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NURSING EXAMS WITH VERIFIED
QUESTIONS AND CORRECT
ANSWERS
- Intracellular fluid (ICF) - ANSWERS-- Fluid inside the cell
- 40% of total body water
- K ANSWERS-- - responsible for osmotic balance of ICF space
- Na ANSWERS-- - responsible for osmotic balance of ECF space
- blastoma (suffix) ANSWERS-- - originates from precursor cells or blasts (immature or embryonic tissue). Ex: children, neuroblastoma, retinoblastoma
- oma (suffix) ANSWERS-- - Benign tumors generally named according to the tissue from which they arise Ex:- benign tumor of fat cells is a lipoma- smooth muscle of uterus is leiomyoma (delayed, cell mediated); a reaction that is mediated by T-Cell Lymphocytes and does not require antibody participation. It is a delayed reaction that occurs in 24-72 hours post-exposure to an antigen. ANSWERS-- - What is Type IV hypersensitivity? (dependent on route the allergen entered the body); include urticarial, rhinitis, conjunctivitis, and asthma ANSWERS-- - What are the clinical manifestations of Type I hypersensitivities?
- The movement of fluid across the arterial end of capillary membranes into the interstitial fluid surrounding the capillary is an example of which fluid movement process?
a. Hydrostatic pressure b. Osmosis c. Diffusion d. Active transport ANSWERS-- - ANS: A Hydrostatic pressure is the mechanical force of water pushing against cellular membranes. In the vascular system, hydrostatic pressure is the blood pressure generated in vessels by the contraction of the heart. Blood reaching the capillary bed has a hydrostatic pressure of 25 to 30 mm Hg, which is sufficient force to push water across the thin capillary membranes into the interstitial space. The remaining options do not correctly identify the process described. PTS: 1 REF: Pages 29- 30 5 Types of Necrosis ANSWERS-- - coagulative, liquefactive, caseous, fat, gangrenous A ANSWERS-- - A person with Type B blood has what antibodies? A antigen ANSWERS-- - A person with Type A blood has what antigen? A chronic, multisystem, inflammatory disease; antibodies are formed against DNA and other nuclear components; antibody antigen complexes are deposited in a variety of tissues and this activates complement ANSWERS-- - What is Systemic Lupus Erythematosus? A pathogen which triggers the immune response ANSWERS-- - What often precipitates autoimmune disease? A pathological immune response to an antigen which causes tissue and cellular damage to the host ANSWERS-- - What is a hypersensitivity? A systemic autoimmune disease that causes chronic inflammation of connective tissues primarily in the joints. ANSWERS-- - What is Rheumatoid Arthritis?
Adrenergic agents effect on K+ ANSWERS-- - albuterol, beta blockers, and alpha adrenergic antagonists cause K+ movement into the cell. Alpha adrenergic receptors shift K+ out of the cell Adrenergic Agonists ANSWERS-- - Stimulants of beta 2 receptors by albuterol increase the activity of the sodium potassium pump and shift potassium into the cell resulting in hypokalemia. Alpha adrenergic receptors cause a shift out of the cell and may lead to hyperkalemia. Beta 2 antagonist cause shift into cell space as well. Aldosterone ANSWERS-- - hormone secreted from the adrenal cortex and increases renal Na resorption and K excretion Allele ANSWERS-- - Paired genes on autosomal chromosomes Allergies to food, medication, pollen, etc. ANSWERS-- - What are most Type I hypersensitivity reactions attributed to? Alpha Fetoprotein (AFP) ANSWERS-- - Liver and germ cell tumors Alpha Fetoprotein Origin ANSWERS-- - Liver and germ cell tumors ALT enzymes are found where? - ANSWERS-- liver cells (L enzyme) An immediate hypersensitivity response to an environmental allergen ANSWERS-- - What it Type I hypersensitivity? anaplasia ANSWERS-- - absence of differentiation Angiogenesis: ANSWERS-- - Micrometastases stimulate the growth of new blood vessels to obtain a blood supply. A blood supply is needed to obtain the oxygen and nutrients necessary for continued tumor growth. Anion ANSWERS-- - Chloride Bicarbonate
Proteins Phosphate Antibody IgE ANSWERS-- - What does the Type I hypersensitivity pathogenesis begin with? Antidiuretic Hormone ANSWERS-- - Secreted by the pituitary gland in response to a water deficit, Na excess or a low BP. It causes the kidneys to reabsorb H2O thus increasing plasma volume. With fluid loss (vomiting, diarrhea or excessive sweating) a decrease in blood volume and blood pressure occurs. Baroreceptors (located in Right and Left atria, large veins, aorta, pulmonary arteries and carotid sinus), signal the hypothalamus to release ADH. Apoptosis ANSWERS-- - Cellular Effect: programmed cell death, normal process Clinical Implications: Death by apoptosis causes loss of cells in many pathologic states including: Severe cell injury, Accumulation of misfolded proteins, Infections (part. viral), Obstruction in tissue ducts dysregulated apoptosis - excessive or insufficient apoptosis. ex: survival of mutated cells can increase cancer risk. Increased apoptosis is known to occur in ischemic injury (MI and stroke)- prevents cellular proliferation resulting in a gigantic body Arrest and extravasation: ANSWERS-- - Cancer cells stop moving, in small blood vessels called capillaries at a distant location. They then invade the walls of the capillaries and migrate into the surrounding tissue AST enzymes are found where? - ANSWERS-- liver cells (s) Atrophy ANSWERS-- - E. Cells decrease in size P. Still functional; imbalance between protein synthesis and degradation. Essentially there is an increase in the catabolism of intracellular organelles, reducing structural components of cell Physiologic: thymus gland in early childhood Pathological: disuse (muscle atrophy d/ decrease workload, pressure, use, blood supply, nutrition, hormonal stimulation, or nervous stimulation) Autosomal chromosomes ANSWERS-- - first 22 of 23 chromosomes
- About 50% of circulating is bound to plasma protein, primarily albumin. Calcium and Phosphorus - ANSWERS-- regulated by 3 hormones: parathyroid (PTH), vit D, and calcitonin
- rigidly controlled.
- inverse relationship: if one increases= other one decreases Cancer cell metastasis usually involves the following 6 steps: ANSWERS-- - Local invasion: Cancer cells invade nearby normal tissue. Intravasation: Cancer cells invade and move through the walls of nearby lymph vessels or blood vessels. Circulation: Cancer cells move through the lymphatic system and the bloodstream to other parts of the body. Arrest and extravasation: Cancer cells arrest, or stop moving, in small blood vessels called capillaries at a distant location. They then invade the walls of the capillaries and migrate into the surrounding tissue (extravasation). Proliferation: Cancer cells multiply at the distant location to form small tumors known as micro metastases. Angiogenesis: Micrometastases stimulate the growth of new blood vessels to obtain a blood supply. A blood supply is needed to obtain the oxygen and nutrients necessary for continued tumor growth. Capillary (plasma) oncotic pressure ANSWERS-- - osmotically attracts water from the interstitial space back into the capillary Capillary hydrostatic pressure (BP) ANSWERS-- - facilitates the outward movement of water from the capillary to the interstitial space Carcino- ANSWERS-- - from epithelial tissue- renal cell carcinoma Carcino- (prefix) ANSWERS-- - arise from epithelial tissue
Carcino- (prefix) ANSWERS-- - Definition:arise from epithelial tissue Ex:Adenocarcinoma: arising from ductal/glandular glands Carcinoembryonic Antigen ANSWERS-- - GI, pancreas, lung, breast tumors Carcinoembryonic Antigen CEA ANSWERS-- - GI, pancreas, lung, breast, ect tumors Carcinoma in Situ ANSWERS-- --preinvasive epithelial malignant tumors of glandular or squamous cell origin
of sites including cervix, skin, oral cavity, esophagus and bronchus
in breast, ductal carcinoma in situ (DCIS) fills the mammary ducts but has not progressed to local tissue invasion Carcinoma in Situ ANSWERS-- - Definition:-preinvasive epithelial malignant tumors of glandular or squamous cell origin- localized to the epithelium- not yet malignant- 3 fates: can remain stable for long time, progress to invasive/met CA, or regress and disappear Ex:- # of sites including cervix, skin, oral cavity, esophagus and bronchus- in breast, ductal carcinoma in situ (DCIS) fills the mammary ducts but has not progressed to local tissue invasion Carcinoma in situ ANSWERS-- - preinvasive epithelial malignant tumors of glandular or squamous cells- cervix Carrier ANSWERS-- - Person who has a diseased gene but is phenotypically normal Caseous ANSWERS-- - necrosis specific to lung tissue and occurs in TB. Dead cells disintegrate, but the debris is not digested completely by hydrolyses, appearance resembles clumped cheese Caseous Necrosis - ANSWERS-- necrosis specific to lung tissue and occurs in TB- combination of coagulative and liquefactive necrosis Caseous Necrosis ANSWERS-- - lung disease- usually TB- tissue looks like clumped cheese
clinical manifestations of Fluid Volume Deficit ANSWERS-- - Poor skin turgor, dry mucous membranes, sunken eyes, sunken fontanels, decreased urine output and fatigue Coagulation Cascade ANSWERS-- - activates the kinin system. function of this system to to form a fibrin mesh to stop bleeding and trap microorganisms Coagulation cascade activated ANSWERS-- --has role in activating kinin and complement system
- Factor XII (Hageman factor) activates kinin
- ultimate function is to form fibrin mesh to stop bleeding and trap microorganisms Coagulative ANSWERS-- - occurs in the kidneys, heart, and adrenal glands most commonly secondary to hypoxia (caused by protein denaturation, tissue firm and slightly swollen) Coagulative Necrosis - ANSWERS-- occurs in the kidneys, heart, and adrenal glands most commonly secondary to hypoxia - hypoxia by chemical injury (esp. mercuric chloride) or severe ischemia Coagulative Necrosis ANSWERS-- kidneys, heart, adrenals- secondary to hypoxia Codominance ANSWERS-- - Both alleles exhibit (blood type AB) Colorectal ANSWERS-- - liver - via mesenteric lymphatics, portal venous system,lungs - via IVC, RV, PA Colorectal ca metastasis ANSWERS-- - Liver, lungs Colorectal Sites of Metastasis ANSWERS-- - liver, lungs Complement ANSWERS-- - functions include bacterial lysis, vasodilation and increase vascular permeability, triggers mast cell degranulation, chemotaxis and opsonization
Complement Cascade Activated ANSWERS-- --MAC-lysis of bacteria
- C2b-increase vasodilation and vascular permeability
- C3a/C5a/C4a-triggers mast cell degranulation
- C5a-attracts neutrophils (chemotaxis)
- C3b-enhances opsonization Contact Dermatitis ANSWERS-- - T-Cell mediated reaction to antigens such as poison ivy, topical drugs, chemicals (nickel), or formaldehyde. Antigens too small to cause an immune response to bind to proteins, causing rash, red bumps, itching and blisters Contact dermatitis, reactive tuberculin skin test, and solid organ transplant rejection ANSWERS-- - What are examples of Type IV hypersensitivity? COX ANSWERS-- - maintain gastric mucosa,fluid and electrolyte balance, and platelet aggregation COX ANSWERS-- - pathway function mainly in the inflammatory process and produce pain and fever cytokine IL ANSWERS-- - causes fever, activates phagocytes and lymphocytes and also increases release of IL 6 cytokine IL ANSWERS-- - stimulates the production of acute phase reactants and promotes the growth and stimulation of blood cells cytokines ANSWERS-- --can react quickly or be delayed
- IL4 released early
- IL3 released later
- TNF released early and late Cytokines ANSWERS-- - released by mast cells; react quickly or may be more delayed, IL 4/TNF is released early in inflammation and IL13 is released later in the inflammatory response
Dysplasia ANSWERS-- - E. Not true adaptation; Cells abnormal change in size, shape, organization (classified as mild, moderate, severe) P. caused by cell injury/irritation, characterized by disordered cell growth. aka atypical hyperplasia or pre-cancer, a disorderly proliferation Physiologic: N/A Pathologic: squamous dysplasia of cervix from HPV shows up on pap smear, breast cancer development; pap smears often show dysplastic cells of the cervix that must undergo laser/surgical tx dystrophic calcification ANSWERS-- - accumulation of Ca in dead or dying tissues calcium salt clump and harden- interfere with cellular structure and function r/t pulmonary TB, atherosclerosis, injured heart valves, chronic pancreatitis Dystrophic Calcification ANSWERS-- - Effects: accumulation of calcium that occurs in dying and dead tissues Clinical Implications: pulmonary TB, atherosclerosis and heart valve injury Dystrophic Calcification Effects and Clinical Implications ANSWERS-- - E- accumulation of calcium that occurs in dying and dead tissues CI- pulmonary TB, atherosclerosis and heart valve injury ECF, EABV - ANSWERS-- volume changes in the ____ compartment will cause changes in the _____ in the same direction Edema ANSWERS-- - Accumulation of fluid within the interstitial space- venous obstruction, Na and water retention C.M. can be localized or dependent, tightness of skin, facial swelling, rales, decreased wound healing, increased risk of pressure sores, weight gain Edema ANSWERS-- - Excessive accumulation of fluid within the interstitial space Edema ANSWERS-- - S/S Swelling or puffiness of tissue, shiny skin, increased abdominal size, dyspnea, SOB, chest pain
Edema Etiology ANSWERS-- - Sitting or standing in one position, DVT, steroid drugs, CHF, Kidney disease, cirrhosis, Effect on oxaloacetate ANSWERS-- - Oxaloacetate is also used in gluconeogenesis, during starvation & uncontrolled DM oxaloacetate levels are insufficient due to gluconeogenesis... this depletion furthers the amount of acetyl-CoA Effect on oxaloacetate ANSWERS-- - Role:Oxaloacetate is also used in gluconeogenesis, during starvation & uncontrolled DM oxaloacetate levels are insufficient due to gluconeogenesis... this depletion furthers the amount of acetyl-CoA which activates ketogenesis Clinical Implications:Oxaloacetate (an intermediate) is involved in: Citric acid cyclegluconeogenesisurea cycleamino acid synthesisfatty acid synthesis Effective Arterial Blood Volume ANSWERS-- - The amount of blood within the arterial space which effectively perfuses the organs and tissues. Effective arterial blood volume ANSWERS-- - The amount of blood within the arterial space- ECF changes will cause changes in the EABV in the same direction Effective Arterial Blood Volume (EABV) ANSWERS-- - Amount of blood within the arterial space which effectively perfuses the organs and tissues Environmental allergies, asthma exacerbation, food allergies, drug allergies, animal allergies, and insect venom allergies Angioedema which causes swelling of lips, eyes, and larynx. (Anaphylaxis is most severe reaction. Is treated with epinephrine). Atopic Disorders include hay fever, asthma, eczema, and urticarial. They have strong genetic disposition. ANSWERS-- - What are some examples of Type I hypersensitivities? Ethanol ANSWERS-- - E. mood altering drug, long term effects on liver and nutritional status P. metabolized by liver, generates free radicals C.M. CNS depression, nutrient deficiencies-Mag, Vit B6, thiamine, PO4, inflammation and fatty infiltration of liver, hepatomegaly, leads to liver failure irreversible
oxidized niacin (NAD+) is reduced to NADH. the increased NADH/NAD+ ratio in the liver causes the following 1.Pyruvate change to lactic acid causing lactic acidosis
- Oxaloacetate converted to malate, preventing gluconeogenesis leading to fasting hypoglycemia
- Glyceraldehyde to glycerol which combines with fatty acids and forms triglycerides, leads to triglycerides in the liver, aka hepatosteatosis
- decreases citric acid cycle production of NADH which leads to utilization of Acetyl- CoA for ketogenesis (causing ketoacidosis) and lipogenesis (causing hepatosteatosis) etiology of edema ANSWERS-- - Increased capillary hydrostatic pressure caused by thrombophlebitis, hepatic obstruction, right heart failure, tight clothing, prolonged standing, CHF and renal failure, liver disease, protein malnutrition (from decreased production of plasma proteins), glomerular disease, trauma, hemorrhage, burns and cirrhosis etiology of Fluid Volume Deficit ANSWERS-- - Dehydration from vomiting or diarrhea and sweating etiology of Fluid Volume Excess ANSWERS-- - Intake or retention of fluid that exceeds fluid needs. Can be caused by renal failure. Euvolemic (hypotonic hyponatremia) ANSWERS-- - skin, GI, lung losses Euvolemic Hypernatremia ANSWERS-- - total body water loss, usually from DI C.M. severe polyuria and mild hypernatremia, weight loss, weak pulses, tachycardia, postural hypotension, fever, restless Euvolemic Hypernatremia ANSWERS-- - Typically caused by diabetes insipidus Euvolemic Hypernatremia clinical manifestations ANSWERS-- - diabetes insipidus Euvolemic Hypernatremia etiology ANSWERS-- - Occurs when the total water loss is equally from all parts of their body and not just simply from the intravascular space.
Euvolemic Hypernatremia Etiology ANSWERS-- - When total water loss is equal from all parts of the body, not just from the intravascular space Evaluate and describe the mechanisms of cancer metastasis and the implications for clinical practice. ANSWERS-- - Metastasis is the spread of cancer from the site of the original tumor to distant tissue. Metastasis contributes significantly to pain and suffering from cancer and is the major cause of death in cancer patients. Mechanisms important in local invasion include recruitment of macrophages and other cell types to the primary tumor, where they promote digestion of connective tissue capsules and other structural barriers by secreted proteases; changes in cell-to-cell adhesion, often by changes in the expression of cell adhesion molecules such as cadherins and integrins, making the cancer cell more slippery and mobile; and increased motility of individual tumor cells. The mechanism of capsular dissolution is unclear. To transition from local to distant metastasis, the cancer cell must also be able to invade local blood and lymphatic vessels, a task facilitated by stimulation of neoangiogenesis and lymphangiogenesis by factors such as VEGF. Finally, a successful metastatic cell must be able to survive in the circulation, attach in an appropriate new environment, and multiply to produce an entire new tumor. Exercise ANSWERS-- - depletes cellular ATP, which open the potassium channels in the muscle cells, which in turn allows potassium to shift out of the cell. Exercise effect on K+ ANSWERS-- - cellular ATP is diminished, opening K+ channels and allowing K+ to leave cell Fat ANSWERS-- - necrosis breast, pancreas and other abdominal structures Fat Necrosis - ANSWERS-- necrosis breast, pancreas and other abdominal structures- cellular dissolution caused by powerful enzymes called lipases Fat Necrosis ANSWERS-- - breast, pancreas, abdominal structures- creates soaps Fatty infiltration ANSWERS-- - Effects: intracellular accumulation of lipids Clinical Implications: most
Fluid volume excess ANSWERS-- - Fluid intake exceeds body's needs C.M. Edema, rales, HTN, weight gain, bounding pulses, intake> output, JVD, restlessness or anxiety Fluid Volume Excess ANSWERS-- - occurs when fluid intake of fluid retention exceeds the bodies fluid needs Fluid Volume Excess ANSWERS-- - S/S edema, tightness of the skin, puffiness of eyes, rales Fluid Volume Excess Etiology ANSWERS-- - CHF, Hepatic failure, renal failure, low protein sources, nephrotic syndrome, corticosteroids, liver cirrhosis Fluid Volume Excess Pathophysiology ANSWERS-- - It is due to shifts in fluid from interstium to plasma, reduce excretion of sodium and water, excessive retention of sodium and water from chronic renal stimuli. Free Radical and Clinical Manafestations ANSWERS-- - to stabilize self, it will steal an electron from another molecule or give up and electron. The free radical will often steal an electron from another molecule, making that molecule a free radical Free Radical and Pathophysiology ANSWERS-- - may by initated with in cells by (1) absorption of extreme energy sources such as radiation or UV light; (2) the occurrence of endogenous reactions, such as redox reactions in which oxygen is reduced to water have role in development of Alzheimer's, Parkinson's, Amyotrophic Lateral Sclerosis. Antioxidants are our bodies' defense, reducing agents that provide missing electron that can stabilize the ________ Free Radical and Reactive Oxygen Species (ROS) ANSWERS-- - Etiology:Free Radical- have unpaired electron in its outer shell, making molecule unstable and highly reactive. aka being oxidized ROS-byproduct of ATP production in the mitochondria Clinical Manif: FR- to stabilize self, it will steal an electron from another molecule or give up an electron. The free radical will often steal an electron from another molecule, making that molecule a free radical ROS- can overwhelm mitochondria and exhaust intracellular antioxidants, causing cell injury/disease Patho: ROS are produced by absorption of high energy sources such as radiation or UV light, have role in development of Alzheimer's, Parkinson's, Amyotrophic Lateral Sclerosis (ALS). ROS cause lipid peroxidation, damage proteins which maintain ion pumps and cellular transport, fragment DNA and causes less
protein synthesis, cause chromatin destruction, and damage mitochondria. Antioxidants are our body's defense against ROS- reducing agents that provide missing electron, stabilizing the free radical Free radical and ROS ANSWERS-- - E. normal byproduct of ATP production, will overwhelm the mitochondria- exhaust intracellular antioxidants P. lipid peroxidation, damage proteins, fragment DNA C.M. development in Alzheimer's, heart disease, Parkinson's disease, Amyotrophic Lateral Sclerosis Free Radical Etiology ANSWERS-- - have unpaired electron in its outer shell, making molecule unstable and highly reactive. aka being oxidized Gangrenous ANSWERS-- - tissue death resulting from severe tissue hypoxia Gangrenous Necrosis - ANSWERS-- tissue death resulting from severe tissue hypoxia- commonly occurring b/c of arteriosclerosis, or blockage, of major arteries, esp. in the lower leg- dry gangrene: result of coagulative necrosis- wet gangrene: develops when neutrophils invade the site causing liquefactive necrosis- gas gangrene: caused by infection of injured tissue by Clostridium (can be deadly) Gangrenous Necrosis ANSWERS-- - Dry- dark shriveled skin Wet- internal organs- can lead to death Gas- from clostridium- antitoxins and hyperbaric therapy Genotype ANSWERS-- - A map of ones specific genes gilomas ANSWERS-- - tissue of the brain and spinal cord Gout ANSWERS-- - E. disturbances in serum urate levels. uncommon for < 30 years old. P. uric acid is deposited in the tissues of kidney, heart, earlobes, and joints. C.M. inflammation, painful joints. result of diuretic use or diet high in cream sauces, red wine, or red meat
