, TESTBANK FOR Advanced Physiology and
Pathophysiology Essentials for Clinical Practice
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,CHAPTER 2: CHEMICAL AND BIOCHEMICAL FOUNDATIONS
OF PATHOPHYSIOLOGY
Multiple-Choice Questions
1. Which of the following best describes why atoms have an overall neutral charge?
a. Electrons orbit on the outside of the atom
@ Incorrect answer. Although it is true that electrons orbit outside the nucleus, this is not the reason why
atoms have an overall neutral charge.
*b. The number of protons equals the number of electrons
@ Correct answer. There are an equal number of protons, which have a positive charge, and electrons,
which have a negative charge. The positive and negative charges balance one another out for an overall
neutral charge.
c. There are more neutrons than protons.
@ Incorrect answer. There are the same number of neutrons as protons. Additionally, neutrons have a
neutral charge.
d. There are four electrons in the outer shell.
@ Incorrect answer. Some elements have four electrons in the outer shell, but this is not the reason for the
overall neutral charge. The number of electrons will match the number of protons.
2. Why do hydrogen and potassium readily interact with other atoms?
a. They only have electrons in the first shell.
@ Incorrect answer. Hydrogen has one electron, but potassium has 19 electrons. Therefore potassium has
two electrons in the first shell, eight in the second and third shells, and one in the fourth shell. Hydrogen
has one electron in the first shell.
b. They have electrons in all shells.
@ Incorrect answer. Hydrogen has one electron in the first shell. Potassium has two electrons in the first
shell, eight in the second and third shells, and one in the fourth shell.
c. They both have four electrons in the outer shell.
@ Incorrect answer. Both hydrogen and potassium have one electron in their outer shells.
*d. They both have one electron in the outer shell.
@ Correct answer. Both hydrogen and potassium have one electron in their outer shells meaning they can
readily interact with other atoms.
3. How many electrons does carbon use to interact with other atoms?
*a. 4
@ Correct answer. Carbon has four electrons in its outer shell. Only the electrons in the outer shell, or
valence electrons, are used to interact with other electrons.
b. 6
@ Incorrect answer. While carbon has a total of six electrons, only the electrons in the outer shell are used
to interact with other electrons. Two of carbon’s six electrons are in the first shell.
c. 1
@ Incorrect answer. Carbon has four valence electrons.
d. 2
@ Incorrect answer. While carbon has two electrons in the first shell, it also has four valence electrons
that are used to interact with other elements.
Copyright © Springer Publishing Company, LLC. All Rights Reserved. 1
,2 Advanced Physiology and Pathophysiology
4. Which of the following is true regarding the role of bicarbonate in maintaining homeostasis?
a. Bicarbonate dissociates from hydroxide to form a free hydroxide that neutralizes acid.
@ Incorrect answer. The dissociation of sodium from a hydroxide ion creates a free hydroxide that
neutralizes acid.
b. Bicarbonate releases protons when diluted with water, which neutralizes acids.
@ Incorrect answer. Acids release protons when placed in water, but bicarbonate is a base.
c. Bicarbonate is partially ionized in water and is considered to be a weak base.
@ Incorrect answer. Acids are ionized in water, not bases like bicarbonate. Both carbonic acid and
phosphoric acid are partly ionized in water, and are considered weak acids.
*d. Bicarbonate functions as a buffer to neutralize acids.
@ Correct answer. Bicarbonate is produced in the pancreas for the purpose of neutralizing the acidity in
chyme as it moves from the stomach to the small intestine. It also plays a major role in the carbonic acid
buffer system.
5. Which of the following occurs when carbonic acid is placed in water?
a. Almost all of the protons are released into the water.
@ Incorrect answer. Carbonic acid is a weak acid. Only in strong acids do most of the protons dissociate
into the water.
*b. Some of the protons are released into the water.
@ Correct answer. Carbonic acid is a weak acid, meaning it is only partly ionized in an aqueous solution.
Some of the protons are released into the water.
c. Some of the electrons are released into the water.
@ Incorrect answer. When acids are placed in water the protons are released. They are classified based on
their tendency to lose protons. Carbonic acid is a weak acid because only a few of its protons are released
into the water.
d. Almost all of the neutrons are released into the water.
@ Incorrect answer. Protons are released when acids are placed in water.
6. Which of the following most fully describes how proteins are used to buffer pH?
a. Proteins are used to neutralize excess acids because they have a carboxylic acid group.
@ Incorrect answer. The carboxylic acid group enables proteins to neutralize excess bases.
b. Proteins have an amino group, which is an acid, therefore they can neutralize excess base.
@ Incorrect answer. The amino group is a base, which enables proteins to neutralize excess acids.
c. Proteins are able to neutralize either excess base or excess acid because they have a neutral amino
group.
@ Incorrect answer. The amino group is a base, which enables proteins to neutralize excess acids. The
carboxylic acid group is an acid, which enables proteins to neutralize excess bases.
*d. Proteins are made up of basic amino groups and acidic carboxylic acid groups, which can be used to
neutralize either excess bases or acids.
@ Correct answer. Proteins can neutralize either excess bases or excess acids because they are made up of
an amino group (base) and a carboxylic acid group (acid).
7. Which of the following correctly describes the bond between two oxygen atoms?
*a. Two oxygen atoms share a double bond, enabling them both to fulfill the octet rule.
@ Correct answer. One oxygen atom will share two of its electrons with the other atom, forming a double
bond and fulfilling the octet rule for both atoms.
b. Two oxygen atoms share bonds with two hydrogen atoms enabling them to fulfill the octet rule.
Copyright © Springer Publishing Company, LLC. All Rights Reserved.
, Chapter 2: Chemical and Biochemical Foundations of Pathophysiology 3
@ Incorrect answer. Two oxygen atoms only need to share two electrons with one another in order to
form a double bond that fulfills the octet rule.
c. Two oxygen atoms share protons, forming a double bond and fulfilling the octet rule.
@ Incorrect answer. Two oxygen atoms share electrons, not protons, to form a double bond and fulfill the
octet rule.
d. Two oxygen atoms share two electrons to form a double bond and eight neutrons to fulfill the octet
rule.
@ Incorrect answer. Two oxygen atoms share only two electrons to form a double bond and fulfill the
octet rule.
8. Which of the following correctly describes a molecule that is most likely to be polar?
*a. A molecule enriched in hydroxyl groups
@ Correct answer. A molecule that contains O-H or N-H bonds is most likely to be polar.
b. A molecule modified with additional methyl groups
@ Incorrect answer. Methyl groups only contain carbon and hydrogen, making them nonpolar.
c. A molecule with 14 carbons, all bonded to hydrogens
@ Incorrect answer. A molecule containing only carbon and hydrogen is a nonpolar molecule.
d. A molecule of carbon dioxide with linear symmetry
@ Incorrect answer. Carbon dioxide cannot have an electrical dipole, because it is a straight, symmetrical
molecule.
9. Electronegativity is the tendency of an element to attract a bonding pair of electrons. Which of the
following elements is the most electronegative?
a. Hydrogen
@ Incorrect answer. Electronegativity increases across the periodic table. Hydrogen has one electron, and
is more likely to release a valence electron.
b. Carbon
@ Incorrect answer. Carbon has four valence electrons.
c. Potassium
@ Incorrect answer. Potassium has one valence electron and is more likely to release it.
*d. Oxygen
@ Correct answer. Oxygen has six valence electrons and is more likely to attract two more electrons to
fulfill the octet rule.
10. Which of the following accurately describes a fact about hydrophobic molecules?
a. Water is nonpolar, so hydrophobic molecules cannot readily dissolve in water.
@ Incorrect answer. Water is polar. Nonpolar molecules are unable to form hydrogen bonds or ionic
interactions with polar molecules. Therefore, hydrophobic molecules cannot dissolve in water.
*b. Hydrophobic molecules help determine the three-dimensional structure of proteins.
@ Correct answer. Many proteins contain both hydrophilic and hydrophobic areas. Hydrophobic
molecules are attracted to other hydrophobic molecules and this interaction contributes to the three-
dimensional structure of the protein.
c. Hydrophobic molecules are unable to dissolve in water because they form hydrogen bonds.
@ Incorrect answer. Hydrophobic molecules are unable to dissolve in water because they cannot form
hydrogen bonds or ionic interactions with water.
d. Hydrophobic molecules cannot be transported in aqueous solutions because they do not dissolve.
@ Incorrect answer. Hydrophobic molecules cannot dissolve in aqueous solutions, but they can be
transported with special packaging.
Copyright © Springer Publishing Company, LLC. All Rights Reserved.
,4 Advanced Physiology and Pathophysiology
11. Why do some individuals have lactose intolerance?
*a. Some adults are unable to produce lactase.
@ Correct answer. Some adults are unable to produce lactase, the enzyme needed to breakdown lactose.
b. In some adults, the enzyme changes shape.
@ Incorrect answer. Some adults are unable to produce lactase.
c. In some adults, the enzyme lactase is unable to breakdown the milk sugars.
@ Incorrect answer. Some adults lack the ability to produce lactase, which is the enzyme needed to
breakdown the milk sugar lactose.
d. In some adults, an inappropriate immune response occurs as a result of exposure to lactose.
@ Incorrect answer. An allergic response is not why some individuals have lactose intolerance. It is a lack
of production of lactase, the enzyme needed to breakdown the milk sugar that causes lactose intolerance.
12. How do carbohydrates impact the brain?
a. Carbohydrates decrease brain activity.
@ Incorrect answer. The brain relies on the carbohydrate glucose for most functions.
b. Glycolipids enhance neural activity.
@ Incorrect answer. Glycolipids are lipids with an added carbohydrate. Glycolipids form a sugary
membrane coat.
*c. The brain relies on glucose for most functions.
@ Correct answer. The carbohydrate glucose is what the brain relies on for most functions.
d. The brain relies on glycoproteins as its main energy source.
@ Incorrect answer. Glycoproteins are proteins with an added carbohydrate. They are abundant in the
plasma membrane.
13. Phospholipids are two fatty acids bound to a glycerol molecule. Which of the following is one reason
why phospholipids are able to form cell membranes?
a. Phospholipids are amphipathic, meaning they have two polar ends.
@ Incorrect answer. Phospholipids are amphipathic, but this means they have one polar end and one
nonpolar end.
b. Phospholipids have two nonpolar ends, so they can form a barrier against water.
@ Incorrect answer. Phospholipids make good plasma membranes because they have one polar end and
one nonpolar end.
c. Phospholipids are not able to spontaneously aggregate, making them more stable as plasma
membranes.
@ Incorrect answer. Phospholipids do spontaneously aggregate, making them stable as plasma
membranes.
*d. Phospholipids have one polar end and one nonpolar end enabling them to form plasma membranes.
@ Correct answer. Phospholipids are amphipathic, the basis for their major biological role in forming cell
membranes.
14. The production of prostaglandins and leukotrienes during inflammation depends on the presence of a
specific:
a. Cell membrane carbohydrate
@ Incorrect answer. Prostaglandins and leukotrienes are made from plasma membrane arachidonic acid.
*b. Cell membrane lipid
@ Correct answer. Cell membrane phospholipids are the source of the fatty acid arachidonic acid.
c. Cell membrane protein
@ Incorrect answer. Prostaglandins and leukotrienes are made from plasma membrane arachidonic acid.
Copyright © Springer Publishing Company, LLC. All Rights Reserved.
, Chapter 2: Chemical and Biochemical Foundations of Pathophysiology 5
d. Intracellular nucleotide
@ Incorrect answer. Prostaglandins and leukotrienes are made from plasma membrane arachidonic acid.
15. Which of the following is true regarding energy storage in the body?
*a. Triglycerides are the major form of energy storage because hydrocarbon chains release large amounts
of energy when they undergo catabolic reactions.
@ Correct answer. Triglycerides, mainly stored in adipose tissue, release large amounts of energy when
the hydrocarbon chains undergo catabolic reactions. Therefore, they are the major source of energy in the
body.
b. Glycoproteins are the major form of energy storage because they are readily broken down into glucose.
@ Incorrect answer. Triglycerides, not glycoproteins, are the major form of energy storage for the body.
c. Triglycerides are a minor form of energy storage because the hydrogen chains break apart easily.
@ Incorrect answer. Triglycerides are made up of hydrocarbon chains that release large amount of energy
when they undergo catabolic reactions.
d. The main storage area for energy is in the mitochondria.
@ Incorrect answer. The main storage area for triglycerides is adipose tissue.
16. The endogenous pathway transports energy packaged in the liver to the tissues for use. Which of the
following delivers the triglycerides to the tissues?
a. High-density lipoproteins (HDL)
@ Incorrect answer. HDL transfers apolipoproteins to VLDL and into the circulation.
b. Low-density lipoproteins (LDL)
@ Incorrect answer. LDL is mostly made of cholesterol and functions in delivery of cholesterol to the
cells.
c. Intermediate-density lipoproteins (IDL)
@ Incorrect answer. IDL are remnants of VLDL after tissues have removed triglyceride.
*d. Very low-density lipoproteins (VLDL)
@ Correct answer. VLDL are rich with triglycerides, which are delivered to the tissues.
17. What is the source of familial forms of hypercholesterolemia?
*a. Mutations in the gene that codes for Apolipoprotein B-100 (Apo B-100).
@ Correct answer. Familial forms of hypercholesterolemia are usually associated with mutations in the
gene that codes for Apo B-100.
b. Mutations in the gene that codes for very low-density lipoproteins.
@ Incorrect answer. Mutations in the gene that codes for Apo B-100 is associated with familial forms of
hypercholesterolemia.
c. Increased intake of saturated fatty acids.
@ Incorrect answer. Mutations in the gene that codes for Apo B-100 is inherited in a dominant fashion in
familial forms of hypercholesterolemia.
d. Environmental factors that cause mutations of the genes that code for triglycerides.
@ Incorrect answer. Familial forms of hypercholesterolemia are usually associated with normal
triglyceride levels.
18. Intrachain bonds between protein chains are dependent on the presence of this amino acid:
a. Alanine
@ Incorrect answer. Alanine has a hydrophobic side chain and cannot make cross-links with other amino
acid side chains.
Copyright © Springer Publishing Company, LLC. All Rights Reserved.
,6 Advanced Physiology and Pathophysiology
b. Aspartate
@ Incorrect answer. Aspartate has an acidic side chain and cannot make cross-links with other amino acid
side chains.
*c. Cysteine
@ Correct answer. Cysteine has a thiol side chain and can form a disulfide bond with another cysteine.
d. Cytosine
@ Incorrect answer. Cytosine is a pyrimidine base, not an amino acid.
19. Which nucleic acid is responsible for transporting information to the ribosomes for protein synthesis?
a. Deoxyribonucleic acid (DNA)
@ Incorrect answer. DNA stores genetic information necessary to produce proteins.
*b. Ribonucleic acid (RNA)
@ Correct answer. RNA transports genetic instructions for production of proteins from the DNA to the
ribosomes.
c. Guanosine triphosphate (GTP)
@ Incorrect answer. GTP provides a timing switch for membrane receptors.
d. Cyclic adenosine monophosphate (cAMP)
@ Incorrect answer. cAMP is an intracellular second messenger, turning on a signaling cascade.
20. What is the cause of hypopigmentation in children with PKU (phenylketonuria)?
a. There is too little phenylalanine
@ Incorrect answer. There are high levels of phenylalanine because the enzyme to convert phenylalanine
into tyrosine is missing.
b. There is an accumulation of phenylacetate
@ Incorrect answer. Through a secondary metabolic pathway, phenylalanine is converted into
phenylacetate, which is then excreted through the urine. Phenylacetate gives urine a mousy odor.
*c. Tyrosine is in short supply
@ Correct answer. Melanin is produced from tyrosine. Tyrosine is reduced in PKU because they are
missing the enzyme responsible for converting phenylalanine into tyrosine.
d. There is an accumulation of melanin
@ Incorrect answer. There is too little melanin due to a short supply of tyrosine. Too little melanin leads
to hypopigmentation.
21. The difference between chemically reactive and chemically inert elements is determined by:
a. The number of protons in the nucleus
@ Incorrect answer. Protons in an atom’s nucleus do not interact with other atoms
b. The number of neutrons in the nucleus
@ Incorrect answer. Neutrons in an atom’s nucleus do not interact with other atoms
*c. The presence or absence of electrons that completely fill the outer, valence shell
@ Correct answer. An incompletely filled valence shell allows an atom to react with other atoms
d. The total number of electrons in the atom
@ Incorrect answer. The determining factor in an element’s reactivity is the filling of the outermost
valence electron shell.
Copyright © Springer Publishing Company, LLC. All Rights Reserved.
, Chapter 2: Chemical and Biochemical Foundations of Pathophysiology 7
22. Which of the following correctly describes the process of sodium chloride dissolving in water?
a. The atoms of sodium and chloride remain attached via an ionic bond
@ Incorrect answer. The ions separate when a sodium chloride molecule dissolves in water.
b. The sodium and chloride atoms separate, retaining their initial atomic valence shell electron
configuration
@ Incorrect answer. The sodium and chloride atoms become ions, with sodium losing one electron to
become a positive ion, and chloride gaining one electron to become a negative ion.
*c. The sodium ion acquires a hydration shell of water molecules, with the oxygens oriented toward the
sodium ion; the chloride ion acquires a hydration shell of water molecules, with hydrogens oriented
toward the chloride ion
@ Correct answer. The electronegative oxygen within polar water molecules is attracted to sodium’s
positive charge, the electropositive hydrogens within water molecules are attracted to chloride’s negative
charge
d. The sodium ion acquires a hydration shell of water molecules, with the hydrogens oriented toward the
sodium ion; the chloride ion acquires a hydration shell of water molecules, with oxygens oriented toward
the chloride ion
@ Incorrect answer. The electronegative oxygen within polar water molecules is attracted to sodium’s
positive charge, the electropositive hydrogens within water molecules are attracted to chloride’s negative
charge
23. Which of the following is not a role of ions in the body?
*a. Formation of hydrophobic membrane barriers
@ Correct answer. Ions are hydrophilic
b. Maintaining acid base balance
@ Incorrect answer. Acids and bases that buffer body fluids are also ions
c. Carrying electrical charges
@ Incorrect answer. Ions are also electrolytes, when in solution they help to carry electrical charges
d. Generation of membrane potentials
@ Incorrect answer. Differential distribution of ions and varying membrane ion permeability help to
create membrane potentials
24. The components of the bicarbonate buffer system include which of these molecules?
a. Amino acid lysine
@ Incorrect answer. Amino acids contribute to buffering by proteins
b. Ammonia
@ Incorrect answer. Buffering by ammonia is independent of the bicarbonate buffer system
*c. Carbonic acid
@ Correct answer. Carbonic acid is the central compound of the bicarbonate buffer system, formed when
bicarbonate ion is exposed to excess acid
d. Hydrochloric acid
@ Incorrect answer. Hydrochloric acid is a strong acid involved in gastric secretion and digestion
25. Nonpolar biomolecules are distinguished by their abundance of which of the following?
*a. Carbon-hydrogen bonds
@ Correct answer. Carbon-hydrogen bonds are nonpolar covalent bonds
b. Carbon-nitrogen-hydrogen bonds
@ Incorrect answer. The presence of nitrogen bonded to hydrogen in a biomolecule constitutes a polar
covalent bond
Copyright © Springer Publishing Company, LLC. All Rights Reserved.
, 8 Advanced Physiology and Pathophysiology
c. Carbon-oxygen-hydrogen bonds
@ Incorrect answer. The presence of oxygen bonded to hydrogen in a biomolecule constitutes a polar
covalent bond
d. Carbon-oxygen-oxygen-hydrogen bonds
@ Incorrect answer. Carbon bonded to two oxygens, one of which is bonded to a hydrogen, describes a
carboxyl group, with polar and charged characteristics
26. Transfer of a phosphate group from ATP to a biomolecule (also known as phosphorylation) involves
this type of chemical reaction:
a. Degradation
@ Incorrect answer, it is an exchange reaction, reactants are not being degraded
*b. Exchange
@ Correct answer
c. Hydroxylation
@ Incorrect answer – a phosphate is being transferred, rather than a hydroxyl group
d. Synthesis.
@ Incorrect answer, it is an exchange reaction, reactants are not being built into larger molecules
27. Which category of biomolecules has the greatest hydrophobicity?
a. Amino acids
@ Incorrect answer. Carbohydrates have charged and polar carboxyl and amine groups and are very polar
and hydrophilic.
b. Carbohydrates
@ Incorrect answer. Carbohydrates are rich in hydroxyl groups and are very polar and hydrophilic
*c. Lipids
@ Correct answer. Fatty acids, triglycerides, and cholesterol are rich in C-H bonds and are very nonpolar
and hydrophobic
d. Nucleotides
@ Incorrect answer. Nucleotides have N-H bonds that increase their polar, hydrophilic qualities
28. What is the major biomolecule group that modifies membrane lipids and proteins, forming glycolipids
and glycoproteins used as cell markers?
a. Amino acids
@ Incorrect answer. Amino acids are rarely found as modifying attachments to membrane lipids and
proteins
b. Fatty acids.
@ Incorrect answer. Carbohydrates, particularly hexose sugars, are the most common biomolecules that
modify membrane lipids and proteins
*c. Hexose sugars
@ Correct answer. Hexose sugars, singly and in chains, are common biomolecules that modify membrane
constituents, forming glycolipids and glycoproteins
d. Nucleotides
@ Incorrect answer. Nucleotides are not commonly found on the outer membrane surface attached to
lipids and proteins.
Copyright © Springer Publishing Company, LLC. All Rights Reserved.
Pathophysiology Essentials for Clinical Practice
Tkacs
Notes
1- The file is chapter after chapter.
2- We have shown you few pages sample.
3- The file contains all Appendix and Excel sheet
if it exists.
4- We have all what you need, we make update
at every time. There are many new editions
waiting you.
5- If you think you purchased the wrong file You
can contact us at every time, we can replace it
with true one.
Our email:
,CHAPTER 2: CHEMICAL AND BIOCHEMICAL FOUNDATIONS
OF PATHOPHYSIOLOGY
Multiple-Choice Questions
1. Which of the following best describes why atoms have an overall neutral charge?
a. Electrons orbit on the outside of the atom
@ Incorrect answer. Although it is true that electrons orbit outside the nucleus, this is not the reason why
atoms have an overall neutral charge.
*b. The number of protons equals the number of electrons
@ Correct answer. There are an equal number of protons, which have a positive charge, and electrons,
which have a negative charge. The positive and negative charges balance one another out for an overall
neutral charge.
c. There are more neutrons than protons.
@ Incorrect answer. There are the same number of neutrons as protons. Additionally, neutrons have a
neutral charge.
d. There are four electrons in the outer shell.
@ Incorrect answer. Some elements have four electrons in the outer shell, but this is not the reason for the
overall neutral charge. The number of electrons will match the number of protons.
2. Why do hydrogen and potassium readily interact with other atoms?
a. They only have electrons in the first shell.
@ Incorrect answer. Hydrogen has one electron, but potassium has 19 electrons. Therefore potassium has
two electrons in the first shell, eight in the second and third shells, and one in the fourth shell. Hydrogen
has one electron in the first shell.
b. They have electrons in all shells.
@ Incorrect answer. Hydrogen has one electron in the first shell. Potassium has two electrons in the first
shell, eight in the second and third shells, and one in the fourth shell.
c. They both have four electrons in the outer shell.
@ Incorrect answer. Both hydrogen and potassium have one electron in their outer shells.
*d. They both have one electron in the outer shell.
@ Correct answer. Both hydrogen and potassium have one electron in their outer shells meaning they can
readily interact with other atoms.
3. How many electrons does carbon use to interact with other atoms?
*a. 4
@ Correct answer. Carbon has four electrons in its outer shell. Only the electrons in the outer shell, or
valence electrons, are used to interact with other electrons.
b. 6
@ Incorrect answer. While carbon has a total of six electrons, only the electrons in the outer shell are used
to interact with other electrons. Two of carbon’s six electrons are in the first shell.
c. 1
@ Incorrect answer. Carbon has four valence electrons.
d. 2
@ Incorrect answer. While carbon has two electrons in the first shell, it also has four valence electrons
that are used to interact with other elements.
Copyright © Springer Publishing Company, LLC. All Rights Reserved. 1
,2 Advanced Physiology and Pathophysiology
4. Which of the following is true regarding the role of bicarbonate in maintaining homeostasis?
a. Bicarbonate dissociates from hydroxide to form a free hydroxide that neutralizes acid.
@ Incorrect answer. The dissociation of sodium from a hydroxide ion creates a free hydroxide that
neutralizes acid.
b. Bicarbonate releases protons when diluted with water, which neutralizes acids.
@ Incorrect answer. Acids release protons when placed in water, but bicarbonate is a base.
c. Bicarbonate is partially ionized in water and is considered to be a weak base.
@ Incorrect answer. Acids are ionized in water, not bases like bicarbonate. Both carbonic acid and
phosphoric acid are partly ionized in water, and are considered weak acids.
*d. Bicarbonate functions as a buffer to neutralize acids.
@ Correct answer. Bicarbonate is produced in the pancreas for the purpose of neutralizing the acidity in
chyme as it moves from the stomach to the small intestine. It also plays a major role in the carbonic acid
buffer system.
5. Which of the following occurs when carbonic acid is placed in water?
a. Almost all of the protons are released into the water.
@ Incorrect answer. Carbonic acid is a weak acid. Only in strong acids do most of the protons dissociate
into the water.
*b. Some of the protons are released into the water.
@ Correct answer. Carbonic acid is a weak acid, meaning it is only partly ionized in an aqueous solution.
Some of the protons are released into the water.
c. Some of the electrons are released into the water.
@ Incorrect answer. When acids are placed in water the protons are released. They are classified based on
their tendency to lose protons. Carbonic acid is a weak acid because only a few of its protons are released
into the water.
d. Almost all of the neutrons are released into the water.
@ Incorrect answer. Protons are released when acids are placed in water.
6. Which of the following most fully describes how proteins are used to buffer pH?
a. Proteins are used to neutralize excess acids because they have a carboxylic acid group.
@ Incorrect answer. The carboxylic acid group enables proteins to neutralize excess bases.
b. Proteins have an amino group, which is an acid, therefore they can neutralize excess base.
@ Incorrect answer. The amino group is a base, which enables proteins to neutralize excess acids.
c. Proteins are able to neutralize either excess base or excess acid because they have a neutral amino
group.
@ Incorrect answer. The amino group is a base, which enables proteins to neutralize excess acids. The
carboxylic acid group is an acid, which enables proteins to neutralize excess bases.
*d. Proteins are made up of basic amino groups and acidic carboxylic acid groups, which can be used to
neutralize either excess bases or acids.
@ Correct answer. Proteins can neutralize either excess bases or excess acids because they are made up of
an amino group (base) and a carboxylic acid group (acid).
7. Which of the following correctly describes the bond between two oxygen atoms?
*a. Two oxygen atoms share a double bond, enabling them both to fulfill the octet rule.
@ Correct answer. One oxygen atom will share two of its electrons with the other atom, forming a double
bond and fulfilling the octet rule for both atoms.
b. Two oxygen atoms share bonds with two hydrogen atoms enabling them to fulfill the octet rule.
Copyright © Springer Publishing Company, LLC. All Rights Reserved.
, Chapter 2: Chemical and Biochemical Foundations of Pathophysiology 3
@ Incorrect answer. Two oxygen atoms only need to share two electrons with one another in order to
form a double bond that fulfills the octet rule.
c. Two oxygen atoms share protons, forming a double bond and fulfilling the octet rule.
@ Incorrect answer. Two oxygen atoms share electrons, not protons, to form a double bond and fulfill the
octet rule.
d. Two oxygen atoms share two electrons to form a double bond and eight neutrons to fulfill the octet
rule.
@ Incorrect answer. Two oxygen atoms share only two electrons to form a double bond and fulfill the
octet rule.
8. Which of the following correctly describes a molecule that is most likely to be polar?
*a. A molecule enriched in hydroxyl groups
@ Correct answer. A molecule that contains O-H or N-H bonds is most likely to be polar.
b. A molecule modified with additional methyl groups
@ Incorrect answer. Methyl groups only contain carbon and hydrogen, making them nonpolar.
c. A molecule with 14 carbons, all bonded to hydrogens
@ Incorrect answer. A molecule containing only carbon and hydrogen is a nonpolar molecule.
d. A molecule of carbon dioxide with linear symmetry
@ Incorrect answer. Carbon dioxide cannot have an electrical dipole, because it is a straight, symmetrical
molecule.
9. Electronegativity is the tendency of an element to attract a bonding pair of electrons. Which of the
following elements is the most electronegative?
a. Hydrogen
@ Incorrect answer. Electronegativity increases across the periodic table. Hydrogen has one electron, and
is more likely to release a valence electron.
b. Carbon
@ Incorrect answer. Carbon has four valence electrons.
c. Potassium
@ Incorrect answer. Potassium has one valence electron and is more likely to release it.
*d. Oxygen
@ Correct answer. Oxygen has six valence electrons and is more likely to attract two more electrons to
fulfill the octet rule.
10. Which of the following accurately describes a fact about hydrophobic molecules?
a. Water is nonpolar, so hydrophobic molecules cannot readily dissolve in water.
@ Incorrect answer. Water is polar. Nonpolar molecules are unable to form hydrogen bonds or ionic
interactions with polar molecules. Therefore, hydrophobic molecules cannot dissolve in water.
*b. Hydrophobic molecules help determine the three-dimensional structure of proteins.
@ Correct answer. Many proteins contain both hydrophilic and hydrophobic areas. Hydrophobic
molecules are attracted to other hydrophobic molecules and this interaction contributes to the three-
dimensional structure of the protein.
c. Hydrophobic molecules are unable to dissolve in water because they form hydrogen bonds.
@ Incorrect answer. Hydrophobic molecules are unable to dissolve in water because they cannot form
hydrogen bonds or ionic interactions with water.
d. Hydrophobic molecules cannot be transported in aqueous solutions because they do not dissolve.
@ Incorrect answer. Hydrophobic molecules cannot dissolve in aqueous solutions, but they can be
transported with special packaging.
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,4 Advanced Physiology and Pathophysiology
11. Why do some individuals have lactose intolerance?
*a. Some adults are unable to produce lactase.
@ Correct answer. Some adults are unable to produce lactase, the enzyme needed to breakdown lactose.
b. In some adults, the enzyme changes shape.
@ Incorrect answer. Some adults are unable to produce lactase.
c. In some adults, the enzyme lactase is unable to breakdown the milk sugars.
@ Incorrect answer. Some adults lack the ability to produce lactase, which is the enzyme needed to
breakdown the milk sugar lactose.
d. In some adults, an inappropriate immune response occurs as a result of exposure to lactose.
@ Incorrect answer. An allergic response is not why some individuals have lactose intolerance. It is a lack
of production of lactase, the enzyme needed to breakdown the milk sugar that causes lactose intolerance.
12. How do carbohydrates impact the brain?
a. Carbohydrates decrease brain activity.
@ Incorrect answer. The brain relies on the carbohydrate glucose for most functions.
b. Glycolipids enhance neural activity.
@ Incorrect answer. Glycolipids are lipids with an added carbohydrate. Glycolipids form a sugary
membrane coat.
*c. The brain relies on glucose for most functions.
@ Correct answer. The carbohydrate glucose is what the brain relies on for most functions.
d. The brain relies on glycoproteins as its main energy source.
@ Incorrect answer. Glycoproteins are proteins with an added carbohydrate. They are abundant in the
plasma membrane.
13. Phospholipids are two fatty acids bound to a glycerol molecule. Which of the following is one reason
why phospholipids are able to form cell membranes?
a. Phospholipids are amphipathic, meaning they have two polar ends.
@ Incorrect answer. Phospholipids are amphipathic, but this means they have one polar end and one
nonpolar end.
b. Phospholipids have two nonpolar ends, so they can form a barrier against water.
@ Incorrect answer. Phospholipids make good plasma membranes because they have one polar end and
one nonpolar end.
c. Phospholipids are not able to spontaneously aggregate, making them more stable as plasma
membranes.
@ Incorrect answer. Phospholipids do spontaneously aggregate, making them stable as plasma
membranes.
*d. Phospholipids have one polar end and one nonpolar end enabling them to form plasma membranes.
@ Correct answer. Phospholipids are amphipathic, the basis for their major biological role in forming cell
membranes.
14. The production of prostaglandins and leukotrienes during inflammation depends on the presence of a
specific:
a. Cell membrane carbohydrate
@ Incorrect answer. Prostaglandins and leukotrienes are made from plasma membrane arachidonic acid.
*b. Cell membrane lipid
@ Correct answer. Cell membrane phospholipids are the source of the fatty acid arachidonic acid.
c. Cell membrane protein
@ Incorrect answer. Prostaglandins and leukotrienes are made from plasma membrane arachidonic acid.
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, Chapter 2: Chemical and Biochemical Foundations of Pathophysiology 5
d. Intracellular nucleotide
@ Incorrect answer. Prostaglandins and leukotrienes are made from plasma membrane arachidonic acid.
15. Which of the following is true regarding energy storage in the body?
*a. Triglycerides are the major form of energy storage because hydrocarbon chains release large amounts
of energy when they undergo catabolic reactions.
@ Correct answer. Triglycerides, mainly stored in adipose tissue, release large amounts of energy when
the hydrocarbon chains undergo catabolic reactions. Therefore, they are the major source of energy in the
body.
b. Glycoproteins are the major form of energy storage because they are readily broken down into glucose.
@ Incorrect answer. Triglycerides, not glycoproteins, are the major form of energy storage for the body.
c. Triglycerides are a minor form of energy storage because the hydrogen chains break apart easily.
@ Incorrect answer. Triglycerides are made up of hydrocarbon chains that release large amount of energy
when they undergo catabolic reactions.
d. The main storage area for energy is in the mitochondria.
@ Incorrect answer. The main storage area for triglycerides is adipose tissue.
16. The endogenous pathway transports energy packaged in the liver to the tissues for use. Which of the
following delivers the triglycerides to the tissues?
a. High-density lipoproteins (HDL)
@ Incorrect answer. HDL transfers apolipoproteins to VLDL and into the circulation.
b. Low-density lipoproteins (LDL)
@ Incorrect answer. LDL is mostly made of cholesterol and functions in delivery of cholesterol to the
cells.
c. Intermediate-density lipoproteins (IDL)
@ Incorrect answer. IDL are remnants of VLDL after tissues have removed triglyceride.
*d. Very low-density lipoproteins (VLDL)
@ Correct answer. VLDL are rich with triglycerides, which are delivered to the tissues.
17. What is the source of familial forms of hypercholesterolemia?
*a. Mutations in the gene that codes for Apolipoprotein B-100 (Apo B-100).
@ Correct answer. Familial forms of hypercholesterolemia are usually associated with mutations in the
gene that codes for Apo B-100.
b. Mutations in the gene that codes for very low-density lipoproteins.
@ Incorrect answer. Mutations in the gene that codes for Apo B-100 is associated with familial forms of
hypercholesterolemia.
c. Increased intake of saturated fatty acids.
@ Incorrect answer. Mutations in the gene that codes for Apo B-100 is inherited in a dominant fashion in
familial forms of hypercholesterolemia.
d. Environmental factors that cause mutations of the genes that code for triglycerides.
@ Incorrect answer. Familial forms of hypercholesterolemia are usually associated with normal
triglyceride levels.
18. Intrachain bonds between protein chains are dependent on the presence of this amino acid:
a. Alanine
@ Incorrect answer. Alanine has a hydrophobic side chain and cannot make cross-links with other amino
acid side chains.
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,6 Advanced Physiology and Pathophysiology
b. Aspartate
@ Incorrect answer. Aspartate has an acidic side chain and cannot make cross-links with other amino acid
side chains.
*c. Cysteine
@ Correct answer. Cysteine has a thiol side chain and can form a disulfide bond with another cysteine.
d. Cytosine
@ Incorrect answer. Cytosine is a pyrimidine base, not an amino acid.
19. Which nucleic acid is responsible for transporting information to the ribosomes for protein synthesis?
a. Deoxyribonucleic acid (DNA)
@ Incorrect answer. DNA stores genetic information necessary to produce proteins.
*b. Ribonucleic acid (RNA)
@ Correct answer. RNA transports genetic instructions for production of proteins from the DNA to the
ribosomes.
c. Guanosine triphosphate (GTP)
@ Incorrect answer. GTP provides a timing switch for membrane receptors.
d. Cyclic adenosine monophosphate (cAMP)
@ Incorrect answer. cAMP is an intracellular second messenger, turning on a signaling cascade.
20. What is the cause of hypopigmentation in children with PKU (phenylketonuria)?
a. There is too little phenylalanine
@ Incorrect answer. There are high levels of phenylalanine because the enzyme to convert phenylalanine
into tyrosine is missing.
b. There is an accumulation of phenylacetate
@ Incorrect answer. Through a secondary metabolic pathway, phenylalanine is converted into
phenylacetate, which is then excreted through the urine. Phenylacetate gives urine a mousy odor.
*c. Tyrosine is in short supply
@ Correct answer. Melanin is produced from tyrosine. Tyrosine is reduced in PKU because they are
missing the enzyme responsible for converting phenylalanine into tyrosine.
d. There is an accumulation of melanin
@ Incorrect answer. There is too little melanin due to a short supply of tyrosine. Too little melanin leads
to hypopigmentation.
21. The difference between chemically reactive and chemically inert elements is determined by:
a. The number of protons in the nucleus
@ Incorrect answer. Protons in an atom’s nucleus do not interact with other atoms
b. The number of neutrons in the nucleus
@ Incorrect answer. Neutrons in an atom’s nucleus do not interact with other atoms
*c. The presence or absence of electrons that completely fill the outer, valence shell
@ Correct answer. An incompletely filled valence shell allows an atom to react with other atoms
d. The total number of electrons in the atom
@ Incorrect answer. The determining factor in an element’s reactivity is the filling of the outermost
valence electron shell.
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, Chapter 2: Chemical and Biochemical Foundations of Pathophysiology 7
22. Which of the following correctly describes the process of sodium chloride dissolving in water?
a. The atoms of sodium and chloride remain attached via an ionic bond
@ Incorrect answer. The ions separate when a sodium chloride molecule dissolves in water.
b. The sodium and chloride atoms separate, retaining their initial atomic valence shell electron
configuration
@ Incorrect answer. The sodium and chloride atoms become ions, with sodium losing one electron to
become a positive ion, and chloride gaining one electron to become a negative ion.
*c. The sodium ion acquires a hydration shell of water molecules, with the oxygens oriented toward the
sodium ion; the chloride ion acquires a hydration shell of water molecules, with hydrogens oriented
toward the chloride ion
@ Correct answer. The electronegative oxygen within polar water molecules is attracted to sodium’s
positive charge, the electropositive hydrogens within water molecules are attracted to chloride’s negative
charge
d. The sodium ion acquires a hydration shell of water molecules, with the hydrogens oriented toward the
sodium ion; the chloride ion acquires a hydration shell of water molecules, with oxygens oriented toward
the chloride ion
@ Incorrect answer. The electronegative oxygen within polar water molecules is attracted to sodium’s
positive charge, the electropositive hydrogens within water molecules are attracted to chloride’s negative
charge
23. Which of the following is not a role of ions in the body?
*a. Formation of hydrophobic membrane barriers
@ Correct answer. Ions are hydrophilic
b. Maintaining acid base balance
@ Incorrect answer. Acids and bases that buffer body fluids are also ions
c. Carrying electrical charges
@ Incorrect answer. Ions are also electrolytes, when in solution they help to carry electrical charges
d. Generation of membrane potentials
@ Incorrect answer. Differential distribution of ions and varying membrane ion permeability help to
create membrane potentials
24. The components of the bicarbonate buffer system include which of these molecules?
a. Amino acid lysine
@ Incorrect answer. Amino acids contribute to buffering by proteins
b. Ammonia
@ Incorrect answer. Buffering by ammonia is independent of the bicarbonate buffer system
*c. Carbonic acid
@ Correct answer. Carbonic acid is the central compound of the bicarbonate buffer system, formed when
bicarbonate ion is exposed to excess acid
d. Hydrochloric acid
@ Incorrect answer. Hydrochloric acid is a strong acid involved in gastric secretion and digestion
25. Nonpolar biomolecules are distinguished by their abundance of which of the following?
*a. Carbon-hydrogen bonds
@ Correct answer. Carbon-hydrogen bonds are nonpolar covalent bonds
b. Carbon-nitrogen-hydrogen bonds
@ Incorrect answer. The presence of nitrogen bonded to hydrogen in a biomolecule constitutes a polar
covalent bond
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, 8 Advanced Physiology and Pathophysiology
c. Carbon-oxygen-hydrogen bonds
@ Incorrect answer. The presence of oxygen bonded to hydrogen in a biomolecule constitutes a polar
covalent bond
d. Carbon-oxygen-oxygen-hydrogen bonds
@ Incorrect answer. Carbon bonded to two oxygens, one of which is bonded to a hydrogen, describes a
carboxyl group, with polar and charged characteristics
26. Transfer of a phosphate group from ATP to a biomolecule (also known as phosphorylation) involves
this type of chemical reaction:
a. Degradation
@ Incorrect answer, it is an exchange reaction, reactants are not being degraded
*b. Exchange
@ Correct answer
c. Hydroxylation
@ Incorrect answer – a phosphate is being transferred, rather than a hydroxyl group
d. Synthesis.
@ Incorrect answer, it is an exchange reaction, reactants are not being built into larger molecules
27. Which category of biomolecules has the greatest hydrophobicity?
a. Amino acids
@ Incorrect answer. Carbohydrates have charged and polar carboxyl and amine groups and are very polar
and hydrophilic.
b. Carbohydrates
@ Incorrect answer. Carbohydrates are rich in hydroxyl groups and are very polar and hydrophilic
*c. Lipids
@ Correct answer. Fatty acids, triglycerides, and cholesterol are rich in C-H bonds and are very nonpolar
and hydrophobic
d. Nucleotides
@ Incorrect answer. Nucleotides have N-H bonds that increase their polar, hydrophilic qualities
28. What is the major biomolecule group that modifies membrane lipids and proteins, forming glycolipids
and glycoproteins used as cell markers?
a. Amino acids
@ Incorrect answer. Amino acids are rarely found as modifying attachments to membrane lipids and
proteins
b. Fatty acids.
@ Incorrect answer. Carbohydrates, particularly hexose sugars, are the most common biomolecules that
modify membrane lipids and proteins
*c. Hexose sugars
@ Correct answer. Hexose sugars, singly and in chains, are common biomolecules that modify membrane
constituents, forming glycolipids and glycoproteins
d. Nucleotides
@ Incorrect answer. Nucleotides are not commonly found on the outer membrane surface attached to
lipids and proteins.
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