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NUR 631 Comprehensive Exam 1 2024
Removal of part of the liver leads to the remaining liver cells undergoing compensatory - Compensatory hyperplasia is an adaptive mechanism that enables certain organs to regenerate. For example, the removal of part of the liver leads to hyperplasia of the remaining liver cells (hepatocytes) to compensate for the loss. Which of the following statements best describes Raynaud disease? a. An inflammatory disorder of small and medium-size arteries in the feet and sometimes in the hands b. A neoplastic disorder of the lining of the arteries and veins of the upper extremities c. A vasospastic disorder of the small arteries and arterioles of the fingers, and less commonly, the toes d. An autoimmune disorder of the large arteries and veins of the upper and lower extremities - c. A vasospastic disorder of the small arteries and arterioles of the fingers, and less commonly, the toes A patient is diagnosed with pulmonary disease and elevated pulmonary vascular resistance. Which of the following heart failures may result from this condition? a. Right heart failure b. Left heart failure c. Low-output failure d. High-output failure - a. Right heart failure Exp: Right heart failure is defined as the inability of the right ventricle to provide adequate blood flow into the pulmonary circulation at a normal central venous pressure. It most often results from the left heart failure when the increase in left ventricular filling pressure that is reflected back into the pulmonary circulation is severe enough. As pressure in the pulmonary circulation rises, the resistance to right ventricular emptying increases. What physical sign is the result of turbulent blood flow through a vessel? a. Increased blood pressure during periods of stress b. Bounding pulse felt on palpation c. Cyanosis observed on excretion d. Murmur heard on auscultation - d. Murmur heard on auscultation Exp: Where flow is obstructed the vessel turns or blood flows over rough surfaces. The flow becomes turbulent with whorls or eddy currents that produce noise causing a murmur to be heard on auscultation such as occurs during blood pressure measurement with a sphygomanometer. This selection is the only option that accurately identifies the physical sign of turbulent vascular blood flow. pg 1113 Which congenital heart defects occur in trisomy 13, trisomy 18 and down syndrome? a. Coarctation of the aorta and pulmonary stenosis b. Tetralogy of Fallot and persistent truncus arteriosus c. Atrial septal defect and dextrocardia d. Ventricular septal defect and patent ductus arteriosus - d. Ventricular septal defect and patent ductus arteriosus
Exp: Congenital heart defects that are related to dysfunction of trisomy 13, trisomy 18 and down syndrome include VSD and PDA see Table 33-2 The other defects are not associated with dysfunction of trisomy 13 or 17 and down syndrome. pg 1200 An infant has a continuous machine/type murmur best heard at the left upper sternal border throughout systole and diastole as well as a bounding pulse and a thrill on palpation. These clinical findings are consistent with which congenital heart defect? a. Atrial septal defect b. Ventricular septal defect c. Patent ductus arteriosus d. Atrioventricular canal defect - c. Patent ductus arteriosus Exp: If pulmonary vascular resistance has fallen then infants with will characteristically have a continuous machine/type murmur best heard at the left upper sternal border throughout systole and diastole. If the PDA is significant then the infant also will have bounding pulses an active precordium, a thrill on palpation and signs and symptoms of pulmonary over circulation. The presentations of the other congenital heart defects are not consistent with the described the symptoms pages 1203- 1204 Which compensatory mechanism is spontaneously used by children diagnosed with tetralogy of Fallot to relieve hypoxic spells? a. Lying on their left side b. Performing the valsalva maneuver c. Squatting d. hyperventilating - c. Squatting Exp: squatting is a spontaneous compensatory mechanism used by older children to alleviate hypoxic spells. Squatting and its variants increase systemic resistance while decreasing venous return to the heart from the inferior vena cava. The other options would not result in these changes. pg 1209 An infant diagnosed with a small patent ductus arteriosus would likely exhibit which symptom? a. Intermittent murmur b. Lack of symptoms c. Need for surgical repair d. Triad of congenital defects - b. Lack of symptoms Exp: Infants with a small PDA usually remain asymptomatic. page 1203- 1204 Fluid in the pleural space characterizes which condition? a. Pleural effusion b. Atelectasis c. Bronchiectasis d. Ischemia - a. Pleural Effusion Exp: Pleural effusion is the presence of fluid in the pleural space. page Which medication classification is generally included in the treatment of silicosis? a. Corticosteroids b. Antiboitics c. Bronchodilators
a. Obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation b. Respiratory disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest X-ray imaging c. P!ulmonary disorder involving an abnormal expression of a protein-producing viscous mucus that obstructs the airways, pancreas, sweat ducts, and vas deferens d. Pulmonary disorder characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency - c. Pulmonary disorder involving an abnormal expression of a protein-producing viscous mucus that obstructs the airways, pancreas, sweat ducts, and vas deferens Exp: Cystic fibrosis is best described as a pulmonary disorder involving an abnormal expression of a protein-producing viscous mucus that obstructs the airways, pancreas, sweat ducts, and vas deferens. This selection is the only option that accurately describes cystic fibrosis. pages 1310- 1311 Cystic fibrosis is caused by which process? a. Autosomal recessive inheritance b. Autosomal dominant inheritance c. Infection d. Malignancy - a. Autosomal recessive inheritance Exp: Cystic fibrosis is an autosomal recessive inherited disorder that is associated with defective epithelial ion transport. None of the other options cause cystic fibrosis. page 1310 What are the abnormalities in cytokines found in children with cystic fibrosis (CF)? a. Deficit of interleukin(IL)-1 and an excess of IL-4, IL-12, and interferon-alpha (IFN- α) b. Deficit of IL-6 and an excess of IL-2, IL-8 and granulocyte colony-stimulating factor (G-CSF) c. Deficit of IL-10 and an excess of IL-1, IL-8 and TNF α d. Deficit of IL-3 and an excess of IL-14, IL- 24 & colony-stimulating factor (CSF) - c. Deficit of IL-10 and an excess of IL-1 , IL-8 and TNF α Exp: Abnormal cytokine profiles have been documented in CF airway fluids, including deficient IL-10 and excessive IL-1, IL-8, and TNF-α, all changes conducive to promoting inflammation. pages 1311- 12 Which hormone is required for water to be reabsorbed in the distal tubule and collecting duct? a. Antidiuretic hormone b. Aldosterone c. Cortisol d. Adrenocorticotropin hormone - a. Antidiuretic hormone
Exp: Antidiuretic hormone is required for water to be reabsorbed in the distal tubule and collecting duct. The later, straight segment of the distal tubule and the collecting duct are permeable to water as controlled by antidiuretic hormone. The other options are not involved in this process. page 1331 The concentration of the final urine is determined by antidiuretic hormone (ADH), which is secreted by which gland? a. Posterior pituitary b. Thyroid c. Parathyroid d. Anterior pituitary - a. Posterior pituitary Exp: ADH which is secreted from the posterior pituitary gland, controls the concentration of the final urine. Pages 1332 and 1333 What is the most common cause of uncomplicated urinary tract infections? a. Staphylococcus b. Klebsiella c. Proteus d. Escherichia coli - d. Escherichia coli ; The most common infecting microorganisms are uropathic strains of E. coli (80% to 85%). page 1350 Which clinical manifestations of a urinary tract infection may be demonstrated in an 85 - year-old individual? a. Confusion and poorly localized abdominal discomfort b. Dysuria, frequency, and suprapubic pain c. Hematuria and flank pain d. Pyuria, urgency, and frequency - a. Confusion and poorly localized abdominal discomfort Exp: Older adults with cystitis may demonstrate confusion or vague abdominal discomfort or otherwise be asymptomatic. page 1351 Pyelonephritis is usually caused by which type of organism? a. Bacteria b. Fungi c. Viruses d. Parasite - a. Bacteria Exp: Pyelonephritis is usually caused by the bacteria Escherichia coli, Proteus, or Pseudomonas. pages 1351- 52 A patient exhibits symptoms including hematuria with red blood cell casts and proteinuria exceeding 3 to 5 g/ day with albumin as the major protein. These data suggest the presence of which disorder? a. Cystitis
b. Renal vasoconstriction c. Renal artery thrombosis d. Hemorrhage e. Hypotension - b. Renal vasoconstriction c. Renal artery thrombosis d. Hemorrhage e. Hypotension Exp: Poor perfusion can result from renal artery thrombosis, hypotension related to hypovolemia (dehydration, diarrhea, fluid shifts) or hemorrhage, renal vasoconstriction and alterations in renal regional blood flow, microthrombi, or kidney edema that restricts arterial blood flow. Bilateral ureteral obstruction is not associated with prerenal injuries. page 1360. What initiates inflammation in acute poststreptococcal glomerulonephritis? a. Lysosomal enzymes b. Endotoxins from Streptococcus c. Immune complexes d. Immunoglobulin E (IgE) mediated response - c. Immune complexes Exp: The immune complexes initiate inflammation and glomerular injury in acute poststreptococcal glomerulonephritis. Antigen-antibody complexes are deposited in the glomerulus, or the antigen may be trapped within the glomerulus and immune complexes formed in situ. The other options are not involved in initiating inflammation in this situation. page 1381 In immunoglobulin G (IgG) nephropathies such as glomerulonephritis, IgG is deposited in which location? a. Juxtamedullary nephrons b. Glomerulus basement membranes c. Mesangium of the glomerular capillaries d. Parietal epithelium - b. Glomerulus basement membranes Exp: Glomerulonephritis develops with the deposition of antigen-antibody complexes (IgG, immunoglobulin A [IgA] and C3 complement) in the glomerulus, or the antigen may be trapped within the glomerulus and immune complexes formed in situ. Immunofluorescence microscopy shows lumpy deposits of IgG and C3 complement on the glomerular basement membrane (see figure 39-5) When considering IgG nephropathies the only location of the IgG immunoglobulins is the correct option. page 1381 By what mechanism does intussusception cause an intestinal obstruction? a. Telescoping of part of the intestine into another section of intestine, usually causing strangulation of the blood supply b. Twisting the intestine on its mesenteric pedicle, causing occlusion of the blood supply c. Loss of peristaltic motor activity in the intestine, causing an adynamic ileus
d. Forming fibrin and scar tissue that attach to the intestinal omentum, causing obstruction - a. Telescoping of part of the intestine into another section of intestine, usually causing strangulation of the blood supply Exp: Intussusception is the telescoping of part of the intestine into another section of intestine, usually causing strangulation of the blood supply. page 1431 Table 41- 2 After a partial gastrectomy or pyloroplasty, clinical manifestations that include increased pulse, hypotension, weakness, pallor, sweating, and dizziness are the results of which mechanism? a. Anaphylactic reaction in which chemical mediators, such as histamine, prostaglandins, and leukotrienes, relax vascular smooth muscles, causing shock b. Postoperative hemorrhage during which a large volume of blood is lost, causing hypotension with compensatory tachycardia c. Concentrated bolus that moves from the stomach into the small intestine, causing hyperglycemia and resulting in polyuria and eventually hypovolemic shock d. Rapid gastric emptying and the creation of a high osmotic gradient in the small intestine, causing a sudden shift of fluid from the blood vessels to the intestinal lumen - d. Rapid gastric emptying and the creation of a high osmotic gradient in the small intestine, causing a sudden shift of fluid from the blood vessels to the intestinal lumen Exp: Dumping syndrome occurs with varying severity in 5% to 10% of individuals who have undergone partial gastrectomy or pyloroplasty. Rapid gastric emptying and the creation of a high osmotic gradient in the small intestine cause a sudden shift of fluid from the vascular compartment to the intestinal lumen. Plasma volume decreases, causing vasomotor responses, such as increased pulse rate, hypotension, weakness, pallor, sweating, and dizziness. Rapid distention of the intestine produces a feeling of epigastric fullness, cramping, nausea, vomiting, and diarrhea. This selection is the only option that accurately identifies the mechanism responsible for the described situation. page 1440 Which term is used to identify an intestinal obstruction caused by meconium formed in utero that is abnormally sticky and adheres firmly to the mucosa of the small intestine? a. meconium cecum b. meconim ileus c. meconium obstruction d. meconium vivax - b. meconim ileus Exp: Meconium ileus is the only term used to identify an intestinal obstruction caused by meconium formed in utero that is abnormally sticky and adheres firmly to the mucosa of the small intestine, resisting passage beyond the terminal ileum. The cause is usually a lack of digestive enzymes during fetal life. page 1490 With which medical diagnosis is meconium ileus often associated? a. Muscular dystrophy
a. Excessive mucus production b. Elevated blood glucose levels c. Low sodium content in perspiration d. Abnormally thin exocrine secretions - a. Excessive mucus production Exp: Excessive mucus production characterizes cystic fibrosis. However, the pathophysiologic triad that is the hallmark of cystic fibrosis includes (1) pancreatic enzyme deficiency, which causes maldigestion; (2) overproduction of mucus in the respiratory tract and an inability to clear secretions, which cause progressive chronic obstructive pulmonary disease; and (3) abnormally elevated sodium and chloride concentrations in sweat. Exocrine secretions tend to be abnormally thick and precipitate in the glandular ducts, obstructing flow. An elevated blood glucose level is not associated with this disorder page 1494 Which medication compensates for the deficiency that occurs as a result of cystic fibrosis? a. Salt tablets b. Pancreatic enzymes c. Antihypertensives d. Antibiotics - b. Pancreatic enzymes Exp: Pancreatic replacement enzymes are administered before or with meals, and high/calorie, high/protein diets with frequent snacks and vitamin supplements are used to treat the deficiency. page 1494 What causes a person with cystic fibrosis to experience an exocrine pancreatic insufficiency? a. Pancreatic ducts are obstructed with mucus. b. Impaired blood supply to the pancreas causes ischemia. c. A genetically impaired pancreas is unable to produce digestive enzymes. d. The pancreas has a volvulus at the ampulla of water - a. Pancreatic ducts are obstructed with mucus. Exp: Approximately 85% of individuals with cystic fibrosis experience pancreatic insufficiency. Obstruction of the pancreatic ducts with thick mucus blocks the flow of pancreatic enzymes and causes degenerative and fibrotic changes in the pancreas. This selection is the only option that accurately describes why an exocrine pancreatic insufficiency is observed in individuals diagnosed with cystic fibrosis. page 1494 What is the cause of faulty digestion of fats in those diagnosed with cystic fibrosis? a Bile ducts obstructed with mucus, prohibiting the release of bile b. Failure to metabolize fat/soluble vitamins c. Deficiency of pancreatic enzymes d. Fat malabsorption that now occurs in the jejunum - c. Deficiency of pancreatic enzymes
Exp: Severe problems with maldigestion of proteins, carbohydrates, and fats occur because of the insufficient secretion of pancreatic enzymes. This selection is the only option that accurately describes why fatty stools are observed in individuals diagnosed with cystic fibrosis. page 1494 Which disorder is characterized by damage to the mucosa of the duodenum and jejunum and impaired secretion of secretin, cholecystokinin, and pancreatic enzymes? a. Wilson disease b. Cystic fibrosis c. Gluten/sensitive enteropathy d. Galactosemia - c. Gluten/sensitive enteropathy Exp: Gluten/sensitive enteropathy is characterized by damage to the mucosa of the duodenum and jejunum and has secondary effects that exacerbate malabsorption. The secretion of intestinal hormones, such as secretin and cholecystokinin, may be diminished. Because these chemical messengers are scarce, secretion of pancreatic enzymes and expulsion of bile from the gallbladder decrease. These statements are not true of the other options. page 1495 What factor associated with gluten/sensitive enteropathy (celiac sprue) causes an infant to bruise and bleed easily? a. Vitamin K deficiency from fat malabsorption b. Bone marrow function depression c. Iron, folate, and B12 deficiency anemias d. Prescribed daily warfarin ;Coumadin - a. Vitamin K deficiency from fat malabsorption Exp: Deficiencies of fat/soluble vitamins (such as vitamin K) are common in children with gluten/sensitive enteropathy. Vitamin K malabsorption leads to hypoprothrombinemia, causing the child to bruise and bleed easily. This selection is the only option that accurately describes the mechanism that causes bruising and bleeding in children diagnosed with celiac sprue. page 1497 In an infant who is 6 weeks old, an increase in bilirubin production and persistent jaundice support which diagnosis? a. Pathologic hyperbilirubinemia b. Physiologic Jaundice c. Hepatitis A d. Infantile cirrhosis - a. Pathologic hyperbilirubinemia Exp: Physiologic jaundice develops during the second or third day after birth and usually subsides in 1 to 2 weeks in full/term infants and in 2 to 4 weeks in premature infants. After this development, increased bilirubin values and persistent jaundice indicate pathologic hyperbilirubinemia. This selection is the only option that accurately identifies the diagnosis associated with these symptoms and timeline. page 1500 - 1501
Meconium ileus - Meconium ileus is intestinal obstruction caused by meconium formed in utero that is abnormally sticky and adheres firmly to the mucosa of the small intestine, resisting passage beyond the terminal ileum. The cause is usually a lack of digestive enzymes during fetal life. page 1490 Celiac Sprue - Guten-sensitive enteropathy, formerly called celiac sprue or celiac disease, is an autoimmune disease that damages the small intestinal villous epithelium when ingestion of gluten (gliadin). the protein component of cereal grains, occurs. page 1490 What type of fracture occurs at a site of a preexisting bone abnormality and is a result of a force that would not normally cause a fracture? a. Idiopathic b. Incomplete c. Pathologic d. Greenstick - c. Pathologic Exp: Only a pathologic fracture is a break at the site of a preexisting abnormality, usually by force that would not fracture a normal bone. page 1541 By the time osteoporosis is visible on an x-ray examination, up to what percent of bone has been lost? a. 30% b. 40% c. 50% d. 60% - a. 30% Exp: Generally, osteoporosis is radiographically detected as increased radiolucency of bone. By the time abnormalities are detected by x-ray examination, as much as 25% to 30% of bone tissue may have been lost. page 1555 A bone density of 645mg/cm would support which diagnosis? a. Osteoplasia b. Osteoporosis c. Osteopenia d. Osteomalacia - b. Osteoporosis Exp: The World Health Organization (WHO) has defined osteoporosis on the basis of bone density. Normal bone is greater than 833 mg/cm ; osteopenia, or decreased bone mass is 633 to 648 mg/cm; osteoporosis is less than 648 mg/cm. This selection is the only accepted option. page 1550 Considering the pathophysiologic process of osteoporosis, after being activated by receptor activator of nuclear factor κB ligand (RANKL) receptor activator of nuclear factor κB (RANK) activates which of the following? a. Osteoclast apoptosis
b. Osteoblast survival c. Osteoprotegerin d. Osteoclast survival - d. Osteoclast survival Exp: RANKL activates the receptor RANK which is expressed on osteoclasts and their precursors and suppresses apoptosis, which leads to activation and the prolongation of osteoclast survival. This statement is not true of any of the other options. page 1553 Considering the pathophysiologic process of osteoporosis, which hormone exerts antiapoptotic effects on osteoblasts but proapoptotic effects on osteoclasts? a. Parathyroid hormone b. Glucocorticoid c. Growth hormone d. Estrogen - d. Estrogen Exp: Data reveal that sex steroids (e.g. estrogens) exert antiapoptotic effects on osteoblasts but exert proapoptotic effects on osteoclasts; in both scenarios activating the extracellular signal-regulated kinases (ERKs) accomplish these effects. This process is not true of any of the other options. page 1553 Considering the pathophysiologic process of osteoporosis, what are the effects of extracellular signal-regulated kinases (ERKs) and receptor activator of nuclear factor κB 2 ligand (RANKL) on osteoblasts and osteoclasts? a. ERKs increase the life span of osteoclasts, and RANKL decreases the life span of osteoblasts. b. ERKs and RANKL increase the life span of osteoclasts and decrease the life span of osteoblasts. c. ERKs and RANKL increase the life span of osteoblasts and decrease the life span of osteoclasts. d. ERKs increase the life span of osteoblasts, and RANKL decreases the life span of osteoclasts - b. ERKs and RANKL increase the life span of osteoclasts and decrease the life span of osteoblasts. Exp: page 1553 What is the most common clinical manifestation of osteoporosis? a. Bone deformity b. Bone pain c. Pathologic fracture d. Muscle strain - a. Bone deformity Exp: page 1555 Which disorder is characterized by the formation of abnormal new bone at an accelerated rate beginning with excessive resorption of spongy bone?
a. Synovium b. Cartilage c. Tendons d. Ligaments - b. Cartilage Exp: Cartilage antigens are proposed as the targets for the immune response and the presentation of such antigens to CD8+ T cells. This statement is not true of any of the other options. page 1573 People with gout are at high risk for which co-morbid condition? a. Renal calculi b. Joint trauma c. Anemia d. Hearing loss - a. Renal calculi Exp: Renal stones are 100 times more prevalent in individuals with primary gout than they are in the general population. This statement is not true of any of the other options. page 1578 What causes the crystallization within the synovial fluid of the joint affected by gouty arthritis? a Reduced excretion of purines b. Overproduction of uric acid c. Increase in the glycosaminoglycan levels d. Overproduction of proteoglycans - b. Overproduction of uric acid Exp: When the uric acid reaches a certain concentration in fluids, it crystallizes, forming insoluble precipitates that are deposited in connective tissues throughout the body. Crystallization in synovial fluid causes acute, painful inflammation of the joint, a condition known as gouty arthritis. This selection is the only option that accurately identifies the cause of crystallization in synovial fluid associated with gouty arthritis. page 1574- 1575 The pathophysiologic presentation of gout is closely linked to the metabolism of which chemical? a. Purine b. Pyrimidine c. Vitamin E d. Amino acid - a. Purine Exp: The pathophysiologic presentation of gout is closely linked only to purine metabolism (or cellular metabolism of purines) and kidney function. page 1575 Which clinical manifestations are associated with fibromyalgia? a. Hot, tender, and edematous muscle groups bilaterally b. Fasciculations of the upper and lower extremity muscles
c. Exercise intolerance and painful muscle cramps d. Sensitivity at tender points and profound fatigue - d. Sensitivity at tender points and profound fatigue Exp: Widespread joint and muscle pain, fatigue, and tender points are characteristics of fibromyalgia, a chronic musculoskeletal syndrome. Increased sensitivity to touch (i.e. tender points) the absence of systemic or localized inflammation, and fatigue and sleep disturbances are common. Fatigue is profound. The remaining options include symptoms not generally associated with fibromyalgia. page 1579- 1580 What term is used to identify the calcium crystals that are associated with chronic gout? a. Stones b. Spurs c. Tophi d. Nodes - c. Tophi Exp: With time, crystal deposition in subcutaneous tissues causes the formation of small white nodules, or tophi, that are visible through the skin. Crystal aggregates deposited in the kidneys can form urate renal stones and lead to renal failure. None of the other options are associated with the calcium crystals resulting from chronic gout. page 1575 Which structures are most often affected by Paget disease? (Select all that apply.) a. Vertebrae b. Skull c. Sternum d. Metacarpals e. Pelvis - Vertebrae, skull, sternum and pelvis. Exp: Paget disease most often affects the axial skeleton% especially the vertebrae, skull, sacrum, sternum, and pelvis. The metacarpals are not associated with the axial skeleton or Paget disease. page 1558 Which muscular dystrophy syndrome develops from an X-linked recessive mode of inheritance? a. Duchenne b. Facioscapulohumeral c. Myotonic d. Limb girdle - a. Duchenne Exp: A deletion of a segment of DNA or a single-gene defect on the short arm of the X chromosome is believed to be the cause of the X-linked inherited type of Duchenne muscular dystrophy. This statement is not true of the other options. page 1606 - 1607 Table 45- 7
a. Pancreas b. Liver c. Lungs d. Brain - c. Lungs Exp: Osteosarcoma disseminates through the bloodstream, usually to the lung. As many as 25% of children diagnosed with osteosarcoma exhibit lung metastases at diagnosis. This statement is not true of any of the other options. page 1610 In latex allergies, which immunoglobulin (Ig) is associated with an immediate reaction? a. IgA b. IgE c. IgG d. IgM - b. IgE Exp: Latex allergy can be either a type IV hypersensitivity to chemicals used in latex rubber processing or a type I immediate hypersensitivity with IgE antibodies formed in response to latex rubber protein. This selection is the only correct option available page 1628 What medical term is used to identify an inflammatory disorder of the skin that is often considered synonymous with dermatitis and characterized by pruritus with lesions that have an indistinct border? a. Eczema b. Psoriasis c. Atopic dermatitis d. Pityriasis rosea - a. Eczema Exp: The most common inflammatory disorder of the skin is eczema, or dermatitis. Eczema and dermatitis are general terms that describe a particular type of inflammatory response in the skin-these terms can be used interchangeably. Pruritus, lesions with indistinct borders, and epidermal changes generally characterize diseases that are considered eczematous. Of the available options, only eczema is associated with these characteristics. page 1627 Lesions on the elbows and knees that are well demarcated, thick, silvery, scaly, and erythematous characterize which type of psoriasis? a. Plaque b. Inverse c. Guttate d. Erythrodermic - a. Plaque Exp: The description provided is characteristic of only lesions observed in plaque psoriasis. These lesions are well-demarcated, thick, silvery, scaly, erythematous plaque surrounded by normal skin. page 1629
Chickenpox (varicella) may be followed years later by which disorder? a. Erysipelas b. Cytomegalovirus c. Warts (Verrucae) d. Herpes Zoster - d. Herpes Zoster Exp: The same herpesvirus
- varicella zoster virus - causes both herpes zoster (shingles) and varicella (chickenpox). Varicella is the primary infection, followed years later by herpes zoster, particularly among those who are immunosuppressed. These statements are not true of any of the other options. page 1636 Which skin lesion is mediated by the immunoglobulin E IgE- stimulated release of histamine, bradykinin, or kallikrein from mast cells? a. Dermatitis b. Scleroderma c. Urticaria d. Cutaneous vasculitis - c. Urticaria Exp: Only urticaria is mediated by the IgE - stimulated release of histamine, bradykinin, or kallikrein from mast cells or basophils, or both which causes the endothelial cells of skin blood vessels to contract. page 1639 What name is given to a benign proliferation of basal cells that produces smooth or warty elevated lesions on the chest, back, and face that are tan or waxy, yellow flesh-colored, or dark brown to black? a. Basal keratosis b. Seborrheic keratosis c. Keratoacanthoma d. Actinic keratosis - b. Seborrheic keratosis Exp: Seborrheic keratosis is a benign proliferation of cutaneous basal cells that produces smooth or warty elevated lesions. The pathogenetic origin is unknown. Seborrheic keratosis usually occurs in older people as multiple lesions on the chest, back, and face. The color varies from tan to waxy, yellow flesh-colored, or dark brown to black. No other option exhibits these characteristics. page 1640 What is the medical term for a fungal infection of the nail plate? a. Paronychia b. Onychomycosis c. Tinea corporis d. Tinea capitis - b. Onychomycosis Exp: Onychomycosis is the only term used to identify a fungal or dermatophyte infection of the nail plate that occurs in 2 to 18% of the population. page 1647
