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Patho2 Week2

Total questions: 117

Worksheet time: 1hrs 12mins

Name
Class
Date
1.

"to make more violent, bitter or severe" best describes

a)

exacerbation

b)

pleura

c)

C-structured proteins

2.

The serous membrane that lines each half of the thorax in mammals and is folded back over the surface of the same side lung

a)

pleura

b)

diaphram

c)

membrane

3.

"A group of chronic disorders characterized by diffuse inflammatory vascular lesions and degenerative changes in connective tisse"

(a)  

4.

The conical sac of serous membrane that encloses the heart and roots of great blood vessels

a)

pericardium

b)

myocardium

c)

epicardium

d)

endocardium

5.

Abnormal enlargement of the lymph nodes

a)

lymphadenopathy

b)

catchment enlargement

c)

swollen nodes

6.

The speed of red blood cells settling in a graduated tube of fresh whole blood best describes (ESR)

a)

Erythocyte sedimation rate

b)

Erythocyte seperation reflex

c)

Erythocyte sedintary rule

7.

A protein present in blood serum in various abnormal states such as inflammation or neoplasia

a)

C-reactive protein

b)

Proteases

c)

Erythocyte

d)

B12 Protein

8.

A chronic system disorder effecting joints and CT throughout the body. Autoimmune disorder characterized with exacerbations and remissions

(a)  

9.

What can rheumatoid arthritis effect

a)

synovial membranes of specific joints

b)

synovial membrane of blood vessels

c)

serous membrane of heart

d)

serous membrane of lungs

e)

serous membrane of eyes

10.

What is the peak onset of rheumatoid arthritis

a)

50-75 yrs

b)

50-60 yrs

c)

65-80 yrs

d)

60-85 yrs

11.

Women are effected 2.5x more than men in regards to rheumatoid arthritis

a)

true

b)

false

12.

rheumatoid arthritis has an uncertain cause

a)

true

b)

false

13.

Rheumatoid arthritis could have possible genetic predeposition through the alteration of human leukocyte antigen which is found on which major histocombatibility complex

a)

MHC 2

b)

MHC 1

14.

70-80% of sufferers have rheumatoid factor (an antibody that reacts with a fragment of IgG to create immune complexes)

a)

true

b)

false

15.

what can increase the severity of RA

a)

smoking

b)

diet

c)

obesity

d)

anti-coagulants

16.

Cytokine production leading to the release of TNF and IL1 which eventually destroys articular carilege and underlying bone best describes the pathiogenesis of____ (rearding RA)

a)

genetic predisposition

b)

inflammatory response

c)

immunological response

d)

angiogenesis of synovium

17.

Inflammatory response releases enzymes which then destroy articular cartilage and subchondral bone happens during which pathogenisis for RA

a)

genetic predisposition

b)

immunologic Response

18.

The normal synovium is 2 layers. How many layers is it when there is inflammation

a)

8-10

b)

3-4

c)

4-5

d)

12-15

19.

What occurs during synovitis

a)

synovial cells attack synovium, causing it to swell

b)

joint capsule stretches

c)

ligaments, muscles, tendons are imbalanced

20.

What occurs during pannus (a characteristic feature of RA)

a)

synovial hyperplasia

b)

angiogenesis

c)

granulation tissue formation that extends to joint margins & articular surface

d)

inflammatory cells within the pannus destroy cartilage and subchondral bone

21.

Reduced joint motion during RA due to pain and generalized inflammation occurs during which stage

a)

early

b)

later

22.

Reduced joint motion during RA due to pannus and disuse muscle atrophy occurs during which stage

a)

early

b)

late

23.

Bony fusion and complete joint immobility defines

(a)  

24.

Progressive joint destruction, subluxation, instability and limited movement (clinical manifestations of RA) are caused from

a)

stretching of ligaments and joint capsule

b)

pannus

c)

ankylosis

d)

osteoporosis

25.

Which of the following are true with regards to systemic and polyarticular articular manifestations of RA

a)

Begins with smaller joints

b)

Any synovial joint can be involved

c)

degree of joint change depends on severity

d)

difficulty with fine motor actions can occur

26.

What occurs with Swan neck deformity (manifestation of RA)

a)

PIP hyperextension

b)

DIP flexion

c)

inability to make a fist

d)

wrist ulnar deviation

27.

What occurs during boutonneirs deformity (manifestation of RA)

a)

DIP hypextended

b)

PIP flexed

c)

inability to make a fist

d)

wrist ulnar deviation

28.

What causes ulnar deviation during the clinical manifestation of RA

a)

MCP defomity

b)

PIP hyperextended

c)

extensor tendons slip to ulnar side of MC heads

29.

What are some early common joints effeceted by RA

a)

wrist

b)

MCP

c)

PIPs

d)

IP of thumb

e)

MTP of big toe with valgus bunion

30.

What occurs from RA effecting the early joints (Wrist, PIP,MCP,IP of thumb, 1stMTP)

a)

pain and difficult of fine motor actions

b)

opening doors

c)

opening jars

d)

dressing

31.

What joints would be effected in a later stage of RA

a)

ankle

b)

knee

c)

shoulder/elbow

d)

spinal involvement

e)

wrist

32.

What would happen from a client having knee RA

a)

genu valgum

b)

genu varum

c)

visible edema

d)

abnormal contour

e)

quadricep atrophy

33.

What are some early systemic manifestations of RA

a)

fatigue/weakness/anorxeia

b)

increased ESR

c)

Increased anti-citrullinated peptide antibody

d)

nodules

34.

What do rheumatoid nodules contain

a)

fibrin

b)

degraded collagen

c)

pus

35.

What is a common location for a rheumatic nodule

a)

extensor surface of ulna

b)

1st MCP

c)

radioulnar joint

d)

flexor surface of radius

36.

Vascilitis is the inflammation of small and medium vessels. What can it create?

a)

skin ulcers

b)

intestinal ulcers

c)

Raynauds

d)

ischemic area in the skin fold

37.

What are some occular changes that can occur d/t a systemic manifestation of RA

a)

blindness

b)

decrease in vision

c)

dry eye

d)

inflammation of sclera

38.

What is pulmonary fibrosis (systemic manifstation of RA)

a)

infammation in pleural space

b)

scar tissue formation in pleural space

c)

thickening of pleural space

d)

collagen build up in pleural space

39.

What is splenomegaly

a)

spleen enlargement

b)

lymph node enlargement

c)

spleen rupture

d)

lumph node rupture

40.

What does a physical exam look for when diagnosing RA

a)

Inflammation and swelling

b)

soft/boggy end feel (synovitis)

c)

decreased ROM

d)

pain that inhibits movement

e)

posture to look for joint fusion

41.

What are some treatment goals for clients with RA

a)

decrease pain, swelling, stiffness

b)

maintain mobility

c)

client education

d)

decrease lymphodema

42.

What are some assitive devices to help with RA treatment

a)

supportive shoes

b)

splints

c)

casts

d)

slings

43.

What are some surgical treatments for clients with RA

a)

total joint repair

b)

hyralunic injections

c)

synovectemy

d)

repair damaged tendons

44.

Which of the following are NSAID's to help relieve clients with RA

a)

ibuprofen

b)

naproxan

c)

emugul

d)

voltaren

e)

aceitominophen

45.

Which drug class decreases the risk of stomach ulcers for clients with RA (eg. celebrex)

a)

NSAID's

b)

Cyclooxygenase-2 inhibitors

c)

Corticosteroids

d)

DMARD's

46.

Which drug class for RA interrupts inflammatory response, is taken short term with a low dose to minimize side effects. Injections decrease synovitis

a)

corticosteroids

b)

NSAIDS

c)

Salicylates

d)

DMARD's

47.

Which drug class for RA is fast acting to decrease S&S + slow progression of disease (eg. methotrexate).

a)

corticosteroids

b)

DMARDS

c)

NSAIDS

d)

Cyclooxygenase-2 inhibitors

48.

"arthralgia" best describes

a)

hair loss

b)

inflammation of the myocardium

c)

pain in one or more joints

49.

"an antibody active against a tissue constituent of the individual producing it" would be called an

(a)  

50.

"the presence of excess protein in the urine" best describes

a)

alopecia

b)

arthralgia

c)

proteinuria

51.

The onset of lupas can be acute or insidious

a)

true

b)

false

52.

"A chronic inflammatory disease that effects many different organs/tissues in the body. Characterized by the formation of autoantibodies and immune complexes" best describes

(a)  

53.

The exact cause of lupus is unknown, what are some resasons for the development of autoantibodies?

a)

genetic predispoisiton

b)

environmental

c)

sex

d)

hereditary

54.

What are some examples of environmental triggers for lupus

a)

UV light

b)

foods

c)

infectious agents

d)

stress

e)

medications

55.

90% of those effected by Lupus are men

a)

true

b)

false

56.

Lupus is related to the defective elimination of self reflective B-cells, reflecting a lack of apoptosis. What does this cause?

a)

body is unable to remove autoantibodies

b)

body is able to remove autontibodies

57.

Which of the following are true with regards to the pathogenesis of lupus

a)

exacerbations and remissions

b)

complimenet activation

c)

perpetrates inflammation

d)

autoantibodies damage tissue/combine w antigens to create immune complexes

58.

What are some of the inittal presentations of lupus

a)

butterfly rash

b)

joint pain

c)

fever

d)

muscle atrophy

59.

Arthralgia and arthritis are present in ____% of sufferers with lupus. Often systemic, effecting any joint.

a)

75

b)

90

c)

60

d)

88

60.

Client with lupus can suffer from arthralgia. What joints does it effect?

a)

PIPs

b)

MCPs

c)

Wrists

d)

Knees

e)

C-Spine

T-Spine

L-Spine

61.

Although rare, a clinical manifestation of lupus could effects the ligaments, tendons, and joint capsules. What type of contracture could these create?

a)

flexor contracture

b)

extensor contracture

62.

Inflammation from lupus can cause edema in which joints

a)

knees

b)

shoulder

c)

hips

d)

MCP's

e)

ankle

63.

Lupus leading to tenosynovitis could cause which tendons to rupture

a)

achillies

b)

intrapetellar

c)

common flexor tendon

d)

sartorius

64.

Where would an acute butterfly rash (falt and raise) from lupus typically be found

a)

nose

b)

cheeks

c)

chest and neck

d)

scalp

65.

Sun sensitivity could cause a sun rash from lupus

a)

true

b)

false

66.

Hives from lupus only happen in the acute stage

a)

true

b)

false

67.

What would a mucous membrane lesion be as a result from lupus

a)

mouth ulcer

b)

lichen planus

c)

oral candidiasis

d)

hairy tongue

68.

What percent of lupus sufferers experiences pleuritis

a)

50

b)

75

c)

90

d)

88

69.

abnormal fluid accumulation which inhibits lung expansion and is a painful pulmonary manifstation of lupus best describes

a)

pleuritis

b)

pleural effusion

70.

What are some cardiovascular manifestations of lupus

a)

hypertension

b)

pericarditis

c)

myocarditis

d)

DVT

71.

Pericarditis effects what percentage of sufferers with lupus

a)

50

b)

75

c)

90

d)

88

72.

The CNS is effected from lupus after strokes, hemmorages due to vasculitis/immune complexes attacking neurons. What can this cause?

a)

depression

b)

seizure

c)

headaches

d)

heart attack

73.

What are some signs and symptoms of glomerulonephritis; a renal manifestation of lupus

a)

hematuria

b)

proteinuria

c)

edema in legs and abdomen

d)

edema in eyes

74.

What are some GI clinical manifestations of lupus

a)

nausea

b)

abdominal pain

c)

anorexia

d)

hyperthyroidism

75.

What are some hematologic clinical manifestations of lupus

a)

leukopenia

b)

lymphopenia

c)

thrombocytopenia

d)

anemia

76.

How is lupus diagnosed

a)

ultrasound

b)

health hx.

c)

blood work analysis

d)

physical examination

77.

What is being assessed when trying to diagnose lupus

a)

decreased WBC's

b)

antiautobodies

c)

anemia

d)

platelet count

e)

systemic infection

78.

What are some treatment aims for Lupus

a)

decreasing exacerbations

b)

prevent complications

c)

manage acute and chronic symptoms

d)

prevent progessive organ loss

e)

decrease autoantibody count

79.

What are some NSAIDs used for lupus. To help with arthritis, myaglia, and arthralgia

a)

naproxen

b)

advil

c)

aleve

d)

motrin

80.

What drug class works as an immunosupressent to help with bolder symptoms of lupus (such as renal or CNS manifestations)

a)

antimalarials

b)

NSAID's

c)

corticosteroids

d)

immunosupressive drugs

81.

What drug class for Lupus helps with rashes, pleuritic, and arthritic symptoms that wouldnt be relieved by NSAID's (eg. Plaquenil)

a)

corticosteroids

b)

antimalarials

c)

immunosupressive drugs

82.

What drug class is used when corticosteroids wont work (eg. cytoxin)

a)

NSAID's

b)

antimalarials

c)

immunosupressive drugs

83.

What Vitamin can help decrease lupus activity while also improving energy levels

a)

Vitamin D

b)

VItamin B12

c)

Vitamin C

d)

Vitamin K

84.

What is the Lupus survival rate in the global north

a)

5 years

b)

10 years

c)

15 years

d)

20 years

85.

What involvement can cause Lupus death within the first few years of active disease

a)

CNS

b)

Renal

c)

Cardiovascular

d)

Pulmonary

86.

What parts of the body are mainly effected by ankylosing spondylitis

a)

spine

b)

hip

c)

SI

d)

AC

87.

Ankylosing spondylitis is 3x more common in ____. The onset is more common in adolecense to early adulthood

a)

men

b)

women

88.

The etiology of ankylosing spondylitis could be autoimmune. What cells are present

a)

monocytes

b)

lymphocytes

c)

synovial cells

d)

erythocytes

89.

Which antigen on MHC is 90% present throughout cases of ankylosing sponylitis

(a)  

90.

What could be some environemntal factors that could contribute to the etiology of ankylosing spondylitis

a)

stress

b)

infection

c)

ulcerative colitis

d)

posture

91.

Multisystem inflammatory joint disorders, mainly affecting axial skeleton best describes

a)

spondylopathies

b)

spondylitis

c)

ankylosis

d)

enthesitis

92.

Stiffness or fixation of a joint by disease or surgery best describes

a)

spondylopathies

b)

spondylitis

c)

ankylosis

d)

enthesitis

93.

The site where a tendon or ligament inserts into a bone is called a

a)

enthesis

b)

spondylosis

c)

ankylosis

d)

spondylopathy

94.

Inflammation of the pigmented middle eye layer is called

a)

uveitis

b)

oclurlitis

95.

Ankylosing spondylitis has exacerbations and remissions

a)

true

b)

false

96.

Back pain from ankylosing spondylitis is worse with activity

a)

true

b)

false

97.

ankylosing spondylitis can be misdiagnosed as a

a)

sprain

b)

strain

c)

tear

d)

spasm

98.

When is back stiffness worse for people with ankylosing spondylitis

a)

morning

b)

post-rest

c)

post-activity

d)

prolonged standing

99.

Pain with ankylosing spondylitis is localted in the lumbarsacral region. Where else can it refer pain/cause discomfort?

a)

posterior thigh

b)

buttocks

c)

hips

d)

knee

100.

Ankylosing spondylitis begins bilaterally at the SI's. it moves ____ to smaller joints. Creating progressive spinal fushion

a)

superiorly

b)

posteriorly

c)

inferiorly

d)

anteriorly

101.

Enthesitis occurs to the inf/sup facet joints + IVD attachements. What happens after?

a)

pain

b)

inflammation

c)

calcification

d)

posterior spinal fusion

e)

eventual anterior fusion

102.

What are the bony protuberances called at the site of ligament attachments

a)

epicondyle

b)

condyle

c)

syndesmophytes

d)

ankylosis

103.

Ankylosing spondylitis can contribute to

a)

thoracic kyphosis

b)

lumbar lordosis

c)

cervical lordosis

104.

Which larger synovial joints could be effected by ankylosing spondylitis

a)

shoulder

b)

knee

c)

hip

d)

ankle

105.

The spine during ankylosing spondylitis fuses in what position with the absense of joint movement

a)

flexion

b)

sideflexion

c)

extension

d)

rotation

106.

What could occur as a result of ankylosing spondylitis

a)

difficulty looking ahead and maintaining balance while walking

b)

osteoporosis

c)

increased fracture risk

d)

hip degeneration/hip OA

107.

Acute anterior uevitis, the most common extraskeletal manifestation of AS can create what problems for the client

a)

blurred vision

b)

dizziness

c)

pain

d)

reddness

108.

What systemic clinical manifestations

a)

weight loss

b)

fever/fatigue

c)

flexion contracture of diaphram

d)

heart and lung constriction in thorax

109.

What would an X-Ray of ankylosing spondylitis show

a)

rigid bamboo like spine

b)

crooked spine (mild scoliosis)

c)

posterior projecting vertebrae

110.

What are lab tests looking for when diagnosing ankylosing spondylitis

a)

Increased ESR

b)

C-Reactive Protein

c)

osteophyte formation

111.

If the nerve root is affected from ankylosing spondylitis. What is the name of the surgery to relieve it

a)

lobotomy

b)

laminectomy

c)

DREZ procedure

112.

What peripheral joint replacement would best help a client with ankylosing spondylitis

a)

hip

b)

knee

c)

shoulder

d)

ankle

113.

What are some good treatments for clients with ankylosing spondylitis

a)

swimming

b)

diaphramatic breathing

c)

ROM exercises

d)

extensor streghtening

114.

How should a client with ankylosing spondylitis sleep

a)

supine

b)

side lying

c)

on hard mattress

d)

small or no pillow

e)

on soft mattress

115.

Which medication class for clients with ankylosing spondylitis best decreases pain, inflammation, and spams

a)

NSAID's

b)

DMARD's

c)

AntiTNF

116.

What ankylosing spondylitis medication is best used for peripheral joint symptoms (eg. methotrexate)

a)

NSAID's

b)

DMARDs

c)

Anti-TNF

117.

What medication class for clients with ankylosing spondylitis is best used to help decrease axial and peripheral joint symptoms

a)

NSAIDs

b)

DMARDs

c)

Anti-TNF