GOULD'S PATHOPHYSIOLOGY FOR THE
HEALTH PROFESSIONS
7TH EDITION
• AUTHOR(S)KARIN C. VANMETER;
ROBERT J. HUBERT
TEST BANK
1
Reference
Ch. 1 — Introduction to Pathophysiology — Homeostasis and
Feedback
Stem
A patient’s body temperature falls in a cold environment. The
hypothalamus triggers cutaneous vasoconstriction and
shivering to restore temperature toward normal. Which
description best explains why these responses represent
negative feedback rather than positive feedback?
Options
A. The responses amplify the initial change to produce a greater
,deviation from the set point.
B. The responses detect the change but do not alter the original
stimulus.
C. The responses produce an effect opposite to the initial
perturbation, returning the system toward the set point.
D. The responses create a new set point that becomes the new
baseline.
Correct Answer
C
Rationales
Correct (C): Negative feedback produces effects opposite the
initial disturbance (cold → vasoconstriction/shivering → heat
generation), returning variables toward the physiologic set
point. This mechanistic loop is central to homeostasis as
described in Gould’s introduction.
Incorrect (A): Amplification of the initial change characterizes
positive feedback, not the corrective mechanisms described.
Incorrect (B): Detecting a change without altering it would be a
sensor-only response; here, effectors act to change
temperature.
Incorrect (D): Creating a new set point is not the normal
corrective act of negative feedback; set points are typically
preserved.
Teaching Point
Negative feedback restores equilibrium by producing effects
opposite the initiating change.
,Citation
VanMeter, K. C., & Hubert, R. J. (2024). Gould’s Pathophysiology
for the Health Professions (7th ed.). Ch. 1.
2
Reference
Ch. 1 — Introduction to Pathophysiology — Cellular
Adaptations: Atrophy
Stem
A 72-year-old bedridden patient develops marked muscle
wasting in the lower limb over weeks. Which intracellular
mechanism most directly explains disuse atrophy in skeletal
muscle?
Options
A. Increased cellular apoptosis via extrinsic death-receptor
signaling.
B. Reduced protein synthesis combined with increased
ubiquitin–proteasome degradation of myofibrillar proteins.
C. Persistent hypertrophy of remaining myocytes leading to net
tissue loss.
D. Accumulation of intracellular lipid deposits causing cellular
shrinkage.
Correct Answer
B
, Rationales
Correct (B): Disuse atrophy results from decreased anabolic
signaling and increased protein catabolism; the ubiquitin–
proteasome pathway selectively degrades myofibrillar proteins,
reducing cell size and tissue mass. This mechanism is
emphasized in the cellular adaptation section.
Incorrect (A): Apoptosis contributes to cell loss in some
conditions, but disuse atrophy primarily involves reduced
synthesis and increased proteolysis rather than programmed
cell death.
Incorrect (C): Hypertrophy is growth of cells, not a cause of
tissue loss; it would increase cell size, not produce wasting.
Incorrect (D): Intracellular lipid accumulation causes
dysfunction (steatosis) but is not the mechanism of disuse-
induced muscle shrinkage.
Teaching Point
Disuse atrophy: decreased synthesis + increased ubiquitin–
proteasome degradation of structural proteins.
Citation
VanMeter, K. C., & Hubert, R. J. (2024). Gould’s Pathophysiology
for the Health Professions (7th ed.). Ch. 1.
3
HEALTH PROFESSIONS
7TH EDITION
• AUTHOR(S)KARIN C. VANMETER;
ROBERT J. HUBERT
TEST BANK
1
Reference
Ch. 1 — Introduction to Pathophysiology — Homeostasis and
Feedback
Stem
A patient’s body temperature falls in a cold environment. The
hypothalamus triggers cutaneous vasoconstriction and
shivering to restore temperature toward normal. Which
description best explains why these responses represent
negative feedback rather than positive feedback?
Options
A. The responses amplify the initial change to produce a greater
,deviation from the set point.
B. The responses detect the change but do not alter the original
stimulus.
C. The responses produce an effect opposite to the initial
perturbation, returning the system toward the set point.
D. The responses create a new set point that becomes the new
baseline.
Correct Answer
C
Rationales
Correct (C): Negative feedback produces effects opposite the
initial disturbance (cold → vasoconstriction/shivering → heat
generation), returning variables toward the physiologic set
point. This mechanistic loop is central to homeostasis as
described in Gould’s introduction.
Incorrect (A): Amplification of the initial change characterizes
positive feedback, not the corrective mechanisms described.
Incorrect (B): Detecting a change without altering it would be a
sensor-only response; here, effectors act to change
temperature.
Incorrect (D): Creating a new set point is not the normal
corrective act of negative feedback; set points are typically
preserved.
Teaching Point
Negative feedback restores equilibrium by producing effects
opposite the initiating change.
,Citation
VanMeter, K. C., & Hubert, R. J. (2024). Gould’s Pathophysiology
for the Health Professions (7th ed.). Ch. 1.
2
Reference
Ch. 1 — Introduction to Pathophysiology — Cellular
Adaptations: Atrophy
Stem
A 72-year-old bedridden patient develops marked muscle
wasting in the lower limb over weeks. Which intracellular
mechanism most directly explains disuse atrophy in skeletal
muscle?
Options
A. Increased cellular apoptosis via extrinsic death-receptor
signaling.
B. Reduced protein synthesis combined with increased
ubiquitin–proteasome degradation of myofibrillar proteins.
C. Persistent hypertrophy of remaining myocytes leading to net
tissue loss.
D. Accumulation of intracellular lipid deposits causing cellular
shrinkage.
Correct Answer
B
, Rationales
Correct (B): Disuse atrophy results from decreased anabolic
signaling and increased protein catabolism; the ubiquitin–
proteasome pathway selectively degrades myofibrillar proteins,
reducing cell size and tissue mass. This mechanism is
emphasized in the cellular adaptation section.
Incorrect (A): Apoptosis contributes to cell loss in some
conditions, but disuse atrophy primarily involves reduced
synthesis and increased proteolysis rather than programmed
cell death.
Incorrect (C): Hypertrophy is growth of cells, not a cause of
tissue loss; it would increase cell size, not produce wasting.
Incorrect (D): Intracellular lipid accumulation causes
dysfunction (steatosis) but is not the mechanism of disuse-
induced muscle shrinkage.
Teaching Point
Disuse atrophy: decreased synthesis + increased ubiquitin–
proteasome degradation of structural proteins.
Citation
VanMeter, K. C., & Hubert, R. J. (2024). Gould’s Pathophysiology
for the Health Professions (7th ed.). Ch. 1.
3
