Copyright © 2019, Elsevier Inc. All Rights Reserved. 1Chapter 05: Genes, Environment-Lifestyle, and Common DiseasesMcCance/Huether: Pathophysiology: The Biologic Basis of Disease in Adults and Children, 8th EditionMULTIPLE CHOICE 1. The data reporting that sickle cell disease affects approximately 1 in 600 American blacks is an example of which concept?a. Incidenceb. Prevalencec. Ratiod. RiskANS: BPrevalence rate is the proportion of the population affected by a disease at a specific point in time. Thus both the incidence rate and the length of the survival period in affected individuals determine prevalence. The incidence rate is the number of new cases of a disease reported during a specific period (typically 1 year), divided by the number of individuals in the population. A numerical expression representing a part of a larger whole or proportion is considered a ratio. Any factor that increases the chance of disease or injury is considered a risk.PTS: 1 DIF: Cognitive Level: Remembering 2. The ratio of the disease among the exposed population to the disease rate in an unexposed population is referred to as what type of risk?a. Attributableb. Contingencyc. Causald. RelativeANS: DA common measure of the effect of a specific risk factor is the relative risk. Assuming a factor is the cause of a disease, attributable risk is the amount of risk that is due to that factor. A future event or circumstance that is possible but cannot be predicted with certainty is a contingency risk. The probability of the outcome is termed a causal risk factor.PTS: 1 DIF: Cognitive Level: Remembering 3. What are empirical risks for most multifactorial diseases based on?a. Chromosomal testingb. Direct observationc. Liability thresholdsd. Relative risksANS: BFor most multifactorial diseases, empirical risks (i.e., risks based on direct observation of data) have been derived. Chromosomal testing, liability thresholds, and relative risks are not the basis for determining the empirical risk of most multifactorial diseases.PTS: 1 DIF: Cognitive Level: Remembering 4. What is the cause of familial hypercholesterolemia (FH)?a. Diet high in saturated fatsb. Increased production of cholesterol by the liverc. Reduction in the number of low-density lipoprotein (LDL) receptors on cell surfacesd. Abnormal function of lipoprotein receptors circulating in the bloodANS: CA reduction in the number of functional LDL receptors on cell surfaces causes FH. Lacking the normal number of LDL receptors, cellular cholesterol uptake is reduced and circulating cholesterol levels increase. High dietary fat intake, increased cholesterol production, and abnormal circulating lipoprotein receptors are not the basis for developing familial FH.PTS: 1 DIF: Cognitive Level: Remembering 5. Which risk factor for hypertension is influenced by genetic factors and lifestyle?a. Sodium intakeb. Physical inactivityc. Psychosocial stressd. ObesityANS: DThe most important environmental risk factors for hypertension are increased sodium intake, decreased physical activity, psychosocial stress, and obesity. However, obesity is, itself, influenced by genes and the environment.PTS: 1 DIF: Cognitive Level: RememberingCopyright © 2019, Elsevier Inc. All Rights Reserved. 2 6. A student asks, “What is the percentage of all cases of breast cancer that are identified as an autosomal dominant form?” What response by the professor is best?a. <1b. 5 to 10c. 15 to 20d. 20 to 30ANS: BAn autosomal dominant form of breast cancer accounts for approximately 5% to 10% of breast cancer cases in the United States.PTS: 1 DIF: Cognitive Level: Understanding 7. When a woman has one first-degree relative with breast cancer, her risk of developing breast cancer is how many times greater?a. 2b. 3c. 6d. 10ANS: AIf a woman has one affected first-degree relative, her risk of developing breast cancer doubles.PTS: 1 DIF: Cognitive Level: Remembering 8. Adoption studies have shown that the offspring of an alcoholic parent have what amount of an increased risk of developing alcoholism when raised by a nonalcoholic parent?a. Twofoldb. Threefoldc. Fourfoldd. TenfoldANS: CAdoption studies have shown that the offspring of an alcoholic parent, even when raised by nonalcoholic parents, have a fourfold increased risk of developing the disorder.PTS: 1 DIF: Cognitive Level: Remembering 9. Studies have identified several genes that play a role in the prevention of obesity by affecting what?a. Regulation of appetiteb. Metabolizing of fatc. Absorption of fatd. Altering the sense of satietyANS: AClinical trials using recombinant leptin have demonstrated moderate weight loss in a subset of obese individuals. In addition, leptin participates in important interactions with other components of appetite control, such as neuropeptide Y and α-melanocyte-stimulating hormone and its receptor, the melanocortin-4 receptor (MC4R). Currently, no research supports the other options as being genetically regulated.PTS: 1 DIF: Cognitive Level: Remembering 10. The BRCA1 and BRCA2 mutations increase the risk of which cancer in women?a. Ovarianb. Lungc. Uterined. PancreaticANS: ABRCA1 mutations increase the risk of ovarian cancer among women (20% to 50% lifetime risk), and BRCA2 mutations also confer an increased risk of ovarian cancer (10% to 20% lifetime prevalence). BRCA1 and BRCA2 mutations are not currently believed to be linked with risks of lung, uterine, or pancreatic cancers.PTS: 1 DIF: Cognitive Level: Remembering 11. What are blood pressure variations associated with?a.β1-Adrenergic receptors to increase heart rateb. The release of an antidiuretic hormone (ADH)c. The renin-angiotensin system’s effect on vasoconstrictiond. Serum bradykinin, causing vasodilationANS: CStudies of blood pressure correlations within families indicate that about 20% to 40% of the variation in both systolic and diastolic blood pressure is caused by genetic factors. Significant research is now focused on specific components that may influence blood pressure variation, such as the renin-angiotensin system (involved in sodium reabsorption and vasoconstriction). β1-Adrenergic receptors, ADH, and bradykinin are not the subjects of such research.PTS: 1 DIF: Cognitive Level: RememberingCopyright © 2019, Elsevier Inc. All Rights Reserved. 3 12. What are the two most important risk factors for type 2 diabetes?a. Autoantibodies and human leukocyte antigen associationsb. Autoantibodies and
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