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 presents with progressive fatigue and pallor.
His CBC shows microcytic anemia. You are asked to consider
disease mechanisms that link clinical findings to physiologic
reserve. Which principle best explains why older patients often
present with atypical or blunted signs of disease?
Options
A. Increased basal metabolic rate in older adults masks clinical
signs.
B. Reduced homeostatic reserve and decreased physiologic
,adaptability.
C. Enhanced inflammatory responses lead to exaggerated signs.
D. Greater organ redundancy produces clearer localizing signs.
Correct Answer
B
Rationales
Correct (B): Aging reduces physiologic reserve and adaptability
of organ systems, so presentation of disease may be atypical or
muted; this links mechanism to clinical assessment.
A: Basal metabolic rate generally decreases with age; it does
not explain blunted signs.
C: Older adults often have impaired, not exaggerated,
inflammatory responses.
D: Organ redundancy may exist for some systems but generally
does not produce clearer signs in older patients.
Teaching Point
Aging reduces physiologic reserve, causing atypical or muted
disease presentations.
Citation
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
2
Reference
Ch. 1 — Introduction
,Question Stem
A patient with a chronic inflammatory disease has periodic
acute exacerbations. As a clinician, you must decide whether a
new symptom reflects disease progression or treatment
complication. Which strategy best applies the textbook’s
framework for linking pathophysiology to clinical decision-
making?
Options
A. Rely solely on symptom chronology without testing.
B. Integrate known disease mechanisms with targeted
diagnostic tests.
C. Assume all new symptoms are drug side effects.
D. Treat empirically for the most common infection.
Correct Answer
B
Rationales
Correct (B): The Introduction emphasizes integrating
pathophysiologic mechanisms with focused diagnostics to
distinguish progression from complications.
A: Chronology alone is insufficient to differentiate causes.
C: Assuming drug side effects risks missing disease progression
or other causes.
D: Empiric treatment without mechanism-based evaluation may
be inappropriate and unsafe.
, Teaching Point
Combine disease mechanisms with targeted diagnostics for
accurate clinical decisions.
Citation
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
3
Reference
Ch. 1 — Introduction
Question Stem
During handoff you must summarize a patient’s risk for acute
organ failure using the textbook’s emphasis on predisposing and
precipitating factors. Which statement best captures that
reasoning?
Options
A. Only precipitating factors matter; predisposing factors are
irrelevant.
B. Predisposing factors set baseline vulnerability; precipitating
factors trigger decompensation.
C. Genetic predisposition always determines acute outcomes
regardless of exposures.
D. Precipitating factors always produce identical outcomes in
different patients.
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 presents with progressive fatigue and pallor.
His CBC shows microcytic anemia. You are asked to consider
disease mechanisms that link clinical findings to physiologic
reserve. Which principle best explains why older patients often
present with atypical or blunted signs of disease?
Options
A. Increased basal metabolic rate in older adults masks clinical
signs.
B. Reduced homeostatic reserve and decreased physiologic
,adaptability.
C. Enhanced inflammatory responses lead to exaggerated signs.
D. Greater organ redundancy produces clearer localizing signs.
Correct Answer
B
Rationales
Correct (B): Aging reduces physiologic reserve and adaptability
of organ systems, so presentation of disease may be atypical or
muted; this links mechanism to clinical assessment.
A: Basal metabolic rate generally decreases with age; it does
not explain blunted signs.
C: Older adults often have impaired, not exaggerated,
inflammatory responses.
D: Organ redundancy may exist for some systems but generally
does not produce clearer signs in older patients.
Teaching Point
Aging reduces physiologic reserve, causing atypical or muted
disease presentations.
Citation
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
2
Reference
Ch. 1 — Introduction
,Question Stem
A patient with a chronic inflammatory disease has periodic
acute exacerbations. As a clinician, you must decide whether a
new symptom reflects disease progression or treatment
complication. Which strategy best applies the textbook’s
framework for linking pathophysiology to clinical decision-
making?
Options
A. Rely solely on symptom chronology without testing.
B. Integrate known disease mechanisms with targeted
diagnostic tests.
C. Assume all new symptoms are drug side effects.
D. Treat empirically for the most common infection.
Correct Answer
B
Rationales
Correct (B): The Introduction emphasizes integrating
pathophysiologic mechanisms with focused diagnostics to
distinguish progression from complications.
A: Chronology alone is insufficient to differentiate causes.
C: Assuming drug side effects risks missing disease progression
or other causes.
D: Empiric treatment without mechanism-based evaluation may
be inappropriate and unsafe.
, Teaching Point
Combine disease mechanisms with targeted diagnostics for
accurate clinical decisions.
Citation
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
3
Reference
Ch. 1 — Introduction
Question Stem
During handoff you must summarize a patient’s risk for acute
organ failure using the textbook’s emphasis on predisposing and
precipitating factors. Which statement best captures that
reasoning?
Options
A. Only precipitating factors matter; predisposing factors are
irrelevant.
B. Predisposing factors set baseline vulnerability; precipitating
factors trigger decompensation.
C. Genetic predisposition always determines acute outcomes
regardless of exposures.
D. Precipitating factors always produce identical outcomes in
different patients.
