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MSN 570 Advanced Pathophysiology Final 2024
1. Anemia of chronic inflammation is generally classified as:
- A. Hypochromic and microcytic.
- B. Hypochromic and macrocytic.
- C. Normochromic and microcytic.
- D. Normochromic and normocytic.
Correct answer: D
Rationale: Anemia of chronic inflammation is typically characterized by normochromic (normal hemoglobin content) and normocytic (normal cell size) red blood cells. Choice A, hypochromic and microcytic, is incorrect because hypochromic refers to reduced hemoglobin content and microcytic refers to smaller than normal red blood cells, which are not typically seen in anemia of chronic inflammation. Choice B, hypochromic and macrocytic, is also incorrect as macrocytic refers to larger than normal red blood cells. Choice C, normochromic and microcytic, is incorrect because microcytic red blood cells are smaller than normal. Therefore, the correct classification for anemia of chronic inflammation is normochromic and normocytic.
2. A 25-year-old just had a colonoscopy and was diagnosed with Crohn disease. Which of the following is consistent with this diagnosis?
- A. Right lower quadrant cramping
- B. Severe bloody diarrhea
- C. Nausea and vomiting
- D. Mostly affects the rectum
Correct answer: A
Rationale: Crohn's disease is a type of inflammatory bowel disease that can affect any part of the digestive tract. Right lower quadrant cramping is consistent with Crohn's disease as it commonly involves the terminal ileum, which is located in the right lower quadrant of the abdomen. Severe bloody diarrhea is more characteristic of ulcerative colitis, another type of inflammatory bowel disease. Nausea and vomiting are not specific symptoms of Crohn's disease. Crohn's disease can affect any part of the digestive tract, not just the rectum, so it is not accurate to say it mostly affects the rectum.
3. A 30-year-old man has a history of heart transplant and is receiving long-term steroids to prevent rejection. The patient is due for routine vaccines. Attenuated vaccines are contraindicated in this patient because the antigen is:
- A. live and can cause infection.
- B. mutated and infectious.
- C. inactive but still infectious
- D. pathogenic
Correct answer: A
Rationale: The correct answer is A: live and can cause infection. Patients who are immunocompromised, like those receiving long-term steroids after an organ transplant, should not receive live vaccines because the live attenuated organisms in these vaccines can cause infections in individuals with weakened immune systems. Choice B is incorrect because attenuated vaccines are live but weakened, not mutated. Choice C is incorrect because while inactive, attenuated vaccines are not infectious. Choice D is incorrect because attenuated vaccines are not pathogenic; they are attenuated (weakened) forms of the pathogen.
4. Which of the following clinical findings in a 51-year-old woman is consistent with Graves disease?
- A. Thin hair, exophthalmos, hyperreflexia, and pretibial edema.
- B. Thin hair, exophthalmos, weight gain, and constipation.
- C. Thick hair, bradycardia, weight loss, and dry skin.
- D. Thick hair, bradycardia, weight gain, and constipation.
Correct answer: A
Rationale: The clinical findings of thin hair, exophthalmos (bulging eyes), hyperreflexia, and pretibial edema are classic manifestations of Graves disease, an autoimmune condition that results in hyperthyroidism. Choice B is incorrect because weight gain and constipation are more indicative of hypothyroidism, not hyperthyroidism seen in Graves disease. Choice C is incorrect as the symptoms described are more characteristic of hypothyroidism, not hyperthyroidism. Choice D is also incorrect as the symptoms listed are not consistent with Graves disease but rather suggest hypothyroidism.
5. A woman is complaining that she feels like the room is spinning even though she is not moving. Which of the following is characteristic of benign positional vertigo?
- A. It usually occurs with a headache.
- B. Pupillary changes are common.
- C. It is usually triggered when the patient bends forward.
- D. Nystagmus continues even when eyes fixate on an object.
Correct answer: C
Rationale: Benign positional vertigo is typically triggered by changes in head position, such as bending forward or turning over in bed. This change in position leads to brief episodes of vertigo, often associated with nystagmus, which is rapid, involuntary eye movements. Pupillary changes and headaches are not typical features of benign positional vertigo, making choices B and A incorrect. Nystagmus in benign positional vertigo usually stops when the eyes fixate on an object, so choice D is also incorrect.
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