McCance & Huether’s Pathophysiology
The Biologic Basis for Disease in Adults
and Children
9th Edition
Author(s)Julia Rogers
TEST BANK
Q1. A 6-year-old boy presents with recurrent bacterial
infections, delayed wound healing, and impaired leukocyte
migration into infected tissues. Genetic analysis identifies
a defect in integrin activation on neutrophils. The impaired
, inflammatory response most directly reflects failure of
which cellular process?
A. Endocytosis-mediated antigen processing
B. Cell-to-cell adhesion during transmigration
C. Lysosomal fusion with phagosomes
D. Oxidative phosphorylation within neutrophils
Correct Answer: B
Rationale:
• Clinical Clue: Recurrent infections with impaired leukocyte
migration suggests defective adhesion and extravasation.
• Mechanism: Integrins mediate firm adhesion of leukocytes
to endothelial cells before transmigration into tissues.
• Why the Correct Answer Is Right: Without integrin
activation, neutrophils cannot establish stable adhesion
required for diapedesis.
• Why the Other Options Are Wrong:
o A: Antigen processing occurs after leukocyte entry
into tissues.
o C: Lysosomal fusion affects intracellular killing, not
migration.
o D: ATP production defects cause generalized energy
failure rather than selective adhesion defects.
,• Exam Trap: Confusing chemotaxis with adhesion; rolling
can still occur despite defective integrin binding.
• High-Yield Clinical Correlation: Leukocyte adhesion
deficiency produces delayed umbilical cord separation and
absent pus formation.
• Memory Anchor: “Integrins anchor immune cells before
tissue entry.”
Q2. A researcher exposes hepatocytes to a toxin that
selectively disrupts rough endoplasmic reticulum function.
Which cellular activity would be expected to decline most
significantly?
A. Steroid hormone synthesis
B. Intracellular ATP generation
C. Synthesis of membrane and secretory proteins
D. Packaging of proteins into secretory vesicles
Correct Answer: C
Rationale:
• Clinical Clue: Rough endoplasmic reticulum is studded with
ribosomes.
• Mechanism: Ribosome-associated rough ER synthesizes
proteins destined for secretion, membranes, or lysosomes.
, • Why the Correct Answer Is Right: Secretory and
membrane proteins require translation on rough ER-
bound ribosomes.
• Why the Other Options Are Wrong:
o A: Steroid synthesis occurs mainly in smooth ER.
o B: ATP generation occurs in mitochondria.
o D: Protein packaging primarily occurs in the Golgi
apparatus.
• Exam Trap: Confusing rough ER protein synthesis with
Golgi processing.
• High-Yield Clinical Correlation: Plasma cells possess
abundant rough ER due to intense immunoglobulin
synthesis.
• Memory Anchor: “Rough ER builds export proteins.”
Q3. A patient develops severe muscle weakness after
exposure to cyanide, which inhibits cytochrome oxidase
within mitochondria. The resulting cellular injury is most
directly caused by failure of which process?
A. Glycogenolysis
B. Oxidative phosphorylation
C. Ribosomal translation
D. Lysosomal hydrolysis
The Biologic Basis for Disease in Adults
and Children
9th Edition
Author(s)Julia Rogers
TEST BANK
Q1. A 6-year-old boy presents with recurrent bacterial
infections, delayed wound healing, and impaired leukocyte
migration into infected tissues. Genetic analysis identifies
a defect in integrin activation on neutrophils. The impaired
, inflammatory response most directly reflects failure of
which cellular process?
A. Endocytosis-mediated antigen processing
B. Cell-to-cell adhesion during transmigration
C. Lysosomal fusion with phagosomes
D. Oxidative phosphorylation within neutrophils
Correct Answer: B
Rationale:
• Clinical Clue: Recurrent infections with impaired leukocyte
migration suggests defective adhesion and extravasation.
• Mechanism: Integrins mediate firm adhesion of leukocytes
to endothelial cells before transmigration into tissues.
• Why the Correct Answer Is Right: Without integrin
activation, neutrophils cannot establish stable adhesion
required for diapedesis.
• Why the Other Options Are Wrong:
o A: Antigen processing occurs after leukocyte entry
into tissues.
o C: Lysosomal fusion affects intracellular killing, not
migration.
o D: ATP production defects cause generalized energy
failure rather than selective adhesion defects.
,• Exam Trap: Confusing chemotaxis with adhesion; rolling
can still occur despite defective integrin binding.
• High-Yield Clinical Correlation: Leukocyte adhesion
deficiency produces delayed umbilical cord separation and
absent pus formation.
• Memory Anchor: “Integrins anchor immune cells before
tissue entry.”
Q2. A researcher exposes hepatocytes to a toxin that
selectively disrupts rough endoplasmic reticulum function.
Which cellular activity would be expected to decline most
significantly?
A. Steroid hormone synthesis
B. Intracellular ATP generation
C. Synthesis of membrane and secretory proteins
D. Packaging of proteins into secretory vesicles
Correct Answer: C
Rationale:
• Clinical Clue: Rough endoplasmic reticulum is studded with
ribosomes.
• Mechanism: Ribosome-associated rough ER synthesizes
proteins destined for secretion, membranes, or lysosomes.
, • Why the Correct Answer Is Right: Secretory and
membrane proteins require translation on rough ER-
bound ribosomes.
• Why the Other Options Are Wrong:
o A: Steroid synthesis occurs mainly in smooth ER.
o B: ATP generation occurs in mitochondria.
o D: Protein packaging primarily occurs in the Golgi
apparatus.
• Exam Trap: Confusing rough ER protein synthesis with
Golgi processing.
• High-Yield Clinical Correlation: Plasma cells possess
abundant rough ER due to intense immunoglobulin
synthesis.
• Memory Anchor: “Rough ER builds export proteins.”
Q3. A patient develops severe muscle weakness after
exposure to cyanide, which inhibits cytochrome oxidase
within mitochondria. The resulting cellular injury is most
directly caused by failure of which process?
A. Glycogenolysis
B. Oxidative phosphorylation
C. Ribosomal translation
D. Lysosomal hydrolysis
