McCance & Huether’s Pathophysiology
The Biologic Basis for Disease in Adults and Children
9th Edition
• Author(s)Julia Rogers
TEST BANK
Reference
Ch. 1 — Prokaryotes and Eukaryotes
Stem
A 34-year-old man with recurrent urinary tract infections is
found to have bacteriuria on urinalysis and Gram-negative rods
on culture. He asks why bacterial cells can quickly exchange
plasmid DNA encoding antibiotic resistance while his white
blood cells cannot. Which cellular explanation best accounts for
the rapid horizontal gene transfer observed in bacteria?
A. Bacterial ribosomes facilitate direct chromosomal
recombination between unrelated species.
B. Bacteria lack membrane-bound nuclei and often carry
plasmids that transfer via conjugation pili.
C. Eukaryotic cells have a more permeable cell membrane that
prevents plasmid uptake.
D. Bacterial phagocytosis of host cells directly incorporates
human DNA into the bacterial genome.
,Correct Answer
B
Rationales
Correct (B): Prokaryotes lack a membrane-bound nucleus, and
many carry extrachromosomal plasmids that are readily
transferred between bacteria via conjugation (pili),
transformation, or transduction — mechanisms described in
McCance that explain rapid spread of resistance. This is the
most accurate cell-level mechanism and safest interpretation
for infection control concerns.
A: Ribosomes synthesize proteins; they do not mediate DNA
recombination across species — this misattributes function.
C: Eukaryotic membranes are not more permeable to plasmids;
uptake requires specialized mechanisms.
D: Bacteria do not phagocytose host cells to integrate human
DNA into their genomes — this is biologically implausible and
inconsistent with prokaryotic gene transfer pathways.
Teaching Point
Bacteria exchange plasmids (conjugation) because they are
prokaryotic and lack a nuclear membrane.
Citation (Simplified APA)
Rogers, J., et al. (2023). Pathophysiology: The Biologic Basis for
Disease in Adults and Children (9th ed.). Ch. 1.
2️⃣
,Reference
Ch. 1 — Cellular Functions
Stem
A 67-year-old woman with chronic heart failure reports fatigue
and orthopnea. Lab results: serum sodium 132 mEq/L, BNP
elevated, and peripheral edema. At the cellular level, which
mechanism best explains her generalized edema in the context
of decreased cardiac output?
A. Increased plasma oncotic pressure from albumin
overproduction causing fluid movement into interstitium.
B. Decreased capillary hydrostatic pressure leading to lymphatic
overload and edema.
C. Elevated venous hydrostatic pressure from reduced forward
flow, forcing fluid out of capillaries.
D. Decreased interstitial hydrostatic pressure causing net
filtration into the vascular space.
Correct Answer
C
Rationales
Correct (C): In heart failure, reduced cardiac output causes
venous congestion and elevated capillary hydrostatic pressure;
McCance explains that increased hydrostatic pressure favors
fluid filtration into the interstitium, producing edema. This links
organ dysfunction to capillary-level fluid shifts.
A: Albumin overproduction would increase oncotic pressure
and retain fluid intravascularly; in heart failure
, hypoalbuminemia (if present) would worsen edema, not
overproduction.
B: Decreased capillary hydrostatic pressure would reduce
filtration, not produce edema.
D: Decreased interstitial hydrostatic pressure would draw fluid
into the vascular compartment, opposite of the observed
phenomenon.
Teaching Point
Elevated capillary hydrostatic pressure from venous congestion
drives edema in heart failure.
Citation (Simplified APA)
Rogers, J., et al. (2023). Pathophysiology: The Biologic Basis for
Disease in Adults and Children (9th ed.). Ch. 1.
3️⃣
Reference
Ch. 1 — Structure and Function of Cellular Components
Stem
A 22-year-old woman presents with progressive exercise
intolerance, muscle cramps, and a resting lactate of 4.8 mmol/L
(normal <2.0). A mitochondrial DNA mutation is suspected.
Which immediate cellular consequence best explains her lactic
acidosis?
A. Enhanced electron transport chain flux causing increased
pyruvate oxidation.
The Biologic Basis for Disease in Adults and Children
9th Edition
• Author(s)Julia Rogers
TEST BANK
Reference
Ch. 1 — Prokaryotes and Eukaryotes
Stem
A 34-year-old man with recurrent urinary tract infections is
found to have bacteriuria on urinalysis and Gram-negative rods
on culture. He asks why bacterial cells can quickly exchange
plasmid DNA encoding antibiotic resistance while his white
blood cells cannot. Which cellular explanation best accounts for
the rapid horizontal gene transfer observed in bacteria?
A. Bacterial ribosomes facilitate direct chromosomal
recombination between unrelated species.
B. Bacteria lack membrane-bound nuclei and often carry
plasmids that transfer via conjugation pili.
C. Eukaryotic cells have a more permeable cell membrane that
prevents plasmid uptake.
D. Bacterial phagocytosis of host cells directly incorporates
human DNA into the bacterial genome.
,Correct Answer
B
Rationales
Correct (B): Prokaryotes lack a membrane-bound nucleus, and
many carry extrachromosomal plasmids that are readily
transferred between bacteria via conjugation (pili),
transformation, or transduction — mechanisms described in
McCance that explain rapid spread of resistance. This is the
most accurate cell-level mechanism and safest interpretation
for infection control concerns.
A: Ribosomes synthesize proteins; they do not mediate DNA
recombination across species — this misattributes function.
C: Eukaryotic membranes are not more permeable to plasmids;
uptake requires specialized mechanisms.
D: Bacteria do not phagocytose host cells to integrate human
DNA into their genomes — this is biologically implausible and
inconsistent with prokaryotic gene transfer pathways.
Teaching Point
Bacteria exchange plasmids (conjugation) because they are
prokaryotic and lack a nuclear membrane.
Citation (Simplified APA)
Rogers, J., et al. (2023). Pathophysiology: The Biologic Basis for
Disease in Adults and Children (9th ed.). Ch. 1.
2️⃣
,Reference
Ch. 1 — Cellular Functions
Stem
A 67-year-old woman with chronic heart failure reports fatigue
and orthopnea. Lab results: serum sodium 132 mEq/L, BNP
elevated, and peripheral edema. At the cellular level, which
mechanism best explains her generalized edema in the context
of decreased cardiac output?
A. Increased plasma oncotic pressure from albumin
overproduction causing fluid movement into interstitium.
B. Decreased capillary hydrostatic pressure leading to lymphatic
overload and edema.
C. Elevated venous hydrostatic pressure from reduced forward
flow, forcing fluid out of capillaries.
D. Decreased interstitial hydrostatic pressure causing net
filtration into the vascular space.
Correct Answer
C
Rationales
Correct (C): In heart failure, reduced cardiac output causes
venous congestion and elevated capillary hydrostatic pressure;
McCance explains that increased hydrostatic pressure favors
fluid filtration into the interstitium, producing edema. This links
organ dysfunction to capillary-level fluid shifts.
A: Albumin overproduction would increase oncotic pressure
and retain fluid intravascularly; in heart failure
, hypoalbuminemia (if present) would worsen edema, not
overproduction.
B: Decreased capillary hydrostatic pressure would reduce
filtration, not produce edema.
D: Decreased interstitial hydrostatic pressure would draw fluid
into the vascular compartment, opposite of the observed
phenomenon.
Teaching Point
Elevated capillary hydrostatic pressure from venous congestion
drives edema in heart failure.
Citation (Simplified APA)
Rogers, J., et al. (2023). Pathophysiology: The Biologic Basis for
Disease in Adults and Children (9th ed.). Ch. 1.
3️⃣
Reference
Ch. 1 — Structure and Function of Cellular Components
Stem
A 22-year-old woman presents with progressive exercise
intolerance, muscle cramps, and a resting lactate of 4.8 mmol/L
(normal <2.0). A mitochondrial DNA mutation is suspected.
Which immediate cellular consequence best explains her lactic
acidosis?
A. Enhanced electron transport chain flux causing increased
pyruvate oxidation.
