Pathophysiology The Biologic Basis for Disease in Adults and Children 8th Edition

1. A child’s diagnosis of Beckwith-Wiedemann syndrome is supported by the presence of what? (Select all that apply.) a. An omphalocele b. Neonatal hypoglycemia c. Creased earlobes d. Low birth weight e. A large tongue ANS: A, B, C, E Beckwith-Wiedemann syndrome is usually identifiable at birth because the child exhibits a large size for gestational age, neonatal hypoglycemia, a large tongue, creases on the earlobe, and omphalocele. PTS: 1 DIF: Cognitive Level: Remembering 2. A diagnosis of Angelman syndrome in a child is supported by which assessment findings? (Select all that apply.) a. Small feet and hands b. Profound intellectual disability c. Obesity d. Ataxic gait e. History of seizures ANS: B, D, E A child diagnosed with Angelman syndrome demonstrates profound intellectual disability, seizures, and an ataxic gait. Chapter 6 - Epigenetics and Disease 62 Pathophysiology The Biologic Basis for Disease in Adults and Children 8th Edition 34 PTS: 1 DIF: Cognitive Level: Remembering Chapter 6 - Epigenetics and Disease 63 Pathophysiology The Biologic Basis for Disease in Adults and Children 8th Edition 34 Chapter 07: Innate Immunity: Inflammation and Wound Healing McCance/Huether: Pathophysiology: The Biologic Basis of Disease in Adults and Children, 8th Edition MULTIPLE CHOICE 1. Which action is a purpose of the inflammatory process? a. To provide specific responses toward antigens b. To lyse cell membranes of microorganisms c. To prevent infection of the injured tissue d. To create immunity against subsequent tissue injury ANS: C If the epithelial barrier is damaged, then a highly efficient local and systemic response (inflammation) is mobilized to limit the extent of damage, to protect against infection, and to initiate the repair of damaged tissue. The response to a specific offending agent is the function of the adaptive immune response. Lysosomes lyse cell membranes. Immunity against a subsequent tissue injury occurs through the action of B cells and T cells. PTS: 1 DIF: Cognitive Level: Remembering 2. How do surfactant proteins A through D provide innate resistance? a. Initiate the complement cascade. b. Promote phagocytosis. c. Secrete mucus. d. Synthesize lysosomes. ANS: B The lung produces and secretes a family of glycoproteins, collectins, which includes surfactant proteins A through D and mannose-binding lectin. Collectin binding facilitates macrophages to recognize the microorganism, enhancing macrophage attachment, phagocytosis, and killing. The complement cascade occurs during the inflammatory phase. These proteins do not secrete mucus of synthesize lysosomes. PTS: 1 DIF: Cognitive Level: Remembering 3. Which secretion is a first line of defense against pathogen invasion that involves antibacterial and antifungal fatty acids, as well as lactic acid? a. Optic tears b. Oral saliva c. Sweat gland perspiration d. Sebaceous gland sebum ANS: D Sebaceous glands in the skin secrete sebum that is made up of antibacterial and antifungal fatty acids and lactic acid that provide the first-line barrier against pathogen invasion. Perspiration, tears, and saliva contain an enzyme (lysozyme) that attacks the cell walls of gram-positive bacteria. PTS: 1 DIF: Cognitive Level: Remembering Chapter 7 - Innate Immunity Inflammation 64 Pathophysiology The Biologic Basis for Disease in Adults and Children 8th Edition 34 4. Which bacterium grows in the intestines after prolonged antibiotic therapy? a. Lactobacillus b. Candida albicans c. Clostridium difficile d. Helicobacter pylori ANS: C Prolonged antibiotic treatment can alter the normal intestinal flora, decreasing its protective activity and leading to the overgrowth of other microorganisms, such as the bacterium C. difficile in the colon. C. albicans can overgrow in the vagina but does not usually cause intestinal issues. Lactobacillus and Helicobacter also do not produce intestinal overgrowth problems with antibiotic use. PTS: 1 DIF: Cognitive Level: Remembering 5. What causes the edema that occurs during the inflammatory process? a. Vasodilation of blood vessels b. Increased capillary permeability c. Endothelial cell expansion d. Emigration of neutrophils ANS: B The increased flow and capillary permeability result in a leakage of plasma from the vessels, causing swelling (edema) in the surrounding tissue and is solely responsible for inflammation-induced edema. Vasodilation (increased size of the blood vessels) causes slower blood velocity and increases blood flow to the injured site. Endothelial cell contraction (not expansion) leads to increased capillary permeability. Emigration of neutrophils to the area of infection/injury leads to increased destruction of the offending agent. PTS: 1 DIF: Cognitive Level: Remembering 6. What process causes heat and redness to occur during the inflammatory process? a. Vasodilation of blood vessels b. Platelet aggregation c. Decreased capillary permeability d. Endothelial cell contraction ANS: A The increased blood flow as a result of vasodilation and increasing concentration of red cells at the site of inflammation cause locally increased warmth and redness. Platelet aggregation is important in the clotting cascade. Decreased capillary permeability would affect local edema. Endothelial cell contraction leads to increased capillary permeability and the formation of edema. PTS: 1 DIF: Cognitive Level: Remembering 7. What does activation of the classical pathway begin with? a. Viruses b. Antigen-antibody complexes c. Mast cells Chapter 7 - Innate Immunity Inflammation 65 Pathophysiology The Biologic Basis for Disease in Adults and Children 8th Edition 34 d. Macrophages ANS: B Activation of the classical pathway begins only with the activation of protein C1 and is preceded by the formation of a complex between an antigen and an antibody to form an antigen-antibody complex (immune complex). Infection with a virus can lead to the start of the inflammatory process, but is not the specific activation factor. Mast cells release the contents of their granules to initiate synthesis of other mediators of inflammation among other actions. Macrophages are one cell type involved in phagocytosis. PTS: 1 DIF: Cognitive Level: Remembering 8. What plasma protein system forms a fibrinous meshwork at an inflamed site? a. Complement b. Coagulation c. Kinin d. Fibrinolysis ANS: B The coagulation (clotting) system is a group of plasma proteins that form a fibrinous meshwork at an injured or inflamed site. This protein system (1) prevents the spread of infection to adjacent tissues, (2) traps microorganisms and foreign bodies at the site of inflammation for removal by infiltrating cells (e.g., neutrophils and macrophages), (3) forms a clot that stops the bleeding, and (4) provides a framework for future repair and healing. The complement system, kinins, and fibrinolysis do not form a fibrinous meshwork at an inflamed site. PTS: 1 DIF: Cognitive Level: Remembering 9. Which component of the plasma protein system tags pathogenic microorganisms for destruction by neutrophils and macrophages? a. Complement cascade b. Coagulation system c. Kinin system d. Immune system ANS: A C3b (a component of the complement cascade) adheres to the surface of a pathogenic microorganism and serves as an efficient opsonin. Opsonins are molecules that tag microorganisms for destruction by cells of the inflammatory system, primarily neutrophils and macrophages. The other options do not accurately identify a component capable of tagging pathogenic microorganisms. PTS: 1 DIF: Cognitive Level: Remembering 10