McCance & Huether’s Pathophysiology
The Biologic Basis for Disease in Adults
and Children
9th Edition
Author(s)Julia Rogers
TEST BANK
Q1. A 6-year-old boy presents with recurrent pyogenic
infections, delayed wound healing, and poor leukocyte
migration into infected tissues. Flow cytometry
demonstrates defective β2-integrin expression on
neutrophils. Failure of which cellular process most directly
explains this patient’s impaired inflammatory response?
, A. ATP generation through oxidative phosphorylation
B. Formation of tight junctions between endothelial cells
C. Cell-to-cell adhesion mediated by integrins
D. Endoplasmic reticulum protein glycosylation
E. Lysosomal degradation of phagocytosed organisms
Correct Answer: C
Rationale:
• Clinical Clue: Recurrent bacterial infections with impaired
neutrophil migration suggests leukocyte adhesion
deficiency.
• Mechanism: β2-integrins are essential adhesion molecules
allowing leukocytes to adhere to endothelium and migrate
into tissues.
• Why the Correct Answer Is Right: Integrin-mediated
adhesion is required for firm attachment during leukocyte
extravasation.
• Why the Other Options Are Wrong:
o A: ATP production defects cause generalized cellular
dysfunction, not selective migration failure.
o B: Tight junctions regulate permeability, not
leukocyte anchoring.
o D: Glycosylation defects produce broader
multisystem abnormalities.
, o E: Lysosomal dysfunction impairs killing after
phagocytosis, not tissue migration.
• Exam Trap: Confusing impaired migration with defective
intracellular killing.
• High-Yield Clinical Correlation: Leukocyte adhesion
deficiency causes delayed umbilical cord separation and
neutrophilia.
• Memory Anchor: “Integrins anchor leukocytes before they
enter tissue.”
Q2. A researcher exposes cultured hepatocytes to cyanide,
leading to abrupt cessation of aerobic ATP production.
Which intracellular structure is most directly inhibited?
A. Golgi apparatus
B. Rough endoplasmic reticulum
C. Lysosome
D. Mitochondrion
E. Peroxisome
Correct Answer: D
Rationale:
• Clinical Clue: Cyanide poisoning blocks aerobic
metabolism.
• Mechanism: Cyanide inhibits cytochrome oxidase within
the mitochondrial electron transport chain.
, • Why the Correct Answer Is Right: Mitochondria are the
principal site of oxidative phosphorylation and ATP
generation.
• Why the Other Options Are Wrong:
o A: Golgi apparatus modifies and packages proteins.
o B: Rough ER synthesizes membrane and secretory
proteins.
o C: Lysosomes digest intracellular debris.
o E: Peroxisomes participate in fatty acid oxidation and
detoxification.
• Exam Trap: Choosing peroxisomes because oxidation
reactions occur there.
• High-Yield Clinical Correlation: Tissues with high oxygen
demand are especially vulnerable to mitochondrial toxins.
• Memory Anchor: “Cyanide shuts down mitochondrial
respiration.”
Q3. A patient with chronic alcohol use develops
hepatocellular injury characterized by accumulation of
misfolded proteins within the cytoplasm. Which organelle
is primarily responsible for synthesis and initial folding of
these proteins?
The Biologic Basis for Disease in Adults
and Children
9th Edition
Author(s)Julia Rogers
TEST BANK
Q1. A 6-year-old boy presents with recurrent pyogenic
infections, delayed wound healing, and poor leukocyte
migration into infected tissues. Flow cytometry
demonstrates defective β2-integrin expression on
neutrophils. Failure of which cellular process most directly
explains this patient’s impaired inflammatory response?
, A. ATP generation through oxidative phosphorylation
B. Formation of tight junctions between endothelial cells
C. Cell-to-cell adhesion mediated by integrins
D. Endoplasmic reticulum protein glycosylation
E. Lysosomal degradation of phagocytosed organisms
Correct Answer: C
Rationale:
• Clinical Clue: Recurrent bacterial infections with impaired
neutrophil migration suggests leukocyte adhesion
deficiency.
• Mechanism: β2-integrins are essential adhesion molecules
allowing leukocytes to adhere to endothelium and migrate
into tissues.
• Why the Correct Answer Is Right: Integrin-mediated
adhesion is required for firm attachment during leukocyte
extravasation.
• Why the Other Options Are Wrong:
o A: ATP production defects cause generalized cellular
dysfunction, not selective migration failure.
o B: Tight junctions regulate permeability, not
leukocyte anchoring.
o D: Glycosylation defects produce broader
multisystem abnormalities.
, o E: Lysosomal dysfunction impairs killing after
phagocytosis, not tissue migration.
• Exam Trap: Confusing impaired migration with defective
intracellular killing.
• High-Yield Clinical Correlation: Leukocyte adhesion
deficiency causes delayed umbilical cord separation and
neutrophilia.
• Memory Anchor: “Integrins anchor leukocytes before they
enter tissue.”
Q2. A researcher exposes cultured hepatocytes to cyanide,
leading to abrupt cessation of aerobic ATP production.
Which intracellular structure is most directly inhibited?
A. Golgi apparatus
B. Rough endoplasmic reticulum
C. Lysosome
D. Mitochondrion
E. Peroxisome
Correct Answer: D
Rationale:
• Clinical Clue: Cyanide poisoning blocks aerobic
metabolism.
• Mechanism: Cyanide inhibits cytochrome oxidase within
the mitochondrial electron transport chain.
, • Why the Correct Answer Is Right: Mitochondria are the
principal site of oxidative phosphorylation and ATP
generation.
• Why the Other Options Are Wrong:
o A: Golgi apparatus modifies and packages proteins.
o B: Rough ER synthesizes membrane and secretory
proteins.
o C: Lysosomes digest intracellular debris.
o E: Peroxisomes participate in fatty acid oxidation and
detoxification.
• Exam Trap: Choosing peroxisomes because oxidation
reactions occur there.
• High-Yield Clinical Correlation: Tissues with high oxygen
demand are especially vulnerable to mitochondrial toxins.
• Memory Anchor: “Cyanide shuts down mitochondrial
respiration.”
Q3. A patient with chronic alcohol use develops
hepatocellular injury characterized by accumulation of
misfolded proteins within the cytoplasm. Which organelle
is primarily responsible for synthesis and initial folding of
these proteins?
