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 58-year-old man presents with unexplained fatigue and
weight loss. Which approach best applies the pathophysiologic
model to narrow the differential diagnosis?
Options
A. Seek a single abnormality that explains all findings and ignore
minor inconsistencies.
B. Map symptoms to disrupted physiologic processes and
prioritize causes that plausibly link multiple findings.
,C. Order all possible tests to rule out rare conditions before
considering common etiologies.
D. Use only population-level incidence data to determine the
most likely diagnosis.
Correct Answer
B
Rationales
Correct: Mapping clinical findings to disrupted physiologic
mechanisms (e.g., catabolic state, endocrine dysfunction,
chronic inflammation) focuses evaluation on plausible,
mechanistically linked causes. This pathophysiologic reasoning
narrows testing and guides targeted therapy.
A (incorrect): Seeking a single explanation while ignoring
inconsistencies risks premature closure and missed comorbid
conditions.
C (incorrect): Broad indiscriminate testing increases false
positives and patient harm; pathophysiologic linkage is a better
initial strategy.
D (incorrect): Incidence informs pretest probability but cannot
replace mechanistic correlation with the individual patient's
findings.
Teaching Point
Use pathophysiologic mapping to link symptoms and prioritize
diagnoses.
,Citation
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
2.
Reference — Ch. 1 — Introduction
Question Stem
During initial evaluation of a new disease entity in a clinic,
which data most improves understanding of natural history and
prognosis?
Options
A. Single cross-sectional snapshot of affected patients.
B. Longitudinal follow-up of a cohort with standardized
outcome measures.
C. Case reports from unrelated centers without standardized
definitions.
D. Patient anecdotes aggregated informally on social media.
Correct Answer
B
Rationales
Correct: Longitudinal cohort data with standardized measures
reveals disease course, complications, and prognosis—essential
elements of natural history.
A (incorrect): Cross-sectional data identify prevalence but give
limited information on progression over time.
, C (incorrect): Case reports can generate hypotheses but lack
systematic follow-up and are subject to selection bias.
D (incorrect): Anecdotes are uncontrolled and unreliable for
establishing natural history or prognosis.
Teaching Point
Longitudinal cohorts best define disease natural history.
Citation
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
3.
Reference — Ch. 1 — Introduction
Question Stem
A clinician wants to determine whether a newly observed
laboratory abnormality is causal or incidental. Which concept
from pathophysiology most directly helps differentiate
causation from correlation?
Options
A. Bradford Hill criteria (temporality, plausibility,
reproducibility).
B. Relying on cross-sectional association strength alone.
C. Assuming causation when two events are temporally
associated.
D. Using prevalence ratios as proof of causation.
Clinical Medicine
8th Edition
Author(s)Gary D. Hammer; Stephen J. McPhee
TEST BANK
1.
Reference — Ch. 1 — Introduction
Question Stem
A 58-year-old man presents with unexplained fatigue and
weight loss. Which approach best applies the pathophysiologic
model to narrow the differential diagnosis?
Options
A. Seek a single abnormality that explains all findings and ignore
minor inconsistencies.
B. Map symptoms to disrupted physiologic processes and
prioritize causes that plausibly link multiple findings.
,C. Order all possible tests to rule out rare conditions before
considering common etiologies.
D. Use only population-level incidence data to determine the
most likely diagnosis.
Correct Answer
B
Rationales
Correct: Mapping clinical findings to disrupted physiologic
mechanisms (e.g., catabolic state, endocrine dysfunction,
chronic inflammation) focuses evaluation on plausible,
mechanistically linked causes. This pathophysiologic reasoning
narrows testing and guides targeted therapy.
A (incorrect): Seeking a single explanation while ignoring
inconsistencies risks premature closure and missed comorbid
conditions.
C (incorrect): Broad indiscriminate testing increases false
positives and patient harm; pathophysiologic linkage is a better
initial strategy.
D (incorrect): Incidence informs pretest probability but cannot
replace mechanistic correlation with the individual patient's
findings.
Teaching Point
Use pathophysiologic mapping to link symptoms and prioritize
diagnoses.
,Citation
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
2.
Reference — Ch. 1 — Introduction
Question Stem
During initial evaluation of a new disease entity in a clinic,
which data most improves understanding of natural history and
prognosis?
Options
A. Single cross-sectional snapshot of affected patients.
B. Longitudinal follow-up of a cohort with standardized
outcome measures.
C. Case reports from unrelated centers without standardized
definitions.
D. Patient anecdotes aggregated informally on social media.
Correct Answer
B
Rationales
Correct: Longitudinal cohort data with standardized measures
reveals disease course, complications, and prognosis—essential
elements of natural history.
A (incorrect): Cross-sectional data identify prevalence but give
limited information on progression over time.
, C (incorrect): Case reports can generate hypotheses but lack
systematic follow-up and are subject to selection bias.
D (incorrect): Anecdotes are uncontrolled and unreliable for
establishing natural history or prognosis.
Teaching Point
Longitudinal cohorts best define disease natural history.
Citation
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
3.
Reference — Ch. 1 — Introduction
Question Stem
A clinician wants to determine whether a newly observed
laboratory abnormality is causal or incidental. Which concept
from pathophysiology most directly helps differentiate
causation from correlation?
Options
A. Bradford Hill criteria (temporality, plausibility,
reproducibility).
B. Relying on cross-sectional association strength alone.
C. Assuming causation when two events are temporally
associated.
D. Using prevalence ratios as proof of causation.
