Test Bank
TEST BANK
,Robbins Basic Pathology 9th Edition Kumar Test Bank
Kumar: Robbins Basic Pathology, 9th Edition
Chapter 3: Hemodynamic Disorders, Thromboembolism, and Shock
Test Bank
MULTIPLE CHOICE
1. A 60-year-old man had congestive heart failure and sodium retention. Pitting edema of the lower
extremities in this patient is most likely associated with an increased blood level of
a. albumin
b. globulin
c. aldosterone
d. troponin
e. plasminogen
ANS: C
Renal hypoperfusion due to heart failure leads to secondary hyperaldosteronism and consequent
retention of sodium and water.
2. A 60-year-old woman had a mastectomy for advanced cancer in her left breast, followed by
chemotherapy and radiation therapy. She developed edema of the left arm. This edema is caused
by
a. obstruction of the lymph flow
b. arterial thrombosis
c. venous thrombosis
d. spread of cancer into the soft tissue of the arm
e. hypoalbuminemia secondary to liver injury caused by hepatic metastases
ANS: A
Arm edema following a mastectomy is a complication of breast cancer treatment caused by an
obstruction of the lymphatics in the axilla. This obstruction of lymphatics is a consequence of
radiation injury or scarring associated with surgery.
3. A 63-year-old woman died 2 days after the onset of severe myocardial ischemia caused by
coronary thrombosis. At autopsy, the lungs were heavy. Upon sectioning of the lungs, frothy
fluid was seen oozing from the cut surface of the parenchyma. Which of the following is the
most likely diagnosis?
a. Pulmonary embolism
b. Pulmonary infarction
c. Pulmonary edema
d. Atelectasis
e. Lobar pneumonia
ANS: C
Copyright © 2013, 2007, 2003, 1997, 1992, 1987, 1981, 1976, 1971 by Saunders, an imprint of Elsevier Inc.
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, Test Bank 3-2
Lungs that are heavy and on cross section show oozing of frothy fluid are filled with edema
fluid. In this case, edema developed due to left-sided heart failure.
4. A 60-year-old man who had longstanding congestive heart failure complained of pain under the
right costal margin. He died of worsening heart failure. At autopsy, the liver appeared enlarged
and congested, showing a "nutmeg pattern" on cross section. Histologically this liver will show
a. atrophy of bile ducts
b. dilatation of bile ducts
c. intralobular cholestasis
d. centrolobular necrosis and loss of hepatocytes
e. fibrosis of the Glisson capsule
ANS: D
Chronic passive congestion of the liver caused by heart failure leads to accumulation of blood in
the terminal hepatic venule and the centrolobular sinusoids. Aggravation of the heart failure
expands the blood-containing spaces, causing centrolobular liver cell necrosis.
5. Which form of hemorrhage is most typical of defective platelet function seen in uremia (end
stage kidney failure)?
a. Multiple petechiae
b. Multiple ecchymoses
c. Solitary ecchymoses
d. Hematoma
e. Hemarthrosis
ANS: A
Defective platelet function in uremia is typically associated with multiple petechiae in the skin
and on mucosal surfaces.
6. Which of the following substances is an anticoagulant secreted by endothelial cells?
a. Von Willebrand factor
b. Prothrombin
c. Inhibitor of plasminogen activator
d. Thrombomodulin
e. Tissue factor
ANS: D
Thrombomodulin is an anticoagulant that acts by binding to thrombin and converting it from a
procoagulant to an anticoagulant capable of activating protein C.
7. Bernard-Soulier syndrome is a bleeding disorder caused by a defect of glycoprotein Ib (GpIb) on
platelets. Platelets lacking GpIb cannot adhere to the wall of the damaged blood vessels, because
GpIb is the receptor for which essential coagulation protein?
a. Hageman factor (factor XII)
b. Von Willebrand factor
c. Fibrinogen
Copyright © 2013, 2007, 2003, 1997, 1992, 1987, 1981, 1976, 1971 by Saunders, an imprint of Elsevier Inc.
, Test Bank 3-3
d. Factor VIII
e. Thrombin
ANS: B
GpIb, a platelet cell membrane glycoprotein, is the receptor for the von Willebrand factor (vWF),
which mediates the adhesion of platelets to the damaged vascular wall. Congenital deficiency of
GpIb, as seen in Bernard-Soulier syndrome, is similar to the deficiency of vWF in von
Willebrand disease and results in a bleeding disorder.
8. The most common form of congenital coagulopathy, factor V mutation (Leyden mutation),
causes the altered coagulation factor V to be resistant to the action of which enzyme?
a. Protein C
b. Protein S
c. Antithrombin III
d. Plasmin
e. Thrombin
ANS: A
Leyden mutation of factor V makes this factor resistant to the action protein C. Under normal
circumstances, protein C inactivates factor V, and the mutation eliminates this very important
anticoagulant control mechanism. As a result of these changes, there is uncontrollable activation
of factor V, which promotes thrombosis.
9. In the antiphospholipid syndrome of systemic lupus erythematosus, arterial thrombi occur most
often in the arteries of the
a. brain
b. heart
c. kidneys
d. intestines
e. bronchi
ANS: A
Antiphospholipid syndrome is characterized by widespread venous and arterial thrombi. Venous
thrombi are found most often in the veins of the lower extremities, whereas the arterial thrombi
are most often found in the cerebral arteries.
10. Which of the following is the most common site for arteriolar thromboembolization?
a. Brain
b. Heart
c. Kidneys
d. Lower extremities
e. Eyes
ANS: D
The lower extremities are the major site of arteriolar thromboemboli. This site is involved in
75% of all cases.
Copyright © 2013, 2007, 2003, 1997, 1992, 1987, 1981, 1976, 1971 by Saunders, an imprint of Elsevier Inc.
TEST BANK
,Robbins Basic Pathology 9th Edition Kumar Test Bank
Kumar: Robbins Basic Pathology, 9th Edition
Chapter 3: Hemodynamic Disorders, Thromboembolism, and Shock
Test Bank
MULTIPLE CHOICE
1. A 60-year-old man had congestive heart failure and sodium retention. Pitting edema of the lower
extremities in this patient is most likely associated with an increased blood level of
a. albumin
b. globulin
c. aldosterone
d. troponin
e. plasminogen
ANS: C
Renal hypoperfusion due to heart failure leads to secondary hyperaldosteronism and consequent
retention of sodium and water.
2. A 60-year-old woman had a mastectomy for advanced cancer in her left breast, followed by
chemotherapy and radiation therapy. She developed edema of the left arm. This edema is caused
by
a. obstruction of the lymph flow
b. arterial thrombosis
c. venous thrombosis
d. spread of cancer into the soft tissue of the arm
e. hypoalbuminemia secondary to liver injury caused by hepatic metastases
ANS: A
Arm edema following a mastectomy is a complication of breast cancer treatment caused by an
obstruction of the lymphatics in the axilla. This obstruction of lymphatics is a consequence of
radiation injury or scarring associated with surgery.
3. A 63-year-old woman died 2 days after the onset of severe myocardial ischemia caused by
coronary thrombosis. At autopsy, the lungs were heavy. Upon sectioning of the lungs, frothy
fluid was seen oozing from the cut surface of the parenchyma. Which of the following is the
most likely diagnosis?
a. Pulmonary embolism
b. Pulmonary infarction
c. Pulmonary edema
d. Atelectasis
e. Lobar pneumonia
ANS: C
Copyright © 2013, 2007, 2003, 1997, 1992, 1987, 1981, 1976, 1971 by Saunders, an imprint of Elsevier Inc.
Visit TestBankDeal.com to get complete for all chapters
, Test Bank 3-2
Lungs that are heavy and on cross section show oozing of frothy fluid are filled with edema
fluid. In this case, edema developed due to left-sided heart failure.
4. A 60-year-old man who had longstanding congestive heart failure complained of pain under the
right costal margin. He died of worsening heart failure. At autopsy, the liver appeared enlarged
and congested, showing a "nutmeg pattern" on cross section. Histologically this liver will show
a. atrophy of bile ducts
b. dilatation of bile ducts
c. intralobular cholestasis
d. centrolobular necrosis and loss of hepatocytes
e. fibrosis of the Glisson capsule
ANS: D
Chronic passive congestion of the liver caused by heart failure leads to accumulation of blood in
the terminal hepatic venule and the centrolobular sinusoids. Aggravation of the heart failure
expands the blood-containing spaces, causing centrolobular liver cell necrosis.
5. Which form of hemorrhage is most typical of defective platelet function seen in uremia (end
stage kidney failure)?
a. Multiple petechiae
b. Multiple ecchymoses
c. Solitary ecchymoses
d. Hematoma
e. Hemarthrosis
ANS: A
Defective platelet function in uremia is typically associated with multiple petechiae in the skin
and on mucosal surfaces.
6. Which of the following substances is an anticoagulant secreted by endothelial cells?
a. Von Willebrand factor
b. Prothrombin
c. Inhibitor of plasminogen activator
d. Thrombomodulin
e. Tissue factor
ANS: D
Thrombomodulin is an anticoagulant that acts by binding to thrombin and converting it from a
procoagulant to an anticoagulant capable of activating protein C.
7. Bernard-Soulier syndrome is a bleeding disorder caused by a defect of glycoprotein Ib (GpIb) on
platelets. Platelets lacking GpIb cannot adhere to the wall of the damaged blood vessels, because
GpIb is the receptor for which essential coagulation protein?
a. Hageman factor (factor XII)
b. Von Willebrand factor
c. Fibrinogen
Copyright © 2013, 2007, 2003, 1997, 1992, 1987, 1981, 1976, 1971 by Saunders, an imprint of Elsevier Inc.
, Test Bank 3-3
d. Factor VIII
e. Thrombin
ANS: B
GpIb, a platelet cell membrane glycoprotein, is the receptor for the von Willebrand factor (vWF),
which mediates the adhesion of platelets to the damaged vascular wall. Congenital deficiency of
GpIb, as seen in Bernard-Soulier syndrome, is similar to the deficiency of vWF in von
Willebrand disease and results in a bleeding disorder.
8. The most common form of congenital coagulopathy, factor V mutation (Leyden mutation),
causes the altered coagulation factor V to be resistant to the action of which enzyme?
a. Protein C
b. Protein S
c. Antithrombin III
d. Plasmin
e. Thrombin
ANS: A
Leyden mutation of factor V makes this factor resistant to the action protein C. Under normal
circumstances, protein C inactivates factor V, and the mutation eliminates this very important
anticoagulant control mechanism. As a result of these changes, there is uncontrollable activation
of factor V, which promotes thrombosis.
9. In the antiphospholipid syndrome of systemic lupus erythematosus, arterial thrombi occur most
often in the arteries of the
a. brain
b. heart
c. kidneys
d. intestines
e. bronchi
ANS: A
Antiphospholipid syndrome is characterized by widespread venous and arterial thrombi. Venous
thrombi are found most often in the veins of the lower extremities, whereas the arterial thrombi
are most often found in the cerebral arteries.
10. Which of the following is the most common site for arteriolar thromboembolization?
a. Brain
b. Heart
c. Kidneys
d. Lower extremities
e. Eyes
ANS: D
The lower extremities are the major site of arteriolar thromboemboli. This site is involved in
75% of all cases.
Copyright © 2013, 2007, 2003, 1997, 1992, 1987, 1981, 1976, 1971 by Saunders, an imprint of Elsevier Inc.
