Deck 46: Alterations of Leukocyte, Lymphoid, and Hemostatic Function

Question 1

Disseminated intravascular coagulation is a paradoxic condition in which clotting and hemorrhage occur within the vascular system simultaneously.

Answer 1

True

Question 2

What change is seen in leukocytes during an allergic disorder (type 1)often caused by asthma,hay fever,and drug reactions?

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

Answer 2

Eosinophilia

Question 3

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

Answer 3

Bruising,fatigue,bone pain,anorexia

Question 4

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

A) There are defects in the ras oncogene,p53 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 create an abnormal,fused gene identified as BCR-ABL.

Question 5

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

Question 6

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 7

In disseminated intravascular coagulation (DIC),a large amount of microvascular and macrovascular occlusion may occur that is not clinically obvious.

Question 8

Which electrolyte imbalance accompanies multiple myeloma?

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

Question 9

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

A) There are defects in the ras oncogene,p53 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 create an abnormal,fused gene identified as BCR-ABL.

Question 10

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

Question 11

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

Question 12

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

Question 13

In infectious mononucleosis (IM),which cytokines released by the CD8 cells are thought to cause the clinical features?

A) a-interferon and macrophage colony-stimulating factor
B) b-interferon and tumor necrosis alpha
C) Delta interferon and colony-stimulating factor
D) g-interferon and interleukin

Question 14

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

Question 15

A 20-year-old patient 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 16

In both Hodgkin disease and non-Hodgkin lymphoma,T cell function is severely decreased.

Question 17

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

Question 18

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

A) Immunoglobulin E (IgE)
B) Immunoglobulin M (IgM)
C) Immunoglobulin G (IgG)
D) Immunoglobulin A (IgA)

Question 19

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 20

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

A) There are defects in the ras oncogene,p53 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 create an abnormal,fused gene identified as BCR-ABL.

Question 21

Immune thrombocytopenia 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 22

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

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

Question 23

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

A)Thrombi composed of platelets with minimal fibrin and erythrocytes 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 24

MATCHING
Match the causes or diagnostic tests with the hematologic disorders.
Chronic myelogenous leukemia

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

Question 25

In disseminated intravascular coagulation (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 26

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 immunoglobulin G (IgG)-mediated autoimmune disorder
D) Liver failure

Question 27

How is heparin induced thrombocytopenia (HIT)described?

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

Question 28

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

A) Disseminated intravascular coagulation (DIC)
B) Immune thrombocytopenic purpura (ITP)
C) Heparin induced thrombocytopenia (HIT)
D) Essential thrombocythemia (ET)

Question 29

MATCHING
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 cell
D)Diagnosed by the Philadelphia chromosome

Question 30

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

A) Petechiae
B) Hematoma
C) Ecchymosis
D) Purpura

Question 31

Both lymphomas and lymphocytic leukemia involve cancer of the lymph system,but why do the leukemias cause clinical manifestations of anemia and bleeding,whereas the lymphomas do not?

A) In leukemia,the lymphatic tissue within the bone marrow is the site of origin,whereas in lymphoma,the lymph node or other lymphatic structure is the site of origin.
B) In leukemia,the lymph node or other lymphatic structure is the site of origin,whereas in lymphoma,the lymphatic tissue within the bone marrow is the site of origin.
C) In leukemia,there is malignant transformation of erythrocytes,platelets,and lymphocytes,whereas in lymphoma,only the lymphocytes are transformed.

Question 32

Which proinflammatory cytokines are responsible for the development and maintenance of disseminated intravascular coagulation (DIC)?

A) Granulocyte colony-stimulating factor (G-CSF),interleukins (Il-2,Il-4,Il-10),and interferon-a
B) Granulocyte-macrophage colony-stimulating factor (GM-CSF),interleukins (Il-3,Il-5,Il-9),and b-interferon
C) Macrophage colony-stimulating factor (M-CSF),interleukins (Il-7,Il-11,Il-14),and platelet-activating factor (PAF)
D) Tumor necrosis factor alpha (TNF-a),interleukins (Il-1,Il-6,Il-8),and platelet-activating actor (PAF)

Question 33

What is the most reliable and specific test for diagnosing disseminated intravascular coagulation (DIC)?

A) Prothrombin time (PT)
B) Activated partial thromboplastin time (aPTT)
C) Fibrin degradation products (FDP)
D) D-dimer

Question 34

How are local signs and symptoms of Hodgkin disease caused?

A) Ischemia and pressure
B) Pressure and obstruction
C) Inflammation and ischemia
D) Obstruction and inflammation

Question 35

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

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

Question 36

MATCHING
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 cell
D)Diagnosed by the Philadelphia chromosome

Question 37

In disseminated intravascular coagulation (DIC),what are indications of microvascular thrombosis?

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

Question 38

What do Reed-Sternberg cells represent?

A) Malignant transformation and proliferation of interleukins (Il-1,Il-2,Il-5,Il-6).
B) Malignant transformation and proliferation of tumor necrosis factor beta.
C) Malignant transformation and proliferation of B cells.
D) Malignant transformation and proliferation of T cells.

Question 39

MATCHING
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 cell
D)Diagnosed by the Philadelphia chromosome

Question 40

What is the most significant cause of thrombus formation?

A) Endothelial injury to blood vessels
B) Turbulent blood flow
C) Rapid coagulation of the blood
D) Stagnant blood flow

Question 41

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

A)Thrombi composed of platelets with minimal fibrin and erythrocytes 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 42

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

A)Thrombi composed of platelets with minimal fibrin and erythrocytes 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 43

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

A)Thrombi composed of platelets with minimal fibrin and erythrocytes 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