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 62-year-old patient presents with fatigue, weight loss, and
new-onset orthostatic hypotension. You suspect chronic disease
causing loss of physiologic reserve. Which concept best explains
why the patient decompensates with minor stressors?
Options
A. Loss of homeostatic set point leading to hyperstasis
B. Decreased physiologic reserve and reduced adaptive capacity
C. Increased allostatic load causing hyperdynamic compensation
D. Acute failure of redundant organ systems due to mutation
,Correct Answer
B
Rationales
Correct: Chronic disease often reduces physiologic reserve, so
otherwise minor stressors (infection, minor surgery) can
produce decompensation because adaptive capacity is
exhausted.
A: “Hyperstasis” is not a recognized concept in physiologic
compensation and misstates homeostasis mechanisms.
C: Allostatic load is chronic stress burden, but “hyperdynamic
compensation” doesn’t explain loss of reserve causing
decompensation.
D: Acute organ failure from mutation is unlikely to present as
insidious loss of reserve in an older adult.
Teaching Point
Physiologic reserve loss makes small stresses produce clinical
decompensation.
Citation (Simplified APA)
Hammer & McPhee (2018). Pathophysiology of Disease (8th
Ed.). Ch. 1.
2. Reference
Ch. 1 — Introduction
Question Stem
A nurse reviews two patients: one with acute ischemic injury
,and one with reversible cell injury. Which bedside finding best
differentiates reversible from irreversible cellular injury?
Options
A. Cellular swelling with intact plasma membrane
B. Karyolysis and loss of nuclear structure on biopsy
C. Presence of intracellular glycogen depletion
D. Mild interstitial edema on chest x-ray
Correct Answer
A
Rationales
Correct: Reversible injury typically shows cellular swelling with
an intact plasma membrane; restoration of perfusion can
reverse changes.
B: Karyolysis and nuclear dissolution indicate irreversible injury
(necrosis).
C: Glycogen depletion may occur in both states and is non-
specific for reversibility.
D: Interstitial edema is a nonspecific imaging finding and does
not reliably distinguish reversible from irreversible at the cell
level.
Teaching Point
Intact plasma membranes with reversible swelling indicate
potential recovery.
, Citation (Simplified APA)
Hammer & McPhee (2018). Pathophysiology of Disease (8th
Ed.). Ch. 1.
3. Reference
Ch. 1 — Introduction
Question Stem
A 45-year-old smoker develops chronic bronchitis. Which
pathophysiologic mechanism most directly links cigarette
exposure to airway remodeling?
Options
A. Increased apoptosis of submucosal gland cells
B. Oxidative injury and chronic inflammation triggering tissue
remodeling
C. Immediate type I hypersensitivity causing mucosal atrophy
D. Direct mutation of airway epithelial oncogenes
Correct Answer
B
Rationales
Correct: Chronic smoke exposure produces oxidative injury and
persistent inflammation, which drive airway remodeling and
mucus gland hypertrophy.
A: Increased apoptosis would not explain gland hypertrophy
seen in chronic bronchitis.
C: Type I hypersensitivity is an allergic mechanism and not the
INTRODUCTION TO CLINICAL MEDICINE
8TH EDITION
AUTHOR(S)GARY D. HAMMER; STEPHEN J.
MCPHEE
TEST BANK
1. Reference
Ch. 1 — Introduction
Question Stem
A 62-year-old patient presents with fatigue, weight loss, and
new-onset orthostatic hypotension. You suspect chronic disease
causing loss of physiologic reserve. Which concept best explains
why the patient decompensates with minor stressors?
Options
A. Loss of homeostatic set point leading to hyperstasis
B. Decreased physiologic reserve and reduced adaptive capacity
C. Increased allostatic load causing hyperdynamic compensation
D. Acute failure of redundant organ systems due to mutation
,Correct Answer
B
Rationales
Correct: Chronic disease often reduces physiologic reserve, so
otherwise minor stressors (infection, minor surgery) can
produce decompensation because adaptive capacity is
exhausted.
A: “Hyperstasis” is not a recognized concept in physiologic
compensation and misstates homeostasis mechanisms.
C: Allostatic load is chronic stress burden, but “hyperdynamic
compensation” doesn’t explain loss of reserve causing
decompensation.
D: Acute organ failure from mutation is unlikely to present as
insidious loss of reserve in an older adult.
Teaching Point
Physiologic reserve loss makes small stresses produce clinical
decompensation.
Citation (Simplified APA)
Hammer & McPhee (2018). Pathophysiology of Disease (8th
Ed.). Ch. 1.
2. Reference
Ch. 1 — Introduction
Question Stem
A nurse reviews two patients: one with acute ischemic injury
,and one with reversible cell injury. Which bedside finding best
differentiates reversible from irreversible cellular injury?
Options
A. Cellular swelling with intact plasma membrane
B. Karyolysis and loss of nuclear structure on biopsy
C. Presence of intracellular glycogen depletion
D. Mild interstitial edema on chest x-ray
Correct Answer
A
Rationales
Correct: Reversible injury typically shows cellular swelling with
an intact plasma membrane; restoration of perfusion can
reverse changes.
B: Karyolysis and nuclear dissolution indicate irreversible injury
(necrosis).
C: Glycogen depletion may occur in both states and is non-
specific for reversibility.
D: Interstitial edema is a nonspecific imaging finding and does
not reliably distinguish reversible from irreversible at the cell
level.
Teaching Point
Intact plasma membranes with reversible swelling indicate
potential recovery.
, Citation (Simplified APA)
Hammer & McPhee (2018). Pathophysiology of Disease (8th
Ed.). Ch. 1.
3. Reference
Ch. 1 — Introduction
Question Stem
A 45-year-old smoker develops chronic bronchitis. Which
pathophysiologic mechanism most directly links cigarette
exposure to airway remodeling?
Options
A. Increased apoptosis of submucosal gland cells
B. Oxidative injury and chronic inflammation triggering tissue
remodeling
C. Immediate type I hypersensitivity causing mucosal atrophy
D. Direct mutation of airway epithelial oncogenes
Correct Answer
B
Rationales
Correct: Chronic smoke exposure produces oxidative injury and
persistent inflammation, which drive airway remodeling and
mucus gland hypertrophy.
A: Increased apoptosis would not explain gland hypertrophy
seen in chronic bronchitis.
C: Type I hypersensitivity is an allergic mechanism and not the
