Understanding Pathophysiology
8th Edition
Author(s)Sue E. Huether
TEST BANK
Chapter 1: Cellular Biology
Q1. A 6-year-old boy presents with recurrent bacterial
infections, poor wound healing, and delayed separation of the
umbilical cord after birth. Neutrophil studies demonstrate
impaired migration from the bloodstream into infected tissues
despite normal neutrophil counts. Defective expression of β2-
integrins on leukocytes is identified.
A. Failure of neutrophils to generate reactive oxygen species
B. Impaired selectin-mediated rolling along the endothelium
C. Defective leukocyte adhesion to endothelial ICAM molecules
D. Inability of neutrophils to recognize opsonized bacteria
E. Reduced production of granulocyte colony-stimulating factor
,Correct Answer: C
Rationale:
Clinical Clue:
Delayed umbilical cord separation and recurrent bacterial
infections strongly suggest leukocyte adhesion deficiency.
Mechanism:
β2-integrins mediate firm adhesion of leukocytes to endothelial
ICAM molecules before transmigration.
Why the Correct Answer Is Right:
Defective β2-integrins prevent stable adhesion of leukocytes to
vascular endothelium, impairing migration into tissues despite
normal circulating counts.
Why the Other Options Are Wrong:
A. Defective oxidative burst occurs in chronic granulomatous
disease.
B. Rolling is mediated primarily by selectins, not integrins.
D. Opsonin recognition defects impair phagocytosis rather than
transmigration.
E. G-CSF deficiency causes neutropenia, not defective adhesion.
Exam Trap (common misconception tested):
Confusing leukocyte rolling with firm adhesion.
High-Yield Clinical Correlation:
Integrin defects impair tissue recruitment of leukocytes while
increasing circulating neutrophil levels.
,Q2. A patient with severe protein-calorie malnutrition develops
generalized edema despite preserved cardiac and renal
function. Laboratory testing shows markedly reduced serum
albumin synthesis by hepatocytes.
A. Increased osmotic movement of water into cells
B. Reduced plasma oncotic pressure causing fluid movement
into interstitial tissues
C. Excess sodium retention from increased aldosterone
secretion
D. Enhanced capillary hydrostatic pressure from systemic
vasoconstriction
E. Increased lymphatic obstruction due to impaired collagen
synthesis
Correct Answer: B
Rationale:
Clinical Clue:
Hypoalbuminemia with edema in the absence of heart or
kidney failure indicates reduced oncotic pressure.
Mechanism:
Albumin maintains plasma colloid osmotic pressure that
opposes fluid filtration into tissues.
Why the Correct Answer Is Right:
Reduced albumin decreases intravascular oncotic pressure,
favoring net fluid movement into the interstitial space.
, Why the Other Options Are Wrong:
A. Cellular swelling involves intracellular osmotic shifts rather
than edema formation.
C. Aldosterone-mediated sodium retention is not the primary
mechanism.
D. Hydrostatic edema results from elevated vascular pressure.
E. Lymphatic obstruction produces localized rather than
generalized edema.
Exam Trap (common misconception tested):
Confusing hydrostatic edema with oncotic edema.
High-Yield Clinical Correlation:
Liver dysfunction and malnutrition commonly produce edema
through impaired protein synthesis.
Q3. During prolonged ischemia, myocardial cells progressively
lose membrane integrity and develop irreversible injury. Which
intracellular event most directly explains this transition from
reversible to irreversible cell damage?
A. Glycogen depletion
B. Ribosomal detachment from the rough endoplasmic
reticulum
C. ATP depletion causing failure of sodium-potassium ATPase
activity
D. Massive influx of calcium activating degradative enzymes
E. Anaerobic glycolysis with lactate accumulation
Correct Answer: D
8th Edition
Author(s)Sue E. Huether
TEST BANK
Chapter 1: Cellular Biology
Q1. A 6-year-old boy presents with recurrent bacterial
infections, poor wound healing, and delayed separation of the
umbilical cord after birth. Neutrophil studies demonstrate
impaired migration from the bloodstream into infected tissues
despite normal neutrophil counts. Defective expression of β2-
integrins on leukocytes is identified.
A. Failure of neutrophils to generate reactive oxygen species
B. Impaired selectin-mediated rolling along the endothelium
C. Defective leukocyte adhesion to endothelial ICAM molecules
D. Inability of neutrophils to recognize opsonized bacteria
E. Reduced production of granulocyte colony-stimulating factor
,Correct Answer: C
Rationale:
Clinical Clue:
Delayed umbilical cord separation and recurrent bacterial
infections strongly suggest leukocyte adhesion deficiency.
Mechanism:
β2-integrins mediate firm adhesion of leukocytes to endothelial
ICAM molecules before transmigration.
Why the Correct Answer Is Right:
Defective β2-integrins prevent stable adhesion of leukocytes to
vascular endothelium, impairing migration into tissues despite
normal circulating counts.
Why the Other Options Are Wrong:
A. Defective oxidative burst occurs in chronic granulomatous
disease.
B. Rolling is mediated primarily by selectins, not integrins.
D. Opsonin recognition defects impair phagocytosis rather than
transmigration.
E. G-CSF deficiency causes neutropenia, not defective adhesion.
Exam Trap (common misconception tested):
Confusing leukocyte rolling with firm adhesion.
High-Yield Clinical Correlation:
Integrin defects impair tissue recruitment of leukocytes while
increasing circulating neutrophil levels.
,Q2. A patient with severe protein-calorie malnutrition develops
generalized edema despite preserved cardiac and renal
function. Laboratory testing shows markedly reduced serum
albumin synthesis by hepatocytes.
A. Increased osmotic movement of water into cells
B. Reduced plasma oncotic pressure causing fluid movement
into interstitial tissues
C. Excess sodium retention from increased aldosterone
secretion
D. Enhanced capillary hydrostatic pressure from systemic
vasoconstriction
E. Increased lymphatic obstruction due to impaired collagen
synthesis
Correct Answer: B
Rationale:
Clinical Clue:
Hypoalbuminemia with edema in the absence of heart or
kidney failure indicates reduced oncotic pressure.
Mechanism:
Albumin maintains plasma colloid osmotic pressure that
opposes fluid filtration into tissues.
Why the Correct Answer Is Right:
Reduced albumin decreases intravascular oncotic pressure,
favoring net fluid movement into the interstitial space.
, Why the Other Options Are Wrong:
A. Cellular swelling involves intracellular osmotic shifts rather
than edema formation.
C. Aldosterone-mediated sodium retention is not the primary
mechanism.
D. Hydrostatic edema results from elevated vascular pressure.
E. Lymphatic obstruction produces localized rather than
generalized edema.
Exam Trap (common misconception tested):
Confusing hydrostatic edema with oncotic edema.
High-Yield Clinical Correlation:
Liver dysfunction and malnutrition commonly produce edema
through impaired protein synthesis.
Q3. During prolonged ischemia, myocardial cells progressively
lose membrane integrity and develop irreversible injury. Which
intracellular event most directly explains this transition from
reversible to irreversible cell damage?
A. Glycogen depletion
B. Ribosomal detachment from the rough endoplasmic
reticulum
C. ATP depletion causing failure of sodium-potassium ATPase
activity
D. Massive influx of calcium activating degradative enzymes
E. Anaerobic glycolysis with lactate accumulation
Correct Answer: D
