"Student Review Questions for
Pathophysiology – All 50 Chapters (8th
Edition)"
Full-Chapter Pathophysiology Test Bank:
Adult and Pediatric Disorders (McCance &
Huether, 8 th edition)"
,
,Table of Contents
1. Cellular Biology
2. Altered Cellular and Tissue Biology: Environmental Agents
3. The Cellular Environment: Fluids and Electrolytes, Acids and Bases
4. Genes and Genetic Diseases
5. Genes, Environment-Lifestyle, and Common Diseases
6. Epigenetics and Disease
7. Innate Immunity: Inflammation
8. Adaptive Immunity
9. Alterations in Immunity and Inflammation
10. Infection
11. Stress and Disease
12. Cancer Biology
13. Cancer Epidemiology
14. Cancer in Children
15. Structure and Function of the Neurologic System
16. Pain, Temperature Regulation, Sleep, and Sensory Function
17. Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function
18. Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction
19. Neurobiology of Schizophrenia, Mood Disorders, and Anxiety Disorders
20. Alterations of Neurologic Function in Children
21. Mechanisms of Hormonal Regulation
,22. Alterations of Hormonal Regulation
23. Obesity and Disorders of Nutrition
24. Structure and Function of the Reproductive Systems
25. Alterations of the Female Reproductive System
26. Alterations of the Male Reproductive System
27. Reproductive Function in Children
28. Structure and Function of the Hematologic System
29. Alterations of Erythrocyte, Platelet, and Hemostatic Function
30. Alterations of Leukocyte and Lymphoid Function
31. Alterations of Hematologic Function in Children
32. Structure and Function of the Cardiovascular and Lymphatic Systems
33. Alterations of Cardiovascular Function
34. Alterations of Cardiovascular Function in Children
35. Structure and Function of the Pulmonary System
36. Alterations of Pulmonary Function
37. Alterations of Pulmonary Function in Children
38. Structure and Function of the Renal and Urologic Systems
39. Alterations of Renal and Urinary Tract Function
40. Alterations of Renal and Urinary Tract Function in Children
41. Structure and Function of the Digestive System
42. Alterations of Digestive Function
43. Alterations of Digestive Function in Children
44. Structure and Function of the Musculoskeletal System
45. Alterations of Musculoskeletal Function
46. Alterations of Musculoskeletal Function in Children
47. Structure and Function of the Integumentary System
48. Alterations of the Integument in Children
49. Shock, Multiple Organ Dysfunction Syndrome, and Burns in Adults
50. Shock, Multiple Organ Dysfunction Syndrome, and Burns in Children
, Chapter 1
1. Question 1
Which of the following best describes passive transport
across the cell membrane?
A. Movement of molecules against their concentration
gradient using ATP
B. Movement of molecules down their concentration
gradient without energy
C. Movement of water across a semipermeable membrane
via aquaporins
D. Engulfment of particles by cell membrane invagination
Correct Answer: B
Rationale:
o Correct (B): Passive transport refers to movement of
substances (e.g., oxygen, carbon dioxide, ions) down
their concentration gradient without the expenditure of
cellular energy (ATP).
o Incorrect (A): Movement against the concentration
gradient using ATP is active transport, not passive
transport.
o Incorrect (C): While water movement via aquaporins
is a form of passive transport (osmosis), answer C is a
specific example rather than a general description. The
question asks for the best general description.
o Incorrect (D): Engulfment of particles (phagocytosis)
is a form of endocytosis, an active, energy-requiring
process, not passive transport.
2. Question 2
Which cellular adaptation is characterized by an increase in
the size of individual cells, resulting in increased tissue
, mass?
A. Hyperplasia
B. Atrophy
C. Hypertrophy
D. Metaplasia
Correct Answer: C
Rationale:
o Correct (C): Hypertrophy refers to an increase in cell
size, often due to increased work demand or hormonal
stimulation, leading to increased tissue mass.
o Incorrect (A): Hyperplasia denotes an increased
number of cells, not size.
o Incorrect (B): Atrophy describes a decrease in cell
size and number, leading to tissue shrinkage.
o Incorrect (D): Metaplasia is the reversible
replacement of one differentiated cell type with
another, not enlargement of existing cells.
3. Question 3
A 45-year-old patient’s cardiac muscle shows enlargement
due to chronic hypertension. This adaptation is primarily
due to:
A. Increased cell number from stem cell activation
B. Accumulation of lipid droplets within cardiac myocytes
C. Increased synthesis of structural proteins in cardiac
myocytes
D. Transformation of myocardial cells into fibroblasts
Correct Answer: C
Rationale:
o Correct (C): Chronic hypertension increases
workload on the heart, stimulating cardiac myocytes to
, synthesize more contractile proteins (actin and
myosin), leading to hypertrophy.
o Incorrect (A): Cardiomyocytes have limited
proliferative capacity; the enlargement is due to
increased cell size, not number.
o Incorrect (B): Lipid droplet accumulation
characterizes certain metabolic disturbances (e.g., fatty
liver), not hypertrophy of cardiac muscle.
o Incorrect (D): Transformation of myocytes into
fibroblasts would indicate fibrosis, not hypertrophy.
4. Question 4
Which of the following is an example of cellular
metaplasia?
A. Barrett’s esophagus (esophageal squamous epithelium
replaced by columnar epithelium)
B. Uterine smooth muscle enlargement during pregnancy
C. Thymic atrophy in aging
D. Thickening of urinary bladder wall from obstruction
Correct Answer: A
Rationale:
o Correct (A): Barrett’s esophagus is classic
metaplasia: chronic acid reflux causes replacement of
squamous epithelium with columnar (intestinal-type)
epithelium.
o Incorrect (B): Uterine enlargement is
hypertrophy/hyperplasia of smooth muscle.
o Incorrect (C): Thymic atrophy is atrophy, not
metaplasia.
o Incorrect (D): Thickening from increased cell number
would be hyperplasia or hypertrophy, not metaplasia.
,5. Question 5
Which environmental agent produces free radicals that
cause lipid peroxidation of cell membranes?
A. Carbon monoxide
B. Ionizing radiation
C. Lead
D. Cholesterol
Correct Answer: B
Rationale:
o Correct (B): Ionizing radiation splits water molecules
to produce hydroxyl (·OH) free radicals, which initiate
lipid peroxidation, damaging cell membranes.
o Incorrect (A): Carbon monoxide binds hemoglobin,
causing hypoxic injury; it does not primarily produce
free radicals.
o Incorrect (C): Lead disrupts calcium homeostasis and
inactivates enzymes; it does not directly generate free
radicals.
o Incorrect (D): Cholesterol is a normal cell membrane
component; while abnormal cholesterol metabolism
can contribute to disease, it does not produce free
radicals in this context.
6. Question 6
During hypoxic injury, which of the following is the
earliest cellular event?
A. Mitochondrial swelling
B. Ribosomal detachment from the endoplasmic reticulum
C. Depletion of ATP
D. Laceration of nuclear chromatin
Correct Answer: C
Rationale:
, o Correct (C): Hypoxia limits oxidative
phosphorylation, rapidly depleting ATP.
o Incorrect (A): Mitochondrial swelling follows ATP
depletion and failure of ion pumps.
o Incorrect (B): Ribosome detachment from RER
occurs secondary to ATP depletion, causing decreased
protein synthesis.
o Incorrect (D): Nuclear chromatin changes
(karyolysis, pyknosis) are late events, not earliest.
7. Question 7
A patient with chronic carbon monoxide (CO) exposure
will have:
A. Cyanosis due to increased deoxyhemoglobin
B. Tissue hypoxia despite normal PaO₂
C. Methemoglobinemia
D. Increased oxygen-carrying capacity
Correct Answer: B
Rationale:
o Correct (B): CO binds hemoglobin with high affinity,
forming carboxyhemoglobin, preventing oxygen
delivery, causing tissue hypoxia despite normal PaO₂.
o Incorrect (A): CO poisoning produces cherry-red skin
color due to bright red carboxyhemoglobin, not
cyanosis.
o Incorrect (C): Methemoglobinemia involves oxidized
iron (Fe³⁺), not CO binding.
o Incorrect (D): CO reduces available hemoglobin for
oxygen binding, decreasing, not increasing, oxygen-
carrying capacity.
8. Question 8
Which of the following best describes reversible cell
, injury?
A. Persistence of severe plasma membrane damage
B. Presence of pyknosis and karyorrhexis
C. Cellular swelling and detachment of ribosomes
D. Leakage of lysosomal enzymes into the cytoplasm
Correct Answer: C
Rationale:
o Correct (C): Reversible injury features include
cellular swelling (hydropic change) and ribosomal
detachment (leading to reduced protein synthesis).
o Incorrect (A): Severe plasma membrane damage is
characteristic of irreversible injury.
o Incorrect (B): Pyknosis (nuclear shrinkage) and
karyorrhexis (fragmentation) are hallmarks of
irreversible nuclear change (cell death).
o Incorrect (D): Lysosomal enzyme leakage indicates
lysosomal rupture and irreversible cell injury.
9. Question 9
Lipid peroxidation in cell membranes primarily results
from:
A. Depletion of ATP
B. Accumulation of lactic acid
C. Reactive oxygen species attacking polyunsaturated fatty
acids
D. Hypertonic extracellular environment
Correct Answer: C
Rationale:
o Correct (C): Reactive oxygen species (ROS), such as
hydroxyl radicals, attack polyunsaturated fatty acids in
phospholipids, leading to lipid peroxidation.
Pathophysiology – All 50 Chapters (8th
Edition)"
Full-Chapter Pathophysiology Test Bank:
Adult and Pediatric Disorders (McCance &
Huether, 8 th edition)"
,
,Table of Contents
1. Cellular Biology
2. Altered Cellular and Tissue Biology: Environmental Agents
3. The Cellular Environment: Fluids and Electrolytes, Acids and Bases
4. Genes and Genetic Diseases
5. Genes, Environment-Lifestyle, and Common Diseases
6. Epigenetics and Disease
7. Innate Immunity: Inflammation
8. Adaptive Immunity
9. Alterations in Immunity and Inflammation
10. Infection
11. Stress and Disease
12. Cancer Biology
13. Cancer Epidemiology
14. Cancer in Children
15. Structure and Function of the Neurologic System
16. Pain, Temperature Regulation, Sleep, and Sensory Function
17. Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function
18. Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction
19. Neurobiology of Schizophrenia, Mood Disorders, and Anxiety Disorders
20. Alterations of Neurologic Function in Children
21. Mechanisms of Hormonal Regulation
,22. Alterations of Hormonal Regulation
23. Obesity and Disorders of Nutrition
24. Structure and Function of the Reproductive Systems
25. Alterations of the Female Reproductive System
26. Alterations of the Male Reproductive System
27. Reproductive Function in Children
28. Structure and Function of the Hematologic System
29. Alterations of Erythrocyte, Platelet, and Hemostatic Function
30. Alterations of Leukocyte and Lymphoid Function
31. Alterations of Hematologic Function in Children
32. Structure and Function of the Cardiovascular and Lymphatic Systems
33. Alterations of Cardiovascular Function
34. Alterations of Cardiovascular Function in Children
35. Structure and Function of the Pulmonary System
36. Alterations of Pulmonary Function
37. Alterations of Pulmonary Function in Children
38. Structure and Function of the Renal and Urologic Systems
39. Alterations of Renal and Urinary Tract Function
40. Alterations of Renal and Urinary Tract Function in Children
41. Structure and Function of the Digestive System
42. Alterations of Digestive Function
43. Alterations of Digestive Function in Children
44. Structure and Function of the Musculoskeletal System
45. Alterations of Musculoskeletal Function
46. Alterations of Musculoskeletal Function in Children
47. Structure and Function of the Integumentary System
48. Alterations of the Integument in Children
49. Shock, Multiple Organ Dysfunction Syndrome, and Burns in Adults
50. Shock, Multiple Organ Dysfunction Syndrome, and Burns in Children
, Chapter 1
1. Question 1
Which of the following best describes passive transport
across the cell membrane?
A. Movement of molecules against their concentration
gradient using ATP
B. Movement of molecules down their concentration
gradient without energy
C. Movement of water across a semipermeable membrane
via aquaporins
D. Engulfment of particles by cell membrane invagination
Correct Answer: B
Rationale:
o Correct (B): Passive transport refers to movement of
substances (e.g., oxygen, carbon dioxide, ions) down
their concentration gradient without the expenditure of
cellular energy (ATP).
o Incorrect (A): Movement against the concentration
gradient using ATP is active transport, not passive
transport.
o Incorrect (C): While water movement via aquaporins
is a form of passive transport (osmosis), answer C is a
specific example rather than a general description. The
question asks for the best general description.
o Incorrect (D): Engulfment of particles (phagocytosis)
is a form of endocytosis, an active, energy-requiring
process, not passive transport.
2. Question 2
Which cellular adaptation is characterized by an increase in
the size of individual cells, resulting in increased tissue
, mass?
A. Hyperplasia
B. Atrophy
C. Hypertrophy
D. Metaplasia
Correct Answer: C
Rationale:
o Correct (C): Hypertrophy refers to an increase in cell
size, often due to increased work demand or hormonal
stimulation, leading to increased tissue mass.
o Incorrect (A): Hyperplasia denotes an increased
number of cells, not size.
o Incorrect (B): Atrophy describes a decrease in cell
size and number, leading to tissue shrinkage.
o Incorrect (D): Metaplasia is the reversible
replacement of one differentiated cell type with
another, not enlargement of existing cells.
3. Question 3
A 45-year-old patient’s cardiac muscle shows enlargement
due to chronic hypertension. This adaptation is primarily
due to:
A. Increased cell number from stem cell activation
B. Accumulation of lipid droplets within cardiac myocytes
C. Increased synthesis of structural proteins in cardiac
myocytes
D. Transformation of myocardial cells into fibroblasts
Correct Answer: C
Rationale:
o Correct (C): Chronic hypertension increases
workload on the heart, stimulating cardiac myocytes to
, synthesize more contractile proteins (actin and
myosin), leading to hypertrophy.
o Incorrect (A): Cardiomyocytes have limited
proliferative capacity; the enlargement is due to
increased cell size, not number.
o Incorrect (B): Lipid droplet accumulation
characterizes certain metabolic disturbances (e.g., fatty
liver), not hypertrophy of cardiac muscle.
o Incorrect (D): Transformation of myocytes into
fibroblasts would indicate fibrosis, not hypertrophy.
4. Question 4
Which of the following is an example of cellular
metaplasia?
A. Barrett’s esophagus (esophageal squamous epithelium
replaced by columnar epithelium)
B. Uterine smooth muscle enlargement during pregnancy
C. Thymic atrophy in aging
D. Thickening of urinary bladder wall from obstruction
Correct Answer: A
Rationale:
o Correct (A): Barrett’s esophagus is classic
metaplasia: chronic acid reflux causes replacement of
squamous epithelium with columnar (intestinal-type)
epithelium.
o Incorrect (B): Uterine enlargement is
hypertrophy/hyperplasia of smooth muscle.
o Incorrect (C): Thymic atrophy is atrophy, not
metaplasia.
o Incorrect (D): Thickening from increased cell number
would be hyperplasia or hypertrophy, not metaplasia.
,5. Question 5
Which environmental agent produces free radicals that
cause lipid peroxidation of cell membranes?
A. Carbon monoxide
B. Ionizing radiation
C. Lead
D. Cholesterol
Correct Answer: B
Rationale:
o Correct (B): Ionizing radiation splits water molecules
to produce hydroxyl (·OH) free radicals, which initiate
lipid peroxidation, damaging cell membranes.
o Incorrect (A): Carbon monoxide binds hemoglobin,
causing hypoxic injury; it does not primarily produce
free radicals.
o Incorrect (C): Lead disrupts calcium homeostasis and
inactivates enzymes; it does not directly generate free
radicals.
o Incorrect (D): Cholesterol is a normal cell membrane
component; while abnormal cholesterol metabolism
can contribute to disease, it does not produce free
radicals in this context.
6. Question 6
During hypoxic injury, which of the following is the
earliest cellular event?
A. Mitochondrial swelling
B. Ribosomal detachment from the endoplasmic reticulum
C. Depletion of ATP
D. Laceration of nuclear chromatin
Correct Answer: C
Rationale:
, o Correct (C): Hypoxia limits oxidative
phosphorylation, rapidly depleting ATP.
o Incorrect (A): Mitochondrial swelling follows ATP
depletion and failure of ion pumps.
o Incorrect (B): Ribosome detachment from RER
occurs secondary to ATP depletion, causing decreased
protein synthesis.
o Incorrect (D): Nuclear chromatin changes
(karyolysis, pyknosis) are late events, not earliest.
7. Question 7
A patient with chronic carbon monoxide (CO) exposure
will have:
A. Cyanosis due to increased deoxyhemoglobin
B. Tissue hypoxia despite normal PaO₂
C. Methemoglobinemia
D. Increased oxygen-carrying capacity
Correct Answer: B
Rationale:
o Correct (B): CO binds hemoglobin with high affinity,
forming carboxyhemoglobin, preventing oxygen
delivery, causing tissue hypoxia despite normal PaO₂.
o Incorrect (A): CO poisoning produces cherry-red skin
color due to bright red carboxyhemoglobin, not
cyanosis.
o Incorrect (C): Methemoglobinemia involves oxidized
iron (Fe³⁺), not CO binding.
o Incorrect (D): CO reduces available hemoglobin for
oxygen binding, decreasing, not increasing, oxygen-
carrying capacity.
8. Question 8
Which of the following best describes reversible cell
, injury?
A. Persistence of severe plasma membrane damage
B. Presence of pyknosis and karyorrhexis
C. Cellular swelling and detachment of ribosomes
D. Leakage of lysosomal enzymes into the cytoplasm
Correct Answer: C
Rationale:
o Correct (C): Reversible injury features include
cellular swelling (hydropic change) and ribosomal
detachment (leading to reduced protein synthesis).
o Incorrect (A): Severe plasma membrane damage is
characteristic of irreversible injury.
o Incorrect (B): Pyknosis (nuclear shrinkage) and
karyorrhexis (fragmentation) are hallmarks of
irreversible nuclear change (cell death).
o Incorrect (D): Lysosomal enzyme leakage indicates
lysosomal rupture and irreversible cell injury.
9. Question 9
Lipid peroxidation in cell membranes primarily results
from:
A. Depletion of ATP
B. Accumulation of lactic acid
C. Reactive oxygen species attacking polyunsaturated fatty
acids
D. Hypertonic extracellular environment
Correct Answer: C
Rationale:
o Correct (C): Reactive oxygen species (ROS), such as
hydroxyl radicals, attack polyunsaturated fatty acids in
phospholipids, leading to lipid peroxidation.
