Final Exam- Requires Respondus LockDown Browser
Question 1
True/False:
Metaplastic cells are not better prepared to survive under stressful circumstances.
True
False
Answer: False
Question 2
True/False:
Hypertrophy can occur under normal and pathological conditions.
True
False
Answer: True
Question 3
Multiple Choice
Which are true of the mitochondria? Select all that apply.
It is involved in cellular respiration
They are found far from the site of energy consumption
They play a role in apoptosis
They control free radicals
Answer: It is involved in cellular respiration
They play a role in apoptosis
Question 4
Which are true of the cell membrane? Select all that apply.
Controls the transport of materials from the outside fluids to within
The main structural component is made of proteins
Helps with the conduction of electrical currents in nerve and muscle cells
Aids in the regulation of cell growth and proliferation
Answer: Controls the transport of materials from the outside fluids to within
Helps with the conduction of electrical currents in nerve and muscle cells
Aids in the regulation of cell growth and proliferation
Question 5
Compare and contrast the two types of gangrenous necrosis.
Your Answer:
Dry gangrene occurs when blood supply is slowly reduced to an area. The area is dehydrated
and becomes dark or black in color. Commonly seen in patients with diabetes. It is not very
painful, but tissues eventually die.
Wet gangrene is casued with a sudden reduction in blood flow. The area is cold and swollen,
with no pulse. This can occur from trauma. Bacteria is involved and is very painful. It has the
appearance of pus, becasue it looks wet. There is also a foul smell.
In dry gangrene the affected tissue becomes dry and shrinks, the skin wrinkles, and its color
changes to dark brown or black. The spread of dry gangrene is slow. It results from a cut off
in arterial blood supply and is a form of coagulation necrosis. In wet gangrene, the affected
area is cold, swollen, and pulseless. The skin is moist, black, and under tension. Blebs form
on the surface, liquefaction occurs, and a foul odor is caused by bacterial action. The spread
of tissue damage is rapid.
Question 6
True/False:
Cell proliferation is the process in which proliferating cells become more specialized cell
types.
True
False
Answer: False
False, cell differentiation
Question 7
True/False:
Cell differentiation is the process of increasing cell numbers by mitotic cell division.
True
False
Answer: False
False, cell proliferation
Question 8
What are two important properties that stem cells possess?
Your Answer: Stem cells possess potency and self-renewal.
Potency and self-renewal
Question 9
These are cells of the same lineage that have not yet differentiated to the extent that they have
lost their ability to divide:
Your Answer: progenitor or parent cells
progenitor or parent cells
Question 10
1. ______ is a systemic treatment that enables drugs to reach the site of the tumor as well as
other distant sites.
2. The profound weight loss and wasting of fat and tissue that accompany cancer is known as
_______.
Your Answer:
1. chemotherapy
2. cancer anorexia-cachexia syndrome
1. chemotherapy
2. cancer anorexia-cachexia syndrome
Question 11
Short answer
Explain the challenges of diagnosing autoimmune disorders.
Your Answer:
There are about 80 autoimmune disorders identified, with many overlapping presentations.
Blood tests can be more generic and results are imprecise. Markers can be elevated in the
Prescence of other diseases.
There are over 80 identified, many with overlapping presentations. Many manifestations are
nonspecific and are seen in other non-autoimmune diseases. Blood testing isn’t perfect either,
as some tests are more generic and can be elevated in the presence of other diseases.
Question 12
True/False:
The T cells that display the host’s MHC antigens and T-cell receptors for a nonself-antigen
are allowed to mature, a process termed negative selection.
True
False
Answer: False
Question 13
Multiple Choice:
Which lab value will typically be increased in a viral infection?
Neutrophils
Eosinophils
Basophils
Lymphocytes
Answer: Lymphocytes
Question 14
A 9-year-old boy with a peanut allergy was exposed to peanuts. He presents to the emergency
room with an anaphylactic reaction. (1) What symptoms might he present with? (2) Does the
quantity of exposure mean he will have a more severe reaction? (3) What is the initial
immediate treatment? (4) What are 2 things people with anaphylaxis should always carry?
Your Answer:
1) Shortness of breath, skin redness/hives, GI discomfort such as cramping, nausea.
2) Does not play a role
3) epinephrine
4) identification of the allergy and EpiPen
(1) Any of the following reactions are accepted.
Grade I: erythema and urticaria, with or without angioedema.
Grade II: hypotension, tachycardia, dyspnea, and GI manifestations, like nausea, vomiting,
diarrhea, and abdominal cramping from mucosal edema.
Grade III: bronchospasm, cardiac dysrhythmias, and cardiac collapse.
Grade IV: cardiac arrest
(2) No
(3) Epinephrine
(4) identification about allergy, EpiPen
Question 15
Multiple Choice:
A 23-year-old African-American man with a history of severe lifelong anemia requiring many
transfusions has nonhealing leg ulcers and recurrent periods of abdominal and chest pain.
These signs and symptoms are most likely to be associated with which one of the following
laboratory abnormalities?
Sickle cells on peripheral blood smear
Loss of intrinsic factor You Answered
Decreased erythropoietin
Decreased ferritin
Your Answer: Decreased erythropoietin
Answer: Decreased erythropoietin
Question 16
Multiple Choice:
Which of the following is NOT true of vitamin B12 deficiency anemia?
Dietary deficiencies are not common
Peripheral neuropathy can be a result of deficiency
Vitamin B12 is bound to intrinsic factor
MCV is decreased
Answer: MCV is decreased
Question 17
Multiple Choice:
Each of the following are risk factors for secondary hyperlipidemia except?
Obesity
Diabetes mellitus
High cholesterol diet
Autosomal dominant disorder of LDL receptor
Answer: Autosomal dominant disorder of LDL receptor
Question 18
Multiple Choice:
Risk factors for coronary heart disease include each of the following except:
HDL > 60
Smoking
Hypertension
Family history of heart disease
Answer: HDL > 60
Question 19
Patient is found to have the above:
1. What risk factors mostly led to this disease state?
2. What is this person at risk for developing?
3. What lifestyle modifications would you suggest for them?
Your Answer:
1) Smoking, poor diet, hyperlipidemia, obesity, diabetes, increased age
2) Coronary artery disease, myocardial infarction
3) Stop smoking, healthy diet, lose weight/exercise, take medications
Answer: Picture is of an atherosclerotic plaque
1. Hyperlipidemia, cigarette smoking, obesity and visceral fat, hypertension, diabetes
mellitus. Increasing age, family history of premature CHD, and male sex. May also include
C-reactive protein (CRP) and serum lipoprotein(a).
2. Coronary artery disease, angina, myocardial infarction, aneurysm, stroke (ischemia,
thrombosis, emboli).
3. Stop smoking, lose weight/exercise, healthy diet (low-fat, low-cholesterol), adhere to
medication for blood pressure, hyperlipidemia, and/or diabetes.
Question 20
_____ is the transfer of gases between the alveoli and the pulmonary capillaries.
Your Answer:
diffusion
Diffusion
Question 21
Multiple Choice:
Each of the following can lead to atelectasis except:
Pleural effusion
Tumor mass
Thrombus
Mucous plug
Answer: Thrombus
Question 22
Short answer:
A 10-year-old boy who is having an acute asthma attack is brought to the ER. He is observed
to be sitting up and struggling to breathe. His breathing is accompanied by use of accessory
muscles, a weak cough, and audible wheezing sounds. His pulse is rapid and weak, and both
heart and breath sounds are distant on auscultation. His parents relate that his asthma began to
worsen after he developed a “cold,” and now he doesn’t get relief from his albuterol inhaler.
Explain the changes in physiologic function underlying his signs and symptoms.
Your Answer:
In asthma patients, airways begin to narrow. A trigger, such as a cold virus, can start a
cascade of inflammatory cells to cause epithelial injury, resulting in airway inflammation.
With severe airway inflammation, patient is experiencing remodeling, which is development
of specific structural changes in the airway wall.
Recruitment of inflammatory cells from the bloodstream into the bronchial wall, where they
directly attack the invading organisms and secrete inflammatory chemicals that are toxic to
the organisms causes airway inflammation. Swelling of the bronchial wall, mucus secretion,
constriction of the airway; bronchial hyper-responsiveness to stimuli causes airway
obstruction or narrowing. They may discuss on a cellular level as well:
Upon a trigger, the cascade of neutrophils, eosinophils, lymphocytes, and mast cells cause
epithelial injury. This causes airway inflammation, which further increases
hyperresponsiveness and decreased airflow. Mast cells release histamine and leukotrienes.
These cause major bronchoconstriction, inflammation, and mucus secretion. Mast cells can
trigger multiple cytokine release, which causes more airway inflammation. The contraction of
the airways and subsequent swelling leads to further airway obstruction.
Question 23
T/F – Make true if False
Oligodendrocytes produce myelin in the PNS.
Your Answer: False
Answer: False, oligodendrocytes produce myelin in the CNS.
Question 24
T/F – Make true if False
Someone in the early stages of Alzheimer’s disease requires assistance for their activities of
daily living.
Your Answer: False
Answer: False, in the early stages of Alzheimer’s disease, individuals are still independent
with their ADLs.
Question 25
Long Answer Essay
A 75-year-old male is brought to the emergency department via ambulance at 5 pm. The
patient’s spouse reports that when they woke up (approximately at 6 am) he reported to her
that he was having some blurred vision but decided to go about his day. As the day
progressed, he started experiencing tingling and feelings of weakness on the entire left side of
his body. He has a past medical history of diabetes. Based upon these symptoms and past
medical history, what do you suspect this patient is experiencing? How would you confirm
this diagnosis? What treatment should be administered? Explain why you chose that
treatment.
Your Answer:
Patient was more than likely experiencing an ischemic stroke. A CT scan and MRI will be
ordered to determine if a blood clot was blocking blood flow and to rule out hemorrhagic
stroke. If a clot is located and the patient is outside the 4 hour treatment window, a catheter
based method to break the clot would be needed.
Answer: This patient is more than likely experiencing an ischemic stroke. A CT scan and
MRI would be needed to determine if a clot was blocking blood flow to the brain tissue and
to rule out a hemorrhagic stroke. If a clot is found, this patient would need to be reperfused
through catheter-base methods as they are outside of the 3-4.5 treatment window for the use
of tPA drugs.
Question 26
Multiple Choice:
Risk factors for gallstone formation include each of the following EXCEPT:
Obesity
Male gender
Age (40’s)
Pregnancy
Your Answer: Pregnancy
Answer: Male gender
Question 27
Multiple Choice
Risk factors for the development of peptic ulcer include each of the following EXCEPT:
pylori infection
Family history of PUD
NSAID use
Alcohol use
Stress
Answer: Stress
Question 28
Short answer
What are rhythmic movements designed to propel the chyme along the small intestine toward
the large intestine?
Your Answer: peristalsis
Answer: Peristaltic movements
Question 29
True/False:
Anti-diarrheal medication can be used with all types of diarrhea.
True
False
Answer: False
Question 30
Which of the following is characteristic of chronic transplant rejection?
Involves humoral immunity
It responds well to immunosuppressive therapy
Involves increased T lymphocytes
Answer: Involves humoral immunity
Question 31
A patient is said to be in stage 2 kidney disease. What would you expect their GFR to be?
A. 97 mL/min/1.73m2
B. 42 mL/min/1.73m2
C. 70 mL/min/1.73m2
D. 14 mL/min/1.73m2
Answer: B. 42 mL/min/1.73m2
Question 32 5 / 5 pts
Short Answer:
Explain how the kidney can maintain a constant GFR despite variations in the arterial blood
pressure of the rest of the body.
Your Answer:
There are 3 mechanisms that regulate remal blood flow and regulate the GFR:
1) renal autoregulation
2) nervous system control
3) hormonal control
Answer: The renal autoregulatory system causes the efferent arteriole to constrict leading to
an increased resistance to outflow from the glomeruli with a subsequent increase in
glomerular pressure and the GFR. When the afferent arteriole constricts there is a reduction in
renal blood flow, glomerular pressure, and the GFR.
Question 33
A patient presents in the emergency department with severe dehydration secondary to
vomiting. The following are the results of their blood work: pH = 8.2, PCO2 = 39 mm, and
HCO3- = 33 mEq/L. Based upon these results, what type of acid-base disorder are they
experiencing? Is compensation occurring? Describe a treatment intervention for this disorder.
Normal values are as follows: pH = 7.35-7.45, PCO2 = 35-45 mm, HCO3- = 22-26 mEq/L.
Your Answer:
Metabolic alkalosis. There is no respiratory compensation because the PCO2 levels fall within
normal range. Treatment is fluid replacement with normal saline solution.
Answer: The patient is in metabolic alkalosis. The respiratory system is not compensating as
PCO2 compensation falls within normal limits. Fluids are replaced with normal saline
solution.
Question 34
Multiple Choice:
Signs and symptoms of Addison’s disease include each of the following EXCEPT:
Hyperpigmentation
Weight loss
Muscle weakness
Hyperglycemia
Answer: Hyperglycemia
Question 35
An endocrine hormone is released into circulation to act on a target organ.
True
False
Answer: True
Question 36
Hormones work through receptors, and the speed of this action varies.
True
False
Answer: True
Question 37
A 45-year-old woman presents with fatigue, weight gain, and cold intolerance. Lab findings
show a low serum T4 and elevated TSH.
1. What diagnosis would her history and lab findings indicate?
2. What type of treatment should be given?
Your Answer: 1) Hypothyroidism
2) Synthetic T4 thyroid hormone called thyroxine is used to treat hypothyroidism
Answer: (1) Hypothyroidism; (2) synthetic T4 thyroid hormone, thyroxine
Question 38
Symptoms of diabetic ketoacidosis (DKA) include each of the following EXCEPT:
Polydipsia
Dehydration
Fruity smell on the breath
Bradycardia
Answer: Bradycardia
Question 39
Multiple Choice:
Which of the following would a patient likely report if you suspect they have OA?
Pain in their MCP joint
Stiffness in the morning that resolves in less than 30 minutes
Pain that would be described as “acute”
They feel “looser” after they move around
Answer: Stiffness in the morning that resolves in less than 30 minutes
Question 40
Blood circulates through bone by what means? (mark all that apply)
Via the central Haversian and Volkmann canals
An anastomosis between perforating and nutrient arteries
Diffusion through the endosteal surface of the bone and the canaliculi
Answer: Via the central Haversian and Volkmann canals
An anastomosis between perforating and nutrient arteries
Diffusion through the endosteal surface of the bone and the canaliculi
Question 41
If someone loses their balance when walking on uneven terrain, explain how tendons and
ligaments work to protect the joint and structures within it.
Your Answer:
Tendons and ligaments are in proprioception, menaing have awareness of one's position in
space or movement of the body. When they undergo stretch, like walking on uneven terrian,
the proprioception nerve fibers cause a reflex response to adjust the tension in the muscle.
This will allow the body to maintain balance. The molecualr structure of tensons and
ligamants are of a collagen that contributes to high tensile strength.
The tendons and ligaments of joints serve in proprioception (the awareness of ones’ position
in space or movement of the body). When these structures undergo stretch or torsional strain,
these proprioceptive nerve fibers will cause a reflexive response to adjust the tension on the
muscles (to maintain balance and not fall over) that support the joint protecting the capsule
and other joint structures.
Question 42
A 72-year-old male is said to be in phase 3 of gout. He is obese and has a history of alcohol
abuse. Develop a treatment plan including specific pharmacologic intervention and a
nonpharmacologic recommendation to manage his disease.
Your Answer: Phase three gout is called inter-critical phase. The goal is to prevent future
attaks by maintaining normal uric acid levels, hense prevent disease progression. Allopurinol
is used to reduce uric acid levels. Lifestyle changes, such asweight loss, reduction in alcohol
consumption, and avoid foods high in purines (fish, bacon, shellfish).
Phase 3 of gout is called inter-critical gout. The patient is asymptomatic, and no joint
abnormalities are present. The goal of treatment in this phase is to maintain normal uric acid
levels and prevent progression of the disease. Allopurinol is a prescription drug that is used to
reduce uric acid levels. This patient should be encouraged to lose weight and decrease his
alcohol consumption. He should also avoid purine rich foods such as fish, bacon, and liver.
(*Note – the student has to provide 1 pharmacologic intervention and 1 non-pharmacologic
recommendation.)
