NURS 3366 Patho Exam 3 Questions And Answers With
Complete Solutions
"Cheerios" claims to reduce cholesterol levels if eaten daily for
at least a few weeks. By what mechanism is this accomplished?
Correct Answers Cheerios contains a substantial amount of
soluble fiber. Soluble fiber has been demonstrated to inhibit the
reuptake of bile salts from the small intestine. Soluble fiber
binds to bile salts thus inhibiting their reuptake.
A 25-year-old man experiences chest pain on exercise when he
attempts to climb three flights of stairs. This pain is relieved by
sublingual nitroglycerin. He is 178 cm tall and weighs 101 kg.
His blood pressure is 130/85 mm Hg. Laboratory studies show a
total serum cholesterol of 550 mg/dL with an HDL cholesterol
component of 25 mg/dL. The blood glucose is 120 mg/dL. He is
worried about these findings because his brother died of a
myocardial infarction at age 34. Which of the following
conditions is this man most likely to have?
A Diabetes mellitus, type II
B Hypertensive emergency
C Familial hypercholesterolemia
D Cushing syndrome
E Morbid obesity Correct Answers (C) CORRECT. The very
high cholesterol with symptoms of coronary artery disease at
such a young age, coupled with the family history, are all
,consistent with familial hypercholesterolemia. In most persons
with hypercholessterolemia from multifactorial causes,
including diet and exercise patterns, the cholesterol rarely
exceeds 400 mg/dL.
A 30-year-old man goes to his physician for a routine health
checkup. On physical examination there are no abnormal
findings. Laboratory test findings include serum glucose 80
mg/dL, hemoglobin A1C 4%, total cholesterol 240 mg/dL, LDL
cholesterol 180 mg/dL, and HDL cholesterol 20 mg/dL.
Through which of the following mechanisms is endothelial
vascular injury in this patient most likely to occur?
A Accumulation of sorbitol
B Insudation of lipid
C Inflammation with neutrophils
D Deposition of immunoglobulins
E Activation of complement Correct Answers (B) CORRECT.
He has hypercholesterolemia with more of the 'bad' LDL
cholesterol that can become oxidized and taken up by modified
arterial wall LDL receptors. The lipid collects in macrophages
that transform to foam cells. These foam cells accumulate and
becomes a lipid lesion--the precursor to more serious
atheromatous plaques.
A 34-year-old previously healthy woman notes that she has
bruises form on her arms and legs with just minor trauma.
,Physical examination reveals areas of purpura from 1 to 3 cm in
size over her trunk and extremities, but no swelling, warmth, or
erythema. Peripheral pulses are all palpable and full. Her blood
pressure is 110/70 mm Hg. An ultrasound examination of her
lower extremities with Doppler flow measurement reveals no
evidence for thrombosis. Laboratory findings include serum urea
nitrogen of 16 mg/dL, LDH 300 U/L, total protein 6.9 g/dL,
albumin 5.3 g/dL, alkaline phosphatase 50 U/L, AST 40 U/L,
and ALT 20 U/L. Which of the following additional laboratory
findings is most likely to be present in this patient?
A Hyperglycemia
B Hypercholesterolemia
C Lactic acidosis
D Thrombocytopenia
E Hypoprothrombinemia
F Anemia Correct Answers (D) CORRECT. The platelets are
responsible for dealing with small leaks in small vessels.
Thrombocytopenia is marked by petechiae and purpura. She
does not have evidence for peripheral vascular disease, since her
circulation is good. Venous thrombosis should lead to swelling
and tenderness.
A 44-year-old woman has a family history of heart disease. Her
father and mother both developed myocardial infarction and
congestive heart failure as a result of occlusive coronary
, atherosclerosis. A dietary modification to include consumption
of which of the following is most likely to reduce her risk for
ischemic heart disease?
A 40% of total caloric intake as fat
B Increased saturated fat
C Foods with cholesterol
D Cold water fish oil
E Fat found in beef products
F Hydrogenated oils with trans-fats Correct Answers (D)
CORRECT. Fish oils diminish arachidonic acid metabolites and
reduce platelet aggregation.
A 45-year-old man dies suddenly and unexpectedly. The
immediate cause of death is found to be a hemorrhage in the
right basal ganglia region. On microscopic examination his renal
artery branches have concentric endothelial cell proliferation
which markedly narrows the lumen, resulting in focal ischemia
and hemorrhage of the renal parenchyma. An elevation in which
of the following substances in his blood is most likely to be
associated with these findings?
A Ammonia
B Calcium
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