Deck 27: Alterations of Leukocyte, Lymphoid, and Hemostatic Function

Question 1

DIC is a paradoxical condition in which clotting and hemorrhage occur within the vascular system simultaneously.

Answer 1

True

Question 2

RS cells represent malignant transformation and proliferation of:

A)IL-1, IL-2, IL-5, and IL-6.
B)tumor necrosis factor-beta.
C)B cells.
D)T cells.

Answer 2

B cells.

Question 3

In infectious mononucleosis (IM), what does the Monospot test detect?

A)IgE
B)IgM
C)IgG
D)IgA

Answer 3

IgM

Question 4

A 20-year-old is diagnosed with infectious mononucleosis (IM).Which of the following is one of the classic clinical manifestations?

A)Lymph node enlargement
B)Hepatitis
C)Rash on the trunk and extremities
D)Edema in the area of the eyes

Question 5

The two major forms of leukemia, acute and chronic, are classified by a predominant cell type and the rate at which the affected person develops clinical symptoms.

Question 6

In Hodgkin disease and non-Hodgkin lymphoma (NHL), T cell function is severely decreased.

Question 7

Which of the following is a description consistent with chronic myelogenous leukemia (CML)?

A)There are defects in the ras oncogene, TP53 tumor-suppressor gene, and INK4A, the gene encoding a cell-cycle regulatory protein.
B)The bone marrow and peripheral blood are characterized by leukocytosis and a predominance of blast cells. As the immature blasts increase, they replace normal myelocytic cells, megakaryocytes, and erythrocytes.
C)There is failure of B cells to mature into plasma cells that synthesize immunoglobulins.
D)The translocation of genetic material from genes 9 and 22 creates an abnormal, fused protein identified as BCR-ABL.

Question 8

In the leukemias, a single progenitor cell undergoes malignant transformation.

Question 9

What change is seen in leukocytes during an allergic disorder (type I) often caused by asthma, hay fever, and drug reactions?

A)Neutrophilia
B)Basophilia
C)Eosinophilia
D)Monocytosis

Question 10

Which of the following is a description consistent with acute lymphocytic leukemia (ALL)?

A)It is a progressive neoplasm defined by the presence of greater than 30% lymphoblasts in the bone marrow or blood.
B)The bone marrow and peripheral blood are characterized by leukocytosis and a predominance of blast cells. As the immature blasts increase, they replace normal myelocytic cells, megakaryocytes, and erythrocytes.
C)There is failure of B cells to mature into plasma cells that synthesize immunoglobulins.
D)The translocation of genetic material from genes 9 and 22 create an abnormal, fused gene identified as BCR-ABL.

Question 11

In DIC, a large amount of microvascular and macrovascular occlusion may occur that is not clinically obvious.

Question 12

Non-Hodgkin lymphoma may be associated with Epstein Barr virus or HIV.

Question 13

Philadelphia chromosome is present in lymph nodes of an individual with Hodgkin disease.

Question 14

Which electrolyte imbalance accompanies multiple myeloma (MM)?

A)Hyperkalemia
B)Hypercalcemia
C)Hyperphosphatemia
D)Hypernatremia

Question 15

A shift to the left describes the premature release of immature neutrophils when the demand for mature neutrophils exceeds the supply.

Question 16

One of the most common causes of disseminated intravascular coagulation (DIC) is sepsis.

Question 17

Arterial thrombi are composed of erythrocytes with larger amounts of fibrin and very few platelets, whereas venous thrombi are composed of mostly platelets held together by fibrin strands.

Question 18

Which of the following is a description consistent with chronic lymphocytic leukemia (CLL)?

A)There are defects in the ras oncogene, TP53 tumor-suppressor gene, and INK4A, the gene encoding a cell-cycle regulatory protein.
B)The bone marrow and peripheral blood are characterized by leukocytosis and a predominance of blast cells. As the immature blasts increase, they replace normal myelocytic cells, megakaryocytes, and erythrocytes.
C)There is failure of B cells to mature into plasma cells that synthesize immunoglobulins.
D)The translocation of genetic material from genes 9 and 22 creates an abnormal, fused protein identified as BCR-ABL.

Question 19

Early detection of acute leukemia would include which of the following symptoms?

A)Dizziness, dehydration, palpitations, hypotension
B)Dyspnea, paresthesia, malaise
C)Bradycardia, abdominal pain, fever
D)Bruising, fatigue, bone pain, anorexia

Question 20

Frequently the initial sign of Hodgkin disease is a painless mass, lump, or swelling, most commonly on the neck.

Question 21

Match the causes or diagnostic tests with the hematologic disorders.
Infectious mononucleosis

A)Epstein-Barr virus
B)Bence Jones protein
C)Diagnosed by the Reed-Sternberg (RS) cell
D)Diagnosed by the Philadelphia chromosome

Question 22

Heparin-induced thrombocytopenia (HIT) is described as a(n):

A)IgG immune-mediated adverse drug reaction that reduces circulating platelets.
B)hematologic reaction to heparin in which the bone marrow is unable to produce sufficient platelets to meet the body's needs.
C)IgE-mediated allergic drug reaction that reduces circulating platelets.
D)cell-mediated drug reaction in which macrophages process the heparin and platelet complexes that are then destroyed by activated cytotoxic T cells.

Question 23

Match the causes or diagnostic tests with the hematologic disorders.
Multiple myeloma

A)Epstein-Barr virus
B)Bence Jones protein
C)Diagnosed by the Reed-Sternberg (RS) cell
D)Diagnosed by the Philadelphia chromosome

Question 24

Match the causes or diagnostic tests with the hematologic disorders.
Chronic myelogenous leukemia (CML)

A)Epstein-Barr virus
B)Bence Jones protein
C)Diagnosed by the Reed-Sternberg (RS) cell
D)Diagnosed by the Philadelphia chromosome

Question 25

Local signs and symptoms of Hodgkin disease-related lymphadenopathy is a result of:

A)pressure and ischemia.
B)pressure and obstruction.
C)inflammation and ischemia.
D)inflammation and pressure.

Question 26

Match the descriptions with the platelet disorders.
Essential (primary) thrombocythemia (ET)

A)Thrombi composed of platelets with minimal fibrin and erythrocytes that occlude arterioles and capillaries
B)Causes ischemic signs and symptoms in the central nervous system
C)Caused by an alteration of multipotent stem cells, resulting in an excess production of platelets
D)Antibody-coated platelets removed from circulation by mononuclear phagocytes in the spleen

Question 27

What is the most common cause of vitamin K deficiency?

A)Administration of warfarin (Coumadin)
B)Total parenteral nutrition (TPN) with antibiotic therapy
C)An IgG-mediated autoimmune disorder
D)Liver failure

Question 28

Vitamin _____ is required for normal clotting factor synthesis by the _____.

A)K; kidneys
B)D; kidneys
C)K; liver
D)D; liver

Question 29

Which disorder is described as an unregulated release of thrombin with subsequent fibrin formation and accelerated fibrinolysis?

A)DIC
B)ITP
C)Heparin-induced thrombocytopenia (HIT)
D)Essential thrombocythemia (ET)

Question 30

Match the causes or diagnostic tests with the hematologic disorders.
Hodgkin disease

A)Epstein-Barr virus
B)Bence Jones protein
C)Diagnosed by the Reed-Sternberg (RS) cell
D)Diagnosed by the Philadelphia chromosome

Question 31

In DIC, what activates the coagulation cascade?

A)Cytokines, such as platelet-activating factor (PAF), and tumor necrosis factor- alpha (TNF-a)
B)Thromboxane A causing platelets to aggregate and consume clotting factors
C)Tissue factor (TF) located in the endothelial layer of blood vessels and subcutaneous tissue
D)Endotoxins from gram-negative and gram-positive bacteria circulating within the bloodstream

Question 32

_____ is the virus associated with Burkitt lymphoma in African children.

A)Cytomegalovirus
B)Adenovirus
C)Human papillomavirus
D)Epstein-Barr virus

Question 33

Which proinflammatory cytokines are responsible for the development and maintenance of DIC?

A)Granulocyte colony-stimulating factor (G-CSF); IL-2, IL-4, and IL-10; and IFN-g
B)Granulocyte-macrophage colony-stimulating factor (GM-CSF); IL-3, IL-5, and IL-9, and IFN-g
C)Macrophage colony-stimulating factor (M-CSF); IL-7, IL-11, and IL-14; and PAF
D)TNF-a; IL-1, IL-6, and IL-8; and PAF

Question 34

Match the descriptions with the platelet disorders.
Thrombotic thrombocytopenic purpura (TTP)

A)Thrombi composed of platelets with minimal fibrin and erythrocytes that occlude arterioles and capillaries
B)Causes ischemic signs and symptoms in the central nervous system
C)Caused by an alteration of multipotent stem cells, resulting in an excess production of platelets
D)Antibody-coated platelets removed from circulation by mononuclear phagocytes in the spleen

Question 35

The most reliable and specific test for diagnosing DIC is:

A)prothrombin time (PT).
B)activated partial thromboplastin time (aPTT).
C)fibrin degradation products (FDP).
D)D-dimer.

Question 36

The most significant risk factors for the development of thrombus formation are referred to as the Virchow triad and include:

A)endothelial injury to blood vessels.
B)turbulent arterial blood flow.
C)rapid coagulation of the blood.
D)stagnant venous blood flow.
E)history of obesity.

Question 37

Immune thrombocytopenia (ITP) is a(n) _____ condition in adults and a(n) _____ condition in children.

A)acute; acute
B)chronic; chronic
C)acute; chronic
D)chronic; acute

Question 38

A patient with a bleeding disorder has a red-purple discoloration caused by diffuse hemorrhage into skin tissues.The nurse documents this discoloration as:

A)petechiae.
B)hematoma.
C)ecchymosis.
D)purpura.

Question 39

In DIC, what are indications of microvascular thrombosis?

A)Reduced amplitude in peripheral pulses
B)Symmetric cyanosis of fingers and toes
C)Numbness and tingling in fingers and toes
D)Pallor and edema of fingers and toes bilaterally

Question 40

Match the descriptions with the platelet disorders.
Immune thrombocytopenic purpura (ITP)

A)Thrombi composed of platelets with minimal fibrin and erythrocytes that occlude arterioles and capillaries
B)Causes ischemic signs and symptoms in the central nervous system
C)Caused by an alteration of multipotent stem cells, resulting in an excess production of platelets
D)Antibody-coated platelets removed from circulation by mononuclear phagocytes in the spleen

Question 41

Match the descriptions with the platelet disorders.
Acute idiopathic thrombotic thrombocytopenic purpura

A)Thrombi composed of platelets with minimal fibrin and erythrocytes that occlude arterioles and capillaries
B)Causes ischemic signs and symptoms in the central nervous system
C)Caused by an alteration of multipotent stem cells, resulting in an excess production of platelets
D)Antibody-coated platelets removed from circulation by mononuclear phagocytes in the spleen