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Advanced Pathophysiology Exam 1

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1. A certain disease is currently found in 1 of every 10 people in the country and 1,000 people contract the disease yearly. The population of the country is 4,500,000. Which of the following statements is correct? a. The prevalence of the disease is 10% and the incidence is .02%. b. The prevalence of the disease is .02% and the incidence is 10%. c. Neither is correct. d. There is insufficient data: A 6. Mr. Forbes complains of "indigestion" and becomes sweaty and pale. His wife takes him to the Emergency Department at Northwestern Memorial Hospital. A cardiac catheterization 2 days later shows partial blockage of his right coronary artery (RCA). Blockage of the right coronary artery can lead to myocardial cell injury because it results in which of the following? a. bilirubin accumulation in myocardial cells b. alteration in the genetic material of myocardial cells c. reduced energy production in myocardial cells d. activation of the complement system: C 7. When myocardial cells are injured, the function of the Na-K membrane pump may be impaired. Which of the following may then result? a. intracellular sodium will increase b. extracellular potassium will decrease c. cell volume will decrease d. all of the above: A 8. Mr. Forbes is being prepared for open heart surgery when he suffers a myocardial infarction in which a large part of his left ventricle has suffered lethal cell injury. Mr. Forbes' CPK-MB and LDH1, enzymes associated with myocardial cells, are significantly elevated. What is the best explanation for this? a. It is a sign that necrotic myocardial cells have released their cytoplasmic contents into the blood. b. It is a sign of reversible fatty accumulation in the myocardial cells c. It is a sign that the myocardial cells are undergoing hypertrophy. d. None of the above.: A 9. If a tissue specimen of myocardial cells were obtained for examination from Mr. Forbes, which of the following findings would indicate irreversible cell injury? a. cellular swelling b. decreased ATP production c. decreased intracellular calcium d. dissolution of nuclear material: D 10. The accumulation of lactic acid that occurs with impaired energy production results from which of the following? a. increased intracellular glucose b. increased anaerobic metabolism c. decreased metabolic rate d. increased oxidative phosphorylation: B

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Advanced Pathophysiology
Exam 1
1. A certain disease is currently found in 1 of every 10 people in
the country and 1,000 people contract the disease yearly. The
population of the country is 4,500,000. Which of the following
statements is correct?
a. The prevalence of the disease is 10% and the incidence is .02%.
b. The prevalence of the disease is .02% and the incidence is 10%.
c. Neither is correct.
d. There is insufficient data: A
2. In relation to disease development, the term "etiology" refers to
which of the following?

a. number of people with the disease
b. cause of the disease
c. definition of the disease
d. outcome of the disease: B
3. Which of the following is(are) true about "symptoms"?
a. objective and measurable
b. the same as "signs"
c. both of the above
d. neither of the above: D
4. In 1992, there were 980 deaths in a Midwestern city with a
population of 1,000,000. At the beginning of that year, 900 cases of
AIDS existed in this population. During the year, 250 new cases of
AIDS were diagnosed, and 75 people died of the disease in 1992.
Using the data given above, what was the incidence rate (per 100,00
popula- tion) at the end of 1992 for AIDS?
a. 6
b. 25
c. 88
d. 116: B
5. What level of prevention is a blood pressure screening program
for high school students who are pregnant?
a. primary


, Advanced Pathophysiology
Exam 1
b. secondary
c. tertiary: B
6. Mr. Forbes complains of "indigestion" and becomes sweaty and pale.
His wife takes him to the Emergency Department at Northwestern
Memorial Hospital. A cardiac catheterization 2 days later shows partial
blockage of his right coronary artery (RCA).
Blockage of the right coronary artery can lead to myocardial cell
injury because it results in which of the following?
a. bilirubin accumulation in myocardial cells
b. alteration in the genetic material of myocardial cells
c. reduced energy production in myocardial cells
d. activation of the complement system: C
7. When myocardial cells are injured, the function of the Na-K
membrane pump may be impaired. Which of the following may
then result?
a. intracellular sodium will increase
b. extracellular potassium will decrease
c. cell volume will decrease
d. all of the above: A
8. Mr. Forbes is being prepared for open heart surgery when
he suffers a myocardial infarction in which a large part of his left
ventricle has suffered lethal cell injury.
Mr. Forbes' CPK-MB and LDH1, enzymes associated with myocardial
cells, are significantly elevated. What is the best explanation for this?
a. It is a sign that necrotic myocardial cells have released their
cytoplasmic contents into the blood.
b. It is a sign of reversible fatty accumulation in the myocardial cells
c. It is a sign that the myocardial cells are undergoing hypertrophy.
d. None of the above.: A
9. If a tissue specimen of myocardial cells were obtained for
examination from Mr. Forbes, which of the following findings would
indicate irreversible cell injury?
a. cellular swelling


, Advanced Pathophysiology
Exam 1
b. decreased ATP production
c. decreased intracellular calcium
d. dissolution of nuclear material: D
10. The accumulation of lactic acid that occurs with impaired
energy production results from which of the following?
a. increased intracellular glucose
b. increased anaerobic metabolism
c. decreased metabolic rate
d. increased oxidative phosphorylation: B
11. A mountain climber is stranded at 23,000 feet in the Swiss
Alps and has lost all his equipment and supplies in an avalanche.
Subsequently, he suffers cell injury due to impaired ATP production.
The reason for the decrease in ATP is which of the following?
a. enzyme inhibition
b. uncoupling
c. hypoxia
d. none of the above: C
12. An elderly patient develops an obstruction in his left middle
cerebral artery. The brain tissue supplied by this artery becomes
hypoxic. The best explanation for this is which of the following?
a. the obstruction results in decreased blood flow
b. the obstruction results in decreased hemoglobin in the blood
c. while blood flow stays the same, the obstruction reduces oxygen
content in the blood
d. none of the above explain the reason for the hypoxia: A
13. Increased mobilization and delivery of free fatty acids to
liver cells can result in fat accumulation. Which of the following
problems results in increased mobilization of free fatty acids?
a. anemia
b. hepatic toxins
c. starvation
d. hypoxia: C



, Advanced Pathophysiology
Exam 1
14. Generalized hypoxia results in a switch to anaerobic
metabolism in cells. Anaerobic metabolism results in which of
the following?
a. decreased lactic acid inside cells
b. decreased arterial pH
c. more effective ATP production
d. increased pH inside cells: B
15. There is a disease of the spleen, which results in an excessive
destruction of RBCs. This increase in RBC destruction can lead to
which of the following?
a. hypoxia
b. hypobilirubinemia
c. an increase in platelets
d. all of the above: A
16. Your body has developed an increased demand
for thyroid hormones. This will lead to of the thyroid gland.
a. atrophy
b. hypertrophy
c. dysplasia
d. metaplasia: B
17. You palpate a gangrenous leg and note the presence of
crepitus. Crepitus is associated with which of the following?
a. wet gangrene
b. dry gangrene
c. gas gangrene
d. all of the above: C
18. Direct cell membrane destruction may result from which of the
following?
a. complement activation
b. bacterial enzymes
c. free radicals
d. all of the above: D
19. Which of the following is true regarding apoptosis?

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