Test Bank Robbins Basic Pathology 10th Edition Kymar Abbas

Test Bank Robbins Basic Pathology 10th Edition Kymar AbbasTable of Contents Chapter 1. The Cell as a Unit of Health and Disease ..........................................................................................................................1 Chapter 2 . Cell Injury, Cell Death, and Adaptations ........................................................................................................................ 9 Chapter 3. Inflammation and Repair ................................................................................................................................................... 16 Chapter 4. Hemodynamic Disorders, Thromboembolism, and Shock ..................................................................................... 23 Chapter 5 . Diseases of the Immune System .................................................................................................................................. 30 Chapter 6 . Neoplasia .............................................................................................................................................................................. 36 Chapter 7. Genetic and Pediatric Diseases ...................................................................................................................................... 43 Chapter 8. Environmental and Nutritional Diseases .................................................................................................................... 50 Chapter 9. General Pathology of Infectious Diseases .................................................................................................................. 56 Chapter 10. Blood Vessels ...................................................................................................................................................................... 62 Chapter 11. Heart ........................................................................................................................................................................................ 71 Chapter 12. Hematopoietic and Lymphoid Systems....................................................................................................................... 78 Chapter 13. Lung ....................................................................................................................................................................................... 84 Chapter 14. Kidney and Its Collecting System ................................................................................................................................ 90 Chapter 15. Oral Cavities and Gastrointestinal Tract .....................................................................................................................96 Chapter 16. Liver and Gallbladder ...................................................................................................................................................... 103 Chapter 17. Pancreas .............................................................................................................................................................................. 109 Chapter 18. Male Genital System and Lower Urinary Tract ........................................................................................................118 Chapter 19. Female Genital System and Breast ............................................................................................................................ 124 Chapter 20. Endocrine System ............................................................................................................................................................ 130 Chapter 21. Bones, Joints, and Soft Tissue Tumors ....................................................................................................................... 136 Chapter 22. Peripheral Nerves and Muscles .................................................................................................................................. 142 Chapter 23. Central Nervous System ............................................................................................................................................... 149 Chapter 24. Skin ...................................................................................................................................................................................... 155 Chapter 1. The Cell as a Unit of Health and Disease 1 The nucleus , which is essential for function and survival of the cell. A) B) 1 | P a g e is the site of protein synthesis contains the genetic codeC) D) 2 A) B) C) D) 3 A) B) C) D) 4 A) B) transforms cellular energy initiates aerobic metabolism Although energy is not made in mitochondria, they are known as the power plants of the cell because they: contain RNA for protein synthesis. utilize glycolysis for oxidative energy. extract energy from organic compounds. store calcium bonds for muscle contractions. Although the basic structure of the cell plasma membrane is formed by a lipid bilayer, most of the specific membrane functions are carried out by: bound and transmembrane proteins. complex, long carbohydrate chains. surface antigens and hormone receptors. a gating system of selective ion channels. To effectively relay signals, cell-to-cell communication utilizes chemical messenger systems that: displace surface receptor proteins. accumulate within cell gap junctions. 2 | P a g eC) D) 5 A) B) C) D) 6 A) B) C) D) 7 A) B) C) D) bind to contractile microfilaments. release secretions into extracellular fluid. Aerobic metabolism, also known as oxidative metabolism, provides energy by: removing the phosphate bonds from ATP. combining hydrogen and oxygen to form water. activating pyruvate stored in the cytoplasm. breaking down glucose to form lactic acid. Exocytosis, the reverse of endocytosis, is important in into the extracellular fluid. Engulfing and ingesting fluid and proteins for transport Killing, degrading, and dissolving harmful microorganisms Removing cellular debris and releasing synthesized substances Destruction of particles by lysosomal enzymes for secretion The process responsible for generating and conducting membrane potentials is: diffusion of current-carrying ions. millivoltage of electrical potential. polarization of charged particles. ion channel neurotransmission. 3 | P a g e8 Epithelial tissues are classified according to the shape of the cells and the number of layers. Which of the following is a correctly matched description and type of epithelial tissue? A) Simple epithelium: cells in contact with intercellular matrix; some do not extend to surface 4 | P a g eB) Stratified epithelium: single layer of cells; all cells rest on basement membrane C) D) Glandular epithelium: arise from surface epithelia and underlying connective tissue Pseudostratified epithelium: multiple layers of cells; deepest layer rests on basement membrane 9 A) B) C) D) 10 Connective tissue contains fibroblasts that are responsible for: providing a fibrous framework for capillaries. synthesis of collagen, elastin, and reticular fibers. forming tendons and the fascia that covers muscles. filling spaces between tissues to keep organs in place. Although all muscle tissue cells have some similarities, smooth muscle (also known as involuntary muscle) differs by: A) B) C) D) 11 A) having dense bodies attached to actin filaments. containing sarcomeres between Z lines and M bands. having rapid contractions and abundant cross- striations. contracting in response to increased intracellular calcium. Which of the following aspects of the function of the nucleus is performed by ribosomal RNA (rRNA)? Copying and carrying DNA instructions for protein synthesis 5 | P a g eB) Carrying amino acids to the site of protein synthesis C) D) 12 Providing the site where protein synthesis occurs Regulating and controlling protein synthesis Breakdown and removal of foreign substances and worn-out cell parts are performed by which of the following organelles? A) B) C) D) 13 A) B) C) D) 14 Lysosomes Golgi apparatus Ribosomes Endoplasmic reticulum (ER) Impairment in the function of peroxisomes would result in: inadequate sites for protein synthesis. an inability to transport cellular products across the cell membrane. insufficient energy production within a cell. accumulation of free radicals in the cytoplasm. After several months of trying to conceive, a couple is undergoing fertility testing. Semen analysis indicates that the mans sperm have decreased motility, a finding that is thought to underlie the couples inability to become pregnant. Which of the following cellular components may be defective within the mans sperm? A) B) C) D) Ribosomes Microtubules Mitochondria Microfilaments 6 | P a g e15 A) B) C) D) 16 A) B) C) D) 17 Which of the following statements is true of glycolysis? Glycolysis requires oxygen. Glycolysis occurs in cells without mitochondria. Glycolysis provides the majority of the bodys energy needs. Glycolysis produces energy, water, and carbon dioxide. Which of the following membrane transport mechanisms requires the greatest amount of energy? Facilitated diffusion Passive transport Vesicular transport Simple diffusion A male patient with a diagnosis of type 1 diabetes mellitus is experiencing hyperglycemia because he lacks sufficient insulin to increase the availability of glucose transporters in his cell membranes. Consequently, his cells lack intracellular glucose and it accumulates in his blood. Which of the following processes would best allow glucose to cross his cell membranes? A) B) C) D) Facilitated diffusion Simple diffusion Secondary active transport Endocytosis 18 A) Which of the following statements is true of skeletal muscle cells? Skeletal muscle cells each have an apical, lateral, and basal surface. 7 | P a g eB) They are closely apposed and are joined by cell-to-cell adhesion molecules. C) D) 19 A) B) C) D) 20 A) B) C) D) Answer Key 1 2 3 4 5 8 | P a g e Their basal surface is attached to a basement membrane. Skeletal muscle is multinucleated, lacking true cell boundaries. Which of the following body tissues exhibits the highest rate of turnover and renewal? The squamous epithelial cells of the skin The connective tissue supporting blood vessels The skeletal muscle that facilitates movement The nervous tissue that constitutes the central nervous system A patient with a pathophysiologic condition that affects the desmosomes is most likely to exhibit: impaired contraction of skeletal and smooth muscle. weakness of the collagen and elastin fibers in the extracellular space. impaired communication between neurons and effector organs. separation at the junctions between epithelial cells. B C A D B6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 C A C B A C A D B B C A D A D Chapter 2 . Cell Injury, Cell Death, and Adaptations 1 Ischemia and other toxic injuries increase the accumulation of intracellular calcium as a result of: A) B) C) D) 2 release of stored calcium from the mitochondria. improved intracellular volume regulation. decreased influx across the cell membrane. attraction of calcium to fatty infiltrates. The patient is found to have liver disease, resulting in the removal of a lobe of his liver. Adaptation to the reduced size of the liver leads to of the remaining liver cells. A) 9 | P a g e metaplasiaB) C) D) organ atrophy compensatory hyperplasia physiologic hypertrophy 3 A person eating peanuts starts choking and collapses. His airway obstruction is partially cleared, but he remains hypoxic until he reaches the hospital. The prolonged cell hypoxia caused a cerebral infarction and resulting in the brain. A) B) C) D) caspase activation coagulation necrosis rapid phagocytosis protein p53 deficiency 4 Bacteria and viruses cause cell damage by unique from the intracellular damage caused by other injurious agents. A) B) C) D) 5 disrupting the sodium/potassium ATPase pump interrupting oxidative metabolism processes replicating and producing continued injury decreasing protein synthesis and function The patient has a prolonged interruption in arterial blood flow to his left kidney, causing hypoxic cell injury and the release of free radicals. Free radicals damage cells by: A) B) C) D) destroying phospholipids in the cell membrane. altering the immune response of the cell. disrupting calcium storage in the cell. inactivation of enzymes and mitochondria. , which is 10 | P a g e6 A) B) C) D) 7 A) B) C) D) 8 A) B) C) D) 9 Injured cells have impaired flow of substances through the cell membrane as a result of: increased fat load. altered permeability. altered glucose utilization. increased surface receptors. Reversible adaptive intracellular responses are initiated by: stimulus overload. genetic mutations. chemical messengers. mitochondrial DNA. Injured cells become very swollen as a result of: increased cell protein synthesis. altered cell volume regulation. passive entry of potassium into the cell. bleb formation in the plasma membrane. A diabetic patient has impaired sensation, circulation, and oxygenation of his feet. He steps on a piece of glass, the wound does not heal, and the area tissue becomes necrotic. The necrotic cell death is characterized by: A) B) C) D) 10 rapid apoptosis. cellular rupture. shrinkage and collapse. chronic inflammation. A 99-year-old woman has experienced the decline of cell function associated with age. A group of theories of cellular aging focus on programmed: 11 | P a g eA) B) C) D) changes with genetic influences. elimination of cell receptor sites. insufficient telomerase enzyme. DNA mutation or faulty repair. 11 An 89-year-old female patient has experienced significant decreases in her mobility and stamina during a 3-week hospital stay for the treatment of a femoral head fracture. Which of the following phenomena most likely accounts for the patients decrease in muscle function that underlies her reduced mobility? A) Impaired muscle cell metabolism resulting from metaplasia B) C) D) 12 Dysplasia as a consequence of inflammation during bone remodeling Disuse atrophy of muscle cells during a prolonged period of immobility Ischemic atrophy resulting from vascular changes while on bedrest A 20-year-old college student has presented to her campus medical clinic for a scheduled Papanicolaou (Pap) smear. The clinician who will interpret the smear will examine cell samples for evidence of: A) B) C) D) 13 changes in cell shape, size, and organization. the presence of unexpected cell types. ischemic changes in cell samples. abnormally high numbers of cells in a specified field. Which of the following pathophysiologic processes is most likely to result in metastatic calcification? 12 | P a g eA) B) C) D) Benign prostatic hyperplasia Liver cirrhosis Impaired glycogen metabolism Hyperparathyroidism 14 Despite the low levels of radiation used in contemporary radiologic imaging, a radiology technician is aware of the need to minimize her exposure to ionizing radiation. What is the primary rationale for the technicians precautions? A) B) C) D) 15 Radiation stimulates pathologic cell hypertrophy and hyperplasia. Radiation results in the accumulation of endogenous waste products in the cytoplasm. Radiation interferes with DNA synthesis and mitosis. Radiation decreases the action potential of rapidly dividing cells. The parents of a 4-year-old girl have sought care because their daughter has admitted to chewing and swallowing imported toy figurines that have been determined to be made of lead. Which of the following blood tests should the care team prioritize? A) B) C) D) White blood cell levels with differential Red blood cell levels and morphology Urea and creatinine levels Liver function panel 16 A 70-year-old male patient has been admitted to a hospital for the treatment of a recent hemorrhagic stroke that has left him with numerous motor and sensory deficits. These deficits are most likely the result of which of the following mechanisms of cell injury? 13 | P a g eA) B) C) D) Free radical injury Hypoxia and ATP depletion Interference with DNA synthesis Impaired calcium homeostasis 17 A) B) C) D) 18 A) B) C) D) 19 Which of the following processes associated with cellular injury is most likely to be reversible? Cell damage resulting from accumulation of fat in the cytoplasm Cellular changes as a result of ionizing radiation Cell damage from accumulation of free radicals Apoptosis The extrinsic pathway of apoptosis can be initiated by: damage to cellular DNA. decreased ATP levels. activation of the p53 protein. activation of death receptors on the cell surface. A patient with severe peripheral vascular disease has developed signs of dry gangrene on the great toe of one foot. Which of the following pathophysiologic processes most likely contributed to this diagnosis? A) B) C) D) Inappropriate activation of apoptosis Bacterial invasion Impaired arterial blood supply Metaplastic cellular changes 14 | P a g e20 A) Which of the following facts underlies the concept of replicative senescence? Genes controlling longevity are present or absent in varying quantities among different individuals. B) C) Telomeres become progressively shorter in successive generations of a cell. The damaging influence of free radicals increases exponentially in later generations of a cell. D) Answer Key 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 15 | P a g e Aging produces mutations in DNA and deficits in DNA repair. A C B C A B C B B A C A D C B16 17 18 19 20 B A D C B Chapter 3. Inflammation and Repair 1 The characteristic, localized cardinal signs of acute inflammation include: A) B) C) D) 2 fever. fatigue. redness. granuloma. The vascular, hemodynamic stage of acute inflammation is initiated by momentary vasoconstriction followed by vasodilation that causes localized: A) B) C) D) 3 bleeding. congestion. pale skin. coolness. The cellular stage of acute inflammation is marked by the movement of leukocytes into the area. Which of the following cells arrives early in great numbers? A) B) C) D) Basophils Lymphocytes Neutrophils Platelets 16 | P a g e4 A) B) C) D) 5 A) B) C) D) 6 The phagocytosis process involves three distinct steps. What is the initial step in the process? Engulfment Intracellular killing Antigen margination Recognition and adherence Which of the following mediators of inflammation causes increased capillary permeability and pain? Serotonin Histamine Bradykinin Nitric oxide Inflammatory exudates are a combination of several types. Which of the following exudates is composed of enmeshed necrotic cells? A) B) C) D) 7 A) B) C) D) 8 Serous Fibrinous Suppurative Membranous The acute-phase systemic response usually begins within hours of the onset of inflammation and includes: fever and lethargy. decreased C-reactive protein. positive nitrogen balance. low erythrocyte sedimentation rate. In contrast to acute inflammation, chronic inflammation is characterized by which of the following phenomena? 17 | P a g eA) B) C) D) 9 Profuse fibrinous exudation A shift to the left of granulocytes Metabolic and respiratory alkalosis Lymphocytosis and activated macrophages Exogenous pyrogens (interleukin-1) and the presence of bacteria in the blood lead to the release of endogenous pyrogens that: A) B) C) D) 10 stabilize thermal control in the brain. produce leukocytosis and anorexia. block viral replication in cells. inhibit prostaglandin release. An older adult patient has just sheared the skin on her elbow while attempted to boost herself up in bed, an event that has precipitated acute inflammation in the region surrounding the wound. Which of the following events will occur during the vascular stage of the patients inflammation? A) B) C) Outpouring of exudate into interstitial spaces Chemotaxis Accumulation of leukocytes along the epithelium D) 11 A) B) C) Phagocytosis of cellular debris Which of the following individuals most likely has the highest risk of experiencing chronic inflammation? A patient who has recently been diagnosed with type 2 diabetes A patient who is a carrier of an antibiotic- resistant organism A patient who is taking oral antibiotics for an upper respiratory infection 18 | P a g eD) A patient who is morbidly obese and who has a sedentary lifestyle 12 A) B) C) D) 13 Which of the following core body temperatures is within normal range? 35.9C (96.6F) 38.0C (100.4F) 35.5C (95.9F) 37.3C (99.1F) A postsurgical patient who is recovering in the postanesthetic recovery unit states that she is freezing cold. Which of the following measures is likely to be initiated in the patients hypothalamus in an effort to reduce heat loss? A) B) C) D) 14 Opening of arteriovenous (AV) shunts Reduced exhalation of warmed air Contraction of pilomotor muscles Decreased urine production An elderly patient is dressed only in a hospital gown and complains of a draft in her room. Consequently, she has requested a warm blanket while she sits in her wheelchair. Which of the following mechanisms of heat loss is most likely the primary cause of her request? A) B) C) D) Evaporation and conduction Radiation and convection Conduction and convection Convection and evaporation 15 Which of the following pathophysiologic processes are capable of inducing the production of pyrogens? Select all that apply. A) 19 | P a g e Acute inflammationB) C) D) E) Obesity Myocardial infarction Malignancy Renal failure 16 A) B) C) D) Which of the following patients is most likely to be susceptible to developing a neurogenic fever? A patient who has stage II Alzheimer disease A patient who has sustained a head injury in a bicycle crash A patient who has become delirious after the administration of a benzodiazepine A patient who has begun taking a selective serotonin-reuptake inhibitor (SSRI) for the treatment of depression 17 Patients are commonly administered antipyretics when their oral temperature exceeds 37.5C (99.5F). Which of the following statements related to the rationale for this action is most accurate? A) Temperatures in excess of 37.5C (99.5F) can result in seizure activity. B) C) D) Lower temperatures inhibit the protein synthesis of bacteria. There is little empirical evidence for this treatment modality. Most common antipyretics have been shown to have little effect on core temperature. 20 | P a g e18 A patient has sought care because of recent malaise and high fever. Upon assessment, the patient states that his current fever began two days earlier, although he states that for the last 2 weeks he is in a cycle of high fever for a couple of days followed by a day or two of normal temperature. Which of the following fever patterns is this patient experiencing? A) B) C) D) Recurrent fever Remittent fever Sustained fever Intermittent fever 19 A febrile, 3-week-old infant has been brought to the emergency department by his parents and is currently undergoing a diagnostic workup to determine the cause of his fever. Which of the following statements best conveys the rationale for this careful examination? A) The immature hypothalamus is unable to perform normal thermoregulation. B) C) D) 20 Infants are susceptible to serious infections because of their decreased immune function. Commonly used antipyretics often have no effect on the core temperature of infants. Fever in neonates is often evidence of a congenital disorder rather than an infection. An 84-year-old patients blood cultures have come back positive, despite the fact that his oral temperature has remained within normal range. Which of the following phenomena underlies the alterations in fever response that occur in the elderly? A) Disturbance in the functioning of the thermoregulatory center B) 21 | P a g e Increased heat loss by evaporation22 | P a g eC) The presence of comorbidities that are associated with lowered core temperature D) Answer Key 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 1 C B C D C D A D B A D D C B A, C, D B C D B A With the exception of the first two steps, what is required in all steps of the clotting process? Chapter 4. Hemodynamic Disorders, Thromboembolism, and Shock 23 | P a g e Persistent closure of arteriovenous shuntsA) B) C) D) 2 A) B) C) D) 3 A) B) C) D) 4 Calcium Prothrombin Tissue factor Plasminogen The first step of hemostasis occurs as a: fibrin clot. platelet plug. clot retraction. vessel spasm. To form a platelet plug, platelets are attracted to the damaged vessel, and then platelet occurs. adhesion fibrinolysis thrombosis thromboxane A2 Blood coagulation is initiated by either of two pathways. The intrinsic pathway requires circulating to begin the step- wise coagulation cascade. A) B) C) D) 5 A) B) C) 24 | P a g e protein C thrombin factor XII tissue factor Increased platelet function, and consequent hypercoagulability, can be caused by: factor V mutation. platelet insensitivity. vascular wall damage.D) 6 A) B) C) D) 7 A) B) C) D) E) 8 A) B) C) D) 9 A) B) C) D) decreased platelet numbers. Immune thrombocytopenia purpura (ITP) is a/an disorder that destroys allergic; fibrinogen alloimmune; factor VIII autoimmune; platelets immunoglobulin; B cells Thrombotic thrombocytopenic purpura (TTP) causes which of the following manifestations? Select all that apply. Purpura Jaundice Petechiae Erythema Confusion Hemophilia A is a hereditary blood disorder caused by inadequate activity or absent: factor VIII. prothrombin. vWF complex. intrinsic factor. Disseminated intravascular coagulation (DIC) is characterized by: headaches. platelet loss. hypertension. hemorrhage. . 25 | P a g e10 A) B) C) D) 11 In persons with a bleeding disorder caused by vascular defects, laboratory tests will most often reveal: normal values. hypocalcemia. polycythemia. thrombocytopenia. Removal of a patients peripheral intravenous catheter resulted in brief bleeding and the loss of a small amount of blood. Which of the following processes occurred during the formation of the platelet plug that helped to stop blood flow? A) B) C) D) 12 Activation of factor X Conversion of prothrombin to thrombin Release of von Willebrand factor from the epithelium Conversion of fibrinogen to fibrin threads A 69-year-old patient who is obese and has a diagnosis of angina pectoris has been prescribed clopidogrel (Plavix) by his primary care provider. The patients medication achieves its therapeutic effect in which of the following ways? A) B) C) D) 13 Prevention of platelet aggregation Activation of plasminogen Inhibition of the intrinsic clotting pathway Deactivation of factor X A public health nurse is conducting a health promotion campaign under the auspices of the local community center. Which of the following measures that the nurse is promoting are likely to influence the participants risk of hypercoagulability disorders? Select all that apply. A) Smoking cessation 26 | P a g eB) C) D) E) Blood glucose screening Weight management Cholesterol screening and management Blood pressure screening and management 14 During a patients admission assessment prior to reduction mammoplasty surgery, the nurse notes a reference to a Leiden mutation in the patients history. The nurse would recognize the patients increased risk for A) B) C) D) 15 Hemorrhage Myocardial infarction Hemophilia A or B Deep vein thrombosis The most recent blood work of a patient with a diagnosis of acute myelogenous leukemia (AML) reveals thrombocytopenia. Where is the patient most likely to experience abnormal bleeding as a result of low platelets? A) B) C) D) 16 In the brain Skin and mucous membranes Sclerae of the eyes Nephrons and ureters A patient was started on a protocol for the prevention of deep vein thrombosis shortly after admission, and has been receiving 5000 units of heparin twice daily for the last 5 days. An immune response to this treatment may increase the patients chance of developing which health problem? A) B) C) Antiphospholipid syndrome Disseminated intravascular coagulation (DIC) Von Willebrand disease 27 | P a g eD) Thrombocytopenia 17 In light of the presence of numerous risk factors for coronary artery disease, a patients primary care provider has recommended that he take low-dose aspirin once daily. Doing so will reduce the patients risk of myocardial infarction by altering which of the following stages of hemostasis? A) B) C) D) Vessel spasm Platelet plug formation Blood coagulation Clot lysis 18 A 23-year-old female patient has been diagnosed with von Willebrand disease following a long history of heavy periods and occasional nosebleeds. Which of the patients following statements demonstrates a sound understanding of her new diagnosis? A) Im really disappointed that I wont be able to do sports anymore. B) C) D) 19 I read on a website that I might have to get blood transfusions from time to time. Ill make sure to take Tylenol instead of aspirin when I get aches and pains. I hope my insurance covers the injections that Ill need to help my blood clot. Which of the following patients likely faces the highest risk of an acquired hypocoagulation disorder and vitamin K deficiency? A) B) A patient who has a diagnosis of liver failure secondary to alcohol abuse A patient who has chronic renal failure as a result of type 1 diabetes mellitus 28 | P a g eC) A patient who is immunocompromised as a result of radiation therapy for the treatment of lung cancer D)