1. Which of the following is the primary pathophysiological mechanism in the
development of atherosclerosis?
a) Increased nitric oxide production
b) Endothelial injury and inflammation ✔
c) Increased parasympathetic tone
d) Hyperkalemia
Rationale: Atherosclerosis primarily involves endothelial injury, which triggers
inflammation and the accumulation of lipids, leading to the formation of plaques in the
arteries. This process is exacerbated by factors like high blood pressure,
hyperlipidemia, and smoking.
2. In which of the following conditions is hypercalcemia most commonly seen?
a) Osteomalacia
b) Hyperparathyroidism ✔
c) Chronic renal failure
d) Cushing's syndrome
Rationale: Hyperparathyroidism causes increased secretion of parathyroid hormone
(PTH), which raises calcium levels by promoting calcium release from bones, increased
renal calcium reabsorption, and enhancing intestinal calcium absorption.
3. What is the underlying mechanism of pain in acute pancreatitis?
a) Direct pancreatic tissue necrosis ✔
b) Increased intra-abdominal pressure
c) Bile duct obstruction
d) Acidosis-induced pain receptors stimulation
Rationale: In acute pancreatitis, the primary mechanism of pain is the direct injury to the
pancreatic tissue and the release of inflammatory mediators, leading to pain.
Additionally, the release of enzymes into the surrounding tissue contributes to local
inflammation and edema, which increases the pain response.
4. Which of the following best describes the pathophysiological changes in asthma?
a) Increased airway smooth muscle relaxation
b) Decreased airway resistance
c) Airway inflammation and bronchoconstriction ✔
d) Impaired surfactant production
,Rationale: Asthma is characterized by chronic airway inflammation, which causes
bronchoconstriction and mucus hypersecretion, leading to airway obstruction and
respiratory symptoms. This inflammation is often triggered by allergens or irritants.
5. Which of the following lab findings is most consistent with diabetic ketoacidosis
(DKA)?
a) Hyponatremia with low blood glucose
b) Metabolic acidosis with decreased blood glucose and no ketones
c) Metabolic acidosis with elevated blood glucose and ketones ✔
d) Hyperkalemia with normal blood glucose
Rationale: Diabetic ketoacidosis (DKA) is characterized by hyperglycemia, metabolic
acidosis, and elevated ketone bodies. This occurs due to insulin deficiency, leading to
fat breakdown and ketone production, which results in acidosis.
6. In congestive heart failure (CHF), which of the following compensatory mechanisms is
most responsible for worsening fluid retention?
a) Increased sympathetic nervous system activity ✔
b) Decreased angiotensin II levels
c) Reduced aldosterone secretion
d) Increased natriuretic peptide production
Rationale: In CHF, the body activates the sympathetic nervous system to increase heart
rate and contractility. However, prolonged activation of this system leads to
vasoconstriction, increased afterload, and stimulation of the renin-angiotensin-
aldosterone system (RAAS), which exacerbates fluid retention and worsens heart
failure.
7. Which of the following is a characteristic feature of cirrhosis?
a) Loss of bile production
b) Fibrosis and scarring of liver tissue ✔
c) Increased hepatic cell proliferation
d) Reduced inflammatory response
Rationale: Cirrhosis is characterized by the progressive replacement of healthy liver
tissue with fibrous scar tissue, leading to impaired liver function.
8. Which of the following is a common cause of acute kidney injury?
, a) Sepsis ✔
b) Hypovolemic shock
c) Diabetes mellitus
d) Congestive heart failure
Rationale: Sepsis can lead to acute kidney injury due to decreased renal perfusion and
the effects of inflammatory mediators on renal blood flow.
9. What is the primary effect of beta-2 agonists on the airway smooth muscle?
a) Relaxation ✔
b) Constriction
c) No effect
d) Stimulation of airway inflammation
Rationale: Beta-2 agonists work by stimulating beta-2 adrenergic receptors, leading to
relaxation of airway smooth muscle, which helps to open up the airways.
10. Which of the following laboratory tests is typically used to diagnose hypokalemia?
a) Basic metabolic panel (BMP)
b) Complete blood count (CBC)
c) Potassium level check ✔
d) Urine analysis
Rationale: A potassium level check is specifically necessary to diagnose hypokalemia,
as it measures the potassium concentration in the blood.
11. Which of the following is a characteristic effect of insulin deficiency in type 1
diabetes?
a) Increased glucose uptake in muscles
b) Decreased glucose release from the liver ✔
c) Increased gluconeogenesis
d) No effect on glucose metabolism
Rationale: Insulin deficiency leads to decreased glucose uptake by muscle cells and
increased gluconeogenesis. However, hepatic glucose output often remains increased,
because insulin typically suppresses glucose release from the liver.
12. Which of the following is a common symptom of acute coronary syndrome?
a) Chest pain ✔
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