CONTENTS
Chapter 01 - Cell Structure and Function ................................ ................................ ..... 2 Chapter 02 - Cellular
... [Show More] Responses to Stress, Injury, and Aging ................................ ..................... 7 Chapter 03 - Inflammation, the Inflammatory Response, and Fever ................................ .............. 13 Chapter 04 - Cell Proliferation, Tissue Regeneration, and Repair ................................ ................ 18 Chapter 05 - Genetic Control of Cell Function and Inheritance ................................ .................. 22 Chapter 06 - Genetic and Congenital Disorders ................................ ............................... 27 Chapter 07 - Neoplasia ................................ ................................ .................... 32 Chapter 08 - Disorders of Fluid, Electrolyte, and Acid-Base Balance ................................ ............. 38 Chapter 09 - Stress and Adaptation ................................ ................................ ......... 44 Chapter 10 - Disorders of Nutritional Status ................................ ................................ .. 49 Chapter 11 - Disorders of White Blood Cells and Lymphoid Tissues ................................ ............. 55 Chapter 12 - Disorders of Hemostasis ................................ ................................ ....... 60 Chapter 13 - Disorders of Red Blood Cells ................................ ................................ .... 66 Chapter 14 - Mechanisms of Infectious Disease ................................ ............................... 72 Chapter 15 - Innate and Adaptive Immunity ................................ ................................ .. 77 Chapter 16 - Disorders of the Immune Response ................................ .............................. 83 Chapter 17 - Control of Cardiovascular Function ................................ .............................. 89 Chapter 18 - Disorders of Blood Flow and Blood Pressure ................................ ..................... 94 Chapter 19 - Disorders of Cardiac Function ................................ ................................ . 100 Chapter 20 - Heart Failure and Circulatory Shock ................................ ............................ 106 Chapter 21 - Control of Respiratory Function ................................ ................................ 111 Chapter 22 - Respiratory Tract Infections, Neoplasms, and Childhood Disorders ................................ .. 117 Chapter 23 - Disorders of Ventilation and Gas Exchange ................................ ...................... 122 Chapter 24 - Structure and Function of the Kidney ................................ ........................... 128 Chapter 25 - Disorders of Renal Function ................................ ................................ ... 134 Chapter 26 - Acute Kidney Injury and Chronic Kidney Disease ................................ ................. 139 Chapter 27 - Disorders of the Bladder and Lower Urinary Tract ................................ ............... 144 Chapter 28 - Structure and Function of the Gastrointestinal System ................................ ............ 150 Chapter 29 - Disorders of Gastrointestinal Function ................................ .......................... 155 Chapter 30 - Disorders of Hepatobiliary and Exocrine Pancreatic Function ................................ ....... 161 Chapter 31 - Mechanisms of Endocrine Control ................................ .............................. 166 Chapter 32 - Disorders of Endocrine Control of Growth and Metabolism ................................ ........ 172 Chapter 33 - Diabetes Mellitus and the Metabolic Syndrome ................................ ................... 178 Chapter 34 - Organization and Control of Neural Function ................................ .................... 183 Chapter 35 - Somatosensory Function, Pain, and Headache ................................ .................... 189 Chapter 36 - Disorders of Neuromuscular Function ................................ .......................... 194 Chapter 37 - Disorders of Brain Function ................................ ................................ ... 200 Chapter 38 - Disorders of Special Sensory Function ................................ .......................... 206 Chapter 39 - Disorders of the Male Genitourinary System ................................ ..................... 211 Chapter 40 - Disorders of the Female Genitourinary System ................................ ................... 217 Chapter 41 - Sexually Transmitted Infections ................................ ................................ 222 Chapter 42 - Structure and Function of the Skeletal System ................................ ................... 228
1 | P a g eChapter 43 - Disorders of the Skeletal System ................................ ............................... 233
Chapter 44 - Disorders of the Skeletal System ................................ ............................... 239
Chapter 45 - Structure and Function of the Integumentum ................................ .................... 244
Chapter 46 - Disorders of Skin Integrity and Function ................................ ........................ 250
Chapter 01 - Cell Structure and Function
1.
The nucleus
, which is essential for function and survival of the cell.
A)
B)
C)
D)
2.
A)
B)
C)
D)
3.
A)
B)
C)
D)
4.
A)
B)
2 | P a g e
is the site of protein synthesis
contains the genetic code
transforms cellular energy
initiates aerobic metabolism
Although energy is not made in mitochondria, they are known as the power plants of the cell
because they:
contain RNA for protein synthesis.
utilize glycolysis for oxidative energy.
extract energy from organic compounds.
store calcium bonds for muscle contractions.
Although the basic structure of the cell plasma membrane is formed by a lipid bilayer,
most of the specific membrane functions are carried out by:
bound and transmembrane proteins.
complex, long carbohydrate chains.
surface antigens and hormone receptors.
a gating system of selective ion channels.
To effectively relay signals, cell-to-cell communication utilizes chemical messenger systems that:
displace surface receptor proteins.
accumulate within cell gap junctions.C)
D)
5.
A)
B)
C)
D)
6.
A)
B)
C)
D)
7.
A)
B)
C)
D)
8.
A)
B)
C)
D)
bind to contractile microfilaments.
release secretions into extracellular fluid.
Aerobic metabolism, also known as oxidative metabolism, provides energy by:
removing the phosphate bonds from ATP.
combining hydrogen and oxygen to form water.
activating pyruvate stored in the cytoplasm.
breaking down glucose to form lactic acid.
Exocytosis, the reverse of endocytosis, is important in
into the extracellular fluid.
Engulfing and ingesting fluid and proteins for transport
Killing, degrading, and dissolving harmful microorganisms
Removing cellular debris and releasing synthesized substances
Destruction of particles by lysosomal enzymes for secretion
The process responsible for generating and conducting membrane potentials is:
diffusion of current-carrying ions.
millivoltage of electrical potential.
polarization of charged particles.
ion channel neurotransmission.
Epithelial tissues are classified according to the shape of the cells and the number of layers.
Which of the following is a correctly matched description and type of epithelial tissue?
Simple epithelium: cells in contact with intercellular matrix; some do not extend to
surface
Stratified epithelium: single layer of cells; all cells rest on basement membrane
Glandular epithelium: arise from surface epithelia and underlying connective tissue
Pseudostratified epithelium: multiple layers of cells; deepest layer rests on basement
membrane
3 | P a g e9.
A)
B)
C)
D)
Connective tissue contains fibroblasts that are responsible for:
providing a fibrous framework for capillaries.
synthesis of collagen, elastin, and reticular fibers.
forming tendons and the fascia that covers muscles.
filling spaces between tissues to keep organs in place.
10. Although all muscle tissue cells have some similarities, smooth muscle (also known as
involuntary muscle) differs by:
A)
B)
C)
D)
having dense bodies attached to actin filaments.
containing sarcomeres between Z lines and M bands.
having rapid contractions and abundant cross-striations.
contracting in response to increased intracellular calcium.
11. Which of the following aspects of the function of the nucleus is performed by ribosomal RNA
(rRNA)?
A)
B)
C)
D)
Copying and carrying DNA instructions for protein synthesis
Carrying amino acids to the site of protein synthesis
Providing the site where protein synthesis occurs
Regulating and controlling protein synthesis
12. Breakdown and removal of foreign substances and worn-out cell parts are performed by which
of the following organelles?
A)
B)
C)
D)
13.
A)
B)
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Lysosomes
Golgi apparatus
Ribosomes
Endoplasmic reticulum (ER)
Impairment in the function of peroxisomes would result in:
inadequate sites for protein synthesis.
an inability to transport cellular products across the cell membrane.C)
D)
insufficient energy production within a cell.
accumulation of free radicals in the cytoplasm.
14. After several months of trying to conceive, a couple is undergoing fertility testing. Semen
analysis indicates that the man’s sperm have decreased motility, a finding that is thought to
underlie the couple’s inability to become pregnant. Which of the following cellular
components may be defective within the man’s sperm?
A)
B)
C)
D)
Ribosomes
Microtubules
Mitochondria
Microfilaments
15. Which of the following statements is true of glycolysis?
A)
Glycolysis requires oxygen.
B)
C)
D)
Glycolysis occurs in cells without mitochondria.
Glycolysis provides the majority of the body’s energy needs.
Glycolysis produces energy, water, and carbon dioxide.
16. Which of the following membrane transport mechanisms requires the greatest amount of energy?
A)
Facilitated diffusion
B)
C)
D)
Passive transport
Vesicular transport
Simple diffusion
17. A male patient with a diagnosis of type 1 diabetes mellitus is experiencing hyperglycemia
because he lacks sufficient insulin to increase the availability of glucose transporters in his
cell membranes. Consequently, his cells lack intracellular glucose and it accumulates in his
blood. Which of the
following processes would best allow glucose to cross his cell membranes?
A)
B)
5 | P a g e
Facilitated diffusion
Simple diffusionC)
D)
Secondary active transport
Endocytosis
18. Which of the following statements is true of skeletal muscle cells?
A)
Skeletal muscle cells each have an apical, lateral, and basal surface.
B)
C)
D)
They are closely apposed and are joined by cell-to-cell adhesion molecules.
Their basal surface is attached to a basement membrane.
Skeletal muscle is multinucleated, lacking true cell boundaries.
19. Which of the following body tissues exhibits the highest rate of turnover and renewal?
A)
The squamous epithelial cells of the skin
B)
C)
D)
The connective tissue supporting blood vessels
The skeletal muscle that facilitates movement
The nervous tissue that constitutes the central nervous system
20. A patient with a pathophysiologic condition that affects the desmosomes is most likely to exhibit:
A)
impaired contraction of skeletal and smooth muscle.
B)
C)
D)
weakness of the collagen and elastin fibers in the extracellular space.
impaired communication between neurons and effector organs.
separation at the junctions between epithelial cells.
Answer Key
1.
B
2.
3.
C
A
4. D
5.
B
6.
6 | P a g e
C7.
8.
9.
A
C
B
10. A
11. C
12. A
13. D
14. B
15. B
16. C
17. A
18. D
19. A
20. D
Chapter 02 - Cellular Responses to Stress, Injury, and Aging
1.
A)
B)
C)
D)
2.
A)
B)
7 | P a g e
Ischemia and other toxic injuries increase the accumulation of intracellular calcium as a result of:
release of stored calcium from the mitochondria.
improved intracellular volume regulation.
decreased influx across the cell membrane.
attraction of calcium to fatty infiltrates.
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.
metaplasia
organ atrophyC)
D)
3.
compensatory hyperplasia
physiologic hypertrophy
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)
B)
C)
D)
4.
A)
B)
C)
D)
5.
A)
B)
C)
D)
6.
A)
B)
C)
D)
7.
8 | P a g e
caspase activation
coagulation necrosis
rapid phagocytosis
protein p53 deficiency
Bacteria and viruses cause cell damage by
damage caused by other injurious agents.
, which is unique from the intracellular
disrupting the sodium/potassium ATPase pump
interrupting oxidative metabolism processes
replicating and producing continued injury
decreasing protein synthesis and function
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:
destroying phospholipids in the cell membrane.
altering the immune response of the cell.
disrupting calcium storage in the cell.
inactivation of enzymes and mitochondria.
Injured cells have impaired flow of substances through the cell membrane as a result of:
increased fat load.
altered permeability.
altered glucose utilization.
increased surface receptors.
Reversible adaptive intracellular responses are initiated by:A)
B)
C)
D)
8.
A)
B)
C)
D)
9.
stimulus overload.
genetic mutations.
chemical messengers.
mitochondrial DNA.
Injured cells become very swollen as a result of:
increased cell protein synthesis.
altered cell volume regulation.
passive entry of potassium into the cell.
bleb formation in the plasma membrane.
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)
B)
C)
D)
rapid apoptosis.
cellular rupture.
shrinkage and collapse.
chronic inflammation.
10. 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)
B)
C)
D)
changes with genetic influences.
elimination of cell receptor sites.
insufficient telomerase enzyme.
DNA mutation or faulty repair.
11. 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 patient’s decrease in muscle function
that underlies her reduced mobility?
A)
9 | P a g e
Impaired muscle cell metabolism resulting from metaplasiaB)
C)
D)
Dysplasia as a consequence of inflammation during bone remodeling
Disuse atrophy of muscle cells during a prolonged period of immobility
Ischemic atrophy resulting from vascular changes while on bedrest
12. 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)
B)
C)
D)
changes in cell shape, size, and organization.
the presence of unexpected cell types.
ischemic changes in cell samples.
abnormally high numbers of cells in a specified field.
13. Which of the following pathophysiologic processes is most likely to result in metastatic calcification?
A)
Benign prostatic hyperplasia
B)
C)
D)
Liver cirrhosis
Impaired glycogen metabolism
Hyperparathyroidism
14. 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 technician’s precautions?
A)
B)
C)
D)
Radiation stimulates pathologic cell hypertrophy and hyperplasia.
Radiation results in the accumulation of endogenous waste products in the cytoplasm.
Radiation interferes with DNA synthesis and mitosis.
Radiation decreases the action potential of rapidly dividing cells.
15. The parents of a 4-year-old girl have sought care because their daughter has admitted to
chewing and swallowing imported toy figurines that have been determined to be made of
lead. Which of the following blood tests should the care team prioritize?
A)
B)
C)
10 | P a g e
White blood cell levels with differential
Red blood cell levels and morphology
Urea and creatinine levelsD)
Liver function panel
16. A 70-year-old male patient has been admitted to a hospital for the treatment of a recent
hemorrhagic stroke that has left him with numerous motor and sensory deficits. These
deficits are most likely the result of which of the following mechanisms of cell injury?
A)
B)
C)
D)
Free radical injury
Hypoxia and ATP depletion
Interference with DNA synthesis
Impaired calcium homeostasis
17. Which of the following processes associated with cellular injury is most likely to be reversible?
A)
Cell damage resulting from accumulation of fat in the cytoplasm
B)
C)
D)
Cellular changes as a result of ionizing radiation
Cell damage from accumulation of free radicals
Apoptosis
18. The extrinsic pathway of apoptosis can be initiated by:
A)
damage to cellular DNA.
B)
C)
D)
decreased ATP levels.
activation of the p53 protein.
activation of death receptors on the cell surface.
19. A patient with severe peripheral vascular disease has developed signs of dry gangrene on the
great toe of one foot. Which of the following pathophysiologic processes most likely
contributed to this diagnosis?
A)
B)
C)
D)
Inappropriate activation of apoptosis
Bacterial invasion
Impaired arterial blood supply
Metaplastic cellular changes
20. Which of the following facts underlies the concept of replicative senescence?
11 | P a g eA)
B)
C)
D)
Genes controlling longevity are present or absent in varying quantities among different individuals.
Telomeres become progressively shorter in successive generations of a cell.
The damaging influence of free radicals increases exponentially in later generations of a cell.
Aging produces mutations in DNA and deficits in DNA repair.
Answer Key
1.
A
2.
3.
4.
5.
6.
7.
8.
9.
C
B
C
A
B
C
B
B
10. A
11. C
12. A
13. D
14. C
15. B
16. B
17. A
18. D
19. C
12 | P a g e20. B
Chapter 03 - Inflammation, the Inflammatory Response, and Fever
1.
The characteristic, localized cardinal signs of acute inflammation include:
A)
B)
C)
D)
2.
A)
B)
C)
D)
3.
A)
B)
C)
D)
4.
A)
B)
C)
13 | P a g e
fever.
fatigue.
redness.
granuloma.
The vascular, hemodynamic stage of acute inflammation is initiated by momentary
vasoconstriction followed by vasodilation that causes localized:
bleeding.
congestion.
pale skin.
coolness.
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?
Basophils
Lymphocytes
Neutrophils
Platelets
The phagocytosis process involves three distinct steps. What is the initial step in the process?
Engulfment
Intracellular killing
Antigen marginationD)
Recognition and adherence
5. Which of the following mediators of inflammation causes increased capillary permeability
and pain?
A)
B)
C)
D)
6.
A)
B)
C)
D)
7.
A)
B)
C)
D)
8.
A)
B)
C)
D)
Serotonin
Histamine
Bradykinin
Nitric oxide
Inflammatory exudates are a combination of several types. Which of the following exudates is
composed of enmeshed necrotic cells?
Serous
Fibrinous
Suppurative
Membranous
The acute-phase systemic response usually begins within hours of the onset of inflammation
and includes:
fever and lethargy.
decreased C-reactive protein.
positive nitrogen balance.
low erythrocyte sedimentation rate.
In contrast to acute inflammation, chronic inflammation is characterized by which of the
following phenomena?
Profuse fibrinous exudation
A shift to the left of granulocytes
Metabolic and respiratory alkalosis
Lymphocytosis and activated macrophages
9.
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Exogenous pyrogens (interleukin-1) and the presence of bacteria in the blood lead to therelease of endogenous pyrogens that:
A)
B)
C)
D)
stabilize thermal control in the brain.
produce leukocytosis and anorexia.
block viral replication in cells.
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 patient’s
inflammation?
A)
B)
C)
D)
Outpouring of exudate into interstitial spaces
Chemotaxis
Accumulation of leukocytes along the epithelium
Phagocytosis of cellular debris
11. Which of the following individuals most likely has the highest risk of experiencing
chronic inflammation?
A)
B)
C)
D)
A patient who has recently been diagnosed with type 2 diabetes
A patient who is a carrier of an antibiotic-resistant organism
A patient who is taking oral antibiotics for an upper respiratory infection
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)
35.9°C (96.6°F)
B)
C)
D)
38.0°C (100.4°F)
35.5°C (95.9°F)
37.3°C (99.1°F)
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 patient’s
hypothalamus in an effort to reduce heat loss?
15 | P a g eA)
B)
C)
D)
Opening of arteriovenous (AV) shunts
Reduced exhalation of warmed air
Contraction of pilomotor muscles
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)
B)
C)
D)
Evaporation and conduction
Radiation and convection
Conduction and convection
Convection and evaporation
15. Which of the following pathophysiologic processes are capable of inducing the
production of pyrogens? Select all that apply.
A)
B)
C)
D)
E)
Acute inflammation
Obesity
Myocardial infarction
Malignancy
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)
C)
D)
17.
A patient who has sustained a head injury in a bicycle crash
A patient who has become delirious after the administration of a benzodiazepine
A patient who has begun taking a selective serotonin-reuptake inhibitor (SSRI) for the
treatment of depression
Patients are commonly administered antipyretics when their oral temperature exceeds 37.5°C
(99.5°F). Which of the following statements related to the rationale for this action is most
accurate?
16 | P a g eA)
B)
C)
D)
Temperatures in excess of 37.5°C (99.5°F) can result in seizure activity.
Lower temperatures inhibit the protein synthesis of bacteria.
There is little empirical evidence for this treatment modality.
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)
B)
C)
D)
Recurrent fever
Remittent fever
Sustained fever
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)
B)
C)
D)
The immature hypothalamus is unable to perform normal thermoregulation.
Infants are susceptible to serious infections because of their decreased immune function.
Commonly used antipyretics often have no effect on the core temperature of infants.
Fever in neonates is often evidence of a congenital disorder rather than an infection.
20. An 84-year-old patient’s 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)
B)
C)
D)
Disturbance in the functioning of the thermoregulatory center
Increased heat loss by evaporation
The presence of comorbidities that are associated with lowered core temperature
Persistent closure of arteriovenous shunts
Answer Key
1.
C
2.
17 | P a g e
B3.
C
4. D
5.
C
6. D
7.
A
8. D
9.
B
10. A
11. D
12. D
13. C
14. B
15.
A, C, D
16. B
17. C
18. D
19. B
20. A
Chapter 04 - Cell Proliferation, Tissue Regeneration, and Repair
1.
Epithelialization, the first component of the proliferative phase of wound healing, is delayed
in open wounds until after has formed.
A)
B)
18 | P a g e
granulation tissue
fibrinous meshworkC) D) 2. A) B) C) D) 3. capillary circulation collagenous layers
A mutation has occurred during mitosis of an individual’s bone marrow cell. This event may be the result of the failure of which of the following?
Progenitor cells Fibroblasts [Show Less]