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Chapter 30 alterations of leukocyte and lymphoid

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Chapter 30: Alterations of Leukocyte and Lymphoid FunctionMcCance/Huether: Pathophysiology: The Biologic Basis of Disease in Adults andChildren, 8th EditionMULTIPLE CHOICE1.In infectious mononucleosis (IM), what does the Monospot test detect?a.Immunoglobulin E (IgE)b.Immunoglobulin M (IgM)c.Immunoglobulin G (IgG)d.Immunoglobulin A (IgA)ANS: BThe Monospot test is used to diagnose infectious mononucleosis by detecting heterophileantibodies. These are a heterogeneous group of immunoglobulin M (IgM) antibodies that areagglutinins against nonhuman red blood cells and are present in IM.PTS: 1DIF:Cognitive Level: Remembering2.A patient has been diagnosed with acute lymphocytic leukemia (ALL) and asks the healthcareprofessional to describe it. What description by the professional ismostaccurate?a.ALL is a progressive neoplasm defined by the presence of greater than 30%lymphoblasts in the bone marrow or blood.b.In ALL, immature blasts cells replace normal myelocytic cells, megakaryocytes,and erythrocytes.c.B cells fail to mature into plasma cells that synthesize immunoglobulins.d.The translocation of genetic material from genes 9 and 22 create an abnormal,fused gene identified asBCR-ABL.ANS: AALL is a progressive neoplasm defined by the presence of greater than 30% lymphoblasts inthe bone marrow or blood. Leukemia is a malignant disorder of leukocytes and does notinvolve immunoglobulins. The BCR-ABL gene has been identified in chronic myelogenousleukemia, not ALL.PTS: 1DIF:Cognitive Level: Understanding3.Which description is consistent with chronic myelogenous leukemia (CML)?a.Defects exist in therasoncogene,TP53tumor-suppressor gene, andINK4A,thegene encoding a cell-cycle regulatory protein.b.Leukocytosis and a predominance of blast cells characterize the bone marrow andperipheral blood. As the immature blasts increase, they replace normal myelocyticcells, megakaryocytes, and erythrocytes.c.B cells fail to mature into plasma cells that synthesize immunoglobulins.d.The translocation of genetic material from genes 9 and 22 creates an abnormal,fused protein identified asBCR-ABL1.ANS: DThe presence of theBCR-ABLIfusion gene distinguishes CML from other myeloproliferativedisorders.Chapter 30 - Alterations of Leukocyte and Lymphoid Function280Pathophysiology The Biologic Basis for Disease in Adults and Children 8th Edition 97803235834
PTS: 1DIF:Cognitive Level: Remembering4.A patient is admitted to the hospital with multiple myeloma (MM). Which diagnostic testshould the healthcare professional assess as thepriority?a.Serum potassium levelb.Serum calcium levelc.Bone scan or limb x-raysd.Bone marrow biopsyANS: BMany clinical manifestations of MM are due to hypercalcemia. Since calcium can affectcardiac conduction, the priority diagnostic test is serum calcium levels. Bone destruction doesoccur in MM, but obtaining images of bones is not a higher priority than the calcium. Thepatient already has been diagnosed with MM, so a bone marrow biopsy may not be needed atthis time. Potassium and other electrolytes will be assessed but not as the priority.

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