Chapter 8 Pathophysiology Flashcards Preview

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Flashcards in Chapter 8 Pathophysiology Deck (138):
1

1. The study of the functioning of an organism in the presence of disease is called:
A) biology.
B) physiology.
C) pathophysiology
D) biochemistry.

C) pathophysiology

2

2. The paramedic is in the BEST position to formulate an appropriate treatment plan for an ill patient if the paramedic:
A) is able to identify the etiology of the patient's illness.
B) obtains a complete list of all the patient's medications.
C) performs a head-to-toe exam to detect all abnormalities.
D) gathers a reliable medical history from the patient's family.

A) is able to identify the etiology of the patient's illness.

3

3. Groups of cells form:
A) tissues.
B) organs.
C) an organism.
D) organ systems.

A) tissues.

4

4. An organ is composed of:
A) a group of cells.
B) multiple organisms.
C) identical cells and tissues.
D) various types of tissues.

D) various types of tissues.

5

5. The __________, which are found within the cell's cytoplasm, operate in a cooperative and organized fashion to maintain the life of the cell.
A) ribosomes
B) organelles
C) microfilaments
D) nuclear pores

B) organelles

6

6. What part of the cell produces the body's major energy source in the form of adenosine triphosphate (ATP)?
A) Nucleus
B) Mitochondria
C) Golgi complex
D) Endoplasmic reticulum

B) Mitochondria

7

7. The ____________ of the cell contains RNA.
A) nucleus
B) cytoplasm
C) Golgi complex
D) mitochondria

A) nucleus

8

8. What type of tissue lines the intestines, blood vessels, and bronchiole tubes?
A) Muscle
B) Nervous
C) Epithelial
D) Connective

C) Epithelial

9


9. Endothelial cells that line the inside of blood vessels:
A) are nonliving cells made of protein.
B) are made of epithelial squamous cells.
C) regulate blood flow and coagulation.
D) are composed of specialized nervous tissue.

C) regulate blood flow and coagulation.

10

10. Which of the following statements regarding connective tissue is MOST correct?
A) Connective tissue is enclosed by fascia.
B) Connective tissue can transmit electrical impulses.
C) Skeletal muscle is a type of connective tissue.
D) Connective tissue binds other types of tissue together.

D) Connective tissue binds other types of tissue together.

11

11. Nonstriated muscle is also called _________ muscle.
A) autonomic
B) smooth
C) skeletal
D) voluntary

B) smooth

12

12. Unlike skeletal muscle, cardiac muscle is:
A) striated voluntary.
B) nonstriated voluntary.
C) nonstriated involuntary.
D) striated involuntary.

D) striated involuntary.

13

13. ___________ nerves exit from between the spinal vertebrae and extend to various parts of the body.
A) Cranial
B) Connecting
C) Somatic
D) Peripheral

D) Peripheral

14

14. What structure conducts electrical impulses away from the cell body?
A) Axon
B) Synapse
C) Dendrite
D) Synaptic gap

A) Axon

15

15. Homeostasis is MOST accurately defined as:
A) a constant effort to preserve a degree of stability or equilibrium.
B) cellular oxygen delivery and carbon dioxide removal from the body.
C) the balance of water or hydration in the cells and body of an organism.
D) the inability of the body to maintain a constant internal environment.

A) a constant effort to preserve a degree of stability or equilibrium.

16

16. Which of the following is an example of homeostatic failure?
A) A pH balance of 7.37 with a respiratory rate of 28 breaths/min
B) Severe vomiting and diarrhea and a heart rate of 120 beats/min
C) Salt and water retention and a blood pressure of 170/98 mm Hg
D) Core body temperature of 98.2°F and an ambient temperature of 28°F

C) Salt and water retention and a blood pressure of 170/98 mm Hg

17

17. In healthy adults, a loss of more than ____% of total body fluid is required to alter homeostasis and cause illness.
A) 10
B) 15
C) 20
D) 30

D) 30

18

18. An endogenous ligand is:
A) any medication that binds to a receptor and causes a reaction.
B) a molecule that is produced by the body and binds to a receptor.
C) any molecule that is not naturally occurring in the human body.
D) a synthetically made hormone that acts upon the endocrine system.

B) a molecule that is produced by the body and binds to a receptor.

19

19. Unlike endocrine hormones, exocrine hormones:
A) are carried to their target organs or cell groups via the blood.
B) reach their targets via a specific duct that opens into an organ.
C) diffuse through intracellular spaces to reach their target organs.
D) move through body water and act upon the cell that secreted them.

B) reach their targets via a specific duct that opens into an organ.

20

20. All of the following are endocrine hormones, EXCEPT:
A) histamine.
B) insulin.
C) adrenaline.
D) thyroxine.

A) histamine.

21

21. Enlargement of the left ventricle due to chronically elevated blood pressure is called:
A) atrophy.
B) dysplasia.
C) hyperplasia.
D) hypertrophy.

D) hypertrophy.

22

22. An alteration in the size, shape, and organization of cells is called:
A) atrophy.
B) metaplasia.
C) dysplasia.
D) hypertrophy.

C) dysplasia.

23

23. Approximately 45% of a person's body weight is:
A) interstitial fluid.
B) intracellular fluid.
C) extracellular fluid.
D) intravascular fluid.

B) intracellular fluid.

24

24. Cerebrospinal fluid and synovial fluid are MOST appropriately classified as ____________ fluids.
A) interstitial
B) intravascular
C) intracellular
D) extracellular

A) interstitial

25

25. Dehydration is generally a more serious concern in older adults than in younger adults because:
A) older adults lose significantly more water through perspiration.
B) total body water constitutes only 45% of body weight in older adults.
C) renal function increases significantly in patients over 60 years of age.
D) a person's total body water increases by 10% for each 10 years of life.

B) total body water constitutes only 45% of body weight in older adults.

26

26. The net effect of osmosis is to:
A) equalize the amount of water on both sides of the cell membrane.
B) shift extracellular fluid to the intracellular and intravascular fluids.
C) passively transport a solution to an area of lower solute concentration.
D) equalize the concentrations of a solute on both sides of the cell membrane.

D) equalize the concentrations of a solute on both sides of the cell membrane.

27

27. The movement of water and a dissolved substance from an area of high pressure to an area of low pressure is called:
A) filtration.
B) active transport.
C) facilitated diffusion.
D) passive transport diffusion.

A) filtration.

28

28. When comparing two solutions, the solution that has a higher solute concentration and a higher osmotic pressure is referred to as a(n) __________ solution.
A) isotonic
B) hypotonic
C) hypertonic
D) crystalloid

C) hypertonic

29

29. Lactated Ringer's is a(n) __________ solution because its solute concentration is equal to that of the inside of the cell.
A) colloid
B) isotonic
C) hypotonic
D) crystalloid

B) isotonic

30

30. If the sodium potassium pump is impaired due to insufficient potassium in the body:
A) the cells will shrink and eventually die.
B) sodium accumulates and causes the cells to swell.
C) excess sodium fills the extracellular space.
D) water shifts from the cell and into the extracellular fluid.

B) sodium accumulates and causes the cells to swell.

31

31. Plasma comprises approximately ___% of the blood.
A) 25
B) 35
C) 45
D) 55

D) 55

32

32. What type of pressure is generated by dissolved proteins in the plasma that are too large to penetrate the capillary membrane?
A) Capillary hydrostatic pressure
B) Tissue hydrostatic pressure
C) Capillary colloidal osmotic pressure
D) Tissue colloidal osmotic pressure

C) Capillary colloidal osmotic pressure

33

33. Ascites is defined as:
A) an abnormal accumulation of fluid in the peritoneal cavity.
B) lower extremity edema caused by lymphatic obstruction.
C) fluid buildup in the lungs due to decreased cardiac function.
D) fluid backup in the periphery due to right atrial dysfunction.

A) an abnormal accumulation of fluid in the peritoneal cavity.

34

34. The cardinal sign of overhydration is:
A) edema.
B) dyspnea.
C) hypertension.
D) tachycardia.

A) edema.

35

35. Acute pulmonary edema:
A) commonly results from right-sided heart failure.
B) results in excess elimination of carbon dioxide.
C) is characterized by progressively worsening dyspnea.
D) impairs oxygen diffusion into the pulmonary capillaries.

D) impairs oxygen diffusion into the pulmonary capillaries.

36

36. Edema in an upper extremity following a mastectomy is the result of:
A) localized vasoconstriction.
B) decreased lymphatic drainage.
C) obstruction of a large blood vessel.
D) surgery-induced inflammation.

B) decreased lymphatic drainage.

37

37. When blood osmolarity increases:
A) the kidneys excrete more water from the body through diuresis in an attempt to normalize the blood's osmolarity.
B) osmoreceptors located in the hypothalamus stimulate the release of vasopressin, which causes the body to retain water.
C) the pituitary gland releases antidiuretic hormone (ADH), which stimulates the kidneys to resorb water and decrease the blood's osmolarity.
D) volume-sensitive receptors in the atria stretch, causing the release of natriuretic proteins that normalize the blood's osmolarity.

C) the pituitary gland releases antidiuretic hormone (ADH), which stimulates the kidneys to resorb water and decrease the blood's osmolarity.

38

38. Baroreceptors, which are located in the carotid artery, aorta, and kidneys, are MOST sensitive to changes in:
A) fluid volume.
B) blood pressure.
C) acid-base balance.
D) sodium concentrations.

B) blood pressure.

39

39. The MOST prevalent cation of the extracellular fluid is:
A) sodium.
B) chloride.
C) potassium.
D) bicarbonate.

A) sodium.

40

40. Renin is a protein that is released into the bloodstream by the _________ in response to changes in __________.
A) kidneys, blood pressure
B) liver, acid-base balance
C) pancreas, insulin levels
D) hypothalamus, body temperature

A) kidneys, blood pressure

41

41. When renin is released:
A) the conversion of angiotensin I to angiotensin II is inhibited, which facilitates excretion of sodium via the kidneys.
B) the lungs convert the plasma protein angiotensinogen to angiotensin I, which dilates the renal blood vessels and increases kidney function.
C) the pancreatic alpha cells secrete the hormone glucagon, which facilitates the conversion of glycogen to glucose in the liver.
D) the angiotensin-converting enzyme (ACE) converts angiotensin I to angiotensin II, which stimulates sodium resorption by the renal tubules.

D) the angiotensin-converting enzyme (ACE) converts angiotensin I to angiotensin II, which stimulates sodium resorption by the renal tubules.

42

42. Aldosterone acts on the kidneys by:
A) increasing potassium reabsorption into the blood and enhancing sodium elimination in the urine.
B) dilating the renal vasculature, thus enhancing renal blood flow and facilitating sodium excretion.
C) increasing sodium reabsorption into the blood and enhancing potassium elimination in the urine.
D) constricting the renal vasculature, thus slowing renal blood flow and decreasing the glomerular filtration rate.

C) increasing sodium reabsorption into the blood and enhancing potassium elimination in the urine.

43


43. The tension exerted on a cell due to water movement across the cell membrane is referred to as:
A) osmosis.
B) tonicity.
C) diffusion.
D) active transport.

B) tonicity.

44

44. A patient with kidney or liver failure would MOST likely develop:
A) severe dehydration.
B) an increase in isotonic fluid.
C) cellular shrinkage and death.
D) excessive hypertonic fluid levels.

B) an increase in isotonic fluid.

45

45. Orthostatic hypotension and oliguria are common manifestations of:
A) dehydration.
B) fluid overload.
C) hypernatremia
D) left-sided heart failure.

A) dehydration.

46

46. Which of the following factors would MOST likely cause hyponatremia?
A) Mild fever
B) A seizure
C) Acute nausea
D) Diuretic use

D) Diuretic use

47

47. Hyperkalemia is defined as:
A) excess potassium in the cells.
B) a relative deficit of sodium.
C) an elevated serum potassium level.
D) a critically low magnesium level.

C) an elevated serum potassium level.

Ans: C
Page: 344
Type: General Knowledge

48

48. All of the following factors would cause potassium to shift into the cell, EXCEPT:
A) alkalosis.
B) epinephrine release.
C) increased vagal tone.
D) insulin administration.

C) increased vagal tone.

Ans: C
Page: 344
Type: General Knowledge

49

49. A diabetic patient who failed to take his or her insulin and presents with peaked T waves on the cardiac monitor and muscle weakness is MOST likely:
A) hypocalcemic.
B) hyperkalemic.
C) hypokalemic.
D) hypoglycemic.

B) hyperkalemic.

Ans: B
Page: 344
Type: General Knowledge

50

50. Which of the following medications does NOT shift potassium into the cells?
A) Insulin
B) Albuterol
C) Bicarbonate
D) 50% dextrose

D) 50% dextrose

Ans: D
Page: 344
Type: General Knowledge

51

51. Muscle cramps and paresthesias in a malnourished patient with alcoholism are MOST likely the result of:
A) hypocalcemia.
B) hypernatremia.
C) hyperkalemia.
D) hypermagnesemia.

A) hypocalcemia.

Ans: A
Page: 345
Type: General Knowledge

52

52. Half of the body's magnesium is stored in the:
A) bones.
B) kidneys.
C) skeletal muscle.
D) extracellular fluid.

A) bones.

Ans: A
Page: 346
Type: General Knowledge

53

53. A patient with chronic renal insufficiency who has been taking laxatives and presents with confusion, muscle weakness, and decreased deep tendon reflexes MOST likely has:
A) decreased serum sodium levels.
B) an overall decrease in serum potassium.
C) an increased serum level of magnesium.
D) increased intracellular magnesium levels.

C) an increased serum level of magnesium.

Ans: C
Page: 346
Type: General Knowledge

54

54. Acid-base balance normally remains in a physiologic pH range of:
A) 7.25-7.35.
B) 7.35-7.45.
C) 7.45-7.55.
D) 7.55-8.25.

B) 7.35-7.45.

Ans: B
Page: 347
Type: General Knowledge

55

55. The MOST major challenge to pH homeostasis is:
A) hyperventilation.
B) CO2 elimination.
C) acute fluid loss.
D) acid production.

D) acid production.

Ans: D
Page: 348
Type: General Knowledge

56

56. Which of the following represents an abnormal electrolyte serum level?
A) Sodium, 140 mEq/L
B) Potassium, 6 mEq/L
C) Calcium, 9.5 mEq/L
D) Magnesium, 1.7 mEq/L

B) Potassium, 6 mEq/L

Ans: B
Page: 347
Type: General Knowledge

57


57. Acidosis is characterized by a(n):
A) increase in hydrogen ions and a decrease in pH.
B) decrease in hydrogen ions and an increase in pH.
C) increase in hydrogen ions and an increase in pH.
D) decrease in hydrogen ions and a decrease in pH.

A) increase in hydrogen ions and a decrease in pH.

Ans: A
Page: 347
Type: General Knowledge

58

58. A person who ingests an excessive amount of salicylate would MOST likely experience:
A) alkalosis.
B) bradycardia.
C) a fall in pH.
D) hypoventilation.



C) a fall in pH.

Ans: C
Page: 351
Type: General Knowledge

59

59. Carpopedal spasm that occurs during respiratory alkalosis is caused by a(n):
A) decrease in arterial CO2.
B) intracellular calcium shift.
C) extracellular sodium shift.
D) intracellular potassium shift.

Ans: B
Page: 350
Type: General Knowledge

B) intracellular calcium shift.

Ans: B
Page: 350
Type: General Knowledge

60

60. A patient who overdosed on heroin and is unconscious with slow, shallow respirations would MOST likely experience:
A) increased CO2 retention.
B) acute metabolic acidosis.
C) excess CO2 elimination.
D) a pH well above 7.45.


A) increased CO2 retention.

Ans: A
Page: 349-350
Type: General Knowledge

61

61. Which of the following conditions would be the LEAST likely to cause hyperventilation?
A) Ketoacidosis
B) Severe infection
C) Aspirin overdose
D) Metabolic alkalosis

D) Metabolic alkalosis

Ans: D
Page: 350-351
Type: General Knowledge

62

62. When cells are hypoxic for more than a few seconds:
A) they produce substances that may damage other local or distant body systems.
B) the respiratory system rapidly decompensates and breathing becomes slow.
C) an increase in cytochrome production occurs and the body makes more energy.
D) lysosomes quickly release enzymes that attempt to rebuild the structure of the cell.

A) they produce substances that may damage other local or distant body systems.

Ans: A
Page: 352
Type: General Knowledge

63

63. What chemical induces hypoxia by blocking oxidative phosphorylation in the mitochondria and preventing oxygen metabolism?
A) Lead
B) Ethanol
C) Cyanide
D) Carbon monoxide



C) Cyanide

Ans: C
Page: 353
Type: General Knowledge

64

64. Infectious cellular injury would LEAST likely occur in a patient:
A) with metastatic cancer.
B) with migraine headaches.
C) who is over 70 years of age.
D) with long-term diabetes.


B) with migraine headaches.

Ans: B
Page: 354
Type: General Knowledge

65

65. Foreign material such as bacteria and other microorganisms are engulfed and destroyed by:
A) basophils.
B) phagocytes.
C) eosinophils.
D) lymphocytes.


B) phagocytes.

Ans: B
Page: 354
Type: General Knowledge

66

66. In the presence of infection, white blood cells release endogenous chemicals called _________, which produce fever.
A) pyrogens
B) histamines
C) leukotrienes
D) catecholamines


A) pyrogens

Ans: A
Page: 355
Type: General Knowledge

67

67. Unlike bacteria, viruses:
A) are unable to replicate.
B) are treated effectively with antibiotics.
C) do not produce an immune response.
D) do not produce exotoxins or endotoxins.


D) do not produce exotoxins or endotoxins.

Ans: D
Page: 355
Type: General Knowledge

68

68. Apoptosis is defined as:
A) hypoxic cell death.
B) normal cell death.
C) pathologic cell death.
D) premature cell death.


B) normal cell death.

Ans: B
Page: 356
Type: General Knowledge

69

69. If an injury leading to cell degeneration is of sufficient intensity and duration:
A) ischemia will result in simple necrosis.
B) the cell will undergo coagulation necrosis.
C) the cell will become inflamed and may burst.
D) irreversible cell injury will lead to cell death.

D) irreversible cell injury will lead to cell death.

Ans: D
Page: 356
Type: General Knowledge

70

70. Which of the following disease processes is more common in women?
A) Gout
B) Lung cancer
C) Osteoporosis
D) Parkinson's disease


C) Osteoporosis

Ans: C
Page: 357
Type: General Knowledge

71

71. The prevalence of a particular disease refers to:
A) the frequency with which the disease occurs.
B) how acutely the disease negatively affects a person.
C) the number of cases in a particular population over time.
D) the number of deaths from the disease in a given population.


C) the number of cases in a particular population over time.


Ans: C
Page: 357
Type: General Knowledge

72

72. Most immunologic diseases that exhibit familial tendencies:
A) are caused by immunosuppression.
B) involve an overactive immune system.
C) are outgrown by the age of 25 years.
D) are caused by immune system hypoactivity.


B) involve an overactive immune system.

Ans: B
Page: 359
Type: General Knowledge

73

73. Allergies are acquired following:
A) most bacterial infections.
B) initial exposure to an allergen.
C) indirect exposure to an allergen.
D) repeated exposure to an allergen.


B) initial exposure to an allergen.

Ans: B
Page: 359
Type: General Knowledge

74

74. Recurrent episodes of rheumatic fever would MOST likely cause:
A) metastatic brain cancer.
B) frequent streptococcal infections.
C) progressive failure of the liver.
D) permanent damage to the heart valves.

D) permanent damage to the heart valves.

Ans: D
Page: 359
Type: General Knowledge

75

75. An inflammatory condition of the respiratory system that results in intermittent wheezing and excess mucus production is called:
A) sinusitis.
B) asthma.
C) bronchitis.
D) emphysema.

B) asthma.

Ans: B
Page: 359
Type: General Knowledge

76

76. Major risk factors for lung cancer include:
A) female sex and age over 40 years.
B) frequent respiratory infections and asthma.
C) cigarette smoking and exposure to asbestos.
D) chewing tobacco use and a history of allergies.

C) cigarette smoking and exposure to asbestos.

Ans: C
Page: 359
Type: General Knowledge

77

77. Early signs or symptoms of breast cancer include:
A) a small, painless lump in the breast.
B) swollen lymph glands in the axilla.
C) significant weight loss and vomiting.
D) nipple discharge and breast tenderness.

A) a small, painless lump in the breast.

Ans: A
Page: 360
Type: General Knowledge

78

78. Patients with type 1 diabetes mellitus:
A) need exogenous insulin to survive.
B) are less likely to develop ketoacidosis.
C) experience excessive cellular uptake of glucose.
D) control their disease with dietary modification.


A) need exogenous insulin to survive.

Ans: A
Page: 360
Type: General Knowledge

79

79. Hemolytic anemia is a disease characterized by:
A) decreased production of red blood cells.
B) premature death of white blood cells.
C) an overproduction of red blood cells.
D) increased destruction of red blood cells.


D) increased destruction of red blood cells.

Ans: D
Page: 361
Type: General Knowledge

80

80. Which of the following statements regarding hemophilia is correct?
A) Hemophilia is caused by excessive production of factor VIII.
B) Hemophilia is an inherited disorder, is characterized by excessive bleeding, and occurs only in males.
C) Hemophilia is characterized by factor VIII deficit and is passed from asymptomatic fathers to daughters.
D) Hemophilia is generally not an inherited disorder and affects males and females in equal numbers.

B) Hemophilia is an inherited disorder, is characterized by excessive bleeding, and occurs only in males.

Ans: B
Page: 361
Type: General Knowledge

81

81. Patients with congenital prolongation of the Q-T interval are at GREATEST risk for:
A) sudden asystole.
B) ventricular arrhythmias.
C) coronary artery disease.
D) acute myocardial infarction.


B) ventricular arrhythmias.

Ans: B
Page: 362
Type: General Knowledge

82

82. Syncope is probably NOT caused by a life-threatening dysrhythmia if it occurs:
A) immediately after a person is startled.
B) following exercise or heavy exertion.
C) in a person whose cousin has syncope.
D) in conjunction with chest pain or pressure.


C) in a person whose cousin has syncope.

Ans: C
Page: 362
Type: General Knowledge

83

83. Hypertrophic cardiomyopathy is characterized by:
A) enlargement or thickening of the heart muscle.
B) progressive shrinking of the right side of the heart.
C) a significant reduction of blood return to the atria.
D) generalized thinning of the left and right ventricles.


A) enlargement or thickening of the heart muscle.

Ans: A
Page: 362
Type: General Knowledge

84

84. Generally, the only physical finding in a patient with a prolapsed mitral valve is:
A) a chronically irregular heart rate.
B) sharp chest pain following strenuous exertion.
C) dyspnea and palpitations while in a sitting position.
D) a clicking sound heard during cardiac auscultation.

D) a clicking sound heard during cardiac auscultation.

Ans: D
Page: 362
Type: General Knowledge

85

85. A person with a normal total cholesterol level:
A) is at high risk for an acute cardiac event if his or her HDL levels are elevated.
B) will probably not develop coronary artery disease, even if his or her HDL levels are low.
C) will likely not experience an acute cardiac event, even if his or her LDL levels are elevated.
D) is still at risk for coronary artery disease if his or her LDL levels are elevated.

D) is still at risk for coronary artery disease if his or her LDL levels are elevated.

Ans: D
Page: 362-363
Type: General Knowledge


86

86. Gout is a condition in which:
A) calcium deposits affect the joints.
B) uric acid accumulates in the blood.
C) the kidneys fail to excrete sodium.
D) synovial fluid is progressively destroyed.


B) uric acid accumulates in the blood.

Ans: B
Page: 363
Type: General Knowledge

87

87. Common signs and symptoms of ulcerative colitis include all of the following, EXCEPT:
A) pus or blood in the stools.
B) recurrent abdominal pain.
C) bloating after milk ingestion.
D) fever, chills, and diarrhea.


C) bloating after milk ingestion.

Ans: C
Page: 364
Type: General Knowledge

88

88. What disease is characterized by erosions in the mucous membrane lining of the gastrointestinal tract, specifically the stomach?
A) Peptic ulcer disease
B) Crohn's disease
C) Cholethiasis
D) Cholecystitis

A) Peptic ulcer disease

Ans: A
Page: 364
Type: General Knowledge

89

89. Common health risks associated with obesity include all of the following, EXCEPT:
A) diabetes.
B) infertility.
C) hypolipidemia.
D) insulin resistance.


C) hypolipidemia.

Ans: C
Page: 364
Type: General Knowledge

90


90. Muscular dystrophy is characterized by:
A) progressive deterioration of involuntary muscles, specifically the diaphragm.
B) weakness and wasting of groups of skeletal muscles, leading to increasing disability.
C) relaxation of the vascular smooth muscles, resulting in progressive hypoperfusion.
D) involuntary rapid, jerky motions and mental deterioration, leading to dementia.


B) weakness and wasting of groups of skeletal muscles, leading to increasing disability.

Ans: B
Page: 365
Type: General Knowledge

91

91. Early manifestations of Alzheimer's disease include:
A) impaired cognition and impaired abstract thinking.
B) inability to carry out activities of daily living.
C) indifference to food and urinary incontinence.
D) memory loss and subtle personality changes.

D) memory loss and subtle personality changes.

Ans: D
Page: 365
Type: General Knowledge

92


92. Gross distortions of reality, withdrawal from social contacts, and bizarre behavior are MOST characteristic of:
A) depression.
B) schizophrenia.
C) bipolar disorder.
D) obsessive-compulsive disorder.



B) schizophrenia.

Ans: B
Page: 366
Type: General Knowledge

93

93. How does the body respond to hypoperfusion?
A) Decreased preload, stroke volume, and heart rate
B) Catecholamine release and increased systemic vascular resistance
C) Splenic retention of red blood cells secondary to systemic hypoxia
D) A compensatory decrease in cardiac output and cardiac oxygen demand



B) Catecholamine release and increased systemic vascular resistance

Ans: B
Page: 366
Type: General Knowledge

94

94. When oxygen does not reach the cell, the cell reverts to:
A) anaerobic metabolism and produces lactic acid.
B) aerobic metabolism and produces carbon dioxide.
C) fat metabolism and begins producing ketoacids.
D) anaerobic metabolism and produces bicarbonate.


A) anaerobic metabolism and produces lactic acid.

Ans: A
Page: 366-367
Type: General Knowledge

95

95. The MOST common cause of cardiogenic shock is:
A) untreated hypertension.
B) blunt force chest trauma.
C) acute myocardial infarction.
D) sustained pulmonary hypertension.

Ans: C
Page: 367
Type: General Knowledge

C) acute myocardial infarction.

Ans: C
Page: 367
Type: General Knowledge

96

96. What type of shock occurs when blood flow becomes blocked in the heart or great vessels?
A) Cardiogenic
B) Peripheral
C) Distributive
D) Obstructive

D) Obstructive

Ans: D
Page: 367
Type: General Knowledge

97

97. The MOST common type of exogenous hypovolemic shock is:
A) severe diarrhea.
B) internal hemorrhage.
C) excess plasma loss.
D) external bleeding.

D) external bleeding.

Ans: D
Page: 368
Type: General Knowledge

98

98. Distributive shock occurs when:
A) central vasoconstriction forces blood from the core of the body.
B) blood pools in expanded vascular beds and tissue perfusion decreases.
C) microorganisms attack the blood vessels, resulting in vasodilation.
D) a significant decrease in cardiac contractility causes decreased perfusion.

B) blood pools in expanded vascular beds and tissue perfusion decreases.

Ans: B
Page: 368
Type: General Knowledge

99

99. Anaphylactic shock is characterized by:
A) labored breathing and hypertension.
B) wheezing and widespread vasodilation.
C) intracellular hypovolemia and hives.
D) a deficiency of circulating histamines.



B) wheezing and widespread vasodilation.

Ans: B
Page: 368-369
Type: General Knowledge

100

100. A loss of normal sympathetic nervous system tone causes:
A) neurogenic shock.
B) obstructive shock.
C) profound vasoconstriction.
D) a reduced absolute blood volume.

A) neurogenic shock.

Ans: A
Page: 369
Type: General Knowledge

101

101. In decompensated shock, systolic blood pressure is:
A) less than 90 mm Hg in adult males.
B) less than 80 mm Hg in adult females.
C) less than the fifth percentile for the age.
D) usually undetectable due to vasodilation.


C) less than the fifth percentile for the age.

Ans: C
Page: 369
Type: General Knowledge

102

102. Strength of a person's peripheral pulses is related to:
A) heart rate and preload.
B) stroke volume and pulse pressure.
C) physical size and blood pressure.
D) cardiac output and heart rate.


B) stroke volume and pulse pressure.

Ans: B
Page: 369
Type: General Knowledge

103

103. Which of the following statements regarding multiple organ dysfunction syndrome (MODS) is correct?
A) MODS typically develops within 20 to 30 minutes following resuscitation from cardiac arrest.
B) At the cellular level, MODS results in aerobic metabolism, metabolic alkalosis, and impaired cellular function.
C) Signs and symptoms of MODS include compensatory hypertension, bradycardia, and a fever greater than 105°F.
D) MODS occurs when injury or infection triggers a massive systemic immune, inflammatory, and coagulation response.

D) MODS occurs when injury or infection triggers a massive systemic immune, inflammatory, and coagulation response.

Ans: D
Page: 369-370
Type: General Knowledge

104

104. Which of the following processes occurs during multiple organ dysfunction syndrome (MODS)?
A) MODS activates the kallikrein-kinin system, which stimulates the release of bradykinin, a potent vasoconstrictor
B) The ischemic pancreas releases myocardial depressant factor, which impairs cardiac contractility
C) Vascular endothelial damage causes depression of the coagulation system, which causes the blood to clot
D) The liver produces too little of the enzymes aspartate aminotransferase and alanine aminotransferase


B) The ischemic pancreas releases myocardial depressant factor, which impairs cardiac contractility

Ans: B
Page: 370
Type: General Knowledge

105

105. The chief white blood cell of the immune response is the:
A) lymphocyte.
B) neutrophil.
C) monocyte.
D) eosinophil.

Ans: A
Page: 371
Type: General Knowledge


A) lymphocyte.

Ans: A
Page: 371
Type: General Knowledge

106

106. Red bone marrow is essential for the formation of:
A) calcium.
B) interstitial fluid.
C) mature blood cells.
D) granular leukocytes.

Ans: C
Page: 371
Type: General Knowledge

C) mature blood cells.

Ans: C
Page: 371
Type: General Knowledge


107

107. After T lymphocytes leave the bone marrow, they mature in the:
A) thymus gland.
B) lymph nodes.
C) hypothalamus.
D) liver and spleen.


A) thymus gland.

Ans: A
Page: 371-372
Type: General Knowledge

108

108. _____________ are the MOST abundant white blood cells, are largely responsible for protecting the body against infection, and are key components of the first response to foreign body invasion.
A) Neutrophils
B) Eosinophils
C) B lymphocytes
D) Basophils




A) Neutrophils

Ans: A
Page: 372
Type: General Knowledge

109

109. Which of the following statements regarding basophils is correct?
A) Basophils release chemicals that destroy parasitic invaders.
B) Basophils account for approximately 70% of the leukocytes.
C) Basophils travel to the tissues, where they become macrophages.
D) Basophils release histamine and other chemicals that dilate blood vessels.

D) Basophils release histamine and other chemicals that dilate blood vessels.

Ans: D
Page: 372-373

110

110. Unlike basophils, mast cells:
A) do not release leukotrienes.
B) do not circulate in the blood.
C) circulate freely in the bloodstream.
D) play a major role in allergic reactions.

B) do not circulate in the blood.

Ans: B
Page: 373
Type: General Knowledge

111

111. An injection of immunoglobulin is a form of:
A) native immunity.
B) passive acquired immunity.
C) innate immunity.
D) active acquired immunity.


B) passive acquired immunity.

Ans: B
Page: 374
Type: General Knowledge

112

112. The induction phase of the immune response begins when:
A) part of the immune system recognizes an antigen.
B) the body is initially exposed to a foreign substance.
C) an antibody binds to a specific antigen and destroys it.
D) biologic mediators release histamine and other chemicals.

A) part of the immune system recognizes an antigen


Ans: A
Page: 374
Type: General Knowledge

113

113. B lymphocytes produce antibodies when they are activated by:
A) mast cells.
B) eosinophils.
C) helper T cells.
D) phagocytes.



C) helper T cells.


Ans: C
Page: 375-376
Type: General Knowledge

114

114. Opsonization is a process in which:
A) antibodies bind to and inactivate toxins produced by bacteria.
B) antibodies cause antigens to clump together to facilitate phagocytosis.
C) a mother passes IgG and IgM antibodies to the fetus via breast milk.
D) an antibody coats an antigen to facilitate its recognition by immune cells.


D) an antibody coats an antigen to facilitate its recognition by immune cells.

Ans: D
Page: 377
Type: General Knowledge

115

115. If nonencapsulated bacteria enter the body:
A) exogenous antibiotic therapy is not effective.
B) antibodies coat them so phagocytosis can occur.
C) macrophages begin to destroy them immediately.
D) antibodies are not produced and released into the blood.


C) macrophages begin to destroy them immediately.

Ans: C
Page: 378
Type: General Knowledge

116

116. Older adults have increased levels of autoantibodies, which:
A) increase the person's risk of infection.
B) are antibodies directed against the patient.
C) predispose the patient to ischemic stroke.
D) cause a decreased level of macrophages.

B) are antibodies directed against the patient.

Ans: B
Page: 378
Type: General Knowledge


117

117. The two MOST common causes of inflammation are:
A) fever and phagocytosis.
B) infection and injury.
C) hypercarbia and hypoxemia.
D) immunosuppression and fever.


B) infection and injury.

Ans: B
Page: 379
Type: General Knowledge

118

118. During the acute inflammatory response:
A) transient arteriolar constriction is followed by arteriolar dilation, which allows an influx of blood under increased pressure.
B) active hyperemia causes the blood vessels to constrict, which diverts blood flow away from the affected site.
C) increased vessel wall permeability forces fluid out of the interstitial spaces, resulting in cell shrinkage and eventual death.
D) chemical mediators, which are primarily produced by monocytes, cause localized constriction of the vessels adjacent to the affected site.


A) transient arteriolar constriction is followed by arteriolar dilation, which allows an influx of blood under increased pressure.

Ans: A
Page: 379
Type: General Knowledge

119

119. Slow-reacting substances of anaphylaxis are also known as:
A) histamine.
B) mast cells.
C) eosinophils.
D) leukotrienes.

D) leukotrienes.

Ans: D
Page: 379
Type: General Knowledge

120

120. Aspirin and NSAIDs reduce inflammation and pain by:
A) inhibiting prostaglandin synthesis.
B) decreasing circulating pyrogen levels.
C) thinning the blood and reducing platelets.
D) promoting mast cell synthesis of prostaglandins.


A) inhibiting prostaglandin synthesis.

Ans: A
Page: 380
Type: General Knowledge


121

121. __________ is the protein that bonds to form the fibrous component of a blood clot.
A) Kinin
B) Plasmin
C) Fibrin
D) Collagen



C) Fibrin

Ans: C
Page: 380
Type: General Knowledge

122

122. The destruction of a blood clot is called:
A) adhesion.
B) fibrinolysis.
C) chemotaxis.
D) agglutination.



B) fibrinolysis.

Ans: B
Page: 380
Type: General Knowledge

123

123. Factor ____ is the antihemophilic factor.
A) VII
B) VIII
C) IX
D) XI


B) VIII

Ans: B
Page: 381
Type: General Knowledge

124

124. Interleukins function by:
A) releasing prothrombin from the liver and converting it to thrombin.
B) stimulating macrophages to help engulf and destroy foreign substances.
C) keeping leukocytes at the infection site until they can perform their task.
D) attracting white blood cells to the sites of injury and bacterial invasion.

D) attracting white blood cells to the sites of injury and bacterial invasion.

Ans: D
Page: 381
Type: General Knowledge

125

125. When nerve cells and cardiac myocytes are injured:
A) they are replaced by regeneration from remaining cells.
B) their cells divide completely and thus heal completely.
C) a slow influx of blood flow causes progressive repair.
D) scar tissue forms because these cells cannot be replaced.

D) scar tissue forms because these cells cannot be replaced.

Ans: D
Page: 381
Type: General Knowledge

126

126. Wounds that heal by primary intention:
A) do not utilize fibrin or fibronectin.
B) heal without the formation of a scab.
C) are generally clean wounds with opposed margins.
D) have a more pronounced and prolonged inflammatory phase.



C) are generally clean wounds with opposed margins.

Ans: C
Page: 381
Type: General Knowledge

127

127. Which of the following disease processes would MOST likely cause delayed or dysfunctional wound healing?
A) Diabetes
B) Hypothyroidism
C) Heart disease
D) Hypertension



A) Diabetes

Ans: A
Page: 383
Type: General Knowledge

128

128. Angiogenesis is defined as:
A) the growth of new blood vessels.
B) the destruction of blood vessels.
C) rerouting of intact blood vessels.
D) regrowth of damaged blood vessels.



A) the growth of new blood vessels.

Ans: A
Page: 383
Type: General Knowledge

129

129. In general, a child's immune system is not fully developed until he or she is between:
A) 1 and 2 years of age.
B) 2 and 3 years of age.
C) 3 and 4 years of age.
D) 4 and 5 years of age.


B) 2 and 3 years of age.

Ans: B
Page: 383
Type: General Knowledge

130

130. The body's rejection of an organ following transplantation is MOST likely the result of:
A) autoimmunity.
B) hypersensitivity.
C) an infection.
D) isoimmunity.

D) isoimmunity.

Ans: D
Page: 383
Type: General Knowledge

131

131. A type I hypersensitivity reaction is:
A) a local reaction that primarily involves IgG antibodies.
B) an acute reaction that occurs in response to a stimulus.
C) an allergic response that occurs within hours of antigen exposure.
D) a cytotoxic reaction and destroys many of the body's healthy cells.

B) an acute reaction that occurs in response to a stimulus.

Ans: B
Page: 383-384
Type: General Knowledge


132

132. Unlike an allergic reaction, an autoimmune reaction:
A) targets an antigen or allergen.
B) is generally predictable.
C) targets a person's own tissues.
D) does not involve antibodies.

C) targets a person's own tissues.

Ans: C
Page: 385
Type: General Knowledge

133

133. All of the following diseases are autoimmune diseases, EXCEPT:
A) rheumatoid arthritis.
B) type 1 diabetes.
C) HIV infection.
D) myasthenia gravis.

C) HIV infection.

Ans: C
Page: 385
Type: General Knowledge

134

134. If the cause of a disease is unknown, it is said to be:
A) idiopathic.
B) organic.
C) functional.
D) pathologic.



A) idiopathic.

Ans: A
Page: 386
Type: General Knowledge

135

135. Type O blood contains:
A) neither A nor B antigens but contains both A and B plasma antibodies.
B) erythrocytes with type A antigens and plasma with type B antibodies.
C) A and B surface antigens, but the plasma contains no ABO antibodies.
D) both A and B surface antigens and both A and B plasma antibodies.


A) neither A nor B antigens but contains both A and B plasma antibodies.

Ans: A
Page: 386
Type: General Knowledge

136

136. If an Rh-negative person receives Rh-positive blood:
A) thrombocytopenia will occur.
B) antibodies will not be released.
C) a transfusion reaction will not occur.
D) hemolysis and anemia can result.

D) hemolysis and anemia can result.

Ans: D
Page: 386
Type: General Knowledge

137

137. The resistance stage of the stress reaction is characterized by:
A) an immediate release of the catecholamines epinephrine and norepinephrine, which causes the fight-or-flight response
B) a reduction of cortisol in the body, which predisposes the person to acute inflammatory processes.
C) stimulation of the adrenal glands to secrete hormones that increase blood glucose levels and maintain blood pressure.
D) adrenal gland depletion, which leads to decreased blood glucose levels, physical exhaustion, and immunocompromise.


C) stimulation of the adrenal glands to secrete hormones that increase blood glucose levels and maintain blood pressure.

Ans: C
Page: 388
Type: General Knowledge

138

138. Severe, prolonged stress:
A) is frequently a direct cause of death.
B) results in the destruction of cholesterol and fat.
C) causes the body to lose its ability to fight disease.
D) results in chronically low levels of cortisol.


C) causes the body to lose its ability to fight disease.

Ans: C
Page: 389
Type: General Knowledge