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MSN 570 Advanced Pathophysiology Final 2024
1. A man with gout has developed large, hard nodules around his toes and elbows. The phase of gout he is in is:
- A. asymptomatic
- B. acute flare
- C. the intercritical period
- D. chronic gout
Correct answer: chronic gout
Rationale: The correct answer is 'chronic gout.' Chronic gout is characterized by the presence of tophi, which are large, hard nodules that can develop around joints like toes and elbows. These tophi are a sign of longstanding, untreated gout. Choice A, 'asymptomatic,' is incorrect as the presence of tophi indicates a symptomatic phase. Choice B, 'acute flare,' is incorrect as acute flares are characterized by sudden and severe pain, inflammation, and redness in the joints, not the development of tophi. Choice C, 'the intercritical period,' is also incorrect as this phase occurs between acute attacks and is typically asymptomatic, without the presence of tophi.
2. What part of the heart is responsible for starting the electrical impulse to conduct a heart rhythm and contraction of the atria and ventricles?
- A. The Purkinje fibers in the ventricles
- B. The right & left bundle branches
- C. The atrioventricular node
- D. The sinoatrial node in the atrium
Correct answer: D
Rationale: The sinoatrial node (SA node) in the atrium is indeed responsible for initiating the electrical impulse that starts the heart's rhythm. The SA node is known as the heart's natural pacemaker. Choices A, B, and C are incorrect because while the Purkinje fibers, bundle branches, and atrioventricular node play crucial roles in the conduction of the electrical impulse throughout the heart, the SA node is specifically responsible for initiating this impulse.
3. The unique clinical presentation of a 3-month-old infant in the emergency department leads the care team to suspect botulism. Which assessment question posed to the parents is likely to be most useful in the differential diagnosis?
- A. Have you ever given your child any honey or honey-containing products?
- B. Is there any family history of neuromuscular diseases?
- C. Has your baby ever been directly exposed to any chemical cleaning products?
- D. Is there any mold in your home that you know of?
Correct answer: A
Rationale: The correct answer is A. Botulism in infants is often linked to honey consumption. Asking the parents if they have ever given their child any honey or honey-containing products can provide crucial information for the differential diagnosis. This is important because infant botulism is commonly associated with the ingestion of honey contaminated with Clostridium botulinum spores. Choices B, C, and D are less relevant to botulism in infants as they do not directly relate to the typical causes of the condition. Family history of neuromuscular diseases (choice B) may be important for other conditions but not specifically for infant botulism. Direct exposure to chemical cleaning products (choice C) and the presence of mold in the home (choice D) are not typical risk factors for infant botulism.
4. What is the process of moving air into the lungs with subsequent distribution to the alveoli called?
- A. Ventilation
- B. Aeration
- C. Enclosure vapor
- D. Residual volume
Correct answer: A
Rationale: The correct answer is A: Ventilation. Ventilation is the process of moving air into the lungs and distributing it to the alveoli for gas exchange. Choice B, Aeration, is not the correct term for this specific process. Choice C, Enclosure vapor, is not related to the movement of air into the lungs. Choice D, Residual volume, refers to the amount of air left in the lungs after maximal expiration and is not the process of moving air into the lungs.
5. During the cellular stage of acute inflammation, which type of cells arrive first and in great numbers?
- A. Basophils
- B. Lymphocytes
- C. Neutrophils
- D. Platelets
Correct answer: C
Rationale: During the cellular stage of acute inflammation, neutrophils are the first responders. Neutrophils arrive at the site of injury in large numbers to combat pathogens and remove debris. Basophils and lymphocytes are also involved in the inflammatory response, but they are not the first to arrive. Platelets play a role in hemostasis and blood clotting, rather than being the primary cells involved in the initial inflammatory response.
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