,CONTEXT
Chapter 1 The Foundational Concepts of Clinical Practice
Chapter 2 Chemical and Biochemical Foundations
Chapter 3 Molecular Biology, Genetics, and Genetic Diseases
Chapter 4 Cell Physiology and Pathophysiology
Chapter 5 Infectious Disease
Chapter 6 The Immune System and Leukocyte Function
Chapter 7 Neoplasia
Chapter 8 Blood and Clotting
Chapter 9 Circulation
Chapter 10 Heart
Chapter 11 Lungs
Chapter 12 Kidneys
Chapter 13 Gastrointestinal Tract
Chapter 14 Liver
Chapter 15 Nervous System
Chapter 16 Musculoskeletal System
Chapter 17 Endocrine System
,Chapter 1: The Foundational Concepts of Clinical
Q1. A 65-year-old patient presents with hypotension after acute blood
loss. Which physiological response represents a primary compensatory
mechanism to restore homeostasis?
A. Increased parasympathetic activity
B. Vasodilation and decreased heart rate
C. Activation of the renin-angiotensin-aldosterone system
D. Suppression of sympathetic nervous system
Answer: C
Rationale: Blood loss triggers decreased renal perfusion, activating the
RAAS, causing vasoconstriction and sodium/water retention to restore
blood pressure.
Keywords: homeostasis, blood pressure, RAAS, compensation
Q2. Which type of feedback mechanism primarily maintains blood
glucose levels within a narrow physiological range?
A. Positive feedback
B. Negative feedback
C. Feedforward regulation
D. Adaptive feedback
Answer: B
Rationale: Negative feedback restores deviations from set points (e.g.,
insulin lowers high glucose, glucagon raises low glucose). Positive
feedback amplifies changes, not restores baseline.
Keywords: negative feedback, glucose homeostasis, insulin, glucagon
Q3. During acute stress, cortisol secretion rises. Which system is mainly
responsible for initiating this response?
A. Somatic nervous system
B. Hypothalamic-pituitary-adrenal axis
C. Sympathetic-adrenal-medullary system
D. Parasympathetic nervous system
,Answer: B
Rationale: The HPA axis responds to stress by releasing CRH → ACTH →
cortisol, which mobilizes energy substrates and modulates inflammation.
Keywords: stress response, cortisol, HPA axis, adaptation
Q4. A patient with chronic hypertension demonstrates left ventricular
hypertrophy. This represents an example of:
A. Pathologic positive feedback
B. Cellular necrosis
C. Physiologic adaptation
D. Homeostatic failure
Answer: C
Rationale: The heart adapts to increased afterload via hypertrophy to
maintain cardiac output—an example of structural adaptation to chronic
stress.
Keywords: adaptation, hypertrophy, chronic stress, compensatory
mechanism
Q5. Which of the following best exemplifies a positive feedback loop?
A. Blood pressure regulation via baroreceptors
B. Oxytocin release during labor contractions
C. Thermoregulation during fever
D. Regulation of blood pH by the kidneys
Answer: B
Rationale: Oxytocin release increases uterine contractions, which
further stimulates oxytocin—classic positive feedback. Negative feedback
loops (BP, pH) restore baseline.
Keywords: positive feedback, oxytocin, labor, amplification
Q6. In the early phase of sepsis, compensatory mechanisms often result
in:
A. Bradycardia and hypotension
B. Tachycardia and vasoconstriction
C. Hypothermia and vasodilation
D. Decreased cardiac output
,Answer: B
Rationale: To maintain perfusion, sympathetic activation leads to
tachycardia and peripheral vasoconstriction, representing acute
compensatory homeostatic responses.
Keywords: sepsis, compensation, sympathetic response, homeostasis
Q7. Which cellular process is most likely triggered when cells experience
prolonged hypoxia?
A. Apoptosis
B. Necrosis
C. Autophagy
D. Hyperplasia
Answer: C
Rationale: Autophagy is an adaptive cellular response to stress (e.g.,
nutrient deprivation or hypoxia) allowing survival by recycling cellular
components.
Keywords: adaptation, hypoxia, autophagy, cellular stress
Q8. A patient’s arterial blood pressure drops suddenly. Which immediate
neural reflex helps restore homeostasis?
A. Chemoreceptor-mediated respiratory adjustment
B. Baroreceptor-mediated sympathetic activation
C. Renal RAAS activation over days
D. Hormonal glucagon release
Answer: B
Rationale: Baroreceptors in the carotid sinus and aortic arch detect
hypotension and stimulate sympathetic activity, increasing heart rate
and vasoconstriction.
Keywords: baroreceptor, negative feedback, acute compensation, blood
pressure
Q9. Chronic exposure to high cortisol can lead to which maladaptive
change?
A. Increased insulin sensitivity
B. Muscle wasting
,C. Enhanced immune response
D. Reduced gluconeogenesis
Answer: B
Rationale: Long-term elevated cortisol promotes protein catabolism,
leading to muscle wasting and immunosuppression, representing
maladaptation to stress.
Keywords: stress, cortisol, maladaptation, catabolism
Q10. Which physiologic mechanism explains why fever enhances
pathogen clearance?
A. Positive feedback increasing cytokine storm
B. Adaptive immune activation and altered enzyme kinetics
C. Suppression of inflammatory mediators
D. Increased parasympathetic activity
Answer: B
Rationale: Fever induces heat-shock protein activation, enhances
leukocyte activity, and creates an environment less favorable for
pathogens—a protective adaptive response.
Keywords: fever, adaptation, immune response, homeostasis
Q11. A patient experiences syncope upon standing rapidly. Which
mechanism initially maintains cerebral perfusion?
A. Parasympathetic-mediated bradycardia
B. Sympathetic vasoconstriction and tachycardia
C. RAAS suppression
D. Oxytocin release
Answer: B
Rationale: Orthostatic hypotension triggers baroreceptor reflex,
increasing sympathetic tone, heart rate, and peripheral resistance to
maintain cerebral perfusion.
Keywords: orthostatic hypotension, baroreceptor, compensation,
homeostasis
,Q12. Heat stress induces sweating. This is an example of which type of
regulatory response?
A. Positive feedback
B. Negative feedback
C. Feedforward anticipation
D. Hormonal adaptation
Answer: B
Rationale: Sweating cools the body, counteracting elevated temperature,
restoring homeostasis—classic negative feedback.
Keywords: thermoregulation, negative feedback, adaptation,
homeostasis
Q13. Which concept best explains the body’s capacity to maintain blood
pH despite large acid or base loads?
A. Allostasis
B. Homeostatic redundancy
C. Compensatory adaptation
D. Positive feedback loop
Answer: C
Rationale: The respiratory and renal systems act to compensate for pH
disturbances (hyperventilation or bicarbonate retention), demonstrating
compensatory adaptation.
Keywords: pH balance, compensation, homeostasis, adaptation
Q14. During prolonged exercise, cardiac output increases. Which system
primarily coordinates this change?
A. Autonomic nervous system
B. Endocrine negative feedback
C. Local myogenic regulation only
D. Positive feedback loop of baroreceptors
Answer: A
Rationale: Sympathetic activation increases heart rate and stroke
volume to meet metabolic demands, illustrating homeostatic adaptation
via autonomic control.
Keywords: exercise, autonomic nervous system, cardiac output,
adaptation
, Q15. A patient with dehydration shows elevated plasma osmolality.
Which hormone is released to restore fluid balance?
A. Aldosterone
B. Antidiuretic hormone
C. Renin
D. Atrial natriuretic peptide
Answer: B
Rationale: High plasma osmolality stimulates ADH release from the
posterior pituitary, promoting water reabsorption in the kidneys—a
homeostatic negative feedback response.
Keywords: dehydration, ADH, osmoregulation, negative feedback
Q16. Which statement correctly differentiates adaptation from pathologic
change?
A. Adaptation always involves cell death
B. Pathologic change is reversible; adaptation is irreversible
C. Adaptation improves function under stress; pathologic change impairs
it
D. Adaptation always causes tissue necrosis
Answer: C
Rationale: Adaptive changes, like hypertrophy or hyperplasia, maintain
function under stress. Pathologic changes impair function (e.g., necrosis,
fibrosis).
Keywords: adaptation, pathophysiology, hypertrophy, homeostasis
Q17. Hypothermia triggers shivering and vasoconstriction. Which type of
homeostatic mechanism is this?
A. Positive feedback
B. Negative feedback
C. Feedforward regulation
D. Allostatic overload
Answer: B
Rationale: Negative feedback restores normal body temperature by
generating heat and reducing heat loss.
Chapter 1 The Foundational Concepts of Clinical Practice
Chapter 2 Chemical and Biochemical Foundations
Chapter 3 Molecular Biology, Genetics, and Genetic Diseases
Chapter 4 Cell Physiology and Pathophysiology
Chapter 5 Infectious Disease
Chapter 6 The Immune System and Leukocyte Function
Chapter 7 Neoplasia
Chapter 8 Blood and Clotting
Chapter 9 Circulation
Chapter 10 Heart
Chapter 11 Lungs
Chapter 12 Kidneys
Chapter 13 Gastrointestinal Tract
Chapter 14 Liver
Chapter 15 Nervous System
Chapter 16 Musculoskeletal System
Chapter 17 Endocrine System
,Chapter 1: The Foundational Concepts of Clinical
Q1. A 65-year-old patient presents with hypotension after acute blood
loss. Which physiological response represents a primary compensatory
mechanism to restore homeostasis?
A. Increased parasympathetic activity
B. Vasodilation and decreased heart rate
C. Activation of the renin-angiotensin-aldosterone system
D. Suppression of sympathetic nervous system
Answer: C
Rationale: Blood loss triggers decreased renal perfusion, activating the
RAAS, causing vasoconstriction and sodium/water retention to restore
blood pressure.
Keywords: homeostasis, blood pressure, RAAS, compensation
Q2. Which type of feedback mechanism primarily maintains blood
glucose levels within a narrow physiological range?
A. Positive feedback
B. Negative feedback
C. Feedforward regulation
D. Adaptive feedback
Answer: B
Rationale: Negative feedback restores deviations from set points (e.g.,
insulin lowers high glucose, glucagon raises low glucose). Positive
feedback amplifies changes, not restores baseline.
Keywords: negative feedback, glucose homeostasis, insulin, glucagon
Q3. During acute stress, cortisol secretion rises. Which system is mainly
responsible for initiating this response?
A. Somatic nervous system
B. Hypothalamic-pituitary-adrenal axis
C. Sympathetic-adrenal-medullary system
D. Parasympathetic nervous system
,Answer: B
Rationale: The HPA axis responds to stress by releasing CRH → ACTH →
cortisol, which mobilizes energy substrates and modulates inflammation.
Keywords: stress response, cortisol, HPA axis, adaptation
Q4. A patient with chronic hypertension demonstrates left ventricular
hypertrophy. This represents an example of:
A. Pathologic positive feedback
B. Cellular necrosis
C. Physiologic adaptation
D. Homeostatic failure
Answer: C
Rationale: The heart adapts to increased afterload via hypertrophy to
maintain cardiac output—an example of structural adaptation to chronic
stress.
Keywords: adaptation, hypertrophy, chronic stress, compensatory
mechanism
Q5. Which of the following best exemplifies a positive feedback loop?
A. Blood pressure regulation via baroreceptors
B. Oxytocin release during labor contractions
C. Thermoregulation during fever
D. Regulation of blood pH by the kidneys
Answer: B
Rationale: Oxytocin release increases uterine contractions, which
further stimulates oxytocin—classic positive feedback. Negative feedback
loops (BP, pH) restore baseline.
Keywords: positive feedback, oxytocin, labor, amplification
Q6. In the early phase of sepsis, compensatory mechanisms often result
in:
A. Bradycardia and hypotension
B. Tachycardia and vasoconstriction
C. Hypothermia and vasodilation
D. Decreased cardiac output
,Answer: B
Rationale: To maintain perfusion, sympathetic activation leads to
tachycardia and peripheral vasoconstriction, representing acute
compensatory homeostatic responses.
Keywords: sepsis, compensation, sympathetic response, homeostasis
Q7. Which cellular process is most likely triggered when cells experience
prolonged hypoxia?
A. Apoptosis
B. Necrosis
C. Autophagy
D. Hyperplasia
Answer: C
Rationale: Autophagy is an adaptive cellular response to stress (e.g.,
nutrient deprivation or hypoxia) allowing survival by recycling cellular
components.
Keywords: adaptation, hypoxia, autophagy, cellular stress
Q8. A patient’s arterial blood pressure drops suddenly. Which immediate
neural reflex helps restore homeostasis?
A. Chemoreceptor-mediated respiratory adjustment
B. Baroreceptor-mediated sympathetic activation
C. Renal RAAS activation over days
D. Hormonal glucagon release
Answer: B
Rationale: Baroreceptors in the carotid sinus and aortic arch detect
hypotension and stimulate sympathetic activity, increasing heart rate
and vasoconstriction.
Keywords: baroreceptor, negative feedback, acute compensation, blood
pressure
Q9. Chronic exposure to high cortisol can lead to which maladaptive
change?
A. Increased insulin sensitivity
B. Muscle wasting
,C. Enhanced immune response
D. Reduced gluconeogenesis
Answer: B
Rationale: Long-term elevated cortisol promotes protein catabolism,
leading to muscle wasting and immunosuppression, representing
maladaptation to stress.
Keywords: stress, cortisol, maladaptation, catabolism
Q10. Which physiologic mechanism explains why fever enhances
pathogen clearance?
A. Positive feedback increasing cytokine storm
B. Adaptive immune activation and altered enzyme kinetics
C. Suppression of inflammatory mediators
D. Increased parasympathetic activity
Answer: B
Rationale: Fever induces heat-shock protein activation, enhances
leukocyte activity, and creates an environment less favorable for
pathogens—a protective adaptive response.
Keywords: fever, adaptation, immune response, homeostasis
Q11. A patient experiences syncope upon standing rapidly. Which
mechanism initially maintains cerebral perfusion?
A. Parasympathetic-mediated bradycardia
B. Sympathetic vasoconstriction and tachycardia
C. RAAS suppression
D. Oxytocin release
Answer: B
Rationale: Orthostatic hypotension triggers baroreceptor reflex,
increasing sympathetic tone, heart rate, and peripheral resistance to
maintain cerebral perfusion.
Keywords: orthostatic hypotension, baroreceptor, compensation,
homeostasis
,Q12. Heat stress induces sweating. This is an example of which type of
regulatory response?
A. Positive feedback
B. Negative feedback
C. Feedforward anticipation
D. Hormonal adaptation
Answer: B
Rationale: Sweating cools the body, counteracting elevated temperature,
restoring homeostasis—classic negative feedback.
Keywords: thermoregulation, negative feedback, adaptation,
homeostasis
Q13. Which concept best explains the body’s capacity to maintain blood
pH despite large acid or base loads?
A. Allostasis
B. Homeostatic redundancy
C. Compensatory adaptation
D. Positive feedback loop
Answer: C
Rationale: The respiratory and renal systems act to compensate for pH
disturbances (hyperventilation or bicarbonate retention), demonstrating
compensatory adaptation.
Keywords: pH balance, compensation, homeostasis, adaptation
Q14. During prolonged exercise, cardiac output increases. Which system
primarily coordinates this change?
A. Autonomic nervous system
B. Endocrine negative feedback
C. Local myogenic regulation only
D. Positive feedback loop of baroreceptors
Answer: A
Rationale: Sympathetic activation increases heart rate and stroke
volume to meet metabolic demands, illustrating homeostatic adaptation
via autonomic control.
Keywords: exercise, autonomic nervous system, cardiac output,
adaptation
, Q15. A patient with dehydration shows elevated plasma osmolality.
Which hormone is released to restore fluid balance?
A. Aldosterone
B. Antidiuretic hormone
C. Renin
D. Atrial natriuretic peptide
Answer: B
Rationale: High plasma osmolality stimulates ADH release from the
posterior pituitary, promoting water reabsorption in the kidneys—a
homeostatic negative feedback response.
Keywords: dehydration, ADH, osmoregulation, negative feedback
Q16. Which statement correctly differentiates adaptation from pathologic
change?
A. Adaptation always involves cell death
B. Pathologic change is reversible; adaptation is irreversible
C. Adaptation improves function under stress; pathologic change impairs
it
D. Adaptation always causes tissue necrosis
Answer: C
Rationale: Adaptive changes, like hypertrophy or hyperplasia, maintain
function under stress. Pathologic changes impair function (e.g., necrosis,
fibrosis).
Keywords: adaptation, pathophysiology, hypertrophy, homeostasis
Q17. Hypothermia triggers shivering and vasoconstriction. Which type of
homeostatic mechanism is this?
A. Positive feedback
B. Negative feedback
C. Feedforward regulation
D. Allostatic overload
Answer: B
Rationale: Negative feedback restores normal body temperature by
generating heat and reducing heat loss.
