Advanced Pathophysiology Final Exam
Course Introduction
Advanced Pathophysiology delves into the complex mechanisms of disease processes affecting human systems at the cellular, organ, and systemic levels. This course emphasizes the integration of physiological alterations and their clinical manifestations, enabling students to better understand the progression of various diseases. Students will analyze and interpret pathophysiological changes in response to genetic, environmental, and lifestyle factors, and explore their implications for diagnosis, management, and treatment. Through case-based learning and critical analysis, participants will develop advanced skills essential for clinical decision-making and evidence-based practice in healthcare settings.
Recommended Textbook
Goulds Pathophysiology for the Health Professions 5th Edition by VanMeter
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Chapter 1: Introduction to Pathophysiology
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Sample Questions
Q1) The manifestations of a disease are best defined as the:
A) subjective feelings of discomfort during a chronic illness.
B) signs and symptoms of a disease.
C) factors that precipitate an acute episode of a chronic illness.
D) early indicators of the prodromal stage of infection.
Answer: B
Q2) The term homeostasis refers to:
A) the causative factors in a particular disease.
B) maintenance of a stable internal environment.
C) a condition that triggers an acute episode.
D) a collection of signs and symptoms.
Answer: B
Q3) Which of the following is the best definition of epidemiology?
A) The science of tracking the occurrence and distribution of diseases
B) The relative number of deaths resulting from a particular disease
C) Identification of a specific disease through evaluation of signs and symptoms
D) The global search for emerging diseases
Answer: A
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3
Chapter 2: Fluid, Electrolyte, and Acid-Base Imbalances
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Q1) Which of the following causes tetany?
A) Increased permeability of nerve membranes due to low serum calcium
B) Excess calcium ions in skeletal muscle due to excess parathyroid hormone (PTH)
C) Excess calcium ions inside somatic nerves as a result of neoplasms
D) Increased stimulation of the nerves in the cerebral cortex
Answer: A
Q2) In which of the following processes is phosphate ion NOT a major component?
A) Bone metabolism
B) Metabolic processes involving adenosine triphosphate (ATP)
C) Blood clotting
D) Acid-base balance
Answer: C
Q3) The bicarbonate-carbonic acid buffer system helps maintain serum pH. The balance of the carbonic acid and bicarbonate ion levels are controlled by the:
A) liver and pancreas.
B) lungs and kidneys.
C) lungs and plasma proteins.
D) kidneys and bone marrow.
Answer: B
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Page 4
Chapter 3: Introduction to Basic Pharmacology and Other Common Therapies
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Q1) The form of therapy that involves assessment of physical function and works to restore any problems and prevent any further dysfunction using methods such as appropriate exercises and ultrasound is referred to as:
A) registered massage therapy.
B) naturopathy.
C) physiotherapy.
D) reflexology.
Answer: C
Q2) At which site are most drugs metabolized and prepared for excretion?
A) Liver
B) Kidneys
C) Circulating blood
D) Lymphoid tissue
Answer: A
Q3) After they are metabolized, most drugs are excreted through the:
A) lungs.
B) pancreas.
C) kidneys.
D) large intestine.
Answer: C
Page 5
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Chapter 4: Pain
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Q1) Pain resulting from a profound, sudden loss of blood flow to an organ or tissues in a specific area of the body is referred to as:
A) chronic pain.
B) central pain.
C) cardiovascular pain.
D) ischemic pain.
Q2) The impulses related to acute pain are usually transmitted by:
A) nociceptors.
B) myelinated A delta fibers.
C) unmyelinated C fibers.
D) any sensory fiber with a low pain threshold.
Q3) Which of the following is a characteristic of chronic pain?
A) It usually initiates a physiological stress response.
B) It always involves a strong emotional response such as high anxiety.
C) It is more difficult to diagnose and treat than is acute pain.
D) It involves tissue damage to a specific organ.
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Chapter 5: Inflammation and Healing
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Q1) Tears are considered to be part of the:
1) first line of defense.
2) second line of defense.
3) third line of defense.
4) specific defenses.
5) nonspecific defenses.
A) 1, 4
B) 1, 5
C) 3, 4
D) 2, 5
Q2) A specific defense for the body is:
A) phagocytosis.
B) sensitized T lymphocytes.
C) the inflammatory response.
D) intact skin and mucous membranes.
Q3) Which chemical mediator is involved in prolonging the inflammatory response?
A) Bradykinin
B) Histamine
C) Leukotrienes
D) Chemotactic factors
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Chapter 6: Infection
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Q1) Entamoeba histolytica is transmitted by which of the following?
A) Mosquitoes (bites)
B) Inhaling contaminated particles
C) Sexual intercourse
D) Cysts in feces
Q2) Which of the following does NOT directly determine the virulence of a microbe?
A) Capacity for opportunism
B) Production of toxins
C) Ability to mutate
D) Invasive qualities
Q3) A bacterial endospore can:
A) also be classified as an acid-fast bacterium.
B) exist in latent form inside a host cell.
C) reproduce very rapidly.
D) survive high temperatures and a dry environment.
Q4) The structure of a virus includes:
A) a cell wall and membrane.
B) metabolic enzymes for replication.
C) a protein coat and either DNA or RNA.
D) a slime capsule and cilia.
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Chapter 7: Immunity
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Q1) Which type of immunity is provided by a vaccination?
A) Active natural
B) Active artificial
C) Passive natural
D) Passive artificial
Q2) Which statement is TRUE regarding infants born to HIV-infected mothers?
A) Infants usually test negative for HIV after birth.
B) There is little risk of infected mothers passing the virus to their infants during delivery.
C) Breast milk does not contain HIV or antibodies.
D) Infants test positive for HIV because of the presence of maternal antibodies.
Q3) Which of the following complications does NOT occur frequently in AIDS patients?
A) Kaposi's sarcoma
B) Wasting syndrome
C) Lymphoma
D) Polyarthritis
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Chapter 8: Skin Disorders
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Q1) Which lesion distinguishes Tinea corporis?
A) Small, brown pruritic lines
B) Painful and pruritic fissures
C) Erythematous ring of vesicles with a clear center
D) Firm, red, painful nodule or pustule
Q2) What is a raised, thin-walled lesion containing clear fluid called?
A) Papule
B) Pustule
C) Vesicle
D) Macule
Q3) All of the following statements apply to malignant melanoma EXCEPT:
A) The malignant cell is a melanocyte.
B) They present as non-pruritic purplish macules.
C) The neoplasm grows rapidly and metastasizes early.
D) The lesion is usually dark or multicolored with an irregular border.
Q4) Which of the following best describes the typical lesion of psoriasis?
A) Purplish papules that can erode and become open ulcers
B) Firm, raised pruritic nodules that can become cancerous
C) Moist, red vesicles, which develop into bleeding ulcers
D) Begins as a red papule and develops into silvery plaques
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Chapter 9: Musculoskeletal Disorders
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Sample Questions
Q1) Systemic effects of rheumatoid arthritis are manifested as:
A) nodules in various tissues, severe fatigue, and anorexia.
B) headache, leukopenia, and high fever.
C) swelling and dysfunction in many organs.
D) progressive damage to a joint.
Q2) Bones classified as "irregular" would include:
A) skull bones.
B) the mandible.
C) wrist bones.
D) the femur.
Q3) Where does inflammation usually begin in an individual with ankylosing spondylitis?
A) Costovertebral joints with progression down the spine
B) Cervical and thoracic vertebrae, causing kyphosis
C) Sacroiliac joints with progression up the spine
D) Peripheral joints and then proceeds to the vertebrae
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Chapter 10: Blood and Circulatory System Disorders
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Q1) In cases of polycythemia vera, blood pressure is elevated as a result of:
A) increased blood volume.
B) frequent infarcts in the coronary circulation.
C) congested spleen and bone marrow.
D) increased renin and aldosterone secretions.
Q2) What are the typical early general signs and symptoms of anemia?
A) Chest pain, palpitations
B) Jaundice, stomatitis
C) Pallor, dyspnea, and fatigue
D) Bradycardia, heat intolerance
Q3) What are the two circulations that comprise the overall circulatory system?
A) Pulmonary and systemic circulations
B) Peripheral and central circulations
C) Cardiovascular and lymphatic circulations
D) Cardiopulmonary and peripheral circulations
Q4) Thalassemia is caused by:
A) a defect in one or more genes for hemoglobin.
B) an abnormal form of heme.
C) abnormal liver production of amino acids and iron.
D) overproduction of hypochromic, microcytic RBCs.
Page 12
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Chapter 11: Lymphatic System Disorders
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Q1) Elephantiasis, caused by the obstruction of lymphatic vessels by parasitic worms, is an example of the condition known as:
A) plasma cell myeloma.
B) diverticulitis.
C) lymphedema.
D) obstructive vessel disorder.
Q2) The atypical cell that serves as a marker for diagnosing Hodgkin's lymphoma is the:
A) monocyte.
B) Ann Arbor cell
C) Hodgkin's lymphocyte
D) Reed-Sternberg cell
Q3) The staging system typically used in determining the stage of the Hodgkin's lymphoma is the:
A) Reed-Sternberg system.
B) sequential staging system.
C) Ann Arbor system.
D) differential landmark system.
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Chapter 12: Cardiovascular System Disorders
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Q1) Aortic stenosis means the aortic valve:
A) allows blood to leak back into the left ventricle during diastole.
B) cannot fully open during systole.
C) functions to increase stroke volume.
D) does not respond to the cardiac cycle.
Q2) The event that causes the QRS wave on an electrocardiogram (ECG) tracing is:
A) atrial depolarization.
B) atrial repolarization.
C) ventricular depolarization.
D) ventricular repolarization.
Q3) Which of the following compensations that develop in patients with congestive heart failure eventually increase the workload of the heart?
A) Faster heart rate and cardiomegaly
B) Peripheral vasoconstriction
C) Increased secretion of renin
D) A and C
E) A, B, and C
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14
Chapter 13: Respiratory System Disorders
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Sample Questions
Q1) A group of common chronic respiratory disorders characterized by tissue degeneration and respiratory obstruction is called:
A) mesothelioma.
B) COPD.
C) CF.
D) MD.
Q2) What is caused by frequent inhalation of irritating particles such as silica?
A) Fibrosis and loss of compliance
B) Frequent bronchospasm
C) Increased number of mucus-producing glands
D) Distorted shape of the thorax
Q3) Which of the following statements is FALSE?
A) TB bacilli are spread by oral droplet.
B) TB bacilli are slow-growing bacteria.
C) Active TB must be treated in hospital for many months.
D) Active TB can be prevented by good host resistance.
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Chapter 14: Neurological Disorders
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Sample Questions
Q1) The best description of a myelomeningocele is:
A) asymptomatic failure of the posterior spinous processes of the vertebrae to fuse.
B) herniation of the meninges through a vertebral defect.
C) herniation of the meninges, CSF, and spinal cord or nerves through a vertebral defect.
D) herniation of brain tissue through a defect in the cranium.
Q2) Which statement is TRUE about tetanus infection?
A) It is caused by a virus.
B) Infection usually develops in deep puncture wounds.
C) It causes flaccid skeletal muscles, impairing mobility.
D) It affects peripheral nerves initially in the legs and feet.
Q3) What is the probable source of an embolus causing a cerebrovascular accident (CVA)?
A) Right ventricle of the heart
B) Femoral vein
C) Common carotid artery
D) Pulmonary artery
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Chapter 15: Disorders of the Eye, Ear, and Other Sensory Organs
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Q1) Narrow-angle glaucoma develops when the angle is decreased between the:
A) retina and ciliary process.
B) lens and ciliary body.
C) iris and cornea.
D) iris and lens.
Q2) What do the extrinsic muscles of the eye control?
A) Movement of the eyeball
B) Movement of the eyelid
C) Size of the pupil
D) Shape of the lens
Q3) Which of the following statements is TRUE?
A) Conduction deafness results from inner ear damage.
B) Cochlear implants may restore hearing in cases of sensorineural loss.
C) Damage to the auditory area of the brain causes deafness in one ear.
D) Cochlear implants can replace the auditory pathway in all deaf individuals.
Q4) Trachoma is indicated by the presence of:
A) purulent exudate and red sclerae.
B) corneal abrasions by the infected eyelids.
C) diplopia and cloudy lens.
D) ptosis and fixed dilation of the pupil.
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Chapter 16: Endocrine System Disorders
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Sample Questions
Q1) What is caused by hypocalcemia due to hypoparathyroidism?
1) Skeletal muscle twitching or spasm
2) Weak cardiac contraction
3) Increased secretion of parathyroid hormone (PTH)
4) Decreased serum phosphate level
A) 1, 2
B) 1, 3
C) 2, 3
D) 3, 4
Q2) Which of the following applies to acromegaly?
A) It occurs in infants and children.
B) It causes excessive longitudinal bone growth.
C) It results from excessive secretion of growth hormone (GH).
D) It does not change soft tissue growth.
Q3) What is the most common cause of endocrine disorders?
A) Malignant neoplasm
B) Infection
C) Congenital defect
D) Benign tumor
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Page 18
Chapter 17: Digestive System Disorders
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Sample Questions
Q1) What pain is typical of diverticulitis?
A) Lower left quadrant
B) Lower right quadrant
C) Sharp, colicky, periumbilical
D) Lower abdominal pain, radiating into the groin
Q2) Small, hidden amounts of blood in stool are referred to as:
A) melena.
B) occult blood.
C) frank blood.
D) hematemesis.
Q3) What is the primary cause of esophageal varices?
A) Increased hydrostatic pressure in the veins
B) Alcohol irritating the mucosa
C) Failure to inactivate estrogen
D) Poor nutritional status
Q4) What causes hypovolemic shock to develop with intestinal obstruction?
A) Continued vomiting and fluid shift into the intestine
B) Hemorrhage into the intestine
C) Rupture of the intestinal wall
D) Repeated bouts of severe diarrhea
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Chapter 18: Urinary System Disorders
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Q1) What is/are a cause(s) of acute tubule necrosis and acute renal failure?
A) Prolonged circulatory shock
B) Sudden significant exposure to nephrotoxins
C) Crush injuries or burns
D) All of the above
Q2) Why does metabolic acidosis develop with bilateral kidney disease?
A) Tubule exchanges are impaired.
B) GFR is increased.
C) Serum urea is increased.
D) More bicarbonate ion is produced.
Q3) Why may acute pyelonephritis and cystitis follow untreated prostatitis?
A) Microbes spread through the circulation.
B) Antibodies have not yet formed.
C) There is no effective treatment.
D) There is a continuous mucosa along the involved structures.
Q4) Choose the basic cause of osteodystrophy associated with chronic renal failure.
A) Development of hypercalcemia
B) Deficit of parathyroid hormone
C) Failure of the kidney to activate vitamin D
D) Excessive loss of phosphate ion
Page 20
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Chapter 19: Reproductive System Disorders
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Sample Questions
Q1) The most common solid tumor found in young men is:
A) prostatic cancer.
B) testicular cancer.
C) bladder cancer.
D) penile cancer.
Q2) Which of the following frequently causes pelvic inflammatory disease (PID) and subsequent infertility?
A) Chlamydia
B) Genital warts
C) Trichomoniasis
D) Herpes simplex
Q3) Which of the following is NOT a characteristic of leukorrhea during the reproductive years?
A) It is clear or whitish.
B) It has a pH of 4 to 5.
C) It does not contain any cells.
D) It contains mucus.
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21
Chapter 20: Neoplasms and Cancer
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Q1) What is a benign neoplasm originating from adipose tissue called?
A) Adenoma
B) Lipoma
C) Fibrosarcoma
D) Adenocarcinoma
Q2) The process of carcinogenesis usually begins with:
A) exposure to promoters causing dysplasia.
B) development of defective genes.
C) an irreversible change in the cell DNA.
D) a single exposure to a known risk factor causing temporary cell damage.
Q3) The most critical adverse effects of chemotherapy and radiation therapy are:
A) thrombocytopenia and leucopenia.
B) headache and lethargy.
C) nausea and constipation.
D) alopecia and weight loss.
Q4) Remission for cancer is generally defined as a period in which:
A) chemotherapy cannot be used.
B) signs and symptoms are absent.
C) complications are evident.
D) metastases occur.
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Chapter 21: Congenital and Genetic Disorders
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Q1) Which term refers to prenatal diagnosis through examination of amniotic fluid?
A) Chorionic villus testing
B) Preparing a family pedigree
C) Amniocentesis
D) Triple-screen test
Q2) The term proteomics refers to the study of:
A) DNA sequences with unknown functions.
B) gene sequences in individual chromosomes.
C) the proteins resulting from activation of specific genes.
D) identifying certain base pairs in DNA.
Q3) Ultrasonography during pregnancy would be helpful in detecting fetal:
A) enzyme deficits.
B) structural anomalies.
C) chromosomal defects.
D) hormonal abnormalities.
Q4) Hemophilia A has been diagnosed in a young boy. He has inherited this defective gene from:
A) his father.
B) his mother.
C) both parents.
Page 23
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Chapter 22: Complications due to Pregnancy
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Q1) Which of the following is a serious potential complication of abruptio placentae indicated by low serum levels of clotting factors?
A) Severe hypertension
B) Disseminated intravascular coagulation (DIC)
C) Jaundice
D) Thromboembolism
Q2) What is the usual cause of hemolysis of fetal erythrocytes during pregnancy?
A) The mother's blood is Rh negative and the fetus is Rh positive.
B) The parents differ in blood type.
C) The mother receives Rh immunoglobulin early in the second pregnancy.
D) Fetal antibodies enter the maternal circulation.
Q3) Adolescent pregnancy is often considered high risk because of:
A) inadequate prenatal care.
B) poor nutrition and lack of vitamin supplements.
C) iron deficiency anemia.
D) All of the above
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24
Chapter 23: Complications due to Adolescence
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Q1) Which of the following would confirm reduced normal linear growth during adolescence?
A) Levels of androgens
B) Abnormally thin epiphyseal plate seen on X-ray
C) Lack of a broader pelvis in males
D) Development of kyphosis
Q2) Obesity in adolescents is:
A) determined by calculating body mass index (BMI).
B) a significant factor in a teen's self-image.
C) related to increased intake of high fat and high carbohydrate snacks, "fast foods."
D) All of the above
Q3) Which of the following might fluid and electrolyte deficits cause in a patient with anorexia nervosa?
A) Cardiac arrhythmias
B) Weight loss
C) Dental caries and esophagitis
D) Amenorrhea
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Chapter 24: Complications due to Aging
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Q1) With advancing age, the major change in the cardiovascular system involves:
A) irregular impulse conduction in the heart.
B) a reduced number of collagen fibers to support cardiac muscle.
C) vascular degeneration, leading to arteriosclerosis and atherosclerosis.
D) the heart valves becoming thin and weak.
Q2) Which of the following does NOT contribute to the increasing life span of the general population?
A) Reduced cognitive and social activities
B) Improved living conditions
C) Better nutrition
D) Advancements in health care
Q3) All of the following changes are associated with aging EXCEPT:
A) loss of elastic fibers.
B) decreased metabolic rate.
C) decreased secretion of all hormones.
D) degenerative vascular changes.
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Chapter 25: Immobility and Associated Problems
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Q1) The major problem associated with immobility and the gastrointestinal tract is:
A) constipation.
B) diarrhea.
C) nausea.
D) increased rate of peristalsis.
Q2) Bladder infections are more likely to develop in immobilized patients because of:
A) stasis of urine in the urinary system.
B) development of hypocalcemia with immobility.
C) fluid overload in the system.
D) lack of neurological control of the bladder.
Q3) What is a major factor predisposing to pulmonary infection in immobilized patients?
A) Decreased activity and demand for oxygen
B) Increased retention of CO<sub>2</sub>
C) Inability to sneeze forcefully
D) Stasis of secretions in the lungs
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Chapter 26: Stress and Associated Problems
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Q1) Selye defined three stages in the stress response. The third stage is designated as the:
A) alarm stage.
B) resistance stage.
C) stage of exhaustion.
D) maladaptive stage.
Q2) Hans Selye defined his general adaptation syndrome concept, which is also known as:
A) fight or flight.
B) compensate or compromise.
C) restrain or release.
D) avoid and flee.
Q3) During the stress response, endorphins act as:
A) pain blockers.
B) cerebral function depressors.
C) stimulators of increased secretion of aldosterone and insulin.
D) an enhancer of the immune response.
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28
Chapter 27: Substance Abuse and Associated Problems
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Q1) A patient who has developed a tolerance for codeine will:
A) demonstrate physical signs when the drug is discontinued.
B) require a larger dose than expected to control pain.
C) require a smaller dose than expected to control pain.
D) show signs or symptoms of drug toxicity.
Q2) Chemical dependency has been associated with all the following EXCEPT:
A) hereditary factors.
B) disease requiring certain prescription drugs.
C) easy access to many kinds of drugs.
D) increased acceptance of alcohol or marijuana to cope with stress.
E) increased work productivity.
Q3) Withdrawal from any drug is best accomplished:
A) with medical support.
B) with legally prescribed drugs.
C) following intensive counseling.
D) using CNS stimulants.
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Chapter 28: Environmental Hazards and Associated Problems
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Q1) Radiation damage may occur from repeated exposure to:
A) ultraviolet rays.
B) X-rays.
C) radioactive substances.
D) A, B, and C
Q2) Inhalants can be:
A) a particulate such as asbestos.
B) gaseous, such as sulfur dioxide.
C) a solvent, such as benzene.
D) A, B, and C
Q3) Which of the following is considered carcinogenic?
A) Lead
B) Carbon monoxide
C) Inhaled particulates
D) Mercury
Q4) The amount of radiation absorbed by the body is measured in rads, or _________.
A) radiation-absorbed doses.
B) roentgen-absorbed doses.
C) radiation-emission number.
D) radiation ionizing rate.
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