SUNY Downstate Medical Center NRMS 5190 | Pathophysiology Final Exam Comprehensive Q&A's with rationales | 100% Updated fall 2025/26, A+ Guide.

SUNY Downstate Medical Center NRMS 5190 | Pathophysiology Final Exam Comprehensive Q&A's with rationales | 100% Updated fall 2025/26, A+ Guide. 1. Which pathway in the study guide carries pain, thermal sensation, crude touch, and pressure? A. Extrapyramidal system B. Discriminative pathway C. Pyramidal motor system D. Anterolateral pathway 2. A patient can identify a screwdriver placed in the hand without looking at it. Which sensory ability is being demonstrated? A. Avolition B. Stereognosis C. Bradykinesia D. Allodynia 3. Which pain fibers are associated with fast pain? A. Oligodendrocytes B. C fibers C. Schwann cells D. A-delta fibers 4. Which tract is associated with sharp, stabbing pain? A. Pyramidal tract B. Nigrostriatal pathway C. Neospinothalamic tract D. Paleospinothalamic tract 5. Which description best matches visceral pain? A. Sharp burning pain originating in skin and subcutaneous tissue B. Pain limited to a ligament after abnormal joint movement C. A painless sensory deficit confined to one peripheral nerve D. Diffuse, poorly defined pain originating in visceral organs 6. A sprained ankle is used in the study guide as an example of which type of pain? A. Cutaneous pain B. Deep somatic pain C. Referred pain D. Visceral pain 7. A patient has recurrent sharp, stabbing facial pain without numbness. Which disorder is most consistent with the study guide? A. Trigeminal neuralgia B. Phantom limb pain C. Complex regional pain syndrome D. Postherpetic neuralgia 8. Trigeminal neuralgia primarily involves which cranial nerve according to the notes? A. Cranial nerve VII B. Cranial nerve X C. Cranial nerve V D. Cranial nerve II 9. Myasthenia gravis in the study guide is caused by which mechanism? A. Progressive destruction of the nigrostriatal pathway B. Antibody-mediated loss of acetylcholine receptors at the neuromuscular junction C. A single recessive gene defect transmitted from mother to male offspring D. Autoimmune destruction of oligodendrocytes in the CNS 10. Which symptom pattern is most characteristic of myasthenia gravis in the uploaded material? A. Resting tremor disappears as the day proceeds B. Weakness is least evident in the morning and worsens with effort as the day proceeds C. Symptoms are limited to sensory loss without muscle fatigue D. Weakness begins rapidly with loss of tendon reflexes and then resolves with activity 11. Guillain-Barre syndrome is described as which type of disorder? A. Autoimmune destruction of CNS oligodendrocytes with remissions and exacerbations B. Degenerative basal ganglia disorder with resting tremor C. Acute immune-mediated polyneuropathy with rapid limb weakness and loss of tendon reflexes D. Inherited muscular dystrophy affecting boys at age 2-3 years 12. Which pathophysiologic change is central to Parkinson disease in the study guide? A. Progressive destruction of the nigrostriatal pathway with reduced striatal dopamine B. Loss of acetylcholine receptors at the neuromuscular junction C. Demyelination of cranial nerve V D. Autoimmune destruction of oligodendrocytes 13. Which finding is described as the most visible manifestation of Parkinson disease? A. Painless hematuria B. Loss of tendon reflexes C. Blank stare lasting a few seconds D. Resting tremor with pill-rolling movements 14. Bradykinesia in Parkinson disease refers to which finding? A. Involuntary loss of urine with coughing B. Loss of awareness with a blank stare C. Pain produced by light touch D. Slowness in initiating and performing movements 15. Multiple sclerosis is primarily associated with which pathophysiologic process? A. Destruction of the nigrostriatal pathway B. Loss of factor VIII and von Willebrand factor C. Autoimmune demyelination of white matter in the brain, spinal cord, and optic nerve D. Antibody-mediated loss of acetylcholine receptors 16. Which clinical course is characteristic of the relapsing-remitting form of multiple sclerosis? A. Gradual deterioration only after a previous relapsing-remitting course B. Continuous neurologic degeneration from the onset without relapses C. A single episode followed by permanent complete recovery D. Episodes of acute neurologic worsening with recovery and a stable course between relapses 17. Which description best matches secondary progressive multiple sclerosis? A. Gradual neurologic deterioration in a person with previous relapsing-remitting disease B. Acute immune-mediated polyneuropathy with loss of reflexes C. Nearly continuous degeneration from the initial onset of symptoms D. Intermittent blank staring without motor activity 18. A seizure that begins in one specific area of one cerebral hemisphere is classified as which onset type? A. Generalized onset B. Tonic-clonic onset only C. Focal onset D. Absence onset only 19. Which seizure type is described as a generalized, nonconvulsive event with a brief blank stare and rapid return to normal activity? A. Tonic-clonic seizure B. Focal motor seizure C. Absence seizure D. Panic attack 20. Which feature is characteristic of a tonic-clonic seizure in the study guide? A. Sharp tonic muscle contraction with extension of the extremities and immediate loss of consciousness B. A brief blank stare without convulsive activity C. A painless enlargement of a single lymph node D. A unilateral resting tremor that disappears with movement 21. Damage to which lobe would most directly impair decision-making, reasoning, concentration, and purposeful behavior according to the final review? A. Temporal lobe B. Frontal lobe C. Parietal lobe D. Occipital lobe 22. Impulse and aggression control are emphasized as functions of which lobe? A. Frontal lobe B. Temporal lobe C. Cerebellum D. Parietal lobe 23. Personality factors, nonverbal memory, and concept formation are emphasized as functions of which lobe? A. Parietal lobe B. Temporal lobe C. Frontal lobe D. Brainstem 24. Which finding is classified as a negative symptom of schizophrenia in the study guide? A. Hallucinations B. Avolition C. Disorganized speech D. Delusions 25. Which dementia is described as progressive deterioration of the frontal and anterior lobes with strong familial tendencies and onset before age 65? A. Vascular dementia B. Frontotemporal dementia C. Wernicke-Korsakoff syndrome D. Creutzfeldt-Jakob disease 26. Which sequence best summarizes hemostasis as emphasized in the review? A. Fibrinolysis, erythropoiesis, and leukocyte migration B. Vasodilation, platelet depletion, and hemolysis C. Platelet destruction, bilirubin conjugation, and clot dissolution D. Vessel spasm, platelet plug formation, and blood coagulation with fibrin clot formation 27. Seconds after vessel injury, which factor binds platelet receptors and promotes adhesion to exposed collagen? A. Bilirubin B. von Willebrand factor C. Erythropoietin D. Plasmin 28. After platelets adhere to damaged vessel collagen, which substances are released to attract additional platelets and promote aggregation? A. Erythropoietin and bilirubin B. ADP and thromboxane C. Histamine and plasminogen D. Iron and globin 29. Failure of clot retraction most strongly suggests which problem according to the notes? A. Low platelet count B. High erythropoietin level C. Excess bilirubin conjugation D. High neutrophil count 30. The process by which a clot dissolves is called which term? A. Thrombocytosis B. Fibrinolysis C. Hemolysis D. Erythropoiesis 31. Plasminogen is converted to which active form during fibrinolysis? A. Plasmin B. Erythropoietin C. Thrombin D. Fibrin 32. Which condition is listed as increasing platelet function and contributing to hypercoagulability? A. Vitamin B12 deficiency B. Smoking C. Aplastic anemia D. Neutropenia 33. Which patient has the greatest thromboembolic risk profile specifically emphasized in the study guide? A. A patient with isolated vitamin B12 deficiency B. A woman older than 35 who smokes and uses oral contraceptives C. A young nonsmoker with no medication use D. A patient with a simple renal cyst and no symptoms 34. Arterial thrombi are most strongly associated with which condition? A. Stasis of blood flow with concentrated coagulation factors B. Failure of erythropoietin production C. Turbulent blood flow and platelet adherence D. Excess bilirubin conjugation 35. Venous thrombi are most strongly associated with which condition? A. Turbulent flow with platelet adherence B. Stasis of blood flow with increased concentrations of coagulation factors C. Increased red-cell destruction D. Low gastric acidity 36. Which laboratory platelet count meets the source definition of thrombocytopenia? A. A neutrophil percentage of 50-60% B. A platelet count below 150,000/uL C. A platelet count above 450,000/uL D. A hemoglobin below 12 g/dL 37. Which finding is especially characteristic of bleeding caused by platelet deficiency? A. Painless hematuria only B. Pill-rolling tremor and rigidity C. Silvery-white plaques D. Petechiae and purpura 38. Immune thrombocytopenic purpura (ITP) is primarily caused by which process? A. Loss of erythropoietin production B. Factor IX deficiency C. Excessive production of neutrophils D. Platelet antibody formation with excessive platelet destruction 39. Which manifestation is consistent with ITP in the study material? A. Bruising, gum bleeding, epistaxis, melena, or abnormal menstrual bleeding B. Thick white odorless vaginal discharge only C. Painless enlargement of a single lymph node only D. Resting tremor and bradykinesia 40. Hemophilia A is associated in the uploaded study guide with deficiency of which factors? A. Factor X only B. Factor IX only C. Erythropoietin and iron D. Factor VIII and von Willebrand factor 41. Hemophilia B is associated with deficiency of which factor? A. von Willebrand factor only B. Factor X C. Factor VIII D. Factor IX 42. Which disorder is described as the most frequently inherited coagulopathy? A. Disseminated intravascular coagulation B. Von Willebrand disease C. Thrombotic thrombocytopenic purpura D. Immune thrombocytopenic purpura 43. What initiates the pathophysiologic sequence of disseminated intravascular coagulation (DIC)? A. Selective inhibition of platelet adhesion without coagulation activation B. Isolated erythropoietin deficiency C. Failure of the liver to conjugate bilirubin D. Massive activation of coagulation with unregulated thrombin generation and systemic fibrin formation 44. Why can severe bleeding occur later in DIC? A. Coagulation proteins and platelets are consumed during widespread clot formation B. Platelet production becomes excessive C. Erythropoietin is overproduced D. Bilirubin becomes water soluble 45. Which group of conditions is specifically associated with DIC in the source? A. Obstetric conditions, cancers, infections, shock, trauma or surgery, and hematologic conditions B. Migraine, insomnia, and depression C. Simple renal cysts, myopia, and rhinitis D. Osteoarthritis, scoliosis, and clubfoot only 46. What is the primary function of red blood cells? A. Produce antibodies against bacteria B. Initiate platelet aggregation C. Transport oxygen from the lungs to the tissues D. Release histamine during allergic reactions 47. Which hormone regulates red blood cell production and is produced by the kidney in response to decreased oxygen levels? A. Erythropoietin B. Thromboxane C. Histamine D. Plasmin 48. Excessive red blood cell destruction can cause jaundice because which substance accumulates? A. Unconjugated bilirubin B. Plasmin C. Conjugated albumin D. Factor IX 49. Which action should be taken immediately if a patient develops signs of a transfusion reaction according to the study guide? A. Continue the transfusion and observe B. Give a second unit before reassessment C. Stop the blood infusion immediately D. Increase the infusion rate 50. Which finding can indicate a delayed hemolytic transfusion reaction 1-2 weeks after transfusion? A. Painless hematuria with urinary urgency B. A rise in platelet count with petechiae C. A fall in hemoglobin with jaundice D. Resting tremor with rigidity 51. Which mechanism is the usual reason for iron deficiency anemia in the study guide? A. Excess erythropoietin production B. Acute neutrophil destruction C. Excess platelet aggregation D. Chronic blood loss 52. Which CBC pattern is expected in iron deficiency anemia according to the source? A. High hemoglobin with increased hematocrit B. Low hemoglobin and hematocrit with reduced MCV and MCHC C. High MCV with normal iron stores D. Normal MCV with marked lymphocytosis only 53. The hallmark of vitamin B12 deficiency in the study guide is which type of anemia? A. Anemia caused only by acute blood loss B. Megaloblastic anemia with enlarged red cells C. Microcytic anemia with reduced MCV D. Hemolytic anemia caused by HbS 54. Aplastic anemia can produce pancytopenia. What does pancytopenia mean? A. Decreased red blood cells, white blood cells, and platelets B. Decreased neutrophils only C. Decreased platelets only D. Increased red cells, white cells, and platelets 55. Which two major consequences of sickling are emphasized for sickle cell disease? A. Hypercalcemia and bone resorption B. Chronic hemolytic anemia and blood vessel occlusion C. Leukopenia and low gastric acidity D. Thrombocytosis and increased fibrinolysis 56. Which factor can precipitate sickling and vessel occlusion according to the study guide? A. Increased calcium intake B. Warm ambient temperature only C. High HDL level D. Dehydration 57. Why does chronic renal failure commonly produce anemia? A. Increased platelet aggregation B. Excess bilirubin conjugation C. Deficiency of erythropoietin D. Excess production of von Willebrand factor 58. Which description matches primary polycythemia? A. An increased erythropoietin response to chronic hypoxia B. A platelet antibody disorder C. A bone marrow proliferative disease with increased red-cell mass and elevated white cells and platelets D. A decrease in all blood cell lines 59. Which white blood cell is the first to arrive at the site of infection and is a major host defense cell? A. Reticulocyte B. Eosinophil C. Basophil D. Neutrophil 60. An increased eosinophil count is particularly associated with which conditions? A. Osteoarthritis and scoliosis B. BPH and stress incontinence C. Allergic reactions and parasitic infections D. Iron deficiency anemia and chronic blood loss 61. Which disorder includes rheumatoid arthritis, decreased white blood cells, splenomegaly, and repeated infections? A. Hodgkin lymphoma B. Multiple myeloma C. Felty syndrome D. Immune thrombocytopenic purpura 62. Which finding is required for a definitive diagnosis of Hodgkin lymphoma? A. Bence Jones protein in urine B. Philadelphia chromosome C. A platelet count below 150,000/uL D. Reed-Sternberg cells in a lymph node biopsy 63. Which presentation is most characteristic of Hodgkin lymphoma in the study guide? A. Honey-colored skin crusts B. Painful hematuria with dysuria only C. Painless lymph node enlargement with pruritus, intermittent fever, night sweats, and possible weight loss D. Resting tremor with pill rolling 64. Which leukemia is associated with the Philadelphia chromosome? A. Acute lymphocytic leukemia (ALL) B. Chronic myelogenous leukemia (CML) C. Acute myelogenous leukemia (AML) D. Chronic lymphocytic leukemia (CLL) 65. Which laboratory finding is specifically described as suggestive of multiple myeloma? A. Reed-Sternberg cells B. Clue cells C. Low MCV and MCHC only D. Bence Jones protein in the urine 66. B-cell dysfunction most directly increases susceptibility to which type of infection according to the study guide? A. Fungal infections only B. Bacterial infections C. Parasitic infections only D. Viral infections only 67. T cells are emphasized as important in defense against which pathogens? A. Viral, fungal, and parasitic invasion B. Bone tumors C. Bacterial invasion only D. Platelet disorders 68. Which hypersensitivity type is described as IgE-mediated? A. Type II hypersensitivity B. Type IV hypersensitivity C. Type I hypersensitivity D. Type III hypersensitivity 69. Which statement best distinguishes gram-positive from gram-negative bacteria according to the review? A. Gram-positive bacteria have a thin outer lipid membrane; gram-negative bacteria lack any membrane B. Gram-positive bacteria have a thick cell wall without an outer lipid membrane; gram-negative bacteria have a thin layer with an outer lipid membrane C. Gram-positive bacteria have no cell wall; gram-negative bacteria have only a thick protein capsule D. Gram-positive bacteria are viruses; gram-negative bacteria are fungi 70. Defective pulmonary function or impaired mucociliary clearance increases risk for infection by which portal of entry? A. Transplacental transmission only B. Inhalation C. Direct contact only D. Ingestion 71. Which disease stage is characterized by active pathogen replication without symptoms? A. Prodromal stage B. Convalescent stage C. Acute stage D. Incubation period 72. Which infection stage represents the maximum impact of the infectious process with rapid proliferation and dissemination of the pathogen? A. Acute stage B. Incubation period C. Prodromal stage D. Convalescent stage 73. HIV primarily targets which immune cell? A. Neutrophils B. CD4 T lymphocytes C. Platelets D. Eosinophils 74. HIV type 1 carries its genetic information in which form? A. Protein only B. Fibrin C. DNA only D. RNA 75. Which enzyme converts HIV RNA into DNA? A. Plasmin B. Reverse transcriptase C. Erythropoietin D. Thrombin 76. Which finding meets the study-guide criteria for AIDS? A. A single episode of influenza-like symptoms B. Any positive HIV test with a normal CD4 count C. CD4 T-cell count below 200 or an AIDS-defining complication D. Any bacterial infection without HIV 77. Which symptom cluster can occur during the primary HIV infection phase? A. Fever, headache, muscle and joint aches, rash, sore throat, lymphadenopathy, cough, and night sweats B. Pill-rolling tremor and bradykinesia C. Painless hematuria with urgency D. Honey-colored skin crusts only 78. Which condition is listed as an AIDS-defining complication in the uploaded notes? A. Stress incontinence B. Pityriasis rosea C. Osteoarthritis D. Pneumocystic pneumonia 79. What is the effect of HAART emphasized in the HIV study guide? A. It decreases viral load, increases CD4 counts, and slows progression from HIV to AIDS B. It increases platelet destruction C. It causes conversion of HIV RNA to DNA D. It eliminates all HIV from the body immediately 80. Condylomata acuminata are caused by which organism? A. Treponema pallidum B. Candida albicans C. Human papillomavirus (HPV) D. Epstein-Barr virus 81. Which description best matches condylomata acuminata? A. Thick white odorless discharge with pruritus B. A painless chancre at the site of exposure C. Copious frothy green-yellow discharge D. Cauliflower-shaped lesions on moist skin surfaces such as the vaginal introitus or anus 82. Which vaginal discharge pattern is characteristic of vulvovaginal candidiasis in the source? A. Creamy yellow urethral discharge B. Thick, white, odorless discharge with pruritus and irritation C. Thin gray-white fishy discharge with clue cells D. Copious frothy malodorous green-yellow discharge 83. Which discharge pattern is characteristic of trichomoniasis? A. Thin gray-white fishy discharge B. Thick white odorless discharge C. No discharge with a painless chancre D. Copious, frothy, malodorous green or yellow discharge 84. Which finding supports bacterial vaginosis in the uploaded notes? A. A painless chancre B. Thin grayish-white discharge with a fishy odor and clue cells C. Cauliflower-shaped genital warts D. Thick white odorless discharge 85. Which lesion is characteristic of primary syphilis? A. Silvery-white plaques B. Honey-colored crusts C. A herald patch on the trunk D. A chancre at the site of exposure 86. Which mechanism is identified as a cause of cystic kidney disease? A. Tubular obstruction that increases intratubular pressure B. Increased gastric acidity C. Increased platelet adhesion D. Excess acetylcholine receptors 87. Which additional mechanism is listed as a cause of cystic kidney disease? A. Basement-membrane changes in renal tubules that predispose to cystic dilatation B. Platelet antibody formation C. Destruction of striatal dopamine D. Loss of skin keratinization 88. Which type of kidney stone accounts for approximately 75-80% of stones in the source? A. Uric acid stones B. Cystine stones C. Calcium stones D. Magnesium ammonium phosphate stones 89. Magnesium ammonium phosphate stones form under which conditions? A. High erythropoietin levels B. Only severe dehydration without infection C. Acidic urine without bacteria D. Alkaline urine in the presence of urease-producing bacteria 90. A stone that enlarges to fill the renal pelvis is commonly called which term in the study guide? A. Sequestrum B. Herald patch C. Reed-Sternberg stone D. Staghorn stone 91. Which type of renal stone is associated with gout in the source? A. Uric acid stone B. Magnesium stone only C. Calcium stone D. Cystine stone 92. Which organism is identified as the most common cause of uncomplicated urinary tract infection? A. Epstein-Barr virus B. Treponema pallidum C. Escherichia coli D. Candida albicans 93. Which symptom pattern is characteristic of an acute episode of cystitis? A. Frequency, dysuria, lower abdominal or back discomfort, and sometimes cloudy foul-smelling urine B. Resting tremor with rigidity C. Painless lymphadenopathy with night sweats D. Silvery plaques on extensor surfaces 94. An older adult develops unexplained altered mental status. Which infection should be considered according to the study guide? A. Hodgkin lymphoma B. Pityriasis rosea C. Urinary tract infection D. Primary syphilis 95. Which presentation is typical of acute pyelonephritis in the notes? A. Resting tremor and pill rolling B. Abrupt fever and chills with costovertebral-angle tenderness, often with nausea, vomiting, or abdominal pain C. Weak urinary stream without fever D. Painless hematuria only 96. What is the most common indicator of acute kidney injury emphasized in the final review? A. Increased platelet count B. Leukocytosis without azotemia C. Hypercalcemia with increased GFR D. Azotemia with a decrease in GFR 97. Prerenal acute kidney injury is characterized by which primary problem? A. Marked decrease in renal blood flow B. Obstruction causing urine retention after the kidney C. Autoimmune destruction of glomeruli only D. Direct structural damage within the kidney 98. Which condition can cause prerenal AKI according to the source? A. Cystine tubular absorption defect B. Reed-Sternberg cell formation C. Platelet antibody formation D. Hemorrhage or extracellular fluid-volume loss 99. Intrarenal AKI is caused by which type of process? A. Damage to structures within the kidney itself B. Only bladder-neck obstruction C. Only decreased vascular filling without renal injury D. Only excessive oral fluid intake 100. Which finding is associated with postrenal AKI in the source? A. Oliguria with retention of urea, potassium, sulfate, and creatinine B. Polyuria with low renal metabolites C. Only isolated lymphocytosis D. Increased platelet aggregation without fluid retention 101. Which test is used to estimate bladder volume and post-void residual? A. Lymph node biopsy B. DXA scan C. Ultrasound bladder scan D. Wet-mount microscopy 102. Which condition is listed as a cause of neurogenic bladder? A. Pityriasis rosea B. Alzheimer disease C. Hodgkin lymphoma D. Parkinson disease 103. Spastic bladder dysfunction is primarily a failure of which bladder function? A. Failure to produce urine B. Failure to form a platelet plug C. Failure to conjugate bilirubin D. Failure to store urine 104. Stress incontinence is best described as which clinical pattern? A. Involuntary urine loss with coughing, laughing, sneezing, or lifting B. Small nighttime leakage from bladder overdistention only C. Strong urgency followed by involuntary loss without increased abdominal pressure D. Inability to reach the toilet because of poor mobility 105. What is the most common sign of bladder cancer according to the review? A. Night sweats with pruritus B. Painless hematuria C. Resting tremor D. Painful joint swelling 106. Erectile dysfunction is defined in the study guide as which problem? A. Persistent erection lasting more than four hours B. Inability to achieve and maintain an erection sufficient for satisfactory sexual intercourse C. Age-related benign enlargement of the prostate D. Inflammation of the epididymis 107. Which is listed as an organic cause of erectile dysfunction? A. Normal pubertal development B. A strained relationship only C. Vascular disease D. Performance anxiety only 108. Benign prostatic hyperplasia is characterized by which process? A. Malignant enlargement arising from the bladder lining B. Acute twisting of the spermatic cord C. Age-related nonmalignant enlargement with benign periurethral lesions D. Inflammation of the epididymis only 109. Which symptom can result from the static component of BPH? A. Honey-colored crusts B. Frothy green vaginal discharge C. Pill-rolling tremor D. Weak urinary stream 110. Why is testicular torsion considered an emergency? A. Twisting of the spermatic cord cuts off blood supply to the ipsilateral testicle B. It produces a benign periurethral lesion C. It causes only chronic painless swelling D. It always produces a skin rash before pain 111. Endometriosis is characterized by which finding? A. A vaginal yeast infection B. Endometrial glands only within the normal endometrium C. Functional endometrial tissue in ectopic sites D. A benign enlargement of the prostate 112. Which is a physical symptom of premenstrual syndrome listed in the review? A. Painful and swollen breasts B. Generalized lymphadenopathy C. Painless hematuria D. Pill-rolling tremor 113. Which factor is identified as a breast cancer risk factor in the final review? A. Long-term use of postmenopausal hormone therapy B. Young age alone as a protective factor C. Absence of hormonal influences D. Low body weight with high activity 114. Which additional breast cancer risk factor is specifically listed? A. Frequent viral upper respiratory infections B. High physical activity C. Physical inactivity D. Low calcium intake only 115. A unilateral varicocele in an older male may raise concern for which underlying problem according to the source? A. A renal tumor invading the renal vein and obstructing spermatic venous drainage B. A benign skin tag C. Primary syphilis D. Candidiasis 116. What do tendons connect? A. Nerve to bone B. Skin to muscle C. Muscle to bone D. Bone to bone 117. What do ligaments connect? A. Bone to bone B. Nerve to muscle C. Skin to fascia D. Muscle to bone 118. A contusion is best described as which injury? A. Soft-tissue injury caused by direct trauma, usually from striking a body part against a hard object B. Stretching injury of a muscle or musculotendinous unit C. Displacement of the ends of a joint D. Ligament injury from abnormal joint movement 119. What is a hematoma? A. A loss of articular cartilage B. A torn skin surface only C. A fixed spinal curvature D. A large area of local hemorrhage 120. A strain involves which structure? A. Only articular cartilage B. Only bone cortex C. Ligamentous structures around a joint D. Muscle or musculotendinous unit 121. A sprain primarily involves which structure? A. Red blood cells B. Renal tubules C. Ligamentous structures surrounding a joint D. Neuromuscular junction receptors 122. Which statement correctly compares sprains and strains in the source? A. Strains are always more severe than sprains B. Sprains are more severe and pain/swelling subside more slowly than in strains C. Strains involve ligaments around a joint D. Sprains involve only muscle fibers 123. Which finding is typical of a fracture? A. Fishy vaginal discharge B. Painless jaundice only C. Pain, tenderness, swelling, loss of function, deformity, or abnormal mobility D. Blank staring for a few seconds 124. Which is one of the three major objectives in fracture treatment? A. Promoting venous stasis B. Increasing platelet destruction C. Reduction of the fracture D. Suppressing erythropoietin 125. Which sequence represents the five stages of bone healing in the study guide? A. Inflammation, fibrinolysis, erythropoiesis, hemolysis, remodeling B. Vasodilation, necrosis, thrombocytosis, fibrosis, lysis C. Adhesion, aggregation, clot retraction, jaundice, remodeling D. Hematoma formation, cellular proliferation, callus formation, ossification, remodeling 126. Once microorganisms enter bone, what sequence is emphasized in the review? A. They cause only transient vasodilation with no bone damage B. They immediately become dormant without tissue injury C. They increase bone mineralization and strengthen cortex D. They proliferate, produce cell death, spread within the bone shaft, and trigger chronic inflammation with further bone destruction 127. What is the hallmark feature of chronic osteomyelitis? A. A sequestrum of infected dead bone separated from living bone B. A Reed-Sternberg cell C. A herald patch D. A Bence Jones protein 128. Which patient profile contains multiple osteoporosis risk factors emphasized in the final review? A. A patient with a single uncomplicated UTI B. A young active male with adequate calcium intake and no smoking C. A child with a short febrile illness D. An aging postmenopausal white woman with a small bone structure, sedentary lifestyle, low calcium intake, and smoking history 129. Which test is listed for diagnosis of osteoporosis? A. Wet-mount microscopy B. Dual-energy x-ray absorptiometry (DXA) of the spine and hip C. Lymph-node biopsy D. Bladder ultrasound 130. Postural scoliosis is distinguished by which feature? A. A curve caused only by neuropathic disease B. A fixed deformity that does not correct with bending C. A small curve that corrects with bending D. A curve caused only by vertebral maldevelopment 131. Structural scoliosis is best described as which finding? A. A painless bladder disorder B. A fixed deformity that does not correct with bending C. A curve that fully corrects with bending D. A purely temporary muscle spasm 132. Which feature favors osteoarthritis rather than rheumatoid arthritis? A. Exacerbations and remissions with prolonged morning stiffness B. Systemic joint swelling with rheumatoid nodules C. Morning stiffness lasting 30 minutes or less and asymmetrical involvement D. Morning stiffness lasting an hour or more with symmetrical involvement 133. Which criterion supports rheumatoid arthritis in the study guide? A. Morning stiffness lasting at least 1 hour for at least 6 weeks B. A single herald patch C. Painless hematuria D. Morning stiffness lasting less than 30 minutes 134. Hyperuricemia is directly associated with which disorder? A. Gout B. Scoliosis C. Osteomyelitis D. Osteoporosis 135. Which group of findings defines the CREST variant of systemic sclerosis? A. Cystitis, retention, embolism, syncope, and torsion B. Cough, rash, edema, splenomegaly, and tremor C. Calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia D. Clot retraction, renal failure, erythema, scoliosis, and thrombosis 136. Which group contains the classic local signs of inflammation listed in the source? A. Jaundice, tremor, polyuria, petechiae, and tinnitus B. Pallor, bradykinesia, hematuria, dysuria, and ataxia C. Redness, swelling, heat, pain, and loss of function D. Fever, lymphocytosis, Bence Jones protein, and edema only 137. Which mediator is described as the first to be released during an acute inflammatory reaction? A. Bilirubin B. Histamine C. Plasminogen D. Erythropoietin 138. What is a major effect of histamine during acute inflammation? A. Increased red blood cell production B. Platelet antibody formation C. Endothelial retraction with increased vascular permeability D. Decreased vascular permeability 139. Which condition can trigger systemic inflammatory response syndrome (SIRS)? A. Uncomplicated pityriasis rosea B. Stable BPH without obstruction C. Simple postural scoliosis D. Sepsis 140. In sepsis-associated SIRS, massive cytokine release can lead to which hemodynamic effect? A. Generalized vasodilation and increased vascular permeability B. Only increased platelet production C. Generalized vasoconstriction with reduced permeability D. Isolated erythropoietin deficiency 141. Which sequence lists the stages of wound healing in the study guide? A. Adhesion, aggregation, and fibrinolysis B. Incubation, prodromal, and acute stages C. Onset, maintenance, and recovery only D. Inflammatory, proliferative, and maturational/remodeling phases 142. Which wound is most likely to heal by primary intention? A. A small, clean wound B. A deep necrotic pressure wound C. A large contaminated wound with substantial tissue loss D. An infected dead-bone sequestrum 143. Which skin finding is characteristic of impetigo? A. Honey-colored crusts or scabs B. Silvery-white scaling plaques C. Purple papules with a white lacelike surface D. A herald patch with central clearing 144. Which lesion is characteristic of psoriasis? A. A painless chancre B. Circumscribed red thickened plaques with an overlying silvery-white scale C. Honey-colored crusts D. A thin gray-white fishy discharge 145. Which finding is characteristic of pityriasis rosea? A. Persistent ulceration with exposed bone B. A herald patch followed by lesions on the trunk and neck that may form a Christmas-tree pattern C. Honey-colored crusts limited to the face D. A single painless genital chancre 146. Pityriasis rosea is described as having what typical course? A. Requires lifelong anticoagulation B. Always chronic and progressive C. Self-limited and usually disappearing in 6-8 weeks D. Rapidly fatal within 24 hours 147. Which description matches first-degree burns in the uploaded guide? A. They involve only the outer layers of the epidermis B. They extend into subcutaneous tissue and may involve muscle and bone C. They involve the epidermis and variable portions of the dermis D. They involve the entire epidermis and dermis 148. Which description matches second-degree partial-thickness burns? A. They always extend into muscle and bone B. They involve only subcutaneous tissue C. They involve the epidermis and various degrees of the dermis D. They involve only the outer epidermis 149. Which description matches third-degree full-thickness burns? A. They involve only the outer epidermis B. They extend into subcutaneous tissue and may involve muscle and bone C. They are limited to the epidermis and superficial dermis D. They cause only transient erythema without tissue injury 150. Which skin condition is described as a localized vesicular eruption distributed over a dermatomal segment? A. Impetigo B. Herpes zoster C. Psoriasis D. Pityriasis rosea