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NSG5003 Advanced Pathophysiology
MIDTERM EXAM
1. Stress-age syndrome directly results in the depressed function of which system?
Respiratory
Endocrine
Digestive
Immune
Question 2. Which predominantly female valvular disorder is thought to have an autosomal dominant inheritance pattern and is thought to be associated with connective tissue disease?
Mitral valve prolapse
Tricuspid stenosis
Tricuspid valve prolapse
Aortic insufficiency
Question 3. Sitting up in a forward-leaning position generally relieves which breathing disorder?
Hyperpnea
Orthopnea
Apnea
Dyspnea on exertion
Question 4. Which intracardiac pressure is generated by atrial contraction?
A wave
C wave
Y descent
X descent
Question 5. Which T-lymphocyte phenotype is the key determinant of childhood asthma?
CD4 helper T 1 (Th1) lymphocytes
CD4 helper T 2 (Th2) lymphocytes
CD8 cytotoxic T (Tc) lymphocytes
Memory T lymphocytes
Question 6. Occlusion of the left anterior descending artery during a myocardial infarction (MI) would interrupt blood supply to which structures?
Left and right ventricles and much of the interventricular septum
Left atrium and the lateral wall of the left ventricle
Upper-right ventricle, right marginal branch, and right ventricle to the apex
Posterior interventricular sulcus and the smaller branches of both ventricles
Question 7. In regulating vascular mediators released from mast cells, the role of eosinophils is to release
Arylsulfatase B, which stimulates the formation of B lymphocytes
Histaminase, which limits the effects of histamine during acute inflammation
Lysosomal enzymes, which activate mast cell degranulation during acute inflammation
Immunoglobulin E (IgE), which defends the body against parasites
Question 8. Which statement is believed to be true concerning helper T 2 (Th2) cells?
Th2 cells are induced by antigens derived from allergens.
They are induced by antigens derived from cancer cells.
Th2 cells produce IL-2, tumor necrosis factor–beta (TNF-β), and Interferon-gamma (IFN-γ).
Th2 cells assist in the development of cell-mediated immunity.
Question 9. Which statement is true regarding ventilation?
Hypoventilation causes hypocapnia.
Hyperventilation causes hypercapnia.
Hyperventilation causes hypocapnia.
Hyperventilation results in an increased partial pressure of arterial carbon dioxide (PaCO2).
Question 10. Which cell has a role in developing cell-mediated immunity?
Helper T 1 (Th1)
CD4
CD8
Helper T 2 (Th2)
Question 11. Neurotransmitters affect the postsynaptic membrane by binding to:
Lipids
Ribosomes
Amphipathic lipids
Receptors
Question 12. Superior vena cava syndrome is a result of a progressive increase of which process?
Inflammation
Occlusion
Distention
Sclerosis
Question 13. Which criterion is used to confirm a diagnosis of asthma in an eight-year-old child?
Parental history of asthma
Serum testing that confirms increased immunoglobulin E (IgE) and eosinophil levels
Reduced expiratory flow rates confirmed by spirometry testing
Improvement on a trial of asthma medication
Question 14. Which compensatory mechanism is spontaneously used by children diagnosed with tetralogy of Fallot to relieve hypoxic spells?
They lie on their left sides.
They perform the Valsalva maneuver.
They squat.
They hyperventilate.
Question 15. Which mode of chemical signaling uses blood to transport communication to cells some distance away
Paracrine
Autocrine
Neurotransmitter
Hormonal
Question 16. When a mucous gland cell creates a new substance from previously absorbed material, this process is known as which specialized cellular function?
Excretion
Metabolic absorption
Reproduction
Secretion
Question 17. Which statement is true regarding hypoxemia?
Hypoxemia results in the increased oxygenation of arterial blood.
Respiratory alterations cause hypoxemia.
Hypoxemia results in the decreased oxygenation of tissue cells.
Various system changes cause hypoxemia.
Question 18. Which enzyme is secreted by the juxtaglomerular cells of the kidney when the circulating blood volume is reduced?
Angiotensin I
Angiotensin II
Aldosterone
Renin
Question 19. During cell injury caused by hypoxia, sodium and water move into the cell because:
Potassium moves out of the cell, and potassium and sodium are inversely related.
The pump that transports sodium out of the cell cannot function because of a decrease in adenosine triphosphate (ATP) levels.
The osmotic pressure is increased, which pulls additional sodium across the cell membrane.
Oxygen is not available to bind with sodium to maintain it outside of the cell.
Question 20. Passive transport is best described by which of the following statements?
It is driven by osmosis, hydrostatic pressure, and diffusion.
It involves receptors that can bind with substances being transported.
It refers to being capable of transporting macromolecules.
It requires energy generated by the cell.
Question 21. What causes the rapid change in the resting membrane potential to initiate an action potential?
Potassium gates open and potassium rushes into the cell, changing the membrane potential from negative to positive.
Sodium gates open and sodium rushes into the cell, changing the membrane potential from negative to positive.
Sodium gates close, allowing potassium into the cell to change the membrane potential from positive to negative.
Potassium gates close, allowing sodium into the cell to change the membrane potential from positive to negative.
Question 22. In a type III hypersensitivity reaction, the harmful effects after the immune complexes are deposited in tissues are a result of:
Cytotoxic T (Tc) cells
Natural killer (NK) cells
Complement activation
Degranulation of mast cells
Question 23. Blood transfusion reactions are an example of:
Autoimmunity
Alloimmunity
Homoimmunity
Hypersensitivity
Question 24. Which receptors are located in the smooth muscles of airways?
Central chemoreceptors
Stretch receptors
Peripheral chemoreceptors
J-receptors
Question 25. Which statement is true regarding maternal antibodies provided to the neonate?
The antibodies enter into the fetal circulation by means of active transport.
The antibodies are transferred to the fetus via the lymphatic system.
The antibodies are directly related to the mother’s nutritional intake.
The antibodies reach protective levels after approximately six months of age.
Question 26. Which characteristic is the most important determinant of immunogenicity when considering the antigen
Size
Foreignness
Complexity
Quantity
Question 27. The abnormal proliferation of cells in response to excessive hormonal stimulation is called:
Dysplasia
Pathologic dysplasia
Hyperplasia
Pathologic hyperplasia
Question 28. Which statement about exotoxins is true?
Exotoxins are contained in cell walls of gram-negative bacteria.
Exotoxins are released during the lysis of bacteria.
Exotoxins are able to initiate the complement and coagulation cascades.
Exotoxins are released during bacterial growth.
Question 29. What is the first stage in the infectious process?
Invasion
Colonization
Spread
Multiplication
Question 30. Chvostek and Trousseau signs indicate which electrolyte imbalance?
Hypokalemia
Hyperkalemia
Hypocalcemia
Hypercalcemia
Question 31. Understanding the various steps of proteolytic cascades, such as caspase-mediated apoptosis and complement cascades, may be useful in designing drug therapy for which human diseases?
Cardiac and vascular disorders
Autoimmune and malignant disorders
Gastrointestinal and renal disorders
Endocrine and gastrointestinal disorders
Question 32. Vaccinations are able to provide protection against certain microorganisms because of the:
Strong response from IgM
Level of protection provided by immunoglobulin G (IgG)
Memory cells for immunoglobulin E (IgE)
Rapid response from immunoglobulin A (IgA)
Question 33. The fluid mosaic model explains:
How a cell membrane functions
Why our bodies appear to be solid
How tissue is differentiated
How fluid moves between the intracellular and extracellular compartments
Question 34. During which phase of the cell cycle is deoxyribonucleic acid (DNA) synthesized?
G1
S
G2
M
Question 35. A person with type O blood is considered to be a universal blood donor because type O blood contains
No antigens
No antibodies
Both A and B antigens
Both A and B antibodies
Question 36. Which option shows the correct sequence of events after atelectasis develops in respiratory distress syndrome (RDS) of the newborn?
Increased pulmonary vascular resistance, atelectasis, and hypoperfusion
Hypoxic vasoconstriction and right-to-left shunt hypoperfusion
Respiratory acidosis, hypoxemia, and hypercapnia
Right-to-left shunt, hypoxic vasoconstriction, and hypoperfusion
Question 37. Most cardiovascular developments occur between which weeks of gestation?
Fourth and seventh weeks
Eighth and tenth weeks
Twelfth and fourteenth weeks
Fifteenth and seventeenth weeks
Question 38. Which component of the plasma protein system tags pathogenic microorganisms for destruction by neutrophils and macrophages?
Complement cascade
Coagulation system
Kinin system
Immune system
Question 39. Carbon monoxide causes tissue damage by:
Competing with carbon dioxide so that it cannot be excreted
Binding to hemoglobin so that it cannot carry oxygen
Destroying the chemical bonds of hemoglobin so it cannot carry oxygen
Removing iron from hemoglobin so it cannot carry oxygen
Question 40. What is the role of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in cell metastasis?
To stimulate growth of nearby tumor cells
To develop new blood vessels to feed cancer cells
To prevent cancer cells from escaping apoptosis
To act as a chemical gradient to guide cells to blood vessels
