Contents
Chapter 1: Cellular Biology................................................................................................................................................. 2
Chapter 2: Altered Cellular and Tissue Biology ............................................................................................................16
Chapter 3: The Cellular Environment: Fluids and Electrolytes, Acids and Bases ..................................................30
Chapter 4: Genes and Genetic Diseases ........................................................................................................................43
Chapter 5: Genes, Environment-Lifestyle, and Common Diseases ..........................................................................54
Chapter 6: Epigenetics and Disease ................................................................................................................................63
Chapter 7: Innate Immunity: Inflammation ..................................................................................................................67
Chapter 8: Adaptive Immunity ........................................................................................................................................82
Chapter 9: Alterations in Immunity and Inflammation ...............................................................................................94
Chapter 10: Infection ..................................................................................................................................................... 106
Chapter 11: Stress and Disease ..................................................................................................................................... 116
Chapter 12: Cancer Biology........................................................................................................................................... 124
Chapter 13: Cancer Epidemiology ............................................................................................................................... 139
Chapter 14: Cancer in Children .................................................................................................................................... 144
Chapter 15: Structure and Function of the Neurologic System .............................................................................. 149
Chapter 16: Pain, Temperature Regulation, Sleep, and Sensory Function ............................................................ 160
Chapter 17: Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function ....................... 174
Chapter 18: Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction .... 188
Chapter 19: Neurobiology of Schizophrenia, Mood Disorders, and Anxiety Disorders .................................... 200
Chapter 20: Alterations of Neurologic Function in Children .................................................................................. 207
Chapter 21: Mechanisms of Hormonal Regulation ................................................................................................... 214
Chapter 22: Alterations of Hormonal Regulation ..................................................................................................... 224
Chapter 23: Obesity and Disorders of Nutrition ....................................................................................................... 236
Chapter 24: Structure and Function of the Reproductive Systems......................................................................... 245
Chapter 25: Alterations of the Female Reproductive System .................................................................................. 255
Chapter 26: Alterations of the Male Reproductive System ...................................................................................... 264
Chapter 27: Sexually Transmitted Infections ............................................................................................................. 270
Chapter 28: Structure and Function of the Hematologic System ........................................................................... 280
Chapter 29: Alterations of Erythrocyte Platelet, Hemostatic Function ................................................................. 291
Chapter 30: Alterations of Leukocyte, Lymphoid Function .................................................................................... 302
Chapter 31: Alterations of Hematologic Function in Children ............................................................................... 312
Chapter 32: Structure and Function of the Cardiovascular and Lymphatic Systems .......................................... 322
Chapter 33: Alterations of Cardiovascular Function................................................................................................. 336
Chapter 34: Alterations of Cardiovascular Function in Children ........................................................................... 351
Chapter 35: Structure and Function of the Pulmonary System............................................................................... 360
Chapter 36: Alterations of Pulmonary Function ....................................................................................................... 370
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,Chapter 37: Alterations of Pulmonary Function in Children .................................................................................. 386
Chapter 38: Structure and Function of the Renal and Urologic Systems .............................................................. 395
Chapter 39: Alterations of Renal and Urinary Tract Function ................................................................................ 406
Chapter 40: Alterations of Renal and Urinary Tract Function in Children ........................................................... 417
Chapter 41: Structure and Function of the Digestive System ................................................................................. 425
Chapter 42: Alterations of Digestive Function .......................................................................................................... 437
Chapter 43: Alterations of Digestive Function in Children ..................................................................................... 449
Chapter 44: Structure and Function of the Musculoskeletal System ...................................................................... 458
Chapter 45: Alterations of Musculoskeletal Function............................................................................................... 469
Chapter 46: Alterations of Musculoskeletal Function in Children ......................................................................... 482
Chapter 47: Structure, Function, and Disorders of the Integument ...................................................................... 491
Chapter 48: Alterations of the Integument in Children............................................................................................ 502
Chapter 49: Shock, Multiple Organ Dysfunction Syndrome, and Burns in Adults ............................................. 510
Chapter 50: Shock, Multiple Organ Dysfunction Syndrome, and Burns in Children ......................................... 519
Chapter 1: Cellular Biology
MULTIPLE CHOICE
1. Which statement best describes the cellular function of metabolic absorption?
a. Cells can produce proteins. c. Cells can take in and use nutrients.
b. Cells can secrete digestive enzymes. d. Cells can synthesize fats.
ANS: C
In metabolic absorption, all cells take in and use nutrients and other substances from their
surroundings. The remaining options are not inclusive in their descriptions of cellular metabolic
absorption.
PTS: 1 REF: Page 2
2. Most of a cell’s genetic information, including RNA and DNA, is contained in the:
a. Mitochondria c. Nucleolus
b. Ribosome d. Lysosome
ANS: C
The nucleus contains the nucleolus, a small dense structure composed largely of RNA, most of the
cellular DNA, and the DNA-binding proteins, such as the histones, which regulate its activity. The
other options do not contain most of a cell’s genetic information.
PTS: 1 REF: Page 2
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,3. Which component of the cell produces hydrogen peroxide (H 2O2) by using oxygen to remove hydrogen
atoms from specific substrates in an oxidative reaction?
a. Lysosomes c. Ribosomes
b. Peroxisomes d. Oxyhydrosomes
ANS: B
Peroxisomes are so named because they usually contain enzymes that use oxygen to remove hydrogen
atoms from specific substrates in an oxidative reaction that produces H2O2, which is a powerful
oxidant and potentially destructive if it accumulates or escapes from peroxisomes. Ribosomes are
RNA-protein complexes (nucleoproteins) that are synthesized in the nucleolus and secreted into the
cytoplasm through pores in the nuclear envelope called nuclear pore complexes. Lysosomes are saclike
structures that originate from the Golgi complex and contain more than 40 digestive enzymes called
hydrolases, which catalyze bonds in proteins, lipids, nucleic acids, and carbohydrates. Oxyhydrosomes
are involved in enzyme production.
PTS: 1 REF: Page 8
4. Which cell component is capable of cellular autodigestion when it is released during cell injury?
a. Ribosome c. Smooth endoplasmic reticulum
b. Golgi complex d. Lysosomes
ANS: D
The lysosomal membrane acts as a protective shield between the powerful digestive enzymes within
the lysosome and the cytoplasm, preventing their leakage into the cytoplasmic matrix. Disruption of
the membrane by various treatments or cellular injury leads to a release of the lysosomal enzymes,
which can then react with their specific substrates, causing cellular self-digestion. The other options do not
correctly describe this process.
PTS: 1 REF: Pages 7-8
5. What is the sequence of steps in the development of a digestive enzyme by the pancreas cells from the
initial transcription to the release from the cell?
a. The enzyme is transcribed from DNA by RNA in the nucleus, proceeds to the ribosome for
synthesis, and is transported in a secretory vesicle to the cell membrane.
b. The enzyme is transcribed from RNA by DNA in the nucleus, proceeds to the lysosome for
synthesis, and is transported in an encapsulated membrane to the cell membrane.
c. The enzyme is transcribed by the mitochondria in the nucleus, proceeds to the ribosome for
synthesis, and is transported in a cytoskeleton to the cell membrane.
d. The enzyme is transcribed from DNA by RNA in the nucleus, proceeds to the
Golgi complex for synthesis, and is transported in a cytosol to the cell membrane.
ANS: A
The enzyme is transcribed from DNA by RNA in the nucleus, proceeds to the ribosome for synthesis,
and is transported in a secretory vesicle to the cell membrane. The other options do not correctly
describe this process.
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, PTS: 1 REF: Page 7 | Figure 1-5
6. During which phase of the cell cycle is DNA synthesized?
a. G1 c. G2
b. S d. M
ANS: B
The four designated phases of the cell cycle are: (1) the G1 phase (G = gap), which is the period
between the M phase (M = mitosis) and the start of DNA synthesis; (2) the S phase (S = synthesis),
during which DNA is synthesized in the cell nucleus; (3) the G2 phase, during which RNA and protein
synthesis occurs, the period between the completion of DNA synthesis and the next phase (M); and
(4) the M phase, which includes nuclear and cytoplasmic division.
PTS: 1 REF: Page 37
7. What organic compound facilitates transportation across cell membranes by acting as receptors,
transport channels for electrolytes, and enzymes to drive active pumps?
a. Lipids c. Proteins
b. Proteases d. Carbohydrates
ANS: C
Proteins act as (1) recognition and binding units (receptors) for substances moving in and out of the
cell; (2) pores or transport channels for various electrically charged particles called ions or electrolytes and
specific carriers for amino acids and monosaccharides; and (3) specific enzymes that drive active
pumps that promote the concentration of certain ions, particularly potassium (K+), within the cell
while keeping concentrations of other ions, for example, sodium (Na+), below the concentrations
found in the extracellular environment. The other options do not correctly describe this process.
PTS: 1 REF: Page 13 | Page 15
8. Understanding the various steps of proteolytic cascades, such as caspase-mediated apoptosis and
complement cascades, may be useful in designing drug therapy for which human diseases?
a. Cardiac and vascular disorders
b. Autoimmune and malignant disorders
c. Gastrointestinal and renal disorders
d. Endocrine and gastrointestinal disorders
ANS: B
Understanding the various steps involved in this process is crucial for designing drug interventions.
Dysregulation of proteases features prominently in many human diseases, including cancer,
autoimmunity, and neurodegenerative disorders. The other options do not correctly describe this
process.
PTS: 1 REF: Page 15
9. Which structure prevents water-soluble molecules from entering cells across the plasma membrane?
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