GOULD'S PATHOPHYSIOLOGY FOR THE
HEALTH PROFESSIONS
7TH EDITION
• AUTHOR(S)KARIN C. VANMETER;
ROBERT J. HUBERT
TEST BANK
1
Reference
Ch. 1 — Introduction to Pathophysiology — What Is
Pathophysiology and Why Study It?
Stem
A 72-year-old man becomes acutely hypotensive after a long
period of vomiting and poor oral intake. Laboratory studies
show decreased perfusion to peripheral tissues. Which
pathophysiologic principle best explains why the patient’s cells
begin to swell within minutes of inadequate perfusion?
A. Increased intracellular ATP production increases osmotic
water entry.
,B. Failure of the Na⁺/K⁺ ATPase pump due to ATP depletion
leading to sodium and water influx.
C. Activation of apoptotic caspases causing regulated cell
swelling.
D. Increased capillary hydrostatic pressure forcing water into
cells.
Correct answer
B
Rationale — Correct (B)
Inadequate perfusion causes hypoxia and decreased ATP
generation. Loss of ATP impairs the energy-dependent Na⁺/K⁺
ATPase, permitting sodium accumulation within the cell; water
follows osmotically, producing cellular swelling (hydropic
change). This sequence is the classical immediate reversible
injury mechanism described in introductory pathophysiology.
Rationale — Incorrect
A. Increased ATP would maintain ion gradients and prevent
swelling; ATP normally falls in hypoperfusion.
C. Apoptosis is an energy-dependent, programmed process that
results in cell shrinkage and membrane integrity, not acute
swelling.
D. Increased capillary hydrostatic pressure causes extracellular
edema, not primary intracellular swelling from pump failure.
Teaching Point
ATP depletion → Na⁺/K⁺ pump failure → intracellular Na⁺ and
water accumulation (cell swelling).
,Citation
VanMeter, K. C., & Hubert, R. J. (2024). Gould’s Pathophysiology
for the Health Professions (7th ed.). Ch. 1.
2
Reference
Ch. 1 — Introduction to Pathophysiology — Introduction to
Cellular Changes
Stem
A 45-year-old office worker develops reduced muscle mass in
her immobilized right arm following a fracture. Considering
cellular adaptation, which mechanism most directly accounts
for the observed reduction in muscle fiber size?
A. Increased apoptosis of muscle cells via caspase activation.
B. Decreased protein synthesis and increased ubiquitin-
proteasome degradation of contractile proteins.
C. Metaplasia of muscle cells to adipose tissue.
D. Hyperplasia resulting in smaller individual fiber size due to
crowding.
Correct answer
B
Rationale — Correct (B)
Disuse atrophy reduces mechanical workload, downregulating
protein synthesis and upregulating proteasomal pathways that
degrade contractile proteins. The net loss of structural proteins
, leads to decreased cell size (atrophy), a reversible adaptive
response described in cellular change sections.
Rationale — Incorrect
A. Apoptosis results in loss of whole cells; disuse atrophy
primarily involves shrinkage of surviving fibers via protein
turnover.
C. Metaplasia is change from one differentiated cell type to
another (e.g., epithelial), not transformation of muscle to fat.
D. Hyperplasia increases cell number rather than reducing fiber
size; it does not explain atrophy after immobilization.
Teaching Point
Atrophy from disuse: decreased synthesis and increased
proteasomal degradation of structural proteins.
Citation
VanMeter, K. C., & Hubert, R. J. (2024). Gould’s Pathophysiology
for the Health Professions (7th ed.). Ch. 1.
3
Reference
Ch. 1 — Introduction to Pathophysiology — Introduction to
Cellular Changes
Stem
A chronic smoker’s bronchoscopic biopsy shows replacement of
normal pseudostratified ciliated columnar epithelium by
stratified squamous epithelium. From a pathophysiologic
HEALTH PROFESSIONS
7TH EDITION
• AUTHOR(S)KARIN C. VANMETER;
ROBERT J. HUBERT
TEST BANK
1
Reference
Ch. 1 — Introduction to Pathophysiology — What Is
Pathophysiology and Why Study It?
Stem
A 72-year-old man becomes acutely hypotensive after a long
period of vomiting and poor oral intake. Laboratory studies
show decreased perfusion to peripheral tissues. Which
pathophysiologic principle best explains why the patient’s cells
begin to swell within minutes of inadequate perfusion?
A. Increased intracellular ATP production increases osmotic
water entry.
,B. Failure of the Na⁺/K⁺ ATPase pump due to ATP depletion
leading to sodium and water influx.
C. Activation of apoptotic caspases causing regulated cell
swelling.
D. Increased capillary hydrostatic pressure forcing water into
cells.
Correct answer
B
Rationale — Correct (B)
Inadequate perfusion causes hypoxia and decreased ATP
generation. Loss of ATP impairs the energy-dependent Na⁺/K⁺
ATPase, permitting sodium accumulation within the cell; water
follows osmotically, producing cellular swelling (hydropic
change). This sequence is the classical immediate reversible
injury mechanism described in introductory pathophysiology.
Rationale — Incorrect
A. Increased ATP would maintain ion gradients and prevent
swelling; ATP normally falls in hypoperfusion.
C. Apoptosis is an energy-dependent, programmed process that
results in cell shrinkage and membrane integrity, not acute
swelling.
D. Increased capillary hydrostatic pressure causes extracellular
edema, not primary intracellular swelling from pump failure.
Teaching Point
ATP depletion → Na⁺/K⁺ pump failure → intracellular Na⁺ and
water accumulation (cell swelling).
,Citation
VanMeter, K. C., & Hubert, R. J. (2024). Gould’s Pathophysiology
for the Health Professions (7th ed.). Ch. 1.
2
Reference
Ch. 1 — Introduction to Pathophysiology — Introduction to
Cellular Changes
Stem
A 45-year-old office worker develops reduced muscle mass in
her immobilized right arm following a fracture. Considering
cellular adaptation, which mechanism most directly accounts
for the observed reduction in muscle fiber size?
A. Increased apoptosis of muscle cells via caspase activation.
B. Decreased protein synthesis and increased ubiquitin-
proteasome degradation of contractile proteins.
C. Metaplasia of muscle cells to adipose tissue.
D. Hyperplasia resulting in smaller individual fiber size due to
crowding.
Correct answer
B
Rationale — Correct (B)
Disuse atrophy reduces mechanical workload, downregulating
protein synthesis and upregulating proteasomal pathways that
degrade contractile proteins. The net loss of structural proteins
, leads to decreased cell size (atrophy), a reversible adaptive
response described in cellular change sections.
Rationale — Incorrect
A. Apoptosis results in loss of whole cells; disuse atrophy
primarily involves shrinkage of surviving fibers via protein
turnover.
C. Metaplasia is change from one differentiated cell type to
another (e.g., epithelial), not transformation of muscle to fat.
D. Hyperplasia increases cell number rather than reducing fiber
size; it does not explain atrophy after immobilization.
Teaching Point
Atrophy from disuse: decreased synthesis and increased
proteasomal degradation of structural proteins.
Citation
VanMeter, K. C., & Hubert, R. J. (2024). Gould’s Pathophysiology
for the Health Professions (7th ed.). Ch. 1.
3
Reference
Ch. 1 — Introduction to Pathophysiology — Introduction to
Cellular Changes
Stem
A chronic smoker’s bronchoscopic biopsy shows replacement of
normal pseudostratified ciliated columnar epithelium by
stratified squamous epithelium. From a pathophysiologic
