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.......................................................................................................... 12
Chapter 05: Genome Structure, Regulation, and Tissue Differentiation ............................................................. 16
Chapter 06: Genetic and Developmental Disorders ........................................................................................... 19
Chapter 07: Neoplasia ....................................................................................................................................... 22
Chapter 08: Infectious Processes ...................................................................................................................... 26
Chapter 09: Inflammation and Immunity ............................................................................................................ 29
Chapter 10: Alterations in Immune Function ...................................................................................................... 33
Chapter 11: Malignant Disorders of White Blood Cells ...................................................................................... 37
Chapter 12: HIV Disease and AIDS ................................................................................................................... 43
Chapter 13: Alterations in Oxygen Transport ..................................................................................................... 48
Chapter 14: Alterations in Hemostasis and Blood Coagulation .......................................................................... 55
Chapter 15: Alterations in Blood Flow................................................................................................................ 60
Chapter 16: Alterations in Blood Pressure ......................................................................................................... 66
Chapter 17: Cardiac Function ............................................................................................................................ 71
Chapter 18: Alterations in Cardiac Function ...................................................................................................... 77
Chapter 19: Heart Failure and Dysrhythmias: Common Sequelae of Cardiac Diseases ..................................... 83
Chapter 20: Shock ............................................................................................................................................. 91
Chapter 21: Respiratory Function and Alterations in Gas Exchange.................................................................. 98
Chapter 22: Obstructive Pulmonary Disorders ................................................................................................. 102
Chapter 23: Restrictive Pulmonary Disorders .................................................................................................. 109
Chapter 24: Fluid and Electrolyte Homeostasis and Imbalances ..................................................................... 119
Chapter 25: Acid–Base Homeostasis and Imbalances .................................................................................... 133
Chapter 26: Renal Function ............................................................................................................................. 141
Chapter 27: Intrarenal Disorders ..................................................................................................................... 147
Chapter 28: Acute Kidney Injury and Chronic Kidney Disease......................................................................... 159
Chapter 29: Disorders of the Lower Urinary Tract ............................................................................................ 171
Chapter 30: Male Genital and Reproductive Function ..................................................................................... 181
Chapter 31: Alterations in Male Genital and Reproductive Function ................................................................ 185
Chapter 32: Female Genital and Reproductive Function .................................................................................. 189
Chapter 33: Alterations in Female Genital and Reproductive Function ............................................................ 194
Chapter 34: Sexually Transmitted Infections ................................................................................................... 201
Chapter 35: Gastrointestinal Function ............................................................................................................. 206
Chapter 36: Gastrointestinal Disorders ............................................................................................................ 213
Chapter 37: Alterations in Function of the Gallbladder and Exocrine Pancreas ................................................ 223
Chapter 38: Liver Diseases ............................................................................................................................. 230
Chapter 39: Endocrine Physiology and Mechanisms of Hypothalamic-Pituitary Regulation ............................. 236
Chapter 40: Disorders of Endocrine Function .................................................................................................. 244
Chapter 41: Diabetes Mellitus.......................................................................................................................... 254
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,Chapter 42: Alterations in Metabolism and Nutrition ........................................................................................ 261
Chapter 43: Structure and Function of the Nervous System ............................................................................ 266
Chapter 44: Acute Disorders of Brain Function ................................................................................................ 276
Chapter 45: Chronic Disorders of Neurologic Function .................................................................................... 286
Chapter 46: Alterations in Special Sensory Function ....................................................................................... 295
Chapter 47: Pain ............................................................................................................................................. 300
Chapter 48: Neurobiology of Psychotic Illnesses ............................................................................................. 305
Chapter 49: Neurobiology of Nonpsychotic Illnesses ....................................................................................... 313
Chapter 50: Structure and Function of the Musculoskeletal System ................................................................ 320
Chapter 51: Alterations in Musculoskeletal Function: Trauma, Infection, and Disease ..................................... 326
Chapter 52: Alterations in Musculoskeletal Function: Rheumatic Disorders ..................................................... 333
Chapter 53: Alterations in the Integumentary System ...................................................................................... 339
Chapter 54: Burn Injuries ................................................................................................................................. 345
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 for
susceptible 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.
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, c. tertiary prevention.
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 altering
susceptibility or reducing exposure for susceptible individuals. Secondary prevention is the
early 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.
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, 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 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 blood
cell 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.
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