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Essentials of Pathophysiology
Concepts of Altered Health States 3rd
edition Porth Test Bank
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3. The cellular stage of acute inflammation is marked by the movement of leukocytes into
the area. Which of the following cells arrives early in great numbers?
A) Basophils
B) Lymphocytes
C) Neutrophils
D) Platelets
4. The phagocytosis process involves three distinct steps. What is the initial step in the
process?
A) Engulfment
B) Intracellular killing
C) Antigen margination
D) Recognition and adherence
Page 1
9. Exogenous pyrogens (interleukin-1) and the presence of bacteria in the blood lead to the
release of endogenous pyrogens that:
A) stabilize thermal control in the brain.
B) produce leukocytosis and anorexia.
C) block viral replication in cells.
D) inhibit prostaglandin release.
10. An older adult patient has just sheared the skin on her elbow while attempted to boost
herself up in bed, an event that has precipitated acute inflammation in the region
surrounding the wound. Which of the following events will occur during the vascular
stage of the patient's inflammation?
A) Outpouring of exudate into interstitial spaces
B) Chemotaxis
C) Accumulation of leukocytes along the epithelium
D) Phagocytosis of cellular debris
11. Which of the following individuals most likely has the highest risk of experiencing
chronic inflammation?
A) A patient who has recently been diagnosed with type 2 diabetes
B) A patient who is a carrier of an antibiotic-resistant organism
C) A patient who is taking oral antibiotics for an upper respiratory infection
D) A patient who is morbidly obese and who has a sedentary lifestyle
Page 2
12. Which of the following core body temperatures is within normal range?
A) 35.9°C (96.6°F)
B) 38.0°C (100.4°F)
C) 35.5°C (95.9°F)
D) 37.3°C (99.1°F)
13. A postsurgical patient who is recovering in the postanesthetic recovery unit states that
she is “freezing cold.” Which of the following measures is likely to be initiated in the
patient's hypothalamus in an effort to reduce heat loss?
A) Opening of arteriovenous (AV) shunts
B) Reduced exhalation of warmed air
C) Contraction of pilomotor muscles
D) Decreased urine production
14. An elderly patient is dressed only in a hospital gown and complains of a draft in her
room. Consequently, she has requested a warm blanket while she sits in her wheelchair.
Which of the following mechanisms of heat loss is most likely the primary cause of her
request?
A) Evaporation and conduction
B) Radiation and convection
C) Conduction and convection
D) Convection and evaporation
15. Which of the following pathophysiologic processes are capable of inducing the
production of pyrogens? Select all that apply.
A) Acute inflammation
B) Obesity
C) Myocardial infarction
D) Malignancy
E) Renal failure
Page 3
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The influence of the revival of the knowledge of Greek literature
came to Germany slowly through its relations with Italy, but in the
knowledge of Greek learning and literature the German scholars
were many years behind their Italian contemporaries, while the
possession of Greek manuscripts in Germany was, before the
middle of the fifteenth century, very exceptional indeed. The
scholarship of the earlier German universities appears also to have
been narrower in its range and more restricted in its cultivation than
that which had been developed in Paris, in Bologna, or in Padua.
The membership of the Universities of Prague and of Vienna, the
two oldest in the German list, was evidently restricted almost entirely
to Germans, Bohemians, Hungarians, etc., that is to say, to the races
immediately controlled by the German Empire.
If a scholar of England were seeking, during the fourteenth and
fifteenth centuries, special instruction or special literary and scholarly
advantages, his steps were naturally directed towards Paris for
theology, Bologna for jurisprudence, and Padua for medicine, and
but few of these travelling English scholars appear to have taken
themselves to Prague, Vienna, or Heidelberg.
In like manner, if English book collectors were seeking
manuscripts, they betook themselves to the dealers in Paris, in
Florence, or in Venice, and it was not until after the manuscript-trade
had been replaced by the trade in the productions of the printing-
press that the German cities can be said to have become centres for
the distribution of literature.
Such literary interests as obtained in Germany during the
fourteenth century, outside of those of the monasteries already
referred to, centred nevertheless about the universities. The oldest of
these universities was that of Prague, which was founded in 1347,
more than a century later than the foundations of Paris and Bologna.
The regulations of the University recognised the existence of scribes,
illuminators, correctors, binders, dealers in parchment, etc., all of
which trades were placed under the direct control of the university
authorities.
Hauslik speaks of the book-trade in the fourteenth century as
being associated with the work of the library of the university, and
refers to licensed scribes and illuminators, who were authorised to
make transcripts, for the use of the members of the university, of the
texts contained in the library.[377]
If we may understand from this reference that the university
authorities had had prepared for the library authenticated copies of
the texts of the works required in the university courses, and that the
transcribing of these texts was carried on under the direct
supervision of the librarians, Prague appears to have possessed a
better system for the preparation of its official texts than we have
record of in either Bologna or Paris. Hauslik goes on to say that the
entire book-trade of the city was placed under the supervision of the
library authorities, which authorities undertook to guarantee the
completeness and the correctness of all transcripts made from the
texts in the library. Kirchhoff presents in support of this theory
examples of one or two manuscripts, which contain, in addition to the
inscription of the name of the scribe or dealer by whom it had been
prepared, the record of the corrector appointed by the library to
certify to the correctness of the text.[378]
The second German university in point of date was that of Vienna,
founded in 1365, and, in connection with the work of this university
the manuscript-trade in Germany took its most important
development. There is record in Vienna of the existence of stationarii
who carried on, under the usual university supervision, the trade of
hiring out pecias, but this was evidently a much less important
function than in Bologna.
The buying and selling of books in Vienna was kept under very
close university supervision, and without the authority of the rector or
of the bedels appointed by him for the purpose, no book could be
purchased from either a magister or a student, or could be accepted
on pledge.
The books which had been left by deceased members of the
university were considered to be the property of the university
authorities, and could be sold only under their express directions.
The commission allowed by the authorities for the sale of books was
limited to 2½ per cent., and before any books could be transferred at
private sale, they must be offered at public sale in the auditorium.
The purpose of this regulation was apparently here as in Paris not
only to insure securing for the books sold the highest market prices,
but also to give some protection against the possibility of books
being sold by those to whom they did not belong.
The regulation of the details of the book business appears to have
fallen gradually into the hands of the bedels of the Faculty, and the
details of the supervision exercised approach more nearly to the
Italian than to the Parisian model.
The third German university was that of Heidelberg, founded in
1386. Here the regulations concerning the book-trade were
substantially modelled upon those of Paris. The scribes and the
dealers in manuscripts belonged to the privileged members of the
university. The provisions in the foundation or charter of the
university, which provided for the manuscript-trade, make express
reference to the precedents of the University of Paris.
By the middle of the fifteenth century, there appears to have been
a considerable trade in manuscripts in Heidelberg and in places
dependent upon Heidelberg. In the library of the University of
Erlangen, there exists to-day a considerable collection of
manuscripts formerly belonging to the monastery of Heilsbronn,
which manuscripts were prepared in Heidelberg between 1450 and
1460. The series includes a long list of classics, indicating a larger
classical interest in Heidelberg than was to be noted at the time in
either Prague or Vienna.[379]
The University of Cologne, founded a few years later, became the
centre of theological scholarship in Germany, and the German
manuscripts of the early part of the fifteenth century which have
remained in existence and which have to do with theological subjects
were very largely produced in Cologne. A number of examples of
these have been preserved in the library of Erfurt.
One reason for the smaller importance in Germany of the
stationarius was the practice that obtained on the part of the
instructors of lecturing or of reading from texts for dictation, the
transcripts being made by the students themselves. The authority or
permission to read for dictation was made a matter of special
university regulation. The regulation provided what works could be
so utilised, and the guarantee as to the correctness of the texts to be
used could either be given by a member of the faculty of the
university itself or was accepted with the certified signature of an
instructor of a well known foreign university, such as Paris, Bologna,
or Oxford.
By means of this system of dictation, the production of
manuscripts was made much less costly than through the work of
the stationarii, and the dictation system was probably an important
reason why the manuscript-trade in the German university cities
never became so important as in Paris or London.
It is contended by the German writers that, notwithstanding the
inconsiderable trade in manuscripts, there was a general knowledge
of the subject-matter of the literature pursued in the university, no
less well founded or extended among the German cities than among
those of France or Italy. This familiarity with the university literature is
explained by the fact that the students had, through writing at
dictation, so largely possessed themselves of the substance of the
university lectures.
In the Faculty of Arts at Ingolstadt, it was ordered, in 1420, that
there should be not less than one text-book (that is to say, one copy
of the text-book) for every three scholars in baccalaureate. This
regulation is an indication of the scarcity of text-books.
The fact that the industry in loaning manuscripts to students was
not well developed in the German universities delayed somewhat the
organisation of the book-trade in the university towns. Nevertheless,
Richard de Bury names Germany among the countries where books
could be purchased, and Gerhard Groote speaks of purchasing
books in Frankfort. This city became, in fact, important in the trade of
manuscripts for nearly a century before the beginning of German
printing.[380]
Æneas Silvius says in the preface of his Europa, written in 1458,
that a librarius teutonicus had written to him shortly before, asking
him to prepare a continuation of the book “Augustalis.”[381] This
publishing suggestion was made eight years after the perfection of
Gutenberg’s printing-press, but probably without any knowledge on
the part of the librarius of the new method for the production of
books.
In Germany there was, during the thirteenth and fourteenth
centuries, outside of the ecclesiastics, very little demand for reading
matter. The women had their psalters, which had, as a rule, been
written out in the monasteries. As there came to be a wider demand
for books of worship, this was provided for, at least in the regions of
the lower Rhine, by the scribes among the Brothers of Common Life.
The Brothers took care also of the production of a large proportion of
the school-books required.
During the fourteenth century and the first half of the fifteenth, the
Brothers took an active part in the production and distribution of
manuscripts. Their work was distinct in various respects from that
which was carried on in monastery or in university towns, but
particularly in this that their books were, for the most part, produced
in the tongue of the common folk, and their service as instructors
and booksellers was probably one of the most important influences
in helping to educate the lower classes of North Germany to read
and to think for themselves. They thus prepared the way for the work
of Luther and Melanchthon.
As has been noted in another chapter, the activity of the Brothers
in the distribution of literature did not cease when books in
manuscripts were replaced by the productions of the printing-press.
They made immediate use of the invention of Gutenberg, and in
many parts of Germany, the first printed books that were brought
before the people came from the printing-presses of the Brothers.
Some general system of public schools seems to have taken
shape in the larger cities at least of North Germany as early as the
first half of the thirteenth century. The teachers in these schools
themselves added to their work and to their earnings by transcribing
text-books and sometimes works of worship. Later, there came to be
some extended interest in certain classes of literature among a few
of the princes and noblemen, but this appears to have been much
less the case in Germany than in Italy or even than in France. In the
castles or palaces where there was a chaplain, the chaplain took
upon himself the work of a scribe, caring not only for the
correspondence of his patron, but occasionally also preparing
manuscripts for the library, so called, of the castle. There is also
record of certain stadtschreiber, or public scribes, licensed as such
in the cities of North Germany, and in some cases the post was held
by the instructors of the schools.
Ulrich Friese, a citizen of Augsburg, writing in the latter half of the
fourteenth century, speaks of attending the Nordlingen Fair with
parchment and books. Nordlingen Church was, it appears, used for
the purpose of this fair, and in Lübeck, in the Church of S. Mary,
booths were opened in which, together with devotional books,
school-books and writing materials were offered for sale.
In Hamburg also, the courts in the immediate neighbourhood of
the churches were the places selected by the earlier booksellers and
manuscript-dealers for their trade. In Metz, a book-shop stood
immediately in front of the cathedral, and in Vienna, the first book-
shop was placed in the court adjoining the cathedral of S. Stephen.
Nicolaus, who was possibly the earliest bookseller in Erfurt, had his
shop, in 1460, in the court of the Church of the Blessed Virgin.
From a school regulation of Bautzen, written in 1418, it appears
that the children were instructed to purchase their school-books from
the master at the prices fixed in the official schedule.[382] A certain
schoolmaster in Hagenau, whose work was carried on between 1443
and 1450, has placed his signature upon a considerable series of
manuscripts, which he claims to have prepared with his own hands,
and which were described in Wilken’s History of the library in
Heidelberg. His name was Diebold Läber, or, as he sometimes wrote
it, Lauber, and he describes himself as a writer, schreiber, in the
town of Hagenau. This inscription appears in so many manuscripts
that have been preserved, that some doubt has been raised as to
whether they could be all the work of one hand, or whether Lauber’s
name (imprint, so to speak) may not have been utilised by other
scribes possibly working in association with him.[383]
Lauber speaks of having received from Duke Ruprecht an order
for seven books, and as having arranged to have the manuscripts
painted (decorated or illuminated) by some other hand. Lauber is
recorded as having been first a school-teacher and an instructor in
writing, later a scribe, producing for sale copies of standard texts,
and finally a publisher, employing scribes, simply certifying with his
own signature to the correctness of the work of his subordinates.
There is every indication that he had actually succeeded in
organising in Hagenau, as early as 1443, an active business in the
production and distribution of manuscripts. The books produced by
him were addressed more generally to the popular taste than was
the case with the productions of the monastery scribes.
In part, possibly, as a result of this early activity in the production
of books, one of the first printing-presses in Germany, outside of that
of Gutenberg in Mayence, was instituted in Hagenau, and its work
appears to have been in direct succession to that of the public writer
Lauber.
The relations between Hagenau and Heidelberg were intimate,
and the scholarly service of the members of the university was
utilised by the Hagenau publishers. The book-trade of Hagenau also
appears to have been increased in connection with the development
of intellectual activity given by the Councils of Constance and Basel.
In regard to the latter Council, Kirchhoff quotes Denis as having said:
Quod concilium, qui scholam librariorum dixerit haud errabit.[384]
Either as a cause or as an effect of the activity of the book
production in Hagenau, the Hagenau schools for scribes during the
first half of the fifteenth century became famous.[385] The work of
producing manuscripts appears to have been divided, according to
the manufacturing system; one scribe prepared the text, a second
collated the same with the original, a third painted in the rubricated
initials, and a fourth designed the painted head-pieces to the pages,
while a fifth prepared the ornamented covers. It occasionally
happened, however, that one scribe was himself able to carry on
each division of the work of the production of an illuminated
manuscript.
Hagen quotes some lines of a Hagenau manuscript, as follows: