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MSN 570 Advanced Pathophysiology Final 2024
1. In which of the following cases is dehydration more likely to occur?
- A. A 50-year-old woman who is a bodybuilder
- B. A 50-year-old man who is morbidly obese
- C. A 10-year-old child who is thin
- D. A 30-year-old with multiple sclerosis
Correct answer: B
Rationale: Dehydration is more likely to occur in a 50-year-old man who is morbidly obese due to the increased risk of conditions like diabetes and heart disease that can lead to fluid imbalances. Being morbidly obese can also strain the body's systems, increasing the need for water. The other choices are less likely to experience dehydration as a primary concern. While being a bodybuilder may require strict hydration practices, dehydration is more prevalent in individuals with conditions like obesity.
2. A 20-year-old college student has presented to her campus medical clinic for a scheduled Pap smear. The clinician who will interpret the smear will examine cell samples for evidence of:
- A. Changes in cell shape, size, and organization
- B. Presence of unexpected cell types
- C. Ischemic changes in cell sample
- D. Abnormally high numbers of cells
Correct answer: A
Rationale: The correct answer is changes in cell shape, size, and organization (Choice A). Pap smears are performed to detect potential precancerous or cancerous conditions by examining the cells for any abnormalities in their shape, size, or organization. This helps in identifying early signs of cervical cancer. Choices B, C, and D are incorrect because Pap smears primarily focus on detecting cellular changes associated with cancer, not unexpected cell types, ischemic changes, or abnormally high numbers of cells.
3. 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: D
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.
4. In addition to matching ABO antigens, a blood transfusion must also be matched for:
- A. HLA type
- B. Rh antigen
- C. Immunoglobulins
- D. Platelet compatibility
Correct answer: B
Rationale: The correct answer is B: Rh antigen. In addition to ABO antigens, Rh antigen must also be matched for a blood transfusion. Rh antigen compatibility is crucial to prevent adverse reactions. Choice A, HLA type, is not directly related to blood transfusions but plays a role in organ transplantation. Choice C, Immunoglobulins, are not typically matched for blood transfusions. Choice D, Platelet compatibility, while important in specific cases, is not a standard requirement for all blood transfusions.
5. Which of the following women are at highest risk for the development of endometrial cancer?
- A. A 50-year-old postmenopausal woman with a history of high-risk human papillomavirus
- B. A 45-year-old woman who is obese and has menstrual irregularities with periods of amenorrhea and infrequent periods.
- C. A 40-year-old woman who is overweight and has hypertension.
- D. A 55-year-old woman who smokes.
Correct answer: B
Rationale: The correct answer is B. Obesity and irregular menstrual cycles, including periods of amenorrhea and infrequent periods, are significant risk factors for the development of endometrial cancer. Choice A is less likely as postmenopausal status reduces the risk. Choice C is not directly associated with a high risk of endometrial cancer. Choice D, smoking, is more strongly linked to other types of cancers like lung cancer rather than endometrial cancer.
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