PATHOPHYSIOLOGY 8TH EDITION MCCANCE POTENTIAL TEST
Chapter 2: Altered Cellular and Tissue Biology
MULTIPLE CHOICE
1. Which type of cell adaptation occurs when normal columnar ciliated epithelial cells of the bronchial
lining have been replaced by stratified squamous epithelial cells? ANS: B
A. Hyperplasia
B. Metaplasia
C. Dysplasia
D. Anaplasia
Metaplasia is the reversible replacement of one mature cell by another, sometimes a less differentiated
cell type. The best example of metaplasia is the replacement of normal columnar ciliated epithelial cells
of the bronchial (airway) lining by stratified squamous epithelial cells. The other options do not
accurately describe the event in the question.
PTS: 1 REF: Page 54
2. The loss of the adenosine triphosphate (ATP) during ischemia causes cells to: ANS: C
A. Shrink because of the influx of calcium (Ca).
B. Shrink because of the influx of potassium chloride (KCl).
C. Swell because of the influx of sodium chloride (NaCl).
D. Swell because of the influx of nitric oxide (NO).
A reduction in ATP levels causes the plasma membrane’s sodium-potassium (Na+–K+) pump and
sodium-calcium exchange to fail, which leads to an intracellular accumulation of sodium and calcium
and diffusion of potassium out of the cell. (The Na+–K+ pump is discussed in Chapter 1.) Sodium and
water can then freely enter the cell, and cellular swelling results. The other options do not accurately
describe the result of ATP at the cellular level.
PTS: 1 REF: Page 57
3. The mammary glands enlarge during pregnancy primarily as a consequence of hormonal: ANS: B
A. Atrophy
B. Hyperplasia
C. Anaplasia
D. Dysplasia
, Hormonal hyperplasia occurs chiefly in estrogen-dependent organs, such as the uterus and breast. The
remaining options do not adequately describe the consequence of hormones on breast tissue during
pregnancy.
PTS: 1 REF: Page 53
4. Free radicals play a major role in the initiation and progression of which diseases? Ans: A
A. Cardiovascular diseases such as hypertension and ischemic heart disease
B. Renal diseases such as acute tubular necrosis and glomerulonephritis
C. Gastrointestinal diseases such as peptic ulcer disease and Crohn disease
D. Muscular disease such as muscular dystrophy and fibromyalgia
Emerging data indicate that reactive oxygen species play major roles in the initiation and progression of
cardiovascular alterations associated with hyperlipidemia, diabetes mellitus, hypertension, ischemic
heart disease, and chronic heart failure. No current research connects the disorders mentioned in the
other options to the effects of free radicals.
PTS: 1 REF: Pages 59-60
5. Free radicals cause cell damage by: ANS: D
A. Stealing the cell’s oxygen to stabilize the electron, thus causing hypoxia
B. Stimulating the release of lysosomal enzymes that digest the cell membranes
C. Transferring one of its charged, stabilized atoms to the cell membrane, which causes lysis
D. Giving up an electron, which causes injury to the chemical bonds of the cell membrane
A free radical is an electrically uncharged atom or group of atoms having an unpaired electron. Having
one unpaired electron makes the molecule unstable; thus to stabilize, the molecule gives up an electron
to another molecule or steals one. Therefore it is capable of forming injurious chemical bonds with
proteins, lipids, or carbohydrates—key molecules in membranes and nucleic acids. The remaining
options do not accurately describe the role played by free radicals in cell damage.
PTS: 1 REF: Page 60
6. What is a consequence of plasma membrane damage to the mitochondria? ANS: B
A. Enzymatic digestion halts DNA synthesis.
B. Influx of calcium ions halts ATP production.
C. Edema from an influx in sodium causes a reduction in ATP production.
D. Potassium shifts out of the mitochondria, which destroys the infrastructure.
The most serious consequence of plasma membrane damage is, as in hypoxic injury, to the
mitochondria. An influx of calcium ions from the extracellular compartment activates multiple enzyme
systems, resulting in cytoskeleton disruption, membrane damage, activation of inflammation, and
eventually DNA degradation. Calcium ion accumulation in the mitochondria causes the mitochondria to
swell, which is an occurrence that is associated with irreversible cellular injury. The injured mitochondria
Chapter 2: Altered Cellular and Tissue Biology
MULTIPLE CHOICE
1. Which type of cell adaptation occurs when normal columnar ciliated epithelial cells of the bronchial
lining have been replaced by stratified squamous epithelial cells? ANS: B
A. Hyperplasia
B. Metaplasia
C. Dysplasia
D. Anaplasia
Metaplasia is the reversible replacement of one mature cell by another, sometimes a less differentiated
cell type. The best example of metaplasia is the replacement of normal columnar ciliated epithelial cells
of the bronchial (airway) lining by stratified squamous epithelial cells. The other options do not
accurately describe the event in the question.
PTS: 1 REF: Page 54
2. The loss of the adenosine triphosphate (ATP) during ischemia causes cells to: ANS: C
A. Shrink because of the influx of calcium (Ca).
B. Shrink because of the influx of potassium chloride (KCl).
C. Swell because of the influx of sodium chloride (NaCl).
D. Swell because of the influx of nitric oxide (NO).
A reduction in ATP levels causes the plasma membrane’s sodium-potassium (Na+–K+) pump and
sodium-calcium exchange to fail, which leads to an intracellular accumulation of sodium and calcium
and diffusion of potassium out of the cell. (The Na+–K+ pump is discussed in Chapter 1.) Sodium and
water can then freely enter the cell, and cellular swelling results. The other options do not accurately
describe the result of ATP at the cellular level.
PTS: 1 REF: Page 57
3. The mammary glands enlarge during pregnancy primarily as a consequence of hormonal: ANS: B
A. Atrophy
B. Hyperplasia
C. Anaplasia
D. Dysplasia
, Hormonal hyperplasia occurs chiefly in estrogen-dependent organs, such as the uterus and breast. The
remaining options do not adequately describe the consequence of hormones on breast tissue during
pregnancy.
PTS: 1 REF: Page 53
4. Free radicals play a major role in the initiation and progression of which diseases? Ans: A
A. Cardiovascular diseases such as hypertension and ischemic heart disease
B. Renal diseases such as acute tubular necrosis and glomerulonephritis
C. Gastrointestinal diseases such as peptic ulcer disease and Crohn disease
D. Muscular disease such as muscular dystrophy and fibromyalgia
Emerging data indicate that reactive oxygen species play major roles in the initiation and progression of
cardiovascular alterations associated with hyperlipidemia, diabetes mellitus, hypertension, ischemic
heart disease, and chronic heart failure. No current research connects the disorders mentioned in the
other options to the effects of free radicals.
PTS: 1 REF: Pages 59-60
5. Free radicals cause cell damage by: ANS: D
A. Stealing the cell’s oxygen to stabilize the electron, thus causing hypoxia
B. Stimulating the release of lysosomal enzymes that digest the cell membranes
C. Transferring one of its charged, stabilized atoms to the cell membrane, which causes lysis
D. Giving up an electron, which causes injury to the chemical bonds of the cell membrane
A free radical is an electrically uncharged atom or group of atoms having an unpaired electron. Having
one unpaired electron makes the molecule unstable; thus to stabilize, the molecule gives up an electron
to another molecule or steals one. Therefore it is capable of forming injurious chemical bonds with
proteins, lipids, or carbohydrates—key molecules in membranes and nucleic acids. The remaining
options do not accurately describe the role played by free radicals in cell damage.
PTS: 1 REF: Page 60
6. What is a consequence of plasma membrane damage to the mitochondria? ANS: B
A. Enzymatic digestion halts DNA synthesis.
B. Influx of calcium ions halts ATP production.
C. Edema from an influx in sodium causes a reduction in ATP production.
D. Potassium shifts out of the mitochondria, which destroys the infrastructure.
The most serious consequence of plasma membrane damage is, as in hypoxic injury, to the
mitochondria. An influx of calcium ions from the extracellular compartment activates multiple enzyme
systems, resulting in cytoskeleton disruption, membrane damage, activation of inflammation, and
eventually DNA degradation. Calcium ion accumulation in the mitochondria causes the mitochondria to
swell, which is an occurrence that is associated with irreversible cellular injury. The injured mitochondria
