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 68-year-old patient presents with progressive fatigue and
weight loss over 3 months. Laboratory tests show normocytic
anemia and low albumin. As a clinician applying
pathophysiologic principles, which next step best uses the
concept of ‘natural history of disease’ to guide care?
Options
A. Order serum iron studies and start oral iron immediately.
B. Review prior records for symptom onset, exposures, and
,prior lab trends.
C. Begin empiric corticosteroids for suspected inflammatory
disease.
D. Discharge with follow-up in 6 months if symptoms persist.
Correct Answer
B
Rationales
Correct: Reviewing prior records and trends applies the natural
history framework—identifying onset, progression, and
potential exposures helps distinguish acute from chronic causes
and guides targeted testing.
A (incorrect): Immediate iron without establishing chronicity or
cause risks misdirected therapy; iron studies are reasonable but
should follow history review.
C (incorrect): Empiric corticosteroids without evidence of
inflammatory etiology risks harm and obscures diagnostic clues.
D (incorrect): Delaying evaluation risks missed reversible
causes; 6 months is not appropriate for progressive
anemia/weight loss.
Teaching Point
Natural history guides timing of diagnostics and differentiates
acute vs chronic disease.
Citation
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
, 2.
Reference — Ch. 1 — Introduction
Question Stem
A nurse explains to a newly admitted patient that many chronic
diseases have a "latent" phase. Which clinical action most
directly follows from understanding a latent (subclinical) phase
in disease?
Options
A. Avoid screening tests because they detect asymptomatic
disease only.
B. Implement targeted screening for high-risk individuals to
detect early disease.
C. Treat symptoms only when they become bothersome to the
patient.
D. Delay preventive measures until clinical signs appear.
Correct Answer
B
Rationales
Correct: Recognizing a latent phase supports targeted screening
in high-risk populations to detect disease before symptoms,
improving outcomes.
A (incorrect): Latent phases are precisely when screening is
useful; avoiding screening would miss early disease.
C (incorrect): Treating only symptomatic disease ignores
, opportunities for earlier intervention during latency.
D (incorrect): Delaying prevention ignores the window for
altering disease course in the latent phase.
Teaching Point
Latent phases justify targeted screening to detect disease
before symptoms.
Citation
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
3.
Reference — Ch. 1 — Introduction
Question Stem
A patient with acute chest pain arrives and initial ECG and
troponin are non-diagnostic. Using the principle of sensitivity
versus specificity in diagnostics, which approach best minimizes
the chance of missing an acute myocardial infarction (safety-
focused decision)?
Options
A. Rely on a single high-specificity test and discharge if negative.
B. Use a highly sensitive initial test and repeat troponin at an
interval.
C. Obtain only imaging studies because labs are too slow.
D. Discharge with outpatient follow-up for all low-risk patients.
Clinical Medicine
8th Edition
Author(s)Gary D. Hammer; Stephen J. McPhee
TEST BANK
1.
Reference — Ch. 1 — Introduction
Question Stem
A 68-year-old patient presents with progressive fatigue and
weight loss over 3 months. Laboratory tests show normocytic
anemia and low albumin. As a clinician applying
pathophysiologic principles, which next step best uses the
concept of ‘natural history of disease’ to guide care?
Options
A. Order serum iron studies and start oral iron immediately.
B. Review prior records for symptom onset, exposures, and
,prior lab trends.
C. Begin empiric corticosteroids for suspected inflammatory
disease.
D. Discharge with follow-up in 6 months if symptoms persist.
Correct Answer
B
Rationales
Correct: Reviewing prior records and trends applies the natural
history framework—identifying onset, progression, and
potential exposures helps distinguish acute from chronic causes
and guides targeted testing.
A (incorrect): Immediate iron without establishing chronicity or
cause risks misdirected therapy; iron studies are reasonable but
should follow history review.
C (incorrect): Empiric corticosteroids without evidence of
inflammatory etiology risks harm and obscures diagnostic clues.
D (incorrect): Delaying evaluation risks missed reversible
causes; 6 months is not appropriate for progressive
anemia/weight loss.
Teaching Point
Natural history guides timing of diagnostics and differentiates
acute vs chronic disease.
Citation
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
, 2.
Reference — Ch. 1 — Introduction
Question Stem
A nurse explains to a newly admitted patient that many chronic
diseases have a "latent" phase. Which clinical action most
directly follows from understanding a latent (subclinical) phase
in disease?
Options
A. Avoid screening tests because they detect asymptomatic
disease only.
B. Implement targeted screening for high-risk individuals to
detect early disease.
C. Treat symptoms only when they become bothersome to the
patient.
D. Delay preventive measures until clinical signs appear.
Correct Answer
B
Rationales
Correct: Recognizing a latent phase supports targeted screening
in high-risk populations to detect disease before symptoms,
improving outcomes.
A (incorrect): Latent phases are precisely when screening is
useful; avoiding screening would miss early disease.
C (incorrect): Treating only symptomatic disease ignores
, opportunities for earlier intervention during latency.
D (incorrect): Delaying prevention ignores the window for
altering disease course in the latent phase.
Teaching Point
Latent phases justify targeted screening to detect disease
before symptoms.
Citation
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
3.
Reference — Ch. 1 — Introduction
Question Stem
A patient with acute chest pain arrives and initial ECG and
troponin are non-diagnostic. Using the principle of sensitivity
versus specificity in diagnostics, which approach best minimizes
the chance of missing an acute myocardial infarction (safety-
focused decision)?
Options
A. Rely on a single high-specificity test and discharge if negative.
B. Use a highly sensitive initial test and repeat troponin at an
interval.
C. Obtain only imaging studies because labs are too slow.
D. Discharge with outpatient follow-up for all low-risk patients.
