Pathophysiology The Biologic Basis for Disease In Adults And Children 8th Edition by Kathryn L. McCance - Test Bank

Pathophysiology The Biologic Basis for Disease In Adults And Children 8th Edition by Kathryn L. McCance – Test Bank

 

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Chapter 05: Genes, Environment-Lifestyle, and Common Diseases

McCance/Huether: Pathophysiology: The Biologic Basis of Disease in Adults and Children, 8th Edition

 

MULTIPLE CHOICE

 

1. The data reporting that sickle cell disease affects approximately 1 in 600 American blacks is an example of which concept?

a.	Incidence
b.	Prevalence
c.	Ratio
d.	Risk

 

 

ANS:  B

Prevalence 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.	Attributable
b.	Contingency
c.	Causal
d.	Relative

 

 

ANS:  D

A 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 testing
b.	Direct observation
c.	Liability thresholds
d.	Relative risks

 

 

ANS:  B

For 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 fats
b.	Increased production of cholesterol by the liver
c.	Reduction in the number of low-density lipoprotein (LDL) receptors on cell surfaces
d.	Abnormal function of lipoprotein receptors circulating in the blood

 

 

ANS:  C

A 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 intake
b.	Physical inactivity
c.	Psychosocial stress
d.	Obesity

 

 

ANS:  D

The 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: Remembering

 

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.	<1
b.	5 to 10
c.	15 to 20
d.	20 to 30

 

 

ANS:  B

An 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.	2
b.	3
c.	6
d.	10

 

 

ANS:  A

If 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.	Twofold
b.	Threefold
c.	Fourfold
d.	Tenfold

 

 

ANS:  C

Adoption 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 appetite
b.	Metabolizing of fat
c.	Absorption of fat
d.	Altering the sense of satiety

 

 

ANS:  A

Clinical 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 a-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.	Ovarian
b.	Lung
c.	Uterine
d.	Pancreatic

 

 

ANS:  A

BRCA1 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.	b1-Adrenergic receptors to increase heart rate
b.	The release of an antidiuretic hormone (ADH)
c.	The renin-angiotensin system’s effect on vasoconstriction
d.	Serum bradykinin, causing vasodilation

 

 

ANS:  C

Studies 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). b₁-Adrenergic receptors, ADH, and bradykinin are not the subjects of such research.

 

PTS:   1                    DIF:    Cognitive Level: Remembering

 

12. What are the two most important risk factors for type 2 diabetes?

a.	Autoantibodies and human leukocyte antigen associations
b.	Autoantibodies and obesity
c.	Obesity and positive family history
d.	HLA associations and positive family history

 

 

ANS:  C

The two most important risk factors for type 2 diabetes are positive family history and obesity. Autoantibodies and human leukocyte antigen associations are not believed to be important risk factors for this form of diabetes.

 

PTS:   1                    DIF:    Cognitive Level: Remembering

 

13. A parent wants to know how to prevent type 1 diabetes in the newborn. The healthcare professional explains that prevention is not possible, because which of these is a major characteristic of type 1 diabetes mellitus?

a.	Partial insulin secretion
b.	An autoimmune cause factor
c.	Insulin resistance
d.	Obesity as a common risk factor

 

 

ANS:  B

A strong association between type 1 diabetes and the presence of several human leukocyte antigen (HLA) class II alleles indicate that type 1 diabetes mellitus is an autoimmune disease. The remaining options are associated with type 2 diabetes.

 

PTS:   1                    DIF:    Cognitive Level: Comprehension

 

14. A patient with several risk factors is concerned about developing type 2 diabetes. The healthcare professional advises the patient to lose weight, explaining that obesity is an important risk factor for type 2 diabetes mellitus because it causes what?

a.	Reduced insulin production by the pancreas
b.	Increased resistance to insulin in the cells
c.	Obstructed outflow of insulin from the pancreas
d.	Stimulation of glucose production by the liver

 

 

ANS:  B

People with type 2 diabetes mellitus suffer from insulin resistance. Obesity causes this resistance so their cells have difficulty using insulin. Obesity does not lead to reduced insulin production, obstructed insulin outflow, or stimulation of glucose production.

 

PTS:   1                    DIF:    Cognitive Level: Remembering

 

15. Traits caused by the combined effects of multiple genes are referred to by which term?

a.	Polygenic
b.	Multifocal
c.	Modifiable
d.	Involuntary

 

 

ANS:  A

Traits in which variation is thought to be caused by the combined effects of multiple genes are polygenic, meaning many genes. Multifocal means relating to or arising from many points. Modifiable refers to the changeability of something. Involuntary suggests being out of the control of someone or something.

 

PTS:   1                    DIF:    Cognitive Level: Remembering

 

16. Regarding type 2 diabetes, obesity is considered to be what type of risk?

a.	Genetic
b.	Empirical
c.	Relative
d.	Modifiable

 

 

ANS:  D

A modifiable risk is one a person can change in order to reduce risk. Obesity is a modifiable risk factor for many diseases including heart disease, stroke, hypertension, and type 2 diabetes. Genetic, empirical, and relative risks are not changeable by individuals in order to reduce their chance of developing diseases.

 

PTS:   1                    DIF:    Cognitive Level: Remembering

 

17. Which disease form is associated with identified empirical risks?

a.	Polygenic
b.	Multifactorial
c.	Monozygotic
d.	Genetic

 

 

ANS:  B

For most multifactorial diseases, empirical risks (i.e., risks based on direct observation of data) have been derived. Traits in which variation is thought to be caused by the combined effects of multiple genes are polygenic. Monozygotic is a term that refers to identical twins. Genetic refers to issues related to genes and their influence on the body.

 

PTS:   1                    DIF:    Cognitive Level: Remembering

 

18. The number of persons living with a specific disease at a specific point in time is referred to by which term?

a.	Relativity
b.	Survivability
c.	Prevalence
d.	Incidence

 

 

ANS:  C

The prevalence 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 term “relativity” is not related to disease statistics. Survivability would refer to the chances of a person being able to survive a specific disease and is also not related to the question. 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.

 

PTS:   1                    DIF:    Cognitive Level: Remembering

 

19. Which type of cancer is said to aggregate among families?

a.	Breast
b.	Lung
c.	Skin
d.	Brain

 

 

ANS:  A

Breast cancer appears to aggregate strongly in families. The other cancers are not believed to be familial in nature.

 

PTS:   1                    DIF:    Cognitive Level: Remembering

 

20. Which dietary lifestyle choice has been associated with a decreased risk for developing colon cancer?

a.	Increased consumption of dairy products
b.	Increased consumption of foods containing vitamin C
c.	Decreased consumption of foods high in fat
d.	Decreased consumption of artificial food coloring

 

 

ANS:  C

A low-fat, high-fiber diet is thought to decrease the risk of colon cancer. Consumption of dairy products, vitamin C, and artificial food coloring are not thought to be related to colon cancer.

 

PTS:   1                    DIF:    Cognitive Level: Remembering

 

21. What is currently believed about the risk for developing Alzheimer disease?

a.	It is not directly related to genetic predisposition.
b.	It is higher among men than it is among women.
c.	It occurs less among Hispanics than in Asians.
d.	It doubles among those with an affected first-degree relative.

 

 

ANS:  D

The risk of developing Alzheimer disease doubles in individuals who have an affected first-degree relative. There is a genetic link to the disease. It is not true that the risk is higher among men than it is among women. Hispanics have relatively low risk of developing this disease.

 

PTS:   1                    DIF:    Cognitive Level: Remembering

 

22. The number of new cases of a disease reported during a specific period divided by the number of individuals in the population is defined as which characteristic of a disease?

a.	Prevalence rate
b.	Incidence rate
c.	Relative risk
d.	Frequency

 

 

ANS:  B

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. The prevalence rate is the proportion of the population affected by a disease at a specific point in time. The relative risk is a ratio of the increased rate of disease among a population exposed to a risk factor compared with the increased rate of the disease in an unexposed population. Frequency is a simple measure of how often something occurs.

 

PTS:   1                    DIF:    Cognitive Level: Remembering

 

MULTIPLE RESPONSE

 

1. Which are cancers that cluster strongly in families? (Select all that apply.)

a.	Breast
b.	Colon
c.	Ovarian
d.	Lung
e.	Brain

 

 

ANS:  A, B, C

Although breast, ovarian, and colon cancers have shown a strong familial tendency, lung and brain cancers have not.

 

PTS:   1                    DIF:    Cognitive Level: Remembering

 

2. Which genes are responsible for an autosomal dominant form of breast cancer? (Select all that apply.)

a.	LCAT
b.	CHK1
c.	CHK2
d.	BRCA1
e.	BRCA2

 

 

ANS:  D, E

Women who inherit a mutation in BRCA1 or BRCA2 experience a 50% to 80% lifetime risk of developing breast cancer. The other options do not carry this risk.

 

PTS:   1                    DIF:    Cognitive Level: Remembering

 

3. Which lifestyle modifications affect health-related risk factors? (Select all that apply.)

a.	Diet
b.	Exercise
c.	Education
d.	Finances
e.	Stress reduction

 

 

ANS:  A, B, E

Lifestyle modification (e.g., diet, exercise, stress reduction) can often reduce health risks significantly. Education and finances have not been shown to have an effect on health in a way that involves lifestyle modifications.

 

PTS:   1                    DIF:    Cognitive Level: Remembering

 

4. What factors are typically considered when assessing an individual’s risk for developing such common diseases as hypertension? (Select all that apply.)

a.	Age
b.	Diet
c.	Exercise habits
d.	Family history
e.	Spiritual beliefs

 

 

ANS:  A, B, C, D

Many factors influence the risk of acquiring a common disease, such as cancer, diabetes, or hypertension. These factors can include age, gender, diet, exercise, and family history of the disease. Current research does not support a connection between spiritual beliefs and the development of hypertension.

 

PTS:   1                    DIF:    Cognitive Level: Remembering

 

5. Which are examples of multifactorial diseases associated with adults? (Select all that apply.)

a.	Breast cancer
b.	Coronary heart disease
c.	Emphysema
d.	Diabetes mellitus
e.	Schizophrenia

 

 

ANS:  A, B, D, E

Multifactorial diseases in adults include coronary heart disease, hypertension, breast cancer, colon cancer, diabetes mellitus, obesity, Alzheimer disease, alcoholism, schizophrenia, and bipolar affective disorder. Emphysema is not considered multifactorial.

 

PTS:   1                    DIF:    Cognitive Level: Remembering