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PATHOPHYSIOLOGY THE BIOLOGIC BASIS FOR DISEASE IN ADULTS AND CHILDREN 8th Edition Kathryn L. McCance, Sue E. Huether (978-0275972486)

Name: PATHOPHYSIOLOGY THE BIOLOGIC BASIS FOR DISEASE IN ADULTS AND CHILDREN 8th Edition Kathryn L. McCance, Sue E. Huether (978-0275972486)
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Contents Chapter 01: Cellular Biology.......................................................................................................................... 4 Chapter 02: Altered Cellular and Tissue Biology: Environmental Agents................................................... 18 Chapter 03: The Cellular Environment: Fluids and Electrolytes, Acids and Bases...................................... 31 Chapter 04: Genes and Genetic Diseases ................................................................................................... 44 Chapter 05: Genes, Environment-Lifestyle, and Common Diseases........................................................... 55 Chapter 06: Epigenetics and Disease.......................................................................................................... 63 Chapter 07: Innate Immunity: Inflammation and Wound Healing ............................................................. 68 Chapter 08: Adaptive Immunity.................................................................................................................. 83 Chapter 09: Alterations in Immunity and Inflammation............................................................................. 95 Chapter 10: Infection ................................................................................................................................108 Chapter 11: Stress and Disease.................................................................................................................117 Chapter 12: Cancer Biology.......................................................................................................................124 Chapter 13: Cancer Epidemiology.............................................................................................................137 Chapter 14: Cancer in Children .................................................................................................................143 Chapter 15: Structure and Function of the Neurologic System................................................................148 Chapter 16: Pain, Temperature Regulation, Sleep, and Sensory Function...............................................159 Chapter 17: Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function...............174 Chapter 18: Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction .................................................................................................................................................................. 188 Chapter 19: Neurobiology of Schizophrenia, Mood Disorders, and Anxiety Disorders............................199 Chapter 20: Alterations of Neurologic Function in Children.....................................................................206 Chapter 21: Mechanisms of Hormonal Regulation...................................................................................213 Chapter 22: Alterations of Hormonal Regulation .....................................................................................222 Chapter 23: Obesity and Disorders of Nutrition .......................................................................................234 Chapter 24: Structure and Function of the Reproductive Systems ..........................................................239 Chapter 25: Alterations of the Female Reproductive System...................................................................249 Chapter 26: Alterations of the Male Reproductive System......................................................................259 Chapter 27: Sexually Transmitted Infections............................................................................................265 Chapter 28: Structure and Function of the Hematologic System.............................................................273 Chapter 29: Alterations of Erythrocytes, Platelets, and Hemostatic Function .........................................283 3 Chapter 30: Alterations of Leukocyte and Lymphoid Function ................................................................293 Chapter 31: Alterations of Hematologic Function in Children..................................................................300 Chapter 32: Structure and Function of the Cardiovascular and Lymphatic Systems................................311 Chapter 33: Alterations of Cardiovascular Function.................................................................................324 Chapter 34: Alterations of Cardiovascular Function in Children...............................................................338 Chapter 35: Structure and Function of the Pulmonary System................................................................346 Chapter 36: Alterations of Pulmonary Function .......................................................................................356 Chapter 37: Alterations of Pulmonary Function in Children.....................................................................373 Chapter 38: Structure and Function of the Renal and Urologic Systems..................................................381 Chapter 39: Alterations of Renal and Urinary Tract Function...................................................................391 Chapter 40: Alterations of Renal and Urinary Tract Function in Children ................................................401 Chapter 41: Structure and Function of the Digestive System...................................................................409 Chapter 42: Alterations of Digestive Function..........................................................................................421 Chapter 43: Alterations of Digestive Function in Children........................................................................432 Chapter 44: Structure and Function of the Musculoskeletal System .......................................................441 Chapter 45: Alterations of Musculoskeletal Function ..............................................................................453 Chapter 46: Alterations of Musculoskeletal Function in Children ............................................................466 Chapter 47: Structure, Function, and Disorders of the Integument.........................................................475 Chapter 48: Alterations of the Integument in Children............................................................................486 Chapter 49: Shock, Multiple Organ Dysfunction Syndrome, and Burns in Adults....................................494 Chapter 50: Shock, Multiple Organ Dysfunction Syndrome, and Burns in Children.................................502 Chapter 01: Cellular Biology MULTIPLE CHOICE 1. Which statement best describes the cellular function of metabolic absorption? a. Cells can produce proteins. b. Cells can secrete digestive enzymes. c. Cells can take in and use nutrients. d. Cells can synthesize fats. ANS: C In metabolic absorption, all cells take in and use nutrients and other substances from their surroundings. The remaining options are not inclusive in their descriptions of cellular metabolic absorption. PTS: 1 DIF: Cognitive Level: Remembering 2. Where is most of a cell’s genetic information, including RNA and DNA, contained? a. Mitochondria b. Ribosome c. Nucleolus d. Lysosome ANS: C The nucleus contains the nucleolus, a small dense structure composed largely of RNA, most of the cellular DNA, and the DNA-binding proteins, such as the histones, which regulate its activity. The mitochondria are responsible for cellular respiration and energy production. Ribosomes’ chief function is to provide sites for cellular protein synthesis. Lysosomes function as the intracellular digestive system. PTS: 1 DIF: Cognitive Level: Remembering 3. Which component of the cell produces hydrogen peroxide (H2O2) by using oxygen to remove hydrogen atoms from specific substrates in an oxidative reaction? a. Lysosomes b. Peroxisomes c. Ribosomes d. Endosome ANS: B Peroxisomes are so named because they usually contain enzymes that use oxygen to remove hydrogen atoms from specific substrates in an oxidative reaction that produces H2O2, which is a powerful oxidant and potentially destructive if it accumulates or escapes from peroxisomes. Ribosomes are RNA-protein complexes (nucleoproteins) that are synthesized in the nucleolus and secreted into the cytoplasm through pores in the nuclear envelope called nuclear pore complexes. Lysosomes are saclike structures that originate from the Golgi complex and contain more than 40 digestive enzymes called hydrolases, which catalyze bonds in proteins, lipids, nucleic acids, and carbohydrates. An endosome is a vesical that has been pinched off from the cellular membrane. PTS: 1 DIF: Cognitive Level: Remembering 4. Which cell component is capable of cellular autodigestion when it is released during cell injury? a. Ribosome b. Golgi complex c. Smooth endoplasmic reticulum d. Lysosomes ANS: D The lysosomal membrane acts as a protective shield between the powerful digestive enzymes within the lysosome and the cytoplasm, preventing their leakage into the cytoplasmic matrix. Disruption of the membrane by various treatments or cellular injury leads to a release of the lysosomal enzymes, which can then react with their specific substrates, causing cellular selfdigestion. The chief function of a ribosome is to provide sites for cellular protein synthesis. The Golgi complex is a network of flattened, smooth vesicles and membranes often located near the cell nucleus. The smooth endoplasmic reticulum is involved in steroid hormone production and removing toxic substances from the cell. PTS: 1 DIF: Cognitive Level: Remembering 5. Which cAMP-mediated response is related to antidiuretic hormone? a. Increased heart rate and force of contraction b. Secretion of cortisol c. Increased retention of water d. Breakdown of fat ANS: C Antidiuretic hormone leads to increased retention of water in the body. Epinephrine causes increases in heart rate and force of contraction. Increased cortisol secretion is due to ACTH. Breakdown of fat is due to glucagon. PTS: 1 DIF: Cognitive Level: Remembering 6. During which phase of the cell cycle is DNA synthesized? a. G1 b. S c. G2 d. M ANS: B The four designated phases of the cell cycle are: (1) the G1 phase (G = gap), which is the period between the M phase (M = mitosis) and the start of DNA synthesis; (2) the S phase (S = synthesis), during which DNA is synthesized in the cell nucleus; (3) the G2 phase, during which RNA and protein synthesis occurs, the period between the completion of DNA synthesis and the next phase (M); and (4) the M phase, which includes nuclear and cytoplasmic division. PTS: 1 DIF: Cognitive Level: Remembering 7. What organic compound facilitates transportation across cell membranes by acting as receptors, transport channels for electrolytes, and enzymes to drive active pumps? a. Lipids b. Proteases c. Proteins d. Carbohydrates ANS: C Proteins have several functions, including acting as receptors, transport channels for electrolytes, and enzymes to drive active pumps Lipids help act as the “glue” holding cell membranes together. Proteases cause the breakdown of protein. Carbohydrates are involved in cellular protection and lubrication and help produce energy via oxidative phosphorylation. PTS: 1 DIF: Cognitive Level: Remembering 8. Understanding the various steps of proteolytic cascades may be useful in designing drug therapy for which human diseases? a. Cardiac and vascular disorders b. Autoimmune and malignant disorders c. Gastrointestinal and renal disorders d. Endocrine and gastrointestinal disorders ANS: B Understanding the various steps involved in this process is crucial for designing drug interventions. Dysregulation of proteases features prominently in many human diseases, including cancer, autoimmunity, and neurodegenerative disorders. Cardiac, vascular, gastrointestinal, renal, and endocrine disorders do not involve this process. PTS: 1 DIF: Cognitive Level: Remembering 9. Which structure prevents water-soluble molecules from entering cells across the plasma membrane? a. Carbohydrate chains b. Glycoprotein channels c. Membrane channel proteins d. Lipid bilayer ANS: D The bilayer’s structure accounts for one of the essential functions of the plasma membrane. It is impermeable to most water-soluble molecules (molecules that dissolve in water) because the water-soluble molecules are insoluble in the oily core region. The bilayer serves as a barrier to the diffusion of water and hydrophilic substances while allowing lipid-soluble molecules, such as oxygen (O2) and carbon dioxide (CO2), to diffuse through it readily. Carbohydrate chains, glycoprotein channels, and membrane channel proteins do not prevent water-soluble molecules from entering cells across the cell membrane. PTS: 1 DIF: Cognitive Level: Remembering 10. A student asks for an explanation of the absolute refractory period of the action potential. What response by the professor is best? a. A stronger than normal impulse will evoke another response. b. No stimulus is able to evoke another response at this time. c. Multiple stimuli can produce more rapid action potentials. d. The hyperpolarized state means a weaker stimulus produces a response. ANS: B During the absolute refractory state of the action potential, no stimulus is able to evoke another response from the cell. A stronger than normal impulse may generate a response in the relative refractory period. This period of time is not related to the number of stimuli. A hyperpolarized state means a stronger than normal stimulus would be needed to generate a response. PTS: 1 DIF: Cognitive Level: Remembering 11. Which form of cell communication is used to communicate within the cell itself and with other cells in direct physical contact?

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Content preview

PATHOPHYSIOLOGY 8TH EDITION MCCANCE TEST BANK t t t t t

Chapter1: CellularBiology t t t

MULTIPLE CHOICE t

1. Which statement best describes the cellular function of metabolic absorption?
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a. Cells can produce proteins. c. Cells can take in and use nutrients.
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b. Cells can secrete digestive enzymes. d. Cells can synthesize fats.
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ANS: C t

In metabolic absorption, all cells take in and use nutrients and other substances from
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theirsurroundings. The remaining options are not inclusive in their descriptions of cellular
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metabolic absorption.
t t

PTS: 1 REF: Page 2 t

2. Most of a cell’s genetic information, including RNA and DNA, is contained in the:
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a. Mitochondria c. Nucleolus
b. Ribosome d. Lysosome
ANS: C t

The nucleus contains the nucleolus, a small dense structure composed largely of RNA, most
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of the cellular DNA, and the DNA-binding proteins, such as the histones, which regulate its
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activity. The other options do not contain most of a cell’s genetic information.
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PTS: 1 REF: Page 2 t

3. Which component of the cell prodNuUceRsSIhNyGd TroBg. CenO M
t p erox ide (H2O2) by using oxygen to t t t t t t t t t

t remove hydrogen atoms from specific substrates in an oxidative reaction?
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a. Lysosomes c. Ribosomes
b. Peroxisomes d. Oxyhydrosomes
ANS: B t

Peroxisomes are so named because they usually contain enzymes that use oxygen to remove t t t t t t t t t t t t t

hydrogen atoms from specific substrates in an oxidative reaction that produces H2O2, which
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is a powerful oxidant and potentially destructive if it accumulates or escapes from
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peroxisomes. Ribosomes are RNA-protein complexes (nucleoproteins) that are synthesized
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in the nucleolus and secreted into the cytoplasm through pores in the nuclear envelope called
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nuclear pore complexes. Lysosomes are saclike structures that originate from the Golgi
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complex and contain more than 40 digestive enzymes called hydrolases, which catalyze
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bonds in proteins, lipids, nucleic acids, and carbohydrates.
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Oxyhydrosomes areinvolved in enzyme production. ǹ t t t t

PTS: 1 REF: Page 8 t

4. Which cell component is capable of cellular autodigestion when it is released during
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t cellinjury?
a. Ribosome c. Smooth endoplasmic reticulum t t

b. Golgi complex t d. Lysosomes

ANS:
tD

NURSINGTB.COM

, PATHOPHYSIOLOGY 8TH EDITION MCCANCE TEST BANK t t t t t

The lysosomal membrane acts as a protective shield between the powerful digestive
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enzymes within the lysosome and the cytoplasm, preventing their leakage into the
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cytoplasmic matrix. Disruption of the membrane by various treatments or cellular injury
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leads to a release of the lysosomal enzymes, which can then react with their specific
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substrates, causing cellular self-digestion. The other options do not correctly describe
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thisprocess.
t

PTS: 1 REF: Pages 7-8 t

5. What is the sequence of steps in the development of a digestive enzyme by the
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t pancreascells from the initial transcription to the release from the cell? t t t t t t t t t t

a. The enzyme is transcribed from DNA by RNA in the nucleus, proceeds to
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the ribosome for synthesis, and is transported in a secretory vesicle to the cell
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membrane. t

b. The enzyme is transcribed from RNA by DNA in the nucleus, proceeds to the
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lysosome for synthesis, and is transported in an encapsulated membrane to the
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cellmembrane.
t

c. The enzyme is transcribed by the mitochondria in the nucleus, proceeds to the
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ribosome for synthesis, and is transported in a cytoskeleton to the cell membrane.
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d. The enzyme is transcribed from DNA by RNA in the nucleus, proceeds to the
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Golgi complex for synthesis, and is transported in a cytosol to the cell membrane.
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ANS: A t

The enzyme is transcribed from DNA by RNA in the nucleus, proceeds to the ribosomefor
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synthesis, and is transported in a secretory vesicle to the cell membrane. The other options do
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not correctly describe this process.
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NURSINGTB.COM
PTS: 1 REF: Page 7 | Figure 1-5 t t t t

6. During which phase of the cell cycle is DNA synthesized?
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a. G1 c. G2
b. S d. M
ANS: B t

The four designated phases of the cell cycle are: (1) the G1 phase (G = gap), which is the
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period between the M phase (M = mitosis) and the start of DNA synthesis; (2) the S phase(S
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= synthesis), during which DNA is synthesized in the cell nucleus; (3) the G2 phase, during
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which RNA and protein synthesis occurs, the period between the completion of DNA
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synthesis and the next phase (M); and (4) the M phase, which includes nuclear and
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cytoplasmic division.
t t

PTS: 1 REF: Page 37 t

7. What organic compound facilitates transportation across cell membranes by acting
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asreceptors, transport channels for electrolytes, and enzymes to drive active pumps?
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a. Lipids c. Proteins
b. Proteases d. Carbohydrates
ANS: C t

NURSINGTB.COM

, PATHOPHYSIOLOGY 8TH EDITION MCCANCE TEST BANK t t t t t

Proteins act as (1) recognition and binding units (receptors) for substances moving in and out
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of the cell; (2) pores or transport channels for various electrically charged particles called
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ions or electrolytes and specific carriers for amino acids and monosaccharides; and
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(3) specific enzymes that drive active pumps that promote the concentration of certainions,
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particularly potassium (K+), within the cell while keeping concentrations of otherions, for
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example, sodium (Na+), below the concentrations found in the extracellular environment.
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The other options do not correctly describe this process.
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PTS: 1 REF: Page 13 | Page 15 t t t t

8. Understanding the various steps of proteolytic cascades, such as caspase-mediated t t t t t t t t t

apoptosis and complement cascades, may be useful in designing drug therapy for
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whichhuman diseases?
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a. Cardiac and vascular disorders t t t

b. Autoimmune and malignant disorders t t t

c. Gastrointestinal and renal disorders t t t

d. Endocrineand gastrointestinal disorders t t t

ANS: B t

Understanding the various steps involved in this process is crucial for designing drug t t t t t t t t t t t t

interventions. Dysregulation of proteases features prominently in many human
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diseases,including cancer, autoimmunity, and neurodegenerative disorders. The other
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options do not correctly describe this process.
t t `n t t t t

PTS: 1 REF: Page 15 t

9. Which structure prevents water-soluble molecules from entering cells across the plasma
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t NURSINGTB.COM
membrane?
a. Carbohydrate chains t c. Membrane channel proteins t t

b. Glycoprotein channels t d. Lipid bilayer t

ANS: D t

The bilayer’s structure accounts for one of the essential functions of the plasma membrane. It
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is impermeable to most water-soluble molecules (molecules that dissolve inwater) because
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the water-soluble molecules are insoluble in the oily core region. The bilayer serves as a
t t t t t t t t t t t t t t t

barrier to the diffusion of water and hydrophilic substances while allowing lipid-soluble
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molecules, such as oxygen (O2) and carbon dioxide (CO2), to diffuse through it readily. The
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other options do not correctly describe this process.
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PTS: 1 REF: Pages 12-13 t

10. The fluid mosaic model explains:
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a. How a cell membrane functions t t t t

b. Why our bodies appear to be solid t t t t t t

c. How tissue is differentiated t t t

d. How fluid moves between the intracellular and extracellular compartments
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ANS: A t

The fluid mosaic model accounts for the flexibility of cellular membranes, their
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self-sealing properties, and their impermeability to many substances. The
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remainingoptions do not explain the mosaic model.
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NURSINGTB.COM

, PATHOPHYSIOLOGY 8TH EDITION MCCANCE TEST BANK t t t t t

PTS: 1 REF: Page 12 | What's New box t t t t t

11. Which form of cell communication is used to communicate within the cell itself and
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t with other cells in direct physical contact?
ǹ t t t t t

a. Protein channel (gap junction) t t t

b. Plasma membrane–bound signaling molecules (involving receptors)
t t t t t

c. Hormone secretion such as neurotransmitters t t t t

d. Extracellular chemical messengers such as ligands t t t t t

ANS: A t

Cells communicate by using hundreds of kinds of signal molecules, for example,
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insulin.Cells communicate in three main ways; they display plasma membrane–bound
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signalingmolecules (receptors) that affect the cell itself and other cells in direct physical
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contact. The other options do not correctly describe this process.
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PTS: 1 REF: Page 20 t

12. Which mode of chemical signaling uses blood to transport communication to cells
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somedistance away?
t t

a. Paracrine c. Neurotransmitter
b. Autocrine d. Hormonal
ANS: D t

Chemical signaling can be classified into three categories: (1) local-chemical mediator,
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(2)hormone, and (3) neurotransmitter. In the local-chemical mediator model, the secreted
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chemical acts on the cells in the immediate environment. Hormones are used for
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communication with distant t ar getNcUeRl lSsI. NFGoTr Be.xCaOmMpl e , cells can secrete a chemical and
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rely on the blood system to deliver the signal to a distant cell. Finally, neurotransmitters are
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secreted by neurons to stimulate an adjoining cell. For example, a neuron might secrete
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acetylcholine to stimulate the movement of a muscle cell.
t t t t t t t t t

PTS: 1 REF: Page 20 t

13. Which mode of chemical signaling uses local chemical mediators that are quickly
t t t t t t t t t t t

t taken up, destroyed, or immobilized?
`n t t t

a. Paracrine c. Neurotransmitter
b. Autocrine d. Hormone
ANS: A t

In paracrine signaling, cells secrete local chemical mediators that are quickly taken
t t t t t t t t t t t

up, destroyed, or immobilized. The other options do not correctly describe this process.
t ǹ t t t t t t t t t t t

PTS: 1 REF: Page 20 t

14. Neurotransmitters affect the postsynaptic membrane by binding t t t t t t

to:
a. Lipids c. Amphipathiclipids t t

b. Ribosomes d. Receptors
ANS: D t

In each type of chemical signaling, the target cell receives the signal by first attaching toits
t t t t t t t t t t t t t t t

receptors. The other options do not correctly describe this process.
t t t t t t t t t t

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PATHOPHYSIOLOGY THE BIOLOGIC BASIS FOR DISEASE IN ADULTS AND CHILDREN 8th Edition Kathryn L. McCance, Sue E. Huether (978-0275972486)

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