TEST BANK FOR Applied Pathophysiology A Conceptual Approach to the Mechanisms of Disease 3rd Edition by Braun
Chapter 1 Introduction to Pathophysiology
... [Show More] 1. The nucleus
, which is essential for function and survival of the cell.
A) B) C) D)
is the site of protein synthesis contains the genetic code transforms cellular energy
initiates aerobic metabolism
2. Although energy is not made in mitochondria, they are known as the power plants of the cell because they:
A) B) C) D)
contain RNA for protein synthesis. utilize glycolysis for oxidative energy. extract energy from organic compounds. store calcium bonds for muscle contractions.
3. 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:
A) B) C) D)
bound and transmembrane proteins. complex, long carbohydrate chains. surface antigens and hormone receptors. a gating system of selective ion channels.
4. To effectively relay signals, cell-to-cell communication utilizes chemical messenger systems that:
A) B) C) D)
displace surface receptor proteins. accumulate within cell gap junctions. bind to contractile microfilaments.
release secretions into extracellular fluid. 5. Aerobic metabolism, also known as oxidative metabolism, provides energy by: 1A)
B)
C)
D)
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.
6. Exocytosis, the reverse of endocytosis, is important in
extracellular fluid.
A)
B)
C)
D)
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
7. The process responsible for generating and conducting membrane potentials is:
A)
B)
C)
D)
diffusion of current-carrying ions.
millivoltage of electrical potential.
polarization of charged particles.
ion channel neurotransmission.
8. 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?
A)
B)
C)
D)
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
9. Connective tissue contains fibroblasts that are responsible for:
A)
B)
C)
D)
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.
2
into the10. 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)
Lysosomes
Golgi apparatus
Ribosomes
Endoplasmic reticulum (ER)
13. Impairment in the function of peroxisomes would result in:
A)
inadequate sites for protein synthesis.
B)
C)
D)
an inability to transport cellular products across the cell membrane.
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 mans sperm have decreased motility, a finding that is thought
to underlie the couples inability to become pregnant.
Which of the following cellular components may be defective within the mans sperm?
A)
B)
C)
Ribosomes
Microtubules
Mitochondria
3D)
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 bodys energy needs.
Glycolysis produces energy, water, and carbon dioxide.
16. Which of the following membrane transport mechanisms requires the greatest amount
of energy?
A)
B)
C)
D)
Facilitated diffusion
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)
C)
D)
Facilitated diffusion
Simple diffusion
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)
The connective tissue supporting blood vessels
The skeletal muscle that facilitates movement
4D)
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)
B)
C)
D)
impaired contraction of skeletal and smooth muscle.
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. C
3. A
4. D
5. B
6. C
7. A
8. C
9. B
10. A
11. C
12. A
13. D
14. B
15. B
16. C
17. A
18. D
19. A
20. D
5Chapter 2 Altered Cells and Tissues
1. Ischemia and other toxic injuries increase the accumulation of intracellular calcium
as a result of:
A)
B)
C)
D)
release of stored calcium from the mitochondria.
improved intracellular volume regulation.
decreased influx across the cell membrane.
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
A)
B)
C)
D)
the remaining liver cells.
metaplasia
organ atrophy
compensatory hyperplasia
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)
B)
C)
D)
caspase activation
coagulation necrosis
rapid phagocytosis
protein p53 deficiency
4. Bacteria and viruses cause cell damage by
A)
B)
C)
D)
intracellular damage caused by other injurious agents.
disrupting the sodium/potassium ATPase pump
interrupting oxidative metabolism processes
replicating and producing continued injury
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.
6
, which is unique from theB)
C)
D)
altering the immune response of the cell.
disrupting calcium storage in the cell.
inactivation of enzymes and mitochondria.
6. Injured cells have impaired flow of substances through the cell membrane as a result of:
A)
B)
C)
D)
increased fat load.
altered permeability.
altered glucose utilization.
increased surface receptors.
7. Reversible adaptive intracellular responses are initiated by:
A)
B)
C)
D)
stimulus overload.
genetic mutations.
chemical messengers.
mitochondrial DNA.
8. Injured cells become very swollen as a result of:
A)
B)
C)
D)
increased cell protein synthesis.
altered cell volume regulation.
passive entry of potassium into the cell.
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)
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)
changes with genetic influences.
elimination of cell receptor sites.
7C)
D)
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 patients decrease in
muscle function that underlies her reduced mobility?
A)
B)
C)
D)
Impaired muscle cell metabolism resulting from metaplasia
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)
B)
C)
D)
Benign prostatic hyperplasia
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 technicians 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
8A)
B)
C)
D)
made of lead. Which of the following blood tests should the care team prioritize?
White blood cell levels with differential
Red blood cell levels and morphology
Urea and creatinine levels
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)
B)
C)
D)
Cell damage resulting from accumulation of fat in the cytoplasm
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
920. Which of the following facts underlies the concept of replicative senescence?
A)
Genes controlling longevity are present or absent in varying quantities among
different individuals.
B)
C)
D)
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. C
3. B
4. C
5. A
6. B
7. C
8. B
9. B
10. A
11. C
12. A
13. D
14. C
15. B
16. B
17. A
18. D
19. C
20. B
Chapter 3 Inflammation and Tissue Repair
101. The characteristic, localized cardinal signs of acute inflammation include:
A)
B)
C)
D)
fever.
fatigue.
redness.
granuloma.
2. The vascular, hemodynamic stage of acute inflammation is initiated by momentary
vasoconstriction followed by vasodilation that causes localized:
A)
B)
C)
D)
bleeding.
congestion.
pale skin.
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)
B)
C)
D)
Basophils
Lymphocytes
Neutrophils
Platelets
4. The phagocytosis process involves three distinct steps. What is the initial step in the
process?
A)
B)
C)
D)
Engulfment
Intracellular killing
Antigen margination
Recognition and adherence
5. Which of the following mediators of inflammation causes increased capillary
permeability and pain?
A)
B)
C)
D)
Serotonin
Histamine
Bradykinin
Nitric oxide
6. Inflammatory exudates are a combination of several types. Which of the following
exudates is composed of enmeshed necrotic cells?
11A)
B)
C)
D)
Serous
Fibrinous
Suppurative
Membranous
7. The acute-phase systemic response usually begins within hours of the onset of
inflammation and includes:
A)
B)
C)
D)
fever and lethargy.
decreased C-reactive protein.
positive nitrogen balance.
low erythrocyte sedimentation rate.
8. In contrast to acute inflammation, chronic inflammation is characterized by which of
the following phenomena?
A)
B)
C)
D)
Profuse fibrinous exudation
A shift to the left of granulocytes
Metabolic and respiratory alkalosis
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)
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 patients 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
12experiencing 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) 35.9C
(96.6F)
B)
38.0C (100.4F)
C)
D)
35.5C (95.9F)
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)
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
1316. Which of the following patients is most likely to be susceptible to developing a neurogenic
fever?
A)
B)
C)
D)
A patient who has stage II Alzheimer disease
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
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)
B)
C)
D)
Temperatures in excess of 37.5C (99.5F) 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.
1420. 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)
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. B
3. 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
15Chapter 4 Altered Immunity
1. The mediators involved in type I hypersensitivity allergic responses are released
from:
A)
B)
C)
D)
mast cells.
plasma cells.
monocytes.
arachidonic acid.
2. A genetically determined hypersensitivity to common environmental allergens causes
reactions, such as:
A)
B)
C)
D)
atopic; urticaria.
autoimmune; diarrhea.
IgM-mediated; infections.
delayed; poison ivy rash:
3. Mismatched blood transfusion reaction with hemolysis of blood cells is an example
of type II,
mediated hypersensitivity reaction.
A)
B)
C)
D)
T-cell
antibody
leukotriene
complement
4. Type III hypersensitivity immune responses can be harmful when immune complex
deposits in tissue activate
that can directly damage area
tissues.
A)
B)
C)
D)
inflammation
autoantibodies
cytotoxic cells
immunoglobulins
5. The mechanism by which humans recognize self-cells from non-self (antigens)- cells is
.
A)
B)
C)
autoimmunity
self-tolerance
non-self anergy
16D) immunocompatibility
6. Organ rejection is a complication of organ transplantation caused by recipient immune cells:
A) B) C) D)
destroying the host T cells. attack on the donor cells.
combining with grafts HLA. being recognized as foreign.
7. The leading cause of death for people with HIV is opportunistic
A) B)
C) D)
leukemia
tuberculosis pneumonia
toxoplasmosis
8. Wasting syndrome, an AIDS-defining illness, is characterized by involuntary weight loss of at least 10% of baseline body weight in the presence of:
A) B) C) D)
diarrhea.
hypermetabolism. weakness and fever.
glucose intolerance.
9. The window period of HIV infection refers to the period of time between infection and:
A) B) C) D)
transmission.
seroconversion. initial symptoms. antibody screening.
10. HIV-positive persons that display manifestations of laboratory category 3 or clinical category C are considered to have:
A) B) C) D)
zero viral load. seroconversion.
complete remission. AIDS-defining illnesses.
17 [Show Less]