1. What hepatic tissue changes have taken place in a patient newly diagnosed with cirrhosis?
a. Hepatic cells are distended and misshapen.
b. Hepatic blood vessels are destroyed.
c. Fibrous tissue replaces normal hepatic cells.
d. Hepatic cells begin to die.
2. A man with a history of alcohol abuse comes to the ED with severe, persistent, piercing epigastric pain that radiates to his back. What's the most likely cause of this patient's pain?
a. perforated gastric ulcer
b. acute pancreatitis
3. A 44-year-old patient comes to the ED complaining of severe midepigastric pain. Which lab tests help confirm acute pancreatitis?
a. white blood cell count and hemoglobin level
b. serum amylase and lipase levels
c. serum cholesterol and trypsin levels
d. serum direct and indirect bilirubin levels
4. A 52-year-old patient is diagnosed with peptic ulcer disease caused byHelicobacter pyloriinfection. Infection with this bacteria leads to ulceration because
a. bacteria colonize the mucous coat.
b. bacteria cause regurgitation of duodenal contents into the stomach.
c. bacteria release a toxin that destroys the stomach's mucous coat.
d. bacteria cause persistent stomach inflammation.
5. A 55-year-old patient has been diagnosed with acute bacterial prostatitis. This is commonly caused by
a. an ascending infection of the urinary tract.
b. lymphatic migration of pathogenic bacteria.
c. benign prostatic hyperplasia.
6. A 62-year-old patient who takes furosemide twice a day complains of pain in her right great toe. Gout is diagnosed. The pain she experiences is caused by deposition of which substance in her great toe?
a. calcium pyrophosphate
b. sodium urate
c. ammonia sulfate
d. sodium bicarbonate
7. An older adult complains of progressively worsening pain in one knee that's more severe in the morning when she arises. This pain is most likely caused by which disorder?
a. rheumatoid arthritis
b. systemic lupus erythematosus
c. gouty arthritis
8. A 73-year-old patient is admitted with difficulty breathing. His admission arterial blood gas (ABG) results are: pH, 7.25; PaCO2, 70 mm Hg; PaO2, 52 mm Hg; and HCO3-, 32 mEq/L. Which acid-base imbalance is this patient exhibiting?
a. metabolic acidosis
b. metabolic alkalosis
c. respiratory acidosis
d. respiratory alkalosis
9. Which statement best describes the pathophysiology behind gastroesophageal reflux disease (GERD)?
a. A weak or incompetent lower esophageal sphincter allows reflux of gastric contents into the esophagus.
b. A recurrent granulomatous inflammatory response affects any part of the gastrointestinal tract.
c. Weakness of the muscularis layer causes an outpouching of the esophageal wall.
d. H. pylori causes a chronic inflammatory condition affecting the antrum and body of the stomach.
1. c In the patient with newly diagnosed cirrhosis, normal hepatic cells are typically replaced by fibrous, nonfunctional tissue.
2. b Acute pancreatitis causes severe, persistent, piercing abdominal pain, usually in the midepigastric region, radiating to the back. Alcohol abuse is the major cause of acute pancreatitis.
3. b Serum amylase and lipase levels are elevated with acute pancreatitis, helping to confirm the diagnosis.
4. cH. pylori release a toxin that destroys the stomach's mucous coat, reducing the epithelium's resistance to acid digestion and causing gastritis and ulcer disease.
5. a Acute bacterial prostatitis usually is caused by an ascending infection of the urinary tract.
6. b Sodium urate forms crystalline deposits in the affected joints.
7. d Osteoarthritis pain is worse on initial movement and commonly is most exaggerated in an isolated weight-bearing joint.
8. c This patient is exhibiting signs of respiratory acidosis (excess carbon dioxide retention), which is present when pH is less than 7.35 and PaCO2 is greater than 45 mm Hg.
9. a In GERD, a weak or incompetent lower esophageal sphincter allows reflux to occur, irritating the esophagus.
Source: Pathophysiology Made Incredibly Easy!! Philadelphia, PA: Lippincott Williams & Wilkins; 2006.