McCance & Huether’s Pathophysiology
The Biologic Basis for Disease in Adults and Children
9th Edition
• Author(s)Julia Rogers
TEST BANK
McCance & Huether — Pathophysiology, 9th Ed. — Chapter 1:
Cellular Biology.
1. Chapter 1 — Prokaryotes and Eukaryotes
Stem: A 4-year-old boy has recurrent infections with
normally nonpathogenic organisms; lab shows impaired
phagocyte intracellular killing. Which cellular feature
differentiates eukaryotic phagocytes from prokaryotes and
is essential for intracellular killing?
A. Lack of membrane-bound organelles
B. Presence of mitochondria producing ROS
C. Presence of a cell wall
D. Circular DNA free in cytoplasm
Correct Answer: B
Rationale — Correct: Eukaryotic phagocytes contain
mitochondria that contribute to reactive oxygen species
, (ROS) generation and ATP needed for oxidative killing;
mitochondria are absent in prokaryotes.
Rationale — A: Incorrect — Prokaryotes, not eukaryotes,
lack membrane-bound organelles; phagocytes are
eukaryotic cells that do have organelles.
Rationale — C: Incorrect — A cell wall is characteristic of
many prokaryotes and fungi, not human phagocytes.
Rationale — D: Incorrect — Circular DNA free in cytoplasm
is a prokaryotic trait; eukaryotic genomic DNA is nuclear.
Teaching Point: Mitochondria support ATP and ROS
generation for intracellular microbial killing.
2. Chapter 1 — Cellular Functions
Stem: A patient with sepsis shows lactic acidosis and low
ATP despite oxygen present. Which change at the cellular
level best explains increased anaerobic glycolysis?
A. Increased mitochondrial oxidative phosphorylation
efficiency
B. Impaired pyruvate dehydrogenase activity
C. Increased activity of Na⁺/K⁺-ATPase
D. Enhanced electron transport chain flux
Correct Answer: B
Rationale — Correct: Impaired pyruvate dehydrogenase
limits pyruvate conversion to acetyl-CoA, shunting
pyruvate to lactate via anaerobic glycolysis, causing lactic
acidosis and low ATP yield.
, Rationale — A: Incorrect — Increased oxidative
phosphorylation would raise ATP and reduce lactate,
opposite of findings.
Rationale — C: Incorrect — Increased Na⁺/K⁺-ATPase uses
ATP but does not directly shift metabolism to anaerobic
glycolysis.
Rationale — D: Incorrect — Enhanced electron transport
increases ATP and reduces lactate; not consistent with
lactic acidosis.
Teaching Point: Pyruvate dehydrogenase dysfunction shifts
metabolism toward lactate production.
3. Chapter 1 — Structure and Function of Cellular
Components (Nucleus)
Stem: A tumor biopsy shows large, irregular nuclei with
prominent nucleoli and frequent mitoses. Which nuclear
abnormality most directly reflects increased transcriptional
activity in cancer cells?
A. Loss of nuclear membrane
B. Prominent nucleoli
C. Increased heterochromatin condensation
D. Reduced nuclear pore density
Correct Answer: B
Rationale — Correct: Prominent nucleoli indicate increased
rRNA synthesis and ribosome biogenesis, supporting high
protein synthesis and proliferation in cancer cells.
, Rationale — A: Incorrect — Nuclear membrane loss occurs
in necrosis; it doesn't specifically indicate transcriptional
upregulation.
Rationale — C: Incorrect — Heterochromatin is
transcriptionally inactive; increased condensation would
decrease transcription.
Rationale — D: Incorrect — Reduced nuclear pores would
limit nucleocytoplasmic transport, not increase
transcription.
Teaching Point: Prominent nucleoli signal increased rRNA
synthesis and cellular proliferation.
4. Chapter 1 — Structure and Function of Cellular
Components (Mitochondria)
Stem: A patient presents with sudden cyanide poisoning.
Which mitochondrial process is directly inhibited and
causes rapid cellular hypoxia?
A. ATP synthase proton flow
B. Electron transport at complex IV (cytochrome c oxidase)
C. Glycolysis in cytosol
D. Pyruvate transport into mitochondria
Correct Answer: B
Rationale — Correct: Cyanide inhibits cytochrome c
oxidase (complex IV), blocking electron transfer to oxygen,
halting oxidative phosphorylation and causing cellular
hypoxia despite adequate oxygen.
The Biologic Basis for Disease in Adults and Children
9th Edition
• Author(s)Julia Rogers
TEST BANK
McCance & Huether — Pathophysiology, 9th Ed. — Chapter 1:
Cellular Biology.
1. Chapter 1 — Prokaryotes and Eukaryotes
Stem: A 4-year-old boy has recurrent infections with
normally nonpathogenic organisms; lab shows impaired
phagocyte intracellular killing. Which cellular feature
differentiates eukaryotic phagocytes from prokaryotes and
is essential for intracellular killing?
A. Lack of membrane-bound organelles
B. Presence of mitochondria producing ROS
C. Presence of a cell wall
D. Circular DNA free in cytoplasm
Correct Answer: B
Rationale — Correct: Eukaryotic phagocytes contain
mitochondria that contribute to reactive oxygen species
, (ROS) generation and ATP needed for oxidative killing;
mitochondria are absent in prokaryotes.
Rationale — A: Incorrect — Prokaryotes, not eukaryotes,
lack membrane-bound organelles; phagocytes are
eukaryotic cells that do have organelles.
Rationale — C: Incorrect — A cell wall is characteristic of
many prokaryotes and fungi, not human phagocytes.
Rationale — D: Incorrect — Circular DNA free in cytoplasm
is a prokaryotic trait; eukaryotic genomic DNA is nuclear.
Teaching Point: Mitochondria support ATP and ROS
generation for intracellular microbial killing.
2. Chapter 1 — Cellular Functions
Stem: A patient with sepsis shows lactic acidosis and low
ATP despite oxygen present. Which change at the cellular
level best explains increased anaerobic glycolysis?
A. Increased mitochondrial oxidative phosphorylation
efficiency
B. Impaired pyruvate dehydrogenase activity
C. Increased activity of Na⁺/K⁺-ATPase
D. Enhanced electron transport chain flux
Correct Answer: B
Rationale — Correct: Impaired pyruvate dehydrogenase
limits pyruvate conversion to acetyl-CoA, shunting
pyruvate to lactate via anaerobic glycolysis, causing lactic
acidosis and low ATP yield.
, Rationale — A: Incorrect — Increased oxidative
phosphorylation would raise ATP and reduce lactate,
opposite of findings.
Rationale — C: Incorrect — Increased Na⁺/K⁺-ATPase uses
ATP but does not directly shift metabolism to anaerobic
glycolysis.
Rationale — D: Incorrect — Enhanced electron transport
increases ATP and reduces lactate; not consistent with
lactic acidosis.
Teaching Point: Pyruvate dehydrogenase dysfunction shifts
metabolism toward lactate production.
3. Chapter 1 — Structure and Function of Cellular
Components (Nucleus)
Stem: A tumor biopsy shows large, irregular nuclei with
prominent nucleoli and frequent mitoses. Which nuclear
abnormality most directly reflects increased transcriptional
activity in cancer cells?
A. Loss of nuclear membrane
B. Prominent nucleoli
C. Increased heterochromatin condensation
D. Reduced nuclear pore density
Correct Answer: B
Rationale — Correct: Prominent nucleoli indicate increased
rRNA synthesis and ribosome biogenesis, supporting high
protein synthesis and proliferation in cancer cells.
, Rationale — A: Incorrect — Nuclear membrane loss occurs
in necrosis; it doesn't specifically indicate transcriptional
upregulation.
Rationale — C: Incorrect — Heterochromatin is
transcriptionally inactive; increased condensation would
decrease transcription.
Rationale — D: Incorrect — Reduced nuclear pores would
limit nucleocytoplasmic transport, not increase
transcription.
Teaching Point: Prominent nucleoli signal increased rRNA
synthesis and cellular proliferation.
4. Chapter 1 — Structure and Function of Cellular
Components (Mitochondria)
Stem: A patient presents with sudden cyanide poisoning.
Which mitochondrial process is directly inhibited and
causes rapid cellular hypoxia?
A. ATP synthase proton flow
B. Electron transport at complex IV (cytochrome c oxidase)
C. Glycolysis in cytosol
D. Pyruvate transport into mitochondria
Correct Answer: B
Rationale — Correct: Cyanide inhibits cytochrome c
oxidase (complex IV), blocking electron transfer to oxygen,
halting oxidative phosphorylation and causing cellular
hypoxia despite adequate oxygen.
