TEST BANK
PATHOPHYSIOLOGY
THE BIOLOGIC BASIS FOR DISEASE IN ADULTS AND CHILDREN
8th Edition
Kathryn L. McCance, Sue E. Huether2
Contents
Chapter 01: Cellular Biology.................................................
...
TEST BANK
PATHOPHYSIOLOGY
THE BIOLOGIC BASIS FOR DISEASE IN ADULTS AND CHILDREN
8th Edition
Kathryn L. McCance, Sue E. Huether2
Contents
Chapter 01: Cellular Biology.......................................................................................................................... 4
Chapter 02: Altered Cellular and Tissue Biology: Environmental Agents...................................................18
Chapter 03: The Cellular Environment: Fluids and Electrolytes, Acids and Bases......................................31
Chapter 04: Genes and Genetic Diseases ...................................................................................................44
Chapter 05: Genes, Environment-Lifestyle, and Common Diseases...........................................................55
Chapter 06: Epigenetics and Disease..........................................................................................................63
Chapter 07: Innate Immunity: Inflammation and Wound Healing.............................................................68
Chapter 08: Adaptive Immunity..................................................................................................................83
Chapter 09: Alterations in Immunity and Inflammation.............................................................................95
Chapter 10: Infection ................................................................................................................................108
Chapter 11: Stress and Disease.................................................................................................................117
Chapter 12: Cancer Biology.......................................................................................................................124
Chapter 13: Cancer Epidemiology.............................................................................................................137
Chapter 14: Cancer in Children.................................................................................................................143
Chapter 15: Structure and Function of the Neurologic System................................................................148
Chapter 16: Pain, Temperature Regulation, Sleep, and Sensory Function...............................................159
Chapter 17: Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function...............174
Chapter 18: Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction
..................................................................................................................................................................188
Chapter 19: Neurobiology of Schizophrenia, Mood Disorders, and Anxiety Disorders ...........................199
Chapter 20: Alterations of Neurologic Function in Children.....................................................................206
Chapter 21: Mechanisms of Hormonal Regulation...................................................................................213
Chapter 22: Alterations of Hormonal Regulation .....................................................................................222
Chapter 23: Obesity and Disorders of Nutrition .......................................................................................234
Chapter 24: Structure and Function of the Reproductive Systems ..........................................................239
Chapter 25: Alterations of the Female Reproductive System ..................................................................249
Chapter 26: Alterations of the Male Reproductive System ......................................................................259
Chapter 27: Sexually Transmitted Infections............................................................................................265
Chapter 28: Structure and Function of the Hematologic System.............................................................273
Chapter 29: Alterations of Erythrocytes, Platelets, and Hemostatic Function.........................................2833
Chapter 30: Alterations of Leukocyte and Lymphoid Function ................................................................293
Chapter 31: Alterations of Hematologic Function in Children..................................................................300
Chapter 32: Structure and Function of the Cardiovascular and Lymphatic Systems ...............................311
Chapter 33: Alterations of Cardiovascular Function.................................................................................324
Chapter 34: Alterations of Cardiovascular Function in Children ..............................................................338
Chapter 35: Structure and Function of the Pulmonary System................................................................346
Chapter 36: Alterations of Pulmonary Function .......................................................................................356
Chapter 37: Alterations of Pulmonary Function in Children.....................................................................373
Chapter 38: Structure and Function of the Renal and Urologic Systems .................................................381
Chapter 39: Alterations of Renal and Urinary Tract Function ..................................................................391
Chapter 40: Alterations of Renal and Urinary Tract Function in Children ................................................401
Chapter 41: Structure and Function of the Digestive System...................................................................409
Chapter 42: Alterations of Digestive Function..........................................................................................421
Chapter 43: Alterations of Digestive Function in Children .......................................................................432
Chapter 44: Structure and Function of the Musculoskeletal System .......................................................441
Chapter 45: Alterations of Musculoskeletal Function ..............................................................................453
Chapter 46: Alterations of Musculoskeletal Function in Children............................................................466
Chapter 47: Structure, Function, and Disorders of the Integument.........................................................475
Chapter 48: Alterations of the Integument in Children............................................................................486
Chapter 49: Shock, Multiple Organ Dysfunction Syndrome, and Burns in Adults....................................494
Chapter 50: Shock, Multiple Organ Dysfunction Syndrome, and Burns in Children ................................502Test Bank - Pathophysiology: The Biologic Basis for Disease in Adults and Children (8th) 4
Chapter 01: Cellular Biology
MULTIPLE CHOICE
1. Which statement best describes the cellular function of metabolic absorption?
a. Cells can produce proteins.
b. Cells can secrete digestive enzymes.
c. Cells can take in and use nutrients.
d. Cells can synthesize fats.
ANS: C
In metabolic absorption, all cells take in and use nutrients and other substances from their
surroundings. The remaining options are not inclusive in their descriptions of cellular metabolic
absorption.
PTS: 1 DIF: Cognitive Level: Remembering
2. Where is most of a cell’s genetic information, including RNA and DNA, contained?
a. Mitochondria
b. Ribosome
c. Nucleolus
d. Lysosome
ANS: C
The nucleus contains the nucleolus, a small dense structure composed largely of RNA, most of
the cellular DNA, and the DNA-binding proteins, such as the histones, which regulate its
activity. The mitochondria are responsible for cellular respiration and energy production.
Ribosomes’ chief function is to provide sites for cellular protein synthesis. Lysosomes function
as the intracellular digestive system.
PTS: 1 DIF: Cognitive Level: Remembering
3. Which component of the cell produces hydrogen peroxide (H2O2) by using oxygen to remove
hydrogen atoms from specific substrates in an oxidative reaction?
a. Lysosomes
b. Peroxisomes
c. Ribosomes
d. Endosome
ANS: BTest Bank - Pathophysiology: The Biologic Basis for Disease in Adults and Children (8th) 5
Peroxisomes are so named because they usually contain enzymes that use oxygen to remove
hydrogen atoms from specific substrates in an oxidative reaction that produces H2O2, which is a
powerful oxidant and potentially destructive if it accumulates or escapes from peroxisomes.
Ribosomes are RNA-protein complexes (nucleoproteins) that are synthesized in the nucleolus
and secreted into the cytoplasm through pores in the nuclear envelope called nuclear pore
complexes. Lysosomes are saclike structures that originate from the Golgi complex and contain
more than 40 digestive enzymes called hydrolases, which catalyze bonds in proteins, lipids,
nucleic acids, and carbohydrates. An endosome is a vesical that has been pinched off from the
cellular membrane.
PTS: 1 DIF: Cognitive Level: Remembering
4. Which cell component is capable of cellular autodigestion when it is released during cell injury?
a. Ribosome
b. Golgi complex
c. Smooth endoplasmic reticulum
d. Lysosomes
ANS: D
The lysosomal membrane acts as a protective shield between the powerful digestive enzymes
within the lysosome and the cytoplasm, preventing their leakage into the cytoplasmic matrix.
Disruption of the membrane by various treatments or cellular injury leads to a release of the
lysosomal enzymes, which can then react with their specific substrates, causing cellular selfdigestion. The chief function of a ribosome is to provide sites for cellular protein synthesis. The
Golgi complex is a network of flattened, smooth vesicles and membranes often located near the
cell nucleus. The smooth endoplasmic reticulum is involved in steroid hormone production and
removing toxic substances from the cell.
PTS: 1 DIF: Cognitive Level: Remembering
5. Which cAMP-mediated response is related to antidiuretic hormone?
a. Increased heart rate and force of contraction
b. Secretion of cortisol
c. Increased retention of water
d. Breakdown of fat
ANS: C
Antidiuretic hormone leads to increased retention of water in the body. Epinephrine causes
increases in heart rate and force of contraction. Increased cortisol secretion is due to ACTH.
Breakdown of fat is due to glucagon.
PTS: 1 DIF: Cognitive Level: Remembering
6. During which phase of the cell cycle is DNA synthesized?
a. G1
b. S
c. G2
d. MTest Bank - Pathophysiology: The Biologic Basis for Disease in Adults and Children (8th) 6
ANS: B
The four designated phases of the cell cycle are: (1) the G1 phase (G = gap), which is the period
between the M phase (M = mitosis) and the start of DNA synthesis; (2) the S phase (S =
synthesis), during which DNA is synthesized in the cell nucleus; (3) the G2 phase, during which
RNA and protein synthesis occurs, the period between the completion of DNA synthesis and the
next phase (M); and (4) the M phase, which includes nuclear and cytoplasmic division.
PTS: 1 DIF: Cognitive Level: Remembering
7. What organic compound facilitates transportation across cell membranes by acting as receptors,
transport channels for electrolytes, and enzymes to drive active pumps?
a. Lipids
b. Proteases
c. Proteins
d. Carbohydrates
ANS: C
Proteins have several functions, including acting as receptors, transport channels for electrolytes,
and enzymes to drive active pumps Lipids help act as the “glue” holding cell membranes
together. Proteases cause the breakdown of protein. Carbohydrates are involved in cellular
protection and lubrication and help produce energy via oxidative phosphorylation.
PTS: 1 DIF: Cognitive Level: Remembering
8. Understanding the various steps of proteolytic cascades may be useful in designing drug therapy
for which human diseases?
a. Cardiac and vascular disorders
b. Autoimmune and malignant disorders
c. Gastrointestinal and renal disorders
d. Endocrine and gastrointestinal disorders
ANS: B
Understanding the various steps involved in this process is crucial for designing drug
interventions. Dysregulation of proteases features prominently in many human diseases,
including cancer, autoimmunity, and neurodegenerative disorders. Cardiac, vascular,
gastrointestinal, renal, and endocrine disorders do not involve this process.
PTS: 1 DIF: Cognitive Level: Remembering
9. Which structure prevents water-soluble molecules from entering cells across the plasma
membrane?
a. Carbohydrate chains
b. Glycoprotein channels
c. Membrane channel proteins
d. Lipid bilayer
ANS: DTest Bank - Pathophysiology: The Biologic Basis for Disease in Adults and Children (8th) 7
The bilayer’s structure accounts for one of the essential functions of the plasma membrane. It is
impermeable to most water-soluble molecules (molecules that dissolve in water) because the
water-soluble molecules are insoluble in the oily core region. The bilayer serves as a barrier to
the diffusion of water and hydrophilic substances while allowing lipid-soluble molecules, such as
oxygen (O2) and carbon dioxide (CO2), to diffuse through it readily. Carbohydrate chains,
glycoprotein channels, and membrane channel proteins do not prevent water-soluble molecules
from entering cells across the cell membrane.
PTS: 1 DIF: Cognitive Level: Remembering
10. A student asks for an explanation of the absolute refractory period of the action potential. What
response by the professor is best?
a. A stronger than normal impulse will evoke another response.
b. No stimulus is able to evoke another response at this time.
c. Multiple stimuli can produce more rapid action potentials.
d. The hyperpolarized state means a weaker stimulus produces a response.
ANS: B
During the absolute refractory state of the action potential, no stimulus is able to evoke another
response from the cell. A stronger than normal impulse may generate a response in the relative
refractory period. This period of time is not related to the number of stimuli. A hyperpolarized
state means a stronger than normal stimulus would be needed to generate a response.
PTS: 1 DIF: Cognitive Level: Remembering
11. Which form of cell communication is used to communicate within the cell itself and with other
cells in direct physical contact?
a. Protein channel (gap junction)
b. Plasma membrane-bound signaling molecules
c. Hormone secretion such as neurotransmitters
d. Extracellular chemical messengers such as ligands
ANS: B
Cells communicate in three main ways; they display plasma membrane-bound signaling
molecules that affect the cell itself and other cells in direct physical contact with it, they affect
receptor proteins inside the target cell, and they form protein channels (gap junctions) that
directly coordinate the activities of adjacent cells. Neurotransmitters are released by neurons and
cross the synaptic cleft to communicate with the cells they innervate. Ligands are involved in
binding processes.
PTS: 1 DIF: Cognitive Level: Remembering
12. Which mode of chemical signaling uses blood to transport communication to cells some distance
away?
a. Paracrine
b. Autocrine
c. Neurotransmitter
d. HormonalTest Bank - Pathophysiology: The Biologic Basis for Disease in Adults and Children (8th) 8
ANS: D
Chemical signaling can be classified into three categories: (1) local-chemical mediator, (2)
hormone, and (3) neurotransmitter. Hormones are released by one set of cells and travel through
tissues or the bloodstream to another set of cells where they produce a response by those cells. In
paracrine signaling, cells secrete local chemical mediators that are quickly absorbed, destroyed,
or immobilized. Paracrine signaling requires close membrane-to-membrane contact. Paracrine
signaling usually involves different cell types; however, cells also may produce signals that they,
themselves, respond to, which is called autocrine signaling. Neurotransmitters are released by
neurons and cross the synaptic cleft to communicate with the cells they innervate.
PTS: 1 DIF: Cognitive Level: Remembering
13. Which mode of chemical signaling uses local chemical mediators that are quickly taken up,
destroyed, or immobilized?
a. Paracrine
b. Autocrine
c. Neurotransmitter
d. Hormone
ANS: A
In paracrine signaling, cells secrete local chemical mediators that are quickly taken up,
destroyed, or immobilized. Autocrine signaling occurs when the target cells produce signals that
they themselves respond to. Neurotransmitters are released by neurons and cross the synaptic
cleft to communicate with the cells they innervate. Hormones are released by one set of cells and
travel through tissues or the bloodstream to another set of cells where they produce a response by
those cells.
PTS: 1 DIF: Cognitive Level: Remembering
14. Neurotransmitters affect the postsynaptic membrane by binding to which structure?
a. Lipids
b. Ribosomes
c. Amphipathic lipids
d. Receptors
ANS: D
In each type of chemical signaling, the target cell receives the signal by first attaching to its
receptors. The other options do not correctly describe this process.
PTS: 1 DIF: Cognitive Level: Remembering
15. How do cells receive communication from the extracellular fluid surrounding them?
a. Protein channel (gap junction)
b. Plasma membrane-bound signaling molecules (involving receptors)
c. Hormone secretion such as neurotransmitters
d. Chemical messengers such as ligands
ANS: DTest Bank - Pathophysiology: The Biologic Basis for Disease in Adults and Children (8th) 9
Signal transduction involves incoming signals or instructions from extracellular chemical
messengers (ligands) that are conveyed to the cell’s interior for execution. The other options do
not correctly describe how cells receive communication from the surrounding extracellular fluid.
PTS: 1 DIF: Cognitive Level: Remembering
16. Which molecule provides the second messenger necessary for extracellular communication to be
activated?
a. Guanosine triphosphate (GTP)
b. Adenosine monophosphate (AMP)
c. Adenosine triphosphate (ATP)
d. Guanosine diphosphate (GDP)
ANS: B
The two major second-messenger pathways are cyclic AMP (cAMP) and calcium (Ca++). GTP,
ATP, and GDP are not major second-messenger pathways. GTP and GDP are “middlemen” or
intermediaries. Nutrients are transformed into energy in the form of ATP.
PTS: 1 DIF: Cognitive Level: Remembering
17. Under anaerobic conditions, what process provides energy for the cell?
a. Oxidative phosphorylation
b. Glycolysis
c. Lactolysis
d. Passive transport
ANS: B
Glycolysis provides energy to the cells when oxygen delivery is insufficient or delayed.
Oxidative phosphorylation is the process by which energy produced from nutrients is transferred
to ATP. Lactolysis is the breakdown of lactose. Passive transport is the movement of water and
small, nonelectrically charge molecules across plasma membranes.
PTS: 1 DIF: Cognitive Level: Remembering
18. What is the mechanism by which the energy produced from carbohydrates, proteins, and lipids is
transferred to adenosine triphosphate (ATP)?
a. Anaerobic glycolysis
b. Oxidative cellular metabolism
c. Oxidative phosphorylation
d. Tricarboxylic acid phosphorylation
ANS: C
Oxidative phosphorylation occurs in the mitochondria and is the mechanism by which the energy
produced from carbohydrates, fats, and proteins is transferred to ATP. Glycolysis provides
energy to the cells when oxygen delivery is insufficient or delayed. Oxidative cellular
metabolism and t
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