D446 Adult Health II - Set 5 - Part 1

Correct Answer: Gravity-assisted perfusion enhanced

Dependent positioning uses gravity to augment arterial flow to ischemic lower extremities, providing pain relief that allows sleep despite compromised circulation.
Option a is incorrect because venous drainage would be impaired in dependent position; the benefit is enhanced arterial flow, not venous return.
Option c is incorrect because sitting may actually increase cardiac workload; the benefit is improved distal perfusion through gravity assistance.
Option d is incorrect because while sitting may help breathing, PAD patients choose this position for improved leg perfusion, not respiratory benefits.

Correct Answer: Provides clotting factors

FFP directly supplies coagulation factors the failing liver cannot produce, temporarily correcting coagulopathy until transfused factors are consumed or degraded.
Option a is incorrect because FFP doesn't stimulate the damaged liver to produce factors; it provides ready-made factors for immediate use.
Option c is incorrect because bleeding tendency improvement is the result, not mechanism; FFP works by supplying missing coagulation factors directly.
Option d is incorrect because FFP doesn't reverse liver damage; it temporarily replaces factors the damaged liver cannot synthesize adequately.

Correct Answer: Vascular proliferation occurring

Chronic hypoxia stimulates vascular endothelial growth factor, causing proliferation of vessels and connective tissue in fingertips, creating the clubbed appearance.
Option a is incorrect because clubbing results from soft tissue and vascular changes, not calcium deposition in the fingertips over time.
Option c is incorrect because clubbing involves organized tissue proliferation, not simple edema fluid accumulation in the digital tissues chronically.
Option d is incorrect because bone doesn't grow larger; soft tissue and vascular proliferation around the fingertip creates clubbing appearance.

Correct Answer: Metabolic acidosis compensation

Deep, rapid breathing eliminates CO2 to reduce carbonic acid, partially compensating for metabolic acidosis from ketone accumulation in diabetic ketoacidosis.
Option a is incorrect because Kussmaul breathing isn't about oxygen needs; it's respiratory compensation attempting to correct metabolic acidosis present.
Option c is incorrect because this breathing pattern is physiological compensation for acidosis, not an anxiety response to illness symptoms.
Option d is incorrect because dehydration doesn't cause this specific breathing pattern; it's compensation for ketoacidosis-induced metabolic acidosis specifically.

Correct Answer: Tissue pressure lowest

Loose periorbital tissue offers minimal resistance to fluid accumulation, making it the first visible site of edema in glomerulonephritis-related fluid retention.
Option a is incorrect because facial edema occurs despite gravity; the key factor is loose tissue allowing easy fluid accumulation initially.
Option c is incorrect because lymphatic drainage isn't specifically impaired periorbitally; loose tissue architecture allows fluid accumulation more readily there.
Option d is incorrect because vascular permeability isn't higher around eyes; loose connective tissue provides less resistance to fluid accumulation.

Correct Answer: Receptor fatigue progressive

Repeated neuromuscular junction stimulation depletes available acetylcholine receptors, causing progressive weakness in constantly used eyelid muscles throughout daily activities.
Option a is incorrect because medication schedules are designed to prevent wearing off; the pattern reflects physiological receptor depletion with use.
Option c is incorrect because inflammation doesn't fluctuate daily; the diurnal pattern results from cumulative receptor fatigue with repeated use.
Option d is incorrect because muscle tissue isn't progressively damaged daily; receptor availability decreases with repeated stimulation causing fatigue pattern.

Correct Answer: Fluid retention occurring

Heart failure causes sodium and water retention through neurohormonal activation, increasing body weight from fluid accumulation despite reduced caloric intake.
Option a is incorrect because muscle mass doesn't increase with poor intake and heart failure; weight gain is from fluid, not tissue.
Option c is incorrect because metabolic changes don't cause rapid weight gain; fluid retention from cardiac dysfunction explains the increase.
Option d is incorrect because fat storage requires caloric excess; weight gain with poor appetite indicates fluid retention, not fat accumulation.

Correct Answer: Ventilation redistribution occurring

Prone positioning redistributes ventilation to better-perfused dorsal lung regions, improving ventilation-perfusion matching and oxygenation in ARDS patients with severe hypoxemia.
Option a is incorrect because while secretions may drain differently, the primary benefit is improved V/Q matching, not secretion clearance.
Option c is incorrect because prone positioning may actually compromise cardiac output; benefit comes from improved ventilation distribution, not circulation.
Option d is incorrect because work of breathing isn't necessarily reduced; improved oxygenation results from better ventilation-perfusion matching achieved.

Correct Answer: Autoimmune infiltration occurring

Thyroid-stimulating antibodies cause glycosaminoglycan deposition in pretibial skin, creating characteristic plaques independent of thyroid hormone levels in Graves' disease.
Option a is incorrect because thyroid hormones don't deposit in skin; the lesions result from autoimmune inflammation, not hormone accumulation.
Option c is incorrect because circulation remains normal; pretibial changes result from autoimmune infiltration, not vascular compromise in hyperthyroidism.
Option d is incorrect because infection doesn't cause pretibial myxedema; it's an autoimmune manifestation of Graves' disease affecting skin.

Correct Answer: Extensive necrosis occurring

Severe hypocalcemia indicates extensive fat necrosis with calcium sequestration, reflecting pancreatic necrosis extent and predicting complicated course with higher mortality.
Option a is incorrect because parathyroids aren't affected in pancreatitis; hypocalcemia results from calcium consumption in fat necrosis areas.
Option c is incorrect because kidney failure isn't the primary cause; hypocalcemia reflects extensive pancreatic and peripancreatic fat necrosis severity.
Option d is incorrect because acute pancreatitis doesn't immediately cause malabsorption; hypocalcemia indicates extensive tissue necrosis and poor prognosis.

Correct Answer: Uremic toxins impairing function

Uremic toxins interfere with platelet adhesion and aggregation, causing bleeding tendency despite normal numbers, requiring dialysis or DDAVP for improvement.
Option a is incorrect because uremia causes functional impairment, not immune-mediated platelet destruction; the problem is quality, not antibody effects.
Option c is incorrect because platelet production is normal; uremic toxins impair function of existing platelets causing bleeding despite normal counts.
Option d is incorrect because platelets aren't sequestered in uremia; they're present in normal numbers but functionally impaired by toxins.

Correct Answer: Forces neural reorganization

Constraining the unaffected limb forces use of the affected side, promoting cortical reorganization and new neural pathway development improving function.
Option a is incorrect because while preventing atrophy helps, the primary mechanism is forcing brain plasticity through mandatory affected limb use.
Option c is incorrect because spasticity isn't directly reduced; improvement comes from neural reorganization creating new motor control pathways.
Option d is incorrect because circulation changes aren't the mechanism; forced use drives neuroplasticity and cortical remapping improving motor function.

Correct Answer: Collateral circulation forming

Portal hypertension causes blood diversion through portosystemic collaterals including hemorrhoidal veins, dilating them as alternate routes around the liver.
Option a is incorrect because arterial pressure isn't elevated; hemorrhoids form from venous collateralization bypassing high portal pressure through systemic connections.
Option c is incorrect because thrombosis would cause acute problems; hemorrhoids in portal hypertension result from chronic collateral flow diversion.
Option d is incorrect because lymphatic obstruction causes different pathology; hemorrhoids result from portosystemic collateral development in portal hypertension.

Correct Answer: Prevents resistance development

Mycobacterium tuberculosis rapidly develops resistance to single agents; combination therapy prevents survival of resistant mutants ensuring treatment success.
Option a is incorrect because multiple drugs don't necessarily speed recovery; the purpose is preventing resistance, not accelerating cure time.
Option c is incorrect because combining drugs may increase side effects; the rationale is resistance prevention, not side effect reduction.
Option d is incorrect because multiple medications complicate adherence; they're necessary for resistance prevention despite compliance challenges created.

Correct Answer: Osmotic demyelination occurring

Rapid sodium correction causes osmotic shifts that damage myelin sheaths, particularly in the pons, causing permanent neurological deficits requiring careful correction.
Option a is incorrect because rapid correction reduces cerebral edema; the danger is osmotic injury to myelin, not worsening brain swelling.
Option c is incorrect because hemorrhage isn't the primary risk; osmotic demyelination syndrome from rapid shifts causes permanent damage feared.
Option d is incorrect because glucose levels aren't directly affected; the specific risk is osmotic injury to myelinated structures from rapid correction.

Correct Answer: Longer contact time

Continuous or prolonged dialysate contact during peritoneal dialysis allows greater protein loss compared to intermittent hemodialysis sessions, requiring dietary supplementation.
Option a is incorrect because peritoneal membrane permeability is similar to artificial membranes; the difference is exposure duration, not permeability.
Option b is incorrect because inflammation isn't routinely present; protein loss results from prolonged dialysate exposure, not membrane inflammation typically.
Option d is incorrect because pressure gradients are lower in peritoneal dialysis; extended contact time explains greater protein losses observed.

Correct Answer: Spinal cord compression risk

Inflammatory destruction of atlantoaxial ligaments allows C1-C2 instability, risking spinal cord compression with neck movement potentially causing quadriplegia or death.
Option a is incorrect because while painful, the critical danger is potential spinal cord injury, not pain severity from the subluxation.
Option c is incorrect because vertebral artery involvement is less common; the primary risk is cervical cord compression from instability.
Option d is incorrect because nerve roots are less critical than the spinal cord compression risk at this high cervical level location.

Correct Answer: Cortisol deficiency severe

Cortisol is essential for gluconeogenesis and counter-regulatory response; its absence in Addisonian crisis prevents glucose production despite stress hormone stimulation.
Option a is incorrect because insulin levels are normal or suppressed; hypoglycemia results from absent cortisol, not insulin excess present.
Option c is incorrect because glucagon production remains intact; the problem is cortisol absence preventing effective gluconeogenesis despite glucagon.
Option d is incorrect because glycogen stores may be normal; inability to mobilize glucose without cortisol causes hypoglycemia in crisis.

Correct Answer: Immunoglobulin loss urinary

Massive proteinuria includes immunoglobulin loss, particularly IgG, compromising humoral immunity and increasing susceptibility to encapsulated bacterial infections like spontaneous peritonitis.
Option a is incorrect because T-cell function remains normal; the problem is antibody loss through proteinuria compromising humoral immunity.
Option c is incorrect because complement may be lost, not excessively activated; immunoglobulin loss is the primary immune deficiency mechanism.
Option d is incorrect because neutrophil production is normal; increased infection risk results from antibody loss, not white cell problems.

Correct Answer: Pump failure continuing

Inadequate cardiac output despite optimal preload means insufficient renal perfusion pressure, causing oliguria from pump failure, not volume or kidney problems.
Option a is incorrect because kidneys may be structurally normal initially; oliguria results from inadequate perfusion, not intrinsic kidney injury.
Option c is incorrect because medications treat shock; persistent oliguria despite adequate preload indicates ongoing pump failure, not drug effects.
Option d is incorrect because obstruction would cause different findings; oliguria in cardiogenic shock results from inadequate cardiac output delivery.