Pathophysiology Test 1
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1.
1. etiology
What are the four interrelated topics of pathophysiolo2. pathogenesis
gy?
3. clinical manifestation
4. treatment implications
2.
etiology
______________ is the study of the proposed cause or
causes of a particular disease process.
3.
true
(T/F) Etiology is a complex notion because most diseases are multifactorial, resulting from interplay between genetic constitution and environmental influences.
4.
clinical manifesta- What describes the signs and symptoms that typically
tions
accompany a particular pathophysiologic process
5.
pathogenesis
_____________ describes the direct effects of the initiating event, as well as the usual physiologic responses
and compensatory mechanisms
6.
stage; acuity;
chronicity
Manifestations may vary depending on the
__________ of disorder, individual variation,
_____________, or _____________-.
7.
false
(T/F) Determining whether clinical findings are normal, abnormal, or normal variation is an essential and
straightforward process in evaluating for the presence
or absence of disease
8.
2
Normal ranges for laboratory tests are typically defined
as the mean +/- ___ standard deviations
9.
predictive value
The ___________ is the extent to which it can differentiate between presence and absence of disease in an
individual.
10. better
Tests with high sensitivity and specificity generally have
____________ predictive value
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11. 1. age
What factors (other than disease/illness) may cause
2. ethnicity
variations in physiologic processes?
3. gender
4. lifestyle
5. socioeconomic
status
6. geographic location
12. epidemiological
Understanding the _____________ aspects of a disease is essential for effective prevention and treatment.
13. Hydropic swelling What is an early indicator of cell injury?
14. Na+ -K+ pump dys- Hydropic swelling is the result of what?
function at the cell
membrane
15. Intracellular accu- What indicates a disorder of cellular metabolism?
mulations of abnormal intracellular endogenous or
exogenous particles.
16. 1. chaperone pro- Damage from accumulation of abnormal intracellular
teins
protein is limited by what two means?
2. ubiquitin-proteosome system
17. they attempt to re- How do chaperone proteins work to mediate damage
fold the protein into from the accumulation of abnormal intracellular proits correct shape teins?
18. by digesting tarHow does the ubiquitin-proteosome system work to
geted proteins into mediate damage from the accumulation of abnormal
fragments
intracellular proteins?
19.
What indicate cellular stress?
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adaptive cellular
responses
20. altered functional What causes cellular stress?
demand or chronic
sublethal injury
21. hypertrophy; hyperplasia
___________ and ___________ generally result from
increased functional demand
22. atrophy
What results from decreased functional demand or
chronic ischemia?
23. metaplasia; dyspla- __________ and ___________ result from persistent
sia
injury
24. necrosis
_______________ occurs when the injury is too severe
or prolonged to allow adaptation and is usually a consequence of disrupted blood supply
25. 1. pain
What are the local and systemic indicators of cell
2. elevated serum death?
enzyme levels
3. inflammation
(fever, increased
WBC cnt., malaise)
4. loss of function
26. coagulation
Heart tissue exemplifies necrosis via _____________
27. liquifaction
Brain tissue exemplifies necrosis via _____________
28. caseation
Lung tissue exemplifies necrosis via _____________
29. fat
How does pancreatic tissue exhibit necrosis?
30. gangrene
_________________ refers to a large area of necrosis
that may be described as dry, wet, or gas
31. gas and wet
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What are the type(s) of gangrene that can be rapidly
fatal?
32. apoptosis
_____________ is cell death resulting from activation
of intracellular signaling cascades that cause cell suicide
33. false
(T/F) Apoptosis is very messy and results in systemic
manifestations of inflammation
34. hypoxia
results from poor oxygenation of the blood or inadequate delivery of blood to the cells
35. hypoxemia
deficient amount of oxygen in the blood
36. ischemia
inadequate blood supply to an organ or part of the body,
especially the heart muscles.
37. reperfusion injury Return of blood to ischemic tissues causes oxygen
derived free radicals, further damaging tissues
38. malnutrition
What type of nutritional disease is rampant in many
poor countries?
39. 1. obesity
2. heart disease
3. diabetes
What type of nutritional disease is rampant in many
industrialized countries?
40. true
(T/F) Cellular damage due to infection and immunologic responses is common
41. chemicals may in- Chemical, physical, and mechanical factors cause cell
terfere with normal injury. How do chemicals cause cell injury?
metabolic processes in the cell
42. injury such as
Chemical, physical, and mechanical factors cause cell
burns and frostinjury. How do physical factors cause cell injury?
bite, causes direct
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destruction of tissues
43. radiation-induced Chemical, physical, and mechanical factors cause cell
cell death is
injury. How do mechanical factors cause cell injury?
primarily a result
of radiolysis of
water, with
resulting free
radical damage to
the cell membrane.
44. maximal life span How is aging distinct from disease?
is limited by the aging process itself
rather than by the
ravages of disease
45. 1. accumulated
Aging is thought to be the result of what 3 means?
DNA damage
2. decreased proliferative damage
3. accumulation of
metabolic damage
46. 1. faulty DNA repair When may cells age more quickly?
mechanisms
2. excessive metabolic damage (due
to reduced antioxidant activity)
47. 1. decrease in func- How can age-related changes generally be described?
tional reserve
2. reduced ability
to adapt to environment demands
48. somatic death
death of the organism as a whole
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49. rigor mortis
stiffness of the body that sets in several hours after
death
50. 24; 48
Within ___ to ___ hours the tissues begin to deteriorate
and rigor mortis gives way to flaccidity
51. 23 pairs
Human DNA is organized into how many pairs of chromosomes
52. true
(T/F) One member of each pair is inherited from the
mother and the other from the father.
53. 22
How many pairs of chromosomes are autosomes?
54. sex chromosomes The one pair of chromosomes that are not autosomal
are ____________
55. XY
What sex chromosomes convey maleness?
56. XX
What sex chromosomes convey femaleness?
57. meiosis
____________ results in four daughter cells, each having one-half the normal number of chromosomes (23
individual)
58. allele
An alternative form of a gene
59. genotype
___________ refers to the particular set of alleles an
individual receives
60. phenotype
___________ refers to an individual's observable attributes
61. true
(T/F) People with different genotypes may have similar
phenotypes
62. single-gene traits
traits that involve only one gene locus
63. false
(T/F) The transmission of single-gene traits are often
very unpredictable.
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64. whether the gene is The expression of single-gene traits is determined by
dominant or reces- what?
sive
65. polygenic
Traits resulting from the interaction of several genes are
____________, and do not follow predictable patterns
of inheritance.
66. dominant; recessive
_____________ genes usually code for functional enzymes; ______________ genes do not
67. 1. chromosomal
What are the three general types of genetic disorders?
aberrations
2. single-gene disorders
3. polygenic disorders
68. chromosome
Why type of disorders result from an abnormality in
number or structure?
69. monosomy
The presence of only one chromosome of a homologous pair is
70. polysomy
presence of an excessive number of chromosomes is
called _____________
71. 1. translocation
2. inversion
3. deletion
4. duplication
What are the different names for the different rearrangements of portions of chromosomes?
72. translocation
Change to a chromosome in which a fragment of one
chromosome attaches to a nonhomologous chromosome.
73. non-homologous
chromosomes
chromosomes that contains alleles for different type of
genes (ex. AB/CD instead of AB/Ab)
74.
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chromosomal inversion
When part of the chromosome becomes oriented in the
reverse of its usual direction
75. chromosomal dele- A mutation involving the loss of a section of a chromotion
some
76. chromosomal duplication
A mutation involving the duplication of a section of a
chromosome
77. Turner Syndrome
______________ is an example of monosomy
78. Down Syndrome
____________ is an example of polysomy.
79. single-gene disor- ______________ result from mutations that alter the
ders
nucleotide sequence of one particular gene
80. true
(T/F) Mendelian disorders are transmitted predictably
and include autosomal dominant , autosomal recessive, and sex-linked disorders.
81. autosomal dominant
Huntington disease is an example of a(n)
___________________ disorder
82. autosomal recessive
Cystic fibrosis is an example of a(n)
___________________ disorder
83. sex-linked
Hemophilia is an example of a(n)
___________________ disorder
84. 1. triple repeat mu- What single-gene disorders violate Mendel's law?
tations
2. mitochondrial
DNA mutations
3. genomic imprinting disorders
85. the interaction of
multiple genes
Multifactorial disorders are very common and result
from what?
86. polygenic
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Disorders such as high blood pressure, cancer, and
diabetes are ___________
87. teratogens
Environmental factors that adversely affect the developing fetus are called _______
88. 3rd-9th
Exposure to teratogens is particularly dangerous during which weeks of gestation?
89. 1. chemicals
2. drugs
3. infections
4. radiation
What are known teratogens?
90. false
(T/F) The teratogenic potential of many chemicals and
drugs is unknown, but it usually safe for pregnant
women to take most drugs.
91. viruses
Of the infectious agents, __________ are the most teratogenic, particularly organisms of the TORCH variety?
92. 1. toxoplasmosis What are the TORCH variety of viruses
2. other
(syphilis, varicella-zoster, parvovirus B19)
3. Rubella
4. Cytomegalovirus
5. Herpes
93. 1. advanced mater- What are the risk factors that indicate the need for
nal age (older than prenatal diagnostic examination and counseling?
35)
2. family history of recessive
or sex-linked disorders
3. previous birth of
a child w/ chro9 / 37
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mosomal or neural
tube defects
94. 1. ultrasound
2. amniocentesis
3. chorionic villus
sampling
What are the mainstays of prenatal assessment for
genetic disorders?
95. gene therapy
________________ is the treatment of genetic disease
by replacing defective genes with normal genes
96. malignant
_______________ tumors have the potential to kill the
host
97. benign
_____________ generally do not have the potential to
kill the host
98. benign
The suffix -oma is used to indicate a __________ tumor
(lipoma)
99. malignant
Carcinoma and sarcoma are used to indicate
_____________ tumors (e.g., fibrosarcoma)
100. 1. melanoma
2. lymphoma
3. hepatoma
What tumors using -oma are melignant?
101. true
(T/F) Malignant cells, such as cancer cells proliferate excessively, become immortal, invade locally, and
may travel to distant sites where they establish new
colonies.
102. false
(T/F) The risk of developing cancer decreases with age
103. men; women
_______ have almost a 1 in 2 lifetime chance of developing cancer, and ______ have a 1 in 3 chance
104. smoking cessation What is an important factor in reducing cancer risk?
105.
When is cancer thought to develop?
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1. when proto-oncogenes become inappropriately activated in a
cell
2. when tumor suppressor genes become inactivated
106. mutation
Changes in gene functions that cause cancer are usually due to cell DNA ___________
107. Mutated proHow do mutated proto-oncogenes contribute to the
to-oncogenes no growth of cancer?
longer regulate cell
proliferation, causing the tumor cells
to reproduce uncontrollably.
108. Rb protein
What is the "master break" on cell proliferation
109. it inhibits transcription factors
How does the Rb protein serve as the "master break"
110. P53
_____ inhibits cell cycling when the cell is damaged to
allow time for DNA repaired; it also initiates apoptosis
of damaged or unwanted cells
111. the tumor supHow does a TS mutation cause the proliferation of
pressor genes no tumor cells?
longer inhibit the
growth of cells or
initiate cells death,
allowing the tumor
cells to live forever.
112. 1. initiation
2. promotion
3. progression
What are the steps of the expression of cancer?
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113. genetic mutation
When does the initiation event of cancer usually occur?
114. when the mutant
cell is induced to
proliferate
The promotion stage of cancer is described as...
115. when the mutant, The progression stage stage of cancer is described
proliferating cells as...
acquire properties
that allow malignant behavior
116. telomerase
Malignant cells commonly produce ______________,
an enzyme that repairs the telomeres and may be a key
for attaining immortality
117. P53
The majority of malignant cells have insufficient
______, allowing the tumor cells to escape apoptosis
despite DNA damage
118. bloodstream or
lymphatics
How does the spread of tumors usually occur?
119. grading and staging
What is done to predict tumor behavior and guide therapy.
120. cancer grading
the histologic characterization of tumor cells
121. Cancer Grade I
well-differentiated, low grade, tissue resembles tissues
of origin
122. Cancer Grade III
poorly-differentiated, high-grade, tumor tissues do not
resemble tissue of origin, many mitoses and cell death,
high pleomorphism
123. cancer staging
describes the location and pattern of tumor spread
within the host
124.
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In the TNM staging __________________ is used to describe the tumor
system of cancer size, lymph nodes affected, and degree of metastasis
125. 1. pain
2. cachexia
3. bone marrow
suppression
4. infection
What are the signs of cancer?
126. 1. anemia
Bone marrow suppression manifests as...
2. leukopenia
3. thrombocytopenia
127. immunosuppression w/
consequent
infection
What is the primary cause of cancer-associated death?
128. 1. surgery
2. radiation
3. chemotherapy
What are the main means of treatment for cancer?
129. true
(T/F) cells that divide rapidly are the most susceptible to
chemotherapy, causing loss of bone marrow, hair, and
gastrointestinal mucosa.
130. 1. thymus
2. bone marrow
What are the primary lymphoid organs?
131. thymus
Where do T-cells develop?
132. bone marrow
where do B cells develop?
133. bone marrow
where are blood cells product?
134. 1. neutrophils
2. basophils
3. eosinophils
What are considered granulocytes?
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135. macrophages
_____________ are considered monocytes
136. lymphocytes
__________ are specific cells that react only to particular antigens
137. 1. B cells
2. T cells
3. NK cells
What types of cells are considered lymphocytes?
138. NK cells
_______ are lymphocytes that lack T-cell and B-cell
markers and function in innate immune responses
139. neutrophils
What are the most numerous WBC in blood?
140. macrophages
Monocytes located in tissue are called
________________
141. T lymphocytes
___________ are major effectors of cell-mediated immunity, and interact with specific antigens on cell surfaces
142. cytokines
T lymphocytes secrete ______________ which boost
the immune response of B cells and other cells types.
143. 1. CD4 (helper)
2. CD8 (cytotoxic)
T cells are composed of two main subtypes:
144. B lymphocytes
__________ are the major effectors of antibody-mediated immunity
145. cytokines
________ are peptide factors released by immune cells
146. 1. inflammatory
What are the functions of cytokines?
mediators
2. chemotaxins
3. intercellular communication
signals
4. growth factors
6. growth inhibitors
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147. 1. macrophages
2. lymphocytes
What are important sources of immune cytokines?
148. inflammation
______________ involves localization of harmful
agents and the bringing of phagocytic cells to the area
149. 1. redness
What are the typical manifestations of inflammation?
2. swelling
3. heat
4. pain
5. loss of function
150. 1. histamines
2. prostaglandins
3. leukotrienes
What inflammatory chemicals are released by the
body?
151. 1. injured tissues
2. mast cells
3. macrophages
4. neutrophils
Inflammatory chemicals are released from...
152. selectins; integrins Emigration of neutrophils and macrophages is facilitated by ______ and _______ present on the surface of
endothelial cells and leukocytes
153. proteolytic enzymes; oxidizing
agents
Neutrophils and macrophages produce
_____________ and _______________ to destroy and
digest antigens
154. growth factors and Healing is mediated my ____________
cytokines
155. 1. platelets
2. immune cells
Growth factors are released from
156. growth factor
___________ stimulate fibroblasts to divide and manufacture extracellular matrix proteins
157. endothelial
_____________ cells respond to angiogenic growth
factors by forming capillary networks
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158. inflammatory
____________________ exudate functions to transport immune cells, antibodies, and nutrients to the tissue and dilute the offending substances
159. serous
_______________ exudate is watery and low in protein
160. fibrinous
______________ exudate is thick, sticky, and high in
protein
161. purulent
_____________ exudate contains infective organisms,
leukocytes, and cellular debris
162. hemorrhagic
______________ exudate contains red blood cells
163. 1. fever
What are the systemic manifestations of inflammation?
2. neutrophilia
3. lethargy
4. lethargy
5. muscle catabolism
6. increased acute
phase proteins
(CRP)
7. increased ESR
164. memory cells
lymphocytes distributed throughout the body that can
recognize and react to a particular antigen
165. antigens
T lymphocytes are able to bind ____________ only
when they are displayed on the surface of cells
166. foreign MHC class I Cytotoxic T cells (CD8+) react to cells that have
proteins
____________ on their surface
167. MHC class II proteins
T helper cells (CD4+) bind to cells that have
_____________ on their surface
168. T helper cells
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Activation of ______________ results in secretion of
the cytokines necessary for clonal expansion of T and
B lymphocytes
169. Cytotoxic T cells
__________________ locate and lyse abnormal cells
through the actions of perforins
170. true
(T/F) T cells cannot respond respond to soluble antigens
171. 1. IgG
2. IgM
3. IgA
4. IgD
5. Ige
What are the five major classes of antibodies?
172. IgG
What is the most prevalent antibody class? (75%)
173. Fc
Antibody class is determined by the structure of the
_____ portion
174. IgM
____ is the first kind to be produced on antigen exposure.
175. IgA
______ is found primarily in body secretions
176. IgD
_____ is present on the B-cell membrane and functions
in signal transduction
177. IgE
______ binds to basophil and mast cell membranes
and mediates inflammation and allergy
178. active immunity
___________ occurs when individuals are exposed to
antigen that stimulates their own lymphocytes to produce memory cells
179. macrophages
____________ secrete cytokines that stimulate WBC
production and help WBCs locate the area
180.
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1. macrophages
2. dendritic cells
________________ are antigen-presenting cells that
engulf and display antigen on their cell surface in association with MHC class II proteins
181. 1. stimulate the
s. T helper cells are activated by the antigens on the
production of
macrophages and dendritic cells and secrete cytokines
WBCs in the mar- that...
row
2. initiate proliferation of mature B
and T cells
3. stimulate
the phagocytic potential of
macrophages and
neutrophils
182. T-cell help
B-cell proliferation and antibody secretion usually require...
183. primary
The immune response to _________ exposure is slow
and often insufficient to prevent illness
184. Memory cells
________________ can mount a more effective response on subsequent exposure and usually prevent
manifestations of illness.
185. 1. regulatory T-cell What are the mechanisms to inhibit and control the
cytokines
immune response include
2. complement inhibitors
3. degradation of
inflammatory mediators
4. circulating antiproteases
5. antioxidants.
186. bone marrow
Where do B lymphocytes mature?
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187. thymus
Where do T cells mature?
188. antibodies
_______________ are proteins that specifically bind a
particular antigen
189. 1. precipitation
What are the functions of antibodies?
2. agglutination
3. neutralization
4. opsonization
4. complement activation.
190. self
T and B lymphocytes must be tolerant to _______
191. autoimmune disor- _______________ occur when the immune system erders
roneously reacts with "self" tissues
192. polygenic and mul- Autoimmune disorders are ____________
tifactorial
193. false
The etiologic process of autoimmune disorders in
known.
194. antigenic mimicry The ____________ theory proposes that since self and
foreign antigens are composed of the same basic building blocks—proteins, carbohydrates, nucleic acids, and
lipids—small alterations in self tissue may lead to immunogenic attack
195. suppressor T cells Abnormal production of subclasses of T lymphocytes,
particularly ___________________, has been proposed as a reason for the development of autoimmunity, as well as the development of abnormal B cells that
do not respond to suppressor T cell signals
196. female
A genetic component of the development of autoimmune disorders is probable, inasmuch as certain autoimmune disorders are more commonly associated with particular Major Histocompatibility Complex
(MHC) types and what gender?
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197. autoantibodies
_________________ injure body tissues through the
mechanisms described for type II and type III hypersensitivity reactions
198. 1
Type ___ hypersensitivity is an immediate allergic or
anaphylactic type of reaction mediated primarily by
sensitized mast cells.
199. IgE
What antibodies are involved in type 1 hypersensitivity
reactions (allergic or anaphylactic)
200. antigen
The reaction is initiated when IgE antibodies located on the mast cell membrane are bound by a(n)
____________
201. mast cell degranu- _________________ releases chemicals that mediate
lation
the signs and symptoms of anaphylaxis
202. 1. increased vascu- Released histamine, kinin, prostaglandins, interlar permeability
leukins, and leukotrienes cause what reactions in the
2. vasodilation
body?
3. hypotension
4. urticaria
5. bronchoconstriction
203. 1. drug reactions
2. bee sting reactions
3. asthma
What are some examples of type 1 reactions?
204. 2
Type ____ hypersensitivity occurs when antibodies are
formed against antigens on cell surfaces, usually resulting in lysis of target cells
205. IgG or IgM
What antibodies are involved in type 2 reactions?
206. 1. activated com- Cell lysis may be mediated by...
plement fragments
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2. phagocytic cells
attracted to target
cells
207. 1. transfusion reac- What are some examples of type 2 hypersensitivity
tions
reactions?
2. erythroblastosis
fetalis
3. myasthenia
gravis
4. hyperacute graft
rejection
208. 3
Type ____ hypersensitivity reactions occur when antigen-antibody complexes are deposited in tissues and
result in the activation of complement and subsequent
tissue inflammation and destruction
209. antigen-antibody
complexes
In type 3 hypersensitivity reactions, ____________ activate the complement cascade and subsequently attract phagocytic cells to the tissue
210. IgG or IgM
What antibodies are involved in Type 3 Hypersensitivity
reactions?
211. 1. persistent
What can result in chronic production of antigen body
low-grade infeccomplexes?
tions
2. inhalation of antigens into alveoli
3. autoimmune production of antibodies
212. 1. glomerulonephritis
2. Systemic Lupus Erythematosus (SLE)
What are some examples of a type 3 hypersensitivity
reaction?
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213. 4
Type ____ hypersensitivity reactions are T-cell mediated and do not require antibody production
214. sensitized cells
In type 4 hypersensitivity reactions, _________ react
with altered or foreign cells and initiate inflammation
215. 1. contact dermati- What are some examples of type 4 hypersensitivity
tis
reactions?
2. tuberculin reactions
3. transplant rejection
4. graft-versus-host disease
216. primary
_______________ deficiencies in immune function
may be from congenital, genetic, or acquired defects
that directly affect immune cell function
217. secondary
_______________ deficiencies are conditions that impair immune function as a result of other nonimmune
system disorders, such as poor nutrition, stress, or
drugs, that secondarily suppress immune function
218. moderate immune Primary genetic immunodeficiency disorders are fairly
impairment
common, with most causing what?
219. false
(T/F) Severe congenital immunodeficiency disorders
are less common, but not clinically significant
220. 1. T cells
2. B cells
Impairment of what results in Severe Combined Immunodeficiency (SCID)?
221. primary
SCID is considered a __________ immunodeficiency
disorder
222. T-cell agenesis re- DiGeorge syndrome is a primary immunodeficiency
lated to a lack of
disorder that occurs with...
thymus function
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223. abnormal T cells
Chronic mucocutaneous candidiasis is a primary imthat cannot remunodeficiency disorder caused by what?
spond to Candida
224. B-cell abnormality Selective IgA deficiency is caused by what?
225. primary
Selective IgA deficiency is what type of immunodeficiency disorder?
226. problems in neu- What are some causes of secondary immunodeficienroendocrine and
cies?
immune system reactions
227. stress
Excessive neuroendocrine response to ________ with
increased corticosteroid production increases susceptibility to infection
228. 1. cytotoxins
2. anesthetics
3. alcohol
4. antibiotics
5. steroids
What medications can cause secondary immunosuppression?
229. malnutrition
________________, a major cause of immune system
dysfunction, leads to lymphocyte dysfunction and altered stem cell development
230. 1. cell type involved (lymphoid
or myeloid)
2. degree of cell
maturation
Classification of the types of leukemia is based on
what?
231. 1. chronic myeloid What are the common myeloid neoplasms?
leukemia (CML)
2. polycythemia
vera
3. essential thrombocythemia
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4. acute myeloid
leukemia (AML)
232. 1. chronic lymWhat are the common lymphoid neoplasms?
phoid leukemia
(CLL)
2. acute
lymphoblastic
leukemia
3. plasma cell
myeloma
4. Hodgkin disease
5. non-Hodgkin
lymphoma
233. 1. exposure to
What are the risk factors for developing hematologic
chemical, viral, and neoplasms?
radiation mutagens
2. chemotherapy
drugs
3. immunodeficiency disorders
234. insufficient WBC,
RBC, and platelet
production
Common manifestations of hematologic neoplasia are
the result of what?
235. 1. pallor
What are the manifestation of Anemia?
2. fatigue
3. dyspnea
4. decreased activity tolerance
236. 1. petechiae
Thrombocytopenia causes what?
2. bleeding gums
3. hematuria
4. prolonged bleeding time
237.
How does leukopenia manifest?
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1. frequent, recurrent infections
2. weight loss
3. anorexia
4. lymphadenopathy
5. bone pain
6. CNS dysfunction
238. chemotherapy
What is the mainstay of management for most hematologic neoplasms?
239. 1. anemia
2. infection
3. bleeding
4. alopecia
5. stomatitis
What are the potential complications of chemotherapy
treatments?
240. chronic myeloid
leukemia (CML)
_________ is a myeloproliferative disorder that affects
adults primarily that has an insidious onset and does
NOT respond well the chemotherapy
241. 1. translocation
CML is characterized by what?
mutation of the 9
and 22 chromosome
2. formation of
Philadelphia chromosome (bcr-abl)
242. acute myeloid
leukemia (AML)
_____________ primarily affects adults, has an acute
onset, and responds well to treatment
243. worse
The prognosis of AML is ____________ than that of
adult acute lymphoblastic leukemia (ALL)
244. granulocytes
AML is usually a malignancy of ______________, although other myeloid cell types may be affected
245.
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Klinefelter's Syndrome
Jordan is a 14-year-old male who is starting high
school. He has complained to his mom that he gets
made fun of in school because of his high-pitched voice.
His mom is worried about him because he seems to
be "behind" in terms of developmental milestones for
a teenage boy. At his routine physical, Jordan's doctor
notes that Jordan is a tall, slender boy with what appears to have gynecomastia and hypogonadism. Jordan's doctor orders blood work to test his levels of
testosterone and discovers that he is producing less
testosterone than what is within normal limits. Upon
talking with Jordan's mother, the doctor discovered that
Jordan has always fallen behind in school and has even
had to repeat a grade. Jordan's doctor decides to order
genetic testing, which reveals that Jordan has an extra
X chromosome in addition to his X and Y chromosomes
on his karyotype.
What could Jordan's condition be?
246. 1. feminine features
2. feminine voice
3. tall and slender
Jordan is a 14-year-old male who is starting high
school. He has complained to his mom that he gets
made fun of in school because of his high-pitched voice.
His mom is worried about him because he seems to
be "behind" in terms of developmental milestones for
a teenage boy. At his routine physical, Jordan's doctor
notes that Jordan is a tall, slender boy with what appears to have gynecomastia and hypogonadism. Jordan's doctor orders blood work to test his levels of
testosterone and discovers that he is producing less
testosterone than what is within normal limits. Upon
talking with Jordan's mother, the doctor discovered that
Jordan has always fallen behind in school and has even
had to repeat a grade. Jordan's doctor decides to order
genetic testing, which reveals that Jordan has an extra
X chromosome in addition to his X and Y chromosomes
on his karyotype.
What led you to determine Jordan's condition?
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247. sex-chromosome
disorder
Jordan is a 14-year-old male who is starting high
school. He has complained to his mom that he gets
made fun of in school because of his high-pitched voice.
His mom is worried about him because he seems to
be "behind" in terms of developmental milestones for
a teenage boy. At his routine physical, Jordan's doctor
notes that Jordan is a tall, slender boy with what appears to have gynecomastia and hypogonadism. Jordan's doctor orders blood work to test his levels of
testosterone and discovers that he is producing less
testosterone than what is within normal limits. Upon
talking with Jordan's mother, the doctor discovered that
Jordan has always fallen behind in school and has even
had to repeat a grade. Jordan's doctor decides to order
genetic testing, which reveals that Jordan has an extra
X chromosome in addition to his X and Y chromosomes
on his karyotype.
What kind of disorder is this an example of?
248. 1. it only effects biological males
2. it can cause
excess X chromosomes
Jordan is a 14-year-old male who is starting high
school. He has complained to his mom that he gets
made fun of in school because of his high-pitched voice.
His mom is worried about him because he seems to
be "behind" in terms of developmental milestones for
a teenage boy. At his routine physical, Jordan's doctor
notes that Jordan is a tall, slender boy with what appears to have gynecomastia and hypogonadism. Jordan's doctor orders blood work to test his levels of
testosterone and discovers that he is producing less
testosterone than what is within normal limits. Upon
talking with Jordan's mother, the doctor discovered that
Jordan has always fallen behind in school and has even
had to repeat a grade. Jordan's doctor decides to order
genetic testing, which reveals that Jordan has an extra
X chromosome in addition to his X and Y chromosomes
on his karyotype.
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How does this disorder differ from other disorders in the
same category?
249. 1. gynecomastia
2. hypogonadism
3. marginally impaired intelligence
4. low testosterone
Jordan is a 14-year-old male who is starting high
school. He has complained to his mom that he gets
made fun of in school because of his high-pitched voice.
His mom is worried about him because he seems to
be "behind" in terms of developmental milestones for
a teenage boy. At his routine physical, Jordan's doctor
notes that Jordan is a tall, slender boy with what appears to have gynecomastia and hypogonadism. Jordan's doctor orders blood work to test his levels of
testosterone and discovers that he is producing less
testosterone than what is within normal limits. Upon
talking with Jordan's mother, the doctor discovered that
Jordan has always fallen behind in school and has even
had to repeat a grade. Jordan's doctor decides to order
genetic testing, which reveals that Jordan has an extra
X chromosome in addition to his X and Y chromosomes
on his karyotype.
What clinical manifestations led you to determine Jordan's condition?
250. There's no cure,
but you can do
hormone therapy
with testosterone;
testosterone is administered to counteract the elevated
estrogen and low
testosterone levels
Jordan is a 14-year-old male who is starting high
school. He has complained to his mom that he gets
made fun of in school because of his high-pitched voice.
His mom is worried about him because he seems to
be "behind" in terms of developmental milestones for
a teenage boy. At his routine physical, Jordan's doctor
notes that Jordan is a tall, slender boy with what appears to have gynecomastia and hypogonadism. Jordan's doctor orders blood work to test his levels of
testosterone and discovers that he is producing less
testosterone than what is within normal limits. Upon
talking with Jordan's mother, the doctor discovered that
Jordan has always fallen behind in school and has even
had to repeat a grade. Jordan's doctor decides to order
genetic testing, which reveals that Jordan has an extra
28 / 37
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X chromosome in addition to his X and Y chromosomes
on his karyotype.
Are there any known cures for Jordan's condition? If
not, what recommendations would you give to help
improve his current symptoms and why?
251. Hodgkin's lymphoma
Maya is a 22-year-old female in college. She has noticed that lately, she has been feeling fatigued without
exertion, has lost weight, gets night sweats, and notices
she keeps getting fevers. She also notices a lump on
the right side of her neck, but it doesn't hurt. She notes
that she hasn't felt the same since she was hospitalized
due to being infected with mono (mononucleosis) six
months ago. She schedules an appointment with her
doctor, and upon examination, her doctor finds swollen
lymph nodes above her right clavicle and on the right
side of her inguinal area. Her doctor decides to order
a full blood panel and biopsy the swollen lymph nodes.
The results of her blood panel come back and show
an increased count for white blood cells and histological findings of the biopsy showed the presence of
Reed-Sternberg cells.
Maya would be diagnosed with what conditions based
on her presented signs and symptoms?
252. Maya's past history with mono
caused a mutation with proto-oncogene, forming an oncogenic,
causing the cells
to grow uncontrollably.
Maya is a 22-year-old female in college. She has noticed that lately, she has been feeling fatigued without
exertion, has lost weight, gets night sweats, and notices
she keeps getting fevers. She also notices a lump on
the right side of her neck, but it doesn't hurt. She notes
that she hasn't felt the same since she was hospitalized
due to being infected with mono (mononucleosis) six
months ago. She schedules an appointment with her
doctor, and upon examination, her doctor finds swollen
lymph nodes above her right clavicle and on the right
side of her inguinal area. Her doctor decides to order
a full blood panel and biopsy the swollen lymph nodes.
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The results of her blood panel come back and show
an increased count for white blood cells and histological findings of the biopsy showed the presence of
Reed-Sternberg cells.
What is the pathogenesis of Maya's disease?
253. 1. night sweats
2. fever, lump oner
her neck
3. increased WBC
4. swollen lymph
nodes
Maya is a 22-year-old female in college. She has noticed that lately, she has been feeling fatigued without
exertion, has lost weight, gets night sweats, and notices
she keeps getting fevers. She also notices a lump on
the right side of her neck, but it doesn't hurt. She notes
that she hasn't felt the same since she was hospitalized
due to being infected with mono (mononucleosis) six
months ago. She schedules an appointment with her
doctor, and upon examination, her doctor finds swollen
lymph nodes above her right clavicle and on the right
side of her inguinal area. Her doctor decides to order
a full blood panel and biopsy the swollen lymph nodes.
The results of her blood panel come back and show
an increased count for white blood cells and histological findings of the biopsy showed the presence of
Reed-Sternberg cells.
How did this disorder clinically manifest itself in Maya's
case that caused suspicion for her diagnosis?
254. 1. it is the most
curable form (1-10
year survival)
2. 80-90% survival
rate
3. most common
in males in early adulthood and
in those who
are immunocompromised
Maya is a 22-year-old female in college. She has noticed that lately, she has been feeling fatigued without
exertion, has lost weight, gets night sweats, and notices
she keeps getting fevers. She also notices a lump on
the right side of her neck, but it doesn't hurt. She notes
that she hasn't felt the same since she was hospitalized
due to being infected with mono (mononucleosis) six
months ago. She schedules an appointment with her
doctor, and upon examination, her doctor finds swollen
lymph nodes above her right clavicle and on the right
side of her inguinal area. Her doctor decides to order
a full blood panel and biopsy the swollen lymph nodes.
30 / 37
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The results of her blood panel come back and show
an increased count for white blood cells and histological findings of the biopsy showed the presence of
Reed-Sternberg cells.
What is the prognosis of this disease and how does
it affect certain demographics of the population when
compared to others?
255. 1. Yes, it is curable
2. chemotherapy
and radiation are
recommended
3. chemo interrupts
the cell cycle and
initiates cell death
4. radiation initiates the Rb factor
Maya is a 22-year-old female in college. She has noticed that lately, she has been feeling fatigued without
exertion, has lost weight, gets night sweats, and notices
she keeps getting fevers. She also notices a lump on
the right side of her neck, but it doesn't hurt. She notes
that she hasn't felt the same since she was hospitalized
due to being infected with mono (mononucleosis) six
months ago. She schedules an appointment with her
doctor, and upon examination, her doctor finds swollen
lymph nodes above her right clavicle and on the right
side of her inguinal area. Her doctor decides to order
a full blood panel and biopsy the swollen lymph nodes.
The results of her blood panel come back and show
an increased count for white blood cells and histological findings of the biopsy showed the presence of
Reed-Sternberg cells.
Describe the mechanism associated with the recommended treatment for this condition. Is it curable?
256. 1. Immune system
weakness
2. diet
3. age 15-35
4. 55 and older
5. Epstein Barr
virus
6. more common in
males than females
Maya is a 22-year-old female in college. She has noticed that lately, she has been feeling fatigued without
exertion, has lost weight, gets night sweats, and notices
she keeps getting fevers. She also notices a lump on
the right side of her neck, but it doesn't hurt. She notes
that she hasn't felt the same since she was hospitalized
due to being infected with mono (mononucleosis) six
months ago. She schedules an appointment with her
doctor, and upon examination, her doctor finds swollen
lymph nodes above her right clavicle and on the right
31 / 37
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side of her inguinal area. Her doctor decides to order
a full blood panel and biopsy the swollen lymph nodes.
The results of her blood panel come back and show
an increased count for white blood cells and histological findings of the biopsy showed the presence of
Reed-Sternberg cells.
What are some risk factors that can be found in individuals who share Maya's suspected condition?
257. lupus
Betty is a 30-year-old female dog walker. She notices
that for the past year, she has been very sensitive to
sunlight, even when she wears sunscreen. She develops large butterfly rashes on the areas of her body
where her skin is exposed, and she has also been
experiencing joint pain and fatigue after her walks. She
becomes worried and schedules an appointment with
her doctor when she starts to notice blood in her urine.
Betty's doctor orders a blood panel that shows a decreased glomerular filtration rate (GFR), and elevated
blood urea nitrogen (BUN). Her doctor diagnosed her
with secondary, stage 3 right kidney failure.
What disease is Betty's kidney failure secondary to?
258. it is not curable be- Betty is a 30-year-old female dog walker. She notices
cause it is an au- that for the past year, she has been very sensitive to
toimmune disease sunlight, even when she wears sunscreen. She develops large butterfly rashes on the areas of her body
where her skin is exposed, and she has also been
experiencing joint pain and fatigue after her walks. She
becomes worried and schedules an appointment with
her doctor when she starts to notice blood in her urine.
Betty's doctor orders a blood panel that shows a decreased glomerular filtration rate (GFR), and elevated
blood urea nitrogen (BUN). Her doctor diagnosed her
with secondary, stage 3 right kidney failure.
Is this condition curable, why or why not?
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259. hypersensitivity
type III (butterfly
rash and
inflammation are
signs of antibody
attack)
Betty is a 30-year-old female dog walker. She notices
that for the past year, she has been very sensitive to
sunlight, even when she wears sunscreen. She develops large butterfly rashes on the areas of her body
where her skin is exposed, and she has also been
experiencing joint pain and fatigue after her walks. She
becomes worried and schedules an appointment with
her doctor when she starts to notice blood in her urine.
Betty's doctor orders a blood panel that shows a decreased glomerular filtration rate (GFR), and elevated
blood urea nitrogen (BUN). Her doctor diagnosed her
with secondary, stage 3 right kidney failure.
Identify this disease's hypersensitivity class and describe its mechanism of action.
260. 1. Pharmaceuticals
(corticosteroids) to
reduce inflammation
2. dialysis to filter
out waste
3. sunblock to help
with rashes
Betty is a 30-year-old female dog walker. She notices
that for the past year, she has been very sensitive to
sunlight, even when she wears sunscreen. She develops large butterfly rashes on the areas of her body
where her skin is exposed, and she has also been
experiencing joint pain and fatigue after her walks. She
becomes worried and schedules an appointment with
her doctor when she starts to notice blood in her urine.
Betty's doctor orders a blood panel that shows a decreased glomerular filtration rate (GFR), and elevated
blood urea nitrogen (BUN). Her doctor diagnosed her
with secondary, stage 3 right kidney failure.
What treatment options are associated with Betty's primary condition? How do they relieve associated symptoms?
261. 1. lupus causes
swelling and irritation in the kidneys
2. deposition of
antibody complex
within the kidneys.
Betty is a 30-year-old female dog walker. She notices
that for the past year, she has been very sensitive to
sunlight, even when she wears sunscreen. She develops large butterfly rashes on the areas of her body
where her skin is exposed, and she has also been
experiencing joint pain and fatigue after her walks. She
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It affects the part of becomes worried and schedules an appointment with
the kidney that fil- her doctor when she starts to notice blood in her urine.
ters.
Betty's doctor orders a blood panel that shows a decreased glomerular filtration rate (GFR), and elevated
blood urea nitrogen (BUN). Her doctor diagnosed her
with secondary, stage 3 right kidney failure.
Explain Betty's development of kidney failure secondary to her condition.
262. chronic myeloid
leukemia (CML)
John is a 52-year-old male who has recently been experiencing fatigue, weight loss, and abdominal pain. His
wife keeps telling him to go to the doctor's office, but he
doesn't think it's anything serious. He presented to the
ED one night when his abdominal pain got so bad, he
couldn't stand it anymore. The doctor noted that John
had splenomegaly and ordered a blood panel. Findings
on his blood panel showed an increased WBC count.
Specifically, his granulocyte count was high. Once his
pain had subsided, genetic testing was done on John
and his doctor told him he had the Philadelphia chromosome.
What would you diagnose John with?
263. the disease is
not idiopathic because the cause
is known, that being the Philadelphia Chromosome
mutation
John is a 52-year-old male who has recently been experiencing fatigue, weight loss, and abdominal pain. His
wife keeps telling him to go to the doctor's office, but he
doesn't think it's anything serious. He presented to the
ED one night when his abdominal pain got so bad, he
couldn't stand it anymore. The doctor noted that John
had splenomegaly and ordered a blood panel. Findings
on his blood panel showed an increased WBC count.
Specifically, his granulocyte count was high. Once his
pain had subsided, genetic testing was done on John
and his doctor told him he had the Philadelphia chromosome.
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Is John's disease considered idiopathic? Explain why
or why not.
264. 1. If left untreated,
John has roughly 2
years to live
2. the disease does
not respond well to
chemo
John is a 52-year-old male who has recently been experiencing fatigue, weight loss, and abdominal pain. His
wife keeps telling him to go to the doctor's office, but he
doesn't think it's anything serious. He presented to the
ED one night when his abdominal pain got so bad, he
couldn't stand it anymore. The doctor noted that John
had splenomegaly and ordered a blood panel. Findings
on his blood panel showed an increased WBC count.
Specifically, his granulocyte count was high. Once his
pain had subsided, genetic testing was done on John
and his doctor told him he had the Philadelphia chromosome.
What is the prognosis for this disease?
265. John presents with
fatigue, weight
loss, and abdominal pains
caused by an
enlarged spleen
(splenomegaly)
John is a 52-year-old male who has recently been experiencing fatigue, weight loss, and abdominal pain. His
wife keeps telling him to go to the doctor's office, but he
doesn't think it's anything serious. He presented to the
ED one night when his abdominal pain got so bad, he
couldn't stand it anymore. The doctor noted that John
had splenomegaly and ordered a blood panel. Findings
on his blood panel showed an increased WBC count.
Specifically, his granulocyte count was high. Once his
pain had subsided, genetic testing was done on John
and his doctor told him he had the Philadelphia chromosome.
Identify the clinical manifestations that led you to this
conclusion.
266. the Philadelphia
chromosome is a
translocation mutation between
John is a 52-year-old male who has recently been experiencing fatigue, weight loss, and abdominal pain. His
wife keeps telling him to go to the doctor's office, but he
doesn't think it's anything serious. He presented to the
ED one night when his abdominal pain got so bad, he
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chromosome 9 and couldn't stand it anymore. The doctor noted that John
22
had splenomegaly and ordered a blood panel. Findings
on his blood panel showed an increased WBC count.
Specifically, his granulocyte count was high. Once his
pain had subsided, genetic testing was done on John
and his doctor told him he had the Philadelphia chromosome.
What is the Philadelphia chromosome?
267. 1. bone marrow
John is a 52-year-old male who has recently been extransplant from
periencing fatigue, weight loss, and abdominal pain. His
a suitable donor
wife keeps telling him to go to the doctor's office, but he
(BMT)
doesn't think it's anything serious. He presented to the
2. autogenic BMT ED one night when his abdominal pain got so bad, he
(less effective)
couldn't stand it anymore. The doctor noted that John
3. Gleevec (imahad splenomegaly and ordered a blood panel. Findings
tinib mesylate + is a on his blood panel showed an increased WBC count.
tyrosine kinase in- Specifically, his granulocyte count was high. Once his
hibitor)
pain had subsided, genetic testing was done on John
and his doctor told him he had the Philadelphia chromosome.
Are there any treatments available for this disease?
268. No, we would
not recommend
chemotherapy as it
is not as effective
compared to the
other treatment options.
John is a 52-year-old male who has recently been experiencing fatigue, weight loss, and abdominal pain. His
wife keeps telling him to go to the doctor's office, but he
doesn't think it's anything serious. He presented to the
ED one night when his abdominal pain got so bad, he
couldn't stand it anymore. The doctor noted that John
had splenomegaly and ordered a blood panel. Findings
on his blood panel showed an increased WBC count.
Specifically, his granulocyte count was high. Once his
pain had subsided, genetic testing was done on John
and his doctor told him he had the Philadelphia chromosome.
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As a medical professional, would you recommend
chemotherapy as a treatment option for his condition?
37 / 37