Deck 19: Medical Physiology: Integration Using Clinical Cases

Question 1

A patient experiencing chest pain and consequent anxiety about possibly having a heart attack could exhibit elevated systemic arterial blood pressure because of:

A)inhibition of the sympathetic nervous system.
B)excessive vasodilation of veins.
C)increased parasympathetic nervous system activity.
D)decreased levels of epinephrine in the bloodstream.
E)activation of the sympathetic nervous system.

Answer 1

E

Question 2

Which of the following symptoms or signs would NOT be expected to occur in an individual whose thyroid hormone secretion is above normal?

A)weight gain
B)increased body temperature
C)elevated perspiration and sweating
D)irritability and anxiety
E)hyperactive reflex reactions

Answer 2

A

Question 3

Which of the following is LEAST likely to explain why a patient's temperature might be elevated?

A)ingestion of food
B)increased blood thyroid hormone level
C)decreased epinephrine release from adrenal glands
D)movements exhibited normally by active skeletal muscle
E)increased activities regulated and sustained through the activity of the sympathetic nervous system

Answer 3

C

Question 4

Proptosis,also known as exopthalmos,refers to:

A)redness and dryness of a patch of skin.
B)audible movement of blood through an artery when listening with a stethoscope.
C)forward bulging of the eyeballs out of their sockets.
D)the leakage of blood backward through a heart valve.
E)double vision.

Question 5

Which of these findings would NOT be expected in a patient with Graves' disease?

A)a goiter
B)high plasma levels of thyroid-stimulating hormone (TSH)
C)exopthalmos
D)high plasma levels of thyroxine (T4)
E)high plasma level of thyroid-stimulating immunoglobulins (TSIs)

Question 6

Hypoxemia is a condition defined by:

A)increased systemic arterial oxygen levels.
B)decreased systemic venous oxygen levels.
C)increased systemic venous carbon dioxide levels.
D)decreased systemic arterial oxygen levels.
E)respiratory alkalosis.

Question 7

An obstruction that blocks blood flow through a vessel is called a(n)________________,and a blood clot in a blood vessel is referred to as a(n)________________.

A)embolism; atelectasis
B)atelectasis; embolism
C)thrombus; emboli
D)bruit; thrombus
E)embolism; thrombus

Question 8

Sepsis,associated with bacterial infections,is defined by which of the following signs/symptoms?

A) decreased respiratory rate and depth
B) elevated neutrophil count
C) decreased arterial PCO₂
D) increased arterial PO₂
E)hypothermia

Question 9

An alteration in either the structure or function of the human body leading away from a state of normal healthy function is called disease.More specifically the study of the changes in function associated with disease is known as:

A)homeopathy.
B)proctoptosis.
C)pathophysiology.
D)necropsy.
E)autopsy.

Question 10

Treatments for hyperthyroidism all involve reduction of the thyroid hormone levels.Which of those listed below is the most likely to do so by interfering with the synthesis of thyroid hormone without destroying viable thyroid gland tissue cells?

A)radioactive nucleotide
B)thyroidectomy
C)propylthiouracil and methimazole
D)beta-adrenergic receptor blockers
E)anti-inflammatory glucocorticoids

Question 11

Which of the following is LEAST likely to be observed in an individual with a hyperactive thyroid gland?

A)enlarged thyroid gland in neck; goiter
B)decreased levels of total and free T4 hormone in blood serum
C)increased TSH in blood serum
D)proptosis and diplopia
E)abnormally low blood glucose level

Question 12

Which of the following is most likely to cause arterial blood pH to increase to values greater than 7.5?

A)atelectasis
B)decreased ventilation of the lungs
C)diarrhea
D)hyperventilation
E)peripheral ischemia

Question 13

Which best explains most of the effects of hyperthyroidism on the cardiovascular system?

A)compensatory increased activity by the parasympathetic nervous system
B)compensatory decreased activity by the sympathetic nervous system
C)up-regulation of beta-adrenergic receptors by thyroid hormone
D)decreased utilization of iodine consequently leaving largely unused amounts in the bloodstream
E)destruction of adrenergic receptors by high levels of circulating thyroxine

Question 14

Which is true regarding the physiological variables that are measured and reported on in clinical laboratory tests?

A)Physiological variables vary within a range that is predefined as "normal," and even when a measurement is slightly outside the normal range it may not indicate the presence of disease.
B)When a physiological variable is measured and the number is different from the number that is the "normal" value,the patient is considered to be diseased.
C)Physiological variables vary with a range that is predefined as "normal," but disease is only considered to exist when a measurement comes back that is above the normal range.
D)Physiological variables vary with a range that is predefined as "normal," but disease is only considered to exist when a measurement comes back that is below the normal range.
E)When three or more physiological variables are measured and the numbers are different from the number that is the "normal" value,the patient is considered to be diseased.

Question 15

During the onset of a fever response,an individual feels "chills" despite body temperature being above normal,because:

A)the homeostatic set point temperature has been reset to a higher value,and the body has not yet reached that value.
B)evaporative cooling by sweat makes the skin feel abnormally cold.
C)vasoconstriction in muscles makes them ischemic,leading to shivering-like twitching.
D)the homeostatic set point temperature has been reset to values that are below normal,by cytokines or bacterial toxins.
E)sweat glands are inhibited,and the accumulation of cool water under the skin causes a chilling feeling.

Question 16

Which of the following conditions is most likely to be the physiological cause of hypoxemia?

A)increased depth and rate of ventilation
B)chronic obstructive lung diseases causing ventilation-perfusion imbalances
C)a ventricular septal defect that permits blood to flow through a hole from the left side of the heart to the right side of the heart
D)inhibition of gas exchange between alveolar capillaries and alveoli due to thickened alveolar epithelial membranes
E)failure of the kidney to produce adequate amounts of renal erythropoietic factor

Question 17

What body region commonly becomes painful during palpation in acute appendicitis?

A)the upper left abdominal quadrant
B)the upper right abdominal quadrant
C)midline of the lower back
D)the lower left abdominal quadrant
E)the lower right abdominal quadrant

Question 18

Elevated white blood cell counts can be indicative of:

A)bacterial infection.
B)viral infection.
C)parasitic infection.
D)immune hypersensitivities/allergic reactions.
E) All of the choices are correct.

Question 19

Which clinical test is most useful for confirming a diagnosis of pulmonary embolism?

A)an X-ray
B)a ventilation-perfusion scan
C)an ultrasound
D)systemic arterial oxygen measurement
E)systemic venous oxygen measurement

Question 20

In the condition known as peritonitis:

A) there is an inflammation of the membranes and fluid-filled space surrounding abdominal organs.
B)perforations of the pleural membranes lead to accumulation of pus and interstitial fluids in the thoracic cavity.
C)the covering connective tissues surrounding the abdominal muscles develop a paralyzing type of infection and may become necrotic.
D)a procedure known as dialysis is done to cleanse the blood of bacterial toxins.
E)an infection of the GI tract is producing referred pain in the abdominal and pubic regions leading to cramping and diarrhea.

Question 21

The practice of medicine can best be described as a skill which requires one to memorize the specific treatment called for in every conceivable disease state.

Question 22

To experience the effects of septic shock due to a bacterial infection,one must have viable reproducing microorganisms present in the bloodstream.

Question 23

Increased levels of lactate in the blood indicate:

A)cells are creating ATP so rapidly that acidosis is a result.
B)rapid excretion of bicarbonate ions in the urine.
C)increasing cellular production of ATP by anaerobic metabolism.
D)the arterial PO₂ and oxygen delivery to tissue cells is more than adequate for the metabolic needs.
E)respiratory alkalosis.

Question 24

A disease state seldom has effects on more than one of the major organ systems at the same time.

Question 25

Acute respiratory alkalosis is characterized by failure to eliminate carbon dioxide as quickly as it is produced by cells of the body.

Question 26

In a systemic inflammatory response,when capillaries become leaky,fluid accumulates in the interstitial space of the lungs,which is known as:

A)sepsis.
B)atelectasis.
C)hypoxia.
D)pulmonary edema.
E)circulatory shock.

Question 27

In a patients with septic shock,which of the following physiological variables is decreased compared to normal?

A)white blood cell count
B)pulse rate
C)concentration of H⁺ in the extracellular fluid
D)core body temperature
E)blood flow to body organs

Question 28

Chest pain and shortness of breath always indicate that a myocardial infarction is occurring.

Question 29

What is the mortality rate of patients who suffer from septic shock?

A)It is never fatal.
B)0-20%
C)20-40%
D)40-60%
E)100%

Question 30

Determining the cause(s)of disease often begins with recognition of the physiological process(es)associated with a particular symptom or sign,and working through the cause and effect relationships between multiple organ systems.

Question 31

Fever:

A)is a reduction in the body temperature caused by sweating and shivering.
B)is an adaptive response that raises the set point temperature of the body to help fight an infection.
C)is a maladaptive response induced by bacterial toxins,by which bacteria create conditions more favorable for their own growth.
D)is a warming of the skin,leading to reduction of the core body temperature and hypothermia.
E) is an adaptive response in which sweat glands dilate and secrete extra fluid,into which bacterial toxins are extruded.

Question 32

Which of these is an infection-fighting agent found in high levels in the pus that results from an infection?

A)necrotic cells
B)macrophages
C)histamine
D)red blood cells
E)interstitial fluids

Question 33

Immediate therapeutic interventions in the treatment of septic shock as a consequence of infection are aimed at __________________,which helps prevent ______________________.

A)increasing mean arterial blood pressure toward normal; widespread tissue ischemia and organ failure
B)reducing body temperature; proliferation of harmful bacteria
C)reducing the total body fluid volume with diuretic drugs; hypertension from developing
D)decreasing the rate and depth of ventilation; respiratory alkalosis
E)decreasing the pH of the blood; respiratory alkalosis

Question 34

Which sign/symptom is characteristic of septic shock?

A)a significant rise in systemic arterial blood pressure
B)a significant decrease in circulating white blood cell numbers
C)a significant decrease in systemic arterial blood pressure
D)a significant decrease in body temperature
E)a significant increase in total peripheral resistance

Question 35

Norepinephrine and vasopressin are used therapeutically to

A) decrease glomerular filtration rates.
B) decrease blood pressure.
C) increase blood pressure.
D) stabilize respiration rates.
E) enhance CO₂ and O₂ exchange between alveoli and alveolar capillaries.