Test Bank for Applied Pathophysiology: A Conceptual Approach to the Mechanisms of Disease, 3rd Edition (Chapters 1-18)

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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:
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A) removing the phosphate bonds from ATP.
B) combining hydrogen and oxygen to form water.
C) activating pyruvate stored in the cytoplasm.
D) breaking down glucose to form lactic acid.
6. Exocytosis, the reverse of endocytosis, is important in _______ into the
extracellular fluid.
A) Engulfing and ingesting fluid and proteins for transport
B) Killing, degrading, and dissolving harmful microorganisms
C) Removing cellular debris and releasing synthesized substances
D) Destruction of particles by lysosomal enzymes for secretion
7. The process responsible for generating and conducting membrane potentials is:
A) diffusion of current-carrying ions.
B) millivoltage of electrical potential.
C) polarization of charged particles.
D) ion channel neurotransmission.
8. Epithelial tissues are classified according to the shape of the cells and the
number of layers. Which of the following is a correctly matched description
and type of epithelial tissue?
A) Simple epithelium: cells in contact with intercellular matrix; some do not
extend to surface
B) Stratified epithelium: single layer of cells; all cells rest on basement
membrane
C) Glandular epithelium: arise from surface epithelia and underlying
connective tissue
D) Pseudostratified epithelium: multiple layers of cells; deepest layer rests on
basement membrane
9. Connective tissue contains fibroblasts that are responsible for:
A) providing a fibrous framework for capillaries.
B) synthesis of collagen, elastin, and reticular fibers.
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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.
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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.
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B) They are closely apposed and are joined by cell-to-cell adhesion
molecules.
C) Their basal surface is attached to a basement membrane.
D) Skeletal muscle is multinucleated, lacking true cell boundaries.
19. Which of the following body tissues exhibits the highest rate of turnover and
renewal?
A) The squamous epithelial cells of the skin
B) The connective tissue supporting blood vessels
C) The skeletal muscle that facilitates movement
D) The nervous tissue that constitutes the central nervous system
20. A patient with a pathophysiologic condition that affects the desmosomes is
most likely to exhibit:
A) impaired contraction of skeletal and smooth muscle.
B) weakness of the collagen and elastin fibers in the extracellular space.
C) impaired communication between neurons and effector organs.
D) separation at the junctions between epithelial cells.
Answer Key
1. B
2. C
3. A
4. D
5. B
6. C
7. A
8. C
9. B
10. A
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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.
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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.
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8. Injured cells become very swollen as a result of:
A) increased cell protein synthesis.
B) altered cell volume regulation.
C) passive entry of potassium into the cell.
D) bleb formation in the plasma membrane.
9. A diabetic patient has impaired sensation, circulation, and oxygenation of his
feet. He steps on a piece of glass, the wound does not heal, and the area tissue
becomes necrotic. The necrotic cell death is characterized by:
A) rapid apoptosis.
B) cellular rupture.
C) shrinkage and collapse.
D) chronic inflammation.
10. A 99-year-old woman has experienced the decline of cell function associated
with age. A group of theories of cellular aging focus on programmed:
A) changes with genetic influences.
B) elimination of cell receptor sites.
C) insufficient telomerase enzyme.
D) DNA mutation or faulty repair.
11. An 89-year-old female patient has experienced significant decreases in her
mobility and stamina during a 3-week hospital stay for the treatment of a
femoral head fracture. Which of the following phenomena most likely accounts
for the patients decrease in muscle function that underlies her reduced
mobility?
A) Impaired muscle cell metabolism resulting from metaplasia
B) Dysplasia as a consequence of inflammation during bone remodeling
C) Disuse atrophy of muscle cells during a prolonged period of immobility
D) Ischemic atrophy resulting from vascular changes while on bedrest
12. A 20-year-old college student has presented to her campus medical clinic for a
scheduled Papanicolaou (Pap) smear. The clinician who will interpret the smear
will examine cell samples for evidence of:
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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?
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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.
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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
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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
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B) Chemotaxis
C) Accumulation of leukocytes along the epithelium
D) Phagocytosis of cellular debris
11. Which of the following individuals most likely has the highest risk of
experiencing chronic inflammation?
A) A patient who has recently been diagnosed with type 2 diabetes
B) A patient who is a carrier of an antibiotic-resistant organism
C) A patient who is taking oral antibiotics for an upper respiratory infection
D) A patient who is morbidly obese and who has a sedentary lifestyle
12. Which of the following core body temperatures is within normal range?
A) 35.9C (96.6F)
B) 38.0C (100.4F)
C) 35.5C (95.9F)
D) 37.3C (99.1F)
13. A postsurgical patient who is recovering in the postanesthetic recovery unit
states that she is freezing cold. Which of the following measures is likely to be
initiated in the patients hypothalamus in an effort to reduce heat loss?
A) Opening of arteriovenous (AV) shunts
B) Reduced exhalation of warmed air
C) Contraction of pilomotor muscles
D) Decreased urine production
14. An elderly patient is dressed only in a hospital gown and complains of a draft in
her room. Consequently, she has requested a warm blanket while she sits in her
wheelchair. Which of the following mechanisms of heat loss is most likely the
primary cause of her request?
A) Evaporation and conduction
B) Radiation and convection
C) Conduction and convection
D) Convection and evaporation
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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
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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
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6. D
7. A
8. D
9. B
10. A
11. D
12. D
13. C
14. B
15. A, C, D
16. B
17. C
18. D
19. B
20. A
Chapter 4 Altered Immunity
1. The mediators involved in type I hypersensitivity allergic responses are
released from:
A) mast cells.
B) plasma cells.
C) monocytes.
D) arachidonic acid.
2. A genetically determined hypersensitivity to common environmental allergens
causes ___________ reactions, such as:
A) atopic; urticaria.
B) autoimmune; diarrhea.
C) IgM-mediated; infections.
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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
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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
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