Test 1 #1
What does the term leukocytosis mean?
A. A low WBC count (<4,000/uL)
B. A high neutrophil count (>7,700/uL w/ total WBC count being <11,000/uL)
C. A high WBC count (>11,000/uL)
D. A low neutrophil count (<1,500/uL)
C.
Normal WBC count is ~4,500-10,000. >11,000 means it is elevated and is known as leukocytosis.
What is the main purpose of the RAAS system?
A. Help raise blood pressure in time of stress/dehydration
B. Help lower blood pressure in times of stress/dehydration
C. Cause excretion of extra water from the body
D. Increase GFR
A.
The RAAS system helps maintain and raise BP in times of stress, dehydration, blood loss, etc. by helping retain extra fluid and electrolytes.
A patient of yours that was getting treated for a DVT suddenly complains of sharp chest pain, difficulty breathing, and severe anxiety. They are pale, tachypneic, tachycardic, and their SpO2 went from 96% to 82%. What is most likely going on with this patient?
A. Pulmonary embolism
B. Myocardial infarction
C. Pneumothorax
D. Angina pectoris
A.
The biggest problem that can arise when someone has a DVT is the clot dislodging and traveling to the heart where it ends up in the pulmonary circulation, becoming a pulmonary embolism.
What is the function of ADH in the body?
A. Causes extra water reabsorption at the kidneys
B. Causes the release of thyroid hormone at the thyroid gland
C. Causes the release of adrenal hormones, like cortisol, from the adrenal glands
D. Causes bone resorption to increase blood calcium levels
A.
ADH is released by the posterior pituitary gland in times of dehydration to help the body retain extra water.
Which disease below is defined as a syndrome of loss of cognitive function and memory that is progressive and impedes the functions of daily living.
A. Delirium
B. TIA
C. Dementia
D. Ischemic stroke
C.
Alzheimer's is the most common type of dementia and dementia usually progresses until the person has trouble remembering family members, performing ADLs, etc.
This is the growth of cells in which one type of cell is replaced by another type of cell.
A. Hyperplasia
B. Metaplasia
C. Dysplasia
D. Neoplasia
B.
Metaplasia is the growth of cells from one type into another type, usually to help compensate for certain environmental changes.
Hyperplasia is when cells increase in number, dysplasia is when cells start to become “disordered” or not like the cells that they arise from, and neoplasia means the growth of new cells, usually cancer cells.
One of your patients is in the hospital to treat a gastric ulcer. On assessment in the morning, you find that they have a rigid, board-like abdomen that is painful to the touch, they are complaining of severe pain, and they now have a fever. What do you suspect is happening to this patient?
A. This is a normal finding for an ulcer of this type
B. The ulcer caused a gastric rupture and they now have peritonitis
C. They are having an episode of gastroenteritis
D. They now have gastritis
B.
Peritonitis is a life-threatening emergency and is usually caused from infections that have spread from other parts of the body or from ruptured GI organs like the stomach, small intestine, and large intestine.
What is the normal blood value for LDL?
A. <200 mg/dL
B. <150 mg/dL
C. <100 mg/dL
D. <130 mg/dL
D.
Normal blood triglycerides should be <150 mg/dL and total cholesterol should be <200 mg/dL
Which Hgb A1c reading would meet criteria to diagnose someone with diabetes?
A. 4.5% - 5.5%
B. >6.5%
C. >7.5%
D. 5.7% - 6.5%
B.
Hgb A1c is a test done to see how someone has been controlling their BG over a long period of time (3+ months). A reading of 5.7% - 6.5% is criteris to be diagnosed w/ prediabetes and >6.5% is criteria to diagnose diabetes.
This disease is known as the "silent disease" and causes bone breakdown and weakening slowly, over time.
A. Osteoarthritis
B. Osteomalacia
C. Osteoporosis
D. Myasthenia gravis
C.
Osteoporosis or "porous bone" can occur because of a few reasons. Some being loss of certain hormones through aging (estrogen, testosterone), poor calcium and vitamin D intake, and certain conditions like cushing's syndrome. It presents a lot of the time by the person affected actually breaking a bone.
Which disease causes the bone marrow to produce low levels of RBCs, WBCs, and platelets and is sometimes caused by chemical or radiation exposure?
A. Aplastic anemia
B. Polycythemia vera
C. Pernicious anemia
D. Acute mylogenous leukemia
A.
Aplastic anemia causes the bone marrow to not produce enough, if any, RBCs, WBCs, and platelets. It is linked to chemical and radiation exposure and requires bone marrow transplants to treat it.
Which is an example of a hypertonic solution?
A. 0.9% Normal saline
B. 0.45% Normal saline
C. 3% Normal saline
D. Lactated Ringer's
C.
0.9% normal saline is isotonic, 0.45% NS is hypotonic, lactated ringer's is isotonic, and 3% NS is hyperonic.
What is the normal reference range for PaCO2 in the blood?
A. 90-100 mmHg
B. 35-45 mmHg
C. 25-35 mmHg
D. 40-50 mmHg
B.
Normal blood PaCO2 (measures in partial pressure) levels range from 35-45 mmHg. Rising levels can be caused by respiratory depression and apnea. Lowering levels can be caused by hyperventilation.
You are on the neuro unit at LGH and you are caring for a patient who is recovering from a head injury. Over the last 8 hours their urinary output has been 5000 ml and they have been complaining of increased thirst. On assessment, you find that they have dry mucus membranes, low BP, they're tachycardic, and they appear lethargic. You obtain some labs and find they have very low urine specific gravity, their urine is very dilute, and they are hypernatremic. What do you suspect is going on with this patient?
A. Diabetes insipidus
B. Addison's disease
C. SIADH
D. Hypothyroidism
A.
Diabetes insipidus (DI) is when the pitutiary gland doesn't secrete enough ADH or the kidneys don't respond to ADH. This causes the kidneys to excrete excess water into the urine, causing dilute urine with low specific gravity, dehydration, increased thirst/water intake, and electrolyte imbalances.
A patient comes to the ER by ambulance because of stroke-like symptoms. While assessing them you find them to have a facial droop, and slurred speech, and left-sided weakness. While they are being prepped for a CT scan, they suddenly lose all s/s and say they "feel normal". What do you think just happened to this patient?
A. Hemorrhagic stroke
B. Ischemic stroke
C. Clonic seizure
D. Transient ischemic attack (TIA)
D.
A TIA is when someone has a "mini stroke" where they have s/s of a stroke but they resolve spontaneously w/ in 24 hours.
What are some characteristics of innate immunity? (select all that apply)
A. Composed of natural barriers like skin and mucous membranes
B. Gives the body long-term immunity
C. Has a very quick response
D. It is composed of the B and T lymphocytes
E. It causes a slower response to an antigen the first time the body is exposed to it
A, C
Innate immunity is made up of natural barriers and defenses like the skin and mucous membranes, is the first line defense against infection, and involves the use of WBCs like neutrophils and monocytes instead of B and T lymphocytes (which make up adaptive immunity).
What are some s/s of a complete large bowel obstruction? (select all)
A. Absent bowel sounds
B. Abdominal distension
C. Excessive flatus
D. Passage of impacted stool
E. Abdominal pain/tenderness
A, B, E
Other s/s are: abdominal rigidity and high pitched bowel sounds on a partial obstruction.
What are the major s/s of someone having a myocardial infarction? (select all)
A. Substernal chest pain that can radiate to the jaw, shoulder, or back
B. Pallor
C. Diaphoresis
D. Chest pain that is relieved by resting
E. Levine's sign
A, B, C, E
Levine's sign is when someone puts their fist to their chest. Other s/s are weak pulses, extreme anxiety, and dyspnea.
You are working on the diabetic/renal unit and you are going around checking the morning BG readings for your patients. One patient of yours turns out to have a BG level of 50 mg/dL. What kind of s/s would you expect to see in this patient? (select all that apply)
A. Diaphoresis
B. Confusion
C. Hot, dry skin
D. Complaints of hunger
E. Polyuria
A, B, D
Hypoglycemia can cause a lot of mental effects like confusion and coma due to the fact the brain needs a constant supply of glucose to function. Other s/s can be things like tachycardia/palpitations, weakness, fatigue, tremors/shakiness, and headaches
What are some s/s of compartment syndrome that you should look out for in the extremity of someone with MS trauma?
A. Cool to the touch
B. Red/pink in color
C. Decreased sensation
D. Decreased pain
E. Pulselessness
A, C, E
This is caused by the swelling of tissue inside of an individual fascia or "compartment", cutting off blood flow to everything distal to the site. S/s of it include: increasing pain besides aggressive pain management, and the 5 Ps (pulselessness, pallor, pain, parathesia, and poikilothermia)
What are some general s/s of Turner syndrome? (select all that apply)
A. Short stature
B. Hyper elastic skin
C. Kyphoscoliosis
D. Webbed neck
E. Infertility
A, D, E
Turner syndrome is a result of a missing X chromosome in females. Other s/s can be broad-shield shaped chest, heart problems, and visual problems.
Which of the following are common signs of liver disorders? (Select all that apply)
A. Jaundice
B. Elevated AST and ALT
C. Hepatomegaly
D. Dark stool
E. LUQ pain
A, B, C
Other s/s are poor wound healing, ascites/edema, dark urine, nausea, fever, etc.
A person with COPD can have one or more individual diseases that contribute to the overall disorder. Which of the following diseases can be a part of COPD?
A. Acute bronchitis
B. Chronic bronchitis
C. Pulmonary edema
D. Emphysema
E. Chronic asthma
B, D, E
Someone with COPD can have one or more of these diseases that contribute to the overall disease process.
A patient of yours was just diagnosed with Cushing's syndrome. What kind of long-term effects of high cortisol production/hyperadrenalism should you tell them about? (select all that apply)
A. Hyperglycemia/glucose intolerance
B. Increased risk for infection
C. Weight gain
D. Hypotension
E. Osteoporosis
A, B, C, E
Overproduction of cortisol and other adrenal hormones can lead to all of these affects as well has hypertension, fluid retention, moon face, buffalo hump, and centrally located fat stores.
Which of the following are major risk factors for having a stroke? (select all that apply)
A. Female gender
B. Age >40
C. HTN
D. Atrial fibrillation
E. Family history
C, D, E
Other risk factors are having TIAs, obesity, smoking, diabetes, excessive alcohol, oral contraceptive use, and lack of exercise.