Understanding Pathophysiology
8th Edition
Author(s)Sue E. Huether
TEST BANK
Q1. A 6-year-old boy develops recurrent bacterial infections,
delayed wound healing, and poor leukocyte migration into
infected tissue despite marked neutrophilia in peripheral blood.
Flow cytometry demonstrates absent β2-integrin expression on
neutrophils. The defective process most directly involves failure
of which cellular function?
A. Ligand-gated ion exchange across the plasma membrane
B. Cell-to-cell adhesion required for transendothelial migration
C. ATP-dependent lysosomal degradation of pathogens
D. G-protein mediated intracellular signal amplification
E. DNA polymerase–dependent cellular replication
Correct Answer: B
,Rationale:
Clinical Clue:
Severe bacterial infections with neutrophilia and impaired
tissue migration indicate defective leukocyte adhesion.
Mechanism:
β2-integrins mediate firm adhesion between leukocytes and
endothelial cells before diapedesis.
Why the Correct Answer Is Right:
Leukocyte extravasation requires adhesion molecules to anchor
neutrophils to vascular endothelium. Loss of β2-integrins
prevents migration into tissues despite adequate neutrophil
production.
Why the Other Options Are Wrong:
A. Ion exchange defects affect excitability, not leukocyte
trafficking.
C. Lysosomal dysfunction impairs intracellular killing rather than
adhesion.
D. Signal amplification defects are broader and would not
specifically abolish migration.
E. DNA replication defects would impair proliferation globally.
Exam Trap (common misconception tested):
Confusing neutrophil quantity with neutrophil functional
competence.
High-Yield Clinical Correlation:
Adhesion molecule defects produce recurrent infections with
,minimal pus formation because leukocytes cannot enter tissues
effectively.
Q2. A hepatocyte exposed to prolonged hypoxia develops
cellular swelling, decreased membrane potential, and
cytoplasmic vacuolization. The earliest pathophysiologic change
most likely resulted from impaired function of which structure?
A. Smooth endoplasmic reticulum
B. Mitochondrial oxidative phosphorylation system
C. Golgi transport vesicles
D. Nuclear chromatin remodeling enzymes
E. Peroxisomal fatty acid oxidases
Correct Answer: B
Rationale:
Clinical Clue:
Hypoxia causing swelling and membrane dysfunction indicates
ATP depletion.
Mechanism:
Mitochondria generate ATP through oxidative phosphorylation.
ATP depletion disables sodium-potassium ATPase activity.
Why the Correct Answer Is Right:
Failure of mitochondrial ATP generation causes intracellular
sodium and water accumulation, producing hydropic swelling.
, Why the Other Options Are Wrong:
A. Smooth ER primarily synthesizes lipids and detoxifies
substances.
C. Golgi dysfunction affects protein packaging, not immediate
swelling.
D. Chromatin remodeling changes occur later with injury
progression.
E. Peroxisomal dysfunction mainly impairs lipid metabolism.
Exam Trap (common misconception tested):
Assuming cellular swelling results directly from membrane
rupture rather than ATP-dependent pump failure.
High-Yield Clinical Correlation:
Cellular swelling is among the earliest reversible manifestations
of ischemic injury.
Q3. A researcher inhibits microtubule polymerization in rapidly
dividing tumor cells. Cells accumulate in metaphase with
inability to separate chromosomes. Which process has been
directly disrupted?
A. Cytoplasmic cytokine signaling
B. Mitochondrial ATP synthesis
C. Mitotic spindle formation
D. Ribosomal protein translation
E. Lysosomal autophagy
Correct Answer: C
8th Edition
Author(s)Sue E. Huether
TEST BANK
Q1. A 6-year-old boy develops recurrent bacterial infections,
delayed wound healing, and poor leukocyte migration into
infected tissue despite marked neutrophilia in peripheral blood.
Flow cytometry demonstrates absent β2-integrin expression on
neutrophils. The defective process most directly involves failure
of which cellular function?
A. Ligand-gated ion exchange across the plasma membrane
B. Cell-to-cell adhesion required for transendothelial migration
C. ATP-dependent lysosomal degradation of pathogens
D. G-protein mediated intracellular signal amplification
E. DNA polymerase–dependent cellular replication
Correct Answer: B
,Rationale:
Clinical Clue:
Severe bacterial infections with neutrophilia and impaired
tissue migration indicate defective leukocyte adhesion.
Mechanism:
β2-integrins mediate firm adhesion between leukocytes and
endothelial cells before diapedesis.
Why the Correct Answer Is Right:
Leukocyte extravasation requires adhesion molecules to anchor
neutrophils to vascular endothelium. Loss of β2-integrins
prevents migration into tissues despite adequate neutrophil
production.
Why the Other Options Are Wrong:
A. Ion exchange defects affect excitability, not leukocyte
trafficking.
C. Lysosomal dysfunction impairs intracellular killing rather than
adhesion.
D. Signal amplification defects are broader and would not
specifically abolish migration.
E. DNA replication defects would impair proliferation globally.
Exam Trap (common misconception tested):
Confusing neutrophil quantity with neutrophil functional
competence.
High-Yield Clinical Correlation:
Adhesion molecule defects produce recurrent infections with
,minimal pus formation because leukocytes cannot enter tissues
effectively.
Q2. A hepatocyte exposed to prolonged hypoxia develops
cellular swelling, decreased membrane potential, and
cytoplasmic vacuolization. The earliest pathophysiologic change
most likely resulted from impaired function of which structure?
A. Smooth endoplasmic reticulum
B. Mitochondrial oxidative phosphorylation system
C. Golgi transport vesicles
D. Nuclear chromatin remodeling enzymes
E. Peroxisomal fatty acid oxidases
Correct Answer: B
Rationale:
Clinical Clue:
Hypoxia causing swelling and membrane dysfunction indicates
ATP depletion.
Mechanism:
Mitochondria generate ATP through oxidative phosphorylation.
ATP depletion disables sodium-potassium ATPase activity.
Why the Correct Answer Is Right:
Failure of mitochondrial ATP generation causes intracellular
sodium and water accumulation, producing hydropic swelling.
, Why the Other Options Are Wrong:
A. Smooth ER primarily synthesizes lipids and detoxifies
substances.
C. Golgi dysfunction affects protein packaging, not immediate
swelling.
D. Chromatin remodeling changes occur later with injury
progression.
E. Peroxisomal dysfunction mainly impairs lipid metabolism.
Exam Trap (common misconception tested):
Assuming cellular swelling results directly from membrane
rupture rather than ATP-dependent pump failure.
High-Yield Clinical Correlation:
Cellular swelling is among the earliest reversible manifestations
of ischemic injury.
Q3. A researcher inhibits microtubule polymerization in rapidly
dividing tumor cells. Cells accumulate in metaphase with
inability to separate chromosomes. Which process has been
directly disrupted?
A. Cytoplasmic cytokine signaling
B. Mitochondrial ATP synthesis
C. Mitotic spindle formation
D. Ribosomal protein translation
E. Lysosomal autophagy
Correct Answer: C
