Test 1 #2
Which nutrient is someone most deficient in if they have pernicious anemia?
A. Iron
B. Vitamin B12
C. Folic acid
D. Protein
B.
Lack of vitamin B12 in the diet/low absorption of B12 causes pernicious anemia.
One of your patients has chronic cholecystitis and is asking about ways to help prevent symptoms. What is one education point to go over with them about helping prevent further irritation of the gallbladder?
A. Consume a low-fat, low-calorie diet
B. Lose weight rapidly
C. Take oral contraceptives
D. Gain a few pounds over the next few weeks
A.
Risk factors for gallbladder disease are female gender, genetics, age 40+, oral contraceptive use, obesity, high fat, high calorie diets and rapid weight loss.
Which lab test is the most effective in diagnosing someone with a myocardial infarction?
A. ECG
B. CPK-mb levels
C. Echocardiogram
D. Troponin levels
D.
If someone has elevated blood troponin levels in any manner, it means they have had some sort of damage done to their myocardium.
What is the effect of glucagon on the body?
A. Causes the uptake of glucose by cells for use in metabolism and to lower blood glucose levels
B. Causes glycogenolysis and gluconeogenisis to raise blood glucose levels
C. Signals the pancreas to increase insulin production
D. Signals the adrenal glands to release cortis
B.
Glucagon is released in times of hypoglycemia and/or starvation to raise blood glucose levels. It is also one form of treatment for hypoglycemic emergencies.
This is the process by which RNA is synthesized from DNA.
A. Translation
B. Expressivity
C. Transcription
D. Penetrance
C.
Transcription is the process by which RNA is synthesized from DNA. Translation is when protein in synthesized from RNA.
Which stage of a pressure ulcer goes through the skin and effects the underlying muscle and adipose tissue but does not go to the bone?
A. Stage 1
B. Stage 3
C. Stage 4
D. Stage 2
B.
Stage 1 doesn’t break the skin but is usually a reddened area on a pressure point that does not blanch when touched.
Stage 2 breaks the skin but does not affect the underlying muscle or adipose tissue.
Stage 4 goes all the way through the skin, muscle, fat, and down to the bone.
A patient comes to the clinic and says they are having abdominal pain in the RLQ (McBurney's point), are running a fever, and claim to feel bloated. They say it has been going on for about 2 days. What do you most suspect is happening with this patient?
A. Gastroenteritis
B. Ulcerative colitis
C. Large bowel obstruction
D. Appendicitis
D.
Classic s/s of appendicitis are abdominal pain at McBurney's point (the RLQ), fever, abdominal distension, and rebound tenderness on palpation.
Which disease can cause alveoli to over inflate and cause air trapping w/ in the lung leading to the retention of CO2?
A. Chronic bronchitis
B. Emphysema
C. Pleural edema
D. Asthma
B
Emphysema is caused by the lungs losing their elasticity, causing retention of Co2 and air to get trapped w/ in the lungs.
Which hormone is released by the adrenal medulla?
A. Epinephrine
B. Cortisol
C. Testosterone
D. Aldosterone
A.
The adrenal medulla (inner/deeper portion of the gland) releases epinephrine and norepinephrine while the adrenal cortex releases corticosteroids and androgens like cortisol, aldosterone, and testosterone.
A patient of yours comes to the clinic complaining of abdominal pain, nausea, and a fever. On assessment you find that she has hepatomegaly and her skin in jaundiced. She says she was recently in a foreign country and ate some raw seafood at a few restaurants. You suspect a hepatitis infection. Which form of hepatitis is most likely causing her symptoms?
A. Hepatitis D
B. Hepatitis B
C. Hepatitis A
D. Hepatitis C
C.
Hepatitis A is spread through the fecal-oral route, usually from food workers handling raw food without washing their hands/cooking tools or food not being cooked to proper temperatures.
Which type of immunoglobulin (Ig) is released when the body is initially exposed to an antigen?
A. IgG
B. IgE
C. IgM
D. IgD
C.
The primary phase occurs when the host cell is exposed to an antigenic invader and proliferation of immunoglobulins to neutralize the invader. The primary immunoglobulin IgM marks the primary response.
One of your patients is suspected of having peptic ulcer. What kind of diagnostic procedure will be most helpful in diagnosing this patient with a peptic ulcer?
A. Upper GI series (barium swallow test)
B. Upper endoscopy
C. Colonoscopy
D. Fecal occult blood test (FOBT)
B.
Upper Endoscopies are done to visualize the inside of the esophagus, stomach, and duodenum. These are used to help diagnose someone with peptic ulcers and/or cancer of the stomach or esophagus.
A patient comes to the clinic and they are complaining of SOB, a cough, night sweats, weight loss, and a low grade fever. What do you suspect they most likely have based on these findings?
A. Pneumonia
B. A lung abscess
C. Acute bronchitis
D. Tuberculosis
D.
Tuberculosis is an infection by Mycobacterium Tuberculosis. This bacteria can be present in other places in the body but mostly infect the lungs. Classic s/s of tuberculosis infection are night sweats, weight loss, cough w/ bloody sputum, dyspnea, anorexia, and a low-grade fever.
Why does someone with DKA most likely have Kussmaul respirations?
A. As compensation for hypovolemia
B. Because they are hypoxic
C. To help blow off extra CO2 from the body as compensation for metabolic acidosis
D. Hyperglycemia causes increased respirations
C.
The more CO2 someone has in their blood, the more acidic it is. In DKA, ketones cause acidosis so the body will do what it can to help compensate for this by getting rid of more CO2 from the blood.
This genetic disease results from a mutation on the FBN1 gene on the 15th chromosome which results in abnormalities in the production of connective tissue in joints, the aorta, heart, etc. People with this are usually very tall and lanky.
A. Ehlers-Danlos Syndrome
B. Turner Syndrome
C. Fragile X Syndrome
D. Marfan Syndrome
D.
Joints are also hypermobile in people with Marfan. They are also at risk for heart arrhythmias and aneurysms.
What are some s/s of thrombocytopenia? (select all that apply)
A. Spontaneous bleeding (like a nosebleed)
B. Difficulty breathing
C. Purpura
D. Ecchymosis
E. Chest pain
A, C, and D
Thrombocytopenia is the term for low platelets. Signs of it are due to the bloods inability to clot well. Signs of it can be spontaneous bruising and bleeding.
What are some s/s of hyperkalemia? (select all)
A. Heart rhythm changes
B. Tingling/numbness of the extremities
C. N/V
D. Oliguria
E. Confusion
A, B, E
Other symptoms are diarrhea, apathy, and muscle cramps
What are some of the major s/s of right sided heat failure? (select all that apply)
A. Dyspnea
B. Ankle edema
C. JVD
D. Cough w/ pink frothy sputum
E. Orthopnea
B, C
Ride-sided HF causes back up of blood into the systemic circulation, causing s/s such as ascites, JVD, and ankle/leg edema. Left-sided causes back up of blood into the pulmonary circulation, causing pulmonary edema, dyspnea, coughing w/ pink, frothy sputum, and orthopnea (worsening SOB while laying down).
What are some major s/s of someone with Graves Disease?
A. Heat intolerance
B. Weight gain
C. Increased appetite
D. Insomnia
E. Fatigue
A, C, D
Graves disease is the number 1 cause of hyperthyroidism and so you would expect the typical s/s associated with hyperthyroidism. Other s/s are weight loss, irritability, slight fever, htn, tachycardia, and bulging eyes (exophthalmos)
What are some of the major causes of heart failure? (select all that apply)
A. Uncontrolled hypertension
B. MIs
C. Genetics
D. Chronic lung disease
E. Caffeine use
A, B, C, D
Other causes are exposure to certain drugs/chemicals like chemotherapy, and chronic dysrhythmias.
What are some general s/s of leukemia? (select all that apply)
A. Anemia
B. Bone pain
C. Blood clots
D. Infections
E. Bruising
A, B, D, E
Leukemia causes the overproduction of immature WBCs and can lower the production of all other blood cells.
One of your patients has acute glomerulonephritis. What are some things you can expect to see in a patient with this? (select all)
A. Hypotension
B. Hematuria
C. Edema
D. Urine negative for protein
E. Recent strep throat infection
B, C, E
Proteinuria, edema, hypertension, hematuria, and tea/cola colored urine are all signs of acute glomerulonephritis.
What are some characteristics of an ulcer that formed because of PAD?
A. Large amounts of drainage
B. Irregular edges
C. A "punched out" look to it
D. Tend to be on the ends of toes/tops of feet
E. Very little tissue granulation
C, D, E
Arterial ulcers form due to poor blood flow/oxygen delivery to the tissue. They also have regular edges, tend to be circular. and have very little drainage.
What are the major lab/physical findings in someone with HHS? (select all that apply)
A. Acidosis
B. Ketonuria
C. BG >600
D. Kussmaul respirations
E. Polyuria
C, E
HHS is more common in type 2 diabetics and DKA is more common in type 1 diabetics. HHS does not cause ketone production, due to the fact that type 2 diabetics make some insulin, and so patients with HHS don't form acidosis, ketonuria, or kussmaul respirations. BG levels tend to be a lot higher in HHS than in DKA (>300 in DKA, >600 in HHS). Both still cause major polyuria, polydypsia, some polyphagia, and subsequent dehydration and electrolyte imbalances.
What are some of the most common diseases to look out for in older adult patients? (select all that apply)
A. Chronic kidney disease
B. Heart failure
C. Osteoporosis
D. Diabetes
E. Dementia
A, B, C, D, and E
Older adults are more at risk for all of these diseases and then some. This is why older adults need more care and are usually on multiple medications at once.