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Patho 8-15

Study Guide 8-15

QuestionAnswer
strepococcus pneumoniae bacterial cocci
histoplasmosis fungus
HIV retrovirus
scabies parasite
helminths parasite
tinea fungus
epstein-barr virus retrovirus
escherichia coli bacterial rods
clostridium boulinum anaerobe
candida fungus
opportunistic infections occur when: resident flora cause infectious disease
the chain of infection btw the organism's reservoir and the victim can be broken at any of the following points EXECPT: a. portal of exit b.portal of entry c.immunization d.mode of transmission immunization
microbial virulence refers to its ability to: cause illness
the gram stain reaction: differentiates btw two groups of bacteria
the most effective method to limit the transmission of infection is: hand washing
epidemiology is the study of the distribution of disease in a defined _____. population
The transition of an infection from one person to another requires 5 unbroken events in a chain. These are ____, ______, ______, _____ and _____. reservoir, portal of entry, mode of transmission, portal of exit, host susceptibility
an inanimate object such as a contaminated eating utensil that participates in the transmission of infection is called a _____. fomite
certain chara. increase the risk for contracting an infection and should prompt diligence in prevention and assessment for infection. These include _____, ______, ______, _______, and ______. disrupted skin/mucus membranes, very young/old, immunosuppresstion, poor nutrition, chronic illness
when no S/S of disease are present, the presence of microorganisms on skin and mucous membranes is called_____. colonization
the microorganisms that affect humans can be grouped into 4 basic categories: ______, ______, ______ and ______. bacteria, fungi, viruses, parasites
most microorganisms that infect humans remain in the extracellular space; however, ______ must gain entry into cells to establish inception. viruses
T/F the primary lymphoid organs are the bone marrow and the thymus true
T/F the lymphocyte is the most numerous WBC type in the peripheral blood false (neutrophils)
T/F the number of neutrophils in the blood increases during acute bacterial infection true
T/F macrophages are mature monocytes true
T/F mast cells are closely related in structure and function to basophils true
T/F an increase in neutrophil bands is indicative of acute bacterial infection true
T/F T lymphocytes are the principle agents of humoral immunity false (T lymphocytes are cellular immunity, B lymphocytes are humoral immunity)
T/F lymphocytes that have CD4 receptors on their cell surface are called T helper cells true
T/F B lymphocytes are the principle agents of antibody-mediated immunity true
T/F cytokines are intercellular communication peptides secreted by cells true
T/F neutrophils marginate along the capillary wall by binding to selection receptors true
T/F most of the systemic effects of inflammation can be attributed to interleukin-1 (IL-1), IL-6, and tumor necrosis factor a (TNF-a). true
T/F previous exposure to foreign antigens is required for activation of neutrophils false
T/F cytotoxic T cells bind antigen displayed on cellular major histocompatibility complex class II proteins. false
T/F B cells function as antigen-presenting cells, displaying antigen on their MHC II proteins. true
All of the following structures are considered secondary lymphoid organs except: spleen, tonsils, bone marrow, lymph glands bone marrow
when used in reference to WBC differential, a "shift to the left" means: an increase in neutrophil bands
a normal total WBC count ranges from about ____ to _____ cells/uL 4000-10,000
the normal % of neutrophils in the WBC count is about: 70%
the WBCs that migate to a site of infection quickly are neutrophils
basophils and mast cells are unique in that they bind and display ____ _______ on their surfaces. IgE antibodies
macrophages have several roles in the inflammatory and immune response, one is synthesis of _____ ______. serum antibodies.
activation of the complement cascade by the classical pathway begins with: C1 binding to antigen-antibody complex
classic local manifestation of inflammation include all of the following except : coolness, redness, swelling, pain coolness
when inflammation is chronic, the predominant cell type is: lymphocyte
the type of inflammatory exudate chars. as thick, sticky and high in protein is termed: fibrinous exudate
which of the following findings is a systemic sign of inflammation? pain, loss of function, elevated erythrocyte sed rate, swelling elevated erythrocyte sed rate
The malaise, fever, and increase in acute phase proteins that occur with inflammation are attributed to increases in: IL_1, IL-6, and TNF-a
specific immunity refers to functions of: B and T lymphocytes
antigens displayed in association with MHC 1 complexes on the cell surfaces are usually: obtains from intracellular proteins
lymphocytes that have CD8 proteins on their cell surface are categorized as: cytotoxic
T helper cells can recognize antigen when it is displayed on the cell surface in association with _____. MHC II
B cells secrete: antibodies
antibody class is determined by: the structure of the Fc region
The first type of antibody to be secreted upon initial exposure to an antigen is: IgM
All of the following antibodies are monomer except: IgD, IgG, IgE, IgM IgM
plasma cells are antibody-secreting B lymphocytes
what is an example of passive immunity placental transfer of antibodies
What type of immune response requires T helper cell assistance? B-cell proliferation and antibody secretion
the antgien-binding specificity of B cells and T cells is determined: randomly, by genetic mechanism
an example of a breach in the "first line of defense" against infection use of an indwelling bladder catheter
macrophages display numerous receptors on their cell surfaces that help them localize antigens. some of these receptors bind to opsins, such as the ______ and _______ receptors; & others bind directly to microorganisms, including____ and ______ receptors. Fc (IgG), C3b (complement); toll-like, LPS (CD14)
pathogenetic mechanism: rheumatoid arthritis (2) Type 3 hypersensitivity and autoimmune
pathogenetic mechanism:asthma type 1 hypersensitivity
pathogenetic mechanism:graves disease (2) type 2 hypersens. and autoimmune
pathogenetic mechanism: hemolytic disease of the newborn type 2 hypersens.
pathogenetic mechanism: contact dermatitis type 4 hypersens.
pathogenetic mechanism: poststreptococcal glomerulonephristis type 3 hypersens
pathogenetic mechanism: Type 1 DM (2) type 2 hypersens. and autoimmune
pathogenetic mechanism:systemic lupus erythematosus (2) type 3 hypersens. and autoimmune
pathogenetic mechanism:allergic rhinitis type 1 hypersens.
pathogenetic mechanism: myasthenia gravis (2) type 2 hypersens. and autoimmune
certain genotypes have been shown to be associated with a higher risk of developing autoimmune diseases. These genes are of the class: MHC genes
Tissue injury associated with autoimmune disease is mediated through: type 2 and type 3 hypersensitivity responses
antibodies are the mediators of all of the hypersensitivity reactions except: Type IV, delayed
graft vs. host disease is an example of: type IV, delayed
the antibody type IgE is involved in which type of hypersensitivity reaction? Type 1, anaphylactic
severe combined immunodeficiency is a disorder of: lymphocyte stem cell failure
chronic stress may cause secondary immunosuppression due to overproduction of ____ cortisol
alterations in immune function may be related to nutritional deficits or excesses. An example of this is.... insufficient calorie and protein intake results in decreased numbers and functions of T cells
aging affects the immune system in all of the following ways except: reduced T cell function, hyperreactivity to new antigens, decrease in antibody production, diminished T cell proliferation hyperreactivity to new antigens
severe combined immunodificiency disorders are usually due to _____ _____ ____ autosomal recessive anomalies
most autoimmune disorder are mediated through type ___ or ___ hypersensitivity mechanisms. II or III
Environmental triggers for autoimmune diseases include ____ and occupational or environmental _____. infection, stress
______ is a therapy for some autoimmune disease where ____ are removed and replaced with colloid solutions. plasmapheresis, autoantibodies
hemolytic disease of the newborn is an example of a type _____ hypersensitivity reaction btw mother's Rh-pos ____ and subsequent fetal Rh-pos blood cells. type II, antibodies
Primary/Secondary: HIV/AIDS P
Primary/Secondary: malnutrition S
Primary/Secondary: cancer S
Primary/Secondary: Severe combined immunodeficiency P
Primary/Secondary: DiGeorge syndrome P
Primary/Secondary: Selective IgA deficiency P
leukemia is chara. by overproduction of _____ in the ____ _____. blasts in the bone marrow
generally speaking the type of leukemia with the best prognosis for cure is acute lymphocytic leukemia
the most common cause of death in patients with leukemia disease is infection
manifestations of untreated acute leukemia include all of the following except: low total WBC count, low platelet count, anemia, bone pain low total WBC count
an important diagnostic feature of chronic myelongenous leukemia is the presence of the ____ _____ philadelphia chromosome
non-hodgkin lymphoma is characterized by painless ____ ____ ____ lymph node enlargement
hodgkin disease most commonly presents with an _____ ____ _____ _____ node. enlarged painless cervical lymph node
bence jones proteins are indicators of ___ ____ ____ plasma cell myeloma
for which disease is radiation therapy most appropriate? acute leukemia, chronic leukemia, hodgkin disease, multiple myeloma hodgkin disease
non-hodgkin lymphoma includes cells of all the folioing types except: NK cells, granulocytes, T cells, B cells granulocytes
The difference btw lymphoma and leukemia is considered to be a difference in the ___ of the disease. stage
myeloid vs. lymphoid: acute monocytic leukemia myeloid
myeloid vs. lymphoid: acute promyelocytic leukimia myeloid
myeloid vs. lymphoid: Burkitt lymphoma lymphoid
myeloid vs. lymphoid: chronic neutrophil leukemia myeloid
myeloid vs. lymphoid: polycythemia vera myeloid
myeloid vs. lymphoid: plasma cell myeloma lymphoid
myeloid vs. lymphoid: hodgkin disease lymphoid
few chemicals have been found to be definitely associated with leukemia; these include, ______, _____ ______, and ______ found in certain foods. benzene, cigarette smoke, bioflavonoids
the bone marrow suppression associated with hematologic malignancies commonly produces _____, ______ and ______. anemia, thrombocytopenia and leukopenia
Bone marrow transplantation may utilize a pt's own stem cells, called _______ transplant, or those of a closely related family member called _____ transplant. autologus, allogenic
example of an exposure with a high risk for acquiring HIV perinatal transmission from HIV infected mother to fetus
HIV virus is called retrovirus because it contains the enzyme _____ _____. reverse transcriptase
HIV primarily infects T helper cells and macrophages because they have ____ receptors on their cell surfaces. CD4
some ppl are resistant to HIV infection because they lack one or more necessary _____ for viral ____ and _____. coreceptors; binding and insertion
A sign that HIV has progressed to AIDS would be a HIV-pos person with pneumonia
The HIV virus is known to mutate frequently within an infected individual. This is because reverse tanscriptase has ____ ____ an makes errors in _____. poor fidelity, transcription
protease inhibitors work by inhibiting _____ _____, ______ ____, and ______. protein splitting, viral assembly, and maturation
the vast majority of HIV/AIDS cases in the world today is found in sub-Saharan Africa
Long-term survival of individuals with HIV infection is associated with all of the following except: inheriting one mutant CCR5 gene, increased CD8 cell function, increased antibody production, low viral load increased antibody production
More than one genotype of HIV virus has been identified, however the great majority of HIV-infected individuals in the US, Europe, Australia, and Central Africa have HIV type ____. 1
Three categories of drugs are used to inhibit HIV replication in cells These are: nucleoside reverse transcriptase inhibitors non-nucleoside reverse transcriptase inhibitors protease inhibitors
An HIV-pos individual is diagnosed with AIDS if the CD4+ lymphocyte count falls below _____ cells/ul or if a category C AIDS indicator condition is present. 200
macrophages serve as both targets and _____ for HIV reservoirs
During the ____ period, the person with HIV has few clinical manifestations but can transmit the infection to others. latency
not actually cells, fragments of megakaryocytes platelets
cells found in the blood that are important in the inflammatory and immune response leukocytes
a hormone produced by the kidney that is necessary for erthropoiesis erythropoietin
average volume of blood in the circulatory system of an adult 5 liters
major component of RBCs to which oxygen molecules bind hemoglobin
normal life span of RBCs 80-120 days
% of blood that contains cells 45%
required for adequate synthesis of RBCs, absorbed intestinally associated with intrinsic factor vit b12
substance released during RBCs degradation bilirubin
mature blood cells that leave the bloodstream for the tissues, where they are powerful phagocytes macrophages
bone marrow cell from which all blood cells are derived pleuripotent stem cell
immature RBCs normally representing 1% of the total RBC count reticulocyte
a factor that influences the affinity of hemoglobin for O2 pH
factor that at high levels stimulates oxygen to bind to hemoglobin partial pressure of O2
amount of hemoglobin bound to oxygen compared with total amount of hemoglobin in the blood O2 sat
saturation is most affected when the PaO2 falls below ____ mm Hg 60
the pancytopenia associated with aplastic anemia may present with what sign ____ bleeding
sickle cell crisis causes symptoms related to the anemia and ____ _____ vascular obstruction
the most serous hemolytic disease in the newborn occurs because Rh factor incompatibility results in _____ _____ against fetal's _____. antibody formation, RBC's
the earliest clinical indicator of acute blood loss is postural hypotension
secondary polycythemia would most likely develop in a pt who has chronic ____ associated with chronic _____. hypoxemia, bronchitis
The arterial oxygen content for a pt with a PaO2 of 75mm Hg and SaO2 of 87% and a hemoglobin level of 12g/dl would be: 14.2 ml oxygen/dl
MCV & MCHC (E, N, D): iron deficiency MCV- decreased MCHC-decreased
MCV & MCHC (E, N, D): aplastic MCV-normal MCHC- decreased
MCV & MCHC (E, N, D): Vit B12 deficiency MCV-elevated MCHC- normal
MCV & MCHC (E, N, D): folate deficiency MCV-elevated MCHC- normal
MCV & MCHC (E, N, D): thalassemia MCV-decreased MCHC- decreased
MCV & MCHC (E, N, D): hemolytic MCV- normal MCHC- normal
MCV & MCHC (E, N, D): acute blood loss MCV- normal MCHC- normal
MCV & MCHC (E, N, D): erythropoietin deficiency MCV-normal MCHC-normal
mature erythrocytes have no organelles and must rely on ___ for cellular energy production glycolysis
when RBCs are degraded, the prophyrin component of hemoglobin is reduced to _____ which is poorly soluble in water and binds to albumin in the plasma. bilirubin
when fully saturated, each gram of hemoglobin carries approximately _____ ml of o2. 1.34
the normal CaO2 is about ___ ml of O2 per deciliter. 20
under normal conditions about ___% of the O2 carried in arterial blood is unloaded at the tissues. 25
the serum erythropoietin level can be helpful in differentiating polycythemia vera from secondary polycythemia because it is elevated in _______ _______ and low in _______ ________. secondary polycythemia, polycythemia vera
_______ is a breakdown byproduct of RBCs that is transported to the liver where it is _____ and eliminated by bile. bilirubin, conjugated
activation of the intrinsic pathway of coagulation is initiated by blood contact with injured vascular _______ endothelium
fibrinolysis is characterized by conversion of plasminogen to ______ plasmin
deficieny production of clotting factors would occur if which of the following organs were functioning abnormally? liver, kidneys, lungs, bone marrow liver
the proper function of the extrinsic pathway of coagulation is best measured by which laboratory test? prothrombin time (PT)/INR
a commonOTC medication that can alter hemostasis is ibuprofen (NSAID)
Vit K deficiency in an adult may be associated with ___ ____ liver disease
pathologic activation of the clotting cascade producing widespread coagulation and subsequent bleeding from a deficiency of clotting factors occurs in ____ ______ ______ (DIC) disseminated intravascular coagulation
all are true regarding primary hemostats except: a. fibrin clots retract and solidify b. vasoconstriction reduces blood loss c. platelets adhere to injured endothelial surfaces d. initial vasoconstriction increases with increased trauma fibrin clots retract and solidify
the two most dangerous bleeding sites are the brain and _____ oropharynx
clotting factors are essential for successful hemostasis. Most clotting factors circulate in active/inactive form. inactive
platelets aggregate together by binding to fibrinogen with their ______ receptors glycoprotein IIb/IIIa
aspirin and other NSAIDs inhibit platelet function by inhibiting the enzyme _______ which decrease the production of prostaglandins and thromboxanes cyclooxygenase
The _____ pathway is activated by external traumatic injury of blood vessel walls, while the _____ pathways is activated by damaged endothelial walls. extrinsic, intrinsic
______ in the medical term for bruise, and _____ means blood in urine. ecchymosis, hematuria
platelet count, PT/INR, aPTT, Bleeding time (E, N, D): Idiopathic thrombocytopenic purpura platelet count: decreased PT/INR:normal aPTT: normal bleeding time: elevated
platelet count, PT/INR, aPTT, Bleeding time (E, N, D): hemophilia A or B platelet count: normal PT/INR:normal aPTT: elevated bleeding time: normal or elevated
platelet count, PT/INR, aPTT, Bleeding time (E, N, D): liver disease platelet count: normal or decreased PT/INR: elevated aPTT: normal or elevated bleeding time: elevated
platelet count, PT/INR, aPTT, Bleeding time (E, N, D): aspirin use platelet count: normal PT/INR: normal aPTT: normal bleeding time: elevated
platelet count, PT/INR, aPTT, Bleeding time (E, N, D): DIC platelet count: decreased PT/INR: elevated aPTT: elevated bleeding time:elevated
T/F like veins, lymphatic vessels have valves that prevent back flow and enhance forward movement. true
T/F a serious complication of a thromboembolus leaving the right atrium is a cerebrovascular accident. false
T/F the greatest risk associated with dissecting aneurysms is rupture. true
T/F a common cause of lymphedema is removal of lymph nodes with surgery for breast cancer. true
T/F arteriosclerosis and atherosclerosis are synonymous terms. false
T/F normal resting cardiac output for an adult is approximately 5L/min true
T/F the intimal layer of artery contains large amounts of muscle false
T/F capillary permeability is determined by the thickness of the basement membrane. false
capillary permeability is greatest in the _____ _____ kidney glomeruli
flow through a blood vessel is primarily regulate by alteration of its ____. radius
blood pressure is highest in the aorta
a common cause of edema is decreased _____ colloid osmotic _____. plasma, pressure
stimulation of the SNS causes constriction of: a. bronchioles b. arterioles c. capillaries d. lyphatics arterioles
what vessel has the most rapid blood flow? vena cava capillaries venules arterioles vena cava
the ability of tissues to maintain local perfusion regardless of systemic arterial pressure is called autoregulation
thrombus formation in the arterial system may produce ______. ischemia
risk factors enhancing the development of atherosclerosis includes elevated LDL cholesterol levels
the "six Ps" associated with an acute arterial occlusion include all of the following except: pallor piloerection pulselessness pain piloerection
the most common cause of pulmonary embolism is deep vein thrombosis
According to Ohm's law (Q=P/R) and increase in resistance will result in a ______ in flow (Q) and an increase in driving pressure (P) will result in an _______ in flow. decrease, increase
Driving pressure is calculated by subtracting the pressure at the distal end of a tube (P2) from the pressure at the proximal end (P1). If the MAp is 80mmHg and the RA pressure is 20mmHg the driving pressure through the vessels would is ____ mmHg. 60
An increase in MAP driving pressure, whereas an increase in RAP will ____ driving pressure. increase, decrease
According to Poiseuille's law a two fold increase in vessel radius will result in a _____-fold reduction in resistance. 16
a twofold increase in vessel length will result in a ____ fold increase in resistance. two
using the law of Laplace, name three conditions that would increase wall tension: increased _______ ______, increased _______, and decreased ____ _____. distending pressure, radius, wall thickness
calculate the capillary filtration pressure if capillary hydrostatic pressure is 40mm Hg, capillary oncotic pressure is 35mm Hg, tissue hydrostatic pressure is 2 mm Hg, and tissue oncontic pressure is zero: 3mm Hg
a tissue can increase its rate of blood flow by reducing its _______. resistance
only a small portion of is harmful the humans. They are classified by shape, cell wall, mechanism of movement, and oxygen requirement Bacteria
smallest known infective agents,. they are composed of DNA or RNA and a capsule surrounding the genetic material. they can only code for 2 to 60 proteins. they are totally dependent on the host cell for energy and the machinery to replicate. Viruses
Viruses are classified by ____makeup, the mode of replication, the structure of viral capsule and the specific host cell that the virus can invade. genetic
Viruses can adhere to the cell membrane and trigger ______. phagocytosis
nonphotosynthetic, eukaryotic protists. they can reproduce by simply dividing or sexually. Certain types are normal flora for the body, but are capable of overgrowth and can cause infection. immune compromised people are the most susceptible. Fungi
Vaccination is an important means of inhibiting the spread of infection by reducing the victim’s susceptibility
Which of the following patients has a higher risk of infection? One with an indwelling urinary catheter
An increase in WBC neutrophils most commonly occurs with which type of infection They are early responders to acute bacterial infections and respond quickly with large numbers.
Which of the following cell types does not evolve from the myelocytic pathway? natural killer cells
Inflammation is said to be nonspecific because the inflammatory reaction is similar regardless of cause.
Antigen-presenting cells function to display foreign antigen on their cell surfaces bound to MHC.
An example of active immunity would be vaccination with polio vaccine.
Activation of the complement cascade results in inflammation.
Which of the following clinical findings is most indicative of an acute bacterial infection? Increased neutrophil bands
Membrane attack complex Complement
Basophil-like cells in tissues Mast cells
Lymphocyte that lacks B/T markers Natural killer cells
Able to bind IgE (Fc end) Basophils
Circulating macrophages Monocytes
Fixed tissue macrophages Histiocytes
Provide protection against helminths Eosinophils
Express CD4 or CD8 markers T lymphocytes
Make up 90% of circulating granulocytes Neutrophils
MHC class I restricted Cytotoxic T cell
Antibody-producing B cells Plasma cells
Antigen-presenting cell Dendritic cell
Dramatic hypotension sometimes accompanies type I hypersensitivity reactions because massive histamine release from mast cells leads to vasodilation.
J.B. developed an opportunistic infection that is to be managed with an antibiotic. J.B. has received this antibiotic once previously with no adverse reactions. Which of the following statements should guide administration of the drug this time? Anaphylaxis is antibody mediated and may occur on second exposure.
Which of the following disorders is associated with a type III hypersensitivity mechanism of injury? Systemic lupus erythematosus
A patient is given an intradermal injection of antigen and develops redness and induration at the site 72 hours later. This is an example of type _____ hypersensitivity. IV
A child with a history of recent strep throat infection develops glomerulonephritis. This is most likely to be a type _____ hypersensitivity reaction. III
In which of the following patients would administration of RhoGAM (an Rh antibody) be appropriate? Rh-negative woman with positive Rh antibody titer carrying Rh-positive fetus
Patients with immunodeficiency disorders are usually identified because they develop infections from opportunistic organisms.
It occurs exclusively in the adult population, men more than women. asymptomatic until it is fairly advanced. The asymptomatic stage often last for many years after malignant transformation. During this time the only complaint may be frequent infections. Clinical manifestations of plasma cell myeloma.
In general, the best prognosis for long-term disease-free survival occurs with ALL
Which of the following groups of clinical findings describes the typical presentation of ALL? Pain in long bones, infection, fever, bruising
All of the following viruses have been implicated as cancer-causing agents except _____ virus. herpes
R.V. is a 28-year-old HIV-positive man recently hospitalized for eval of symptoms of progressive weakness, dyspnea, weight loss, and low-grade fever. A biopsy of R.V.’s lung tissue reveals Pneumocystis carinii pneumonia. This diagnosis means that R.V. has AIDS.
The immune system disorder associated with HIV is: AIDS
Which of the following HIV-positive patients should be given a diagnosis of AIDS? One who has a CD4 count of 300/µl
Which of the following statements about HIV testing is correct? HIV testing should be avoided in persons with no risk factors and no symptoms.
Which of the following modes of transmission does not occur with HIV infection? Fomite transmission to intact skin
The primary source of erythropoietin is the: the kidney
Which conditions are associated with a “shift to the right” of the oxyhemoglobin dissociation curve? A shift the the right enhances oxygen release to the cell.
Which of the following is indicative of hemolytic anemia? Jaundice
A low mean corpuscular hemoglobin concentration (MCHC) and mean corpuscular volume (MCV) are characteristic of which type of anemia? Iron deficient anemia (iron deficiency is the most common nutritional deficiency in the world. and the most common cause on anemia.)and Thalassemia (disease that causes a decrease in RBC survival rates.
Which of the following laboratory findings would usually be found in aplastic anemia? Thrombocytopenia
Pernicious anemia is caused by a lack of intrinsic factor.
The most common cause of anemia is iron deficiency.
The final step in clot formation is conversion of fibrinogen to fibrin.
Dysfunction of which of the following organs would lead to clotting factor deficiency? Liver
A commonly ingested substance associated with prolongation of the bleeding time is aspirin.
Created by: BrandiLynn