Pathophysiology of Disease: An Introduction to
Clinical Medicine
8th Edition
Author(s)Gary D. Hammer; Stephen J. McPhee
TEST BANK
1
Reference
Ch. 1 — Introduction
Question Stem
A 52-year-old patient presents with fatigue and new jaundice
after starting a herbal supplement. Using pathophysiologic
reasoning, what is the best immediate diagnostic step to
determine whether the presentation is iatrogenic liver injury?
Options
A. Measure serum aminotransferases (AST, ALT) and bilirubin
levels.
,B. Order liver biopsy immediately.
C. Start empiric high-dose corticosteroids.
D. Assume disease is genetic and refer for genetic testing.
Correct Answer
A
Rationales
Correct: Initial evaluation of suspected iatrogenic liver injury is
laboratory assessment (AST/ALT, bilirubin) to quantify injury and
pattern (hepatocellular vs cholestatic), which guides further
management.
B: Biopsy is invasive and reserved for unclear diagnoses or
when labs/clinical course indicate; not first step.
C: Empiric corticosteroids are not indicated without evidence of
immune-mediated injury or confirmed diagnosis.
D: Genetic causes are unlikely to present acutely after starting a
new agent; genetic testing is not the initial step.
Teaching Point
Iatrogenic liver injury evaluation begins with targeted liver
function tests.
Citation (Simplified APA)
Hammer & McPhee (2019). Pathophysiology of Disease (8th
Ed.). Ch. 1.
2
,Reference
Ch. 1 — Introduction
Question Stem
When constructing a differential diagnosis for acute dyspnea,
which of the following best demonstrates applying
pathophysiologic principles rather than rote symptom recall?
Options
A. Listing all diseases that include the word “dyspnea.”
B. Prioritizing pulmonary embolism in a post-op patient with
sudden hypoxemia and tachycardia.
C. Ordering an echocardiogram for every patient with shortness
of breath.
D. Assuming anxiety is the cause without objective data.
Correct Answer
B
Rationales
Correct: Prioritizing PE in a postoperative patient uses
mechanism (venous stasis → thrombosis → embolization) and
clinical risk factors to guide testing — a pathophysiologic
approach.
A: Pure symptom-word lists lack mechanistic prioritization and
are low-value.
C: Routine echo for all dyspnea is inefficient; imaging should be
driven by suspected pathophysiology.
D: Assuming anxiety without evaluation ignores possible life-
threatening mechanisms.
, Teaching Point
Clinical hypotheses should reflect mechanism plus contextual
risk factors.
Citation (Simplified APA)
Hammer & McPhee (2019). Pathophysiology of Disease (8th
Ed.). Ch. 1.
3
Reference
Ch. 1 — Introduction
Question Stem
A nursing student confuses “pathogenesis” and “manifestation.”
Which example best distinguishes pathogenesis from
manifestation?
Options
A. Autoimmune destruction of pancreatic beta cells →
hyperglycemia.
B. Recording patient’s complaint of thirst.
C. Listing medication side effects.
D. Measuring blood glucose value.
Correct Answer
A
Rationales
Correct: This links the mechanism (autoimmune beta-cell
Clinical Medicine
8th Edition
Author(s)Gary D. Hammer; Stephen J. McPhee
TEST BANK
1
Reference
Ch. 1 — Introduction
Question Stem
A 52-year-old patient presents with fatigue and new jaundice
after starting a herbal supplement. Using pathophysiologic
reasoning, what is the best immediate diagnostic step to
determine whether the presentation is iatrogenic liver injury?
Options
A. Measure serum aminotransferases (AST, ALT) and bilirubin
levels.
,B. Order liver biopsy immediately.
C. Start empiric high-dose corticosteroids.
D. Assume disease is genetic and refer for genetic testing.
Correct Answer
A
Rationales
Correct: Initial evaluation of suspected iatrogenic liver injury is
laboratory assessment (AST/ALT, bilirubin) to quantify injury and
pattern (hepatocellular vs cholestatic), which guides further
management.
B: Biopsy is invasive and reserved for unclear diagnoses or
when labs/clinical course indicate; not first step.
C: Empiric corticosteroids are not indicated without evidence of
immune-mediated injury or confirmed diagnosis.
D: Genetic causes are unlikely to present acutely after starting a
new agent; genetic testing is not the initial step.
Teaching Point
Iatrogenic liver injury evaluation begins with targeted liver
function tests.
Citation (Simplified APA)
Hammer & McPhee (2019). Pathophysiology of Disease (8th
Ed.). Ch. 1.
2
,Reference
Ch. 1 — Introduction
Question Stem
When constructing a differential diagnosis for acute dyspnea,
which of the following best demonstrates applying
pathophysiologic principles rather than rote symptom recall?
Options
A. Listing all diseases that include the word “dyspnea.”
B. Prioritizing pulmonary embolism in a post-op patient with
sudden hypoxemia and tachycardia.
C. Ordering an echocardiogram for every patient with shortness
of breath.
D. Assuming anxiety is the cause without objective data.
Correct Answer
B
Rationales
Correct: Prioritizing PE in a postoperative patient uses
mechanism (venous stasis → thrombosis → embolization) and
clinical risk factors to guide testing — a pathophysiologic
approach.
A: Pure symptom-word lists lack mechanistic prioritization and
are low-value.
C: Routine echo for all dyspnea is inefficient; imaging should be
driven by suspected pathophysiology.
D: Assuming anxiety without evaluation ignores possible life-
threatening mechanisms.
, Teaching Point
Clinical hypotheses should reflect mechanism plus contextual
risk factors.
Citation (Simplified APA)
Hammer & McPhee (2019). Pathophysiology of Disease (8th
Ed.). Ch. 1.
3
Reference
Ch. 1 — Introduction
Question Stem
A nursing student confuses “pathogenesis” and “manifestation.”
Which example best distinguishes pathogenesis from
manifestation?
Options
A. Autoimmune destruction of pancreatic beta cells →
hyperglycemia.
B. Recording patient’s complaint of thirst.
C. Listing medication side effects.
D. Measuring blood glucose value.
Correct Answer
A
Rationales
Correct: This links the mechanism (autoimmune beta-cell
