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Understanding Pathophysiology ANZ Adaptation 2nd Ed By Craft – 

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Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 01: Introduction to clinical science

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A sign is:

 

a. an alteration to normal body function.
b. a subjective indication of the patient experience reported by the patient.
c. an objective measurement or recording.
d. a localised response to disease.

 

REF: p 5

 

  1. When a patient has a set of signs and symptoms that occur together and are specific to a particular condition with an unknown cause, this is referred to as a/n:

 

a. disease.
b. disorder.
c. aetiology.
d. syndrome.

 

REF: p 5

 

  1. Frank presents to the emergency room at your local hospital and reports feelings of nausea and pain in the abdomen. Frank’s self-reported experiences are referred to as:

 

a. disorders.
b. signs.
c. symptoms.
d. syndromes.

 

REF: p 5

 

  1. In relation to disease, the term incidence refers to:

 

a. the number of people who have the disease at any one time.
b. the number of new cases that have been diagnosed and confirmed within a set time period.
c. the presence of several diseases in the same patient.
d. the proportion of the population with the disease.

 

REF: p 6

 

  1. Jane has been diagnosed with type 2 diabetes, and her physician has told her that she is also obese and will need to lose some weight. In Jane’s case, obesity is:

 

a. a comorbidity
b. a measure of mortality
c. a symptom
d. an incidence.

 

REF: p 6

 

  1. The sagittal plane:

 

a. divides the body into left and right.
b. refers to the exact middle of the body.
c. divides the body into upper and lower segments.
d. divides the body into front and back.

 

REF: p 8

 

  1. The frontal plane:

 

a. divides the body into left and right.
b. refers to the exact middle of the body.
c. divides the body into upper and lower segments.
d. divides the body into front and back.

 

REF: p 8

 

  1. The transverse plane:

 

a. divides the body into left and right.
b. refers to the exact middle of the body.
c. divides the body into upper and lower segments.
d. divides the body into front and back.

 

REF: p 8

 

  1. The nose is:

 

a. superior to the forehead.
b. medial to the ear.
c. ipsilateral to the ear.
d. dorsal to the forehead.

 

REF: p 9

 

  1. The term ventral refers to the:

 

a. anterior of the body.
b. posterior surface of the body.
c. medial plane of the body.
d. dorsal surface of the body.

 

REF: p 9

 

  1. The elbow is:

 

a. distal to the finger.
b. medial to the stomach.
c. proximal to the wrist.
d. superior to the head.

 

REF: p 9

 

  1. The dorsal cavity contains the:

 

a. brain and spinal cord.
b. liver and spleen.
c. heart and lungs.
d. mediastinum.

 

REF: p 9

 

  1. Which of the following are NOT located in the ventral body cavity?

 

a. brain and spinal cord
b. liver and spleen
c. heart and lungs
d. gallbladder and thymus

 

REF: p 9

 

  1. A deficiency of oxygen in the blood is referred to as:

 

a. hypoxia.
b. hyperoxia.
c. hypoxaemia.
d. hypotension.

 

REF: p 10

 

  1. The prefixes a- or an- mean:

 

a. fat.
b. lack of.
c. self.
d. within.

 

REF: p 11

 

  1. In medical terms when something is low or deficient the prefix used is:

 

a. hypo.
b. hyper.
c. hepat.
d. heam.

 

REF: p 11

 

  1. In medical terms when something is ‘equal to’ the prefix used is:

 

a. inter.
b. hypo.
c. leuco.
d. iso.

 

REF: p 11

 

  1. In medical terms suffix ‘cyte’ refers to:

 

a. cell.
b. in the blood.
c. inflammation.
d. tumour.

 

REF: p 11

 

  1. Which of the following is an example of an element found in the human body?

 

a. carbon
b. sodium chloride
c. sodium bicarbonate
d. hydrochloric acid

 

REF: p 13

 

  1. Which of the following substances is a cation?

 

a. carbon
b. calcium
c. chloride
d. hydroxide

 

REF: p 13

 

  1. Which of the following substances is an anion?

 

a. hydroxide
b. hydrogen
c. nitrogen
d. magnesium

 

REF: p 13

 

  1. A cation is defined as:

 

a. a positively charged ion.
b. an acid.
c. a negatively charged ion.
d. a base.

 

REF: p 13

 

  1. A molecule:

 

a. contains two or more different elements.
b. contains two or more of the same element.
c. contains water.
d. is an acid.

 

REF: p 13

 

  1. A compound:

 

a. contains two or more different elements.
b. contains two or more of the same element.
c. is an acid.
d. is a base.

 

REF: p 13

 

  1. The specific name for elements that carry an electrical charge is:

 

a. molecules.
b. compounds.
c. atoms.
d. ions.

 

REF: p 13

 

  1. A patient is given a drink that contains a substance that does not mix well with water. This substance would be described as:

 

a. hydrophilic.
b. hydrophobic.
c. lipophilic.
d. amphipathic.

 

REF: p 13

 

  1. In chemistry an acid is a substance that:

 

a. has a high pH.
b. releases H+ in solution.
c. does not mix with water.
d. binds H+ in solution.

 

REF: p 14

 

  1. When an equal number of molecules of hydrochloric acid and sodium bicarbonate are mixed together:

 

a. the solution becomes acidic.
b. the pH rises above 8.
c. the solution becomes alkaline.
d. the acid is neutralised.

 

REF: p 14

 

  1. The normal pH range of the blood is:

 

a. 6.33–7.33.
b. 7.00–7.50.
c. 7.35–7.45.
d. 7.80–8.00.

 

REF: p 14

 

  1. A patient’s blood results show that the arterial blood pH is 7.24. This patient:

 

a. has a pH within the normal range.
b. is suffering from an alkalosis.
c. is suffering from an acidosis.
d. has too much base in the blood.

 

REF: p 14

 

  1. Which of the following has the lowest pH?

 

a. bicarbonate of soda
b. soap
c. pure water
d. stomach contents

 

REF: p 15

 

  1. Alkaline substances tend to:

 

a. decrease the pH of a solution they are added to.
b. taste bitter.
c. feel slippery to touch.
d. taste sour.

 

REF: p 14

 

  1. Enzymes are used by the body:

 

a. to provide a protective buffer around the internal organs.
b. as the main fuel source.
c. as the key structural component of cell membranes.
d. to speed up chemical reactions.

 

REF: pp 15

 

  1. Lipids are made up of:

 

a. simple and complex sugars.
b. glycerol and fatty acids.
c. amino acids.
d. nucleic acids.

 

REF: p 16

 

  1. If the number of particles of gas within a container stays constant, and the volume of the container is reduced, then:

 

a. the pressure within the container will rise.
b. the pressure within the container will fall.
c. the pressure within the container will remain unchanged.
d. the pressure outside of the container will fall.

 

REF: p 17

 

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 02: Homeostasis

 

Test Bank

 

MULTIPLE CHOICE

 

  1. Homeostasis:

 

a. keeps the body in a static state.
b. works towards a dynamic equilibrium.
c. modifies the external environment to protect bodily function.
d. maintains variables at one precise set point.

 

REF: p 21

 

  1. The normal or reference range of blood pH is:

 

a. 7.35–7.45.
b. 7.25–7.55.
c. 7.25–7.85.
d. 7.35–7.55.

 

REF: p 21

 

  1. Tom had his blood pH measured twice at the hospital. The first time his blood pH was 7.39, and the second time his blood pH was 7.42. The doctor said that these values are normal and are nothing to worry about. The doctor’s conclusion can be explained by the fact that

 

a. blood pH should always have the same value but sometimes hospital equipment is not accurate.
b. normal blood pH values occur within a range rather than a set point.
c. Tom’s first reading was not normal, but his blood pH was corrected in time for the second reading.
d. normal blood pH occurs anywhere within the range 7.25-7.55.

 

REF: p 21

 

  1. The fluid that is located between cells is called:

 

a. cytoplasm.
b. plasma fluid.
c. interstitial fluid.
d. intravascular fluid.

 

REF: p 21

 

  1. The biggest fluid compartment in the human body is the:

 

a. interstitial compartment.
b. intravascular compartment.
c. extracellular compartment.
d. intracellular compartment.

 

REF: p 22

 

  1. In a normal healthy adult male, the total body water as a percentage in relation to body weight is:

 

a. 50%.
b. 60%.
c. 70%.
d. 80%.

 

REF: p 22

 

  1. The extracellular fluid compartment contains ______ of the total body water.

 

a. one-third
b. one-quarter
c. three-quarters
d. two-thirds

 

REF: p 22

 

  1. In order to maintain cellular homeostasis:

 

a. oxygen and carbon dioxide move from the blood into the cell.
b. oxygen and carbon dioxide move from the cell into the blood.
c. carbon dioxide and lactic acid move from the blood into the cell.
d. carbon dioxide and lactic acid move from the cell into the blood.

 

REF: p 22

 

  1. Which of the following electrolytes are found in a higher proportion inside the cell than in the extracellular compartment?

 

a. sodium
b. potassium
c. calcium
d. carbon

 

REF: p 23

 

  1. Which of the following electrolytes are found in higher proportion in the extracellular compartment than in the cell?

 

a. sodium
b. potassium
c. calcium
d. A and C only

 

REF: p 23

 

  1. Which of the following statements is true of neuron signalling?

 

a. During neuron signalling, most of the sodium is in the extracellular fluid.
b. Following neuron signalling, sodium must be returned to the extracellular fluid to allow another signal to be sent.
c. When the neuron is at rest, most of the sodium is in the intracellular compartment.
d. Following neuron signalling, sodium must be returned to the intracellular fluid to allow another signal to be sent.

 

REF: p 24

 

  1. Which of the following is an example of cellular homeostasis?

 

a. blood clotting following a small cut
b. wound healing following a small wound
c. extracellular fluid moving into a dehydrated cell
d. an immune response against invading bacteria

 

REF: p 24

 

  1. Which of the following is an example of homeostasis of the local area?

 

a. carbon dioxide entering the blood from a cell
b. sodium moving into a neuron during signalling
c. extracellular fluid moving into a dehydrated cell
d. an immune response against invading bacteria

 

REF: p 24

 

  1. Blood glucose levels will rise after eating a meal, which will result in a/an _________ in insulin release and therefore a/an ____________ in blood glucose.

 

  1. decrease; decrease
  2. decrease; increase
  3. increase; decrease
  4. increase; increase

 

REF: p 26

 

  1. The central nervous system detects changes to a variable using:

 

a. an effector.
b. a control centre.
c. a sensor.
d. a hormone.

 

REF: p 26

 

  1. In the case of a pain reflex arc, the control centre is located in the:

 

a. damaged tissue.
b. spinal cord.
c. brain.
d. central endocrine organ.

 

REF: p 26

 

  1. The control centre in the negative feedback pathway is located in the:

 

a. central nervous system.
b. endocrine system.
c. cardiac system.
d. respiratory system.

 

REF: p 26

 

  1. The effector in a negative feedback pathway is:

 

a. the part of the nervous system that send signals to mediate a response.
b. the section of the nervous system that matches information from the sensor with information about the normal range.
c. that neuron that can detect a variable.
d. the target organ.

 

REF: p 26

 

  1. When the levels of carbon dioxide in the body build up, the normal homeostatic response is to:

 

a. increase breathing.
b. decrease breathing.
c. increase urine output.
d. decrease heart rate.

 

REF: p 29

 

  1. When the levels of carbon dioxide in the body decrease below normal, the normal homeostatic response is to:

 

a. increase breathing.
b. decrease breathing.
c. increase urine output.
d. decrease heart rate.

 

REF: p 26

 

  1. John arrives at the emergency ward with tachypnoea (a fast breathing rate). John is most likely experiencing an imbalance in his blood ___________ levels.

 

a. carbon dioxide
b. fluid
c. glucose
d. sodium

 

REF: p 26

 

  1. Maintenance of blood pressure and fluid balance homeostasis is controlled by:

 

a. the brain only.
b. the endocrine system only.
c. both the nervous and endocrine systems.
d. both the nervous and respiratory systems.

 

REF: p 28

 

  1. The sensor that detects abnormalities in sodium levels is located in the:

 

a. brain.
b. spinal cord.
c. intestine.
d. kidneys.

 

REF: p 27

 

  1. Ruby is on a diet that she read about in a women’s magazine that suggests that she can lose weight by drinking at least three litres of water a day. Ruby drinks two litres of water in one sitting, which causes her blood volume and blood pressure to increase. Which of the following mechanisms will help to correct Ruby’s blood volume and pressure?

 

a. Effector signals to the blood vessels causing vasoconstriction
b. Effector signals from the brain causing increased thirst
c. Effector signals to the endocrine system causing decreased urination
d. Hormone signals causing water retention in the urine

 

REF: p 28

 

  1. Which of the following is NOT a homeostatic mechanism that maintains fluid balance?

 

a. regulation of blood sodium levels
b. regulation of urine output
c. vasoconstriction
d. thirst reflex

 

REF: p 28

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 03: Cellular structure and function

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A cell is observed to have a nucleolus. Which of the following would also be observed?

 

a. single circular chromosome
b. nucleus
c. freely floating nuclear material
d. no organelles

 

REF: p 34

 

  1. A human cell is undergoing DNA replication. In which region of the cell would most of the genetic information be contained?

 

a. mitochondria
b. ribosome
c. nucleolus
d. nucleus

 

REF: p 34

 

  1. Small granules of proteins and RNA responsible for protein synthesis are called:

 

a. ribosomes.
b. mitochondria.
c. centrioles.
d. cisternae.

 

REF: p 34

 

  1. An organelle that is involved in the movement of proteins and protein synthesis is called:

 

a. a ribosome.
b. a mitochondrion.
c. the Golgi apparatus.
d. the endoplasmic reticulum.

 

REF: p 35

 

  1. Which of the following organelles can be rough or smooth?

 

a. Endoplasmic reticulum
b. Golgi apparatus
c. Lysosomes
d. Nucleus

 

REF: p 35

 

  1. An organelle that receives lipids and proteins, and modifies packages and distributes them to other parts of the cell is called:

 

a. a ribosome.
b. a mitochondrion.
c. the Golgi apparatus.
d. the endoplasmic reticulum.

 

REF: p 35

 

  1. The term apoptosis refers to:

 

a. programmed cell death.
b. the digestion of old organelles.
c. the digestion of foreign substances such as bacteria.
d. anaerobic metabolism.

 

REF: p 35

 

  1. Which of the following is a function of peripheral membrane proteins?

 

a. channels
b. receptors
c. membrane pumps
d. joining cells together

 

REF: p 38

 

  1. According to the fluid mosaic model, which of the following are embedded in the fluid lipid bilayer?

 

a. peripheral membrane proteins
b. integral membrane proteins
c. glycoproteins
d. cell adhesion molecules

 

REF: p 38

 

  1. Plasma membrane receptors bind to:

 

a. oxygen.
b. ribosomes.
c. amphipathic lipids.
d. ligands.

 

REF: p 39

 

  1. Drugs that stimulate a receptor are called:

 

a. agonists.
b. antagonists.
c. amphipathic.
d. neurotransmitters.

 

REF: p 40

 

  1. The movement of small solute molecules through a semipermeable barrier is an example of:

 

a. osmosis.
b. diffusion.
c. hydrostatic pressure.
d. active transport.

 

REF: p 41

 

  1. Electrolytes are:

 

a. small lipid-soluble molecules.
b. large protein molecules.
c. micronutrients used to produce ATP.
d. electrically charged molecules.

 

REF: p 41

 

  1. Which of the following is true regarding the predominant extracellular cation?

 

a. It has a negative charge.
b. It migrates toward the positive pole.
c. It is sodium.
d. It is potassium.

 

REF: p 41

 

  1. The mechanical force of water pushing against cellular membranes is an example of which process of fluid movement?

 

a. hydrostatic pressure
b. osmosis
c. diffusion
d. active transport

 

REF: p 41

 

  1. Osmosis is:

 

a. the diffusion of sodium down the concentration gradient.
b. the movement of water down its own concentration gradient.
c. a form of hydrostatic pressure.
d. a type of active transport.

 

REF: p 42

 

  1. A patient has a body fluid concentration of 300 mOsm/kg. This measure is termed:

 

a. osmolality.
b. osmolarity.
c. osmotic pressure.
d. effective osmolality.

 

REF: p 42

 

  1. How is the transport of glucose from the blood to the cell accomplished?

 

a. by active transport
b. by active diffusion
c. by passive osmosis
d. by facilitated diffusion

 

REF: p 42

 

  1. A patient who has diarrhoea receives a hypertonic saline solution intravenously to replace the sodium and chloride lost in the stool. What effect will this fluid replacement have on cells?

 

a. Cells will become hydrated.
b. Cells will swell or burst.
c. Cells will shrink.
d. Cells will divide.

 

REF: p 42

 

  1. The sodium-potassium pump is an example of:

 

a. Facilitated diffusion
b. Osmosis
c. Active transport
d. Filtration

 

REF: p 43

 

  1. The process of cellular ingestion of large particles such as bacteria is referred to as:

 

a. protocytosis.
b. pinocytosis.
c. phagocytosis.
d. exocytosis.

 

REF: p 43

 

  1. The process of ingestion of fluids and solute molecules through small vesicles is referred to as:

 

a. protocytosis.
b. pinocytosis.
c. phagocytosis.
d. exocytosis.

 

REF: p 43

 

  1. The process of secretion of macromolecules by cells is referred to as:

 

a. endocytosis.
b. pinocytosis.
c. phagocytosis.
d. exocytosis.

 

REF: p 44

 

  1. A cell is observed to absorb oxygen and use it to transform nutrients to energy. Which of the following cellular functions is it displaying?

 

a. metabolic absorption
b. communication
c. secretion
d. respiration

 

REF: p 45

 

  1. The term catabolism refers to:

 

a. digestion.
b. energy-using processes.
c. energy-releasing processes.
d. the citric acid cycle.

 

REF: p 45

 

  1. The term anabolism refers to:

 

a. digestion.
b. energy-using processes.
c. energy-releasing processes.
d. the citric acid cycle.

 

REF: p 45

 

  1. Which of the following is a type of loose connective tissue?

 

a. adipose tissue
b. bone
c. blood
d. cartilage

 

REF: p 47

 

  1. Reticular tissue:

 

a. is a type of adipose tissue.
b. forms a scaffold for other cells.
c. is located in tendons and ligaments.
d. is cartilage.

 

REF: p 47

 

  1. Stratified squamous epithelial tissue is located in the:

 

a. air sacs in the lungs.
b. bladder.
c. ovary surface.
d. mouth and skin.

 

REF: p 47

 

  1. Transitional epithelial tissue is located in the:

 

a. air sacs in the lungs.
b. bladder.
c. ovary surface.
d. mouth and skin.

 

REF: p 47

 

  1. Simple cuboidal epithelial tissue is located:

 

a. in the air sacs in the lungs.
b. in the bladder.
c. on the ovary surface.
d. in the mouth and skin.

 

REF: p 47

 

  1. Simple squamous epithelial tissue is located:

 

a. in the air sacs in the lungs.
b. in the bladder.
c. on the ovary surface.
d. in the mouth and skin.

 

REF: p 48

 

  1. The muscle tissue that would cause the contraction of the stomach is:

 

a. Cardiac muscle
b. Skeletal muscle
c. Smooth muscle
d. Voluntary muscle

 

REF: p 47

 

  1. Which of the following is NOT a process associated with ageing?

 

a. Decreased height
b. Increased body fat mass
c. Muscle hyperplasia
d. Lengthening of the nose and ears

 

REF: p 50

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 04: Altered cellular function

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A common pathway of irreversible cell injury involves increased intracellular:

 

a. sodium.
b. potassium.
c. magnesium.
d. calcium.

 

REF: p 58

 

  1. A 55-year-old male has swelling of the feet secondary to hypoxia. Which of the following aided in development of swelling?

 

a. increased ATP
b. K+ movement out of the cell
c. Na+ movement into the cell
d. decreased osmotic pressure

 

REF: p 58

 

  1. Hypoxia is a potent cause of cellular injury. Which of the following processes is NOT commonly associated with hypoxia?

 

a. reduced ATP synthesis
b. increased cellular calcium
c. cell swelling
d. hyperplasia

 

REF: p 58

 

  1. A 75-year-old male presents with chest pain on exertion. He was previously diagnosed with arteriosclerosis. The chest pain is most likely due to hypoxic injury secondary to:

 

a. malnutrition.
b. free radicals.
c. ischaemia.
d. chemical toxicity.

 

REF: p 58

 

  1. Sodium and water accumulation in an injured cell are a direct result of:

 

a. decreased ATP production.
b. reverse osmosis.
c. ribosome detachment.
d. cellular atrophy.

 

REF: p 58

 

  1. A 52-year-old male suffered a myocardial infarction secondary to atherosclerosis and ischaemia. Once oxygen returned to the damaged heart, reperfusion injury occurred as a result of:

 

a. free-radical formation.
b. vacuolation.
c. increased metabolic state.
d. lactic acid accumulation.

 

REF: p 59

 

  1. Which of the following processes is NOT commonly associated with an increase in concentration of calcium inside the cell?

 

  1. reduced ATP production
  2. damage to cell membranes
  3. activation of enzymes
  4. creation of free radicals

REF: p 60

 

  1. A 75-year-old female with Alzheimer’s disease has increased lipid peroxidation secondary to free-radical production. Lipid peroxidation results in:

 

a. organelle membrane reconstruction.
b. increased lipid transportation.
c. increased protein synthesis.
d. cell membrane damage.

 

REF: p 60

 

  1. Which of the following substances reduces the risk of cataracts?

 

a. vitamin C
b. vitamin K
c. vitamin D
d. lipofuscin

 

REF: p 61

 

  1. Muscular atrophy involves a decrease in muscle cell:

 

a. number.
b. size.
c. vacuoles.
d. lipofuscin.

 

REF: p 62

 

  1. Patients immobilised by multiple bone fractures often exhibit:

 

a. skeletal muscle atrophy.
b. skeletal muscle hypertrophy.
c. disuse hyperplasia.
d. disuse hypertrophy.

 

REF: p 62

 

  1. Regeneration of liver cells is an example of:

 

a. compensatory atrophy.
b. hormonal hyperplasia.
c. compensatory hyperplasia.
d. pathological hyperplasia.

 

REF: p 63

 

  1. Cellular hyperplasia involves an increase in cell:

 

a. number.
b. size.
c. vacuoles.
d. lipofuscin.

 

REF: p 63

 

  1. Cellular hypertrophy involves an increase in cell:

 

a. number.
b. size.
c. vacuoles.
d. lipofuscin.

 

REF: p 63

 

  1. Cells that have undergone atrophy:

 

a. contain fewer mitochondria than normal cells.
b. have decreased protein catabolism compared with normal cells.
c. have increased anabolism compared with normal cells.
d. have more endoplasmic reticulum compared with normal cells.

 

REF: p 62

 

  1. In response to an increased workload, cardiac myocardial cells will:

 

a. increase in size.
b. decrease in length.
c. increase in excitability.
d. increase in number.

 

REF: p 63

 

  1. A 55-year-old male is diagnosed with hepatocellular cancer secondary to hepatitis C. If the cancerous region of the liver were removed, the remaining cells would undergo:

 

a. dysplasia.
b. metaplasia.
c. compensatory hyperplasia.
d. compensatory dysplasia.

 

REF: p 63

 

  1. A 55-year-old male with a 30-year history of smoking is examined for respiratory disturbance. Examination of his airway (bronchial) reveals that stratified squamous epithelial cells have replaced the normal columnar ciliated cells. The type of cellular adaptation is called:

 

a. hypertrophy.
b. hyperplasia.
c. metaplasia.
d. dysplasia.

 

REF: p 64

 

  1. The mammary glands enlarge during pregnancy primarily as a consequence of:

 

a. compensatory hyperplasia.
b. hormonal hyperplasia.
c. hormonal anaplasia.
d. hormonal dysplasia.

 

REF: p 63

 

  1. A 24-year-old female presents with excessive menstrual bleeding. Laboratory results reveal an imbalance of progesterone and oestrogen, with oestrogen secretion being elevated. This imbalance would most likely cause endometrial changes referred to as:

 

a. dysplasia.
b. pathological dysplasia.
c. hyperplasia.
d. pathological hyperplasia.

 

REF: p 63

 

  1. Metaplasia is stimulated by:

 

a. excessive hormonal stimulation.
b. the presence of a persistent irritant.
c. loss of tissue.
d. production of growth factors.

 

REF: p 64

 

  1. A 40-year-old female is undergoing treatment for cervical cancer. Which of the following cellular changes is most likely to be associated with her cancer?

 

a. metaplasia
b. atrophy
c. hypertrophy
d. dysplasia

 

REF: p 64

 

  1. Which of the following process is not a truly adaptive?

 

  1. atrophy
  2. dysplasia
  3. hyperplasia
  4. hypertrophy

 

REF: p 64

 

  1. Progressive cell injury that causes cell death with severe cell swelling and breakdown of organelles is referred to as:

 

a. adaptation.
b. pathological calcification.
c. apoptosis.
d. necrosis.

 

REF: p 66

 

  1. Apoptosis is a condition in which cells program themselves to:

 

a. atrophy.
b. die.
c. regenerate.
d. age.

 

REF: p 66

 

  1. The death of neurons during normal development in childhood and adolescence is an example of:

 

  1. physiological apoptosis $
  2. pathological apoptosis
  3. physiological necrosis
  4. pathological necrosis

REF: p 66

 

  1. Liquefactive necrosis occurs in the brain because:

 

a. debris is not digested by hydrolases.
b. of protein denaturation.
c. it is rich in hydrolytic enzymes and lipids.
d. ischaemia results in chemical injury.

 

REF: p 68

 

  1. A woman decided to poison her middle-aged husband with mercuric chloride. Following ingestion of the poison, his kidney function was impaired and his heart began to fail. Which of the following was the most likely cause?

 

a. karyorrhexis
b. coagulative necrosis
c. liquefactive necrosis
d. caseous necrosis

 

REF: p 67

 

  1. A group of prison inmates developed tuberculosis following exposure to an infected inmate. On examination, tissues were soft and granular like clumped cheese. Which of the following is the most likely cause?

 

a. coagulative necrosis
b. liquefactive necrosis
c. caseous necrosis
d. autolysis

 

REF: p 68

 

  1. On examination, a tissue sample appears opaque and chalk-like. Which of the following is the most likely cause?

 

a. coagulative necrosis
b. liquefactive necrosis
c. caseous necrosis
d. fat necrosis

 

REF: p 68

 

  1. The term karyolysis refers to:

 

a. the dissolving of the nucleus due to enzymes.
b. liquefactive necrosis.
c. shrinkage of the nucleus.
d. fat necrosis.

 

REF: p 68

 

  1. A 90-year old woman presents at the emergency department with a blackened toe. The mostly likely diagnosis is:

 

  1. caseous necrosis
  2. fat necrosis
  3. gangrenous necrosis
  4. liquefactive necrosis

REF: p 68

 

  1. In distinguishing ageing from diseases:

 

a. it is difficult to tell the difference because both processes are believed to result from cell injury.
b. it is easy to tell normal processes from abnormal processes.
c. disease, unlike ageing, has a genetic component.
d. ageing is a pathological process.

 

REF: p 69

 

  1. Muscle stiffening occurring within 6 to 14 hours after death is called:

 

a. livor mortis.
b. gangrene.
c. algor mortis.
d. rigor mortis.

 

REF: p 70

 

  1. Following somatic death, the body temperature equalises with environmental temperature after:

 

a. 5 hours.
b. 15 hours.
c. 24 hours.
d. 36 hours.

 

REF: p 70

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 05: Genes

 

Test Bank

 

MULTIPLE CHOICE

 

  1. An ordered photographic display of a set of chromosomes from a single cell is a/n:

 

a. metaphase spread.
b. autosomal spread.
c. karyotype.
d. anaphase spread.

 

REF: p 74

 

  1. The phase of the cell cycle during which the cell prepares for division is referred to as:

 

a. interphase.
b. telophase.
c. prophase.
d. M phase.

 

REF: p 75

 

  1. Cell chromosomes are duplicated during:

 

a. anaphase.
b. the S phase.
c. interphase.
d. the M phase.

 

REF: p 75

 

  1. The phase of the cell cycle during which each pair of chromosomes are pulled apart is referred to as:

 

a. anaphase.
b. telophase.
c. prophase.
d. metaphase.

 

REF: p 76

 

  1. Which of the following is NOT a phase of mitosis?

 

a. anaphase
b. telophase
c. interphase
d. metaphase

 

REF: p 75

 

  1. During which phase of the cell cycle does a cell produce additional organelles and cytoplasm?

 

a. G0
b. G1
c. S
d. G2

 

REF: p 75

 

  1. Human sperm cells contain ____ chromosomes:

 

a. 22
b. 23
c. 44
d. 46

 

REF: p 75

 

  1. The basic components of DNA are:

 

a. pentose sugars and four phosphate bases.
b. a phosphate molecule, deoxyribose and four nitrogenous bases.
c. adenine, guanine and purine.
d. codons, oxygen and cytosine.

 

REF: p 77

 

  1. Which of the following checkpoints determines that chromosomes are intact before allowing the cycle to proceed to mitosis?

 

a. G1/S
b. G2/S
c. G2/M
d. final phase M

 

REF: p 77

 

  1. The base components of DNA are:

 

a. A, G, C and U.
b. U, G, C and T.
c. A, G, C and T.
d. X, XX, XY and YY.

 

REF: p 77

 

  1. A DNA strand has a region with the sequence ATCGGATC. Which of the following would be a complementary strand?

 

a. CGATACGT
b. TAGCCTAG
c. TUGCCTUG
d. UAGCCUAG

 

REF: p 78

 

  1. When considering how nitrogenous bases pair to form a double helix, which of the following bases will pair with cytosine?

 

a. uracil
b. thymine
c. adenine
d. guanine

 

REF: p 78

 

  1. The process by which RNA directs the synthesis of protein is called:

 

a. termination.
b. transcription.
c. promotion.
d. translation.

 

REF: p 79

 

  1. The process by which DNA is copied into messenger RNA is called:

 

a. termination.
b. transcription.
c. promotion.
d. translation.

 

REF: p 79

 

  1. A section of DNA has the following sequence: AACTGTC. The complimentary mRNA for this section of DNA would be:

 

  1. UUGACAG
  2. TTGACAG
  3. TTGUCUG
  4. CCAGTGA

 

REF: p 79

 

  1. Which of the following types of RNA forms a DNA template?

 

  1. tRNA
  2. mRNA
  3. rRNA

d dRNA

REF: p 79

 

  1. The term ‘allele’ refers to:

 

a. a tangled mass of DNA.
b. the location of chromosomes in a cell.
c. the location of genes on a chromosome.
d. an alternative form of a gene at a specific location.

 

REF: p 80

 

  1. An individual has two identical copies of an allele at a given locus. This person would be _____ for that particular allele.

 

a. homozygous
b. heterozygous
c. phenotypic
d. genotypic

 

REF: p 81

 

  1. An individual has two different copies of an allele at a given locus. This person would be _____ for that particular allele.

 

a. homozygous
b. heterozygous
c. phenotypic
d. genotypic

 

REF: p 81

 

  1. The phenotype of an individual:

 

a. is the genetic composition of the individual.
b. is fixed at conception.
c. remains constant throughout life.
d. comprises the characteristics and features displayed by the individual.

 

REF: p 81

 

  1. The genotype of an individual:

 

a. may be affected by the environment.
b. may change throughout life.
c. remains constant throughout life.
d. comprises the characteristics and features displayed by the individual.

 

REF: p 81

 

  1. A couple has three offspring: one child with a dominant disease trait and two who are normal. The father is affected by the disease, but the mother does not have the disease gene. What is the risk of this disease for their next child?

 

a. 50%
b. 33%
c. 25%
d. impossible to determine

 

REF: p 82

 

  1. Blue eye colour is recessive, whereas brown eye colour is a dominant trait. A child is born with blue eyes (bb). The child’s mother has blue eyes and the father has brown eyes. Which of the following represents the father?

 

a. bb
b. Bb
c. BB
d. Bb or BB

 

REF: p 82

 

  1. Freckles are determined by a dominant gene. A mother has freckles and the father does not. Their child also has freckles. The mother’s genotype would be

 

  1. f/f
  2. F/f
  3. F/F
  4. F/F or F/f

 

REF: p 82

 

  1. Freckles are determined by a dominant gene. A mother has freckles and the father does not. Their child also has freckles. The child’s genotype would be

 

  1. f/f
  2. F/f
  3. F/F
  4. F/F or F/f

 

REF: p 82

 

  1. If two copies of an allele are required for its effect to be seen, the allele is:

 

a. dominant.
b. codominant.
c. recessive.
d. sex-linked.

 

REF: p 81

 

  1. The ABO blood groups are an example of:

 

a. dominant traits.
b. codominant traits.
c. recessive traits.
d. sex-linked traits.

 

REF: p 83

 

  1. A father has type O blood and the mother’s genotype is iA/iO. What percentage of their offspring will have type A blood?

 

a. 25%
b. 50%
c. 75%
d. 100%

 

REF: p 83

 

  1. A father has type O blood and the mother’s genotype is iA/iA. What percentage of their offspring will have type A blood?

 

a. 25%
b. 50%
c. 75%
d. 100%

 

REF: p 83

 

  1. A mother has type AB blood and the father’s genotype is iO/iO. What percentage of their offspring will have type B blood?

 

a. 25%
b. 50%
c. 75%
d. 100%

 

REF: p 83

 

  1. Which is the rarest blood type?

 

a. A
b. B
c. AB
d. O

 

REF: p 84

 

  1. Which is the most common blood type in the Australian population?

 

a. A
b. B
c. AB
d. O

 

REF: p 84

 

  1. The test that screens newborns for more than 30 inherited disorders is called the:

 

a. Guthrie test.
b. PKU test.
c. codominance test.
d. Punnett test.

 

REF: p 84

 

  1. Phenylketonuria:

 

a. causes irreversible mental retardation in untreated children.
b. is a test that screens for inherited disorders in newborns.
c. is a method of predicting the likelihood of an individual inheriting a particular trait.
d. occurs in every one in 800 babies.

 

REF: p 84

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 06: The structure and function of the neurological system

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The somatic nervous system consists of pathways that control:

 

a. the heart.
b. the spinal cord.
c. skeletal muscle.
d. smooth muscle organs.

 

REF: p 91

 

  1. Afferent impulses in peripheral nerves are conducted by:

 

a. sensory neurons towards the CNS.
b. sensory neurons away from the CNS.
c. motor neurons towards the CNS.
d. motor impulses away from the CNS.

 

REF: p 90

 

  1. Which division of the nervous system controls heart rate?

 

a. somatic
b. afferent
c. autonomic
d. sensory

 

REF: p 91

 

  1. A special function of the neurofibrils in neurons is to assist:

 

a. the cell membrane control ion movement.
b. with the transport of substances along the axon.
c. with maintaining the resting membrane potential.
d. the neuron when it undergoes mitosis.

 

REF: p 91

 

  1. Motor neurons are structurally classified as:

 

a. unipolar neurons.
b. pseudounipolar neurons.
c. bipolar neurons.
d. multipolar neurons.

 

REF: p 92

 

  1. A cell was isolated from the CNS. Studies revealed that its main function was to clear cellular debris. Which of the following is the most likely cell type?

 

a. astrocyte
b. ependymal cell
c. microglial
d. Schwann cell

 

REF: p 93

 

  1. All of the following are neuroglial cells, except:

 

a. astrocyte
b. oligodendrocyte
c. neuron
d. ependymal cell

 

REF: p 93

 

  1. Which of the following is located in the peripheral nervous system?

 

a. astrocyte
b. ependymal cell
c. microglia
d. Schwann cell

 

REF: p 93

 

  1. Which of the following neurons have the capacity for regeneration?

 

a. unmyelinated neurons in the brain
b. myelinated neurons in the spinal cord
c. myelinated peripheral neurons
d. postganglionic motor neurons

 

REF: p 94

 

  1. When a neuron is resting (not sending any impulses), which ion is at a higher concentration in the neural intracellular fluid than in the extracellular fluid?

 

a. sodium
b. calcium
c. chloride
d. potassium

 

REF: p 95

 

  1. Depolarisation of the neural membrane in the early phase of the axon potential occurs when:

 

a. sodium ions move into the neuron.
b. sodium ions exit the neuron.
c. potassium ions move into the neuron.
d. potassium ions exit the neuron.

 

REF: p 95

 

  1. A nerve is stimulated by an electrical current. Upon stimulation, neurotransmitters are released from the:

 

a. synapse.
b. synaptic vesicle.
c. synaptic cleft.
d. receptor.

 

REF: p 96

 

  1. Neurotransmitters interact with the postsynaptic membrane by binding to a:

 

a. receptor.
b. Nissl body.
c. glial cell.
d. neurofibril.

 

REF: p 96

 

  1. A 20-year-old male was brought to the ED for severe burns. He requested something for the excruciating pain he was experiencing. Blocking which of the following neurotransmitters would reduce his pain?

 

a. enkephalin
b. dopamine
c. acetylcholine
d. substance P

 

REF: p 99

 

  1. Which of the following transmit a nerve impulse at the highest rate?

 

a. large nonmyelinated axons
b. large myelinated axons
c. small nonmyelinated axons
d. small myelinated axons

 

REF: p 98

 

  1. The convolutions on the surface of the cerebrum are called:

 

a. sulci.
b. fissures.
c. reticular formations.
d. gyri.

 

REF: p 101

 

  1. The region responsible for motor aspects of speech is termed:

 

a. Wernicke’s area.
b. Broca’s area.
c. the primary speech area.
d. the insula.

 

REF: p 101

 

  1. A 32-year-old female suffers from severe brain damage following a motor vehicle accident. After rehabilitation she notices that her thought processes and goal-oriented behaviour are impaired. The area most likely responsible is the:

 

a. thalamus.
b. limbic.
c. prefrontal.
d. occipital.

 

REF: p 102

 

  1. The primary visual cortex is located in the:

 

a. frontal lobe.
b. temporal lobe.
c. occipital lobe.
d. parietal lobe.

 

REF: p 101

 

  1. The major somatosensory brain area is located in the:

 

a. cerebellum.
b. corpus callosum.
c. parietal lobe.
d. frontal lobe.

 

REF: p 101

 

  1. A 79 year old female has a stroke which leaves her paralysed down her right side. The area of her brain that is damaged is most likely the:

 

a. right motor cortex.
b. left motor cortex.
c. right post central gyrus.
d. left temporal lobe.

 

REF: p 101

 

  1. A 45-year-old male was previously diagnosed with Parkinson’s disease. He has impaired fine repetitive motor movements. Which of the following areas is most likely damaged?

 

a. basal nuclei.
b. prefrontal area
c. hippocampus
d. temporal lobe

 

REF: p 103

 

  1. The area responsible for language comprehension located mainly in the left temporal lobe is:

 

a. the insula.
b. the pre-central gyrus.
c. Broca’s area.
d. Wernicke’s area.

 

REF: p 103.

 

  1. The _____ is a transverse fibre tract that connects the two cerebral hemispheres.

 

a. peduncle
b. corpus callosum
c. basal ganglia
d. pons

 

REF: p 102

 

  1. The collection of cell bodies located deep in the white matter of each cerebral hemisphere that function in fine tuning voluntary muscle activity and inhibit unnecessary movement are the:

 

a. cerebellum.
b. cerebral tracts.
c. basal nuclei.
d. thalamus.

 

REF: p 103

 

  1. Maintenance of homeostasis and instinctive behavioural control arise from the:

 

a. thalamus.
b. medulla.
c. cerebellum.
d. hypothalamus.

 

REF: p 103

 

  1. A 19-year-old male university student complains to his doctor that he cannot stay awake in class regardless of how much sleep he gets. A drug that stimulates which of the following areas would best treat his problem?

 

a. corpora quadrigemina
b. reticular activating system
c. cerebellum
d. hypothalamus

 

REF: p 105

 

  1. Reflex activities concerned with heart rate and blood pressure are controlled by the:

 

a. medulla oblongata.
b. pons.
c. midbrain.
d. cerebrum.

 

REF: p 105

 

  1. A patient presents with altered respiratory patterns following head trauma. A lesion in which of the following areas would cause these symptoms?

 

a. cerebrum
b. cerebellum
c. midbrain
d. medulla

 

REF: p 105

 

  1. Regulation of body temperature primarily occurs in the:

 

a. cerebrum
b. brain stem
c. hypothalamus
d. pituitary gland

 

REF: p 103

 

  1. The sleep control centre is located in the:

 

a. prefrontal cortex.
b. thalamus.
c. hypothalamus.
d. cerebellum.

 

REF: p 106

 

  1. Which sleep phase shows EEG patterns with brain activity similar to the normal awake pattern? (REM = rapid eye movement; NREM = non-rapid eye movement)

 

a. NREM stage I
b. NREM stage II
c. NREM stage III
d. REM

 

REF: p 105

 

  1. Most dreams occur during:

 

a. NREM stage I sleep.
b. NREM stage IV sleep.
c. REM sleep.
d. daydreams.

 

REF: p 105

 

  1. Loss of temperature control occurs in:

 

a. non-REM sleep.
b. light sleep.
c. REM sleep.
d. 20 minutes after falling asleep.

 

REF: p 105

 

  1. REM sleep occurs about every:

 

a. 15 minutes.
b. 30 minutes.
c. 60 minutes.
d. 90 minutes.

 

REF: p 105

 

  1. Sensory pathways in the spinal cord include the:

 

a. corticospinal tract.
b. pyramids.
c. spinothalamic tract.
d. anterior column.

 

REF: p 109

 

  1. The membrane that separates the cerebellum from the cerebrum is known as the:

 

a. tentorium cerebelli.
b. falx cerebri.
c. arachnoid membrane.
d. falx cerebelli.

 

REF: p 109

 

  1. Corticospinal neural pathways travel from the:

 

a. motor cortex to the spinal cord to skeletal muscles.
b. skeletal muscles to the spinal cord to the motor cortex.
c. peripheral sensory receptors to the spinal cord to the cortex.
d. autonomic effector organs to the spinal cord to the cortex.

 

REF: p 109

 

  1. The outermost membrane surrounding the brain is the:

 

a. dura mater.
b. arachnoid mater.
c. pia mater.
d. falx cerebri.

 

REF: p 109

 

  1. A 12-year-old female presents with hydrocephalus, a condition where there is an increase in cerebrospinal fluid (CSF) volume and pressure. Blockage of which of the following would cause this condition?

 

a. cerebral aqueduct
b. inferior colliculi
c. red nucleus
d. tegmentum

 

REF: p 112

 

  1. CSF can accumulate around the brain when there is injury to the sites of CSF reabsorption, which are called the:

 

a. arachnoid villi.
b. epidural foramina.
c. lateral apertures.
d. choroid plexuses.

 

REF: p 113

 

  1. The brain receives approximately _____ of the cardiac output.

 

a. 80%
b. 20%
c. 40%
d. 10%

 

REF:  p 113

 

  1. A cell that is involved in forming the blood-brain barrier is the:

 

a. microglia.
b. Schwann cell.
c. oligodendrocyte.
d. astrocyte.

 

REF: p 113

 

  1. The _____ ensures collateral blood flow from blood vessels supplying the brain.

 

a. carotid arteries
b. basal artery
c. circle of Willis
d. vertebral arteries

 

REF: p 114

 

  1. A 40-year-old male suffers from a head trauma that affects cranial nerve I. Which of the following symptoms would be expected?

 

a. visual disturbances
b. loss of sense of smell
c. loss of ability to taste
d. hearing disturbances

 

REF: p 116

 

  1. Parasympathetic motor neurons release the neurotransmitter:

 

a. adrenaline
b. serotonin.
c. acetylcholine.
d. substance P.

 

REF: p 120

 

  1. Stimulation of the vagus nerve causes:

 

a. increased gastrointestinal activity.
b. increased heart rate.
c. pupil constriction.
d. vasoconstriction.

 

REF: p 117

 

  1. An effect of b-1 receptor stimulation is:

 

a. dilation of the coronary arteries.
b. arterial vasoconstriction.
c. an increase in the strength of myocardial contraction.
d. a decrease in the rate of myocardial contraction.

 

REF: p 122

 

  1. A patient begins taking a new drug that causes pupil dilation, vasoconstriction, decreased gastrointestinal motility and goose bumps. Which of the following receptors are activated?

 

a. alpha 1
b. alpha 2
c. beta 1
d. beta 2

 

REF: p 122

 

  1. The structure of the eye that prevents light from scattering in the eye is the:

 

a. iris.
b. pupil.
c. choroid.
d. retina.

 

REF: p 126

 

  1. A 50-year-old patient with diabetes experiences visual disturbances and decides to visit his GP. After examination, the GP tells the patient that the cells that allow him to see are degenerated. Which of the following structures is most likely damaged?

 

a. lens
b. pupil
c. cornea
d. retina

 

REF: p 126

 

  1. Which structure connects the middle ear with the pharynx?

 

a. organ of Corti
b. eustachian tube
c. semicircular canal
d. auditory canal

 

REF: p 127

 

  1. Which disease is associated with increased intraocular pressures?

 

a. glaucoma
b. ocular degeneration
c. diplopia
d. astigmatism

 

REF: p 129

 

  1. A 70-year-old male presents to his GP complaining of loss of vision. He reports that he has hypertension and smokes cigarettes. Which of the following disorders is most likely causing his visual loss?

 

a. presbyopia
b. macular degeneration
c. strabismus
d. amblyopia

 

REF: p 129

 

  1. Red-green color blindness most often occurs in:

 

a. males.
b. females.
c. older people.
d. children.

 

REF: p 129

 

  1. The most common form of sensorineural hearing loss in older people is:

 

a. conductive hearing loss.
b. acute otitis media.
c. presbycusis.
d. Ménière’s disease.

 

REF: p 130

 

  1. A 15-year-old female is diagnosed with an outer ear infection. Which of the following is most likely to cause this infection?

 

a. Haemophilus
b. Streptococcus pneumoniae
c. Moraxella catarrhalis
d. Escherichia coli

 

REF:  p 131

 

  1. During infancy, what is the fastest growing part of the body?

 

a. spinal cord
b. limb bones
c. head
d. vertebral column

 

REF: p 132

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 07: Pain

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The system responsible for an individual’s emotional and behavioral responses to pain is the:

 

a. sensory/discriminative system.
b. motivational/affective system.
c. sensory/motivational system.
d. cognitive/evaluative system.

 

REF: p 138

 

  1. A 55-year-old male presented to his GP complaining of severe headaches. Investigative tests suggested his pain was psychogenic in nature. This type of pain:

 

a. is associated with stimulation of internal nociceptors.
b. is caused by damage to one or more cranial nerves.
c. is attributed to damage within the central nervous system.
d. appears to have no underlying pathology.

 

REF: p 140

 

  1. The pain that occurs to a stimulus such as light stroking that normally does not provoke pain is termed:

 

a. hyperalgesia.
b. analgesia.
c. allodynia.
d. causalgia.

 

REF: p 141

 

  1. Pain that is felt in a different body part to the source of the pain is called:

 

a. neuropathic pain.
b. referred pain.
c. psychogenic pain.
d. hyperalgesia.

 

REF: p 140

 

  1. Chronic pain is pain that has lasted longer than:

 

a. 1 month.
b. 3 months.
c. 1 year.
d. 2 to 3 years.

 

REF: p 140

 

  1. A 20-year-old female pricked her left hand while sewing. Which area in her brain would have received the pain signals and perceived them as pain?

 

a. right somatosensory cortex
b. left somatosensory cortex
c. right precentral gyrus on the frontal lobe
d. left precentral gyrus on the frontal lobe

 

REF: p 142

 

  1. One location in which nociceptors can be found is the:

 

a. skin.
b. spinal cord.
c. efferent pathways.
d. hypothalamus.

 

REF: p 140

 

  1. Cutaneous polymodal nociceptors are activated by:

 

a. mechanical injury only.
b. thermal stimuli such as heat only.
c. light touch and gentle stroking.
d. mechanical injury, heat and chemicals.

 

REF: p 143

 

  1. Which CNS tract is responsible for carrying sensory information from the nociceptors to the brain?

 

a. spinothalamic
b. corticospinal
c. corticobulbular
d. reticulospinal

 

REF: p 142

 

  1. Inflammation in visceral tissues activates:

 

a. thermoreceptors.
b. cutaneous nociceptors.
c. efferent pathways.
d. silent nociceptors.

 

REF: p 144

 

  1. Which one of the following is an excitatory neuromodulator that enhances pain transmission?

 

a. beta endorphin
b. encephalin
c. substance P
d. dynorphin

 

REF: p 146

 

  1. A 15-year-old female scrapes her knee while playing soccer and complains of sharp and well-localised pain. Which of the following would most accurately characterise her pain?

 

a. chronic pain
b. referred pain
c. somatic pain
d. visceral pain

 

REF: p 141

 

  1. A 5-year-old female breaks her leg after falling from a merry-go-round. Which brain area would receive the impulses that make her aware of her pain?

 

a. basal nuclei
b. cerebellum
c. precentral gyrus
d. postcentral gyrus

 

REF: p 141

 

  1. A 50-year-old male crushes his hand while working in a sawmill. Long after his injury has healed he still feels burning pain in his hand. This pain is referred to as:

 

a. neuropathic pain.
b. peripheral pain.
c. psychogenic pain.
d. acute pain.

 

REF: p 149

 

  1. The pain threshold in children is:

 

a. higher than that of adults.
b. lower than that of adults.
c. the same as that of adults.
d.  both b and c are correct

 

REF: p 149

 

  1. The lowest intensity of a stimulus that is perceived as painful is termed:

 

a. affective-motivational aspect.
b. pain sensitisation.
c. pain threshold.
d. pain tolerance.

 

REF:  p 146

 

  1. A 76-year-old female presented to her doctor complaining of burning pain extending across the right side of her upper back. On examination she had no obvious skin lesions but she did have shingles 12 months ago. The type of pain that she has is likely to be:

 

a. trigeminal neuralgia.
b. postherpetic neuralgia.
c. diabetic neuropathy.
d. psychogenic pain.

 

REF: p 150

 

  1. Intravertebral disc herniations cause a lot of pain and morbidity. The majority of these occur between vertebral levels (cervical, C; thoracic, T; lumbar, L; sacral, S):

 

a. C1 to C3.
b. T1 to T4.
c. T12 to L3.
d. L4 to S1.

 

REF: p 150

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 08: Concepts of neurological dysfunction

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A compensatory alteration in the diameter of cerebral blood vessels in response to increased intracranial pressure is called:

 

a. herniation.
b. vasodilation.
c. autoregulation.
d. amyotrophy.

 

REF: p 156

 

  1. A 20-year-old male is admitted to the neurological critical care unit with a severe closed head injury. When an intraventricular catheter is inserted, the intracranial pressure is recorded at 24 mmHg. This reading is:

 

a. higher than normal.
b. lower than normal.
c. normal.
d. borderline.

 

REF: p 157

 

  1. A 70-year-old female is being closely monitored in the neurological critical care unit for a severe closed head injury. After 48 hours her condition begins to deteriorate. Her pupils are small and sluggish, pulse pressure is widening, and she is bradycardic. These clinical findings are evidence of what stage of intracranial hypertension (raised intracranial pressure)?

 

a. early compensated
b. late compensated
c. early decompensated
d. fully decompensated

 

REF: p 159

 

  1. A decrease in cerebral perfusion pressure is related to which of the following changes?

 

a. increase in arterial blood pressure
b. increase in cerebral blood flow
c. increase in intracranial pressure
d. cerebral artery vasodilation

 

REF: p 158

 

  1. A direct consequence of increased intracranial pressure is:

 

a. brain tissue hypoxia.
b. intracranial hypotension.
c. ventricular swelling.
d. expansion of the cranial vault.

 

REF: p 159

 

  1. A 15-year-old female is admitted to the intensive care unit with a severe closed head injury. This diagnosis puts her at risk for:

 

a. cerebral oedema.
b. metabolic coma.
c. dysphagia.
d. echolalia.

 

REF: p 158

 

  1. Cerebral oedema is an accumulation of fluid in the:

 

a. brain ventricles.
b. brain tissue.
c. subarachnoid space.
d. neuroglia.

 

REF: p 161

 

  1. Vasogenic oedema is clinically important because (ICP = intracranial pressure):

 

a. it usually has an infectious cause.
b. the blood-brain barrier is disrupted.
c. ICP is higher than in other forms of cerebral oedema.
d. it always causes herniation.

 

REF: p 161

 

  1. An infant is diagnosed with non-communicating hydrocephalus. An immediate concern for this patient is:

 

a. metabolic oedema.
b. interstitial oedema.
c. vasogenic oedema.
d. ischemic oedema.

 

REF: p 163

 

  1. Hydrocephalus in adults is most often caused by (CSF = cerebral spinal fluid):

 

a. overproduction of CSF.
b. intercellular oedema.
c. elevated arterial blood pressure.
d. defective CSF reabsorption.

 

REF: p 163

 

  1. An infant is diagnosed with congenital hydrocephalus. Which of the following characteristics would you expect to see?

 

a. enlarged ventricles
b. decreased cerebrospinal fluid production
c. increased resorption of cerebrospinal fluid
d. smaller than average head circumference

 

REF: p 163

 

  1. Arousal is mediated by the:

 

a. cerebral cortex.
b. medulla oblongata.
c. reticular activating system.
d. cingulate gyrus.

 

REF: p 164

 

  1. A 16-year-old male took a recreational drug that decreased his level of arousal. Physical exam revealed a localised response to pain, equal and reactive pupils, and roving eye movements. Which of the following is the most likely diagnosis?

 

a. psychogenic arousal alteration
b. metabolically induced coma
c. structurally induced coma
d. structural arousal alteration

 

REF: p 165

 

  1. A teenage boy sustains a severe closed head injury following an automobile accident. He is in a state of deep sleep that requires vigorous stimulation to elicit eye opening. Which of the following describes his condition?

 

a. confusion
b. coma
c. obtundation
d. stupor

 

REF: p 167

 

  1. The breathing pattern that reflects respirations based primarily on CO2 levels in the blood is:

 

a. Cheyne-Stokes.
b. ataxic.
c. central neurogenic.
d. normal.

 

REF: p 168

 

  1. A 50-year-old male suffers a severe head injury when his motorcycle hits a tree. His breathing becomes deep and rapid but with normal pattern. This condition is called:

 

a. gasping.
b. ataxic breathing.
c. apneusis.
d. central neurogenic hyperventilation.

 

REF: p 168

 

  1. Dilated fixed pupils can be caused by:

 

a. brain stem hypoxia.
b. cerebral contusions.
c. compression of the optic nerve.
d. spinal shock.

 

REF: p 169

 

  1. A 51-year-old male is admitted to the neurological critical care unit with a severe closed head injury. All four extremities are in rigid extension, his forearm is hyperpronated, and his legs are in plantar extension. This condition is known as:

 

a. decorticate posturing.
b. decerebrate posturing.
c. caloric posturing.
d. excitation posturing.

 

REF: p 170

 

  1. A 16-year-old male fell off the bed of a pickup truck and hit his forehead on the road. In ED he is comatose with flexion of his forearms, wrists and fingers, adduction of his upper extremities and internal rotation and plantar flexion in his lower limbs. His abnormal posturing is:

 

a. decorticate rigidity.
b. decerebrate rigidity.
c. pontine level dysfunction.
d. spinal cord dysfunction.

 

REF: p 170

 

  1. Pupillary reflexes to light are controlled by cranial nerves:

 

a. I and II.
b. II and III.
c. III and IV.
d. IV and V.

 

REF: p 165

 

  1. A 20-year-old male suffers a severe closed head injury in a motor vehicle accident. He remains in a post-coma unresponsive state one month after the accident. He does not require assistance to breathe. Which of the following structures is most likely damaged?

 

a. cerebral cortex
b. brain stem
c. spinal cord
d. cerebellum

 

REF: p 170

 

  1. When thought content and arousal level are intact but a patient cannot communicate, the patient has:

 

a. cerebral death.
b. locked-in syndrome.
c. dysphagia.
d. cerebellar motor syndrome.

 

REF: p 171

 

  1. A 10-year-old female was brought to the ED following a sudden onset of convulsions. The doctors think she experienced an explosive, disorderly discharge of cerebral neurons referred to as:

 

a. reflex.
b. seizure.
c. inattentiveness.
d. brain death.

 

REF: p 171

 

  1. A peculiar sensation that immediately precedes a seizure is called a(n):

 

a. prodroma.
b. agnosia.
c. spasm.
d. aura.

 

REF: p 174

 

  1. A 30-year-old female had a seizure that causes her to experience numbness and tingling extending from her left forearm to her left fingertips without loss of consciousness. This condition is known as:

 

a. myoclonic seizure.
b. Toni-clonic seizure.
c. simple partial seizure.
d. atonic seizure.

 

REF: p 174

 

  1. A 20-year-old male was at the supermarket when he fell to the ground. Bystanders reported that he lost consciousness and his body tensed up then relaxed, then tensed and relaxed several times. He most likely was experiencing a(n):

 

a. partial seizure.
b. absence seizure.
c. myoclonic seizure.
d. tonic-clonic seizure.

 

REF:  pp 174-175

 

  1. Febrile seizures in children are thought to arise as a result of:

 

a. the rate at which the core temperature increases.
b. a combination of genetic and environmental factors.
c. a hypersensitivity reaction to analgesic medication.
d. congenital abnormalities in the central nervous system.

 

REF: p 176

 

  1. An alcoholic checked into a rehabilitation centre. He experiences delirium, inability to concentrate, and is easily distracted. Which of the following is he most likely to be affected by?

 

a. acute confusional state
b. echolalia
c. dementia
d. dysphagia

 

REF: p 175

 

  1. Dementia is manifested by:

 

a. violent behaviour.
b. hyperactivity.
c. depressive personality.
d. loss of recent and remote memory.

 

REF: p 178

 

  1. A 65-year-old male recently suffered a stroke. He is now unable to recognise and identify objects by sight even though his vision is intact. This condition is a form of:

 

a. hypomimesis.
b. agnosia.
c. dysphasia.
d. agraphia.

 

REF: p 178

 

  1. A 75-year-old female with a history of dementia develops impaired comprehension of language, but she is able to speak. This clinical manifestation is called:

 

a. motor aphasia.
b. Broca’s aphasia.
c. expressive dysphasia.
d. receptive dysphasia.

 

REF: p 178

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 09: Alterations of neurological function across the life span

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A 30-year-old white male recently suffered a cerebrovascular accident (stroke). Which of the following is the most likely factor that contributed to his stroke?

 

a. age
b. gender
c. diabetes
d. race

 

REF: p 186

 

  1. A 72-year-old male demonstrates left-sided weakness of upper and lower extremities, blurred vision and dizziness. The symptoms disappear in 24 hours. He most likely experienced a(n):

 

a. stroke-in-evolution.
b. arteriovenous malformation.
c. transient ischaemic attack.
d. cerebral haemorrhage.

 

REF: p 188

 

  1. A major contributing process in strokes is the development of atheromatous plaques in cerebral circulation. These most commonly form:

 

a. in the larger veins.
b. near capillary sphincters.
c. in cerebral arteries.
d. in the venous sinuses.

 

REF:  p 187

 

  1. One risk factor for thrombotic stroke is:

 

a. hyperthyroidism.
b. fat embolus.
c. iron deficiency anaemia.
d. high blood cholesterol.

 

REF: p 188

 

  1. A 75-year-old male experienced a lacunar stroke. This type of stroke is most often associated with:

 

a. an embolus.
b. hypertension.
c. a haemorrhage.
d. an aneurysm.

 

REF:  p 188

 

  1. A 60-year-old female with a recent history of head trauma and a long-term history of hypertension presents to the ED for changes in mental status. MRI reveals that she had a haemorrhagic stoke. This type of stroke is often caused by:

 

a. rheumatic heart disease.
b. thrombi.
c. aneurysms.
d. hypotension.

 

REF: p 188

 

  1. A 48-year-old female presents at the ED complaining of an acute severe headache, nausea, photophobia and nuchal rigidity. These signs and symptoms are probably caused by:

 

a. diffuse brain injury.
b. subarachnoid haemorrhage.
c. epidural haematoma.
d. classic concussion.

 

REF: p 188

 

  1. A 65-year-old male suffers a subarachnoid haemorrhage secondary to uncontrolled hypertension. He appears drowsy and confused with pronounced focal neurologic deficits. This condition is classified as grade:

 

a. I.
b. II.
c. III.
d. IV.

 

REF: p 194

 

  1. A 25-year-old male was in an automobile accident. At impact, his forehead struck the windshield. In this situation, the coup injury would occur in the:

 

a. frontal region.
b. temporal region.
c. parietal region.
d. occipital region.

 

REF: p 197

 

  1. The main source of bleeding in extradural (epidural) haematomas is:

 

a. arterial.
b. venous.
c. capillary.
d. sinus.

 

REF: p 197

 

  1. The most common type of traumatic brain injury is:

 

a. penetrating trauma.
b. diffuse axonal injury.
c. focal brain injury.
d. concussion.

 

REF: p 199

 

  1. A 69-year-old male with a history of alcohol abuse presents to the ED after a month-long episode of headaches and confusion. Based on his alcoholism, a likely cause of his neurologic symptoms is:

 

a. concussion.
b. chronic subdural haematoma.
c. epidural haematoma.
d. subacute subdural haematoma.

 

REF: p 198

 

  1. A 15-year-old male was struck by a motor vehicle and suffered a traumatic brain injury. Paramedics found him unconscious at the scene of the accident. During the ambulance ride he regained consciousness and was able to maintain a conversation with the medical staff. Upon arrival to hospital he was alert and oriented. Physical exam reveals confusion and impaired responsiveness. What is the probable nature of his brain injury based on this history?

 

a. class IV (classic) concussion
b. subdural haematoma
c. extradural (epidural) haematoma
d. diffuse axonal injury

 

REF: p 197

 

  1. Mild concussion is characterised by:

 

a. a brief loss of consciousness.
b. significant behavioural changes.
c. retrograde amnesia.
d. transient confusion.

 

REF: p 199

 

  1. A 65-year-old female loses her balance while bushwalking, causing her to fall and hit her head. She loses consciousness and is in a coma for 5 days. She is diagnosed as having diffuse brain injury. Which of the following would most likely occur in this patient?

 

a. complete loss of vision
b. arrhythmia
c. blunted affect
d. meningitis infection

 

REF: p 199

 

  1. A 10-year-old male was climbing on a house and fell. He suffered a severe brain injury. His Glasgow Coma Scale was 5 initially and 7 after one day. He remained unconscious for two weeks, then was confused and suffered from anterograde amnesia. Which of the following is he most likely experiencing?

 

a. mild diffuse brain injury
b. moderate diffuse brain injury
c. severe diffuse brain injury
d. postconcussive syndrome

 

REF: p 199

 

  1. A 15-year-old male suffered diffuse brain injury after wrecking an all-terrain vehicle. He had momentary confusion and retrograde amnesia after five to 10 minutes. His injury could be categorised as:

 

a. grade I.
b. grade II.
c. grade III.
d. a mild concussion.

 

REF: p 199

 

  1. _____ are most at risk of spinal cord injury from trauma.

 

a. Infants
b. Men
c. Women
d. Older people

 

REF: p 200

 

  1. A 17-year-old male is brought to the ED for treatment of injuries received in a motor vehicle accident. A spinal cord injury is suspected. The two regions most likely to be damaged are the:

 

a. cervical and thoracic regions.
b. thoracic and lumbar regions.
c. lumbar and sacral regions.
d. cervical and lumbar regions.

 

REF: p 200

 

  1. Paralysis of the lower extremities is called:

 

a. paraplegia.
b. quadriplegia.
c. infraparaplegia.
d. tetraplegia.

 

REF: p 200

 

  1. An initial clinical manifestation associated with acute spinal cord injury is:

 

a. pain below the level of the injury.
b. loss of autonomic reflexes above the injury.
c. loss of voluntary control below the injury.
d. hyperactive spinal reflexes below the injury.

 

REF: p 201

 

  1. The transient nature of spinal shock is directly related to which of the following mechanisms?

 

a. incomplete transection of the spinal cord
b. accumulation of oedema within the spinal cord
c. partial necrosis of the spinal cord
d. free-radical injury and scarring of the glial cells

 

REF: p 200

 

  1. Spinal shock is characterised by:

 

a. loss of voluntary motor function with preservation of reflexes.
b. cessation of spinal cord function below the lesion.
c. loss of spinal cord function at the level of the lesion only.
d. temporary loss of spinal cord function above the lesion.

 

ANS:  B                             REF: 201

 

  1. A 33-year-old male is brought to the ED for treatment of injuries received in a motor vehicle accident. An MRI reveals an injury of the cervical cord. Cord swelling in this region may be life threatening because:

 

a. increased intracranial pressure may occur.
b. reflexes will be disrupted.
c. diaphragm function may be impaired.
d. bladder emptying will not occur.

 

REF: p 201

 

  1. A 15-year-old male is brought to the ED for treatment of injuries received in a motor vehicle accident. An MRI reveals spinal cord injury, and his body temperature fluctuates markedly. The most accurate explanation of this phenomenon is that:

 

a. he developed pneumonia.
b. his sympathetic nervous system has been damaged and thermal control disturbed.
c. as well as a brain injury he has sustained injuries to other body areas.
d. he has septicaemia from an unknown source.

 

REF: p 201

 

  1. Six weeks ago a female patient suffered a T6 spinal cord injury. She then developed a blood pressure of 200/120, a severe headache, blurred vision and bradycardia. She is likely experiencing:

 

a. extreme spinal shock.
b. acute anxiety.
c. autonomic hyperreflexia.
d. parasympathetic areflexia.

 

REF: p 201

 

  1. A 20-year-old female suffered from spinal cord injury that resulted from a motor vehicle accident. She had spinal shock lasting 15 days and is now experiencing an uncompensated cardiovascular response to sympathetic stimulation. This condition may accompany:

 

a. toxic accumulation of free radicals below the level of the injury.
b. pain stimulation above the level of the spinal cord lesion.
c. a distended bladder or rectum.
d. an abnormal vagal response.

 

REF: p 201

 

  1. The pathological brain changes that occur with Alzheimer’s disease include neurofibrillary tangles and accumulations of senile plaques that are concentrated in:

 

a. basal nuclei and hypothalamus.
b. cerebral cortex and hippocampus.
c. spinothalamic tracts and thalamus.
d. cerebellum and midbrain.

 

REF: p 204

 

  1. The clinical manifestations that arise in Parkinson’s disease result from which one of the following changes in the basal nuclei?

 

a. degeneration of cholinergic neurons.
b. overstimulation of dopaminergic neurons.
c. lack of dopaminergic inhibition of cholinergic neurons.
d. reduced cholinergic stimulation of dopaminergic neurons.

 

REF: p 205

 

  1. The classic triad of manifestations occurring with Parkinson’s disease includes all of the following except:

 

a. tremor.
b. rigidity.
c. akinesia.
d. hyperkinesia.

 

REF: p 205

 

  1. A 40-year-old male complains of abnormal movement and progressive dysfunction of intellectual and thought processes. He is experiencing movement problems that begin in the face and arms and eventually affect the entire body. The most likely diagnosis is:

 

a. tardive dyskinesia.
b. Huntington’s disease.
c. hypokinesia.
d. Alzheimer’s disease.

 

REF: p 207

 

  1. A 23-year-old female begins having problems with tiredness, weakness and visual changes. Her diagnosis is multiple sclerosis (MS). The pathogenic model of MS includes:

 

a. depletion of dopamine in the central nervous system (CNS).
b. demyelination of axon tracts in the CNS.
c. the development of neurofibril webs in the CNS.
d. reduced amounts of acetylcholine at the neuromuscular junction.

 

REF:  p 207

 

  1. The cause of MS seems to be an interaction between:

 

a. vascular and metabolic factors.
b. bacterial infection and the inflammatory response.
c. autoimmunity and genetic susceptibility.
d. neurotransmitters and inherited genes.

 

REF: p 207

 

  1. Classic amyotrophic lateral sclerosis (ALS), also known as motor neuron disease, presents with:

 

a. progressive dementia.
b. muscle weakness and atrophy.
c. severe paresthesias.
d. autonomic dysfunction.

 

REF: p 208

 

  1. Myasthenia gravis results from:

 

a. viral infection of skeletal muscle.
b. atrophy of motor neurons in the spinal cord.
c. demyelination of skeletal motor neurons.
d. autoimmune injury at the neuromuscular junction.

 

REF: p 210

 

  1. A 25-year-old female presents to her GP complaining of fever, headache, nuchal rigidity and decreased consciousness. She was previously treated for sinusitis. Which of the following is the most likely diagnosis?

 

a. aseptic meningitis
b. bacterial meningitis
c. fungal meningitis
d. nonpurulent meningitis

 

REF: p 211

 

  1. Currently, the most common cause of bacterial meningitis in children aged under 5 years is:

 

a. Haemophilus influenza.
b. Neisseria meningitides.
c. Streptococcus pneumonia.
d. Escherichia coli.

 

REF: p 211

 

  1. Viral meningitis:

 

a. is always sudden in onset.
b. often occurs with measles, mumps or herpes.
c. is effectively treated with antibiotics.
d. rarely causes encephalopathy.

 

REF: p 211

 

  1. In viral meningitis, laboratory analysis of CSF reveals a heavy presence of:

 

a. neutrophils.
b. basophils.
c. lymphocytes.
d. eosinophils.

 

REF: p 212

 

  1. Most causes of encephalitis are:

 

a. bacterial.
b. viral.
c. fungal.
d. toxoid.

 

REF: p 212

 

  1. The most common primary intracerebral CNS tumours in adults are:

 

a. meningiomas.
b. medulloblastomas.
c. astrocytomas.
d. angiomas.

 

REF: p 214

 

  1. A 45-year-old male presents with seizures. An MRI reveals a meningioma most likely originating from the:

 

a. dura mater and arachnoid membrane.
b. astrocytes.
c. pia mater.
d. CNS neurons.

 

REF: p 216

 

  1. What nutrient deficiency increases the risk of neural tube defects in the early stages of pregnancy?

 

a. protein
b. iron
c. vitamin D
d. folic acid

 

REF: p 217

 

  1. The most common type of cerebral palsy is:

 

a. ataxic.
b. dyskinetic.
c. spastic.
d. mixed.

 

REF: p 218

 

  1. A child is diagnosed with cerebral palsy, characterised by extreme difficulty in fine motor coordination and purposeful movement. Which of the following types of cerebral palsy is he experiencing?

 

a. ataxic
b. dyskinetic
c. spastic
d. mixed

 

REF: p 218

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 10: The structure and function of the endocrine system

 

Test Bank

 

MULTIPLE CHOICE

 

  1. To adapt to high hormone concentrations, many target cells have the capacity for:

 

a. negative feedback.
b. positive feedback.
c. down-regulation.
d. up-regulation.

 

REF: p 225

 

  1. Target cell receptors for most water-soluble hormones are located in the:

 

a. cytosol.
b. cell membrane.
c. endoplasmic reticulum.
d. nucleus.

 

REF: p 225

 

  1. Lipid-soluble hormone receptors cross the plasma membrane by:

 

a. diffusion.
b. osmosis.
c. active transport.
d. endocytosis.

 

REF: p 225

 

  1. A new hormone was isolated and found to be a water-soluble amine. Which of the following is most like this new hormone?

 

a. growth hormone
b. luteinising hormone
c. antidiuretic hormone
d. adrenaline

 

REF: p 226

 

  1. Which of the following is a protein hormone?

 

a. cortisol
b. aldosterone
c. testosterone
d. insulin

 

REF: p 227

 

  1. Gonadotrophin-releasing hormone from the hypothalamus stimulates the anterior pituitary to release:

 

a. growth hormone.
b. follicle-stimulating hormone.
c. thyroid-stimulating hormone.
d. oxytocin.

 

REF: p 229

 

  1. Most of the hormones released from the anterior pituitary are trophic hormones that cause intracellular responses in body cells by:

 

a. first stimulating the nervous system to activate target cells.
b. causing increased or decreased secretion of another hormone.
c. exerting direct effects via receptors on tissues and cells.
d. causing upregulation of receptors on target cells.

 

REF: p 227

 

  1. The releasing hormones that are made in the hypothalamus travel to the anterior pituitary via the:

 

a. vessels of the zona fasciculata.
b. neurons in the infundibular stem.
c. median eminence and pars nervosa.
d. hypophyseal portal system.

 

REF: p 227

 

  1. Which one of the following hormones is produced in the hypothalamus?

 

a. adrenocorticotrpic hormone (ACTH)
b. oxytocin
c. prolactin (PRL)
d. thyroid-stimulating hormone (TSH)

 

REF: p 229

 

  1. Target cells for oxytocin are located in the:

 

a. renal tubules.
b. thymus.
c. liver.
d. uterus.

 

REF: p 229

 

  1. Antidiuretic hormone (ADH) and oxytocin are secreted into the bloodstream as active hormones by the:

 

a. anterior pituitary.
b. posterior pituitary.
c. hypothalamus.
d. pineal gland.

 

REF: p 229

 

  1. Removal of the posterior pituitary would cause a decrease in the release of which hormone?

 

a. prolactin (PRL)
b. antidiuretic hormone (ADH)
c. adrenocorticotrophic hormone (ACTH)
d. growth hormone (GH)

 

REF: p 229

 

  1. ADH release from the posterior pituitary is stimulated by:

 

a. low blood pressure sensed by baroreceptors in the kidneys.
b. high serum osmolarity sensed by osmoreceptors in the hypothalamus.
c. low osmolarity sensed by osmoreceptors in the kidneys.
d. high concentration of potassium sensed by chemoreceptors in the carotid body.

 

REF: p 230

 

  1. Antidiuretic hormone is important in:

 

a. the body’s water balance and urine concentration.
b. maintaining electrolyte levels and concentrations.
c. follicular maturation.
d. regulation of metabolic processes.

 

REF: p230

 

  1. A 50-year-old male patient is deficient in ADH production. Which of the following would be an expected symptom?

 

a. increased blood volume
b. increased urine osmolality
c. increased urine volume
d. increased arterial vasoconstriction

 

REF: p 230

 

  1. High levels of thyroxine (T4) inhibit the release of thryrotrophin-releasing hormone (TRH) and thyroid-stimulating hormone (TSH). This way of controlling thyroid hormone release is an example of:

 

a. positive feedback.
b. negative feedback.
c. neural regulation.
d. substrate regulation.

 

REF: p 225

 

  1. A 45-year-old female has elevated thyroxine production. Which of the following would accompany this condition?

 

a. increased thyrotrophin-releasing hormone (TRH)
b. increased anterior pituitary stimulation
c. decreased triiodothyrinine (T3)
d. decreased thyroid-stimulating hormone (TSH)

 

REF: p 232

 

  1. An essential ingredient for thyroid hormone synthesis is:

 

a. zinc.
b. sodium.
c. iodine.
d. calcium.

 

REF: p 231

 

  1. A 70-year-old female has brittle bones secondary to osteoporosis. Her doctor prescribes calcitonin to:

 

a. activate vitamin D.
b. stimulate osteoclastic activity.
c. inhibit calcium resorption from bones.
d. promote thyroid hormone release.

 

REF: p 233

 

  1. Which of the following alterations would slow down the rate of parathyroid hormone secretion?

 

a. increased serum calcium levels
b. decreased serum calcium levels
c. decreased levels of TSH
d. increased levels of TSH

 

REF: p 233

 

  1. A 40-year-old male undergoes surgery for removal of a parathyroid hormone-secreting tumour. Which of the following would be expected following surgery?

 

a. increased serum calcium
b. decreased bone formation
c. decreased calcium reabsorption in the kidney
d. increased calcitonin

 

REF: p 233

 

  1. Insulin is primarily regulated by:

 

a. metabolic rate.
b. serum glucose levels.
c. prostaglandins.
d. enzyme activation.

 

REF: p 235

 

  1. A 30-year-old male is diagnosed with a hormone-secreting tumour of the pancreas alpha cells. Which of the following would most likely be increased in this patient?

 

a. amylin
b. glucagon
c. insulin
d. somatostatin

 

REF: p 236

 

  1. The most potent naturally occurring glucocorticoid is:

 

a. aldosterone.
b. testosterone.
c. cortisol.
d. prolactin.

 

REF: p 237

 

  1. A 39-year-old female underwent surgery to remove an adrenal tumour. To completely remove it, the zona glomerulosa had to be removed. Secretion of which of the following hormones would be expected to decrease?

 

a. aldosterone
b. cortisol
c. adrenaline
d. testosterone

 

REF: p 237

 

  1. Adrenocorticotrophic hormone (ACTH) release can be stimulated by:

 

a. high serum levels of cortisol.
b. hypotension.
c. hyperglycaemia.
d. stress.

 

REF: p 238

 

  1. The main site of aldosterone synthesis is the:

 

a. liver.
b. kidneys.
c. adrenal cortex.
d. hypothalamus.

 

REF: p 237

 

  1. A 50-year-old male with one kidney had to undergo surgery for an adrenal tumour. His zona glomerulosa was largely removed during the surgery. Which of the following would most likely occur?

 

a. hypernatraemia
b. dehydration
c. hypokalaemia
d. alkalosis

 

REF: p 238

 

  1. Aldosterone secretion is regulated by:

 

a. the sympathetic nervous system.
b. adrenocorticotrophic hormone (ACTH).
c. the renin-angiotensin system.
d. positive feedback control systems.

 

REF: p 238

 

  1. Which of the following hormones is secreted by the adrenal medulla?

 

a. cortisol
b. adrenaline
c. androgens
d. oestrogens

 

REF: p 240

 

  1. Catecholamines promote:

 

a. nutrient absorption.
b. fluid retention.
c. hypotension.
d. hyperglycaemia.

 

REF: p 240

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 11: Alterations of endocrine function across the life span

 

Test Bank

 

MULTIPLE CHOICE

 

  1. Abnormal responses to a hormone by target cells include:

 

a. abnormal receptor activity.
b. abnormal hormone levels.
c. increased synthesis of second messengers.
d. extracellular electrolyte alterations.

 

REF: p 245

 

  1. The most common cause of elevated levels of antidiuretic hormone (ADH) secretion is:

 

a. autoimmune disease.
b. cancer.
c. pregnancy.
d. heart failure.

 

REF: p 246

 

  1. A 54-year-old patient with pulmonary tuberculosis (lung infection) is evaluated for syndrome of inappropriate ADH secretion (SIADH). Which of the following electrolyte imbalances would be expected in this patient?

 

a. hyponatraemia
b. hyperkalaemia
c. hypernatraemia
d. hypokalaemia

 

REF: p 246

 

  1. A 54-year-old patient with pulmonary tuberculosis (lung infection) is evaluated for SIADH. Which of the following clinical manifestations would be expected in this patient?

 

a. peripheral oedema
b. tachycardia
c. low blood pressure
d. concentrated urine

 

REF: p 246

 

  1. A severe consequence of SIADH is:

 

a. stroke.
b. diabetes insipidus.
c. neurologic damage.
d. renal failure.

 

REF: p 246

 

  1. A 22-year-old male is admitted to the intensive care unit with a closed head injury sustained in a motorcycle accident. The injury has caused severe damage to the posterior pituitary. Which of the following complications should be anticipated?

 

a. dilutional hyponatraemia
b. dehydration from polyuria
c. cardiac arrest from hyperkalaemia
d. metabolic acidosis

 

REF: p 246

 

  1. A side effect of some general anesthetic agents is _____ diabetes insipidus.

 

a. neurogenic
b. nephrogenic
c. psychogenic
d. allogenic

 

REF: p 247

 

  1. Clinical manifestations of diabetes insipidus include:

 

a. polyuria and intense thirst.
b. concentrated urine and hypertension.
c. pitting oedema and dyspnoea.
d. full bounding pulse and vomiting.

 

REF: p 247

 

  1. A 50-year-old male patient presents with polyuria and extreme thirst. He was given exogenous ADH. For which of the following would this treatment be effective?

 

a. neurogenic diabetes insipidus
b. psychogenic diabetes insipidus
c. nephrogenic diabetes insipidus
d. syndrome of inappropriate antidiuretic hormone

 

REF: p 248

 

  1. The most common cause of primary hyperaldosteronism (Conn’s syndrome) is:

 

a. pituitary failure.
b. benign adrenal adenoma.
c. excessive salt ingestion.
d. chronic hypertension.

 

REF: p 248

 

  1. Laboratory investigation of a patient with hyperaldosteronism would reveal:

 

a. hypokalaemia.
b. hyperkalaemia.
c. hyponatraemia.
d. decreased urinary potassium.

 

REF: p 248

 

  1. Characteristic physical features of individuals with Cushing’s syndrome include:

 

a. weight loss and muscle wasting.
b. truncal obesity and thin skin.
c. pallor and swollen tongue.
d. depigmented skin and eyelid lag.

 

REF: p 250

 

  1. A 49-year-old female is diagnosed with hypercortisolism. An increase in which of the following would be expected?

 

a. protein catabolism and muscle wasting
b. fat storage and glucose utilisation
c. production and secretion of adrenal medullary hormones
d. fat, protein and carbohydrate anabolism

 

REF: p 250

 

  1. Cushing’s disease can manifest with elevated levels of:

 

a. antidiuretic hormone.
b. oxytocin.
c. adrenocorticotrophic hormone (ACTH).
d. aldosterone.

 

REF: p 249

 

  1. A 50-year-old female presents with lightheadedness and overall abnormal feelings. CT scan reveals an adrenal cortical tumour. Lab tests reveal that the tumour is hormone secreting. Which of the following would be expected?

 

a. increased renin levels
b. hypotension
c. hypokalaemia
d. hyponatraemia

 

REF: p 248

 

  1. A 35-year-old female took corticosteroid therapy for several months. Which of the following would be expected?

 

a. renal toxicity
b. episodes of hypoglycaemia
c. increased bone density
d. type 2 diabetes mellitus

 

REF: p 250

 

  1. Which of the following alterations would you expect to find in a patient with untreated Cushing’s disease or syndrome?

 

a. bradycardia
b. tachypnoea
c. hyperkalaemia
d. hypertension

 

REF: p 251

 

  1. A 12-year-old female is newly diagnosed with type 1 diabetes mellitus. Which of the following is the most likely cause of her disease?

 

a. a familial, autosomal dominant gene defect
b. obesity and lack of exercise
c. immune destruction of the pancreas
d. hyperglycaemia from eating too many sweets

 

REF: p 253

 

  1. A 12-year-old male is newly diagnosed with type 1 diabetes mellitus. Which of the following is most beneficial in confirming the diagnosis?

 

a. fasting and postprandial plasma glucose levels
b. testing urine glucose levels
c. genetic testing
d. random plasma glucose levels

 

REF: p 254

 

  1. An 11-year-old male is newly diagnosed with type 1 diabetes mellitus. Before treatment he most likely experienced:

 

a. recurrent infections, visual changes, fatigue and paraesthesias.
b. polydipsia, polyuria, polyphagia, and weight loss.
c. vomiting, abdominal pain, fruity breath, dehydration and heavy breathing.
d. weakness, vomiting, hypotension, and mental confusion.

 

REF: p 253

 

  1. A 19-year-old female with type 1 diabetes mellitus was admitted to hospital with the following lab values: serum glucose 18 mmol/L (high); serum K+ 2 mmol/L (low); serum Na+ 130 mmol/L (low). Her parents state that she has been sick with the ‘flu’ for a week. What relationship do these values have with her insulin deficiency?

 

a. increased glucose utilisation causes the shift of fluid from the intravascular to the intracellular space
b. decreased insulin causes hyperglycaemia and osmotic diuresis
c. increased glucose and fatty acid metabolism stimulates renal diuresis and electrolyte loss
d. increased insulin use results in protein catabolism, tissue wasting and electrolyte loss

 

REF: p 253

 

  1. Management of diabetes mellitus involves measuring glycated (glycosylated) haemoglobin (haemoglobin A1c) levels. The purpose of this test is to:

 

a. measure fasting glucose levels.
b. monitor long-term serum glucose control.
c. detect acute complications of diabetes.
d. check for hyperlipidaemia.

 

REF: p 254

 

  1. A 35-year-old female with Graves’ disease is admitted to a medical-surgical unit. Laboratory tests would most likely reveal:

 

a. high levels of circulating thyroid-stimulating antibodies.
b. ectopic secretion of thyroid-stimulating hormone (TSH).
c. low circulating levels of thyroid hormones.
d. stimulation of thyroid-binding globulin.

 

REF: p 255

 

  1. The level of triiodothyronine (T3) in Graves’ disease is usually abnormally:

 

a. low.
b. high.
c. variable.
d. absent.

 

REF: p 255

 

  1. Visual disturbances are a common occurrence in patients with untreated Graves’ disease. The main cause of these complications is:

 

a. decreased blood flow to the eye.
b. orbital oedema and extraocular muscle paralysis.
c. thyroid-stimulating hormone neurotoxicity to retinal cells.
d. localised lactic acidosis.

 

REF: p 256

 

  1. A 35-year-old female with Graves’ disease is admitted to a medical-surgical unit. Which of the following symptoms would be expected before treatment?

 

a. weight gain, cold intolerance
b. slow heart rate, rash
c. skin hot and moist, rapid heart rate
d. constipation, confusion

 

REF: p 255

 

  1. A 25-year-old female with Graves’ disease is admitted to a medical-surgical unit. Palpation of her neck would most likely reveal:

 

a. a normal-sized thyroid.
b. a small discrete thyroid nodule.
c. multiple discrete thyroid nodules.
d. diffuse thyroid enlargement.

 

REF: p 256

 

  1. The basal metabolic rate is unusually _____ with hypothyroidism.

 

a. high
b. low
c. steady
d. variable

 

REF: p 259

 

  1. A problem associated with chronic hyperparathyroidism is:

 

a. seizure disorder.
b. vitamin D malabsorption.
c. hyponatraemia.
d. osteoporosis and pathologic fractures.

 

REF: p 261

 

  1. Hypoparathyroidism is most commonly caused by:

 

a. pituitary hyposecretion.
b. parathyroid adenoma.
c. parathyroid gland injury.
d. hypothalamic inactivity.

 

REF: p 262

 

  1. A 45-year-old female with Graves’ disease underwent surgical removal of her thyroid gland. During the postoperative period, her serum calcium was low. The most probable reason for her low serum calcium is:

 

a. hyperparathyroidism secondary to Graves’ disease.
b. myxedema secondary to surgery.
c. hypoparathyroidism caused by surgical injury to the parathyroid glands.
d. hypothyroidism resulting from lack of thyroid replacement.

 

REF: p 262

 

  1. A 30-year-old female with Graves’ disease is admitted to your hospital unit for the surgical removal of her thyroid gland. During the postoperative period, you note that her serum calcium is low. She should be observed for which of the following signs/symptoms?

 

a. muscle weakness and constipation
b. laryngeal spasms and hyperreflexia
c. abdominal pain
d. anorexia, nausea and vomiting

 

REF: p 263

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 12: The structure and function of the immune system

 

Test Bank

 

MULTIPLE CHOICE

 

  1. Which of the following is not a component of the innate immune system?

 

a. B cells
b. skin
c. phagocytes
d. natural killer cells

 

REF: p 271

 

  1. Which of the following is an example of biochemical secretions that trap and kill microorganisms?

 

a. hormones
b. phagocytic cells
c. earwax
d. gastric acid

 

REF: p 272

 

  1. A 25-year-old female presents to her GP complaining of vaginal discharge of a white, viscous, and foul-smelling substance. She reports that she has been taking antibiotics for the past 6 months. Which of the following is the most likely reason for her discharge?

 

a. Staphylococcus overgrowth
b. decreased Lactobacillus, allowing Candida albicans overgrowth
c. Streptococcus overgrowth
d. decreased Candida albicans, causing Lactobacillus overgrowth

 

REF: p 272

 

  1. Which of the following cells is capable of engulfing pathogens and debris?

 

a. T cells
b. mast cells
c. basophils
d. macrophages

 

REF: p 272

 

  1. The function of a natural killer cell is to:

 

a. phagocytose pathogens and debris.
b. produce antibodies.
c. kill virus-infected and cancer cells.
d. regulate the function of T cells.

 

REF: p 272

 

  1. Interferon alpha:

 

a. signals to macrophages
b. boosts the function of the lymph nodes.
c. induces the production of anti-viral proteins.
d. activates the thymus.

 

REF: p 273

 

  1. Interleukins are an example of:

 

a. a type of white blood cell.
b. a cytokine.
c. gut-associated lymphoid tissue.
d. an MHC molecule.

 

REF: p 274

 

  1. Memory and specificity are characteristics of:

 

a. natural killer cells.
b. B and T cells.
c. antigen-presenting cells.
d. phagocytes.

 

REF: p 275

 

  1. Antigens that are too small to activate the immune system by themselves but become immunogenic after combining with larger molecules are called:

 

a. haptens.
b. epitopes.
c. MHC molecules.
d. interleukins.

 

REF: p 276

 

  1. A molecule is isolated from the human body and studied. It is found to react with antibodies on B cells. Further testing reveals that the molecule is large and chemically diverse. Which of the following would best describe the molecule?

 

a. antigen
b. immunogen
c. epitope
d. mimotope

 

REF: p 275

 

  1. Which of the following can increase an antigen’s ability to be immunogenic?

 

a. small size
b. minimal chemical complexity
c. combining with carrier molecules
d. extremely high concentrations

 

REF: p 276

 

  1. Which of the following cells is responsible for presenting the antigen to the immune cells?

 

a. antibodies
b. B cells
c. macrophages
d. lymphocytes

 

REF: p 278

 

  1. Both B and T cells are originally derived from cells of the:

 

a. bone marrow.
b. lymph nodes.
c. gut-associated lymphoid tissue.
d. thymus.

 

REF: p 277

 

  1. An experiment is designed to determine specific cell types involved in cell-mediated immune response. The experimenter is interested in finding cells that attack cells that have specific antigens. Which cells should be isolated?

 

a. lymphokine-producing cells
b. cytotoxic T cells
c. helper T cells
d. B cells

 

REF: p 278

 

  1. Which of the following is not a secondary lymph organ?

 

a. spleen
b. peyer patches
c. adenoids
d. liver

 

REF: p 277

 

  1. After exposure to a specific antigen, B cells differentiate into___ and _______:

 

a. B cytotoxic cells, directly kill their target.
b. clonal equivalents,  await further instructions.
c. plasma cells, produce antibodies.
d. bursal cells, produce immunoglobulins.

 

REF: p 278

 

  1. A 6-year-old female is diagnosed with a bacterial infection of the respiratory system. Which of the following will most likely try to fight the antigen?

 

a. B cells and antibodies
b. cytotoxic T cells
c. NK cells
d. helper T cells

 

REF: p 279

 

  1. Humoral immunity refers to:

 

a. the production of cytotoxic T cells.
b. the production of circulating antibodies.
c. the circulation of antigen-presenting cells.
d. the production of cell-signalling molecules.

 

REF: p 279

 

  1. The most abundant class of antibody in the serum is:

 

a. IgG.
b. IgM.
c. IgA.
d. IgE.

 

REF: p 280

 

  1. The predominant antibody of a typical primary immune response is:

 

a. IgG.
b. IgM.
c. IgA.
d. IgE.

 

REF: p 280

 

  1. The primary role of secretory IgA is to prevent infections in:

 

a. blood vessels.
b. the kidneys.
c. the lungs.
d. mucous membranes.

 

REF: p 280

 

  1. A 23-year-old pregnant female visits her doctor for her final prenatal checkup. The doctor determines that the fetus has developed an infection in utero. Which of the following would be increased in the fetus at birth?

 

a. IgG
b. IgA
c. IgM
d. IgD

 

REF: p 280

 

  1. A 10-year-old male is stung by a bee while playing in the yard. He experiences a severe allergic reaction and has to go to the ED. The immunoglobulin involved in this response is:

 

a. IgG.
b. IgA.
c. IgE.
d. IgM.

 

REF: p 280

 

  1. A 20-year-old female is applying for nursing school and is required to be tested for immunity against several illnesses. Testing that looks at which of the following would be the best to determine her state of immunity?

 

a. Neutralisation of antibodies
b. Agglutination of antibodies
c. Precipitation of antibodies
d. Titre of antibodies

 

REF: p 282

 

  1. A 25-year-old female has sexual intercourse with her boyfriend. Later she is told by her boyfriend that he is infected with Neisseria gonorrhoeae. Testing reveals that she does not have the disease. How is it possible that she did not contract the disease?

 

a. Antibodies covered the bacterial sites of attachment.
b. She was vaccinated against it.
c. Antibodies activated inflammatory components.
d. IgE was released.

 

REF: p 282

 

  1. Histocompatibility antigens help the immune system:

 

a. determine whether to mount a primary or secondary response.
b. identify haptens.
c. recognise different blood types.
d. distinguish self from nonself.

 

REF: p 275

 

  1. A patient is diagnosed with cancer. Which of the following cell types would be produced in the greatest number?

 

a. CD8 (cytotoxic) T cells
b. B cells
c. Antigen presenting cells
d. Macrophages

 

REF: p 284

 

  1. A 20-year-old female has been diagnosed with AIDS. HIV has been shown to diminish helper T cell (CD4) number. How would this affect her immune system?

 

a. Her cell-mediated immunity would be reduced.
b. Her humoral immunity would be reduced.
c. The helper T cell activates humoral and cytotoxic immunities when appropriate, so both would be affected.
d. The helper T cells are not affected with HIV.

 

REF: p 283

 

  1. A CD8 cell was isolated and analysed for major histocompatibility complex. Which of the following would be expected?

 

a. MHC I only
b. MHC II only
c. MHC I and II
d. neither MHC I or MHC II

 

REF: p 284

 

  1. A cell that is produced in the thymus and interacts with MHC II molecules would have which of the following surface proteins?

 

a. CD4
b. CD8
c. Th1
d. superantigen

 

REF: p 283

 

  1. An infant is brought to a paediatrician for recurrent colds. The child is fed formula, and the other family members have not been ill. The illness is likely to have resulted from the fact that the maternal antibodies deplete after about:

 

a. 4 months.
b. 6 months.
c. 10 months.
d. 12 months.

 

REF: p 287

 

  1. Increased age is associated with:

 

a. increased T cell function.
b. increased hypersensitivity responses.
c. decreased production of autoantibodies.
d. decreased numbers of circulating immune complexes.

 

REF: p 288

 

  1. A 5-month-old child is admitted to hospital with recurring respiratory infections. A possible cause of this condition is:

 

a. hypergammaglobulinaemia.
b. increased maternal IgG.
c. immune insufficiency.
d. decreased maternal antibody breakdown, resulting in hyposensitivity.

 

REF: p 287

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 13: Inflammation and fever

 

Test Bank

 

MULTIPLE CHOICE

 

  1. What 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

 

REF: p 292

 

  1. A child fell off a swing and scraped her knee. The injured area becomes red and painful. Which of the following would also occur?

 

a. vasoconstriction
b. decreased red blood cell concentration at the injured site
c. fluid movement from tissue to vessels
d. fluid movement from vessels to tissues

 

REF: p 292

 

  1. The mast cell, a major activator of inflammation, initiates the inflammatory response through the process of:

 

a. cytokinesis.
b. endocytosis.
c. degranulation.
d. haemolysis.

 

REF: p 295

 

  1. A 13-year-old fell on her knee while skating. The area became inflamed and sore to touch. Which of the following would result from activation of the plasma system secondary to her injury?

 

a. mast cell degranulation
b. release of cellular products
c. cellular infiltration
d. pathogenic invasion

 

REF: p 295

 

  1. A 20-year-old apprentice shoots their hand with a nail gun while replacing roofing shingles. Which of the following cell types would be the first to aid in killing bacteria to prevent infection in their hand?

 

a. eosinophils
b. neutrophils
c. leukotrienes
d. monocytes

 

REF: p 295

 

  1. The predominant phagocyte of early inflammation is the:

 

a. eosinophil.
b. neutrophil.
c. lymphocyte.
d. macrophage.

 

REF: p 295

 

  1. A 10-year-old male is diagnosed with a large tapeworm. Which of the following cells would be produced in response to this worm?

 

a. monocytes
b. eosinophils
c. neutrophils
d. natural killer cells

 

REF: p 297

 

  1. The directional movement of cells in response to a chemical gradient is termed:

 

a. chemotaxis.
b. immigration.
c. margination.
d. diapedesis.

 

REF: p 299

 

  1. Histamine is released from:

 

a. eosinophils.
b. mast cells.
c. lymphocytes.
d. natural killer cells.

 

REF: p 299

 

  1. The phagocyte’s role begins when the inflammatory response causes it to stick avidly to capillary walls in a process called:

 

a. margination.
b. exudation.
c. diapedesis.
d. emigration.

 

REF: p 297

 

  1. Which of the following is a consequence of histamine release?

 

a. stimulation of pain receptors
b. fever
c. increased capillary permeability
d. decreased platelet adhesion and aggregation

 

REF: p 299

 

  1. A 25-year-old female experiences a headache and takes aspirin for relief. Which of the following effects will relieve the headache?

 

a. decreased leukotriene production
b. increased histamine release
c. decreased prostaglandin production
d. increased platelet-activating factor

 

REF: p 300

 

  1. Leukotrienes differ from histamine in which of the following ways?

 

a. site of production
b. vascular effect is more localised with histamine
c. chemotactic ability is more powerful with leukotrienes
d. they have a later and prolonged response

 

REF: p 301

 

  1. An infant develops a fever secondary to a bacterial infection. Which of the following most likely triggered the fever?

 

a. interleukin-1
b. interleukin-6
c. interleukin-10
d. interferons

 

REF: p 300

 

  1. A 25-year-old male is in a car accident and sustains a fracture to his left femur with extensive soft-tissue injury. The pain associated with the injury is related to:

 

a. histamine and serotonin.
b. kinins and prostaglandins.
c. vasoconstriction.
d. immune complex formation.

 

REF: p 303

 

  1. The complement system, clotting system and kinin system share which of the following characteristics?

 

a. activation of an inactive first component
b. phagocytosis initiation
c. granulocyte production
d. activated by interferon

 

REF: p 303

 

  1. The end product of the clotting system is:

 

a. plasmin.
b. fibrin.
c. collagen.
d. factor X.

 

REF: p 303

 

  1. A 5-year-old male is diagnosed with a bacterial infection. Cultures of the bacteria revealed lipopolysaccharides on the bacterial cell surface. Which of the complement pathways would be activated in this case?

 

a. classical pathway
b. lectin pathway
c. alternative pathway
d. kinin pathway

 

REF: p 303

 

  1. Opsonins are molecules that:
a. are composed of fatty acids.
b. regulate inflammation.
c. degranulate mast cells.
d. enhance phagocytosis.

 

REF: p 303

 

  1. The classic pathway of the complement system is activated by:

 

a. histamine.
b. antigen-antibody complexes.
c. leukotrienes.
d. prostaglandins.

 

REF: p 303

 

  1. The primary actions of the complement cascade include:

 

a. increased vascular permeability and vasodilation, chemotaxis, opsonisation and cell lysis.
b. mast cell degranulation, activation of T cells, formation of immunoglobulins and angiogenesis.
c. phagocytosis, clotting, macrophage activation and vasodilation.
d. release of pyrogens, prostaglandins and stimulation of fibroblasts.

 

REF: p 303

 

  1. Bradykinin is involved in:
a. increasing vascular permeability.
b. vasoconstriction.
c. stimulating the clotting system.
d. increasing degradation of prostaglandins.

 

REF: p 303

 

  1. A 35-year-old male is diagnosed with lobar pneumonia (lung infection). Which of the following exudates would be present in highest concentration at the site of this advanced inflammatory response?

 

a. serous
b. purulent
c. haemorrhagic
d. fibrinous

 

REF: p 305

 

  1. During inflammation, the liver is stimulated to release plasma proteins, collectively known as:

 

a. opsonins.
b. acute phase reactants.
c. antibodies.
d. inflammatory enzymes.

 

REF: p 306

 

  1. Heat loss is achieved through:

 

a. decreased respiratory rate.
b. radiation.
c. shivering.
d. peripheral vasoconstriction.

 

REF: p 306

 

  1. Hyperthermia is:

 

a. caused by infection.
b. associated with fluid overload.
c. associated with vasoconstriction.
d. not associated with pyrogens.

 

REF: p 306

 

  1. A pyrogen:

 

a. increases serum copper, zinc and iron levels.
b. causes fever.
c. slows down the transformation of lymphocytes.
d. decreases prostaglandin production.

 

REF: p 309

 

  1. A 12-year-old male is fighting with another child when he receives a puncture wound from a pencil. The school nurse cleans and bandages the wound. After about a week the wound has closed. What cell type helps with this process??

 

a. Contractile cells
b. Subdermal reactant cells
c. Myofibroblasts
d. Epithelial cells

 

REF: p 312

 

  1. A patient with diabetes generally expresses impaired wound healing caused by a lack of:

 

a. glucose, required for leucocyte chemotaxis.
b. vitamin E, required for skin healing
c. vitamin K, required for blood clotting
d. pyridoxine, required for DNA synthesis

 

REF: p 313

 

  1. A 30-year-old male was involved in a motor vehicle accident. The glass from the shattered window cut his face and neck. The scar, however, was raised and extended beyond the original boundaries of the wound. This pattern of scarring is caused by:

 

a. nutritional deficiency.
b. impaired collagen synthesis.
c. impaired epithelialisation.
d. impaired contraction.

 

REF: p 313

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 14: Infection

 

Test Bank

 

MULTIPLE CHOICE

 

  1. An infectious disease that spreads rapidly and widely throughout the world is termed a(n):

 

a. superinfection.
b. pandemic.
c. epidemic.
d. opportunistic infection.

 

REF: p 320

 

  1. The microorganisms that make up the normal human flora are important for:

 

a. regulating inflammation.
b. secreting bacteriostatic substances.
c. activating white blood cells.
d. preventing colonisation of pathogens.

 

REF: p 320

 

  1. The potency of a pathogen measured in terms of the number of microorganisms required to kill a host is termed:

 

a. pathogenicity.
b. immunogenicity.
c. virulence.
d. LD50.

 

REF: p 321

 

  1. A patient is infected by a microorganism that is motile. The microbe would be a:

 

a. virus.
b. prion.
c. bacterium.
d. fungi.

 

REF: p 323

 

  1. Some bacterial pathogens can defend themselves from an immune response by:

 

a. producing capsules.
b. phagocytosis.
c. retreating.
d. developing antibodies.

 

REF: p 323

 

  1. A 5-year-old male becomes ill with a severe cough. Histological examination reveals a bacterial infection and further laboratory testing reveals cell membrane damage and decreased protein synthesis. Which of the following is the most likely cause of this illness?

 

a. endotoxin
b. exotoxin
c. toxoid
d. septicemia

 

REF: p 324

 

  1. Endotoxins are produced by ______ and are made of __________:

 

a. gram-negative bacteria, lipopolysaccharide
b. gram-positive bacteria, protein.
c. gram-negative bacteria, protein
d. gram-positive bacteria, lipopolysaccharide.

 

REF: p 324

 

  1. A 50-year-old female experiences decreased blood pressure, decreased oxygen delivery, cardiovascular shock and subsequent death. Which of the following is the most likely cause?

 

a. gram-positive bacteria
b. fungi
c. gram-negative bacteria
d. virus

 

REF: p 325

 

  1. A patient is infected by a microorganism that contains RNA or DNA and has no organelles. The microbe would be a:

 

a. virus.
b. bacterium.
c. protozoan.
d. yeast.

 

REF: p 327

 

  1. Viruses:

 

a. contain mitochondria.
b. are capable of independent reproduction.
c. replicate their genetic material inside host cells.
d. are easily killed by antimicrobials.

 

REF: p 327

 

  1. Varicella, the virus that causes chicken pox:

 

a. integrates its DNA with the host cell DNA.
b. can replicate outside the host cell.
c. replicates using reverse transcriptase.
d. lives in the cytoplasm.

 

REF: p 327

 

  1. A 25-year-old female reports having unprotected sexual intercourse with several men. Blood tests reveal she is positive for human papilloma virus. Which of the following may occur because of the infection?

 

a. vaginal discharge
b. liver failure
c. immunodeficiency
d. cancer

 

REF: p 327

 

  1. A patient has been treated with antibiotics for an ongoing illness, and has also been diagnosed with thrush (candidiasis). Which of the following may explain what has happened?

 

a. The thrush is unrelated to her antibiotic treatment.
b. The Candida has utilised the antibiotics as a food source and grown rapidly.
c. The Candida must have become resistant to the antibiotics.
d. Her vaginal bacterial flora have been affected and allowed the overgrowth of the Candida yeast.

 

REF: p 329

 

  1. Fungi causing deep or systemic infections:

 

a. are easily treated with penicillin.
b. are extremely rare.
c. never occur with other infections.
d. are commonly opportunistic.

 

REF: p 329

 

  1. A patient develops superficial mycoses. The infection is:

 

a. viral.
b. bacterial.
c. fungal.
d. algal.

 

REF: p 329

 

  1. When genes from different strains of a viruses recombine to cause major changes in antigenicity, this is termed:

 

a. antigenic drift.
b. antigenic shift
c. pathogenicity.
d. class switching.

 

REF: p 329

 

  1. The hallmark symptom of most infectious diseases is:

 

a. fever.
b. jaundice.
c. vomiting.
d. pain.

 

REF: p 329

 

  1. A bacteriostatic drug:

 

a. kills bacteria.
b. mimics a section of host cell DNA.
c. stops bacterial replication.
d. interferes with cell wall synthesis.

 

REF: p 332

 

  1. Most viral vaccines contain:

 

a. active viruses.
b. attenuated viruses.
c. killed viruses.
d. viral toxins.

 

REF: p 332

 

  1. When a person is given an attenuated antigen as a vaccine, the antigen is:

 

a. alive but less infectious.
b. mutated but highly infectious.
c. normal but not infectious.
d. inactive but infectious.

 

REF: p 332

 

  1. Most bacterial vaccines contain:

 

a. active bacteria.
b. attenuated bacteria.
c. dead bacteria.
d. bacterial toxins.

 

REF: p 333

 

  1. Which of the following pathogens can cause gastritis and peptic ulcer?

 

a. Escherichia coli
b. respiratory syncytial virus
c. Staphylococcus aureus
d. Helicobacter pylori

 

REF: p 335

 

  1. The most common cause of community-acquired urinary tract infections is:

 

a. Escherichia coli.
b. respiratory syncytial virus.
c. Staphylococcus aureus.
d. Helicobacter pylori.

 

REF: p 336

 

  1. Bacteria become resistant to antimicrobials by:

 

a. proliferation.
b. attenuation.
c. specialisation.
d. mutation.

 

REF: p 336

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 15: Alterations of immune function across the life span

 

Test Bank

 

MULTIPLE CHOICE

 

  1. Hypersensitivity is best defined as:

 

a. a reduced immune response found in most pathologic states.
b. a normal immune response to an infectious agent.
c. an excessive or inappropriate response of the immune system to a sensitising antigen.
d. antigenic desensitisation.

 

REF: p 341

 

  1. Seasonal allergic rhinitis is expressed through:

 

a. IgE-mediated reactions.
b. tissue-specific reactions.
c. antigen-antibody complexes.
d. type II hypersensitivity reactions.

 

REF: p 343

 

  1. A 10-year-old male presents to his GP complaining of wheezing and difficulty breathing. History reveals that both of the child’s parents suffer from allergies. Which of the following terms would be used to classify the child?

 

a. autosensitive
b. atopic
c. attenuated
d. immunodeficient

 

REF: p 343

 

  1. A 25-year-old female is suffering from rhinitis. Which of the following would be an expected symptom?

 

a. bronchial dilation
b. oedema
c. vasoconstriction
d. constipation

 

REF: p 343

 

  1. A 10-year-old male is stung by a bee while playing in the yard. He begins itching and develops pain, swelling, redness, low blood pressure and respiratory difficulties. He is suffering from:

 

a. alloimmunity.
b. autoimmunity.
c. anaphylaxis.
d. tissue-specific hypersensitivity.

 

REF: p 344

 

  1. The most severe consequence of a type I hypersensitivity reaction is:

 

a. urticaria.
b. hives.
c. anaphylaxis.
d. antibody-dependent cell-mediated cytotoxicity (ADCC).

 

REF: p 344

 

7 If both rhinitis and bee stings both use type I reactions, why do the responses differ so greatly?

 

a. Bee stings are a contact allergy, so are more severe.
b. Systemic exposure (bee sting) gives a widespread reaction for anaphylaxis.
c. Local exposure causes less serious responses in small areas of the body.
d. Both b and c are correct.

 

REF: p 344

 

  1. A 25-year-old female is suffering from anaphylaxis and uses an EpiPen to treat it. Which of the following is an action of adrenaline?

 

a. bronchodilation
b. increased capillary permeability
c. decreased blood pressure
d. redness

 

REF: p 344

 

  1. A 30-year-old female presents to her GP complaining of fatigue, excessive sweating and increased appetite. Physical examination reveals protruding eyes, and laboratory testing reveals hyperthyroidism secondary to autoantibody production. This disorder falls into which of the following categories?

 

a. type I hypersensitivity
b. type II hypersensitivity
c. type III hypersensitivity
d. type IV hypersensitivity

 

REF: p 345

 

  1. A 55-year-old woman suspected of having active tuberculosis has a positive Mantoux test. Which of the following immune reactions is she experiencing?

 

a. IgE-mediated
b. tissue-specific
c. immune complex
d. cell-mediated

 

REF: p 346

 

  1. Which of the following hypersensitivity reactions does not involve an antibody response?

 

a. type I
b. type II
c. type III
d. type IV

 

REF: p 345

 

  1. Contact dermatitis is an example of which type of immune disorder, and what is the most common allergen for this sensitivity type in Australia?

 

a. autoimmune, so there is no allergen
b. complement deficiency, so this is not related to an external allergen
c. type III hypersensitivity, antibodies
d. type IV hypersensitivity, nickel

 

REF: p 346

 

  1. A 45-year-old male is given an organ transplant. After a period of months with checkups, a follow-up biopsy of the organ demonstrates cellular infiltration characteristic of a cell-mediated response. What type of rejection is occurring?

 

a. type II hyperacute rejection
b. type I anaphylactic
c. type IV acute rejection
d. type IV chronic rejection

 

REF: p 347

 

  1. If a person has type O blood, she is likely to have high titres (levels) of anti-_____ antibodies.

 

a. A only
b. B only
c. A and B
d. O

 

REF: p 348

 

15 AB blood type people produce:

 

a. A antibodies only.
b. O antibodies only.
c. both A and B antibodies, which is why they are defined as an AB blood group.
d. no A or B antibodies, or they would destroy their own red cells.

 

REF: p 348

 

  1. In addition to matching ABO antigens, a blood transfusion must also be matched for:

 

a. HLA type.
b. Rh antigen.
c. immunoglobulins.
d. platelet compatibility.

 

REF: p 349

 

  1. A 15-year-old male suffers from severe haemorrhage following a motor vehicle accident. He is given a blood transfusion, but shortly afterwards the red blood cells are destroyed by agglutination and lysis. Which of the following blood type to transfusion type matches would cause this?

 

a. A-A
b. B-O
c. AB-O
d. A-AB

 

REF: p 349

 

  1. Haemolytic disease of the newborn occurs when:

 

a. an Rh positive mother is sensitised against an Rh positive baby.
b. an Rh negative mother is sensitised against an Rh positive baby.
c. an Rh positive mother is sensitised against an Rh negative baby.
d. an Rh negative mother is sensitised against an Rh negative baby

 

REF: p 349

 

  1. People with type AB blood are considered the universal recipients for a transfusion because:

 

a. they lack antibodies to A and B antigens.
b. they lack A and B antigens.
c. they produce anti-A and anti-B antibodies.
d. they lack Rh-D antibodies and antigens

 

REF: p 349

 

  1. Systemic lupus erythematosus (SLE) is an example of:
a. autoimmunity.
b. alloimmunity.
c. homoimmunity.
d. alleimmunity.

 

REF: p 350

 

  1. A 30-year-old female complains of fatigue, arthritis, rash and changes in urine colour. Laboratory testing reveals anaemia, lymphopenia and kidney inflammation. Assuming a diagnosis of SLE, which of the following is also likely to be present?

 

a. anti-LE antibodies
b. autoantibodies
c. antiherpes antibodies
d. anti-CMV antibodies

 

REF: p 350

 

  1. A 40-year-old female is diagnosed with SLE. Which of the following symptoms would be considered a symptom of this disease?

 

a. gastrointestinal ulcers
b. decreased glomerular filtration rate
c. a rash on the face, trunk and extremities
d. photosensitivity

 

REF: p 351

 

  1. Primary immune deficiencies occur as a result of:

 

a. a genetic defect.
b. recurrent infections.
c. chronic disease affecting immune system function.
d. autoantibody production.

 

REF: p 352

 

  1. A common symptom of individuals with immunodeficiency is:

 

a. anaemia.
b. recurrent infections.
c. hypersensitivity.
d. autoantibody production.

 

REF: p 353

 

  1. A 22-year-old prostitute was recently diagnosed with AIDS. A decrease in which of the following cell types would be expected to accompany this virus?

 

a. CD4 T-helper
b. CD8 T-helper
c. CDC cells
d. B cells

 

REF: p 354

 

  1. Which of the following is a characteristic of HIV that causes AIDS?

 

a. HIV only infects T-helper cells.
b. HIV is a retrovirus.
c. Infection does not require a host cell receptor.
d. After infection, cell death is immediate.

 

REF: p 355

 

  1. The period between infection and the appearance of antibodies in the serum is called the:

 

a. early stage.
b. asymptomatic stage.
c. window period.
d. latent period.

 

REF: p 356

 

  1. A 30-year-old male was diagnosed with HIV. Which of the following treatments would be most effective?

 

a. reverse transcriptase inhibitors
b. protease inhibitors
c. entrance inhibitors
d. highly active antiretroviral therapy

 

REF: p 360

 

  1. A 30-year-old male was diagnosed with HIV. Which of the following treatments would be effective?

 

a. reverse transcriptase inhibitors
b. ribavirin
c. cell wall synthesis inhibitors
d. inhibitors of metabolism

 

REF: p 360

 

  1. A 38-year-old male presents with lymphadenopathy, cognitive dysfunction, pneumocytosis and candidiasis. He most likely has:

 

a. herpes simplex encephalopathy
b. a primary immune deficiency
c. an autoimmune disorder
d. HIV infection

 

REF: pp 357-360

 

  1. A malignancy particularly associated with AIDS is:

 

a. rhabdomyosarcoma
b. Kaposi’s sarcoma
c. glioma
d. lung cancer

 

REF: p 357

 

  1. Which of the following is an opportunistic infection associated with AIDS?

 

a. cryptococcus
b. staphylococcus
c. pseudomonas
d. adenovirus

 

REF: p 357

 

  1. HIV-associated cognitive dysfunction is thought to result from:

 

a. atherosclerotic changes to the brain.
b. staphylococcal infection of the brain.
c. neurological malignancies.
d. direct brain infection by the virus.

 

REF: p 360

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 16: The structure and function of the haematological system

 

Test Bank

 

MULTIPLE CHOICE

 

  1. Plasma proteins synthesised by lymphocytes in the lymph nodes are:

 

a. globulins.
b. albumins.
c. clotting factors.
d. complement proteins.

 

REF: p 366

 

  1. The most abundant cells in the blood are:

 

a. leucocytes.
b. lymphocytes.
c. erythrocytes.
d. thrombocytes.

 

REF: p 367

 

  1. A blood sample is analysed in a laboratory. Assuming a normal sample, which type of white blood cell accounts for the highest percentage?

 

a. neutrophils
b. eosinophils
c. monocytes
d. lymphocytes

 

REF: p 367

 

  1. All of the following properties allow erythrocytes to function as gas carriers except:

 

a. biconcavity.
b. reversible deformability.
c. presence of haemoglobin in cytoplasm.
d. presence of many mitochondria.

 

REF: p 369

 

  1. A group of cells is isolated in the laboratory. The cells have membrane-bound granules in their cytoplasm and they show phagocytic activity. Which of the following cells is most similar?

 

a. monocyte
b. macrophage
c. lymphocyte
d. eosinophils

 

REF: p 368

 

  1. The predominant phagocyte of early inflammation is the:

 

a. eosinophil.
b. lymphocyte.
c. macrophage.
d. neutrophil.

 

REF: p 369

 

  1. Which of the following types of white blood cells contain preformed granules of vasoactive amines?

 

a. neutrophils
b. eosinophils
c. monocytes
d. basophils

 

REF: p 370

 

  1. Monocytes are blood cells that mature (differentiate) into:

 

a. macrophages.
b. neutrophils.
c. eosinophils.
d. mast cells.

 

REF: p 370

 

  1. Platelets circulate for approximately:

 

a. 2 days.
b. 10 days.
c. 55 days.
d. 120 days.

 

REF: p 370

 

  1. Kupffer cells are an example of a type of:

 

a. lymphocyte.
b. neutrophil.
c. natural killer cell.
d. macrophage.

 

REF: p 370

 

  1. During an infection, lymph nodes enlarge and become tender because:

 

a. macrophages are rapidly dividing.
b. oedema accumulates within the fibrous capsule.
c. microorganisms are accumulating.
d. the nodes are not functioning properly.

 

REF: p 371

 

  1. The main site of haematopoiesis in the fetus is the:

 

a. bone marrow.
b. liver.
c. lymph nodes.
d. spleen.

 

REF: p 372

 

  1. Which of the following participate in haematopoiesis?

 

a. colony-stimulating factors
b. eosinophils
c. basophils
d. neutrophils

 

REF: p 374

 

  1. A blood test demonstrates that a patient’s reticulocyte count is decreased. This indicates that:

 

a. erythrocyte production has increased.
b. erythrocyte production has decreased.
c. the bone marrow is overactive.
d. the spleen is underactive.

 

REF: p 375

 

  1. Haemoglobin contains haem groups that allow it to carry oxygen. How many oxygen molecules can one molecule of haemoglobin carry?

 

a. one
b. two
c. four
d. eight

 

REF: p 375

 

  1. Secretion of erythropoietin is stimulated by:

 

a. low blood pressure.
b. hypercarbia.
c. inflammation.
d. hypoxia.

 

REF: p 375

 

  1. Erythropoietin is produced in the:

 

a. liver.
b. bone marrow.
c. kidneys.
d. spleen.

 

REF: p 375

 

  1. The greatest proportion of total body iron is located in the:

 

a. erythrocytes.
b. spleen pulp.
c. bone marrow.
d. liver tissue.

 

REF: p 376

 

  1. Recycled iron from macrophages is delivered to the bone marrow bound to:

 

a. ferritin.
b. haemoglobin.
c. haemosiderin.
d. transferrin.

 

REF: p 376

 

  1. After erythrocytes have circulated for about 120 days, they are removed by macrophages, which are mainly in the:

 

a. liver.
b. spleen.
c. appendix.
d. bone marrow.

 

REF: p 376

 

  1. Which of the following nutritional components is needed for erythropoiesis?

 

a. vitamin B12
b. vitamin B1
c. vitamin D
d. zinc

 

REF: p 376

 

  1. Leucopoiesis refers to the production of:

 

a. white blood cells.
b. platelets.
c. erythrocytes.
d. megakaryocytes.

 

REF: p 377

 

  1. A newborn baby is diagnosed with a blood disorder in which her platelet count is low. Which of the following could be the reason?

 

a. increased megakaryocytes
b. increased cell division
c. decreased thrombopoietin
d. decreased spleen function

 

REF: p 377

 

  1. Which of the following molecules is the insoluble end product of the clotting cascade?

 

a. collagen
b. fibrinogen
c. thrombin
d. fibrin

 

REF: p 378

 

  1. Which of the following is a natural anticoagulant?

 

a. thrombin
b. fibrinogen
c. antithrombin III
d. ADP

 

REF: p 381

 

  1. Which electrolyte is necessary for normal platelet function?

 

a. sodium
b. potassium
c. magnesium
d. calcium

 

REF: p 379

 

  1. A newborn baby has a clotting disorder that results in her body being unable to produce thrombin. Which of the following phases of platelet degranulation would be impossible?

 

a. subendothelial exposure
b. adhesion
c. activation
d. stabilisation of the platelet plug

 

REF: p 379

 

  1. Tissue factor is involved in:

 

a. activation of the intrinsic pathway.
b. activation of the extrinsic pathway.
c. stimulation of blood cell lineages.
d. fibrinolysis.

 

REF: p 380

 

  1. Fibrinolysis is mediated by:

 

a. heparin.
b. fibrinogen.
c. plasmin.
d. albumin.

 

REF: p 383

 

  1. Which of the following changes to haematological function occur in older people?

 

a. Platelet numbers decline.
b. Fibrinogen levels decline.
c. Erythrocyte plasma membranes become fragile.
d. Erythrocyte life span is decreased.

 

REF: p 385

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 17: Alterations of haematological function across the life span

 

Test Bank

 

MULTIPLE CHOICE

 

  1. Erythrocytes that are _____ contain an abnormally low concentration of haemoglobin.

 

a. hyperchromic
b. hypochromic
c. macrocytic
d. microcytic

 

REF: p 390

 

  1. A 5-year-old male is diagnosed with normocytic-normochromic anaemia. Which of the following anaemias falls into this category?

 

a. sideroblastic anaemia
b. haemolytic anaemia
c. pernicious anaemia
d. iron deficiency anaemia

 

REF: p 390

 

  1. What haemodynamic change occurs after initial compensation for a reduction in the number of circulating erythrocytes?

 

a. increased viscosity of blood
b. decreased cardiac output
c. altered coagulation
d. hyperdynamic blood flow

 

REF: p 391

 

  1. A 25-year-old female has a heavy menses during which she loses a profuse amount of blood. Which of the following adaptations could be expected?

 

a. movement of fluid into the cell
b. decreased cardiac output
c. decreased oxygen release from haemoglobin
d. capillary dilation

 

REF: p 391

 

  1. A 21-year-old female was recently diagnosed with iron deficiency anaemia. In addition to fatigue and weakness, which of the following clinical signs and symptoms would she most likely exhibit?

 

a. hyperactivity
b. red, sore tongue
c. gait problems
d. petechiae and purpura

 

REF: p 392

 

  1. Which of the following tests directly measure iron stores?

 

a. serum ferritin
b. transferrin saturation
c. bone marrow biopsy
d. total iron-binding capacity

 

REF: p 393

 

  1. A 34-year-old male presents in the ED with extreme fatigue and shortness of breath. His skin and sclera appear to have a yellowish discoloration. These findings are consistent with which type of anaemia?

 

a. posthaemorrhagic anaemia
b. iron deficiency anaemia
c. aplastic anaemia
d. haemolytic anaemia

 

REF: p 395

 

  1. A 67-year-old female has chronic gastrointestinal bleeding. The primary cause of her anaemia is:

 

a. vitamin B12 deficiency.
b. iron deficiency.
c. folate deficiency.
d. bone marrow failure.

 

REF: p 395

 

  1. A newborn is diagnosed with congenital intrinsic factor deficiency. From which of the following types of anaemia does he suffer?

 

a. iron deficiency anaemia
b. pernicious anaemia
c. sideroblastic anaemia
d. haemolytic anaemia

 

REF: p 394

 

  1. A 35-year-old female is diagnosed with vitamin B12 deficiency anaemia. A decrease in which of the following is the most likely cause?

 

a. ferritin
b. gastric enzymes
c. intrinsic factor
d. erythropoietin

 

REF: p 394

 

  1. Which of the following individuals is at highest risk for developing a vitamin B12 deficiency anaemia?

 

a. a 47-year-old male who had a gastrectomy procedure (removal of the stomach)
b. a 64-year-old male with a history of duodenal ulcers and gastrointestinal bleeding
c. a 26-year-old female in the second trimester of her first pregnancy
d. a 3-year-old female who is a fussy eater

 

REF: p 394

 

  1. A 40-year-old male vegetarian is diagnosed with folate deficiency anaemia. He reports that he is an alcoholic. Which of the following factors put him at greatest risk for developing his disease?

 

a. being vegetarian
b. being alcoholic
c. age
d. gender

 

REF: p 394

 

  1. A 50-year-old male experiences loss of appetite, weight loss and a beefy red tongue shortly before his death. Autopsy would most likely reveal:

 

a. brain hypoxia.
b. liver hypoxia.
c. heart failure.
d. kidney failure.

 

REF: p 394

 

  1. The Schilling test for pernicious anaemia involves:

 

a. the administration of radioactive vitamin B12 and the measurement of its excretion in the urine.
b. the measurement of antigen-antibody immune complexes.
c. the measurement of serum ferritin and total iron-binding capacity.
d. the administration of folate and evaluation of folate content in a blood serum sample.

 

REF: p 394

 

  1. Aplastic anaemia is caused by:

 

a. iron deficiency.
b. excess levels of erythropoietin.
c. haemolysis.
d. bone marrow suppression.

 

REF: p 395

 

  1. Maternal-fetal blood incompatibility may exist in which of the following conditions?

 

a. The mother is Rh-positive and the fetus is Rh-negative.
b. The mother is Rh-negative and the fetus is Rh-positive.
c. The mother has type A blood and the fetus has type O blood.
d. The mother has type AB blood and the fetus has type B blood.

 

REF: p 395

 

  1. A 67-year-old female is admitted to the ED with a diagnosis of polycythaemia vera. This has occurred as a result of:

 

a. hyperactivity.
b. dehydration.
c. abnormal proliferation of red cells.
d. exposure to high altitude.

 

REF: p 396

 

  1. Thrombocytopenia may be:

 

a. transient or consistent.
b. normal or abnormal.
c. congenital or acquired.
d. active or inactive.

 

REF: p 397

 

  1. A 52-year-old male IV drug user was diagnosed with hepatitis C 5years ago. He is now experiencing impaired blood clotting. A decrease in which of the following vitamins could be the cause?

 

a. K
b. D
c. E
d. B12

 

REF: p 400

 

  1. Haemophilia B is caused by a deficiency of functional:

 

a. factor IX.
b. factor VIII.
c. factor VI.
d. factor X.

 

REF: p 400

 

  1. Individuals with liver disease often suffer from coagulation disorders because:

 

a. the liver is often the site of platelet pooling.
b. clotting factors are produced in the liver.
c. high levels of bilirubin interfere with the clotting system.
d. treatment medications for liver failure cause fibrinolysis.

 

REF: p 400

 

  1. A 40-year-old female develops disseminated intravascular coagulation (DIC). The most likely cause of this condition is:

 

a. snake venom.
b. blood transfusion.
c. sepsis.
d. immune thrombocytopenic purpura (ITP).

 

REF: p 402

 

  1. The sequence of events in DIC is initiated by the release of:

 

a. histamine.
b. fibrin.
c. tissue factor.
d. plasmin.

 

REF: p 402

 

  1. In DIC, active bleeding occurs after intravascular clotting because:

 

a. prothrombin is activated.
b. clotting factors are depleted.
c. inflammatory mediators are released.
d. tissue factor (TF) is inactivated.

 

REF: p 402

 

  1. A common, life-threatening complication of a thrombus in a deep vein is:

 

a. disseminated intravascular coagulation.
b. lower extremity oedema.
c. stroke.
d. pulmonary embolus.

 

REF: p 403

 

  1. A 22-year-old female just delivered a healthy baby girl. She suffered from eclampsia during her pregnancy, and on the second postnatal day she complained of bleeding gums and bruising on her arms and legs. Haematology lab tests indicate she has DIC. Further testing reveals an increase in:

 

a. platelets.
b. haematocrit.
c. fibrin degradation products (FDPs).
d. factor X.

 

REF: p 403

 

  1. Leucocytosis can be defined as:

 

a. a normal leucocyte count.
b. a high leucocyte count.
c. a low leucocyte count.
d. another term for leucopenia.

 

REF: p 404

 

  1. A 15-year-old female presents with splenomegaly, hepatomegaly and lymph node enlargement. She is diagnosed with infectious mononucleosis. Further testing would indicate an acute infection of:

 

a. neutrophils.
b. B lymphocytes.
c. T lymphocytes.
d. eosinophils.

 

REF: p 405

 

  1. A 15-year-old male is diagnosed with infectious mononucleosis. The most likely cause is:

 

a. adenovirus.
b. Epstein-Barr virus (EBV).
c. cytomegalovirus (CMV).
d. Toxoplasma gondii.

 

REF: p 405

 

  1. A 15-year-old male with infectious mononucleosis is being given instructions on how to prevent the spread of this infection to others. Which statement represents a correct instruction?

 

a. Wear a surgical mask when others are in the room.
b. Do not share drinking glasses or eating utensils.
c. Avoid all contact with other people.
d. No precautions are necessary.

 

REF: p 405

 

  1. A 15-year-old male is diagnosed with infectious mononucleosis. He most likely presented with the classic triad of symptoms: fever, sore throat and:

 

a. lymph node enlargement.
b. hepatitis.
c. rash on the trunk and extremities.
d. dyspnoea.

 

REF: p 406

 

  1. The most common childhood cancer is:

 

a. acute lymphoblastic leukaemia.
b. chronic myelocytic leukaemia.
c. non-Hodgkin’s lymphoma.
d. Hodgkin’s lymphoma.

 

REF: p 408

 

  1. A 5-year-old male is diagnosed with leukaemia. Which of the following symptoms would be expected?

 

a. fatigue
b. jaundice
c. irritability
d. bradycardia

 

REF: p 408

 

  1. A 10-year-old male with Down syndrome undergoes chemotherapy for cancer. Following treatment, he is most susceptible to:

 

a. acute lymphoblastic leukaemia.
b. acute myeloid leukaemia.
c. non-Hodgkin’s lymphoma.
d. Hodgkin’s lymphoma.

 

REF: p 408

 

  1. Known causes of acute leukaemia include:

 

a. cytomegalovirus (CMV) infection.
b. eating genetically modified food.
c. chemotherapy treatment for other cancers.
d. excessive ultraviolet radiation exposure.

 

REF: p 408

 

  1. A 10-year-old male is diagnosed with leukaemia. Which of the following could be associated with his disease?

 

a. Down syndrome
b. haemophilia
c. hyperthyroidism
d. pheochromocytoma

 

REF: p 408

 

  1. A 5-year-old female is diagnosed with acute leukaemia. She will most likely be treated with:

 

a. bone marrow transplant.
b. immunotherapy.
c. chemotherapy.
d. localised radiation therapy.

 

REF: p 409

 

  1. A 35-year-old female is diagnosed with lymphadenopathy. The most likely finding leading to this diagnosis is:

 

a. small, hard lymph nodes.
b. disordered lymph nodes.
c. nonpalpable, nontender lymph nodes.
d. enlarged lymph nodes.

 

REF: p 409

 

  1. A 35-year-old male has enlarged lymph nodes in the neck and a mediastinal mass. He is diagnosed with Hodgkin’s lymphoma. Which of the following abnormal cells would be expected with this disease?

 

a. Merkel cell
b. Schwann cell
c. Reed-Sternberg cell
d. Kupffer cell

 

REF: p 412

 

  1. A 62-year-old female tells her healthcare provider she has been experiencing regular night sweats that cause her to wake up drenched. She also remarks that she has been unintentionally losing weight. Physical exam reveals enlarged lymph nodes on her neck that do not appear to be painful. She should be screened for which of the following cancers?

 

a. non-Hodgkin’s lymphoma
b. Hodgkin’s lymphoma
c. acute leukaemia
d. Burkitt’s lymphoma

 

REF: p 412

 

  1. Multiple myeloma can be defined as a neoplasm of:

 

a. T cells.
b. B cells.
c. plasma cells.
d. mature red blood cells.

 

REF: p 413

 

  1. A 65-year-old male is diagnosed with multiple myeloma. He complains of severe pain. This pain can be attributed to:

 

a. neuropathic infiltrations.
b. destruction of bone tissue.
c. tissue hypoxia.
d. accumulation of toxic proteins.

 

REF: p 413

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 18: The structure and function of the integumentary system

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The appendages of the skin include all of the following structures except:

 

a. sweat glands.
b. nails.
c. dermal papilla.
d. hair.

 

REF: p 419

 

  1. Keratinocytes are found in which layer of the skin?

 

a. epidermis
b. papillary layer of the dermis
c. reticular layer of the dermis
d. hypodermis

 

REF: p 419

 

  1. Which cells are involved in initiating immune responses in the skin?

 

a. Langerhans’ cells
b. Merkel cells
c. keratinocytes
d. melanocytes

 

REF: p 419

 

  1. The deepest layer of the epidermis is called the:

 

a. stratum spinosum.
b. stratum basale.
c. papillary layer
d. reticular layer.

 

REF: p 419

 

  1. The layer of the epidermis in which the nuclei of the keratinocytes begins to degenerate and the cells begin to flatten is called the:

 

a. stratum spinosum.
b. stratum basale.
c. stratum corneum
d. stratum granulosum.

 

REF: p 420

 

  1. The layer of the epidermis that consists of 20-30 rows of flattened, dead keratinocytes is called the:

 

a. stratum spinosum.
b. stratum basale.
c. stratum corneum.
d. stratum granulosum.

 

REF: p 420

 

  1. The stratum lucidum is only found in:.

 

a. the dermis.
b. thick skin.
c. the papillary layer.
d. thin skin.

 

REF: p 420

 

  1. The layer of the dermis composed of dense irregular connective tissue is called the:

 

a. stratum spinosum.
b. stratum basale.
c. papillary layer.
d. reticular layer.

 

REF: p 422

 

  1. The layer of the dermis rich in blood vessels is called the:

 

a. stratum spinosum.
b. stratum basale.
c. papillary layer.
d. reticular layer.

 

REF: p 422

 

 

  1. Nails contain:

 

a. melanocytes.
b. ureic acid.
c. lipid-impregnated epidermal cells.
d. keratinised epidermal cells.

 

REF: p 425

 

  1. A 12-year-old female notices her hair and skin feel more oily than normal. Her doctor explains that this is because her ___ glands enlarge during puberty:

 

a. sebaceous.
b. apocrine.
c. eccrine.
d. progesterone.

 

REF: p 425

 

  1. Of the sweat glands, the _____ glands are most abundant in the axilla and genital areas.
a. eccrine
b. apocrine
c. sebaceous
d. subcutaneous

 

REF: p 425

 

  1. More heat may be conserved by the body if blood is shunted away from the blood vessels in the:

 

a. epidermis.
b. dermis.
c. hypodermis.
d. fascia beneath the skin.

 

REF: p 426

 

  1. Nociceptors detect:

 

a. touch.
b. temperature.
c. pain.
d. two-point discrimination.

 

REF: p 426

 

  1. The Merkel cell and its associated disc detect:

 

a. light touch.
b. temperature.
c. pain.
d. two-point discrimination.

 

REF: p 426

 

  1. Meissner’s corpuscles in the dermal papillae detect:

 

a. vibration.
b. temperature.
c. pain.
d. two-point discrimination.

 

REF: p 426

 

  1. Pacinian corpuscles detect:

 

a. deep pressure and vibration.
b. light touch.
c. pain.
d. two-point discrimination.

 

REF: p 426

 

  1. Which of the following do not protect an individual against infection?

 

a. acid sweat
b. Langerhans’ cells
c. lysozyme
d. melanin

 

REF: p 426

 

  1. The vernix caseosa is:

 

a. an oily substance containing sebum.
b. a type of cell found in the stratum germinosum.
c. a secretion of eccrine glands.
d. a secretion of apocrine glands.

 

REF: p 427

 

  1. Which of the following is not a cause of ageing-related changes to the skin?

 

a. tobacco smoking
b. coded genetic changes
c. exposure to ultraviolet radiation
d. health status

 

REF: p 427

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 19: Alterations of the integumentary system across the life span

 

Test Bank

 

MULTIPLE CHOICE

 

  1. Which of the following is the most common type of skin carcinoma in Australia and New Zealand?

 

a. Melanoma
b. Squamous cell carcinoma
c. Basal cell carcinoma
d. Solar keratosis

 

REF: p 435

 

  1. Plaques are______ and are a sign of ______

 

a. vesicles filled with serous fluid; herpes zoster.
b. elevated, rough lesions more than 1 cm in diameter; psoriasis.
c. fine, irregular red lines produced by dilated capillaries; telangiectasia.
d. elevated, firm, deep in the dermis lesions; erythema nodosum.

 

REF: p 437

 

  1. Which of the following is the correct series of events for the pathogenesis of melanoma?

 

a. Change to melanocyte, melanocyte proliferation, dysplasia, melanoma, invasion and metastasis
b. Dysplasia, change to melanocyte, melanocyte proliferation, melanoma, invasion and metastasis
c. Change to melanocyte, dysplasia, melanoma, melanocyte proliferation , invasion and metastasis
d. Change to melanocyte, melanocyte proliferation, melanoma, dysplasia, invasion and metastasis

 

REF: p 439

 

  1. Irritant contact dermatitis can be differentiated from allergic contact dermatitis by:

 

a. the fact that it is caused by exposure to chemical or physical agents, and not an allergen.
b. the fact that it is triggered by a T cell response.
c. the fact that it can be patched tested to determine the sensitising trigger.
d. none of the above: the two are fundamentally similar but the symptoms are different.

 

REF: p 440

 

  1. Latex allergies may occur as:

 

a. type I hypersensitivity.
b. type II hypersensitivity.
c. type IV hypersensitivity.
d. A and C are correct.

 

REF: p 442

 

  1. The main difference between the pathophysiology of acne vulgaris and acne rosacea is that:

 

a. vulgaris is an inflammatory condition that affects the hair follicle, while rosacea has reactive oxygen species and enzymes that destroy the dermis.
b. vulgaris has genetic linkages.
c. rosacea is not exacerbated by sunlight, while vulgaris is.
d. rosacea declines with age, while vulgaris does not.

 

REF: p 443

 

  1. Which of the following conditions is defined by lesions with well-defined edges and silver scales?

 

a. Cutaneous lupus erythematosus
b. Psoriasis
c. Acne rosacea
d. Seborrhoeic dermatitis

 

REF: p 445

 

  1. ‘School sores’ are common in children. What are they formally known as, and what organisms have been associated with them?

 

a. Scalded skin syndrome, Staphylococcus aureus
b. Impetigo, Staphylococcus aureus and Streptococci
c. Cellulitis, Staphylococcus aureus, Streptococci
d. Folliculitis, Staphylococcus aureus

 

REF: p 445

 

  1. The relationship of herpes zoster to chickenpox is that:
a. herpes zoster occurs on the face, while chickenpox affects the body all over.
b. herpes zoster affects only adults while chickenpox affects only children.
c. herpes zoster is a reactivation of the varicella virus from childhood chickenpox.
d. the two are unrelated.

 

REF: p 448

 

  1. Which are the following are more common in children than adults?

 

a. Molluscum contagiosum, impetigo, head lice
b. Cellulitis, tinea, scabies
c. Head lice, cellulitis, varicella
d. Molluscum contagiosum, tinea, varicella

 

REF: p 449

 

  1. Which of the following is the most likely cause of pressure sores:

 

a. Acute injury
b. Prolonged deep tissue ischaemia
c. Wound infection
d. Increased blood flow to tissues

 

REF: p 453

 

  1. A pressure injury in which subcutaneous fat but not bone, muscle or tendon is visible is categorised as a:

 

a. stage I Non-blanchable erythema.
b. stage II Partial thickness.
c. stage III Full-thickness skin loss.
d. stage IV Full-thickness tissue loss.

 

REF: p 453

 

  1. In a burn case, the wound area with decreased tissue perfusion is known as the:

 

a. zone of coagulative necrosis
b. middle zone
c. zone of hyperaemia
d. danger zone

 

REF: p 456

 

  1. If a patient has burns to the chest and front and back of their left arm, what percentage of their body is burnt?

 

a. 27%
b. 18%
c. 9%
d. 36%

 

REF: p 456

 

  1. A patient receives a deep-dermal partial thickness burn. How long would it be expected to take to heal, and what risk of hypertrophic scarring does the patient have?

 

a. A few days, no risk of hypertrophic scarring
b. 2 weeks, moderate risk of hypertrophic scarring
c. No healing unless a skin graft is applied, scarring will occur
d. More than 3 weeks, high risk of hypertrophic scarring

 

REF: p 458

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 20: The structure and function of the musculoskeletal system

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The component of the bone matrix that gives bone tensile strength is:

 

a. calcium.
b. phosphate.
c. collagen.
d. magnesium.

 

REF: p 464

 

  1. Which cells are found within mineralised bone matrix?

 

a. osteoclasts
b. osteocytes
c. fibrocytes
d. osteoids

 

REF: p 465

 

  1. Osteocalcin is a:

 

a. non-collagenous protein.
b. hormone.
c. mineral.
d. vitamin.

 

REF: p 465

 

  1. Which of the following molecules is not part of the bone matrix?

 

a. collagen fibres
b. elastin fibres
c. proteoglycans
d. glycoproteins

 

REF: p 466

 

  1. Which substance forms solid hexagonal crystals?

 

a. hydroxyapatite
b. sialoprotein
c. osteodentin
d. albumin

 

REF: p 466

 

  1. Hydroxyapatite in the bone matrix contains which of the following molecules in its crystalline structure?

 

a. calcium and magnesium
b. collagen and phosphate
c. phosphate and calcium
d. magnesium and hydrogen

 

REF: p 466

 

  1. The major difference between compact bone and spongy bone is the:

 

a. organisation of the structural elements.
b. location within the body.
c. activating chemicals in each.
d. types of minerals in the bone matrix.

 

REF: p 466

 

  1. Which of these structures are not present in compact bone?

 

a. haversian canals
b. trabeculae
c. lacunae
d. lamellae

 

REF: p 466

 

  1. Blood vessels penetrate to the inner structures of the bone via:

 

a. Volkmann canals.
b. canaliculi.
c. Sharpey’s canals.
d. osteons.

 

REF: p 467

 

  1. Which of the following shapes is not an accepted classification for the 206 bones of the axial and appendicular skeleton?

 

a. long
b. flat
c. short
d. regular

 

REF: p 468

 

  1. After puberty, the epiphyseal plate calcifies and the epiphysis and _____ merge.

 

a. epiphyseal line
b. diaphyseal plate
c. metaphysis
d. articular cartilage

 

REF: p 469

 

  1. The internal structure of bone is maintained by remodelling, a three-phase process in which existing bone is resorbed and new bone is laid down to replace it. Resorption is carried out by bone cells called:

 

a. precursor stimulating cells.
b. osteoclasts.
c. osteoblasts.
d. haversian system cells.

 

REF: p 469

 

  1. Phase 2 of the bone remodelling cycle involves bone:

 

a. formation.
b. activation.
c. resorption.
d. fracturing.

 

REF: p 469

 

  1. Joints are classified according to the degree of movement they permit. Which of the following terms describes a freely movable joint?

 

a. synarthrosis
b. amphiarthrosis
c. biarthrosis
d. diarthrosis

 

REF: p 470

 

  1. Generally, fibrous joints are:

 

a. immovable.
b. slightly movable.
c. freely movable.
d. calcified.

 

REF: p 470

 

  1. Which of the following are both subclassifications of cartilaginous joints?

 

a. sutures and gomphosis
b. syndesmosis and gomphosis
c. symphysis and synchondrosis
d. gomphosis and synchondrosis

 

REF: p 471

 

  1. The joints between the teeth and the maxilla or mandible are examples of a:

 

a. symphysis.
b. diarthrosis.
c. gomphosis.
d. syndesmosis.

 

REF: p 471

 

  1. Costal cartilage is located between:

 

a. the vertebrae.
b. the ribs and sternum.
c. the sutures of the skull.
d. the facial bones.

 

REF: p 471

 

  1. The elbow joint is an example of:

 

a. an amphiarthrosis.
b. a diarthrosis.
c. a synarthrosis.
d. a symphysis.

 

REF: p 472

 

  1. Which of the following is not a synovial joint in the body?

 

a. a syndesmosis type that connects two vertebrae
b. a spheroid type found in the shoulder
c. a hinge type found in the elbow
d. a gliding type found in the hand

 

REF: p 472

 

  1. Skeletal muscle is controlled directly by the central nervous system via a system of motor and sensory nerve fibres. Which of the following terms is not used to describe skeletal muscle?

 

a. voluntary
b. striated
c. extrafusal
d. fibrotic

 

REF: p 475

 

  1. The epimysium, perimysium and endomysium are made of:

 

a. bone.
b. epithelium.
c. fascia.
d. cartilage.

 

REF: p 477

 

  1. Which layer forms the fascicles in skeletal muscle?

 

a. tendon sheath
b. endomysium
c. epimysium
d. perimysium

 

REF: p 477

 

  1. An isolated muscle is believed to be a type 1 fibre. Which of the following should be observed upon stimulation?

 

a. slow contraction speed
b. large fibre diameter
c. rapid firing frequency
d. glycolysis metabolism

 

REF: p 477

 

  1. Which of the following structures is the contractile unit of a muscle cell?

 

a. motor unit
b. basement membrane
c. myofibril
d. ribosome

 

REF: p 478

 

  1. An isolated muscle is believed to be a type 2 fibre. Which of the following should be observed upon stimulation?

 

a. slow contraction speed
b. fatigued easily
c. profuse capillary supply
d. oxidative metabolism

 

REF: p 478

 

  1. Which structure is the contractile subunit of the myofibril?

 

a. sarcoplasmic reticulum
b. actin
c. motor endplate
d. sarcomere

 

REF: p 478

 

  1. _____ ions directly control the contraction of muscles.

 

a. Sodium
b. Potassium
c. Calcium
d. Magnesium

 

REF: p 479

 

  1. Which molecule prevents a muscle contraction from occurring when the muscle is at rest?

 

a. calcium
b. troponin-tropomyosin
c. actin
d. myosin

 

REF: p 482

 

  1. The main energy source or fuel for skeletal muscle contraction is:

 

a. calcium.
b. lactic acid.
c. ATP.
d. actin.

 

REF: p 483

 

  1. Which of the following describes a functional muscle contraction in which the muscle contracts but the limb does not move?

 

a. isotonic contraction
b. isometric contraction
c. eccentric contraction
d. concentric contraction

 

REF: p 484

 

  1. When a muscle acts as the prime mover, it is called the:

 

a. flexor.
b. recruiter.
c. antagonist.
d. agonist.

 

REF: p 484

 

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 21: Alterations of musculoskeletal function across the life span

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A 65-year-old female is admitted to hospital with a pathologic, compound, oblique fracture of the femur. Which of the following statements best describes this type of fracture?

 

a. The fracture line is parallel to the bone.
b. The fracture line is diagonal to the shaft of the bone.
c. The fracture line is perpendicular to the bone.
d. The fracture line is vertical to the shaft of the bone.

 

REF: p 491

 

  1. A 70-year-old female with osteoporosis fractures her leg at a location of pre-existing abnormality. She reports that the fracture occurred following a minor fall. Which of the following best describes the fracture?

 

a. idiopathic fracture
b. iatrogenic fracture
c. pathological fracture
d. greenstick fracture

 

REF: p 492

 

  1. A 32-year-old obese male begins a jogging routine. A week after beginning, he fractures his leg. This fracture is referred to as a(n) _____ fracture.

 

a. insufficiency
b. greenstick
c. fatigue
d. compound

 

REF: p 492

 

  1. Transchondral fractures are most prevalent in:

 

a. adolescents.
b. older adults.
c. infants.
d. premenopausal females.

 

REF: p 492

 

  1. A 35-year-old female suffers a broken clavicle following a motor vehicle accident. X-ray reveals that the bone surfaces in the joint partially lost contact with each other. This condition is called:

 

a. dislocation.
b. subluxation.
c. sublimation.
d. nonunion.

 

REF: p 494

 

  1. A 12-year-old female hurts her ankle while playing basketball. Tests reveal she tore a ligament. This condition is known as a:

 

a. sprain.
b. strain.
c. disunion.
d. fracture.

 

REF: p 495

 

  1. A 36-year-old male complains of pain and weakness in the elbow. He reports that he is a warehouse worker and lifts boxes daily. MRI reveals inflammation of the tendon where it attaches to bone. This condition is called:

 

a. periosteitis.
b. pericondylitis.
c. bursitis.
d. epicondylitis.

 

REF: p 496

 

  1. After running a marathon, seven runners were admitted to local hospitals with suspected myoglobinuria (rhabdomyolysis). What is the most likely cause of myoglobinuria in these athletes?

 

a. tendon injury
b. undiagnosed hypertension
c. excessive muscular activity
d. undetected cardiac abnormalities

 

REF: p 497

 

  1. Which of the following hospital patients is at the highest risk for developing myoglobinuria (rhabdomyolysis)?

 

a. admitted to the hospital for hip surgery and has had problems with anaesthesia in the past
b. admitted to the hospital for exacerbation of left heart failure and takes diuretic medications
c. admitted to the hospital for a bone marrow transplant to treat leukaemia
d. admitted to the hospital to deliver a preterm infant

 

REF: p 498

 

  1. A 70-year-old female presents with a hip fracture. She is diagnosed with osteoporosis. This condition is caused by an increase in bone:

 

a. density.
b. formation.
c. resorption.
d. mineralisation.

 

REF: p 499

 

  1. A 70-year-old female presents with a hip fracture. She is diagnosed with osteoporosis. One factor that most likely contributed to her condition is:

 

a. increased androgen levels.
b. decreased oestrogen levels.
c. strenuous exercise.
d. excessive dietary calcium.

 

REF: p 501

 

  1. A 76-year-old female was diagnosed with osteoporosis by radiological exam. She is at high risk for:

 

a. bone infections.
b. joint injuries.
c. bone fractures.
d. osteomalacia.

 

REF: p 500

 

  1. A 35-year-old female presents with impaired motor function, gradual deafness and visual disturbances. Physical examination reveals asymmetric shape of skull and displaced teeth. X-ray reveals thickened and disorganised bones caused by abnormal and excessive bone remodelling. This condition is referred to as:

 

a. rickets.
b. Paget’s disease.
c. osteoporosis.
d. osteomyelitis.

 

REF: p 506

 

  1. The cause of Paget’s disease is:

 

a. fluoride deficiency.
b. unknown at present.
c. excess vitamin A.
d. osteogenic sarcoma.

 

REF: p 506

 

 

  1. Incidence of Legg-Calvé-Perthes disease peaks at age:

 

a. 2.
b. 6.
c. 10.
d. 12.

 

REF: p 506

 

  1. Legg-Calvé-Perthes disease affects which of the following joints?

 

a. vertebral
b. shoulder
c. hip
d. knee

 

REF: p 506

 

  1. Osgood-Schlatter disease causes inflammation of the:

 

a. shoulder joint.
b. patellar tendon.
c. elbow ligaments.
d. hip cartilage.

 

REF: p 507

 

  1. Structural scoliosis with no known cause, termed _____ scoliosis, accounts for 80% of the cases.

 

a. idiopathic
b. aetiologic
c. iatrogenic
d. primary

 

REF: p 508

 

  1. An 80-year-old male presents with skeletal pain and tenderness, especially in the hips. He is diagnosed with osteomalacia caused by:

 

a. collagen breakdown in the bone matrix.
b. excessive bone resorption.
c. crowding of bone marrow by excessive bone growth.
d. inadequate bone mineralisation.

 

REF: p 504

 

  1. Researchers have now determined that rheumatoid arthritis:

 

a. is curable with antiviral agents.
b. is an autoimmune disease.
c. arises from rheumatic fever.
d. has the same causes as osteoarthritis.

 

REF: p 509

 

  1. A 34-year-old female was recently diagnosed with rheumatoid arthritis. Physical examination revealed that inflammation started in the:

 

a. synovial membrane.
b. articular cartilage.
c. subchondral bone.
d. surrounding ligaments.

 

REF: p 509

 

  1. A five-year-old female was diagnosed with juvenile rheumatoid arthritis. The treatment option for this disease is:

 

a. supportive.
b. curative.
c. nonexistent.
d. experimental.

 

REF: p 513

 

  1. A 21-year-old female presents with low back pain and stiffness that is alleviated by physical activity. She was diagnosed with ankylosing spondylitis. Which of the following joints would be most affected?

 

a. vertebral and sacroiliac
b. carpal and pharyngeal
c. shoulder and hip
d. all hinge joints

 

REF: p 514

 

  1. A 29-year-old male was recently diagnosed with ankylosing spondylitis. He is interested in obtaining more information about his disease. Patient teaching would include all of the following statements except:

 

a. a diagnosis is made from history, physical examination, X-rays and serum analysis.
b. inflammation of the fibrocartilage in cartilaginous joints results in the erosion of bone structure, scar tissue formation and joint fusion.
c. the more common signs and symptoms of early disease include restricted joint movement and increased pain after physical activity.
d. the usual treatment includes anti-inflammatory and analgesic medications, exercises and physical therapy.

 

REF: p 514

 

  1. Which of the following people is at highest risk for the development of gout?

 

a. men age 40 to 60 years
b. premenopausal women
c. male adolescents
d. female children

 

REF: p 515

 

  1. A 46-year-old male presents with severe pain, redness and tenderness in the right big toe. He is diagnosed with gouty arthritis. The symptoms he experiences are caused by the crystallisation of _____ within the synovial fluid.

 

a. purines
b. pyrimidines
c. uric acid
d. acetic acid

 

REF: p 515

 

  1. A 46-year-old male presents with severe pain, redness and tenderness in the right big toe. He is diagnosed with gouty arthritis. He is at risk of developing:

 

a. cholelithiasis.
b. myocarditis.
c. renal disease.
d. liver failure.

 

REF: p 516

 

  1. A 51-year-old male experiences severe acute gouty arthritis. Which of the following is the most common trigger for the symptoms?

 

a. trauma
b. anaemia
c. high-fat foods
d. lack of exercise

 

REF: p 516

 

  1. The final stage of gout, characterised by crystalline deposits in cartilage, synovial membranes, and soft tissue, is called:

 

a. monarticular arthritis.
b. tophaceous gout.
c. asymptomatic hyperuricaemia.
d. complicated gout.

 

REF: p 516

 

  1. A 54-year-old male was recently diagnosed with osteoarthritis. Which of the following symptoms is he most likely experiencing?

 

a. joint swelling
b. hypermobility of joints
c. contractures
d. joint pain

 

REF: p 520

 

  1. A 70-year-old male presents with back pain, fever and weight loss. He reports that he had a recent respiratory infection from which he thought he recovered. Tests revealed increased white blood cell count and a diagnosis of endogenous osteomyelitis was made. The organisms causing this condition entered the bone through:

 

a. blood capillaries.
b. open fractures.
c. animal bites.
d. infected bedsores.

 

REF: p 522

 

  1. A 6-year-old male presents with fever, pain, swelling and warmth. Tests reveal osteomyelitis and development of an involucrum. Treatment should include:

 

a. antibiotics only.
b. surgical debridement and antibiotics.
c. limb amputation.
d. no intervention.

 

REF: p 523

 

  1. A 32-year-old male was injured in a motor vehicle accident and confined to bed for 3 weeks. During this time, the size and strength of muscle fibres decreased, a condition referred to as:

 

a. myodysplasia.
b. ischaemic atrophy.
c. disuse atrophy.
d. deconditioning hypoplasia.

 

REF: p 525

 

  1. Fibromyalgia is a chronic musculoskeletal disorder characterised by:

 

a. pain resulting from joint and muscle inflammation.
b. muscle pain in the back and gastrointestinal symptoms.
c. neurologic pain in the skeletal muscles.
d. diffuse pain, fatigue and point tenderness.

 

REF: p 525

 

  1. A 56-year-old male is admitted to hospital with a diagnosis of osteomalacia. History reveals he takes anticonvulsants, underwent a small-bowel resection 3 years earlier, and suffers from chronic pancreatitis. What is the common link between these three factors and the development of osteomalacia?

 

a. impaired phosphate absorption
b. increased calcium excretion
c. vitamin D deficiency
d. impaired vitamin C metabolism

 

REF: p 494

 

  1. A 3-year-old male presents with developmental delay. Testing reveals that the child has muscular dystrophy. This disease causes:

 

a. hypertrophy of smooth muscle cells.
b. atrophy of smooth muscle cells.
c. hyperplasia of skeletal muscle fibres.
d. degeneration of skeletal muscle fibres.

 

REF: p 529

 

  1. Duchenne’s muscular dystrophy has a(n) _____ inheritance pattern.

 

a. autosomal recessive
b. X-linked
c. Y-linked
d. chromosomal

 

REF: p 529

 

  1. Seventy-five per cent of individuals with Duchenne’s muscular dystrophy will die before age:

 

a. 6.
b. 12.
c. 21.
d. 30.

 

REF: p 529

 

  1. A 22-year-old female has a brother with Duchenne’s muscular dystrophy and wants to know if her children will inherit it. A fairly accurate test to identify female carriers of the disease is measurement of serum levels of:

 

a. dystrophin.
b. myoglobin.
c. creatine kinase.
d. troponin.

 

REF: p 529

 

  1. Which of the following is a warning sign of non-accidental trauma in children?

 

a. flat bone fracture in ambulant children
b. a hypophysical fracture
c. long bone fracture in non-ambulant children
d. a greenstick fracture

 

REF: p 532

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 22: The structure and function of the cardiovascular and lymphatic systems

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A 52-year-old female is admitted to the cardiac unit with a diagnosis of pericarditis. She asks the nurse to explain where the infection is. In providing an accurate description, the nurse states that the pericardium is:

 

a. the outer muscular layer of the heart.
b. the innermost lining of the heart chambers.
c. a membranous sac that encloses the heart.
d. the heart’s fibrous skeleton.

 

REF: p 541

 

  1. A function of the pericardium is to:

 

a. provide a barrier against extracardial infections.
b. improve blood flow through the heart.
c. play a role in cardiac conduction.
d. assist in cardiac contraction.

 

REF: p 541

 

  1. A 65-year-old male develops a blockage in the pulmonary artery. As a result, blood would first back up into the:

 

a. aorta.
b. left ventricle.
c. pulmonary veins.
d. right ventricle.

 

REF: p 544

 

  1. The chamber of the heart that generates the highest pressure is the:

 

a. right atrium.
b. left atrium.
c. left ventricle.
d. right ventricle.

 

REF: p 544

 

  1. The chamber that receives blood from the systemic circulation is the:

 

a. right atrium.
b. right ventricle.
c. left atrium.
d. left ventricle.

 

REF: p 544

 

  1. Oxygenated blood flows through the:

 

a. superior vena cava.
b. pulmonary veins.
c. pulmonary artery.
d. cardiac veins.

 

REF: p 544

 

  1. A 20-year-old male underwent an echocardiogram to assess chest pain. Results revealed a congenital defect in the papillary muscles. Which of the following would occur?

 

a. semilunar valve closure
b. backward expulsion of the atrioventricular valves
c. atrioventricular valve closure
d. backward expulsion of the semilunar valves

 

REF: p 545

 

  1. _____ are the anchors of the atrioventricular valves.

 

a. Chordae tendineae
b. Great vessels
c. Coronary ostia
d. Trabeculae carneae

 

REF: p 545

 

  1. The coronary ostia (the openings to the coronary arteries) are found in the:

 

a. left ventricle.
b. inferior vena cava.
c. coronary sinus.
d. aorta.

 

REF: p 550

 

  1. Venous blood from the coronary circulation drains into the:

 

a. superior vena cava.
b. inferior vena cava.
c. right atrium.
d. left atrium.

 

REF: p 552

 

  1. The _____ conducts action potentials down the atrioventricular septum.

 

a. Bachmann’s bundle
b. bundle of His
c. sinoatrial node
d. left and right bundle branches

 

REF: p 555

 

  1. A 13-year-old female took a weight loss drug that activated the sympathetic nervous system. Which of the following would be expected?

 

a. decreased myocardial contraction
b. decreased heart rate
c. increased cardiac cycle speed
d. increased intranodal conduction time

 

REF: p 556

 

  1. A 50-year-old female receives trauma to the chest that causes severe impairment of the primary pacemaker cells of the heart. Which of the following areas received the greatest damage?

 

a. AV node
b. SA node
c. bundle of His
d. ventricles

 

REF: p 556

 

  1. Depolarisation of a cardiac muscle cell occurs as the result of:

 

a. a decrease in the permeability of the cell membrane to ions.
b. the rapid movement of ions across the cell membrane.
c. a blockade by calcium ions.
d. stimuli instigated during the refractory period.

 

REF: p 555

 

  1. In a normal electrocardiogram, the PR interval represents:

 

a. atrial depolarisation.
b. ventricular depolarisation.
c. onset of atrial activation to onset of ventricular activity.
d. ‘electrical systole’ of the ventricles.

 

REF: p 558

 

  1. The _____ represents the sum of all ventricular muscle cell depolarisation.

 

a. PR interval
b. QRS complex
c. QT interval
d. P wave

 

REF: p 559

 

  1. The cardiac electrical impulse normally begins spontaneously in the SA node because:

 

a. of its superior location in the right atrium.
b. it is the only area of the heart capable of spontaneous depolarisation.
c. it has rich sympathetic innervation via the vagus nerve.
d. it depolarises more rapidly than other automatic cells of the heart.

 

REF: p 556

 

  1. A 28-year-old female with seizure disorder has a vagal nerve stimulator implanted to help control seizure activity. Which of the following would also be expected to occur?

 

a. increased speed of cardiac cycle
b. increased cardiac contractility
c. decreased vasodilation
d. decreased cardiac conduction

 

REF: p 555

 

  1. A new drug is released to aid in weight loss. It stimulates the sympathetic system to increase heart rate by:

 

a. inhibiting the release of catecholamines.
b. hyperpolarising the cell membrane.
c. decreasing the conduction time through the AV node.
d. increasing the influx of calcium.

 

REF: p 556

 

  1. The effect of acetylcholine on the heart is to:

 

a. decrease the refractory period.
b. increase calcium influx.
c. increase the strength of myocardial contraction.
d. decrease the heart rate.

 

REF: p 556

 

  1. One difference between cardiac muscle and skeletal muscle is that:

 

a. cardiac muscle cells are arranged in branching networks.
b. skeletal muscle cells have only one nucleus.
c. cardiac muscle cells appear striped.
d. skeletal muscle cells contain sarcomeres.

 

REF: p 556

 

  1. _____ are thickened areas of the sarcolemma of myocardial cells that enable electrical impulses to travel in a continuous cell-to-cell fashion.

 

a. Sclerotic plaques
b. Intercalated discs
c. Cross-bridges
d. A-bands

 

REF: p 553

 

  1. _____ is the process by which an action potential in the plasma membrane of a myocardial cell triggers the events that directly cause contraction of the myocardial cells.

 

a. Electrocontraction
b. Intercalated communication
c. Excitation-contraction coupling
d. Myosin communication

 

REF: p 554

 

  1. The substance that binds with troponin to allow actin-myosin cross-bridge formation is:

 

a. sodium.
b. tropomyosin.
c. calcium.
d. myosinia.

 

REF: p 553

 

  1. _____ is the pressure generated at the end of diastole.

 

a. Preload
b. Afterload
c. Systemic vascular resistance
d. Total peripheral resistance

 

REF: p 561

 

  1. As stated by the Frank-Starling law, there is a direct relationship between the _____ of the blood in the heart at the end of diastole and the _____ of contraction during the next systole.

 

a. pressure, duration
b. volume, force
c. viscosity, force
d. viscosity, duration

 

REF: p 561

 

  1. Within a normal physiological range, an increase in left ventricular end-diastolic volume leads to:

 

a. an increased force of contraction.
b. a decrease in cardiac output.
c. an increase in heart rate.
d. heart failure.

 

REF: p 560

 

  1. Left ventricular afterload is determined by:

 

a. vascular resistance in the systemic vessels.
b. right end-diastolic pressure.
c. pressures in the vena cavae.
d. pulmonary vascular resistance.

 

REF: p 562

 

  1. Pressure in the left ventricle must exceed pressure in the _____ before the left ventricle can eject blood.

 

a. coronary arteries
b. aorta
c. inferior vena cava
d. pulmonary veins

 

REF: p 562

 

  1. The primary cardiovascular control centre is located in the:

 

a. cerebral cortex.
b. midbrain.
c. medulla.
d. cervical spinal cord.

 

REF: p 563

 

  1. A 50-year-old female was prescribed a drug that acts as a negative inotrope. Which of the following endogenous substances would be most similar?

 

a. acetylcholine
b. dopamine
c. adrenaline
d. thyroid hormone

 

REF: p 562

 

  1. The Bainbridge reflex:

 

a. increases the heart rate after intravenous infusions.
b. decreases blood pressure in response to baroreceptors.
c. increases the rate and depth of respiration.
d. decreases myocardial contractility.

 

REF: p 563

 

  1. A 50-year-old female presents with a low heart rate and low blood pressure. She is given an IV infusion of fluids. The increase in atrial distension results in:

 

a. renal retention of fluids.
b. depressed myocardial contractility.
c. release of acetylcholine.
d. increased urine output.

 

REF: p 564

 

  1. Multiplying heart rate by stroke volume determines:

 

a. vascular resistance.
b. preload.
c. cardiac output.
d. ejection fraction.

 

REF: p 559

 

  1. The internal lining of the cardiovascular system is formed by what tissue?

 

a. columnar epithelium
b. connective
c. mesothelium
d. endothelium

 

REF: p 540

 

  1. Poiseuille’s formula states that resistance to blood flow is inversely related to:

 

a. blood viscosity.
b. blood vessel diameter.
c. blood pressure.
d. blood vessel length.

 

REF: p 571

 

  1. Baroreceptors are located in the:

 

a. renal artery.
b. superior vena cava.
c. carotid sinus.
d. circle of Willis.

 

REF: p 573

 

  1. Which of the following statements correctly describes a direct end effect of the renin-angiotensin-aldosterone system?

 

a. Angiotensin II causes systemic vasoconstriction.
b. Renin promotes the excretion of sodium and water in the renal tubules.
c. Aldosterone increases renal retention of water only.
d. Angiotensin I promotes sodium and water reabsorption by the kidneys.

 

REF: p 575

 

  1. One of the most important mechanisms for maintaining venous return to the right atrium is:

 

a. cardiac output.
b. capillary hydrostatic pressure.
c. skeletal muscle contraction.
d. respiratory cycling.

 

REF: p 577

 

  1. Local myogenic regulation of blood vessel diameter and thus blood flow through a vessel is an example of:

 

a. autonomic regulation.
b. somatic regulation.
c. autoregulation.
d. metabolic regulation.

 

REF: p 577

 

  1. The thoracic lymphatic duct drains into the:

 

a. right subclavian artery.
b. right atrium.
c. right subclavian vein.
d. left subclavian vein.

 

REF: p 578

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 23: Alterations of cardiovascular function across the life span

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A 60-year-old male presents to his GP complaining of chest pain. He is diagnosed with atherosclerosis. This disease is caused by:

 

a. arterial wall thinning and weakening.
b. abnormally dilated arteries and veins.
c. abnormal thickening and hardening of vessel walls.
d. autonomic nervous system imbalances.

 

REF: p 593

 

  1. In general, atherosclerosis is triggered by:

 

a. high serum cholesterol levels.
b. endothelial injury and inflammation
c. an increase in antithrombotic substances.
d. congenital heart disease.

 

REF: p 593

 

  1. Foam cells in a fatty streak are:

 

a. deposited adipose cells.
b. injured neutrophils.
c. macrophages that engulf LDL.
d. lipid-laden mast cells.

 

REF: p 593

 

  1. Normal blood pressure for adults aged 18 years or older is:

 

a. systolic pressure less than 140 mmHg and diastolic pressure less than 90 mmHg.
b. systolic pressure less than 120 mmHg and diastolic pressure less than 80 mmHg.
c. systolic pressure less than 100 mmHg regardless of diastolic pressure.
d. systolic pressure greater than 90 mmHg and diastolic pressure greater than 60 mmHg.

 

REF: p 586

 

  1. Most cases of combined systolic and diastolic hypertension have no known cause and are diagnosed as _____ hypertension.
a. primary
b. secondary
c. congenital
d. acquired

 

REF: p 586

 

  1. A 52-year-old male is diagnosed with primary hypertension. He could be treated with a drug that acts by which of the following mechanisms?

 

a. beta-adrenergic agonist.
b. angiotensin ll agonist.
c. diuretic.
d. calcium channel agonist.

 

REF: p 591

 

  1. A 55-year-old female has undiagnosed hypertension. She presents to her GP complaining of impaired vision and chronic oedema. Lab tests reveal she also has renal insufficiency. The most likely cause for these findings is:

 

a. clotting and gangrene.
b. free-radical injury and cell toxicity.
c. end-organ damage.
d. hypertrophy and hyperplasia.

 

REF: p 590

 

  1. Orthostatic hypotension refers to a sustained drop in blood pressure with:

 

a. exertion.
b. eating.
c. standing up
d. lying down.

 

REF: p 591

 

  1. A 50-year-old male is diagnosed with orthostatic hypotension. Which of the following symptoms would he most likely experience?

 

a. headache and blurred vision.
b. nausea and vomiting.
c. chest pain and palpitations.
d. syncope and fainting.

 

REF: p 591

 

  1. Acute orthostatic hypotension can be caused by:

 

a. starvation
b. antihypertensive drugs
c. dehydration
d. all the above.

 

REF: p 592

 

  1. A 65-year-old female presents to the ED complaining of difficulty swallowing and shortness of breath. A CT scan would most likely reveal an aneurysm in the:

 

a. cerebral vessels.
b. renal arteries.
c. inferior vena cava.
d. aorta.

 

REF: p 611

 

  1. A detached blood clot is called a(n):

 

a. thrombus.
b. embolus.
c. thromboembolus.
d. varicosity.

 

REF: p 613

 

  1. A 32-year-old female presents with lower leg pain and redness. An ultrasound reveals venous thrombus. Which of the following would be most likely to have caused her condition?

 

a. vascular injury and inflammation.
b. heart valve damage.
c. bacterial infection.
d. atherosclerosis.

 

REF: p 612

 

  1. A 28-year-old female presents with severe chest pain and shortness of breath. She is diagnosed with pulmonary embolism, which most likely originated from the:

 

a. left ventricle.
b. systemic arteries.
c. deep veins of the leg.
d. superficial veins of the arm.

 

REF: p 613

 

  1. A 75-year-old obese female presents to her GP complaining of oedema in the lower extremities. Physical exam reveals that she has varicose veins. Which of the following is a most likely cause?

 

a. extreme exercise.
b. long periods of standing.
c. dyslipidemia.
d. ischaemia.

 

REF: p 614

 

  1. A 52-year-old male presents with pooling of blood in the veins of the lower extremities and oedema. He is predisposed to:

 

a. deep vein thrombosis.
b. skin hyperpigmentation.
c. stasis ulcers.
d. all the above.

 

REF: p 614

 

  1. A 52-year-old female is diagnosed with coronary heart disease. She would be expected primarily to suffer from myocardial:

 

a. hypertrophy.
b. ischaemia.
c. necrosis.
d. dilation.

 

REF: p 599

 

  1. A 56-year-old male is diagnosed with coronary heart disease. Which of the following modifiable risk factors would most likely influence development of this disease?

 

a. eating meat.
b. the geographic location of home.
c. exposure to infection.
d. cigarette smoking.

 

REF: p 597

 

  1. A 50-year-old obese male with hypertension and coronary artery disease visits a nutritionist for food counselling. He is told that foods which ____ LDL levels and ___ HDL levels should be avoided.

 

a. raise, raise
b. raise, lower
c. lower, lower
d. lower, raise

 

REF: p 597

 

  1. The most common cause of myocardial ischaemia is:

 

a. idiopathic vasospasm.
b. arterial emboli from heart valve vegetation.
c. atherosclerosis.
d. venous emboli.

 

REF: p 599

 

  1. A 53-year-old male presents with recurrent chest pain on exertion. He is diagnosed with angina pectoris. The pain he experiences occurs when:
a. cardiac output has fallen below normal levels.
b. the myocardial oxygen supply has fallen below demand.
c. myocardial stretch has exceeded the upper limits.
d. the vagus nerve is stimulated.

 

REF: p 600

 

  1. A 62-year-old male presents to his GP complaining of chest pain at rest and on exertion. He does not have a history of coronary artery disease and reports that the pain often occurs at night. He is most likely experiencing which type of angina?

 

a. unstable
b. stable
c. Prinzmetal’s
d. silent

 

REF: p 601

 

  1. A 51-year-old male is at his health clinic for an annual physical exam. After walking from the car to the clinic, he developed a substernal pain. He also reported discomfort in his left shoulder and his jaw, lasting two to three minutes and then subsiding with rest. He indicates that this has occurred frequently over the past few months with similar exertion. He is most likely to be experiencing:
a. stable angina.
b. unstable angina.
c. Prinzmetal’s angina.
d. myocardial infarction.

 

REF: p 601

 

  1. A 49-year-old male presents to his GP complaining of chest pain. An ECG reveals ST elevation. He is diagnosed with myocardial ischaemia. Which of the following interventions would be most beneficial?
a. decrease in ventricular volume with diuretic
b. increase myocardial oxygen supply
c. increase heart rate
d. increase cardiac contractility

 

REF: p 602

 

  1. A 68-year-old male presents to the ED complaining of chest pain. He has a history of stable angina that now appears to be unstable. This indicates:
a. mild to moderate atherosclerosis.
b. myocardial infarction may soon follow.
c. electrical conduction problems in the heart.
d. decreased myocardial oxygen demand.

 

REF: p 603

 

  1. A 55-year-old male died of myocardial infarction. Autopsy would most likely reveal:
a. embolisation of plaque from the aorta.
b. decreased ventricular diastolic filling time.
c. platelet aggregation within an atherosclerotic coronary artery.
d. smooth muscle dysplasia in the coronary artery.

 

REF: p 604

 

  1. Cardiac cells can withstand ischaemic conditions for _____ before irreversible cell injury occurs.

 

a. 1 minute
b. 20 minutes
c. 30 minutes
d. 60 minutes

 

REF: p 605

 

  1. A 60-year-old female had a myocardial infarction. She was brought to hospital 30 minutes later. She survived but now has impaired ventricular function because:

 

a. there was a temporary alteration in electrolyte balance.
b. there was too much stress on the heart.
c. the cells became hypertrophic.
d. the resulting ischaemia led to hypoxic injury and myocardial cell death.

 

REF: p 607

 

  1. A 75-year-old male presents with severe chest pain. Lab tests in hospital reveal elevated levels of creatine kinase and lactic dehydrogenase. These elevated levels indicate probable:

 

a. Raynaud’s disease.
b. myocardial infarction.
c. orthostatic hypertension.
d. varicose veins.

 

REF: p 609

 

  1. A 28-year-old female presents to the ED complaining of severe chest pain that worsens with respirations or lying down. She has a low grade fever, tachycardia and a friction rub. The most likely cause of these symptoms is:

 

a. acute pericarditis.
b. myocardial infarction.
c. stable angina.
d. pericardial effusion.

 

REF: p 619

 

  1. Many valvular stenosis and regurgitation disorders in adults have a common aetiology. Which of the following can result in both types of valve dysfunction?

 

a. heart failure
b. connective tissue disorders
c. rheumatic fever or heart disease
d. syphilis infection

 

REF: p 621

 

  1. In valvular _____, the valve opening is constricted and narrowed because the valve leaflets, or cusps, fail to open completely.
a. regurgitation
b. insufficiency
c. stenosis
d. incompetence

 

REF: p 622

 

  1. A 67-year-old female was previously diagnosed with rheumatic heart disease. Tests reveal lipoprotein deposition with chronic inflammation that impairs blood flow from the left ventricle into the aorta. Which of the following is the most likely diagnosis?

 

a. aortic sclerosis
b. aortic stenosis
c. valvular regurgitation
d. valvular stenosis

 

REF: p 621

 

  1. A 60-year-old female was diagnosed with mitral stenosis. As a result, she has incomplete emptying of the:

 

a. right atrium.
b. right ventricle.
c. left atrium.
d. left ventricle.

 

REF: p 622

 

  1. A 72-year-old female has a history of hypertension and atherosclerosis. An echocardiogram reveals backflow of blood into the left ventricle. Which of the following is the most likely diagnosis?

 

a. mitral regurgitation
b. mitral stenosis
c. aortic regurgitation
d. aortic stenosis

 

REF: p 623

 

  1. Which valve disorder is manifested by a widened pulse pressure and throbbing peripheral pulses?
a. mitral regurgitation
b. mitral stenosis
c. aortic regurgitation
d. aortic stenosis

 

REF: p 624

 

  1. A 10-year-old male presents with fever, lymphadenopathy, arthralgia and nose bleeds. He is diagnosed with rheumatic heart disease. The most likely cause of this disease is:

 

a. congenital heart defects.
b. HIV infections.
c. group A ß-haemolytic streptococcus infections.
d. acute pericarditis.

 

REF: p 625

 

  1. Rheumatic heart disease is thought to involve:

 

a. organisms that adhere to the endothelium of blood vessels.
b. an autoimmune response.
c. high fevers that damage collagen.
d. rheumatoid factor in the blood, stimulating valvular degeneration.

 

REF: p 624

 

  1. A newborn child experiences hypoxia and cyanosis. The most likely diagnosis is a congenital heart defect causing a(n) _____ shunt.

 

a. right-to-left
b. left-to-right
c. ductus venosus
d. umbilical

REF: p 616

 

  1. The patent opening between the aorta and pulmonary artery in a fetus is called the:

 

a. foramen ovale.
b. ductus venosus.
c. ductus arteriosus.
d. foramen magnum.

 

REF: p 615

 

  1. An 8-week-old infant presents to her GP for a check-up. Physical exam reveals a murmur, and an echocardiogram shows a large ventricular septal defect. Left untreated, this defect tends to cause:

 

a. pulmonary hypertension.
b. cyanosis.
c. dysrhythmias.
d. valve damage.

 

REF: p 617

 

  1. A newborn baby is severely cyanotic. An echocardiogram reveals transposition of the great arteries. Which of the following occurs with this defect?

 

a. the pulmonary artery leaves the right ventricle
b. the aorta leaves the right ventricle
c. ventricular septal defect
d. atrial septal defect

 

REF: p 616

 

  1. A 5-year-old female is found to have hypertension during three separate visits to her doctor. Lab tests reveal that the hypertension is secondary to:

 

a. renal disease.
b. brain tumour.
c. hypocalcaemia.
d. hyponatraemia.

 

REF: p 587

 

  1. A 30-year-old female presents to her doctor with fever, cardiac murmur and petechial skin lesions. She is diagnosed with infective endocarditis. The most likely cause of her disease is:

 

a. bacteria.
b. viruses.
c. fungi.
d. parasites.

 

REF: p 627

 

  1. White blood cells have difficulty in attacking microorganisms in infective endocarditis because:

 

a. the microorganisms are resistant.
b. the valves are avascular.
c. the microorganisms are sequestered in a fibrin clot.
d. the colonies overwhelm the phagocytes.

 

REF: p 626

 

  1. A 50-year-old male visits the cardiologist for an ECG. Results indicate he has no P-R interval and a variable rate QRS with rhythm irregularity. Which of the following is the most likely diagnosis?

 

a. atrial tachycardia
b. atrial fibrillation
c. sinus dysrhythmia
d. idioventricular rhythm

 

REF: p 630

 

  1. As left heart failure progresses:

 

a. left ventricular preload increases.
b. systemic vascular resistance decreases.
c. left end-diastolic volume decreases.
d. pulmonary vascular resistance decreases.

 

REF: p 633

 

  1. A 65-year-old male with a history of untreated hypertension is now experiencing left heart failure. The most likely reason is:

 

a. ventricular dilation and wall thinning.
b. myocardial hypertrophy and ventricular remodelling.
c. inhibition of renin and aldosterone.
d. alterations in alpha and beta receptor function.

 

REF: p 633

 

  1. A 59-year-old female is diagnosed with left ventricular failure. The associated decrease in kidney perfusion would tend to cause:

 

a. decreased left ventricular preload.
b. increased pulmonary capillary permeability.
c. increased systemic vascular resistance.
d. decreased cardiac oxygen demand.

 

REF: p 633

 

  1. A 68-year-old female is experiencing left heart failure. Physical exam reveals elevated blood pressure, which is most likely caused by:

 

a. sympathetic nervous system compensation for decreased cardiac output.
b. stress hormones promoting increased cardiac contractility.
c. cardiotoxic effects of catecholamines and angiotensin.
d. diastolic dysfunction.

 

REF: p 635

 

  1. Pulmonary symptoms, such as dyspnoea and cough, common to left heart failure are a result of:

 

a. inflammatory pulmonary oedema.
b. hypoxaemia.
c. pulmonary vascular congestion.
d. bronchoconstriction.

 

REF: p 636

 

  1. A 65-year-old male is diagnosed with chronic pulmonary disease and elevated pulmonary vascular resistance. Which of the following heart failures generally results from this condition?

 

a. right heart failure
b. left heart failure
c. low-output failure
d. high-output failure

 

REF: p 637

 

  1. A 72-year-old female has a history of right heart failure caused by a right ventricular myocardial infarction. Which of the following symptoms are directly related to her right heart failure?

 

a. significant oedema to both lower legs and feet
b. hypertension
c. decreased urine output
d. pulmonary congestion

 

REF: p 637

 

  1. When a person is in shock, impairment in cellular metabolism is caused by:

 

a. release of toxic substances.
b. free-radical formation.
c. inadequate tissue perfusion.
d. lack of nervous or endocrine stimulation.

 

REF: p 639

 

  1. One consequence of switching from aerobic to anaerobic cellular metabolism during shock states is:

 

a. decreased ATP production.
b. cellular dehydration.
c. cellular alkalosis.
d. free-radical formation.

 

REF: p 639

 

  1. During shock states, glucose uptake is usually:

 

a. enhanced.
b. normal.
c. impaired.
d. energy intensive.

 

REF: p 639

 

  1. A 50-year-old male was admitted to the intensive care unit with a diagnosis of acute myocardial infarction. He is being treated for shock. His cardiopulmonary symptoms include low blood pressure, tachycardia and tachypnoea. His skin is pale and cool. The primary cause of his shock is most likely:

 

a. rapid heart rate.
b. decreased cardiac contractility.
c. increased capillary permeability.
d. decreased afterload due to vasodilation.

 

REF: p 640

 

  1. An 82-year-old female was admitted to hospital with confusion and severe hypotension. Her body’s compensatory mechanisms are increased heart rate, vasoconstriction and movement of large volumes of interstitial fluid to the vascular compartment. What kind of shock do you suspect?

 

a. anaphylactic
b. hypovolaemic
c. neurogenic
d. septic

 

REF: p 641

 

  1. A 27-year-old male is admitted to a neurologic unit with a complete C-5 spinal cord transaction. On initial assessment, he is bradycardic, hypotensive and hyperventilating. He appears to be going into shock. The most likely mechanism of his shock is:

 

a. hypovolaemia caused by blood loss.
b. hypovolaemia caused by evaporative fluid losses.
c. vasodilation caused by gram-negative bacterial infection.
d. vasodilation caused by a decrease in sympathetic stimulation.

 

REF: p 642

 

  1. Neurogenic shock can be caused by any factor that inhibits the:

 

a. parasympathetic nervous system.
b. sympathetic nervous system.
c. somatic nervous system.
d. thalamus.

 

REF: p 642

 

  1. A 15-year-old male who is allergic to peanuts inadvertently eats something containing peanuts. He then goes into anaphylactic shock and develops:

 

a. bradycardia, decreased arterial pressure and oliguria.
b. bronchoconstriction, hives, oedema and hypotension.
c. hypertension, anxiety and tachycardia.
d. fever, hypotension and pustular rash.

 

REF: p 643

 

  1. The onset of anaphylactic shock is usually:

 

a. mild.
b. immediate and life threatening.
c. delayed by several hours.
d. delayed by 24 hours.

 

REF: p 643

 

  1. A 20-year-old female is being admitted to hospital with fever and septic shock. Which set of clinical manifestations would you expect her to exhibit?

 

a. bradycardia, palpitations, confusion, truncal rash
b. severe respiratory distress, jugular venous distention, chest pain
c. low blood pressure, tachycardia, generalised oedema
d. reduced cardiac output, increased systemic vascular resistance, moist cough

 

REF: p 643

 

  1. The hypotensive state seen in septic shock can cause:

 

a. an amplified anti-inflammatory response.
b. gut lining disruption and the tr
c. the location of bacteria into the bloodstream.
d. the increased oxygen demand of highly metabolic tissue.
e. the increased spread of infection.

 

REF: p 643

 

  1. The most common cause of multiple organ dysfunction syndrome (MODS) is:

 

a. myocardial infarction.
b. pulmonary disease.
c. septic shock.
d. autoimmune disease.

 

REF: p 646

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 24: The structure and function of the pulmonary system

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The nasopharynx is lined with a ciliated mucosal membrane with a highly vascular blood supply. One function of the membrane is to:

 

a. absorb air.
b. humidify air.
c. cool air.
d. exchange gases.

 

REF: p 656

 

  1. The slit-shaped space between the true vocal cords forms the:

 

a. glottis.
b. epiglottis.
c. larynx.
d. carina.

 

REF: p 657

 

  1. After entering a room of chemical fog, a 20-year-old male cannot stop sneezing. Which of the following structures is primarily responsible for his sneezing?

 

a. upper respiratory tract mucosa
b. irritant receptors in the trachea and large airways
c. irritant receptors in the nostrils
d. nasal hairs and turbinates

 

REF: pp 661

 

  1. All of the following may be found in the walls of the respiratory bronchi except:

 

a. smooth muscle.
b. surfactant-producing glands.
c. goblet cells.
d. ciliated cells.

 

REF: p 661

 

  1. A newborn is in respiratory distress and requires ventilation. Tests reveal he does not produce surfactant due to the absence of:

 

a. type I alveolar cells.
b. type II alveolar cells.
c. alveolar macrophages.
d. goblet cells.

 

REF: p 662

 

  1. The movement of blood into and out of the capillary beds of the lungs to the body organs and tissues is called:

 

a. perfusion.
b. ventilation.
c. diffusion.
d. active transport.

 

REF: p 656

 

  1. Diffusion of respiratory gases takes place at the membrane between the:

 

a. alveolar ducts and lymphatic capillaries.
b. type I alveolar cells and pulmonary capillaries.
c. type I and type II alveolar cells.
d. type II alveolar cells and pulmonary venules.

 

REF: p 662

 

  1. Students in a histology class are assigned to identify regions of the lung. The slide shows a basement membrane, capillary lumen and macrophages. They are looking at the:

 

a. trachea.
b. bronchioles.
c. alveoli.
d. bronchus.

 

REF: p 661

 

  1. The pleural membranes are examples of _____ membranes.

 

a. mucous
b. serous
c. synovial
d. peritoneal

 

REF: p 663

 

  1. A 42-year-old male was involved in a motor vehicle accident during which he suffered a severe head injury. He died shortly after the accident from loss of respiration. The area of the brain most likely involved is the:

 

a. cerebral cortex.
b. thalamus.
c. basal ganglia.
d. brain stem.

 

REF: p 670

 

  1. The receptors that respond to increased pulmonary capillary pressure are called:

 

a. irritant receptors.
b. chemoreceptors.
c. stretch receptors.
d. J receptors.

 

REF: p 671

 

  1. The _____ is the maximum amount of gas that can be displaced (expired) from the lung.

 

a. vital capacity
b. total lung capacity
c. functional capacity
d. residual volume

 

REF: p 669

 

  1. _____ are receptors in the lung that decrease ventilatory rate and volume when stimulated.

 

a. Carbon dioxide receptors
b. Baroreceptors
c. Stretch receptors
d. Chemoreceptors

 

REF: p 671

 

  1. The lung receives parasympathetic innervation by the _____ nerve.

 

a. vagus
b. phrenic
c. brachial
d. pectoral

 

REF: p 672

 

  1. If an individual with respiratory difficulty was retaining too much carbon dioxide, which of the following receptors would be stimulated in an attempt to maintain a normal homeostatic state?

 

a. irritant receptors
b. stretch receptors
c. peripheral chemoreceptors
d. central chemoreceptors

 

REF: p 672

 

  1. If an individual with respiratory difficulty were retaining too much carbon dioxide, which of the following compensatory responses would be initiated?

 

a. increase in respiratory rate
b. decrease in ventilation rate
c. increase in tidal volume
d. vasodilation of the pulmonary arterioles

 

REF: p 672

 

  1. During quiet inspiration, muscular contraction of the diaphragm causes air to move into the lung. The mechanisms that drive air movement during quiet inspiration are:

 

a. a decrease in intraalveolar pressure and lifting of the rib cage.
b. a decrease in the size of the thorax and alveolar expansion.
c. an increase in the size of the thorax and a decrease in intrapleural pressure.
d. an increase in atmospheric pressure and intrapleural pressure.

 

REF: p 666

 

  1. The pressure required to inflate an alveolus is inversely related to:

 

a. wall thickness.
b. surface tension.
c. minute volume.
d. alveolar radius.

 

REF: p 666

 

  1. Surfactant facilitates alveolar distension and ventilation by:

 

a. decreasing thoracic compliance.
b. attracting water to the alveolar surface.
c. decreasing surface tension in alveoli.
d. increasing diffusion in alveoli.

 

REF: p 666

 

  1. Which of the following occurs when there is a balance between outward recoil of the chest wall and inward recoil of lungs at rest?

 

a. FRC is reached.
b. VC is reached.
c. TLC is reached.
d. IC is reached.

 

REF: p 667

 

  1. At sea level, the percentage of oxygen in the air is approximately:

 

a. 16%.
b. 21%.
c. 32%.
d. 78%.

 

REF: p 674

 

  1. Determine the partial pressure of oxygen in the lung given the following conditions:

Percentage of oxygen in air: 20

Barometric pressure: 700 mmHg

 

a. 111 mmHg
b. 124 mmHg
c. 131 mmHg
d. 140 mmHg

 

REF: p 674

 

  1. At the base of the lungs:

 

a. alveolar gas pressure exceeds arterial perfusion pressure.
b. arterial perfusion pressure and alveolar gas pressure are less than at the apex.
c. arterial perfusion pressure exceeds alveolar gas pressure.
d. arterial perfusion and alveolar gas pressure are equal.

 

REF: p 675

 

  1. Alveoli in the apexes of the lungs are _____ than alveoli in the bases.

 

a. larger
b. more numerous
c. more compliant
d. better perfused

 

REF: p 675

 

  1. Approximately 1000 mL (1 litre) of oxygen is transported to cells each minute. Most of the oxygen is transported:

 

a. dissolved in the plasma.
b. bound to haemoglobin.
c. in the form of CO2.
d. as a free-floating molecule.

 

REF: p 676

 

  1. If a patient’s haemoglobin concentration (Hb) is 14 g/100 mL and arterial oxygen saturation (SaO2) is 98%, what would be his arterial oxygen content? Remember that 1.34 mL O2 is the maximum amount of oxygen that can be transported per gram of haemoglobin. Hint: O2 content = (1.34 × Hb) SaO2.

 

a. 13.72 mL O2 per 100 mL blood
b. 18.38 mL O2 per 100 mL blood
c. 18.76 mL O2 per 100 mL blood
d. 19.30 mL O2 per 100 mL blood

 

REF: p 678

 

  1. In a patient with acidosis or a fever, you would expect the oxyhaemoglobin dissociation curve to:

 

a. shift to the right, causing more O2 to be released to the cells.
b. shift to the left, allowing less O2 to be released to the cells.
c. shift downwards, allowing less O2 to dissolve in the plasma.
d. shift upwards, allowing more O2 to dissolve in the plasma.

 

REF: p 678

 

  1. Carbon dioxide is mainly transported in the blood:

 

a. attached to oxygen.
b. dissolved in red blood cells.
c. combined with albumin.
d. in the form of bicarbonate ion.

 

REF: p 679

 

  1. An 80-year-old male presents to his GP complaining of difficulty breathing. Pulmonary function tests reveal he has increased residual volume. The most likely cause of this disorder is _____ in lung compliance.

 

a. an increase
b. a decrease
c. no change
d. an absence

 

REF: p 680

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 25: Alterations of pulmonary function across the life span

 

Test Bank

 

MULTIPLE CHOICE

 

  1. Asthma is thought to be caused by:

 

a. an autosomal recessive trait.
b. autoimmunity.
c. excessive use of antibiotics as a young child.
d. interactions between genetic and environmental factors.

 

REF: p 685

 

  1. In asthma, _____ is (are) reduced.

 

a. lung volumes
b. expiratory flow rates
c. air trapping
d. dead space

 

REF: p 685

 

  1. A 13-year-old female is diagnosed with asthma. Which of the following should she recognise as part of an asthmatic attack?

 

a. headache
b. chest pain
c. wheezing
d. bradycardia

 

REF: p 687

 

  1. Airway hyper-responsiveness in asthma is related to:

 

a. increased sympathetic nervous system response.
b. the release of stress hormones.
c. exposure to an allergen causing mast cell degranulation.
d. hereditary decrease in IgE responsiveness.

 

REF: p 685

 

  1. Airway obstruction contributing to increased airflow resistance and hypoventilation in asthma is caused by:

 

a. type II alveolar cell injury and decreased surfactant.
b. alveolar fibrosis and pulmonary oedema.
c. mucous secretion, bronchoconstriction and airway oedema.
d. collapse of the cartilaginous rings in the bronchi.

 

REF: p 685

 

  1. A 10-year-old male is brought to the ED with prolonged bronchospasm and severe hypoxaemia. The most likely diagnosis is:

 

a. exercise-induced asthma.
b. chronic obstructive pulmonary disease.
c. status asthmaticus.
d. bronchiectasis.

 

REF: p 688

 

  1. A 60-year-old female with emphysema is having difficulty expiring a given volume of air. She is most likely experiencing _____ pulmonary disease.

 

a. restrictive
b. obstructive
c. atelectatic
d. pleuritic

 

REF: p 694

 

  1. A 52-year-old female presents with chronic bronchitis. Tests reveal closure of the airway during expiration. This condition is most likely caused by:

 

a. thick mucus from hypertrophied glands.
b. ventilation-perfusion mismatch.
c. hyperventilation.
d. thinning smooth muscle in the bronchioles.

 

REF: p 695

 

  1. A 45-year-old male presents with chronic bronchitis of 5 months’ duration. Which of the following is most likely to cause this condition?

 

a. chronic asthma
b. air pollution
c. cigarette smoke
d. recurrent pneumonia

 

REF: p 695

 

  1. A 45-year-old male presents with chronic bronchitis of 5 months’ duration. Which of the following is the most significant concern in this patient?

 

a. left heart failure
b. pulmonary embolus
c. immunosuppression
d. recurrent pulmonary infections

 

REF: p 695

 

  1. Individuals with a recent diagnosis of emphysema most often present with:

 

a. a productive cough.
b. cyanosis.
c. dyspnoea.
d. cor pulmonale.

 

REF: p 698

 

  1. A 53-year-old male with a 20-year history of smoking is diagnosed with emphysema. His airways are obstructed because of:

 

a. excessive mucous production.
b. loss of elastic recoil.
c. infection and inflammation.
d. airway oedema.

 

REF: p 695

 

  1. A 60-year-old female with a 25-year history of smoking is diagnosed with emphysema. She has an increased anterior-posterior chest diameter because of:

 

a. air trapping.
b. increased inspiratory reserve volumes.
c. increased flow rates.
d. alveolar destruction.

 

REF: p 695

 

  1. A 15-year-old female is diagnosed with restrictive lung disease caused by cystic fibrosis. Which of the following is expected?

 

a. increased residual volume
b. increased tidal volume
c. decreased respiratory rate
d. decreased tidal volume

 

REF: p 700

 

  1. A 42-year-old female presents with dyspnoea, rapid, shallow breathing, inspiratory crackles, decreased lung compliance and hypoxaemia. Tests reveal a fulminant form of respiratory failure characterised by acute lung inflammation and diffuse alveolar-capillary injury. Which of the following is the most likely diagnosis?

 

a. acute respiratory distress syndrome
b. sarcoidosis
c. postoperative respiratory failure
d. malignant respiratory failure

 

REF: p 703

 

  1. Which of the following shows a correct cause and effect sequence in the development of acute respiratory distress syndrome (ARDS)?

 

a. impaired alveolar compliance causing decreased surfactant production
b. a massive inflammatory response causing alveolar-capillary membrane injury
c. hyaline membrane formation and fibrosis causing pulmonary oedema
d. increased alveolar-capillary membrane permeability causing metabolic acidosis

 

REF: p 703

 

  1. A 57-year-old male presents with cough, sputum production, dyspnoea and decreased lung volume. He is diagnosed with pneumoconiosis. His illness is probably caused by:

 

a. inhalation of silica, asbestos or mica.
b. autoimmune disease.
c. allergic reactions.
d. flail chest.

 

REF: p 705

 

  1. Pneumonia is caused by:

 

a. use of anaesthetic agents in surgery.
b. atelectasis.
c. chronic lung changes seen with ageing.
d. viral or bacterial infections.

 

REF: p 706

 

  1. A 30-year-old male prison inmate contracted tuberculosis during an outbreak. The organism that caused this condition is a:

 

a. bacterium.
b. fungus.
c. virus.
d. parasite.

 

REF: p 707

 

  1. A 30-year-old male prison inmate contracted tuberculosis during an outbreak. He can transmit this disease through:

 

a. skin contact.
b. faecal-oral contact.
c. airborne droplets.
d. blood transfusions.

 

REF: p 707

 

  1. A 6-month-old female presents with rhinorrhoea, cough, poor feeding, lethargy and fever. She is diagnosed with bronchiolitis. Which of the following is most likely causing her condition?

 

a. parainfluenza virus
b. Haemophilus B influenzae
c. respiratory syncytial virus
d. group A beta-haemolytic streptococcus

 

REF: p 710

 

  1. A 50-year-old male with a 30-year history of smoking was diagnosed with lung cancer. He was previously exposed to air pollution, asbestos and radiation at his job. Which of the following most likely had the greatest impact on development of his cancer?

 

a. radiation
b. cigarette smoke
c. asbestos
d. air pollution

 

REF: p 711

 

  1. A 60-year-old male with a 40-year history of smoking presents with chest pain, cough and an atypical Cushing’s syndrome. Tests reveal widespread metastatic cancer. Which of following is the most likely type of cancer?

 

a. adenoma
b. large cell carcinoma
c. small cell carcinoma
d. squamous cell carcinoma

 

REF: p 713

 

  1. A 10-year-old male was diagnosed with obstructive sleep apnoea. Which of the following treatments would most likely be tried first?

 

a. tonsillectomy and adenoidectomy
b. weight loss
c. continuous positive airway pressure
d. drug therapy

 

REF: p 715

 

  1. A 1-year-old female is diagnosed with croup. The most likely cause of this disease is:

 

a. bacterial infection.
b. acute hyperventilation.
c. allergy.
d. viral infection.

 

REF: p 716

 

  1. A 1-year-old female is diagnosed with croup. Which of the following symptoms is most likely present?

 

a. haemoptysis and mucus production
b. high fever and dry cough
c. respiratory stridor and barking cough
d. drooling and snoring

 

REF: p 717

 

  1. A newborn has respiratory distress syndrome. Which of the following is the most important predisposing factor for this condition?

 

a. low birth weight
b. alcohol consumption by the mother during pregnancy
c. premature birth
d. smoking by the mother during pregnancy

 

REF: p 717

 

  1. A newborn has respiratory distress syndrome. He develops atelectasis because of:

 

a. lack of surfactant.
b. pulmonary oedema.
c. airway obstruction.
d. pulmonary fibrosis.

 

REF: p 717

 

  1. A newborn has respiratory distress syndrome. This condition appeared:

 

a. within minutes of birth.
b. 2 to 3 hours after birth.
c. within the first 12 to 24 hours after birth.
d. 24 to 48 hours after exposure to an infectious organism.

 

REF: p 718

 

  1. During a respiratory assessment of an infant with respiratory distress syndrome, a sinking in the supraclavicular and intercostal areas of the thorax was noted with inspiration. This observation is called:

 

a. grunting.
b. tachypnoea
c. retractions.
d. nasal flaring.

 

REF: p 718

 

  1. Cystic fibrosis is an:

 

a. autosomal recessive disease.
b. autosomal dominant disease.
c. X-linked recessive disease.
d. X-linked dominant disease.

 

REF: p 698

 

  1. A 1-year-old child with cystic fibrosis would demonstrate elevated levels of which of these compounds in both sweat and salivary gland secretions?

 

a. potassium
b. chloride
c. magnesium
d. carbonic acid

 

REF: p 698

 

  1. A 7-month-old male presents with failure to thrive and frequent, loose and oily stools. Sweat testing reveals increased chloride. Which of the following would also accompany this disease?

 

a. autoantibodies that target the lungs and pancreas
b. a thick mucus
c. enzymes that degrade surfactant in the alveoli
d. a toxic amount of electrolytes from secretory glands

 

REF: p 698

 

  1. A young patient is admitted to the paediatric unit with cystic fibrosis exacerbation. The main cause of respiratory difficulties in individuals with cystic fibrosis is:

 

a. airway rigidity.
b. pulmonary oedema.
c. recurrent pneumonia.
d. asthma-like bronchospasm.

 

REF: p 700

 

  1. Sudden infant death syndrome (SIDS) occurs most often between _____ months of age.

 

a. 1 and 2
b. 3 and 4
c. 6 and 8
d. 8 and 12

 

REF: p 719

 

  1. A 5-month-old female is found dead in her cot. The coroner ruled SIDS as the cause of death. Which of the following risk factors is most likely associated?

 

a. congenital heart disease
b. female gender
c. Caucasian race
d. frequent respiratory infections

 

REF: p 719

 

  1. To prevent SIDS, parents should be instructed to:

 

a. place infants on a soft mattress for sleeping.
b. always lie infants down on their backs to sleep.
c. breastfeed their infants.
d. keep the infant’s room very warm.

 

REF: p 7190

 

  1. A 70-year-old female is in the hospital for pelvic fracture. She develops pulmonary thromboembolism. This condition is the result of occlusion of a portion of the pulmonary vascular bed by an embolus of:

 

a. fat.
b. air.
c. tissue fragment.
d. blood clot.

 

REF: p 716

 

  1. A 50-year-old male is diagnosed with pulmonary embolism. Which of the following symptoms most likely occurred before treatment?

 

a. dry cough and inspiratory crackles
b. shallow respirations and wheezing
c. chest pain and shortness of breath
d. Kussmaul respirations and back pain

 

REF: p 720

 

  1. A massive pulmonary embolism will most likely lead to:

 

a. damage to the lung microcapillaries.
b. chronic obstructive pulmonary disease.
c. disseminated intravascular coagulation.
d. shock and death.

 

REF: p 720

 

  1. The most common cause of pulmonary oedema is:

 

a. right heart failure.
b. left heart failure.
c. asthma.
d. lung cancer.

 

REF: p 722

 

  1. A 47-year-old male is diagnosed with pulmonary oedema. Which of the following would be expected with this condition?

 

a. thick mucus secretions
b. pink, frothy sputum
c. hypocapnia
d. wheezing

 

REF: p 722

 

  1. Reduced oxygenation of arterial blood is called:

 

a. ischaemia.
b. hypoxia.
c. hypoxaemia.
d. hypocapnia.

 

REF: p 723

 

  1. A group of mountain climbers experience confusion, tachycardia, oedema and decreased renal output after climbing a mountain at very high altitude. This condition is caused by:

 

a. bronchoconstriction.
b. hypoventilation.
c. decreased inspired oxygen.
d. diffusion abnormalities.

 

REF: p 723

 

  1. A low ventilation-perfusion ratio results in:

 

a. increased dead space.
b. shunting.
c. alveolar collapse.
d. bronchoconstriction.

 

REF: p 723

 

  1. The condition in which a series of alveoli in the left lower lobe receive adequate ventilation but do not have adequate perfusion is called:

 

a. a right-to-left shunt.
b. alveolar dead space.
c. a low ventilation-perfusion ratio.
d. pulmonary hypotension.

 

REF: p 723

 

  1. A 30-year-old male is experiencing respiratory failure. Which of the following lab values would be expected?

 

a. electrolyte imbalances
b. low PaCO2
c. low haematocrit
d. low blood pH

 

REF: p 724

 

  1. A 26-year-old female recently underwent surgery and is now experiencing dyspnoea, cough, fever and leucocytosis. Tests reveal she has a collapsed lung caused by removal of air from obstructed alveoli. This condition is called:

 

a. compression atelectasis.
b. bronchiectasis.
c. absorption atelectasis.
d. hypoventilation.

 

REF: p 724

 

  1. A 50-year-old male presents with hypotension, hypoxaemia and tracheal deviation to the left. Tests reveal the air pressure in the pleural cavity exceeds barometric pressure in the atmosphere. The most likely diagnosis is:

 

a. pleural effusion.
b. tension pneumothorax.
c. open pneumothorax.
d. transudative pneumothorax.

 

REF: p 724

 

  1. An 80-year-old female develops pneumonia in hospital. She becomes cyanotic, tachycardic, and develops a fever and cough. Chest X-ray reveals pus in the pleural space. Which of the following is the most likely diagnosis?

 

a. empyema
b. emphysema
c. pleurisy
d. chyle

 

REF: p 725

 

  1. A 65-year-old male recently had a cerebrovascular accident that resulted in dysphagia. He now has aspiration of gastric contents. This condition could cause:

 

a. pneumonia.
b. bronchiectasis.
c. pneumothorax.
d. emphysema.

 

REF: p 725

 

  1. A 10-year-old female develops pneumonia following a urinary tract infection. Physical exam reveals subcostal and intercostal retractions. She reports that breathing is difficult and she feels she cannot get enough air. This condition is referred to as:

 

a. cyanosis.
b. dyspnoea.
c. hyperpnoea.
d. orthopnoea.

 

REF: p 727

 

  1. A 20-year-old male presents to his GP complaining of difficulty breathing when lying down. This condition is referred to as:

 

a. dyspnoea on exertion.
b. orthopnoea.
c. apnoea.
d. tachypnoea.

 

REF: p 727

 

  1. Paroxysmal nocturnal dyspnoea generally occurs with:

 

a. pulmonary fibrosis.
b. asthma.
c. left ventricular failure.
d. hypertension.

 

REF: p 769

 

  1. A 20-year-old male is in acute pain. An arterial blood gas reveals decreased carbon dioxide levels. Which of the following is the most likely cause?

 

a. hyperventilation
b. hypoventilation
c. apnoea
d. cyanosis

 

REF: p 727

 

  1. A 65-year-old female with emphysema presents to the ED for difficulty breathing. Physical exam reveals bluish skin and mucous membranes. This condition is referred to as:

 

a. cyanosis.
b. haemoptysis.
c. haematemesis.
d. ischaemia.

 

REF: p 728

 

  1. A 50-year-old male with diabetes did not take his medication and is now in metabolic acidosis. He is experiencing Kussmaul respirations that can be characterised by:

 

a. audible wheezing or stridor.
b. an increased ventilatory rate, large tidal volumes and no expiratory pause.
c. rapid respirations with periods of apnoea.
d. very slow inhalations and rapid expirations.

 

REF: p 728

 

  1. A 30-year-old female received a severe head injury in a motor vehicle accident. She is now experiencing respiratory abnormalities characterised by alternating periods of deep and shallow breathing. This condition is referred to as:

 

a. Cheyne-Stokes.
b. Frank-Starling.
c. apnoea.
d. orthopnoea.

 

REF: p 728

 

  1. A 28-year-old male complains to his GP that he has had a cold for a week and is coughing up bloody secretions. This condition is referred to as:

 

a. haematemesis.
b. cyanosis.
c. rhinitis.
d. haemoptysis.

 

REF: p 728

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 26: The structure and function of the digestive system

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The gastrointestinal tract performs all of the following processes except:

 

a. absorption of digested food.
b. chemical breakdown of food particles.
c. micturition.
d. mechanical breakdown of food particles.

 

REF: p 733

 

  1. Which sphincter keeps stomach acid from regurgitating into the oesophagus?

 

a. pyloric
b. lower oesophageal
c. upper oesophageal
d. gastric

 

REF: p 737

 

  1. A new drug is being tested that is known to inhibit parasympathetic nervous system activity. It is expected that the salivary glands will become:

 

a. hyperactive.
b. hypoactive.
c. atrophied.
d. enlarged.

 

REF: p 738

 

  1. Analysis of a sample of normal bile would most likely reveal:

 

a. amylase.
b. lipase.
c. trypsin.
d. bilirubin.

 

REF: p 751

 

  1. Food moves down the oesophagus via:
a. peristalsis.
b. retropulsion.
c. haustral segmentation.
d. defecation.

 

REF: p 735

 

  1. Salivary amylase (ptyalin) initiates the digestion of:

 

a. proteins.
b. carbohydrates.
c. fats.
d. amino acids.

 

REF: p 740

 

  1. A 15-year-old female begins taking a new weight-loss drug. The drug inhibits the smooth muscle action of the stomach. It most likely acts by increasing _____ stimulation.

 

a. somatic
b. sympathetic
c. parasympathetic
d. hormonal

 

REF: p 735

 

  1. Autonomic control is involved in gastrointestinal motility and:

 

a. defecation.
b. swallowing.
c. mastication.
d. digestive enzyme secretion.

 

REF: p 735

 

  1. The _____ cells of the gastric glands secrete hydrochloric acid.

 

a. chief
b. parietal
c. zymogenic
d. surface epithelial

 

REF: p 742

 

  1. Mucus production to form the mucosal barrier in the stomach is stimulated by the release of:

 

a. somatostatin.
b. gastrin.
c. prostaglandins.
d. histamine.

 

REF: p 743

 

  1. A young male student becomes very hungry during class. He begins thinking of a cheeseburger and fries, his favourite meal. These thoughts will trigger which phase of gastric secretion?

 

a. Cephalic
b. Caudal
c. Enteral
d. Intestinal

 

REF: p 744

 

  1. Which sphincter prevents reflux of digested material from the colon into the small intestine?

 

a. haustral
b. lower oesophageal
c. pyloric
d. ileocaecal valve

 

REF: p 744

 

  1. The ileum and jejunum are suspended by folds of the peritoneum known as the _____ that contains an extensive vascular and nervous network.

 

a. myenteric plexus
b. mesentery
c. Auerbach’s fold
d. Meissner’s plexus

 

REF: p 744

 

  1. Absorption of nutrients from the intestine occurs initially through the:

 

a. lacteals.
b. villi and microvilli.
c. lamina propria.
d. coeliac veins.

 

REF: p 744

 

  1. Digested fats are primarily absorbed into the:

 

a. lacteals.
b. central arterioles.
c. lamina propria.
d. villus capillaries.

 

REF: p 751

 

  1. The _____ reflex inhibits gastric motility when the ileum becomes overdistended.

 

a. Ileogastric
b. Gastroduodenal
c. Gastroileal
d. Colointestinal

 

REF: p 745

 

  1. The capillaries of the liver are more commonly known as hepatic:

 

a. canaliculi.
b. ducts.
c. sinusoids.
d. papillae.

 

REF: p 747

 

  1. The primary bile salts are produced from _____ by hepatocytes lining the bile canaliculi.

 

a. Lecithin
b. fatty acids
c. Cholesterol
d. Testosterone

 

REF: p 751

 

  1. The capillaries of the liver are lined in part by _____ cells, which are phagocytic.

 

a. Glisson
b. Kupffer
c. Meissner
d. Lieberkühn

 

REF: p 751

 

  1. During the cephalic and gastric phases of digestion, gallbladder contraction is mediated by branches of the:

 

a. sympathetic nervous system.
b. somatic nervous system.
c. vagus nerve.
d. glossopharyngeal nerve.

 

REF: p 753

 

  1. When relaxed, which sphincter allows bile to flow into the duodenum?

 

a. pyloric sphincter
b. sphincter of Oddi
c. ampulla of Vater
d. ileocaecal valve

 

REF: p 753

 

  1. The function of the acinar cells of the pancreas is to secrete:

 

a. bicarbonate.
b. enzymes.
c. mucus.
d. electrolytes.

 

REF: p 754

 

  1. The exocrine portion of the pancreas contains:

 

a. alpha cells.
b. beta cells.
c. ducts.
d. islets of Langerhans.

 

REF: p 754

 

  1. The vermiform appendix is attached to the:

 

a. duodenum.
b. ileum.
c. caecum.
d. sigmoid colon.

 

REF: p 754

 

  1. The _____ sphincter controls the movement of chyme from the sigmoid colon into the rectum.

 

a. Oddi
b. Ileocaecal
c. O’Beirne
d. internal anal

 

REF: p 754

 

  1. Parasympathetic stimulation to the pancreas causes which of the following reactions?

 

a. hormonal inhibition
b. enzyme secretion
c. vasoconstriction
d. decreased bicarbonate production

 

REF: p 754

 

  1. The _____ reflex initiates propulsion in the entire colon, usually during or immediately after eating.

 

a. Gastrocolic
b. Ileocolic
c. duodenalcolic
d. Cephalocolic

 

REF: p 756

 

  1. The defecation reflex can be overridden voluntarily by:

 

a. sitting.
b. performing the Valsalva manoeuvre.
c. contracting the external anal sphincter.
d. constricting the rectal valve.

 

REF: p 756

 

  1. The primary function of the large intestine is to:

 

a. absorb water.
b. absorb carbohydrates.
c. digest fats.
d. digest and absorb fats and proteins.

 

REF: p 758

 

  1. Polysaccharides are primarily obtained from:

 

a. honey and sugar.
b. meat and dairy products.
c. fish.
d. plants.

 

REF: p 759

 

  1. A 70-year-old male presents complaining of frequent gastrointestinal problems. His GP explains that during ageing GI changes, such as _____, occur.

 

a. decreased gastric juice secretion
b. decreased gallbladder function
c. increased liver size
d. increased pancreas size

 

REF: p 761

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 27: Alterations of digestive function across the life span

 

Test Bank

 

MULTIPLE CHOICE

 

  1. Which of the gastrointestinal cancers has the highest rate of incidence and is responsible for the highest number of deaths?

 

a. oesophageal
b. stomach
c. pancreatic
d. colorectal

 

REF: p 766

 

  1. A 40-year-old male who consumes a diet high in fat and low in fibre is at risk for:

 

a. cancer of the stomach.
b. cancer of the liver and biliary ducts.
c. cancer of the small intestine.
d. cancer of the colon and rectum.

 

REF: p 766

 

  1. Which modifiable risk factor is associated with oesophageal, stomach and colorectal cancer?

 

a. Helicobacter pylori infection
b. cigarette and alcohol use
c. ionising radiation exposure
d. obesity and sedentary lifestyle

 

REF: p 767

 

  1. A 60-year-old male is diagnosed with cancer of the oesophagus. Which of the following factors most likely contributed to his disease?

 

a. reflux oesophagitis
b. intestinal parasites and polyps
c. nitrates and salty foods
d. aflatoxin from moldy peanuts

 

REF: p 772

 

  1. Which of the following symptoms would help a healthcare provider distinguish between ulcerative colitis and Crohn’s disease?

 

a. abdominal pain
b. pattern of remission and exacerbation
c. diarrhoea
d. malabsorption and steatorrhoea

 

REF: p 774

 

  1. A 16-year-old female presents with abdominal pain in the right lower quadrant. Physical examination reveals rebound tenderness and a low-grade fever. A possible diagnosis would be:

 

a. colon cancer.
b. pancreatitis.
c. appendicitis.
d. ascites.

 

REF: p 779

 

  1. A 42-year-old female presents with abdominal discomfort, epigastric tenderness and bleeding. Gastroscopy reveals degeneration of the gastric mucosa in the body and fundus of the stomach. Which of the following would most likely follow?

 

a. pernicious anaemia
b. osmotic diarrhoea
c. increased acid secretion
d. decreased gastrin secretion

 

REF: p 779

 

  1. A 54-year-old male is diagnosed with gastric ulcer disease. This condition is most likely caused by:

 

a. hereditary hormonal imbalances with high gastrin levels.
b. breaks in the mucosa and presence of corrosive secretions.
c. decreased vagal activity and vascular engorgement.
d. gastric erosions related to high ammonia levels and bile reflux.

 

REF: p 781

 

  1. A 46-year-old female is diagnosed with gastric ulcers. This disease is associated with:

 

a. an increase in gastric acid production.
b. an increased risk of gastric cancer.
c. regurgitation of bile.
d. decreased gastrin production.

 

REF: p 782

 

  1. The primary cause of duodenal ulcers is:

 

a. hypersecretion of pepsin by the stomach.
b. chronic gastritis.
c. hypersecretion of acid by the duodenum.
d. Helicobacter pylori infection.

 

REF: p 781

 

  1. A 22-year-old male underwent brain surgery to remove a tumour. Following surgery, he experienced a peptic ulcer. His ulcer is referred to as a(n) _____ ulcer.

 

a. Addison’s
b. Cushing’s
c. ischaemic
d. Curling

 

REF: p 782

 

  1. A 3-month-old female develops colicky pain, abdominal distension and diarrhoea after drinking cow’s milk. The best explanation for her symptoms is:

 

a. a deficiency of bile that stimulates digestive secretions and bowel motility.
b. an excess of amylase, which increases the breakdown of starch and causes an osmotic diarrhoea.
c. an overgrowth of bacteria from undigested fat molecules, which leads to gas formation and decreased bowel motility.
d. an excess of undigested lactose in her digestive tract, resulting in increased fluid movement into the digestive lumen and increased bowel motility.

 

REF: p 784

 

  1. A 1-week-old female is brought to her paediatrician for abdominal distension and unstable temperature. Physical examination reveals bradycardia and apnoea. Tests reveal hypoxic injury to the bowel resulting in bacterial invasion and perforation. This condition is referred to as:

 

a. infective enteropathy.
b. necrotising enterocolitis.
c. mucoviscidosis.
d. ileus.

 

REF: p 783

 

  1. Coeliac disease is caused by alterations of the intestinal:

 

a. glands.
b. villi.
c. smooth muscle wall.
d. sphincters.

 

REF: p 784

 

  1. A 13-month-old infant presents with: vomiting; abdominal pain; and pale, bulky, greasy and foul-smelling stools. A possible diagnosis would be:

 

a. failure to thrive.
b. gluten-sensitive enteropathy.
c. gastro-oesophageal reflux.
d. meconium ileus.

 

REF: p 785

 

  1. Reflux oesophagitis is defined as:

 

a. an immune response to gastro-oesophageal reflux.
b. an inflammatory response to gastro-oesophageal reflux.
c. a congenital anomaly.
d. a secretory response to hiatus hernia.

 

REF: p 788

 

  1. A 50-year-old male is experiencing reflux of chyme from the stomach. He is diagnosed with gastro-oesophageal reflux. This condition is caused by:

 

a. fibrosis of the lower third of the oesophagus.
b. sympathetic nerve stimulation.
c. loss of muscle tone at the lower oesophageal sphincter.
d. reverse peristalsis of the stomach.

 

REF: p 788

 

  1. Occurrence of gastro-oesophageal reflux is highest in which paediatric population?

 

a. premature infants
b. infants with Down syndrome
c. children with cystic fibrosis
d. children with oesophageal atresia

 

REF: p 790

 

  1. A 45-year-old male complains of heartburn after eating and difficulty swallowing. He probably has:

 

a. pyloric stenosis.
b. gastric cancer.
c. achalasia.
d. hiatal hernia.

 

REF: p 791

 

  1. A mother brings her 2-week-old infant to the paediatrician because he vomits forcefully for no apparent reason and food sometimes is regurgitated through his nose. The infant is most likely suffering from:

 

a. pyloric stenosis.
b. meconium ileus.
c. oesophageal atresia.
d. galactosaemia.

 

REF: p 832

 

  1. A sign that a newborn infant is suffering from pyloric stenosis is:

 

a. diarrhoea.
b. bile regurgitation.
c. vomiting after feeding.
d. ascites.

 

REF: p 790

 

  1. A 6-month-old male infant is brought to the ED after the sudden development of abdominal pain, irritability and vomiting followed by passing of ‘currant jelly’ stool. Ultrasound reveals intestinal obstruction in which the ileum collapsed through the ileocaecal valve and invaginated into the large intestine. This type of obstruction is referred to as:

 

a. prolapse.
b. introlapse.
c. intussusception.
d. imperforation.

 

REF: p 791

 

  1. A serious complication of para-oesophageal hiatus hernia is:

 

a. haemorrhage.
b. strangulation.
c. peritonitis.
d. ascites.

 

REF: p 789

 

  1. A 29-year-old male presents complaining of colicky pain followed by vomiting, sweating, nausea and hypotension. Testing reveals a condition in which one part of the intestine telescopes into another. From which type of intestinal obstruction is he suffering?

 

a. hernia
b. ileus
c. torsion
d. intussusception

 

REF: p 791

 

  1. The vomiting reflex can be stimulated by:

 

a. severe pain.
b. hypertension.
c. fluid aspiration.
d. diarrhoea.

 

REF: p 793

 

  1. Congenital _____ is a functional obstruction of the colon caused by inadequate motility.

 

a. ganglionic microcolon
b. aganglionic megacolon
c. hyperganglionic megacolon
d. hyperparasympathetic megacolon

 

REF: p 793

 

  1. The primary characteristic of Hirschsprung’s disease is:

 

a. bowel dilation and faecal impaction.
b. pancreatic insufficiency.
c. hyperactive peristalsis.
d. ileal or jejunal atresia.

 

REF: p 793

 

  1. A 38-year-old female complains of epigastric fullness following a meal, nausea and epigastric pain. Tests reveal narrowing of the opening between the stomach and the duodenum. This condition is referred to as:

 

a. ileocaecal obstruction.
b. hiatal hernia.
c. pyloric obstruction.
d. hiatus obstruction.

 

REF: p 791

 

  1. A 2-month-old female with Down syndrome is diagnosed with Hirschsprung’s disease following chronic constipation. The most likely cause of these symptoms is a malformation in the:

 

a. central nervous system.
b. parasympathetic nervous system.
c. sympathetic nervous system.
d. somatic nervous system.

 

REF: p 793

 

  1. A 34-year-old male was diagnosed with a bacterial gastrointestinal infection. Which of the following types of diarrhoea would most likely occur with his condition?

 

a. osmotic
b. secretory
c. hypotonic
d. motility

 

REF: p 796

 

  1. A 20-year-old male was recently diagnosed with lactose intolerance. He eats ice-cream and develops diarrhoea. His diarrhoea can be classified as:

 

a. osmotic diarrhoea.
b. secretory diarrhoea.
c. hypotonic diarrhoea.
d. motility diarrhoea.

 

REF: p 796

 

  1. A 50-year-old male complains of abdominal pain, diarrhoea and stools with blood and pus on the surface. A possible diagnosis would be:

 

a. ulcerative colitis.
b. hiatus hernia.
c. pyloric obstruction.
d. achalasia.

 

REF: p 775

 

  1. Prolonged diarrhoea is more serious in children than adults because children:

 

a. have lower adipose reserves.
b. have lower fluid reserves.
c. have a lower metabolic rate.
d. are more resistant to antimicrobial therapy.

 

REF: p 797

 

  1. A 22-year-old male presents with difficulty swallowing. Tests reveal a loss of oesophageal peristalsis and failure of the lower oesophageal sphincter to relax. Which of the following is the most likely cause?

 

a. neurologic dysfunction
b. intrinsic mechanical obstruction
c. extrinsic mechanical obstruction
d. smooth muscle hyperplasia

 

REF: p 797

 

  1. The most common disorder associated with upper gastrointestinal bleeding is:

 

a. diverticulosis.
b. haemorrhoids.
c. peptic ulcer.
d. cancer.

 

REF: p 798

 

  1. A 55-year-old male died in a motor vehicle accident. Autopsy revealed an enlarged liver caused by fatty infiltration, testicular atrophy and mild jaundice secondary to cirrhosis. The most likely cause of his condition is:

 

a. bacterial infection.
b. viral infection.
c. alcoholism.
d. drug overdose.

 

REF: p 802

 

  1. In alcoholic cirrhosis, hepatocellular damage is caused by:

 

a. acetaldehyde accumulation.
b. bile toxicity.
c. acidosis.
d. fatty infiltrations.

 

REF: p 801

 

  1. Hepatitis A is characterised by:

 

a. an incubation period of 180 days.
b. an insidious onset.
c. a positive carrier state.
d. a faecal-oral transmission.

 

REF: p 803

 

  1. Outbreaks of hepatitis _____ often occur in young children attending day care centres and can be attributed to poor hand washing.

 

a. A
b. B
c. C
d. D

 

REF: p 802

 

  1. A 27-year-old male presents with fever, gastrointestinal bleeding, hepatomegaly and transient joint pain. He reports that as a child he received blood transfusions following a motor vehicle accident. He also indicates he was vaccinated against hepatitis B. Which of the following types of hepatitis does he most likely have?

 

a. A
b. B
c. C
d. D

 

REF: p 803

 

  1. The icteric phase of hepatitis is characterised by which of the following clinical manifestations?

 

a. fatigue, malaise, vomiting
b. jaundice, dark urine, enlarged liver
c. resolution of jaundice, liver function returns to normal
d. fulminant liver failure, hepatorenal syndrome

 

REF: p 804

 

  1. A 54-year-old male complains that he has been vomiting blood. Tests reveal portal hypertension. Which of the following is the most likely cause of his condition?

 

a. thrombosis in the spleen
b. cirrhosis of the liver
c. left ventricular failure
d. renal stenosis

 

REF: p 806

 

  1. A common clinical manifestation of portal hypertension is:

 

a. rectal bleeding.
b. duodenal bleeding.
c. oesophageal bleeding.
d. intestinal bleeding.

 

REF: p 806

 

  1. A 60-year-old female with a history of alcoholism complains of recent weight gain and right flank pain. Physical examination reveals severe ascites. This condition is caused by:

 

a. decreased albumin and capillary oncotic pressure.
b. decreased capillary filtration pressure.
c. decreased capillary permeability.
d. aldosterone and antidiuretic hormone suppression.

 

REF: p 808

 

  1. Problems associated with hepatic encephalopathy from chronic liver disease are the result of:

 

a. hyperbilirubinaemia and jaundice.
b. fluid and electrolyte imbalances.
c. impaired ammonia clearance.
d. decreased cerebral blood flow.

 

REF: p 809

 

  1. Increased bilirubin production and impaired hepatic excretion of bilirubin can lead to:

 

a. biliary hypertrophy.
b. jaundice.
c. hepatitis A.
d. infantile cirrhosis.

 

REF: p 811

 

  1. A 39-year-old female presents with abdominal pain and jaundice. She is diagnosed with gallstones and undergoes cholecystectomy. An analysis of her gallstones would most likely reveal a high concentration of:

 

a. phosphate.
b. bilirubin.
c. urate.
d. cholesterol.

 

REF: p 811

 

  1. A 55-year-old female has general symptoms of gallstones but also has jaundice. IV cholangiography would most likely reveal that the gallstones are obstructing the:

 

a. intrahepatic bile canaliculi.
b. gallbladder.
c. cystic duct.
d. common bile duct.

 

REF: p 811

 

  1. Cholecystitis is inflammation of the gallbladder wall usually caused by:

 

a. accumulation of bile in the hepatic duct.
b. obstruction of the cystic duct by a gallstone.
c. accumulation of gallstone in the gallbladder.
d. viral infection of the gallbladder.

 

REF: p 814

 

  1. Tissue damage in pancreatitis is caused by:

 

a. insulin toxicity.
b. autoimmune destruction of the pancreas.
c. premature activation of pancreatic proenzymes.
d. hydrochloric acid reflux into the pancreatic duct.

 

REF: p 814

 

  1. A 40-year-old male presents with left upper quadrant pain. Tests reveal acute pancreatitis. The most likely cause of his condition is:

 

a. pancreatic duct obstruction by a malignant tumour.
b. surgical trauma to the pancreas.
c. intake of large quantity of alcohol and sausages.
d. toxic injury to the pancreas from nonprescription medications.

 

REF: p 814

 

  1. Acute pancreatitis often manifests with pain to which of the following regions?

 

a. right lower quadrant
b. right upper quadrant
c. left upper quadrant
d. suprapubic

 

REF: p 814

 

  1. Shock can develop with acute pancreatitis for which of the following reasons?

 

a. The pancreas is always infected in pancreatitis.
b. Large amount of exudates which result in hypovolaemia.
c. Pancreatitis usually results in severe bleeding.
d. Insulin deficiency and hyperglycaemia lead to a high output state.

 

REF: p 815

 

  1. A 31-year-old female presents with midabdominal pain. She is suspected to have acute pancreatitis. Which of the following lab results is (are) most specific to this diagnosis?

 

a. low haematocrit and haemoglobin
b. elevated white blood cell count
c. elevated serum amylase
d. hyperglycaemia

 

REF: p 815

 

  1. Hypotension and shock are serious consequences of pancreatitis caused by:

 

a. a shift of fluids to the peritoneal cavity.
b. a loss of protein to the gut lumen.
c. a neurogenic reflex to the sympathetic nervous system.
d. malabsorption.

 

REF: p 815

 

  1. A 52-year-old female presents with continuous abdominal pain that intensifies after eating. She is diagnosed with chronic pancreatitis. Which of the following is the most likely cause of her disease?

 

a. chronic alcohol abuse
b. narcotic addiction
c. gallbladder disease
d. malabsorption syndrome

 

REF: p 815

 

  1. A 52-year-old presents with bleeding from the rectum. This condition is referred to as:

 

a. melaena.
b. occult bleeding.
c. haematochezia.
d. haematemesis.

 

REF: p 818

 

  1. A 22-year-old presents with epigastric pain and coffee brown-coloured vomitus. This condition is referred to as:

 

a. melaena.
b. food poisioning
c. haematochezia.
d. haematemesis.

 

REF: p 782

 

  1. A 22-year-old complains about epigastric pain when he feels hungry and in the middle of the night. This condition is referred to as:

 

a. gastric ulcer.
b. gastritis.
c. duodenum ulcer.
d. gastro-oesophageal reflux.

 

REF: p 788

 

  1. A 62-year-old complains about epigastric pain immediately after he starts to eat. This condition is referred to as:

 

a. gastric ulcer.
b. gastritis.
c. duodenum ulcer.
d. gastro-oesophageal reflux.

 

REF: p 781

 

  1. A 52-year-old complains about epigastric pain immediately within 1 hour after she starts to eat. This condition is referred to as:

 

a. gastric ulcer.
b. gastritis.
c. duodenum ulcer.
d. gastro-oesophageal reflux.

 

REF: p 788

 

  1. A 32-year-old complains about a recent onset of mild epigastric pain within black stools every day. This condition is referred to as:

 

a. melaena.
b. food poisoning
c. haematochezia.
d. haematemesis.

 

REF: p 782

 

  1. The proton pump inhibitor can relieve the symptoms in patients with duodenal ulcer, because there is

 

a. hypersecretion of acid by the stomach.
b. Helicobacter pylori infection in the stomach.
c. not enough acid production by the stomach.
d. not enough bicarbonate produced by the stomach.

 

REF: p 783

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 28: The structure and function of the urinary system

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The functional unit of the kidney is the:

 

a. calyx.
b. nephron.
c. collecting duct.
d. pyramid.

 

REF: p 823

 

  1. All of the following are components of the nephron except the:

 

a. loop of Henle.
b. renal corpuscle.
c. proximal tubule.
d. renal pelvis.

 

REF: p 823

 

  1. Together, the glomerulus and Bowman’s capsule are referred to as the renal:

 

a. corpuscle.
b. capsule.
c. medulla.
d. pyramid.

 

REF: p 823

 

  1. _____ nephrons account for 85% of all nephrons.

 

a. Juxtamedullary
b. Juxtacortical
c. Cortical
d. Medullary

 

REF: p 824

 

  1. Lying between the layers of the renal corpuscle is a population of phagocytic cells called:

 

a. podocytes.
b. macula densa cells.
c. mesangial cells.
d. renal macrophages.

 

REF: p 824

 

  1. Plasma proteins are not commonly found in the urine because:

 

a. all proteins filtered are subsequently secreted.
b. plasma proteins are commonly too large to fit through the fenestrations.
c. all proteins filtered are subsequently degraded before elimination.
d. the proteins are co-transported out of the filtrate.

 

REF: p 824

 

  1. On average the kidneys receive approximately _____ of the cardiac output.

 

a. 5%
b. 15%
c. 25%
d. 35%

 

REF: p 824

 

  1. The sodium-sensing cells of the glomerulus are called the:

 

a. podocytes.
b. macula densa.
c. mesangial cells.
d. loop of Henle.

 

REF: p 826

 

  1. Which of the following structures supplies blood to the medulla?

 

a. renal arteries
b. arcuate arteries
c. peritubular capillaries
d. vasa recta

 

REF: p 825

 

  1. The transport maximum for glucose refers to the:

 

a. maximum rate of glucose filtration.
b. glucose reabsorption that is limited by the number of carrier molecules.
c. small amounts of glucose found in the urine of most individuals.
d. ability of the kidneys to regulate blood glucose.

 

REF: p 828

 

  1. The percentage of filtered sodium that is subsequently reabsorbed back into the plasma in the renal tubules is 99.5%. The majority of this sodium reabsorption takes place in the:

 

a. proximal tubule.
b. loop of Henle.
c. distal tubule.
d. collecting duct.

 

REF: p 828

 

  1. A kidney has a glomerular capillary hydrostatic pressure of 50 mmHg, a Bowman’s capsule hydrostatic pressure of 15 mmHg, and a glomerular capillary oncotic pressure of 12 mmHg. What is the net filtration pressure?

 

a. 23 mmHg
b. 27 mmHg
c. 35 mmHg
d. 38 mmHg

 

REF: p 827

 

  1. The descending segment of the loop of Henle primarily allows for:

 

a. sodium secretion.
b. potassium secretion.
c. hydrogen ion secretion.
d. water reabsorption.

 

REF: p 829

 

  1. Which of the following substances are actively secreted by the renal tubules?

 

a. sodium and chlorine
b. phosphate and calcium
c. hydrogen and potassium
d. bicarbonate and carbonic acid

 

REF: p 830

 

  1. Reabsorption of water in the collecting ducts requires which of these hormones?

 

a. antidiuretic hormone
b. atrial natriuretic factor
c. renin
d. aldosterone

 

REF: p 830

 

  1. The nephrons that determine the concentration of the urine are _____ nephrons.

 

a. juxtamedullary
b. juxtacortical
c. cortical
d. medullary

 

REF: p 8305

 

  1. A 35-year-old hypertensive male begins taking a thiazide diuretic. Which of the following is a common side effect of this medication?

 

a. hypokalaemia
b. hyponatraemia
c. increased uric acid secretion
d. hypernatraemia

 

REF: p 832

 

  1. The filtration of the plasma per unit of time is known as the glomerular filtration rate (GFR). GFR is directly related to the:

 

a. perfusion pressure in the glomerular capillaries.
b. oncotic pressure in the glomerular capillaries.
c. vascular resistance in the glomerular arterioles.
d. hydrostatic pressure in the Bowman’s capsule.

 

REF: p 833

 

  1. On average, what percentage of renal plasma flow to the glomerulus is filtered into the Bowman’s capsule?

 

a. 20%
b. 40%
c. 50%
d. 75%

 

REF: p 832

 

  1. The blood vessels of the kidneys are innervated by the:

 

a. vagus nerve.
b. sympathetic nervous system.
c. somatic nervous system.
d. parasympathetic nervous system.

 

REF: p 834

 

  1. The renin-angiotensin system will be activated by:

 

a. increased blood volume.
b. elevated sodium concentrations.
c. decreased blood pressure in the afferent arterioles.
d. renal hypoxia.

 

REF: p 834

 

  1. Renal secretion of renin causes the direct activation of:

 

a. angiotensin I.
b. angiotensin II.
c. antidiuretic hormone.
d. aldosterone.

 

REF: p 834

 

  1. The best clinical measure of renal function is:

 

a. glomerular filtration rate.
b. circulating ADH levels.
c. volume of urine output.
d. urine-specific gravity.

 

REF: p 835

 

  1. An ACE inhibitor would have the following effect:

 

a. increase glomerular filtration rate.
b. increase the volume of urine output.
c. increase the blood pressure.
d. increase urinary osmolality.

 

REF: p 835

 

  1. A serum marker of renal function is:

 

a. bilirubin.
b. glucose.
c. urea.
d. ketones.

 

REF: p 836

 

  1. Glomerular filtration rate and plasma creatinine concentration are _____ related.

 

a. directly
b. indirectly
c. inversely
d. not

 

REF: p 837

 

  1. The renal structure that drains through the renal papillae and into the calyces is the:

 

a. distal tubule.
b. collecting duct.
c. pyramid.
d. renal pelvis.

 

REF: p 837

 

  1. Just before entering the ureter, urine passes through the:

 

a. collecting duct.
b. renal pelvis.
c. urethra.
d. major calyx.

 

REF: p 837

 

  1. The trigone is defined as:

 

a. the orifice of the ureter.
b. the inner area of the kidney.
c. a triangular area between the openings of the two ureters and the urethra.
d. the three divisions of the loop of Henle.

 

REF: p 838

 

  1. The portion of the male urethra that is closest to the bladder is the:

 

a. membranous portion.
b. prostatic portion.
c. cavernous portion.
d. vas deferens portion.

 

REF: p 839

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 29: Fluids and electrolytes, acids and bases

 

Test Bank

 

MULTIPLE CHOICE

 

  1. Water balance is closely related to _____ balance.

 

a. potassium
b. chloride
c. bicarbonate
d. sodium

 

REF: p 846

 

  1. Plasma is referred to as:

 

a. intracellular fluid.
b. extracellular fluid.
c. interstitial fluid.
d. intravascular fluid.

 

REF: p 844

 

  1. A 35-year-old male weighs 70 kg. Approximately how much of this weight is intracellular fluid?

 

a. 5 L
b. 10 L
c. 28 L
d. 42 L

 

REF: p 844

 

  1. Which of the following alterations would result in fluid movement into the interstitial space?

 

a. increased capillary oncotic pressure
b. increased interstitial hydrostatic pressure
c. decreased capillary hydrostatic pressure
d. decreased capillary oncotic pressure

 

REF: p 846

 

  1. A 70-year-old male with chronic renal failure presents with oedema. Which of the following is the most likely cause of this condition?

 

a. increased capillary oncotic pressure
b. increased interstitial oncotic pressure
c. increased capillary hydrostatic pressure
d. increased interstitial hydrostatic pressure

 

REF: p 846

 

  1. Which of the following conditions would decrease oncotic pressure in the capillaries?

 

a. high-protein diet
b. liver failure
c. low blood pressure
d. high blood-glucose

 

REF: p 847

 

  1. A 10-year-old male is brought to the ED because he is incoherent and semiconscious. CT scan reveals he is suffering from cerebral oedema. This type of oedema is referred to as:

 

a. localised oedema.
b. generalised oedema.
c. pitting oedema.
d. lymphoedema.

 

REF: p 848

 

  1. Secretion of antidiuretic hormone (ADH) is stimulated by:

 

a. increased plasma osmolality
b. increased plasma osmolality.
c. decreased renal blood flow.
d. generalised oedema.

 

REF: p 849

 

  1. A 60-year-old male with a 30-year history of smoking is diagnosed with a hormone-secreting lung tumour. Further testing indicates that the tumour secretes ADH. Which of the following would be expected to result from this condition?

 

a. increased urine osmolality
b. decreased blood volume
c. increased plasma osmolality
d. increased urine output

 

REF: p 849

 

  1. Secretion of aldosterone results in:

 

a. decreased plasma osmolality.
b. increased serum potassium levels.
c. increased blood volume.
d. localised oedema.

 

REF: p 850

 

  1. A 25-year-old male is diagnosed with a hormone-secreting tumour of the adrenal cortex. Which of the following would be expected to accompany this condition?

 

a. decreased blood volume
b. decreased blood K+ levels
c. increased urine Na+ levels
d. increased renin secretion

 

REF: p 857

 

  1. A 5-year-old male presents to the ED with delirium and sunken eyes. After diagnosing him with severe dehydration, the doctor orders fluid replacement. The nurse administers a hypertonic IV solution. Which of the following would be expected?

 

a. his symptoms would subside quickly
b. increased intracellular fluid volume
c. decreased extracellular fluid volume
d. intracellular dehydration

 

REF: p 853

 

  1. The most common cause of pure water deficit is:

 

a. renal water loss.
b. hyperventilation.
c. sodium loss.
d. insufficient water intake.

 

REF: p 854

 

  1. A 52-year-old male with diabetes presents to the ED with lethargy, confusion and depressed reflexes. His wife indicates that he does not follow the prescribed diet and takes his medication sporadically. Which of the following is most likely to occur?

 

a. diabetes insipidus
b. dilutional hyponatraemia
c. decreased urine formation
d. decreased extracellular fluid osmolality

 

REF: p 855

 

  1. Which of the following would most likely cause hypochloraemia?

 

a. hypernataemia
b. hypokalaemia
c. hypercalcaemia
d. elevated bicarbonate

 

REF: p 856

 

  1. A 42-year-old female presents to her GP complaining of muscle weakness and cardiac abnormalities. Laboratory tests indicate that she is hypokalaemic. Which of the following could be the cause of her condition?

 

a. respiratory acidosis
b. constipation
c. hypoglycaemia
d. frusemide therapy

 

REF: p 857

 

  1. Hyperkalaemia causes:

 

a. an increase in resting membrane potential with increased excitability of cardiac muscle.
b. a decrease in resting membrane potential with increased excitability of cardiac muscle.
c. an increase in resting membrane potential with decreased excitability of cardiac muscle.
d. a decrease in resting membrane potential with decreased excitability of cardiac muscle.

 

REF: p 858

 

  1. Which of the following would result in hyperkalaemia?

 

a. excess aldosterone
b. acute acidosis
c. insulin
d. alkalosis

 

REF: p 859

 

  1. A 19-year-old male presents to his GP complaining of restlessness, muscle cramping and diarrhoea. Lab tests reveal that he is hyperkalaemic. Which of the following could have caused his condition?

 

a. primary hyperaldosteronism
b. acidosis
c. insulin secretion
d. alkalosis

 

REF: p 8594

 

  1. A 60-year-old female is diagnosed with hyperkalaemia. Which of the following would be an expected symptom?

 

a. weak pulse
b. excessive thirst
c. neuromuscular irritability
d. constipation

 

REF: p 859

 

  1. Which of the following buffer pairs is considered the major plasma buffering system?

 

a. NaCl/KPO4
b. HCO3/H2CO3
c. HPO4/H2PO4
d. NH3/NH4

 

REF: p 864

 

  1. Long-term regulation of acid-base balance through removal or retention of acids is accomplished by the:

 

a. buffer systems.
b. kidneys.
c. lungs.
d. liver.

 

REF: p 864

 

  1. Causes of respiratory acidosis include:

 

a. vomiting.
b. hyperventilation.
c. pneumonia.
d. an increase in noncarbonic acids.

 

REF: p 865

 

  1. A 54-year-old male with a long history of smoking complains of excessive tiredness and shortness of breath. Lab results reveal decreased pH, increased CO2 and normal bicarbonate ion. The most likely diagnosis is:

 

a. respiratory alkalosis.
b. metabolic acidosis.
c. respiratory acidosis.
d. metabolic alkalosis.

 

REF: p 865

 

  1. Chronic compensation for respiratory acidosis includes:

 

a. kidney excretion of H+.
b. kidney excretion of HCO3.
c. prolonged exhalations to blow off CO2.
d. protein buffering.

 

REF: p 865

 

  1. A 55-year-old female presents to her GP complaining of dizziness, confusion and tingling in the extremities. Blood tests reveal an elevated pH, decreased PCO2 and slightly decreased HCO3. Which of the following is the most likely diagnosis?

 

a. respiratory alkalosis with renal compensation
b. respiratory acidosis with renal compensation
c. metabolic alkalosis with respiratory compensation
d. metabolic acidosis with respiratory compensation

 

REF: p 866

 

  1. One cause of metabolic alkalosis is:

 

a. retention of metabolic acids.
b. hypoaldosteronism.
c. excessive vomiting.
d. hyperventilation.

 

REF: p 866

 

  1. Acute compensation for metabolic acidosis includes:

 

a. kidney excretion of H+.
b. hyperventilation.
c. CO2 retention.
d. aldosterone secretion.

 

REF: p 866

 

  1. Infants are at a higher risk for developing dehydration because they have:

 

a. a lower total body water volume.
b. a greater body surface area.
c. a decreased intravascular volume.
d. an increased tendency towards developing oedema.

 

REF: p 867

 

  1. Older people are at a higher risk for developing dehydration because they have:

 

a. a higher total body water volume.
b. a decreased lean body mass.
c. a decreased intravascular volume.
d. an increased tendency towards developing oedema.

 

REF: p 867

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 30: Alterations of renal and urinary tract function across the life span

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A 25-year-old female is diagnosed with urinary tract obstruction. She is expected to have hydronephrosis and a decreased glomerular filtration rate caused by:

 

a. decreased renal blood flow.
b. decreased peritubular capillary pressure.
c. increased hydrostatic pressure in the glomerular capsule.
d. stimulation of antidiuretic hormone.

 

REF: p 872

 

  1. The most common type of renal stone is composed of:

 

a. magnesium.
b. struvite.
c. calcium.
d. phosphate.

 

REF: p 874

 

  1. The most important factor in renal calculus formation is:

 

a. urine pH.
b. body temperature.
c. gender.
d. serum mineral concentrations.

 

REF: p 874

 

  1. A 24-year-old female is diagnosed with renal calculus that is causing obstruction. Which of the following symptoms would she most likely experience?

 

a. anuria
b. haematuria
c. pyuria
d. flank pain

 

REF: p 874

 

  1. A 35-year-old male received a traumatic brain injury in a motor vehicle accident. CT scan revealed a lesion above the pontine micturition center. Which of the following would be expected?

 

a. dyssynergia
b. detrusor hyperreflexia
c. detrusor areflexia
d. detrusor sphincter dyssynergia

 

REF: p 875

 

  1. A 75-year-old male complains to his GP of loss of urine on coughing, sneezing or laughing. Which of the following is the most likely diagnosis?

 

a. urge incontinence
b. stress incontinence
c. overflow incontinence
d. functional incontinence

 

REF: p 875

 

  1. Mechanisms for defence against urinary pathogens in women include:

 

a. the long length of the urethra.
b. acid pH of urine.
c. antimicrobial secretions from the vagina.
d. antimicrobial secretions from the prostate.

 

REF: p 878

 

  1. A 25-year-old female presents with burning urination. She was diagnosed with a urinary tract infection. Which of the following organisms is most likely infecting her urinary tract?

 

a. Streptococcus
b. Candida albicans
c. Chlamydia
d. Escherichia coli

 

REF: p 878

 

  1. A 28-year-old female presents with fever, chills and flank pain. She is diagnosed with pyelonephritis. Her infection is located in the:

 

a. bladder.
b. renal pelvis.
c. renal tubules.
d. glomerulus.

 

REF: p 879

 

  1. The most common condition associated with the development of acute pyelonephritis is:

 

a. cystitis.
b. renal cancer.
c. urinary tract obstruction.
d. nephrotic syndrome.

 

REF: p 879

 

  1. Urinary tract infections are uncommon in newborns, and when they do occur, they are usually:

 

a. blood-borne infections.
b. caused by bacteria from the GI tract.
c. yeast infections.
d. viral infections.

 

REF: p 880

 

  1. A 15-year-old male was diagnosed with pharyngitis. Eight days later he developed acute glomerulonephritis. Which of the following is the most likely cause of this disease?

 

a. Klebsiella
b. human immunodeficiency virus
c. genital herpes virus
d. Streptococcus

 

REF: p 882

 

  1. Acute poststreptococcal glomerulonephritis is primarily caused by:

 

a. swelling of mesangial cells in the Bowman space in response to the presence of bacteria.
b. antigen-antibody complex deposition in the glomerular capillaries and inflammatory damage.
c. inflammatory factors that stimulate cellular proliferation of epithelial cells.
d. accumulation of antiglomerular basement membrane antibodies.

 

REF: p 882

 

  1. A 30-year-old male is demonstrating haematuria with red blood cell casts and proteinuria exceeding 3 to 5 g/day. The most probable diagnosis is:

 

a. cystitis.
b. chronic pyelonephritis.
c. acute glomerulonephritis.
d. nephrotic syndrome.

 

REF: p 882

 

  1. A 45-year-old male presents with oliguria. He is diagnosed with chronic glomerulonephritis. Oliguria is related to:

 

a. thickening of the glomerular membrane and decreased renal blood flow.
b. increased glomerular capillary oncotic pressure and tubular obstruction.
c. activation of renin-angiotensin from decreased blood volume.
d. vasoconstriction of the efferent arterioles.

 

REF: p 882

 

  1. A 15-year-old female presents with flank pain, irritability, malaise and fever. Tests reveal glomerulonephritis. Which of the following is the most likely diagnosis?

 

a. poststreptococcal glomerulonephritis
b. immunoglobulin A nephropathy
c. nephrotic syndrome
d. Potter’s syndrome

 

REF: p 882

 

  1. If nephrotic syndrome is not caused initially by kidney disease, it is termed _____ nephrotic syndrome.

 

a. primary
b. secondary
c. tertiary
d. idiopathic

 

REF: p 885

 

  1. A 4-year-old male is diagnosed with nephrotic syndrome. Which of the following accompanies this condition?

 

a. proteinuria
b. decreased BUN
c. haematuria
d. sodium loss

 

REF: p 886

 

  1. A 54-year-old female is diagnosed with nephrotic syndrome. Which of the following is a common symptom of this disease?

 

a. haematuria
b. dysuria
c. oliguria
d. proteinuria

 

REF: p 885

 

  1. Which of the following clusters of symptoms would make a clinician suspect a child has developed glomerulonephritis?

 

a. pyuria, fever and abdominal pain
b. proteinuria, hypotension and ascites
c. dysuria, urinary frequency and abdominal tenderness
d. gross haematuria, flank pain and hypertension

 

REF: p 886

 

  1. A 5-year-old male was diagnosed with glomerulonephritis. History reveals that he had an infection 3 weeks before the onset of this condition. The infection was most likely located in the:

 

a. lungs.
b. GI tract.
c. pharynx.
d. ear.

 

REF: p 886

 

  1. A 10-year-old male is diagnosed with glomerulonephritis. Tests reveal the deposition of immunoglobulin IgA in the glomerular capillaries. He would most likely have recurrent:

 

a. infections.
b. haematuria.
c. vomiting.
d. enuresis.

 

REF: p 886

 

  1. A 25-year-old male has a severe kidney obstruction leading to removal of the affected kidney. Which of the following would be expected to occur?

 

a. atrophy of the remaining kidney
b. compensatory hypertrophy of the remaining kidney
c. dysplasia in the remaining kidney
d. renal failure

 

REF: p 888

 

  1. A 45-year-old female presents with hypertension, anorexia, nausea and vomiting, and anaemia. She is diagnosed with chronic kidney disease. Anaemia in this patient is caused by:

 

a. red blood cells being lost in the urine.
b. inadequate production of erythropoietin.
c. inadequate iron absorption in the gut.
d. red blood cells being injured as they pass through the glomerulus.

 

REF: p 891

 

  1. A 42-year-old female is diagnosed with chronic kidney disease. Treatment includes restricting:

 

a. fats.
b. complex carbohydrates.
c. proteins.
d. sugars.

 

REF: p 892

 

  1. Bone fractures are a risk factor in chronic renal failure because:

 

a. calcium is lost in the urine.
b. osteoblast activity is excessive.
c. the kidneys fail to activate vitamin D.
d. autoantibodies to calcium molecules develop.

 

REF: p 890

 

  1. A 42-year-old male is involved in a motor vehicle accident during which he loses a lot of blood. He develops acute kidney injury caused by:

 

a. kidney stones.
b. immune complex deposition in the glomerulus.
c. inadequate renal blood flow.
d. obstruction of the proximal tubule.

 

REF: p 893

 

  1. A 35-year-old female was severely burned and is hospitalised. She is now suffering from acute tubular necrosis. Which of the following is the most likely diagnosis?

 

a. prerenal
b. intrarenal
c. extrarenal
d. postrenal

 

REF: p 894

 

  1. A 56-year-old male presents with flank pain and polyuria. Tests reveal that he has an enlarged prostate. Which of the following types of acute kidney injury is most likely to occur?

 

a. prerenal
b. intrarenal
c. extrarenal
d. postrenal

 

REF: p 895

 

  1. A 60-year-old male is diagnosed with acute kidney injury. Which of the following lab values would be most consistent with this diagnosis?

 

a. elevated plasma creatinine level
b. decreased plasma potassium level
c. metabolic alkalosis
d. increased urea clearance

 

REF: p 892

 

  1. Upon examination of a male infant, it is determined that the urethral meatus is located on the undersurface of the penis. This condition is called:

 

a. hypospadias.
b. epispadias.
c. hydroureter.
d. nidus.

 

REF: p 897

 

  1. A 3-year-old female presents with recurrent urinary tract infections, fever, poor growth and development, and feeding problems. Tests reveal a retrograde flow of urine from the urinary bladder into the ureters. This condition is known as:

 

a. vesicoureteral reflux.
b. vesicourethral reflux.
c. vesicourethral influx.
d. hydronephrosis.

 

REF: p 899

 

  1. A 7-year-old male presents to his GP for incontinence. His mother indicates he has never been continent. Which of the following is the most likely diagnosis?

 

a. nocturnal enuresis
b. diurnal enuresis
c. primary enuresis
d. secondary enuresis

 

REF: p 900

 

  1. Wilms’ tumours are found in the:

 

a. kidneys.
b. ureters.
c. bladder.
d. urethra.

 

REF: p 902

 

  1. A 20-year-old male is diagnosed with Wilms’ tumour. Which of the following clinical conditions is often associated with this disease?

 

a. cystic disease of the liver
b. aniridia (lack of an iris in the eye)
c. anaemia
d. hypothyroidism

 

REF: p 902

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 31: The structure and function of the reproductive systems

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The major hormonal determinant of sexual differentiation in utero is:

 

a. oestrogen.
b. progesterone.
c. growth hormone.
d. testosterone.

 

REF: p 919

 

  1. Puberty in males and females is triggered by the hormone:

 

a. follicle-stimulating hormone (FSH).
b. luteinising hormone (LH).
c. leptin.
d. oestrogen.

 

REF: p 918

 

  1. Which body structure contains the openings to the vagina and urinary meatus?

 

a. vestibule
b. mons pubis
c. introitus
d. perineal body

 

REF: p 913

 

  1. What muscles aid in temperature control of the testes by raising and lowering them?

 

a. bulbocavernosus.
b. levator ani.
c. gluteus medius.
d. cremaster

 

REF: p 910

 

  1. The thick middle layer of the uterine wall is the:

 

a. epithelial layer.
b. endometrium.
c. myometrium.
d. perimetrium.

 

REF: p 915

 

  1. The duct that carries the ovum from the ovary to the uterus is called the:

 

a. isthmus.
b. ductus deferens.
c. endocervical canal.
d. fallopian tube.

 

REF: p 915

 

  1. Which part of a sperm is required for the energy to fuel sperm movement?

 

a. tail
b. midpiece
c. head
d. flagellum

 

REF: p 921

 

  1. The usual site of fertilisation is the:

 

a. uterus.
b. fimbriae.
c. ampulla of the fallopian tubes.
d. os of the fallopian tubes.

 

REF: p 928

 

  1. Cells of the ____ have receptors for gonadotrophins.

 

a. uterus
b. breast
c. ovary
d. vagina

 

REF: p 918

 

  1. The oocytes are each contained within an ovarian:

 

a. corpus luteum.
b. follicle.
c. stroma.
d. infundibulum.

 

REF: p 924

 

  1. Having ejected a mature ovum, the ovarian follicle then develops into:

 

a. an atretic follicle.
b. a thecal follicle.
c. a corpus luteum.
d. scar tissue.

 

REF: p 924

 

  1. The most dominant form of oestrogen during the normal uterine cycle is:

 

a. oestradiol.
b. testosterone.
c. oestrone.
d. oestriol.

 

REF: p 919

 

  1. Progesterone is primarily secreted by the:

 

a. follicle.
b. corpus luteum.
c. granulose cells.
d. anterior pituitary.

 

REF: p 924

 

  1. A 56-year-old female is in menopause. She has ovarian failure. Which of the following also occurs?

 

a. increased FSH
b. increased oestrogen
c. decreased GnRH
d. decreased LH

 

REF: p 936

 

  1. Progesterone is often referred to as ‘the hormone of pregnancy’. Which of the following phrases describes its action during pregnancy?

 

a. stimulates lactation
b. increases ciliary action in the fallopian tubes
c. thins the endometrium
d. prevents smooth muscle contraction of the uterus

 

REF: p 920

 

  1. Menstruation is followed by the _____ phase of the menstrual cycle.

 

a. proliferative
b. luteal
c. secretory
d. ischaemic

 

REF: p 940

 

  1. When oestrogen and progesterone levels drop, the endometrium enters:

 

a. the proliferative phase.
b. the luteal phase.
c. the menstrual phase.
d. the recovery phase.

 

REF: p 925

 

  1. A 25-year-old female has a menstrual cycle of 28 days’ duration. On what day of the cycle will ovulation occur?

 

a. 14
b. 21
c. 25
d. 28

 

REF: p 925

 

  1. During the menstrual cycle, ovulation occurs after:

 

a. the gradual decrease in oestrogen levels.
b. a sharp rise in luteinising hormone (LH).
c. a surge in progesterone.
d. the release of activin.

 

REF: p 925

 

  1. Endometrial thickening during the proliferative phase is stimulated by increased levels of:

 

a. oestrogen.
b. progesterone.
c. FSH and LH.
d. inhibin.

 

REF: p 924

 

  1. Changes in the cervical mucus can be used to identify the periods in which a female is most fertile. During ovulation, cervical mucus can be described as:

 

a. blood-tinged.
b. thick and sticky.
c. absent.
d. abundant, clear and non-viscous.

 

REF: p 924

 

  1. Spermatogenesis occurs in the:

 

a. epididymis.
b. inguinal canals.
c. seminiferous tubules.
d. ductus deferens.

 

REF: p 920

 

  1. Which paired glands lie posterior to the urinary bladder in the male?

 

a. seminal vesicles
b. prostate glands
c. Cowper’s glands
d. parabladder glands

 

REF: p 912

 

  1. Male sex hormones are collectively known as:

 

a. gonadotrophins.
b. testosterones.
c. catabolic steroids.
d. androgens.

 

REF: p 919

 

  1. The glands of Montgomery are located in the:

 

a. testes.
b. breasts.
c. uterus.
d. vagina.

 

REF: p 916

 

  1. Which of the following structures secretes fructose-rich fluid into the semen?

 

a. seminal vesicles
b. ejaculatory duct
c. prostate gland
d. Cowper’s gland

 

REF: p 912

 

  1. Which hormone promotes breast development during puberty?

 

a. progesterone
b. prolactin
c. oxytocin
d. oestrogen

 

REF: p 916

 

  1. Which of the following hormones plays a role in breast milk ejection (let down) during lactation?

 

a. cortisol
b. prolactin
c. oxytocin
d. progesterone

 

REF: p 916

 

  1. Which of the following is not a characteristic associated with declining ovarian function with age?

 

a. increased risk of myocardial infarction
b. decline in bone mass
c. decreased risk of coronary disease
d. atrophy of the uterus

 

REF: p 936

 

  1. In males, the process of meiosis produces which of the following?

 

a. oocytes
b. spermatogonia
c. spermatids
d. spermatocytes

 

REF: p 920

 

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 32: Alterations of the reproductive systems across the life span

 

Test Bank

 

MULTIPLE CHOICE

 

  1. This method of controlling fertility involves removal of part of the ductus (vas) deferens.

 

a. tubal ligation
b. barrier method
c. vasectomy
d. orchidectomy

 

REF: p 974

 

  1. An 18-year-old female is diagnosed with dysmenorrhoea. Which of the following symptoms will she most likely experience?

 

a. absence of menstruation
b. painful menstruation
c. unusually long menstrual period
d. menstrual irregularity

 

REF: p 957

 

  1. A 20-year-old female presents with pelvic and back pain severe enough to miss work. She reports that the pain occurs with the onset of menses. Physical examination fails to find pelvic pathology. The most likely cause of her condition is:

 

a. lack of oestrogen.
b. stress.
c. elevated prostaglandins.
d. poor nutrition.

 

REF: p 957

 

  1. A 55-year-old female presents with irregular and heavy menstrual bleeding including the passage of large clots, and anaemia. She is most likely experiencing:

 

a. premenstrual syndrome.
b. dysfunctional uterine bleeding.
c. polycystic ovarian syndrome.
d. primary dysmenorrhoea.

 

REF: p 957

 

  1. Which of the following forms of contraception offers the highest failure rate?

 

a. Rhythm method
b. Condoms
c. Intrauterine device
d. Oral contraceptive pill

 

REF: p 975

 

  1. A 25-year-old female presents with amenorrhoea and hirsutism. She is diagnosed with polycystic ovary syndrome. Lab testing will most likely reveal:

 

a. oestrogen deficit.
b. genetic cancerous mutations.
c. cortisol excess.
d. hyperinsulinaemia.

 

REF: p 955

 

  1. A 30-year-old female with newly diagnosed polycystic ovary syndrome is being counselled by her gynaecologist. The doctor indicates that this condition often results in:

 

a. ovarian cancer.
b. infertility.
c. early menopause.
d. pelvic inflammatory disease.

 

REF: p 956

 

  1. A 23-year-old sexually active female presents with copious white vaginal discharge and itch. She is diagnosed with yeast vaginitis caused by overgrowth of which microorganism?

 

a. Escherichia coli
b. Lactobacillus acidophilus
c. Candida albicans
d. Neisseria gonorrhoeae

 

REF: p 960

 

  1. The descent of the bladder and the anterior vaginal wall into the vaginal canal is called a:

 

a. rectocele.
b. varicocele.
c. cystocele.
d. urethrocele.

 

REF: p 962

 

  1. A 40-year-old female presents with cramping and excessive vaginal bleeding. Ultrasound reveals benign uterine tumours in the smooth muscle cells of the myometrium. These tumours are commonly called:

 

a. adenomyosis.
b. myometrial polyps.
c. leiomyomas.
d. adenomas.

 

REF: p 954

 

  1. A 35-year-old female is diagnosed with endometriosis. Suppressing which of the following would be the most appropriate medical treatment for this disease?

 

a. infection
b. ovulation
c. prostaglandins
d. fertilisation

 

REF: p 955

 

  1. A 21-year-old female is infected with human papillomavirus following unprotected sexual intercourse with a male she recently met. She is now at higher risk of developing which of the following cancers?

 

a. cervical
b. ovarian
c. endometrial
d. vulvar

 

REF: p 982

 

  1. An 18-year-old male presents with urethral itching and burning and increased frequency and urgency with urination. He reports recently having unprotected sex with a new partner. What is the most likely cause of his symptoms?

 

a. Neisseria gonorrhoea
b. Chlamydia trachomatis
c. herpes infection
d. Escherichia coli

 

REF: p 978

 

  1. A 30-year-old male presents with penile tenderness and discharge. Physical examination reveals that his foreskin cannot be retracted back over the glans penis. He is suffering from:

 

a. paraphimosis.
b. phimosis.
c. pre-phimosis.
d. priapism.

 

REF: p 965

 

  1. An 18-year-old male presents complaining of difficulty having sexual intercourse. He reports that his penis curves during erection. This condition is referred to as:

 

a. phimosis.
b. lateral phimosis.
c. lateral paraphimosis.
d. Peyronie’s disease.

 

REF: p 965

 

  1. _____ is inflammation of the glans penis.

 

a. Phimosis
b. Balanitis
c. Priapism
d. Hydrocele

 

REF: p 965

 

  1. Cryptorchidism can be defined as:

 

a. a normal developmental state of the testes.
b. an abnormal state in which the testes are overdeveloped.
c. lack of a scrotum.
d. problems with testicular descent.

 

REF: p 968

 

  1. A 21-year-old male presents with inflammation of the testes (orchitis). He has a high fever and oedema and redness of the testes. Which organism is the most likely the cause of his symptoms?

 

a. herpes virus
b. Escherichia coli
c. mumps
d. cytomegalovirus

 

REF: p 969

 

  1. The risk of testicular cancer is greater for men with a history of:

 

a. priapism.
b. phimosis.
c. cryptorchidism.
d. testicular torsion.

 

REF: p 968

 

  1. An important risk factor in the development of benign prostatic hypertrophy (BPH) is:

 

a. recurrent prostatitis.
b. a diet high in fat.
c. cigarette smoking.
d. increased age.

 

REF: p 970

 

  1. A middle-aged male speaks to his doctor about benign prostatic hypertrophy. He reveals that his father was recently diagnosed with this condition, and he wants to know if he could have it. The doctor tells him that a common complaint from men with mild-to-moderate benign prostatic hypertrophy is:

 

a. decreased urinary stream.
b. infertility.
c. sexual dysfunction.
d. prostatodynia.

 

REF: p 970

 

  1. Symptoms of prostatitis are similar to symptoms of:

 

a. prostate cancer.
b. benign prostatic hypertrophy.
c. urinary tract infection.
d. epididymitis.

 

REF: p 971

 

  1. Prostate cancer:

 

a. has no known association with diet.
b. usually occurs before age 50.
c. is the leading type of cancer in men
d. is more common in Caucasian men

 

REF: p 942

 

  1. A 40-year-old male is concerned about the possibility of developing prostate cancer. He reports that his father died of prostate cancer, and he wants to take all preventive measures. He is told to consume a diet low in:

 

a. fat.
b. lycopene.
c. fibre.
d. calcium.

 

REF: p 949

 

  1. A 35-year-old non-pregnant female presents complaining of breast discharge. This condition is most likely caused by:

 

a. infection.
b. hormonal imbalances.
c. tissue injury.
d. cancer.

 

REF: p 973

 

  1. Which of the following signs is usually the first clinical manifestation of breast cancer?

 

a. dimpling
b. nipple discharge
c. chest pain
d. a painless lump

 

REF: p 942

 

  1. Gynaecomastia is:

 

a. lack of breast development in women.
b. over-development of breast tissue in males.
c. a type of breast cancer.
d. inflammation of the mammary glands in lactating women.

 

REF: p 973

 

  1. A 35-year-old female presents with infertility and gradual blindness. She reports that she has otherwise been healthy. History reveals that she was promiscuous and had unprotected sexual intercourse several times when she was younger. Which of the following sexually transmitted infection does she most likely have?

 

a. syphilis
b. chlamydia
c. gonorrhoea
d. genital herpes

 

REF: p 978

 

  1. A 19-year-old female presents with genital warts. Which of the following would cause this condition?

 

a. Chlamydia trachomatis
b. adenovirus
c. human papillomavirus
d. herpes simplex virus

 

REF: p 980

 

  1. A 25-year-old sexually active female presents with pain during intercourse, dysuria and spotting. She is diagnosed with trichomoniasis, which is a:

 

a. virus.
b. parasite.
c. bacterium.
d. spirochete.

 

REF: p 980

 

  1. An example of a parasitic sexually transmitted infection that is transmitted through close skin-to-skin contact is:

 

a. chlamydia.
b. syphilis.
c. scabies.
d. Gardnerella.

 

REF: p 980

 

  1. The hormone that may be injected to stimulate ovulation in cases of infertility related to anovulation is:

 

a. oestrogen.
b. human chorionic gonadotrophin.
c. progesterone.
d. oxytocin.

 

REF: p 976

 

  1. The term ‘primary dysmenorrhoea’ describes:

 

a. pain experienced at the time of ovulation.
b. lack of menstrual bleeding.
c. irregular menstrual cycles.
d. severe pain experienced during menstruation.

 

REF: p 957

 

  1. It is recommended that this food is avoided in women suffering from PMS:

 

a. complex carbohydrates.
b. fibre.
c. water.
d. caffeine.

 

REF: p 959

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 33: Introduction to contemporary health issues

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The projected life expectancy for a female in Australia in 2020 is:

 

a. 75.1 years.
b. 86.2 years.
c. 54.2 years.
d. 81.4 years.

 

REF: p 992

 

  1. The most obvious condition that leads to altered health status in Australia and New Zealand is:

 

a. obesity.
b. hypertension.
c. vascular disease.
d. poverty.

 

REF: p 990

 

  1. A person who lives in a rural area is most likely to:

 

a. have a higher life expectancy than their urban counterparts.
b. have a lower life expectancy than their urban counterparts.
c. have the same life expectancy as their urban counterparts.
d. have a lower life expectancy than their Indigenous counterparts.

 

REF: p 990

 

  1. Researchers predict that the dramatic increase in life expectancy will:

 

a. continue to increase.
b. fluctuate.
c. be unlikely to continue.
d. decrease.

 

REF: p 992

 

  1. The highest ranking cause of deaths in Australia is:

 

a. stroke.
b. coronary heart disease.
c. suicide.
d. colorectal cancer.

 

REF: p 992

 

  1. Physical stressors do not include:

 

a. grief.
b. pain.
c. exercise.
d. physical activity.

 

REF: p 995

 

  1. An increase in the consumption of fast foods high in fats and sugars is a particular concern for people in the age range of:

 

a. 15-24 years.
b. 3-14 years.
c. 45-55 years.
d. 25-35 years.

 

REF: p 995

 

  1. One activity leading to obesity in children includes:

 

a. swim safe programs.
b. higher consumption of fruit and vegetables.
c. compulsory schooling.
d. watching television.

 

REF: p 996

 

  1. A 45-year-old female who is 160 cm tall and weighs 90 kg does not consider herself overweight. This is because:

 

a. she is peri-menopausal.
b. she considers her weight within the acceptable range.
c. all her family members are of a similar weight.
d. she has the correct BMI for her age.

 

REF: p 997

  1. It has been estimated that mental illness in Australia and New Zealand will effect

 

a. 25% of the population.
b. 60% of the population.
c. 45% of the population
d. 10% of the population

 

REF: p 999

 

  1. The number of adults who do not undertake regular exercise is:

 

a. 1 in 5.
b. 1 in 10.
c. 1 in 20.
d. 1 in 7.

 

REF: p 996

 

  1. The life expectancy of an Indigenous Australian male is approximately:

 

a. 20 years fewer than a non-Indigenous Australian male.
b. 11.5 years fewer than a non-Indigenous Australian male.
c. slowly increasing.
d. the same as a non-Indigenous Australian male.

 

REF: p 1000

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 34: Stress and chronic disease

 

Test Bank

 

MULTIPLE CHOICE

 

  1. Which of the following is true regarding stress?

 

a. It worsens but does not cause disease.
b. It decreases immune function.
c. It is a psychological rather than a biological event.
d. It is a passive event.

 

REF: p 1005

 

  1. Stress is a complex process that involves relationships with which of the following systems?

 

a. the CNS, genitourinary and musculoskeletal system
b. the CNS, autonomic nervous system, endocrine system and the immune system
c. the genitourinary, gastric and sympathetic nervous system
d. the autonomic nervous system, musculoskeletal and limbic system

 

REF: p 1005

 

  1. A student is driving to university when another driver nearly hits her. Her heart begins beating harder and faster as she becomes scared. Which of the following stages of Selye’s general adaptation syndrome is she experiencing?

 

a. alarm stage
b. stage of resistance
c. adaptation
d. exhaustion

 

REF: p 1006

 

  1. In the alarm stage, stressors activate:

 

a. hypothalamus and parasympathetic system
b. prolactin
c. hypothalamus and sympathetic nervous system
d. somatotropin

 

REF: p 1007

 

  1. A 35-year-old male is diagnosed with a hormone-secreting tumour of the adrenal medulla. He experiences elevated blood pressure, pupil dilation, ‘goose bumps’, and excessive sweating of the armpits and hands. Which of the following hormones is the predominant one released by the tumour?

 

a. dopamine
b. ACTH
c. noradrenaline
d. cortisol

 

REF: p 1007

 

  1. In general, a person experiences stress:

 

a. when the demand exceeds their coping abilities.
b. when their energy exceeds the physical demand.
c. when their coping abilities are underutilised.
d. when they are passive.

 

REF: p 1020

 

  1. Stress induces sympathetic stimulation of the adrenal medulla. This causes the secretion of catecholamines, which include:

 

a. adrenaline and aldosterone.
b. noradrenaline and cortisol.
c. adrenaline and noradrenaline.
d. cortisol and aldosterone.

 

REF: p 1007

 

  1. The term ‘feed and faze out’ can be defined as:

 

a. socialising with friends over coffee.
b. ignoring any signs of stress.
c. coping with stress by binge drinking.
d. a reaction to stress that involves eating and watching television.

 

REF: p 1007

 

  1. The control centre for the stress response is the:

 

a. posterior pituitary.
b. hypothalamus.
c. anterior pituitary.
d. hippocampus.

 

REF: p 1007

 

  1. A 30-year-old male has a large number of painful and irritating insect bites. His doctor prescribes a synthetic cortisol cream. How will the cortisol relieve his symptoms?

 

a. inhibiting TH1 cell activity
b. increasing cytokine secretion
c. increasing blood pressure
d. decreasing gastric secretion

 

REF: p 1011

 

  1. The production of cortisol in response to stress is initiated by the:

 

a. hypothalamus.
b. posterior pituitary.
c. sympathetic nerve fibres.
d. adrenal medulla.

 

REF: p 1009

 

  1. Cortisol:

 

a. decreases blood lipid levels.
b. increases blood glucose levels.
c. increases immune response.
d. increases allergic reactions.

 

REF: p 1010

 

  1. Which of the following would not be useful to assess stress?

 

a. monocytes and basophils
b. leucocytes
c. eosinophils
d. cholesterol level

 

REF: p 1013

 

  1. Which of the following conditions is associated with the presence of Helicobacter pylori?

 

a. hyperthyroidism
b. hyperglycaemia
c. gastric ulcers
d. decubitus ulcers

 

REF: p 1015

 

  1. Osteoporosis can be attributed to stress due to:

 

a. increased intestinal calcium absorption.
b. increased renal calcium excretion.
c. decreased renal perfusion.
d. increased blood calcium levels.

 

REF: p 1015

 

  1. Coping is best defined as the process of:

 

a. adjusting to disease.
b. preventing psychological distress.
c. mediating anger.
d. managing stressful challenges.

 

REF: p 1020

 

  1. In females, a hormone that has stress-decreasing properties is:

 

a. syntocin.
b. oxytocin.
c. testosterone.
d. progesterone

 

REF: p 1020

 

  1. A taxi driver who works during the night may have difficulty sleeping during the day due to:

 

a. suppression of melatonin.
b. increased production of melatonin.
c. increased levels of thyroxine.
d. decreased levels of thyroxine.

 

REF: p 1023

 

  1. A security guard who works shifts will have normal hormone levels for the first few days but over time may develop a decrease in:

 

a. cortisol.
b. growth hormone.
c. thyroid-stimulating hormone.
d. glucagon.

 

REF: p 1023

 

  1. With ageing, which of the following is likely to occur?

 

a. decreased cortisol secretion
b. decreased blood coagulation
c. chronic inflammation
d. decreased catecholamine secretion

 

REF: p 1024

 

  1. The physiological effects of catecholamines include:

 

a. increased gastric secretion.
b. increased blood coagulation.
c. decreased ventilation of the lungs.
d. decreased glucose production by the liver.

 

REF: p 1024

 

  1. Which of the following is not a physiological effect of cortisol?

 

a. decreased protein production
b. increased urinary excretion of calcium.
c. decreased glucose production by the liver
d. increased gastric secretion

 

REF: p 1011

 

Craft, Gordon: Understanding Pathophysiology, 2nd Edition

 

Chapter 35: Obesity and diabetes mellitus

 

Test Bank

 

MULTIPLE CHOICE

 

  1. Body mass index (BMI) is a widely used method for measuring body fat mass. How is this measurement calculated?

 

a. weight (kg) × age
b. age × height squared (m2)
c. weight (kg) ÷ height squared (m2)
d. age ÷ weight (kg)

 

REF: p 1030

 

  1. When measuring the waist circumference of an individual, the optimum position for accurate measurement is:

 

a. standing, relaxing and inhaling.
b. standing, relaxing and exhaling.
c. sitting, relaxing and exhaling.
d. sitting, relaxing and inhaling.

 

REF: p 1030

 

  1. An individual who presents with peripheral obesity will be:

 

a. apple shaped with fat stored in the hips and buttocks.
b. pear shaped with fat stored in the viscera and abdomen.
c. apple shaped with fat stored in the viscera and abdomen.
d. pear shaped with fat stored in hips and buttocks.

 

REF: p 1031

 

  1. An unhealthy diet would consist of:

 

a. large amounts of fats and simple sugars and small amounts of protein and vitamins.
b. large amounts of protein and simple sugars and small amounts of vitamins and fibre.
c. large amounts of fibre and protein and small amounts of sugars.
d. large amounts of fruit and vegetables.

 

REF: p 1032

 

  1. A student nurse who undertakes an adequate amount of physical activity would exercise:

 

a. 30 minutes of moderate exercise 7 days a week.
b. 30 minutes of moderate exercise 5 days a week.
c. 30 minutes of rigorous exercise twice a day.
d. 150 minutes of exercise daily.

 

REF: p 1033

 

  1. An individual who presents with central obesity will be more at risk of developing:

 

a. hypolipidaemia, cardiovascular disease and type 1 diabetes.
b. hypotension, cerebral vascular disease and type 1 diabetes.
c. cerebral vascular disease, hypolipidaemia and type 2 diabetes.
d. hyperlipidaemia, cardiovascular disease and type 2 diabetes.

 

REF: p 1033

 

  1. Appetite is controlled by stimulation of:

 

a. salivary glands.
b. hypothalamus.
c. gastrointestinal tract.
d. food intake.

 

REF: p 1034

 

  1. Effects of elevated levels of leptin include:

 

a. increased appetite and food intake.
b. increased metabolism.
c. decreased appetite and food intake.
d. increased sympathetic activity.

 

REF: p 1035

 

  1. Obese individuals may experience sleep apnoea due to:

 

a. excessive alcohol consumption.
b. increased glucose levels.
c. excess abdominal weight compressing the diaphragm.
d. excess weight around the neck constricting the upper airways.

 

REF: p 1035

 

  1. An individual who has been recommended a very low energy diet would consume how many kilojoules a day?

 

a. 1700-3300
b. 2000-4000
c. 4000-5000
d. none

 

REF: p 1037

 

  1. A 40-year-old female who is obese and unable to lose weight m