Patho Exam 2

Which cytokine will act on Mast cells to cause degranulation and local inflammation? TNF-alpha IL1 IL12 IL6

IL1

All the following stress-induced hormones increase blood glucose except a. aldosterone. b. cortisol. c. norepinephrine. d. epinephrine.

ANS: A Aldosterone results in water and sodium retention and potassium loss in the urine. It does not affect blood glucose. Cortisol is a glucocorticoid secreted by the adrenal cortex. Cortisol stimulates gluconeogenesis in the liver, thus increasing blood glucose. Norepinephrine inhibits insulin secretion, thus increasing blood sugar. Epinephrine increases glucose release from the liver and inhibits insulin secretion, thus increasing blood glucose.

Selye's three phases of the stress response include all the following except a. allostasis. b. resistance. c. alarm. d. exhaustion.

ANS: A Allostasis is defined as the ability to successfully adapt to challenges. Allostasis may/may not occur in response to stress. Alarm, resistance, and exhaustion are the three phases of the stress response as described by Selye in the general adaptation syndrome

An increase in intracellular calcium ion results in myocardial contraction, because calcium a. activates membrane calcium pumps. b. binds troponin, causing actin-binding sites to be exposed. c. increases affinity of myosin for actin cross-bridge sites. d. promotes ATP synthesis

ANS: B Each troponin is composed of three subunits called troponins T, I, and C. Troponin T binds to tropomyosin, troponin I participates in the inhibitory actions of tropomyosin, and troponin C binds up to four molecules of Ca2+. Intracellular calcium ions do not activate membrane calcium pumps in myocardial contraction. Calcium ions do not increase the affinity of myosin for actin cross-bridge sites. Myosin cleaves to ATP to release energy for muscle contraction

Persistence of the alarm stage will ultimately result in a. stress reduction. b. permanent damage and death. c. movement into the resistance stage. d. exhaustion of the sympathetic nervous system.

ANS: B If the alarm stage were to persist, the body would soon suffer undue wear and tear and become subject to permanent damage and even death. Actions taken by the individual during the resistance stage lead to stress reduction. The resistance stage may or may not occur following the alarm stage, based on resource availability. The sympathetic nervous system will continue to function, resulting in continued release of stress hormones.

Peripheral edema is a result of a. arterial insufficiency. b. venous thrombosis. c. hypertension. d. atherosclerosis.

ANS: B In the venous system, thrombosis alters venous return, impairing removal of metabolic wastes and producing edema. In arterial obstruction, distal flow results in ischemia. Hypertension does not cause peripheral edema. Atherosclerosis is not directly associated with peripheral edema.

The most reliable indicator that a person is experiencing an acute myocardial infarction (MI) is a. severe, crushing chest pain. b. ST-segment elevation. c. dysrhythmias. d. pain radiating to the lower legs.

ANS: B Injuries to cardiac tissue caused by myocardial ischemia and infarction are indicated on the ECG by ST-segment changes. ST-segment elevation on the ECG indicates that ischemic injury is ongoing and that efforts to improve perfusion or reduce oxygen demand may be effective in preserving myocardial muscle. In some instances, an MI is entirely asymptomatic. Dysrhythmias that accompany MI are attributed to injured and ischemic cells that have not yet become necrotic. Pain radiating to the jaw and neck, not the lower legs, is symptomatic of an MI

Corticosteroids are powerful anti-inflammatory drugs. They act by what mechanism to block inflammation? Blocking Mast cell degranulation Blocking the synthesis of arachidonic acid Blocking Macrophage activation Blocking Neutrophil migration

Blocking the synthesis of arachidonic acid

Which plasma protein system is part of the innate immune system, can be activated by the adaptive immune system, and is capable of directly killing pathogenic bacteria? Complement System Clotting System Kinin System None of these

Complement System

On which cells would you expect to find MHCII proteins? Neutrophils Basophils Dendritic cells CD4 T cells

Dendritic cells

All white blood cells are derived from the pluripotent hematopoietic stem cells found in red bone marrow. This pluripotent cell will form two major cells lines: the myeloid and lymphoid progenitor cell lines. Which of these cells lines will give rise to all the cells of our adaptive immune system? Lymphoid Myeloi

Lymphoid

Which leukocyte is responsible for managing the duration of an inflammatory response and triggering the switch to a reparative/healing response? Macrophages Mast cells CD4 T cells Neutrophils

Macrophages

Which immune cells is the first cell to migrate to an area of active acute inflammation? Mast cells Macrophages Neutrophils Basophils

Neutrophils

What is an antigen? A protein produced by B lymphocytes A surface marker that identifies a cell of microorganism A nucleic acid that forms the envelope of viruses A lipid structure found on the surface of bacterial cells

A surface marker that identifies a cell of microorganism

Selye's three phases of the stress response include all the following except a. allostasis. b. resistance. c. alarm. d. exhaustion

ANS: A Allostasis is defined as the ability to successfully adapt to challenges. Allostasis may/may not occur in response to stress. Alarm, resistance, and exhaustion are the three phases of the stress response as described by Selye in the general adaptation syndrome

An erroneously low blood pressure measurement may be caused by a. positioning the arm above the heart level. b. using a cuff that is too small. c. positioning the arm at heart level. d. measuring blood pressure after exercise

ANS: A An erroneous blood pressure result could occur with the arm above the level of the heart. It is important to measure blood pressure with the appropriate size cuff. The arm should be positioned at the level of the heart for a more accurate reading. Measuring pressure after exercise yields a higher measurement.

Antigen-presenting cells function to a. display foreign antigen on their cell surfaces bound to MHC. b. stimulate cytokine production by macrophages. c. phagocytose and degrade foreign antigens. d. initiate the complement cascade by way of the alternative pathway.

ANS: A Antigen-presenting cells function to display foreign antigen on their cell surfaces bound to MHC for T-cell recognition. Antigen-presenting cells do not stimulate cytokine production or initiate the complement cascade. They also do not phagocytose and degrade foreign antigens, but instead present these to T cells for these functions.

At very high heart rates, cardiac output a. decreases. b. increases. c. stays the same. d. reverses.

ANS: A At very high heart rates, cardiac output falls. At high heart rates (not very high heart rates), cardiac output increases. Cardiac output does not stay the same in the presence of very high heart rates. Cardiac output does not reverse in the presence of very high heart rates

Functions of B cells include a. synthesizing antibodies. b. secreting cytokines. c. killing antigen-presenting cells. d. stimulating B cells. e. killing virally infected cells.

ANS: A B lymphocytes mature into plasma cells and synthesize antibodies. B cells do not secrete cytokines, kill antigen-presenting cells, or kill virally infected cells; T cells do these.

Which clinical finding is most indicative of an acute bacterial infection? a. Increased (band) neutrophils b. Elevated temperature c. Elevated erythrocyte sedimentation rate d. Elevated WBC count

ANS: A Neutrophils are early responders and most active in bacterial infections, and the number of neutrophil bands indicates the severity of the infection. Elevated temperature can occur in infection caused by any organism. The erythrocyte sedimentation rate is non-specific for the type of organism causing an infection. The total WBC count can increase in any infection. The specific type of WBC that is elevated indicates the type of organism involved.

Many of the responses to stress are attributed to activation of the sympathetic nervous system and are mediated by a. norepinephrine. b. cortisol. c. glucagon. d. ACTH.

ANS: A Norepinephrine is secreted in response to activation of the sympathetic nervous system during stress by the adrenal medulla. Cortisol is secreted by the adrenal cortex. Glucagon is secreted by the pancreas. ACTH is secreted by the pituitary gland.

Which is a true statement about the affect of the Frank-Starling law on the heart? a. Increased diastolic stretching of myocardial fibers produces increased stroke volume. b. Sympathetic activation leads to increased myocardial contractility and heart rate. c. An increase in heart chamber diameter increases myocardial wall tension. d. An increase in coronary artery diameter results in less rapid coronary blood flow

ANS: A The Frank-Starling law states that an increase in resting muscle fiber length results in a greater development of muscle tension that produces increased stroke volume. An increase in preload result in a greater force of contraction according to the Frank-Starling law. The Frank-Starling law does not state that an increase in heart chamber diameter will increase myocardial wall tension. According to the Frank-Starling law, increasing the coronary artery diameter does not create a decrease in coronary blood flow

Which finding is indicative of orthostatic hypotension in a person with a supine blood pressure (BP) of 110/70 and a heart rate (HR) of 100? a. Sitting BP 88/60, HR 118 b. Sitting BP 108/68, HR 102 c. Sitting BP 110/78, HR 98 d. Sitting BP 120/80, HR 100

ANS: A The definition of orthostatic hypotension is a decrease in systolic blood pressure greater than 20 mm Hg or a decrease in systolic pressure that is greater than 10 mm Hg within 3 minutes of moving to an upright position. The measurements of BP 108/68, HR 102 and BP 110/78, HR 98 are not indicative of orthostatic hypotension. An increase in blood pressure do not occur with orthostatic hypotension.

During which phase of the cardiac cycle is the mitral valve normally open? a. Atrial systole b. Isovolumic contraction c. Isovolumic relaxation d. Ventricular ejection

ANS: A The mitral valve is open during the period of ventricular contraction, which is the period of systole. Isovolumic contraction is a period immediately following atrial systole. The isovolumic relaxation phase begins with semilunar valve closure in response to falling ventricular pressures and ends when the AV valves open to allow ventricular filling. Ventricular contraction results in a rapid rise in ventricular pressure. As ventricular pressure exceeds aortic pressure (or pulmonic), the valve is forced open and a period of rapid ejection of blood from the ventricle follows.

The primary function of eosinophils is to a. kill parasitic helminths (worms). b. kill bacteria. c. stop viral replication. d. phagocytize fungi

ANS: A The primary function of eosinophils is to kill parasitic helminths (worms); this is evident by the elevation in eosinophil level in parasitic infections. Neutrophils, not eosinophils, function to kill bacteria. Eosinophils have no role in stopping viral replication. The primary role of eosinophils does not involve phagocytizing fungi.

The relationship of blood flow (Q), resistance (R), and pressure (P) in a vessel can be expressed by which equation? a. Q = P/R b. Q = R/P c. R = PQ d. P = Q/R

ANS: A The relationship between the variables of pressure and resistance is expressed by Ohm's law: Q = P/R. Q is the blood flow, P is the pressure difference, and R is the resistance. Ohm's law is Q = P/R. R = PQ is not the expression for the relationship between blood flow, resistance, and pressure. P = Q/R is not the correct expression reflecting Ohm's law.

The v wave of an atrial pressure tracing corresponds to a. atrial filling. b. ventricular systole. c. atrial systole. d. mitral valve closure

ANS: A The v wave of atrial pressure corresponds to atrial filling. The c wave corresponds to the AV valve bulging during ventricular contraction. The a wave corresponds to atrial contraction. Mitral valve closure is not a measurement in atrial pressure tracing

Parasympathetic stimulation of the heart generally leads to a decrease in heart rate, because acetylcholine a. increases intracellular cAMP levels and opens calcium channels. b. opens potassium channels allowing potassium ion efflux. c. binds and blocks receptors on the cell membrane. d. inhibits voltage-gated sodium channels in the membrane

ANS: B Acetylcholine is the neurotransmitter released by parasympathetic nerve endings. Acetylcholine binding to muscarinic receptors on heart cells inhibits cAMP production, and increases membrane permeability to potassium ions allowing them to leak from the cell. Intracellular cAMP levels are decreased while potassium is allowed into the cell. B Receptors on heart muscle cell membranes increase the production of cAMP. Autonomic neurotransmitters inhibit voltage-gated sodium from entering the membrane.

Angiotensin-converting enzyme (ACE) inhibitors block the a. release of rennin. b. conversion of angiotensin I to angiotensin II. c. conversion of angiotensinogen to angiotensin I. d. effect of aldosterone on the kidney

ANS: B Angiotensin I is converted into angiotensin II while it is circulating through the pulmonary vessels, by the angiotensin-converting enzyme. ACE inhibitors block the conversion of angiotension I to angiotension II. Renin plays a role in the regulation of arterial blood pressure. ACE inhibitors do not block the conversion of angiotensinogen to angiotensin or the effect of aldosterone on the kidney.

Clinical manifestations of chronic arterial obstruction include a. edema. b. intermittent claudication. c. decreased pressure proximal to the obstruction. d. distal hyperemia

ANS: B Arterial thrombosis is usually manifested by intermittent claudication (pain with activity) in the affected limb that improves with rest. Venous obstructions are manifested by edema. Ischemia can occur distal to the point of the occlusion. An increase in blood flow causes hyperemia, which is located in the area proximal to the obstruction.

Blood flow throughout the periphery is regulated by a. cardiac output. b. the autonomic nervous system. c. velocity. d. hemodynamics.

ANS: B Blood flow throughout the periphery is controlled by central mechanisms that are mediated by the autonomic nervous system, the venous and thoracic pumps, and intrinsic autoregulatory mechanisms. Cardiac output does not control peripheral blood flow. Velocity is the measure of distance traveled in a given interval. Hemodynamics is the principle that governs the quantity of blood passing by a given point at a certain period.

Myocardial cells are connected by gap junctions enabling them to a. all be stimulated simultaneously. b. function as a coordinated syncytium. c. be affected by the autonomic nervous system. d. share ATP.

ANS: B Cardiac cells are joined together by gap junctions, which allow the rapid passage of electrical impulses from one cell to the next. This functional syncytium is what allows the separate cells of the myocardium to work in a coordinated manner. The gap junctions allow the myocardial cells to work in a coordinated manner. Myocardial cells are not affected by the autonomic nervous system. ATP is a necessary requirement of the contractile elements and ion pumps

Drug resistance of microbes occurs secondary to a. patient allergy to a drug. b. mutation of the microbe. c. enhance pathogenicity of the microbe. d. using high doses of drugs.

ANS: B Drug resistance develops secondary to chance mutations of microbes in response to a change in the host's environment. Patient allergy to a drug does not cause drug resistance. Although drug resistance may lead to enhanced pathogenicity of a microbe, pathogenicity does not lead to drug resistance. Using low doses of a drug to treat infection leads to drug resistance

Risk factors for atherosclerosis include a. female gender. b. hyperlipidemia. c. high-protein diet. d. low-fiber diet

ANS: B Hyperlipidemia is a modifiable risk factor associated with atherosclerosis. Men have a higher incidence of atherosclerosis earlier in life than women. A high-protein diet is not associated with atherosclerosis. Dietary fats do play a role as a modifiable risk factor. A low-fiber diet is not a risk factor for atherosclerosis

Which condition enhances lymphatic flow? a. Increased tissue hydrostatic pressure b. Increased interstitial fluid colloid osmotic pressure c. Decreased capillary hydrostatic pressure d. Increased capillary oncotic pressure

ANS: B Lymphatic flow is controlled by increasing interstitial fluid colloid osmotic pressure and by the stimulation of the contractile fibers (often called lymphatic pumps) as they are stretched. Increasing interstitial fluid colloid osmotic pressure enhances lymphatic flow. Lymphatic flow is not enhanced by decreased capillary hydrostatic pressure. Lymphatic flow is controlled by increases in osmotic pressure, not oncotic pressure.

When systemic vascular resistance is decreased, blood flow a. increases. b. decreases. c. stays the same. d. moves to the extremities.

ANS: B NURSINGTB.COM Pathophysiology 6th Edition Banasik Test Bank NURSINGTB.COM When SVR is pathologically decreased, the blood is spread over a larger area and blood flow slows dramatically. Individual organs, such as the kidney and brain, may not obtain sufficient blood flow to meet metabolic needs. Blood flow decreases in response to decreases in vascular resistance. When SVR is pathologically decreased, the blood is spread over a larger area and blood flow slows dramatically. Individual organs, such as the kidney and brain, may not obtain sufficient blood flow to meet metabolic needs. Blood flow is not diverted to the extremities when systemic vascular resistance is decreased. However, the vital organs may not have sufficient blood flow to maintain metabolic needs.

Immunity to a specific organism can be determined by a. active phase protein count. b. antibody titer. c. erythrocyte sedimentation rate. d. WBC count.

ANS: B Specific serum antibody concentration for a particular organism can be measured by a blood antibody titer. Active phase protein count indicates level of inflammation. Erythrocyte sedimentation rate indicates degree of inflammation. WBC count helps determine if infection with any organism is present.

A vessel that normally contains desaturated (venous) blood is the a. bronchial artery. b. pulmonary artery. c. pulmonary vein. d. coronary artery

ANS: B The right side of the heart receives deoxygenated blood from the systemic circulation and pumps it through the lungs by way of the pulmonary artery. The bronchial artery is not involved in venous blood flow. The pulmonary vein carries oxygenated blood. Blood supply to the heart is provided by coronary arteries

A vessel that normally contains desaturated (venous) blood is the a. bronchial artery. b. pulmonary artery. c. pulmonary vein. d. coronary artery.

ANS: B The right side of the heart receives deoxygenated blood from the systemic circulation and pumps it through the lungs by way of the pulmonary artery. The bronchial artery is not involved in venous blood flow. The pulmonary vein carries oxygenated blood. Blood supply to the heart is provided by coronary arteries

Activation of the complement cascade results in (Select all that apply.) a. antibody production. b. inflammation. c. immunosuppression. d. autoimmunity. e. chemotaxis.

ANS: B, E Activation of the complement cascade result is enhanced inflammation and chemotaxis. The complement cascade does not result in antibody production or autoimmunity. It also does not result in immunosuppression; it enhances immune function.

One role of ATP in cardiac muscle contraction is a. providing energy to pump calcium into the cell. b. inducing a conformational change in tropomyosin. c. altering myosin affinity for actin-binding sites. d. releasing sequestered calcium from the sarcoplasmic reticulum.

ANS: C ATP hydrolysis provides energy for contraction and affects the capability of myosin to bind actin. ATP does not provide energy to pump calcium into the cell. Tropomyosin is not changed by the addition of ATP. ATP does not release calcium during the cardiac musclecontraction.

Blood is transported from the right ventricle to the lungs by the a. pulmonary veins. b. aorta. c. pulmonary artery. d. bronchial arteries

ANS: C Deoxygenated blood is received from the right side of the heart and pumps it through the lungs by way of the pulmonary artery. Blood is delivered to the left atrium by the pulmonary veins. The aorta supplies the arteries of the systemic circulation. Blood is not transported to the lungs by way of the bronchial arteries

While caring for a geriatric patient, the changes in the heart that may be expected include a. increased oxygen consumption. b. increased coronary artery blood flow. c. decreased response to an elevated heart rate. d. cardiomyopathy.

ANS: C During stress or exercise, the aging heart is unable to respond quickly with an elevated rate, and the maximal heart rate elevation is reduced. Once the heart rate is elevated, it takes a much longer time for the heart to reach its resting level. Oxygen consumption in the myocardium is reduced, resulting in less efficient function when stressed. In the geriatric population, there is a decrease in coronary artery blood flow to the myocardium. With aging, the heart size generally does not change

Phase 0 of the cardiac muscle cell action potential is associated with ________ channels. a. opening of slow calcium ion b. opening of fast potassium ion c. opening of fast sodium ion d. closure of sodium leak

ANS: C Phase 0 begins when the membrane potential approaches threshold and voltage-gated "fast" sodium channels open momentarily. Calcium enters the cell during Phase 2. Potassium enters the cell during phase 1. Phase 0 of the cardiac muscle cell action is not associated with the closure of the slow sodium leak.

Pulse pressure is defined as a. two thirds of systolic pressure + diastolic pressure. b. systolic pressure + diastolic pressure. c. systolic pressure - diastolic pressure. d. systolic pressure systemic resistance

ANS: C Pulse pressure is defined as the difference between systolic and diastolic blood pressure. Pulse pressure is the difference between systolic and diastolic pressure. Pulse pressure is not thesum of the systolic and diastolic pressures. Systemic resistance is not involved in determining the pulse pressure

21. Atherosclerotic plaques with large lipid cores are prone to a. dislodgement. b. binding. c. rupture. d. attachment

ANS: C Rupture of atherosclerotic plaques with large lipid cores initiates platelet aggregation and thrombus formation. Dislodgement is not an occurrence of atherosclerotic plaques with large lipid cores. Atherosclerotic plaques with large lipid cores are not prone to binding. Large lipid cores of atherosclerotic plaques are not prone to attachment

A characteristic of some bacteria a. is intracellular parasite. b. is composed of RNA or DNA. c. contains cell wall endotoxin. d. cannot replicate extracellularly.

ANS: C Some bacteria contain endotoxin in the cell wall. Viruses are intracellular parasites using host cell components to replicate; bacteria do not use host cell components to replicate. Viruses are composed of RNA or DNA, as opposed to bacteria. Bacteria can replicate extracellularly.

Tissues are able to autoregulate their rate of blood flow by controlling a. perfusion pressure. b. arterial blood pressure. c. vascular resistance. d. venous return to the heart

ANS: C Systemic vascular resistance is used to determine the resistance of vessels, diseases, or drug therapies that affect vessels. Any condition that increases vascular resistance requires more work for the heart to overcome the resistance and eject blood volume. Blood moves from an area of higher pressure to an area of lower pressure. The arterial and arteriolar walls with their muscular media coats provide the high-pressure end of the gradient. Seeking a lower pressure, blood moves toward the venous system. The thinner, more pliable walls of the venous bed furnish the low-pressure portion of the pressure gradient

Cardiac myosin has a high affinity for actin when the myosin has what molecule(s) bound to it? a. Calcium b. ATP c. ADP and phosphate d. Creatine phosphate

ANS: C The affinity of the myosin head for actin depends on whether ATP is bound or ADP and phosphate are bound. Free myosin heads bind ATP and hydrolyze it to ADP and phosphate. Calcium ions are needed for muscle contraction. Myosin has a high affinity for actin when ADP and phosphate are bound, and low affinity when ATP is bound. When there is an excess of ATP, myocardial cells transfer energy to a storage form called creatine phosphate

Which physiologic change increases cardiac work but does not enhance cardiac output? a. Increased preload b. Increased heart rate c. Increased contractility d. Increased afterload

ANS: D A major determinant of stroke volume is afterload, which refers to the impedance or resistance that must be overcome to eject blood from the chamber. The workload imposed on the heart chambers by preload is sometimes called the volume work of the heart. An increase in preload increases the volume work of the heart which must be met by increased oxygen uptake to maintain adequate ATP production. An increase in heart rate results in an increase in cardiac output. However, the increased heart rate is undermined by impaired pumping efficiency. Contractility is independent of fiber end-diastolic length and is therefore not affected by preload

13. What compensatory sign would be expected during periods of physical exertion in a patient with limited ventricular stroke volume? a. Hypotension b. Bradycardia c. Aortic regurgitation d. Tachycardia

ANS: D An individual with reduced stroke volume would exhibit compensatory increases in heart rate. Hypertension is associated with decreased ventricular stroke volume. An individual with reduced stroke volume would exhibit compensatory increases in heart rate; therefore, bradycardia would not be expected. Aortic regurgitation would not be an expected compensatory sign of limited stroke volume

What is the effect on resistance if the radius of a vessel is halved? a. Resistance doubles. b. Resistance decreases by a factor of 16. c. Resistance decreases by half. d. Resistance increases by a factor of 16

ANS: D Doubling the radius of a vessel on the flow of blood results in a 16 times greater blood flow that increases the vessel's resistance by a factor of 16. The resistance is not doubled, it is increased by a factor of 16. The resistance is not decreased when the radius of a vessel is halved

Which is true about blood flow from the atria? a. Occurs primarily during systole, because perfusion pressure is high b. Is controlled primarily by the autonomic nervous system c. Is increased with elevated right atrial pressure d. Occurs primarily during ventricular diastole

ANS: D During diastole the ventricles are relaxed and blood flows in from the atria through open AV valves. Blood flow from the atria occurs during diastole. Blood flow through the heart is a part of the circulatory system. Atrial contraction helps to load the ventricle quickly, but blood flow is not increased with elevated pressure

High blood pressure increases the workload of the left ventricle, because it increases a. stroke volume. b. blood volume. c. preload. d. afterload.

ANS: D Hypertension reflects an elevation in SVR; rising afterload increases myocardial oxygen demand and overall cardiac workload. The workload of the left ventricle does not increase the stroke volume, blood volume, or preload

Venous obstruction leads to edema because it ________ pressure. a. increases capillary oncotic b. increases arterial blood c. decreases tissue d. increases capillary hydrostatic

ANS: D Increased fluid accumulation in the interstitial space also occurs when the lymphatic flow is impaired or when capillaries become more permeable and "leak" fluid. These pressure gradients lead to edema. Interstitial fluid colloid osmotic pressure increases play a role in edema. Arterial blood pressure does not lead to edema. Decreased tissue pressure does not lead to edema in venous obstruction.

Which is not normally secreted in response to stress? a. Norepinephrine b. Cortisol c. Epinephrine d. Insulin

ANS: D Insulin secretion is impaired during stress to promote energy from increased blood glucose. Norepinephrine is secreted during stress as a mediator of stress and adaptation. Cortisol is secreted during stress as a mediator of stress and adaptation and stimulates gluconeogenesis in the liver to supply the body with glucose. Epinephrine is secreted during stress as a mediator of stress and adaptation and increases glycogenolysis and the release of glucose from the liver.

The primary function of kinins is a. phagocytosis of antigens. b. production of antibodies. c. to limit immune reactions. d. vasodilation to enhance inflammation

ANS: D Kinins are especially active in inflammation via powerful vasodilation to bring immune cells to the site of infection. Kinins are not phagocytic, but bring phagocytes to an area of infection via vasodilation. B cells produce antibodies. Kinins do not limit immune reactions.

The movement of blood through the vascular system is opposed by the force of a. viscosity. b. the vessel length. c. the vessel radius. d. resistance

ANS: D The movement of blood through the vascular system is opposed by the force of resistance. Three determinants of resistance are vessel length, vessel radius, and blood viscosity. Viscosity is the thickness of fluid and has an effect on resistance. The length of the vessel does have an effect on the resistance. Vessel radius has an effect on resistance.

Which vessel normally demonstrates the most rapid blood flow? a. An arteriole b. A capillary c. A venule d. The vena cava

ANS: D The vena cava has the most rapid rate of flow. Arterioles don't offer the most rapid blood flow. Capillaries are composed of a single thickness of endothelial cells attached to a protein network called the basement membrane and don't offer the most rapid blood flow. A venule begins where the arteriole ends and doesn't offer the most rapid blood flow

What kinds of physical changes in the body did Hans Selye notice when he chronically exposed his laboratory rats to a wide range of stressful stimuli? Shrinking of lymphoid structures like the spleen Gastric and duodenal ulcers Enlargement of the Adrenal Cortex All of these

All of these

Which immune cell is functionally identical to the Mast cells but found in circulation? Eosinophils Basophils B lymphocytes Monocytes

Basophils

What is the function of the T lymphocyte with the CD4 surface marker? CD4 T cells produce antibodies CD4 T cells act as phagocytic cells CD4 T cells coordinate and direct all adaptive immune responses CD4 T cells kill virus-infected host cells or abnormal host cells

CD4 T cells coordinate and direct all adaptive immune responses

The process of removing auto-reactive B and T cells during maturation is called: Clonal switching Antigen maturation Clonal deletion Anerg

Clonal deletion

In which part of the brain are stressful stimuli first recognized? Hippocampus Prefrontal cortex Olfactory bulb Hypothalamus

Prefrontal cortex

In which phase of the General Adaptation Syndrome do we observe a decrease in glucocorticoid activity despite repeated exposure to the same stressful stimuli? All of these Resistance Phase Exhaustion phase Alarm phase

Resistance Phase

Which of the following events can trigger a local inflammatory reaction? Presence of a pathogen All of these Hypoxia Tissue injury

all of these

Which of the following events occur as part of a local acute inflammatory reaction? Vasodilation Increased capillary permeability All of these migration of phagocytic leukocytes to the area

all of these

Which of the following types of stimuli is capable of triggering a stress response? encountering a bear on a hike All of these Going on a roller coaster when you have a fear of heights exercise

all of these

Any form of stimuli that activates the amygdala will result in a reaction... involving sadness and lethargy involving joy involving hunger involving mortal fear or rag

involving mortal fear or rag

Which of the following tissue leukocytes will most likely initiate an inflammatory reaction in response to presence of a pathogen but no tissue injury? Basophils Neutrophils Mast cells Macrophages

macrophages

Automatic pacemaker cells spontaneously depolarize, because a. leak channels (If) allow calcium and sodium ions into the cell. b. they lack efficient sodium/potassium pumps. c. voltage-sensitive sodium channels open spontaneously. d. chloride leaks into the cell during rest

ANS: A Automatic pacemaker cells have an action potential that is characterized by a sloping phase 4. Cell membrane channels automatically open as leak channels allow calcium and sodium to enter the cell. Automatic pacemaker cells allow an influx of calcium. The channels open and close quickly. Many channels open through autonomic neurotransmitters. Chloride does not leak into the cell during rest

The effects of excessive cortisol production include a. immune suppression. b. hypoglycemia. c. anorexia. d. inflammatory reactions.

ANS: A Cortisol suppresses immune function and inflammation and stimulates appetite. Cortisol leads to hyperglycemia by stimulating gluconeogenesis in the liver.

The progressive stage of hypovolemic shock is characterized by a. tachycardia. b. hypertension. c. lactic acidosis. d. cardiac failure.

ANS: A In the progressive stage of hypovolemic shock, the patient is anxious and confused, with decreased blood pressure and heart rate greater than 120 beats/minute. In this stage of shock, the blood pressure is decreased. Lactic acidosis does not occur in the progressive stage of hypovolemic shock. Cardiac failure is not likely to occur in the earlier stages of hemorrhagic shock.

1. Left-sided heart failure is characterized by a. pulmonary congestion. b. decreased systemic vascular resistance. c. jugular vein distention. d. peripheral edema

ANS: A Left-sided heart failure is characterized by pulmonary congestion and edema. Right-sided heart failure is characterized by congestion in the systemic venous system that increases systemic vascular resistance. Jugular vein distention is a classic sign of right-sided heart failure. Peripheral edema is seen in right-sided failure.

Which causes vasoconstriction? a. Norepinephrine b. Calcium channel blocker c. a-Adrenergic antagonist d. Acetylcholine

ANS: A The release of norepinephrine results in arterial vasoconstriction via receptors located on the vascular smooth muscle walls. Calcium channel blockers produce vasodilation by interfering with calcium intake into the vascular smooth muscle cells. a-Adrenergic antagonists do not cause vasoconstriction. Acetylcholine does not have an effect on vasoconstriction.

The primary adaptive purpose of the substances produced in the alarm stage is a. energy and repair. b. invoke resting state. c. produce exhaustion. d. set a new baseline steady-state

ANS: A These resources are used for energy and as building blocks, especially the amino acids, for the later growth and repair of the organism. The substances do not produce a resting state. The substances can produce exhaustion if they continue, but that is not the adaptive purpose of these. Although a new baseline steady-state may result from the stress response that is not the adaptive purpose of the substances produced during the alarm stage.

Creatine phosphate is a. a waste product of cellular metabolism. b. synthesized when ATP levels are high. c. enzymatically degraded to form creatine kinase. d. an indicator of myocardial cell damage

ANS: B Under conditions of ATP excess, myocardial cells are able to transfer energy to a storage form called creatine phosphate. Creatine phosphate provides an immediate source of energy when ATP levels drop. Creatine kinase is an enzyme that enhances transfer from ATP to creatine phosphate. Elevated levels of blood CK (creatine kinase) are indicative of myocardial damage.

Proteins that are increased in the bloodstream during acute inflammation are called a. membrane attack complexes. b. selectin receptors. c. acute phase proteins. d. major histocompatibility complexes.

ANS: C Acute phase proteins are produced in the liver during acute inflammation and circulate in the bloodstream. Two of the most important acute phase proteins are C-reactive protein (CRP) and serum amyloid A. Membrane attack complexes are porelike structures that function within the complement system. Selectin receptors are receptors on neutrophils that help neutrophils stick to capillary endothelium. Major histocompatibility complexes are a cluster of genes on chromosome 6 involved in antigen presentation.

Interleukin-1, interleukin-6, and tumor necrosis factor- are inflammatory cytokines secreted by a. plasma cells. b. neutrophils. c. lymphocytes. d. macrophages.

ANS: D Macrophages secrete cytokines, including IL-1, IL-6, IL-12, and tumor necrosis factor- that promote inflammation. Plasma cells, neutrophils, and lymphocytes do not secrete inflammatory cytokines.

The effect of stress on the immune system a. is unknown. b. has been demonstrated to be non-existent in studies. c. most often involves enhancement of the immune system. d. may involve enhancement or impairment the immune system.

ANS: D Many studies demonstrate that long-term stress impairs the immune system, but many researchers identify that short-term stress may enhance the immune system.

Indicators that an individual is experiencing high stress include all the following except a. tachycardia. b. diaphoresis. c. increased peripheral resistance. d. pupil constriction

ANS: D Pupils dilate during stress from the effects of catecholamines. Tachycardia, diaphoresis, and increased peripheral resistance are indicators of stress and also occur because of catecholamine release.

Indicators that an individual is experiencing high stress include all the following except a. tachycardia. b. diaphoresis. c. increased peripheral resistance. d. pupil constriction.

ANS: D Pupils dilate during stress from the effects of catecholamines. Tachycardia, diaphoresis, and increased peripheral resistance are indicators of stress and also occur because of catecholamine release.

The "classical pathway" for activation of the complement cascade is triggered by a. activation of C3. b. inflammation. c. first recognition of an antigen. d. antigen-antibody complexes

ANS: D The classical pathway for activation of the complement cascade is triggered by the presence of IgG or IgM antigen-antibody complexes. Activation of C3 initiates the alternative pathway. Inflammation does not initiate the classical pathway, but instead inflammation is enhanced by the complement cascade. First recognition of an antigen initiates the lectin pathway or the alternative pathway.

The membrane attack complex formed by complement is similar in function to a. CD4+. b. granzymes. c. CD8. d. perforin.

ANS: D The membrane attack complex functions in a similar manner to perforin. CD4+ do not function similar to the membrane attack complex. Granzymes do not function similar to the membrane attack complex. CD8 does not function similar to the membrane attack complex

Which is true about the mitral valve? a. Opens during ventricular systole b. Is located between the right atrium and right ventricle c. Has three valve leaflets d. Allows blood to flow from the left atrium to the left ventricle

ANS: D The mitral valve directs blood flow from the left atrium to the left ventricle. Papillary muscles prevent the valve leaflets from opening during ventricular contraction. The mitral valve is located between the left atrium and left ventricle. The tricuspid valve has three leaflets; the mitral valve has two.

The spleen is an important defense against infection, because it a. activates the complement cascade. b. initiates inflammation. c. controls phagocytosis. d. filters the blood.

ANS: D The spleen filters the blood; macrophages in the spleen filter out foreign substances. Lymphocytes activated in the spleen can be transported to other lymphoid tissue to fight infection. The spleen does not activate the complement cascade, initiate inflammation, or have a role in controlling phagocytosis.

The process of generating the diversity of T cell receptors as T cells mature is done how? Through inherited exposure to antigens in utero None of these Through a process of exposure to antigens from the environment Through random recombination of the genes used to code for the T cell receptor

Through random recombination of the genes used to code for the T cell receptor