Contents
Chapter 01: Introduction to Pathophysiology ................................................................................................................................................ 2
Chapter 02: Homeostasis, Allostasis, and Adaptive Responses to Stressors ............................................................................................. 5
Chapter 03: Cell Structure and Function ......................................................................................................................................................... 8
Chapter 04: Cell Injury, Aging, and Death .................................................................................................................................................... 11
Chapter 05: Genome Structure, Regulation, and Tissue Differentiation ................................................................................................. 15
Chapter 06: Genetic and Developmental Disorders ................................................................................................................................... 18
Chapter 07: Neoplasia ...................................................................................................................................................................................... 21
Chapter 08: Infectious Processes .................................................................................................................................................................... 25
Chapter 09: Inflammation and Immunity ..................................................................................................................................................... 27
Chapter 10: Alterations in Immune Function .............................................................................................................................................. 31
Chapter 11: Malignant Disorders of White Blood Cells ............................................................................................................................. 35
Chapter 12: HIV Disease and AIDS .............................................................................................................................................................. 41
Chapter 13: Alterations in Oxygen Transport .............................................................................................................................................. 46
Chapter 14: Alterations in Hemostasis and Blood Coagulation ................................................................................................................ 52
Chapter 15: Alterations in Blood Flow .......................................................................................................................................................... 58
Chapter 16: Alterations in Blood Pressure .................................................................................................................................................... 63
Chapter 17: Cardiac Function ......................................................................................................................................................................... 68
Chapter 18: Alterations in Cardiac Function ................................................................................................................................................ 74
Chapter 19: Heart Failure and Dysrhythmias: Common Sequelae of Cardiac Diseases ........................................................................ 79
Chapter 20: Shock ............................................................................................................................................................................................. 86
Chapter 21: Respiratory Function and Alterations in Gas Exchange ....................................................................................................... 93
Chapter 22: Obstructive Pulmonary Disorders ............................................................................................................................................ 97
Chapter 23: Restrictive Pulmonary Disorders ............................................................................................................................................ 103
Chapter 24: Fluid and Electrolyte Homeostasis and Imbalances ............................................................................................................ 113
Chapter 25: Acid–Base Homeostasis and Imbalances .............................................................................................................................. 126
Chapter 26: Renal Function ........................................................................................................................................................................... 134
Chapter 27: Intrarenal Disorders .................................................................................................................................................................. 140
Chapter 28: Acute Kidney Injury and Chronic Kidney Disease.............................................................................................................. 151
Chapter 29: Disorders of the Lower Urinary Tract.................................................................................................................................... 163
Chapter 30: Male Genital and Reproductive Function ............................................................................................................................. 172
Chapter 31: Alterations in Male Genital and Reproductive Function .................................................................................................... 176
Chapter 32: Female Genital and Reproductive Function ......................................................................................................................... 180
Chapter 33: Alterations in Female Genital and Reproductive Function ................................................................................................ 184
Chapter 34: Sexually Transmitted Infections .............................................................................................................................................. 191
Chapter 35: Gastrointestinal Function ........................................................................................................................................................ 196
Chapter 36: Gastrointestinal Disorders ....................................................................................................................................................... 203
Chapter 37: Alterations in Function of the Gallbladder and Exocrine Pancreas .................................................................................. 212
Chapter 38: Liver Diseases ............................................................................................................................................................................ 218
Chapter 39: Endocrine Physiology and Mechanisms of Hypothalamic-Pituitary Regulation ............................................................ 224
Chapter 40: Disorders of Endocrine Function .......................................................................................................................................... 232
Chapter 41: Diabetes Mellitus ....................................................................................................................................................................... 241
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,Chapter 42: Alterations in Metabolism and Nutrition .............................................................................................................................. 248
Chapter 43: Structure and Function of the Nervous System ................................................................................................................... 253
Chapter 44: Acute Disorders of Brain Function ........................................................................................................................................ 263
Chapter 45: Chronic Disorders of Neurologic Function.......................................................................................................................... 272
Chapter 46: Alterations in Special Sensory Function ................................................................................................................................ 280
Chapter 47: Pain .............................................................................................................................................................................................. 285
Chapter 48: Neurobiology of Psychotic Illnesses ...................................................................................................................................... 290
Chapter 49: Neurobiology of Nonpsychotic Illnesses .............................................................................................................................. 297
Chapter 50: Structure and Function of the Musculoskeletal System ...................................................................................................... 304
Chapter 51: Alterations in Musculoskeletal Function: Trauma, Infection, and Disease ...................................................................... 310
Chapter 52: Alterations in Musculoskeletal Function: Rheumatic Disorders ........................................................................................ 317
Chapter 53: Alterations in the Integumentary System .............................................................................................................................. 323
Chapter 54: Burn Injuries............................................................................................................................................................................... 328
Chapter 01: Introduction to Pathophysiology
MULTIPLE CHOICE
1. C.Q. was recently exposed to group A hemolytic Streptococcus and subsequently developed apharyngeal
infection. His clinic examination reveals an oral temperature of 102.3°F, skin rash,dysphagia, and
reddened throat mucosa with multiple pustules. He complains of sore throat, malaise, and joint stiffness.
A throat culture is positive for Streptococcus, and antibiotics havebeen prescribed. The etiology of C.Q.’s
disease is
a. a sore throat.
b. streptococcal infection.
c. genetic susceptibility.
d. pharyngitis.
ANS: B
Etiology refers to the proposed cause or causes of a particular disease process. A sore throat isthe
manifestation of the disease process. Genetic susceptibility refers to inherited tendency to develop a
disease. Pharyngitis refers to inflammation of the throat and is also a clinical manifestation of the disease
process.
2. A 17-year-old college-bound student receives a vaccine against an organism that causesmeningitis.
This is an example of
a. primary prevention.
b. secondary prevention.
c. tertiary prevention.
d. disease treatment.
ANS: A
Primary prevention is prevention of disease by altering susceptibility or reducing exposure forsusceptible
individuals, in this case by providing vaccination. Secondary prevention is the early detection, screening,
and management of the disease. Tertiary prevention includes rehabilitative and supportive care and
attempts to alleviate disability and restore effective functioning. Disease treatment involves management
of the disease once it has developed.
3. An obese but otherwise healthy teen is given a prescription for a low-calorie diet and exerciseprogram.
This is an example of
a. primary prevention.
b. secondary prevention.
c. tertiary prevention.
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, d. disease treatment.
ANS: B
Secondary prevention is the early detection, screening, and management of the disease such asprescribing
diet and exercise for an individual who has already developed obesity. Primary prevention is prevention of
disease by altering susceptibility or reducing exposure for susceptible individuals. Tertiary prevention
includes rehabilitative and supportive care and attempts to alleviate disability and restore effective
functioning. Disease treatment involves management of the disease once it has developed.
4. A patient with high blood pressure who is otherwise healthy is counseled to restrict sodiumintake. This
is an example of
a. primary prevention.
b. secondary prevention.
c. tertiary prevention.
d. disease treatment.
ANS: B
Secondary prevention is the early detection, screening, and management of the disease, such as by
prescribing sodium restriction for high blood pressure. Primary prevention is preventionof disease by
altering susceptibility or reducing exposure for susceptible individuals. Tertiary prevention includes
rehabilitative and supportive care and attempts to alleviate disability and restore effective functioning.
Disease treatment involves management of the disease once it has developed.
5. After suffering a heart attack, a middle-aged man is counseled to take a cholesterol-loweringmedication.
This is an example of
a. primary prevention.
b. secondary prevention.
c. tertiary prevention.
d. disease treatment.
ANS: C
Tertiary prevention includes rehabilitative and supportive care and attempts to alleviate disability and
restore effective functioning such as prescribing a cholesterol-lowering medication following a heart
attack. Primary prevention is prevention of disease by alteringsusceptibility or reducing exposure for
susceptible individuals. Secondary prevention is theearly detection, screening, and management of the
disease. Disease treatment involves management of the disease once it has developed.
6. A patient has been exposed to meningococcal meningitis, but is not yet demonstrating signs ofthis disease.
This stage of illness is called the stage.
a. prodromal
b. latent
c. sequela
d. convalescence
ANS: B
Incubation refers to the interval between exposure of a tissue to an injurious agent and the firstappearance
of signs and symptoms. In infectious diseases, this period is often called the incubation (latent) period.
Prodromal refers to the appearance of the first signs and symptoms indicating the onset of a disease.
These are often nonspecific, such as headache, malaise, anorexia, and nausea, which are associated with a
number of different diseases. Sequela refersto subsequent pathologic condition resulting from a disease.
Convalescence is the stage of recovery after a disease, injury, or surgical operation.
7. A disease that is native to a particular region is called
a. epidemic.
b. endemic.
c. pandemic.
d. ethnographic.
ANS: B
A disease that is native to a particular region is called endemic. An epidemic is a disease thatspreads to
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, many individuals at the same time. Pandemics are epidemics that affect large geographic regions, perhaps
spreading worldwide. Ethnographic does not describe a disease distribution pattern.
8. In general, with aging, organ size and function
a. increase.
b. decrease.
c. remain the same.
d. are unknown.
ANS: B
In general, with aging, organ size and function decrease.
9. The stage during which the patient functions normally, although the disease processes are wellestablished,
is referred to as
a. latent.
b. subclinical.
c. prodromal.
d. convalescence.
ANS: B
The stage during which the patient functions normally, although the disease processes are wellestablished,
is called the subclinical stage. The interval between exposure of a tissue to an injurious agent and the first
appearance of signs and symptoms may be called a latent period or, in the case of infectious diseases, an
incubation period. The prodromal period, or prodrome, refers to the appearance of the first signs and
symptoms indicating the onset of a disease. Convalescence is the stage of recovery after a disease, injury,
or surgical operation.
MULTIPLE RESPONSE
1. Your patient’s red blood cell count is slightly elevated today. This might be explained by(Select all that
apply.)
a. gender difference.
b. situational factors.
c. normal variation.
d. cultural variation.
e. illness.
ANS: A, B, C, E
Gender, situations (e.g., altitude), normal variations, and illness may all determine red bloodcell count.
Culture affects how manifestations are perceived (normal versus abnormal).
2. Socioeconomic factors influence disease development because of (Select all that apply.)
a. genetics.
b. environmental toxins.
c. overcrowding.
d. nutrition.
e. hygiene.
ANS: B, C, D, E
Socioeconomic factors influence disease development via exposure to environmental toxins
(occupational) and overcrowding, nutrition (over- or undernutrition), and hygiene (e.g., in developing
countries). Genetics is not influenced by socioeconomic factors.
3. When determining additional data to gather before making a diagnosis, what factors need tobe
considered? (Select all that apply.)
a. Reliability
b. Expense
c. Validity
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