Ch.

1
1 It is true that a eukaryotic cell:
Is smaller than a prokaryotic cell.
Contains structures called organelles.
Lacks a well-defined nucleus.
Does not contain histones.
Eukaryotic cells contain organelles and histones, they have a well-defined nucleus, and are larger
than prokaryotic cells.

2. The function of a histone found in a eukaryote cell focuses on cellular:

Division
Movement
Activities
Deoxyribonucleic acid (DNA) folding
The histones are binding proteins that cause the supercoiling of DNA into chromosomes and do
not affect cellular division, movement, or activities.

3 An organelle that is responsible for the metabolism of cellular energy is referred to as a:

Golgi complex
Mitochondrion
Endoplasmic reticulum
Nucleolus
Mitochondria play a role in cellular metabolism, cellular respiration, and energy production. The
Golgi complex is responsible for processing and packaging proteins from the endoplasmic
reticulum, where they are synthesized. The nucleolus is a small, dense structure that contains the
ribonucleic acid (RNA), DNA, and DNA-binding proteins.

4. Which statement is correct regarding cellular energy?

Glycolysis is the building of sugar molecules.
Oxidative cellular metabolism is a single reaction making adenosine triphosphate
(ATP).
Oxidative phosphorylation occurs in the mitochondria.
Anaerobic glycolysis occurs in the presence of oxygen.
Oxidative phosphorylation occurs in the mitochondria. This is the mechanism by which the
energy produced from carbohydrates, fats, and proteins is transferred to ATP. Glycolysis is a
process that breaks down glucose molecules; it produces a net of two ATP molecules. Oxidation
is a process during which a pair of electrons are removed and transferred. Oxidative cellular
metabolism involves 10 biochemical reactions. Anaerobic glycolysis occurs in the absence of
oxygen. Aerobic means in the presence of oxygen.

5. Movement of a solute molecule from an area of high concentration to an area of low

concentration is called:
Diffusion
Filtration
Osmosis
Hydrostatic pressure
Diffusion is the movement of a solute from an area of high concentration to an area of low
concentration. Osmosis is the movement of water down a concentration gradient from an area of
higher water concentration to an area of lower water concentration. Filtration is the movement of
water and solute through a membrane because of a greater pushing pressure on one side of the
membrane than the other. Hydrostatic pressure is the mechanical force of water pushing against a
cell membrane.

6. Which of the following describes the term chemotaxis?

Uses the second messenger system
Cellular signal affecting the cell of origin
 Movement of cells along a chemical gradient
Ligands bind with receptors, triggering a second reaction
Chemotaxis is cellular movement along a chemical gradient caused by chemical attraction.

7. Which of the following are functions of a protein? (Select all that apply.)
Pores or transport channels
Enzymes that drive pumps
Cell surface markers
Synapses for cells
Proteins may act as transport channels, pores, cell surface markers, enzymes that drive pumps,
catalysts, and cell adhesion molecules (CAMs), or they may act as the key components of ATP
synthesis. Synapses are the connections between two nerve cells.

Chapter 2
1 Which of the following is the most common cause of cellular injury?
Free radicalinduced injury
Chemical injury
Hypoxia
Mechanical factors
Hypoxia is the most common cause of cellular injury and can be initiated by decreased oxygen in
the environment, decreased hemoglobin, decreased red blood cells, or cardiovascular collapse.

2. Which chemical interferes with the excretion of urate while affecting the nervous and
hematopoietic systems?
Carbon monoxide
Carbon tetrachloride
Lead
Mercury
Lead can interfere with the excretion of urate and thus increase an individuals predisposition to
gout; it affects the hematopoietic and nervous systems.

3. Which form of necrosis is associated with tuberculous infections?

Coagulative
Liquefactive
Fat
Caseous
Caseous necrosis is normally found in the lung from tuberculosis. Tissues appear soft and
granular and resemble clumped cheese (hence the name caseous) and are surrounded by a
granulomatous inflammatory wall; this pulmonary infection is caused by Mycobacterium
tuberculosis. It is a combination of liquefactive and coagulation necrosis. Coagulative necrosis
occurs primarily in the kidneys, heart, and adrenal glands and is caused by protein degradation.
Liquefactive necrosis commonly occurs in the neurons and glial cells. Fat necrosis occurs in the
breast, pancreas, and other abdominal structures. It is cellular dissolution caused by powerful
enzymes called lipases. Necrosis is accidental cell death that occurs to local cells
after a severe and sudden injury.

Chapter 3
1. When considering water balance, which statement is the correct balance?
Isotonic fluids cause increased cellular swelling.
Hypertonic fluid causes increased cellular swelling.
Hypotonic fluid causes cellular swelling.
Hypernatremia causes cellular swelling.
Hypotonic extracellular fluid (ECF) causes intracellular water gain and swelling. When the ECF
is hypotonic, water moves from the intravascular space to the interstitial space, across the cell
membrane, and into the cell. This action causes the cell to swell. An isotonic solution is equal to
the plasma in concentration of solute molecules. Therefore no net water will move because
equilibrium exists. The cell size is unchanged. A hypertonic fluid has excessive solute; therefore
water will leave the cell and move into the vascular space to help balance this excess. Water
leaving the cell results in cell shrinkage. Hypernatremia can occur with an acute gain in sodium
or a loss of water, but generally it does not cause cellular swelling.

2. It is true that hyponatremia:

Is commonly caused by inadequate sodium intake.
Can occur with a decrease in total body water (TBW).
Never occurs with burns, vomiting, or diarrhea.
Occurs when sodium drops below 135 mEq/L.
Hyponatremia occurs when the serum sodium drops below 135 mEq/L. It is the most common
electrolyte disorder in individuals who are hospitalized. Although inadequate sodium intake can
cause hyponatremia, it is uncommon. It can also occur with an increase in TBW or as a result of
burns, vomiting, diarrhea, or gastrointestinal suctioning.

3. Which statement is true regarding potassium balance?

Potassium is the major extracellular electrolyte.
During acidosis, potassium shifts into the cell.
Aldosterone is secreted when potassium is decreased.
Insulin causes the movement of potassium into the cell.
Insulin causes movement of potassium into the cell and is one of the treatments for hyperkalemia. Potassium is the
major intracellular electrolyte and maintains the osmotic balance of the intracellular fluid (ICF)space. During
acidosis, potassium is shifted out of the cell in exchange for hydrogen ions. Aldosterone is secreted when potassium
is elevated, resulting in the excretion of potassium by the kidneys.

4. Hypernatremia is defined as levels above:

147 mEq/L
5.5 mEq/L
105 mEq/L
8.5 mg/dl
Hypernatremia is defined as serum levels above 147 mEq/L. Hyperkalemia is defined as serum levels above 5.5
mEq/L, Hypocalcemia occurs when serum calcium concentrations are less than 8.5 mg/dl.

6. Acidemia is a state in which the pH of arterial blood is less than 7.35. Alkalemia is a state in
which the pH of arterial blood is greater than 7.45. A systemic increase in hydrogen ion
concentration or loss of base is termed acidosis. A systemic decrease in hydrogen ion
concentration or an excess of base is termed alkalosis.

7. Common causes of edema formation (increased filtration of fluid from capillaries and
lymph into surrounding tissues) include which of the following? (Select all that apply.)
Increased hydrostatic pressure
Decreased plasma oncotic pressure
Increased capillary membrane permeability
Lymphatic obstruction Correct
Sodium retention

8. Which treatments are appropriate for hyperkalemia? (Select all that apply.)
Calcium gluconate
Treating the contributing cause
Administering glucagon
Sodium bicarbonate
Calcium gluconate can be administered to restore normal neuromuscular irritability
when serum potassium levels are dangerously high. Glucose, which readily stimulates insulin
secretion, or the administration of glucose and insulin for those with diabetes, facilitates cellular
entry of potassium. Sodium bicarbonate corrects metabolic acidosis and lowers serum potassium.
Ch
1. Which statement is true regarding the inflammatory response?
Inflammatory response is the third line of defense.
Inflammatory response relies on cellular components only.
Inflammatory response generates a nonspecific response.
Inflammatory response occurs at healthy tissue.
The inflammatory response is the second line of defense. It occurs at the site of tissue injury and
generates a nonspecific response that involves cellular and chemical components.

2. Which statement regarding mast cells is true?

Histamine causes vasoconstriction. Incorrect
Mast cells are found only in blood vessels.
Snake bites, bee venoms, and toxins may cause activation.
Mast cells are not involved in allergic reactions.
A number of things cause the activation of mast cells, including physical injury, chemical agents
(including toxins, bee venom, and snake bites), immunologic means, and activation of an
inflammatory response. Histamine is released from mast cells and causes vasodilation. Mast cells
are found in loose connective tissue close to blood vessels. Mast cells are involved in initiating
many allergic reactions.

3. Which statement is true regarding neutrophils?

Neutrophils are agranular.
Neutrophils are the predominant phagocytes of early inflammation.
Neutrophils are the largest blood cells.
Neutrophils enter the site of injury after lymphocytes and macrophages.
Neutrophils are the predominant phagocytes of early inflammation. They arrive before
lymphocytes and macrophages. Monocytes are the largest blood cells and are granular.

4. Chronic inflammation is characterized by a(an):

Lack of giant cells
Absence of exudate
Dense infiltrate of lymphocytes and macrophages
Inflammation that lasts less than 2 weeks
Chronic inflammation is characterized by a dense infiltrate of lymphocytes and macrophages.
Giant cells are multinucleated cells that are formed by fused macrophages during granuloma
formation. Chronic inflammation often results in pus formation, purulent discharge, and
incomplete wound healing. Chronic inflammation of any cause lasts longer than 2 weeks.

5. Which functions of the clotting system are exhibited at the site of injury or
inflammation? (Select all that apply.)
Prevents the spread of infection to adjacent tissues.
Traps microorganisms at the site of greatest inflammatory cell activity.
Prevents clot formation at the site of injury.
Provides a framework for future repair and healing.
The clotting system exhibits the following functions: (1) prevents the spread of infection to
adjacent tissues; (2) traps microorganisms and foreign bodies at the site of inflammation for
removal by infiltrating cells such as neutrophils and macrophages; (3) forms a clot that stops
bleeding; and (4) provides a framework for future repair and healing.

6. Which of the following are systemic effects of inflammation? (Select all that apply.)
Abscess formation
Fever
Leukocytosis
Increased levels of plasma proteins
Decreased levels of plasma proteins
The three primary systemic changes associated with an acute inflammatory response are fever,
leukocytosis, and increased levels in circulating plasma proteins.

Chapter 8
1. Antigens are recognized as foreign substance and initiate the immune response. Immunoglobulins and
antibodies are part of the adaptive immune response; they attack the antigen. Lymphocytes are a
type of blood cell that is part of the adaptive response.

2. The thymus is where (T lymphocytes) are located and bone marrow (B lymphocytes).

3. T cells attack cancerous cells, and are part of cellular immunity.

4. Active immunity is produced by an individual after either a natural exposure or an immunization.

5. It is true that immunoglobulin E (IgE) is:

Designed to protect the host from large viruses
The primary cause of common allergies
The only inflammatory cell that can damage a virus
Specifically designed to prevent the invasion and attachment of pathogens through
mucous membranes.
- IgE is an antibody that is designed to protect the host from parasites and is the only inflammatory
cell that can damage a parasite.

6. Which statement is true regarding aging and the immune system function?
Older adults have decreased circulating antibodies.
T-cell function is increased.
Antibody production to specific antigens is inferior.
Response to infection is rapid.
Aging and immune system: T-cell function is decreased, and immune responses are delayed. B-cell production is
inferior; however, the cells have increased circulating antibody levels.

7. The five classes of immunoglobulin are IgG, IgA, IgM, IgD, and IgE.

Ch 9
1. Which definition is true?
Allergy means the deleterious effects of hypersensitivity.
Immunity means an altered immunologic response.
Hypersensitivity means the protective response to an antigen.
Autoimmunity means the normal response to foreign antigens.

2. Which statement is true regarding hypersensitivity reactions?

They require sensitization against a particular antigen.
They occur after the primary immune response.
Reactions are always delayed.
The most delayed reaction is anaphylaxis.
A hypersensitivity reaction requires sensitivity to an antigen and occurs after an adequate
secondary immune response. These reactions may then be immediate or delayed. The most
immediate reaction is anaphylaxis.

3. Most type I reactions are allergic. They are mediated by IgE. Most occur against environmental
antigens and can contribute to some autoimmune diseases.

4. Which statement is true regarding a type IV allergic reaction (Tuberculin reaction or PPD test)?
Is immediate in its action.
Is infiltrated with B cells.
Has a red, soft center.
 Can be transferred by cells.
Type IV hypersensitivity reactions can be transferred by cells but not by serum. Their actions are
delayed because their onset takes from 24 to 72 hours. The site is infiltrated with T lymphocytes (T cells)
and macrophages. A clear hard center surrounds the erythema (redness).

5. Which are examples of an alloimmune disease?

Graves disease
Myasthenia gravis

6. Histamine release leads to which of the following? (Select all that apply.)
Bronchial smooth muscle contraction
Bronchoconstriction
Decreased vascular permeability
Vasoconstriction
Edema
- Histamine contracts bronchial smooth muscle, which causes bronchoconstriction. Vascular
permeability, edema, and vasodilation also increase.

7. Viruses enter the cell and may bypass many defense mechanisms. Viruses are the most common
form of infection. They contain deoxyribonucleic acid (DNA) and RNA for their genetic
information.

8. Which statement regarding fever is true?

Fever is a failure of the body to regulate temperature.
An endogenous pyrogen may produce fever.
The bodys central thermostat is the pituitary gland.
Fever is a failure of the bodys defense system.
A pyrogen is a substance that causes fever. Exogenous and endogenous pyrogens exist and affect
the regulatory set point in the hypothalamus, which is the bodys thermostat. Fever is not a
failure of the bodys defense system but may be beneficial. The body does not fail to
regulate temperature; rather, the temperature is regulated at a higher level than normal with a
fever.

9. Overuse of antibiotics can lead to the destruction of the normal flora and
selective overgrowth of antibiotic-resistant strains.

Ch
1. A stress response results in the stimulation of which sympathetic nervous system
receptors?
-Adrenergic receptors
-Receptors
Adrenocorticotropic hormone (ACTH)
Growth hormone (GH)
- The stress response is initiated in the central nervous and endocrine systems.

2. Which statement is true regarding the effects of circulating epinephrine in the body?
The heart rate will slow down.
The hearts contractility will decrease.
Blood vessels to skeletal muscle will constrict.
Transient hyperglycemia will result.
Epinephrine dilates blood vessels of the muscles and causes transient hyperglycemia. The
epinephrine will increase heart rate and contractility. The venous return to the heart will increase,
thus increasing cardiac output and blood pressure.

3. Which statement is true regarding how cortisol reacts when activated by ACTH?
Cortisol is plasma bound to corticotropin.
 Gluconeogenesis is halted.
Cortisol increases blood glucose.
Cortisol decreases protein synthesis.
Cortisol has many actions. It stimulates gluconeogenesis, increases glucose production, and increases protein
synthesis. Stress can activate an excessive immune response through cortisol.

4. Which statement is true regarding the immune system in response to stress?

T-helper 1 (Th1) cells increase.
A shift in Th1 cells occurs.
The immune system is not affected.
Cortisol is released.
The steroid hormones are stimulated by the hypothalamus, which sets off a chain of events
during which steroid hormones are secreted from the adrenal cortex. Cortisol is one of the
primary steroid hormones.

5. Which of the following is a function of norepinephrine?

Increases contraction of the heart
Constricts smooth muscle in all blood vessels
Secretes steroid hormones
Stimulates adrenal medulla
Norepinephrine is released from the adrenal medulla and regulates blood pressure by constricting
smooth muscle in all blood vessels.
Epinephrine increases myocardial contractility and heart rate.

6. Which statement regarding corticotropin-releasing hormone (CRH) and its influence on

the immune system is true?
CRH is also released from peripheral inflammatory sites.
CRH causes vasoconstriction.
CRH causes decreased vascular permeability.
Red blood cells are the peripheral targets.
CRH is released from the hypothalamus and from peripheral inflammatory sites. Because this
hormone is proinflammatory, it causes vasodilation and increased vascular permeability. The
primary target of peripheral CRH is the mast cell.

7. Which statement is true regarding stress and the immune system?

Cardiovascular disease, aging, cancer, osteoporosis, arthritis, type II diabetes mellitus, and
chronic obstructive pulmonary disease (COPD) are associated with the prolonged presence of
proinflammatory cytokines. These proinflammatory cytokines increase during stress. Negative
emotions are directly associated with the increased level of these proinflammatory cytokines.

8. The three successive stages in the development of the general adaptation syndrome: alarm,
resistance, and exhaustion.