Quiz 29: Alterations of Leukocyte, Lymphoid, and Hemostatic Function

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Quiz 29: Alterations of Leukocyte, Lymphoid, and Hemostatic Function

Questions 34
Instructor Verified Answers Included
WarofGrades Guaranteed A+ Graded Tutorial

MULTIPLE CHOICE

1. What change is observed in leukocytes during an allergic disorder (type I hypersensitivity) often caused by asthma, hay fever, and drug reactions?
a. Neutrophilia c. Eosinophilia
b. Basophilia d. Monocytosis

2. In infectious mononucleosis (IM), what does the Monospot test detect?
a. Immunoglobulin E (IgE) c. Immunoglobulin G (IgG)
b. Immunoglobulin M (IgM) d. Immunoglobulin A (IgA)

3. Which description is consistent with acute lymphocytic leukemia (ALL)?
a. ALL is a progressive neoplasm defined by the presence of greater than 30% lymphoblasts in the bone marrow or blood.
b. Leukocytosis and a predominance of blast cells characterize the bone marrow and peripheral blood. As the immature blasts increase, they replace normal myelocytic cells, megakaryocytes, and erythrocytes.
c. B cells fail 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.

4. Which description is consistent with chronic myelogenous leukemia (CML)?
a. Defects exist in the ras oncogene, TP53 tumor-suppressor gene, and INK4A, the gene encoding a cell-cycle regulatory protein.
b. Leukocytosis and a predominance of blast cells characterize the bone marrow and peripheral blood. As the immature blasts increase, they replace normal myelocytic cells, megakaryocytes, and erythrocytes.
c. B cells fail 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-ABL1.

5. Which description is consistent with chronic lymphocytic leukemia (CLL)?
a. Defects exist in the ras oncogene, TP53 tumor-suppressor gene, and INK4A, the gene encoding a cell-cycle regulatory protein.
b. Leukocytosis and a predominance of blast cells characterize the bone marrow and peripheral blood. As the immature blasts increase, they replace normal myelocytic cells, megakaryocytes, and erythrocytes.
c. B cells fail 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.

6. Which electrolyte imbalance accompanies multiple myeloma (MM)?
a. Hyperkalemia c. Hyperphosphatemia
b. Hypercalcemia d. Hypernatremia

7. Reed-Sternberg (RS) cells represent malignant transformation and proliferation of which of the following?
a. Interleukin (IL)–1, IL-2, IL-5, and IL-6
b. Tumor necrosis factor–beta
c. B cells
d. T cells

8. Local signs and symptoms of Hodgkin disease–related lymphadenopathy are a result of which of the following?
a. Pressure and ischemia c. Inflammation and ischemia
b. Pressure and obstruction d. Inflammation and pressure

9. Which virus is associated with Burkitt lymphoma in African children?
a. Cytomegalovirus c. Human papillomavirus
b. Adenovirus d. Epstein-Barr virus

10. Which term is used to describe a red-purple discoloration caused by diffuse hemorrhage into the skin tissue?
a. Petechiae c. Ecchymosis
b. Hematoma d. Purpura

11. Which statement best describes heparin-induced thrombocytopenia (HIT)?
a. Immunoglobulin G 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. Immunoglobulin E–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.

12. Immune thrombocytopenia (ITP) is a(n) _____ condition in adults and a(n) _____ condition in children.
a. Acute; acute c. Acute; chronic
b. Chronic; chronic d. Chronic; acute

13. Vitamin _____ is required for normal clotting factor synthesis by the _____.
a. K; kidneys c. K; liver
b. D; kidneys d. D; liver

14. What is the most common cause of vitamin K deficiency?
a. Administration of warfarin (Coumadin)
b. Total parenteral nutrition with antibiotic therapy
c. An immunoglobulin G–mediated autoimmune disorder
d. Liver failure

15. 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)

16. In disseminated intravascular coagulation (DIC), what activates the coagulation cascade?
a. Cytokines, such as platelet-activating factor (PAF), and tumor necrosis factor- alpha (TNF-)
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 in the bloodstream

17. Which proinflammatory cytokines are responsible for the development and maintenance of disseminated intravascular coagulation (DIC)?
a. Granulocyte colony-stimulating factor (G-CSF); interleukin (IL)–2, IL-4, and IL-10; and tumor necrosis factor-gamma (IFN-)
b. Granulocyte-macrophage colony-stimulating factor (GM-CSF); and IL-3, IL-5, IL-9, and IFN-
c. Macrophage colony-stimulating factor (M-CSF); IL-7, IL-11, and IL-14; and PAF
d. Tumor necrosis factor-alpha (TNF-); IL-1, IL-6, and IL-8; and platelet-activating factor (PAF)

18. In disseminated intravascular coagulation (DIC), what are the 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. Bilateral pallor and edema of fingers and toes

19. 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

20. What term is used to identify thrombi that occlude arterioles and capillaries and are made up of platelets with minimal fibrin and erythrocytes?
a. Essential (primary) thrombocythemia (ET)
b. Acute idiopathic thrombotic thrombocytopenic purpura
c. Thrombotic thrombocytopenic purpura (TTP)
d. Immune thrombocytopenic purpura (ITP)

21. Which of the following is characterized by what is referred to as pathognomonic pentad of symptoms?
a. Acute idiopathic thrombotic thrombocytopenic purpura
b. Essential (primary) thrombocythemia (ET)
c. Immune thrombocytopenic purpura (ITP)
d. Thrombotic thrombocytopenic purpura (TTP)

22. Which statement relates to immune thrombocytopenic purpura (ITP)?
a. ITP is formed in conditions of low flow and is made up of mostly red cells with larger amounts of fibrin and few platelets.
b. An alteration of multipotent stem cells, resulting in an excess production of platelets, causes ITP.
c. Mononuclear phagocytes in the spleen remove antibody-coated platelets from circulation.
d. Arterial clots are made up of mostly platelet aggregates held together by fibrin strands.

23. When the demand for mature neutrophils exceeds the supply, immature neutrophils are released indicating:
a. A shift to the right c. Leukocytosis
b. A shift to the left d. Leukemia

24. Hodgkin disease is characterized by the presence of which of the following?
a. Philadelphia chromosome c. Microvascular thrombi
b. Virchow triad d. Reed-Sternberg (RS) cells

MULTIPLE RESPONSE

25. Which classic clinical manifestations are symptoms of IM? (Select all that apply.)
a. Lymph node enlargement
b. Hepatitis
c. Pharyngitis
d. Edema in the area of the eyes
e. Fever

26. Early detection of acute leukemia would include which of the following symptoms? (Select all that apply.)
a. Dizziness
b. Paresthesia
c. Anorexia
d. Bruising
e. Bone pain

27. What are the most significant risk factors for the development of thrombus formation as referred to by the Virchow triad? (Select all that apply.)
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

28. Which statements are true regarding leukemias? (Select all that apply.)
a. A single progenitor cell undergoes a malignant change.
b. Leukemia is a result of uncontrolled cellular proliferation.
c. Bone marrow becomes overcrowded.
d. Leukocytes are under produced.
e. Hematopoietic cell production is decreased.

29. The two major forms of leukemia, acute and chronic, are classified by which criteria? (Select all that apply.)
a. Predominant cell type
b. Rate of progression
c. Age of individual when cells differentiation occurs
d. Stage of cell development when malignancy first occurs
e. Serum level of leukocytes

30. What are the clinical manifestations of advanced non-African Burkitt lymphoma? (Select all that apply.)
a. Abdominal swelling
b. Night sweats
c. Fever
d. Weight gain
e. Dementia

MATCHING

Match the causes or diagnostic tests with the hematologic disorders.
______ A. Epstein-Barr virus
______ B. Bence Jones protein
______ C. Diagnosed by the Reed-Sternberg cell
______ D. Diagnosed by the Philadelphia chromosome

31. Infectious mononucleosis

32. Chronic myelogenous leukemia

33. Multiple myeloma

34. Hodgkin lymphoma

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