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 patient presents with fatigue and unintended
weight loss. You plan problem-focused history and physiologic
reasoning to narrow differential diagnoses. Which initial
approach best reflects pathophysiologic problem-solving
emphasized in the chapter?
,Options
A. List all possible diseases alphabetically and order tests to rule
them out.
B. Identify disturbed homeostatic mechanisms and prioritize
tests that evaluate those mechanisms.
C. Start empiric broad-spectrum therapy immediately to avoid
delay.
D. Order the most sensitive test available for the most common
disease first.
Correct Answer
B
Rationales
Correct: The Introduction emphasizes reasoning from disrupted
normal physiology and homeostasis to generate targeted
diagnostic steps; this narrows differential efficiently.
A: Alphabetical listing is non-analytical and ignores
pathophysiology.
C: Immediate empiric therapy may be necessary in emergencies
but is not the initial analytic diagnostic approach.
D: Choosing tests by disease prevalence alone can miss
pathophysiologic clues and lead to unnecessary testing.
Teaching Point
Start with disrupted physiologic mechanisms to guide focused
testing.
,Citation (Simplified APA)
Hammer & McPhee (2018). Pathophysiology of Disease (8th
Ed.). Ch. 1.
2.
Reference
Ch. 1 — Introduction
Question Stem
A patient’s arterial blood gas shows acute respiratory acidosis.
Using the pathophysiologic framework from the Introduction,
which next step best applies mechanistic reasoning to patient
care?
Options
A. Begin high-dose steroids to reduce inflammation.
B. Check for causes that impair ventilation (airway obstruction,
drug overdose) to correct the primary disturbance.
C. Immediately intubate every patient with respiratory acidosis.
D. Treat only with oxygen; ventilation is not the concern.
Correct Answer
B
Rationales
Correct: The chapter recommends identifying the primary
physiologic derangement (reduced ventilation) and its causes so
therapy targets mechanism (airway, drugs).
A: Steroids are not a primary treatment for most causes of
, acute ventilatory failure.
C: Intubation may be needed but is not reflexive; assessment of
cause and severity guides airway management.
D: Oxygen treats hypoxemia but not hypoventilation causing
hypercapnia.
Teaching Point
Target treatment to the primary physiologic disturbance and its
cause.
Citation (Simplified APA)
Hammer & McPhee (2018). Pathophysiology of Disease (8th
Ed.). Ch. 1.
3.
Reference
Ch. 1 — Introduction
Question Stem
A novice clinician interprets a lab abnormality in isolation.
According to the chapter’s approach to clinical medicine, which
pitfall is most likely and why?
Options
A. Overreliance on a single test leads to anchoring bias and
missed alternative mechanisms.
B. Single tests are usually diagnostic and eliminate the need for
history.
C. Lab values are always definitive; clinical correlation is