Pathophysiology for Physical Therapists
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Course Introduction
This course provides an in-depth exploration of the pathophysiological processes underlying common diseases and disorders that impact human movement and function, with a strong emphasis on principles relevant to physical therapy practice. Students will examine how cellular and systemic alterations lead to clinical manifestations affecting the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and other body systems. The course integrates foundational scientific concepts with clinical implications, equipping future physical therapists with the knowledge needed to recognize pathology, understand its effects on rehabilitation, and collaborate effectively in interprofessional healthcare settings.
Recommended Textbook
Goulds Pathophysiology for the Health Professions 5th Edition by VanMeter
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28 Chapters
1204 Verified Questions
1204 Flashcards
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Chapter 1: Introduction to Pathophysiology
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Sample Questions
Q1) 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
Q2) The term cancer refers to:
A) dysplasia.
B) hyperplasia.
C) metaplasia.
D) malignant neoplasm.
Answer: D
Q3) Why are the predisposing factors for a specific disease important to health professionals?
A) To predict the prognosis
B) To determine treatments
C) To develop preventive measures
D) To develop morbidity statistics
Answer: C
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Page 3
Chapter 2: Fluid, Electrolyte, and Acid-Base Imbalances
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Sample Questions
Q1) Hypocalcemia causes weak cardiac contractions because:
A) permeability of nerve membranes increases.
B) insufficient calcium ions are available for muscle contraction.
C) low phosphate ion levels prevent muscle contraction.
D) excessive amounts of calcium are stored in cardiac muscle.
Answer: B
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.
Answer: D
Q3) When the osmotic pressure of the blood is elevated above normal, water would shift from the:
A) blood into the cells.
B) interstitial compartment into the cells.
C) interstitial compartment into the blood.
D) cells into the interstitial compartment.
Answer: C
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Chapter 3: Introduction to Basic Pharmacology and Other Common Therapies
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Sample Questions
Q1) What is the unique, simple, and official name assigned to a specific drug for worldwide use?
A) Trade name
B) Chemical name
C) Proprietary name
D) Generic name
Answer: D
Q2) Which of the following are considered to be the toxic effects of a drug?
A) Additional, mild, unwanted effects
B) Unusual, unexpected mild effects
C) Serious, possibly life-threatening effects
D) Reduction of the allergic response
Answer: C
Q3) A placebo may be described as a tablet or capsule:
A) that does not contain an active drug.
B) that contains a small amount of active drug for use in clinical trials.
C) that contains a different drug to be used for its psychological effect.
D) that contains high amounts of a drug to determine the maximum dose allowed.
Answer: A
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Chapter 4: Pain
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Sample Questions
Q1) Which of the following statements is TRUE?
A) The brain is more aware of pain impulses when the reticular activating system is depressed.
B) Acute pain does not cause a reflex response at the spinal cord synapses.
C) Young infants typically respond to pain with tachycardia and increased blood pressure.
D) Chronic pain is easier to tolerate without negative effects.
Q2) 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.
Q3) Pain perceived in the left arm during the course of a heart attack is an example of: A) referred pain.
B) phantom pain.
C) chronic pain.
D) subjective pain response.
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6
Chapter 5: Inflammation and Healing
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Sample Questions
Q1) An abscess contains:
A) serous exudate.
B) purulent exudate.
C) fibrinous exudate.
D) hemorrhagic exudate.
Q2) A typical source of infection in burn areas is:
A) the skin grafts.
B) microbes surviving in the hair follicles in the burn area.
C) circulating blood bringing microbes to the burn wound.
D) opportunistic virus in digestive tract.
Q3) In normal capillary exchange, what is net hydrostatic pressure based on?
A) The difference between the hydrostatic pressure within the capillary, as compared with the hydrostatic pressure of the interstitial fluid
B) The relative osmotic pressures in the blood and the interstitial fluid
C) The difference between the hydrostatic pressure and osmotic pressure within the capillary
D) The difference between the concentrations of blood cells, plasma proteins, and dissolved substances in the blood and the interstitial fluid
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Chapter 6: Infection
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Sample Questions
Q1) Host resistance is promoted by all of the following EXCEPT:
A) prescribed immunizations.
B) chronic respiratory disease.
C) vitamin and mineral supplements.
D) appropriate inflammatory or immune response.
Q2) What does "bacteremia" refer to?
A) Numerous pathogens circulating and reproducing in the blood
B) Uncontrolled sepsis throughout the body
C) Multiple infections, primary and secondary, established in the body
D) Microbes present in the blood
Q3) Inflamed tissue is likely to become infected because:
A) the immune system is not effective in inflamed tissue.
B) the increased fluid and protein in the inflamed area supports microbial growth.
C) phagocytes cannot penetrate the inflamed areas.
D) capillaries are less permeable in the affected area.
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8
Chapter 7: Immunity
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Sample Questions
Q1) Which of the following statements applies to the complement system?
A) It is activated by IgE.
B) It blocks the inflammatory response.
C) It consists of proteins in the blood that must be activated.
D) It may destroy antibodies in the circulation.
Q2) The most common cause of death in patients who have AIDS is:
A) HIV encephalopathy.
B) tuberculosis.
C) Pneumocystis carinii pneumonia.
D) Candida infection.
Q3) Which of the following causes anaphylaxis?
A) A severe, systemic allergic reaction
B) Type III hypersensitivity
C) Cell-mediated hypersensitivity
D) Immune complex deposits in many tissues
Q4) CD4-positive helper T cells function by:
A) direct cytotoxic action.
B) facilitating all immune system activity.
C) producing immunoglobulins.
D) inactivating allergens.
9
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Chapter 8: Skin Disorders
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Sample Questions
Q1) How can pediculosis be diagnosed?
A) Pruritus in hairy areas of the body
B) Loss of blood due to lice bites
C) Finding lice in clothing
D) The presence of nits at the base of hair shafts
Q2) What causes the pruritus associated with scabies?
A) An allergic reaction to the causative microbe due to endotoxins
B) Mites burrowing into the epidermis and reaction to their feces
C) Bleeding and injected toxin from bites of the larvae
D) Neurotoxins secreted by mites on the skin surface
Q3) 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
Q4) Which of the following applies to actinic keratoses?
A) They predispose to malignant melanoma.
B) They arise on skin exposed to ultraviolet radiation.
C) They occur primarily on dark-skinned persons.
D) They are malignant and invasive.
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Chapter 9: Musculoskeletal Disorders
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Sample Questions
Q1) Fluid-filled sacs composed of synovial membrane located between structures such as tendons and ligaments and act as additional cushions are called:
A) articular capsules.
B) bursae.
C) synovial sacs.
D) hyaline chambers.
Q2) Joints affected by osteoarthritis can sometimes affect healthy joints by:
A) causing enzymes to be released that travel to other joints.
B) bacteria traveling from the affected join to a healthy one through the bloodstream.
C) inflammation and edema affecting the entire limb.
D) the affected individual's exerting stress on the normal joint to protect the damaged one.
Q3) All of the following predispose to osteoporosis EXCEPT:
A) weight-bearing activity.
B) a sedentary lifestyle.
C) long-term intake of glucocorticoids.
D) calcium deficit.
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11
Chapter 10: Blood and Circulatory System Disorders
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Sample Questions
Q1) Which of the following statements applies to hemochromatosis. It is:
A) caused by excessive iron intake in the diet.
B) results from excessive hemolysis of RBCs.
C) a metabolic error that leads to excess amounts of hemosiderin, causing damage to organs.
D) an inherited defect that results in abnormal hemoglobin.
Q2) Thrombophilia can result in conditions such as:
A) severe chronic kidney disease.
B) peripheral vascular disease.
C) deficient calcium levels in the long bones.
D) excessive bleeding of hematomas.
Q3) In which blood dyscrasia does pancytopenia develop?
A) Pernicious anemia
B) Aplastic anemia
C) Iron deficiency anemia
D) Sickle cell anemia
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12
Chapter 11: Lymphatic System Disorders
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Sample Questions
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) A rare illness that involves the overgrowth of lymphoid tissue, although not itself considered a cancer is:
A) Castleman disease.
B) hyperlymphatic disease.
C) hypolymphatic disease.
D) Ann Arbor disease.
Q3) Non-Hodgkin's lymphomas are increasing in incidence, partly due to the numbers associated with:
A) an increase in resistant microorganisms.
B) an increase in adult obesity.
C) an increase in high cholesterol levels.
D) an increase in HIV infections.
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13
Chapter 12: Cardiovascular System Disorders
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Sample Questions
Q1) The cardiac reserve is:
A) afterload.
B) the difference between the apical and radial pulses.
C) the ability of the heart to increase cardiac output when needed.
D) the extra blood remaining in the heart after it contracts.
Q2) The initial effect on the heart in cases of rheumatic fever is:
A) infection in the heart by hemolytic streptococci.
B) highly virulent microbes causing vegetations on the heart valves.
C) septic emboli obstructing coronary arteries.
D) acute inflammation in all layers of the heart due to abnormal immune response.
Q3) A common adverse effect of many antihypertensive medications is:
A) orthostatic hypotension.
B) bradycardia.
C) altered blood coagulation.
D) peripheral edema.
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14
Chapter 13: Respiratory System Disorders
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Sample Questions
Q1) What are typical signs and symptoms of epiglottitis?
A) Hyperinflation of the chest and stridor
B) Hoarse voice and barking cough
C) Sudden fever, sore throat, and drooling saliva
D) Sneezing, mild cough, and fever
Q2) Which of the following is typical of chronic bronchitis?
A) Decreased activity of the mucous glands
B) Fibrosis of the bronchial wall
C) Overinflation of bronchioles and alveoli
D) Formation of blebs or bullae on the lung surface
Q3) What does carbaminohemoglobin refer to?
A) Replacement of oxygen by carbon monoxide on hemoglobin molecules
B) Full saturation of all heme molecules by oxygen
C) Carbon dioxide attached to an amino group on the hemoglobin molecule
D) Oxygen combined with iron in the hemoglobin molecule
Q4) What is the pathophysiology of an acute attack of extrinsic asthma?
A) Gradual degeneration and fibrosis
B) Continuous severe attacks unresponsive to medication
C) A hypersensitivity reaction involving release of chemical mediators
D) Hyperresponsive mucosa
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Chapter 14: Neurological Disorders
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Sample Questions
Q1) What is the effect of an enlarging brain abscess on cardiovascular activity?
A) Increased heart rate and systemic vasodilation
B) Low blood pressure and irregular heart and respiratory rates
C) Systemic vasoconstriction and slower heart rate
D) Immediate depression of the cardiac control centers
Q2) Which of the following are typical early signs of Alzheimer's disease?
1) Behavioral changes
2) Reduced ability to reason and problem solve
3) Decreased verbal responses
4) Urinary incontinence
A) 1, 2
B) 1, 4
C) 2, 3
D) 1, 3, 4
Q3) Which of the following is the most common cause of brain damage in children with cerebral palsy?
A) Hyperbilirubinemia
B) Hypoglycemia
C) Hypoxia
D) Trauma
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Chapter 15: Disorders of the Eye, Ear, and Other Sensory Organs
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Sample Questions
Q1) Herpes simplex virus is a common cause of:
A) conjunctivitis.
B) corneal ulceration and scarring.
C) eye infection in the neonate.
D) total blindness.
Q2) Which of the statements apply to infection of the eye by Staphylococcus aureus?
1) It involves the conjunctiva.
2) It is highly contagious.
3) It is commonly known as "pinkeye."
4) It usually causes keratitis and permanent visual loss.
A) 1, 3
B) 2, 3
C) 2, 4
D) 1, 2, 3
Q3) Why does vertigo occur with Ménière's syndrome?
A) Fluid is lost from the inner ear.
B) Increased blood pressure causes edema in the middle and inner ears.
C) Damage occurs to the vestibular branch of the auditory nerve.
D) Excessive endolymph impairs the function of hair cells in the labyrinth.
Page 17
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Chapter 16: Endocrine System Disorders
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Sample Questions
Q1) What is the cause of diabetic ketoacidosis?
A) Excess insulin in the body
B) Loss of glucose in the urine
C) Failure of the kidney to excrete sufficient acids
D) Increased catabolism of fats and proteins
Q2) All these tissues use glucose without the aid of insulin EXCEPT:
A) liver.
B) digestive system.
C) exercising skeletal muscle.
D) brain.
Q3) Catabolic effects of Cushing's syndrome include:
A) osteoporosis.
B) hypertension.
C) increased erythrocyte production.
D) moon face and buffalo hump.
Q4) Which of the following may cause insulin shock to develop?
A) Strenuous exercise
B) Missing an insulin dose
C) Eating excessively large meals
D) Sedentary lifestyle
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Chapter 17: Digestive System Disorders
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Sample Questions
Q1) What usually initiates acute appendicitis?
A) Infection in the appendix
B) An episode of severe diarrhea
C) Obstruction of the lumen of the appendix
D) Eating a low-fiber diet
Q2) Which of the following applies to hepatitis A infection?
A) It is also called serum hepatitis.
B) It is transmitted by the fecal-oral route.
C) It contains a double strand of DNA.
D) It frequently leads to chronic hepatitis.
Q3) What is the initial pathological change in alcoholic liver disease?
A) Formation of nodules with shrinkage of the liver
B) Inflammation with necrosis
C) Development of fibrous bands of tissue
D) Accumulation of fat in hepatocytes with hepatomegaly
Q4) Which type(s) of hepatitis increase(s) the risk of hepatocellular carcinoma?
A) HBV
B) HCV
C) HBV and HCV
D) Neither HBV nor HCV
Page 19
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Chapter 18: Urinary System Disorders
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Sample Questions
Q1) Common causes of urolithiasis include all of the following EXCEPT:
A) hypercalcemia.
B) hyperlipidemia.
C) inadequate fluid intake.
D) hyperuricemia.
Q2) Autoregulation in the kidneys refers to:
A) control of blood flow by the SNS.
B) the secretion of renin and activation of angiotensin.
C) local minor reflex adjustments in the arterioles to maintain normal blood flow.
D) the control of systemic blood pressure by the kidneys.
Q3) Wilms' tumor is:
A) a malignant tumor in the bladder.
B) an encapsulated mass in one kidney.
C) not considered to have a genetic origin.
D) manifested in adulthood.
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Chapter 19: Reproductive System Disorders
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Sample Questions
Q1) Vaginal candidiasis is frequently predisposed by:
A) systemic antibacterial therapy.
B) insertion of an intrauterine device.
C) sexual intercourse with an infected partner.
D) previous viral infection.
Q2) Why does frequent need for urination occur with benign prostatic hypertrophy?
A) Increased volume of dilute urine
B) Irritation of the bladder and urethra
C) Impaired micturition reflex
D) Incomplete emptying of the bladder
Q3) With pelvic inflammatory disease, why does infection spread easily into the peritoneal cavity?
A) The fallopian tubes are obstructed, and purulent exudate cannot drain into the uterus.
B) The uterus is perforated because of infection, allowing bacteria to leak out.
C) Most of the primary infections do not respond to antimicrobial drugs.
D) Microbes are highly virulent.
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Chapter 20: Neoplasms and Cancer
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Sample Questions
Q1) Which factor provides the basis for the grading of newly diagnosed malignant tumors?
A) Size of the tumor
B) Number of metastases
C) Degree of differentiation of the cells
D) Number of lymph nodes involved
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) Benign tumors in the brain are often life-threatening because they:
A) metastasize early in their development.
B) create excessive pressure within the skull.
C) cannot be removed.
D) cause serious systemic effects.
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22
Chapter 21: Congenital and Genetic Disorders
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Sample Questions
Q1) 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.
Q2) Developmental disorders can result from all the following EXCEPT:
A) exposure to radiation.
B) mercury in foods and water.
C) drugs and alcohol.
D) folic acid.
Q3) Down syndrome is an example of a/an:
A) autosomal dominant disorder.
B) multifactorial disorder.
C) developmental defect.
D) chromosomal disorder.
Q4) In the case of an X-linked recessive disorder, a carrier mother and unaffected father could produce a/an:
A) normal female.
B) affected female.
C) male carrier.
Page 23
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Chapter 22: Complications due to Pregnancy
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Sample Questions
Q1) Which of the following indicates development of pregnancy-induced hypertension?
A) Proteinuria, edema, and weight gain
B) Persistent blood pressure measuring above 140/90
C) Vaginal bleeding
D) Blood clots forming in the legs
Q2) 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
Q3) Edema and congestion normally develop in many tissues during pregnancy as a result of:
A) reduced kidney function.
B) decreased serum albumin.
C) increased blood volume.
D) increases in blood pressure.
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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) Acne vulgaris can best be described as an infection involving the:
A) sweat glands of the upper body.
B) dermis and epidermis of the skin.
C) apocrine glands.
D) sebaceous glands and hair follicles.
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25
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 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
Q3) Theories about the causes of aging include:
A) apoptosis.
B) wear and tear.
C) altered protein (amyloid) accumulation.
D) All the above
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Page 26
Chapter 25: Immobility and Associated Problems
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Q1) 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
Q2) Immobility may lead to dehydration primarily as a result of:
A) changes in hormonal secretions due to increased blood in the thorax.
B) destruction of the kidneys as a result of ischemia and necrosis.
C) blockage of the ureters, causing retention of urine.
D) toxins being produced by infectious microorganisms.
Q3) The major problem associated with immobility and the gastrointestinal tract is:
A) constipation.
B) diarrhea.
C) nausea.
D) increased rate of peristalsis.
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Chapter 26: Stress and Associated Problems
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Q1) 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.
Q2) Possible complications caused by prolonged, severe stress include all of the following EXCEPT:
A) hypertension.
B) tension headache.
C) diabetes mellitus.
D) blindness.
Q3) In which of the following situations would the stress response be used to prevent blood pressure from dropping too low?
A) Increasing anger during an argument
B) Writing a final examination
C) Fear about a medical diagnosis
D) Internal hemorrhage from injuries in a car accident
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28
Chapter 27: Substance Abuse and Associated Problems
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Q1) Chronic alcoholism is likely to cause all of the following EXCEPT:
A) cirrhosis.
B) mental confusion.
C) loss of motor coordination.
D) altered personality and amnesia.
E) respiratory failure.
Q2) Synergism can cause an emergency situation when:
A) antidotes for respiratory depression are given too quickly.
B) a combination of alcohol and drugs has been taken.
C) a large dose of a drug affects the CNS.
D) an individual involuntarily develops a habit.
Q3) What is a common indication of substance abuse?
A) Behavioral change
B) Weight gain
C) Depression
D) Loss of sensory function
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29
Chapter 28: Environmental Hazards and Associated Problems
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Q1) Bites and stings cause disease in which three ways?
A) Injection of toxins, transmission of infectious agents, or allergic reactions
B) High fever and chills, transmission of infectious agents, or nausea and vomiting
C) Bone marrow damage, extensive skin rashes, or allergic reactions
D) Injection of neurotoxins, transmission of infectious agents, or kidney damage
Q2) A common illness for tourists in developing countries is "traveler's diarrhea," often caused by:
A) Salmonella
B) Shigella
C) E. coli
D) Listeria
Q3) Two types of eye damage that can be caused by a laser beam are:
A) chemical and structural.
B) thermal burn and photochemical damage.
C) tissue necrosis and vascular occlusions.
D) formation of deep lesions in the optic nerve and in the sclera.
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