Nurs 212a - Pathophys (Pp) - Chapter 2: Cell Response To Stress, Injury, & Aging

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Nurs 212a - Pathophys (Pp) - Chapter 2: Cell Response To Stress, Injury, & Aging

From the textbook Essentials of Pathophysiology by Carol Porth. Second edition. ISBN-13: 978-0-7817-7087-3 ISBN-10: 0-7817-7087-4


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Questions and Answers
  • 1. 
    There are numerous molecular mechanisms mediating cellular adaptation. These mechanisms depend largely on signals transmitted by chemical messengers that exert their effects by altering gene function. At the cellular levels, which genes are generally affected by said mechanisms?
    • A. 

      "Housekeeping" genes

    • B. 

      Genes that are necessary for the normal function of a cell

    • C. 

      Genes that determine the differentiating characteristics of a particular cell type

    • D. 

      Genes that change size and form

    • E. 

      All of the above

  • 2. 
    True or False:Once the cell differentiating genes have been exposed to the alterating mechanisms (and undergone adaptation cellular responses that alters the differentiating genes) it cannot be reversed.
    • A. 

      True

    • B. 

      False

  • 3. 
     True or False: Cellular atrophy also called organ atrophy
    • A. 

      True

    • B. 

      False

  • 4. 
    Hypertrophy
    • A. 

      Represents a decrease in cell size

    • B. 

      Represents a decrease in the cell size as well as a decrease in the amount of functioning tissue mass

    • C. 

      Represents an increase in cell cell

    • D. 

      Represents an increase in cell size as well as an increase in the amount of functioning tissue mass

    • E. 

      Is consistent evidence of abnormal pathologic conditions

  • 5. 
    Which tissue is hypertrophy most commonly seen in?
    • A. 

      Cardiac

    • B. 

      Lymphatic

    • C. 

      Skeletal muscle

    • D. 

      A and B

    • E. 

      A and C

  • 6. 
    Stewie Griffin begins a workout regimen and subsequently experiences an increase in muscle size, this is:
    • A. 

      Tissue Atrophy

    • B. 

      Physiologic hyperplasia

    • C. 

      Pathologic metaplasia

    • D. 

      Pathologic dysplasia

    • E. 

      Physiologic hypertrophy

  • 7. 
    True or False:Hypertension can lead to compensatory hypertrophy.
    • A. 

      True

    • B. 

      False

  • 8. 
    True or False:There is a limit for hypertrophy.
    • A. 

      True

    • B. 

      False

  • 9. 
    • A. 

      Refers to an increase in the size of cells in an organ or tissue

    • B. 

      Occurs in nerve cells, skeletal muscle cells, and cardiac muscle cells

    • C. 

      Occurs in response to an appropriate stimulus and is unable to be controlled or stopped

    • D. 

      Occurs in tissues with cells that are capable of mitotic division

    • E. 

      All of the above

  • 10. 
    • A. 

      It is irreversible

    • B. 

      When one adult cell type (epithelial or mesenchymal) is replaced by another cell time but never oversteps the boundaries of the primary groups of tissue

    • C. 

      Is usually a response to chronic irritation and inflammation

    • D. 

      Allows cells that are better able to survive under circumstances in which a more fragile cell type might succumb.

    • E. 

      Is thought to involve the reprogramming of undifferentiated stem cells that are present in the tissue undergoing the metaplastic changes

  • 11. 
    Which of the following is not true of dysplasia
    • A. 

      Is a cancer

    • B. 

      Is cells that vary in size, shape, and appearance

    • C. 

      Involves sequential mutations in proliferating cells

    • D. 

      In many cases, reverts to former form and function

    • E. 

      None of the above

  • 12. 
    Which of the following is not true of intracellular accumulation of glycogen?
    • A. 

      It involves enzymes

    • B. 

      Can be a genetic disorder

    • C. 

      Most common form is von Gierke disease

    • D. 

      When an enzyme is not present to break down glycogen into glucose, glycogen accumulates

    • E. 

      None of the above

  • 13. 
    Which of the following is not true about intracellular accumulation of abnormal proteins?
    • A. 

      Defects in protein folds can lead to loss of cell function

    • B. 

      Can result in neurodegerative disorders, including Alzheimer disease and Parkinson disease

    • C. 

      Aggregations of abnormally folded proteins can be a result of genetic mutations, aging, or unknown environmental insults

    • D. 

      The deviant protein structure sole cause is from an inherited mutation that alters a normal amino acid sequence

    • E. 

      Consequences of misfolded proteins include extracellular deposition of aggregated proteins, retention of secretory proteins, or formation of toxic proteins that accumulate in the cell

  • 14. 
    Which is true about Icterus?
    • A. 

      Is an yellow-brown pigment

    • B. 

      Results from insoluble pigments introduced into the skin

    • C. 

      It is an exogenous pigments

    • D. 

      Involves carbon

    • E. 

      None of above

  • 15. 
    Which of the following is not an intracellular accumulation of a pigment?
    • A. 

      Tattoos

    • B. 

      Lipofuscin

    • C. 

      Carbon

    • D. 

      Lead poisoning

    • E. 

      None of the above

  • 16. 
    Which is not true about pathologic calcification?
    • A. 

      Is known as dystrophic calcification when it occurs in normal tissue

    • B. 

      Involves the abnormal tissue deposition of primarily magnesium salts, with smaller amounts of iron and other minerals

    • C. 

      Is known as metastatic calcification when it occurs in dead or dying tissue

    • D. 

      All of the above are false

    • E. 

      None of the above are false

  • 17. 
    Cellular swelling
    • A. 

      Is a form of reversible cell injury

    • B. 

      Occurs with impairment of cellular volume regulation

    • C. 

      Resulting in impaired functioning of sodium/potassium ATPase membrane pump

    • D. 

      Involves disruption of cell membrane permeability, thus allowing passive entry of sodium into the cell

    • E. 

      All of the above

  • 18. 
    Fatty changes
    • A. 

      In obese people, the organs most affected with fatty changes are in the spleen and the digestive tract

    • B. 

      Small vacuoles of fat are dispersed in the nucleus

    • C. 

      Formation of of blebs on the plasma membrane

    • D. 

      All of the above

    • E. 

      None of the above

  • 19. 
    Which of the following is not a general cause of cell atrophy
    • A. 

      Reduced functional demand

    • B. 

      Loss of trophic stimuli

    • C. 

      Aging

    • D. 

      Persistent cell injury

    • E. 

      None of the above

  • 20. 
    Trophic signals
    • A. 

      Are produced exclusively from the nervous system

    • B. 

      Denervation atrophy is from a loss of central nervous system stimuli

    • C. 

      Lack of endocrine stimulation produces a form of disuse atrophy

    • D. 

      A and B

    • E. 

      B and C

  • 21. 
    • A. 

      Cells

    • B. 

      Muscle tissue

    • C. 

      Endocrine tissue

    • D. 

      Liver tissue

    • E. 

      Dermal tissue

  • 22. 
    True or False:Lois Griffin has suffered broken legs related to an injury induced by her son, Stewie Griffin. Her legs have been encased in plaster casts. Consequently, she has suffered permanent disuse atrophy to the muscles encased in the cast. Now her mission is to obtain Joe’s wheelchair and to seek revenge on Stewie
    • A. 

      True

    • B. 

      False

  • 23. 
    Atrophy from persistent cell injury is
    • A. 

      Most often caused by chronic inflammation usually from prolonged viral or bacterial infections

    • B. 

      Also known as disuse atrophy

    • C. 

      Most often caused by chronic inflammation that can be from immunologic and granulomatous disorders

    • D. 

      A and B

    • E. 

      A and C

  • 24. 
    As individuals age (we’re talking very old),
    • A. 

      Most organs of the body, especially the brain and heart, decrease in size

    • B. 

      Most organs of the body, except the brain and heart, decrease in size

    • C. 

      Most organs of the body, especially the brain and heart, experience atrophy

    • D. 

      A and B

    • E. 

      A and C

  • 25. 
    • A. 

      Causes the cell to revert to anaerobic metabolism

    • B. 

      Causes power failure

    • C. 

      Includes ischemia

    • D. 

      Causes cellular pH to raise, becoming more basic

    • E. 

      Causes cell damage

  • 26. 
    Which of the following is untrue about the physical agents which cause cell injury?
    • A. 

      In regards to electrical damage, the greater the skin resistance, the the less amount of local skin burn, and the less the resistance, the greater is the deep and systemic effects

    • B. 

      Biologic agents include viruses and bacteria

    • C. 

      Mechanical forces occur when the body impacts with another object, which can split and tear tissue, injury blood vessels, and disrupt blood flow

    • D. 

      Low intensity heat causes cell injury by inducing vascular injury, accelerating cell metabolism, inactivating temperature-sensitive enzymes, and disrupting the cell membrane

    • E. 

      Extreme cold increases blood viscosity and induces vasconstriction, may cause hypoxic tissue injury, and if freezing, can cause ice crystal formation and vasoconstriction.

  • 27. 
    • A. 

      Lead poisoning is considered a biologic agent

    • B. 

      It has the ability to compete with calcium for incorporation into bones

    • C. 

      Manifestations of lead toxicity include anemia

    • D. 

      Lead crosses the umbilical cord

    • E. 

      All are true

  • 28. 
    Which of the following statements is not true?
    • A. 

      APT depletion is an effect of injurious agents

    • B. 

      APT depletion is associated with hypoxia and chemical (toxic) cell injury

    • C. 

      Earliest effects of ATP depletion is acute cellular swelling

    • D. 

      The ischemia that occurs is painful and irreversible

    • E. 

      When ATP depletion occurs, injury to the lysosomal membranes results in leakage of destructive lysosomal enzymes into the cell; this can be measured with lab tests

  • 29. 
    • A. 

      Arises from an atom that has a two unpaired electrons

    • B. 

      Free radicals are foreign to the body

    • C. 

      Free radicals can be best controlled if blood flow has been interrupted

    • D. 

      Defenses include Vitamin K, Vitamin D, and Vitamin B

    • E. 

      All of the above

  • 30. 
    • A. 

      Calcium functions as a messenger

    • B. 

      Ischemia and certai toxins lead to an increase in cytosolic calicum

    • C. 

      Intracellular calcium is kept at a higher concentration than extracellular calcium

    • D. 

      Impaired calcium homeostasis activates enzymes including: phospholipases, proteases, ATPases, and endonucleases

    • E. 

      None of the above

  • 31. 
    Apoptosis is:
    • A. 

      A form of cellular build up

    • B. 

      Equated with cell vitality

    • C. 

      Is initiated by mitochondrial or extrinsic pathways

    • D. 

      Can be divided into wet or dry apoptosis

    • E. 

      Is an abnormal process

  • 32. 
    Which is true about liquefaction necrosis?
    • A. 

      Acidosis develops and denatures the enzymatic and strucutral proteins in a cell

    • B. 

      Has a soft, cheeselike center

    • C. 

      Related to the immune system

    • D. 

      The cell dies but the catalytic enzymes are not destroyed

    • E. 

      All of the above

  • 33. 
    Which is true about coagulation necrosis?
    • A. 

      Acidosis develops and denatures the enzymatic and structural proteins in the cell

    • B. 

      I.e. tissue death

    • C. 

      Associated with tubercular lesions

    • D. 

      Resulting form immune mechanisms

    • E. 

      All of the above

  • 34. 
    Which is true about infarction necrosis?
    • A. 

      Artery supplying an organ of the body becomes occulded

    • B. 

      No supply of blood

    • C. 

      I.e. tissue death

    • D. 

      Artery supplying a tissue of the body becomes occulded

    • E. 

      All of the above

  • 35. 
    Which of the following is true about caseous necrosis?
    • A. 

      Has a soft, cheeselike center

    • B. 

      Associated with tubercular lesions

    • C. 

      Ultimately resulting from immune mechanisms

    • D. 

      All of the above

  • 36. 
    Which of the following is dry gangrene?
    • A. 

      Lack of arterial blood supply

    • B. 

      Present venous flow

    • C. 

      Tissue coagulation

    • D. 

      A and B

    • E. 

      All of the above

  • 37. 
    Which of the following is wet gangrene?
    • A. 

      Lack of venous flow leading to accumulation in tissue

    • B. 

      High chance of infection

    • C. 

      Resulting from Clostridium infection

    • D. 

      A and B

    • E. 

      All of the above

  • 38. 
    Which of the following is gas gangrene?
    • A. 

      Toxins and H2S bubbles present

    • B. 

      Lack of venous flow allows fluid to accumulate in tissue

    • C. 

      Tissue tends to coagulate

    • D. 

      A and B

    • E. 

      All of the above