Gould’s Pathophysiology for The Health Professions, 5th Edition by Karin C. VanMeter – Test Bank A+

Description

Chapter 05: Inflammation and Healing

Test Bank

MULTIPLE CHOICE

1. Tears are considered to be part of the:
2. first line of defense.
3. second line of defense.
4. third line of defense.
5. specific defenses.
6. nonspecific defenses.

a.	1, 4
b.	1, 5
c.	3, 4
d.	2, 5

ANS: B REF: 66

1. A specific defense for the body is:

a.	phagocytosis.
b.	sensitized T lymphocytes.
c.	the inflammatory response.
d.	intact skin and mucous membranes.

ANS: B REF: 66

1. The inflammatory response is a nonspecific response to:

a.	phagocytosis of foreign material.
b.	local vasodilation.
c.	any tissue injury.
d.	formation of purulent exudates.

ANS: C REF: 66

1. Chemical mediators released during the inflammatory response include:

a.	albumin and fibrinogen.
b.	growth factors and cell enzymes.
c.	macrophages and neutrophils.
d.	histamine and prostaglandins.

ANS: D REF: 69

1. Which of the following result directly from the release of chemical mediators following a moderate burn injury?
2. Pain
3. Local vasoconstriction
4. Increased capillary permeability
5. Pallor

a.	1, 2
b.	1, 3
c.	2, 3
d.	2, 4

ANS: B REF: 69

1. Granulation tissue is best described as:

a.	highly vascular, very fragile, and very susceptible to infection.
b.	an erosion through the wall of viscera, leading to complications.
c.	a type of adhesion with no vascularization.
d.	a form of stenosis, in a duct, that is extremely tough and resists attack by microbes.

ANS: A REF: 76

1. Edema associated with inflammation results directly from:

a.	increased fluid and protein in the interstitial compartment.
b.	increased phagocytes in the affected area.
c.	decreased capillary permeability.
d.	general vasoconstriction.

ANS: A REF: 70

1. The warmth and redness related to the inflammatory response results from:

a.	increased interstitial fluid.
b.	production of complement.
c.	a large number of white blood cells (WBCs) entering the area.
d.	increased blood flow into the area.

ANS: D REF: 70

1. What is the correct order of the following events in the inflammatory response immediately after tissue injury?
2. Increased permeability of blood vessels
3. Dilation of blood vessels
4. Transient vasoconstriction
5. Migration of leukocytes to the area
6. Hyperemia

a.	5, 3, 2, 1, 4
b.	1, 2, 4, 5, 3
c.	2, 3, 5, 4, 1
d.	3, 2, 5, 1, 4

ANS: D REF: 69

1. The process of phagocytosis involves the:

a.	ingestion of foreign material and cell debris by leukocytes.
b.	shift of fluid and protein out of capillaries.
c.	formation of a fibrin mesh around the infected area.
d.	movement of erythrocytes through the capillary wall.

ANS: A REF: 70

1. Systemic effects of severe inflammation include:

a.	erythema and warmth.
b.	loss of movement at the affected joint.
c.	fatigue, anorexia, and mild fever.
d.	abscess formation.

ANS: C REF: 71

1. The term leukocytosis means:

a.	increased white blood cells (WBCs) in the blood.
b.	decreased WBCs in the blood.
c.	increased number of immature circulating leukocytes.
d.	significant change in the proportions of WBCs.

ANS: A REF: 72

1. Which of the following statements applies to fever?

a.	Viral infection is usually present.
b.	Heat-loss mechanisms have been stimulated.
c.	It is caused by a signal to the thalamus.
d.	It results from release of pyrogens into the circulation.

ANS: D REF: 71

1. Mechanisms to bring an elevated body temperature down to the normal level include:

a.	general cutaneous vasodilation.
b.	generalized shivering.
c.	increased heart rate.
d.	increased metabolic rate.

ANS: A REF: 71

1. Replacement of damaged tissue by similar functional cells is termed:

a.	fibrosis.
b.	regeneration.
c.	resolution.
d.	repair by scar tissue.

ANS: B REF: 73

1. Scar tissue consists primarily of:

a.	granulation tissue.
b.	epithelial cells.
c.	collagen fibers.
d.	new capillaries and smooth muscle fibers.

ANS: C REF: 76

1. Which of the following promotes rapid healing?

a.	Closely approximated edges of a wound
b.	Presence of foreign material
c.	Exposure to radiation
d.	Vasoconstriction in the involved area

ANS: A REF: 76

1. Glucocorticoids are used to treat inflammation because they directly:

a.	promote the release of prostaglandins at the site.
b.	decrease capillary permeability.
c.	mobilize lymphocytes and neutrophils.
d.	prevent infection.

ANS: B REF: 74

1. Patients taking glucocorticoids for long periods of time are likely to develop all of the following EXCEPT:

a.	decreased bone density.
b.	wasting of skeletal muscle.
c.	opportunistic infections.
d.	increased leukocyte production.

ANS: D REF: 75

1. Which of the following drugs relieves fever and some types of pain but is NOT an anti-inflammatory agent?

a.	Acetaminophen
b.	Prednisone
c.	Aspirin
d.	Ibuprofen

ANS: A REF: 74

1. A burn area in which the epidermis and part of the dermis is destroyed is classified as:

a.	full-thickness.
b.	deep partial-thickness.
c.	superficial partial-thickness.
d.	first-degree.

ANS: B REF: 79

1. A woman has burns on the anterior surfaces of her right arm, chest, and right leg. The percentage of body surface area burned is approximately:

a.	13.5%.
b.	18%.
c.	22.5%.
d.	31.5%.

ANS: C REF: 80 | 82

1. The characteristic appearance of a full-thickness burn is:

a.	painful with multiple blisters.
b.	heavy bleeding.
c.	red with some swelling.
d.	dry, firm, charred, or hard white surface.

ANS: D REF: 79

1. A typical source of infection in burn areas is:

a.	the skin grafts.
b.	microbes surviving in the hair follicles in the burn area.
c.	circulating blood bringing microbes to the burn wound.
d.	opportunistic virus in digestive tract.

ANS: B REF: 83

1. A large burn area predisposes to decreased blood pressure because:

a.	bleeding occurs under the burn surface.
b.	the heart is damaged by toxic materials from the burn.
c.	fluid and protein shift out of the blood.
d.	vasoconstriction occurs in the burn area.

ANS: C REF: 82

1. During an inflammatory response, hyperemia is caused by:

a.	increased blood flow in the area.
b.	increased capillary permeability.
c.	irritation of sensory nerve endings by histamine.
d.	increased leukocytes in the area.

ANS: A REF: 69

1. The advantages of applying a biosynthetic skin substitute to a large area of full-thickness burns include:
2. reduced risk of infection.
3. decreased loss of plasma protein and fluid.
4. developing stronger fibrous scar tissue.
5. more rapid healing.
6. regeneration of all glands, nerves, and hair follicles.

a.	1, 3
b.	4, 5
c.	1, 2, 4
d.	2, 3, 5

ANS: C REF: 84

1. Purulent exudates usually contain:

a.	small amounts of plasma protein & histamine in water.
b.	red blood cells & all types of white blood cells.
c.	numerous leukocytes, bacteria, and cell debris.
d.	large amounts of water containing a few cells.

ANS: C REF: 71

1. Isoenzymes in the circulating blood:

a.	are a type of plasma protein normally present in the circulating blood.
b.	often indicate the precise location of an inflammatory response.
c.	are normally released from leukocytes during the inflammatory response.
d.	are pyrogens, causing low-grade fever.

ANS: B REF: 72

1. A serous exudate is best described as a:

a.	thin, watery, colorless exudate.
b.	thick, sticky, cloudy secretion.
c.	thick, greenish material containing microbes.
d.	brownish, clotted material.

ANS: A REF: 70

1. Systemic manifestations of an inflammatory response include:

a.	edema and erythema.
b.	area of necrosis and loss of function.
c.	pain and tenderness.
d.	fever and malaise.

ANS: D REF: 71

1. Some local effects of a general inflammatory response would include:

a.	high, spiking fever and chills.
b.	redness, warmth, and swelling.
c.	leukopenia and reduced erythrocyte sedimentation rate (ESR).
d.	anorexia and headaches.

ANS: B REF: 67

1. Prolonged administration of glucocorticoids such as prednisone may cause:
2. atrophy of lymphoid tissue.
3. increased resistance to infection.
4. thrombocytopenia.
5. decreased protein synthesis.

a.	1, 2
b.	1, 3
c.	1, 4
d.	2, 4

ANS: C REF: 75

1. Application of ice to an injured knee reduces edema by:

a.	promoting return of lymph fluid.
b.	causing local vasoconstriction.
c.	increasing the rate of tissue repair.
d.	causing systemic vasodilation.

ANS: B REF: 75

1. Healing of large areas of skin loss (including dermis and epidermis) would be most successful through:

a.	rapid mitosis and regeneration of skin layers.
b.	resolution of damaged cells in the area.
c.	covering the area with biosynthetic skin substitute.
d.	graft of fibrous tissue to the area.

ANS: C REF: 84

1. Prostaglandins are produced from ___________ and cause ___________.

a.	activated plasma protein; increased capillary permeability
b.	mast cells; vasodilation and pain
c.	platelets; attraction of neutrophils, chemotaxis
d.	mast cell granules; activation of histamines and kinins

ANS: B REF: 69

1. The number of neutrophils in the blood is increased significantly:

a.	during allergic reactions.
b.	during chronic inflammation.
c.	to produce antibodies.
d.	in order to promote phagocytosis.

ANS: D REF: 69-70

1. An abscess contains:

a.	serous exudate.
b.	purulent exudate.
c.	fibrinous exudate.
d.	hemorrhagic exudate.

ANS: B REF: 71

1. Nonspecific agents that protect uninfected cells against viruses are called:

a.	neutrophils.
b.	macrophages.
c.	interferons.
d.	pyrogens.

ANS: C REF: 66

1. Causes of inflammation include:

a.	direct physical damage such as cuts and sprains.
b.	allergic reactions.
c.	infection.
d.	All the above

ANS: D REF: 67

1. In normal capillary exchange, what is net hydrostatic pressure based on?

a.	The difference between the hydrostatic pressure within the capillary, as compared with the hydrostatic pressure of the interstitial fluid
b.	The relative osmotic pressures in the blood and the interstitial fluid
c.	The difference between the hydrostatic pressure and osmotic pressure within the capillary
d.	The difference between the concentrations of blood cells, plasma proteins, and dissolved substances in the blood and the interstitial fluid

ANS: A REF: 66

1. The cardinal signs of inflammation include all of the following EXCEPT:

a.	redness.
b.	loss of function.
c.	nausea.
d.	swelling.

ANS: C REF: 67

1. Drugs that have anti-inflammatory, analgesic, and antipyretic activities include:
2. COX-2 inhibitors (NSAIDs).
3. glucocorticoids (e.g., prednisone).
4. ibuprofen (NSAID).
5. acetaminophen.
6. aspirin (ASA).

a.	1, 2
b.	2, 4
c.	1, 3, 5
d.	1, 4, 5

ANS: C REF: 74

1. Aspirin (ASA) is discouraged for treatment of viral infection in children because of:

a.	decreased bone growth after puberty.
b.	frequent production of blood clots.
c.	formation of a granuloma filled with virus.
d.	the risk of developing Reye’s syndrome.

ANS: D REF: 74

1. Systemic manifestations of inflammation include all EXCEPT:

a.	pyrexia.
b.	malaise.
c.	local swelling.
d.	anorexia.

ANS: C REF: 71

1. Which of the following cellular elements found in the inflammatory response are responsible for phagocytosis?

a.	Macrophages
b.	Basophils
c.	B lymphocytes
d.	T lymphocytes
e.	Eosinophils

ANS: A REF: 66

1. Which chemical mediator is involved in prolonging the inflammatory response?

a.	Bradykinin
b.	Histamine
c.	Leukotrienes
d.	Chemotactic factors

ANS: C REF: 69

1. Potential complications after healing by scar formation include all the following EXCEPT:

a.	lack of sensory function in the area.
b.	contractures and adhesions.
c.	increased hair growth.
d.	keloid formation.

ANS: C REF: 77-78

1. All of the following are correct statements regarding wound healing EXCEPT:

a.	Resolution occurs where there is minimal tissue damage and the cells can recover.
b.	Granulation tissue forms a permanent replacement for damaged tissue.
c.	Regeneration occurs where the cells are capable of mitosis.
d.	Scar tissue forms where the surrounding cells are incapable of mitosis.

ANS: B REF: 73 | 75-76

1. Which of the following statements regarding inflammation is incorrect?

a.	Inflammation caused by an allergen or a burn will typically produce a serous exudate.
b.	Infection is one cause of inflammation.
c.	Inflammation is the body’s nonspecific response to tissue injury.
d.	Disorders are named using the ending -sarcoma to indicate inflammation.

ANS: D REF: 66 | 67 | 70

1. Which of the following helps to localize and “wall off” the foreign material during an inflammatory response?

a.	Lymphocytes
b.	Increased fluid
c.	Fibrinogen
d.	Antibodies

ANS: C REF: 69

1. Why is an application of cold recommended as part of the RICE first aid measures immediately following an inflammatory response due to injury?

a.	It improves circulation in the area removing chemical mediators.
b.	It causes local vasoconstriction to reduce local edema.
c.	It draws more phagocytic cells to the area to remove debris.
d.	It promotes immediate healing.

ANS: B REF: 75

1. One goal for current research in tissue engineering is to:

a.	create a functional replacement tissue when regeneration is not possible.
b.	adapt cells from the injured organ to produce replacement tissue.
c.	design a nonliving synthetic replacement tissue.
d.	use stem cells as a temporary covering for damaged tissue.

ANS: A REF: 76

1. Identify the proper sequence in the healing process.

a.	A blood clot forms; granulation tissue grows into the gap; new blood vessels develop; phagocytosis of foreign material and cell debris occurs; and collagen fibers form a tight, strong scar.
b.	A blood clot forms; phagocytes remove foreign material and cell debris; granulation tissue grows into the gap; new blood vessels form; and collagen fibers promote formation of a tight, strong scar.
c.	Collagen fibers form in the damaged area; a blood clot forms; granulation tissue grows into the gap; angiogenesis takes place; and foreign material and cell debris are removed by phagocytes.
d.	Foreign material and cell debris are removed by phagocytes; a blood clot forms; granulation tissue grows into the gap; new blood vessels form; and collagen fibers grow and cross-link.

ANS: B REF: 76

1. All of the following are factors that promote healing EXCEPT:

a.	good nutrition: protein, vitamins A and C.
b.	a clean, undisturbed wound.
c.	effective circulation.
d.	advanced age.

ANS: D REF: 77

1. Identify the correct statement about burns:

a.	The severity of the burn depends on the temperature, duration, and extent of the burn.
b.	Young children are less likely to suffer severe burns from immersion in excessively hot water.
c.	Burns to the palms of the hands are more damaging than burns on the face.
d.	With a major burn, excessive bleeding usually causes shock.

ANS: A REF: 78

1. Which statement applies to the recommended emergency care for burns?

a.	Drop and lie completely still on your back.
b.	Call a neighbor for help if the burn appears to be extensive.
c.	Apply lotion and cover burn tightly with a sheet or towel.
d.	Cover the burn area with clean, cool, or tepid water and remove nonsticking clothing.

ANS: D REF: 82

1. Inhalation of carbon monoxide is a threat for many burn patients because this gas:

a.	causes swelling in the trachea.
b.	quickly reduces the available oxygen in the blood.
c.	prevents full expansion of the lungs.
d.	is toxic to the nervous system.

ANS: B REF: 82

1. Hypermetabolism is common with major burns because of:

a.	increased heat loss from the burn wound.
b.	demand for tissue repair.
c.	recurrent stress response.
d.	All of the above

ANS: D REF: 83

1. How does scar tissue usually cause obstructions to develop in tube-like structures?

a.	Scar tissue continues to grow and spread, causing a blockage.
b.	Scar tissue does not stretch, but rather shrinks in time, causing narrowing.
c.	Scar tissue twists and forms knots as it develops.
d.	Scar tissue attaches to nearby normal tissue, causing obstruction.

ANS: B REF: 78

1. Which of the following is a serious potential complication found only with the anti-inflammatory COX-2 inhibitor drugs?

a.	Increased risk of infection at the site of inflammation
b.	Reye’s syndrome developing in children and young adults
c.	Increased incidence of heart attacks
d.	Greatly delayed blood clotting

ANS: C REF: 74

Chapter 07: Immunity

Test Bank

MULTIPLE CHOICE

1. Neutrophils:

a.	are phagocytic cells.
b.	produce histamine.
c.	produce antibodies.
d.	are elevated during an allergic response.

ANS: A REF: 115

1. Which cells are required to process and present antigens from foreign material as the initial step in the immune response?

a.	T–helper cells
b.	Macrophages
c.	Eosinophils
d.	Monocytes

ANS: B REF: 115

1. Humoral immunity is mediated by:

a.	natural killer cells.
b.	T lymphocytes (T cells).
c.	B lymphocytes (B cells).
d.	neutrophils.

ANS: C REF: 115

1. A secondary immune response differs from the primary immune response in that:

a.	it is more rapid than the primary response and results in higher antibody levels.
b.	it is slower than the primary response and doesn’t change the antibody levels.
c.	it occurs at the same time as the primary response but results in a decrease in antibodies.
d.	it only occurs in hyperallergic reactions and results in a decrease of antibodies.

ANS: A REF: 118

1. Which type of immunity is provided by a vaccination?

a.	Active natural
b.	Active artificial
c.	Passive natural
d.	Passive artificial

ANS: B REF: 119

1. When an allergen binds with IgE antibodies on mast cells, resulting in release of chemical mediators, this reaction is called:

a.	cytotoxic hypersensitivity.
b.	immune complex hypersensitivity.
c.	type I hypersensitivity.
d.	type IV hypersensitivity.

ANS: C REF: 122

1. The role of memory cells is to:

a.	change into an antibody-secreting cell following activation.
b.	immediately secrete antibodies following the first exposure to antigen.
c.	recognize the antigen and stimulate the immune response.
d.	bind complement to the antibody.

ANS: C REF: 115

1. Which statement applies to contact dermatitis?

a.	It occurs when IgE antibodies on the skin react with the causative substance.
b.	It may result from ingested foods.
c.	Urticaria (hives) gradually spread over the body.
d.	A type IV reaction occurs in affected areas.

ANS: D REF: 126

1. Which of the following causes anaphylaxis?

a.	A severe, systemic allergic reaction
b.	Type III hypersensitivity
c.	Cell-mediated hypersensitivity
d.	Immune complex deposits in many tissues

ANS: A REF: 124

1. Following a positive HIV antibodies blood test and ELISA test, what is the test commonly used for confirmation?

a.	Agglutination
b.	Double immunodiffusion test
c.	Western blot test
d.	Sedimentation rate test

ANS: C REF: 135

1. Incompatible blood transfusions result in:

a.	hemolysis of erythrocytes.
b.	a type I immune response.
c.	deposits in multiple organs.
d.	immune deficiency.

ANS: A REF: 124

1. An autoimmune disease is:

a.	excessive formation of antibodies following exposure to foreign material.
b.	an extreme response to normally harmless material in the environment.
c.	an abnormal response to ingested food and drugs.
d.	failure of the immune system to distinguish self from nonself.

ANS: D REF: 127

1. Systemic lupus erythematosus is caused by:

a.	a chronic allergic condition.
b.	development of an immune-deficient state.
c.	a deficiency of T lymphocytes.
d.	immune complex deposits of antinuclear antibodies.

ANS: D REF: 127-128

1. Distinguishing clinical features of systemic lupus erythematosus include:

a.	inflammation in multiple organs.
b.	lack of a specific diagnostic blood test.
c.	acute onset and nonprogressive course.
d.	typical skin rash on the chest and back.

ANS: A REF: 128

1. Which of the following are the target cells for HIV?

a.	Helper T lymphocytes (CD4 lymphocytes)
b.	B lymphocytes
c.	Natural killer cells
d.	Macrophages

ANS: A REF: 130 | 131

1. A diagnosis of HIV positive means that:

a.	the number of T lymphocytes in the circulating blood is decreased.
b.	significant opportunistic infection is present in the body.
c.	the individual has AIDS.
d.	the virus and its antibodies are present in the blood.

ANS: D REF: 131

1. HIV infection impairs:

a.	humoral immunity.
b.	cell-mediated immunity.
c.	both humoral and cell-mediated immunity.
d.	neither type of immunity.

ANS: C REF: 133

1. Immunodeficiencies may result in an increased risk of infections by normally harmless microorganisms. These infections are referred to as:

a.	opportunistic.
b.	prophylactic.
c.	abnormal.
d.	transient.

ANS: A REF: 134

1. Serious infections frequently occurring in patients with AIDS include:
2. tuberculosis.
3. Pneumocystis carinii pneumonia.
4. influenza.
5. tetanus.

a.	1, 2
b.	1, 4
c.	2, 3
d.	3, 4

ANS: A REF: 135

1. Which of the following statements does NOT apply to major histocompatibility complex (MHC) proteins or molecules?

a.	They are genes on chromosome 6.
b.	All members of a family have identical MHCs.
c.	They alert the immune system to virus-infected cells.
d.	A close match is essential for successful tissue transplants.

ANS: B REF: 114

1. CD4-positive helper T cells function by:

a.	direct cytotoxic action.
b.	facilitating all immune system activity.
c.	producing immunoglobulins.
d.	inactivating allergens.

ANS: B REF: 117

1. Host-versus-graft disease refers to:

a.	hyperacute rejection of tissue.
b.	T cells in grafted tissue attacking host cells.
c.	infection resulting from immunosuppression therapy.
d.	transplant rejection by the recipient’s immune system.

ANS: D REF: 121

1. Which of the following complications does NOT occur frequently in AIDS patients?

a.	Kaposi’s sarcoma
b.	Wasting syndrome
c.	Lymphoma
d.	Polyarthritis

ANS: D REF: 135-136

1. Which of the following characteristics apply to HIV?
2. It contains two strands of DNA.
3. It tends to mutate frequently to form new strains.
4. The incubation period is extremely short.
5. It is inactivated by heat and many disinfectants.

a.	1, 2
b.	1, 3
c.	2, 4
d.	3, 4

ANS: C REF: 135 | 137

1. In cases of HIV infection, the “window period” refers to the time between:

a.	entry of the virus into the blood and the initial manifestations.
b.	entry of the virus into the body and the appearance of antibodies in the blood.
c.	entry of the virus into the body and a significant drop in CD4 T-helper lymphocyte count.
d.	diagnosis of “HIV positive” and diagnosis of “AIDS.”

ANS: B REF: 133

1. Which of the following is an effect of cytokines? They:

a.	activate and stimulate proliferation of B and T lymphocytes.
b.	destroy antigens quickly.
c.	increase the rate of mitosis in tumors.
d.	cause immediate pain.

ANS: A REF: 115

1. What does seroconversion mean in relation to HIV and AIDS?

a.	The virus has been identified in the blood and body fluids.
b.	Antibodies for HIV have been identified in the blood.
c.	HIV was found in lymphocytes.
d.	Active infection has developed in the patient.

ANS: B REF: 119 | 132

1. Which of the following statements is TRUE regarding a patient who is HIV positive?

a.	No medication is required until the CD4 cell count drops below normal range.
b.	Antibodies are present, destroying the virus and preventing transmission to others.
c.	Antibodies in the blood indicate presence of virus and possible transmission to others.
d.	Enzymes have not yet converted RNA to DNA for replication.

ANS: C REF: 134

1. The term tolerance refers to:

a.	surveillance and destruction of new cancer cells by the immune system.
b.	the ability of the immune system to ignore “self” cells.
c.	the ability of T and B lymphocytes to work together.
d.	the role of lymphoid tissue in the body defenses.

ANS: B REF: 118

1. Which of the following statements applies to the complement system?

a.	It is activated by IgE.
b.	It blocks the inflammatory response.
c.	It consists of proteins in the blood that must be activated.
d.	It may destroy antibodies in the circulation.

ANS: C REF: 118

1. Which of the following statements regarding immunoglobulins is TRUE?

a.	They consist of a unique sequence of amino acids.
b.	They are produced in the red bone marrow.
c.	They are attached to mucosal membranes at entry points into the body.
d.	IgA binds to allergens.

ANS: A REF: 117

1. Which of the following is NOT a cause of immunodeficiency?

a.	Hypoplasia of the thymus
b.	Delayed hypersensitivity
c.	Immunosuppressive drugs
d.	Atrophy of the lymph nodes

ANS: B REF: 130

1. Which statement is TRUE regarding infants born to HIV-infected mothers?

a.	Infants usually test negative for HIV after birth.
b.	There is little risk of infected mothers passing the virus to their infants during delivery.
c.	Breast milk does not contain HIV or antibodies.
d.	Infants test positive for HIV because of the presence of maternal antibodies.

ANS: D REF: 134

1. The most common cause of death in patients who have AIDS is:

a.	HIV encephalopathy.
b.	tuberculosis.
c.	Pneumocystis carinii pneumonia.
d.	Candida infection.

ANS: C REF: 135

1. Tissue transferred between two genetically identical twins is referred to as a/an:

a.	allograft.
b.	syngraft.
c.	isograft.
d.	autograft.

ANS: C REF: 121

Chapter 09: Musculoskeletal Disorders

Test Bank

MULTIPLE CHOICE

1. Which of the following cells produce new bone?

a.	Osteocytes
b.	Osteoblasts
c.	Osteoclasts
d.	Stem cells from the bone marrow

ANS: B REF: 159

1. What is the chemical transmitter released at the neuromuscular junction?

a.	Norepinephrine
b.	GABA
c.	Serotonin
d.	Acetylcholine

ANS: D REF: 161

1. What are the two types of bone tissue?

a.	Vascular and nonvascular
b.	Spongy and calcified
c.	Compact and cancellous
d.	Dense and pliable

ANS: C REF: 159

1. Which of the following would identify an open or compound fracture?

a.	The skin and soft tissue are exposed at the fracture site.
b.	A bone is crushed into many small pieces.
c.	The bone appears bent with a partial fracture line.
d.	One end of a bone is forced into an adjacent bone.

ANS: A REF: 164

1. Which of the following describes a Colles’ fracture?

a.	The distal radius is broken.
b.	The distal fibula is broken.
c.	A vertebra appears crushed.
d.	A spontaneous fracture occurs in weakened bone.

ANS: A REF: 165

1. During the fracture healing process, the hematoma:

a.	is broken down and absorbed immediately.
b.	provides the base for bone cells to produce new bone.
c.	is the structure into which granulation tissue grows.
d.	produces fibroblasts to lay down new cartilage.

ANS: C REF: 166

1. When a fracture is healing, the procallus or fibrocartilaginous callus:

a.	can bear weight.
b.	serves as a splint across the fracture site.
c.	is the tissue that lays down new cartilage.
d.	is made up of new bone.

ANS: B REF: 166

1. The inflammation surrounding a fracture site during the first few days may complicate healing by causing:

a.	excessive bone movement.
b.	severe ischemia and tissue necrosis.
c.	malunion or nonunion.
d.	fat emboli to form.

ANS: B REF: 166-167

1. What is a sign of a dislocation?

a.	Crepitus
b.	Pain and tenderness
c.	Increased range of motion at a joint
d.	Deformity at a joint

ANS: D REF: 168

1. All of the following predispose to osteoporosis EXCEPT:

a.	weight-bearing activity.
b.	a sedentary lifestyle.
c.	long-term intake of glucocorticoids.
d.	calcium deficit.

ANS: A REF: 169

1. Which of the following statements does NOT apply to osteoporosis?

a.	Bone resorption is greater than bone formation.
b.	It causes compression fractures of the vertebrae.
c.	Osteoporosis is always a primary disorder.
d.	It often leads to kyphosis and loss of height.

ANS: C REF: 169

1. Which of the following best describes the typical bone pain caused by osteogenic sarcoma?

a.	Intermittent, increasing with activity
b.	Sharp, increased with joint movement
c.	Mild, aching when weight-bearing
d.	Steady, severe, and persisting with rest

ANS: D REF: 171

1. How is Duchenne’s muscular dystrophy inherited?

a.	Autosomal recessive gene
b.	X-linked recessive gene
c.	Autosomal dominant gene
d.	Codominant gene

ANS: B REF: 172

1. Which of the following is true about Duchenne’s muscular dystrophy?

a.	There is difficulty climbing stairs or standing up at 2 to 3 years of age.
b.	It involves only the legs and pelvis.
c.	Skeletal muscle atrophy can be seen in the legs of a toddler.
d.	It cannot be detected in any carriers.

ANS: A REF: 172

1. The most common type of joint, which are freely movable, are called:

a.	Synarthroses
b.	Amphiarthroses
c.	Anarthroses
d.	Diarthroses

ANS: D REF: 163

1. Which of the following is characteristic of osteoarthritis?

a.	Inflammation and fibrosis develop at the joints.
b.	Degeneration of articulating cartilage occurs in the large joints.
c.	It progresses bilaterally through the small joints.
d.	There are no changes in the bone at the affected joints.

ANS: B REF: 173-174

1. What is a typical characteristic of the pain caused by osteoarthritis?

a.	Decreases over time
b.	Quite severe in the early stages
c.	Aggravated by general muscle aching
d.	Increased with weight-bearing and activity

ANS: D REF: 174

1. What limits joint movement in osteoarthritis?

a.	The osteophytes and irregular cartilage surface
b.	The wider joint space
c.	Decreased amount of synovial fluid in the cavity
d.	Fibrosis involving the joint capsule and ligaments

ANS: A REF: 174

1. Joints affected by osteoarthritis can sometimes affect healthy joints by:

a.	causing enzymes to be released that travel to other joints.
b.	bacteria traveling from the affected join to a healthy one through the bloodstream.
c.	inflammation and edema affecting the entire limb.
d.	the affected individual’s exerting stress on the normal joint to protect the damaged one.

ANS: D REF: 174

1. What is the typical joint involvement with rheumatoid arthritis?

a.	Random single joints, progressing to involve other joints
b.	Bilateral small joints, symmetrical progression to other joints
c.	Abused or damaged joints first, then joints damaged by compensatory movement
d.	Progressive degeneration in selected joints

ANS: B REF: 177

1. What is the basic pathology of rheumatoid arthritis?

a.	Degenerative disorder involving the small joints
b.	Chronic inflammatory disorder affecting all joints
c.	Systemic inflammatory disorder due to an autoimmune reaction
d.	Inflammatory disorder causing damage to many organs

ANS: C REF: 175-177

1. How is the articular cartilage damaged in rheumatoid arthritis?

a.	Enzymatic destruction by the pannus
b.	Inflamed synovial membrane covers the cartilage
c.	Fibrous tissue connects the ends of the bones
d.	Blood supply to the cartilage is lost

ANS: A REF: 175

1. How does the joint appear during an exacerbation of rheumatoid arthritis?

a.	Relatively normal
b.	Enlarged, firm, crepitus with movement
c.	Deformed, pale, and nodular
d.	Red, warm, swollen, and tender to touch

ANS: D REF: 177

1. Ankylosis and deformity develop in rheumatoid arthritis because:

a.	skeletal muscle hypertrophies.
b.	fibrosis occurs in the joint.
c.	replacement cartilage changes alignment.
d.	ligaments and tendons shorten.

ANS: A REF: 176

1. Systemic effects of rheumatoid arthritis are manifested as:

a.	nodules in various tissues, severe fatigue, and anorexia.
b.	headache, leukopenia, and high fever.
c.	swelling and dysfunction in many organs.
d.	progressive damage to a joint.

ANS: A REF: 176

1. What is a common effect of long-term use of glucocorticoids to treat rheumatoid arthritis?

a.	Leukocytosis
b.	Osteoporosis
c.	Severe anemia
d.	Orthostatic hypotension

ANS: B REF: 177

1. Juvenile rheumatoid arthritis (JRA) differs from the adult form in that:

a.	only small joints are affected.
b.	rheumatoid factor is not present in JRA, but systemic effects are more severe.
c.	onset is more insidious in JRA.
d.	deformity and loss of function occur in most children with JRA.

ANS: B REF: 177

1. Which of the following distinguishes septic arthritis?

a.	Multiple joints that are swollen, red, and painful at one time
b.	Presence of mild fever, fatigue, and leukocytosis
c.	Purulent synovial fluid present in a single, swollen joint
d.	Presence of many antibodies in the blood

ANS: C REF: 178

1. Which of the following may precipitate an attack of gout?

a.	A sudden increase in serum uric acid levels
b.	Severe hypercalcemia
c.	Mild trauma to the toes
d.	Development of a tophus

ANS: A REF: 178

1. Where does inflammation usually begin in an individual with ankylosing spondylitis?

a.	Costovertebral joints with progression down the spine
b.	Cervical and thoracic vertebrae, causing kyphosis
c.	Sacroiliac joints with progression up the spine
d.	Peripheral joints and then proceeds to the vertebrae

ANS: C REF: 178

1. What is a common outcome of fibrosis, calcification, and fusion of the spine in ankylosing spondylitis?

a.	Damage to the spinal nerves and loss of function
b.	Frequent fractures of long bones
c.	Impaired heart function
d.	Rigidity, postural changes, and osteoporosis

ANS: D REF: 178-179

1. Which statement applies to menisci?

a.	They are found in the hip joints.
b.	They are secretory membranes in joints.
c.	They prevent excessive movement of joints.
d.	They are found in the shoulder joint.

ANS: C REF: 163

1. Which factors delay healing of bone fractures?
2. Lack of movement of the bone
3. Prolonged inflammation and ischemia
4. Presence of osteomyelitis
5. Close approximation of bone ends

a.	1, 2
b.	1, 3
c.	2, 3
d.	3, 4

ANS: C REF: 166-167

1. What is the likely immediate result of fat emboli from a broken femur?

a.	Additional ischemia in the broken bone
b.	Nonunion or malunion of the fracture
c.	Pulmonary inflammation and obstruction
d.	Abscess and infection at a distant site

ANS: C REF: 167

1. A sprain is a tear in a:

a.	ligament.
b.	tendon.
c.	skeletal muscle.
d.	meniscus.

ANS: A REF: 168

1. Therapeutic measures for osteoporosis include:

a.	non–weight-bearing exercises.
b.	dietary supplements of calcium and vitamin D.
c.	transplants of osteoblasts.
d.	avoidance of all hormones.

ANS: B REF: 170

1. What is the distinguishing feature of primary fibromyalgia syndrome?

a.	Joint pain and stiffness throughout the body
b.	Degeneration and atrophy of skeletal muscles in back and lower limbs
c.	Localized areas of constant pain
d.	Specific trigger points for pain and tenderness

ANS: D REF: 173

1. Ewing’s sarcoma metastasizes at an early stage to the:

a.	brain.
b.	liver.
c.	lungs.
d.	other bones.

ANS: C REF: 171

1. Immovable joints are called:

a.	amphiarthroses.
b.	synarthroses.
c.	diarthroses.
d.	synovial joints.

ANS: B REF: 163

1. Rickets results from:

a.	excessive bone resorption by osteoclasts.
b.	a deficit of vitamin D and phosphates.
c.	replacement of bone by fibrous tissue.
d.	hyperparathyroidism.

ANS: B REF: 170

1. Paget’s disease often leads to which of the following?

a.	A reduction in bone fractures
b.	Decreased intracranial pressure
c.	Cardiovascular disease
d.	Disintegration of joint cartilage

ANS: C REF: 170

1. Bones classified as “irregular” would include:

a.	skull bones.
b.	the mandible.
c.	wrist bones.
d.	the femur.

ANS: B REF: 159

1. A dislocation is:

a.	the tearing of a tendon in the joint.
b.	the separation of bones in the joint with a loss of contact.
c.	the twisting of a joint, causing excessive inflammation of the surrounding tissue.
d.	the overstressing of ligaments, causing loss of elasticity.

ANS: B REF: 167

1. A diagnostic test that measures the electrical charge of muscle contraction and can help differentiate muscle disorders from neurological disease is a/an:

a.	electromyogram.
b.	arthroscopy.
c.	radiograph.
d.	electroencephalograph.

ANS: A REF: 164

1. The type of compound fracture in which there are multiple fracture lines and bone fragments is referred to as a/an:

a.	compression fracture.
b.	greenstick fracture.
c.	simple fracture.
d.	comminuted fracture.

ANS: D REF: 164

1. Fluid-filled sacs composed of synovial membrane located between structures such as tendons and ligaments and act as additional cushions are called:

a.	articular capsules.
b.	bursae.
c.	synovial sacs.
d.	hyaline chambers.