Ch. 7 - Mosby's 7th - General Pathology

Stem cells that can differentiate into pancreatic islet beta-cells include: a. Bone marrow-derived and tooth-derived stem cells b. Amniotic fluid-derived and tooth-derived stem cells c. Umbilical cord and bone marrow-derived stem cells d. Amniotic fluid-derived and umbilical cord stem cells

Correct answer: A. Bone marrow-derived and tooth-derived stem cells Bone marrow-derived and tooth-derived stem cells can differentiate into pancreatic islet -cells. Incorrect answer explanations: B, C, and D. Amniotic fluid-derived and umbilical cord stem cells do not differentiate into pancreatic islet -cells.

Sickle cell anemia exemplifies: a. Autosomal dominant inheritance b. Autosomal recessive inheritance c. X-linked recessive inheritance d. Multifactorial inheritance

Correct answer: B. Autosomal recessive inheritance Sickle cell anemia is an example of an autosomal-recessive inheritance disorder. Incorrect answer explanations: A. Neurofibromatosis is an example of an autosomal-dominant inheritance disorder. C. Hemophilia B is an example of an X-linked recessive inheritance disorder. D. Cleft lip is an example of a multi-factorial inheritance disorder.

Determining which of two or more diseases with similar signs and symptoms is the one the client is manifesting refers to: a. Appearance diagnosis b. Differential diagnosis c. Definitive diagnosis d. Working diagnosis

Correct answer: B. Differential diagnosis Differential diagnosis is the listing of pathologic conditions in order of most likely to least likely and involves a conceptual process of determining which of two or more of the diseases is the one the person is manifesting. Incorrect answer explanations: A. Appearance diagnosis is incorrect terminology. C. Definitive diagnosis is the actual diagnosis once the disease has been identified and confirmed. D. Working diagnosis is the term that refers to the condition considered to be the most likely cause of a presenting lesion; also referred to as preliminary or tentative diagnosis or clinical impression.

Ribonucleic acid (RNA) analysis is not as stable as deoxyribonucleic acid (DNA)-based diagnosis. It cannot, as yet, be used to detect and quantify viruses such as human immunodeficiency virus (HIV) or hepatitis C virus. a. Both statements are TRUE b. Both statements are FALSE c. The first statement is TRUE, and the second statement is FALSE d. The first statement is FALSE, and the second statement is TRUE

Correct answer: C. The first statement is TRUE, and the second statement is FALSE Ribonucleic acid (RNA) analysis is not as stable as DNA analysis; however, it can be useful for the detection and quantification of RNA viruses such as human immunodeficiency virus (HIV) and hepatitis C virus. Incorrect answer explanations: A, B, and D are incorrect choices because the second statement given is false. RNA analysis can be useful for the detection and quantification of RNA viruses.

During the inflammatory response, neutrophils are replaced by monocytes in: a. 2 to 12 hours b. 6 to 12 hours c. 12 to 24 hours d. 24 to 48 hours

Correct answer: D. 24 to 48 hours Neutrophils are replaced by monocytes in 24 to 48 hours during the inflammatory response. A. Delayed prolonged leakage associated with increased permeability of the microvasculature occurs in 2 to 12 hours. Incorrect answer explanations: B and C are incorrect responses since this process does not occur within 6 to 24 hours.

How many genes do humans have? a. 20,000 to 25,000 b. 25,000 to 30,000 c. 30,000 to 35,000 d. 35,000 to 40,000

Correct answer: A. 20,000 to 25,000 Humans have 20,000 to 25,000 genes. Incorrect answer explanations: B, C, and D are incorrect options.

The formation of new blood vessels in wound healing is: a. Angiogenesis b. Granulomatous tissue c. Granulation tissue d. Parenchymal cells

Correct answer: A. Angiogenesis Angiogenesis is the creation of new blood vessels. Incorrect answer explanations: B. Granulomatous tissue is found during inflammation. C. Granulation tissue is the pink soft tissue that appears on the surface of wounds representing the hallmark of healing. D. Parenchymal cells are the essential or functional elements of an organ

Which chemical mediator produces prostaglandins, leukotrienes, and lipoxins? a. Arachidonic acid b. Bradykinin c. Complement d. Serotonin

Correct answer: A. Arachidonic acid Arachidonic acid produces prostaglandins, leukotrienes, and lipoxins. Incorrect answer explanations: B, C, and D are chemical mediators responsible for other vascular changes but do not produce prostaglandins, leukotrienes, or lipoxins.

Granulation tissue represents a hallmark of healing. The amount of granulation tissue that forms depends on the size of the wound and the intensity of the inflammation. a. Both statements are TRUE b. Both statements are FALSE c. The first statement is TRUE, and the second statement is FALSE d. The first statement is FALSE, and the second statement is TRUE

Correct answer: A. Both statements are TRUE Granulation tissue is a hallmark of healing, and the amount that forms depends on the size of the wound and the intensity of the inflammation. Incorrect answer explanations: B, C, and D are incorrect choices.

The inflammatory response consists of a vascular reaction and a cellular reaction. These reactions are mediated by chemical factors derived from plasma proteins or cells. a. Both statements are true b. Both statements are false c. The first statement is true, and the second statement is false d. The first statement is false, and the second statement is true

Correct answer: A. Both statements are true Both statements about inflammation are true. The inflammatory response consists of a vascular reaction and a cellular reaction. These reactions are mediated by chemical factors derived from plasma proteins or cells. Incorrect answer explanations: B, C, and D are incorrect responses.

Sepsis occurs in severe bacterial infections because large quantities of cytokines cause thrombosis and coagulation, which eventually lead to multiple organ failure. a. Both the statement and the reason are correct and related b. Both the statement and the reason are correct but not related c. The statement is correct, but the reason is not correct d. The statement is not correct, but the reason is correct e. NEITHER the statement NOR the reason is correct

Correct answer: A. Both the statement and the reason are correct and related Both the statement about sepsis and the reason are correct and related. Incorrect answer explanations: B,C, D, and E are incorrect responses.

Examples of acute phase proteins include: a. C-reactive protein and fibrinogen b. Serum amyloid A and lipoxin c. Substance P and neurokinin A d. Hageman factor and fibrinogen

Correct answer: A. C-reactive protein and fibrinogen C-reactive protein and fibrinogen are acute-phase proteins. Incorrect answer explanations: B. Serum amyloid A is also an acute-phase protein, but lipoxin is a chemical mediator. C. Substance P and neurokinin A are chemical mediators. D. Fibrinogen is an acute-phase protein, but Hageman factor is not.

Trisomy is an example of: a. Genome mutation b. Chromosome mutation c. Submicroscopic chromosome mutation d. Submicroscopic gene mutation

Correct answer: A. Genome mutation Trisomy is an example of a genome mutation. Incorrect answer explanations: B and C are incorrect choices since these are not gene mutations. D. represents incorrect terminology.

A host response to injury that consists of vascular responses, activation of white blood cells, and systemic reactions refers to: a. Inflammation b. Regeneration c. Autoimmune response d. Angiogenesis

Correct answer: A. Inflammation Inflammation is the host response to cellular injury that consists of vascular responses, activation of white blood cells, and systemic reactions. Incorrect answer explanations: B. Regeneration refers to growth of cells and tissues to replace lost structures. C. Autoimmune response involves the production of antibodies directed against one's own tissues. D. Angiogenesis is the formation of new blood vessels.

A client presents with an enlargement of soft tissue. Which conceptual stage of the differential diagnosis process does this represent? a. Stage 1—classification of the abnormality by primary manifestation b. Stage 2—listing of secondary features and contributing factors c. Stage 3—listing of conditions capable of causing primary manifestations d. Stage 4—elimination of unlikely causes

Correct answer: A. Stage 1—classification of the abnormality by primary manifestation A client presenting with an enlargement of soft tissue represents stage 1 of the differential diagnosis process—classification of the abnormality by primary manifestation. Incorrect answer explanations: B, C, and D are not the appropriate stages for this example.

A complication of wound healing commonly seen in lower extremity wounds with peripheral vascular disease is: a. Ulceration b. Hypertrophic scar c. Contracture d. Fibrosis

Correct answer: A. Ulceration Ulceration is a complication of wound healing commonly seen in lower extremity wounds with peripheral vascular disease. Incorrect answer explanations: B,C, and D are incorrect choices for this wound condition. Hypertrophic scar, contracture and fibrosis are rarely observed .

In approximately what percentage of human DNA is the uniqueness of humans encoded? a. 0.1% b. 0.5% c. 1% d. 5% percent

Correct answer: B. 0.5% The uniqueness of humans is encoded in approximately 0.5% of DNA, which represents 15 million base pairs. Incorrect answer explanations: A, C, and D are incorrect percentage options

The adult stem cells that are isolated from aspirates of liposuction are: a. Amniotic fluid stem cells b. Adipose-derived stem cells c. Bone marrow-derived stem cells d. Dental stem cells

Correct answer: B. Adipose-derived stem cells Adipose-derived stem cells are derived from lipectomy or liposuction aspirates. Incorrect answer explanations: A. Amniotic fluid-derived stem cells are isolated from amniocentesis during genetic counseling. C. Bone marrow-derived stem cells consist of both hematopoietic stem cells and stromal or mesenchymal cells. D. Dental stem cells are developed from material created during the development of the nervous system and can differentiate into neural cell lines.

Which of the following are the most commercially available stem cells? a. Amniotic fluid-derived stem cells b. Bone marrow-derived stem cells c. Tooth-derived stem cells d. Adipose-derived stem cells

Correct answer: B. Bone marrow-derived stem cells Bone marrow-derived stem cells are the most commercially available at this time. Incorrect answer explanations: A, C, and D. These stem cells are incorrect choices.

Which complement protein enhances phagocytosis by acting as opsonin? a. C3a b. C3b c. C4a d. C5a

Correct answer: B. C3b C3b enhances phagocytosis by acting as opsonin. Incorrect answer explanations: A, C, and D. These complement proteins create a vascular phenomenon and stimulate histamine release from mast cells.

During which phase of phagocytosis does the pH drop? a. Engulfment b. Killing and degradation c. Release of leukocyte products d. Apoptosis

Correct answer: B. Killing and degradation During killing and degradation, the pH drops to between 4 and 5. Incorrect answer explanations: A, C, and D are phases of phagocytosis but do not involve pH changes

Which chemical mediator is important in the pathogenesis of bronchial asthma? a. Lipoxins b. Leukotrienes c. Prostaglandins d. Nitric oxide

Correct answer: B. Leukotrienes Leukotrienes are important in the pathogenesis of bronchial asthma as they can cause intense vasoconstriction and bronchospasm. Incorrect answer explanations: A. Lipoxins inhibit leukocyte recruitment, neutrophil chemotaxis, and adhesion to endothelium. C. Prostaglandins cause increased permeability, chemotactic effects of other mediators, and vasodilation, resulting in edema, pain, and fever. D. Nitric oxide causes vasodilation by relaxing vascular smooth muscle and is a mediator of host defense against infection.

All of the following white blood cells are involved in the immune response EXCEPT one. Which one is the EXCEPTION? a. Macrophage b. Neutrophil c. Lymphocyte d. Eosinophil

Correct answer: B. Neutrophil Neutrophils are responsible for phagocytosis but are not involved in the immune response. Incorrect answer explanations: A. Macrophages are capable of phagocytosis and are helper cells during the immune response. C. Lymphocytes are involved in both chronic inflammation and the immune response. D. Eosinophils are involved in immune reactions and parasitic infections.

A wound with a narrow incisional space will heal by: a. Primary intervention b. Primary intention c. Secondary intervention d. Secondary intention

Correct answer: B. Primary intention A wound with a narrow incisional space will heal by primary intention or union. Incorrect answer explanations: A and C. Primary intervention and secondary intervention are incorrect terms; the terms should be primary intention and secondary intention. D. Secondary intention or union is defined as healing that occurs for wounds with separate edges.

A client presents with an ulceration with a pattern of healing followed by recurrence. Which conceptual stage of the differential diagnosis process does this represent? a. Stage 1—classification of the abnormality by primary manifestation b. Stage 2—listing of secondary features and contributing factors c. Stage 3—listing of conditions capable of causing primary manifestations d. Stage 4—elimination of unlikely causes

Correct answer: B. Stage 2—listing of secondary features and contributing factors A client presenting with an ulceration that has a pattern of healing and recurrence describes stage 2 of the differential diagnosis process—listing of secondary features and contributing factors. Incorrect answer explanations: A, C, and D are not the appropriate stages for this example.

The process of a stem cell from one adult tissue generating to cell types of another tissue is known as: a. Unipotent b. Transdifferentiation c. Undifferentiation d. Biologic viability

Correct answer: B. Transdifferentiation Trans-differentiation refers to the ability of stem cells from one adult tissue to generate cell types of another tissue. Incorrect answer explanations: A. Unipotent refers to cells that are capable of developing into only one type of cell or tissue. C. Undifferentiated cells are not changed in character or form. D. Biologic variability is a contrived term used as a distractor.

In an inflammatory reaction, with infection, the white blood cell count can increase to: a. 4,000 to 10,000/mm3 b. 10,000 to 15,000/mm3 c. 15,000 to 20,000/mm3 d. 20,000 to 25,000/mm3

Correct answer: C. 15,000 to 20,000/mm3 The white blood cell count can increase to 15,000 to 20,000 mm3 in an inflammatory reaction, particularly with infection. Incorrect answer explanations: A. 4,000 to 10,000mm3 represents the normal count of white blood cells. B and D are incorrect choices.

Local factors that influence wound healing include all the following EXCEPT one. Which one is the EXCEPTION? a. Size and location of wound b. Early movement c. Blood supply d. Infection

Correct answer: C. Blood supply Blood supply is a systemic factor that influences wound healing. Incorrect answer explanations: A, B, and D are all local factors that affect wound healing.

The adult stem cells which are isolated from hematopoietic stem cells and stromal cells are: a. Amniotic fluid stem cells b. Adipose-derived stem cells c. Bone marrow-derived stem cells d. Dental stem cells

Correct answer: C. Bone marrow-derived stem cells Bone marrow-derived stem cells consist of both hematopoietic stem cells and stromal or mesenchymal cells. Incorrect answer explanations: A. Amniotic fluid-derived stem cells are isolated from amniocentesis during genetic counseling. B. Adipose tissue-derived stem cells are derived from lipectomy or liposuction Aspirates. D. Dental stem cells are developed from material created during the development of the nervous system and can differentiate into neural cell lines.

A complication of wound healing commonly seen in serious burn injuries is: a. Ulceration b. Hypertrophic scar c. Contracture d. Fibrosis

Correct answer: C. Contracture Contracture is a complication of wound healing commonly seen in burn injuries. Incorrect answer explanations: A, B, and D are incorrect choices for this wound condition because ulceration, hypertrophic scar and fibrosis are rarely observed.

If all diseases except one are eliminated from the differential diagnosis, then that gives the: a. Appearance diagnosis b. Preliminary diagnosis c. Definitive diagnosis d. Working diagnosis

Correct answer: C. Definitive diagnosis Definitive diagnosis is the term used when all but one disease are eliminated from the differential diagnosis. Incorrect answer explanations: A. Appearance diagnosis is incorrect terminology. B and D. Preliminary and working diagnosis both refer to the condition considered to be the most likely cause of a presenting lesion.

The two main categories of stem cells are: a. Embryonic and pluripotent stem cells b. Primary and secondary stem cells c. Embryonic and adult stem cells d. Somatic and adult stem cells

Correct answer: C. Embryonic and adult stem cells Embryonic and adult stem cells are the two major categories of stem cells. Incorrect answer explanations: A, B, and D are incorrect choices. The remaining options are just distracters.

With autosomal dominant disorders, when some persons inherit the mutant gene but are phenotypically normal, this refers to: a. Variable expressivity b. Successive transmission c. Incomplete penetrance d. Autosomal inheritance

Correct answer: C. Incomplete penetrance Incomplete penetrance is the term used to describe an autosomal-dominant inheritance, in which some persons inherit the mutant gene but are phenotypically normal. Incorrect answer explanations: A. Variable expressivity refers to a trait seen in all individuals that is expressed differently among them. B and D are contrived terms.

Heat (calor) found during the inflammatory response is caused by: a. Vasoconstriction of blood vessels b. Exudation of fluid c. Increased blood flow d. Stretching of pain receptors

Correct answer: C. Increased blood flow Heat during the inflammatory process is associated with increased blood flow and the release of chemical mediators. Incorrect answer explanations: A. Vasoconstriction of blood vessels is a transient vascular response that lasts for several seconds. B. Exudation of fluid causes edema or tissue swelling (tumor). D. Stretching of pain receptors is associated with pain (dolor).

Acute inflammation is characterized by rapid onset and short duration. It is manifested by the presence of lymphocytes and macrophages, blood vessels, and fibrosis. a. Both statements are true b. Both statements are false c. The first statement is true, and the second statement is false d. The first statement is false, and the second statement is true

Correct answer: C. The first statement is true, and the second statement is false Acute inflammation is characterized by rapid onset and short duration. Chronic inflammation is manifested by the presence of leukocytes and macrophages, blood vessels, and fibrosis. It is NOT manifested by the presence of lymphocytes and macrophages, blood vessels, and fibrosis. Incorrect answer explanations: A, B and D are incorrect responses. The first statement is true. Acute inflammation is characterized by rapid onset and short duration and the second is false because it is NOT manifested by the presence of lymphocytes and macrophages, blood vessels, and fibrosis.

Chemical mediators bind to specific receptor on target cells. Most are short lived, and harmless. a. Both statements are true b. Both statements are false c. The first statement is true, and the second statement is false d. The first statement is false, and the second statement is true

Correct answer: C. The first statement is true, and the second statement is false Chemical mediators bind to specific receptors on target cells and are short lived, but they cause harmful effects to surrounding tissues and cells. Incorrect answer explanations: A, B, and D are incorrect choices because chemical mediators are harmful to hard and soft tissues, e.g., tissue breakdown and bone resorption

The inflammatory reaction is more intense with healing by secondary union because of the presence of a larger clot and the formation of more epidermis in the area. a. Both the statement and the reason are correct and related b. Both the statement and the reason are correct but not related c. The statement is correct, but the reason is not correct d. The statement is not correct, but the reason is correct e. NEITHER the statement NOR the reason is correct

Correct answer: C. The statement is correct, but the reason is not correct A more intense inflammatory reaction occurs with healing by secondary union because of the presence of a larger clot and more necrotic debris and exudates that must be moved from the defect. The epidermis becomes thinner, and more scar tissue forms. Incorrect answer explanations: A, B, D, and E are incorrect choices. The reason given, i.e., because of the presence of a larger clot and the formation of more epidermis in the area is wrong.

Two major cytokines that induce the systemic acute phase responses of infection and injury, including fever, loss of appetite and release of corticosteroids are: a. Histamine and serotonin b. Complement and bradykinin c. Tumor necrosis factor and interleukin-1 d. Prostaglandins and leukotrienes

Correct answer: C. Tumor necrosis factor and interleukin-1 Tumor necrosis factor and interleukin-1 are two major cytokines responsible for inducing the systemic acute phase responses of infection and injury, including fever, loss of appetite, release of neutrophils, corticotrophin, and corticosteroids. A. Histamine and serotonin are vasoactive amines that cause vasodilation and increased permeability. Incorrect answer explanations: B. Complement causes increased permeability, chemotaxis, and opsonization; bradykinin increases vascular permeability and causes contraction of smooth muscles, dilation of blood vessels, and pain. D. Prostaglandins cause increased permeability, chemotactic effects of other mediators, and vasodilation, resulting in edema, pain, and fever; leukotrienes cause intense vasoconstriction, bronchospasm, and increased vascular permeability.

Duchenne muscular dystrophy exemplifies: a. Autosomal dominant inheritance b. Autosomal recessive inheritance c. X-linked recessive inheritance d. Multifactorial inheritance

Correct answer: C. X-linked recessive inheritance Duchenne muscular dystrophy is an example of an X-linked recessive inheritance disorder. Incorrect answer explanations: A. Huntington's disease is an example of an autosomal-dominant inheritance disorder. B. Cystic fibrosis is an example of an autosomal-recessive inheritance disorder. D. Hypertension is an example of a multi-factorial inheritance disorder.

Tissues recover approximately 70% of tensile strength over: a. 1 to 3 weeks b. 4 to 6 weeks c. 7 to 11 weeks d. 12 to 15 weeks

Correct answer: D. 12 to 15 weeks Tissue recovers approximately 70% to 80% of tensile strength over a 3-month period. Incorrect answer explanations: A, B, and C. These time frames are not sufficient to allow for the recovery of significant tensile strength.

Examples of systemic diseases affected by chronic inflammation include: a. Cardiovascular disease and diabetes b. Cancer and asthma c. Alzheimer's disease and periodontal disease d. All of the above

Correct answer: D. All of the above Cardiovascular disease, cancer, diabetes, asthma, Alzheimer's disease, and periodontal disease are examples of systemic diseases affected by chronic inflammation.

Dental stem cells can be obtained from: a. Permanent third molars (wisdom teeth) b. Pulp of primary teeth c. Periodontal ligament d. All of the above

Correct answer: D. All of the above Dental stem cells can be obtained from the pulp of primary and healthy permanent teeth, permanent third molars, and the periodontal ligament. Incorrect answer explanations: A, B, and C are all correct choices. All three choices collectively are most correct.

Outcomes of acute inflammation consist of: a. Complete resolution b. Healing by connective tissue replacement c. Progression of tissue response to chronic inflammation d. All of the above

Correct answer: D. All of the above Outcomes of acute inflammation include complete resolution, healing by connective tissue replacement, and progression of tissue response to chronic inflammation.

Phagocytosis is greatly enhanced by: a. Plasma lectins b. Complement proteins c. Opsonins d. All of the above

Correct answer: D. All of the above Plasma lectins, complement proteins, and opsonins all enhance phagocytosis.

The adult stem cells that develop from material created during the development of the nervous system and can differentiate into neural cell lines are: a. Amniotic fluid stem cells b. Adipose-derived stem cells c. Bone marrow-derived stem cells d. Dental stem cells

Correct answer: D. Dental stem cells Dental stem cells are developed from material created during the development of the nervous system and can differentiate into neural cell lines. Incorrect answer explanations: A. Amniotic fluid-derived stem cells are isolated from amniocentesis during genetic Counseling. B. Adipose tissue-derived stem cells are derived from lipectomy or liposuction Aspirates. C. Bone marrow-derived stem cells consist of both hematopoietic stem cells and stromal or mesenchymal cells.

The white blood cell that emigrates to injured tissue and converts to a macrophage is the: a. Neutrophil b. Mast cell c. Lymphocyte d. Monocyte

Correct answer: D. Monocyte The monocyte emigrates to injured tissue and becomes a macrophage. Incorrect answer explanations: A, B, and C are white blood cells that do not convert to become a macrophage.

Allogenous stem cells are derived from the individual being treated. They may be multipotent or unipotent. a. Both statements are TRUE b. Both statements are FALSE c. The first statement is TRUE, and the second statement is FALSE d. The first statement is FALSE, and the second statement is TRUE

Correct answer: D. The first statement is FALSE, and the second statement is TRUE Allogenous stem cells are derived from other individuals. They may be multipotent, or unipotent. They may also be totipotent. Incorrect answer explanations: A, B, and C are incorrect choices.

All of the following conditions have a genetic component EXCEPT one. Which one is the EXCEPTION? a. Cardiovascular disease b. Diabetes c. Cleft lip d. Trauma

Correct answer: D. Trauma Trauma is the one condition that is not associated with a genetic component. Incorrect answer explanations: A, B, and C. Cardiovascular disease, cancer, and cleft lip are common diseases with a genetic component.

All of the following stem cells may differentiate into fat cells EXCEPT one. Which one is the EXCEPTION? a. Amniotic fluid-derived stem cells b. Adipose-derived stem cells c. Tooth-derived stem cells d. Umbilical cord stem cells

Correct answer: D. Umbilical cord stem cells Umbilical cord stem cells do not differentiate into fat cells. Incorrect answer explanations: A, B, and C. Amniotic fluid-derived, adipose tissue-derived, and tooth-derived stem cells all may differentiate into fat cells.

Which of the following stem cells may differentiate into immune cells? a. Amniotic fluid-derived stem cells b. Adipose-derived stem cells c. Tooth-derived stem cells d. Umbilical cord stem cells

Correct answer: D. Umbilical cord stem cells Umbilical cord stem cells may differentiate into immune cells. Incorrect answer explanations: A, B, and C. Amniotic fluid-derived, adipose tissue-derived and tooth-derived stem cells do not differentiate into immune cells.