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 child is diagnosed with a congenital
disorder characterized by recurrent bacterial infections,
delayed wound healing, and defective leukocyte
migration. Laboratory evaluation demonstrates impaired
expression of integrins on neutrophils. The impaired host
defense most directly results from disruption of which
cellular process?
, A. Intracellular protein degradation by lysosomes
B. Cell-to-cell adhesion required for transendothelial
migration
C. ATP generation through oxidative phosphorylation
D. Endoplasmic reticulum–mediated protein folding
Correct Answer: B
Rationale:
• Clinical Clue: Recurrent infections with impaired leukocyte
migration suggest defective adhesion molecules.
• Mechanism: Integrins mediate firm adhesion of leukocytes
to endothelial cells before diapedesis.
• Why the Correct Answer Is Right: Loss of adhesion impairs
neutrophil extravasation into infected tissues.
• Why the Other Options Are Wrong:
o A: Lysosomal dysfunction causes impaired
intracellular killing, not migration failure.
o C: ATP deficiency would produce generalized cellular
dysfunction rather than selective migration defects.
o D: Protein folding abnormalities do not specifically
impair leukocyte adhesion.
• Exam Trap: Confusing leukocyte migration defects with
phagocytic killing disorders.
,• High-Yield Clinical Correlation: Leukocyte adhesion
deficiency causes delayed umbilical cord separation and
absent pus formation.
• Memory Anchor: “Integrins anchor leukocytes to vessel
walls.”
Q2. A researcher exposes cultured hepatocytes to cyanide,
resulting in rapid cessation of aerobic ATP production. The
earliest intracellular consequence is most likely which of
the following?
A. Failure of sodium-potassium ATPase activity
B. DNA fragmentation from endonuclease activation
C. Increased synthesis of membrane phospholipids
D. Immediate rupture of lysosomal membranes
Correct Answer: A
Rationale:
• Clinical Clue: Cyanide blocks oxidative phosphorylation and
ATP generation.
• Mechanism: ATP depletion rapidly disables membrane ion
pumps.
• Why the Correct Answer Is Right: Sodium-potassium
ATPase failure causes sodium and water accumulation
with cellular swelling.
• Why the Other Options Are Wrong:
, o B: DNA fragmentation occurs later during irreversible
injury or apoptosis.
o C: ATP depletion suppresses biosynthesis.
o D: Lysosomal rupture is generally a later event.
• Exam Trap: Assuming irreversible injury occurs
immediately after ATP depletion.
• High-Yield Clinical Correlation: Hydropic swelling is often
the earliest morphologic manifestation of hypoxic injury.
• Memory Anchor: “Low ATP first disables pumps.”
Q3. A patient with uncontrolled diabetes mellitus develops
cataracts caused by intracellular accumulation of sorbitol
within the lens. This process most directly reflects which
principle of cellular metabolism?
A. Oxidative phosphorylation uncoupling
B. Osmotic injury caused by alternative glucose
metabolism
C. Increased beta-oxidation of fatty acids
D. Competitive inhibition of glycolysis enzymes
Correct Answer: B
Rationale:
• Clinical Clue: Sorbitol accumulation in diabetes is
associated with osmotic tissue injury.
The Biologic Basis for Disease in Adults
and Children
9th Edition
Author(s)Julia Rogers
TEST BANK
Q1. A 6-year-old child is diagnosed with a congenital
disorder characterized by recurrent bacterial infections,
delayed wound healing, and defective leukocyte
migration. Laboratory evaluation demonstrates impaired
expression of integrins on neutrophils. The impaired host
defense most directly results from disruption of which
cellular process?
, A. Intracellular protein degradation by lysosomes
B. Cell-to-cell adhesion required for transendothelial
migration
C. ATP generation through oxidative phosphorylation
D. Endoplasmic reticulum–mediated protein folding
Correct Answer: B
Rationale:
• Clinical Clue: Recurrent infections with impaired leukocyte
migration suggest defective adhesion molecules.
• Mechanism: Integrins mediate firm adhesion of leukocytes
to endothelial cells before diapedesis.
• Why the Correct Answer Is Right: Loss of adhesion impairs
neutrophil extravasation into infected tissues.
• Why the Other Options Are Wrong:
o A: Lysosomal dysfunction causes impaired
intracellular killing, not migration failure.
o C: ATP deficiency would produce generalized cellular
dysfunction rather than selective migration defects.
o D: Protein folding abnormalities do not specifically
impair leukocyte adhesion.
• Exam Trap: Confusing leukocyte migration defects with
phagocytic killing disorders.
,• High-Yield Clinical Correlation: Leukocyte adhesion
deficiency causes delayed umbilical cord separation and
absent pus formation.
• Memory Anchor: “Integrins anchor leukocytes to vessel
walls.”
Q2. A researcher exposes cultured hepatocytes to cyanide,
resulting in rapid cessation of aerobic ATP production. The
earliest intracellular consequence is most likely which of
the following?
A. Failure of sodium-potassium ATPase activity
B. DNA fragmentation from endonuclease activation
C. Increased synthesis of membrane phospholipids
D. Immediate rupture of lysosomal membranes
Correct Answer: A
Rationale:
• Clinical Clue: Cyanide blocks oxidative phosphorylation and
ATP generation.
• Mechanism: ATP depletion rapidly disables membrane ion
pumps.
• Why the Correct Answer Is Right: Sodium-potassium
ATPase failure causes sodium and water accumulation
with cellular swelling.
• Why the Other Options Are Wrong:
, o B: DNA fragmentation occurs later during irreversible
injury or apoptosis.
o C: ATP depletion suppresses biosynthesis.
o D: Lysosomal rupture is generally a later event.
• Exam Trap: Assuming irreversible injury occurs
immediately after ATP depletion.
• High-Yield Clinical Correlation: Hydropic swelling is often
the earliest morphologic manifestation of hypoxic injury.
• Memory Anchor: “Low ATP first disables pumps.”
Q3. A patient with uncontrolled diabetes mellitus develops
cataracts caused by intracellular accumulation of sorbitol
within the lens. This process most directly reflects which
principle of cellular metabolism?
A. Oxidative phosphorylation uncoupling
B. Osmotic injury caused by alternative glucose
metabolism
C. Increased beta-oxidation of fatty acids
D. Competitive inhibition of glycolysis enzymes
Correct Answer: B
Rationale:
• Clinical Clue: Sorbitol accumulation in diabetes is
associated with osmotic tissue injury.
