Test Bank Porth Pathophysiology Concepts of Altered Health States 2nd Canadian Edition

Test Bank Porth Pathophysiology Concepts of Altered Health States 2nd Canadian EditionTable of Contents Chapter 01: Concepts of Health and Disease ......................................................................................................................................... 2 Chapter 02: Concepts of Altered Health in Children ............................................................................................................................14 Chapter 03: Concepts of Altered Health in Older Adults .....................................................................................................................19 Chapter 04: Cell and Tissue Characteristics .........................................................................................................................................23 Chapter 05: Cellular Adaptation, Injury, and Death .............................................................................................................................27 Chapter 06: Genetic Control of Cell Function and Inheritance ...........................................................................................................31 Chapter 07: Genetic and Congenital Disorders ....................................................................................................................................35 Chapter 08: Neoplasia .............................................................................................................................................................................38 Chapter 09: Stress and Adaptation .......................................................................................................................................................49 Chapter 10: Alterations in Temperature Regulation ...........................................................................................................................53 Chapter 11: Activity Tolerance and Fatigue..........................................................................................................................................57 Chapter 12: Blood Cells and the Hematopoietic System ....................................................................................................................68 Chapter 13: Disorders of Hemostasis ...................................................................................................................................................72 Chapter 14: Disorders of Red Blood Cells.............................................................................................................................................76 Chapter 15: Disorders of White Blood Cells and Lymphoid Tissues ..................................................................................................80 Chapter 16: Mechanisms of Infectious Disease ...................................................................................................................................84 Chapter 17: Innate and Adaptive Immunity ..........................................................................................................................................88 Chapter 18: Inflammation, Tissue Repair, and Wound Healing .........................................................................................................92 Chapter 19: Disorders of the Immune Response ................................................................................................................................94 Chapter 20: Acquired Immunodeficiency Syndrome ...........................................................................................................................98 Chapter 21: Structure and Function of the Cardiovascular System ............................................................................................... 105 Chapter 22: Disorders of Blood Flow in the Systemic Circulation................................................................................................... 109 Chapter 23: Disorders of Blood Pressure Regulation ...................................................................................................................... 113 Chapter 24: Disorders of Cardiac Function ........................................................................................................................................ 122 Chapter 25: Disorders of Cardiac Conduction and Rhythm ............................................................................................................. 126 Chapter 26: Heart Failure and Circulatory Shock .............................................................................................................................. 135 Chapter 27: Structure and Function of the Respiratory System ..................................................................................................... 139 Chapter 28: Respiratory Tract Infections, Neoplasms, and Childhood Disorders ......................................................................... 142 Chapter 29: Disorders of Ventilation and Gas Exchange ................................................................................................................. 146 Chapter 30: Structure and Function of the Kidney ........................................................................................................................... 150 Chapter 31: Disorders of Fluid and Electrolyte Balance .................................................................................................................. 154 Chapter 32: Disorders of Acid—Base Balance .................................................................................................................................. 158 Chapter 33: Disorders of Renal Function ........................................................................................................................................... 167 1 | P a g eChapter 34: Acute Renal Injury and Chronic Kidney Disease ........................................................................................................... 171 Chapter 35: Disorders of the Bladder and Lower Urinary Tract ...................................................................................................... 175 Chapter 36: Structure and Function of the Gastrointestinal System ............................................................................................. 179 Chapter 37: Disorders of Gastrointestinal Function ......................................................................................................................... 183 Chapter 38: Disorders of Hepatobiliary and Exocrine Pancreas Function ..................................................................................... 187 Chapter 39: Alterations in Nutritional Status .................................................................................................................................... 191 Chapter 40: Mechanisms of Endocrine Control ................................................................................................................................. 194 Chapter 41: Disorders of Endocrine Control of Growth and Metabolism ...................................................................................... 198 Chapter 42: Diabetes Mellitus and the Metabolic Syndrome .......................................................................................................... 202 Chapter 43: Structure and Function of the Male Genitourinary System ........................................................................................ 206 Chapter 44: Disorders of the Male Genitourinary System ............................................................................................................... 210 Chapter 45: Structure and Function of the Female Reproductive System .................................................................................... 218 Chapter 47: Sexually Transmitted Infections .................................................................................................................................... 230 Chapter 48: Organization and Control of Neural Function .............................................................................................................. 234 Chapter 50: Disorders of Motor Function .......................................................................................................................................... 237 Chapter 52: Sleep and Sleep Disorders ............................................................................................................................................. 252 Chapter 53: Disorders of Thought, Mood, and Memory .................................................................................................................. 255 Chapter 54: Disorders of Visual Function .......................................................................................................................................... 261 Chapter 55: Disorders of Hearing and Vestibular Function ............................................................................................................. 270 Chapter 56: Structure and Function of the Musculoskeletal System ............................................................................................. 278 Chapter 57: Disorders of Musculoskeletal Function: Trauma, Infection, and Neoplasms ........................................................... 282 Chapter 58: Disorders of Musculoskeletal Function: Developmental and Metabolic Disorders ................................................. 286 Chapter 59: Disorders of Musculoskeletal Function: Rheumatic Disorders .................................................................................. 290 Chapter 60: Structure and Function of the Skin ................................................................................................................................ 298 Chapter 61: Disorders of Skin Integrity and Function ...................................................................................................................... 302 Chapter 01: Concepts of Health and Disease MULTIPLE CHOICE 1. Which of the following would be the most likely cause of an iatrogenic disease? a. b. 2 | P a g e An inherited disorder A combination of specific etiological factorsc. d. An unwanted effect of a prescribed drug Prolonged exposure to toxic chemicals in the environment ANS: C REF: 6 2. The manifestations of a disease are best defined as the: a. subjective feelings of discomfort during a chronic illness. b. c. d. signs and symptoms of a disease. factors that precipitate an acute episode of a chronic illness. early indicators of the prodromal stage of infection. ANS: B REF: 6 3. The best definition of the term prognosis is the: a. precipitating factors causing an acute episode. b. c. d. number of remissions to be expected during the course of a chronic illness. predicted outcome or likelihood of recovery from a specific disease. exacerbations occurring during chronic illness. ANS: C REF: 7 4. Which of the following is considered a systemic sign of disease? a. Swelling of the knee b. c. Fever Pain in the neck 3 | P a g ed. Red rash on the face ANS: B REF: 6 5. Etiology is defined as the study of the: a. causes of a disease. b. c. d. course of a disease. expected complications of a disease. manifestations of a disease. ANS: A REF: 5 6. A type of cellular adaptation in which there is a decrease in cell size is referred to as: a. hypertrophy. b. c. d. metaplasia. anaplasia. atrophy. ANS: D REF: 8 7. A change in a tissue marked by cells that vary in size and shape and show increased mitotic figures would be called: a. b. c. d. 4 | P a g e metaplasia. atrophy. dysplasia. hypertrophy.ANS: C REF: 8 8. A deficit of oxygen in the cells usually due to respiratory or circulatory problems is called: a. apoptosis. b. c. d. ischemia. hypertrophy. necrosis. ANS: B REF: 9 9. When a group of cells in the body dies, the change is called: a. ischemia. b. c. d. ANS: D REF: 10 10. Rigorous weight lifting/body building regimens may result in the skeletal muscle cells undergoing: a. hypertrophy. b. c. d. ANS: A REF: 8 5 | P a g e dysplasia. atrophy. regeneration. gangrene. hypoxia. necrosis.11. The term cancer refers to: a. b. c. d. dysplasia. hyperplasia. metaplasia. malignant neoplasm. ANS: D REF: 9 12. To which of the following does the term apoptosis refer? a. Increased rate of mitosis by certain cells b. c. d. Ischemic damage to cells Liquefaction of necrotic tissue Preprogrammed cell self-destruction ANS: D REF: 9 13. Which of the following statements is TRUE? a. Alteration of DNA does not change cell function. c. d. All types of cells die at the same rate. Mild ischemia causes immediate cell death. ANS: B REF: 10 14. Caseation necrosis refers to an area where: a. cell proteins have been denatured. b. 6 | P a g e cell are liquefied by enzymes.c. dead cells form a thick cheesy substance. d. bacterial invasion has occurred. ANS: C REF: 10 15. Routine application of sun block to skin would be an example of: a. an iatrogenic cause of cancer. b. c. d. a preventive measure. a precipitating factor. a predisposing condition. ANS: B REF: 6 16. A circumstance that causes a sudden acute episode of a chronic disease to occur is termed: a. latent stage. b. d. predisposing factor. precipitating factor. ANS: D REF: 7 17. The term homeostasis refers to: a. the causative factors in a particular disease. b. c. d. 7 | P a g e maintenance of a stable internal environment. a condition that triggers an acute episode. a collection of signs and symptoms.ANS: B REF: 2 18. Which term is used to describe a new and secondary or additional problem that arises after the original disease has been established? a. Symptoms b. c. d. Occurrence Manifestations Complication ANS: D REF: 7 19. Pathophysiology involves the study of: a. the structure of the human body. b. c. the functions of various organs in the body. functional or structural changes resulting from disease processes. ANS: C REF: 2 20. Which of the following is the best definition of epidemiology? a. The science of tracking the occurrence and distribution of diseases b. c. d. The relative number of deaths resulting from a particular disease Identification of a specific disease through evaluation of signs and symptoms The global search for emerging diseases ANS: A REF: 7 21. Which of the following can cause cell injury or death? 1. Hypoxia 8 | P a g e2. Exposure to excessive cold 3. Excessive pressure on a tissue 4. Chemical toxins a. 1, 2 b. c. d. 2, 4 1, 3, 4 1, 2, 3, 4 ANS: D REF: 9 22. All of the following are part of the Seven Steps to Health EXCEPT: a. follow cancer screening guidelines. b. c. d. use sun block agents whenever exposed. participate in strenuous exercise on a regular daily basis. choose high fiber, lower fat foods. ANS: C REF: 2 23. The term disease refers to: a. the period of recovery and return to a normal healthy state. b. c. d. ANS: B REF: 2 9 | P a g e a deviation from the normal state of health and function. the treatment measures used to promote recovery. a basic collection of signs and symptoms.24. A collection of signs and symptoms, often affecting more than one organ or system, that usually occur together in response to a certain condition is referred to as a (an): a. b. c. d. acute disease. multiorgan disorder. syndrome. manifestation. ANS: C REF: 7 25. All of the following statements are correct about cell damage EXCEPT: a. The initial stage of cell damage often causes an alteration in metabolic reactions. If the factor causing the damage is removed quickly, the cell may be able to recover and return to its b. c. d. normal state. If the noxious factor remains for an extended period of time, the damage becomes irreversible and the c dies. Initially, cell damage does not change cell metabolism, structure, or function. ANS: D REF: 9 26. Which of the following conditions distinguishes double blind studies used in health research? Neither the members of the control group or the experimental group nor the person administering the a. b. treatment knows who is receiving the experimental therapy. Both groups of research subjects and the person administering the treatment know who is receiving the experimental therapy. The research subjects do not know, but the person administering the treatment knows who is receiving c. d. 10 | P a g e placebo or standard therapy. Only members of the control group know they are receiving standard therapy.ANS: A REF: 3 | 4 27. If the data collected from the research process confirm that the new treatment has increased effectiveness and is safe, this is called: a. the placebo effect. b. c. d. evidence-based research. blind research studies. approval for immediate distribution. ANS: B REF: 4 28. A short-term illness that develops very quickly with perhaps a high fever or severe pain is called: a. acute. b. c. d. latent. chronic. manifestation. ANS: A REF: 6 29. The term prognosis refers to the: a. period of recovery and return to a normal state. b. c. d. expected outcome of the disease. mortality and morbidity rates for a given population. typical collection of signs and symptoms. ANS: B REF: 7 30. When prolonged ischemia occurs to an area of the heart, the resulting damage is referred to as: 11 | P a g ea. atrophy. b. c. d. ANS: D REF: 10 31. During the evaluation process for a new therapys effectiveness and safety, a double blind study may be conducted during: a. the first stage. c. d. the third stage. any of these stages. ANS: C REF: 3 32. Why are the predisposing factors for a specific disease important to health professionals? a. To predict the prognosis b. c. d. To determine treatments To develop preventive measures To develop morbidity statistics ANS: C REF: 3 33. Cell damage may be caused by exogenous sources such as: a. abnormal metabolic processes. b. 12 | P a g e certain food additives. liquefactive necrosis. apoptosis. infarction.c. genetic defects. d. localized hypoxia. ANS: B REF: 9 | 10 34. Which of the following is usually included in a medical history? 1. Past illnesses or surgeries 2. Current illnesses, acute and chronic 3. Prescribed medication or other treatments 4. Nonprescription drugs and herbal remedies a. 1, 3 b. c. d. ANS: D REF: 4 | 5 35. A situation when there is a higher than expected number of cases of an infectious disease within a given area is called a/an: a. epidemic. b. c. d. ANS: A REF: 7 36. The term pathogenesis refers to: 13 | P a g e exacerbation. morbidity. pandemic. 2, 4, 5 1, 3, 4 1, 2, 3, 4, 5a. b. c. d. the development of a disease or sequence of events related to tissue changes involved in the disease process. the determination of the cause(s) involved in the development of a malignant neoplasm. the specific signs and symptoms involved in the change from an acute disease to a chronic disease. the changes in cells of affected tissue that result in necrosis. Chapter 02: Concepts of Altered Health in Children MULTIPLE CHOICE 1. The biological changes associated with adolescence are stimulated primarily by: a. b. c. d. the peripheral nervous system. the thalamus. increased secretion of estrogen and progesterone. the pituitary gland. ANS: D REF: 592 2. What is a lateral curvature of the spine called? a. Lordosis b. c. d. ANS: C REF: 595 3. How is scoliosis identified? 14 | P a g e Kyphosis Scoliosis Kyphoscoliosisa. b. c. d. Bowed or hunched-over position of head and shoulders Unevenly aligned hips and shoulders A swayback posture One arm and leg shorter than the other ANS: B REF: 595 4. What are common local signs of osteomyelitis? a. Joint swelling, limited movement b. c. d. ANS: D REF: 597 5. Which of the following comprise typical early signs of Stills disease, a form of juvenile rheumatoid arthritis? 1. Presence of rheumatoid factor in the blood 2. High fever and skin rash 3. Swollen painful knees, wrists, and elbows 4. Deformity of the hands and feet a. 1, 3 b. c. d. 15 | P a g e 1, 4 2, 3 2, 4 Deformity of a limb, pain at rest Fever, leukocytosis, and malaise A red, swollen area, pain increasing with movementANS: C REF: 597 6. Which of the following might fluid and electrolyte deficits cause in a patient with anorexia nervosa? a. Cardiac arrhythmias b. c. d. Weight loss Dental caries and esophagitis Amenorrhea ANS: A REF: 598 7. Bulimia nervosa is characterized by: a. a refusal to eat. b. c. d. extreme weight loss. alternating binge eating and purging. chronic diarrhea. ANS: C REF: 598 8. Acne vulgaris can best be described as an infection involving the: a. sweat glands of the upper body. b. c. d. dermis and epidermis of the skin. apocrine glands. sebaceous glands and hair follicles. ANS: D REF: 599 9. Infectious mononucleosis can be diagnosed by the presence of: 16 | P a g ea. b. c. d. sore throat, fever, and lymphadenopathy. abnormal lymphocytes and positive antibody test. the causative bacteria in the saliva. extreme fatigue and malaise. ANS: B REF: 599-600 10. Which statement applies to testicular cancer? b. It is related to chromosome abnormalities such as monosomy X. c. d. The tumor presents as a painful red lump in the scrotum. The cancer usually causes sterility. ANS: A REF: 600 11. An autoimmune disease that causes chronic inflammation in the joints of children is: a. lordosis. b. c. d. juvenile rheumatoid arthritis (JRA). osteomyelitis. metabolic syndrome. ANS: B REF: 597 12. Which of the following would confirm reduced normal linear growth during adolescence? a. Levels of androgens b. 17 | P a g e Abnormally thin epiphyseal plate seen on X-rayc. d. Lack of a broader pelvis in males Development of kyphosis ANS: B REF: 593 13. Obesity in adolescents is: a. determined by calculating body mass index (BMI). c. d. related to increased intake of high fat and high carbohydrate snacks, fast foods. All of the above ANS: D REF: 593-594 14. Three factors common to metabolic syndrome include: presence of significant abdominal fat mass, changes in glucose metabolism, and changes in lipoprotein a. b. metabolism. increased fat mass throughout the body, changes in glucose metabolism, and delayed sexual maturation significant increase of fat on hips and thighs, delayed linear growth, and change in calcium and vitamin c. d. metabolism. BMI at the 85th percentile, type 2 diabetes mellitus, and hypertension. ANS: A REF: 594 15. Infectious mononucleosis is characterized by all EXCEPT: a. sore throat, fever, fatigue, malaise, and rash on trunk. b. c. 18 | P a g e enlarged lymph nodes (lymphadenopathy) and spleen (splenomegaly). increased occurrence in infants and young children.d. the presence of atypical T lymphocytes. Chapter 03: Concepts of Altered Health in Older Adults MULTIPLE CHOICE 1. All of the following changes are associated with aging EXCEPT: a. c. d. loss of elastic fibers. decreased secretion of all hormones. degenerative vascular changes. ANS: C REF: 604 2. Predisposing factors to osteoporosis in older women include all of the following EXCEPT: a. decreased estrogen secretion. b. c. d. genetic factors. sedentary lifestyle. decreased parathyroid hormone. ANS: D REF: 606 3. Lung expansion in the elderly may be reduced because of decreased: 1. tissue elasticity. 2. rib mobility. 3. control by the respiratory center. 4. skeletal muscle strength. a. 1, 3 b. 1, 4 19 | P a g ec. 2, 3, 4 d. 1, 2, 4 ANS: D REF: 607 4. Vision in the elderly may be impaired when the eyeball becomes less elastic, thus preventing accommodation and resulting in: a. b. c. d. presbyopia. cataracts. glaucoma. damage to the retina. ANS: A REF: 608 5. What is a major factor leading to increased occurrence of cancer in the elderly? a. Widespread vascular degeneration b. c. d. Cumulative exposure to carcinogens Hereditary factors Increased immune surveillance ANS: B REF: 609 6. Senescence refers to the period of time when: a. mitosis is accelerated. b. c. 20 | P a g e apoptosis is reduced. aging changes become apparent.d. cell death exceeds cell replacement. ANS: D REF: 603 7. Theories about the causes of aging include: b. wear and tear. c. d. ANS: D REF: 604 8. Which of the following does NOT contribute to the increasing life span of the general population? a. Reduced cognitive and social activities b. c. d. ANS: A REF: 603 9. The term given to the change that occurs in women at around age 50 with the cessation of the menstrual cycle is: a. menopause. b. c. d. 21 | P a g e dysmenorrhea. amenorrhea. menarche. Improved living conditions Better nutrition Advancements in health care altered protein (amyloid) accumulation. All the aboveANS: A REF: 604 10. Recommendations to reduce the risk factors and the progression of osteoporosis with aging include: b. maintaining walking and weight-bearing exercise. c. d. increasing bone resorption. maintaining glucocorticoid therapy. ANS: B REF: 607 11. All are physiological changes that occur with aging EXCEPT: a. reduced skeletal muscle mass. b. c. d. degeneration of fibrocartilage in intervertebral discs in the spine. increased basal metabolic rate (BMR). reduced bladder capacity and incomplete bladder emptying. ANS: C REF: 607 | 609 12. With advancing age, the major change in the cardiovascular system involves: a. irregular impulse conduction in the heart. b. c. d. a reduced number of collagen fibers to support cardiac muscle. vascular degeneration, leading to arteriosclerosis and atherosclerosis. the heart valves becoming thin and weak. ANS: C REF: 605 13. Which of the following factors lead to delayed wound healing in the elderly? 1. Reduced rate of mitosis 22 | P a g e2. Inadequate circulation 3. High risk of infection 4. More effective immune system a. b. c. d. ANS: D REF: 609 14. Which of the following may develop in an elderly patient who has several medical problems and is markedly obese? a. Osteoarthritis and cardiovascular complications b. c. d. Decreased activity and diabetes mellitus Undesirable interactions with multiple prescription drugs and over-the-counter (OTC) medications A, B, and C Chapter 04: Cell and Tissue Characteristics 1. 1, 2 1, 3 2, 4 1, 2, 3 The nucleus , which is essential for function and survival of the cell. A) B) C) D) 2. A) B) 23 | 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.C) D) 3. A) B) C) D) 4. A) B) C) D) 5. A) B) C) D) 6. A) B) C) D) 7. A) B) C) D) 8. A) B) C) D) 9. A) 24 | P a g e 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. 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 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 into the extracellular fluid. 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 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 membran Connective tissue contains fibroblasts that are responsible for: providing a fibrous framework for capillaries.B) C) D) 10. A) B) C) D) synthesis of collagen, elastin, and reticular fibers. forming tendons and the fascia that covers muscles. filling spaces between tissues to keep organs in place. Although all muscle tissue cells have some similarities, smooth muscle (also known as involuntary muscle) differs by: 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 (rRN A) Copying and carrying DNA instructions for protein synthesis B) C) D) 12. A) B) C) D) 13. A) B) C) D) Carrying amino acids to the site of protein synthesis Providing the site where protein synthesis occurs Regulating and controlling protein synthesis Breakdown and removal of foreign substances and worn-out cell parts are performed by which of th following organelles? 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. insufficient energy production within a cell. accumulation of free radicals in the cytoplasm. 14. A) B) C) D) 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 coup inability to become pregnant. Which of the following cellular components may be defective within mans sperm? Ribosomes Microtubules Mitochondria Microfilaments 15. Which of the following statements is true of glycolysis? A) B) 25 | P a g e Glycolysis requires oxygen. Glycolysis occurs in cells without mitochondria.C) D) 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) B) C) D) A male patient with a diagnosis of type 1 diabetes mellitus is experiencing hyperglycemia because h 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? Facilitated diffusion Simple diffusion Secondary active transport Endocytosis 18. Which of the following statements is true of skeletal muscle cells? A) B) C) D) Skeletal muscle cells each have an apical, lateral, and basal surface. 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) B) C) D) 20. A) B) C) D) Answer Key 1. 2. 3. 4. 5. 26 | P a g e The squamous epithelial cells of the skin The connective tissue supporting blood vessels The skeletal muscle that facilitates movement The nervous tissue that constitutes the central nervous system A patient with a pathophysiologic condition that affects the desmosomes is most likely to exhibit: 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. B C A D B6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. C A C B A C A D B B C A D A D Chapter 05: Cellular Adaptation, Injury, and Death 1. Ischemia and other toxic injuries increase the accumulation of intracellular calcium as a result of: A) B) C) D) 2. A) B) C) D) 3. A) B) C) D) 27 | P a g e 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 reduced size of the liver leads to of the remaining liver cells. metaplasia organ atrophy compensatory hyperplasia physiologic hypertrophy A person eating peanuts starts choking and collapses. His airway obstruction is partially cleared, but remains hypoxic until he reaches the hospital. The prolonged cell hypoxia caused a cerebral infarctio and resulting in the brain. caspase activation coagulation necrosis rapid phagocytosis protein p53 deficiency4. A) B) C) D) 5. A) B) C) D) 6. A) B) C) D) 7. A) B) C) D) 8. A) B) C) D) 9. A) B) C) D) 10. 28 | P a g e Bacteria and viruses cause cell damage by caused by other injurious agents. , which is unique from the intracellular damage 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: 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 piec glass, the wound does not heal, and the area tissue becomes necrotic. The necrotic cell death is characterized by: rapid apoptosis. cellular rupture. shrinkage and collapse. chronic inflammation. 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. A) B) C) D) 12. A) B) C) D) An 89-year-old female patient has experienced significant decreases in her mobility and stamina du a 3- week hospital stay for the treatment of a femoral head fracture. Which of the following phenom most likely accounts for the patients decrease in muscle function that underlies her reduced mobility 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 A 20-year-old college student has presented to her campus medical clinic for a scheduled Papanicol (Pap) smear. The clinician who will interpret the smear will examine cell samples for evidence of: 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 calcificatio A) B) C) D) 14. A) B) C) D) 15. A) B) C) D) 29 | P a g e Benign prostatic hyperplasia Liver cirrhosis Impaired glycogen metabolism Hyperparathyroidism Despite the low levels of radiation used in contemporary radiologic imaging, a radiology technician aware of the need to minimize her exposure to ionizing radiation. What is the primary rationale for t technicians precautions? 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. The parents of a 4-year-old girl have sought care because their daughter has admitted to chewing an swallowing imported toy figurines that have been determined to be 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 A 70-year-old male patient has been admitted to a hospital for the treatment of a recent hemorrhagic stroke16. A) B) C) D) 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? 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) 18. A) B) C) D) 19. 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 The extrinsic pathway of apoptosis can be initiated by: damage to cellular DNA. decreased ATP levels. activation of the p53 protein. activation of death receptors on the cell surface. A patient with severe peripheral vascular disease has developed signs of dry gangrene on the great t of one foot. Which of the following pathophysiologic processes most likely contributed to this diagnosis? 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? Genes controlling longevity are present or absent in varying quantities among different A) B) C) D) Answer Key 1. 2. 3. 4. 5. 6. 30 | P a g e A C B C A B 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.7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. C B B A C A D C B B A D C B Chapter 06: Genetic Control of Cell Function and Inheritance 1. Triplet codes of three bases are the genetic codes used in transmitting genetic information necessary f A) B) C) D) 2. A) B) C) D) 3. A) B) C) D) 4. A) B) 31 | P a g e chromatin formation. protein synthesis. enzyme activation. nucleotide bonding. Unlike messenger RNA (mRNA) and transfer RNA (tRNA), ribosomal RNA (rRNA): is produced in the nucleolus. delivers activated amino acids. is formed by transcription. coordinates RNA translation. Splicing of mRNA during processing permits a cell to: form different proteins. increase DNA content. stop copying DNA onto RNA. add nucleic acid end pieces. When an infant is born with gene mutations in his/her cells, the errors may be a result of all of the following except of base pairs. deletion substitutionC) D) 5. A) B) C) D) 6. A) B) C) D) 7. A) B) C) D) 8. A) B) C) D) 9. A) B) C) D) 10. A) B) C) D) differentiation rearrangement Identifying the genetic sex of a child is based on finding intracellular Barr bodies that consist of: inactive chromatin material. male-specific chromosomes. homologous chromosomes. excess autosomal material. Multifactorial inheritance is similar to polygenic inheritance because both involve: environmental effects on alleles. multiple alleles at different loci. predictable somatic allele effects. homozygous pairing of two alleles. Crossing over of chromatid segments during meiosis division 1 results in: spontaneous gene mutations. initial DNA synthesis. bivalent X and Y genes. new gene combinations. During the transcription process, RNA: polymerase attaches to DNA. exon sequences are reversed. delivers activated amino acids. reverses redundant base pairs. The process of gene expression is increased by: mutation of normal suppressor genes. induction by an external influence. repression of internal penetrance. activation of growth control genes. Gene therapy, insertion of genes into the genome of multicellular organisms, is accomplished by: restriction enzymes. transferring genes. DNA fragment separation. cross-over gene exchange. 11. Which of the following statements is true of genetic mutations? A) B) 32 | P a g e Errors in DNA duplication are normally irreparable. Mutations that occur in somatic cells are inheritable.C) D) Mutations may result from extrinsic factors or from spontaneous error. Errors in DNA replication are most often fatal. 12. A) B) C) D) Individual differences in appearance, behavior, and disease susceptibility are a result of: karyotyping. mutations. DNA repair. a haplotype. 13. Which of the following statements is true of messenger RNA (mRNA)? A) B) C) D) 14. A) B) C) D) mRNA is produced in the nucleolus. mRNA provides the template for protein synthesis. Each mRNA molecule has two recognition sites. mRNA delivers the activated form of an amino acid to the protein being synthesized. Prenatal genetic testing that counts the number of Barr bodies in a chromosome is able to determine the genetic sex of a child. susceptibility to hemophilia B. the presence of fragile X syndrome. fetal viability. The gene responsible for a particular congenital cardiac anomaly is said to have complete penetranc 15. What are the clinical implications of this fact? A) B) C) D) 16. A) B) C) D) The anomaly is a result of polygenetic inheritance. The heart defect does not result from any other gene. Multiple alleles contribute to the defect. All the individuals who possess the gene will exhibit the anomaly. A dominant genetic trait: is expressed only in a heterozygous pairing. is expressed in either a homozygous or heterozygous pairing. is expressed only in a homozygous pairing. is expressed in some carriers. 17. Which of the following methods of genetic mapping focuses on the measurement of enzyme activit A) B) C) D) Hybridization studies Haplotype mapping Linkage studies Gene dosage studies 18. Which of the following facts underlies the application of RNA interference in the treatment of disea A) 33 | P a g e Restriction enzymes are able to cleave genetic molecules at predictable sites.B) C) D) 19. A) B) C) D) It is possible to produce proteins that have therapeutic properties. Faulty gene activity that produces unwanted proteins can sometimes be stopped. Individual differences are attributable to a very small percentage of the genes in the human bo Although the majority of cellular DNA exists in the cell nucleus, part of the cell DNA is located in t mitochondria. Golgi apparatus. smooth endoplasmic reticulum. microfilaments. 20. Which of the following is an application of recombinant DNA technology? A) B) C) D) Answer Key 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 34 | P a g e B A A C A B D A B B C D B A D B D C A A Production of human insulin DNA fingerprinting Gene dosage studies Somatic cell hybridizationChapter 07: Genetic and Congenital Disorders 1. Genetic disorders that involve a single gene trait are characterized by: A) B) C) D) 2. A) B) C) D) 3. A) B) C) D) multifactorial gene mutations. chromosome rearrangements. Mendelian patterns of transmission. abnormal numbers of chromosomes. In addition to having a 50% chance of inheriting an autosomal dominant disorder from an affected pa such a disorder is characterized by: aneuploidy of genes in all cells. deficiencies in enzyme synthesis. affected X transmission to daughters. varied gene penetration and expression. Autosomal recessive disorders are characterized by: age of onset later in life. abnormal protein structure. inborn errors of metabolism. one in two risk of a carrier child. 4. When a male child inherits an X-linked disorder from his heterozygous carrier mother, A) B) C) D) 5. A) B) C) D) 6. A) B) C) D) 7. 35 | P a g e his sons will be carriers. his father has the disorder. some of his sisters will be carriers. his daughters will have the disorder. Multifactorial inheritance disorders, such as cleft palate, are often caused by development. multiple gene mutations dominant gene expression X-linked crossover problem polyploidy of chromosomes The newborn has the distinctive physical features of trisomy 21, Down syndrome, which includes: upward slanting of eyes. large, protruding ears. thin lips and small tongue. long fingers with extra creases. Aneuploidy of the X chromosome can result in a monosomy or polysomy disorder. The manifestation monosomy X, Turner syndrome, differ from polysomy X disorders in numerous ways that include: during feA) B) C) D) 8. A) B) C) D) 9. A) B) C) D) 10. A) B) C) D) 11. A) B) C) D) short-stature female individual.. mental retardation. enlarged breasts. early onset puberty. A teratogenic environmental agent can cause birth defects when: inherited as a recessive trait. intense exposure occurs at birth. disjunction occurs during meiosis. retained during early pregnancy. Fetal alcohol syndrome (FAS) is unlike other teratogens in that the harmful effects on the fetus: directly result in liver damage. extend throughout the pregnancy. is most noticeable in adulthood. cause death in early childhood. Prenatal diagnosis methods include the use of ultrasonography for identifying cytogenic skeletal chromosomal a-fetoprotein A woman who is a carrier for which of the following diseases possesses the greatest likelihood of passing the disease to her future children when heterozygous pairing exists? Phenylketonuria (PKU) Tay-Sachs disease Neurofibromatosis Cystic fibrosis 12. Which of the following statements is true of autosomal recessive disorders? A) B) C) D) 13. A) B) 36 | P a g e Onset is typically late in childhood or early in adulthood. Symptomatology is less uniform than with autosomal dominant disorders. Mitochondrial DNA is normally the site of genetic alteration. Effects are typically the result of alterations in enzyme function. The parents of a newborn infant are relieved that their baby was born healthy, with the exception of cleft lip that will be surgically corrected in 10 or 12 weeks. Which of the nurses following statemen the parents best conveys the probable cause of the infants cleft lip? Though you are both healthy, you likely both carry the gene for a cleft lip. Provided one of you had the gene for a cleft lip, your baby likely faced a 50/50 chance of hav one. abnormalitC) Your childs cleft lip likely results from the interplay between environment and genes. A cleft lip can sometimes result from taking prescription drugs, even when theyre taken as D) 14. A) B) C) D) 15. A) B) C) D) 16. A) B) C) D) ordered. Which of the following practitioners is most likely to be of assistance in the early care of an infant w a cleft lip? Lactation consultant Respiratory therapist Occupational therapist Social worker A 41-year-old woman has made the recent decision to start a family, and is eager to undergo testing mitigate the possibility of having a child with Down syndrome. Which of the following tests is mos likely to provide the data the woman seeks? Genetic testing of the woman Genetic testing of the woman and the father Prenatal blood tests Ultrasonography Genetic testing has revealed that a male infant has been born with an extra X chromosome. What ar most likely implications of this finding? The child is unlikely to survive infancy The child is likely to have no manifestations of this chromosomal abnormality The child will have significant neurological and cognitive defects The child will be unable to reproduce 17. Which of the following variables determine the extent of teratogenic drug effects? Select all that ap A) B) C) D) E) 18. A) B) C) D) Maternal health history Molecular weight of the drug Stage of pregnancy when the drug was taken Duration of drug exposure Fetal blood type A woman who has just learned that she is pregnant for the first time has sought advice from her healthcare provider about the safe use of alcohol during pregnancy. What advice should the clinicia provide to the woman? Its likely best to eliminate alcohol from your diet while youre pregnant. Moderation in alcohol use is critical while you are pregnant. You should limit yourself to a maximum of one drink daily while youre pregnant. You should drink no alcohol until you are in your second trimester. 19. Which of the following health problems may be identified by a TORCH screening test? A) 37 | P a g e Rubella and herpesB) C) D) Tenovaginitis and human papillomavirus Rhinovirus and Ormond disease Chlamydia and rickets 20. A) B) C) D) Answer Key 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. Ultrasonography is most likely to detect which of the following fetal abnormalities? Neural tube defects Skeletal abnormalities Chromosomal defects Single-gene disorders C D C C A A A D B B C D C A C B B, C, D A A B Chapter 08: Neoplasia MULTIPLE CHOICE 1. What is a benign neoplasm originating from adipose tissue called? a. 38 | P a g e Adenomab. Lipoma c. d. Fibrosarcoma Adenocarcinoma ANS: B REF: 550 2. What are malignant neoplasms arising from connective tissue cells called? a. b. c. d. Carcinomas Sarcomas Melanomas Fibromas ANS: B REF: 550 3. Which of the following is a characteristic of a benign tumor? a. It is unencapsulated and invasive. b. c. d. It consists of undifferentiated cells. It exerts systemic effects. Cells appear relatively normal. ANS: D REF: 550 4. Which factor provides the basis for the grading of newly diagnosed malignant tumors? a. Size of the tumor b. 39 | P a g e Number of metastasesc. Degree of differentiation of the cells d. Number of lymph nodes involved ANS: C REF: 551 5. A warning sign of possible cancer would be any of the following EXCEPT: a. persistent, unusual bleeding. c. d. sudden development of fever, nausea, and diarrhea. a change in shape, color, or surface of a skin lesion. ANS: C REF: 552 6. The common local effects of an expanding tumor mass include: 1. obstruction of a tube or duct. 2. anemia and weight loss. 3. cell necrosis and ulceration. 4. tumor markers in the circulation. a. 1, 2 b. c. d. 1, 3 2, 4 3, 4 ANS: B REF: 552 7. Which of the following does paraneoplastic syndrome refer to? a. The effects of substances such as hormones secreted by the tumor cells b. 40 | P a g e Severe weight loss and cachexia associated with advanced cancerc. d. The decreased resistance to infection resulting from malignant tumors The effects of multiple metastatic tumors ANS: A REF: 553 8. Which term refers to the spread of malignant cells through blood and lymph to distant sites? b. Seeding c. d. Metastasis Systemic effect ANS: C REF: 554 9. One reason for staging a malignant tumor at the time of diagnosis is to: a. identify the original cell from which the tumor developed. b. c. d. locate and identify the primary tumor. decide the initiating factor for a particular tumor. determine the best treatment and prognosis. ANS: D REF: 556 10. The process of carcinogenesis usually begins with: a. exposure to promoters causing dysplasia. b. c. d. 41 | P a g e development of defective genes. an irreversible change in the cell DNA. a single exposure to a known risk factor causing temporary cell damage.ANS: C REF: 557 11. What would be an external source of ionizing radiation? a. A needle containing a radioisotope implanted beside the tumor c. d. A dose of a radioactive drug to be ingested A fluid containing radioactive material instilled in a body cavity ANS: B REF: 560 12. Radiation therapy destroys: a. all cells in the tumor at one time. b. c. d. the cells in the center of the tumor. primarily rapidly dividing cells. radioresistant cells. ANS: C REF: 560 13. The most critical adverse effects of chemotherapy and radiation therapy are: a. thrombocytopenia and leucopenia. b. c. d. headache and lethargy. nausea and constipation. alopecia and weight loss. ANS: A REF: 567 14. Chemotherapy usually involves a combination of drugs in order to: 1. reduce the adverse effects. 42 | P a g e2. guarantee that all cancer cells are destroyed. 3. be effective in more phases of the cell cycle. 4. totally block the mitotic stage. b. c. d. ANS: A REF: 561 15. Why does ovarian cancer have a poor prognosis? a. 1, 4 2, 3 3, 4 The ovaries are inaccessible for examination. b. c. d. Specific signs rarely appear until after secondary tumors have developed. The same tumor markers are present with many types of cancer. No effective treatment is available. ANS: B REF: 565 16. Select the correct pair representing a malignant tumor and its marker: a. colon cancer: carcinoembryonic antigen (CEA) b. c. d. hepatic cancer: CA125, AFP prostate cancer: human chorionic gonadotropin (hCG) testicular cancer: Philadelphia chromosome ANS: A REF: 553 17. Antiangiogenesis drugs act on a malignant tumor by: 43 | P a g ea. c. d. promoting the immune response and removal of abnormal tumor cells. reducing blood flow and nutrient supply to tumor cells. transporting radioisotopes into the tumor. ANS: C REF: 563 18. The development of neutropenia during chemotherapy for cancer means: a. the cancer cells are being destroyed quickly. b. c. d. the patient is likely to hemorrhage. higher doses of chemotherapy could be tolerated by this patient. the patient is at high risk for infection. ANS: D REF: 562 19. Malignant brain tumors: a. metastasize quickly to all parts of the body. b. c. d. spread first to lungs and bone. spread to other parts of CNS. do not metastasize anywhere at any time. ANS: C REF: 565-566 20. Identify the common dose-limiting factor for chemotherapy: a. Alopecia b. d. 44 | P a g e Bone marrow depression Weight lossANS: B REF: 562 21. Glucocorticoids are often prescribed during a course of chemotherapy and radiation because: a. glucocorticoids greatly potentiate the effect of chemotherapy. b. c. d. the immune system is stimulated. skeletal muscle atrophy will be decreased. inflammation around the tumor may be reduced. ANS: D REF: 563 22. Vomiting frequently follows a chemotherapy treatment because: a. the gastrointestinal tract is irritated. b. c. d. the chemicals stimulate the emetic center. the drugs have an unpleasant odor. A and B ANS: D REF: 562 23. What type of normal cells are often damaged during chemotherapy and radiation treatments? a. Epithelial cells b. c. Skeletal muscle cells Nerve tissue ANS: A REF: 561 24. Remission for cancer is generally defined as a period in which: a. chemotherapy cannot be used. 45 | P a g eb. signs and symptoms are absent. c. d. complications are evident. metastases occur. ANS: B REF: 564 25. All of the following are correct statements about skin cancers EXCEPT: a. They are difficult to diagnose and treat. b. c. d. They usually develop slowly on the head, neck, or back of individuals with fair skin. The number of skin cancer cases is increasing. Basal cell carcinoma is the most common form of skin cancer. ANS: A REF: 564 26. High risk factors for cancer include: 1. human papilloma virus. 2. chronic irritation and inflammation. 3. repeated sun exposure. 4. high family incidence. a. b. d. ANS: D REF: 556 | 557 27. The term apoptosis refers to: 46 | P a g e 1, 3 3, 4 1, 2, 3, 4a. b. c. d. programmed cell death. abnormal or immature cells. degree of differentiation of cells. the development of new capillaries in a tumor. ANS: A REF: 549 28. The warning signs for cancer include: a. unusual bleeding. b. c. d. ANS: D REF: 552 29. A classification process that applies to a specific malignant tumor and describes the extent of the disease at a given time is called: a. seeding. b. c. mutation. staging. ANS: C REF: 556 30. Benign tumors can often be differentiated from malignant tumors because benign tumors: a. often have systemic effects. b. 47 | P a g e contain cells showing increased mitosis and atypical rapid growth. change in a wart or mole (e.g., color). a new solid lump, often painless. All the above