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MN 551 PATHO UNIT 2 QUESTIONS &
ANSWERS
1. Which of the following phenomena would be least likely to result in acti-
vation of the complement system? ANS Recognition of an antibody bound to the surface of a microbe The binding of mannose residues on microbial glycoproteins *******Activation of Toll-like receptors (TLRs) on complement proteins Direct recognition of microbial proteins
2. A tourist presented to a primary care health clinic complaining of malaise,
fever, and headache. She has subsequently been diagnosed with Rocky Mountain spotted fever, a pathology caused by Rickettsiaceae. Which of the followed statements best captures a characteristic trait of Rickettsiaceae?- ANS They are eukaryotic. ********They have both RNA and DNA. They have a distinct spiral-shaped morphology. They are neither gram-negative nor gram-positive.
3. A 23-year-old man has received a recent diagnosis of appendicitis follow-
ing 24 hours of acute abdominal pain. The nurse practitioner providing care for the man is explaining that while it is unpleasant, the inflammation of his appendix is playing a role in his body's fight against the underlying infectious
process. Which of the following teaching points should the nurse practitioner eliminate from his teaching for the patient? ANS "Inflammation can help to remove the body tissue cells that have been damaged by infection." "Inflammation will start your body on the path to growing new, healthy tissue at the site of infection. ********"Inflammation helps your body to produce the right antibodies to fight the infection." "Inflammation ultimately aids in eliminating the initial cause of the cell injury in your appendix."
4. Which of the following patients is most likely to benefit from transplanta-
tion of thymic tissue or major histocompatibility complex (MHC)-compatible
anti-infective therapies. Which of the following teaching points should the nurse practitioner exclude? ANS "Interferon can help your father's unaffected cells adjacent to his infected cells produce antiviral proteins that limit the spread of the infection." "Interferon can help limit the replication of the virus that's affecting your father." "Interferon helps your father's body recognize infected cells more effectively." *********"Interferon can bolster your father's immune system by stimulating natural killer cells that attack viruses."
7. A 14-year-old boy has been diagnosed with infectious mononucleosis.
Which of the following pathophysiological phenomena is most responsible for his symptoms? ANS The Epstein-Barr virus (EBV) is lysing many of the boy's neutrophils. *****Viruses are killing some of his B cells and becoming incorporated into the genomes of others. The EBV inhibits the maturation of white cells within his peripheral lymph nodes. The virus responsible for mononucleosis inhibits the maturation of myeloblasts into promyelocytes.
8. A couple who are expecting their first child have been advised by friends to
consider harvesting umbilical cord blood in order to have a future source of stem cells. The couple have approached their nurse practitioner with this request and are seeking clarification of exactly why stem cells are valuable and what they might expect to gain from harvesting them. How can the nurse practitioner best respond to the couple's inquiry? ANS "Stem cells can help correct autoimmune diseases and some congenital defects." "Stem cells can be used to regenerate damaged organs should the need ever arise." ********"Stem cells can be used as a source of reserve cells for the entire blood production system."
She most likely has ANS ANS A mild parasitic infection *******A severe bacterial infection A mild viral infection A severe fungal infection
11. Which of the following statements most accurately conveys an aspect of
lymphatic system activity? ANS ********B and T lymphocyte development begins in the bone marrow and ends in the peripheral lymphoid structures. B cells and macrophages are released from the bone marrow in their completed state. Stem cells in the lymph nodes initiate and regulate the process of white cell synthesis. Leukocytes bypass vascular circulation and are distributed instead by the lymphat- ic system.
12. Following a course of measles, a 5-year-old girl developed scattered
bruising over numerous body surfaces and was diagnosed with immune thrombocytopenic purpura (ITP). As part of her diagnostic workup, blood work was performed. Which of the following results is most likely to be con- sidered unexpected by the health care team?
ANS ********Increased thrombopoietin levels - help make blood cells and platelets Decreased platelet count Normal vitamin K levels Normal leukocyte levels
13. The blood work of a 44-year-old male patient with a diagnosis of liver
disease secondary to alcohol abuse indicates low levels of albumin. Which of the following phenomena would a clinician be most justified in anticipat- ing? ANS Impaired immune function Acid-base imbalances
******Bacterial
16. A 16-year-old female has been brought to her primary care nurse prac-
titioner by her mother due to the girl's persistent sore throat and malaise. Which of the following facts revealed in the girl's history and examination would lead the nurse practitioner to rule out infectious mononucleosis? ANS The girl has a temperature of 38.1°C (100.6°F) and has enlarged lymph nodes. Her liver and spleen are both enlarged. Blood work reveals an increased white blood cell count. *****Chest auscultation reveals crackles in her lower lung fields bilaterally.
17. A 2-year-old girl has had repeated ear and upper respiratory tract in-
fections since she was born. A pediatrician has determined a diagnosis of transient hypogammaglobulinemia of infancy. What is the physiological origin of the child's recurrent infections? ANS Antibody production by plasma cells is compromised because of impaired communication between B and T cells. **********The child had a congenital absence of immunoglobulin G (IgG) antibodies and her body is only slowly beginning to produce them independently. The child was born with immunoglobulin A (IgA) and immunoglobulin (IgM) anti- bodies, suggesting intrauterine infection. The child lacks the antigen presenting cells integral to normal B-cell antibody production.
18. A patient presented to the emergency department of the hospital with a
swollen, reddened, painful leg wound and has been diagnosed with methi- cillin-resistant Staphylococcus aureus cellulitis. The patient's nurse practi- tioner has ordered a complete blood count and white cell differential. Which of the following blood components would the nurse practitioner most likely anticipate to be elevated? ANS Basophils Eosinophils Platelets
20. A 30-year-old man has spent 5 hours on a cross-country flight seated next
to a passenger who has been sneezing and coughing, and the man has been inhaling viral particles periodically. Which of the following situations would most likely result in the stimulation of the man's T lymphocytes and adaptive immune system? ANS Presentation of a foreign antigen by a familiar immunoglobulin *****Recognition of a foreign MHC molecule Recognition of a foreign peptide bound to a self MHC molecule Cytokine stimulation of a T lymphocyte with macrophage or dendritic cell mediation
21. Mononucleosis
ANS infectious disease marked by increased numbers of leuko- cytes and enlarged cervical lymph nodes caused by Epstein-Barr Virus
22. cytokine
ANS Any of a group of proteins secreted by a number of cell types, includ- ing macrophages and helper T cells, that regulate the function of lymphocytes and other cells of the immune system.
