Clinical Pathophysiology
Midterm Exam
Course Introduction
Clinical Pathophysiology explores the physiological processes underlying human diseases, integrating foundational concepts in anatomy, physiology, and biochemistry to explain how disruptions at the molecular, cellular, and organ levels lead to clinical manifestations. Students examine major disease mechanisms including inflammation, infection, immune responses, hemodynamic disorders, and neoplasia while linking these mechanisms to specific conditions affecting various body systems. Through case studies and real-world examples, the course emphasizes diagnostic reasoning, clinical correlations, and the application of pathophysiological principles in medical decision-making and patient care.
Recommended Textbook
Pathophysiology for the Health Professions 4th Edition by Barbara Gould
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28 Chapters
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1172 Flashcards
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Chapter 1: Introduction to Pathophysiology
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Sample Questions
Q1) Which of the following statements is TRUE?
A)Alteration of DNA does not change cell function.
B)Damaged cells may be able to repair themselves.
C)All types of cells die at the same rate.
D)Mild ischemia causes immediate cell death.
Answer: B
Q2) Routine application of sun block to skin would be an example of:
A)an iatrogenic cause of cancer
B)a preventative measure
C)a precipitating factor
D)a predisposing condition
Answer: B
Q3) A short-term illness that develops very quickly with perhaps a high fever or severe pain is called:
A)acute
B)latent
C)chronic
D)manifestation
Answer: A
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Page 3
Chapter 2: Inflammation and Healing
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Sample Questions
Q1) Causes of inflammation include:
A)direct physical damage such as cuts and sprains
B)ischemia or infarction
C)allergic reactions
D)infection
E)all the above
Answer: E
Q2) Which of the following result directly from the release of chemical mediators following a moderate burn injury
1)pain
2)local vasoconstriction
3)increased capillary permeability
4)pallor
A)1,2
B)1,3
C)2,3
D)2,4
Answer: B
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Chapter 3: Immunity and Abnormal Responses
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Sample Questions
Q1) Which statement applies to contact dermatitis?
A)It occurs when IgE antibodies on the skin react with the causative substance.
B)It may result from ingested foods.
C)Urticaria (hives)gradually spread over the body.
D)A type IV reaction occurs in specific areas.
Answer: D
Q2) HIV infection impairs:
A)humoral immunity
B)cell-mediated immunity
C)both humoral and cell-mediated immunity
D)neither type of immunity
Answer: C
Q3) HIV is transmitted by:
A)kissing or coughing into another's face
B)infected secretions on toilet seats
C)any contaminated surface and skin
D)blood,semen,and vaginal secretions from an infected person
Answer: D
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5
Chapter 4: Infection
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Sample Questions
Q1) All of the following are mechanisms of antiviral drug action EXCEPT:
A)interference with attachment to host cell
B)block assembly of viral particles
C)interference with mitosis
D)shedding of protein coat
Q2) The principle of Universal Precautions is based on:
A)using disinfectants at all times to eliminate cross-infections
B)not touching any open or bleeding lesions
C)sterilizing all instruments and equipment after each use
D)assuming that all body fluids from all individuals are possible sources of infection
Q3) Which of the following factors would NOT increase the virulence of a specific microbe?
A)secretion of endotoxin
B)presence of a bacterial capsule
C)production of interferons
D)secretion of invasive enzymes
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Chapter 5: Neoplasms
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Sample Questions
Q1) The common local effects of an expanding tumor mass include:
1)obstruction of a tube or duct
2)anemia and weight loss
3)cell necrosis and ulceration
4)tumor markers in the circulation
A)1,2
B)1,3
C)2,4
D)3,4
Q2) Select the correct pair representing a malignant tumor and its marker:
A)colon cancer: carcinoembryonic antigen (CEA)
B)hepatic cancer: CA125,AFP
C)prostate cancer: human chorionic gonadotropin (hCG)
D)testicular cancer: Philadelphia chromosome
Q3) What is a benign neoplasm originating from adipose tissue called?
A)Adenoma
B)Lipoma
C)Fibrosarcoma
D)Adenocarcinoma
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Page 7
Chapter 6: Fluid, Electrolyte and Acid-Base Imbalances
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Sample Questions
Q1) Which serum value indicates decompensated metabolic acidosis?
A)pH is below normal range
B)pH is above normal range
C)bicarbonate level decreases
D)bicarbonate level increases
Q2) In patients with impaired expiration associated with emphysema,effective compensation for the acid-base imbalance would be:
A)increased rate and depth of respiration
B)decreased rate and depth of respiration
C)increased urine pH and decreased serum bicarbonate
D)decreased urine pH and increased serum bicarbonate
Q3) Prolonged diarrhea results in:
A)loss of fluid and bicarbonate ions leading to metabolic acidosis
B)increased fluid and serum bicarbonate ions leading to metabolic acidosis
C)loss of chloride ions only,leading to metabolic alkalosis
D)surplus bicarbonate ions,leading to respiratory alkalosis
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8
Chapter 7: Congenital and Genetic Disorders
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Sample Questions
Q1) Which of the following statements applies to Huntington's disease?
A)The effects are obvious at birth.
B)There is a test for the defective gene.
C)There is a 50% probability that the child of an affected parent will be a carrier.
D)The child must inherit the defective gene from both parents in order to be affected.
Q2) The purpose of the Human Genome Project was to:
A)map the nucleotide sequence and identify the genes on each human chromosome
B)study the common patterns of inheritance of single gene disorders
C)manipulate the sequence of DNA in microorganisms and animals
D)identify spontaneous alterations in genetic material caused by teratogens
Q3) Blood tests are primarily performed on neonates in order to:
A)determine need for immediate surgical correction of anomalies
B)commence immediate treatment for metabolic abnormalities
C)identify the presence of any inherited disorders
D)rule out the presence of any infection
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9
Chapter 8: Diseases Associated With Adolescence
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Sample Questions
Q1) Which statement applies to testicular cancer?
A)It often develops from untreated,undescended testes.
B)It is related to chromosome abnormalities such as monosomy X.
C)The tumor presents as a painful red lump in the scrotum.
D)The cancer usually causes sterility.
Q2) Which of the following comprise typical early signs of juvenile rheumatoid arthritis?
1)presence of rheumatoid factor in the blood
2)high fever and skin rash
3)swollen painful knees,wrists,and elbows
4)deformity of the hands and feet
A)1,3
B)1,4
C)2,3
D)2,4
Q3) What is a lateral curvature of the spine called?
A)lordosis
B)kyphosis
C)scoliosis
D)kyphoscoliosis
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Page 10
Chapter 9: Potential Complications of Pregnancy
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Sample Questions
Q1) What is the usual time period between the first day of the last menstrual period and the time of birth? It is:
A)38 weeks
B)termed the gestation period
C)referred to as gravidity
D)the embryonic period
Q2) The term primigravida refers to:
A)length of time since the first day of the last menstrual period
B)a woman who is pregnant for the first time
C)estimated date of delivery
D)withdrawal of a small amount of amnionic fluid
Q3) Diagnosis of pregnancy is confirmed through elevated serum levels of:
A)hCG
B)progesterone
C)AFP
D)estrogen
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11
Chapter 10: Aging and Disease Processes
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Sample Questions
Q1) Which of the following factors lead to delayed wound healing in the elderly?
1)reduced rate of mitosis
2)inadequate circulation
3)high risk of infection
4)more effective immune system
A)1,2
B)1,3
C)2,4
D)1,2,3
E)2,3,4
Q2) What is a major factor leading to increased occurrence of cancer in the elderly?
A)widespread vascular degeneration
B)cumulative exposure to carcinogens
C)hereditary factors
D)increased immune surveillance
Q3) Senescence refers to the period of time when:
A)mitosis is accelerated
B)apoptosis is reduced
C)aging changes become apparent
D)cell death exceeds cell replacement
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Chapter 11: Effects of Immobility
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Sample Questions
Q1) Paralysis of the lower part of the body is called:
A)hemiplegia
B)paraplegia
C)quadriplegia
D)None of the above are correct.
Q2) What do prolonged periods of immobility frequently lead to?
1)orthostatic hypotension
2)increased blood pressure and heart rate
3)increased risk of thrombi and emboli
4)rapid,deep respirations
A)1,2
B)1,3
C)2,4
D)3,4
Q3) Atelectasis may occur with a prolonged period of bed rest due to:
A)reduced removal of pulmonary secretions
B)increased expansion of the lower lobes of the lungs
C)increased risk of aspiration in a sitting position
D)loss of cough reflex
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Chapter 12: The Influence of Stress
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Sample Questions
Q1) The basic physiologic response to stress is the same in all individuals.
A)True
B)False
Q2) In which of the following disorders is stress NOT considered to be an exacerbating factor?
A)cystic fibrosis
B)rheumatoid arthritis
C)herpes simplex
D)multiple sclerosis
Q3) The stress response involves the integrated action of the:
1)hypothalamus
2)hypophysis
3)sympathetic nervous system
4)adrenal glands
A)1,3
B)2,3
C)1,2,4
D)1,2,3,4
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14
Chapter 13: Pain
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Sample Questions
Q1) According to the gate-control theory,passage of pain impulses may be naturally blocked:
A)at the synapse by entry of other sensory impulses
B)by the stress response
C)by administration of morphine directly into the spinal cord
D)by referring the pain to other parts of the body
Q2) What is a common analgesic administered to control a moderate level of pain?
A)meperidine
B)acetaminophen
C)codeine
D)ibuprofen
Q3) Which of the following applies to spinal anesthesia?
A)It causes analgesia with loss of consciousness.
B)The drug is injected into CSF or the epidural space of the spinal cord.
C)The drug stimulates release of endorphins in the spinal cord.
D)The transmission of pain impulses is blocked in a small area of the body.
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15
Chapter 14: Substance Abuse
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Sample Questions
Q1) Which of the following statements is characteristic of alcohol? It:
A)is primarily a CNS stimulant
B)may cause congenital defects in infants born to alcoholic mothers
C)does not interact with other drugs in the CNS
D)usually causes severe kidney damage
Q2) What is a common indication of substance abuse?
A)behavioral change
B)weight gain
C)depression
D)loss of sensory function
Q3) What is physiologic dependence?
A)an intense emotional need for a drug in order to function
B)adaptation of the body to a drug resulting in withdrawal signs after the drug is discontinued
C)the need for an ever-increasing dose to produce the same effect
D)continuing to take a drug when it is not required medically
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Chapter 15: Environmental Hazards
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Sample Questions
Q1) Which of the following is a potential effect of a bite or sting?
A)immediate heart failure
B)anaphylaxis
C)severe nausea,vomiting,and diarrhea
D)bone marrow damage
Q2) Inhalants can be:
A)a particulate such as asbestos
B)gaseous,such as sulfur dioxide
C)a solvent,such as benzene
D)a,c
E)a,b,c
Q3) A common illness for tourists in developing countries is "traveler's diarrhea," often caused by:
A)Salmonella
B)Shigella
C)E.coli
D)Listeria
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Chapter 16: Introduction to Basic Pharmacology and Selected Therapies
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Sample Questions
Q1) Traditional drug or surgical therapy is incorporated with nontraditional methods by: A)chiropractors
B)naturopaths
C)homeopaths
D)osteopaths
Q2) What is the official name assigned to a specific drug for worldwide use?
A)trade name
B)chemical name
C)proprietary name
D)generic name
Q3) The full course of a prescribed antimicrobial drug should be completed so as to prevent:
A)undesirable side effects
B)development of resistant microbes
C)an allergic response
D)any recurrence of infection in the distant future
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Chapter 17: Blood and Lymphatic Disorders
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Sample Questions
Q1) Following hemolysis,which part of the hemoglobin molecule produces bilirubin?
A)heme
B)globin
C)a chain of amino acids
D)iron
Q2) What is the primary treatment for the leukemias?
A)radiation
B)chemotherapy
C)surgery
D)immunotherapy
Q3) Which of the following applies to the leukemias?
A)Chronic leukemias are more common in older people.
B)AML is the most common childhood leukemia.
C)Exposure to chemicals is not considered a predisposing factor.
D)Lymphoid tissue produces abnormal leukocytes.
Q4) Petechiae and purpura are common signs of:
A)excessive hemolysis
B)leucopenia
C)increased bleeding tendencies
D)hemoglobin deficit
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Chapter 18: Cardiovascular Disorders
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Sample Questions
Q1) For which of the following would a cardiac pacemaker likely be inserted?
A)angina pectoris
B)heart block
C)congestive heart failure
D)ventricular fibrillation
Q2) Which of the following may cause pericarditis?
1)infection
2)abnormal immune responses
3)injury
4)malignant neoplasm
A)1,2
B)3,4
C)1,3,4
D)1,2,3,4
Q3) Which of the following could be the source of an embolus causing an obstruction in the brain?
A)femoral vein
B)pulmonary vein
C)carotid artery
D)coronary artery
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Chapter 19: Respiratory Disorders
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Sample Questions
Q1) What is the pathophysiology of an acute attack of extrinsic asthma?
A)gradual degeneration and fibrosis
B)continuous severe attacks unresponsive to medication
C)type 1 hypersensitivity reaction
D)hyperresponsive mucosa
Q2) Select the statement related to tuberculosis:
A)The microbe is present in the sputum of all patients with a positive TB skin test.
B)The infection is transmitted primarily by blood from an infected person.
C)The microbe is an acid-fast bacillus,resistant to many disinfectants.
D)The microbe is quickly destroyed by the immune response.
Q3) Why does hypercalcemia occur with bronchogenic carcinoma?
A)invasion of the parathyroid gland by the tumor
B)secretion of parathyroid or like hormone by the tumor
C)destruction of the ribs
D)failure of the kidney to excrete calcium ions
Q4) Whenever PO levels decrease below normal,then PCO levels:
A)increase
B)decrease also
C)may or may not change
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Chapter 20: Digestive System Disorders
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Sample Questions
Q1) Which of the following is/are (a)manifestation(s)of hemolytic jaundice?
A)increased unconjugated bilirubin in the blood
B)increased bleeding tendencies
C)pale stool and dark urine
D)elevated liver enzymes in the blood
Q2) What is a common sign of acute gastritis?
A)colicky right upper quadrant pain
B)vomiting with epigastric tenderness
C)projectile vomiting after eating
D)diarrhea with abdominal distention
Q3) What does the term periodontitis refer to?
A)erosion of the enamel tooth surface
B)bacterial damage to the ligaments and bone surrounding teeth
C)inflammation and infection of the gingivae
D)formation of calcified plaque on the tooth
Q4) What would be the result of chronic bleeding from gastric carcinoma?
A)occult blood in the stool and anemia
B)hematemesis and shock
C)abdominal pain and distention
D)red blood on the surface of the stool
Page 22
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Chapter 21: Urinary System Disorders
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Sample Questions
Q1) Which of the following results from decreased blood flow into the kidneys?
A)decreasing blood pressure
B)dilation of the afferent arterioles
C)decreased aldosterone secretion
D)increased angiotensin and systemic vasoconstriction
Q2) Which factor contributes to severe anemia in individuals with chronic renal failure?
A)increased erythropoietin secretion
B)limited protein intake
C)compensatory increase in bone marrow activity
D)inability to absorb Vitamin B and iron
Q3) Which of the following results from obstruction of the left ureter by a renal calculus?
A)mild flank pain on the affected side
B)hydronephrosis in both kidneys
C)immediate cessation of urine production
D)an attack of renal colic
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23
Chapter 22: Acute Neurological Disorders
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Sample Questions
Q1) The rabies virus is usually transmitted by:
A)respiratory droplets
B)insects such as mosquitoes
C)bites from infected animals
D)the fecal-oral route
Q2) In many types of encephalitis,such as St.Louis encephalitis,how are the viruses transmitted?
A)carriers
B)bites of mosquitoes and ticks
C)respiratory droplet
D)septic emboli in the circulation
Q3) Which signs are indicative of post-polio syndrome?
A)progressive spastic paralysis
B)ascending flaccid paralysis
C)progressive fatigue and weakness
D)increasing numbness and paresthesias
Q4) How does the heart rate change as intracranial pressure increases?
A)rate decreases
B)rate increases
C)no change in rate
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Chapter 23: Chronic Neurologic Disorders
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Sample Questions
Q1) Which statement does NOT apply to the pathophysiology of multiple sclerosis?
A)demyelination of axons
B)it affects the brain,spinal cord,and cranial nerves
C)it affects motor,sensory,and autonomic fibers
D)progressive random degeneration of peripheral nerves
Q2) Which of the following are typical characteristics associated with schizophrenia?
A)disorganized thought processes,short attention span,delusions
B)lack of energy and motivation,poor concentration,insomnia
C)hyperventilation,tachycardia,intense anxiety
D)memory loss,mood swings,hostile behavior
Q3) Which disease is associated with excessive dopamine secretion,decreased gray matter in the temporal lobes,and abnormal hippocampal cells in the brain?
A)Creutzfeldt-Jakob disease
B)schizophrenia
C)panic disorder
D)depression
Q4) The defective gene for Huntington's disease can be detected in carriers.
A)true
B)false
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Chapter 24: Disorders of the Eye and Ear
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Q1) Which of the following is a sign of a detached retina?
A)painless blurring of vision
B)eye pain,halos around lights,and nausea
C)progressive loss of central vision
D)no pain,but an increasing dark area in the visual field
Q2) What must happen for the pupil of the eye to dilate?
A)The circular muscle of the iris must contract.
B)Cranial nerve III must be activated.
C)Stimulation of the sympathetic nervous system is required.
D)The optic nerve must be stimulated.
Q3) Which term refers to near-sightedness?
A)hyperopia
B)presbyopia
C)myopia
D)diplopia
Q4) Which of the following involves a gradual clouding of the lens of the eye?
A)glaucoma
B)cataract
C)macular degeneration
D)keratitis
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Chapter 25: Endocrine Disorders
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Q1) Which of the following conditions may precipitate or exacerbate hyperglycemia?
A)hypothyroidism
B)Cushing's disease
C)Addison's disease
D)growth hormone deficit
Q2) Which one of the following develops hypoglycemia more frequently?
A)Type I diabetics
B)Type II diabetics
C)patients with a poor stress response
D)those with a regular exercise and meal plan
Q3) Compensation mechanisms occurring in the early stage of diabetic ketoacidosis include:
A)Kussmaul's respirations
B)polydipsia
C)ketonuria
D)seizures
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Chapter 26: Musculoskeletal Disorders
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Sample Questions
Q1) Which of the following cells produce new bone?
A)osteocytes
B)osteoblasts
C)osteoclasts
D)stem cells from the bone marrow
Q2) Which of the following is characteristic of osteoarthritis?
A)Inflammation and fibrosis develop at the joints.
B)Degeneration of articulating cartilage occurs in the large joints.
C)It progresses bilaterally through the small joints.
D)There are no changes in the bone at the affected joints.
Q3) Paget's disease often leads to:
A)multiple pathologic fractures
B)increased intracranial pressure
C)both a and b
D)neither a nor b
Q4) Therapeutic measures for osteoporosis include:
A)non-weight-bearing exercises
B)dietary supplements of calcium and vitamin D
C)transplants of osteoblasts
D)avoidance of all hormones
28
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Chapter 27: Skin Disorders
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Sample Questions
Q1) What is the major predisposing factor to squamous cell carcinoma?
A)viral infection
B)presence of nevi (moles)on the skin
C)exposure to ultraviolet light
D)frequent hypersensitivity reactions
Q2) Which of the following factors have contributed to the increased incidence of Kaposi's sarcoma?
A)excessive sun exposure
B)increased number of nevi
C)increase in immunosuppressed individuals
D)presence of more seborrheic keratoses
Q3) Which of the following areas lacks blood vessels and nerves?
A)epidermis
B)dermis
C)subcutaneous tissue
D)fatty tissue
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29
Chapter 28: Reproductive System Disorders
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Q1) Which of the following STDs is considered to be a systemic infection?
A)gonorrhea
B)chlamydia
C)syphilis
D)condylomata acuminate
Q2) Benign prostatic hypertrophy usually progresses to prostatic cancer.
A)true
B)false
Q3) Which statement does NOT apply to vaginal candidiasis?
A)It is classified as an STD.
B)The cause is an opportunistic yeast.
C)It causes dysuria and dyspareunia.
D)The mucosa becomes red and pruritic.
Q4) Which of the following applies to the corpus luteum?
A)It forms a mature ovarian follicle.
B)It secretes hCG.
C)It secretes estrogen and progesterone during the last half of the menstrual cycle.
D)It produces gonadotropins for the next cycle.
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