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 man with progressive dyspnea has reduced
diffusion capacity on pulmonary function testing and a history
of long-term silica exposure. Which concept from
pathophysiology best explains why continued exposure
accelerates disease progression?
Options
A. Homeostatic redundancy preserves function despite injury.
B. Repetitive injury with maladaptive repair leads to fibrosis and
loss of functional units.
,C. Acute inflammation always resolves without permanent
tissue change.
D. Cellular metaplasia increases regenerative capacity and
reverses injury.
Correct Answer
B
Rationales
Correct: Repetitive inhalational injury produces chronic
inflammation and aberrant repair with extracellular matrix
deposition (fibrosis), destroying gas-exchange units and
accelerating dysfunction.
A: Homeostatic redundancy delays dysfunction but cannot
prevent progressive loss from ongoing injury.
C: Acute inflammation may resolve, but chronic/repetitive
injury leads to permanent structural change.
D: Metaplasia may be adaptive but does not typically restore
normal architecture or reverse fibrotic loss.
Teaching Point
Chronic repetitive injury causes maladaptive repair and tissue
fibrosis.
Citation
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
2
,Reference
Ch. 1 — Introduction
Question Stem
A hospital quality team tracks hospital-acquired infection rates
and observes a sudden spike. Which epidemiologic concept
best guides immediate action to identify cause and reduce
future cases?
Options
A. Prevalence — proportion of current cases in the population.
B. Incidence — rate of new cases over time to detect outbreaks.
C. Case fatality rate — proportion of deaths among cases.
D. Relative risk — ratio comparing exposures in different
diseases.
Correct Answer
B
Rationales
Correct: Incidence (new cases over a time interval) is the key
measure for detecting outbreaks and prompting immediate
investigation and prevention efforts.
A: Prevalence describes existing burden but is less useful for
identifying a sudden increase in new events.
C: Case fatality rate addresses severity, not the occurrence of
new infections.
D: Relative risk compares exposure groups and is useful in
etiologic studies, not immediate outbreak detection.
, Teaching Point
Incidence detects changes over time and guides outbreak
response.
Citation
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
3
Reference
Ch. 2 — Genetic Disease
Question Stem
A newborn screening returns abnormal tandem mass spec
suggesting a fatty-acid oxidation disorder. The clinician orders
targeted gene testing revealing a homozygous nonsense
mutation in an enzyme essential for β-oxidation. Which
molecular mechanism most likely explains the enzyme
deficiency?
Options
A. Missense substitution producing a partially active enzyme.
B. Nonsense mutation causing premature stop codon and
truncated protein subject to nonsense-mediated decay.
C. Silent mutation with no effect on protein.
D. Promoter polymorphism increasing transcription.
Correct Answer
B
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 man with progressive dyspnea has reduced
diffusion capacity on pulmonary function testing and a history
of long-term silica exposure. Which concept from
pathophysiology best explains why continued exposure
accelerates disease progression?
Options
A. Homeostatic redundancy preserves function despite injury.
B. Repetitive injury with maladaptive repair leads to fibrosis and
loss of functional units.
,C. Acute inflammation always resolves without permanent
tissue change.
D. Cellular metaplasia increases regenerative capacity and
reverses injury.
Correct Answer
B
Rationales
Correct: Repetitive inhalational injury produces chronic
inflammation and aberrant repair with extracellular matrix
deposition (fibrosis), destroying gas-exchange units and
accelerating dysfunction.
A: Homeostatic redundancy delays dysfunction but cannot
prevent progressive loss from ongoing injury.
C: Acute inflammation may resolve, but chronic/repetitive
injury leads to permanent structural change.
D: Metaplasia may be adaptive but does not typically restore
normal architecture or reverse fibrotic loss.
Teaching Point
Chronic repetitive injury causes maladaptive repair and tissue
fibrosis.
Citation
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
2
,Reference
Ch. 1 — Introduction
Question Stem
A hospital quality team tracks hospital-acquired infection rates
and observes a sudden spike. Which epidemiologic concept
best guides immediate action to identify cause and reduce
future cases?
Options
A. Prevalence — proportion of current cases in the population.
B. Incidence — rate of new cases over time to detect outbreaks.
C. Case fatality rate — proportion of deaths among cases.
D. Relative risk — ratio comparing exposures in different
diseases.
Correct Answer
B
Rationales
Correct: Incidence (new cases over a time interval) is the key
measure for detecting outbreaks and prompting immediate
investigation and prevention efforts.
A: Prevalence describes existing burden but is less useful for
identifying a sudden increase in new events.
C: Case fatality rate addresses severity, not the occurrence of
new infections.
D: Relative risk compares exposure groups and is useful in
etiologic studies, not immediate outbreak detection.
, Teaching Point
Incidence detects changes over time and guides outbreak
response.
Citation
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
3
Reference
Ch. 2 — Genetic Disease
Question Stem
A newborn screening returns abnormal tandem mass spec
suggesting a fatty-acid oxidation disorder. The clinician orders
targeted gene testing revealing a homozygous nonsense
mutation in an enzyme essential for β-oxidation. Which
molecular mechanism most likely explains the enzyme
deficiency?
Options
A. Missense substitution producing a partially active enzyme.
B. Nonsense mutation causing premature stop codon and
truncated protein subject to nonsense-mediated decay.
C. Silent mutation with no effect on protein.
D. Promoter polymorphism increasing transcription.
Correct Answer
B
