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 — Clinical approach to disease
Question Stem
A 58-year-old patient presents with sudden chest pain; ECG is
nondiagnostic and troponin pending. Which initial reasoning
step best follows the pathophysiologic approach promoted in
Hammer & McPhee to prioritize life-threatening causes?
A. Focus on the most likely diagnosis based on prevalence.
B. Immediately treat for the most dangerous (life-threatening)
possibilities first.
,C. Wait for confirmatory tests before initiating any therapy.
D. Rely solely on history because early tests can be misleading.
Correct Answer
B
Rationales
• Correct (B): The text emphasizes using pathophysiologic
reasoning to rule out life-threatening conditions first;
immediate treatment for dangerous causes is prioritized
before lower-risk differentials.
• A: Prevalence helps form differential diagnoses but should
not override treatment of immediately life-threatening
conditions.
• C: Waiting for confirmatory tests can harm patients when
early empiric therapy is indicated by risk.
• D: History is crucial but insufficient alone when immediate
intervention for life-threatening pathology is required.
Teaching Point
Prioritize and treat life-threatening causes first using
pathophysiologic reasoning.
Citation (Simplified APA)
Hammer & McPhee (2019). Pathophysiology of Disease (8th
Ed.). Ch. 1.
2
,Reference
Ch. 1 — Introduction — Signs, symptoms, and manifestations of
disease
Question Stem
A nurse documents “systemic sign” versus “local sign” when
assessing a patient with infection. Which finding is a systemic
sign and why, per the book’s definitions?
A. Redness at the wound (erythema) — systemic sign due to
vascular dilation.
B. Fever — systemic sign reflecting cytokine-mediated
hypothalamic set-point change.
C. Localized swelling — systemic sign because edema involves
fluid shift.
D. Pain at the site — systemic sign produced by nociceptors.
Correct Answer
B
Rationales
• Correct (B): Hammer & McPhee define systemic signs as
whole-body physiologic responses; fever from cytokine
(e.g., IL-1)-mediated prostaglandin effects on
hypothalamus is a classic systemic sign.
• A: Erythema is a local sign resulting from local vasodilation.
• C: Localized swelling is a local sign due to increased
vascular permeability at the injury site.
, • D: Pain at the site is a local manifestation from nociceptor
activation, not a systemic sign.
Teaching Point
Fever is a systemic manifestation mediated by cytokines and
hypothalamic PGE₂.
Citation (Simplified APA)
Hammer & McPhee (2019). Pathophysiology of Disease (8th
Ed.). Ch. 1.
3
Reference
Ch. 1 — Introduction — Case-based clinical reasoning
Question Stem
A case-based approach emphasizes linking abnormal findings to
underlying mechanisms. Given a patient with tremor, weight
loss, and heat intolerance, which pathophysiologic link most
efficiently guides the diagnostic workup?
A. Excess sympathetic activity causing catabolic state —
consider hyperthyroidism.
B. Autoimmune destruction of muscle fibers — consider
polymyositis.
C. Primary CNS degeneration — consider Parkinson disease.
D. Peripheral neuropathy— consider diabetic neuropathy.
Clinical Medicine
8th Edition
Author(s)Gary D. Hammer; Stephen J. McPhee
TEST BANK
1
Reference
Ch. 1 — Introduction — Clinical approach to disease
Question Stem
A 58-year-old patient presents with sudden chest pain; ECG is
nondiagnostic and troponin pending. Which initial reasoning
step best follows the pathophysiologic approach promoted in
Hammer & McPhee to prioritize life-threatening causes?
A. Focus on the most likely diagnosis based on prevalence.
B. Immediately treat for the most dangerous (life-threatening)
possibilities first.
,C. Wait for confirmatory tests before initiating any therapy.
D. Rely solely on history because early tests can be misleading.
Correct Answer
B
Rationales
• Correct (B): The text emphasizes using pathophysiologic
reasoning to rule out life-threatening conditions first;
immediate treatment for dangerous causes is prioritized
before lower-risk differentials.
• A: Prevalence helps form differential diagnoses but should
not override treatment of immediately life-threatening
conditions.
• C: Waiting for confirmatory tests can harm patients when
early empiric therapy is indicated by risk.
• D: History is crucial but insufficient alone when immediate
intervention for life-threatening pathology is required.
Teaching Point
Prioritize and treat life-threatening causes first using
pathophysiologic reasoning.
Citation (Simplified APA)
Hammer & McPhee (2019). Pathophysiology of Disease (8th
Ed.). Ch. 1.
2
,Reference
Ch. 1 — Introduction — Signs, symptoms, and manifestations of
disease
Question Stem
A nurse documents “systemic sign” versus “local sign” when
assessing a patient with infection. Which finding is a systemic
sign and why, per the book’s definitions?
A. Redness at the wound (erythema) — systemic sign due to
vascular dilation.
B. Fever — systemic sign reflecting cytokine-mediated
hypothalamic set-point change.
C. Localized swelling — systemic sign because edema involves
fluid shift.
D. Pain at the site — systemic sign produced by nociceptors.
Correct Answer
B
Rationales
• Correct (B): Hammer & McPhee define systemic signs as
whole-body physiologic responses; fever from cytokine
(e.g., IL-1)-mediated prostaglandin effects on
hypothalamus is a classic systemic sign.
• A: Erythema is a local sign resulting from local vasodilation.
• C: Localized swelling is a local sign due to increased
vascular permeability at the injury site.
, • D: Pain at the site is a local manifestation from nociceptor
activation, not a systemic sign.
Teaching Point
Fever is a systemic manifestation mediated by cytokines and
hypothalamic PGE₂.
Citation (Simplified APA)
Hammer & McPhee (2019). Pathophysiology of Disease (8th
Ed.). Ch. 1.
3
Reference
Ch. 1 — Introduction — Case-based clinical reasoning
Question Stem
A case-based approach emphasizes linking abnormal findings to
underlying mechanisms. Given a patient with tremor, weight
loss, and heat intolerance, which pathophysiologic link most
efficiently guides the diagnostic workup?
A. Excess sympathetic activity causing catabolic state —
consider hyperthyroidism.
B. Autoimmune destruction of muscle fibers — consider
polymyositis.
C. Primary CNS degeneration — consider Parkinson disease.
D. Peripheral neuropathy— consider diabetic neuropathy.
