Pathophysiology of Disease an Introduction to Clinical Medicine Exam by
Hammer McPhee | Expert Questions & 100% Accurate Answers | Latest
Edition 2026 | 100% Guaranteed A+
MULTIPLE CHOICE
1. A 58‑year‑old with a 40‑pack‑year smoking history has progressive dyspnea and a barrel‑shaped chest.
Which finding is expected on pulmonary function testing?
A) Increased FEV1/FVC ratio
B) Decreased residual volume
C) Reduced DLCO
D) Normal total lung capacity
Answer: C
Reduced diffusing capacity for carbon monoxide reflects alveolar destruction in emphysema.
2. A 72‑year‑old with hypertension presents with shortness of breath and crackles in both lung bases. S3
gallop is heard. What is the most likely pathophysiologic mechanism?
A) Reduced left ventricular compliance
B) Right ventricular outflow obstruction
C) Pericardial constriction
D) Increased pulmonary vascular resistance
Answer: A
Reduced compliance increases filling pressures, causing pulmonary congestion and S3.
3. A 45‑year‑old with type 2 diabetes has progressive leg numbness and a painless foot ulcer. What nerve
fibers are predominantly affected?
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,A) Large myelinated sensory fibers
B) Small unmyelinated C fibers
C) Preganglionic autonomic fibers
D) Alpha motor neurons
Answer: A
Diabetic sensory polyneuropathy initially damages large fibers, impairing proprioception and protective
sensation.
4. A 30‑year‑old woman with systemic lupus erythematosus develops hematuria and red blood cell casts.
What glomerular lesion is most likely?
A) Minimal change disease
B) Membranous nephropathy
C) Diffuse proliferative glomerulonephritis
D) Focal segmental glomerulosclerosis
Answer: C
Lupus nephritis class IV shows diffuse proliferative glomerulonephritis with subendothelial immune
complexes.
5. A 60‑year‑old with chronic hepatitis C has ascites, splenomegaly, and palmar erythema. Which
laboratory abnormality reflects hepatic synthetic dysfunction?
A) Elevated INR
B) Hyperbilirubinemia
C) Increased AST/ALT
D) Hyperammonemia
Answer: A
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,Prolonged INR indicates impaired synthesis of clotting factors by the diseased liver.
6. A 55‑year‑old with chest pain after heavy exertion shows ST‑segment depression on ECG. Troponin is
normal. What is the dominant mechanism?
A) Plaque rupture with thrombotic occlusion
B) Fixed coronary stenosis with increased oxygen demand
C) Coronary vasospasm at rest
D) Embolization from a left ventricular thrombus
Answer: B
Stable angina results from fixed atherosclerosis where demand exceeds supply without necrosis.
7. A 25‑year‑old with sickle cell disease has sudden severe back pain and dyspnea. Oxygen saturation is
85%. What is the most likely acute complication?
A) Aplastic crisis
B) Acute chest syndrome
C) Sequestration crisis
D) Osteomyelitis
Answer: B
Acute chest syndrome is a pulmonary sickling event causing hypoxia and infiltrates.
8. A 70‑year‑old with Parkinson’s disease develops orthostatic hypotension and constipation. These are
due to degeneration of which nervous system division?
A) Somatic motor
B) Sympathetic cholinergic
C) Parasympathetic and sympathetic postganglionic
3|Page SUCCESS!!!
, D) Corticospinal tract
Answer: C
Autonomic failure in Parkinson’s affects both parasympathetic and sympathetic postganglionic neurons.
9. A 40‑year‑old with alcohol use disorder presents with confusion, nystagmus, and ataxia. Thiamine is
given. What is the pathophysiology of the untreated syndrome?
A) Demyelination of mammillary bodies and periaqueductal gray
B) Necrosis of the basal ganglia
C) Cortical laminar necrosis
D) Cerebellar Purkinje cell loss only
Answer: A
Wernicke encephalopathy shows symmetric hemorrhagic lesions in mammillary bodies and brainstem.
10. A 65‑year‑old with chronic kidney disease has bone pain and serum calcium 9.5 mg/dL, phosphate 5.8
mg/dL, PTH 450 pg/mL. Which bone histology is expected?
A) Osteomalacia
B) Osteitis fibrosa cystica
C) Osteoporosis
D) Osteopetrosis
Answer: B
Secondary hyperparathyroidism causes high bone turnover with marrow fibrosis.
11. A 35‑year‑old with recurrent sinusitis and bronchiectasis has situs inversus on chest x‑ray. Which
subcellular defect is present?
A) Ciliary dynein arm deficiency
4|Page SUCCESS!!!
Hammer McPhee | Expert Questions & 100% Accurate Answers | Latest
Edition 2026 | 100% Guaranteed A+
MULTIPLE CHOICE
1. A 58‑year‑old with a 40‑pack‑year smoking history has progressive dyspnea and a barrel‑shaped chest.
Which finding is expected on pulmonary function testing?
A) Increased FEV1/FVC ratio
B) Decreased residual volume
C) Reduced DLCO
D) Normal total lung capacity
Answer: C
Reduced diffusing capacity for carbon monoxide reflects alveolar destruction in emphysema.
2. A 72‑year‑old with hypertension presents with shortness of breath and crackles in both lung bases. S3
gallop is heard. What is the most likely pathophysiologic mechanism?
A) Reduced left ventricular compliance
B) Right ventricular outflow obstruction
C) Pericardial constriction
D) Increased pulmonary vascular resistance
Answer: A
Reduced compliance increases filling pressures, causing pulmonary congestion and S3.
3. A 45‑year‑old with type 2 diabetes has progressive leg numbness and a painless foot ulcer. What nerve
fibers are predominantly affected?
1|Page SUCCESS!!!
,A) Large myelinated sensory fibers
B) Small unmyelinated C fibers
C) Preganglionic autonomic fibers
D) Alpha motor neurons
Answer: A
Diabetic sensory polyneuropathy initially damages large fibers, impairing proprioception and protective
sensation.
4. A 30‑year‑old woman with systemic lupus erythematosus develops hematuria and red blood cell casts.
What glomerular lesion is most likely?
A) Minimal change disease
B) Membranous nephropathy
C) Diffuse proliferative glomerulonephritis
D) Focal segmental glomerulosclerosis
Answer: C
Lupus nephritis class IV shows diffuse proliferative glomerulonephritis with subendothelial immune
complexes.
5. A 60‑year‑old with chronic hepatitis C has ascites, splenomegaly, and palmar erythema. Which
laboratory abnormality reflects hepatic synthetic dysfunction?
A) Elevated INR
B) Hyperbilirubinemia
C) Increased AST/ALT
D) Hyperammonemia
Answer: A
2|Page SUCCESS!!!
,Prolonged INR indicates impaired synthesis of clotting factors by the diseased liver.
6. A 55‑year‑old with chest pain after heavy exertion shows ST‑segment depression on ECG. Troponin is
normal. What is the dominant mechanism?
A) Plaque rupture with thrombotic occlusion
B) Fixed coronary stenosis with increased oxygen demand
C) Coronary vasospasm at rest
D) Embolization from a left ventricular thrombus
Answer: B
Stable angina results from fixed atherosclerosis where demand exceeds supply without necrosis.
7. A 25‑year‑old with sickle cell disease has sudden severe back pain and dyspnea. Oxygen saturation is
85%. What is the most likely acute complication?
A) Aplastic crisis
B) Acute chest syndrome
C) Sequestration crisis
D) Osteomyelitis
Answer: B
Acute chest syndrome is a pulmonary sickling event causing hypoxia and infiltrates.
8. A 70‑year‑old with Parkinson’s disease develops orthostatic hypotension and constipation. These are
due to degeneration of which nervous system division?
A) Somatic motor
B) Sympathetic cholinergic
C) Parasympathetic and sympathetic postganglionic
3|Page SUCCESS!!!
, D) Corticospinal tract
Answer: C
Autonomic failure in Parkinson’s affects both parasympathetic and sympathetic postganglionic neurons.
9. A 40‑year‑old with alcohol use disorder presents with confusion, nystagmus, and ataxia. Thiamine is
given. What is the pathophysiology of the untreated syndrome?
A) Demyelination of mammillary bodies and periaqueductal gray
B) Necrosis of the basal ganglia
C) Cortical laminar necrosis
D) Cerebellar Purkinje cell loss only
Answer: A
Wernicke encephalopathy shows symmetric hemorrhagic lesions in mammillary bodies and brainstem.
10. A 65‑year‑old with chronic kidney disease has bone pain and serum calcium 9.5 mg/dL, phosphate 5.8
mg/dL, PTH 450 pg/mL. Which bone histology is expected?
A) Osteomalacia
B) Osteitis fibrosa cystica
C) Osteoporosis
D) Osteopetrosis
Answer: B
Secondary hyperparathyroidism causes high bone turnover with marrow fibrosis.
11. A 35‑year‑old with recurrent sinusitis and bronchiectasis has situs inversus on chest x‑ray. Which
subcellular defect is present?
A) Ciliary dynein arm deficiency
4|Page SUCCESS!!!
