MSN 570 Pathophys Heme Exam Questions & Answers

Which type of cell adaptation occurs when normal columnar ciliated epithelial cells of the bronchial lining have been replaced by stratified squamous epithelial cells? a. Hyperplasia b. Metaplasia c. Dysplasia d. Anaplasia - B. Metaplasia The loss of the adenosine triphosphate (ATP) during ischemia causes cells to: a. Shrink because of the influx of calcium (Ca). b. Shrink because of the influx of potassium chloride (KCl). c. Swell because of the influx of sodium chloride (NaCl). d. Swell because of the influx of nitric oxide (NO). - C. Swell because of the influx of NaCl The mammary glands enlarge during pregnancy primarily as a consequence of hormonal: a. Atrophy b. Hyperplasia c. Anaplasia d. Dysplasia - B. Hyperplasia Free radicals play a major role in the initiation and progression of which diseases? a. Cardiovascular diseases such as hypertension and ischemic heart disease b. Renal diseases such as acute tubular necrosis and glomerulonephritis c. Gastrointestinal diseases such as peptic ulcer disease and Crohn disease d. Muscular disease such as muscular dystrophy and fibromyalgia - A. Cardiovascular diseases such as hypertension and ischemic heart disease Free radicals cause cell damage by: a. Stealing the cell's oxygen to stabilize the electron, thus causing hypoxia b. Stimulating the release of lysosomal enzymes that digest the cell membranes c. Transferring one of its charged, stabilized atoms to the cell membrane, which causes lysis d. Giving up an electron, which causes injury to the chemical bonds of the cell membrane - D. Giving up an electron, which causes injury to the chemical bonds of the cell membrane What is a consequence of plasma membrane damage to the mitochondria? a. Enzymatic digestion halts DNA synthesis. b. Influx of calcium ions halts ATP production c. Edema from an influx of sodium causes a reduction in ATP production. d. Potassium shifts out of the mitochondria, which destroys the infrastructure - B. Influx of calcium ions halts ATP production What is a consequence of leakage of lysosomal enzymes during chemical injury? a. Enzymatic digestion of the nucleus and nucleolus occurs, halting DNA synthesis. b. Influx of potassium ions into the mitochondria occurs, halting the ATP production. c. Edema of the Golgi body occurs, preventing the transport of proteins out of the cell. d. Shift of calcium out of the plasma membrane occurs, destroying the cytoskeleton. - A. Enzymatic digestion of the nucleus and nucleolus occurs, halting DNA synthesis. Lead causes damage within the cell by interfering with the action of: a. Sodium and chloride b. Potassium c. Calcium d. ATP - C. Calcium Which statement is a description of the characteristics of apoptosis? a. Programmed cell death of scattered, single cells b. Characterized by swelling of the nucleus and cytoplasm c. Unpredictable patterns of cell death d. Results in benign malignancies - A. Programmed cell death of scattered, single cells Lead poisoning affects the nervous system by: a. Interfering with the function of neurotransmitters b. Inhibiting the production of myelin around nerves c. Increasing the resting membrane potential d. Altering the transport of potassium into the nerves - A. Interfering with the function of neurotransmitters Carbon monoxide causes tissue damage by: a. Competing with carbon dioxide so that it cannot be excreted b. Binding to hemoglobin so that it cannot carry oxygen c. Destroying the chemical bonds of hemoglobin so it cannot carry oxygen d. Removing iron from hemoglobin so it cannot carry oxygen - B. Binding to hemoglobin so that it cannot carry oxygen Acute alcoholism mainly affects which body system? a. Hepatic b. Gastrointestinal c. Renal d. Central nervous - D. Central nervous During cell injury caused by hypoxia, an increase in the osmotic pressure occurs within the cell because: a. Plasma proteins enter the cell. b. The adenosine triphosphatase (ATPase)-driven pump is stronger during hypoxia. c. Sodium chloride enters the cell. d. An influx of glucose occurs through the injured cell membranes. - C. Sodium chloride enters the cell. Which statement is true regarding the difference between subdural hematoma and epidural hematoma? a. No difference exists, and these terms may be correctly used interchangeably. b. A subdural hematoma occurs above the dura, whereas an epidural hematoma occurs under the dura. c. A subdural hematoma is often the result of shaken baby syndrome, whereas an epidural hematoma rapidly forms as a result of a skull fracture. d. A subdural hematoma usually forms from bleeding within the skull, such as an aneurysm eruption, whereas an epidural hematoma occurs from trauma outside the skull, such as a blunt force trauma - C. A subdural hematoma is often the result of shaken baby syndrome, whereas an epidural hematoma rapidly forms as a result of a skull fracture. What physiologic change occurs during heat exhaustion? a. Hemoconcentration occurs because of the loss of salt and water. b. Cramping of voluntary muscles occurs as a result of salt loss. c. Thermoregulation fails because of high core temperatures. d. Subcutaneous layers are damaged because of high core temperatures. - A. Hemoconcentration occurs because of the loss of salt and water. In hypoxic injury, sodium enters the cell and causes swelling because: a. The cell membrane permeability increases for sodium during periods of hypoxia. b. ATP is insufficient to maintain the pump that keeps sodium out of the cell. c. The lactic acid produced by the hypoxia binds with sodium in the cell. d. Sodium cannot be transported to the cell membrane during hypoxia. - B. ATP is insufficient to maintain the pump that keeps sodium out of the cell. What is the most common site of lipid accumulation? a. Coronary arteries b. Kidneys c. Liver d. Subcutaneous tissue - C. Liver What mechanisms occur in the liver cells as a result of lipid accumulation? a. Accumulation of lipids that obstruct the common bile duct, preventing flow of bile from the liver to the gallbladder b. Increased synthesis of triglycerides from fatty acids and decreased synthesis of apoproteins c. Increased binding of lipids with apoproteins to form lipoproteins d. Increased conversion of fatty acids to phospholipids - B. Increased synthesis of triglycerides from fatty acids and decreased synthesis of apoproteins Hemoprotein accumulations are a result of the excessive storage of: a. Iron, which is transferred from the cells to the bloodstream b. Hemoglobin, which is transferred from the bloodstream to the cells c. Albumin, which is transferred from the cells to the bloodstream d. Amino acids, which are transferred from the cells to the bloodstream - A. Iron, which is transferred from the cells to the bloodstream Hemosiderosis is a condition that results in the excess of what substance being stored as hemosiderin in cells of many organs and tissues? a. Hemoglobin b. Ferritin c. Iron d. Transferrin - C. Iron What is the cause of free calcium in the cytosol that damages cell membranes by uncontrolled enzyme activation? a. Activation of endonuclease interferes with the binding of calcium to protein. b. Activation of phospholipases, to which calcium normally binds, degrades the proteins. c. An influx of phosphate ions competes with calcium for binding to proteins. d. Depletion of ATP normally pumps calcium from the cell. - D. Depletion of ATP normally pumps calcium from the cell. What two types of hearing loss are associated with noise? a. Acoustic trauma and noise-induced b. High frequency and low frequency c. High frequency and acoustic trauma d. Noise-induced and low frequency - A. Acoustic trauma and noise-induced What type of necrosis results from ischemia of neurons and glial cells? a. Coagulative b. Liquefactive c. Caseous d. Gangrene - B. Liquefactive What type of necrosis is often associated with pulmonary tuberculosis? a. Bacteriologic b. Caseous c. Liquefactive d. Gangrenous - B. Caseous What type of necrosis is associated with wet gangrene? a. Coagulative b. Liquefactive c. Caseous d. Gangrene - B. Liquefactive Current research supports the believe that, after heart muscle injury, the damage: a. Remains indefinitely because cardiac cells do not reproduce. b. Is repaired by newly matured cardiomyocytes. c. Gradually decreases in size as mitotic cell division occurs. d. Is replaced by hypertrophy of remaining cells - B. Is repaired by newly matured cardiomyocytes. After ovulation, the uterine endometrial cells divide under the influence of estrogen. This process is an example of hormonal: a. Hyperplasia b. Dysplasia c. Hypertrophy d. Anaplasia - A. Hyperplasia The abnormal proliferation of cells in response to excessive hormonal stimulation is called: a. Dysplasia b. Pathologic dysplasia c. Hyperplasia d. Pathologic hyperplasia - D. Pathologic hyperplasia Removal of part of the liver leads to the remaining liver cells undergoing compensatory: a. Atrophy b. Metaplasia c. Hyperplasia d. Dysplasia - C. Hyperplasia What is the single most common cause of cellular injury? a. Hypoxic injury b. Chemical injury c. Infectious injury d. Genetic injury - A. Hypoxic injury During cell injury caused by hypoxia, sodium and water move into the cell because: a. Potassium moves out of the cell, and potassium and sodium are inversely related. b. The pump that transports sodium out of the cell cannot function because of a decrease in ATP levels. c. The osmotic pressure is increased, which pulls additional sodium across the cell membrane. d. Oxygen is not available to bind with sodium to maintain it outside of the cell. - B. The pump that transports sodium out of the cell cannot function because of a decrease in ATP levels. In decompression sickness, emboli are formed by bubbles of: a. Oxygen b. Nitrogen c. Carbon monoxide d. Hydrogen - B. Nitrogen Which is an effect of ionizing radiation exposure? a. Respiratory distress b. Sun intolerance c. DNA aberrations d. Death - C. DNA aberrations What is an example of compensatory hyperplasia? a. Hepatic cells increase cell division after part of the liver is excised. b. Skeletal muscle cells atrophy as a result of paralysis. c. The heart muscle enlarges as a result of hypertension. d. The size of the uterus increases during pregnancy. - A. Hepatic cells increase cell division after part of the liver is excised. It is true that nondividing cells are: a. Found in gastrointestinal lining b. Affected by hyperplasia c. Incapable of synthesizing DNA d. Affected by only hypertrophy - A. Found in gastrointestinal lining Dysplasia refers to a(n): a. Abnormal increase in the number of a specific cell type b. True adaptive process at the cellular level c. Modification in the shape of a specific cell type d. Lack of oxygen at the cellular level - C. Modification in the shape of a specific cell type Current research has determined that chemical-induced cellular injury: a. Affects the permeability of the plasma membrane. b. Is often the result of the damage caused by reactive free radicals. c. Is rarely influenced by lipid peroxidation. d. Seldom involves the cell's organelles. - B. Is often the result of the damage caused by reactive free radicals. Which organs are affected by lead consumption? (Select all that apply.) a. Bones b. Muscles c. Pancreas d. Nerves e. Eyes - A. Bones + D. Nerves What effect does fetal alcohol syndrome have on newborns? (Select all that apply.) a. Failure of alveoli to open b. Cognitive impairment c. Incompetent semilunar values d. Esophageal stricture e. Facial anomalies - B. Cognitive impairment + E Facial anomalies What organs are affected by the type of necrosis that results from either severe ischemia or chemical injury? (Select all that apply.) a. Lungs b. Brain c. Kidneys d. Muscles e. Heart - C. Kidneys + E. Heart It is true that melanin is: (Select all that apply.) a. Rarely found in epithelial cells b. Found in cells called keratinocytes, which are present in the retina c. A factor in the prevention of certain types of cancer d. Most influential in managing the effects of short-term sunlight exposure e. Accumulated in specific cells found in the skin - B, C + E Examples of adaptive cellular responses include: (Select all that apply.) a. Atrophy b. Dysplasia c. Hypertrophy d. Hyperplasia e. Metaplasia - A, C, D +E Blunt force injuries would include a: (Select all that apply.) a. Bruise to the upper arm, resulting from a fall b. Simple tibia fracture sustained in a skiing accident c. Cut on the finger while slicing vegetables for a salad d. Spleen laceration caused by a punch during a physical fight e. Small caliber gunshot wound to the foot while target shooting - A, B + D Which statements are true regarding the effects of marijuana use? (Select all that apply.) a. Smoking the drug results in greater absorption that eating it. b. Heavy use can result in psychomotor impairments. c. Smoking four "joints" a day equals smoking approximately 20 cigarettes. d. Research does not support marijuana use as a factor in developing lung cancer. e. Fetal development appears to be unharmed by marijuana use. - A, B + C Which action is a purpose of the inflammatory process? a. To provide specific responses toward antigens b. To lyse cell membranes of microorganisms c. To prevent infection of the injured tissue d. To create immunity against subsequent tissue injury - C. To prevent infection of the injured tissue How do surfactant proteins A through D provide innate resistance? a. Initiate the complement cascade. b. Promote phagocytosis. c. Secrete mucus. d. Synthesize lysosomes. - B. Promote phagocytosis. Which secretion is a first line of defense against pathogen invasion that involves antibacterial and antifungal fatty acids, as well as lactic acid? a. Optic tears b. Oral saliva c. Sweat gland perspiration d. Sebaceous gland sebum - D. Sebaceous gland sebum Which bacterium grows in the intestines after prolonged antibiotic therapy? a. Lactobacillus b. Candida albicans c. Clostridium difficile d. Helicobacter pylori - C. Clostridium difficile What causes the edema that occurs during the inflammatory process? a. Vasodilation of blood vessels b. Increased capillary permeability c. Endothelial cell contraction d. Emigration of neutrophils - B. Increased capillary permeability What process causes heat and redness to occur during the inflammatory process? a. Vasodilation of blood vessels b. Platelet aggregation c. Decreased capillary permeability d. Endothelial cell contraction - A. Vasodilation of blood vessels Activation of the classical pathway begins with: a. Viruses b. Antigen-antibody complexes c. Mast cells d. Macrophages - B. Antigen-antibody complexes What plasma protein system forms a fibrinous meshwork at an inflamed site? a. Complement b. Coagulation c. Kinin d. Fibrinolysis - B. Coagulation Which component of the plasma protein system tags pathogenic microorganisms for destruction by neutrophils and macrophages? a. Complement cascade b. Coagulation system c. Kinin system d. Immune system - A. Complement cascade What is the vascular effect of histamine released from mast cells? a. Platelet adhesion b. Initiation of the clotting cascade c. Vasodilation d. Increased endothelial adhesiveness - C. Vasodilation What is an outcome of the complement cascade? a. Activation of the clotting cascade b. Prevention of the spread of infection to adjacent tissues c. Inactivation of chemical mediators such as histamine d. Lysis of bacterial cell membranes - D. Lysis of bacterial cell membranes The function of opsonization related to the complement cascade is to: a. Tag of pathogenic microorganisms for destruction by neutrophils and macrophages. b. Process pathogenic microorganisms so that activated lymphocytes can be created for acquired immunity. c. Destroy glycoprotein cell membranes of pathogenic microorganisms. d. Promote anaphylatoxic activity, resulting in mast cell degranulation. - A. Tag of pathogenic microorganisms for destruction by neutrophils and macrophages. In the coagulation (clotting) cascade, the intrinsic and the extrinsic pathways converge at which factor? a. XII b. VII c. X d. V - C. X Which chemical interacts among all plasma protein systems by degrading blood clots, activating complement, and activating the Hageman factor? a. Kallikrein b. Histamine c. Bradykinin d. Plasmin - D. Plasmin The chemotactic factor affects the inflammatory process by: a. Causing vasodilation around the inflamed area b. Stimulating smooth muscle contraction in the inflamed area c. Directing leukocytes to the inflamed area d. Producing edema around the inflamed area - C. Directing leukocytes to the inflamed area What affect does the process of histamine binding to the histamine-2 (H2) receptor have on inflammation? a. Inhibition b. Activation c. Acceleration d. Termination - A. Inhibition Frequently when H1 and H2 receptors are located on the same cells, they act in what fashion? a. Synergistically b. Additively c. Antagonistically d. Agonistically - C. Antagonistically Some older adults have impaired inflammation and wound healing because of which problem? a. Circulatory system cannot adequately perfuse tissues. b. Complement and chemotaxis are deficient. c. Underlying chronic illness(es) exists. d. Number of mast cells is insufficient. - C. Underlying chronic illness(es) exists. Which chemical mediator derived from mast cells retracts endothelial cells to increase vascular permeability and to cause leukocyte adhesion to endothelial cells? a. Leukotrienes b. Prostaglandin c. Platelet-activating factor d. Bradykinin - C. Platelet-activating factor What is the inflammatory effect of nitric oxide (NO)? a. Increases capillary permeability, and causes pain. b. Increases neutrophil chemotaxis and platelet aggregation. c. Causes smooth muscle contraction and fever. d. Decreases mast cell function, and decreases platelet aggregation. - D. Decreases mast cell function, and decreases platelet aggregation. What is the correct sequence in phagocytosis? a. Engulfment, recognition, fusion, destruction b. Fusion, engulfment, recognition, destruction c. Recognition, engulfment, fusion, destruction d. Engulfment, fusion, recognition, destruction - C. Recognition, engulfment, fusion, destruction When considering white blood cell differentials, acute inflammatory reactions are related to elevations of which leukocyte? a. Monocytes b. Eosinophils c. Neutrophils d. Basophils - C. Neutrophils In the later stages of an inflammatory response, which phagocytic cell is predominant? a. Neutrophils b. Monocytes c. Chemokines d. Eosinophils - B. Monocytes In regulating vascular mediators released from mast cells, the role of eosinophils is to release: a. Arylsulfatase B which stimulates the formation of B lymphocytes b. Histaminase, which limits the effects of histamine during acute inflammation c. Lysosomal enzymes, which activate mast cell degranulation during acute inflammation d. Immunoglobulin E, which defends the body against parasites - B. Histaminase, which limits the effects of histamine during acute inflammation What is the role of a natural killer (NK) cells? a. Initiation of the complement cascade b. Elimination of malignant cells c. Binding tightly to antigens d. Proliferation after immunization with antigen - B. Elimination of malignant cells Which cytokine is produced and released from virally infected host cells? a. IL-1 b. IL-10 c. TNF-a d. IFN-a - D. IFN-a IFN-a is secreted from which cells? a. Virally infected cells b. Bacterial infected cells c. Macrophages d. Mast cells - C. Macrophages Which manifestation of inflammation is systemic? a. Formation of exudates b. Fever and leukocytosis c. Redness and heat d. Pain and edema - B. Fever and leukocytosis The acute inflammatory response is characterized by fever that is produced by the hypothalamus being affected by: a. Endogenous pyrogens b. Bacterial endotoxin c. Antigen-antibody complexes d. Exogenous pyrogens - A. Endogenous pyrogens What occurs during the process of repair after tissue damage? a. Nonfunctioning scar tissue replaces destroyed tissue. b. Regeneration occurs; the original tissue is replaced. c. Resolution occurs; tissue is regenerated. d. Epithelialization replaces destroyed tissue - A. Nonfunctioning scar tissue replaces destroyed tissue. The role of fibroblasts during the reconstructive phase of wound healing is to: a. Generate new capillaries from vascular endothelial cells around the wound. b. Establish connections between neighboring cells and contract their fibers. c. Synthesize and secrete collagen and the connective tissue proteins. d. Provide enzymes that débride the wound bed of dead cells. - C. Synthesize and secrete collagen and the connective tissue proteins. A keloid is the result of which dysfunctional wound healing response? a. Epithelialization b. Contraction c. Collagen matrix assembly d. Maturation - C. Collagen matrix assembly Which solution is best to use when cleaning a wound that is healing by epithelialization? a. Normal saline b. Povidone-iodine c. Hydrogen peroxide d. Dakin solution - A. Normal saline Many neonates have a transient depressed inflammatory response as a result of which condition? a. The circulatory system is too immature to perfuse tissues adequately. b. Complement and chemotaxis are deficient. c. Mast cells are lacking. d. The respiratory system is too immature to deliver oxygen to tissues. - B. Complement and chemotaxis are deficient. During phagocytosis, what is occurring during the step referred to as opsonization? a. Phagocytes recognize and adhere to the bacteria. b. Microorganisms are ingested. c. Microorganisms are killed and digested. d. An intracellular phagocytic vacuole is formed. - A. Phagocytes recognize and adhere to the bacteria. Fusion is the step in phagocytosis during which: a. Microorganisms are killed and digested. b. An intracellular phagocytic vacuole is formed. c. Lysosomal granules enter the phagocyte. d. Microorganisms are ingested. - C. Lysosomal granules enter the phagocyte. During the process of endocytosis, the phagosome step results in: a. Microorganisms are ingested. b. Microorganisms are killed and digested. c. Phagocytes recognize and adhere to bacteria. d. An intracellular phagocytic vacuole is formed. - D. An intracellular phagocytic vacuole is formed. When cellular damage occurs and regeneration is minor with no significant complications, the process of returning the cells to preinjury function is referred to as: a. Restoration b. Resolution c. Regrowth d. Replacement - B. Resolution Newborns often have deficiencies in collectin-like proteins, making them more susceptible to what type of infection? a. Cardiac b. Urinary c. Respiratory d. Gastrointestinal - C. Respiratory Which cell is the body's primary defense against parasite invasion? a. Eosinophil b. Neutrophils c. T lymphocytes d. B lymphocytes - A. Eosinophil Which chemical mediators induce pain during an inflammatory response? (Select all that apply.) a. Prostaglandins b. Leukotrienes c. Tryptase d. Phospholipase e. Bradykinin - A + E Sebaceous glands protect the body from infection by secreting: (Select all that apply.) a. Antibacterial fatty acids b. Antifungal fatty acids c. Ascorbic acid d. Lactic acid e. Hydrochloric acid - A, B + D Which body fluid has the ability to attack the cell walls of gram-positive bacteria? (Select all that apply.) a. Perspiration b. Semen c. Tears d. Saliva e. Urine - A, C + D The main function of NK cells includes: (Select all that apply.) a. Recognizing virus-infected cells b. Eliminating virus-infected cells c. Recognizing bacteria-infected cells d. Eliminating bacteria-infected cells e. Eliminating previously identified cancer cells - A, B + E Normal bacterial flora found in the intestines produce vitamin K to assist in the absorption of which of the following? (Select all that apply.) a. Calcium b. Fatty acids c. Large polysaccharides d. Iron e. Magnesium - A, D + E