APhA Immunization and Final Exam F2 with complete solutions

Which of the following key questions is important to as a patient before adminestering IIV? - ANSWER-are you sick today? HZV should not be administered to a patient with a history of anaphylaxis to: - ANSWER-gelatin How often are the Healthy People targets for vaccination rates updated? Every *blank years* - ANSWER-10 years Which type of vaccine involves stimulation of B cells without the assistance of T helper cells? *blank* polysaccharide *blank* - ANSWER-pure vaccines Which of the following documents must be given to every patient or patient's caregiver before administration of a vaccine covered under the National Childhood Vaccine Injury Act (NCVIA)? - ANSWER-VIS The presence of fever, diffuse maculopapular rash, and Koplik spots are characteristic of which of the following diseases? - ANSWER-measles RotaTeq (RV5) should be administered as a: *blank*-dose series to infants *blank,blank,blank* months of age - ANSWER-3 246 If a patient is a candidate for revaccination with PPSV23, what is the ACIP-recommended interval between doses of this vaccine? *blank years* - ANSWER-5 years The monitoring system that health care providers should use to report serious adverse events after vaccination is: - ANSWER-VAERS After reconstitution, within what time frame must HZV be administered? *blank mins* - ANSWER-30 mins Prior to the introduction of a vaccine, what was the leading cause of bacterial meningitis in children younger than 5 years of age? *Haemophilus influenzae type BLANK* - ANSWER-b HealthMap Vaccine Finder is a free online tool that allows pharmacists to: *List their vaccination BLANK so patients can find them when searching the website for nearby immunizers.* - ANSWER-services Even though state laws may have specific mandates, how long should pharmacists maintain records of immunizations? *for the patients BLANK* - ANSWER-lifetime Justin is a healthy 16-year-old boy who has no documentation of varicella vaccine or history of the disease. He should receive: *BLANK# of doses of varicella vaccine separated by at least BLANK# weeks* - ANSWER-2 4 Kyle is a 5-year-old boy who is up to date with his vaccinations. He has never experienced any adverse effects from vaccinations. At his next well-child check-up, Kyle will be receiving the following vaccines: IPV, MMR, varicella vaccine, and a tetanus-containing vaccine. Which of the following tetanus-containing vaccines would be appropriate for him? - ANSWER-DTaP A 69 year-old man received Td vaccination 4 years ago. He is preparing to travel to see his newborn granddaughter next month. Which of the following vaccines containing tetanus, diphtheria, and/or pertussis would be most appropriate for him? - ANSWER-Tdap Which vaccine does ACIP recommend for all college freshmen, aged 21 years or younger, living in dormitories, who have not been previously vaccinated? - ANSWER-MCV4 Emily is a 16-year-old high-school student with no chronic medical conditions. Emily's immunization record shows that she completed the primary series for IPV, HepA, Hib, DTaP, and MMR, and she had a physician-diagnosed case of chickenpox at 2 years of age. Which of the following would be the most appropriate recommendation for her today? *BLANK, HPV, MCV, HepB, and influenza, if during influenza season* - ANSWER-Tdap Which of these vaccines is an inactivated vaccine? - ANSWER-Tdap Herd immunity refers to which of the following situations? *Vaccination of BLANK individuals in a community to protect those who BLANK be vaccinated.* - ANSWER-enough cannot If a patient with an egg allergy experiences hives following influenza vaccination, what is ACIP's recommendation for vaccinating this patient against influenza? Administer any age-appropriate *ACTIVATED/inactivated* influenza vaccine (IIV) or recombinant influenza vaccine (RIV) - ANSWER-inactivated Which of the following patients are appropriate candidates for the 2-dose schedule of HPV9? *BLANK year-old girl with NO medical conditions, series has not been started* - ANSWER-11 John is a 46-year-old man with diabetes. He requests a refill of his diabetes testing supplies on October 21st. His immunization record indicates that he has completed the primary series of MMR, DTaP, HepA, and HepB vaccines. John has a documented history of chickenpox, and his last Td booster dose was 19 years ago. Which of the following vaccines should he receive? *PPSV23, Tdap, and IIV* - ANSWER-PPSV23, Tdap, and IIV What is the time interval for which the development of Guillain-Barré syndrome following influenza vaccination would result in a precaution for future influenza vaccines? *within BLANK# weeks* - ANSWER-6 For which age group is the adjuvanted inactivated influenza vaccine approved? *BLANK# years and older* - ANSWER-65 Which of the following best describes how to administer MMR vaccine to an adult patient weighing 210 lb? Inject *blank* at a *BLANK° angle in the outer aspect of the upper arm. - ANSWER-subq 45 Which of the following best describes an opportunity for pharmacists to use diagnosis-based screening to identify people at risk for vaccine-preventable diseases? Performing a *BLANK* review for a patient who has *blankS* - ANSWER-medication diabetes Which of the following is the best example of a group with which individual pharmacists can collaborate to increase immunization rates in their communities? *Immunization BLANKs* - ANSWER-coalitions The childhood/adolescent and adult immunization schedules are updated and published annually during which months? *January OR BLANK* - ANSWER-february If pharmacists are called upon to assist with vaccination efforts following a natural disaster, which vaccine is likely to be needed by many of the victims? - ANSWER-Tetanus There should be a flat hard surface in the area where vaccines will be administered to ensure: There is room for the patient to *sit/lie down* if fainting occurs or CPR is required. - ANSWER-lie down Vaccines as well as exposure to natural disease are both examples of which type of immunity? *blank immunity* - ANSWER-active Which of the following diseases are transmitted through mosquito bites? *Blank fever and Blank encephalitis* - ANSWER-yellow japanese If a vial of influenza vaccine is left out of the refrigerator on the pharmacy counter overnight, what should be done with the vaccine? *mark "do NOT use", and place in the BLANK, and call the manufacturer for further guidance* - ANSWER-fridge Alan is a 47-year-old man who has no documentation of a primary series of tetanus-containing vaccine. Which of the following would be an appropriate primary series for Alan? Tdap *next/today*, Td in *blank#* weeks, Td *blank#* months after the second dose - ANSWER-today 4 6 A health care provider who has not been vaccinated against hepatitis B is stuck by a contaminated needle after administering an immunization to a hepatitis B-positive patient. In addition to hepatitis B vaccine, the health care provider also should receive hepatitis B Immunoglobulin (HBIG) as postexposure prophylaxis because the HBIG provides: *blank* immunity - ANSWER-prompt Which of the following is most likely to result in an influenza pandemic? Antigenic *shift/formation* in an influenza A virus - ANSWER-shift Which of the following statements about pharmacy-based vaccination programs is true? Administratively, *BLANK* for vaccines covered by Medicare Part D may be easier for pharmacists than physicians. - ANSWER-billing What is the type of immunity that occurs when a pregnant woman is vaccinated with Tdap to protect the infant from pertussis after birth? *blank immunity* - ANSWER-passive Which of the following patients would be a candidate for PPSV23? *blank# year-old man who *blanks* - ANSWER-25 smokes Tom is a 9-year old boy who has never had an influenza vaccine. Tom's mother shows you his up-to-date immunization record and reports that he has never had any adverse reactions to vaccinations. What dose and schedule of IIV should be administered to Tom? inject *blank# mL; *blank#* of dose/s - ANSWER-0.5 1 Adolescents should be routinely vaccinated with MCV4 on the following schedule: 1 dose at age *blank to blank years, followed by a booster dose at age 16 years. - ANSWER-11 12 According to ACIP recommendations, which of the following needle lengths would be appropriate for administering HZV to an adult patient? *#/# inch* - ANSWER-5/8 Which of the following statements is true regarding varicella-containing vaccines? The potency of *BLANK* is greater than that of the varicella Vaccine - ANSWER-hzv A history of anaphylaxis caused by neomycin would be a contraindication to receiving which of the following vaccines? - ANSWER-IPV The incubation period for influenza can range from: *blank TO blank* days - ANSWER-1 to 4 Alex is a 32-year-old man who is scheduled to travel to a country where hepatitis A is endemic. He leaves in 3 weeks and will be gone a month. He received his first dose of hepatitis A vaccine today. Alex should be counseled to return for his second dose of hepatitis A vaccine: in *blank* months - ANSWER-6 Robert is a 48-year-old pharmacist who is preparing to provide immunizations in his pharmacy for the first time next fall. He has no documentation of receiving the hepatitis B vaccine and would like to be vaccinated before administering vaccines in his practice. What is the recommended routine schedule for vaccination against hepatitis B? Blank, blank and blank months? *numbers only no spaces* - ANSWER-016 Which of the following best describes how to administer Tdap vaccine to an adult patient weighing 185 lb? Inject *IM/subq* at a 90 degree angle in the *blank* muscle - ANSWER-im deltoid What is the standard dose of epinephrine for managing anaphylaxis? *blank* mg/kg, UP TO a max of *BLANK* mg - ANSWER-0.01 0.5 Which of the following statements about live attenuated vaccines is true? They should be *given/avoided* to immunocompromised individuals - ANSWER-avoided Which viruses are associated with the development of cancer? - ANSWER-hpv hep b According to the Advisory Committee on Immunization Practices (ACIP), which of the following would be considered adequate evidence of immunity to varicella, indicating that administration of varicella vaccine is unnecessary? diagnosis of *blank* by a health care provider - ANSWER-chickenpox At what point during pregnancy is it recommended to administer the influenza vaccine? - ANSWER-anytime A history of anaphylaxis caused by gelatin would be a contraindication to receiving which of the following vaccines? *varicella/tdap* - ANSWER-varicella Federal law makes offering an annual influenza vaccination a requirement for continued federal funding in which setting? - ANSWER-LTC David is a healthy 5-year-old boy who is scheduled to see his pediatrician for a checkup in July prior to starting kindergarten. David's immunization record reveals that he has received the following vaccines: 3 doses of HepB 4 doses of PCV13 2 doses of HepA 3 doses of IPV 2 doses of rotavirus 1 dose of MMRV 4 doses of DTaP 4 doses of Hib Which vaccines should David receive at this visit? DTap, IPV, MMR, and *influenza/varicella* - ANSWER-varicella Which disease is almost certain to cause death if infected patients do not receive postexposure prophylaxis? - ANSWER-rabies According to ACIP recommendations, HZV is indicated for the prevention of herpes zoster in adults aged: *60/65* and older - ANSWER-60 Which of the following statements is true regarding how vaccines evoke an immune response? The antigen in the vaccine activates *B/T* cells, which produce antigen-specific antibodies and memory cells. - ANSWER-b Kimberly is a 34 year-old woman who is 30 weeks pregnant. She received a Td booster dose 1 year ago when she cut her hand while working in the kitchen. She has no documentation of receiving a Tdap vaccine. The most appropriate recommendation would be to administer: *zoster/Tdap* as soon as possible - ANSWER-Tdap After completion of a primary vaccine series and documentation of a one-time dose of Tdap, Td booster doses are recommended every: *blank years* - ANSWER-10 years Upon giving a VIS to a patient who is to receive a vaccine cover under the National Childhood Vaccine Injury Act, what must be documented? The date the VIS was *printed/given* to the patient or caregiver and the date printed on the VIS - ANSWER-given Which of the following vaccines may be administered to boys and young men aged 9 through 26 years to reduce the likelihood of acquiring genital warts? - ANSWER-hpv9 Barbara is a 60-year-old woman who presents to the pharmacy for two vaccines: HZV and IIV. Which of the following are the appropriate doses and routes for administering these vaccines to this patient? Your Choice HZV 0.65 mL *subq/IM*; IIV 0.5 mL *subq/IM* - ANSWER-subq im What is meant by the term "immunization neighborhood"? Immunization *coalition/stakeholders* collaborate to meet community immunization needs. - ANSWER-stakeholders During which step of the Pharmacists' Patient Care Process would a pharmacist analyze a patient's need for certain vaccines? SOAP? - ANSWER-A Which influenza vaccine is approved to be used with the jet injector needle-free system? The only vaccines approved for such use are *blank* and *Blank* Quadrivalent. This approval is for individuals ages *# through # years* - ANSWER-afluria 18 through 64 years Why are water bottles recommended to be placed in refrigerators in which vaccines are stored? - ANSWER-stabilize the temp The circulatory system includes: the *blank*, the *blank* vessels, and the *blank* - ANSWER-heart blood blood The Pulmonary circuit is high in *blank* and low in *blank*. Blood flows from the right heart to *blank* - ANSWER-co2 o2 lungs The systemic circuit is high in *blank* and low in *blank*. Blood flows from the heart to all *blankS* - ANSWER-o2 co2 cells Major functions of blood are: 1. carries *blank* and nutrients to the bodies cells and transports *blank* products away from the same cells 2. deliver *blank* cells to fight infections 3. maintains integrity of *blank* vessel - ANSWER-o2 waste immune blood Components of blood are: *blank*% plasma and *blank*% wbc, platelets, and RBCs - ANSWER-55 45 Fetus develop blood cells in the *blank* sac, *blank*, and spleen After 5 years blood cells are made from *blank* bones and marrow cavities After age 20 only marrow cavities of the upper *blank* and *blank*, *blank* bones - ANSWER-yolk liver long humerus femur flat Hematopoietic stem cells (bone marrow cells): are constantly *blank* and renewable Bone Marrow Micro environment: connected via cell surface receptors, *blank* molecules, secreted *blankS*, and *blank* factors - ANSWER-active adhesion cytokines growth with appropriate signal, hematopoietic stem cells *blank*, differentiate and mature in blood cells according to *blank* they may produce MILLIONS of cells per second - ANSWER-proliferate demand Hierarchy of Stem Cell differentiation are Some People Live Mature *blank* cells, *blanks*, Lineage committed precursors, Mature *blank* cells - ANSWER-stem progenitors effector Ratio of WBC myeloid series:matureing RBC is *#:#* RBC in the peripheral blood is *blank* times more than that of WBC WBC life span is *shorter/longer* than that of RBC - ANSWER-75:25 500 shorter RBC's are derived from it's precursor cell *blank* a mature RBC is *nucleated/non-nucleated* (in mammals) and bi-concave Average life span of a RBC is *blank* days Dead cells are phagocytosed by macrophages in the *blank*, *blank*, and bone marrow - ANSWER-proerythroblast non-nucleated 120 spleen liver RBC's With anemia they are 3 classifications 1. defect in *blank* production 2. Cell *blank* defect 3. Decreased RBC *blank* - ANSWER-marrow maturation survival Primary cause to marrow production defect in RBC's is mild to moderate *blank* deficiency Some secondary causes are chemo treatment, radiation, viral infection Chronic diseases associated with marrow production include: acute and chronic *blankS*, AIDS, cancer, AUTOimmune disorders, inflammed *blank* disease Excessive intake of what medication can cause this and go undetected? - ANSWER-iron infections bowel aspirin RBC iron deficiency anemia happens at birth b/c material deficiency of diet only consisting of *blank* milk which is LOW in absorb able iron Growth *blank* make adolescents susceptible to iron deficiency Women are susceptible b/c of heavy *blank*(3 letters) associated with heavy blood loss - ANSWER-cow spurts PMS *T/F* Redistribution of blood from cutaneous tissues or lack of hemoglobin causes *dyspnea* (decreased Hb) - ANSWER-f pallor *t/F* depending on the severity of the anemia, easy fatigability, dyspnea (tissue hypoxia due to defect in oxygen transport) MAY OCCUR - ANSWER-t *T/F* tachycardia and palpitations may occur as the body tries to compensate with an increase in cardiac output - ANSWER-t Deficiency in B12 and *blank* acid leads to impaired DNA synthesis and RBC maturation The RBC is *smaller/enlarged* due to impaired maturation and division due to impaired DNA synthesis Megaloblastic anemias develop slowly so symtoms are *few/many* until advanced - ANSWER-folic enlarged few Megaloblastic anemia causes are b12 defect which are associated with: malabsorption, partial gastrectomy, inflammation of terminal ilium and *blank* abnormalities manifestation Lab test include *blank* anemia, abnormally low serum for VITamin *blank*, and *blank* acid levels - ANSWER-neurological macrocytic b12 folic Blood loss anemia can reach *blank*% without occurrence of sign or symptoms and depends on if *blank* or *blank* - ANSWER-50 internal external Shortened RBC life span can be caused by *blank* cause which is mostly hereditary AND *blank* factors including immune mechanisms, mechanical *blank*, and infection - ANSWER-intrinsic extrinsic trauma Inherited disorders of RBC are usually treated with a *blank* to reduce RBC destruction and blood transfusions to support the circulation during a crisis - ANSWER-splenectomy Hemoglobinopathy: sickle cell anemia is caused by a mutation of *2/1* amino acid which causes the RBC to become fragile leading to hemolytic anemia. This type of cell will deliver *blank* oxygen to the body tissues The lifespan of a RBC with Sickle Cell disease is *blank*# days and factors asssociated with sickling: cold, stress, physical exertion, dehydration, infection *be able to recognize these* - ANSWER-1 less 20 Deficiency of G6PD for treatment it's necessary to *take/avoid* known *blank* drugs - ANSWER-avoid oxidant Acquired Hemolytic Anemias Several acquired factors exogenous to the red blood cell produce hemolysis by *indirect/direct* membrane destruction or antibody-mediated lysis Various drugs, chemicals, toxins, *venoms/viruses*, and infections such as malaria destroy red cell membranes Hemolysis can also be caused by mechanical factors such as prosthetic heart valves, vasculitis, and severe *rashes/burns* - ANSWER-direct venoms burns Anemia is an increasingly common health problem in the *young/elderly* impacting 1/4 - ANSWER-elderly Porphyrias are a group of disorders due to abnormalities in the pathway of biosynthesis of *RBC/heme* characterized by excessive excretion. This is also *genetic/non-genetic* acquired - ANSWER-heme genetic Polycythemia is abnormally *low/high* total circulating RBC's with a hematocrit higher than *#%* - ANSWER-high 50 EPO: Erythropoietin is a hormone secreted by the *liver/kidney* and it acts on bone marrow stimulating RBC production Treatment for seconday polycythemia focuses on relieving hypoxia- *high/low* flow oxygen - ANSWER-kidney low the main 2 blood groups are *3-LETTERS* (carb antigen) and *BLANK* D-positive/D-negative - ANSWER-abo Rh If a blood type is say B then it has the antigen *LETTER* and antibody *letter* *NO SPACES IN ANSWER* - ANSWER-ba the most common blood type in frequency in the US is? The most LEAST common blood type in frequency in the US is? - ANSWER-O AB If you mix incompatible plasma then the cells will *blank* this is explained by mixing type A with Type B which causes the antibodies in type A to react with the antigens in type B - ANSWER-clump Hematocrit is the fraction or % of whole blood that is made up on *RBC/WBC* and is also known as PCV (*BLANK BLANK BLANK*) the percentage of *reticulocytes/erythrocytes* provides an index of the rate of RBC production - ANSWER-RBC packed cell volume reticulocytes half-life of a Neutrophil in circulation is *# hours* *blankS* cells contain specific granules (neutrophil, eosinophil, and basophil) Agranulocytes *blank* granules (lymphocytes and monocytes) - ANSWER-6 hours granulocytes lack Neutrophils constitute *##-##*% of the total WBC. They are defense against bacteria, *blank*, and foreign substances Eosinophils constitute about *#-#*% of total WBC and increase during *blank* infection Basophils constitute *#.#-#.#*% of total WBC and is involved in allergy and hypersensitivity RXNS - ANSWER-50-70 fungi 1-4 parasitic 0.3-0.5 PMN granulocytes cytoplasm is filled with granules that contain enzymes called *blank* pathogens - ANSWER-digest Lymphocytes constitute about *##*% of total WBC - ANSWER-30 Monocytes are the largest of the WBC *#-#*% of total WBC - ANSWER-2-8 Hypersensitivity Allergy, anaphylaxis Type 1 major player is Ig*blank* Phases are SAE: *blank* *blank* Effector Major Mediators are mast cells and degranulation - ANSWER-e sensitization activation Hypersensitivity Type 2 is mediated by cell *blank* antigens The 3 types are KID which means? - ANSWER-surface kill irritate disrupt Hypersensitivity Type 3 major player is *blank* complexes The 3 stages are FDI: Immune complex *blank*, immune complex *blank*, complemented-mediated inflammation Stage 3 complemented-mediated inflammation has 2 types *blank* and *blank* - ANSWER-immune formation deposition systemic localized Hypersensitivity Type 4 major player is *blank*-cells types are: DD *blank* cd*#* and *blank* cd*#* cells - ANSWER-t direct delayed Hypersensitivity RXNs 4 types: Type 1: *2 letters* IgE Mast Cells Type 2: *2 letters* AntiBody Cytotoxic Type 3: *2 letters* Immune Complex Type 4: *2 letter* T-cell mediated - ANSWER-AA BC CI DD *Momen AL* Steps of Hierarchies of Hematopoiesis? *blank* cells, Progenitors,Lineage commited *blankS*, and mature *blank* cells - ANSWER-stem precursors effector *Momen AL* Name the mophologically recognizable developmental blood cells within bone marrow? Morphologically regonizable developmental blood cells: all *blank* cells stages of different blood cell *blank* - ANSWER-blast types *Momen AL* Steps of Erythropoiesis: Multipotent *blank*topoietic stem cells, *blankOID* progenitor, proerythroblast/pronormoblast, erthroblast, *blankCYTE*, *blankCYTE* - ANSWER-hema myeloid reticulocyte erythrocyte *Momen AL* What factors regulate the RBC production? Impaired o2 delivery to tissue due to *Decreased/increased* RBC (anemia), Impaired *co2/o2* loading of the Hb, High *co2/o2* affinity mutant Hb, impaired blood flow to the *kidney/liver* - ANSWER-decreased o2 o2 kidney *Momen AL* Process of RBC breakdown is due to low *o2/co2* delivery in the *liver/kidney*, increased erythropoietin is produced in the *liver/kidney* and released in to the circulation to go to the *blank blank* for erythropoiesis. LIfe span of a RBC is *blank* days and broken down by phagocytic cells in the *liver/spleen*, *liver/kidney*, or bone marrow - ANSWER-o2 kidney kidney bone marrow 120 spleen liver *Momen AL* Summerize the sources of iron for erythropoiesis -Absportion from GI tract, and transported in the circulation, from storage as *blankIN* in the *kidney/liver*, recycling from aged RBC that are destroyed in the *liver/spleen* - ANSWER-ferritin liver spleen *Momen AL* Summerize the utilization of iron for erythropoiesis -Iron absorbed from the instestine is tored as ferritin in the *blank* EP or transported in the plasma as *blank* -In Bone marrow obtain iron for Hb *blank* from plasma transferrin OR from recyling of senescent erythrocytes by *blank* in bone marrow, *blank*,*blank* -Excess iron not used for Hb production is stored in macrophages as ferritin, which is oxidized to *ferrous/hemosiderin* - ANSWER-intestinal trasferrin synthesis macrophages spleen liver hemosiderin *Momen AL* What is Polycythemia? -Abnormally *low/high* total circulating RBC with a hematocrit of *blank*% - ANSWER-high 50 *Momen AL* What factors contribute to the development of Polycythemia? -General polycythemia is due to *increased/decreased* in plasma volume such as Severe *blank* excess use of diuretics, GI *blank* loss - ANSWER-decreased burn fluid *Momen AL* What factors contribute to the development of Secondary Polycythemia? -due to *increased/decreased* production of Erythropoietin (*blank3LETTERS*) due to tissue hypoxia in -high altitude, *blankERS*, Chronic obstructive pulmondary disease, Congential heart disease and *increase/decrease* blow flow in *liver/kidney* - ANSWER-increased EPO smokers decreased kidney *Momen AL* RBC maturation defect Anemia is due to : -*Blank* defects which is mostly iron deficiency and *blank* defects including b12 deficiency, drug induced and refractory *blank* - ANSWER-cytoplasmic nuclear anemia *Momen AL* Major element needed for RBC maturation include: -Blank, vitamins *blank* and *blank* - ANSWER-iron b12 b9 *Momen AL* Common Causes for iron deficiency anemia is: -*blank*, loss of *blank* through bleeding, and increased demands in growth *blankS* - ANSWER-dietary iron spurts *Momen AL* Common clinical features for iron deficiency anemia are: -decreased Hb of the skin (called *blank*), easy fatigability, and dyspnea - ANSWER-Pallor *Momen AL* What is aplastic anemia? Hypoproliferative or reduced production production of blood cells caused by Primary marrow *blank*- *idiopathic/immunologic*, Cancer treatment such as chemo, radiation. - ANSWER-aplasia idiopathic *Momen AL* Explain the Etiology of pathophysiology of hereditary spherocytosis -Transmitted as an autosomal *recessive/dominant* trait in about *blank*% of cases -Defective membrane protein leads to RBC to become a *loose/tight* sphere -Poorly deformable and susceptible to destruction by *liver/spleen* - ANSWER-dominant 75 tight spleen *Momen AL* Non-neoplastice causes of Neutrophilic leukocytosis -idiopathic -drug induced by glucocorticoids, Li, and Epi -Infection by *blank* and fungal -*blank* disorders- ketoacidosis, acute renal failure, eclampsia, acute poisoning - ANSWER-bacterial metabolic *Momen AL* Explain non-neoplastic causes of lymphocytic leukocytosis -most often *blank* infection -Other infections include: Rubella, Varicella (*blank3letters*), Mumps, and CMV -*Acute/chronic* inflammation - ANSWER-viral vzv chronic *Momen AL* Explain non-neoplastic causes of Eosinophilic leukocytosis -Drug induced by: Iodine, *blank*, sulphonamide, penicillin -Parasitic infestation - ANSWER-aspirin *Momen AL* What cells become active in an infection with Epstein Bar Virus (*EBV*)? -*blankTOSIS* with activated lymphocytes - ANSWER-lymphocytosis *Momen AL* Define agranulocytosis -extremely *high/low* levels of *blank* (500/mm^3) - ANSWER-low neutrophils *Momen AL* Drugs that may cause both Neutropenia and Lymphopenia are: -*blank* mustard, antimetabolites, noncytotoxic agents, tranquilizers, anticonvulsants, anti *inflam/diurectics* - ANSWER-nitrogen inflam *Momen AL* Common pathways for intrinsic and extrinsic coagulation -Antithrombin (AT)/ *blank* drug -Tissue factor pathway inhibitor -*blank* C/S/ *blank* drug -Fibrinolytic system - ANSWER-heparin warfarin *Momen AL* How is a stabilized blood clot degraded? What physiological factors regulate blood coagulation and why this regulation is important? -Tissue *plasmids/plasminogen* activator produces plasmin from plasminogen. It breaks down fibrin clot into fibrin degradation products. Both inhibit clots to stay on the *blank* for an extended period - ANSWER-plasminogen vessel *Momen AL* Steps of Hemostatis? -*Blank* (immediate), Platelet Plug, Blood Coagulation, *blank* retraction, and *blank* dissolution or *blank* - ANSWER-vasospasm clot clot lysis *Momen AL* Platelet plug formation is initiated at the site of *blank injury* when circulating platelets adhere to exposed collagen and are activated by *distant/locally* generated mediators. Activated platelets undergo shape change and granule release, and platelet *formation/aggregates* - ANSWER-vascular injury locally aggregates *Momen AL* Hemophilia is 80% a factor *blank* and is *x/y*linked and mostly found in males. These people bleed rapidly due to an inability to rapidly form blood *blankS*. - ANSWER-8 x clots *Momen AL* Vitamin K is required for synthesis of several clotting factors including factor *blankLETTER* and factor *blank#* and is necessary for factor 7, IX. - ANSWER-x 2 *Momen AL* Common causes of DIC are: -*blank* is the most common and Obstetric disorders account for *blankPERCENT* of cases. -Another rare but typical reason is massive *blank* - ANSWER-sepsis 50 trauma *Momen AL* Important laboratory test for coagulation and bleeding conditions are PT aka *blank time*, international normalized ration (INR), activated *blank* thromboplastin time (aPTT), *blankLETTER*-dimer (a fibrin degradation production - ANSWER-prothrombin time partial d *Momen AL* Urine analysis may have proteinuria the condition most likely is impaired *liver/kidney* function state , prolonged *blank*, severe *liver/kidney* disease - ANSWER-kidney starvation liver *Momen AL* 3 important plasma proteins are: A,G,F - ANSWER-albumin globulin fibrinogen *Momen AL* Water balance in figure 6 shows arteriole water into *blank* of the Interstitial tissue and out to the *blank* - ANSWER-capillary venous *Momen AL* The only major class of plasma proteins *NOT* synthesized by the liver is the Ig's secreted by the *blank* cell, a derivative of lymphocytes - ANSWER-plasma *Momen AL* Hypovolemic shock is loss of *blank* or *blank* volume due to mostly following causes hemorrhage and plasma lose - ANSWER-plasma blood *Momen AL* Clinical manifestation of hypovolemic shock are *hyper/hypo*tension, tachycardia, cold clammy *blank*, dyspnea, altered *blank* status - ANSWER-hypo skin mental *Rao Questions* What removes the start and stop sites of intron regions? - ANSWER-spliceosomes *Rao Questions* Tandem repeats clustered around centromeres of certain chromosomes are called *blank* dna - ANSWER-satellite *Rao Questions* What gene has mutations that can cause breast cancer? - ANSWER-BRCA1 *Rao Questions* What is the role of the promoter in a protein-coding region? -The promoter is a key *translator/promoter* of *blank* expression - ANSWER-promoter gene *Rao Questions* At what stage of Meiosis does chromosome crossover occur? - ANSWER-meiosis 1 *Rao Questions* What is the name of Dr. Rao's cats? Tyra Banks and *bl