Test Bank For Pathophysiology, 6th Edition

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Chapter 1: Introduction to PathophysiologyTest BankMULTIPLE CHOICE1.C.Q. was recently exposed to group A hemolyticStreptococcusand subsequently developed apharyngeal infection. His clinic examination reveals an oral temperature of 102.3° F, skinrash, dysphagia, and reddened throat mucosa with multiple pustules. He complains of sorethroat, malaise, and joint stiffness. A throat culture is positive forStreptococcus, andantibiotics have been prescribed. The etiology of C.Q.’s disease isa.a sore throat.b.streptococcal infection.c.genetic susceptibility.d.pharyngitis.ANS:BEtiology refers to the proposed cause or causes of a particular disease process. A sore throat isthe manifestation of the disease process. Genetic susceptibility refers to inherited tendency todevelop a disease. Pharyngitis refers to inflammation of the throat and is also a clinicalmanifestation of the disease process.REF:Pg. 22.A 17-year-old college-bound student receives a vaccine against an organism that causesmeningitis. This is an example ofa.primary prevention.b.secondary prevention.c.tertiary prevention.d.disease treatment.ANS:APrimary prevention is prevention of disease by altering susceptibility or reducing exposure forsusceptible individuals by providing vaccination. Secondary prevention is the early detection,screening, and management of the disease. Tertiary prevention includes rehabilitative andsupportive care and attempts to alleviate disability and restore effective functioning. Diseasetreatment involves management of the disease once it has developed.REF:Pg. 93.An obese but otherwise healthy teen is given a prescription for a low-calorie diet and exerciseprogram. This is an example ofa.primary prevention.b.secondary prevention.c.tertiary prevention.d.disease treatment.ANS:B

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Secondary prevention is the early detection, screening, and management of the disease such asprescribing diet and exercise for an individual who has already developed obesity. Primaryprevention is prevention of disease by altering susceptibility or reducing exposure forsusceptible individuals. Tertiary prevention includes rehabilitative and supportive care andattempts to alleviate disability and restore effective functioning. Disease treatment involvesmanagement of the disease once it has developed.REF:Pgs. 9-104.A patient with high blood pressure who is otherwise healthy is counseled to restrict sodiumintake. This is an example ofa.primary prevention.b.secondary prevention.c.tertiary prevention.d.disease treatment.ANS:BSecondary prevention is the early detection, screening, and management of the disease, suchas by prescribing sodium restriction for high blood pressure. Primary prevention is preventionof disease by altering susceptibility or reducing exposure for susceptible individuals. Tertiaryprevention includes rehabilitative and supportive care and attempts to alleviate disability andrestore effective functioning. Disease treatment involves management of the disease once ithas developed.REF:Pgs. 9-105.After suffering a heart attack, a middle-aged man is counseled to take a cholesterol-loweringmedication. This is an example ofa.primary prevention.b.secondary prevention.c.tertiary prevention.d.disease treatment.ANS:CTertiary prevention includes rehabilitative and supportive care and attempts to alleviatedisability and restore effective functioning such as prescribing a cholesterol loweringmedication following a heart attack. Primary prevention is prevention of disease by alteringsusceptibility or reducing exposure for susceptible individuals. Secondary prevention is theearly detection, screening, and management of the disease. Disease treatment involvesmanagement of the disease once it has developed.REF:Pgs. 9-106.A patient has been exposed to meningococcal meningitis, but is not yet demonstrating signs ofthis disease. This stage of illness is called the _____ stage.a.prodromalb.latentc.sequelad.convalescenceANS:B

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Incubation refers to the interval between exposure of a tissue to an injurious agent and the firstappearance of signs and symptoms. In infectious diseases, this period is often called theincubation (latent) period. Prodromal refers to the appearance of the first signs and symptomsindicating the onset of a disease. These are often nonspecific, such as headache, malaise,anorexia, and nausea, which are associated with a number of different diseases. Sequela refersto subsequent pathologic condition resulting from a disease. Convalescence is the stage ofrecovery after a disease, injury, or surgical operation.REF:Pg. 37.A disease that is native to a particular region is calleda.epidemic.b.endemic.c.pandemic.d.ethnographic.ANS:BA disease that is native to a particular region is called endemic. An epidemic is a disease thatspreads to many individuals at the same time. Pandemics are epidemics that affect largegeographic regions, perhaps spreading worldwide.REF:Pg. 68.In general, with aging, organ size and functiona.increase.b.decrease.c.remain the same.d.is unknown.ANS:BIn general, with aging, organ size and function decrease.REF:Pg. 59.The stage during which the patient functions normally, although the disease processes are wellestablished, is referred to asa.latent.b.subclinical.c.prodromal.d.convalescence.ANS:BThe stage during which the patient functions normally, although the disease processes are wellestablished, is called the subclinical stage. The interval between exposure of a tissue to aninjurious agent and the first appearance of signs and symptoms may be called a latent periodor, in the case of infectious diseases, an incubation period. The prodromal period, orprodrome, refers to the appearance of the first signs and symptoms indicating the onset of adisease. Convalescence is the stage of recovery after a disease, injury, or surgical operation.REF:Pg. 3

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MULTIPLE RESPONSE10.Your patient’s red blood cell is slightly elevated today. This might be explained by(Select allthat apply.)a.gender difference.b.situational factors.c.normal variation.d.cultural variation.e.illness.ANS:A, B, C, EGender, situations (e.g., altitude), normal variations, and illness may all determine red bloodcell count. Culture affects how manifestations areperceived(normal versus abnormal).REF:Pgs. 5-611.Socioeconomic factors influence disease development due to(Select all that apply.)a.genetics.b.environmental toxins.c.overcrowding.d.nutrition.e.hygiene.ANS:B, C, D, ESocioeconomic factors influence disease development via exposure to environmental toxins(occupational) and overcrowding, nutrition (over- or undernutrition), and hygiene (e.g., indeveloping countries). Genetics is not influenced by socioeconomic factors.REF:Pgs. 7-8COMPLETION12.When the cause is unknown, a condition is said to be ________.ANS:idiopathicMany diseases are idiopathic in nature.REF:Pg. 213.The nurse is swabbing a patient’s throat to test for streptococcal pharyngitis. The nurse mustunderstand that tests such as this differ in the probability that they will be positive for acondition when applied to a person with the condition; this probability is termed ________.ANS:sensitivityThe sensitivity of any test refers to the probability that the test will be positive when appliedto a person with the condition and will not provide a false negative result. In contrast,specificity is the probability that a test will be negative when applied to a person who does nothave a given condition.

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REF:Pg. 5

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Chapter 2: Homeostasis and Adaptive Responses to StressorsTest BankMULTIPLE CHOICE1.Indicators that an individual is experiencing high stress include all the followingexcepta.tachycardia.b.diaphoresis.c.increased peripheral resistance.d.pupil constriction.ANS:DPupils dilate during stress from the effects of catecholamines. Tachycardia, diaphoresis, andincreased peripheral resistance are indicators of stress and also occur due to catecholaminerelease.REF:Pg. 18 | Pg. 212.Which isnotnormally secreted in response to stress?a.Norepinephrineb.Cortisolc.Epinephrined.InsulinANS:DInsulin secretion is impaired during stress to promote energy from increased blood glucose.Norepinephrine is secreted during stress as a mediator of stress and adaptation. Cortisol issecreted during stress as a mediator of stress and adaptation and stimulates gluconeogenesis inthe liver to supply the body with glucose. Epinephrine is secreted during stress as a mediator ofstress and adaptation and increases glycogenolysis and the release of glucose from the liver.REF:Pg. 173.Selye’s three phases of the stress response include all the followingexcepta.allostasis.b.resistance.c.alarm.d.exhaustion.ANS:AAllostasis is defined as the ability to successfully adapt to challenges. Allostasis may/may notoccur in response to stress. Alarm, resistance, and exhaustion are the three phases of the stressresponse as described by Selye in the general adaptation syndrome.

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REF:Pgs. 13-144.Many of the responses to stress are attributed to activation of the sympathetic nervous systemand are mediated bya.norepinephrine.b.cortisol.c.glucagon.d.ACTH.ANS:ANorepinephrine is secreted in response to activation of the sympathetic nervous system duringstress by the adrenal medulla. Cortisol is secreted by the adrenal cortex. Glucagon is secreted bythe pancreas. ACTH is secreted by the pituitary gland.REF:Pg. 175.The effects of excessive cortisol production includea.immune suppression.b.hypoglycemia.c.anorexia.d.inflammatory reactions.ANS:ACortisol suppresses immune function and inflammation and stimulates appetite. Cortisol leads tohyperglycemia by stimulating gluconeogenesis in the liver.REF:Pgs. 21-226.All the following stress-induced hormones increase blood glucoseexcepta.aldosterone.b.cortisol.c.norepinephrine.d.epinephrine.ANS:AAldosterone results in water and sodium retention and potassium loss in the urine. It does notaffect blood glucose. Cortisol is a glucocorticoid secreted by the adrenal cortex. Cortisolstimulates gluconeogenesis in the liver, thus increasing blood glucose. Norepinephrine inhibitsinsulin secretion, thus increasing blood sugar. Epinephrine increases glucose release from theliver and inhibits insulin secretion, thus increasing blood glucose.REF:Pgs. 17-19

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7.Allostasis is best defined asa.steady state.b.a state of equilibrium, of balance withinthe organism.c.the process by which the body healsfollowing disease.d.the overall process of adaptive changenecessary to maintain survival andwell-being.ANS:DAllostasis refers to the overall process of adaptive change necessary to maintain survival andwell-being.REF:Pg. 138.The primary adaptive purpose of the substances produced in the alarm stage isa.energy and repair.b.invoke resting state.c.produce exhaustion.d.set a new baseline steady state.ANS:AThese resources are used for energy and as building blocks, especially the amino acids, for thelater growth and repair of the organism. The substances do not produce a resting state. Thesubstances can produce exhaustion if they continue, but that is not the adaptive purpose of these.Although a new baseline steady state may result from the stress response that is not the adaptivepurpose of the substances produced during the alarm stage.REF:Pgs. 15-169.Persistence of the alarm stage will ultimately result ina.stress reduction.b.permanent damage and death.c.movement into the resistance stage.d.exhaustion of the sympathetic nervoussystem.ANS:BIf the alarm stage were to persist, the body would soon suffer undue wear and tear and becomesubject to permanent damage and even death. Actions taken by the individual during theresistance stage lead to stress reduction. The resistance stage may or may not occur following the

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alarm stage, based on resource availability. The sympathetic nervous system will continue tofunction, resulting in continued release of stress hormones.REF:Pg. 1610.The effect of stress on the immune systema.is unknown.b.has been demonstrated to be non-existentin studies.c.most often involves enhancement of theimmune system.d.may involve enhancement or impairmentthe immune system.ANS:DMany studies demonstrate that long-term stress impairs the immune system, but manyresearchers identify that short-term stress may enhance the immune system.REF:Pg. 19MULTIPLE RESPONSE11.Aldosterone may increase during stress, leading to(Select all that apply.)a.decreased urinary output.b.increased blood potassium.c.increased sodium retention.d.increased blood volume.e.decreased blood pressure.ANS:A, C, DAldosterone increases water and sodium reabsorption and potassium excretion by the renal distaltubules and collecting ducts, thus leading to decreased urinary output, sodium retention in thebody, and increased extracellular fluid volume. Because it leads to potassium excretion,aldosterone leads to decreased blood potassium.REF:Pg. 1812.Chronic activation of stress hormones can lead to(Select all that apply.)a.cardiovascular disease.b.depression.c.impaired cognitive function.d.autoimmune disease.

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e.overactive immune function.ANS:A, B, C, DExcessive cortisol levels promote hypertension, atherosclerosis, and the development ofcardiovascular disease. Chronic overactive stress hormones may result in atrophy and death ofbrain cells. Elevated levels of stress hormones are found in individuals with depressive disorders.Chronic stress leads to immune function impairment, rather than overactive immune function,and has been implicated in autoimmune disorders.REF:Pgs. 21-2213.Events which occur during the alarm stage of the stress response include secretion of(Select allthat apply.)a.catecholamines.b.ACTH.c.glucocorticoids.d.immune cytokines.e.TSH.ANS:A, B, C, DDuring the alarm stage, catecholamines (epinephrine, norepinephrine), ACTH, glucocorticoids,and immune cytokines are secreted. TSH is not secreted during the stress response.REF:Pgs. 14-15

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Chapter 3: Cell Structure and FunctionTest BankMULTIPLE CHOICE1.Glycolysis is the metabolic process of breaking down a glucose molecule to forma.CO2and H2O.b.2 ATP and 2 pyruvate.c.30 ATP.d.oxygen.ANS:BGlycolysis produces a net gain of 2 ATP molecules and breaks down glucose modules toproduce two pyruvate molecules. Oxidative phosphorylation produces CO2and H2O.Oxidative phosphorylation produces 30 ATP molecules. Oxygen is not produced byglycolysis, but it is necessary for oxidative phosphorylation.REF:Pg. 342.The benefit of glycolysis is that this phase suppliesa.ATP to meet energy needs of the body.b.pyruvate to the citric acid cycle.c.energy for oxidative phosphorylationd.lactate during anaerobic conditions.ANS:BThe benefit of glycolysis is to supply pyruvate to the citric acid cycle of cellular metabolism,which then produces much ATP. Glycolysis only produces 2 ATP modules, which isinsufficient for energy needs. Glycolysis does not supply energy for oxidativephosphorylation. Lactate produced during prolonged anaerobic conditions builds up and canlead to lactic acidosis, which is an undesirable outcome.REF:Pg. 343.Repolarization of a neuron after a depolarizing action potential is due toa.activation of the Na+-K+pump.b.influx of calcium.c.efflux of potassium.d.influx of sodium.ANS:CRepolarization is due to efflux of potassium from the cell. The Na+-K+pump maintainscellular volume via osmotic pressure and helps to maintain resting membrane potential.Calcium influx prolongs the action potential. Influx of sodium initiates depolarization.REF:Pg. 454.Excitable cells are able to conduct action potentials because they havea.receptors for neurotransmitters.b.tight junctions.

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c.ligand-gated channels.d.voltage-gated channels.ANS:DVoltage-gated channels respond to changes in membrane potential and are responsible forconducting action potentials. Receptors for neurotransmitters allow neurotransmitters to bindto the cell membrane but are not directly responsible for action potentials in excitable cells.Tight junctions are intercellular connections that help segregate proteins on the cell membraneand are not involved in conducting action potentials. Ligand-gated channels respond tobinding of a signaling molecule such as a neurotransmitter, but are not directly responsible foraction potentials in excitable cells.REF:Pgs. 42-445.The resting membrane potential in nerve and skeletal muscle is determined primarily bya.extracellular sodium ion concentration.b.the ratio of intracellular to extracellular potassium ions.c.activation of voltage-gated sodium channels.d.activity of energy-dependent membrane pumps.ANS:BThe major determinant of the resting membrane potential is the difference in potassium ionconcentration across the membrane. Extracellular sodium helps to maintain cell volume andresting membrane potential but it is not the primary determinant. Activation of voltage-gatedsodium channels help to initiate an action potential. Channels are not linked to an energysource; ions flow passively across the cell membrane.REF:Pgs. 42-436.An increase in extracellular potassium ion from 4.0 to 6.0 mEq/L woulda.hyperpolarize the resting membrane potential.b.make it more difficult to reach threshold and produce an action potential.c.hypopolarize the resting membrane potential.d.alter the threshold potential.ANS:CAn increase in extracellular potassium hypopolarizes the cell (makes it less negative) becausemore K+ions stay inside the cell owing to the reduced concentration gradient.Hyperpolarization of the resting membrane potential (makes it more negative) is caused by adecrease in extracellular potassium. Hyperpolarization due to a decrease in extracellularpotassium makes it more difficult to reach threshold and produce an action potential. Thethreshold for action potential does not change with a change in extracellular potassium.REF:Pg. 437.GTP-binding proteins (G proteins) function toa.activate receptors on the extracellular surface.b.degrade second-messenger molecules.c.activate intracellular enzyme systems.d.synthesize ATP.ANS:C

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G-proteins activate specific target enzymes within the cell and these enzymes then producesecond messenger molecules that trigger specific intracellular function. Membrane-boundG-protein channels are a component of the cell membrane; they do not activate other receptorson the extracellular surface. G-proteins do not degrade second messengers, but insteadproduce these. G-proteins do not synthesize ATP.REF:Pg. 498.Phospholipids spontaneously form lipid bilayers, because they area.polar.b.charged.c.insoluble.d.amphipathic.ANS:DPhospholipids have a hydrophilic (water-loving) polar end and a hydrophobic (water-fearing)polar end. This amphipathic nature causes the lipids to form bilayers. It is the water-lovingand water-fearing nature of the end rather than simply being polar, charged, or insoluble thatforms the bilayers.REF:Pg. 279.Cell-to-cell communication through secretion of chemical signals into the bloodstream totarget cells throughout the body is called _____ signaling.a.synapticb.paracrinec.endocrined.autocrineANS:CEndocrine signaling is accomplished by specialized endocrine cells that secrete hormones thattravel via the bloodstream to target cells throughout the body. Synaptic signaling occurs atspecialized junctions between the nerve cell and its target cell; the neuron secretes a chemicalneurotransmitter into a small space between the nerve and target cell. In paracrine signalingchemicals are secreted into a localized area, and only those cells in the immediate area areaffected. Autocrine signaling occurs when cells respond to signaling molecules that theysecrete and provides feedback to that cell rather than other cells.REF:Pg. 4710.Ribosomes are very important organelles within the cell that have the function ofa.detoxifying substances.b.synthesizing proteins.c.converting energy to forms that can be used.d.coding for protein synthesis.ANS:BRibosomes primary function is the synthesis of proteins. Lysosomes and peroxisomesdetoxify substances. Mitochondria convert energy to forms that can be used to drive cellreactions. The nucleus contains genomic DNA that codes for protein synthesis.

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REF:Pg. 3111.The cardiac drug digitalis enhances myocardial contraction, because ita.increases intracellular calcium level in cardiac cells.b.inhibits sodium from entering cardiac cells.c.enhances the sodium-potassium pump.d.increases the sodium gradient across the cell membrane.ANS:ADigitalis inhibits the sodium-potassium pump and allows the accumulation of intracellularsodium, decreasing the sodium gradient across the cell membrane. This leads to less efficientcalcium removal by the sodium-dependent calcium pump. Increased calcium inside thecardiac cell leads to more forceful cardiac muscle contraction to treat congestive heart failuredue to cardiac muscle weakness.REF:Pg. 4112.The organelle that contains enzymes necessary for oxidative phosphorylation to produce ATPis thea.mitochondria.b.ribosome.c.lysosome.d.nucleus.ANS:AThe inner membrane of the mitochondria contains many enzymes that promote oxidativephosphorylation which produces ATP. Ribosomes synthesize proteins. Lysosomes andperoxisomes detoxify substances. The nucleus contains genomic DNA that codes for proteinsynthesis.REF:Pg. 3213.Ion channels open and close in response to all the followingexcepta.mechanical pressure.b.ligand binding.c.voltage changes.d.temperature changes.ANS:DNo temperature change channels are present on the cell membrane. Mechanically gatedchannels respond to mechanical deformation. Ligand-gated channels respond to the binding ofa signaling molecule (neurotransmitter or hormone). Voltage-gated channels respond to achange in membrane potential.REF:Pg. 4214.Gap junctions are connecting channels that allow passage of small molecules from one cell tothe next and are especially important fora.distance signaling.b.tissues requiring synchronized function.c.communication within a cell.

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d.passage of large molecules.ANS:BGap junctions are especially important in tissues in which synchronized functions are requiredsuch as in cardiac muscle contraction. Gap junctions are channels between adjacent cells, notdistant cells. Gap junctions function to promote communication not within a cell, but betweenadjacent cells. Gap junctions allow passage of small molecules, but not large molecules.REF:Pg. 45COMPLETION15.During conditions of prolonged insufficient oxygen availability (e.g., respiratory orcardiovascular disease) anaerobic glycolysis accumulated pyruvate can lead to _____ acidosis.ANS:lacticPyruvate is converted to lactate and released into the blood stream, resulting in lactic acidosis.REF:Pg. 3416.The phase of cellular metabolism in which energy is released during breakdown of nutrientsources is ________.ANS:catabolismCatabolism involves energy release via breakdown of nutrient sources such as glucose toprovide ATP to the cell. In contrast, anabolism refers to energy-using processes that result incomplex molecules such as fats.REF:Pg. 3417.Some individuals inherit a gene that results in dangerously high blood cholesterol due toimpaired ________ of low-density lipoproteins (LDLs).ANS:endocytosisThe defective gene inhibits the synthesis of LDL protein receptors on the cell membrane. Thisimpairs endocytosis of LDL. High levels of LDL in the blood predispose to atherosclerosis.REF:Pg. 38

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