NIH, you ask the pt to close their eyes, hand them a pen, and ask them to identify the object. They are unable, what is this called?: Tactile agnosia 52. A few patients are coming out post op. Which ones do you suspect will need pain medications?: -Rotator cuff repair -Gallbladder removal -Crush injury 53. What are the pain transmitting neurons in the spinal cord?: Dorsal gan- glion root 54. What are endogenous opioids?: Endorphins 55. What other disorder do you look for in a pt with a diagnosis of pituitary hypothalamic adrenal systems?: Major depression disorder 56. What is decreased in major depression disorder?: Serotonin 57. What electrolyte dysfunction do you see in lithium toxicity?: Hyponatrem- ia 58. Deschenes Muscular Dystrophy is what type of genetic disorder?: - X-linked recessive 59. What is the association between major depression and cortisol levels?- : Increased cortisol levels lead to inflammation, then depression. 60. What is the pericardium?: A fibrous tissue sac that encases the heart. 61. A patient has a PR interval of 0.3. What does that mean?: A delay in conduction 62. Where are the papillary muscles located in the heart?: Valves 63. What do the papillary muscles do?: Open and shut the valves, preventing backflow. 64. What electrolyte dysfunction do you see in phase 0 of the cardiac cycle?- : Hyponatremia 65. What is Raynaud's disease?: Vasospastic disorder of the vessels in the hands and sometimes toes. 66. A patient is admitted with s/sx of MI. What labs do we check?: CKMB Troponin I (recheck in 3 hrs) BNP 67. What are some differential diagnoses for pulse paradoxes?: DVT Pericardial effusion 68. Why would we see pulse paradoxes in the case of pericardial effusion?- : Low blood volume in all 4 chambers of the heart 69. What might we see in a patient with COPD and increased pulmonary vascular resistance?: Right sided heart failure 70. What is a heart defect in Down Syndrome?: Ventricular Septal Defect (VSD) 71. A patient comes in with projectile vomiting with no fever or other symp- toms. What do you order?: CT of head to r/o injury 72. What do you call frank red blood from the rectum?: Hematochezia 73. Fullness of the stomach could indicate what differential diagnoses?: - -Constipation -GERD -Crohn's -Cancer -SBO 74. What bacterial infection is prevalent in pre-schools?: Impetigo 75. What are symptoms present in the prodromal phase of hepatitis?: Non- specific -N/V -Fatigue -Hyperalgesia (pain hypersensitivity) 76. Why do we see physiological jaundice in newborns?: Conjugated hyper- bilirubinemia 77. What does surfactant do?: Reduces surface tension in the alveoli. 78. Why would you see clubbing in a respiratory diagnosis?: Improper gas exchange results in a chronic hypoxic state. 79. What type of bronchiectasis causes constriction and dilation in the bronchi?: Varicose bronchiectasis 80. What is it called when there is fluid in the pleural space?: Pleural effusion 81. Patient is not in distress but has a transudate pleural effusion, what would you test for & why?: Blood work to check protein sources 82. What is the secondary condition you would monitor for in ARDS?: Pneu- monia 83. You have a patient with respiratory distress & emphysema with no appar- ent cause, what testing would you do?: Genetic 84. What findings would you suspect in a pulmonary HTN patient?: SOB with activity -JVD -Peripheral edema 85. Why do we worry about nasal congestion in infants?: Infants are nose breathers 86. What causes a mucous plug in cystic fibrosis patients?: Insufficient secre- tion of chloride and excess absorption of sodium. 87. How do we assess renal function status?: GFR 88. What labs are normal in the elderly but not in the younger population?: - Increased urine specific gravity 89. What do natriuretic peptides do when the heart is dilating?: Stop renin & aldosterone 90. How do potassium and magnesium influence kidney stones?: If there is enough of both, it stops crystal formation of stones. 91. What are some potential complications of streptococcal infections?: - -Rheumatic fever -Glomerulonephritis -Pediatric autoimmune neuropsychiatric disorders (PANDAS) 92. Why do patients with glomerulonephritis have brown urine?: RBCs in the urine 93. Patient has RBCs & protein in urine. What test should be run?: Renal biopsy to check for glomerulonephritis 94. Where do you see IgG deposited in patients with glomerulonephritis?: - Basement membrane 95. What causes ureteral reflux in children?: A shorter ureter may not provide proficient stop of backward flow. 96. If a patient has a spinal cord injury, where would a urinary obstruction come from?: Could be anywhere pre- intra-, and post-renal. 97. What glycoproteins transport essential hormones?: Bone albumin 98. What maintains bone matrix?: Osteocytes 99. What is a pathological fracture?: A fracture not resulting from trauma d/t an underlying condition. 100. Why do women develop osteoporosis more than men?: Increased oxida- tive stress, increased intercellular reactive oxygen 101. An older women was found down in bathroom. What would you test?: - CK, creatinine. Check for rhabdo. 102. What causes Paget's disease?: Bone reabsorption is defective. New bone is abnormally shaped, weak, and brittle. 103. An x-ray of osteomyelitis says "sequestrum", what does that mean?: - De-vascularized and devitalized. 104. What is ankylosing spondylitis?: Chronic inflammation that causes the spine to fuse to itself. 105. You have a child whose hip is rotate but maintaining contact with the joint and not well seated. What is this called?: Subluxation of the hip (partial dislocation) 106. What is an elevated, round, firm, irregular marking over a site of injury?- : Keloid 107. What do allergic contact dermatitis and contact dermatitis have in com- mon?: Red & itchy skin 108. What skin condition is demarcated, thick, & scaley?: Plaque psoriasis 109. What is a collection of hair follicles that is infected and painful?: Carbun- cle 110. Chick pox is the same thing as .: Herpes zoster 111. What is tenea corpus?: Ring worm 112. What does ringworm look like?: Red scaly circle patches 113. What is kaposi sarcoma?: Vascular malignancy cancer seen in immunosup- pressed patients. Often seen as purple/brown skin blotches. 114. What is a growth with a depressed center, rolled corners, seen on the neck?: Basal cell cancer 115. What is pelvic inflammtory disease?: Permanent changes in the epithelium of the fallopian tubes. 116. What is a benign uterine tumor in the myometrium from smooth muscle cells?: Uterine fibroids OR leiomyoma 117. What does it mean to have a cervical carcinoma "in situ"?: Full epithelial thickness and encapsulated in place 118. What mutation causes ovarian cancer?: BRACA 1 119. How do you differentiate between a breast cyst or tumor?: Cyst is squishy and fluid filled. Tumor is hard and deep. 120. What clinical finding is suspicious of testicular cancer?: Painless, firm mass 121. What is balanitis?: inflammation of the glans penis 122. What does balanitis indicate?: Uncontrolled diabetes 123. Patient presents with fatigue, lower back pain, chills, and urinary reten- tion. What do you suspect?: UTI, check UA. 124. A patient cannot retract the foreskin on their penis. What is this called?- : Phimosis 125. What do you see in newborns infected with gonorrhea?: Corneal ulcera- tions 126. What goes with a gonorrhea diagnosis?: Chlamydia 127. At what stage of syphilis do we see skin and bone breakdown?: Tertiary neurosyphilis 128. What organism causes syphilis?: Treponema pallidum (bacteria) 129. If you see strawberry spots on a woman's cervix, how do you treat?: - Flagyl 130. What is Naegele's rule?: Add 7 days to the first day of the last menstrual period (LMP) and subtract 3 months to estimate a woman's estimated date of confinement/delivery (EDC). 131. GTPAL: Gravida - # of pregnancies, including current Term - # of term deliveries that were carried to 37 wks Preterm - # of pregnancies carried between 20-37 wks Abortions - # of losses prior to 20 wks Living - # of living children 132. S/sx of pre-eclampsia include...: -HTN -Proteinuria -RUQ and flank pain -Hand/facial swelling -Weight gain -Headache 133. Patient is 34 weeks pregnant with bright red bleeding. What does this indicate?: Placenta previa 134. Which type of cell adaptation occurs when normal columnar ciliated epithelial cells of the bronchial lining have been replaced by stratified squa- mous epithelial cells?: Metaplasia 135. What syndrome, characterized by an absent homologous X chromo- some with only a single X chromosome, exhibits features that include a short stature, widely spaced nipples, and webbed neck?: Turner syndrome 136. Which structure prevents water-soluble molecules from entering cells across the plasma membrane?: Phospholipid bilayer 137. Which cell is the body's primary defense against parasite invasion?: - Eosinophils 138. A patient suffered multiple traumatic injuries and received many blood transfusions within a few days of the injuries. For which medical condition should the health care professional monitor the patient?: Hemosiderosis 139. What is the clinical hallmark of neurogenic shock as a result of the overstimulation of the parasympathetic nervous system?: Vasodilation 140. What are genes responsible for the maintenance of all cells referred to as?: Housekeeping genes 141. How does an established gonococcal infection usually express itself in newborns?: Bilateral corneal ulcerations 142. Occlusion of the left anterior descending artery during a myocardial infarction would interrupt blood supply to which structures?: The left and right ventricles and much of the interventricular septum 143. In immunoglobulin G (IgG) nephropathies such as glomerulonephritis, IgG is deposited in which location?: Glomerular basement membranes 144. What does vomiting-induced metabolic alkalosis cause?: Compensatory hypoventilation 145. What are some things we see with carbon monoxide poisoning? Why?- : Normal pulse ox. Hemoglobin is bound up with carbon monoxide, not oxygen, depriving tissues of O2. 146. What do we see with excessive vomiting? Why?: Metabolic alkalosis. Holding onto bicarb. 147. How can a newborn have type 1 diabetes?: Autoimmune 148. What causes type II hypersensitivity?: Antibodies bind antigens on cell surface. 149. In a patient with organ transplant, why might we see tissue damage?: - Th1 cells release excess cytokines, which attack endothelial cells 150. Why are we susceptible to illness under stress?: Helper T cells are sup- pressed by cortisol. 151. What would we see in a chronically stressed patient?: Hypoglycemia 152. In a MODS patient, proinflammatory response is LEAST likely to be stimulated by...?: IL4 153. What causes reperfusion injury?: Re-exposure to oxygen after it having been cut off causes damage to tissues. 154. Why do we give pressors to shock patients?: Vasoconstriction with ADH 155. Why do diabetic patients pee so much?: Trying to expel excess glucose. 156. Why are obese patients at risk for hypertension?: Increased angiotensin. 157. What is the theory of regulating pain transmission in and out of spinal cord?: Gate control theory 158. What kind of nerve fibers transmit pain?: Delta A fibers 159. Normal PR interval?: Less than 0.2 160. Troponin in chest pain patient is normal. What next?: Recheck in 4 hrs 161. A crescendo-descendo systolic ejection murmur is common in what defect?: ASD 162. What does a crescendo-descendo systolic ejection murmur sounds like?: Wide, fixed splitting of S2 163. How does conjugation of bilirubin happen?: Unconjugated, fat soluble bilirubin binds to albumin to become water-soluble. 164. If I have a lactase deficiency, what deficiency do I have?: Watery osmotic 165. S/sx of SBO?: Distention (early) N/V (late) 166. In what disorder do we see hepatic fat accumulation?: ETOH cirrhosis 167. Cleft palate: Incomplete fusion of the nasomedial and inner maxillary process 168. What part of a joint heals the slowest?: Articular cartilage 169. Risks for prostate cx?: Over 65, African American, diet, and family history 170. Where would you see oncytosis?: Nailbed 171. Hx of PID, R sided abd pain, missed periods, dark red vaginal dis- charge?: Ectopic pregnancy