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In the liver, amino acids are used to produce complex molecules by means of

anabolic processes

Which of the following cells in the gastric mucosa produce intrinsic factor and hydrochloric acid?

parietal cells

Which of the following is the primary site for absorption of nutrients?


When highly acidic chime enters the duodenum, which hormone stimulated the release of pancreatic secretions that contains very high bicarbonate ion content?


Which of the following breaks protein down into peptides?


In which structure is oxygenated blood (arterial) mixed with unoxygenated blood (venous) so as to support the functions of the structure?


Which of the following stimulates increased peristalsis and secretions in the digestive tract?

vagus nerve

Which of the following is contained in pancreatic exocrine secretions?

bicarbonate ion

An alkaline environment is required in the duodenum to

activate intestinal and pancreatic enzymes

Which of the following processes is likely to occur in the body immediately after a meal?


What does the term gluconeogenesis refer to?

formation of glucose from protein and fat

The early stage of vomiting causes

metabolic alkalosis

Prolonged vomiting cause a state of acidosis due to

catabolism of proteins and lipids

What is the first change in arterial blood gases with diarrhea?

decreased bicarbonate ion

Dehydration causes acidosis because of increased

hypovolemia and lactic acid production

Following gastric resection, the onset of nausea, cramps, and dizziness immediately after meals indicates

a large volume of chime has entered the intestines, causing distention

Which of the following is/are (a) manifestation(s) of hemolytic jaundice?

increased unconjugated bilirubin in the blood

Why does mild hyperbilirubinemia occur in newborns?

the immature liver cannot process bilirubin quickly enough

What is the major effect when a gallstone obstructs the cystic duct?

severe colicky pain in upper right quadrant

Which of the following applies to hepatitis A infection?

it is transmitted by the fecal-oral route

What can be concluded if the hepatitis B antigen level remains high in the serum?

chronic infection has developed

What is the most common type of hepatitis transmitted by blood transfusion?


What causes elevated serum level of AST and ALT during the preicteric stage of hepatitis?

necrosis of liver cells

What indicates the presence of third-stage alcohol hepatitis?

accumulation of fat in the hepatocytes and hepatomegaly

A primary factor causing encephalopathy with cirrhosis is the elevated

serum ammonia

In patients with cirrhosis, serum ammonia may increase when

bleeding occurs in the digestive tract

What is the primary cause of esophageal varices?

portal hypertension

What is the primary cause of increased bleeding tendencies associated with cirrhosis?

deficit of vitamin K and prothrombin

Which of the following is NOT usually present during the icteric stage of viral hepatitis?

esophageal varices

Which type(s) of hepatitis increase(s) the risk of hepatocellular carcinoma?


Which of the following occurs with hepatitis B?

the liver is inflamed and enlarged

What is the initial pathological change in alcoholic liver disease?

accumulation of fat in hepatocytes with hepatomegaly

Which type of hepatitis virus requires the presence of hepatitis B virus so as to replicate?


Which of the following structures is most likely to be located in the renal medulla?

loop of Henle

Which of the following is NOT a function of the kidney?

production of albumin

Which of the following describes the correct flow of blood in the kidney?

afferent arteriole to the glomerular capillaries to the efferent arteriole

Which of the following describes the flow of filtrate in the kidney?

Bowman's capsule to the proximal convoluted tubule to the loop of Henle

Which of the following describes the normal flow of urine?

collecting duct to the renal pelvis to the ureter to the bladder

Which statement about the bladder is TRUE?

Three openings from the urinary bladder form the trigone

Which of the following increases glomerular filtration rate?

increased hydrostatic pressure in the glomerular capillaries

Normally, which of the following is reabsorbed completely from the filtrate?


Which substance directly controls the reabsorption of water from the collecting ducts?

antidiuretic hormone

Under what circumstances do cells in the kidneys secrete renin?

blood flow in the afferent arteriole decreases

Which of the following should be present in the filtrate in the proximal convoluted tubule?

sodium and potassium ions

From the following, choose the substance likely to appear in the urine when the glomerulus is inflamed


Which of the following is a significant indicator of renal insufficiency?

increased serum urea and creatinine

Choose the basic cause of osteodystrophy associated with chronic renal failure

failure of the kidney to activate vitamin D

The normal pH of urine is


Which of the following functions would be impaired when tubular epithelial cells have been damaged?

adjusting the specific gravity of the urine

When a respiratory infection with high fever is present in the body, how would the kidney tubules maintain normal pH of body fluids?

secrete more acids and reabsorb more bicarbonate ions

When comparing normal kidney function with dialysis, which of the following mechanisms is not possible in dialysis?

active transport

What is the cause of most cases of pyelonephritis?

an ascending infection by E. coli

Which disease is manifested by dysuria and pyuria?


Why may acute pyelonephritis and cystitis follow untreated prostatitis?

there is a continuous mucosa along these structures

Pyelonephritis may be distinguished from cystitis by the presence in pyelonephritis of

urinary casts and flank pain

In a case of acute pyelonephritis, what is the cause of flank pain?

inflammation, stretching the renal capsule

Which pathophysiologic process applies to acute poststreptococcal glomerulonephritis?

immune complexes deposit glomerular tissue, casing inflammation

What causes the dark urine associated with acute poststreptococcal glomerulonephritis?

increased glomerular permeability resulting in gross hematuria

Renal disease frequently causes hypertension because

congestion and ischemia stimulates release of renin

Urinary casts are present with acute poststreptococcal glomerulonephritis because of

inflamed tubules mold RBCs and protein into a typical mass

Which disease would cause an increased ASO titer and elevated serum ASK?

acute poststreptococcal glomerulonephritis

Why does metabolic acidosis develop with bilateral kidney disease?

tubule exchanges are impaired

What is the first indicator in the arterial blood gases of acidosis caused by kidney disease?

decreased bicarbonate ion

What would be the long-term effects of chronic infection or inflammation of the kidneys?

gradual necrosis, fibrosis, and development of uremia

What factors contribute to headache, anorexia and lethargy with kidney disease?

1.) increased blood pressure
2.) elevated serum urea
3.) anemia
4.) acidosis

What are the significant signs of nephrotic syndrome?

hyperlipidemia and lipiduria

Why does blood pressure often remain near normal in patients with nephrotic syndrome?

Hypoproteinemia results in significant fluid shift to the interstitial compartment

Common causes of urolithiasis include all of the following EXCEPT


Which of the following results from obstruction of the left ureter by a renal calculus?

an attack of renal colic

What does hydronephrosis lead to?

ischemia and fibrosis in the compressed area

Reduced urine output resulting from inflammation and necrosis of the tubules is called?


Which of the following does NOT usually result from nephrosclerosis?

acute renal failure

Which of the following relates to polycystic kidney disease?

it results in gradual degeneration and chronic renal failure

Which of the following indicates the early stage of acute renal failure?

very low GFR and increased serum urea

What is a cause of acute tubule necrosis and acute renal failure?

all of the above

Which of the following would likely cause chronic renal failure?

persistent bilateral glomerulonephritis

What causes polyuria during the stage of renal insufficiency?

loss of tubule function

What is the primary reason for hypocalcemia developing during end-stage renal failure or uremia?

a deficit activated vitamin D and hyperphosphatemia

Cystitis is more common in females due to

the urethra is short, wide, and adjacent to areas with resident flora

Which of the following indicate a decreased GFR?

increased serum urea and decreased serum bicarbonate

Which of the following is NOT likely to lead to hydronephrosis?


Which of the following congenital defects is a common cause of cystitis in young children?

vesicoureteral reflux

Which factor contributes to severe anemia in individuals with chronic renal failure?

limited protein intake

When acidosis becomes decompensated in renal failure, a key indicator is

serum pH dropping below 7.35

Which of the following causes acute renal failure?

bilateral acute glomerulonephritis

Uremic signs of renal failure include all of the following EXCEPT

congestive heart failure

Choose the basic cause of osteodystrophy associated with chronic renal failure

failure of the kidney to activate vitamin D

Agenesis is often not diagnosed because

one kidney provides more that adequate function

Which of the following results from decreased blood flow into the kidneys?

increased angiotensin and systemic vasoconstriction

In acute post-streptococcal glomerulonephritis, the glomerular inflammation results from

type III hypersensitivity reaction

In acute post-streptococcal glomerulonephritis, the inflammation causes

a.) increases permeability of the glomerular capillaries
b.) glomerular congestion and decreased GFR

The reabsorption of water and electrolytes by the kidneys is directly controlled by

1.) atrial natriuretic hormone
2.) antidiuretic hormone

Uncontrolled essential hypertension may cause chronic renal failure because of

damage to afferent arterioles and renal ischemia

Autoregulation in the kidneys refers to

local minor reflex adjustments in the arterioles to maintain normal blood flow

The defective gene for Huntington's disease can be detected in carriers


The best description of a myelomeningocele is

herniation of the meninges, CSF, and spinal cord or nerves through a vertebral defect

What characteristics is common to all individuals with cerebral palsy?

a form of motor disability

Which of the following is characteristic of generalizes seizures?

the uncontrolled discharge of neurons in both hemispheres

What does the clonic stage of a seizure consist of?

alternating contractions and relaxation of skeletal muscles

Which type of seizure commonly occurs in children?

generalized absence

Which of the following is NOT a typical effect of advanced Parkinson's disease?

loss of vision

Which of the following classes of drugs may provide temporary improvement in cases of myasthenia gravis?

anticholinesterase agents

Which of the following is NOT considered to be a common contributing factor to AIDS dementia?

development of arteriosclerosis

Failure of the spinous processes to fuse but without herniation of the meninges is called

spina bifida occulta

Creutfeldt-Jakob disease is caused by

infection in the brain by a prion

In case of noncommunicating hydrocephalus, why does excess cerebrospinal fluid accumulate?

an obstruction is present in the aqueduct of Sylvius or other channel

All of the following are typical signs of hydrocephalus in the neonate EXCEPT

vomiting, headache, and paralysis

How is the presence of spina bifida diagnosed?

prenatally by ultrasound or detection of AFP in maternal blood or amniotic fluid

Which of the following applies to cerebral palsy?

nonprogressive brain damage to the fetus or neonate

From the following, choose the two events (in correct sequence) that immediately follow the aura during a tonic-clonic event

loss of consciousness, then the tonic stage

How would a seizure consisting of bizarre or inappropriate activity be classified?

a psychomotor seizure

Which of the following is characteristic of multiple sclerosis?

remissions and exacerbations

Which statement does NOT apply to the pathophysiology of multiple sclerosis?

progressive random degeneration of peripheral nerves

Which of the following are common early signs of multiple sclerosis?

tremors, weakness in the legs, visual problems

Which of the following applies to Parkinson's disease?

onset occurs in men and women over 60 years of age

What is the pathophysiologic change in Parkinson's disease?

degeneration of the basal nuclei with a deficit of dopamine

Which of the following are common early manifestations of Parkinson's disease?

tremors at rest in the hands and difficulty initiating voluntary movements

In which type of neuron is progressive degeneration occurring with amyotrophic lateral sclerosis (ALS)?

upper and lower motor neurons

Which of the following statements does NOT apply to myasthenia gravis?

dementia develops in the later stage

Which statement applies to Huntington's disease? It

presents with choreiform movements in the upper body and decreased ability to concentrate

What are the characteristic changes in the brain with Alzheimer's disease?

cortical atrophy with plaques and neurofibrillary tangles, impairing conduction

Which disease is associated with excessive dopamine secretion, decreased gray matter in the temporal lobes, and abnormal hippocampal cells in the brain?


In which disorders do biochemical abnormalities involving the neurotransmitters in the brain occur?

1.) bipolar disorder
2.) schizophrenia
3.) Huntington's disease

Which of the following are typical characteristics associated with schizophrenia?

disorganized thought processes, short attention span, delusions

Which of the following is characteristic of generalized seizures?

the uncontrolled discharge of neurons in both hemispheres

What is the typical initial effects of a herniated intervertebral disc at the L4 to L5 level?

lower back pain radiating down the leg

What causes a herniated intervertebral disc?

a protrusion of the nucleus pulposus through the annulus fibrosis

Which of the following dietary supplements has reduced the incidence of spina bifida in recent years?

folic acid

Which of the following is the most common cause of brain damage in children with cerebral palsy?


The ataxic form of cerebral palsy results from damage to the


Which of the following is used both to confirm the diagnosis and classify seizures?


Which statement does NOT apply to status epilepticus?

this condition occurs only in idiopathic seizures

All of the following may precipitate a seizure EXCEPT

severe acidosis

Which of the following is a typical early sign of amyotrophic lateral sclerosis (ALS)?

weakness and muscle atrophy in upper limbs

Which of the following are typical early signs of Alzheimer's disease?

1.) behavioral changes
2.) reduced ability to reason and problem solve

Communicating hydrocephalus causes increased intracranial pressure because of

failure of the subarachnoid to absorb CSF

Which statement is TRUE about amyotrophic lateral sclerosis (ALS)?

cognitive function remains normal

Which statement is TRUE about the condition depression?

a.) it is classified as a mood disorder
c.) it is marked by periods of sadness, hopelessness and inability to concentrate

What must happen for the pupil of the eye to dilate?

stimulation of the sympathetic nervous system is required

Which of the following indicates corneal trauma or infection?

severe pain and photophobia

Which disorder is manifested by loss of peripheral vision?

chronic (wide-angle) glaucoma

Which of the following is an example of conduction deafness?

adhesions reducing the movement of the ossicles

How does otosclerosis cause hearing loss?

fixation of the stapes to the oval window

Which is the early effect of age-related macular degeneration?

loss of central visual acuity

Which fluid is found surrounding the optic disc?

cerebrospinal fluid

Narrow-angle glaucoma develops when the angle is decreased between the

iris and cornea

Which term refers to near-sightedness?


What is the chemical transmitter released at the neuromuscular junction?


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

the skin and soft tissue is expose at the fracture site

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