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Pathophysiology:
A Practical Approach
Lachel Story
Additional Test Bank
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CHAPTER 1
QUESTIONS
_____ 1. The movement of water or another solvent across the cellular membrane from
an area of low solute concentration to an area of high solute concentration is referred to
as
A. meiosis.
B. osmosis.
C. lysis.
D. mitosis.
_____ 2. Cells become specialized in their structure and function through
A. proliferation.
B. atrophy.
C. differentiation.
D. pinocytosis.
_____ 3. Eradicating the disease is the goal of
A. palliative treatment.
B. all cancer treatment.
C. prophylactic treatment.
D. curative treatment.
_____ 4. The fetus is most vulnerable to environmental influences during which period of
gestation?
A. 10 to 15 days
B. The first 30 days
C. 15 to 60 days
D. The first trimester
_____ 5. Which form of cellular adaptation occurs because of decreased work demands
on the cell?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
_____ 6. What are the sex chromosomes that a female has?
A. Paired X chromosomes
B. Autosomes
C. One X and one Y chromosome
D. Two Y chromosomes
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_____ 7. Which disorders are passed from an affected parent to an offspring regardless of
sex?
A. Sex-linked disorders
B. Fragile X syndrome
C. Autosomal dominant disorders
D. All of the above
_____ 8. Gangrene is a form of
A. caseous necrosis.
B. liquefaction necrosis.
C. coagulative necrosis.
D. fat necrosis.
_____ 9. The genetic information for a cell is contained in the
A. nucleus.
B. organelles.
C. lipid bilayer.
D. cytoplasm.
_____ 10. The disease state of a neoplasm is
A. apoptosis.
B. atrophy.
C. exocytosis.
D. cancer.
_____ 11. A possible teratogen is a(n)
A. lipid bilayer.
B. allele.
C. infection.
D. chromosome.
_____ 12. How many chromosomes do we have?
A. 23
B. 46
C. Several thousand
D. About 3 billion
_____ 13. Selective permeability allows free passage in and out of cells to
A. enzymes.
B. glucose.
C. electrolytes.
D. all of the above.
_____ 14. Which type of cellular adaptation is undergone by the muscles of an extremity
that has been in a cast for a long period of time?
A. Hypertrophy
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B. Metaplasia
C. Dysplasia
D. Hyperplasia
_____ 15. Which tumors are usually undifferentiated?
A. Malignant tumors
B. All tumors are undifferentiated.
C. Benign tumors
D. Tumors with less anaplastic cells
_____ 16. One cause of cell death is
A. ischemia.
B. apoptosis.
C. necrosis.
D. all of the above.
_____ 17. Variations of a gene are known as
A. alleles.
B. autosomes.
C. a karotype.
D. DNA.
_____ 18. A form of cell division that occurs only in mature sperm and ova is
A. mitosis.
B. prophase.
C. oncogene.
D. meiosis.
_____ 19. Which of the following diseases affects only females?
A. Monosomy X (Turner’s syndrome)
B. Trisomy 21 (Down syndrome)
C. Polysomy X (Klinefelter’s syndrome)
D. Tay-Sachs disease
_____ 20. A cancer patient’s likelihood for surviving a cancer is referred to as his or her
A. remission.
B. prognosis.
C. carcinogenesis.
D. grading.
_____ 21. Metaplasia refers to which of the following?
A. An increase in the number of cells in an organ or tissue.
B. Cell mutation into cells of a different size, shape, and appearance.
C. An increase in the size of cells in an attempt to meet increased demand.
D. The process of one adult cell being replaced by another cell type
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_____ 22. When caustic enzymes dissolve and liquefy necrotic cells, this is known as
A. coagulative necrosis.
B. liquefaction necrosis.
C. fat necrosis.
D. caseous necrosis.
_____ 23. Which type of disorder is phenylketonuria (PKU)?
A. Sex-linked disorder
B. Autosomal recessive disorder
C. Multifactorial disorder
D. Autosomal dominant disorder
_____ 24. When cells increase in number in an organ or tissue, this is known is
A. apoptosis.
B. hyperplasia.
C. metaplasia.
D. dysplasia.
_____ 25. In grading cancer cells, which grade has well differentiated cells?
A. Grade 1
B. Grade 2
C. Grade 3
D. Grade 4
ANSWER KEY
1. B
2. C
3. D
4. C
5. C
6. A
7. C
8. C
9. A
10. D
11. C
12. B
13. D
14. A
15. A
16. D
17. A
18. D
19. A
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20. B
21. D
22. B
23. B
24. B
25. A
RATIONALES
1. Osmosis refers to the movement of water or another solvent across the cellular
membrane from an area of low solute concentration to an area of high solute
concentration. Meiosis is a form of cell division that occurs only in mature sperm and
ova. Lysis occurs when too much water enters a cell membrane. Mitosis is the most
common form of cell division.
2. Cells become specialized in their structure and function through differentiation.
Proliferation is the process by which cells divide and reproduce. Atrophy refers to a type
of cell adaptation. Pinocytosis refers to cell drinking.
3. Curative treatment seeks to eradicate the disease. Not all cancer treatment does this.
Palliative treatment treats symptoms to increase comfort. Prophylactic treatment seeks to
prevent cancer.
4. The fetus is most vulnerable to environmental influences from 15 to 60 days of
gestation. This is the period immediately after fertilization and implantation, when much
of the cellular differentiation is taking place.
5. Atrophy is the type of cellular adaptation that occurs because of decreased work
demands on the cell. Hypertrophy is the opposite; it occurs when cells increase in size to
try to meet increased work demand. Hyperplasia is an increase in the number of cells in
an organ or tissue. Metaplasia is the process in which one adult cell is replaced by
another cell type.
6. A female has two X chromosomes. A male has one X and one Y chromosome. No one
has two Y chromosomes. Autosomes make up 22 of the 23 sets of paired chromosomes,
with the remaining pair being the sex chromosomes.
7. Autosomal dominant disorders are passed from an affected parent to an offspring
regardless of sex. This is not true of all sex-linked disorders. Fragile X syndrome is a sexlinked disorder which affects males.
8. Gangrene is a form of coagulative necrosis, which results in an interruption in blood
flow. Caseous necrosis happens when necrotic cells disintegrate but cellular debris
remains. Liquefaction necrosis occurs when caustic enzymes dissolve and liquefy
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necrotic cells. Fat necrosis happens when lipase enzymes break down triglycerides into
free fatty acids.
9. The genetic information for a cell is contained in the nucleus. The organelles are
internal cellular structures that perform the work that maintains the cell’s life. A lipid
bilayer is what makes up the cell membrane. Cytoplasm is a colorless, viscous liquid in
the cell containing water, nutrients, and other substances.
10. Cancer is the disease state of a neoplasm. Apoptosis is a mechanism of cell death.
Atrophy is one kind of cell adaptation. Exocytosis is the release of materials from a cell.
11. Infection is a possible teratogen. The other terms are distracters for this question.
12. We have 46 chromosomes, in 23 paired sets.
13. Selective permeability allows free passage in and out of cells to enzymes, glucose,
and electrolytes.
14. Hypertrophy is the type of cellular adaptation is undergone by the muscles of an
extremity that has been in a cast for a long period of time. Metaplasia, dysplasia, and
hyperplasia are other forms of cellular adaptation. In metaplasia, one adult cell is
replaced by another cell type. In dysplasia, cells mature into cells of a different size,
shape, and appearance. Hyperplasia is an increase in the number of cells in an organ or
tissue.
15. Malignant tumors are usually undifferentiated. Benign tumors usually consist of
differentiated, or less anaplastic, cells.
16. Causes of cell death include ischemia, apoptosis, and necrosis.
17. Variations of a gene are known as alleles. Autosomes refers to the 22 sets of paired
chromosomes that are not sex chromosomes. A karotype is a representation of a person’s
individual set of chromosomes. DNA makes up the long double-stranded chain of
nucleotides known as chromosomes.
18. A form of cell division that occurs only in mature sperm and ova is meiosis. Mitosis
is the most common form of cell division. Prophase refers to the first phase of mitosis.
An oncogene can cause cancer.
19. Monosomy X (Turner’s syndrome) affects only females. Trisomy 21 (Down
syndrome) and Tay-Sachs disease affect both females and males. Polysomy X
(Klinefelter’s syndrome) affects only males.
20. A cancer patient’s likelihood for surviving a cancer is referred to as his or her
prognosis. A remission takes place when cancer responds to treatment and is under
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control. Carcinogenesis is the process by which cancer develops. Grading determines the
degree of differentiation of cancer.
21. Metaplasia refers to the process of one adult cell being replaced by another cell type.
An increase in the number of cells in an organ or tissue is hyperplasia. Cell mutation into
cells of a different size, shape, and appearance is dysplasia. An increase in the size of
cells in an attempt to meet increased demand is hypertrophy.
22. Liquefaction necrosis occurs when caustic enzymes dissolve and liquefy necrotic
cells. Coagulative necrosis usually results as an interruption in blood flow. Fat necrosis
occurs when lipase enzymes break down intracellular triglycerides into free fatty acids.
Caseous necrosis occurs when necrotic cells disintegrate but the cellular debris remains
for months or years.
23. Phenylketonuria (PKU) is an autosomal recessive disorder.
24. When cells increase in number in an organ or tissue, this is known is hyperplasia.
Apoptosis is a type of cell death. Metaplasia is the process of one adult cell being
replaced by another cell type. In dysplasia, cells mutate into cells of a different size,
shape, and appearance.
25. In grading cancer cells, grade 1 has well-differentiated cells. The other grades have
progressively less differentiation. Grade 4 cells are undifferentiated.
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CHAPTER 2
QUESTIONS
_____ 1. Which of the following is true concerning primary immunodeficiency?
A. Primary immunodeficiency is caused by pathogens.
B. It reflects a defect with the immune system.
C. Primary immunodeficiency is a loss of immune function because of a specific
cause.
D. Drug therapy can cause primary immunodeficiency.
_____ 2. Molecules released by macrophages that have been exposed to bacteria are
known as
A. pyrogens.
B. interferons.
C. T cells.
D. complement proteins.
_____ 3. Antibody production is turned off by
A. effector cells.
B. killer cells.
C. suppressor cells.
D. cytotoxic cells.
_____ 4. Which statement is true about T cells?
A. T cells mature in the thyroid gland.
B. They are responsible for hypersensitivity and transplant rejection.
C. T cells are part of the body’s first line of defense.
D. They mature in the bone marrow.
_____ 5. Bodily changes that are associated with stress were first described by Hans
Selye in the
A. 1780s.
B. 1860s.
C. 1930s.
D. 1990s.
_____ 6. Which of the following is a characteristic of systemic lupus erythematosus?
A. Butterfly rash over the cheeks
B. Photosensitivity
C. Arthritis
D. All of the above
_____ 7. The inflammatory response is part of the body’s
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A. first line of defense.
B. second line of defense.
C. third line of defense.
D. none of the above
_____ 8. In type III hypersensitivity,
A. circulating antigen-antibody complexes accumulate and are deposited in the
tissue.
B. macrophages perform delayed processing of the antigen.
C. allergens activate T cells, which bind to mast cells.
D. the target cell is destroyed by an antibody-directed, cell-surface antigen.
_____ 9. Small proteins that are released from cells infected by viruses are known as
A. regulator cells.
B. effector cells.
C. interferons.
D. pyrogens.
_____ 10. Catecholamines and cortisol are released, causing the fight-or-flight response,
in which stage of the general adaptation syndrome?
A. The resistance stage
B. Hypersensitivity
C. The exhaustion stage
D. The alarm stage
_____ 11. The skin and mucous membranes are part of the body’s
A. first line of defense.
B. second line of defense.
C. third line of defense.
D. fourth line of defense.
_____ 12. An inflated response to an antigen is
A. hypersensitivity.
B. immunodeficiency.
C. the general adaptation syndrome.
D. autologous.
_____ 13. Which of the following is a maladaptive coping strategy for stress?
A. Physical activity
B. Overeating
C. Biofeedback
D. Distraction
_____ 14. Anxiety, depression, insomnia, infections, and cardiovascular disease have
been attributed to
A. killer cell attacks.
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B. type II hypersensitivity.
C. pyrogen.
D. stress.
_____ 15. Factors that place individuals at risk for an impaired immune system include
A. spending time outdoors.
B. reducing stress.
C. smoking.
D. increasing fluid intake.
_____ 16. The membrane-attack complex is part of which line of defense?
A. First line of defense
B. Second line of defense
C. Third line of defense
D. All of the above
_____ 17. The type of rejection reaction that occurs only with bone marrow transplants is
A. graft-versus-host rejection.
B. graft-versus-graft rejection.
C. host-versus-host rejection.
D. host-versus-graft rejection.
_____ 18. Category 2 of HIV infection progression refers to
A. CD4 cell count ≥ 500 cells/mm3.
B. Asymptomatic HIV infection.
C. CD4 cell count 200–499 cells/mm3.
D. CD4 cell count < 200 cells/mm3.
_____ 19. The first stage of the general adaptation syndrome is the
A. resistance stage.
B. exhaustion stage.
C. stress response.
D. alarm stage.
_____ 20. Children who are HIV positive may experience
A. problems walking.
B. excess weight gain.
C. high rates of growth.
D. an absence of common childhood illnesses.
_____ 21. Which statement is true about autoimmune reactions?
A. Autoimmune disorders affect women more than men.
B. They can be systemic or can affect particular organs.
C. Diagnostic procedures for autoimmune disorders often begin with eliminating
all other causes.
D. All of the above
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_____ 22. Cells that have invaded the body are destroyed by
A. T cells.
B. B cells.
C. cellular immunity.
D. all of the above
_____ 23. Transplants that use tissue from the identical twin of the host are
A. autologous transplants.
B. syngenic transplants.
C. allogenic transplants.
D. all of the above
_____ 24. Erythema, edema, heat, and pain characterize
A. the third line of defense.
B. general adaptation syndrome.
C. the inflammatory response.
D. acquired immunity.
_____ 25. Antibody-producing cells and memory cells are types of
A. T cells
B. killer cells
C. B cells.
D. antigens.
ANSWER KEY
1. B
2. A
3. C
4. B
5. C
6. D
7. B
8. A
9. C
10. D
11. A
12. A
13. B
14. D
15. C
16. B
17. A
18. C
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19. D
20. A
21. D
22. D
23. B
24. C
25. C
RATIONALES
1. Primary immunodeficiency reflects a defect with the immune system. Secondary
immunodeficiency is a loss of immune function because of a specific cause, such as
pathogens or drug therapy.
2. Molecules released by macrophages that have been exposed to bacteria are known as
pyrogens. Interferons and complement proteins are other components of the second line
of defense. T cells are part of the third line of defense.
3. Antibody production is turned off by suppressor cells. Effector cells, or killer cells,
work to destroy antigens. Cytotoxic cell is another term used for killer cell.
4. T cells are responsible for hypersensitivity and transplant rejection. They mature in the
thymus, not the thyroid gland or bone marrow. They are part of the body’s third line of
defense.
5. Hans Selye first described bodily changes associated with stress in the 1930s.
6. Characteristics of systemic lupus erythematosus include butterfly rash over the cheeks,
photosensitivity, and arthritis.
7. The inflammatory response is part of the body’s second line of defense.
8. In type III hypersensitivity, circulating antigen-antibody complexes accumulate and are
deposited in the tissue. Macrophages perform delayed processing of the antigen in type
IV hypersensitivity. Allergens activate T cells, which bind to mast cells, in type I
hypersensitivity. The target cell is destroyed by an antibody-directed, cell-surface antigen
in type II hypersensitivity.
9. Small proteins that are released from cells infected by viruses are known as interferons.
Regulator cells and effector cells are types of T cells that work to destroy antigens.
Pyrogens are molecules released by macrophages that have been exposed by bacteria.
10. Catecholamines and cortisol are released, causing the fight-or-flight response, in the
alarm stage of the general adaptation syndrome.
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11. The skin and mucous membranes are part of the body’s first line of defense.
12. An inflated response to an antigen is hypersensitivity. Immunodeficiency is a
diminished or absent immune response. The general adaptation syndrome is the stress
response. Autologous is a term used with transplants in which both the host and donor are
the same person.
13. Overeating is a maladaptive coping strategy for stress. Physical activity, biofeedback,
and distraction are positive coping strategies for stress.
14. Anxiety, depression, insomnia, infections, and cardiovascular disease have been
attributed to stress.
15. Smoking is one factor that places individuals at risk for an impaired immune system.
Spending time outdoors, reducing stress, and increasing fluid intake are strategies to build
a healthy immune system.
16. The membrane-attack complex is part of the second line of defense
17. Graft-versus-host rejection occurs only with bone marrow transplants.
18. Category 2 of HIV infection progression refers to a CD4 cell count of 200 to 499
cells/mm3. Category 1 refers to a CD4 cell count ≥ 500 cells/mm3. Category 3 refers to a
CD4 cell count < 200 cells/mm3. Asymptomatic HIV infection is one of the categories in
another HIV classification system based on symptom presentation.
19. The first stage of the general adaptation syndrome is the alarm stage. Resistance is the
second stage and exhaustion is the third stage. The whole process is the stress response.
20. Children who are HIV positive may experience problems walking. They may
experience difficulty gaining weight and growing normally, and may have severe forms
of common childhood illnesses.
21. Autoimmune disorders affect women more than men, and can be systemic or can
affect particular organs. Diagnostic procedures for autoimmune disorders often begin
with eliminating all other causes.
22. T cells, B cells, and cellular immunity all destroy cells that have invaded the body.
23. Syngenic transplants use tissue from the identical twin of the host. In autologous
transplants, the host and donor are the same person. Allogenic transplants are those in
which tissue is used from the same species of similar tissue type, but it is not identical.
24. Erythema, edema, heat, and pain characterize the inflammatory response.
25. Antibody-producing cells and memory cells are types of B cells.
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CHAPTER 3
QUESTIONS
_____ 1. A deficit of clotting factor VIII, or an abnormality of clotting factor VIII, is
found in
A. von Willebrand’s disease.
B. disseminated intravascular coagulation (DIC).
C. hemophilia A.
D. idiopathic thrombocytopenic purpura (ITP).
_____ 2. The most plentiful type of blood cell in the human body is
A. erythrocytes.
B. leukocytes.
C. thrombocytes.
D. stem cells.
_____ 3. Clinical manifestations of Hodgkin’s disease include
A. weight loss.
B. pruritus.
C. swollen, painless lymph nodes.
D. all of the above
_____ 4. Cyanocobalamin (vitamin B12) deficiency is found in
A. pernicious anemia.
B. aplastic anemia.
C. hemolytic anemia.
D. sickle cell anemia.
_____ 5. With proper management, patients with sickle cell disease live into their
A. teens.
B. 20s.
C. 30s.
D. 50s.
_____ 6. Blood gets its red color from
A. von Willebrand factor.
B. DIC.
C. hemoglobin.
D. pancytopenia.
_____ 7. Blood formation occurs primarily in the
A. plasma.
B. bone marrow.
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C. hemoglobin.
D. none of the above
_____ 8. The most common anemia worldwide is
A. pernicious anemia.
B. iron deficiency anemia.
C. aplastic anemia.
D. sickle cell anemia.
_____ 9. Which of the following statements about polycythemia vera is true?
A. Polycythemia vera is disease in which too few blood cells are produced.
B. It is a common disease.
C. Polycythemia vera occurs most frequently in women.
D. It is a rare disease.
_____ 10. Another name for white blood cells is
A. erythrocytes.
B. thrombocytes.
C. leukocytes.
D. plasmin.
_____ 11. The immune system destroys its own platelets in
A. thrombotic thrombocytopenic purpura (TTP).
B. disseminated intravascular coagulation (DIC).
C. hemophilia A.
D. idiopathic thrombocytopenic purpura (ITP)
_____ 12. Which leukemia affects mainly adults?
A. Acute myeloid leukemia
B. Chronic lymphoid leukemia
C. Chronic myeloid leukemia
D. All of the above
_____ 13. Thalassemia patients who are effectively treated can survive into their
A. teens.
B. 30s.
C. 50s.
D. 70s.
_____ 14. There are a number of causes of anemias, but a common clinical manifestation
is
A. weight gain.
B. weakness.
C. bradycardia.
D. bone pain.
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_____ 15. Anemia is diagnosed in females when hematocrit is less than
A. 37%
B. 50%
C. 75%
D. 93%
_____ 16. An abnormal type of hemoglobin, called hemoglobin S, is the cause of
A. polycythemia vera.
B. aplastic anemia.
C. sickle cell anemia.
D. pernicious anemia.
_____ 17. In which stage of Hodgkin’s lymphoma are the lymphoma cells found in one
lymph node group, or in only one part of a tissue or organ?
A. Stage I
B. Stage II
C. Stage III
D. Stage IV
_____ 18. The liquid protein component of blood is the
A. plasma.
B. red blood cells.
C. leukocytes.
D. stem cells.
_____ 19. Coagulation is controlled by
A. thrombocytes.
B. hematopoiesis.
C. clotting factors.
D. both A and C, above
_____ 20. Hemoglobin binds to
A. nitrogen.
B. oxygen.
C. leukocytes.
D. plasma.
_____ 21. Multiple myeloma is a cancer of the
A. plasma cells.
B. neutrophils.
C. thromboplastin.
D. all of the above
_____ 22. Another name for red blood cells is
A. stem cells.
B. erythrocytes.
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C. leukocytes.
D. thrombocytes.
_____ 23. A lack of enough erythrocytes, leukocytes, and platelets is referred to as
A. leukemia.
B. pancytopenia.
C. neutropenia.
D. anemia.
_____ 24. Which of the following statements is true about disseminated intravascular
coagulation (DIC)?
A. Bleeding of a person with DIC is quickly halted by his or her clotting factors.
B. Few clotting factors are present in the bloodstream of an individual with DIC.
C. Clotting factors become abnormally active in DIC.
D. To treat DIC, it is merely necessary to treat the bleeding.
_____ 25. Hematocrit refers to how much of the blood volume is occupied by
A. thrombocytes.
B. neutrophils.
C. erythrocytes.
D. leukocytes.
ANSWER KEY
1. C
2. A
3. D
4. A
5. D
6. C
7. B
8. B
9. D
10. C
11. D
12. D
13. B
14. B
15. A
16. C
17. A
18. A
19. D
20. B
21. A
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22. B
23. B
24. C
25. C
RATIONALES
1. A deficit of clotting factor VIII, or an abnormality of clotting factor VIII, is found in
hemophilia A.
2. Erythrocytes are the most plentiful type of blood cell in the human body. Millions can
be found in a single drop of blood.
3. Clinical manifestations of Hodgkin’s disease include weight loss; pruritus; and
swollen, painless lymph nodes.
4. Cyanocobalamin (vitamin B12) deficiency is found in pernicious anemia.
5. With proper management, patients with sickle cell disease live into their 50s.
6. Blood gets its red color from hemoglobin.
7. Blood formation occurs primarily in the bone marrow. Plasma and hemoglobin are
components of blood.
8. The most common anemia worldwide is iron deficiency anemia.
9. Polycythemia vera is a rare disease. In polycythemia vera, too many blood cells are
produced. It occurs most frequently in men.
10. Another name for white blood cells is leukocytes. Erythrocytes are another name for
red blood cells. Thrombocytes are another name for platelets. Plasmin is an enzyme that
dissolves clots.
11. The immune system destroys its own platelets in idiopathic thrombocytopenic
purpura (ITP). Thrombotic thrombocytopenic purpura (TTP) results from a deficiency of
an enzyme necessary to cleave von Willebrand factor. Disseminated intravascular
coagulation (DIC) is a disorder that uses up the clotting factors. Hemophilia A is an Xlinked recessive bleeding disorder.
12. Acute myeloid leukemia, chronic lymphoid leukemia, and chronic myeloid leukemia
all affect mainly adults. Acute lymphoblastic leukemia affects mainly children.
13. Thalassemia patients who are effectively treated can survive into their 30s.
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14. There are a number of causes of anemias, but a common clinical manifestation is
weakness.
15. Anemia is diagnosed in females when hematocrit is less than 37%.
16. An abnormal type of hemoglobin, called hemoglobin S, is the cause of sickle cell
anemia.
17. In stage I of Hodgkin’s lymphoma, the lymphoma cells are found in one lymph node
group, or in only one part of a tissue or organ. In stage II, the lymphoma cells are in at
least two lymph node groups on the same side of the diaphragm, or in one part of a tissue
or an organ and the lymph nodes near that organ on the same side of the diaphragm. In
stage II, the lymphoma cells are in lymph nodes above and below the diaphragm, and
may also be in one part of a tissue or organ near the lymph node groups and in the spleen.
In stage IV, lymphoma cells are found in several parts of one or more organs or tissues,
or in an organ and in distant lymph nodes.
18. The liquid protein component of blood is the plasma.
19. Coagulation is controlled by thrombocytes and clotting factors. Hematopoiesis is the
process of blood formation.
20. Hemoglobin binds to oxygen. Hemoglobin gives blood its red color.
21. Multiple myeloma is a cancer of the plasma cells.
22. Another name for red blood cells is erythrocytes. Another name for white blood cells
is leukocytes. Another name for platelets is thrombocytes. Stem cells are also called
primitive cells.
23. A lack of enough erythrocytes, leukocytes, and platelets is referred to as
pancytopenia. Leukemia is a cancer of the leukocytes. Neutropenia is a decrease in
circulating neutrophils. Anemia is a disorder of the erythrocytes.
24. Clotting factors become abnormally active in disseminated intravascular coagulation
(DIC). Bleeding of a person with DIC is excessive and is not quickly halted by his or her
clotting factors. Clotting factors are present in the bloodstream of an individual with DIC
but have essentially been used up. To treat DIC, it is necessary both to treat the bleeding
and to prevent clots.
25. Hematocrit refers to how much of the blood volume is occupied by erythrocytes, or
red blood cells.
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CHAPTER 4
QUESTIONS
_____ 1. Inflammation of the myocardium (heart muscle) is
A. angina.
B. myocarditis.
C. automaticity.
D. pericarditis.
_____ 2. Which of the following statements is true about the entry of blood into the
heart?
A. When blood enters the heart, it is high in oxygen and low in carbon dioxide.
B. Blood enters the heart from the aorta.
C. When blood enters the heart, it is low in oxygen and rich in carbon dioxide.
D. Blood enters the left side of the heart from the systemic circulation.
_____ 3. The pressure that the left ventricle must exert in order to get the blood out of the
heart and into the aorta is called
A. peripheral vascular resistance (PVR).
B. stroke volume.
C. afterload.
D. preload.
_____ 4. A bacteria’s endotoxins activate an immune reaction in
A. distributive shock.
B. septic shock.
C. anaphylactic shock.
D. neurogenic shock.
_____ 5. The lymphatic system includes
A. lymph nodes.
B. spleen.
C. tonsils.
D. all of the above
_____ 6. Which of the following statement is true about heart failure?
A. Heart failure can be acute or chronic.
B. Systolic dysfunction is characterized by decreased ventricular filling.
C. Heart failure is characterized by increased contractility and stroke volume.
D. Congestive heart failure differs from heart failure in the side of the heart
involved.
_____ 7. Pulse pressure is the
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A. top number in the usual blood pressure notation.
B. difference between the systolic and diastolic pressures.
C. bottom number in the usual blood pressure notation.
D. the force opposing the blood in the peripheral circulation.
_____ 8. Lymphedema can be caused by
A. surgery.
B. radiation.
C. cancer.
D. all of the above
_____ 9. Blood is carried away from the heart by
A. arteries.
B. capillaries.
C. veins.
D. venules.
_____ 10. Risk factors for hypertension include
A. race.
B. being overweight or obese.
C. tobacco use.
D. all of the above
_____ 11. Blood to be oxygenated is carried to the lungs by the
A. pulmonary artery.
B. aorta.
C. pulmonary vein.
D. mitral valve.
_____ 12. When fluid accumulates in the pericardial cavity to the point that it compresses
the heart, this is known as
A. constrictive pericarditis.
B. infective endocarditis.
C. cardiac tamponade.
D. myocarditis.
_____ 13. The most common type of hypertension is
A. secondary hypertension.
B. malignant hypertension.
C. primary hypertension.
D. pregnancy-induced hypertension (PIH).
_____ 14. The inner epithelial layer of the heart that makes up the valves is called the
A. pericardium.
B. myocardium.
C. endocardium.
23
D. all of the above
_____ 15. Which statement is true about dysrhythmias?
A. Dysrhythmias are another term for sinus rhythm.
B. Some can cause sudden death.
C. Dysthythmias are caused by the domination of electrical impulses that
originate in the SA node.
D. Both A and B, above.
_____ 16. Which of the following is the smallest?
A. Capillaries
B. Veins
C. Arterioles
D. Venules
_____ 17. The superior vena cava empties into the
A. right ventricle.
B. lung.
C. right atrium.
D. left ventricle.
_____ 18. Electrical impulses can be initiated by
A. the sinoatrial (SA) node only.
B. the atrioventricular (AV) node only.
C. the bundle of His.
D. all cardiac muscle cells.
_____ 19. The initial treatment of a myocardial infraction is
A. morphine.
B. oxygen.
C. nitroglycerin.
D. all of the above
_____ 20. The middle layer of blood vessel walls is known as the
A. tunica intima.
B. tunica media.
C. tunica adventitia.
D. none of the above
_____ 21. Which statement is true about myocardial infarction (MI)?
A. While an MI is severe, a heart attack can be worse.
B. Sometimes there are no symptoms.
C. If a patient survives an MI, it is vital to avoid future physical activity.
D. None of the above
_____ 22. Venous return reduces because of external volume losses in
24
A. hypovolemic shock.
B. cardiogenic shock.
C. distributive shock.
D. neurogenic shock.
_____ 23. When a weakened area of an arterial wall balloons outward, this is known as
A. atherosclerosis.
B. automaticity.
C. aneurysm.
D. dromotopic.
_____ 24. Approximately how many Americans are affected by hypertension?
A. 1 million
B. 10 million
C. 25 million
D. 50 million
_____ 25. Stimulating the sympathetic nervous system (SNS)
A. decreases the heart rate and blood pressure.
B. increases the heart rate and blood pressure.
C. has no effect on blood pressure.
D. increases the blood pressure, but has no effect on heart rate.
ANSWER KEY
1. B
2. C
3. C
4. B
5. D
6. A
7. B
8. D
9. A
10. D
11. A
12. C
13. C
14. C
15. B
16. A
17. C
18. D
19. D
20. B
25
21. B
22. A
23. C
24. D
25. B
RATIONALES
1. Myocarditis is inflammation of the myocardium (heart muscle). Angina is chest pain
caused by reduction in oxygen to the cardiac muscle. Automaticity refers to the ability of
cardiac cells to generate an impulse to contract even with no external nerve stimulus.
Pericarditis is inflammation of the pericardium.
2. When blood enters the heart, it is low in oxygen and rich in carbon dioxide. Blood
leaves the heart from the aorta. Blood enters the right side of the heart from the systemic
circulation.
3. The pressure that the left ventricle must exert in order to get the blood out of the heart
and into the aorta is called afterload. Peripheral vascular resistance (PVR) is the force
opposing the blood in the peripheral circulation. Stroke volume is the amount of blood
ejected from the heart with each contraction. Preload refers to the amount of blood
returning to the heart.
4. A bacteria’s endotoxins activate an immune reaction in septic shock. In distributive
shock, vasodilation causes hypovolemia. Anaphylactic shock results from an allergic
reaction. Neurogenic shock is caused by a loss of sympathetic tone in vascular smooth
muscle and autonomic function leading to massive vasodilatation.
5. The lymphatic system includes lymph nodes, the spleen, and tonsils.
6. Heart failure can be acute or chronic. Diastolic dysfunction is characterized by
decreased ventricular filling. Heart failure is characterized by decreased contractility and
stroke volume. Congestive heart failure is another name for heart failure.
7. Pulse pressure is the difference between the systolic and diastolic pressures. The top
number in the usual blood pressure notation is the systolic pressure. The bottom number
in the usual blood pressure notation is the diastolic pressure. The force opposing the
blood in the peripheral circulation is called peripheral vascular resistance (PVR).
8. Causes of lymphedema include surgery, radiation, and cancer.
9. Blood is carried away from the heart by arteries. Veins return blood to the heart.
10. Risk factors for hypertension include race, being overweight or obese, and tobacco
use.
26
11. Blood to be oxygenated is carried to the lungs by the pulmonary artery.
12. When fluid accumulates in the pericardial cavity to the point that it compresses the
heart, this is known as cardiac tamponade.
13. The most common type of hypertension is primary hypertension. Secondary
hypertension accounts for about 5% to 10% of hypertension cases. Malignant
hypertension is an intensified form of hypertension that may not respond well to
treatment efforts. Pregnancy-induced hypertension (PIH) occurs in 5% to 8% of
pregnancies.
14. The inner epithelial layer of the heart that makes up the valves is called the
endocardium. The pericardium is the sac enclosing the heart. The myocardium is the
muscle.
15. Some dysrhythmias can cause sudden death.
16. Capillaries are smaller than veins, arterioles, and venules.
17. The superior vena cava empties into the right atrium.
18. Electrical impulses can be initiated by all cardiac muscle cells. Normally, however,
they originate in the sinoatrial (SA) node. The atrioventricular (AV) node does not
usually initiate impulses unless the SA node is failing.
19. The initial treatment of a myocardial infraction includes morphine, oxygen, and
nitroglycerin.
20. The middle layer of blood vessel walls is known as the tunica media. The tunica
intima is the inner layer, and the tunica adventitia is the outer layer.
21. Sometimes a myocardial infarction (MI) has no symptoms. Heart attack is another
name for an MI. If a patient survives an MI, physical activity will likely be recommended
to help prevent another MI.
22. Venous return reduces because of external volume losses in hypovolemic shock.
Cardiogenic shock results when the left ventricle can’t maintain adequate cardiac output.
In distributive shock, vasodilatation causes hypovolemia. Neurogenic shock results when
a loss of sympathetic tone in vascular smooth muscle and autonomic function lead to
massive vasodilatation.
23. When a weakened area of an arterial wall balloons outward, this is known as
aneurysm.
24. Approximately 50 million Americans are affected by hypertension.
27
25. Stimulating the sympathetic nervous system (SNS) increases the heart rate and blood
pressure.
28
CHAPTER 5
QUESTIONS
_____ 1. A common viral infection in children is
A. cystic fibrosis.
B. pleurisy.
C. laryngotracheobronchitis.
D. pink puffers.
_____ 2. Which of the following statements is true about influenza?
A. Influenza affects only the lower respiratory tract.
B. Type B is the most common type of influenza?
C. Influenza affects both the upper and lower respiratory tract.
D. Type C has been the cause of large epidemics.
_____ 3. Acute respiratory distress syndrome (ARDS) develops within about what period
following a systemic inflammatory response?
A. 1 minute.
B. 90 minutes.
C. 5 hours.
D. 1 day.
_____ 4. The trachea, bronchi, bronchioles, and alveoli comprise the
A. lower respiratory tract.
B. upper respiratory tract.
C. middle respiratory tract.
D. entire respiratory tract.
_____ 5. The normal VQ ratio is
A. 0.5
B. 0.7
C. 0.8
D. 1.2
_____ 6. The most serious type of pneumothorax is
A. tension pneumothorax.
B. traumatic pneumothorax.
C. spontaneous pneumothorax.
D. ARDS.
_____ 7. A life-threatening condition of the epiglottis is
A. bacterial pneumonia.
B. epiglottitis.
29
C. Hib (Haemophilus influenza type B) infection.
D. extrinsic asthma.
_____ 8. The sum of the tidal volume and reserves is the
A. vital capacity.
B. minute respiratory volume.
C. residual volume.
D. medulla.
_____ 9. A cause of sinusitis is
A. viral infection.
B. bacterial infection.
C. fungal infection.
D. all of the above
_____ 10. Which of the following is true about expiration?
A. Expiration is passive.
B. It occurs by the diaphragm contracting, lowering, and flattening.
C. Expiration can be active.
D. Both A and C, above
_____ 11. Which statement is true about legionnaires’ disease?
A. People can recover from legionnaires’ disease without incident.
B. It is highly contagious.
C. Legionnaires’ disease can be fatal if untreated.
D. Both A and C, above.
_____ 12. The common cold is a(n)
A. less serious infection than infectious rhinitis.
B. lower respiratory infection.
C. upper respiratory infection.
D. infection caused exclusively by coronavirus.
_____ 13. The site for gas exchange with the bloodstream is the
A. surfactant.
B. alveoli.
C. cilia.
D. epiglottis.
_____ 14. Which of the following is a patchy pneumonia throughout several lobes?
A. Lobar pneumonia
B. Bronchopneumonia
C. Interstitial pneumonia
D. None of the above
30
_____ 15. A dome-shaped muscle that separates the thoracic and abdominal cavities is
the
A. alveolus.
B. bronchus.
C. trachea.
D. diaphragm.
_____ 16. Tuberculosis is
A. on the decline.
B. a cause of illness but not death.
C. confined to the lungs.
D. increasing globally.
_____ 17. “Blue bloaters” is a nickname applied to patients with
A. chronic obstructive pulmonary disease.
B. emphysema.
C. chronic bronchitis.
D. cystic fibrosis.
_____ 18. Which of the following is NOT a clinical manifestation of lung cancer?
A. Hoarseness
B. Dyspnea
C. Weight gain
D. Fatigue
_____ 19. Intermittent, reversible airway obstruction is produced by
A. asthma.
B. chronic obstructive pulmonary disease (COPD).
C. emphysema.
D. atelectasis.
_____ 20. Which of the following might be compared to the strings of a guitar or violin?
A. Epiglottis
B. Trachea
C. Larynx
D. Bronchi
_____ 21. Incomplete alveolar expansion or collapse of the alveoli is known as
A. atelectasis.
B. asthma.
C. infectious rhinitis.
D. pleurisy.
_____ 22. The mortality rate with lung cancer is about
A. 15%.
B. 25%.
31
C. 57%.
D. 90%
_____ 23. Pneumonia that can occur when the gag reflex is impaired, such as during
anesthesia, is
A. viral pneumonia.
B. aspiration pneumonia.
C. bacterial pneumonia.
D. pneumocystic carinii pneumonia.
_____ 24. Bronchiolitis occurs most often in
A. children under 1 year of age.
B. teenagers.
C. summer months.
D. the elderly.
_____ 25. Tuberculosis treatment requires an average of
A. 2 weeks.
B. 3 months.
C. 6 to 9 months.
D. 15 months.
ANSWER KEY
1. C
2. C
3. B
4. A
5. C
6. A
7. B
8. A
9. D
10. D
11. D
12. C
13. B
14. B
15. D
16. D
17. C
18. C
19. A
20. C
21. A
32
22. D
23. B
24. A
25. C
RATIONALES
1. A common viral infection in children is laryngotracheobronchitis. Cystic fibrosis is
inherited. Pleurisy is excess fluid in the pleural cavity. Pink puffers is a term used to refer
to patients with emphysema.
2. Influenza affects both the upper and lower respiratory tract. Type A is the most
common type of influenza. Type C has never been connected with a large epidemic
(types A and B have).
3. Acute respiratory distress syndrome (ARDS) develops within about 90 minutes
following a systemic inflammatory response.
4. The trachea, bronchi, bronchioles, and alveoli comprise the lower respiratory tract.
5. The normal VQ ratio is 0.8
6. The most serious type of pneumothorax is tension pneumothorax.
7. A life-threatening condition of the epiglottis is epiglottitis.
8. The sum of the tidal volume and reserves is the vital capacity. The minute respiratory
volume is the amount inhaled and exhaled in 1 minute. Residual volume is the air
remaining in the lungs after exhalation. The medulla oblongata controls the process of
breathing.
9. Causes of sinusitis include viral infection, bacterial infection, and fungal infection.
10. Expiration is passive, in that it does not require muscle contraction. But expiration
can also be active when the chest and abdominal muscles are contracted. Inspiration, not
expiration, occurs by the diaphragm contracting, lowering, and flattening.
11. People can recover from legionnaires’ disease without incident , but the disease can
be fatal if untreated.
12. The common cold is an upper respiratory infection. Infectious rhinitis is another name
for the common cold. Coronavirus is one of the many viruses that can cause the common
cold, but the rhinovirus is the most common cause.
13. The site for gas exchange with the bloodstream is the alveoli.
33
14. Bronchopneumonia is a patchy pneumonia throughout several lobes. Lobar
pneumonia is confined to a single lobe. Interstitial pneumonia occurs in the areas between
the alveoli.
15. The diaphragm is a dome-shaped muscle that separates the thoracic and abdominal
cavities.
16. Tuberculosis is increasing globally. It was once on the decline. Tuberculosis can
cause both illness and death. During the active infection phase of the illness, it can spread
to organs other than the lungs.
17. “Blue bloaters” is a nickname applied to patients with chronic bronchitis.
18. Weight gain is not a clinical manifestation of lung cancer. Weight loss, hoarseness,
dyspnea, and fatigue are clinical manifestations of lung cancer.
19. Intermittent, reversible airway obstruction is produced by asthma.
20. The larynx can be compared to the strings of a guitar or violin. Also called the voice
box, the larynx plays a central role in swallowing and talking.
21. Incomplete alveolar expansion or collapse of the alveoli is known as atelectasis.
22. The mortality rate with lung cancer is about 90%.
23. Pneumonia that can occur when the gag reflex is impaired, such as during anesthesia,
is aspiration pneumonia. Viral pneumonia and bacterial pneumonia are caused by the
organisms of their respective names. Pneumocystic carinii pneumonia is caused by a
yeastlike fungus, Pneumocystosis jiroveci.
24. Bronchiolitis occurs most often in children under 1 year of age.
25. Tuberculosis treatment requires an average of 6 to 9 months.
34
CHAPTER 6
QUESTIONS
_____ 1. Which statement is true about hypotonic solutions?
A. Hypotonic solutions have a higher concentration of solutes than those in the
intravascular compartment.
B. They cause fluid to shift from the intracellular to the intravascular space.
C. Hypotonic solutions have a lower concentration of solutes than those in the
intravascular compartment.
D. They have concentrations of solutes equal to those in the intravascular
compartment.
_____ 2. Cations are
A. positively charged.
B. neutral in charge.
C. negatively charged.
D. important but play no role in homeostasis.
_____ 3. The main diagnostic tool for evaluating acid-base balance is
A. Chvostek’s sign.
B. arterial blood gas (ABG).
C. dehydration.
D. Trousseau’s sign.
_____ 4. Fluid that is found between the cells is called
A. interstitial.
B. intracellular.
C. intravascular.
D. none of the above
_____ 5. Hyponatremia results from
A. low serum potassium levels.
B. high serum sodium levels.
C. low serum chloride levels.
D. low serum sodium levels.
_____ 6. About two-thirds of the body’s water is accounted for by
A. transcellular fluid.
B. extracellular fluid.
C. intracellular fluid.
D. intravascular fluid.
_____ 7. Fluid deficit can be caused by
35
A. inadequate fluid intake.
B. nephrosis.
C. excessive diaphoresis.
D. all of the above
_____ 8. The electrolyte whose main function is to control serum osmolality and water
balance is
A. potassium.
B. sodium.
C. magnesium.
D. chloride.
_____ 9. A serum potassium level above 5 mEq/L defines
A. hypokalemia.
B. hyperkalemia.
C. hypercalcemia.
D. hypocalcemia.
_____ 10. Most of the body’s phosphorus is found in the
A. bloodstream.
B. bones.
C. muscle.
D. teeth.
_____ 11. The osmotic pressure of two solutions separated by a semipermeable
membrane is
A. the anion gap.
B. pH.
C. tonicity.
D. uncompensated
_____ 12. A clinical manifestation of fluid deficit is
A. bounding pulse.
B. hypotension.
C. rapid weight gain.
D. hypertension.
_____ 13. The most significant cation is considered to be
A. calcium.
B. magnesium.
C. sodium.
D. potassium.
_____ 14. Trosseau’s sign and Chvostek’s sign may be seen with
A. hypocalcemia.
B. hypercalcemia.
36
C. hyperphosphatemia.
D. hypomagnesemia.
_____ 15. A role in acid-base balance is played by
A. body fluids.
B. the lungs.
C. the kidneys.
D. all of the above
_____ 16. A major buffer mechanism is the
A. bicarbonate-carbonic acid system.
B. phosphate system.
C. hemoglobin system.
D. all of the above
_____ 17. Edema refers to
A. fluid excess.
B. fluid deficit.
C. dehydration.
D. hypovolemia.
_____ 18. With aging, the thirst sensation
A. can decrease.
B. no longer functions.
C. can increase.
D. none of the above.
_____ 19. Electrolytes in the body include
A. phosphorus.
B. magnesium.
C. potassium.
D. all of the above
_____ 20. Most of the body’s calcium is found in
A. an ionized, or unbound, form.
B. the bones and teeth.
C. the intracellular space.
D. the bloodstream.
_____ 21. The primary intracellular cation is
A. calcium.
B. sodium.
C. phosphorus.
D. potassium.
_____ 22. Metabolic alkalosis results from
37
A. excess bicarbonate.
B. deficient acid.
C. both A and B, above
D. none of the above
_____ 23. The most abundant buffering system is the
A. protein system.
B. hemoglobin system.
C. phosphate system.
D. bicarbonate-carbonic acid system.
_____ 24. Death occurs if serum pH rises above
A. 6.9.
B. 7.2.
C. 7.6.
D. 7.8.
_____ 25. Which of the following results from a deficiency of bicarbonate (base) or an
excess of hydrogen (acid).
A. Metabolic alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Respiratory alkalosis
ANSWER KEY
1. C
2. A
3. B
4. A
5. D
6. C
7. D
8. B
9. B
10. B
11. C
12. B
13. C
14. A
15. D
16. D
17. A
18. A
38
19. D
20. B
21. D
22. C
23. A
24. D
25. C
RATIONALES
1. Hypotonic solutions have a lower (not higher) concentration of solutes than those in
the intravascular compartment. Hypertonic (not hypotonic) solutions cause fluid to shift
from the intracellular to the intravascular space. Isotonic solutions have concentrations of
solutes equal to those in the intravascular compartment.
2. Cations are positively charged. Anions are negatively charged. Cations and anions play
a vital role in homeostasis.
3. The main diagnostic tool for evaluating acid-base balance is arterial blood gas (ABG).
Chvostek’s sign and Trousseau’s sign are used to evaluate for hypocalcemia. Dehydration
is not the main diagnostic tool for evaluating acid-base balance.
4. Fluid that is found between the cells is called interstitial fluid. Intracellular fluid is
found inside the cells. Intravascular fluid is found inside the blood vessels.
5. Hyponatremia results from low serum sodium levels. Hypokalemia results from low
serum potassium levels. Hypernatremia results from high serum sodium levels.
Hypochloremia results from low serum chloride levels.
6. About two-thirds of the body’s water is accounted for by intracellular fluid. The
remaining one-third of the body’s fluid makes up the extracellular fluid. Transcellular
fluid is about 1% of the body’s fluid. Intravascular fluid is one type of extracellular fluid.
7. The causes of fluid deficit include inadequate fluid intake, nephrosis, and excessive
diaphoresis.
8. Sodium is the electrolyte whose main function is to control serum osmolality and water
balance. Potassium plays a role in electrical conduction, acid-base balance, and
metabolism. Magnesium helps maintain normal muscle and nerve function, keeps heart
rhythm steady, supports a healthy immune system, and has other functions. Chloride
assists in fluid distribution by attaching to sodium or water.
39
9. A serum potassium level above 5 mEq/L defines hyperkalemia. Hypokalemia is
defined as a serum potassium level below 3.5 mEq/L. Hyper- and hypocalemia refer to
calcium levels.
10. Most of the body’s phosphorus is found in the bones. Smaller amounts of phosphorus
are found in the bloodstream.
11. Tonicity is the osmotic pressure of two solutions separated by a semipermeable
membrane.
12. A clinical manifestation of fluid deficit is hypotension. A bounding pulse, rapid
weight gain, and hypertension are clinical manifestations of fluid excess.
13. The most significant cation is considered to be sodium. It is the most prevalent
electrolyte of extracellular fluid. Its main function is to control serum osmolality and
water balance. It also helps maintain acid-base balance.
14. Trosseau’s sign and Chvostek’s sign may be seen with hypocalcemia.
15. A role in acid-base balance is played by body fluids, the lungs, and the kidneys.
16. Major buffer mechanisms include the bicarbonate-carbonic acid system, the
phosphate system, and the hemoglobin system.
17. Edema refers to fluid excess. Fluid deficit can also be referred to as dehydration.
Hypovolemia refers to fluid deficit of the intravascular compartment.
18. With aging, the thirst sensation can decrease.
19. Electrolytes in the body include phosphorus, magnesium, potassium, sodium,
chloride, and calcium.
20. Most of the body’s calcium is found in the bones and teeth.
21. The primary intracellular cation is potassium.
22. Metabolic alkalosis results from excess bicarbonate and deficient acid.
23. The most abundant buffering system is the protein system.
24. Death occurs if serum pH rises above 7.8. Death can also occur if serum pH falls
below 6.8.
25. Metabolic acidosis results from a deficiency of bicarbonate (base) or an excess of
hydrogen (acid). Metabolic alkalosis results from excess bicarbonate, deficient acid, or
both. Respiratory acidosis results from carbon dioxide retention, increasing carbonic acid
40
and, in turn, decreasing pH. Respiratory alkalosis results from excess exhalation of
carbon dioxide that leads to carbonic acid deficit and pH increase.
41
CHAPTER 7
QUESTIONS
_____ 1. The loss of urine while laughing is an example of
A. nocturnal enuresis.
B. urge incontinence.
C. stress incontinence.
D. gross total incontinence.
_____ 2. Which of the following statements is true about renal calculi?
A. Renal calculi can be as large as a golf ball.
B. Only males get renal calculi.
C. Renal calculi are much more likely to cause obstruction than kidney stones.
D. They are likely to coincide with gallstones.
_____ 3. Chronic renal failure (CRF) tends to be
A. noticed once about 10% of nephrons are destroyed.
B. irreversible.
C. unrelated to hypertension.
D. easily reversed.
_____ 4. Wilms’ tumor affects mainly
A. older men.
B. adults.
C. children.
D. the elderly of both genders.
_____ 5. Urine is stored in the
A. urethra.
B. urinary bladder.
C. kidneys.
D. all of the above
_____ 6. Hepatitis B and systemic lupus erythematosus might cause
A. urolithiasis.
B. nephrotic syndrome.
C. Bowman’s capsule.
D. nephritic syndrome.
_____ 7. Which of the following statements is true about urinary incontinence?
A. Although embarrassing, urinary incontinence does not lead to complications.
B. At present, there is no effective treatment for urinary incontinence.
42
C. An aggressive form of treatment is an artificial urinary sphincter controlled by
a manual subcutaneous valve.
D. Without treatment, enuresis does not resolve.
_____ 8. An important metabolic waste managed by the kidneys is
A. ammonia.
B. urea.
C. uric acid.
D. all of the above
_____ 9. Brain injury, spina bifida, and nervous system tumors might be expected to lead
to
A. neurogenic bladder.
B. polycystic kidney disease (PKD).
C. Wilms’ tumor.
D. none of the above
_____ 10. The microscopic filtering unit of the kidney is known as the
A. calyx.
B. nephron.
C. UTI.
D. renal hilum.
_____ 11. Among all infections, UTIs are the
A. most common.
B. second most common.
C. tenth most common.
D. sixteenth most common.
_____ 12. Which of the following is NOT a risk factor for urinary incontinence?
A. Advancing age
B. Smoking
C. Male gender
D. Excess weight
_____ 13. Filtering of the blood is done by
A. glomerular filtration.
B. tubular reabsorption.
C. tubular secretion.
D. all of the above
_____ 14. A renal function test is
A. BUN.
B. serum creatinine.
C. urinalysis.
D. all of the above
43
_____ 15. Which of the following statements is true about acute renal failure (ARF)?
A. It is generally reversible.
B. An individual with ARF is symptomatic in the initial phase.
C. The mortality rate is 95%.
D. A low-calorie diet is supportive.
_____ 16. A test to screen for prostate cancer, or to indicate the effectiveness of treatment
for prostate cancer, is
A. IVP.
B. BUN.
C. PSA.
D. all of the above
_____ 17. Urine is transported by the
A. kidneys.
B. ureters.
C. urethra.
D. Both B and C, above
_____ 18. Functional incontinence tends to occur in
A. older adults, especially people in nursing homes.
B. patients with spinal cord injury.
C. smokers.
D. children.
_____ 19. Benign prostatic hyperplasia (BPH) is
A. a synonym for prostate cancer.
B. untreatable.
C. common.
D. rare.
_____ 20. Approximately how many nephrons does each kidney contain?
A. 300
B. 50,000
C. 125,000
D. 1 to 2 million
_____ 21. In women, the urethra is about
A. one-fourth as long as in men.
B. one-half as long as in men.
C. the same as in men.
D. twice as long as in men.
_____ 22. The final phase of chronic renal failure (CRF) is
A. renal impairment.
44
B. renal insufficiency.
C. end-stage renal disease.
D. the diuretic phase.
_____ 23. Bowman’s capsule is found in the
A. glomerulus.
B. loop of Henle
C. nephron.
D. urinary bladder.
_____ 24. A technique of preventing UTIs is
A. increasing hydration.
B. wearing cotton underwear.
C. avoiding bubble baths.
D. all of the above
_____ 25. Which of the following statements is true about tumors in the urinary system?
A. Urinary system tumors are confined to the kidneys.
B. Most urinary system tumors are malignant.
C. Being female is a risk factor for renal cell carcinoma.
D. Urinary system tumors tend to be benign.
ANSWER KEY
1. C
2. A
3. B
4. C
5. B
6. B
7. C
8. D
9. A
10. B
11. B
12. C
13. D
14. D
15. A
16. C
17. D
18. A
19. C
20. D
45
21. A
22. C
23. C
24. D
25. B
RATIONALES
1. The loss of urine while laughing is an example of stress incontinence. Nocturnal
enuresis is bed-wetting by a child. Urge incontinence is a sudden, intense urge to urinate,
followed by an involuntary loss of urine. Gross total incontinence refers to continuous
leaking of urine, or episodic uncontrollable leaking of large amounts of urine.
2. Renal calculi range in size from as small as a grain of sand to as large as a golf ball.
Both males and females get renal calculi. Kidney stones are a different term for renal
calculi. The development of renal calculi and gallstones is unrelated.
3. Chronic renal failure (CRF) tends to be irreversible. Unfortunately, it tends not to be
noticed until about 50% of nephrons are destroyed. Hypertension is a frequent cause.
4. Wilms’ tumor affects mainly children.
5. The urinary bladder is where urine is stored. The urethra transports urine to the outside
of the body. Kidneys eliminate wastes from the blood and have regulatory functions but
do not store urine.
6. Nephrotic syndrome can be caused by hepatitis B and systemic lupus erythematosus.
Urolithiasis and nephritic syndrome are not subject to those causes, and Bowman’s
capsule is an anatomical component of the nephron.
7. An aggressive form of treatment is an artificial urinary sphincter controlled by a
manual subcutaneous valve. Urinary incontinence can lead to complications. There are a
number of treatments for urinary incontinence. Enuresis usually resolves with or without
treatment.
8. Metabolic waste managed by the kidneys includes ammonia, urea, and uric acid.
9. Brain injury, spina bifida, and nervous system tumors might be expected to lead to
neurogenic bladder. Polycystic kidney disease (PKD) is an inherited disease. Wilms’
tumor is a rare cancer mainly affecting the kidneys of children.
10. The microscopic filtering unit of the kidney is known as the nephron. The calyx is a
tube through which urine drains into the renal pelvis. UTI stands for urinary tract
46
infection. The renal hilum is the opening in the kidneys through which the renal artery
and nerves enter and the renal vein and ureter exit.
11. Among all infections, UTIs are the second most common.
12. Male gender is not a risk factor for urinary incontinence. Advancing age, smoking,
and excess weight are risk factors.
13. The nephron performs three processes that contribute to filtering the blood:
glomerular filtration, tubular reabsorption, and tubular secretion.
14. Renal function tests include BUN, serum creatinine, and urinalysis.
15. Acute renal failure (ARF) is generally reversible. People with ARF are usually
asymptomatic in the initial phase. The mortality rate is 10% to 60%, depending on the
cause. A high-calorie diet, rather than a low-calorie diet, is supportive.
16. A test to screen for prostate cancer, or to indicate the effectiveness of treatment for
prostate cancer, is prostate specific antigen (PSA). Intravenous pyelogram (IVP) allows
visualization of the kidneys, renal pelvis, ureters, and bladder. Blood urea nitrogen is a
test for liver and kidney function.
17. Urine is transported by the ureters and the urethra. The ureters transport urine from
the kidneys to the urinary bladder. The urethra transports urine to the outside of the body.
18. Functional incontinence tends to occur in older adults, especially people in nursing
homes. A physical or mental impairment prevents toileting in time.
19. Benign prostatic hyperplasia (BPH) is common. It presents in a similar way to
prostate cancer, but is not the same thing. BPH is treatable.
20. Each kidney contains approximately 1 to 2 million nephrons.
21. In women, the urethra is about one-fourth as long as in men.
22. End-stage renal disease is the third and final phase of chronic renal failure (CRF).
Renal impairment is the first phase, and renal insufficiency is the second phase. The
diuretic phase occurs in acute renal failure (ARF) rather than in CRF.
23. Bowman’s capsule is found in the nephron. The glomerulus and loop of Henle are
also found in the nephron. The urinary bladder is another part of urinary system.
24. Techniques of preventing UTIs include increasing hydration, wearing cotton
underwear, and avoiding bubble baths.
47
25. Most urinary system tumors are malignant. They are not confined to the kidneys.
Being male, rather than female, is a risk factor for renal cell carcinoma.
48
CHAPTER 8
QUESTIONS
_____ 1. A protective, lubricating fluid is secreted during sexual intercourse by
A. the labia minora.
B. the endometrium.
C. Skene’s gland.
D. the uterus.
_____ 2. Which of the following statements is true about breast cancer?
A. Wearing underwire bras increases the risk of breast cancer.
B. Only older women can develop breast cancer.
C. Most women who develop breast cancer do not have a family history of breast
cancer.
D. Breast cancer only occurs because of mutations in the BRCA1 and BRCA2
genes.
_____ 3. The testes, epididymides, and lower spermatic cords are contained in the
A. scrotum.
B. sex accessory glands.
C. vasa deferentia.
D. none of the above
_____ 4. When the rectum protrudes through the posterior wall of the vagina, this is
known as
A. cystocele.
B. rectocele.
C. uterine prolapse.
D. endometriosis.
_____ 5. Which of the following statements is true about testicular cancer?
A. Testicular cancer is uncommon.
B. It can occur as a slow-growing tumor.
C. Testicular cancer can affect one or both testicles.
D. All of the above
_____ 6. Usually the uterus is
A. tilted backward
B. retroflexed.
C. tilted forward.
D. none of the above
49
_____ 7. A hollow, tunnel-like structure that extends from the cervix to the external
genitalia is the
A. vagina.
B. hymen.
C. vestibule.
D. mons pubis.
_____ 8. The scrotum is contracted or relaxed by
A. the ampulla.
B. the penis.
C. the cremaster muscle.
D. testicular torsion.
_____ 9. Only one of these statements is true. Which is it?
A. Pregnancy is not possible during menstruation.
B. Sexual intercourse during menstruation may relieve discomfort.
C. Sex is unhealthy during menstruation.
D. Taking a bath during menstruation has inherent risks.
_____ 10. Among men, the most common cancer is
A. prostate cancer.
B. penile cancer.
C. testicular cancer.
D. breast cancer.
_____ 11. Which of these assertions concerning condylomata acuminata is true?
A. Genital warts are benign whereas condylomata acuminata can be fatal.
B. Condylomata acuminata can be fatal if transmitted to infants at birth.
C. Condylomata acuminata is not reportable to the CDC.
D. No vaccine is available.
_____ 12. Paired, almond-shaped organs located on each side of the uterus are the
A. Bartholin’s glands.
B. fallopian tubes.
C. ovaries.
D. none of the above
_____ 13. Which disease is the most commonly reported STI to the CDC?
A. Chlamydia
B. Gonorrhea
C. Syphilis
D. Prostatitis.
_____ 14. In early stages, breast cancer is
A. a cause of bone pain.
B. often asymptomatic.
50
C. a cause for weight loss.
D. responsible for change in the size or shape of the affected breast.
_____ 15. The function of the vasa deferentia is to
A. produce male sex steroids.
B. conduct sperm to the urethra.
C. provide a proper temperature for the testes.
D. all of the above
_____ 16. The vulva includes the
A. mons pubis.
B. labia minora.
C. clitoris.
D. all of the above
_____ 17. A dilated vein in the spermatic cord is known as
A. varicocele.
B. testicular torsion.
C. spermatocele.
D. hydrocele.
_____ 18. Conditions that affect the uterus include
A. benign tumors.
B. congenital disorders.
C. malignant tumors.
D. all of the above
_____ 19. Which statement is true about cancer deaths?
A. The death rate from ovarian cancer is much higher than the death rate from
endometrial cancer.
B. Endometrial cancer is a much more frequent cancer than ovarian cancer.
C. Cervical cancer rates are on the increase.
D. Both A and B, above.
_____ 20. Priapism is
A. another name for penile cancer.
B. a synonym for impotence.
C. sometime caused by a poisonous venom, such as from a scorpion or black
widow spider.
D. a condition where the foreskin cannot be retracted from the glans penis.
_____ 21. The first stage of genital herpes is
A. shedding herpes genitalis.
B. latent herpes genitalis.
C. recurrent herpes genitalis.
D. primary herpes genitalis.
51
_____ 22. A cyst that contains sperm and that develops between the testis and epididymis
is a(n)
A. spermatocele.
B. cystocele.
C. leiomyoma.
D. ampulla.
_____ 23. When the urethral meatus is on the ventral surface of the penis instead of the
end, this is known as
A. epispadias.
B. hypospadias.
C. cryptorchidism.
D. erectile dysfunction.
_____ 24. Treatment strategies for cryptorchidism include
A. testicle implants.
B. testicle removal.
C. manual manipulation.
D. all of the above
_____ 25. Which of the following is NOT a clinical manifestation of cervical cancer?
A. Bone fractures.
B. Weight loss.
C. Metrorrhagia.
D. Leaking of urine or feces from the vagina.
ANSWER KEY
1. C
2. C
3. A
4. B
5. D
6. C
7. A
8. C
9. B
10. A
11. B
12. C
13. A
14. B
15. B
16. D
52
17. A
18. D
19. D
20. C
21. D
22. A
23. B
24. D
25. C
RATIONALES
1. Skene’s gland, located in the mucosal lining of the vagina, secretes a protective,
lubricating fluid during sexual intercourse. The labia minora are part of the external
female genitalia. The endometrium is the inner mucosal lining of the uterus that
facilitates and maintains pregnancy.
2. Most women who develop breast cancer do not have a family history of breast cancer.
Wearing underwire bras does not increase the risk of breast cancer. Women of all ages
can develop breast cancer, though the risk does increase with age. Mutations in the
BRCA1 and BRCA2 genes do increase the risk of breast cancer, but most women with
breast cancer do not have this mutation.
3. The testes, epididymides, and lower spermatic cords are contained in the scrotum.
4. When the rectum protrudes through the posterior wall of the vagina, this is known as
rectocele. A cystocele occurs when the bladder protrudes into the anterior wall of the
vagina. Uterine prolapsed is the descent of the uterus or cervix into the vagina.
Endometriosis refers to the growth of the endometrium in areas outside the uterus.
5. Testicular cancer is uncommon, can occur as a slow-growing tumor, and can affect one
or both testicles.
6. Usually the uterus is tilted forward.
7. The vagina is a hollow, tunnel-like structure that extends from the cervix to the
external genitalia. The hymen is thin connective tissue that may partly cover the external
vaginal opening. The vestibule is the area of the female genitalia that covers the urethral
and vaginal opening. The mons pubis is the pad of fat over the female pubic bone.
8. The scrotum is contracted or relaxed by the cremaster muscle. The ampulla is a pouch
in the duct system, and the penis is unaffected by the cremaster muscle. Testicular torsion
is an abnormal rotation of the testes on the spermatic cord.
53
9. Sexual intercourse during menstruation may relieve discomfort. Pregnancy is possible
during menstruation. There is nothing unhealthy about sex during menstruation, and
taking a bath during menstruation has no inherent risks.
10. Among men, the most common cancer is prostate cancer.
11. Condylomata acuminata can be fatal if transmitted to infants at birth. Genital warts
and condylomata acuminata are names for the same thing. Condylomata acuminata is
reportable to the CDC. A vaccine is available.
12. The ovaries are paired, almond-shaped organs located on each side of the uterus.
Bartholin’s glands lie just within the labia minor and provide lubrication during
intercourse. The fallopian tubes extend from the fundus of the uterus to near the ovaries.
13. Chlamydia is the most commonly reported STI to the CDC.
14. In its early stages, breast cancer is often asymptomatic. Bone pain, weight loss, and
possible change in the size or shape of the breast can come in later stages.
15. The function of the vasa deferentia is to conduct sperm to the urethra. Male sex
steroids are produced by the testes. The scrotum provides a proper temperature for the
testes.
16. The vulva includes the mons pubis, labia minora, and clitoris.
17. A dilated vein in the spermatic cord is known as varicocele. Testicular torsion is an
abnormal rotation of the testes on the spermatic cord. Spermatocele is a sperm-containing
cyst that develops between the testis and the epididymis. Hydrocele is fluid accumulation
between layers of the tunica vaginalis or along the spermatic cord.
18. Conditions that affect the uterus include benign tumors, congenital disorders, and
malignant tumors.
19. The death rate from ovarian cancer is much higher than the death rate from
endometrial cancer. Endometrial cancer is a much more frequent cancer than ovarian
cancer. Cervical cancer rates are not on the increase but on the decline.
20. Priapism, a prolonged erection, is sometime caused by a poisonous venom, such as
from a scorpion or black widow spider. Phimosis is a condition where the foreskin cannot
be retracted from the glans penis.
21. The first stage of genital herpes is primary herpes genitalis. Then come latent,
shedding, and recurrent herpes genitalis.
22. A cyst that contains sperm and that develops between the testis and epididymis is a
spermatocele. A cystocele occurs when the bladder protrudes in to the anterior wall of the
54
vagina. Leiomyoma is a uterine fibroid. Ampulla is part of the duct system of the male
genitalia.
23. When the urethral meatus is on the ventral surface of the penis instead of the end, this
is known as Hypospadias. Epispadias refers to the opposite—the urethral meatus
occurring on the dorsal (upper) surface of the penis. Cryptorchidism is a condition in
which one or both testes do not descend from the abdomen to the scrotum before birth.
Erectile dysfunction refers to impotence.
24. Treatment strategies for cryptorchidism include testicle implants, testicle removal,
and manual manipulation.
25. Metrorrhagia is not a clinical manifestation of cervical cancer. Instead, it refers to
vaginal bleeding between menstrual periods. Bone fractures, weight loss, and leaking of
urine or feces from the vagina are possible manifestations of cervical cancer.
55
CHAPTER 9
QUESTIONS
_____ 1. A part of the upper gastrointestinal tract is the
A. stomach.
B. esophagus.
C. oral cavity.
D. all of the above
_____ 2. The innermost layer of the GI tract is the
A. submucosa.
B. mucosa.
C. circular muscle.
D. longitudinal muscle.
_____ 3. Clinical manifestations of pyloric stenosis usually appear
A. within a few weeks after birth.
B. by age 2 years.
C. by age 15 years.
D. by age 20 years.
_____ 4. Which of the following is NOT a cause of gastroesophageal reflux disease?
A. Alcohol consumption
B. Smoking
C. Normal body weight
D. Pregnancy
_____ 5. When the stomach is empty, its wall shrinks, forming
A. chyme.
B. rugae.
C. the pyloric sphincter.
D. all of the above
_____ 6. For people of age 50 and above, the American Cancer Society and the CDC
recommend
A. flexible sigmoidoscopy every 5 years.
B. colonoscopy every 2 years.
C. flexible sigmoidoscopy every 10 years.
D. colonoscopy every 10 years.
_____ 7. The most common cause of chronic gastritis is
A. gastroenteritis.
B. Helicobacter pylori infection.
56
C. intestinal obstruction.
D. none of the above
_____ 8. The type of ulcer caused by a major stressor on the body, such as a large burn, is
a
A. stress ulcer.
B. duodenal ulcer.
C. gastric ulcer.
D. both A and C, above
_____ 9. Approximately how many different functions does the liver perform?
A. 5
B. 50
C. 500
D. 5000
_____ 10. In which type of viral hepatitis can jaundice be present?
A. Type A
B. Type D
C. Type E
D. All types
_____ 11. For inflammatory bowel disease and irritable bowel syndrome, who gets these
diseases most frequently?
A. Men
B. Women
C. Infants
D. The elderly
_____ 12. The large, serous membrane that lines the abdominal cavity is the
A. diverticulum.
B. rugae.
C. peritoneum.
D. large intestine.
_____ 13. In the United States, the most frequent cause of cirrhosis is
A. chronic alcohol abuse.
B. hepatitis.
C. autoimmune conditions.
D. medications.
_____ 14. An inflammation of the vermiform appendix is known as
A. atrophic gastritis.
B. peristalsis.
C. appendicitis.
D. ascites.
57
_____ 15. A strong, unproductive effort to vomit is called
A. nausea.
B. retching.
C. emesis.
D. all of the above
_____ 16. A cause of esophageal cancer is
A. smoked tobacco.
B. smokeless tobacco.
C. both A and B, above
D. none of the above
_____ 17. The overall 5-year survival rate for pancreatic cancer is
A. 95%.
B. 50%.
C. 17%.
D. 5%.
_____ 18. The rectum is part of the
A. large intestine.
B. colon.
C. small intestine.
D. cecum.
_____ 19. Bowel movement frequency among normal, healthy people is in the range of
A. one every two days to two a week.
B. one to two a day.
C. two a day to two a week.
D. three a day to three a week.
_____ 20. Crohn’s disease is a type of
A. ulcerative colitis.
B. inflammatory bowel disease.
C. irritable bowel syndrome.
D. diverticular disease.
_____ 21. A cause of diverticula is thought to be
A. a high-fiber diet.
B. the effort of moving soft stools.
C. a low-fiber diet.
D. none of the above
_____ 22. Hydrochloric acid is a digestive juice found in the
A. pancreas.
B. stomach.
58
C. liver.
D. salivary glands.
_____ 23. Which of the following is NOT a treatment strategy for gastroesophageal
reflux disease?
A. Surgery
B. Reducing stress
C. Eating larger meals at greater intervals
D. Herbal therapies
_____ 24. The most common chronic cause of pancreatitis is
A. alcohol abuse.
B. cholelithiasis.
C. metabolic disorders.
D. pancreatic tumors.
_____ 25. A fluoroscopic examination of the pharynx and esophagus is the
A. barium swallow.
B. cholescintigraphy.
C. colorectal cancer allelotyping for chromosomes 17p and 18q.
D. barium enema.
ANSWER KEY
1. D
2. B
3. A
4. C
5. B
6. D
7. B
8. A
9. C
10. D
11. B
12. C
13. A
14. C
15. B
16. C
17. D
18. A
19. D
20. B
21. C
59
22. B
23. C
24. A
25. A
RATIONALES
1. The upper gastrointestinal tract includes the oral cavity, pharynx, esophagus, and
stomach.
2. The innermost layer of the GI tract is the mucosa. Next come the submucosa, then the
circular muscle, and then the longitudinal muscle.
3. Clinical manifestations of pyloric stenosis usually appear within a few weeks after
birth.
4. Normal body weight is not a cause of gastroesophageal reflux disease. Alcohol
consumption, smoking, and pregnancy can be causes.
5. When the stomach is empty, its wall shrinks, forming rugae. Chyme is a mixture of
food, acid, and enzymes in the stomach. The pyloric sphincter is the exit route for chyme
from the stomach into the duodenum.
6. For people of age 50 and above, the American Cancer Society and the CDC
recommend colonoscopy every 10 years.
7. The most common cause of chronic gastritis is Helicobacter pylori infection.
8. The type of ulcer caused by a major stressor on the body, such as a large burn, is a
stress ulcer. A duodenal ulcer is usually caused by excessive acid or Helicobacter pylori
infection. A gastric ulcer is usually associated with malignancy and nonsteroidal antiinflammatory drug use.
9. The liver performs approximately 500 different functions.
10. Jaundice can be present in all types of hepatitis.
11. Women most frequently get inflammatory bowel disease and irritable bowel
syndrome.
12. The peritoneum is the large, serous membrane that lines the abdominal cavity. The
diverticulum is an outwardly bulging pouch of the intestinal wall. Rugae are folds in the
stomach wall. The large intestine is that portion of the alimentary canal between the small
intestine and the anus.
60
13. In the United States, the most frequent cause of cirrhosis is chronic alcohol abuse.
Hepatitis, autoimmune conditions, and medications are other causes.
14. An inflammation of the vermiform appendix is known as appendicitis. Atrophic
gastritis is inflammation of the stomach lining. Peristalsis is the wave-like motion that
propels food through the GI tract. Ascites refers to fluid accumulation in the peritoneal
cavity.
15. A strong, unproductive effort to vomit is called retching. Nausea is a subjective urge
to vomit. Emesis is another term for vomiting.
16. Both smoked tobacco and smokeless tobacco can cause esophageal cancer.
17. The overall 5-year survival rate for pancreatic cancer is 5%.
18. The rectum is part of the large intestine. The colon and cecum are other parts of the
large intestine.
19. Bowel movement frequency among normal, healthy people is in the range of three a
day to three a week.
20. Crohn’s disease is a type of inflammatory bowel disease.
21. A cause of diverticula is thought to be a low-fiber diet.
22. Hydrochloric acid is a digestive juice found in the stomach.
23. Eating larger meals at greater intervals is not a treatment strategy for
gastroesophageal reflux disease. Surgery, reducing stress, and herbal therapies are
treatments.
24. A The most common chronic cause of pancreatitis is alcohol abuse. Cholelithiasis is
the most common acute cause. Metabolic disorders and pancreatic tumors are other
causes.
25. A fluoroscopic examination of the pharynx and esophagus is the barium swallow.
Cholescintigraphy involves injection of a radioactive dye into an IV line to evaluate
gallbladder and common bile duct function. Colorectal cancer allelotyping for
chromosomes 17p and 18q is a lab test for genes known to suppress tumor development.
A barium enema is a study of colon mucosa to show neoplasms and other structural
abnormalities.
61
CHAPTER 10
QUESTIONS
_____ 1. A form of glucose intolerance diagnosed during pregnancy is
A. type 1 diabetes.
B. adult-onset diabetes.
C. gestational diabetes.
D. type 2 diabetes.
_____ 2. Hunger is stimulated by
A. ghrelin.
B. amylin.
C. somatostatin.
D. insulin.
_____ 3. An autoimmune condition that stimulates thyroid hormone production is
A. hyperthyroidism.
B. Graves’ disease.
C. Hashimoto’s thyroiditis
D. hypoparathyroidism.
_____ 4. Hormones regulate
A. growth and development.
B. metabolism.
C. mood stability.
D. all of the above
_____ 5. In diabetes mellitus, increased appetite because of energy loss as glucose is
excreted is
A. polyuria.
B. polyphagia.
C. glucosuria.
D. polydipsia.
_____ 6. Gamete production and hormone production by the gonads are stimulated by
A. growth hormone.
B. gonadotropins (FSH and LH).
C. prolactin.
D. melanocyte-stimulating hormone.
_____ 7. Hypoglycemia can result from
A. excessive dietary carbohydrate intake.
B. insufficient diabetic pharmacologic therapy.
62
C. aggressive diabetic pharmacologic therapy.
D. Both A and B, above
_____ 8. Glucagon is secreted in the pancreas by
A. alpha cells.
B. beta cells.
C. delta cells.
D. PP cells.
_____ 9. Excessive amounts of one or all of the pituitary hormones are secreted in
A. hypopituitarism.
B. hyperglycemia.
C. hyperpituitarism.
D. hyperthyroidism.
_____ 10. The adrenal glands are located
A. on each kidney.
B. on the back of the thyroid.
C. below the larynx at the base of the neck.
D. underneath the stomach and between the two kidneys.
_____ 11. A deficiency of adrenal cortex hormones is referred to as
A. metabolic syndrome.
B. polydipsia.
C. Cushing’s syndrome.
D. Addison’s disease.
_____ 12. Thyroid-stimulating hormone is secreted by the
A. pituitary gland.
B. adrenal gland.
C. thyroid gland.
D. parathyroid gland.
_____ 13. Which of the following statements is true?
A. Eating too much sugar causes diabetes.
B. Drinking water excretes extra sugar in the blood.
C. The amount of fruit eaten by people with diabetes should be controlled.
D. Chocolate is off limits for people with diabetes.
_____ 14. Which of the following is NOT a clinical manifestation of hypothyroidism?
A. Fatigue
B. Unexplained weight gain
C. Increased sensitivity to cold
D. Exophthalmos
_____ 15. The fight-or-flight response of the sympathetic nervous system is mediated by
63
A. epinephrine.
B. norepinephrine.
C. aldosterone.
D. both A and B, above
_____ 16. Increased renal water retention caused by excessive antidiuretic hormone
levels is referred to as
A. hyperprolactinemia.
B. acromegaly.
C. syndrome of inappropriate antidiuretic hormone (SIADH).
D. Cushing’s syndrome.
_____ 17. The pituitary gland is regulated by
A. hypothalamus.
B. gonads.
C. thyroid.
D. all of the above
_____ 18. The principal mineralocorticoid is
A. cortisol.
B. aldosterone.
C. estrogen.
D. androgen.
_____ 19. Increased bone size caused by excessive growth hormone levels in adulthood
is known as
A. gigantism.
B. hyperprolactinemia.
C. acromegaly.
D. SIADH.
_____ 20. Adrenocorticotropin, prolactin, growth hormone, and other hormones are
produced by the
A. posterior pituitary.
B. adrenal gland.
C. gonads.
D. anterior pituitary.
_____ 21. Which statement is true about insulin?
A. Insulin increases serum glucose levels.
B. It suppresses cellular uptake of glucose.
C. Insulin decreases serum glucose levels.
D. It is released when serum glucose levels decrease.
_____ 22. Milk production is stimulated by
A. prolactin.
64
B. gonadotropins.
C. thyroid-stimulating hormone.
D. all of the above
_____ 23. Approximately how many islets of Langerhans are contained in the human
pancreas?
A. 1
B. 100
C. 10,000
D. 1,000,000
_____ 24. The combination of hyperglycemia, high blood pressure,
hypercholesterolemia, and increased weight circumference is known as
A. Hashimoto’s thyroiditis.
B. metabolic syndrome.
C. Graves’ disease.
D. thyrotoxicosis.
_____ 25. Insulin is secreted in the pancreas by
A. alpha cells.
B. beta cells.
C. delta cells.
D. PP cells.
ANSWER KEY
1. C
2. A
3. B
4. D
5. B
6. B
7. C
8. A
9. C
10. A
11. D
12. A
13. C
14. D
15. D
16. C
17. A
18. B
19. C
65
20. D
21. C
22. A
23. D
24. B
25. B
RATIONALES
1. Gestational diabetes is a form of glucose intolerance diagnosed during pregnancy.
Type 1 diabetes usually affects children and young adults. Adult-onset diabetes is another
name for type 2 diabetes, and is associated with advancing age and other factors.
2. Hunger is stimulated by ghrelin. Amylin and insulin react synergistically to control
glucose. Somatostatin regulates insulin and glucagon. All are produced by the pancreas.
3. Graves’ disease is an autoimmune condition that stimulates thyroid hormone
production. Hyperthyroidism is a hypermetabolic state caused by excessive thyroid
hormones. Hashimoto’s thyroiditis is autoimmune thyroiditis. Hypoparathyroidism is a
condition in which the parathyroid gland does not produce enough PTH.
4. Hormones regulate growth and development, metabolism, and mood stability.
5. In diabetes mellitus, increased appetite because of energy loss as glucose is excreted is
polyphagia. Polyuria is increased urine output. Glucosuria is glucose excreted in the
urine. Polydipsia is increased thirst because of the dehydration caused by increased urine
output.
6. Gamete production and hormone production by the gonads are stimulated by
gonadotropins (FSH and LH). Growth hormone stimulates cell growth. Prolactin
stimulates milk production by the breast. The function of melanocyte-stimulating
hormone is unknown.
7. Hypoglycemia can result from aggressive diabetic pharmacologic therapy.
8. Glucagon is secreted in the pancreas by alpha cells. Beta cells secrete amylin and
insulin. Delta cells secrete somatostatin. PP cells secrete a pancreatic polypeptide.
9. Excessive amounts of one or all of the pituitary hormones are secreted in
hyperthyroidism. Hypopituitarism refers to a condition in which the pituitary gland does
not produce sufficient amounts of some or all of its hormones. Hyperpituitarism refers to
its opposite. Hyperglycemia is high serum glucose levels.
10. The adrenal glands are located on each kidney.
66
11. A deficiency of adrenal cortex hormones is referred to as Addison’s disease.
Metabolic syndrome is a combination of hyperglycemia, high blood pressure,
hypercholesterolemia, and increased waist circumference. Polydipsia is increased thirst
caused by increased urine output. Cushing’s syndrome is a condition of excessive
amounts of glucocorticoids.
12. Thyroid-stimulating hormone is secreted by the pituitary gland.
13. The amount of fruit eaten by people with diabetes should be controlled. The other
three statements are false.
14. Exophthalmos is not a clinical manifestation of hypothyroidism. It is a clinical
manifestation of hyperthyroidism. Fatigue, unexplained weight gain, and increased
sensitivity to cold are clinical manifestations of hypothyroidism.
15. The fight-or-flight response of the sympathetic nervous system is mediated by
epinephrine and norepinephrine.
16. Increased renal water retention caused by excessive antidiuretic hormone levels is
referred to as syndrome of inappropriate antidiuretic hormone (SIADH).
Hyperprolactinemia is a condition in which excessive prolactin levels result in menstrual
dysfunction and galactorrhea. Acromegaly is increased bone size caused by excessive
growth hormone levels in adulthood. Cushing’s syndrome is a condition caused by
excessive cortisol levels resulting from increased ACTH levels.
17. The pituitary gland is regulated by hypothalamus.
18. The principal mineralocorticoid is aldosterone. Cortisol is a glucocorticoid. Estrogen
and androgen are sex hormones.
19. Increased bone size caused by excessive growth hormone levels in adulthood is
known as acromegaly. Gigantism is tall stature caused by excessive growth hormone
levels before puberty. Hyperprolactinemia is menstrual dysfunction and galactorrhea
caused by excessive prolactin levels. SIADH is increased renal water retention caused by
excessive antidiuretic hormone levels.
20. Adrenocorticotropin, prolactin, growth hormone, and other hormones are produced by
the anterior pituitary.
21. Insulin decreases serum glucose levels. It stimulates cellular uptake of glucose. It is
released when serum glucose levels increase.
22. Prolactin stimulates milk production.
23. Approximately 1,000,000 islets of Langerhans are contained in the human pancreas.
67
24. The combination of hyperglycemia, high blood pressure, hypercholesterolemia, and
increased weight circumference is known as metabolic syndrome. Hashimoto’s
thyroiditis is autoimmune thyroiditis. Graves’ disease is an autoimmune condition that
stimulates thyroid hormone production. Thyrotoxicosis, or thyroid crisis, is a sudden
worsening of hyperthyroidism.
25. Insulin is secreted in the pancreas by beta cells. Alpha cells secrete glucagon, delta
cells secrete somatostatin, and PP cells secrete a pancreatic polypeptide.
68
CHAPTER 11
QUESTIONS
_____ 1. The pons is found in the
A. cerebellum.
B. midbrain.
C. brain stem.
D. medulla.
_____ 2. Which of the following is NOT part of AIDS dementia complex?
A. Encephalitis
B. Behavioral changes
C. Improved dexterity
D. Difficulty with concentration
_____ 3. An aura is
A. actually a simple focal seizure.
B. a repetitive behavior such as blinking.
C. a generalized seizure.
D. an absence seizure.
_____ 4. The type of seizure that originates in just one part of the brain is a
A. generalized seizure
B. focal seizure.
C. petit mal seizure.
D. none of the above
_____ 5. Another name for cerebral vascular accident is
A. countercoup.
B. epilepsy.
C. coup.
D. stroke.
_____ 6. Body temperature, respiration, and heartbeat are controlled by the
A. hypothalamus.
B. cerebellum.
C. brain stem.
D. basal nuclei.
_____ 7. Depolarization occurs when
A. sodium ions are concentrated on the outside of the cell.
B. action potential is inhibited.
69
C. a rapid flow into the cell of positively charged sodium ions increases the
charge.
D. none of the above
_____ 8. How many pairs of thoracic nerves are there?
A. 5 pairs
B. 8 pairs
C. 10 pairs
D. 12 pairs
_____ 9. The Monro-Kellie hypothesis states that
A. the cranial cavity can be compressed as circumstances dictate.
B. there is no detectable relationship between ICP, volume of CSF, and cerebral
perfusion.
C. the cranial cavity cannot be compressed, and the volume inside the cavity is
fixed.
D. all of the above
_____ 10. Which of the following statements is true about the period immediately
following a head injury?
A. Direct pressure should be applied to the bleeding site.
B. Objects sticking out of a wound should be left in place.
C. The wound should be washed.
D. If a helmet is present, it should be removed.
_____ 11. The area of the skin innervated by a given pair of spinal sensory nerves is
known as a(n)
A. dorsal root.
B. axon.
C. dermatome.
D. dendrite.
_____ 12. The fundamental unit of the nervous system is the
A. neuron.
B. axon.
C. dendrite.
D. gyrus.
_____ 13. Which statement about cerebrospinal fluid (CSF) is true?
A. CSF fills the space between the arachnoid and the pia mater.
B. It is produced by choroid plexus cells.
C. Excess CSF drains into the bloodstream.
D. all of the above
_____ 14. An abnormal protein particle implicated in Creutzfeldt-Jakob disease is the
A. cauda equina.
70
B. prion.
C. dendrite.
D. pons.
_____ 15. During the postictal period, the person having a generalized seizure may
A. be confused.
B. be fatigued.
C. fall into a deep sleep.
D. all of the above
_____ 16. When does a countercoup injury occur?
A. When there is a simple crack in the skull
B. When the brain strikes one side of the skull and then rebounds, causing another
area of damage
C. When there are several fracture lines.
D. When brain tissue is exposed.
_____ 17. Which statement about brain tumors is true?
A. All brain tumors are secondary tumors.
B. Whether benign or malignant, they can be life threatening.
C. Prevalence and mortality rates are highest among females.
D. The 5-year survival rate is less than 4%.
_____ 18. In a depressed skull fracture,
A. bone fragments are displaced into the brain.
B. brain tissue is exposed.
C. the base of the skull is fractured and usually CSF leaks.
D. all of the above
_____ 19. Tonic seizures cause
A. repeated jerking movements of muscles on both sides of the body.
B. stiffening of muscles of the body, especially those in the back and extremities.
C. a loss of normal muscle tone.
D. jerks or twitches of the upper body, arms, or legs.
_____ 20. As the gene that causes Huntington’s disease is transmitted from one
generation to the next,
A. the disease tends to get milder.
B. the number of CAG repeats gets smaller.
C. the faster the disease progresses.
D. the later in life symptoms appear.
_____ 21. Temporary suppression of neurologic function because of spinal cord
compression is referred to as
A. spinal shock.
B. cauda equina syndrome.
71
C. autonomic hyperreflexia.
D. neurogenic shock.
_____ 22. The peripheral nervous system is made up of
A. the brain
B. the spinal cord
C. the nerves
D. all of the above
_____ 23. Which color is present in the brain?
A. White
B. Black
C. Red
D. All of the above
_____ 24. An epidural hematoma occurs
A. outside the dura and under the skull.
B. beneath the dura but outside the brain.
C. within the substance of the brain tissue.
D. none of the above
_____ 25. Pathologic characteristics associated with Alzheimer’s disease are
A. amyloid plaques.
B. neurofibrillary tangles.
C. connections between neurons responsible for memory and learning are lost.
D. all of the above
ANSWER KEY
1. C
2. C
3. A
4. B
5. D
6. A
7. C
8. D
9. C
10. B
11. C
12. A
13. D
14. B
15. D
16. B
72
17. B
18. A
19. B
20. C
21. A
22. C
23. D
24. A
25. D
RATIONALES
1. The pons is found in the brain stem.
2. Improved dexterity is not part of AIDS dementia complex. Encephalitis, behavioral
changes, and concentration difficulty are part of the complex.
3. An aura is actually a simple focal seizure.
4. The type of seizure that originates in just one part of the brain is a focal seizure. A
generalized seizure is a result of abnormal neuronal activity on both sides of the brain. In
what was formerly called a petit mal seizure, and is now called an absence seizure, a
person may appear to be staring into space and/or have jerking or twitching muscles.
5. Another name for cerebral vascular accident is stroke.
6. Body temperature, respiration, and heartbeat are controlled by the hypothalamus.
7. Depolarization occurs when a rapid flow into the cell of positively charged sodium
ions increases the charge. Resting potential is a charge at rest, because sodium ions are
concentrated on the outside of the cell.
8. There are 12 pairs of thoracic nerves.
9. The Monro-Kellie hypothesis states that the cranial cavity cannot be compressed, and
the volume inside the cavity is fixed. The hypothesis explains the delicate relationship
between ICP, volume of CSF, and cerebral perfusion.
10. During the period immediately following a head injury, objects sticking out of a
wound should be left in place. Direct pressure should not be applied to the bleeding site.
The wound should not be washed if it is deep or bleeding a lot. If a helmet is present, it
should be left on.
73
11. The area of the skin innervated by a given pair of spinal sensory nerves is known as a
dermatome. A dorsal root is formed from about 6 to 8 rootlets. Axons and dendrites are
projections from a neuron that make connections with nearby cells.
12. The fundamental unit of the nervous system is the neuron.
13. Cerebrospinal fluid (CSF) fills the space between the arachnoid and the pia mater,
and is produced by choroid plexus cells. Excess CSF drains into the bloodstream.
14. An abnormal protein particle implicated in Creutzfeldt-Jakob disease is the prion.
15. During the postictal period, the person having a generalized seizure may be confused,
fatigued, or fall into a deep sleep.
16. A countercoup injury occurs when the brain strikes one side of the skull and then
rebounds, causing another area of damage. When there is a simple crack in the skull, this
is a linear skull fracture. When there are several fracture lines, this is a comminuted skull
fracture. When brain tissue is exposed, this is a compound skull fracture.
17. Whether benign or malignant, brain tumors can be life threatening. This is because
they often increase ICP and are difficult to access. Most, but not all, brain tumors are
secondary tumors. Prevalence and mortality rates are highest among Caucasians and
males. The 5-year survival rate is almost 35%.
18. In a depressed skull fracture, bone fragments are displaced into the brain. Brain tissue
is exposed in a compound skull fracture. The base of the skull is fractured and usually
CSF leaks with a basilar skull fracture.
19. Tonic seizures cause stiffening of muscles of the body, especially those in the back
and extremities. Clonic seizures cause repeated jerking movements of muscles on both
sides of the body. Atonic seizures cause a loss of normal muscle tone. Myoclonic seizures
cause jerks or twitches of the upper body, arms, or legs.
20. As the gene that causes Huntington’s disease is transmitted from one generation to
the next, the faster the disease progresses. It does not tend to get milder; instead,
symptoms can develop at younger and younger ages. The number of CAG repeats
increases.
21. Temporary suppression of neurologic function because of spinal cord compression is
referred to as spinal shock. Cauda equina syndrome refers to injury to the nerve roots in
the area of the cauda equina. Autonomic hyperreflexia is a complication of spinal cord
injury in which a massive sympathetic response occurs that can cause headaches,
hypertension, tachycardia, seizures, stroke, and death. Neurogenic shock, another
complication of spinal cord injury, is an abnormal vasomotor response secondary to
disruption of sympathetic impulses.
74
22. The peripheral nervous system is made up of the nerves. The brain and spinal cord are
parts of the central nervous system.
23. Colors present in the brain include white, black, and red.
24. An epidural hematoma occurs outside the dura and under the skull. A subdural
hematoma occurs beneath the dura but outside the brain. An intracerebral hematoma
occurs within the substance of the brain tissue.
25. Pathologic characteristics associated with Alzheimer’s disease include amyloid
plaques, neurofibrillary tangles, and lost connections between neurons responsible for
memory and learning.
75
CHAPTER 12
QUESTIONS
_____ 1. A fracture with multiple fracture lines and bone pieces is a(n)
A. spiral fracture.
B. oblique fracture.
C. comminuted fracture.
D. open fracture.
_____ 2. When Rickets occurs in adults it is called
A. Paget’s disease.
B. osteopenia.
C. osteomalacia.
D. kyphosis.
_____ 3. Which statement is true about short bones?
A. Short bones have bodies that are longer than they are wide.
B. They are approximately as wide as they are long.
C. Examples include the femur and humerus.
D. Short bones provide protection to the body’s vital organs.
_____ 4. A sprain would be graded Grade III if there is
A. complete disruption of the ligament.
B. minimal damage or disruption.
C. moderate damage.
D. none of the above
_____ 5. Ankylosing spondylitis affects the
A. sacroiliac joints.
B. hands.
C. femur.
D. skeletal muscle.
_____ 6. Shiny connective tissue that is tough and flexible is known as
A. ligaments.
B. cartilage.
C. amphiarthroses.
D. the matrix.
_____ 7. Approximately what percentage of the body’s weight is made up by skeletal
muscles?
A. 20%
B. 40%
76
C. 60%
D. 80%
_____ 8. The type of fracture that results when the skin is broken is a(n)
A. open fracture.
B. complete fracture.
C. oblique fracture.
D. comminuted fracture.
_____ 9. Which of the following statement is true about arthritis?
A. Cracking your joints causes arthritis.
B. Being double-jointed increases your risk for arthritis.
C. Vaccinations can cause arthritis.
D. None of the above.
_____ 10. Osteosarcoma begins in the
A. cartilage cells commonly found on the ends of bones.
B. bone cells.
C. femur, tibia, or fibula.
D. both B and C, above
_____ 11. An inflammatory disease resulting from deposits of uric acid crystals is called
A. gout.
B. ankylosing spondylitis.
C. rheumatoid arthritis.
D. osteoarthritis.
_____ 12. An increase in the curvature of the thoracic spine outward is known as
A. kyphosis.
B. scoliosis.
C. lordosis.
D. none of the above
_____ 13. How many bones does the human skeleton contain?
A. 43
B. 110
C. 206
D. 719
_____ 14. Treatment for bone tumors could be
A. surgical excision.
B. amputation.
C. radiation.
D. all of the above
_____ 15. Which of the following statements is true about fibromyalgia?
77
A. Fibromyalgia is an autoimmune disease.
B. The symptoms of fibromyalgia are caused by depression.
C. Fibromyalgia is a psychologic problem.
D. None of the above
_____ 16. The separation of two bones where they meet at a joint is
A. diaphysis.
B. dislocation.
C. incomplete fracture.
D. simple fracture.
_____ 17. Osteoarthritis typically begins after age
A. 20.
B. 40.
C. 60.
D. 80.
_____ 18. Muscles that connect to bone are called
A. smooth muscles.
B. cardiac muscles.
C. skeletal muscles.
D. tendons.
_____ 19. Which of the following might be a treatment strategy for rheumatoid arthritis?
A. Physical therapy
B. Regular exercise
C. NSAIDs
D. All of the above
_____ 20. The “blood cell factory” is
A. yellow marrow.
B. periosteum.
C. red marrow.
D. the synovial joints.
_____ 21. Which statement is true about muscles?
A. All skeletal muscles make bones move.
B. Some skeletal muscles steady joints, allowing other muscles to act.
C. Muscle fibers have low action potential.
D. All muscles are under voluntary control.
_____ 22. Repeated excessive stress can result in a(n)
A. pathologic fracture.
B. stress fracture.
C. depressed fracture.
D. open fracture.
78
_____ 23. Which of the following statements is true about bone tumors?
A. The overall 5-year survival rate is approximately 31%.
B. The majority are benign.
C. They rarely occur as primary tumors.
D. The overall 5-year survival rate is approximately 95%.
_____ 24. A lateral deviation of the spine is known as
A. lordosis.
B. kyphosis.
C. gout.
D. scoliosis.
_____ 25. The smooth muscles are
A. involuntary.
B. the most frequently occurring muscle type.
C. voluntary.
D. consciously controlled by the brain.
ANSWER KEY
1. C
2. C
3. B
4. A
5. A
6. B
7. B
8. A
9. D
10. D
11. A
12. A
13. C
14. D
15. D
16. B
17. B
18. C
19. D
20. C
21. B
22. B
23. C
24. D
79
25. A
RATIONALES
1. A fracture with multiple fracture lines and bone pieces is a comminuted fracture. A
spiral fracture twists around the bone shaft. An oblique fracture is at an angle to the bone
shaft. An open fracture, or compound fracture, results when the skin is broken.
2. When Rickets occurs in adults it is called osteomalacia.
3. Short bones are approximately as wide as they are long. Long bones have bodies that
are longer than they are wide. The femur and humerus are examples of long bones. Flat
bones provide protection to the body’s vital organs.
4. A sprain would be graded Grade III if there is complete disruption of the ligament.
With minimal damage or disruption, it would be Grade I. With moderate damage, it
would be Grade II.
5. Ankylosing spondylitis affects the sacroiliac joints.
6. Shiny connective tissue that is tough and flexible is known as cartilage.
7. Approximately 40% of the body’s weight is made up by skeletal muscles.
8. An open fracture is the type of fracture that results when the skin is broken. A
complete fracture occurs when the bone is broken into two or more separate pieces. An
oblique fracture is a fracture at an angle to the bone shaft. A comminuted fracture is a
fracture with multiple fracture lines and bone pieces.
9. None of the statements are true. Cracking your joints, being double-jointed, and
vaccinations do not cause or increase the risk for arthritis.
10. Osteosarcoma begins in the bone cells, usually in the femur, tibia, or fibula.
11. Gout is an inflammatory disease resulting from deposits of uric acid crystals.
Ankylosing spondylitis is a progressive inflammatory disorder affecting the sacroiliac
joints, intervertebral spaces, and costovertebral joints. Rheumatoid arthritis is a systemic,
autoimmune condition involving multiple joints. Osteoarthritis is a localized joint disease
12. An increase in the curvature of the thoracic spine outward is known as kyphosis.
Scoliosis refers to a lateral deviation of the spine. Lordosis is an exaggerated concave of
the lumbar spine.
13. The human skeleton contains 206 bones.
80
14. Treatment possibilities for bone tumors include surgical excision, amputation, and
radiation.
15. None of the statements are true about fibromyalgia. Fibromyalgia is not an
autoimmune disease, its symptoms are not caused by depression, and it is not a
psychologic problem.
16. The separation of two bones where they meet at a joint is dislocation.
17. Osteoarthritis typically begins after age 40.
18. Muscles that connect to bone are called skeletal muscles. Smooth muscles line the
walls of organs and tubes. Cardiac muscles make up the heart. Tendons are bands of
connective tissue.
19. Treatment strategies for rheumatoid arthritis include physical therapy, regular
exercise, and NSAIDs.
20. The “blood cell factory” is red marrow of the bones. Yellow marrow replaces red
marrow as we age. The periosteum is a layer of connective tissue that covers compact
bone surfaces. The synovial joints contain cartilage lubricated by synovial fluid.
21. Some skeletal muscles steady joints, allowing other muscles to act. Not all skeletal
muscles make bones move. Muscle fibers are excitable, with high action potential. Not all
muscles are under voluntary control.
22. Repeated excessive stress can result in a stress fracture. Pathologic fractures result
from a weakness in the bone structure resulting from a condition such as tumors or
osteoporosis. A depressed fracture occurs in the skull when the broken piece is forced
inward on the brain. An open fracture refers to a fracture when the skin is broken.
23. Bone tumors rarely occur as primary tumors. The overall 5-year survival rate is
approximately 68%. The majority are malignant.
24. A lateral deviation of the spine is known as scoliosis. Lordosis refers to an
exaggerated concave shape of the lumbar spine. Kyphosis refers to an increase in the
curvature of the thoracic spine outward. Gout is an inflammatory disease.
25. The smooth muscles are involuntary, which means that they work without conscious
control by the brain. Skeletal muscles are the most frequently occurring muscle type.
81
CHAPTER 13
QUESTIONS
_____ 1. The outermost layer of the skin is the
A. dermis.
B. epidermis.
C. hypodermis.
D. subcutaneous tissue.
_____ 2. Which of the following statements is true about acne vulgaris?
A. Acne vulgaris affects only adolescents.
B. Tea tree oil and brewer’s yeast should be avoided.
C. Acne vulgaris can affect people of any age.
D. A low level of humidity is a risk factor.
_____ 3. Direct exposure to an irritant or allergen-producing substance causes
A. urticaria.
B. contact dermatitis.
C. psoriasis.
D. cellulitis.
_____ 4. The highest prevalence rates for skin cancer are in
A. females.
B. Caucasians.
C. African Americans.
D. those with no family history of the disease.
_____ 5. Which of the following statements is true about birthmarks?
A. Birthmarks generally result from something the mother ate while pregnant.
B. They are typically related to trauma to the skin during childbirth.
C. Birthmarks result from maternal activities during pregnancy.
D. None of the above
_____ 6. Sweat is secreted through skin pores by
A. eccrine glands.
B. apocrine glands.
C. keratin.
D. melanin.
_____ 7. With a burn, it is a good idea to
A. blow on the burn.
B. apply ointment to a severe burn.
C. remove clothing stuck to the skin.
82
D. none of the above
_____ 8. In terms of frequency, skin cancer is the
A. most frequently occurring cancer.
B. rarest cancer.
C. second-most frequently occurring cancer.
D. fifth most common cancer.
_____ 9. First-degree burns affect the
A. epidermis and dermis.
B. epidermis only.
C. deeper tissues.
D. all of the above
_____ 10. A boil is also called
A. folliculitis.
B. impetigo.
C. a furuncle.
D. cellulitis.
_____ 11. An example of localized albinism is
A. Chédiak-Higashi syndrome.
B. tuberous sclerosis.
C. Waardenburg’s syndrome.
D. all of the above.
_____ 12. The death rate from necrotizing fasciitis is
A. 5%
B. 25%
C. 50%
D. 80%
_____ 13. Herpes simplex (HSV) type 1 is transmitted by contact with
A. a parasite.
B. a fungus.
C. infected saliva.
D. all of the above
_____ 14. Which statement is true about the most aggressive forms of skin cancer?
A. With early detection, they can be successfully treated.
B. They are uniformly fatal.
C. Cancerous growths are left in place.
D. None of the above.
_____ 15. A mite infestation causes
A. pediculosis.
83
B. tinea.
C. scabies.
D. ringworm.
_____ 16. Which of the following is NOT a potential complication of burns?
A. Hyperthemia
B. Sepsis
C. Shock
D. Hypovolemia
_____ 17. The integumentary system accounts for approximately what percentage of the
body’s weight?
A. 5%
B. 10%
C. 15%
D. 28%
_____ 18. Impetigo is
A. uncommon.
B. an infection of the hair follicles.
C. highly contagious.
D. typically caused by a streptococcal infection.
_____ 19. Birthmarks the color of coffee with milk are
A. port-wine stains.
B. café au lait spots.
C. hemangiomas.
D. macular stains.
_____ 20. Eating shellfish or nuts might trigger
A. contact dermatitis.
B. psoriasis.
C. tinea pedis.
D. urticaria.
_____ 21. Which of the following statements is true about acne?
A. Foods that increase blood sugar may play a role in acne.
B. Acne is caused by greasy foods.
C. Hard scrubbing with strong soaps improves acne.
D. None of the above
_____ 22. Skin tags are more common in
A. older people.
B. on the neck.
C. in people who are underweight.
D. both A and B, above
84
_____ 23. Rosacea is prevalent in
A. dark-skinned people.
B. men.
C. infants only.
D. women.
_____ 24. A protein that protects the skin from ultraviolet (UV) rays is
A. melanin.
B. lentigo.
C. keratin.
D. tinea.
_____ 25. Albinism often impairs
A. intellectual development.
B. vision.
C. both A and B, above
D. none of the above
ANSWER KEY
1. B
2. C
3. B
4. C
5. D
6. A
7. D
8. A
9. B
10. C
11. D
12. B
13. C
14. A
15. C
16. A
17. C
18. C
19. B
20. D
21. A
22. D
23. D
24. A
85
25. B
RATIONALES
1. The outermost layer of the skin is the epidermis. Moving inward from the epidermis
come the dermis and then the hypodermis or subcutaneous tissue.
2. Acne vulgaris can affect people of any age. Tea tree oil and brewer’s yeast are
sometimes used for treatment. A high level of humidity is a risk factor
3. Direct exposure to an irritant or allergen-producing substance causes contact
dermatitis. Urticaria is caused by a type I hypersensitivity reaction. The cause of psoriasis
is unknown, but may be an autoimmune reaction. Cellulitis is caused by infection.
4. The highest prevalence rates for skin cancer are in African Americans.
5. None of the statement about birthmarks is true. Birthmarks do not result from
something the mother ate or did while pregnant, and they are not related to trauma to the
skin during childbirth.
6. Sweat is secreted through skin pores by eccrine glands. Apocrine glands open into hair
follicles. Keratin is a protein that strengthens the skin. Melanin is a pigment that protects
the skin from UV rays.
7. It is not a good idea to blow on a burn, apply ointment to a severe burn, or remove
clothing stuck to burned skin.
8. In terms of frequency, skin cancer is the most frequently occurring cancer.
9. First-degree burns affect the epidermis only. Second-degree burns affect the epidermis
and dermis. Third-degree burns affect deeper tissues.
10. A boil is also called a furuncle. Folliculitis is an infection of the hair follicles.
Impetigo and cellulitis are skin infections.
11. Chédiak-Higashi syndrome, tuberous sclerosis, and Waardenburg’s syndrome are all
examples of localized albinism.
12. The death rate from necrotizing fasciitis is about 25%.
13. Herpes simplex (HSV) type 1 is transmitted by contact with infected saliva.
14. With early detection, the most aggressive forms of skin cancer can be successfully
treated. They are uniformly fatal. Cancerous growths are removed.
86
15. A mite infestation causes scabies. Pediculosis is caused by a lice infestation. Tinea is
a fungal infection; when it occurs on the body, it is called ringworm.
16. Hyperthermia is not a potential complication of burns. Sepsis, shock, and
hypovolemia are potential complications.
17. The integumentary system accounts for approximately 15% of the body’s weight.
18. Impetigo is highly contagious. It is common. It is not an infection of the hair follicles
(folliculitis is). Typically impetigo is caused by a staphyloccal, rather than streptococcal,
infection.
19. Birthmarks the color of coffee with milk are café au lait spots. Port-wine stains,
hemangiomas, and macular stains are types of vascular birthmarks.
20. Eating shellfish or nuts might trigger urticaria. Contact dermatitis is caused by direct
exposure to an irritant or allergen-producing substance. The cause of psoriasis is
unknown, but may be an autoimmune reaction. Tinea pedis (athlete’s foot) is a fungal
infection.
21. Foods that increase blood sugar may play a role in acne. Acne is not caused by greasy
foods. Hard scrubbing with strong soaps should be avoided.
22. Skin tags are more common in older people, and often occur on the neck. They also
often occur in people who are overweight.
23. Rosacea is prevalent in women.
24. A protein that protects the skin from ultraviolet (UV) rays is melanin. Lentigo refers
to age spots, or liver spots. Keratin is a protein that strengthens the skin. Tinea is a fungal
infection.
25. Albinism often impairs vision. It does not affect intellectual development.
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CHAPTER 14
QUESTIONS
_____ 1. Noxious stimuli to internal organs causes
A. visceral pain.
B. somatic pain.
C. referred pain.
D. neuropathic pain.
_____ 2. A gaze deviation of one eye is known as
A. retinal detachment.
B. cataract.
C. strabismus.
D. none of the above
_____ 3. In the ear, which structure vibrates when struck by sound waves?
A. Cochlea
B. Ossicles
C. Tympanic membrane
D. External auditory canal
_____ 4. Which of the following statements is true about pain?
A. Pain is a protective mechanism.
B. It is unaffected by affective or cognitive factors.
C. Pain is the most common reason people seek medical attention.
D. Both A and C, above
_____ 5. Age-related hearing loss is called
A. presbycusis.
B. anotia.
C. atresia.
D. congenital hearing loss.
_____ 6. Otitis media is an infection of the
A. organ of Corti.
B. outer ear.
C. middle ear.
D. inner ear.
_____ 7. The colored portion of the eye is called the
A. cornea.
B. iris.
C. pupil.
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D. retina.
_____ 8. Pain that exists after the removal of a body part is known as
A. neuropathic pain.
B. phantom pain.
C. somatic pain.
D. pain tolerance.
_____ 9. The leading cause of blindness is
A. secondary glaucoma.
B. open-angle glaucoma.
C. diabetic retinopathy.
D. closed-angle glaucoma.
_____ 10. Which of the following statements is true about the eye?
A. Each eye contains about 150 million cones.
B. Each eye contains approximately 400,000 cones and rods.
C. Each eye contains fewer than 6 million rods.
D. Each eye contains about 150 million rods.
_____ 11. When your ears pop while taking off in an airplane, this is a result of pressure
being released from the
A. eustachian tube.
B. cochlea.
C. auricle.
D. semicircular canal.
_____ 12. In what percentage of elderly persons are vision deficits severe enough to
impair driving ability?
A. 5%
B. 15% to 20%
C. 30%
D. 65% to 70%
_____ 13. Which statement is true about glaucoma?
A. Congenital glaucoma is the result of certain medications.
B. Closed-angle glaucoma is a medical emergency.
C. Closed-angle glaucoma is the most common type.
D. Open-angle glaucoma is a medical emergency.
_____ 14. With age, the senses tend to become
A. more acute.
B. less able to distinguish details.
C. less acute.
D. both B and C, above
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_____ 15. A function of the ear is
A. helping maintain balance.
B. detecting light touch.
C. detecting and processing sound.
D. both A and C, above
_____ 16. In the eye, images are focused on the retina by the
A. sclera.
B. optic nerve.
C. lens.
D. choroid.
_____ 17. Somatic pain is
A. the result of noxious stimuli to internal organs.
B. pain sensed at locations distant from the originating organ.
C. chronically progressing pain.
D. the result of noxious stimuli to the skin, joints, muscles, and tendons.
_____ 18. The dark opening in the center of the eye is the
A. sclera.
B. iris.
C. pupil.
D. retina.
_____ 19. Which statement is true about the sensory cancers?
A. Any sensory organ can develop cancer.
B. Cancer of the ear is common.
C. Many of the sensory organs do not develop cancer.
D. None of the above
_____ 20. Pacinian corpuscles are the receptors used for the sense of
A. light touch.
B. temperature.
C. pressure.
D. pain.
_____ 21. An underdeveloped, small auricle is referred to as
A. anotia.
B. atresia.
C. presbycusis.
D. microtia.
_____ 22. An acute condition of the eye is
A. retinal detachment.
B. amblyopia.
C. strabismus.
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D. cataract.
_____ 23. An abnormal bone growth in the middle ear is known as
A. otosclerosis.
B. Meniere’s disease.
C. otitis externa.
D. otitis media.
_____ 24. Hearing receptors, the hair cells, are contained in the
A. cochlear duct.
B. organ of Corti.
C. tympanic duct.
D. vestibular duct.
_____ 25. An inflammation of the cornea is
A. conjunctivitis.
B. keratitis.
C. glaucoma.
D. all of the above
ANSWER KEY
1. A
2. C
3. C
4. D
5. A
6. C
7. B
8. B
9. C
10. D
11. A
12. B
13. B
14. D
15. D
16. C
17. D
18. C
19. A
20. C
21. D
22. A
23. A
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24. B
25. B
RATIONALES
1. Noxious stimuli to internal organs causes visceral pain. Somatic pain results from
noxious stimuli to the skin, joints, muscles, and tendons. Referred pain is visceral pain
sensed on body surfaces at different locations. Neuropathic pain results from damage to
peripheral nerves by disease or injury.
2. A gaze deviation of one eye is known as strabismus. Retinal detachment occurs when
the retina separates from its supporting structures. A Cataract is opacity or clouding of
the lens of the eye.
3. In the ear, the tympanic membrane vibrates when struck by sound waves. The cochlea
converts fluid waves to nerve impulses. The ossicles transmit sound to the cochlea.
4. Pain is a protective mechanism, and is the most common reason people seek medical
attention. It is affected by affective and cognitive factors.
5. Age-related hearing loss is called presbycusis. Anotia refers to the absence of the
auricle. Atresia refers to the lack of an external ear canal. Congenital hearing loss can be
caused by maternal rubella or syphilis during pregnancy.
6. Otitis media is an infection of the middle ear.
7. The colored portion of the eye is called the iris. The cornea is the clear lens. The pupil
is the dark opening in the center of the iris. The retina is the innermost layer of the eye.
8. Pain that exists after the removal of a body part is known as phantom pain.
Neuropathic pain results from damage to peripheral nerves. Somatic pain results from
stimuli to the skin, joints, muscles, and tendons. Pain tolerance can result from unrelieved
pain.
9. Diabetic retinopathy is the leading cause of blindness, and glaucoma is second.
10. Each eye contains about 150 million rods. In contrast, each eye contains “only” about
6 million cones.
11. When your ears pop while taking off in an airplane, this is a result of pressure being
released from the eustachian tube.
12. Vision deficits are severe enough to impair driving ability in 15% to 20% of elderly
people.
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13. Closed-angle glaucoma is a medical emergency. Secondary glaucoma is the result of
certain medications. Open-angle glaucoma is the most common type.
14. With age, the senses tend to become less able to distinguish details and less acute.
15. A function of the ear is helping maintain balance and detecting and processing sound.
Detecting light touch is the responsibility of Meissner’s corpuscle, found just below the
epidermis.
16. In the eye, images are focused on the retina by the lens.
17. Somatic pain is the result of noxious stimuli to the skin, joints, muscles, and tendons.
Visceral pain is the result of noxious stimuli to internal organs. Referred pain is pain
sensed at locations distant from the originating organ. Chronically progressing pain is
intractable pain.
18. The dark opening in the center of the eye is the pupil. The sclera is the white area of
the outermost layer of the eye. The iris is the colored portion of the eye. The retina is the
innermost layer of the eye.
19. Any sensory organ can develop cancer. Cancer of the ear is uncommon.
20. Pacinian corpuscles are the receptors used for the sense of pressure. Light touch is
detected by Meissner’s corpuscles. Temperature and pain are detected by naked nerve
endings.
21. An underdeveloped, small auricle is referred to as microtia. Anotia is the absence of
the auricle. Atresia is the absence of an external ear canal. Presbycusis is age-related loss
of hearing.
22. An acute condition of the eye is retinal detachment. Amblyopia is the loss of one
eye’s ability to see details. Strabismus is gaze deviation of one eye. A cataract is opacity
or clouding of the lens of the eye.
23. An abnormal bone growth in the middle ear is known as otosclerosis. Meniere’s
disease is a disorder of the inner ear. Otitis externa (swimmer’s ear) is an infection or
inflammation of the external ear canal or auricle. Otitis media is an infection or
inflammation of the middle ear.
24. Hearing receptors, the hair cells, are contained in the organ of Corti.
25. An inflammation of the cornea is keratitis. Conjunctivitis is an infection or
inflammation of the lining of the eyelids and sclera. Glaucoma refers to a group of
conditions that lead to damage of the optic nerve.
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