
Course Introduction
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Course Introduction
Pathophysiology explores the functional changes that occur in the body as a result of disease processes, bridging the gap between basic biomedical science and clinical practice. This course provides students with an understanding of how normal physiological mechanisms are altered by various diseases and conditions, highlighting the underlying causes, progression, and effects of common disorders. Emphasis is placed on the molecular, cellular, and systemic responses to injury and illness, enabling students to interpret signs and symptoms and appreciate the rationale behind therapeutic interventions. This foundational knowledge equips students to apply pathophysiological concepts in clinical decision-making and patient care.
Recommended Textbook
Pathophysiology The Biologic Basis for Disease in Adults And Children 5th Edition by Kathryn L. McCance
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Q1) A patient who has diarrhea receives a 3% 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.
Answer: C
Q2) What organic compound facilitates transportation across cell membranes by acting as receptors,transport channels for electrolytes,and enzymes to drive active pumps?
A) Lipids
B) Proteolytic cascade
C) Proteins
D) Carbohydrates
Answer: C
Q3) Lipids and proteins are the major components of the plasma membrane.
A)True
B)False
Answer: True
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Q1) Acute alcoholism mainly affects the _____ system.
A) hepatic
B) gastrointestinal
C) renal
D) central nervous
Answer: D
Q2) What,if any,is the difference between subdural hematoma and epidural hematoma?
A) There is no difference.These terms may be used interchangeably.
B) A subdural hematoma occurs above the dura,whereas an epidural hematoma occurs under the dura.
C) A subdural hematoma usually is formed from venous blood that collects slowly,whereas an epidural hematoma is formed from arterial blood that collects rapidly.
D) A subdural hematoma usually forms from bleeding within the skull such as an aneurysm eruption,whereas an epidural hematoma occurs from trauma outside the skull such as a blunt force trauma.
Answer: C
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Q1) Both loss of sodium and gain of water can cause hyponatremia.
A)True
B)False
Answer: True
Q2) Which of the following buffers works the fastest (in minutes to hours)?
A) Hemoglobin Hb/HHb
B) Bicarbonate/Carbonic acid (HCO<sub>3</sub>/H<sub>2</sub>CO<sub>3</sub>)
C) Phosphate (HPO<sub>4</sub>/H<sub>2</sub>PO<sub>4</sub>)
D) Ammonia (NH<sub>3</sub>/NH<sub>4</sub>)
Answer: B
Q3) Which groups are at risk for fluid imbalance?
A) Elderly persons,thin women,and infants
B) Infants,children,and obese persons
C) Thin women,obese persons,and elderly persons
D) Obese persons,elderly persons,and infants
Answer: D
Q4) Insulin and glucose can be given to correct hyperkalemia.
A)True
B)False
Answer: True

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Q1) A genetically normal male is always _____ for genes on the X chromosome.
A) homozygous
B) heterozygous
C) hemizygous
D) ambizygous
Q2) Which clinical manifestations would be expected for a child who has complete trisomy of the twenty-first chromosome?
A) Widely spaced nipples,reduced carrying angle at the elbow,and sparse body hair
B) An IQ of 25 to 70,low nasal bridge,protruding tongue,and flat,low-set ears
C) High-pitched voice,tall stature,gynecomastia,and an IQ of 60 to 90
D) Circumoral cyanosis,edema of the feet,short stature,and mental slowness
Q3) RNA polymerase is the most important protein in DNA replication.
A)True
B)False
Q4) If a boy who has hemophilia A inherited it from his:
A) father.
B) mother.
C) mother and father.
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Q1) The recurrence risk becomes higher if more than one family member has a multifactorial disease.
A)True
B)False
Q2) Empirical risks for most multifactorial diseases are based on:
A) chromosomal testing. B) direct observation.
C) liability thresholds. D) relative risks.
Q3) The body weight of adopted children correlates significantly with the body weights of their adopted parents.
A)True
B)False
Q4) A low-fat and high-fiber diet is thought to increase the risk of colon cancer.
A)True
B)False
Q5) Some families are more susceptible to colorectal cancer than other families.
A)True B)False
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Q1) Perspiration
A)Secrete antibacterial and antifungal fatty acids and lactic acid
B)Attack cell walls of gram positive bacteria
Q2) In the clotting cascade,the intrinsic and the extrinsic pathways converge at:
A) factor XII.
B) Hageman factor.
C) factor X.
D) factor V.
Q3) Microorganisms are ingested
A)Opsonization
B)Engulfment
C)Phagosome
D)Fusion
E)Destruction
Q4) Frequently histamine 1 (H1)and histamine 2 (H2)receptors are located on the same cells and act in a/an _____ fashion.
A) synergistic
B) additive
C) antagonistic
D) agonistic

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Q1) If a person had very low levels of Ig__,he or she may be more susceptible to infections of mucous membranes.
A) G
B) M
C) A
D) E
Q2) Mediates many common allergic responses
A)Immunoglobulin A (IgA)
B)Immunoglobulin E (IgE)
C)Immunoglobulin G (IgG)
D)Immunoglobulin M (IgM)
Q3) Are induced by antigens derived from viral or bacterial pathogens
A)Helper T1 lymphocytes (Th1)
B)Helper T2 lymphocytes (Th2)
Q4) T lymphocytes are primarily responsible for protection against bacteria and a variety of viruses.
A)True
B)False
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Q1) What mechanism occurs in Raynaud phenomenon that classify it as a type III hypersensitivity reaction?
A) Immune complexes are deposited in capillary beds blocking circulation.
B) Mast cells bind to specific endothelial receptors that cause them to degranulate creating a localized inflammatory reaction that occludes capillary circulation.
C) Cytotoxic T lymphocytes attack and destroy the capillaries so that they are unable to perfuse local tissues.
D) Antibodies detect the capillaries as foreign protein and destroy them using lysosomal enzymes and toxic oxygen species.
Q2) Which blood cell carries the carbohydrate antigens for blood type?
A) Platelets
B) Neutrophils
C) Lymphocytes
D) Erythrocytes
Q3) Blood transfusion reactions are an example of:
A) autoimmunity.
B) alloimmunity.
C) homoimmunity.
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Q1) Which statement about vaccines is true?
A) Most bacterial vaccines contain attenuated organisms.
B) Most viral vaccines are made by using dead organisms.
C) Vaccines with booster injections induce primary and secondary immune responses.
D) Vaccines provide effective protection for all people against viruses,bacteria and fungal infections.
Q2) Once they have penetrated the first line of defense,which microorganisms do natural killer cells actively attack?
A) Bacteria
B) Fungi
C) Viruses
D) Mycoplasma
Q3) The ability of an agent to produce disease
A)Toxigenicity
B)Infectivity
C)Colonization
D)Pathogenicity
E)Virulence
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Q1) Which hormone increases the formation of glucose from amino acids and free fatty acids?
A) Epinephrine
B) Norepinephrine
C) Cortisol
D) Growth hormone
Q2) Cortisol circulates in the plasma free (unbound)and bound to protein.
A)True
B)False
Q3) The _____ is stimulated during the alarm phase of the general adaptation syndrome?
A) adrenal cortex
B) hypothalamus
C) anterior pituitary
D) limbic system
Q4) What effect does estrogen have on lymphocytes?
A) Depression of B cells and enhancement of T cells
B) Depression of T cells and enhancement of B cells
C) Depression of both B cells and T cells
D) Enhancement of both B cells and T cells
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Q1) Normally,which cells,if any,are "immortal" (never die)?
A) None,all cells eventually die
B) Stems cells and germ cells
C) Blood cells
D) Epithelial cells
Q2) What is autocrine stimulation?
A) The ability of cancer cells to stimulate angiogenesis to create their own blood supply
B) The ability of cancer cells to stimulate secretions that turn off normal growth inhibitors
C) The ability of cancer cells to secrete growth factors that stimulate their own growth
D) The ability of cancer cells to divert nutrients away from normal tissue for their own use
Q3) Pleomorphic
A)Loss of differentiation
B)Cancer cells secrete growth factor for their own growth
C)Cells that vary in size and shape
D)Unaltered normal allele
E)Responsible for maintenance of genomic integrity
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Q1) Monoclonal antibodies
A)Provides cell-derived antiviral and immunomodulating proteins
B)Provides direct cytotoxic effect on cancer cells
C)Forms antibodies specific for tumor antigen
D)Attacks cancerous cells in the cell cycle
E)Provides nonspecific stimulation of the immune system
Q2) What protects tumor cells within an emboli from the host defenses and facilitates attachment to vascular epithelium?
A) Macrophages
B) Fibrin-platelet complex
C) Vascular endothelial growth factor
D) Proteolytic enzymes
Q3) Small bowel
A)Pressure
B)Compression
C)Stretching
D)Obstruction
E)Tissue destruction
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Q1) Mutation of proto-oncogenes into oncogenes stimulates uncontrolled cell growth.
A)True
B)False
Q2) What percentage of children with cancer can be cured?
A) 48%
B) 58%
C) 68%
D) 78%
Q3) There is a carcinogenic relationship between Hodgkin disease and the:
A) herpes simplex virus.
B) human immunodeficiency virus.
C) varicella virus.
D) Epstein-Barr virus.
Q4) Leukemia is the most common malignancy in children.
A)True
B)False
Q5) Childhood cancer has a longer latency period than cancer in adults.
A)True
B)False
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Q1) Vestibulocochlear nerve
A)Innervates muscles that move the eye downward and inward
B)Has both motor and sensory functions to face,mouth,nose,and eyes
C)Carries motor functions to tongue and sensory impulses from tongue to brain
D)Controls size,shape,and equality of pupils
E)Causes motor functions to pharynx and salivary glands and sensory functions from pharynx and tongue
F)Innervated muscles that move the eye laterally
G)Carries sensory and motor action to the tongue
H)Carries impulse for sense of smell
I)Carries motor and sensory fibers of abdominal organs
J)Transmits impulses for sense of hearing
K)Carries sensory and motor fibers to pharynx and larynx
Q2) The parasympathetic nervous system functions to conserve and restore energy.
A)True
B)False
Q3) Microglia perform phagocytosis in the central nervous system.
A)True
B)False

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Q1) Pricking one's finger with a needle would cause minimal pain,whereas cutting one's finger with a knife would produce more pain.This is an example of which theory of pain?
A) Gate control theory
B) Intensity theory
C) Specificity theory
D) Pattern theory
Q2) The fingers are more sensitive to pain than the back because the fingers have more nociceptors to pain.
A)True
B)False
Q3) In general,as people age,their pain thresholds decrease.
A)True
B)False
Q4) Coronary artery disease is most affected by _____ sleep.
A) non-REM
B) light
C) REM
D) delta wave

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Q1) Decrease in voluntary movement
A)Paroxysmal dyskinesia
B)Flaccidity
C)Wernicke disease
D)Spasticity
E)Akinesia
F)Broca area
Q2) The general pathophysiologic mechanisms underlying cognitive network deficits are compression and ischemia.
A)True
B)False
Q3) Antipsychotic drugs cause tardive dyskinesia by mimicking the effects of increased:
A) dopamine.
B) gamma aminobutyric acid (GABA).
C) norepinephrine (NE).
D) acetylcholine.
Q4) Vegetative state is another term for locked-in syndrome.
A)True
B)False
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Q1) The type of vascular malformation that most often hemorrhages is:
A) cavernous angiomA.
B) venous angioma.
C) capillary telangiectasis.
D) arteriovenous malformation.
Q2) Which clinical finding is almost diagnostic for an arteriovenous malformation?
A) Systolic bruit over the carotid artery
B) Decreased level of consciousness
C) Hypertension with bradycardia
D) Diastolic bruit over the temporal artery
Q3) Because spinal cord swelling increases the degree of dysfunction,it is difficult to distinguish between permanent and temporary loss of function until the swelling is resolved.
A)True
B)False
Q4) In cases of subarachnoid hemorrhage,the intracranial pressure may approach levels of diastolic blood pressure.
A)True
B)False
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Q1) What is thought to be the alteration produced by electroconvulsive therapy (ECT)when treating individuals with depression?
A) It produces an alteration in the monoamine systems.
B) It produces an alteration in serotonin.
C) It produces an alteration in norepinephrine.
D) It produces an alteration in the limbic system.
Q2) Characterized by elevated levels of euphoria
A)Schizophrenia
B)Mania
C)Depression
D)Panic disorder
E)Obsessive-compulsive disorder
Q3) Hallucinations,delusions,thought disorder,and bizarre behavior occurs with alterations in the:
A) temporal lobe.
B) parietal lobe.
C) hypothalamus.
D) cerebral cortex.
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Q1) What causes the deficits found in children with phenylketonuria (PKU)?
A) They are unable to synthesize melanin,thyroxine and catecholamines.
B) They are unable to synthesize renin,erythropoietin and antidiuretic hormone.
C) They are unable to synthesize aldosterone,cortisol and androgens.
D) They are unable to synthesize neurotransmitters gamma aminobutyric acid (GABA)and acetylcholine.
Q2) Craniosynostosis is the premature closure of one or more of the cranial sutures during the first 6 months of the infant's life.
A)True
B)False
Q3) Obstructive hydrocephalus is most commonly caused by an obstruction between the lateral ventricles and third ventricle.
A)True
B)False
Q4) Although cerebral palsy is nonprogressive,its clinical manifestations change with growth and maturation of the child.
A)True
B)False
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Q1) What are the effects of high levels of aldosterone?
A) Hypokalemia and alkalosis
B) Hyperkalemia and alkalosis
C) Hyperkalemia and acidosis
D) Hypokalemia and acidosis
Q2) Growth hormone
A)Anterior pituitary
B)Posterior pituitary
C)Thyroid
D)Adrenal cortex
E)Adrenal medulla
Q3) Cortisol
A)Anterior pituitary
B)Posterior pituitary
C)Thyroid
D)Adrenal cortex
E)Adrenal medulla
Q4) Adrenocorticotropic hormone (ACTH)directly affects melanocyte stimulation.
A)True
B)False

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Q1) What is the first lab test that indicates a patient with type 1 diabetes is developing nephropathy?
A) Dipstick test for urine ketones
B) Increase in serum creatinine and blood urea nitrogen (BUN)
C) Protein in the urinalysis
D) Cloudy urine on the urinalysis
Q2) Diabetes insipidus results from:
A) antidiuretic hormone (ADH)hyposecretion.
B) antidiuretic hormone (ADH)hypersecretion.
C) insulin hyposecretion.
D) insulin hypersecretion.
Q3) Syndrome of inappropriate antidiuretic hormone (SIADH)is characterized by increased levels of antidiuretic hormone (ADH).
A)True
B)False
Q4) Diagnosing thyroid carcinoma is best done with:
A) measurement of serum thyroid levels.
B) radioisotope scanning.
C) ultrasonography.
D) fine-needle aspiration biopsy.

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Q1) Relaxes the myometrium and prevents lactation until the fetus is born
A)Gonadotropin-releasing hormone (GnRH)
B)Follicle-stimulating hormone (FSH)
C)Luteinizing hormone (LH)
D)Estrogen
E)Progesterone
Q2) Penile erections begin:
A) before birth.
B) shortly after birth.
C) shortly before puberty.
D) after puberty.
Q3) Estrogen is needed for the closure of long bones after the growth spurt in puberty.
A)True
B)False
Q4) Which hormone is linked to obesity and early puberty?
A) Inhibin
B) Leptin
C) Activin
D) Follistatin

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Q1) Which are clinical manifestations of testicular cancer?
A) Firm,nontender testicular mass
B) Painful,mobile,firm testicular mass
C) Painful fluid-filled testicular mass
D) Soft,nontender testicular mass
Q2) What is the leading cause of infertility?
A) Pelvic inflammatory disease
B) Endometriosis
C) Salpingitis
D) Polycystic ovary syndrome
Q3) Testicular torsion
A)Painless diverticulum of the epididymis located between the head of the epididymis and the testis
B)Collection of fluid in the tunica vaginalis
C)Rotation of a testis,which twists blood vessels of the spermatic cord
D)Abnormal dilation of the vein within the spermatic cord
Q4) The risk of testicular cancer is 35 to 50 times greater for men with cryptorchidism than for the general male population.
A)True
B)False
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Q1) The most common local complication of a gonococcal infection in females is:
A) acute salingitis.
B) cystitis.
C) vaginitis.
D) cervicitis.
Q2) Why do adolescent girls have the greatest risk for sexually transmitted exposure and infection?
A) Because they are in an experimental phase with sexual intercourse and believe they are resistant to developing sexually transmitted infections
B) Because of the immaturity of their cervix and lack of immunity
C) Because the length of the vaginal canal is shorter,which allows a greater concentration of microorganisms within the internal genitalia
D) Because of the close proximity of the anus to the vaginal introitus
Q3) A major concern in the treatment of gonococci infections is:
A) development of antibiotic resistance.
B) changes in virulence.
C) changes in pathogenicity.
D) mutations into different strains.
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Q1) Erythrocytes and platelets lack cell nuclei.
A)True
B)False
Q2) Erythropoietin induces the selective proliferation of proerythroblasts.
A)True
B)False
Q3) Erythropoiesis
A)Clotting
B)Red blood cell development
C)Red blood cell destruction
D)Platelet formation
E)Blood cell production
Q4) Two important characteristics allow erythrocytes to function as gas carriers.These are:
A) biconcavity and permanent shape.
B) permanent shape and reversible deformability.
C) reversible deformability and biconcavity.
D) biconcavity and the presence of hyperactive mitochondria.
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Q1) Which of the following anemias is classified as a macrocytic-normochromic anemia?
A) Iron deficiency anemia
B) Pernicious anemia
C) Sideroblastic anemia
D) Hemolytic anemia
Q2) What is the most common cause of iron deficiency anemia?
A) Decreased dietary intake
B) Chronic blood loss
C) Vitamin deficiency
D) Autoimmune disease
Q3) A patient has cheilosis,stomatitis,and painful ulceration of the buccal mucosa and mouth.He complains of dysphagia and watery diarrhea.These clinical manifestations are indicative of which anemia?
A) Pernicious anemia
B) Folate deficiency anemia
C) Anemia of chronic disease
D) Iron deficiency anemia
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Q1) Compensatory erythropoiesis is compromised,thus limiting the number of erythrocytes that are replaced
A)Vaso-occlusive crisis
B)Aplastic crisis
C)Sequestration crisis
D)Hyperhemolytic crisis
Q2) Sickle cell trait may provide protection against the lethal form of malaria.
A)True
B)False
Q3) Between 4 years of age and the onset of puberty,dietary iron deficiency is common. A)True
B)False
Q4) Hemophilia B is caused by clotting factor _____ deficiency.
A) V
B) VIII
C) IX
D) X
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Q1) Depolarization of a cardiac muscle cell occurs as the result of a:
A) decrease in the permeability of the cell membrane to potassium.
B) rapid movement of sodium into the cell.
C) rapid movement of calcium into the cell.
D) slow movement of sodium out of the cell.
E) slow movement of calcium out of the cell.
Q2) While both produce vasoconstriction,the effects of norepinephrine are quantitatively more vasoconstrictive than the effects of epinephrine.
A)True
B)False
Q3) 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;force
B) volume;strength
C) viscosity;force
D) viscosity;strength
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Q1) What is the most common cardiac disorder associated with acquired immunodeficiency syndrome (AIDS)resulting from myocarditis and infective endocarditis?
A) Inflammatory cardiomyopathy
B) Hypertrophic cardiomyopathy
C) Dilated cardiomyopathy
D) Restrictive cardiomyopathy
Q2) Atrial and brain natriuretic peptides are increased in congestive heart failure and may have some protective effect in decreasing preload.
A)True
B)False
Q3) Of the following risk factors for coronary artery disease,which is responsible for a twofold to threefold increase in risk?
A) Diabetes mellitus
B) Hypertension
C) Obesity
D) High alcohol consumption
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Q1) Ostium primum
A)Causes atrial separation
B)Gap between the septum primum and the septum secundum
C)Conal portion of the ventricular septum
D)Communication between the aorta and the pulmonary artery
E)Allows right-to-left shunting
Q2) Which of the following statements is true?
A) At birth,both systemic resistance and pulmonary resistance fall.
B) At birth,there is a shift in gas exchange from the placenta to the lung.
C) At birth,systemic resistance falls and pulmonary resistance rises.
D) At birth,both systemic resistance and pulmonary resistance rise.
Q3) Which heart defect produces a systolic ejection murmur at the right upper sternal border that transmits to the neck and left lower sternal border with an occasional ejection click?
A) Coarctation of the aorta
B) Pulmonic stenosis
C) Aortic stenosis
D) Hypoplastic left heart syndrome
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Q1) Which part of the brainstem provides basic automatic rhythm of respiration by sending efferent impulses to the diaphragm and intercostal muscles?
A) Dorsal respiratory group
B) Ventral respiratory group
C) Pneumotaxic center
D) Apneustic center
Q2) What permits air to pass between alveoli providing collateral ventilation and even distribution among alveoli?
A) Type I alveolar cells
B) Pores of Kohn
C) Acinus pores
D) Alveolar pores
Q3) Where in the lung does gas exchange occur?
A) Trachea
B) Segmental bronchi
C) Alveolocapillary membrane
D) Both B and C
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Q1) In adult respiratory distress syndrome (ARDS),what change causes alveoli and respiratory bronchioles to fill with fluid?
A) Pores of Kohn are compressed preventing collateral ventilation.
B) Increased capillary permeability causes alveoli and respiratory bronchioles to fill with fluid.
C) Surfactant is inactivated and type II alveolar cells are impaired.
D) Increased capillary hydrostatic pressure forces fluid into the alveoli and respiratory bronchioles.
Q2) What causes respirations that are characterized by alternating periods of deep and shallow breathing?
A) Decreased blood flow to the medulla oblongata
B) Decreased pH,increased PaCO<sub>2</sub>,and decreased PaO<sub>2</sub>
C) Stimulation of stretch or J receptors
D) Fatigue of the intercostal muscles and diaphragm
Q3) What is the most common route of lower respiratory tract infection?
A) Aspiration of oropharyngeal secretions
B) Inhalation of microorganisms
C) Microorganisms spread to lung via blood
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Q1) What is the direct action of atrial natriuretic hormone?
A) Retain sodium
B) Excrete sodium
C) Retain water
D) Excrete water
Q2) The concentration of the final urine is determined by antidiuretic hormone (ADH),which is secreted by the:
A) posterior pituitary.
B) right atrium.
C) left atrium.
D) anterior pituitary.
E) hypothalamus.
Q3) The best estimate of functioning renal tissue is:
A) glomerular filtration rate (GFR).
B) hourly urine output.
C) serum blood urea nitrogen and creatinine.
D) the specific gravity of the solute concentration of the urine.
Q4) The target tissue for angiotensin II is the blood vessels and adrenal medulla.
A)True
B)False
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Q1) Bladder cancer is associated with mutation of which gene?
A) c-erbB2
B) HER2
C) p53
D) myc
Q2) Obstruction and stasis of urine contributing to bacteremia and hydronephrosis;irritation of epithelial lining with entrapment of bacteria
A)Kidney stones
B)Vesicoureteral reflux
C)Pregnancy
D)Neurogenic bladder
E)Female sexual trauma
Q3) Which statement is false about struvite stones?
A) They are more common in women than men.
B) They are associated with chronic laxative use in women.
C) They grow large and branch into a staghorn configuration in renal pelvis and calyces.
D) They are closely associated with urinary tract infections caused by urease-producing bacteria,such as Pseudomonas.
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Q1) Which of the following is not considered part of the nephrotic syndrome in children?
A) Proteinuria
B) Pyuria
C) Hyperlipidemia
D) Edema
Q2) IgA nephropathy causing inflammation to glomerular blood vessels
A)Hemolytic-uremic syndrome
B)Henoch-Schönlein nephritis
C)Renal dysplasia
D)Ureteropelvic junction obstruction
E)Polycystic kidney disease
Q3) What causes the smoky,brown-colored urine in acute poststreptococcal glomerulonephritis (PSGN)?
A) The presence of red blood cells
B) The presence of urobilinogen
C) The slough from the collecting tubules
D) The protein that is in the urine
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Q1) The ileogastric reflex inhibits gastric motility when the ileum becomes distended,but the gastroileal reflex stimulates ileal motility and relaxes of the ileocecal sphincter.
A)True
B)False
Q2) Which stimulus increases the tone of the esophageal sphincter?
A) Progesterone
B) Glucagon
C) Motilin
D) Gastrin
Q3) Which water-soluble vitamin is absorbed by passive diffusion?
A) Vitamin B<sub>6</sub>
B) Vitamin B<sub>1</sub>
C) Vitamin C
D) Folic acid
Q4) The chief cells of the gastric glands secrete pepsinogen,which breaks down carbohydrates.
A)True
B)False
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Q1) Hepatic fat accumulation is seen in _____ cirrhosis.
A) biliary
B) metabolic
C) postnecrotic
D) alcohol
Q2) Alterations in immunoglobulin A production have been found in individuals with this disorder.
A)Ulcerative colitis
B)Crohn disease
Q3) Older adults experience which clinical manifestations of chronic gastritis?
A) Hemorrhage or perforation
B) Epigastric pain relieved by ingestion of food
C) Chronic intermittent pain in the epigastric area
D) Epigastric pain that interrupts sleep
Q4) How does an intestinal obstruction at the pylorus or high in the small intestine cause metabolic alkalosis?
A) By the gain of bicarbonate from pancreatic secretions that cannot be absorbed
B) By an excessive loss of hydrogen ions normally absorbed from gastric juice
C) By an excessive loss of potassium promoting atony of the intestinal wall
D) By the loss of bile acid secretions that cannot be absorbed
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Q1) The primary cause of intrahepatic portal hypertension in children is cirrhosis.
A)True
B)False
Q2) In about 80% of cases of congenital aganglionic megacolon,the aganglionic segment is limited to the ascending colon.
A)True
B)False
Q3) Failure to thrive is a disorder having both organic (e.g. ,gastrointestinal and endocrine disorders)and nonorganic (e.g. ,psychosocial)deprivation causes.
A)True
B)False
Q4) Why does an infant with gluten-sensitive enteropathy (celiac sprue)bruise and bleed easily?
A) Because he has a vitamin K deficiency from fat malabsorption
B) Because his bone marrow function is depressed
C) Because he has iron,folate,and B<sub>12</sub> deficiency anemias
D) Because he is taking Coumadin
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Q1) Stage of bone healing that requires hours to complete.
A)Callus replacement
B)Hematoma formation
C)Remodeling
D)Procallus formation
E)Callus formation
Q2) Stage of bone healing that requires years to complete.
A)Callus replacement
B)Hematoma formation
C)Remodeling
D)Procallus formation
E)Callus formation
Q3) Compact bone is highly organized,solid,and extremely strong.The basic structural unit in compact bone is:
A) small channels called canaliculi.
B) osteocytes within the lacunae.
C) tiny spaces within the lacunae.
D) the haversian system.
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Q1) Cutaneous,sinus,ear,and dental infections are primary sources of bacteria in hematogenous bone infections.
A)True
B)False
Q2) Bone is unique among body tissue because after a fracture that destroys bone,a new bone is formed,but there is no scar tissue.
A)True
B)False
Q3) Which is an outcome of improper reduction or immobilization of a fractured femur?
A) After the cast is removed,the muscles around the fracture site are weak.
B) The fracture healing requires 6 to 8 weeks to complete.
C) After the cast is removed,the skin under the cast is dry and flaky.
D) After the cast is removed,the bone is not straight.
Q4) What characterizes rhabdomyolysis?
A) Paralysis of skeletal muscles resulting from impaired nerve supply
B) Smooth muscle degeneration resulting from ischemia
C) Lysis of skeletal muscle cells through the initiation of the complement cascade
D) Release of myoglobin from damaged striated muscle cells
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Q1) Autosomal dominant with a slow rate of progression and frequent mental retardation
A)Duchenne muscular dystrophy
B)Facioscapulohumeral muscular dystrophy
C)Scapuloperoneal muscular dystrophy
D)Myotonic dystrophy
E)Becker muscular dystrophy
Q2) The face is expressionless and pouting of the lips makes whistling impossible
A)Duchenne muscular dystrophy
B)Facioscapulohumeral muscular dystrophy
C)Scapuloperoneal muscular dystrophy
D)Myotonic dystrophy
E)Becker muscular dystrophy
Q3) Which of the following is a very late sign or symptom of developmental dysplasia of the hip?
A) Asymmetry of the gluteal or thigh folds
B) Leg length discrepancy
C) Waddling gait
D) Pain
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Q1) _____ is a benign proliferation of basal cells that produces smooth or warty elevated lesions on the chest,back,and face that are tan or waxy yellow,flesh colored,or dark brown-black.
A) Basalokeratosis
B) Seborrheic keratosis
C) Keratoacanthoma
D) Actinic keratosis
Q2) Nevi (flat mole)
A)Elevated,firm circumscribed area less than 1 cm in diameter
B)Elevated,firm,and rough lesion with flat top surface greater than 1 cm in diameter
C)Flat circumscribed area that is less than 1 cm in diameter
D)Elevated irregular-shaped area of cutaneous edema;solid,transient;with a variable diameter
E)Elevated circumscribed,superficial lesion filled with serous fluid,less than 1 cm in diameter
Q3) The initiating site of inflammation in vasculitis may be blood,vessel wall,or adjacent tissue.
A)True
B)False

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Q1) Which vascular anomaly is a congenital malformation of dermal capillaries that does not fade with age?
A) Cutaneous hemangioma
B) Port-wine (nevus flammeus)stain
C) Strawberry hemangioma
D) Cavernous hemangioma
Q2) Rubeola is a highly contagious,acute _____ disease of children.
A) bacterial
B) fungal
C) yeast
D) viral
Q3) Bullous impetigo is caused by a strain of _____ that produces an exfoliative toxin,resulting in a disruption in cellular adhesion.
A) Staphylococcus aureus
B) Streptococcus pyogenes
C) Escherichia coli
D) Candida albicans
Q4) Scalded-skin syndrome is the result of staphylococcal infection of burned skin.
A)True
B)False
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Q1) The fluid most often used in fluid resuscitation following a major burn injury is: A) saline.
B) albumin.
C) lactated Ringer.
D) dextrose in water.
Q2) What type of shock results from endotoxins,release of chemical mediators,and activation of the complement cascade?
A) Septic shock
B) Hypovolemic shock
C) Anaphylactic shock
D) Neurogenic shock
Q3) When proteins are broken down anaerobically,ammonia and urea are produced.
A)True
B)False
Q4) The level of interleukin 1 (IL-1)detected in the serum of a burned individual correlates directly with the burn survival;high levels are associated with a higher mortality.
A)True
B)False

46
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Q1) Results from direct contact with high and low voltage current
A)Scald burns
B)Contact burns
C)Flame burns
D)Electrical burns
E)Chemical burns
Q2) Compared with the ebb phase,what are characteristics of the catabolic flow phase in metabolism after a burn injury in a child?
A) Reduced oxygen consumption
B) Elevation of catecholamines
C) Impaired circulation
D) Cellular shock
Q3) Caused by hot grease
A)Scald burns
B)Contact burns
C)Flame burns
D)Electrical burns
E)Chemical burns
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Q1) In disseminated intravascular coagulation (DIC),what are indications of microvascular thrombosis?
A) Reduced amplitude in peripheral pulses
B) Symmetric cyanosis of fingers and toes
C) Patient reports of numbness and tingling in fingers and toes
D) Pallor and edema of fingers and toes bilaterally
Q2) What is the most reliable and specific test for diagnosing disseminated intravascular coagulation (DIC)?
A) Prothrombin time (PT)
B) Activated partial thromboplastin time (aPTT)
C) Fibrin degradation products (FDP)
D) D-dimer
Q3) Vitamin _____ is required for normal clotting factor synthesis by the _____.
A) K;kidneys
B) D;kidneys
C) K;liver
D) D;liver
Q4) In the leukemias,a single progenitor cell undergoes malignant transformation.
A)True
B)False
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Q1) Pharyngeal problems
A)Sonorous snoring
B)Muffled voice
C)High-pitched inspiratory sound,voice change,hoarse
D)Expiratory stridor or central wheeze
E)Expiratory wheezes
Q2) Surfactant production is being produced by the fourth week of gestation.
A)True
B)False
Q3) Bronchiolitis tends to occur during the first years of life and is most often caused by _____ infection.
A) respiratory syncytial virus
B) influenza virus
C) adenoviruses
D) Epstein-Barr virus
Q4) All alveoli are present and functioning at birth.
A)True
B)False
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