Patho Test 4 – Flashcards
Unlock all answers in this set
Unlock answersquestion
Choose the correct proportion of water to body weight to be expected in a healthy male adult's body: a. 30% b. 45% c. 60% d. 70%
answer
C
question
Choose the correct proportion of blood (to body weight) in an adult male's body: a. 30% b. 20% c. 10% d. 4%
answer
D
question
When the osmotic pressure of the blood is elevated above normal, water would shift from the: a. blood into the cells b. interstitial compartment into the cells c. interstitial compartment into the blood d. cells into the interstitial compartment
answer
C
question
3. Insensible fluid loss refers to water lost through: a. perspiration only b. feces only c. perspiration and expiration d. urine and feces
answer
C
question
Which of the following would result from a deficit of plasma proteins? a. increased osmotic pressure b. decreased osmotic pressure c. increased hydrostatic pressure d. decreased hydrostatic pressure
answer
B
question
Which of the following would cause edema? a. decreased capillary hydrostatic pressure b. increased capillary osmotic pressure c. decreased capillary permeability d. increased capillary permeability
answer
D
question
. Which of the following would likely be related to an elevated hematocrit reading? a. fluid excess b. fluid deficit c. increased sodium level d. decreased erythrocytes
answer
B
question
Which of the following is a typical sign of dehydration? a. rapid, strong pulse b. low hematocrit c. increased urine output d. rough oral mucosa
answer
D
question
Which of the following terms refers to a combination of decreased circulating blood volume combined with excess fluid in a body cavity? a. dehydration b. third-spacing c. hypovolemia d. water retention
answer
B
question
Which of the following is a characteristic of sodium ion? a. It is a cation. b. It is present primarily in the intracellular fluid. c. It shifts out of the blood by active transport. d. Blood levels are controlled by ADH (antidiuretic hormone).
answer
A
question
Which of the following is a common cause of hyponatremia? a. loss of the thirst mechanism b. excessive sweating c. excessive aldosterone secretion d. prolonged period of rapid, deep respirations
answer
B
question
Which of the following is a common effect of both hypokalemia and hyperkalemia? a. skeletal muscle twitch and cramps b. oliguria c. elevated serum pH d. cardiac arrhythmias
answer
D
question
Choose the correct effect of increased parathyroid hormone: a. increased movement of calcium ions into the bones b. increased activation of vitamin D c. increased absorption of calcium from the digestive tract d. decreased reabsorption of calcium in the kidneys
answer
C
question
Which of the following results from hypocalcemia? 1. low serum phosphate levels 2. nausea and constipation 3. skeletal muscle twitch and spasms 4. weak cardiac contractions a. 1, 2 b. 1, 4 c. 2, 3 d. 3, 4
answer
D
question
Which of the following causes tetany? a. increased permeability of nerve membranes b. insufficient calcium in skeletal muscle c. excess calcium ions inside somatic nerves d. increased stimulation of the nerves in the cerebral cortex
answer
A
question
n which of the following processes is phosphate ion NOT a major component? a. bone metabolism b. metabolic processes involving ATP c. blood clotting d. acid-base balance
answer
C
question
. Which of the following would be considered normal serum pH? a. 4.5-8 b. 7.0 c. 7.4 d. 8
answer
C
question
When many excess hydrogen ions accumulate in the blood, what happens to serum pH? The pH: a. decreases b. increases c. remains constant
answer
A
question
What is the slowest, but most effective control for acid-base balance? a. respiratory system b. buffer systems in the blood c. kidneys d. brain
answer
C
question
Which of the following is essential in order to maintain serum pH within normal range? a. Carbonic acid and bicarbonate ion must be present in equal quantities. b. All excess carbonic acid must be excreted by the kidneys. c. The concentration of bicarbonate ion must remain constant. d. The ratio of carbonic acid to bicarbonate ion must be 1:20.
answer
D
question
Which is the correct effect on the body of abnormally slow respirations? a. increased carbonic acid b. decreased carbonic acid c. increased bicarbonate ion d. decreased bicarbonate ion
answer
A
question
Which condition is likely to cause metabolic acidosis? a. slow, shallow respirations b. prolonged diarrhea c. mild vomiting d. excessive fluid in the body
answer
B
question
What would a serum pH of 7.33 in a patient with kidney disease indicate? a. metabolic alkalosis b. metabolic acidosis c. respiratory alkalosis d. respiratory acidosis
answer
B
question
Which serum value indicates decompensated metabolic acidosis? a. pH is below normal range b. pH is above normal range c. bicarbonate level decreases d. bicarbonate level increases
answer
A
question
25. When excessive lactic acid accumulates in the body, serum: a. bicarbonate ion levels decrease b. bicarbonate ion levels increase c. carbonic acid levels increase d. pH increases
answer
A
question
What does acidosis cause? a. CNS hyperexcitability and nervousness b. hypokalemia c. CNS depression and drowsiness d. hypernatremia
answer
C
question
Compensation mechanisms in the body for dehydration would include: a. increased ADH b. decreased aldosterone c. slow, strong heart contraction d. peripheral vasodilation
answer
A
question
Which acid-base imbalance results from impaired expiration due to emphysema? a. metabolic acidosis b. metabolic alkalosis c. respiratory acidosis d. respiratory alkalosis
answer
C
question
In patients with impaired expiration associated with emphysema, effective compensation for the acid-base imbalance would be: a. increased rate and depth of respiration b. decreased rate and depth of respiration c. increased urine pH and decreased serum bicarbonate d. decreased urine pH and increased serum bicarbonate
answer
D
question
An anxiety attack often causes hyperventilation leading to: a. increased Pco2 b. decreased Pco2 c. respiratory acidosis d. metabolic acidosis
answer
B
question
Young infants are more vulnerable to serious dehydration because of their: a. decreased body surface area and insensible fluid loss b. limited renal compensation c. decreased proportion of fluid to body weight d. slower metabolic rate
answer
B
question
Compensation for respiratory system depression due to anesthesia and sedation would be: a. decreased reabsorption of bicarbonate ions in the kidneys b. increased secretion of hydrogen ions into the filtrate c. increased respiratory rate and depth d. increased renin secretion
answer
B
question
Strenuous physical exercise on a hot day is likely to result in: a. hypokalemia b. hypernatremia c. hyperchloremia d. hypovolemia
answer
D
question
Place the following events in the correct sequence of events when ketoacids increase in the blood of a diabetic. Not all options are used in the answers. 1. serum pH decreases 2. serum bicarbonate decreases 3. PCO2 decreases 4. respiration decreases 5. respiration increases 6. serum pH increases 7. urine pH decreases a. 1, 3, 7, 4, 2, 6 b. 5, 2, 7, 3, 4, 1 c. 2, 1, 5, 3, 7, 6 d. 3, 1, 2, 5, 7, 6
answer
C
question
Which of the following is a manifestation of respiratory alkalosis? a. bradycardia b. drowsiness c. muscle twitches d. decreased urine pH
answer
C
question
Prolonged diarrhea results in: a. loss of fluid and bicarbonate ions leading to metabolic acidosis b. increased fluid and serum bicarbonate ions leading to metabolic acidosis c. loss of chloride ions only, leading to metabolic alkalosis d. surplus bicarbonate ions, leading to respiratory alkalosis
answer
A
question
In the initial stage, vomiting results in: a. metabolic acidosis b. metabolic alkalosis c. respiratory alkalosis d. None of the above are correct.
answer
B
question
Which two ions are most important in acid-base balance in the body? a. K+, Na+ b. Cl- and HCO3- c. Ca++, Na+ d. Na+, Cl-
answer
B
question
The bicarbonate-carbonic acid buffer system helps maintain serum pH. The balance of the carbonic acid and bicarbonate ion levels are controlled by the: a. liver and pancreas b. lungs and kidneys c. lungs and plasma proteins d. kidneys and bone marrow
answer
B
question
Alkalosis increases irritability and spontaneous stimulation of nerves by: a. blocking normal nerve conduction b. increasing the permeability of nerve membranes c. blocking movement of calcium ions d. depressing inhibitory actions
answer
B
question
Hypocalcemia causes weak cardiac contractions because: a. permeability of nerve membranes increases b. insufficient calcium ions are available for muscle contraction c. low phosphate ion levels prevent muscle contraction d. excessive amounts of calcium are stored in cardiac muscle
answer
B
question
Serum potassium levels are affected by: 1. ADH 2. aldosterone 3. serum H+ levels 4. insulin levels a. 2 only b. 1, 2 c. 1, 3 d. 2, 3, 4 e. 1, 2, 3
answer
D
question
Which of the following is the primary control of serum Na+ levels? a. ADH b. aldosterone c. serum H+ levels d. serum K+ levels
answer
B
question
The control centre for thirst is located in the: a. kidneys b. thalamus c. medulla d. hypothalamus
answer
D
question
Which statements apply to atrial naturetic peptide? 1. It is secreted by heart muscle cells. 2. It is a hormone secreted by the kidneys. 3. It helps to control water and sodium balance. 4. It is released in response to low blood pressure. a. 1, 3 b. 1, 4 c. 2, 3 d. 2, 4
answer
A
question
Which of the following refers to fibrocystic breast disease? a. progressive development of fluid-filled cysts and fibrous tissue b. proliferation of atypical cells with high risk of malignancy c. benign tumors that develop after menopause d. any tissue changes other than the normal response to hormonal changes
answer
A
question
Which of the following applies to carcinoma of the breast? a. It presents as a tender, painful, firm nodule. b. Tumor cells may demonstrate estrogen receptors on the membrane. c. Occasionally, a genetic factor may have a small role in tumor development. d. The tumor is invasive but does not metastasize until very late.
answer
B
question
Which is considered to be the stage of carcinoma in situ in cervical cancer? a. the invasive stage b. the stage of mild dysplasia c. the time before it can be detected by a Pap test d. noninvasive severe dysplasia
answer
D
question
What is a major predisposing factor to cervical cancer? a. high estrogen levels b. familial incidence c. infection with HPV d. early age for onset of menstrual cycles
answer
C
question
What is a significant early sign of endometrial carcinoma? a. a positive Pap test b. minor vaginal bleeding or spotting c. infection resistant to treatment d. painful intercourse
answer
B
question
Which term refers to bleeding between menstrual periods? a. amenorrhea b. dysmenorrhea c. oligomenorrhea d. metrorrhagia
answer
D
question
A chancre is best described as: a. a vesicle surrounded by a red inflamed area b. a pustule filled with purulent exudate c. an area of necrosis and fibrosis d. a firm painless ulcerated nodule
answer
D
question
Adjuvant chemotherapy and radiation may be used in cases of breast cancer in order to: a. slow the growth of the primary tumor b. destroy any micrometastases c. prevent the removal of any lymph nodes d. reduce the need for a mastectomy
answer
B
question
Which of the following structures is most likely to be located in the renal medulla? a. proximal convoluted tubule b. glomerulus c. loop of Henle d. afferent arteriole
answer
C
question
Which of the following is NOT a function of the kidney? a. regulation of body fluid concentrations b. removal of nitrogenous and acidic wastes c. activation of vitamin D d. production of albumin
answer
D
question
Which of the following describes the correct flow of blood in the kidney? a. afferent arteriole to the peritubular capillaries to the venule b. efferent arteriole to the glomerular capillaries to the peritubular capillaries c. peritubular capillaries to the glomerular capillaries to the venule d. afferent arteriole to the glomerular capillaries to the efferent arteriole
answer
D
question
Which of the following describes the flow of filtrate in the kidney? a. the collecting duct to the distal convoluted tubule to the renal pelvis b. Bowman's capsule to the proximal convoluted tubule to the loop of Henle c. the loop of Henle to the collecting duct to Bowman's capsule d. the distal convoluted tubule to the loop of Henle to the collecting duct
answer
B
question
Which of the following describes the normal flow of urine? a. collecting duct to the renal pelvis to the ureter to the bladder b. renal pelvis to the urethra to the bladder to the ureter c. ureter to the renal pelvis to the urethra to the bladder d. collecting duct to the ureter to the urethra
answer
B
question
Which statement about the bladder is TRUE? a. The bladder wall lacks rugae. b. Three openings from the urinary bladder form the trigone. c. It contracts when stimulated by the sympathetic nervous system. d. Continuous peristalsis in the bladder wall promotes urine flow.
answer
B
question
Which of the following increases glomerular filtration rate? a. increased plasma osmotic pressure b. dilation of the efferent arteriole c. increased hydrostatic pressure in the glomerular capillaries d. constriction of the afferent arteriole
answer
C
question
Normally, which of the following is reabsorbed completely from the filtrate? a. glucose b. sodium c. water d. Urea
answer
A
question
Which substance directly controls the reabsorption of water from the collecting ducts? a. renin b. aldosterone c. angiotensin d. antidiuretic hormone
answer
D
question
Under what circumstances do cells in the kidneys secrete renin? a. The urine pH decreases. b. Blood flow in the afferent arteriole decreases. c. Serum potassium levels are high. d. Serum osmotic pressure increases.
answer
B
question
Which of the following should be present in the filtrate in the proximal convoluted tubule? a. plasma proteins b. erythrocytes c. sodium and potassium ions d. leukocytes
answer
C
question
From the following, choose the substance likely to appear in the urine when the glomerulus is inflamed. a. albumin b. urea c. sodium d. creatinine
answer
a
question
Which of the following functions would be impaired when tubular epithelial cells have been damaged? a. adjusting the specific gravity of the urine b. reabsorbing the plasma proteins c. secreting renin d. exchanging sodium ions for bicarbonate ions
answer
a
question
When a respiratory infection with high fever is present in the body, how would the kidney tubules maintain normal pH of body fluids? a. Increase the flow of filtrate. b. Secrete more acids and reabsorb more bicarbonate ions. c. Excrete a larger volume of more dilute urine. d. Retain more potassium ions in exchange for sodium ions.
answer
b
question
When comparing normal kidney function with dialysis, which of the following mechanisms is not possible in dialysis? a. diffusion b. osmosis c. ultrafiltration d. active transport
answer
d
question
What is the cause of most cases of pyelonephritis? a. an ascending infection by E. coli b. abnormal immune response, causing inflammation c. dialysis or other invasive procedure d. virulent bacteria in the blood
answer
a
question
Which disease is manifested by dysuria and pyuria? a. nephrotic syndrome b. cystitis c. glomerulonephritis d. urolithiasis
answer
b
question
Why may acute pyelonephritis and cystitis follow untreated prostatitis? a. Microbes spread through the circulation. b. Antibodies have not yet formed. c. There is no effective treatment. d. There is a continuous mucosa along these structures.
answer
d
question
Pyelonephritis may be distinguished from cystitis by the presence in pyelonephritis of: a. microbes, leukocytes, and pus in the urine b. painful micturition c. urgency and frequency d. urinary casts and flank pain
answer
d
question
In a case of acute pyelonephritis, what is the cause of flank pain? a. inflammation, causing ischemia in the tubules b. inflammation, stretching the renal capsule c. increasing glomerular permeability, creating an increased volume of filtrate in the kidney d. microbes irritating the tissues
answer
b
question
Which pathophysiologic process applies to acute poststreptococcal glomerulonephritis? a. streptococcal infection affects both the glomerular and tubule functions b. ischemic damage occurs in the tubules, causing obstruction and decreased GFR c. immune complexes deposit in glomerular tissue, causing inflammation d. increased glomerular permeability for unknown reasons
answer
c
question
Renal disease frequently causes hypertension because: a. albuminuria increases vascular volume b. congestion and ischemia stimulates release of renin c. ADH secretion is decreased d. damaged tubules absorb large amounts of filtrate
answer
b
question
Urinary casts are present with acute poststreptococcal glomerulonephritis because of: a. large numbers of microbes and leukocytes enter the filtrate b. ruptured capillaries release debris into the tubules c. normal reabsorption of cells and proteins cannot take place d. inflamed tubules mold RBCs and protein into a typical mass
answer
d
question
Which disease would cause an increased ASO titer and elevated serum ASK? a. nephrotic syndrome b. acute poststreptococcal glomerulonephritis c. pyelonephritis d. polycystic kidney
answer
b
question
Why does metabolic acidosis develop with bilateral kidney disease? a. Tubule exchanges are impaired. b. GFR is increased. c. Serum urea is increased. d. More bicarbonate ion is produced.
answer
a
question
What is the first indicator in the arterial blood gases of acidosis caused by kidney disease? a. increased carbonic acid b. increased bicarbonate ion c. pH less than 7.35 d. decreased bicarbonate ion
answer
d
question
What would be the long-term effects of chronic infection or inflammation of the kidneys? a. dehydration and hypovolemia b. gradual necrosis, fibrosis, and development of uremia c. sudden anuria and azotemia d. severe back or flank pain
answer
b
question
What factors contribute to headache, anorexia, and lethargy with kidney disease? 1. increased blood pressure 2. elevated serum urea 3. anemia 4. acidosis a. 1 only b. 2, 4 c. 1, 3, 4 d. 1, 2, 3, 4
answer
d
question
What are the significant signs of nephrotic syndrome? a. hyperlipidemia and lipiduria b. pyuria and leucopenia c. hypertension and heart failure d. gross hematuria and pyuria
answer
a
question
Why does blood pressure often remain near normal in patients with nephrotic syndrome? a. Massive amounts of fluid are lost from the body with polyuria. b. Renin and aldosterone are no longer secreted. c. Tubules do not respond to ADH and aldosterone. d. Hypoproteinemia results in significant fluid shift to the interstitial compartment.
answer
d
question
Common causes of urolithiasis include all of the following EXCEPT: a. hypercalcemia b. hyperlipidemia c. inadequate fluid intake d. hyperuricemia
answer
b
question
Which of the following results from obstruction of the left ureter by a renal calculus? a. mild flank pain on the affected side b. hydronephrosis in both kidneys c. immediate cessation of urine production d. an attack of renal colic
answer
d
question
What does hydronephrosis lead to? a. ischemia and fibrosis in the compressed area b. multiple hemorrhages in the kidney c. severe colicky pain radiating into the groin d. increased GFR
answer
a
question
Which of the following is a predisposing factor to bladder cancer? a. prostatic cancer b. hormonal abnormalities c. exposure to chemicals and cigarette smoke d. presence of embryonic tissue
answer
c
question
What is the common initial sign of adenocarcinoma of the kidney? a. gross hematuria b. microscopic hematuria c. sharp flank pain d. oliguria
answer
b
question
Which of the following does NOT usually result from nephrosclerosis? a. secondary hypertension b. chronic renal failure c. acute renal failure d. increased renin and aldosterone secretions
answer
c
question
Which of the following relates to polycystic kidney disease? a. It affects only one of the kidneys. b. It results in gradual degeneration and chronic renal failure. c. The kidneys are displaced and the ureters are twisted. d. The prognosis is good because there is adequate reserve for normal life.
answer
b
question
Which of the following is related to Wilms' tumor? a. direct exposure to carcinogens b. hormonal imbalance c. repeated infections d. a genetic defect
answer
d
question
With severe kidney disease, either hypokalemia or hyperkalemia may occur and cause: a. cardiac arrhythmias b. encephalopathy c. hypervolemia d. skeletal muscle twitch or spasm
answer
a
question
Which of the following indicates the early stage of acute renal failure? a. polyuria with urine a fixed, low specific gravity b. hypotension and increased urine output c. development of decompensated acidosis d. very low GFR and increased serum urea
answer
d
question
What is a cause of acute tubule necrosis and acute renal failure? a. prolonged circulatory shock b. sudden significant exposure to nephrotoxins c. crush injuries or burns d. all of the above
answer
d
question
Which of the following would likely cause chronic renal failure? a. cystitis with pyelonephritis in the right kidney b. circulatory shock c. persistent bilateral glomerulonephritis d. obstruction of a ureter by a renal calculus
answer
c
question
What causes polyuria during the stage of renal insufficiency? a. loss of tubule function b. increased blood pressure c. decreased aldosterone secretion d. increased GFR
answer
a
question
What is the primary reason for hypocalcemia developing during end-stage renal failure or uremia? a. decreased parathyroid hormone secretion b. insufficient calcium in the diet c. excessive excretion of calcium ions in the urine d. a deficit of activated vitamin D and hyperphosphatemia
answer
d
question
Cystitis is more common in females due to: a. the mucosa in the urinary tract is continuous b. the urethra is short, wide, and adjacent to areas with resident flora c. the pH of urine is more acidic in females d. females have a higher incidence of congenital anomalies
answer
b
question
hich of the following indicate a decreased GFR? a. increased serum urea and decreased serum bicarbonate b. urine with low specific gravity and dark color c. albuminuria and hematuria d. hyponatremia and hypokalemia
answer
a
question
Which of the following is NOT likely to lead to hydronephrosis? a. renal calculi b. pyelonephritis c. nephrosclerosis d. benign prostatic hypertrophy
answer
c
question
Which of the following congenital defects is a common cause of cystitis in young children? a. polycystic kidney b. horseshoe kidney c. hypoplasia of the kidney d. vesicoureteral reflux
answer
d
question
Which factor contributes to severe anemia in individuals with chronic renal failure? a. increased erythropoietin secretion b. limited protein intake c. compensatory increase in bone marrow activity d. inability to absorb Vitamin B12 and iron
answer
b
question
When acidosis becomes decompensated in renal failure, a key indicator is: a. increased PCO2 b. increased bicarbonate ion c. serum pH dropping below 7.35 d. serum buffer ratio of 20 bicarbonate ion to 1 carbonic acid
answer
c
question
What is the primary action of the diuretic furosemide? a. decreased reabsorption of sodium and water b. decreased reabsorption of H+ in the tubules c. increased secretion of antidiuretic hormone d. inhibition of renin
answer
a
question
Which of the following causes acute renal failure? a. polycystic kidney disease b. pyelonephritis in the right kidney c. nephrosclerosis d. bilateral acute glomerulonephritis
answer
d
question
Which of the following is a significant indicator of renal insufficiency? a. urine with pH of 5 b. increased serum urea and creatinine c. urine with high specific gravity d. increased blood pressure
answer
b
question
Uremic signs of renal failure include all of the following EXCEPT: a. encephalopathy b. congestive heart failure c. osteodystrophy d. azotemia and acidosis
answer
b
question
Choose the basic cause of osteodystrophy associated with chronic renal failure. a. development of hypercalcemia b. deficit of parathyroid hormone c. failure of the kidney to activate vitamin D d. excessive loss of phosphate ion
answer
c
question
Agenesis is often not diagnosed because: a. the kidney is displaced from its normal position b. it is a genetic defect and asymptomatic until mid-life c. the two functioning kidneys are fused together d. one kidney provides more than adequate function
answer
d
question
The normal pH of urine is: a. 7.35-7.45 b. 4.5- 8.0 c. 1.5-7.5 d. 1.0-7.0
answer
b
question
Wilms' tumor is: a. a malignant tumor in the bladder b. an encapsulated mass in one kidney c. not considered to have a genetic origin d. manifested in adulthood
answer
b
question
Reduced urine output resulting from inflammation and necrosis of the tubules is called: a. oliguria b. anuria c. pyuria d. polyuria
answer
a
question
The micturition reflex is initiated by: a. sympathetic nerves in the sacral spinal cord b. relaxation of the internal sphincter of the bladder c. increased pressure distending the bladder d. contraction of the bladder
answer
c
question
Which of the following results from decreased blood flow into the kidneys? a. decreasing blood pressure b. dilation of the afferent arterioles c. decreased aldosterone secretion d. increased angiotensin and systemic vasoconstriction
answer
d
question
In acute post-streptococcal glomerulonephritis, the glomerular inflammation results from: a. the antecedent infection b. type III hypersensitivity reaction c. ascending infection from the bladder d. spread of infection from the tubules
answer
b
question
In acute post-streptococcal glomerulonephritis, the inflammation causes: a. increased permeability of the glomerular capillaries b. glomerular congestion and decreased GFR c. decreased blood pressure and edema d. a, b e. a, c
answer
d
question
Circulatory shock causes: a. decreased GFR and increased renin secretion b. increased ADH and decreased aldosterone secretion c. immediate tubule necrosis and obstruction d. SNS stimulation and vasodilation of afferent and efferent arterioles e. increased angiotensin II and systemic vasodilation
answer
a
question
Autoregulation in the kidneys refers to: a. control of blood flow by the sympathetic nervous system b. the secretion of renin and activation of angiotensin c. local minor reflex adjustments in the arterioles to maintain normal blood flow d. the control of systemic blood pressure by the kidneys
answer
c
question
The reabsorption of water and electrolytes by the kidneys is directly controlled by: 1. atrial natriuretic hormone 2. antidiuretic hormone 3. angiotensin 4. the levels of bicarbonate ion a. 2 only b. 3 only c. 1, 2 d. 2, 4 e. 1, 3, 4
answer
c
question
Uncontrolled essential hypertension may cause chronic renal failure because of: a. predisposition to recurrent urinary tract infections b. damage to afferent arterioles and renal ischemia c. failure of tubules to respond to hormonal controls d. glomerular congestion causes damaged capillaries
answer
b
question
Vaginal candidiasis is frequently predisposed by: a. systemic antibacterial therapy b. insertion of an intrauterine device c. sexual intercourse with an infected partner d. previous viral infection
answer
a
question
chancre is best described as: a. a vesicle surrounded by a red inflamed area b. a pustule filled with purulent exudate c. an area of necrosis and fibrosis d. a firm painless ulcerated nodule
answer
d
question
Adjuvant chemotherapy and radiation may be used in cases of breast cancer in order to: a. slow the growth of the primary tumor b. destroy any micrometastases c. prevent the removal of any lymph nodes d. reduce the need for a mastectomy
answer
b
question
Ovarian cancer has a poor prognosis because: a. it does not respond to chemotherapy or radiation b. vague signs and hidden location lead to late diagnosis c. premenopausal women are not likely to notice changes d. hormone therapy is ineffective
answer
b
question
Specific genetic links have been shown for: 1. cervical cancer 2. testicular cancer 3. breast cancer 4. prostatic cancer a. 1, 2 b. 3, 4 c. 1, 3, 4 d. 2, 3, 4
answer
d
question
In which cancers has there been a recent significant increase in incidence? a. uterine cancer b. breast cancer c. ovarian cancer d. cervical cancer in situ
answer
d
question
Adenocarcinomas make up the most common cancers found in the: a. prostate b. testes c. ovary d. cervix
answer
a
question
Infertility in women may result from: a. endometriosis b. hormonal imbalances c. a and b d. neither a nor b
answer
c
question
Viable sperm may not be able to access an ovum when: a. cervical mucus is highly viscous b. vaginal pH is abnormal c. structural abnormalities are present d. b, c e. a, b, c
answer
e
question
In the liver, amino acids are used to produce complex molecules by means of: a. glycogenesis b. anabolic processes c. catabolic processes d. autodigestion
answer
b
question
Which of the following cells in the gastric mucosa produce intrinsic factor and hydrochloric acid? a. parietal cells b. chief cells c. mucous cells d. gastrin cells
answer
a
question
Which of the following is the primary site for absorption of nutrients? a. stomach b. duodenum c. ileum d. ascending colon
answer
c
question
When highly acidic chyme enters the duodenum, which hormone stimulates the release of pancreatic secretions that contains very high bicarbonate ion content? a. gastrin b. secretin c. cholecystokinin d. histamine
answer
b
question
Which of the following breaks protein down into peptides? a. amylase b. peptidase c. lactase d. trypsin
answer
d
question
In which structure is oxygenated blood (arterial) mixed with unoxygenated blood (venous) so as to support the functions of the structure? a. pancreas b. liver c. small intestine d. spleen
answer
b
question
Which of the following stimulates increased peristalsis and secretions in the digestive tract? a. sympathetic nervous system b. vagus nerve c. increased saliva d. absence of food in the system
answer
b
question
Which of the following is contained in pancreatic exocrine secretions? a. bicarbonate ion b. hydrochloric acid c. activated digestive enzymes d. insulin
answer
a
question
An alkaline environment is required in the duodenum to: a. activate pepsinogen b. activate intestinal and pancreatic enzymes c. activate bile salts d. produce mucus
answer
b
question
Which of the following processes is likely to occur in the body immediately after a meal? a. lipolysis b. ketogenesis c. gluconeogenesis d. glycogenesis
answer
d
question
What does the term gluconeogenesis refer to? a. breakdown of glycogen to produce glucose b. conversion of excess glucose into glycogen for storage c. formation of glucose from protein and fat d. breakdown of glucose into carbon dioxide and water
answer
c
question
Normally, proteins or amino acids are required to produce all of the following EXCEPT: a. peptide hormones b. clotting factors and antibodies c. cellular energy d. hemoglobin
answer
c
question
Which of the following statements applies to bile salts? a. They give feces the characteristic brown color. b. They are enzymes used to break down fats into free fatty acids. c. They emulsify lipids and lipid-soluble vitamins. d. They are excreted in the feces.
answer
c
question
The visceral peritoneum: a. lines the abdominal wall b. hangs from the stomach over the loops of small intestine c. contains many pain receptors d. forms the outer covering of the stomach and intestines e. covers the kidneys and bladder
answer
d
question
The early stage of vomiting causes: a. metabolic alkalosis b. metabolic acidosis c. increased respirations d. increased excretion of hydrogen ions
answer
a
question
Prolonged vomiting cause a state of acidosis due to: a. catabolism of proteins and lipids b. continued loss of gastric secretions c. loss of pancreatic enzymes d. retention of sodium ions and water
answer
a
question
What is the first change in arterial blood gases with diarrhea? a. increased bicarbonate ion b. decreased bicarbonate ion c. increased carbonic acid d. increased serum pH
answer
b
question
Dehydration causes acidosis because of increased: a. ketones produced b. CO2 retained in the lungs and kidneys c. hypovolemia and lactic acid production d. metabolic rate
answer
c
question
Which of the following applies to the act of swallowing? a. requires coordination of cranial nerves V, IX, X, and XII b. is entirely voluntary c. is controlled by a center in the hypothalamus d. does not affect respiration
answer
a
question
What does the defecation reflex require? a. stimulation by the sympathetic nervous system b. contraction of the internal anal sphincter c. coordination through the sacral spinal cord d. voluntary contraction of abdominal muscles
answer
c
question
What is the definition of achalasia? a. a herniation of the gastric mucosa through a segment of weakened muscle b. recurrent reflux of chime into the esophagus c. absence of a connection of the esophagus to the stomach d. lack of a nerve plexus to relax the lower esophageal sphincter
answer
d
question
What does esophageal atresia cause? a. direct passage of saliva and food from the mouth into the trachea b. repeated reflux of gastric secretions into the esophagus c. no fluid or food entering the stomach d. gastric distention and cramps
answer
c
question
Which of the following applies to cleft palate? a. The mandibular processes do not fuse. b. The hard and soft palates do not fuse during the first trimester of pregnancy. c. Exposure to environmental factors in the last trimester causes the defect. d. Speech and eating are not affected.
answer
b
question
oral candidiasis is considered to: a. be a common bacterial infection in infants and young children b. cause painful ulcerations in the mucosa and tongue c. cause white patches in the mucosa that cannot be scraped off d. be an opportunistic fungal infection of the mouth
answer
d
question
Why does herpes simplex infection tend to recur? a. Active infection is usually asymptomatic. b. The virus builds up a resistance. c. The virus persists in latent form in sensory nerve ganglia. d. The virus mutates; therefore, no effective immunity develops.
answer
c
question
What does the term periodontitis refer to? a. erosion of the enamel tooth surface b. bacterial damage to the ligaments and bone surrounding teeth c. inflammation and infection of the gingivae d. formation of calcified plaque on the tooth
answer
b
question
What is/are common location(s) for oral cancer? a. floor of the mouth or tongue borders b. mucosa lining the cheeks c. hard and soft palate d. gingivae near the teeth
answer
a
question
What is a common cause of hiatal hernia? a. an abnormally long esophagus b. increased intra-abdominal pressure c. stenosis of the hiatus in the diaphragm d. a small fundus in the stomach
answer
b
question
What is a common sign of acute gastritis? a. colicky right upper quadrant pain b. vomiting with epigastric tenderness c. projectile vomiting after eating d. diarrhea with abdominal distention
answer
b
question
What does the pathophysiology of chronic gastritis include? a. atrophy of the gastric mucosa with decreased secretions b. hyperchlorhydria and chronic peptic ulcers c. frequent vomiting and diarrhea d. episodes of acute inflammation and edema of the mucosa
answer
a
question
What is a common cause of gastroenteritis due to Salmonella? a. unrefrigerated custards or salad dressings b. poorly canned foods c. raw or undercooked poultry or eggs d. contaminated water
answer
c
question
Which of the following individuals is likely to develop acute gastritis? a. a long-term, heavy cigarette smoker b. patient with arthritis taking enteric-coated aspirin on a daily basis c. a person with an autoimmune reaction in the gastric mucosa d. an individual with an allergy to shellfish
answer
d
question
What does congenital pyloric stenosis involve? a. absence of peristalsis in the lower section of the stomach b. failure of an opening to develop between the stomach and duodenum c. hypertrophy and hyperplasia of smooth muscle in the pylorus d. thickening of the gastric wall due to chronic inflammation
answer
c
question
A patient with acquired pyloric stenosis would likely: a. have an increase in appetite b. have chronic diarrhea c. develop severe colicky pains d. vomit undigested food from previous meals
answer
d
question
Prolonged or severe stress predisposes to peptic ulcer disease because: a. of reduced blood flow to the gastric wall and mucous glands b. of reduced bicarbonate content in bile and pancreatic secretions c. stress increases the number of acid/pepsinogen secreting cells d. increased epinephrine increases motility
answer
a
question
The pathophysiology of peptic ulcer disease may involve any of the following EXCEPT: a. decreased resistance of the mucosal barrier b. increased stimulation of pepsin and acid secretions c. infection by H. pylori d. increased stimulation of mucus-producing glands
answer
d
question
Which of the following would a perforated gastric ulcer likely cause? a. severe anemia b. chemical peritonitis c. severe gastric hemorrhage d. pyloric obstruction
answer
b
question
What is frequently the first manifestation of stress ulcers? a. abdominal discomfort between meals and at night b. nausea and diarrhea c. hematemesis and hypotension d. sharp colicky pain with food intake
answer
c
question
What would be the result of chronic bleeding from gastric carcinoma? a. occult blood in the stool and anemia b. hematemesis and shock c. abdominal pain and distention d. red blood on the surface of the stool
answer
a
question
Following gastric resection, the onset of nausea, cramps, and dizziness immediately after meals indicates: a. a large volume of chyme has entered the intestines, causing distention b. severe hypoglycemia has developed c. the pylorus is restricting the flow of chyme d. bile and pancreatic secretions are irritating the small intestine
answer
a
question
Which of the following is/are (a) manifestation(s) of hemolytic jaundice? a. increased unconjugated bilirubin in the blood b. increased bleeding tendencies c. pale stool and dark urine d. elevated liver enzymes in the blood
answer
a
question
Why does mild hyperbilirubinemia occur in newborns? a. blood incompatibility between mother and child b. there is damage to many erythrocytes during the birth process c. poor circulation and albumin transport for bilirubin d. the immature liver cannot process bilirubin quickly enough
answer
d
question
Predisposing factors to cholelithiasis include excessive: a. bilirubin or cholesterol concentration in the bile b. water content in the bile c. bile salts in the bile d. bicarbonate ions in the bile
answer
a
question
What is the major effect when a gallstone obstructs the cystic duct? a. intrahepatic jaundice b. acute pancreatitis c. severe colicky pain in upper right quadrant d. inflammation and infection in the gall bladder
answer
c
question
Which of the following describes the supply of bile following a cholecystectomy? a. Bile is no longer available for digestion. b. Bile is stored in the liver sinusoids until a fatty meal is consumed. c. Bile is not diluted and is less effective as an emulsifier. d. Small amounts of bile are continuously secreted and flow into the duodenum.
answer
d
question
Which of the following applies to hepatitis A infection? a. It is also called serum hepatitis. b. It is transmitted by the fecal-oral route. c. It contains a double strand of DNA. d. It frequently leads to chronic hepatitis.
answer
b
question
What can be concluded if the hepatitis B antigen level remains high in the serum? a. Acute infection is present. b. Chronic infection has developed. c. Liver failure is in progress. d. The usual prolonged recovery from any viral infection is occurring.
answer
b
question
What is the most common type of hepatitis transmitted by blood transfusion? a. HAV b. HBV c. HCV d. HEV
answer
c
question
What causes elevated serum levels of AST and ALT during the preicteric stage of hepatitis? a. systemic effects of viral infection b. obstruction of bile ducts and malabsorption c. necrosis of liver cells d. ammonia toxicity
answer
c
question
What is the likely effect of long-term exposure to a hepatotoxin? a. full recovery to normal tissue after the toxic material is removed b. acute onset of vomiting, steatorrhea, and jaundice c. continued mild inflammation of the liver without permanent damage d. gradual irreversible damage to the liver and cirrhosis
answer
d
question
What indicates the presence of third-stage alcohol hepatitis? a. below normal blood levels of AST and ALT b. ULQ tenderness and dull pain c. a small, firm, nodular liver and portal hypertension d. accumulation of fat in the hepatocytes and hepatomegaly
answer
d
question
A primary factor causing encephalopathy with cirrhosis is the elevated: a. serum urea b. conjugated bilirubin c. serum ammonia d. serum pH
answer
c
question
In patients with cirrhosis, serum ammonia may increase when: a. ingesting excessive lipids b. bleeding occurs in the digestive tract c. an increase in unconjugated bilirubin occurs in the serum d. less bile is produced
answer
b
question
What is the primary cause of esophageal varices? a. portal hypertension b. alcohol irritating the mucosa c. failure to inactivate estrogen d. poor nutritional status
answer
a
question
What is the primary cause of increased bleeding tendencies associated with cirrhosis? a. anemia and leucopenia b. jaundice and pruritus c. recurrent infections d. deficit of vitamin K and prothrombin
answer
d
question
Which factors contribute to ascites in patients with cirrhosis? a. increased aldosterone and deficit of albumin b. severe anemia and increased serum bilirubin c. hypokalemia and increased serum ammonia d. hyperproteinemia and persistent hypotension
answer
a
question
Which of the following is a major cause of primary hepatocellular cancer? a. metastatic tumors b. acute hepatitis c. long-term exposure to certain chemicals d. chronic cholelithiasis
answer
c
question
What causes massive inflammation and necrosis in acute pancreatitis? a. formation of multiple thrombi and ischemia b. infection by intestinal microbes c. immune complex reaction d. activation and spread of proteolytic enzymes
answer
d
question
How does chemical peritonitis and shock frequently result from acute pancreatitis? a. Inflammation and increased vascular permeability of the peritoneum affect fluid balance. b. Erosions in the intestinal wall causes release of bacteria. c. Fat necrosis and hypocalcemia develop. d. Secretions from the pancreas and intestine become more acidic.
answer
a
question
Malnutrition may develop in children with celiac disease because of: a. damage to the intestinal villi b. obstruction in the pancreatic ducts c. acidosis preventing activation of digestive enzymes d. insufficient bile for absorption
answer
a
question
Which of the following best describes steatorrhea? a. a light gray-colored stool b. a tarry black stool c. bulky, fatty, foul-smelling stools d. watery stools with mucus and blood
answer
c
question
What is the dietary requirement for a child with celiac disease? a. low sodium, high fat b. high carbohydrate, low protein c. high calorie with vitamin supplements d. gluten-free
answer
d
question
What are the typical changes occurring with Crohn's disease? a. degeneration and flattening of the villi in the small intestine b. multiple herniations of the mucosa through weak areas of the muscularis c. a continuous area of mucosal inflammation and ulceration in the rectum and colon d. inflamed areas of the wall of the ileum alternating with thick fibrotic or normal areas
answer
d
question
Stools that are more liquid and contain mucus, frank blood, and pus are typical of: a. diverticulitis b. ulcerative colitis c. Crohn's disease d. celiac disease
answer
b
question
How may a fistula form with Crohn's disease? a. lack of peristalsis leading to dilated areas of intestine b. fibrosis and thickening of the wall causing obstruction c. erosion of the mucosa causing bleeding d. recurrent inflammation, necrosis, and fibrosis forming a connection between intestinal loops
answer
d
question
How does iron-deficiency anemia frequently develop with ulcerative colitis? a. loss of surface area for absorption in the ileum b. bone marrow depression by toxic wastes c. chronic blood loss in stools d. insufficient hydrochloric acid for iron absorption
answer
c
question
What is the cause of inflammatory bowel disease? a. physical and emotional stress b. an autoimmune reaction c. a combination of recessive genes d. idiopathic
answer
d
question
What pain is typical of diverticulitis? a. lower left quadrant b. lower right quadrant c. sharp, colicky, periumbilical d. lower abdominal pain, radiating into the groin
answer
a
question
What usually initiates acute appendicitis? a. infection in the appendix b. an episode of severe diarrhea c. obstruction of the lumen of the appendix d. eating a low-fiber diet
answer
c
question
With acute appendicitis, localized pain and tenderness in the lower right quadrant results from: a. increased peristalsis in the adjacent colon b. inflammation and stretching of the appendiceal wall c. increased gas and fluid inside the appendix d. local inflammation of the parietal peritoneum
answer
d
question
How does localized peritonitis develop from acute appendicitis before rupture? a. The omentum walls off the inflamed area. b. Intestinal bacteria escape through the necrotic appendiceal wall. c. The obstructing object inside the appendix perforates the wall. d. Bacteria escape into the circulating blood.
answer
b
question
What is a typical early sign of cancer in the ascending colon? a. change in shape of the stool b. bleeding with defecation c. mild but persistent pain in the lower left quadrant d. occult blood in the stool
answer
d
question
To which site does colon cancer usually first metastasize? a. lungs b. stomach c. liver d. spleen
answer
c
question
How does a volvulus cause localized gangrene in the intestine? a. Hypotension and shock causes ischemia. b. The mesenteric arteries are compressed in the twisted section of intestine. c. A section of intestine herniates between the muscles of the abdominal wall. d. The distention of the intestinal wall causes increased permeability of the tissue.
answer
b
question
Which of the following is a typical indicator of an intestinal obstruction caused by paralytic ileus? a. excessive audible bowel sounds b. intermittent colicky pain c. severe steady abdominal pain d. visible peristalsis
answer
c
question
Partial obstruction of the sigmoid colon resulting from diverticular disease would likely: a. cause severe colicky pain b. cause frequent diarrhea c. develop very rapidly d. result in a small, hard stool
answer
d
question
What causes hypovolemic shock to develop with intestinal obstruction? a. continued vomiting and fluid shift into the intestine b. hemorrhage into the intestine c. rupture of the intestinal wall d. repeated bouts of severe diarrhea
answer
a
question
What causes the characteristic rigid abdomen found in the patient with peritonitis? a. increased fluid and gas causing abdominal distention b. inflammation of the peritoneum and organs causing a firm mass in the abdomen c. inflamed peritoneum resulting in reflex abdominal muscle spasm d. the patient voluntarily contracts the abdominal muscles as a protective mechanism
answer
c
question
79. What would be the likely outcome from chemical peritonitis related to a perforated gall bladder? a. leakage of intestinal bacteria into blood and the peritoneal cavity b. massive hemorrhage and shock c. breakdown of the gallstones d. increasing peristalsis with intermittent painful spasms
answer
a
question
How does pelvic inflammatory disease frequently lead to bacterial peritonitis? a. Chemical irritation by excessive ovarian and uterine secretions causes inflammation. b. Ulceration and perforation of the uterus allows the bacteria to spread. c. Infection spreads through the fallopian tubes directly into the peritoneal cavity. d. Gangrene in the uterine wall spreads through into the pelvic cavity.
answer
c
question
Choose the significant change in arterial blood gases expected with prolonged severe vomiting: a. increased bicarbonate ion, increased PCO2, serum pH 7.4 b. decreased bicarbonate ion, decreased PCO2, serum pH 7.35 c. increased bicarbonate ion, decreased PCO2, serum pH 7.35 d. decreased bicarbonate ion, increased PCO2, serum pH 7.45
answer
b
question
When dehydration reduces the compensation possible for acidosis resulting from prolonged diarrhea, what significant change in arterial blood gases indicates this? a. serum pH would rise above 7.45 b. serum bicarbonate levels would increase, serum pH would remain in normal range c. serum bicarbonate levels would decrease, serum pH would drop below 7.35 d. serum PCO2 would rise, serum pH would be around 7.4
answer
c
question
How do body defenses respond immediately after the gall bladder ruptures? a. A localized inflammatory response occurs. b. The omentum and peritoneum seal off the area. c. Blood clots seal the perforation. d. a and b e. a and c
answer
c
question
Dehydration limits compensation available for an acid-base imbalance resulting from prolonged vomiting and diarrhea because: a. hypovolemia limits renal function b. increased respirations cannot remove more H+ c. increased ADH blocks secretion of H+ d. more sodium and potassium ions are retained
answer
a
question
Which of the following is the most frequent location of peptic ulcers? a. lower esophagus b. antrum of the stomach c. proximal duodenum d. distal duodenum
answer
c
question
In peptic ulcer disease, which of the following does NOT decrease the resistance of the mucosal barrier? a. prolonged vasoconstriction b. excessive glucocorticoid intake c. proteases and cytotoxins from H. pylori d. decreased vagal stimulation
answer
d
question
An individual with peptic ulcer disease exhibits hematemesis. What does this probably indicate? a. perforation b. obstruction c. erosion of a large blood vessel d. development of malignancy
answer
c
question
What does the term melena mean? a. blood in a dark-colored stool b. occult blood in the stool c. blood in the sputum d. blood in vomitus
answer
a
question
Which of the following is NOT a common predisposing factor to gastric carcinoma? a. ingestion of smoked foods b. genetic factors c. ingestion of foods preserved with nitrates d. anti-inflammatory medications such as ASA
answer
d
question
Which of the following frequently occurs 2-3 hours after meals in post-gastrectomy patients? a. hypoglycemia b. hypovolemia c. abdominal cramps and distention d. increased peristalsis and diarrhea
answer
a
question
Which term refers to obstruction of the biliary tract by gallstones? a. cholelithiasis b. cholecystitis c. cholangitis d. choledocholithiasis
answer
d
question
Which of the following is NOT usually present during the icteric stage of viral hepatitis? a. hepatomegaly b. elevated serum liver enzymes c. esophageal varices d. lighter-colored stools
answer
c
question
Which of the following statements about jaundice is/are true? 1. It is often the first manifestation of hepatitis. 2. Jaundice indicates permanent liver damage. 3. Individuals with hepatitis are always jaundiced. 4. Jaundice usually develops with hepatocellular carcinoma. a. 1 only b. 4 only c. 1, 3 d. 2, 4
answer
b
question
Which type(s) of hepatitis increase(s) the risk of hepatocellular carcinoma? a. HBV b. HCV c. HBV and HCV d. neither HBV nor HCV
answer
c
question
Which of the following are related to post-hepatic jaundice? a. pruritic skin and light-colored stools b. dark-colored stools and urine c. increased serum levels of unconjugated bilirubin d. loss of all metabolic functions
answer
a
question
Which of the following occurs with hepatitis B? a. The liver is inflamed and enlarged. b. Blood clotting delays are apparent at onset. c. Hepatocytes can not regenerate when virus is present. d. Infection is self-limiting.
answer
a
question
Identify a major reason making it difficult to prevent the spread of hepatitis B. a. A vaccine is not available. b. The incubation period is too short to track contacts. c. Infection is often asymptomatic. d. Antibodies are not produced.
answer
c
question
What is the initial pathological change in alcoholic liver disease? a. formation of nodules with shrinkage of the liver b. inflammation with necrosis c. development of fibrous bands of tissue d. accumulation of fat in hepatocytes with hepatomegaly
answer
d
question
How does serum bilirubin change with cirrhosis? a. increased unconjugated bilirubin b. increased conjugated bilirubin c. increased conjugated and unconjugated bilirubin d. decreased conjugated and unconjugated bilirubin
answer
c
question
Which type of hepatitis virus requires the presence of hepatitis B virus so as to replicate? a. HAV b. HCV c. HDV d. HEV
answer
c
question
. Deficiencies of vitamins A, D, and K occur in patients with cirrhosis primarily because of decreased? a. liver metabolism b. production of bile for absorption c. pancreatic secretions in the intestine d. storage of all vitamins
answer
b
question
Tetany may develop in patients with acute pancreatitis because: a. digestion and absorption of calcium is impaired b. hemorrhage and fluid shift displace calcium from the blood c. calcium ions are used up in blood coagulation process d. calcium ions bind with fatty acids in necrotic tissue
answer
d
question
Which factors appear to have a role in the etiology of inflammatory bowel diseases? a. dietary factors b. environmental toxins c. genetic and immunologic factors d. chronic alcoholism
answer
c
question
In which condition is a deficit of protein and vitamins most likely to occur? a. regional ileitis b. ulcerative colitis c. diverticulitis d. appendicitis
answer
a
question
When a portion of the proximal stomach and the paraesophageal junction move above the diaphragm, this is called a: a. dysphagia b. rolling hernia c. sliding hernia d. pyloric stenosis e. gastroesophageal reflux disease
answer
c
question
Which of the following applies to gastric cancer? a. It usually appears as polyp or protruding mass. b. Most cases involve an adenocarcinoma of the mucous glands. c. Genetics or geographic area does not affect the incidence. d. It is usually diagnosed in an early stage because of pyloric obstruction.
answer
b
question
Pancreatic cancer may be diagnosed early if obstruction of bile or pancreatic secretions develops when the tumor is located: a. at the head of the pancreas b. in the body of the pancreas c. in the tail of the pancreas d. in the endocrine glands of the pancreas
answer
a
question
108. "A gluten-free diet as required" for the client with celiac disease means avoiding: a. products containing lactose b. any trans-fat c. certain grains d. proteins containing certain amino acids
answer
c
question
The telescoping of one section of bowel inside another section is called: a. volvulus b. hernia c. adhesion d. intussusceptions
answer
d
question
Hirschsprung's disease refers to: a. congenital lack of PNS innervations in a segment of the colon b. multiple polyps in the colon c. impaired motility in the intestines resulting from diffuse scar tissue d. chronic inflammation causing recurrent diarrhea and cramps
answer
a
question
What kind of control mechanism is indicated when increased blood glucose levels stimulate increased secretion of insulin? a. control by releasing hormones b. control by tropic hormones c. negative feedback control d. hypothalamus/hypophysis coordination
answer
c
question
What is the most common cause of endocrine abnormalities? a. malignant neoplasm b. infection c. congenital defect d. benign tumor
answer
d
question
Choose the statement that applies to Type I diabetes mellitus. a. Onset often occurs during childhood. b. Relative insufficiency of insulin or insulin resistance develops. c. It can be treated by diet, weight control and exercise, or oral hypoglycemics. d. Complications rarely occur.
answer
a
question
Why does polyuria develop with diabetes mellitus? a. increased thirst b. ketoacidosis c. glucosuria develops d. diabetic nephropathy
answer
c
question
What is the cause of diabetic ketoacidosis? a. excess insulin in the body b. loss of glucose in the urine c. failure of the kidney to excrete sufficient acids d. increased catabolism of fats and proteins
answer
d
question
What is a precipitating factor for diabetic ketoacidosis? a. skipping a meal b. strenuous exercise c. serious infection d. insulin overdose
answer
c
question
Which of the following may cause insulin shock to develop? a. recurrent vomiting b. missing an insulin dose c. eating excessively large meals d. sedentary lifestyle
answer
a
question
Which of the following indicates hypoglycemia in a diabetic? a. deep, rapid respirations b. flushed dry skin and mucosa c. thirst and oliguria d. staggering gait, disorientation, and confusion
answer
d
question
Which of the following are signs of diabetic ketoacidosis in an unconscious person? a. pale moist skin b. thirst and poor skin turgor c. deep rapid respirations and fruity breath odor d. tremors and strong rapid pulse
answer
c
question
Which of the following indicates compensated acidosis in the diabetic? a. increased serum bicarbonate b. serum pH of 7.35 c. increased serum carbonic acid d. urine pH 8.0
answer
b
question
What causes loss of consciousness in a person with diabetic ketoacidosis? a. toxic effects of excessive insulin b. excessive glucose in the blood c. acidosis and hypovolemia d. lack of glucose in brain cells
answer
c
question
Which of the following does NOT usually develop as a complication of diabetes? a. osteoporosis b. nephropathy c. impotence d. peripheral neuropathy
answer
a
question
ow do many oral hypoglycemic drugs act? a. to replace insulin in patients with IDDM b. to transport glucose into body cells c. to prevent gluconeogenesis d. to stimulate the pancreas to produce more insulin
answer
d
question
Visual impairment may develop in diabetics, primarily because of: a. abnormal metabolism in the lens b. macroangiopathy c. neuropathy affecting cranial nerves d. development of exophthalmos
answer
a
question
. Which of the following applies to diabetic macro-angiography? 1. It affects the small arteries and arterioles. 2. It is related to elevated serum lipids. 3. It leads to increased risk of myocardial infarction and peripheral vascular disease. 4. It frequently causes damage to the kidneys. a. 1, 3 b. 1, 4 c. 2, 3 d. 2, 4
answer
c
question
Why is amputation frequently a necessity in diabetics? a. necrosis and gangrene in the feet and legs b. lack of glucose to the cells in the feet and legs c. severe dehydration in the tissues d. elevated blood glucose increasing blood viscosity
answer
a
question
How do the different types of available insulin vary? 1. time until onset of action 2. time until peak effect 3. duration of effect 4. source of insulin a. 1, 2 b. 3, 4 c. 1, 2, 4 d. 1, 2, 3, 4
answer
d
question
Which one of the following develops hypoglycemia more frequently? a. Type I diabetics b. Type II diabetics c. patients with a poor stress response d. those with a regular exercise and meal plan
answer
a
question
Which of the following hormonal imbalances causes Addison's disease? a. increased glucocorticoids b. decreased glucocorticoids c. deficit of ADH d. deficit of T3 and T4
answer
B
question
Which of the following hormonal imbalances causes myxedema? a. increased glucocorticoids b. decreased glucocorticoids c. deficit of ADH d. deficit of T3 and T4
answer
d
question
Which of the following hormonal imbalances causes diabetes insipidus? a. increased insulin b. decreased glucocorticoids c. deficit of ADH d. deficit of T3 and T4
answer
c
question
What is caused by hyperparathyroidism? a. hypocalcemia b. tetany c. bone demineralization d. deficit of vitamin D
answer
c
question
What is caused by hypocalcemia due to hypoparathyroidism? 1. skeletal muscle twitching or spasm 2. weak cardiac contraction 3. increased secretion of PTH 4. decreased serum phosphate level a. 1, 2 b. 1, 3 c. 2, 3 d. 3, 4
answer
a
question
Which of the following applies to acromegaly? a. It occurs in infants and children. b. It causes excessive longitudinal bone growth. c. It results from excessive secretion of GH. d. It does not change soft tissue growth.
answer
c
question
Which of the following may cause goiter? 1. hyperthyroidism 2. hypothyroidism 3. lack of iodine in the diet 4. pheochromocytoma a. 1, 4 b. 2, 3 c. 1, 2, 3 d. 1, 2, 3, 4
answer
c
question
Which signs are typical of Graves' disease? a. facial puffiness, bradycardia, and lethargy b. exophthalmos, heat intolerance, and restlessness c. delayed physical and intellectual development d. goiter and decreased BMR
answer
b
question
Characteristics of Cushing's syndrome include all of the following EXCEPT: a. heavy body and round face b. atrophied skeletal muscle in the limbs c. staring eyes with infrequent blinking d. atrophy of the lymph nodes
answer
c
question
Why does diabetes insipidus cause polyuria? a. There is increased osmotic pressure of the filtrate. b. Damaged tubules cannot reabsorb sufficient fluid. c. Excessive ADH secretion is present. d. There is a deficit of ADH. e. Excessive aldosterone is secreted.
answer
d
question
Which of the following is an effect of long-term glucocorticoid therapy? a. decreased secretion from the adrenal cortex gland b. an increased inflammatory response to irritants c. hypotension and poor circulation d. increased number of hypersensitivity reactions
answer
a
question
Which of the following is an effect of Addison's disease? a. elevated blood glucose levels b. high blood pressure c. low serum potassium levels d. poor stress response
answer
d
question
What is the most common cause of type 1 diabetes mellitus? a. increased glucose production in the liver b. destruction of pancreatic cells by an autoimmune reaction c. increased resistance of body cells to insulin action d. chronic obesity
answer
b
question
Why does glucosuria occur in diabetics? a. Excess ketoacids displace glucose into the filtrate. b. Excess water in the filtrate draws more glucose into the urine. c. The amount of glucose in the filtrate exceeds the renal tubule transport limit. d. Sufficient insulin is not available for glucose reabsorption.
answer
c
question
Which of the following are common early signs of a pituitary adenoma? 1. persistent headaches 2. hemianopia 3. hypertension 4. papilledema a. 1, 4 b. 2, 3 c. 1, 2 d. 1, 3, 4
answer
c
question
Which of the following does NOT apply to inappropriate ADH syndrome? a. The cause is excess ADH secretion. b. Severe hyponatremia results. c. Excessive sodium is retained. d. Fluid retention increases.
answer
c
question
What is/are the effect(s) of thyrotoxic crisis? a. hyperthermia and heart failure b. hypotension and hypoglycemia c. toxic goiter and hypometabolism d. decreased stress response
answer
a
question
What is the recommended treatment for insulin shock if the patient remains conscious? a. administration of insulin b. administration of intravenous glucose c. administration of epinephrine d. oral administration of concentrated glucose
answer
d
question
Which of the following conditions may precipitate or exacerbate hyperglycemia? a. hypothyroidism b. Cushing's disease c. Addison's disease d. growth hormone deficit
answer
b
question
Which of the following conditions may cause immunosuppression? a. Graves' disease b. acromegaly c. Cushing's disease d. diabetes insipidus
answer
c
question
Which characteristic of hyperosmolar hyperglycemic nonketotic coma (HHNK) differentiates it from diabetic ketoacidosis? a. Dehydration is less severe. b. Ketonuria is not present. c. It only develops in Type 1 diabetes mellitus. d. CNS depression develops.
answer
b
question
Which of the following is recommended for immediate treatment of hypoglycemic shock? 1. if conscious, immediately give sweet fruit juice, honey, candy, or sugar 2. if unconscious, give nothing by mouth (require intravenous glucose 50%) 3. treat immediately with insulin 4. give large quantity of clear fluids for shock a. 1, 2 b. 1, 3 c. 2, 3 d. 1, 3, 4
answer
a
question
All these tissues use glucose without the aid of insulin EXCEPT: a. liver b. digestive system c. exercising skeletal muscle d. brain
answer
a
question
Differences between Type I and Type II diabetes include: a. Type 1 diabetes weight gain is common, and Type II weight loss often occurs b. Type 1 diabetes leads to fewer complications than Type II diabetes c. Type 1 diabetes may be controlled by adjusting dietary intake and exercise, but Type II diabetes requires insulin replacement d. Type 1 diabetes occurs more frequently in children and adolescents, and Type II diabetes occurs more often in adults e. None of the above are correct.
answer
D
question
Complications of diabetes mellitus include: a. peripheral neuropathy b. frequent infections c. cataracts d. a, c e. a, b, c
answer
E
question
Which of the following often causes hyperparathyroidism? a. a malignant tumor in the parathyroid glands b. end-stage renal failure c. osteoporosis d. radiation involving the thyroid gland and neck area
answer
D
question
Dwarfism is caused by: a. excessive levels of somatotropin (GH) b. a deficit of somatotropin (GH) c. excessive levels of insulin d. excessive levels of parathyroid hormone
answer
B
question
Which of the following results from a deficit of antidiuretic hormone (ADH)? a. inappropriate ADH syndrome b. gigantism c. diabetes insipidus d. myxedema
answer
C
question
Goiters occur more frequently in persons living in the: a. Great Lakes or mountainous regions b. southwest USA c. temperate regions d. areas bordering the oceans
answer
A
question
Which of the following is caused by Graves' disease? a. increased metabolic rate b. decreased size of thyroid gland c. bradycardia and hypothermia d. decreased blood levels of T3, T4, and TSH e. increased epinephrine and norepinephrine
answer
A
question
Which diagnostic test is useful in determining if a pituitary dysfunction is causing a thyroid disorder? a. serum levels of thyroxine and triiodothyronine b. serum TSH levels c. uptake of radioactive iodine (T3 uptake test) d. presence of antibodies to T3 and T4
answer
B
question
Severe impairment of all aspects of growth and development, including difficulty feeding, mental retardation, and stunted skeletal growth are associated with: a. myxedema b. Cushing's syndrome c. diabetes insipidus d. cretinism e. Graves' disease
answer
D
question
A benign tumor of the adrenal medulla that secretes epinephrine and norepinephrine is called: a. pheochromocytoma b. Cushing's syndrome c. Graves' disease d. Addison's disease
answer
A
question
The anterior pituitary gland secretes all of the following hormones EXCEPT: a. prolactin (PRL) b. glucagon c. adrenocorticotropic hormone (ACTH) d. growth hormone (GH) e. antidiuretic hormone
answer
B
question
Which of the following applies to oxytocin? 1. It stimulates contraction of the uterus after delivery. 2. It stimulates ejection of breast milk during lactation. 3. It stimulates mammary gland production of milk. 4. It is released from the adenohypophysis. a. 1, 2 b. 1, 4 c. 1, 3, 4 d. 1, 2, 3, 4
answer
A
question
Which of the following is a major function of the hormone norepinephrine? a. inhibition of an excessive stress response b. visceral and cutaneous vasoconstriction c. increased force of heart contraction d. vasodilation in skeletal muscle
answer
B
question
Early signs of hyperglycemia include polyphagia, which means: a. thirst b. increased urine output c. hunger d. glucose in the urine
answer
c
question
Which of the following hormones is involved in both the stress response and the anti-inflammatory response? a. aldosterone b. norepinephrine c. thyroxine d. cortisol
answer
d
question
Polydipsia occurs with diabetes mellitus when: a. lack of insulin causes hunger b. ketone levels rise in the blood c. polyuria causes dehydration d. glucosuria causes ketoacidosis
answer
c
question
Trophic hormones include: a. insulin b. glucagon c. triiodothyronine d. adrenocorticotropic hormone
answer
d
question
Metabolic syndrome is marked by: a. abnormal lipid and glucose metabolism b. periodic hypotension c. deficit of glucagon d. early onset on Type I diabetes mellitus
answer
a
question
Compensation mechanisms occurring in the early stage of diabetic ketoacidosis include: a. Kussmaul's respirations b. polydipsia c. ketonuria d. seizures
answer
a
question
Which of the following may occur with a pituitary adenoma? a. low blood pressure and bradycardia b. headache and seizures c. vomiting and diarrhea d. loss of vision in one eye
answer
b
question
Which of the following may cause hypertension? a. hypoparathyroidism b. hypoglycemia c. pheochromocytoma d. Addison's disease
answer
c
question
Catabolic effects of Cushing's syndrome include: a. osteoporosis b. hypertension c. increased erythrocyte production d. moon face and buffalo hump
answer
a
question
Blood glucose levels are increased by: 1. glucocorticoids 2. glucagon 3. epinephrine 4. norepinephrine 5. parathormone a. 1, 2 b. 1, 2, 3 c. 2, 4, 5 d. 1, 3, 4, 5 e. all of the above
answer
b
question
Which of the following are likely present in a patient immobilized for a long period of time? a. hypocalcemia and low serum PTH levels b. hypocalcemia and high serum PTH levels c. hypercalcemia and low serum PTH levels d. hypercalcemia and high serum PTH levels
answer
c
question
Which of the following may cause high serum levels of parathyroid hormone? a. hypoparathyroidism b. chronic renal failure c. hypercalcemia d. adenoma in the thyroid gland
answer
b
question
Diabetic retinopathy results from: a. degeneration of large blood vessels supplying the eye b. abnormal metabolism in the lens of the eye c. neuropathy affecting the optic nerve d. obstruction or rupture of retinal blood vessels
answer
d
question
Why does hypocalcemia cause tetany? a. Skeletal muscle contractions are weaker. b. Nerves to skeletal muscle are more excitable. c. Calcium is not stored in skeletal muscle cells. d. Serum phosphate levels are low.
answer
b
