, Table of contents
Chapter 1 - Cellular Biology ___________________________________________________________ 3
Chapter 2 - Altered Cellular and Tissue Biology Environmental Agents 16 Chapter 3 - The Cellular
Environment Fluids and Electrolytes Acids and
Bases ______________________________________________________________________________ 28
Chapter 4 - Genes and Genetic Diseases __________________________________________________ 41
Chapter 5 - Genes Environment-Lifestyle and Common Diseases _______________________________ 51
Chapter 6 - Epigenetics and Disease ______________________________________________________ 59
Chapter 7 - Innate Immunity Inflammation __________________________________________________ 64
Chapter 8 - Adaptive Immunity ___________________________________________________________ 78
Chapter 9 - Alterations in Immunity and Inflammation _______________________________________ 89
Chapter 10 - Infection ________________________________________________________________ 102
Chapter 11 - Stress and Disease _______________________________________________________ 110
Chapter 12 - Cancer Biology___________________________________________________________ 117
Chapter 13 - Cancer Epidemiology ______________________________________________________ 129
Chapter 14 - Cancer in Children ________________________________________________________ 135
Chapter 15 - Structure and Function of the Neurologic System ________________________________ 140
Chapter 16 - Pain Temperature Regulation Sleep and Sensory Function 151 Chapter 17 - Alterations in
Cognitive Systems Cerebral Hemodynamics and
Motor Function _____________________________________________________________________ 165
Chapter 18 - Disorders of the Central and Peripheral Nervous Systems and
the Neuromuscular Junction ___________________________________________________________ 179
Chapter 19 - Neurobiology of Schizophrenia Mood Disorders and Anxiety Disorders 189
Chapter 20 - Alterations of Neurologic Function in Children __________________________________ 195
Chapter 21 - Mechanisms of Hormonal Regulation 202
Chapter 22 - Alterations of Hormonal Regulation ___________________________________________ 211
Chapter 23 - Obesity and Disorders of Nutrition NEW _______________________________________ 223
Chapter 24 - Structure and Function of the Reproductive Systems _____________________________ 228
Chapter 25 - Alterations of the Female Reproductive System _________________________________ 237
Chapter 26 - Alterations of the Male Reproductive System ___________________________________ 246
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,Chapter 27 - Sexually Transmitted Infections ___________________________ 252
Chapter 28 - Structure and Function of the Hematologic System ___________ 260
Chapter 29 - Alterations of Erythrocyte Platelet and Hemostatic Function ____ 270
Chapter 30 - Alterations of Leukocyte and Lymphoid Function _____________ 280
Chapter 31 - Alterations of Hematologic Function in Children ______________ 287
Chapter 32 - Structure and Function of the Cardiovascular and Lymphatic
Systems _______________________________________________________ 297
Chapter 33 - Alterations of Cardiovascular Function _____________________ 309
Chapter 34 - Alterations of Cardiovascular Function in Children ____________ 323
Chapter 35 - Structure and Function of the Pulmonary System _____________ 331
Chapter 36 - Alterations of Pulmonary Function _________________________ 341
Chapter 37 - Alterations of Pulmonary Function in Children _______________ 357
Chapter 38 - Structure and Function of the Renal and Urologic Systems _____ 365
Chapter 39 - Alterations of Renal and Urinary Function ___________________ 375
Chapter 40 - Alterations of Renal and Urinary Tract Function in Children _____ 385
Chapter 41 - Structure and Function of the Digestive System ______________ 393
Chapter 42 - Alterations of Digestive Function __________________________ 404
Chapter 43 - Alterations of Digestive Function in Children _________________ 415
Chapter 44 - Structure and Function of the Musculoskeletal System_________ 424
Chapter 45 - Alterations of Musculoskeletal Function ____________________ 436
Chapter 46 - Alterations of Musculoskeletal Function in Children ___________ 448
Chapter 47 - Structure Function and Disorders of the Integument ___________ 457
Chapter 48 - Alterations of the Integument in Children____________________ 468
Chapter 49 - Shock Multiple Organ Dysfunction Syndrome and Burns in
Adults _________________________________________________________ 476
Chapter 50 - Shock Multiple Organ Dysfunction Syndrome and Burns in
Children ________________________________________________________ 483
, 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
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, 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
self-digestion. 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 mbilayer’s mstructure maccounts mfor mone mof mthe messential mfunctions mof mthe mplasma
mmembrane. mIt mis mimpermeable mto mmost mwater-soluble mmolecules m(molecules mthat
mdissolve min mwater) mbecause mthe mwater-soluble mmolecules mare minsoluble min mthe moily
mcore mregion. mThe mbilayer mserves mas ma mbarrier mto mthe mdiffusion mof mwater mand
mhydrophilic msubstances mwhile mallowing mlipid-soluble mmolecules, msuch mas moxygen
m(O2) mand mcarbon mdioxide m(CO2), mto mdiffuse mthrough mit mreadily.
Carbohydrate mchains, mglycoprotein mchannels, mand mmembrane mchannel mproteins mdo mnot
mprevent mwater-soluble mmolecules mfrom mentering mcells macross mthe mcell mmembrane.
PTS: m m1 DIF: Cognitive mLevel: mRemembering
10. A mstudent masks mfor man mexplanation mof mthe mabsolute mrefractory mperiod mof mthe
maction mpotential. mWhat mresponse mby mthe mprofessor mis mbest?
a. A mstronger mthan mnormal mimpulse mwill mevoke manother mresponse.
b. No mstimulus mis mable mto mevoke manother mresponse mat mthis mtime.
c. Multiple mstimuli mcan mproduce mmore mrapid maction mpotentials.
d. The mhyperpolarized mstate mmeans ma mweaker mstimulus mproduces ma mresponse.
ANS: m B
During mthe mabsolute mrefractory mstate mof mthe maction mpotential, mno mstimulus mis mable
mto mevoke manother mresponse mfrom mthe mcell. mA mstronger mthan mnormal mimpulse mmay
mgenerate ma mresponse min mthe mrelative mrefractory mperiod. mThis mperiod mof mtime mis mnot
mrelated mto mthe mnumber mof mstimuli. mA mhyperpolarized mstate mmeans ma mstronger mthan
mnormal mstimulus mwould mbe mneeded mto mgenerate ma mresponse.
PTS: m m1 DIF: Cognitive mLevel: mRemembering
11. Which mform mof mcell mcommunication mis mused mto mcommunicate mwithin mthe mcell
mitself mand mwith mother mcells min mdirect mphysical mcontact?
a. Protein mchannel m(gap mjunction)
b. Plasma mmembrane-bound msignaling mmolecules
c. Hormone msecretion msuch mas mneurotransmitters
d. Extracellular mchemical mmessengers msuch mas mligands
ANS: m B
Cells mcommunicate min mthree mmain mways; mthey mdisplay mplasma mmembrane-bound
msignaling mmolecules mthat maffect mthe mcell mitself mand mother mcells min mdirect mphysical
mcontact mwith mit, mthey maffect mreceptor mproteins minside mthe mtarget mcell, mand mthey mform
mprotein mchannels m(gap mjunctions) mthat mdirectly mcoordinate mthe mactivities mof madjacent
mcells. mNeurotransmitters mare mreleased mby mneurons mand mcross mthe msynaptic mcleft mto
mcommunicate mwith mthe mcells mthey minnervate. mLigands mare minvolved min mbinding
mprocesses.
PTS: m m1 DIF: Cognitive mLevel: mRemembering
12. Which mmode mof mchemical msignaling muses mblood mto mtransport mcommunication mto
mcells msome mdistance maway?
a. Paracrine
b. Autocrine
ANS: D