Goulds pathophysiology for the health professions 6th edition vanmeter test bank

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Chapter 10: Blood and Circulatory System Disorders Test Bank MULTIPLE CHOICE 1. Which of the following would result from a reduced number of erythrocytes in the blood? a. Increased hemoglobin in the blood b. Decreased hematocrit c. Increased risk of hemostasis d. Decreased osmotic pressure of the blood ANS: B

REF: 185

2. What term is used to describe a deficit of all types of blood cells? a. Leucopenia b. Neutropenia c. Pancytopenia d. Erythrocytosis ANS: C

REF: 205

3. Capillary walls consist of: a. multiple endothelial layers. b. a thick layer of smooth muscle. c. two or three epithelial layers. d. a single endothelial layer.

ANS: D

REF: 183

4. Vitamin K is required by the liver to synthesize: a. heparin. b. prothrombin. c. amino acids. d. bilirubin.

ANS: B

REF: 190 | 202

5. Individuals with type O blood are considered to be universal donors because their blood: a. contains A and B antibodies. b. contains A and B antigens. c. lacks A and B antibodies. d. lacks A and B antigens.

ANS: D

REF: 192

6. What are the two circulations that comprise the overall circulatory system? a. Pulmonary and systemic circulations b. Peripheral and central circulations c. Cardiovascular and lymphatic circulations d. Cardiopulmonary and peripheral circulations ANS: A

REF: 183

7. Chronic blood loss causes anemia because of the: a. shortened life span of the erythrocytes. b. lower metabolic rate. c. loss of protein and electrolytes. d. smaller amount of recycled iron available.

ANS: D

REF: 193

8. What is the cause of sickle cell anemia? a. A defective gene inherited from both parents b. A chronic bacterial infection c. Bone marrow depression d. An autoimmune reaction ANS: A

REF: 198

9. Which of the following best describes the characteristic erythrocyte associated with pernicious

anemia? a. Hypochromic, microcytic b. Normochromic, normocytic c. Elongated, sickle-shaped d. Megaloblastic or macrocytic nucleated cells ANS: D

REF: 201

10. What causes numbness and tingling in the fingers of individuals with untreated pernicious

anemia? a. Persistent hyperbilirubinemia b. Increasing acidosis affecting metabolism c. Vitamin B12 deficit causing peripheral nerve demyelination d. Multiple small vascular occlusions affecting peripheral nerves ANS: C

REF: 195

11. Jaundice is one typical sign of: a. sickle cell anemia. b. aplastic anemia. c. iron deficiency anemia. d. acute leukemia.

ANS: A

REF: 198

12. What are the typical early general signs and symptoms of anemia? a. Chest pain, palpitations b. Jaundice, stomatitis c. Pallor, dyspnea, and fatigue d. Bradycardia, heat intolerance ANS: C

REF: 193

13. What is the cause of oral ulcerations and delayed healing occurring with any severe anemia? a. Lack of folic acid for DNA synthesis

b. Frequent microinfarcts in the tissues c. Deficit of oxygen for epithelial cell mitosis and metabolism d. Elevated bilirubin levels in blood and body fluids ANS: C

REF: 193

14. Which of the following is present with pernicious anemia? a. Pancytopenia b. Hypochlorhydria c. Leukocytosis d. Multiple infarcts ANS: B

REF: 195

15. Why is pernicious anemia treated with injections of vitamin B12? a. An immune reaction in the stomach would destroy the vitamin. b. Digestive enzymes would destroy the vitamin. c. The vitamin irritates the gastric mucosa. d. The ingested vitamin would not be absorbed into the blood.

ANS: D

REF: 195

16. Why do abnormally low hemoglobin values develop with pernicious anemia? a. Decreased production of erythrocytes b. Shorter life span of erythrocytes c. Abnormal structure of hemoglobin chains d. Deficit of folic acid ANS: B

REF: 195

17. What are the common early signs of aplastic anemia? a. Painful joints and skeletal deformity b. Abdominal discomfort and splenomegaly c. Excessive bleeding and recurrent infections d. Palpitations and chest pain ANS: C

REF: 197

18. Why do vascular occlusions and infarcts occur frequently with sickle cell anemia? a. The red blood cells are abnormally large. b. Increased hemolysis of erythrocytes occurs. c. Erythrocytes change to sickle shape when hypoxia occurs. d. HbS is unable to transport oxygen.

ANS: C

REF: 199

19. Which of the following applies to sickle cell trait? a. Most hemoglobin is in the form of HgS b. Sickling of erythrocytes occurs with severe hypoxia. c. Painful sickling crises with multiple infarctions occur frequently. d. A child’s skeletal growth is delayed.

ANS: B

REF: 198

20. What is the basic abnormality in thalassemia? a. Several amino acids in the globin chains have been replaced by substitute amino

acids. b. More than four globin chains are found in the erythrocytes. c. The iron molecule is displaced in hemoglobin. d. There is failure to synthesize either the alpha or beta chains in the hemoglobin molecule.

ANS: D

REF: 200

21. Which of the following can result from a malabsorption problem? a. Aplastic anemia b. Sickle cell anemia c. Thalassemia major d. Pernicious anemia ANS: D

REF: 195

22. In individuals with pernicious anemia, antibodies form to: a. vitamin B12. b. intrinsic factor or parietal cells. c. mucus-producing glands. d. hydrochloric acid.

ANS: B

REF: 195

23. In cases of polycythemia vera, blood pressure is elevated as a result of: a. increased blood volume. b. frequent infarcts in the coronary circulation. c. congested spleen and bone marrow. d. increased renin and aldosterone secretions.

ANS: A

REF: 205

24. Petechiae and purpura are common signs of: a. excessive hemolysis. b. leucopenia. c. increased bleeding. d. hemoglobin deficit.

ANS: C

REF: 201

25. Which statement applies to the disorder hemophilia A? a. It is transmitted as an X-linked dominant trait. b. There is usually a total lack of factor VIII in the blood. c. Males and females can be carriers. d. Hematomas and hemarthroses are common.

ANS: D

REF: 203

26. Which of the following occurs when disseminated intravascular coagulation develops? a. Increased thrombocytes and blood clotting

b. Hemolysis with loss of blood cells c. Massive sepsis and hemorrhage d. Multiple thrombi and deficit of clotting factors ANS: D

REF: 203-204

27. Which of the following substances acts as an anticoagulant? a. Prothrombin b. Heparin c. Fibrinogen d. Vitamin K ANS: B

REF: 190

28. In individuals with acute leukemia, the increased number of malignant leukocytes leads to:

1. decreased hemoglobin.

2. thrombocytopenia.

3. bone pain with increased activity.

4. splenomegaly. a. 1, 3 b. 1, 2, 4 c. 2, 3, 4 d. 1, 2, 3, 4 ANS: B

REF: 206-208

29. Multiple opportunistic infections develop with acute leukemia primarily because: a. the number of white blood cells is decreased. b. many circulating leukocytes are immature. c. severe anemia interferes with the immune response. d. decreased appetite and nutritional intake reduce natural defenses.

ANS: B

REF: 206-207

30. Why is excessive bleeding a common occurrence with acute leukemia? a. Deficit of calcium ions b. Impaired production of prothrombin and fibrinogen c. Decreased platelets d. Dysfunctional thrombocytes ANS: C

REF: 206-207

31. Predisposing factors to leukemia commonly include: a. exposure to radiation. b. certain fungal and protozoal infections. c. familial tendency. d. cigarette smoking.

ANS: A

REF: 207

32. Von Willebrand disease is caused by: a. defective erythrocytes that become deformed in shape, causing occlusions. b. excessive lymphocytes that do not mature.

c. absence of a clotting factor that helps platelets clump and stick. d. a lack of hemoglobin due to iron deficiency.

ANS: C

REF: 203

33. Thrombophilia can result in conditions such as: a. severe chronic kidney disease. b. peripheral vascular disease. c. deficient calcium levels in the long bones. d. excessive bleeding of hematomas.

ANS: B

REF: 204

34. Multiple myeloma is a malignant tumor involving: a. plasma cells. b. granulocytes. c. bone cells. d. lymph nodes.

ANS: A

REF: 209

35. What is the primary treatment for the leukemias? a. Radiation b. Chemotherapy c. Surgery d. Immunotherapy ANS: B

REF: 207

36. Which of the following statements applies to hemochromatosis. It is: a. caused by excessive iron intake in the diet. b. results from excessive hemolysis of RBCs. c. a metabolic error that leads to excess amounts of hemosiderin, causing damage to

organs. d. an inherited defect that results in abnormal hemoglobin.

ANS: C

REF: 188

37. Thalassemia is caused by: a. a defect in one or more genes for hemoglobin. b. an abnormal form of heme. c. abnormal liver production of amino acids and iron. d. overproduction of hypochromic, microcytic RBCs. ANS: A

REF: 200

38. Secondary polycythemia may be associated with: a. frequent angina attacks. b. certain types of anemia. c. severe chronic bronchitis. d. renal disease.

ANS: C

REF: 205

39. All of the following apply to vitamin K EXCEPT: a. it is used as an antidote for warfarin (Coumadin). b. the liver requires it to produce prothrombin. c. it is a fat-soluble vitamin. d. the bone marrow requires it to synthesize hemoglobin.

ANS: D

REF: 189 | 190 | 202

40. Leukemia is sometimes linked to chromosome abnormalities, as evidenced by: a. the presence of Philadelphia chromosome translocation in cases of acute

myelogenous leukemia (AML). b. very low incidence in persons with Down syndrome. c. little evidence of familial incidence. d. transmission as a recessive gene.

ANS: A

REF: 206-207

41. Iron deficiency anemia frequently results from any of the following EXCEPT: a. certain vegetarian diets. b. excessive menstrual flow. c. malabsorption syndromes. d. diabetes mellitus.

ANS: D

REF: 193

42. Which of the following applies to the leukemias? a. Chronic leukemias are more common in older people. b. AML is the most common childhood leukemia. c. Exposure to chemicals is not considered a predisposing factor. d. Lymphoid tissue produces abnormal leukocytes.

ANS: A

REF: 207

43. A high percentage of blast cells in the leukocyte population indicates a poor prognosis for an

individual with: a. thalassemia. b. acute myelogenous leukemia (AML). c. myelodysplastic syndrome. d. multiple myeloma.

ANS: B

REF: 208

44. Which of the following applies to erythropoietin? a. It is produced by the liver. b. It increases iron absorption for heme production. c. It stimulates production of red blood cells. d. Hypoxia stimulates the red bone marrow to produce erythropoietin.

ANS: C

REF: 187 | 192

45. Which of the following diagnostic tests would be within the normal range for an individual

with hemophilia A?

a. b. c. d.

Bleeding time Coagulation time PTT time Prothrombin time

ANS: A

REF: 192

46. Which of the following applies to the condition disseminated intravascular coagulation (DIC)? a. It is usually a secondary complication. b. It is always initiated by excessive bleeding. c. It results in an inability of platelets to adhere. d. It is not life threatening.

ANS: A

REF: 203-204

47. In which blood dyscrasia does pancytopenia develop? a. Pernicious anemia b. Aplastic anemia c. Iron deficiency anemia d. Sickle cell anemia ANS: B

REF: 205

48. Which of the following applies to the etiology of aplastic anemia? It is: a. idiopathic in many cases. b. a genetic disorder. c. predisposed by exposure to myelotoxins. d. Both A and C. ANS: D

REF: 197

49. Microcytic and hypochromic erythrocytes are commonly found as a result of: a. iron deficiency anemia. b. polycythemia. c. disseminated intravascular coagulation. d. hemophilia A. ANS: A

REF: 201