Chapter 1. THE FOUNDATIONAL CONCEPTS OF CLINICAL
PRACTICE
1. The characteristic, localized cardinal signs of acute inflammation include:
A) fever.
B)
... [Show More] fatigue.
C) redness.
D) granuloma.
2. The vascular, hemodynamic stage of acute inflammation is initiated by
momentary vasoconstriction followed by vasodilation that causes localized:
A) bleeding.
B) congestion.
C) pale skin.
D) coolness.
3. The cellular stage of acute inflammation is marked by the movement of
leukocytes into the area. Which of the following cells arrives early in great
numbers?
A) Basophils
B) Lymphocytes
C) Neutrophils
D) Platelets
Advanced Physiology and Pathophysiology Essentials for
Clinical Practice 1st Edition Tkacs Test Bank
4. The phagocytosis process involves three distinct steps. What is the initial
step in the process?
A) Engulfment
B) Intracellular killing
C) Antigen margination
D) Recognition and adherence
5. Which of the following mediators of inflammation causes increased capillary
permeability and pain?
A) Serotonin
B) Histamine
C) Bradykinin
D) Nitric oxide
6. Inflammatory exudates are a combination of several types. Which of the
following exudates is composed of enmeshed necrotic cells?
A) Serous
B) Fibrinous
C) Suppurative
D) Membranous
7. The acute-phase systemic response usually begins within hours of the onset
of inflammation and includes:
A) fever and lethargy.
B) decreased C-reactive protein.
C) positive nitrogen balance.
D) low erythrocyte sedimentation rate.
8. In contrast to acute inflammation, chronic inflammation is characterized by
which of the following phenomena?
A) Profuse fibrinous exudation
B) A shift to the left of granulocytes
C) Metabolic and respiratory alkalosis
D) Lymphocytosis and activated macrophages
8. In contrast to acute inflammation, chronic inflammation is characterized by
which of the following phenomena?
A) Profuse fibrinous exudation
B) A shift to the left of granulocytes
C) Metabolic and respiratory alkalosis
D) Lymphocytosis and activated macrophages
9. Exogenous pyrogens (interleukin-1) and the presence of bacteria in the blood
lead to the release of endogenous pyrogens that:
A) stabilize thermal control in the brain.
B) produce leukocytosis and anorexia.
C) block viral replication in cells.
D) inhibit prostaglandin release.
10
.
An older adult patient has just sheared the skin on her elbow while attempted
to boost herself up in bed, an event that has precipitated acute inflammation
in the region surrounding the wound. Which of the following events will
occur during the vascular stage of the patients inflammation?
A) Outpouring of exudate into interstitial spaces
B) Chemotaxis
C) Accumulation of leukocytes along the epithelium
D) Phagocytosis of cellular debris
11
.
Which of the following individuals most likely has the highest risk of
experiencing chronic inflammation?
A) A patient who has recently been diagnosed with type 2 diabetes
B) A patient who is a carrier of an antibiotic-resistant organism
C) A patient who is taking oral antibiotics for an upper respiratory infection
D) A patient who is morbidly obese and who has a sedentary lifestyle
12
.
Which of the following core body temperatures is within normal range?
A) 35.9C (96.6F)
B) 38.0C (100.4F)
C) 35.5C (95.9F)
D) 37.3C (99.1F)
12
.
Which of the following core body temperatures is within normal range?
A) 35.9C (96.6F)
B) 38.0C (100.4F)
C) 35.5C (95.9F)
D) 37.3C (99.1F)
13
.
A postsurgical patient who is recovering in the postanesthetic recovery unit
states that she is freezing cold. Which of the following measures is likely to
be initiated in the patients hypothalamus in an effort to reduce heat loss?
A) Opening of arteriovenous (AV) shunts
B) Reduced exhalation of warmed air
C) Contraction of pilomotor muscles
D) Decreased urine production
14
.
An elderly patient is dressed only in a hospital gown and complains of a
draft in her room. Consequently, she has requested a warm blanket while she
sits in her wheelchair. Which of the following mechanisms of heat loss is
most likely the primary cause of her request?
A) Evaporation and conduction
B) Radiation and convection
C) Conduction and convection
D) Convection and evaporation
15
.
Which of the following pathophysiologic processes are capable of inducing
the production of pyrogens? Select all that apply.
A) Acute inflammation
B) Obesity
C) Myocardial infarction
D) Malignancy
E) Renal failure
16
.
Which of the following patients is most likely to be susceptible to
developing a neurogenic fever?
A) A patient who has stage II Alzheimer disease
B) A patient who has sustained a head injury in a bicycle crash
C) A patient who has become delirious after the administration of a
benzodiazepine
16
.
Which of the following patients is most likely to be susceptible to
developing a neurogenic fever?
A) A patient who has stage II Alzheimer disease
B) A patient who has sustained a head injury in a bicycle crash
C) A patient who has become delirious after the administration of a
benzodiazepine
D) A patient who has begun taking a selective serotonin-reuptake inhibitor
(SSRI) for the treatment of depression
17
.
Patients are commonly administered antipyretics when their oral temperature
exceeds 37.5C (99.5F). Which of the following statements related to the
rationale for this action is most accurate?
A) Temperatures in excess of 37.5C (99.5F) can result in seizure activity.
B) Lower temperatures inhibit the protein synthesis of bacteria.
C) There is little empirical evidence for this treatment modality.
D) Most common antipyretics have been shown to have little effect on core
temperature.
18
.
A patient has sought care because of recent malaise and high fever. Upon
assessment, the patient states that his current fever began two days earlier,
although he states that for the last 2 weeks he is in a cycle of high fever for a
couple of days followed by a day or two of normal temperature. Which of
the following fever patterns is this patient experiencing?
A) Recurrent fever
B) Remittent fever
C) Sustained fever
D) Intermittent fever
19
.
A febrile, 3-week-old infant has been brought to the emergency department
by his parents and is currently undergoing a diagnostic workup to determine
the cause of his fever. Which of the following statements best conveys the
rationale for this careful examination?
A) The immature hypothalamus is unable to perform normal
thermoregulation.
B) Infants are susceptible to serious infections because of their decreased
immune function.
C) Commonly used antipyretics often have no effect on the core temperature
of infants.
D) Fever in neonates is often evidence of a congenital disorder rather than an
infection.
ypygggpthe cause of his fever. Which of the following statements best conveys the
rationale for this careful examination?
A) The immature hypothalamus is unable to perform normal
thermoregulation.
B) Infants are susceptible to serious infections because of their decreased
immune function.
C) Commonly used antipyretics often have no effect on the core temperature
of infants.
D) Fever in neonates is often evidence of a congenital disorder rather than an
infection.
20
.
An 84-year-old patients blood cultures have come back positive, despite the
fact that his oral temperature has remained within normal range. Which of
the following phenomena underlies the alterations in fever response that
occur in the elderly?
A) Disturbance in the functioning of the thermoregulatory center
B) Increased heat loss by evaporation
C) The presence of comorbidities that are associated with lowered core
temperature
D) Persistent closure of arteriovenous shunts
Answer Key
1. C
2. B
3. C
4. D
5. C
6. D
7. A
8. D
9. B
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A
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D
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D
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C
14B
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A
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D
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D
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C
14
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B
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A, C, D
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B
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C
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D
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B
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A
Chapter 2. CHEMICAL AND BIOCHEMICAL FOUNDATIONS
1. Ischemia and other toxic injuries increase the accumulation of intracellular
calcium as a result of:
A) release of stored calcium from the mitochondria.
B) improved intracellular volume regulation.
C) decreased influx across the cell membrane.
D) attraction of calcium to fatty infiltrates.
2. The patient is found to have liver disease, resulting in the removal of a lobe
of his liver. Adaptation to the reduced size of the liver leads to ___________
of the remaining liver cells.
A) metaplasia
B) organ atrophy
C) compensatory hyperplasia
D) physiologic hypertrophy
2. The patient is found to have liver disease, resulting in the removal of a lobe
of his liver. Adaptation to the reduced size of the liver leads to ___________
of the remaining liver cells.
A) metaplasia
B) organ atrophy
C) compensatory hyperplasia
D) physiologic hypertrophy
3. A person eating peanuts starts choking and collapses. His airway obstruction
is partially cleared, but he remains hypoxic until he reaches the hospital. The
prolonged cell hypoxia caused a cerebral infarction and resulting
__________ in the brain.
A) caspase activation
B) coagulation necrosis
C) rapid phagocytosis
D) protein p53 deficiency
4. Bacteria and viruses cause cell damage by _______, which is unique from
the intracellular damage caused by other injurious agents.
A) disrupting the sodium/potassium ATPase pump
B) interrupting oxidative metabolism processes
C) replicating and producing continued injury
D) decreasing protein synthesis and function
5. The patient has a prolonged interruption in arterial blood flow to his left
kidney, causing hypoxic cell injury and the release of free radicals. Free
radicals damage cells by:
A) destroying phospholipids in the cell membrane.
B) altering the immune response of the cell.
C) disrupting calcium storage in the cell.
D) inactivation of enzymes and mitochondria.
6. Injured cells have impaired flow of substances through the cell membrane as
a result of:
A) increased fat load.
B) altered permeability.
C) altered glucose utilization.
D) increased surface receptors.
6. Injured cells have impaired flow of substances through the cell membrane as
a result of:
A) increased fat load.
B) altered permeability.
C) altered glucose utilization.
D) increased surface receptors.
7. Reversible adaptive intracellular responses are initiated by:
A) stimulus overload.
B) genetic mutations.
C) chemical messengers.
D) mitochondrial DNA.
8. Injured cells become very swollen as a result of:
A) increased cell protein synthesis.
B) altered cell volume regulation.
C) passive entry of potassium into the cell.
D) bleb formation in the plasma membrane.
9. A diabetic patient has impaired sensation, circulation, and oxygenation of his
feet. He steps on a piece of glass, the wound does not heal, and the area
tissue becomes necrotic. The necrotic cell death is characterized by:
A) rapid apoptosis.
B) cellular rupture.
C) shrinkage and collapse.
D) chronic inflammation.
10
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A 99-year-old woman has experienced the decline of cell function associated
with age. A group of theories of cellular aging focus on programmed:
A) changes with genetic influences.
B) elimination of cell receptor sites.
C) insufficient telomerase enzyme.
D) DNA mutation or faulty repair.
A) changes with genetic influences.
B) elimination of cell receptor sites.
C) insufficient telomerase enzyme.
D) DNA mutation or faulty repair.
11
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An 89-year-old female patient has experienced significant decreases in her
mobility and stamina during a 3-week hospital stay for the treatment of a
femoral head fracture. Which of the following phenomena most likely
accounts for the patients decrease in muscle function that underlies her
reduced mobility?
A) Impaired muscle cell metabolism resulting from metaplasia
B) Dysplasia as a consequence of inflammation during bone remodeling
C) Disuse atrophy of muscle cells during a prolonged period of immobility
D) Ischemic atrophy resulting from vascular changes while on bedrest
12
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A 20-year-old college student has presented to her campus medical clinic for
a scheduled Papanicolaou (Pap) smear. The clinician who will interpret the
smear will examine cell samples for evidence of:
A) changes in cell shape, size, and organization.
B) the presence of unexpected cell types.
C) ischemic changes in cell samples.
D) abnormally high numbers of cells in a specified field.
13
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Which of the following pathophysiologic processes is most likely to result in
metastatic calcification?
A) Benign prostatic hyperplasia
B) Liver cirrhosis
C) Impaired glycogen metabolism
D) Hyperparathyroidism
14
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Despite the low levels of radiation used in contemporary radiologic imaging,
a radiology technician is aware of the need to minimize her exposure to
ionizing radiation. What is the primary rationale for the technicians
precautions?
A) Radiation stimulates pathologic cell hypertrophy and hyperplasia.
B) Radiation results in the accumulation of endogenous waste product [Show Less]