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NURS5315 FINAL EXAM /QUESTIONS AND ANSWERS
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Anion gap level Normal range is 3- 10 Osmol gap normal range and heat does an elevated value mean Normal range is <10 mOsm/kg; elevated levels indicate ethyl alcohol (etoh) consumption What triggers renin releases Triggered by dehydration; involved in the regulation of blood pressure What does a cirrhosis and HF do to oncotic pressure Increased in cirrhosis; decreased in heart failure What does an elevated serum osmolality pull Elevated levels pull potassium What acid base imbalance can thiazide diuretics cause and why Cause metabolic alkalosis due to aldosterone stimulation of Na and bicarb reabsorption in proximal tubule
ACIDOSIS r/t potassium Associated with hyperkalemia What IL is associated with Crohns and why inflammation associated with IL- 4 Adherence seen with WBC Diapedesis First line of immune defense and example Innate immunity; intact mucosal An anamnestic immune response due to maternal antibodies Hemolytic anemia of a newborn Flu and infection release Cytokine Mycobacterium avium Acid fast bacteria with a super thick cell wall; requires long haul antibiotics to break through
Causes loss of atrial kick, resulting in lack of cardiac output and potential syncope A-fib Can cause pulmonary edema; hypertrophy is not acute during surgery Aortic stenosis Community-acquired pneumonia is caused by Caused by Streptococcus pneumoniae Hypovolemic shock from diarrhea causes pyruvate to produce.... Caused by diarrhea, leading to pyruvate production and lactic acidosis Croup often causes by Caused by parainfluenza virus Factor V Leiden Mutation often causes Causes hypercoagulability and is associated with pulmonary embolism COPD FEV Characterized by low FEV
Takes weeks to develop and is seen in elderly individuals who fall Subdural hematoma Fontanels are not all closed until Do not close until 18 months Cerebral palsy causes Caused by injury or abnormal brain development; hemorrhage during birth can be a cause Responsible for lack of coordination Cerebellum Subarachnoid can cause irritation to meninges due to contact with ______ Pia Decrease cerebral blood flow and glucose metabolism can lead to______ due to_______ Can lead to depression due to decreased 5-HT Addison's Hypofunction of adrenal cortex; lack of aldosterone and cortisol
Prostaglandins cause Cause pain and clotting Leukocyte whispers that stimulate the hypothalamus Leukotrienes Complement system is a part of Part of the immune response Kinin system is associated with Involved in pain and blood vessels Leukocytes are related to IL-1 and TNF NK cells are related to IL- 2 Mast and eosinophils are related to IL-4 and IL- 5
Monocytes and granulocytes are related to CSF Interleukins that communicate with white blood cells and are released by macrophages and lymphocytes Cytokines Released by macrophages; causes fever and acts as a pyrogen TNF Active Immunity (B or T cell) T cell-related Cell-mediated immunity (B or T cell) T cell-related Adaptive immunity (B or T cell) B cell-mediated Humoral immunity (B or T cell) B cell-mediated
SLE diagnosed with Diagnosed with ANA test Rhemuathoid Arth diagnosed with Diagnosed with presence of ACPA, RF, and CRP levels Staph bacteria type Gram-positive bacteria; type A affects upper body, type B affects vaginal and lower body E. coli bacteria gram Gram-negative bacteria Rapid mutation seen in flu and RNA viruses Antigenic drift Gene switching and species switching; takes approximately 3 days Antigenic shift Enzymes released by bacteria that cause an immune response Exotoxins
Lipopolysaccharides found in gram-negative bacteria that cause a pyrogenic response Endotoxins Enters the nucleus and transcribes mRNA to make proteins Viral DNA Cytoplasm translation makes viral proteins Viral RNA Endotoxin with flying structures that propel around the cell Listeria Hides in macrophages and fills them up, leading to necrosis TB measles contagious period Contagious 5 days before rash and 4 days after rash appears
Purine antagonists MOA. Example Prevent growth of DNA within T cells Ex: azathioprine Mycophenolate mofetil MOA Inhibits action of inosine, limiting DNA and RNA synthesis Corticosteroids MOA Prevent RNA and DNA synthesis, cytokine release, and production of IL- 2 WBC normal range Normal range is 5,000-10,000mm RBC normal range Normal range for males is 4.7-6.1 and for females is 4.2-5.
Hgb normal range Normal range for males is 14-18 and for females is 12- 16 HCT normal range Normal range for males is 42-52% and for females is 37-47% MCV normal range Average size of RBC; normal range is 80-100mm Reticulocyte count indicates and normal range is? Indicative of bone marrow response; normal range is 0.5%-2% Neutrophils normal range Normal range is 55-70% Bands normal range. Elevation indicates Immature neutrophils; normal range is 0.2mm
Microcytic anemia MCV count and causes MCV <80; caused by iron deficit Normocytic anemia MCV count and causes MCV 80-100; caused by sickle cell, chronic infection, or inflammation Macrocytic anemia MCV count and causes MCV >100; caused by pernicious anemia (deficit in B12) or folate deficit Anemia relation to vessels Vasoconstriction and RAAS activation occur when oxygen delivery is reduced; mass vasodilation can occur Sickle cell genes Homozygous for disease, heterozygous for trait PT
Measurement of extrinsic pathway; prolonged time indicates deficit of vitamin K, factor deficit, liver disease, or warfarin use aPTT Measurement of intrinsic pathway; used to monitor heparin therapy Thrombocytopenia Decreased platelet count; severe cases have platelets <10k and exhibit signs of bleeding Thrombotic thrombocytopenic purpura Platelet aggregation leading to occlusion; caused by familial large vWF and low ADAMTS13; normal PT/PTT; elevated creatine, BUN, LDH, and bilirubin; fragmented cells on smear Hemophilia A labs Normal PT, abnormal aPTT, decreased factor VIII
Eosinopenia Decrease in eosinophil count; seen in pancytopenia and steroid use Basophilia Increase in basophil count; seen in allergic reactions Monocytosis Increase in monocyte count; seen in recovery from infection or presence of TB Monocytopenia Decrease in monocyte count; seen in steroid use and HIV infections Lymphocytosis Increase in lymphocyte count; seen in viral infections, lymphoma, and leukemia
Lymphocytopenia Decrease in lymphocyte count; seen in AIDS and steroid use ALL Characterized by >30% lymphoblasts; common in children AML Characterized by proliferation of myeloid cells; associated with chromosomal abnormalities CLL Malignancy of B lymphocytes; long lifespan; associated with neutropenia CML Characterized by the Philadelphia chromosome (translocation between chromosomes 9 and 22); fusion of BCR; 3-stage progression Leukemia
