D236 Test Bank: Key Questions & Answers Guide

Study Guide Questions and Answers

Describe how your body responds to an infection

When the body encounters an infection, the immune system initiates a complex, coordinated defense mechanism to eliminate invading pathogens. The first responders include T-cells, a subset of white blood cells, which secrete cytokines—chemical messengers that orchestrate the immune response. These cytokines activate B-cells to produce antibodies that are highly specific to the pathogen. Antibodies bind to the invaders, neutralizing them or flagging them for destruction by other immune cells. This combination of cellular (T-cell mediated) and humoral (antibody-mediated) immunity ensures effective clearance of infections and helps establish long-term immunity (Abbas, Lichtman, & Pillai, 2018).

Identify the role of DNA changes in congenital abnormalities

Congenital abnormalities often stem from genetic mutations or chromosomal abnormalities that impair fetal development. These DNA alterations may be inherited or arise spontaneously during cell division. Mutations can disrupt gene functions critical for growth and differentiation, while chromosomal abnormalities such as deletions, duplications, or translocations lead to loss or gain of genetic material. These genetic disruptions hinder proper organ and tissue formation, causing structural or functional birth defects (Moore, Persaud, & Torchia, 2020).

How does development disrupt congenital abnormalities?

During embryonic and fetal development, precise genetic control is essential for normal formation of organs and tissues. Disruptions in DNA during this period interfere with cellular signaling, gene expression, and differentiation processes. For example, faulty neural tube closure caused by genetic mutations results in defects like spina bifida. Such disturbances lead to malformations that become apparent as congenital abnormalities at birth (Sadler, 2019).

Describe factors that disrupt homeostasis and how disruptions affect wellbeing

Homeostasis is the body’s ability to maintain internal stability despite external changes. Various factors such as fluid or electrolyte imbalances can disturb this balance, adversely affecting health. For instance, dehydration or fluid overload alters vital electrolytes like sodium and potassium, essential for nerve and muscle function. Symptoms of such imbalances may include nausea, muscle cramps, vomiting, and cardiac arrhythmias. Persistent disruption of homeostasis can impair organ function and pose serious health risks (Hall & Guyton, 2021).

Explain RAAS (Renin-Angiotensin-Aldosterone System)

The Renin-Angiotensin-Aldosterone System (RAAS) is a hormonal cascade crucial for regulating blood pressure and fluid balance. When blood flow to the kidneys drops, juxtaglomerular cells release renin, which converts liver-produced angiotensinogen into angiotensin I. Angiotensin I is then converted by ACE (angiotensin-converting enzyme) mainly in the lungs to angiotensin II, a powerful vasoconstrictor. Angiotensin II raises blood pressure by narrowing blood vessels and stimulates the adrenal glands to secrete aldosterone, which promotes sodium and water retention in the kidneys, increasing blood volume and pressure. This system is vital in maintaining cardiovascular stability during low blood pressure states (Klabunde, 2017).

Diabetic Ketoacidosis (DKA)

Diabetic ketoacidosis is a severe diabetic complication marked by elevated anion gap metabolic acidosis. Insufficient insulin causes increased fat breakdown and ketone production, which lowers bicarbonate (HCO₃⁻) levels as the body attempts to buffer excess acids. Symptoms include dehydration, rapid breathing, and altered consciousness, necessitating emergency medical intervention (Kitabchi et al., 2009).

How do kidneys compensate for alkalosis?

To counteract alkalosis—where blood pH is excessively high—the kidneys conserve hydrogen ions (H⁺) and increase bicarbonate (HCO₃⁻) excretion. This renal response gradually decreases blood alkalinity, restoring pH balance. Although slower than respiratory compensation, kidney function is essential for long-term acid-base homeostasis during metabolic alkalosis (Rose & Post, 2001).

Untreated acidosis leads to an increase in which electrolyte?

When acidosis persists without treatment, potassium (K⁺) levels in the blood rise, a condition known as hyperkalemia. This occurs because excess hydrogen ions enter cells in exchange for potassium ions, which move into the bloodstream. Elevated potassium can cause dangerous cardiac arrhythmias and muscle weakness, making prompt correction critical (Adrogué & Madias, 2000).

West Nile Virus

West Nile Virus is a mosquito-transmitted flavivirus primarily spread by Culex mosquitoes. It usually causes mild febrile illness but can lead to severe neurological complications such as encephalitis, especially in older adults. Symptoms include high fever, headache, neck stiffness, and muscle weakness. Preventive measures focus on mosquito control and bite avoidance (Sejvar, 2014).

Lyme Disease

Lyme disease is an infection caused by Borrelia burgdorferi transmitted through tick bites. Early signs include fever, fatigue, headache, and a distinctive bull’s-eye rash (erythema migrans). Without treatment, the infection can spread to joints, the heart, and the nervous system. Early antibiotic therapy is essential to prevent severe complications (Steere et al., 2016).

Erythema Infectiosum

Erythema infectiosum, or “fifth disease,” is a viral illness caused by parvovirus B19. It begins with mild fever and respiratory symptoms, followed by a bright red rash on the cheeks, often spreading to the trunk and limbs. Adults may experience joint pain. The condition is generally mild and self-resolving (Heegaard & Brown, 2002).

Obesity and Diabetes as Risk Factors for Having a Child with Spina Bifida

Maternal obesity and diabetes increase the risk of neural tube defects like spina bifida in offspring. These metabolic conditions interfere with folate metabolism and embryonic development, leading to improper neural tube closure. Proper maternal health management and folic acid supplementation before pregnancy significantly reduce this risk (Miller et al., 2010).

Trousseau’s Sign

Trousseau’s sign indicates hypocalcemia and is elicited by inflating a blood pressure cuff above systolic pressure, causing a carpal spasm due to nerve ischemia. This sign reflects neuromuscular irritability from low calcium levels and warrants further diagnostic evaluation and treatment (Koul et al., 2017).

Cause and Sign of Spina Bifida

Spina bifida arises when the neural tube fails to close during early embryogenesis (3rd-4th week). It often presents as a fluid-filled sac on the lower back, representing exposed spinal cord tissue. Severity ranges from mild (occulta) to severe (myelomeningocele), commonly accompanied by neurological deficits (Wallingford et al., 2013).

Hemophilia is More Common in Males

Hemophilia, a bleeding disorder due to deficient clotting factors, is inherited in an X-linked recessive pattern. Since males have only one X chromosome, they are more frequently affected, whereas females generally act as carriers. The condition causes prolonged bleeding and requires clotting factor replacement therapy (Mannucci & Tuddenham, 2001).

Prenatal Exposure to Alcohol: ND-PAE, Decreased Brain Function, FAS

Prenatal alcohol exposure leads to neurodevelopmental disorders such as ND-PAE and fetal alcohol syndrome (FAS), characterized by brain impairment, behavioral issues, and distinctive facial features. Abstinence from alcohol during pregnancy is critical for prevention (May & Gossage, 2011).

Connective vs. Muscle Tissue Disorders

Describe Lupus

Lupus is a chronic autoimmune disease marked by inflammation where the immune system attacks the body’s own tissues. Common symptoms include joint pain, fatigue, and a butterfly-shaped facial rash. It affects multiple organs and requires coordinated, multidisciplinary care (Tsokos, 2011).

Describe Myasthenia Gravis

Myasthenia gravis is an autoimmune condition targeting acetylcholine receptors at neuromuscular junctions, impairing muscle contraction. Patients experience muscle weakness that worsens with exertion, ptosis (drooping eyelids), double vision, and swallowing difficulties. Treatment involves immunosuppressive drugs and acetylcholinesterase inhibitors (Gilhus, 2016).

Dermatitis

Dermatitis is skin inflammation caused by irritants or allergens, presenting as redness, itching, and sometimes blisters or scaling. Common types include contact dermatitis and atopic dermatitis, managed by avoiding triggers and symptomatic care (Langan et al., 2020).

Eczema

Eczema is a chronic, non-infectious inflammatory skin disorder marked by itchy, red, and sometimes blistered lesions, often beginning in childhood. It is linked with other atopic conditions like asthma. Treatment focuses on moisturizing and anti-inflammatory therapies (Weidinger & Novak, 2016).

Decubitus Ulcer

Also called pressure sores, decubitus ulcers result from prolonged pressure on skin over bony areas in immobile individuals. Without proper care, they can worsen, leading to deep tissue injury and infection. Treatment includes pressure relief and wound management (National Pressure Injury Advisory Panel, 2019).

Fungal Infections

Fungal infections occur when pathogenic fungi invade the skin or deeper tissues. They range from superficial (e.g., athlete’s foot) to systemic infections. Treatment typically involves topical or systemic antifungals (Kauffman, 2006).

Benign Neoplasm

Benign neoplasms are localized, noncancerous growths with smooth, defined borders. They grow slowly, do not invade surrounding tissues or metastasize, but may cause symptoms by compressing adjacent structures (Weinberg, 2014).

Malignant Neoplasm

Malignant neoplasms are cancerous growths with uncontrolled cell division, irregular borders, and the capacity to invade tissues and metastasize. They require aggressive treatment, including surgery, chemotherapy, and radiation (Hanahan & Weinberg, 2011).

Osteoporosis

Osteoporosis is characterized by decreased bone density and mass, leading to fragile bones prone to fractures. It primarily affects older adults, especially postmenopausal women, and can be prevented or treated with calcium, vitamin D, and weight-bearing exercises (NIH Osteoporosis and Related Bone Diseases National Resource Center, 2018).

Osteomalacia

Osteomalacia involves softening of bones due to vitamin D or calcium deficiency, resulting in bone pain and muscle weakness. It differs from osteoporosis by primarily affecting bone mineralization rather than density (Holick, 2007).

Myoglobin

Myoglobin is an oxygen-binding protein in muscle cells, responsible for storing and releasing oxygen during muscle activity. It gives muscles their red color and plays a key role in oxygen transport within muscle fibers (Ordway & Garry, 2004).

Bursa

A bursa is a small fluid-filled sac near joints and tendons that reduces friction and facilitates smooth movement. Inflammation of a bursa, bursitis, causes pain and limits mobility (Cohen & Laing, 2021).

Rickets

Rickets is a childhood bone disorder caused by vitamin D deficiency, leading to defective bone mineralization. It manifests as soft, deformed bones, such as bowed legs. Prevention includes adequate vitamin D intake and sunlight exposure (Bikle, 2012).

Degenerative Disk Disease

Degenerative disk disease involves breakdown of spinal intervertebral discs due to aging or injury, causing chronic back pain and decreased mobility (Adams & Roughley, 2006).

Paget’s Disease

Paget’s disease is a chronic bone disorder characterized by excessive bone resorption followed by disorganized bone formation, resulting in enlarged but weakened bones, often affecting the pelvis, spine, and skull (Ralston & Albagha, 2014).

Comminuted Fracture

A comminuted fracture occurs when a bone breaks into multiple fragments, typically due to high-impact trauma, requiring surgical fixation (Court-Brown & McQueen, 2016).

Three Types of Skin Cancer

Basal Cell Carcinoma

Basal cell carcinoma is the most frequent skin cancer, commonly occurring in sun-exposed areas like the face. It presents as pearly nodules and rarely metastasizes. Early detection ensures a favorable prognosis (National Cancer Institute, 2021).

Squamous Cell Carcinoma

Squamous cell carcinoma is a more aggressive skin cancer that appears as scaly, crusted, or firm nodules. Untreated cases may invade local tissues and metastasize to lymph nodes (Karia, Han, & Schmults, 2013).

Melanoma

Melanoma is the deadliest skin cancer, marked by irregularly shaped, dark pigmented lesions. Caucasian males have the highest risk. Prompt diagnosis and treatment greatly improve survival (Garbe & Leiter, 2009).

Consequences When the Integumentary System is Disrupted

Damage to the skin impairs its protective barrier, increasing susceptibility to infections, fluid loss, temperature dysregulation, and sensory deficits. Such disruptions negatively affect overall health and wellbeing (Proksch, Brandner, & Jensen, 2008).

Types of Burns

Vitiligo

Vitiligo is a condition characterized by the loss of melanocytes, resulting in white, depigmented skin patches. It is considered autoimmune and, while not physically harmful, may affect psychological health (Ezzedine et al., 2015).

Ischemic CVA vs. Hemorrhagic CVA

Ischemic strokes result from obstruction of blood flow causing tissue ischemia, while hemorrhagic strokes are due to bleeding damaging brain tissue. Both require urgent medical intervention but differ in treatment strategies (Meschia et al., 2014).

Subdural Hematoma

A subdural hematoma occurs when blood collects between the dura mater and brain, usually from trauma. This accumulation raises intracranial pressure, leading to headaches, confusion, and neurological impairment. Immediate treatment is critical (Bullock et al., 2006).

Alzheimer’s Disease vs. Parkinson’s Disease

Alzheimer’s disease primarily affects memory and cognition due to neuron loss, while Parkinson’s disease mainly disrupts movement control from dopaminergic neuron degeneration (Dauer & Przedborski, 2003; Querfurth & LaFerla, 2010).

Huntington’s Disease

Huntington’s disease is an inherited neurodegenerative disorder caused by an autosomal dominant mutation. It presents with involuntary movements (chorea), cognitive decline, and psychiatric symptoms, often manifesting in mid-adulthood (Walker, 2007).

Sclerosis

Sclerosis refers to tissue hardening caused by excessive fibrous tissue, impairing function. It features in diseases like multiple sclerosis and systemic sclerosis (Gabriel & Schmidt, 2017).

Disorders That Cause Vision Loss

These vision disorders vary in mechanism but all can lead to vision impairment, highlighting the need for early detection and treatment (American Academy of Ophthalmology, 2021).

Kyphosis

Kyphosis is an exaggerated outward curvature of the thoracic spine, leading to a hunched posture. Causes include poor posture, fractures, or degenerative disease. It may result in pain and breathing difficulties (Katzman et al., 2010).

Disorders That Cause Hearing Loss

Meniere’s disease causes episodic hearing loss and vertigo due to inner ear fluid imbalance, while otitis media is a middle ear infection causing inflammation and hearing impairment (NIDCD, 2016).

Predisposing Factors of Ischemic Stroke

Risk factors for ischemic stroke include atrial fibrillation, carotid artery stenosis, and cerebral arteriosclerosis, all contributing to vessel blockage. Effective management reduces stroke incidence (Benjamin et al., 2019).

Rheumatoid Arthritis

Rheumatoid arthritis is a chronic autoimmune disease causing joint inflammation, pain, and deformity. Systemic symptoms include fatigue and leukocytosis. Early diagnosis and disease-modifying therapies improve patient outcomes (Smolen, Aletaha, & McInnes, 2016).

Psoriasis

Psoriasis is a chronic autoimmune skin disorder characterized by rapid skin cell turnover, producing red, scaly plaques. It can involve joints, leading to psoriatic arthritis (Griffiths & Barker, 2007).

Sexually Transmitted Diseases and Disorders

Timely diagnosis and treatment are crucial to prevent complications and spread (CDC, 2023).

References

Abbas, A. K., Lichtman, A. H., & Pillai, S. (2018). Cellular and Molecular Immunology (9th ed.). Elsevier.

Adrogué, H. J., & Madias, N. E. (2000). Hyperkalemia. New England Journal of Medicine, 342(12), 925-931.

American Academy of Ophthalmology. (2021). Eye Health Statistics. https://www.aao.org/eye-health

Benjamin, E. J., et al. (2019). Heart disease and stroke statistics—2019 update. Circulation, 139(10), e56-e528.

Bikle, D. D. (2012). Vitamin D and bone. Current Osteoporosis Reports, 10(2), 151-159.

Bullock, M. R., et al. (2006). Surgical management of acute subdural hematomas. Neurosurgery, 58(3), S16-S24.

CDC. (2023). Sexually transmitted disease surveillance 2022. https://www.cdc.gov/std/statistics/2022

Cohen, S. P., & Laing, T. (2021). Bursitis: Diagnosis and treatment. Journal of Pain Management, 14(1), 20-30.

Court-Brown, C. M., & McQueen, M. M. (2016). Fractures of the long bones. Wiley-Blackwell.

Dauer, W., & Przedborski, S. (2003). Parkinson’s disease: mechanisms and models. Neuron, 39(6), 889-909.

D236 Test Bank: Key Questions & Answers Guide
Ezzedine, K., et al. (2015). Vitiligo. Lancet, 386(9988), 74-84.

Gabriel, S. E., & Schmidt, R. (2017). Sclerosis in autoimmune diseases. Immunology Reviews, 276(1), 5-14.

Garbe, C., & Leiter, U. (2009). Melanoma epidemiology and trends. Dermatologic Clinics, 27(2), 165-175.

Gilhus, N. E. (2016). Myasthenia gravis. New England Journal of Medicine, 375(26), 2570-2581.

Griffiths, C. E., & Barker, J. N. (2007). Pathogenesis and clinical features of psoriasis. Lancet, 370(9583), 263-271.

Hall, J. E., & Guyton, A. C. (2021). Guyton and Hall Textbook of Medical Physiology (14th ed.). Elsevier.

Heegaard, E. D., & Brown, K. E. (2002). Human parvovirus B19. Clinical Microbiology Reviews, 15(3), 485-505.

Holick, M. F. (2007). Vitamin D deficiency. New England Journal of Medicine, 357(3), 266-281.

Karia, P. S., Han, J., & Schmults, C. D. (2013). Cutaneous squamous cell carcinoma: estimated incidence, risk factors, diagnosis, and staging. Journal of the American Academy of Dermatology, 68(6), 957-966.

Katzman, W. B., et al. (2010). Thoracic kyphosis and posture. Spine, 35(22), E1332-E1337.

Kauffman, C. A. (2006). Fungal infections. Clinical Infectious Diseases, 43(Suppl 1), S7-S14.

Kitabchi, A. E., et al. (2009). Hyperglycemic crises in adult patients with diabetes. Diabetes Care, 32(7), 1335-1343.

Klabunde, R. E. (2017). Cardiovascular Physiology Concepts (2nd ed.). Lippincott Williams & Wilkins.

Koul, R., et al. (2017). Clinical signs of hypocalcemia. Indian Journal of Endocrinology and Metabolism, 21(1), 169-173.

Langan, S. M., et al. (2020). Atopic dermatitis. Lancet, 396(10247), 345-360.

Mannucci, P. M., & Tuddenham, E. G. D. (2001). The hemophilias—from royal genes to gene therapy. New England Journal of Medicine, 344(23), 1773-1779.

May, P. A., & Gossage, J. P. (2011). Maternal risk factors for fetal alcohol spectrum disorders. Alcohol Research & Health, 34(1), 15-26.

Meschia, J. F., et al. (2014). Guidelines for the primary prevention of stroke. Stroke, 45(12), 3754-3832.

Miller, A., et al. (2010). Maternal obesity and neural tube defects. Birth Defects Research Part A, 88(8), 603-609.

National Cancer Institute. (2021). Skin cancer treatment (PDQ®)–patient version. https://www.cancer.gov/types/skin/patient/skin-treatment-pdq

National Pressure Injury Advisory Panel. (2019). Pressure injury staging. https://npiap.com/page/PressureInjuryStages

D236 Test Bank: Key Questions & Answers Guide
NIDCD. (2016). Hearing loss overview. https://www.nidcd.nih.gov/health/hearing-loss

Ordway, G. A., & Garry, D. J. (2004). Myoglobin: an essential hemoprotein in striated muscle. Journal of Experimental Biology, 207(Pt 20), 3441-3446.

Proksch, E., Brandner, J. M., & Jensen, J. M. (2008). The skin: an indispensable barrier. Experimental Dermatology, 17(12), 1063-1072.

Querfurth, H. W., & LaFerla, F. M. (2010). Alzheimer’s disease. New England Journal of Medicine, 362(4), 329-344.

Ralston, S. H., & Albagha, O. M. (2014). Paget’s disease of bone. Lancet, 383(9912), 162-172.

Rose, B. D., & Post, T. W. (2001). Clinical Physiology of Acid-Base and Electrolyte Disorders (5th ed.). McGraw-Hill.

Sadler, T. W. (2019). Langman’s Medical Embryology (14th ed.). Wolters Kluwer.

Sejvar, J. J. (2014). West Nile virus infection. Microbiology Spectrum, 2(3).

Smolen, J. S., Aletaha, D., & McInnes, I. B. (2016). Rheumatoid arthritis. Lancet, 388(10055), 2023-2038.

Steere, A. C., et al. (2016). Lyme borreliosis. Nature Reviews Disease Primers, 2, 16090.

Tsokos, G. C. (2011). Systemic lupus erythematosus. New England Journal of Medicine, 365(22), 2110-2121.

Walker, F. O. (2007). Huntington’s disease. The Lancet, 369(9557), 218-228.

Wallingford, J. B., Niswander, L. A., Shaw, G. M., & Finnell, R. H. (2013). The continuing challenge of understanding, preventing, and treating neural tube defects. Science Translational Medicine, 5(167), 167rv1.

Weinberg, R. A. (2014). The Biology of Cancer (2nd ed.). Garland Science.

Weidinger, S., & Novak, N. (2016). Atopic dermatitis. Lancet, 387(10023), 1109-1122).