Pathophysiology Test Bank: Cellular Mechanisms of Disease, Exams of Infectious disease

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CONCEPTUAL APPROACH TO

THE MECHANISMS OF DISEASE

3RD EDITION.

Applied Pathophysiology A Conceptual Approach to the

Mechanisms of Disease 3rd Edition Braun Test Bank

Chapter 1Introduction to Pathophysiology

1. The nucleus , which is essential for function and survival of the cell. A) is the site of protein synthesis B) contains the genetic code C) transforms cellular energy D) initiates aerobic metabolism
2. Although energy is not made in mitochondria, they are known as the power plants of the cell because they: A) contain RNA for protein synthesis. B) utilize glycolysis for oxidative energy. C) extract energy from organic compounds. D) store calcium bonds for muscle contractions.
3. Although the basic structure of the cell plasma membrane is formed by a lipid bilayer, most of the specific membrane functions are carried out by: A) bound and transmembrane proteins. B) complex, long carbohydrate chains. C) surface antigens and hormone receptors. D) a gating system of selective ion channels.
4. To effectively relay signals, cell-to-cell communication utilizes chemical messenger systems that: A) displace surface receptor proteins. B) accumulate within cell gap junctions. C) bind to contractile microfilaments. D) release secretions into extracellular fluid.
5. Aerobic metabolism, also known as oxidative metabolism, provides energy by:

C) forming tendons and the fascia that covers muscles.

D) filling spaces between tissues to keep organs in place.

10. Although all muscle tissue cells have some similarities, smooth muscle (also known as involuntary muscle) differs by:

A) having dense bodies attached to actin filaments.

B) containing sarcomeres between Z lines and M bands.

C) having rapid contractions and abundant cross-striations.

D) contracting in response to increased intracellular calcium.

11. Which of the following aspects of the function of the nucleus is performed by ribosomal RNA (rRNA)?

A) Copying and carrying DNA instructions for protein synthesis

B) Carrying amino acids to the site of protein synthesis

C) Providing the site where protein synthesis occurs

D) Regulating and controlling protein synthesis

12. Breakdown and removal of foreign substances and worn-out cell parts are performed by which of the following organelles?

A) Lysosomes

B) Golgi apparatus

C) Ribosomes

D) Endoplasmic reticulum (ER)

13. Impairment in the function of peroxisomes would result in:

A) inadequate sites for protein synthesis.

B) an inability to transport cellular products across the cell membrane.

C) insufficient energy production within a cell.

D) accumulation of free radicals in the cytoplasm.

14. After several months of trying to conceive, a couple is undergoing fertility testing. Semen analysis indicates that the mans sperm have decreased motility, a finding that is thought to underlie the couples inability to become pregnant.

Which of the following cellular components may be defective within the mans sperm?

A) Ribosomes

B) Microtubules

C) Mitochondria

D) Microfilaments

15. Which of the following statements is true of glycolysis?

A) Glycolysis requires oxygen.

B) Glycolysis occurs in cells without mitochondria.

C) Glycolysis provides the majority of the bodys energy needs.

D) Glycolysis produces energy, water, and carbon dioxide.

16. Which of the following membrane transport mechanisms requires the greatest amount of energy?

A) Facilitated diffusion

B) Passive transport

C) Vesicular transport

D) Simple diffusion

17. A male patient with a diagnosis of type 1 diabetes mellitus is experiencing hyperglycemia because he lacks sufficient insulin to increase the availability of glucose transporters in his cell membranes. Consequently, his cells lack intracellular glucose and it accumulates in his blood. Which of the following processes would best allow glucose to cross his cell membranes?

A) Facilitated diffusion

B) Simple diffusion

C) Secondary active transport

D) Endocytosis

18. Which of the following statements is true of skeletal muscle cells?

A) Skeletal muscle cells each have an apical, lateral, and basal surface.

11. C

12. A

13. D

14. B

15. B

16. C

17. A

18. D

19. A

20. D

Chapter 2 Altered Cells and Tissues

1. Ischemia and other toxic injuries increase the accumulation of intracellular calcium as a result of: A) release of stored calcium from the mitochondria. B) improved intracellular volume regulation. C) decreased influx across the cell membrane. D) attraction of calcium to fatty infiltrates.
2. The patient is found to have liver disease, resulting in the removal of a lobe of his liver. Adaptation to the reduced size of the liver leads to of the remaining liver cells. A) metaplasia B) organ atrophy C) compensatory hyperplasia D) physiologic hypertrophy
3. A person eating peanuts starts choking and collapses. His airway obstruction is partially cleared, but he remains hypoxic until he reaches the hospital. The prolonged cell hypoxia caused a cerebral infarction and resulting in the brain.

A) caspase activation

B) coagulation necrosis

C) rapid phagocytosis

D) protein p53 deficiency

4. Bacteria and viruses cause cell damage by , which is unique from the intracellular damage caused by other injurious agents.

A) disrupting the sodium/potassium ATPase pump

B) interrupting oxidative metabolism processes

C) replicating and producing continued injury

D) decreasing protein synthesis and function

5. The patient has a prolonged interruption in arterial blood flow to his left kidney, causing hypoxic cell injury and the release of free radicals. Free radicals damage cells by:

A) destroying phospholipids in the cell membrane.

B) altering the immune response of the cell.

C) disrupting calcium storage in the cell.

D) inactivation of enzymes and mitochondria.

6. Injured cells have impaired flow of substances through the cell membrane as a result of:

A) increased fat load.

B) altered permeability.

C) altered glucose utilization.

D) increased surface receptors.

7. Reversible adaptive intracellular responses are initiated by:

A) stimulus overload.

B) genetic mutations.

C) chemical messengers.

D) mitochondrial DNA.

A) changes in cell shape, size, and organization.

B) the presence of unexpected cell types.

C) ischemic changes in cell samples.

D) abnormally high numbers of cells in a specified field.

13. Which of the following pathophysiologic processes is most likely to result in metastatic calcification?

A) Benign prostatic hyperplasia

B) Liver cirrhosis

C) Impaired glycogen metabolism

D) Hyperparathyroidism

14. Despite the low levels of radiation used in contemporary radiologic imaging, a radiology technician is aware of the need to minimize her exposure to ionizing radiation. What is the primary rationale for the technicians precautions?

A) Radiation stimulates pathologic cell hypertrophy and hyperplasia.

B) Radiation results in the accumulation of endogenous waste products in the cytoplasm.

C) Radiation interferes with DNA synthesis and mitosis.

D) Radiation decreases the action potential of rapidly dividing cells.

15. The parents of a 4-year-old girl have sought care because their daughter has admitted to chewing and swallowing imported toy figurines that have been determined to be made of lead. Which of the following blood tests should the care team prioritize?

A) White blood cell levels with differential

B) Red blood cell levels and morphology

C) Urea and creatinine levels

D) Liver function panel

16. A 70-year-old male patient has been admitted to a hospital for the treatment of a recent hemorrhagic stroke that has left him with numerous motor and sensory deficits. These deficits are most likely the result of which of the following mechanisms of cell injury?

A) Free radical injury

B) Hypoxia and ATP depletion

C) Interference with DNA synthesis

D) Impaired calcium homeostasis

17. Which of the following processes associated with cellular injury is most likely to be reversible?

A) Cell damage resulting from accumulation of fat in the cytoplasm

B) Cellular changes as a result of ionizing radiation

C) Cell damage from accumulation of free radicals

D) Apoptosis

18. The extrinsic pathway of apoptosis can be initiated by:

A) damage to cellular DNA.

B) decreased ATP levels.

C) activation of the p53 protein.

D) activation of death receptors on the cell surface.

19. A patient with severe peripheral vascular disease has developed signs of dry gangrene on the great toe of one foot. Which of the following pathophysiologic processes most likely contributed to this diagnosis?

A) Inappropriate activation of apoptosis

B) Bacterial invasion

C) Impaired arterial blood supply

D) Metaplastic cellular changes

20. Which of the following facts underlies the concept of replicative senescence?

A) Genes controlling longevity are present or absent in varying quantities among different individuals.

B) Telomeres become progressively shorter in successive generations of a cell.

C) The damaging influence of free radicals increases exponentially in later generations of a cell.

B) fatigue.

C) redness.

D) granuloma.

2. The vascular, hemodynamic stage of acute inflammation is initiated by momentary vasoconstriction followed by vasodilation that causes localized:

A) bleeding.

B) congestion.

C) pale skin.

D) coolness.

3. The cellular stage of acute inflammation is marked by the movement of leukocytes into the area. Which of the following cells arrives early in great numbers?

A) Basophils

B) Lymphocytes

C) Neutrophils

D) Platelets

4. The phagocytosis process involves three distinct steps. What is the initial step in the process?

A) Engulfment

B) Intracellular killing

C) Antigen margination

D) Recognition and adherence

5. Which of the following mediators of inflammation causes increased capillary permeability and pain?

A) Serotonin

B) Histamine

C) Bradykinin

D) Nitric oxide

6. Inflammatory exudates are a combination of several types. Which of the following exudates is composed of enmeshed necrotic cells?

A) Serous

B) Fibrinous

C) Suppurative

D) Membranous

7. The acute-phase systemic response usually begins within hours of the onset of inflammation and includes:

A) fever and lethargy.

B) decreased C-reactive protein.

C) positive nitrogen balance.

D) low erythrocyte sedimentation rate.

8. In contrast to acute inflammation, chronic inflammation is characterized by which of the following phenomena?

A) Profuse fibrinous exudation

B) A shift to the left of granulocytes

C) Metabolic and respiratory alkalosis

D) Lymphocytosis and activated macrophages

9. Exogenous pyrogens (interleukin-1) and the presence of bacteria in the blood lead to the release of endogenous pyrogens that:

A) stabilize thermal control in the brain.

B) produce leukocytosis and anorexia.

C) block viral replication in cells.

D) inhibit prostaglandin release.

10. An older adult patient has just sheared the skin on her elbow while attempted to boost herself up in bed, an event that has precipitated acute inflammation in the region surrounding the wound. Which of the following events will occur during the vascular stage of the patients inflammation?

A) Outpouring of exudate into interstitial spaces

15. Which of the following pathophysiologic processes are capable of inducing the production of pyrogens? Select all that apply.

A) Acute inflammation

B) Obesity

C) Myocardial infarction

D) Malignancy

E) Renal failure

16. Which of the following patients is most likely to be susceptible to developing a neurogenic fever?

A) A patient who has stage II Alzheimer disease

B) A patient who has sustained a head injury in a bicycle crash

C) A patient who has become delirious after the administration of a benzodiazepine

D) A patient who has begun taking a selective serotonin-reuptake inhibitor (SSRI) for the treatment of depression

17. Patients are commonly administered antipyretics when their oral temperature exceeds 37.5C (99.5F). Which of the following statements related to the rationale for this action is most accurate?

A) Temperatures in excess of 37.5C (99.5F) can result in seizure activity.

B) Lower temperatures inhibit the protein synthesis of bacteria.

C) There is little empirical evidence for this treatment modality.

D) Most common antipyretics have been shown to have little effect on core temperature.

18. A patient has sought care because of recent malaise and high fever. Upon assessment, the patient states that his current fever began two days earlier, although he states that for the last 2 weeks he is in a cycle of high fever for a couple of days followed by a day or two of normal temperature. Which of the following fever patterns is this patient experiencing?

A) Recurrent fever

B) Remittent fever

C) Sustained fever D) Intermittent fever

19. A febrile, 3-week-old infant has been brought to the emergency department by his parents and is currently undergoing a diagnostic workup to determine the cause of his fever. Which of the following statements best conveys the rationale for this careful examination? A) The immature hypothalamus is unable to perform normal thermoregulation. B) Infants are susceptible to serious infections because of their decreased immune function. C) Commonly used antipyretics often have no effect on the core temperature of infants. D) Fever in neonates is often evidence of a congenital disorder rather than an infection.
20. An 84-year-old patients blood cultures have come back positive, despite the fact that his oral temperature has remained within normal range. Which of the following phenomena underlies the alterations in fever response that occur in the elderly? A) Disturbance in the functioning of the thermoregulatory center B) Increased heat loss by evaporation C) The presence of comorbidities that are associated with lowered core temperature D) Persistent closure of arteriovenous shunts

Answer Key

1. C

2. B

3. C

4. D

5. C

D) delayed; poison ivy rash:

3. Mismatched blood transfusion reaction with hemolysis of blood cells is an example of type II, mediated hypersensitivity reaction.

A) T-cell

B) antibody

C) leukotriene

D) complement

4. Type III hypersensitivity immune responses can be harmful when immune complex deposits in tissue activate that can directly damage area tissues.

A) inflammation

B) autoantibodies

C) cytotoxic cells

D) immunoglobulins

5. The mechanism by which humans recognize self-cells from non-self (antigens)- cells is.

A) autoimmunity

B) self-tolerance

C) non-self anergy

D) immunocompatibility

6. Organ rejection is a complication of organ transplantation caused by recipient immune cells:

A) destroying the host T cells.

B) attack on the donor cells.

C) combining with grafts HLA.

D) being recognized as foreign.

7. The leading cause of death for people with HIV is opportunistic.

A) leukemia

B) tuberculosis

C) pneumonia

D) toxoplasmosis

8. Wasting syndrome, an AIDS-defining illness, is characterized by involuntary weight loss of at least 10% of baseline body weight in the presence of:

A) diarrhea.

B) hypermetabolism.

C) weakness and fever.

D) glucose intolerance.

9. The window period of HIV infection refers to the period of time between infection and:

A) transmission.

B) seroconversion.

C) initial symptoms.

D) antibody screening.

10. HIV-positive persons that display manifestations of laboratory category 3 or clinical category C are considered to have:

A) zero viral load.

B) seroconversion.

C) complete remission.

D) AIDS-defining illnesses.

11. Contact with poison ivy has resulted in intense pruritus, erythema, and weeping on a patients forearm. Which of the following processes resulted in the patients signs and symptoms?

A) IgE-mediated mast cell degranulation

B) Formation of antigen-antibody complexes

C) Cytokine release by sensitized T cells

D) Formation of antibodies against cell surface antigens