Pathophysiology test bank PDF

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Pathophysiology by Lachel Story, 4th edition (Fourth Edition)...

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Pathophysiology: A Practical Approach Lachel Story

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CHAPTER 1 QUESTIONS _____ 1. The movement of water or another solvent across the cellular membrane from an area of low solute concentration to an area of high solute concentration is referred to as A. meiosis. B. osmosis. C. lysis. D. mitosis. _____ 2. Cells become specialized in their structure and function through A. proliferation. B. atrophy. C. differentiation. D. pinocytosis. _____ 3. Eradicating the disease is the goal of A. palliative treatment. B. all cancer treatment. C. prophylactic treatment. D. curative treatment. _____ 4. The fetus is most vulnerable to environmental influences during which period of gestation? A. 10 to 15 days B. The first 30 days C. 15 to 60 days D. The first trimester _____ 5. Which form of cellular adaptation occurs because of decreased work demands on the cell? A. Hypertrophy B. Hyperplasia C. Atrophy D. Metaplasia _____ 6. What are the sex chromosomes that a female has? A. Paired X chromosomes B. Autosomes C. One X and one Y chromosome D. Two Y chromosomes

3 _____ 7. Which disorders are passed from an affected parent to an offspring regardless of sex? A. Sex-linked disorders B. Fragile X syndrome C. Autosomal dominant disorders D. All of the above _____ 8. Gangrene is a form of A. caseous necrosis. B. liquefaction necrosis. C. coagulative necrosis. D. fat necrosis. _____ 9. The genetic information for a cell is contained in the A. nucleus. B. organelles. C. lipid bilayer. D. cytoplasm. _____ 10. The disease state of a neoplasm is A. apoptosis. B. atrophy. C. exocytosis. D. cancer. _____ 11. A possible teratogen is a(n) A. lipid bilayer. B. allele. C. infection. D. chromosome. _____ 12. How many chromosomes do we have? A. 23 B. 46 C. Several thousand D. About 3 billion _____ 13. Selective permeability allows free passage in and out of cells to A. enzymes. B. glucose. C. electrolytes. D. all of the above. _____ 14. Which type of cellular adaptation is undergone by the muscles of an extremity that has been in a cast for a long period of time? A. Hypertrophy

4 B. Metaplasia C. Dysplasia D. Hyperplasia _____ 15. Which tumors are usually undifferentiated? A. Malignant tumors B. All tumors are undifferentiated. C. Benign tumors D. Tumors with less anaplastic cells _____ 16. One cause of cell death is A. ischemia. B. apoptosis. C. necrosis. D. all of the above. _____ 17. Variations of a gene are known as A. alleles. B. autosomes. C. a karotype. D. DNA. _____ 18. A form of cell division that occurs only in mature sperm and ova is A. mitosis. B. prophase. C. oncogene. D. meiosis. _____ 19. Which of the following diseases affects only females? A. Monosomy X (Turner’s syndrome) B. Trisomy 21 (Down syndrome) C. Polysomy X (Klinefelter’s syndrome) D. Tay-Sachs disease _____ 20. A cancer patient’s likelihood for surviving a cancer is referred to as his or her A. remission. B. prognosis. C. carcinogenesis. D. grading. _____ 21. Metaplasia refers to which of the following? A. An increase in the number of cells in an organ or tissue. B. Cell mutation into cells of a different size, shape, and appearance. C. An increase in the size of cells in an attempt to meet increased demand. D. The process of one adult cell being replaced by another cell type

5 _____ 22. When caustic enzymes dissolve and liquefy necrotic cells, this is known as A. coagulative necrosis. B. liquefaction necrosis. C. fat necrosis. D. caseous necrosis. _____ 23. Which type of disorder is phenylketonuria (PKU)? A. Sex-linked disorder B. Autosomal recessive disorder C. Multifactorial disorder D. Autosomal dominant disorder _____ 24. When cells increase in number in an organ or tissue, this is known is A. apoptosis. B. hyperplasia. C. metaplasia. D. dysplasia. _____ 25. In grading cancer cells, which grade has well differentiated cells? A. Grade 1 B. Grade 2 C. Grade 3 D. Grade 4

ANSWER KEY 1. B 2. C 3. D 4. C 5. C 6. A 7. C 8. C 9. A 10. D 11. C 12. B 13. D 14. A 15. A 16. D 17. A 18. D 19. A

6 20. B 21. D 22. B 23. B 24. B 25. A

RATIONALES 1. Osmosis refers to the movement of water or another solvent across the cellular membrane from an area of low solute concentration to an area of high solute concentration. Meiosis is a form of cell division that occurs only in mature sperm and ova. Lysis occurs when too much water enters a cell membrane. Mitosis is the most common form of cell division. 2. Cells become specialized in their structure and function through differentiation. Proliferation is the process by which cells divide and reproduce. Atrophy refers to a type of cell adaptation. Pinocytosis refers to cell drinking. 3. Curative treatment seeks to eradicate the disease. Not all cancer treatment does this. Palliative treatment treats symptoms to increase comfort. Prophylactic treatment seeks to prevent cancer. 4. The fetus is most vulnerable to environmental influences from 15 to 60 days of gestation. This is the period immediately after fertilization and implantation, when much of the cellular differentiation is taking place. 5. Atrophy is the type of cellular adaptation that occurs because of decreased work demands on the cell. Hypertrophy is the opposite; it occurs when cells increase in size to try to meet increased work demand. Hyperplasia is an increase in the number of cells in an organ or tissue. Metaplasia is the process in which one adult cell is replaced by another cell type. 6. A female has two X chromosomes. A male has one X and one Y chromosome. No one has two Y chromosomes. Autosomes make up 22 of the 23 sets of paired chromosomes, with the remaining pair being the sex chromosomes. 7. Autosomal dominant disorders are passed from an affected parent to an offspring regardless of sex. This is not true of all sex-linked disorders. Fragile X syndrome is a sexlinked disorder which affects males. 8. Gangrene is a form of coagulative necrosis, which results in an interruption in blood flow. Caseous necrosis happens when necrotic cells disintegrate but cellular debris remains. Liquefaction necrosis occurs when caustic enzymes dissolve and liquefy

7 necrotic cells. Fat necrosis happens when lipase enzymes break down triglycerides into free fatty acids. 9. The genetic information for a cell is contained in the nucleus. The organelles are internal cellular structures that perform the work that maintains the cell’s life. A lipid bilayer is what makes up the cell membrane. Cytoplasm is a colorless, viscous liquid in the cell containing water, nutrients, and other substances. 10. Cancer is the disease state of a neoplasm. Apoptosis is a mechanism of cell death. Atrophy is one kind of cell adaptation. Exocytosis is the release of materials from a cell. 11. Infection is a possible teratogen. The other terms are distracters for this question. 12. We have 46 chromosomes, in 23 paired sets. 13. Selective permeability allows free passage in and out of cells to enzymes, glucose, and electrolytes. 14. Hypertrophy is the type of cellular adaptation is undergone by the muscles of an extremity that has been in a cast for a long period of time. Metaplasia, dysplasia, and hyperplasia are other forms of cellular adaptation. In metaplasia, one adult cell is replaced by another cell type. In dysplasia, cells mature into cells of a different size, shape, and appearance. Hyperplasia is an increase in the number of cells in an organ or tissue. 15. Malignant tumors are usually undifferentiated. Benign tumors usually consist of differentiated, or less anaplastic, cells. 16. Causes of cell death include ischemia, apoptosis, and necrosis. 17. Variations of a gene are known as alleles. Autosomes refers to the 22 sets of paired chromosomes that are not sex chromosomes. A karotype is a representation of a person’s individual set of chromosomes. DNA makes up the long double-stranded chain of nucleotides known as chromosomes. 18. A form of cell division that occurs only in mature sperm and ova is meiosis. Mitosis is the most common form of cell division. Prophase refers to the first phase of mitosis. An oncogene can cause cancer. 19. Monosomy X (Turner’s syndrome) affects only females. Trisomy 21 (Down syndrome) and Tay-Sachs disease affect both females and males. Polysomy X (Klinefelter’s syndrome) affects only males. 20. A cancer patient’s likelihood for surviving a cancer is referred to as his or her prognosis. A remission takes place when cancer responds to treatment and is under

8 control. Carcinogenesis is the process by which cancer develops. Grading determines the degree of differentiation of cancer. 21. Metaplasia refers to the process of one adult cell being replaced by another cell type. An increase in the number of cells in an organ or tissue is hyperplasia. Cell mutation into cells of a different size, shape, and appearance is dysplasia. An increase in the size of cells in an attempt to meet increased demand is hypertrophy. 22. Liquefaction necrosis occurs when caustic enzymes dissolve and liquefy necrotic cells. Coagulative necrosis usually results as an interruption in blood flow. Fat necrosis occurs when lipase enzymes break down intracellular triglycerides into free fatty acids. Caseous necrosis occurs when necrotic cells disintegrate but the cellular debris remains for months or years. 23. Phenylketonuria (PKU) is an autosomal recessive disorder. 24. When cells increase in number in an organ or tissue, this is known is hyperplasia. Apoptosis is a type of cell death. Metaplasia is the process of one adult cell being replaced by another cell type. In dysplasia, cells mutate into cells of a different size, shape, and appearance. 25. In grading cancer cells, grade 1 has well-differentiated cells. The other grades have progressively less differentiation. Grade 4 cells are undifferentiated.

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CHAPTER 2 QUESTIONS _____ 1. Which of the following is true concerning primary immunodeficiency? A. Primary immunodeficiency is caused by pathogens. B. It reflects a defect with the immune system. C. Primary immunodeficiency is a loss of immune function because of a specific cause. D. Drug therapy can cause primary immunodeficiency. _____ 2. Molecules released by macrophages that have been exposed to bacteria are known as A. pyrogens. B. interferons. C. T cells. D. complement proteins. _____ 3. Antibody production is turned off by A. effector cells. B. killer cells. C. suppressor cells. D. cytotoxic cells. _____ 4. Which statement is true about T cells? A. T cells mature in the thyroid gland. B. They are responsible for hypersensitivity and transplant rejection. C. T cells are part of the body’s first line of defense. D. They mature in the bone marrow. _____ 5. Bodily changes that are associated with stress were first described by Hans Selye in the A. 1780s. B. 1860s. C. 1930s. D. 1990s. _____ 6. Which of the following is a characteristic of systemic lupus erythematosus? A. Butterfly rash over the cheeks B. Photosensitivity C. Arthritis D. All of the above _____ 7. The inflammatory response is part of the body’s

10 A. first line of defense. B. second line of defense. C. third line of defense. D. none of the above _____ 8. In type III hypersensitivity, A. circulating antigen-antibody complexes accumulate and are deposited in the tissue. B. macrophages perform delayed processing of the antigen. C. allergens activate T cells, which bind to mast cells. D. the target cell is destroyed by an antibody-directed, cell-surface antigen. _____ 9. Small proteins that are released from cells infected by viruses are known as A. regulator cells. B. effector cells. C. interferons. D. pyrogens. _____ 10. Catecholamines and cortisol are released, causing the fight-or-flight response, in which stage of the general adaptation syndrome? A. The resistance stage B. Hypersensitivity C. The exhaustion stage D. The alarm stage _____ 11. The skin and mucous membranes are part of the body’s A. first line of defense. B. second line of defense. C. third line of defense. D. fourth line of defense. _____ 12. An inflated response to an antigen is A. hypersensitivity. B. immunodeficiency. C. the general adaptation syndrome. D. autologous. _____ 13. Which of the following is a maladaptive coping strategy for stress? A. Physical activity B. Overeating C. Biofeedback D. Distraction _____ 14. Anxiety, depression, insomnia, infections, and cardiovascular disease have been attributed to A. killer cell attacks.

11 B. type II hypersensitivity. C. pyrogen. D. stress. _____ 15. Factors that place individuals at risk for an impaired immune system include A. spending time outdoors. B. reducing stress. C. smoking. D. increasing fluid intake. _____ 16. The membrane-attack complex is part of which line of defense? A. First line of defense B. Second line of defense C. Third line of defense D. All of the above _____ 17. The type of rejection reaction that occurs only with bone marrow transplants is A. graft-versus-host rejection. B. graft-versus-graft rejection. C. host-versus-host rejection. D. host-versus-graft rejection. _____ 18. Category 2 of HIV infection progression refers to A. CD4 cell count ≥ 500 cells/mm3. B. Asymptomatic HIV infection. C. CD4 cell count 200–499 cells/mm3. D. CD4 cell count < 200 cells/mm3. _____ 19. The first stage of the general adaptation syndrome is the A. resistance stage. B. exhaustion stage. C. stress response. D. alarm stage. _____ 20. Children who are HIV positive may experience A. problems walking. B. excess weight gain. C. high rates of growth. D. an absence of common childhood illnesses. _____ 21. Which statement is true about autoimmune reactions? A. Autoimmune disorders affect women more than men. B. They can be systemic or can affect particular organs. C. Diagnostic procedures for autoimmune disorders often begin with eliminating all other causes. D. All of the above

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_____ 22. Cells that have invaded the body are destroyed by A. T cells. B. B cells. C. cellular immunity. D. all of the above _____ 23. Transplants that use tissue from the identical twin of the host are A. autologous transplants. B. syngenic transplants. C. allogenic transplants. D. all of the above _____ 24. Erythema, edema, heat, and pain characterize A. the third line of defense. B. general adaptation syndrome. C. the inflammatory response. D. acquired immunity. _____ 25. Antibody-producing cells and memory cells are types of A. T cells B. killer cells C. B cells. D. antigens.

ANSWER KEY 1. B 2. A 3. C 4. B 5. C 6. D 7. B 8. A 9. C 10. D 11. A 12. A 13. B 14. D 15. C 16. B 17. A 18. C

13 19. D 20. A 21. D 22. D 23. B 24. C 25. C

RATIONALES 1. Primary immunodeficiency reflects a defect with the immune system. Secondary immunodeficiency is a loss of immune function because of a specific cause, such as pathogens or drug therapy. 2. Molecules released by macrophages that have been exposed to bacteria are known as pyrogens. Interferons and complement proteins are other components of the second line of defense. T cells are part of the third line of defense. 3. Antibody production is turned off by suppressor cells. Effector cells, or killer cells, work to destroy antigens. Cytotoxic cell is another term used for killer cell. 4. T cells are responsible for hypersensitivity and transplant rejection. They mature in the thymus, not the thyroid gland or bone marrow. They are part of the body’s third line of defense. 5. Hans Selye first described bodily changes associated with stress in the 1930s. 6. Characteristics of systemic lupus erythematosus include butterfly rash over the cheeks, photosensitivity, and arthritis. 7. The inflammatory response is part of the body’s second line of defense. 8. In type III hypersensitivity, circulating antigen-antibody complexes accumulate and are deposited in the tissue. Macrophages perform delayed processing of the antigen in type IV hypersensitivity. Allergens activate T cells, which bind to mast cells, in type I hypersensitivity. The target cell is destroyed by an antibody-directed, cell-surface antigen in type II hypersensitivity. 9. Small proteins that are released from cells infected by viruses are known as interferons. Regulator cells and effector cells are types of T cells that work to destroy antigens. Pyrogens are molecules released by macrophages that have been exposed by bacteria. 10. Catecholamines and cortisol are released, causing the fight-or-flight response, in the alarm stage of the general adaptation syndrome.

14 11. The skin and mucous membranes are part of the body’s first line of defense. 12. An inflated response to an antigen is hypersensitivity. Immunodeficiency is a diminished or absent immune response. The general adaptation syndrome is the stress response. Autologous is a term used with transplants in which both the host and donor are the same person. 13. Overeating is a maladaptive coping strategy for stress. Physical activity, biofeedback, and distraction are positive coping strategies for stress. 14. Anxiety, depression, insomnia, infections, and cardiovascular disease have been attributed to stress. 15. Smoking is one factor that places individuals at risk for an impaired immune system. Spending time outdoors, reducing stress, and increasing fluid intake are strategies to build a healthy immune system. 16. The membrane-attack complex is part of the second line of defense 17. Graft-versus-host rejection occurs only with bone marrow transplants. 18. Category 2 of HIV infection progression refers to a CD4 cell count of 200 to 499 cells/mm3. Category 1 refers to a CD4 cell count ≥ 500 cells/mm3. Category 3 refers to a CD4 cell count < 200 cells/mm3. Asymptomatic HIV infection is one of the categories in another HIV classification system based on symptom presentation. 19. The first stage of the general adaptation syndrome is the alarm stage. Resistance is the second stage and exhaustion is the third stage. The whole process is the stress response. 20. Children who are HIV positive may experience problems walking. They may experience difficulty gaining weight and growing normally, and may have severe forms of common childhood illnesses. 21. Autoimmune disorders affect women more than men, and can be systemic or can affect particular organs. Diagnostic procedures for autoimmune disorders often begin with eliminating all other causes. 22. T cells, B cells, and cellular immunity all destroy cells that have invaded the body. 23. Syngenic transplants use tissue from the identical twin of the host. In autologous transplants, the host and donor are the same person. Allogenic transplants are those in which tissue is used from the same species of similar tissue type, but it is not identical. 24. Erythema, edema, heat, and pain characterize the inflammatory response. 25. Antibody-producing cells and memory cells are types of B cells.

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CHAPTER 3 QUESTIONS _____ 1. A deficit of clotting factor VIII, or an abnormality of clotting factor VIII, is found in A. von Willebrand’s disease. B. disseminated intravascular coagulation (DIC). C. hemophilia A. D. idiopathic thrombocytopenic purpura (ITP). _____ 2. The most plentiful type of blood cell in the human body is A. erythrocytes. B. leukocytes. C. thrombocytes. D. stem cells. _____ 3. Clinical manifestations of Hodgkin’s disease include A. weight loss. B. pruritus. C. swollen, painless lymph nodes. D. all of the above _____ 4. Cyanocobalamin (vitamin B12) deficiency is found in A. pernicious anemia. B. aplastic anemia. C. hemolytic anemia. D. sickle cell anemia. _____ 5. With proper management, patients with sickle cell disease live into their A. teens. B. 20s. C. 30s. D. 50s. _____ 6. Blood gets its red color from A. von Willebrand factor. B. DIC. C. hemoglobin. D. pancytopenia. _____ 7. Blood formation occurs primarily in the A. plasma. B. bone marrow.

16 C. hemoglobin. D. none of the above _____ 8. The most common anemia worldwide is A. pernicious anemia. B. iron deficiency anemia. C. aplastic anemia. D. sickle cell anemia. _____ 9. Which of the following statements about polycythemia vera is true? A. Polycythemia vera is disease in which too few blood cells are produced. B...