McCance & Huether’s Pathophysiology
The Biologic Basis for Disease in Adults and Children
9th Edition
• Author(s)Julia Rogers
TEST BANK
1
Reference
Ch. 1 — Prokaryotes and Eukaryotes
Stem
A 24-year-old nursing student presents with persistent low-
grade fever and lymphadenopathy after a pet turtle bite;
peripheral smear shows occasional intracellular inclusions in
macrophages and the patient reports fatigue but otherwise
normal vitals. Which cellular feature most helps the immune
system distinguish this organism as prokaryotic and elicit a
targeted innate response?
Options
A. Presence of membrane-bound organelles.
B. Lack of a membrane-bound nucleus and presence of
peptidoglycan.
C. Greater size and complex cytoskeleton.
,D. Presence of mitochondria that generate reactive oxygen
species.
Correct answer
B
Rationale — Correct
Prokaryotes lack a membrane-bound nucleus and often have
cell walls composed of peptidoglycan; innate immune pattern
recognition receptors detect these microbial-associated
molecular patterns (peptidoglycan, lipoteichoic acid, LPS) to
initiate phagocytosis and inflammatory signaling. This aligns
with McCance’s description of prokaryote/eukaryote structural
differences and innate immune recognition.
Rationale — Incorrect
A. Membrane-bound organelles are characteristic of
eukaryotes, not prokaryotes — not useful to distinguish a
bacterial pathogen.
C. Prokaryotes are generally smaller and have simpler
cytoskeletons; size/complexity is not a reliable innate immune
cue.
D. Mitochondria are eukaryotic organelles; bacterial cells do not
contain mitochondria and so this is not a distinguishing feature.
Teaching point
Peptidoglycan and absence of a nucleus define prokaryotes;
pattern recognition triggers innate responses.
,Citation
Rogers, J., et al. (2023). Pathophysiology: The Biologic Basis for
Disease in Adults and Children (9th ed.). Ch. 1.
2
Reference
Ch. 1 — Cellular Functions
Stem
A 68-year-old man is admitted with chronic heart failure and
muscle wasting; he reports decreased appetite and difficulty
conserving heat. On exam he has thin, brittle hair and delayed
wound healing. Which change in specialized cellular function
best explains his systemic decline?
Options
A. Increased cellular secretion leading to catabolic cachexia.
B. Impaired metabolic absorption and reduced ATP production.
C. Enhanced cellular conductivity causing tissue
hypometabolism.
D. Increased reproductive capacity of muscle cells.
Correct answer
B
Rationale — Correct
Impaired metabolic absorption and reduced cellular ATP (from
mitochondrial dysfunction or malnutrition) lead to decreased
anabolic processes, impaired protein synthesis, poor
, thermoregulation, and delayed wound healing—mechanisms
described in McCance as core cellular functions affecting organ
systems.
Rationale — Incorrect
A. Increased secretion does not explain systemic catabolism or
energy deficit.
C. Cellular conductivity (electrical signaling) is not the primary
driver of nutrition-related wasting.
D. Muscle cells have limited regenerative/reproductive capacity;
increased reproduction would not cause wasting.
Teaching point
Reduced cellular ATP and metabolic absorption impair protein
synthesis and tissue repair.
Citation
Rogers, J., et al. (2023). Pathophysiology (9th ed.). Ch. 1.
3
Reference
Ch. 1 — Structure and Function of Cellular Components
Stem
A 43-year-old woman presents with progressive jaundice,
elevated serum ammonia, and confusion following
acetaminophen overdose. Liver biopsy shows swollen
hepatocytes with disrupted cristae and decreased ATP. Which
organelle dysfunction best accounts for these findings?
The Biologic Basis for Disease in Adults and Children
9th Edition
• Author(s)Julia Rogers
TEST BANK
1
Reference
Ch. 1 — Prokaryotes and Eukaryotes
Stem
A 24-year-old nursing student presents with persistent low-
grade fever and lymphadenopathy after a pet turtle bite;
peripheral smear shows occasional intracellular inclusions in
macrophages and the patient reports fatigue but otherwise
normal vitals. Which cellular feature most helps the immune
system distinguish this organism as prokaryotic and elicit a
targeted innate response?
Options
A. Presence of membrane-bound organelles.
B. Lack of a membrane-bound nucleus and presence of
peptidoglycan.
C. Greater size and complex cytoskeleton.
,D. Presence of mitochondria that generate reactive oxygen
species.
Correct answer
B
Rationale — Correct
Prokaryotes lack a membrane-bound nucleus and often have
cell walls composed of peptidoglycan; innate immune pattern
recognition receptors detect these microbial-associated
molecular patterns (peptidoglycan, lipoteichoic acid, LPS) to
initiate phagocytosis and inflammatory signaling. This aligns
with McCance’s description of prokaryote/eukaryote structural
differences and innate immune recognition.
Rationale — Incorrect
A. Membrane-bound organelles are characteristic of
eukaryotes, not prokaryotes — not useful to distinguish a
bacterial pathogen.
C. Prokaryotes are generally smaller and have simpler
cytoskeletons; size/complexity is not a reliable innate immune
cue.
D. Mitochondria are eukaryotic organelles; bacterial cells do not
contain mitochondria and so this is not a distinguishing feature.
Teaching point
Peptidoglycan and absence of a nucleus define prokaryotes;
pattern recognition triggers innate responses.
,Citation
Rogers, J., et al. (2023). Pathophysiology: The Biologic Basis for
Disease in Adults and Children (9th ed.). Ch. 1.
2
Reference
Ch. 1 — Cellular Functions
Stem
A 68-year-old man is admitted with chronic heart failure and
muscle wasting; he reports decreased appetite and difficulty
conserving heat. On exam he has thin, brittle hair and delayed
wound healing. Which change in specialized cellular function
best explains his systemic decline?
Options
A. Increased cellular secretion leading to catabolic cachexia.
B. Impaired metabolic absorption and reduced ATP production.
C. Enhanced cellular conductivity causing tissue
hypometabolism.
D. Increased reproductive capacity of muscle cells.
Correct answer
B
Rationale — Correct
Impaired metabolic absorption and reduced cellular ATP (from
mitochondrial dysfunction or malnutrition) lead to decreased
anabolic processes, impaired protein synthesis, poor
, thermoregulation, and delayed wound healing—mechanisms
described in McCance as core cellular functions affecting organ
systems.
Rationale — Incorrect
A. Increased secretion does not explain systemic catabolism or
energy deficit.
C. Cellular conductivity (electrical signaling) is not the primary
driver of nutrition-related wasting.
D. Muscle cells have limited regenerative/reproductive capacity;
increased reproduction would not cause wasting.
Teaching point
Reduced cellular ATP and metabolic absorption impair protein
synthesis and tissue repair.
Citation
Rogers, J., et al. (2023). Pathophysiology (9th ed.). Ch. 1.
3
Reference
Ch. 1 — Structure and Function of Cellular Components
Stem
A 43-year-old woman presents with progressive jaundice,
elevated serum ammonia, and confusion following
acetaminophen overdose. Liver biopsy shows swollen
hepatocytes with disrupted cristae and decreased ATP. Which
organelle dysfunction best accounts for these findings?
