Exam #3 Advanced Assessment

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Fluid58

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About This Quiz

Exam #3 Advanced Assessment tests understanding of hematological disorders. It covers neutrophil and lymphocyte responses in infections, RBC indices like MCV and MCH, and differentiates types of microcytic anemia, focusing on iron deficiency anemia.

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2.

MCV or Mean Corpuscular Volume is the average volume/size of RBC's in the blood and the normal values are between 80-100?
- True
- False
Correct Answer

A. True

Explanation

The correct answer is true because MCV, or Mean Corpuscular Volume, refers to the average volume or size of red blood cells in the blood. Normal values for MCV typically range between 80-100.

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3.

MCH or mean corpuscular hemoglobin is the average amount of hemoglobin on a RBC, normal is 1.68-1.92
- True
- False
Correct Answer

A. True

Explanation

The statement is true because MCH, or mean corpuscular hemoglobin, is indeed the average amount of hemoglobin on a red blood cell (RBC). The normal range for MCH is 1.68-1.92, indicating the average amount of hemoglobin present in a healthy RBC.

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4.

Client has a blood work profile that includes a low H & H, low MCV/MCH, low ferritin level and an increased total iron binding capacity (TIBC). What is the suspected anemic cause?
- Lead poisoning
- Iron deficiency
- Thalassemia
- Option 4
Correct Answer

A. Iron deficiency

Explanation

The client's blood work profile shows low H & H, low MCV/MCH, low ferritin level, and increased total iron binding capacity (TIBC). These findings are consistent with iron deficiency anemia. Iron deficiency is a common cause of anemia and can result from inadequate dietary intake, poor absorption, or excessive blood loss. The low levels of hemoglobin and red blood cells (H & H), small size of red blood cells (MCV/MCH), low ferritin (iron stores), and increased TIBC (reflecting the body's attempt to increase iron uptake) all point towards iron deficiency as the likely cause of anemia in this client.

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5.

Types of Microcytic anemia's.
- Iron Deficiency Anemia
- Thalassemia
- B12/folate deficiency anemia
- Lead Poisoning
Correct Answer(s)

A. Iron Deficiency Anemia
A. Thalassemia
A. Lead Poisoning

Explanation

These anemia's occur as a result of a low MCV or low volume of RBC's.

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6.

Normocytic and normochromic anemia types:
- Chronic disease states
- Acute Blood Loss/Trauma/Surgery
- Thalassemia
- Aplastic Anemia
Correct Answer(s)

A. Chronic disease states
A. Acute Blood Loss/Trauma/Surgery
A. Aplastic Anemia

Explanation

Aplastic Anemia-body stops producing enough new RBC's-can be fatal.

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7.

Select those that are associated with megaloblastic anemia.
- Low H and H
- MCV >100
- B12/folate or folic acid deficiency
- Low Mean Corpuscular Volume of RBC.
Correct Answer(s)

A. Low H and H
A. MCV >100
A. B12/folate or folic acid deficiency

Explanation

The given answer options correctly identify the characteristics associated with megaloblastic anemia. Megaloblastic anemia is characterized by low hemoglobin (H) and hematocrit (H) levels, as indicated by the option "Low H and H." Additionally, an elevated mean corpuscular volume (MCV) greater than 100 is a characteristic feature of megaloblastic anemia, as mentioned in the option "MCV >100." Lastly, megaloblastic anemia can be caused by deficiencies in vitamin B12 or folate/folic acid, as stated in the option "B12/folate or folic acid deficiency."

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8.

Client presents with a high MCV and a low H and H, provider suspects a megaloblastic anemia. With an increased Methylmalonic acid what does the provider assume is the cause of the anemia?
- Vitamin E deficiency
- Folate deficiency
- B12 deficiency
- Low iron level
Correct Answer

A. B12 deficiency

Explanation

If the Methylmalonic acid is normal then we would suspect that the folate level is low and the cause of the megaloblastic anemia.

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9.

Another cause of macrocytic anemia is alcoholism/liver disease?
- True
- False
Correct Answer

A. True

Explanation

Alcoholism and liver disease can lead to macrocytic anemia. Chronic alcohol consumption can result in nutritional deficiencies, particularly of folate and vitamin B12, which are essential for red blood cell production. Additionally, liver disease can impair the liver's ability to store and release these vitamins, further contributing to anemia. Therefore, it is true that alcoholism and liver disease can cause macrocytic anemia.

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10.

Client has a b12 deficiency but it is found that the anti-intrinsic factor is +, what is suspected as the cause of the macrocytic anemia associated with extended G2 phase of cell reproduction?
- Megaloblastic anemia due to folic acid deficiency
- Pernicious Anemia
- Lead poisoning
- Thalassemia
Correct Answer

A. Pernicious Anemia

Explanation

A positive anti-intrinsic factor means that the stomach lining is not producing enough intrinsic factor and the body is unable to absorb enough b12.

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11.

ALP and ALT are elevated in which disease state?
- Pancreatitis
- Cirrhosis
- Cholecystitis
- Option 4
Correct Answer

A. Cholecystitis

Explanation

ALP (alkaline phosphatase) and ALT (alanine aminotransferase) are liver enzymes that are commonly measured in blood tests. In cholecystitis, which is inflammation of the gallbladder, these liver enzymes can be elevated. This is because cholecystitis can lead to inflammation and irritation of the liver, causing an increase in the release of these enzymes into the bloodstream. Therefore, the correct answer is cholecystitis.

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12.

Liver enzymes are non-specific as the values are representative of normal cellular decay in healthy individuals. It is not necessary to follow-up with enzymes unless the values are 2 or more times the normal values?
- True
- False
Correct Answer

A. True

Explanation

Liver enzymes are substances produced by liver cells that are released into the bloodstream when liver cells are damaged or die. The values of liver enzymes in healthy individuals are within a certain range, which is considered normal. These values can slightly vary from person to person. However, liver enzymes are not specific to liver diseases and can also be elevated in other conditions. Therefore, a slight increase in liver enzyme values may not necessarily indicate liver disease. It is generally recommended to follow-up with liver enzymes only if the values are significantly higher, typically 2 or more times the normal range. Hence, the statement "It is not necessary to follow-up with enzymes unless the values are 2 or more times the normal values" is true.

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13.

If you have a microcytic anemia and you have a normal ferritin level you could rule out Iron deficiency and suspect lead poisoning or thalassemia?
- True
- False
Correct Answer

A. True

Explanation

If a person has a microcytic anemia (a condition characterized by small red blood cells) and a normal ferritin level (a protein that stores iron), it is unlikely to be caused by iron deficiency. Iron deficiency is a common cause of microcytic anemia and is usually associated with low ferritin levels. Therefore, ruling out iron deficiency suggests that the microcytic anemia may be due to other causes such as lead poisoning or thalassemia.

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14.

The _______ test which when elevated may be the first indicator of cirrhosis.

Correct Answer
INR

Explanation
Normal INR is 0.8-1.1, you need to make sure the client is on no blood thinning agents.

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15.

A decreased serum Albumin, elevated INR and elevated bilirubin indicate?
- Cirrhosis
- Pancreatitis
- Peritonitis
Correct Answer

A. Cirrhosis

Explanation

A decreased Albumin is the likely cause for ascites with reduced osmotic pull of fluids into the veins/capillaries from the interstitial spaces caused by a lack of protein. Liver enzymes are a poor test with chronic cirrhosis as the liver tissue is not decaying/dying as fast with less viable tissue left. Tests may be normal.

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16.

What is the goal LDL for diabetics and then Cardiac patients?
- 100/70
- 120/80
- 300/200
- 80/60
Correct Answer

A. 100/70

Explanation

The goal LDL (low-density lipoprotein) for diabetics and cardiac patients is 100/70. LDL cholesterol is often referred to as "bad" cholesterol because high levels of it can increase the risk of heart disease. Diabetics and cardiac patients are at a higher risk of developing heart disease, so maintaining a lower LDL level is important for their overall health and well-being. The recommended goal of 100/70 indicates the desired levels of LDL cholesterol in the blood for these individuals.

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17.

The patient has an elevated BUN with a slightly and slower elevating creatinine test, the BUN/Creatinine ration is >20. We can suspect a pre-renal failure such as renal stenosis or dehydration?
- True
- False
Correct Answer

A. True

Explanation

Urine osmolality will be elevated with dehydration as the body is trying to retain fluid. Urine Na will be lower than 20

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18.

Client has suspected kidney failure, the BUN is rising but slowly compared to the creatinine level, the BUN/Creatinine level is <20 and the patient is a diabetic. What kind of renal failure is likely?
- Post-renal
- Pre-renal
- Intra- renal
- Not a renal failure
Correct Answer

A. Intra- renal

Explanation

Likely in diabetic renal failure, urine Na will be over 30.

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19.

The BUN and Creatinine both increase relative to each other and the client has painful urination, likely post renal failure such as a kidney stone?
- True
- False
Correct Answer

A. True

Explanation

The given answer is true because an increase in both BUN (blood urea nitrogen) and creatinine levels indicates impaired kidney function. Painful urination can be a symptom of post renal failure, which can be caused by a kidney stone blocking the urinary tract. Therefore, the combination of increased BUN and creatinine levels along with painful urination suggests the possibility of post renal failure, such as a kidney stone.

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20.

Select the risk factors for penile cancer.
- Un circumcised with poor hygiene.
- Phimosis
- HPV infection
- Increased age
- Smoker
- HIV positive
- UV light exposure of psoriasis
Correct Answer(s)

A. Un circumcised with poor hygiene.
A. Phimosis
A. HPV infection
A. Increased age
A. Smoker
A. HIV positive
A. UV light exposure of psoriasis

Explanation

The risk factors for penile cancer include being uncircumcised with poor hygiene, having phimosis, HPV infection, increased age, being a smoker, being HIV positive, and UV light exposure in individuals with psoriasis. These factors can increase the likelihood of developing penile cancer, emphasizing the importance of practicing good hygiene, getting vaccinated against HPV, quitting smoking, and protecting oneself from UV light.

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21.

Testicular CA risk factors
- Male 20-54
- White
- Undescended testicle
- Hx of testicular CA
- Family Hx of testicular CA
Correct Answer(s)

A. Male 20-54
A. White
A. Undescended testicle
A. Hx of testicular CA
A. Family Hx of testicular CA

Explanation

The given answer includes all the known risk factors for testicular cancer. Testicular cancer is more common in males between the ages of 20-54, and white males are at a higher risk compared to other ethnicities. Having an undescended testicle increases the risk, as well as having a personal history or family history of testicular cancer. Therefore, all the factors mentioned in the answer contribute to an increased risk of developing testicular cancer.

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22.

This state of penile being is possibly caused by leukemia, sickle cell disease or standard ED treatment.
- Phimosis
- Priapism
- Hydrocele
- Balanitis
Correct Answer

A. Priapism

Explanation

Priapism refers to a prolonged and painful erection that lasts for more than four hours without sexual stimulation. This condition can be caused by various factors, including leukemia, sickle cell disease, or certain medications used to treat erectile dysfunction (ED). Leukemia and sickle cell disease can affect blood flow, leading to priapism. Additionally, some ED treatments, such as injections or medications, can cause priapism as a side effect. Therefore, the given statement suggests that priapism can be caused by these conditions or treatments.

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23.

The left testicle hangs lower than the right in general due to a longer spermatic chord on the left?
- True
- False
Correct Answer

A. True

Explanation

The left testicle hanging lower than the right is generally true because the left testicle has a longer spermatic cord. The spermatic cord is responsible for connecting the testicles to the rest of the reproductive system, and its length can cause one testicle to hang lower than the other.

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24.

Scrotal edema is related to a genital disease state in most cases?
- True
- False
Correct Answer

A. False

Explanation

Scrotal edema is generally not a genital condition sign but rather a sign of renal, cardiac or hepatic disease.

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25.

A strangulated hernia is not reducible and requires prompt surgical intervention?
- True
- False
Correct Answer

A. True

Explanation

A strangulated hernia occurs when a part of the intestine becomes trapped and the blood supply to that area is cut off. This leads to severe pain, tenderness, and swelling. In such cases, the hernia cannot be pushed back into place (reduced) manually and immediate surgical intervention is necessary to release the trapped intestine and restore blood flow. Therefore, the statement that a strangulated hernia is not reducible and requires prompt surgical intervention is true.

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26.

Having no sensitivity to painful stimuli in the testes may be a result of Diabetic neuropathy or syphilis?
- True
- False
Correct Answer

A. True

Explanation

Having no sensitivity to painful stimuli in the testes may be a result of diabetic neuropathy or syphilis. Diabetic neuropathy is a condition that affects the nerves and can lead to loss of sensation, including in the testes. Syphilis, a sexually transmitted infection caused by the bacterium Treponema pallidum, can also cause nerve damage and result in decreased sensitivity to pain. Therefore, it is true that both diabetic neuropathy and syphilis can cause a lack of sensitivity to painful stimuli in the testes.

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27.

Client presents with acute, very painful right testicle, reports N and V with anorexia. Client has an absent Cremasteric reflex on the right side. No reports of fever or malaise. Client is an adolescent who is very active. What is likely cause?
- Phymosis
- Testicular torsion
- Epididymitis
- Hydrocele
Correct Answer

A. Testicular torsion

Explanation

The client's symptoms of acute, severe pain in the right testicle, along with the absence of the Cremasteric reflex, suggest testicular torsion as the likely cause. Testicular torsion occurs when the spermatic cord twists, cutting off the blood supply to the testicle. This condition is a medical emergency and requires immediate intervention to prevent permanent damage to the testicle. The absence of fever or malaise and the client's age and activity level further support this diagnosis. Phymosis, epididymitis, and hydrocele do not typically present with the same symptoms or require urgent intervention.

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28.

Client presents with a mildly edematous scrotum that has gradually become more tender. The client reports a fever and general fatigue. He also reports pyuria and pus drainage from the urethra. He has no N/V to report. Client reports recent sexual activity and is 26. You note a firm lumpy epididymitis and beading of the vas deferens. What is likely cause?
- Spermatocele
- Torsion
- Epididymitis
- Paraphymosis
Correct Answer

A. Epididymitis

Explanation

The client's symptoms of a mildly edematous scrotum, tenderness, fever, fatigue, pyuria, and pus drainage from the urethra, along with the physical examination findings of a firm lumpy epididymitis and beading of the vas deferens, are consistent with epididymitis. Epididymitis is an inflammation of the epididymis, which is commonly caused by a bacterial infection. It often occurs as a result of a urinary tract infection or sexually transmitted infection. The client's recent sexual activity and age of 26 also support the diagnosis of epididymitis.

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29.

You could suspect gonococcal urethritis if patient presents with green/yellow discharge with painful/burning urination?
- True
- False
Correct Answer

A. True

Explanation

The presence of green/yellow discharge and painful/burning urination are common symptoms of gonococcal urethritis. This condition is caused by the bacteria Neisseria gonorrhoeae, which is transmitted through sexual contact. The green/yellow discharge is a result of the infection, while the painful/burning urination is caused by inflammation of the urethra. Therefore, if a patient presents with these symptoms, it is reasonable to suspect gonococcal urethritis.

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30.

Risk factors for prostate cancer.
- Diet high in animal fat, dairy and calcium
- Age over 50
- Black
- Gene mutations of BRCA 1 and 2
- Inactivity
- Family history
- High androgen levels
Correct Answer(s)

A. Diet high in animal fat, dairy and calcium
A. Age over 50
A. Black
A. Gene mutations of BRCA 1 and 2
A. Inactivity
A. Family history
A. High androgen levels

Explanation

The risk factors for prostate cancer include a diet high in animal fat, dairy, and calcium, being over the age of 50, being of black ethnicity, having gene mutations of BRCA 1 and 2, being inactive, having a family history of prostate cancer, and having high androgen levels. These factors have been identified through research and studies as being associated with an increased risk of developing prostate cancer.

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31.

The prostate should feel like a pencil erases with some mobility, smooth and nodular free, will have a central sulcus with 2 lobes. Healthy prostrate will extend less than 1cm into the rectum.
- True
- False
Correct Answer

A. True

Explanation

The explanation for the given correct answer is that a healthy prostate should have certain characteristics, such as feeling like a pencil eraser with some mobility, being smooth and nodular free, having a central sulcus with 2 lobes, and extending less than 1cm into the rectum. Therefore, the statement "The prostate should feel like a pencil erases with some mobility, smooth and nodular free, will have a central sulcus with 2 lobes. Healthy prostrate will extend less than 1cm into the rectum" is true.

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32.

If on examination of the prostate there is urethral drainage you should collect and culture the drainage?
- True
- False
Correct Answer

A. True

Explanation

If there is urethral drainage during examination of the prostate, it is important to collect and culture the drainage. This is because the presence of drainage may indicate an infection or inflammation in the prostate or urinary tract. Collecting and culturing the drainage allows for the identification of any potential pathogens present, which can help guide appropriate treatment decisions. It is an important step in diagnosing and managing prostate and urinary tract infections.

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33.

Hemorrhoids in children are rare and may indicate serious underlying problem such as portal hypertension?
- True
- False
Correct Answer

A. True

Explanation

Hemorrhoids in children are indeed rare and can be a cause for concern as they may indicate a serious underlying issue such as portal hypertension. Portal hypertension refers to high blood pressure in the portal vein, which carries blood from the digestive organs to the liver. When this vein is blocked or damaged, it can lead to the development of hemorrhoids. Therefore, the statement "True" is correct in stating that hemorrhoids in children may indicate a serious underlying problem like portal hypertension.

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34.

Small flat flaps of skin around the rectum (Condylomas) are commonly from hpv infection?
- True
- False
Correct Answer

A. True

Explanation

Small flat flaps of skin around the rectum, known as condylomas, are commonly caused by HPV infection. HPV, or human papillomavirus, is a sexually transmitted infection that can cause genital warts. Condylomas are a type of genital wart that can occur in and around the rectal area. HPV is a very common infection, with many different strains, and it can be spread through sexual contact. Therefore, it is true that condylomas are commonly caused by HPV infection.

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35.

Tufts of hair, sinuses and dimpling of the pilonidal area may indicate spinal deformities and alert the examiner for a need of ultrasound to evaluate potential spinal deformities?
- True
- False
Correct Answer

A. True

Explanation

Tufts of hair, sinuses, and dimpling of the pilonidal area are all signs that may indicate the presence of spinal deformities. These deformities can affect the alignment and structure of the spine, potentially causing pain and other complications. Therefore, if these signs are observed, it would be prudent for the examiner to consider the possibility of spinal deformities and recommend an ultrasound to further evaluate the condition.

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36.

A constantly empty rectum in children with presence of constipation should alert to hirschsprung disease.
- True
- False
Correct Answer

A. True

Explanation

The statement is true because Hirschsprung disease is a condition where there is a lack of nerve cells in the rectum and colon, leading to difficulty in passing stool. This can result in constipation. If a child consistently has an empty rectum despite having constipation, it suggests that there may be an underlying issue such as Hirschsprung disease. Therefore, the presence of a constantly empty rectum in children with constipation should indeed alert to Hirschsprung disease.

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37.

Prostatitis findings acute:
- Fever, chills and shakes
- Bacteremia on massage- get sample cultured
- Boggy fluctuant prostate that is asymmetric.
- Acute pain with sexual dysfunction and urination problems.
- Bacteria in urine.
Correct Answer(s)

A. Fever, chills and shakes
A. Bacteremia on massage- get sample cultured
A. Boggy fluctuant prostate that is asymmetric.
A. Acute pain with sexual dysfunction and urination problems.
A. Bacteria in urine.

Explanation

Prostatitis can be result of a biopsy or sti

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38.

Client presents with typical symptoms of frequency, dysuria, hesitancy, nocturia and incomplete emptying/retention. The client labs show no bacteremia. Prostate feels enlarged with a smooth symmetric and slightly boggy feel. What is suspected?
- Prostate cancer
- BPH
- Prostatitis
- Healthy prostate
Correct Answer

A. BPH

Explanation

Based on the client's symptoms of frequency, dysuria, hesitancy, nocturia, and incomplete emptying/retention, along with the physical examination findings of an enlarged prostate with a smooth symmetric and slightly boggy feel, the suspected condition is BPH (Benign Prostatic Hyperplasia). BPH is a non-cancerous enlargement of the prostate gland that commonly occurs in older men. It can cause urinary symptoms similar to those described by the client, and the physical examination findings are consistent with an enlarged prostate. Prostate cancer would typically present with different symptoms and may not have the same physical examination findings. Prostatitis is another possible condition, but the absence of bacteremia makes it less likely. "Healthy prostate" is not a plausible explanation given the client's symptoms and examination findings.

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39.

Male client presents with symptoms consistent with BpH, on exam the prostate feels hard and asymmetric with no tenderness and the median sulcus is obliterated. What is suspected?
- Prostatitis
- BPH
- Prostate CA
- Colon CA
Correct Answer

A. Prostate CA

Explanation

PSA would likely be elevated at this point.

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40.

Characteristics of normal nevi
- Uniform color
- Irregular boarders
- Flat texture, uniform texture
- Less than 6mm in size
- 10-40 typical
Correct Answer(s)

A. Uniform color
A. Flat texture, uniform texture
A. Less than 6mm in size
A. 10-40 typical

Explanation

Normal nevi, or moles, typically have certain characteristics. They have a uniform color, meaning that the color is consistent throughout the mole. They also have a flat texture and uniform texture, meaning that the surface of the mole is smooth and even. Normal nevi are usually less than 6mm in size, and it is common to have 10-40 of them on the body.

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41.

Characteristics of abnormal or dysplastic nevi
- Irregular, ill defined boarders
- Varying color within the nevi
- Smooth dome shape
- Larger than 6mm
- Most commonly found on the back
Correct Answer(s)

A. Irregular, ill defined boarders
A. Varying color within the nevi
A. Larger than 6mm
A. Most commonly found on the back
42.

People with dysplastic nevi are at more risk for melanoma?
- True
- False
Correct Answer

A. True

Explanation

People with dysplastic nevi, which are atypical moles, are at a higher risk for melanoma. Dysplastic nevi often have irregular borders, uneven coloration, and a larger size compared to normal moles. These characteristics indicate cellular changes that increase the likelihood of developing melanoma, a type of skin cancer. Regular monitoring and early detection of any changes in these moles are crucial for individuals with dysplastic nevi to prevent the progression to melanoma. Therefore, the statement "people with dysplastic nevi are at more risk for melanoma" is true.

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43.

Skin turgor is a fairly reliable was to check fluid volume status, you should always check turgor on the back of the hand?
- True
- False
Correct Answer

A. False

Explanation

Turgor should be checked on the forearm and or sternum, the back of the hand has elastic/fibrotic breakdown and may give a poor assessment.

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44.

This kind of light is used to help determine any presence of some types of fungus on the skin and will fluorescence green/yellow. Also used to determine hypo and hyper pigmentation demarcation lines.
- Fluorescent lighting
- Woods lamp
- LCD lighting
- Candle light
Correct Answer

A. Woods lamp

Explanation

A Woods lamp is the correct answer because it is a type of light that is used to determine the presence of certain types of fungus on the skin. This light emits ultraviolet rays that cause certain substances, such as fungus, to fluoresce green or yellow. Additionally, a Woods lamp can be used to identify hypo and hyperpigmentation demarcation lines on the skin. Fluorescent lighting, LCD lighting, and candle light do not have the specific properties necessary for these purposes.

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45.

Client has a green/black singular nail bed, reports that he has pain on palpation. We can rule out pseudomonas infection as a result. What is the likely diagnosis?
- Subungal infection
- Splinter hemorrhages
- Trauma to the nail bed.
- Cellulitis
Correct Answer

A. Trauma to the nail bed.

Explanation

The client's green/black singular nail bed, along with the report of pain on palpation, suggests that there has been some form of injury or trauma to the nail bed. This is the likely diagnosis because the symptoms are consistent with trauma rather than an infection or other conditions such as subungal infection or cellulitis. Splinter hemorrhages typically present as small lines of blood under the nail and are not associated with pain on palpation. Therefore, trauma to the nail bed is the most plausible explanation for the client's symptoms.

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46.

Which is a common finding with aging nails?
- Splinter hemorrhages
- Longitudinal ridging
- Nail pitting
- Clubing
Correct Answer

A. Longitudinal ridging

Explanation

Longitudinal ridging is a common finding with aging nails. As individuals age, the nails may develop vertical ridges or lines running from the cuticle to the tip of the nail. This is often a normal part of the aging process and is not usually a cause for concern. These ridges can be more pronounced in some individuals and may be more noticeable in certain lighting. However, it is important to note that if the ridges are accompanied by other symptoms or changes in the nails, it may be necessary to consult a healthcare professional for further evaluation.

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47.

If your bands on a CBC are increasing but overall WBC's are going down the prognosis is poor?
- True
- False
Correct Answer

A. True

Explanation

conversely if bands are rising and WBC's are rising prognosis is good.

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48.

GGT increases with ETOH/Barbiturate/Dilantin use
- True
- False
Correct Answer

A. True

Explanation

The statement is true because ETOH (alcohol), barbiturates, and Dilantin (phenytoin) are known to increase the levels of gamma-glutamyl transferase (GGT) in the body. GGT is an enzyme found in various organs, including the liver, and its levels can be used as a marker for liver damage or disease. These substances can cause liver toxicity and therefore elevate GGT levels.

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49.

ALP and ALt increase with?
- Hepatitis
- ETOH abuse
- Cholecystitis
- Cirrhosis
Correct Answer

A. Cholecystitis

Explanation

Cholecystitis is inflammation of the gallbladder, which can cause increased levels of alkaline phosphatase (ALP) and alanine transaminase (ALT) in the blood. ALP is an enzyme found in various tissues, including the liver and bile ducts, and its levels can rise in conditions affecting these organs. ALT is primarily found in the liver and is released into the bloodstream when there is liver damage or inflammation. Therefore, cholecystitis can lead to increased ALP and ALT levels.

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Quiz Created by
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Exam #3 Advanced Assessment

Quiz Preview

MCV or Mean Corpuscular Volume is the average volume/size of RBC's in the blood and the normal values are between 80-100?

MCH or mean corpuscular hemoglobin is the average amount of hemoglobin on a RBC, normal is 1.68-1.92

Client has a blood work profile that includes a low H & H, low MCV/MCH, low ferritin level and an increased total iron binding capacity (TIBC). What is the suspected anemic cause?

Types of Microcytic anemia's.

Normocytic and normochromic anemia types:

Select those that are associated with megaloblastic anemia.

Client presents with a high MCV and a low H and H, provider suspects a megaloblastic anemia. With an increased Methylmalonic acid what does the provider assume is the cause of the anemia?

Another cause of macrocytic anemia is alcoholism/liver disease?

Client has a b12 deficiency but it is found that the anti-intrinsic factor is +, what is suspected as the cause of the macrocytic anemia associated with extended G2 phase of cell reproduction?

ALP and ALT are elevated in which disease state?

Liver enzymes are non-specific as the values are representative of normal cellular decay in healthy individuals. It is not necessary to follow-up with enzymes unless the values are 2 or more times the normal values?

If you have a microcytic anemia and you have a normal ferritin level you could rule out Iron deficiency and suspect lead poisoning or thalassemia?

The _______ test which when elevated may be the first indicator of cirrhosis.

A decreased serum Albumin, elevated INR and elevated bilirubin indicate?

What is the goal LDL for diabetics and then Cardiac patients?

The patient has an elevated BUN with a slightly and slower elevating creatinine test, the BUN/Creatinine ration is >20. We can suspect a pre-renal failure such as renal stenosis or dehydration?

Client has suspected kidney failure, the BUN is rising but slowly compared to the creatinine level, the BUN/Creatinine level is <20 and the patient is a diabetic. What kind of renal failure is likely?

The BUN and Creatinine both increase relative to each other and the client has painful urination, likely post renal failure such as a kidney stone?

Select the risk factors for penile cancer.

Testicular CA risk factors

This state of penile being is possibly caused by leukemia, sickle cell disease or standard ED treatment.

The left testicle hangs lower than the right in general due to a longer spermatic chord on the left?

Scrotal edema is related to a genital disease state in most cases?

A strangulated hernia is not reducible and requires prompt surgical intervention?

Having no sensitivity to painful stimuli in the testes may be a result of Diabetic neuropathy or syphilis?

Client presents with acute, very painful right testicle, reports N and V with anorexia. Client has an absent Cremasteric reflex on the right side. No reports of fever or malaise. Client is an adolescent who is very active. What is likely cause?

You could suspect gonococcal urethritis if patient presents with green/yellow discharge with painful/burning urination?

Risk factors for prostate cancer.

The prostate should feel like a pencil erases with some mobility, smooth and nodular free, will have a central sulcus with 2 lobes. Healthy prostrate will extend less than 1cm into the rectum.

If on examination of the prostate there is urethral drainage you should collect and culture the drainage?

Hemorrhoids in children are rare and may indicate serious underlying problem such as portal hypertension?

Small flat flaps of skin around the rectum (Condylomas) are commonly from hpv infection?

Tufts of hair, sinuses and dimpling of the pilonidal area may indicate spinal deformities and alert the examiner for a need of ultrasound to evaluate potential spinal deformities?

A constantly empty rectum in children with presence of constipation should alert to hirschsprung disease.

Prostatitis findings acute:

Client presents with typical symptoms of frequency, dysuria, hesitancy, nocturia and incomplete emptying/retention. The client labs show no bacteremia. Prostate feels enlarged with a smooth symmetric and slightly boggy feel. What is suspected?

Male client presents with symptoms consistent with BpH, on exam the prostate feels hard and asymmetric with no tenderness and the median sulcus is obliterated. What is suspected?

Characteristics of normal nevi

Characteristics of abnormal or dysplastic nevi

People with dysplastic nevi are at more risk for melanoma?

Skin turgor is a fairly reliable was to check fluid volume status, you should always check turgor on the back of the hand?

This kind of light is used to help determine any presence of some types of fungus on the skin and will fluorescence green/yellow. Also used to determine hypo and hyper pigmentation demarcation lines.

Client has a green/black singular nail bed, reports that he has pain on palpation. We can rule out pseudomonas infection as a result. What is the likely diagnosis?

Which is a common finding with aging nails?

If your bands on a CBC are increasing but overall WBC's are going down the prognosis is poor?

GGT increases with ETOH/Barbiturate/Dilantin use

ALP and ALt increase with?