Copyright © 2019, Elsevier Inc. All Rights Reserved. 1Chapter 02: Altered Cellular and Tissue Biology: Environmental AgentsMcCance/Huether: Pathophysiology: The Biologic Basis of Disease in Adults and Children, 8th EditionMULTIPLE CHOICE 1. Which type of cell adaptation occurs when normal columnar ciliated epithelial cells of the bronchial lining have been replaced by stratified squamous epithelial cells?a. Hyperplasiab. Metaplasiac. Dysplasiad. AnaplasiaANS: BMetaplasia is the reversible replacement of one mature cell by another, sometimes a less-differentiated cell type. The best example of metaplasia is the replacement of normal columnar-ciliated epithelial cells of the bronchial (airway) lining by stratified squamous epithelial cells. The other options do not accurately describe the event in the question.PTS: 1 DIF: Cognitive Level: Remembering 2. What does the loss of the adenosine triphosphate (ATP) during ischemia cause cells to do?a. Shrink because of the influx of calcium (Ca)b. Shrink because of the influx of potassium chloride (KCl)c. Swell because of the influx of sodium chloride (NaCl)d. Swell because of the influx of nitric oxide (NO)ANS: CA reduction in ATP levels causes the plasma membrane’s sodium–potassium (Na+–K+) pump and sodium–calcium exchange to fail, which leads to an intracellular accumulation of sodium and calcium and diffusion of potassium out of the cell. (The Na+–K+ pump is discussed in Chapter 1.) Sodium and water can then freely enter the cell, and cellular swelling results. The other options do not accurately describe the result of ATP at the cellular level.PTS: 1 DIF: Cognitive Level: Remembering 3. The mammary glands enlarge during pregnancy primarily as a consequence of what hormonal process?a. Atrophyb. Hyperplasiac. Anaplasiad. DysplasiaANS: BHormonal hyperplasia occurs chiefly in estrogen-dependent organs, such as the uterus and breast. Atrophy is a decrease or shrinkage in cellular size. Anaplasia is a condition of poor cellular differentiation, a characteristic of cancer cells. Dysplasia is a change in the size, shape, and organization of mature cells.PTS: 1 DIF: Cognitive Level: Remembering 4. Free radicals play a major role in the initiation and progression of which diseases?a. Cardiovascular diseases such as hypertension and ischemic heart diseaseb. Renal diseases such as acute tubular necrosis and glomerulonephritisc. Gastrointestinal diseases such as peptic ulcer disease and Crohn diseased. Muscular disease such as muscular dystrophy and fibromyalgiaANS: AEmerging data indicate that reactive oxygen species play major roles in the initiation and progression of cardiovascular alterations associated with hyperlipidemia, diabetes mellitus, hypertension, ischemic heart disease, and chronic heart failure. Free radical damage is not a contributing mechanism for the renal, gastrointestinal, or muscular diseases listed.PTS: 1 DIF: Cognitive Level: Remembering 5. How do free radicals cause cell damage?a. Stealing the cell’s oxygen to stabilize the electron, thus causing hypoxiab. Stimulating the release of lysosomal enzymes that digest the cell membranesc. Transferring one of its charged, stabilized atoms to the cell membrane, which causes lysisd. Giving up an electron, which causes injury to the chemical bonds of the cell membraneANS: DA free radical is an electrically uncharged atom or group of atoms having an unpaired electron. Having one unpaired electron makes the molecule unstable; thus to stabilize, the molecule gives up an electron to another molecule or steals one. Therefore it is capable of forming injurious chemical bonds with proteins, lipids, or carbohydrates—key molecules in membranes and nucleic acids. Free radical damage is not caused by hypoxia, lysosomal enzymes, or transferring atoms.PTS: 1 DIF: Cognitive Level: RememberingCopyright © 2019, Elsevier Inc. All Rights Reserved. 2 6. What is a consequence of plasma membrane damage to the mitochondria?a. Enzymatic digestion halts DNA synthesis.b. Influx of calcium ions halts ATP production.c. Edema from an influx in sodium causes a reduction in ATP production.d. Potassium shifts out of the mitochondria, which destroys the infrastructure.ANS: BCalcium alterations are an important mechanism of cell injury and death. Cell membrane injury leads to calcium influx into the cell. An influx of calcium ions from the extracellular compartment activates multiple enzyme systems, resulting in cytoskeleton disruption, membrane damage, activation of inflammation, and eventually DNA degradation. Calcium ion accumulation in the mitochondria causes the mitochondria to swell, which is an occurrence that is associated with irreversible cellular injury. The injured mitochondria can no longer generate ATP, but they do continue to accumulate calcium ions. Mitochondrial consequences of cell membrane damage do not include enzymatic digestion, reduced ATP production due to edema, or infrastructure damage from potassium shifts.PTS: 1 DIF: Cognitive Level: Remembering 7. What is a consequence of leakage of lysosomal enzymes during chemical injury?a. Enzymatic digestion of the nucleus and nucleolus occurs, halting DNA synthesis.b. Influx of potassium ions into the mitochondria occurs, halting the ATP production.c. Edema of the Golgi body prevents the transport of proteins out of the cell.d. Shift of calcium out of the plasma membrane occurs, destroying the cytoskeleton.ANS: AAcid hydrolases from leaking lysosomes are activated in the reduced pH of the injured cell and they digest cytoplasmic and nuclear components. Influx of potassium ions into the mitochondria, edema of Golgi bodies, and calcium destruction of the cytoskeleton are not a consequence of leakage of lysosomal enzymes during chemical injury.PTS: 1 DIF: Cognitive Level: Remembering 8. Lead causes damage within the cell by interfering with the action of what?a. Sodium and chlorideb. Potassiumc. Calciumd. ATPANS: CLead affects many different biologic activities at the cellular and molecular levels, many of which may be related to its ability to interfere with the functions and homeostasis of calcium. Lead does not appear to cause damage by interfering with the action of sodium, chloride, potassium, or ATP.PTS: 1 DIF: Cognitive Level: Remembering 9. A health professions student asks the professor to explain apoptosis. What response is most accurate?a. Programmed cell deathb. Due to chemical injuryc.
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