Patho Quiz 5 – Flashcards
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The initial reproductive structures of the male and female embryos appear the same until which week of gestation?
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eighth
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The absence of which major hormone is a determinant of sexual differentiation (wolffian system) in utero?
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testosterone
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Which gland produces the associated hormones that are found in high levels in a female fetus?
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Anterior pituitaryfollicle-stimulating hormone (FSH) and luteinizing hormone (LH).
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Which hormone is linked to an increase in appetite during puberty?
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Leptin
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The Skene glands are located on either side of which structure?
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urinary meatus
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What is the function of the mucus secreted by the Bartholin glands?
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Enhancement of the motility of sperm
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Which change is a result of puberty and defends the vagina from infection?
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Vaginal pH becomes more acidic.
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What happens to the vagina's lining at puberty?
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It becomes thicker.
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Which structure is lined with columnar epithelial cells?
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Endocervical canal
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Where is the usual site of fertilization of an ovum?
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Ampulla of the fallopian tubes
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Where is the usual site of cervical dysplasia or cancer in situ?
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Columnar epithelium of the cervix meets the squamous epithelium of the vagina.
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Having ejected a mature ovum, the ovarian follicle develops into a(n):
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Corpus Luteum
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The mucosal secretions of the cervix secrete which immunoglobulin?
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IgA
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The equivalent to the female gonad is the male:
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Testes
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A surge of which hormone causes the corpus luteum to produce progesterone?
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Luteinizing hormone
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What directly causes ovulation during the menstrual cycle?
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Sudden increase of LH
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Which anatomic structure secretes follicle stimulating hormone (FSH) and luteinizing hormone (LH)?
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Anterior pituitary
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During the time that ovulation occurs, which statement concerning basal body temperature is true?
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BBT fluctuates around 37° C (98° F).
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What structure in the male lies posterior to the urinary bladder?
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seminal vesicles
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When do penile erections begin?
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before birt
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Which statement is true regarding the major difference between male and female sex hormone production?
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In a man, sex hormone production is relatively constant.
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Where in the male body does spermatogenesis occur?
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seminiferous tubules
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Which immunoglobulin is contained in breast milk?
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IgA
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Which hormone promotes the development of the lobular ducts in the breast?
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Estrogen
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What causes the vasomotof flushes (hot flashes) that are associated with declining ovarian function with age?
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Rapid changes in estrogen levels
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When does the male body begin to produce sperm?
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at puberty
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The human zygote has a total of how many chromosomes?
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46
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Which hormone promotes the development of testosterone in both males and females?
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Prolactin
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Which hormone stimulates gonads to produce both male and female hormones?
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(LH) Luteinizing hormone
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Which hormone relaxes the myometrium and prevents lactation until the fetus is born?
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Progesterone
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A Sims-Huhner test is of particular interest to a patient experiencing which condition?
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Infertility
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In 95% of children of delayed puberty, the problem is caused by:
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physiologic hormonal delays
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What is the first sign of puberty in girls?
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breast enlargement
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Which type of precocious puberty causes the child to develop some secondary sex characteristics of the opposite sex?
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Mixed
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The release of which chemical mediator causes primary dysmenorrhea?
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Prostaglandins
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Considering the pathophsyiologic characteristics of primary amenorrhea, what anatomic structure is involved in compartment II?
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ovary
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Considering the pathophysiologic characteristics of primary amenorrhea, what anatomic structure is involved in compartment IV?
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hypothalamus
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Which condition is considered a clinical cause of amenorrhea?
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failure to ovulate
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Clinical manifestations that include irregular or heavy bleeding, the passage of large clotes, and the depletion of iron stores support which diagnoses?
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Dysfunctional uterine bleeding
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What statement concerning the pathogenetic mechanisms of polycystic ovarian syndrome is true?
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POS is a result of a combination of conditions that include oligo-ovulation or anovulation, elevated levels of androgens, or clinical signs of hyperandrogenism and polycystic ovaries.
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What is the leading cause of infertility in women?
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Polycystic ovary syndrome
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Considering the mediated factors of premenstral syndrome (PMS), which medication may be used either continually or only during the menstrual period as a treatment for the condition?
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SSRIs
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Which statement regarding pelvic inflammatory disease (PID) is true?
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Contracting this infection increases the risk for uterine cancer
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When a woman's uterus is assesssed as protruding through the entrance of the vagina to the hymen, which grade of prolapse does this indicate?
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2
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Which term is used to identify the descent of the posterior bladder and trigone into the vaginal canal?
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Cystocele
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What type of cyst develops when an ovarian follicle is stimulated by no dominant follicle developles and competes the maturity process?
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Benign ovarian
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Which term is used to identify benign uterine tumors that develop from smooth muscle cells in the myometrium and are commonly called uterine fibroids?
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Leiomyomas
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What theory is used to describe the cause of endometriosis?
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Endometrial tissue passes through the fallopian tubes and into the peritoneal cavity and reain responsive to hormones.
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Which virus is a precursor for developing cervical intraepithelial neoplasia (CIN) and cervical cancer?
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Humal Papillomavirus (HPV)
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Which description is used when a progressive neoplastic change involves the full epithelial thickness of the cervix?
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Cervial carcinoma in situ
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Which factor increases the risk for ovarian cancer after the age of 40 years?
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Use of fertility drugs
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Infertility is defined as the inability to conceive after how many months of unprotected intercourse with the same partner?
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12
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Which of the following is not considered a cause of galactorrhea?
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Proliferation of the lactiferous ducts of the breast.
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Fluid-filled squishy sacs characterize which breast disorder?
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Nonproliferative breast lesions
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What are typical findings on breast palpation of a woman diagnosed with simple fibroadenoma?
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smooth, solid, mobile, and well-circumscribed mass
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Which benign breast tumor affects postmenopausal woman and is characterized by the principal lactiferous ducts becoming dilated and filled with cellular debris?
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mammary duct ectasia
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The majority of the small percentage of ovarian cancers taht are associated iwth a known pattern of inheritance are associated with:
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Susceptibility of the BRCA1 gene
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What is usually the first clinical manifestation of breast cancer?
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painless lump
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In the 95% of those with delayed puberty, the problem is caused by which condition?
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physiologic hormonal delays
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What is the first sign of puberty in boys?
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Enlargement of the testes
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Which type of precocious puberty causes the child to develop some secondary sex characteristics of the opposite sex?
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mixed
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What term is used to identify a condition in which the foreskin cannot be retracted over the glans and penis?
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Phimosis
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What term is used to identify a fibrotic condition that causes lateral curvature of the penis during erection, which is associated with a local vasculitis-like inflammatory reaction and decreased tissue oxygenation?
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peyronie disease
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What term is used to identify an inflammation of the glans penis?
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Balanitis
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Cryptorchidism can be defined as which of the following?
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Testicular maldescent
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What is the most common infectious cause of orchitis and one that usually affects postpubertal boys?
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Mumps
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The risk of which cancer is greater if the man has a history of cryptorchidism?
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testicular
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What are the clinical manifestation of testicular cancer?
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firm, nontender testicular mass
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How does the epididymis become infected?
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the pathogenic microorganisms ascend the vasa deferentia from an already infected urethra or bladder
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Symptoms of benign prostatic hyperplasia (BPH) are a result of which pathophysiologic condition?
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Compression of the urethra
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Which infecito has clinical manifestations that include the sudden onset of malaise, low back pain, and perineal pain with high fever and chills, dysuria, nocturia, and urinary retention?
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bacterial prostatitis
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Priapism has been associated witht he abuse of what substance?
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Cocaine
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Which age group should be targeted for testicular cancer education and screening?
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15-35 year olds
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What is the reason breast cancer in men has such a poor prognoses?
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Treatment is usually delayed as a result of late detection
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What unique factor causes adolescent girls to have a high risk for sexually transmitted infections (STIs)?
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The adolescent cervix is immature and lacks immunity
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How is gonorrhea transmitted from a pregnant woman to her fetus?
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Predominately through infected cervical and secretions during the birth process
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Which statement is false about the factors that facilitate the ascent of gonococci into the uterus and fallopian tubes?
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Ascent of gonococci is facilitated because the vaginal pH decreases to 2 or 3.
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In women wha ti sthe usual site of original gonococcal infection?
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Endocervical canal
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What is the primary site for uncomplicated local conococci infections in men?
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Urethra
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What local complication of a gonococcal infection is diagnosed in approximately 10% of affected women?
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Acute salpingitis
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Which laboratory test is considered adequate for an accurate and reliable diganoses of gonococcal urethritis in a symptomatic man?
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Gram-stain technique
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How does na established gonococcal infection usually express itself in newborns?
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bilateral corneal ulceration
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What is the major concern regarding the treatment of gonococci infections?
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development of antibiotic resistance
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Which sexually transmitted infection frequently coexists with gonorrhea?
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Chlamydia
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During which stage of syphilis do bloodborne bacteria spread to all the major organ systems?
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secondary
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In which stage of syphilis would the following clinical manifestations be found: destructive skin, bone and soft tissue lesions, aneurysms, heart failure, and neurosyphilis?
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Tertiary
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Which organism is responsible for the development of syphilis?
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Treponemia pallidum
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Which is a characteristic lesion of secondary syphilis?
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condylomata lata
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By which method is the organism that causes syphilis best identified?
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darkfield microscopy
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When a patient has small, vesicular lesions that last between 10-20 days, which sexually transmitted infection is suspected?
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Genital herpes
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Which statement is false regarding the risk of transmission of the herpes simplex virus (HSV) from mother to fetus?
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Neonatal infection of HSV rarely occurs in the intrapartum or postpartum period.
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during the latent period of a herpes virus infection, where in the host cell is the genome of the virus maintained?
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nucleus
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During reactivation (release from latency), herpes virus genomes are transported through which nerves to the dermal surface?
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Peripheral sensory
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Which statement provides the most accurate information regarding the transmission fo herpes simplex virus (HSV)?
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The risk of transmission is present even during latent periods.
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Which drug may be prescribed orally for outbreak managmeent of herpes simplex viral (HSV) infections?
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Acyclovir (Zovirax)
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Which of the following cuases condylomata acuminata or genital warts?
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Human Papillomavirus (HPV)
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Which treatment is used for trichomoniasis?
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topical application of 5-Fluorouracil (5-FU)
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A woman diagnosed with trichomoniasis asks if her sexual partner should be treated as well. What is the appropriate response?
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Sexual partners should be treated even if they are asymptomatic
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Which microorganism is sexually transmitted, primarily by homosexual men, through infected feces?
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Shigellosis
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Which hepatitis virus is known to be sexually transmitted?
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B
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Which sexually transmitted disease occasionally causes clinical manifestations of scant intermittent penile discharge, slight pruritus, and mild dysuria?
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Trichomoniasis
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What is the most abudnant class of plasma protein?
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albumin
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What is the effect of low plasma albumin?
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Osmotic pressure decreases, thus water moves from the capillaries to the intersitium.
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What is the life span of an erythrocyte (in days)?
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100-120
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Which statement concerning erythrocytes is true?
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Erythrocytes have the ability to change shape to squeeze through microcirculation.
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Granulocytes that contain granules of vasoactive amines, such as histamine, are called:
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Eosinophils
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Which of the following are formed elements of the blood that are not cells but are disk-shaped cytoplasmic fragments essential for blood clotting?
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platelets
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Blood cells that differentiate into macrophages are known as:
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Monocytes
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Without prior exposure to an antigen, which cells are able to destroy some types of tumor cells and some virus-infected cells?
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NK-Natural killer cells
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What is the life span of platelets (in days)?
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10
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Fetal hematopoeisis occurs in which structure?
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spleen
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What is the consequence of a splenectomy?
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the number of defective cells in the circulation increases
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During an infection, why do lymph nodes enlarge and become tender?
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The B lymphocites proliferate
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Which blood cells are the chief phagocytes involved in the early inflammation process?
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neutrophils
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Which blood cells are biconcave in shape and have the capacity to be reversibly deformed?
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Erythrocytes
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Which hemoglobin is made from oxidized ferric iron (Fe3+) and lacks the ability to bind to oxygen?
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methemoglobin
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The absence of parietal cells would prevent the absorption of an essential nutrient necessary to prevent which type of anemia?
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pernicious anemia
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Which nutrients are necessary for the synthesis of DNA and the maturation of erythrocytes?
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Cobalamin (Vit B12) and folate
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Which nutrients are necessary for hemoglobin synthesis?
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Iron and Vit B6 (pyridoxine)
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Recycling of iron from erythrocytes is made possible by which of the following?
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transferrin
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By which structure are mature erythrocytes removed from the bloodstream?
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Spleen
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Which substance is used to correct the chronic anemia associated with chronic renal failure?
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erythropoietin
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What is the role of thromboxane A (TXA2) in the secretion stage of hemotasis?
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stimulates platelet aggregation
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Which of the following is the role of nitric oxide (NO) in hemostasis?
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Controls platelet activation through cyclic adenosine monophosphate (cAMP)-mediated signaling.
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The drug heperin acts in hemostatis by which process?
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inhibiting thrombin and antithrombin III (AT-III)
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What is plasmin's role in the clotting process?
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degrades the fibrin within blood clots
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What does polycythemia at birth indicate?
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hypoxia in utero
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Where are Kupffer cells located?
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liver
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Where are Langerhans cells found?
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skin
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What is the role of collagen in the clotting process?
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activates platelets
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Which form of iron (Fe) can be used in the formation of normal hemoglobin?
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Fe2+
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Where are alveolar macrophages found?
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lungs
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What changes to the hemotologic system is related to age?
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lymphocyte function decreases
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What is the function of erythrocytes?
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tissue oxygenation
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What term is used to describe the capacity of some erythrocytes to vary in size, especially in relationship to some anemias?
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anisocytosis
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What is the fundamental physiologic manifestation of anemia?
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Hypoxia
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The paresthesia that occurs in Vitamin B12 deficiency anemia is a result of which of the following?
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Myelin degeneration in the spinal cord.
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Which of the following describes how the body compensates for anemia?
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increasing rate and depth of breathing
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Which of the following is classified as a megaloblastic anemia?
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pernicious
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Deficiencies in folate and vitamin B12 alter the synthesis of which of the following?
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DNA
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The underlying disorder of which anemia is a result of the defective secretion of the intrinsic factor, which is essential for the absorption of vitamin B 12?
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Pernicious
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After a person has a subtotal gastrectomy for chronic gastritis, which type of anemia will result?
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pernicious
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What causes the atrophy of gastric mucosal cells that result in pernicious anemia?
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Vitamin B12 malabsorption
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Which statement best describes a Schilling test?
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Administration of radioactive cobalamin and the measurement of its excretion in the urine to test for vitamin B 12 deficiency.
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What is the treatment of choice for pernicious anemia (PA)?
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Vitamin B12 by injection
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Which condition resulting from untreated pernicious anemia (PA) is fatal?
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Heart failure
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How is the effectiveness of vitamin B12 therapy measured?
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reticulocyte count
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Which statement about folic acid is FALSE?
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folic acid absorption is dependent on the enzyme folacin
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Which anemia produces small, pale erythrocytes?
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iron deficiency
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Which type of anemia is characterized by fatigue, weakness, and dyspnea, as well as conjunctiva of the eyes and brittle, concave nails?
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iron deficiency
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What is the most common cause of iron deficiency anemia (IDA)?
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chronic blood loss
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Continued therapy of pernicious anemia (PA) generally lasts how long?
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the rest of one's life
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Sideroblastic anemia can occasionally result from an autosomal recessive transmission inherited from which relative?
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mother
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Clinical manifestations of mild-to-moderate splenomegaly and hepatomegaly, bronze-colored skin, and cardiac dysrhythmias are indicative of which anemia?
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sideroblastic
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Considering sideroblastic anemia, what would be the expected effect on the plasma iron levels?
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plasma iron levels would be high
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In aplastic anemia (AA), pancytopenia develops as a result of which of the following?
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suppression of the bone marrow to produce adequate amounts of erythrocytes, leukocytes, and thrombocytes.
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What is the most common pathophysiologic process that triggers aplastic anemia (AA)?
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Autoimmune disease against hematopoiesis by activated cytotoxic T (Tc) cells
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An allogenic bone marrow transplantation remains the preferred method for treating which anemia?
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aplastic
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Which statement is true regarding warm autoimmune hemolytic anemia?
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Erythrocytes are bound to macrophages and sequestered in the spleen.
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When considering hemolytic anemia, which statement is TRUE regarding the occurrence of jaundice?
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Heme destruction exceeds the liver's ability to conjugate and excrete bilirubin
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Erythrocyte life span of less than 120 days, ineffective bone marrow response to erythropoietin, and altered iron metabolism describe the pathophysiologic characteristics of which type of anemia?
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anemia of chronic disease
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What is the primary cause of the symptoms of polycythemia vera?
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increased blood viscosity
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Treatment for polycythemia vera involves which of the following?
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therapeutic phlebotomy and radioactive phosphorus
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Considering iron replacement therapy prescribed for iron deficiency anemia, who is likely to require long-term daily maintenance dosage?
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a woman who has not yet experience menopause
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Which statement is TRUE regarding the physical manifestations of vitamin B12 deficiency anemia?
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symptoms are a result of demyelination
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What change is observed in leukocytes during an allergic disorder (Type 1 hypersensitivity) often caused by asthma, hay fever, and drug reactions?
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eosinophilia
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In infectious mononucleosis (IM), what does the Monospot test detect?
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Immunoglobulin M (IgM)
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Which description is consistent with acute lymphocytic leukemia (ALL)
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ALL is a progressive neoplasm defined by the presence of greater than 30% lymphoblasts in the bone marrow or blood.
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Which description is consistent with chronic myelogenous leukemia (CML)?
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The translocation of genetic material from genes 9 and 22 creates abnormal, fused protein identified as BCR-ABL1.
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Which description is consistent with chronic lymphocytic leukemia (CLL)?
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B cells fail to mature into plasma cells that synthesize immunoglobulins.
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Which electrolyte imbalance accompanies multiple myeloma (MM)?
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hypercalcemia
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Reed-sternberg (RS) cells represent malignant transformation and proliferation of which of the following?
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B cells
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Local signs and symptoms of Hodgkin disease-related lymphadenopathy are a result of which of the following?
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pressure and obstruction
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Which virus is associated with Burkitt Lymphoma in African children?
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Epstein-Barr virus
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Which term is used to describe a red-purple discoloration caused by diffuse hemorrhage into the skin tissue?
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pupura
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Which statement best describes heparin-induced thrombocytopenia (HIT)?
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Immunoglobulin G immune-mediated adverse drug reaction that reduces circulating platelets.
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Immune Thrombocytopenia (ITP) is a _______ condition in adults and an _________ condition in children.
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chronic; acute
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Vitamin ______ is required for normal clotting factor synthesis by the _______.
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K; liver
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What is the most common cause of vitamin K deficiency?
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TPN with antibiotic therapy.
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Which disorder is described as an unregulated release of thrombin with subsequent fibrin formation and accelerated fibrinolysis?
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Disseminated intravascular coagulation (DIC)
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In disseminated intravascular coagulation (DIC), What activates the coagulation cascade?
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TF (tissue factor) located in the endothelial layer of blood vessels and subcutaneous tissue
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Which proinflammatory cytokines are responsible for the development and maintenance of disseminated intravascular coagulation (DIC)?
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Tumor necrosis factor-alpha; IL-1, IL-6, and IL-8; and platelet-activating factor (PAF).
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In disseminated intravascular coagulation (DIC), what are the indicated of microvascular thrombosis?
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symmetric cyanosis of fingers and toes
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What is the most reliable and specific test for diagnosing disseminated intravascular coagulation?
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D-dimer
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What term is used to identify thrombi that occludes arterioles and capillaries and are made up of platelets with minimal fibrin and erythrocytes?
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TTP - Throbotic thrombocytopenic purpura
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Which of the following is characterized by what is referred to as "pathognomonic pentad" of symptoms?
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Acute idiopathic thrombotic thrombocytopenic purpura
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Which statement relates to immune thrombocytopenic purpura (ITP)?
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mononuclear phagocytes in the spleen remove antibody-coated platelets from circulation.
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When the demand for mature neutrophils exceeds the supply, immature neutrophils are released indicating:
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a shift to the left.
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Hodgkin disease is characterized by the presence of which of the following?
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reed-sternberg (RS) cells
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What is the cause of polycythemia in the fetus?
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increased erythropoiesis occurs in response to the hypoxic intrauterine environment.
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Why does fetal hemoglobin have a greater affinity for oxygen than adult hemoglobin?
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fetal hemoglobin interacts less readily with DPG (diphosphoglycerate), which inhibits hemoglobin-oxygen binding.
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Which blood cell type is elevated at birth but decreases to adult levels during the first year of life?
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monocytes
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In a full-term infant, the normal erythrocyte life span is _____ days, whereas the adult erythrocyte life span is ______ days.
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60-80; 120
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What is the most common cause of insufficient erythropoiesis in children?
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Iron deficiency
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How does hemolytic disease of the newborn (HDN) cause acquired congenital hemolytic anemia?
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HDN is an alloimmune disease in which the mother's immune system produces antibodies against fetal erythrocytes, which are recognized as foreign and removed from circulation.
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Erythroblastosis fetalis is defined as an:
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alloimmune disease in which maternal blood and fetal blood are antigenically incompatible
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An infant's hemoglobin must fall below ____ g/dl before signs of pallor, tachycardia, and systolic murmurs occur.
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5
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Which vitamin improves the absorption of oral iron taken to treat iron deficiency anemia in children?
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C
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Hemolytic disease of the newborn (HDN) can occur if the mother:
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Is Rh-negative and the fetus is Rh-positive.
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When diagnosed with hymolytic disease of the newborn (HDN), why does the newborn develop hyperbilirubinemia after birth but not in utero?
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excretion of unconjugated bilirubin through the placenta into the mother's circulation is no longer possible.
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fetuses who do not survive anemia in utero are usually still born with gross edema of the entire body. Which term is used to identify this condition?
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hydrops fetalis
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What is the name of the disorder in which levels of bilirubin remain excessively high in the newborn and are deposited in to the brain?
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kernicterus
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What treatment prevents the development of kernicterus in an infant born with hemolytic disease of the newborn (HDN)?
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replacement trasfusion of new Rh-positive blood that is not contaminated with anti-Rh antibodies
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Glucose 6-phosphate dehydrogenase (G6PD) deficiency is what type of inherited disorder?
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x-linked recessive
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Sickle cell disease is classified as a:
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disorder initiated by hypoxemia and acidosis
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Hemoglobin S (HbS) is formed in sickle cell disease as a result of which process?
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genetic mutation in which one amino acid (valine) is replaced by another (glutamic acid)
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Sickle Cell disease (SCD) is waht type of inherited disorder?
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autosomal recessive
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What is the reason most children diagnosed with sickle cell anemia are not candidates for either bone marrow or stem cell transplants?
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well-matched stem cell donors are difficult to find
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Which manifestations of vasoocclusive crisis are associated with sickle cell disease (SCD) in infants?
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Edema of the hands and feet
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What is the chance with each pregnancy that a child born to two parents with sickle trait will have sickle cell disease (SCD)?
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25%
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Which type of anemia occurs as a result of thalassemia?
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microcytic, hypochromic
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What is the fundamental defect that results in beta-thalssemia major?
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A severe uncoupling of alpha and beta-chain synthesis occurs
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The alpha and beta-thalassemias are considered what types of inherited disorder?
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autosomal recessive
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Hemophilia B is caused by a deficiency of which clotting factor?
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IX
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Hemophilia A is considered to be what type of inherited disorder?
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x-linked recessive
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Which disease is an autosomal dominant inherited hemorrhagic disease?
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Von Willebrand disease
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Idiopathic thrombocytopenic purpura (ITP) is an autoimmune process involving antibodies attacking which type of cells?
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platelets
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which disorder results in decreased erythrocytes and platelets with changes in leukocytes and has clinical manifestations of pallor, fatigue, petechiae, purpura, bleeding, and fever?
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Acute lymphocytic leukemia (ALL)
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When does fetal erythrocyte production shift from the liver to the bone marrow?
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fifth month of gestation
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Which disease is caused by clotting factor VIII deficiency and an autosomal dominant trait?
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Von Willebrand Disease
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Which type of hemophilia affects only men?
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hemophilia A
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which hemophilia occurs equally in both men and women?
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Hemophilia C
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During childhood, when is dietary iron deficiency commonly diagnosed?
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between 6 months and 2 years.
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What is the significance of hyperdiploidy when diagnosing and treating leukemia?
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hyperdiploidy indicates a good prognosis
