Chapter 01: Introduction to Pathophysiology
Banasik: Pathophysiology, 7th Edition
MULTIPLE CHOICE
1. C.Q. was recently exposed to group A hemolytic Streptococcus and subsequently developed a
pharyngeal infection. His clinic examination reveals an oral temperature of 102.3°F, skin rash,
dysphagia, and reddened throat mucosa with multiple pustules. He complains of sore throat,
malaise, and joint stiffness. A throat culture is positive for Streptococcus, and antibiotics have
been prescribed. The etiology of C.Q.’s disease is
a. a sore throat.
b. streptococcal infection.
c. genetic susceptibility.
d. pharyngitis.
ANS: B
Etiology refers to the proposed cause or causes of a particular disease process. A sore throat is
the manifestation of the disease process. Genetic susceptibility refers to inherited tendency to
develop a disease. Pharyngitis refers to inflammation of the throat and is also a clinical
manifestation of the disease process.
2. A 17-year-old college-bound student receives a vaccine against an organism that causes
meningitis. This is an example of
a. primary prevention.
b. secondary prevention.
c. tertiary prevention.
d. disease treatment.
ANS: A
Primary prevention is prevention of disease by altering susceptibility or reducing exposure for
susceptible individuals, in this case by providing vaccination. Secondary prevention is the
early detection, screening, and management of the disease. Tertiary prevention includes
rehabilitative and supportive care and attempts to alleviate disability and restore effective
functioning. Disease treatment involves management of the disease once it has developed.
3. An obese but otherwise healthy teen is given a prescription for a low-calorie diet and exercise
program. This is an example of
a. primary prevention.
b. secondary prevention.
c. tertiary prevention.
d. disease treatment.
ANS: B
Secondary prevention is the early detection, screening, and management of the disease such as
prescribing diet and exercise for an individual who has already developed obesity. Primary
prevention is prevention of disease by altering susceptibility or reducing exposure for
susceptible individuals. Tertiary prevention includes rehabilitative and supportive care and
attempts to alleviate disability and restore effective functioning. Disease treatment involves
management of the disease once it has developed.
,4. A patient with high blood pressure who is otherwise healthy is counseled to restrict sodium
intake. This is an example of
a. primary prevention.
b. secondary prevention.
c. tertiary prevention.
d. disease treatment.
ANS: B
Secondary prevention is the early detection, screening, and management of the disease, such
as by prescribing sodium restriction for high blood pressure. Primary prevention is prevention
of disease by altering susceptibility or reducing exposure for susceptible individuals. Tertiary
prevention includes rehabilitative and supportive care and attempts to alleviate disability and
restore effective functioning. Disease treatment involves management of the disease once it
has developed.
5. After suffering a heart attack, a middle-aged man is counseled to take a cholesterol-lowering
medication. This is an example of
a. primary prevention.
b. secondary prevention.
c. tertiary prevention.
d. disease treatment.
ANS: C
Tertiary prevention includes rehabilitative and supportive care and attempts to alleviate
disability and restore effective functioning such as prescribing a cholesterol-lowering
medication following a heart attack. Primary prevention is prevention of disease by altering
susceptibility or reducing exposure for susceptible individuals. Secondary prevention is the
early detection, screening, and management of the disease. Disease treatment involves
management of the disease once it has developed.
6. A patient has been exposed to meningococcal meningitis, but is not yet demonstrating signs of
this disease. This stage of illness is called the stage.
a. prodromal
b. latent
c. sequela
d. convalescence
ANS: B
Incubation refers to the interval between exposure of a tissue to an injurious agent and the first
appearance of signs and symptoms. In infectious diseases, this period is often called the
incubation (latent) period. Prodromal refers to the appearance of the first signs and symptoms
indicating the onset of a disease. These are often nonspecific, such as headache, malaise,
anorexia, and nausea, which are associated with a number of different diseases. Sequela refers
to subsequent pathologic condition resulting from a disease. Convalescence is the stage of
recovery after a disease, injury, or surgical operation.
7. A disease that is native to a particular region is called
a. epidemic.
b. endemic.
c. pandemic.
d. ethnographic.
, ANS: B
A disease that is native to a particular region is called endemic. An epidemic is a disease that
spreads to many individuals at the same time. Pandemics are epidemics that affect large
geographic regions, perhaps spreading worldwide. Ethnographic does not describe a disease
distribution pattern.
8. In general, with aging, organ size and function
a. increase.
b. decrease.
c. remain the same.
d. are unknown.
ANS: B
In general, with aging, organ size and function decrease.
9. The stage during which the patient functions normally, although the disease processes are well
established, is referred to as
a. latent.
b. subclinical.
c. prodromal.
d. convalescence.
ANS: B
The stage during which the patient functions normally, although the disease processes are well
established, is called the subclinical stage. The interval between exposure of a tissue to an
injurious agent and the first appearance of signs and symptoms may be called a latent period
or, in the case of infectious diseases, an incubation period. The prodromal period, or
prodrome, refers to the appearance of the first signs and symptoms indicating the onset of a
disease. Convalescence is the stage of recovery after a disease, injury, or surgical operation.
MULTIPLE RESPONSE
1. Your patient’s red blood cell count is slightly elevated today. This might be explained by
(Select all that apply.)
a. gender difference.
b. situational factors.
c. normal variation.
d. cultural variation.
e. illness.
ANS: A, B, C, E
Gender, situations (e.g., altitude), normal variations, and illness may all determine red blood
cell count. Culture affects how manifestations are perceived (normal versus abnormal).
2. Socioeconomic factors influence disease development because of (Select all that apply.)
a. genetics.
b. environmental toxins.
c. overcrowding.
d. nutrition.
e. hygiene.
, ANS: B, C, D, E
Socioeconomic factors influence disease development via exposure to environmental toxins
(occupational) and overcrowding, nutrition (over- or undernutrition), and hygiene (e.g., in
developing countries). Genetics is not influenced by socioeconomic factors.
3. When determining additional data to gather before making a diagnosis, what factors need to
be considered? (Select all that apply.)
a. Reliability
b. Expense
c. Validity
d. Generalizability
e. Repetition
ANS: A, C
Two considerations one must use when choosing additional data to gather include the
reliability and validity of the tests being weighed. Reliability, or precision, is the ability of a
test to give the same result in repeated measurements. Validity, or accuracy, is the degree to
which a measurement reflects the true value of the object it is intended to measure. Expense,
generalizability, and repetition are not characteristics that are typically considered.
4. Which of the following statements are accurate when considering diagnostic testing for an
individual with a possible medical condition? (Select all that apply.)
a. The more often a patient has a test, the more accurate the average result is.
b. Sensitivity is the chance the test will be positive if the hypothesized disease is
present.
c. Testing is generally not accurate during the prodromal stage to make a diagnosis.
d. Specificity shows that a test will be negative if the person does not have the
disease.
e. Reliability demonstrates a test is accurate under a number of different conditions.
ANS: B, D
Sensitivity is the probability that the test will be positive when applied to a person with the
condition. Specificity is the probability that a test will be negative when applied to a person
who does not have a given condition. Test results are usually not aggregated and averaged. A
disease process is well established during the prodromal phase of illness, so some diagnostic
testing would indicate its presence. Reliability, or precision, is the ability of a test to give the
same result in repeated measurements.
,Chapter 02: Homeostasis, Allostasis, and Adaptive Responses to Stressors
Banasik: Pathophysiology, 7th Edition
MULTIPLE CHOICE
1. Indicators that an individual is experiencing high stress include all the following except
a. tachycardia.
b. diaphoresis.
c. increased peripheral resistance.
d. pupil constriction.
ANS: D
Pupils dilate during stress from the effects of catecholamines. Tachycardia, diaphoresis, and
increased peripheral resistance are indicators of stress and also occur because of
catecholamine release.
2. Which is not normally secreted in response to stress?
a. Norepinephrine
b. Cortisol
c. Epinephrine
d. Insulin
ANS: D
Insulin secretion is impaired during stress to promote energy from increased blood glucose.
Norepinephrine is secreted during stress as a mediator of stress and adaptation. Cortisol is
secreted during stress as a mediator of stress and adaptation and stimulates gluconeogenesis in
the liver to supply the body with glucose. Epinephrine is secreted during stress as a mediator
of stress and adaptation and increases glycogenolysis and the release of glucose from the liver.
3. Selye’s three phases of the stress response include all the following except
a. allostasis.
b. resistance.
c. alarm.
d. exhaustion.
ANS: A
Allostasis is defined as the ability to successfully adapt to challenges. Allostasis may/may not
occur in response to stress. Alarm, resistance (or adaptation), and exhaustion are the three
phases of the stress response as described by Selye in the general adaptation syndrome.
4. Many of the responses to stress are attributed to activation of the sympathetic nervous system
and are mediated by
a. norepinephrine.
b. cortisol.
c. glucagon.
d. ACTH.
ANS: A
Norepinephrine is secreted in response to activation of the sympathetic nervous system during
stress by the adrenal medulla. Cortisol is secreted by the adrenal cortex. Glucagon is secreted
by the pancreas. ACTH is secreted by the pituitary gland.
5. The effects of excessive cortisol production include
a. immune suppression.
b. hypoglycemia.
c. anorexia.
d. inflammatory reactions.
ANS: A
, Cortisol suppresses immune function and inflammation and stimulates appetite. Cortisol leads
to hyperglycemia by stimulating gluconeogenesis in the liver. Cortisol also leads to increased
appetite and food-seeking behaviors and plays a significant role in inflammatory reactions.
6. All the following stress-induced hormones increase blood glucose except
a. aldosterone.
b. cortisol.
c. norepinephrine.
d. epinephrine.
ANS: A
Aldosterone results in water and sodium retention and potassium loss in the urine. It does not
affect blood glucose. Cortisol is a glucocorticoid secreted by the adrenal cortex. Cortisol
stimulates gluconeogenesis in the liver, thus increasing blood glucose. Norepinephrine
inhibits insulin secretion, thus increasing blood sugar. Epinephrine increases glucose release
from the liver and inhibits insulin secretion, thus increasing blood glucose.
7. Allostasis is best defined as
a. a steady state.
b. a state of equilibrium, of balance within the organism.
c. the process by which the body heals following disease.
d. the overall process of adaptive change necessary to maintain survival and
well-being.
ANS: D
Allostasis refers to the overall process of adaptive change necessary to maintain survival and
well-being.
8. The primary adaptive purpose of the substances produced in the alarm stage is
a. energy and repair.
b. invoke resting state.
c. produce exhaustion.
d. set a new baseline steady-state.
ANS: A
These resources are used for energy and as building blocks, especially the amino acids, for the
later growth and repair of the organism. The substances do not produce a resting state. The
substances can produce exhaustion if they continue, but that is not their adaptive purpose.
Although a new baseline steady state may result from the stress response that is not the
adaptive purpose of the substances produced during the alarm stage.
9. Persistence of the alarm stage will ultimately result in
a. stress reduction.
b. permanent damage and death.
c. movement into the resistance stage.
d. exhaustion of the sympathetic nervous system.
ANS: B
If the alarm stage were to persist, the body would soon suffer undue wear and tear and
become subject to permanent damage and even death. Actions taken by the individual during
the resistance stage lead to stress reduction. The resistance stage may or may not occur
following the alarm stage, based on resource availability. The sympathetic nervous system
will continue to function, resulting in continued release of stress hormones.
10. The effect of stress on the immune system
Banasik: Pathophysiology, 7th Edition
MULTIPLE CHOICE
1. C.Q. was recently exposed to group A hemolytic Streptococcus and subsequently developed a
pharyngeal infection. His clinic examination reveals an oral temperature of 102.3°F, skin rash,
dysphagia, and reddened throat mucosa with multiple pustules. He complains of sore throat,
malaise, and joint stiffness. A throat culture is positive for Streptococcus, and antibiotics have
been prescribed. The etiology of C.Q.’s disease is
a. a sore throat.
b. streptococcal infection.
c. genetic susceptibility.
d. pharyngitis.
ANS: B
Etiology refers to the proposed cause or causes of a particular disease process. A sore throat is
the manifestation of the disease process. Genetic susceptibility refers to inherited tendency to
develop a disease. Pharyngitis refers to inflammation of the throat and is also a clinical
manifestation of the disease process.
2. A 17-year-old college-bound student receives a vaccine against an organism that causes
meningitis. This is an example of
a. primary prevention.
b. secondary prevention.
c. tertiary prevention.
d. disease treatment.
ANS: A
Primary prevention is prevention of disease by altering susceptibility or reducing exposure for
susceptible individuals, in this case by providing vaccination. Secondary prevention is the
early detection, screening, and management of the disease. Tertiary prevention includes
rehabilitative and supportive care and attempts to alleviate disability and restore effective
functioning. Disease treatment involves management of the disease once it has developed.
3. An obese but otherwise healthy teen is given a prescription for a low-calorie diet and exercise
program. This is an example of
a. primary prevention.
b. secondary prevention.
c. tertiary prevention.
d. disease treatment.
ANS: B
Secondary prevention is the early detection, screening, and management of the disease such as
prescribing diet and exercise for an individual who has already developed obesity. Primary
prevention is prevention of disease by altering susceptibility or reducing exposure for
susceptible individuals. Tertiary prevention includes rehabilitative and supportive care and
attempts to alleviate disability and restore effective functioning. Disease treatment involves
management of the disease once it has developed.
,4. A patient with high blood pressure who is otherwise healthy is counseled to restrict sodium
intake. This is an example of
a. primary prevention.
b. secondary prevention.
c. tertiary prevention.
d. disease treatment.
ANS: B
Secondary prevention is the early detection, screening, and management of the disease, such
as by prescribing sodium restriction for high blood pressure. Primary prevention is prevention
of disease by altering susceptibility or reducing exposure for susceptible individuals. Tertiary
prevention includes rehabilitative and supportive care and attempts to alleviate disability and
restore effective functioning. Disease treatment involves management of the disease once it
has developed.
5. After suffering a heart attack, a middle-aged man is counseled to take a cholesterol-lowering
medication. This is an example of
a. primary prevention.
b. secondary prevention.
c. tertiary prevention.
d. disease treatment.
ANS: C
Tertiary prevention includes rehabilitative and supportive care and attempts to alleviate
disability and restore effective functioning such as prescribing a cholesterol-lowering
medication following a heart attack. Primary prevention is prevention of disease by altering
susceptibility or reducing exposure for susceptible individuals. Secondary prevention is the
early detection, screening, and management of the disease. Disease treatment involves
management of the disease once it has developed.
6. A patient has been exposed to meningococcal meningitis, but is not yet demonstrating signs of
this disease. This stage of illness is called the stage.
a. prodromal
b. latent
c. sequela
d. convalescence
ANS: B
Incubation refers to the interval between exposure of a tissue to an injurious agent and the first
appearance of signs and symptoms. In infectious diseases, this period is often called the
incubation (latent) period. Prodromal refers to the appearance of the first signs and symptoms
indicating the onset of a disease. These are often nonspecific, such as headache, malaise,
anorexia, and nausea, which are associated with a number of different diseases. Sequela refers
to subsequent pathologic condition resulting from a disease. Convalescence is the stage of
recovery after a disease, injury, or surgical operation.
7. A disease that is native to a particular region is called
a. epidemic.
b. endemic.
c. pandemic.
d. ethnographic.
, ANS: B
A disease that is native to a particular region is called endemic. An epidemic is a disease that
spreads to many individuals at the same time. Pandemics are epidemics that affect large
geographic regions, perhaps spreading worldwide. Ethnographic does not describe a disease
distribution pattern.
8. In general, with aging, organ size and function
a. increase.
b. decrease.
c. remain the same.
d. are unknown.
ANS: B
In general, with aging, organ size and function decrease.
9. The stage during which the patient functions normally, although the disease processes are well
established, is referred to as
a. latent.
b. subclinical.
c. prodromal.
d. convalescence.
ANS: B
The stage during which the patient functions normally, although the disease processes are well
established, is called the subclinical stage. The interval between exposure of a tissue to an
injurious agent and the first appearance of signs and symptoms may be called a latent period
or, in the case of infectious diseases, an incubation period. The prodromal period, or
prodrome, refers to the appearance of the first signs and symptoms indicating the onset of a
disease. Convalescence is the stage of recovery after a disease, injury, or surgical operation.
MULTIPLE RESPONSE
1. Your patient’s red blood cell count is slightly elevated today. This might be explained by
(Select all that apply.)
a. gender difference.
b. situational factors.
c. normal variation.
d. cultural variation.
e. illness.
ANS: A, B, C, E
Gender, situations (e.g., altitude), normal variations, and illness may all determine red blood
cell count. Culture affects how manifestations are perceived (normal versus abnormal).
2. Socioeconomic factors influence disease development because of (Select all that apply.)
a. genetics.
b. environmental toxins.
c. overcrowding.
d. nutrition.
e. hygiene.
, ANS: B, C, D, E
Socioeconomic factors influence disease development via exposure to environmental toxins
(occupational) and overcrowding, nutrition (over- or undernutrition), and hygiene (e.g., in
developing countries). Genetics is not influenced by socioeconomic factors.
3. When determining additional data to gather before making a diagnosis, what factors need to
be considered? (Select all that apply.)
a. Reliability
b. Expense
c. Validity
d. Generalizability
e. Repetition
ANS: A, C
Two considerations one must use when choosing additional data to gather include the
reliability and validity of the tests being weighed. Reliability, or precision, is the ability of a
test to give the same result in repeated measurements. Validity, or accuracy, is the degree to
which a measurement reflects the true value of the object it is intended to measure. Expense,
generalizability, and repetition are not characteristics that are typically considered.
4. Which of the following statements are accurate when considering diagnostic testing for an
individual with a possible medical condition? (Select all that apply.)
a. The more often a patient has a test, the more accurate the average result is.
b. Sensitivity is the chance the test will be positive if the hypothesized disease is
present.
c. Testing is generally not accurate during the prodromal stage to make a diagnosis.
d. Specificity shows that a test will be negative if the person does not have the
disease.
e. Reliability demonstrates a test is accurate under a number of different conditions.
ANS: B, D
Sensitivity is the probability that the test will be positive when applied to a person with the
condition. Specificity is the probability that a test will be negative when applied to a person
who does not have a given condition. Test results are usually not aggregated and averaged. A
disease process is well established during the prodromal phase of illness, so some diagnostic
testing would indicate its presence. Reliability, or precision, is the ability of a test to give the
same result in repeated measurements.
,Chapter 02: Homeostasis, Allostasis, and Adaptive Responses to Stressors
Banasik: Pathophysiology, 7th Edition
MULTIPLE CHOICE
1. Indicators that an individual is experiencing high stress include all the following except
a. tachycardia.
b. diaphoresis.
c. increased peripheral resistance.
d. pupil constriction.
ANS: D
Pupils dilate during stress from the effects of catecholamines. Tachycardia, diaphoresis, and
increased peripheral resistance are indicators of stress and also occur because of
catecholamine release.
2. Which is not normally secreted in response to stress?
a. Norepinephrine
b. Cortisol
c. Epinephrine
d. Insulin
ANS: D
Insulin secretion is impaired during stress to promote energy from increased blood glucose.
Norepinephrine is secreted during stress as a mediator of stress and adaptation. Cortisol is
secreted during stress as a mediator of stress and adaptation and stimulates gluconeogenesis in
the liver to supply the body with glucose. Epinephrine is secreted during stress as a mediator
of stress and adaptation and increases glycogenolysis and the release of glucose from the liver.
3. Selye’s three phases of the stress response include all the following except
a. allostasis.
b. resistance.
c. alarm.
d. exhaustion.
ANS: A
Allostasis is defined as the ability to successfully adapt to challenges. Allostasis may/may not
occur in response to stress. Alarm, resistance (or adaptation), and exhaustion are the three
phases of the stress response as described by Selye in the general adaptation syndrome.
4. Many of the responses to stress are attributed to activation of the sympathetic nervous system
and are mediated by
a. norepinephrine.
b. cortisol.
c. glucagon.
d. ACTH.
ANS: A
Norepinephrine is secreted in response to activation of the sympathetic nervous system during
stress by the adrenal medulla. Cortisol is secreted by the adrenal cortex. Glucagon is secreted
by the pancreas. ACTH is secreted by the pituitary gland.
5. The effects of excessive cortisol production include
a. immune suppression.
b. hypoglycemia.
c. anorexia.
d. inflammatory reactions.
ANS: A
, Cortisol suppresses immune function and inflammation and stimulates appetite. Cortisol leads
to hyperglycemia by stimulating gluconeogenesis in the liver. Cortisol also leads to increased
appetite and food-seeking behaviors and plays a significant role in inflammatory reactions.
6. All the following stress-induced hormones increase blood glucose except
a. aldosterone.
b. cortisol.
c. norepinephrine.
d. epinephrine.
ANS: A
Aldosterone results in water and sodium retention and potassium loss in the urine. It does not
affect blood glucose. Cortisol is a glucocorticoid secreted by the adrenal cortex. Cortisol
stimulates gluconeogenesis in the liver, thus increasing blood glucose. Norepinephrine
inhibits insulin secretion, thus increasing blood sugar. Epinephrine increases glucose release
from the liver and inhibits insulin secretion, thus increasing blood glucose.
7. Allostasis is best defined as
a. a steady state.
b. a state of equilibrium, of balance within the organism.
c. the process by which the body heals following disease.
d. the overall process of adaptive change necessary to maintain survival and
well-being.
ANS: D
Allostasis refers to the overall process of adaptive change necessary to maintain survival and
well-being.
8. The primary adaptive purpose of the substances produced in the alarm stage is
a. energy and repair.
b. invoke resting state.
c. produce exhaustion.
d. set a new baseline steady-state.
ANS: A
These resources are used for energy and as building blocks, especially the amino acids, for the
later growth and repair of the organism. The substances do not produce a resting state. The
substances can produce exhaustion if they continue, but that is not their adaptive purpose.
Although a new baseline steady state may result from the stress response that is not the
adaptive purpose of the substances produced during the alarm stage.
9. Persistence of the alarm stage will ultimately result in
a. stress reduction.
b. permanent damage and death.
c. movement into the resistance stage.
d. exhaustion of the sympathetic nervous system.
ANS: B
If the alarm stage were to persist, the body would soon suffer undue wear and tear and
become subject to permanent damage and even death. Actions taken by the individual during
the resistance stage lead to stress reduction. The resistance stage may or may not occur
following the alarm stage, based on resource availability. The sympathetic nervous system
will continue to function, resulting in continued release of stress hormones.
10. The effect of stress on the immune system
