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Pathophysiology 9th Edition McCance 9780323789882 , All Chapters with Answers and Rationals .

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Pathophysiology 9th Edition McCance 9780323789882 , All Chapters with Answers and Rationals .

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  • August 20, 2024
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Test Bank For Pathophysiology 9th Edition McCance
9780323789882 , All Chapters with Answers and Rationals .

Which type of cell adaptation occurs when normal columnar ciliated epithelial cells of the bronchial
lining have been replaced by stratified squamous epithelial cells?
a. Hyperplasia
b. Metaplasia
c. Dysplasia
d. Anaplasia - ANSWER: ANS: B
Metaplasia is the reversible replacement of one mature cell by another, sometimes a
lessdifferentiated cell type. The best example of metaplasia is the replacement of normal
columnarciliated epithelial cells of the bronchial (airway) lining by stratified squamous epithelial cells.
The other options do not accurately describe the event in the question.

What does the loss of the adenosine triphosphate (ATP) during ischemia cause cells to do?
a. Shrink because of the influx of calcium (Ca)
b. Shrink because of the influx of potassium chloride (KCl)
c. Swell because of the influx of sodium chloride (NaCl)
d. Swell because of the influx of nitric oxide (NO) - ANSWER: ANS: C
A reduction in ATP levels causes the plasma membrane's sodium-potassium (Na+ -K + ) pump and
sodium-calcium exchange to fail, which leads to an intracellular accumulation of sodium and calcium
and diffusion of potassium out of the cell. (The Na+ -K + pump is discussed in Chapter 1.) Sodium and
water can then freely enter the cell, and cellular swelling results. The other options do not accurately
describe the result of ATP at the cellular level.

The mammary glands enlarge during pregnancy primarily as a consequence of what hormonal
process?
a. Atrophy
b. Hyperplasia
c. Anaplasia
d. Dysplasia - ANSWER: ANS: B
Hormonal hyperplasia occurs chiefly in estrogen-dependent organs, such as the uterus and breast.
Atrophy is a decrease or shrinkage in cellular size. Anaplasia is a condition of poor cellular
differentiation, a characteristic of cancer cells. Dysplasia is a change in the size, shape, and
organization of mature cells

. Free radicals play a major role in the initiation and progression of which diseases?
a. Cardiovascular diseases such as hypertension and ischemic heart disease
b. Renal diseases such as acute tubular necrosis and glomerulonephritis
c. Gastrointestinal diseases such as peptic ulcer disease and Crohn disease
d. Muscular disease such as muscular dystrophy and fibromyalgia - ANSWER: ANS: A
Emerging data indicate that reactive oxygen species play major roles in the initiation and progression
of cardiovascular alterations associated with hyperlipidemia, diabetes mellitus, hypertension,
ischemic heart disease, and chronic heart failure. Free radical damage is not a contributing
mechanism for the renal, gastrointestinal, or muscular diseases listed.

. How do free radicals cause cell damage?
a. Stealing the cell's oxygen to stabilize the electron, thus causing hypoxia
b. Stimulating the release of lysosomal enzymes that digest the cell membranes
c. Transferring one of its charged, stabilized atoms to the cell membrane, which causes lysis
d. Giving up an electron, which causes injury to the chemical bonds of the cell membrane - ANSWER:
ANS: D
A free radical is an electrically uncharged atom or group of atoms having an unpaired electron. Having
one unpaired electron makes the molecule unstable; thus to stabilize, the molecule gives up an
electron to another molecule or steals one. Therefore it is capable of forming injurious chemical

,bonds with proteins, lipids, or carbohydrates—key molecules in membranes and nucleic acids. Free
radical damage is not caused by hypoxia, lysosomal enzymes, or transferring atoms.

What is a consequence of plasma membrane damage to the mitochondria?
a. Enzymatic digestion halts DNA synthesis.
b. Influx of calcium ions halts ATP production.
c. Edema from an influx in sodium causes a reduction in ATP production.
d. Potassium shifts out of the mitochondria, which destroys the infrastructure. - ANSWER: ANS: B
Calcium alterations are an important mechanism of cell injury and death. Cell membrane injury leads
to calcium influx into the cell. An influx of calcium ions from the extracellular compartment activates
multiple enzyme systems, resulting in cytoskeleton disruption, membrane damage, activation of
inflammation, and eventually DNA degradation. Calcium ion accumulation in the mitochondria causes
the mitochondria to swell, which is an occurrence that is associated with irreversible cellular injury.
The injured mitochondria can no longer generate ATP, but they do continue to accumulate calcium
ions. Mitochondrial consequences of cell membrane damage do not include enzymatic dige

What is a consequence of leakage of lysosomal enzymes during chemical injury?
a. Enzymatic digestion of the nucleus and nucleolus occurs, halting DNA synthesis.
b. Influx of potassium ions into the mitochondria occurs, halting the ATP production.
c. Edema of the Golgi body prevents the transport of proteins out of the cell.
d. Shift of calcium out of the plasma membrane occurs, destroying the cytoskeleton. - ANSWER: ANS:
A
Acid hydrolases from leaking lysosomes are activated in the reduced pH of the injured cell and they
digest cytoplasmic and nuclear components. Influx of potassium ions into the mitochondria, edema of
Golgi bodies, and calcium destruction of the cytoskeleton are not a consequence of leakage of
lysosomal enzymes during chemical injury.

Lead causes damage within the cell by interfering with the action of what?
a. Sodium and chloride
b. Potassium
c. Calcium
d. ATP - ANSWER: ANS: C
Lead affects many different biologic activities at the cellular and molecular levels, many of which may
be related to its ability to interfere with the functions and homeostasis of calcium. Lead does not
appear to cause damage by interfering with the action of sodium, chloride, potassium, or ATP.

A health professions student asks the professor to explain apoptosis. What response is most
accurate?
a. Programmed cell death
b. Due to chemical injury
c. Unpredictable patterns of cell death
d. Results in benign malignancies - ANSWER: ANS: A
Apoptosis is an active process of cellular self-destruction, also known as programmed cell death,
which is implicated in normal and pathologic tissue changes. Apoptosis causes cell death in many
pathologic states, not just from chemical injury. A predictable, tightly regulated cellular program leads
to apoptosis. Apoptosis does not cause benign malignancies.

A healthcare professional is assessing a child whose parents report poor grades in school, trouble
paying attention, and "naughty" behaviors that have become so frequent the child is always in
trouble. For which health condition should the professional facilitate testing?
a. Hypoxic injury
b. Lead poisoning
c. Mercury exposure
d. Cadmium injection - ANSWER: ANS: B
Decreased academic achievement, IQ, and specific cognitive measures; increased incidence of
attention-related behaviors and problem behaviors are related to lead exposure. Hypoxic injury is
usually caused by ischemia, which is not apparent in this child. Exposure to mercury poisoning in

, utero can lead to deafness, blindness, intellectual disability, cerebral palsy, and central nervous
system (CNS) defects. The main effects of cadmium poisoning are renal tubular disease and
obstructive lung disease.

A student asks why carbon monoxide causes tissue damage. What response by the professor is best?
a. Competes with carbon dioxide so that it cannot be excreted
b. Binds to hemoglobin so that it cannot carry oxygen
c. Destroys the chemical bonds of hemoglobin so it cannot carry oxygen
d. Removes iron from hemoglobin so it cannot carry oxygen - ANSWER: ANS: B
Because carbon monoxide's affinity for hemoglobin is 200 times greater than that of oxygen, it quickly
binds with the hemoglobin, preventing oxygen molecules from doing so. Carbon monoxide does not
cause tissue damage by competing with carbon dioxide, destroying chemical bonds, or removing iron
from hemoglobin.

A healthcare professional is working with a person who drinks several 6-packs of beer a week. What
testing does the professional encourage the person to get?
a. Hepatic function
b. Gastrointestinal function
c. Renal function
d. Central nervous system function - ANSWER: ANS: A
Chronic alcohol use/abuse affects the hepatic system primarily. The gastrointestinal and renal systems
are not as significantly impacted. Central nervous system problems are often seen in acute alcohol
intoxication, and may be seen in advanced alcoholic liver disease.

During cell injury caused by hypoxia, why does an increase in the osmotic pressure within the cell
occur?
a. Plasma proteins enter the cell.
b. The adenosine triphosphatase (ATPase)-driven pump is stronger during hypoxia.
c. Sodium chloride enters the cell.
d. An influx of glucose occurs through the injured cell membranes. - ANSWER: ANS: C
In hypoxic injury, movement of fluid and ions into the cell is associated with acute failure of
metabolism and a loss of ATP production. Normally, the pump that transports sodium ions out of the
cell is maintained by the presence of ATP and ATPase, the active transport enzyme. In metabolic
failure caused by hypoxia, reduced ATP and ATPase levels permit sodium to accumulate in the cell,
whereas potassium diffuses outward. The increase of intracellular sodium increases osmotic pressure,
which draws more water into the cell. (Transport mechanisms are described in Chapter 1.) The
remaining options do not accurately describe the cell injury that results in increased osmotic pressure
caused by hypoxia

Which statement is true regarding the difference between subdural hematoma and epidural
hematoma? a. No difference exists, and these terms may be correctly used interchangeably.
b. A subdural hematoma occurs above the dura, an epidural hematoma occurs under the dura.
c. A subdural hematoma is often the result of shaken baby syndrome, whereas an epidural hematoma
rapidly forms as a result of a skull fracture.
d. A subdural hematoma usually forms from bleeding within the skull, an epidural hematoma occurs
from trauma outside the skull. - ANSWER: ANS: C
A subdural hematoma is a collection of blood between the inner surface of the dura mater and the
surface of the brain, resulting from the shearing of small veins that bridge the subdural space.
Subdural hematomas can be the result of blows, falls, or sudden acceleration-deceleration of the
head, which occurs in the shaken baby syndrome. An epidural hematoma is a collection of blood
between the inner surface of the skull and the dura and is almost always associated with a skull
fracture. The other options do not accurately describe the differences between the two hematomas.

A healthcare professional is working at the health tent during a marathon. A runner is brought to the
tent complaining of nausea and weakness. What is the first thing the professional should do?
a. Call 911.
b. Have the person lie down.

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