ZOOL 4400 - Exam 4

What is the first event in the pathophysiology of atherosclerosis? A) Fibrous plaque development
B) Fatty streak formation
C) Endothelial damage
D) Lipid accumulation

C) Endothelial damage

Which condition is caused by vasospastic attacks often triggered by cold exposure?

A) Atherosclerosis
B) Raynaud Phenomenon
C) DVT
D) Pulmonary embolism

B) Raynaud Phenomenon

What is a major danger of a deep venous thrombosis (DVT)?

A) Stroke
B) Pulmonary embolism
C) Heart attack
D) Aortic dissection

B) Pulmonary embolism

Which condition results from a tumor compressing the superior vena cava?

A) Superior Vena Cava Syndrome
B) Coronary artery disease
C) Pulmonary embolism
D) Valvular stenosis

A) Superior Vena Cava Syndrome

What is a common genetic factor contributing to hypertension?

A) Hyperinsulinemia
B) Abnormal sodium excretion
C) Increased pulmonary compliance
D) Decreased vascular tone

B) Abnormal sodium excretion

What medication class is typically first-line treatment for hypertension?

A) Beta-blockers
B) ACE inhibitors
C) Thiazide diuretics
D) Calcium channel blockers

C) Thiazide diuretics

Overactivity of which system leads to increased heart rate and vasoconstriction?

A) RAAS
B) Parasympathetic nervous system
C) Sympathetic nervous system (SNS)
D) Renal system

C) Sympathetic nervous system (SNS)

Which organ system is LEAST likely to be directly damaged by chronic hypertension?

A) Brain
B) Kidneys
C) Lungs
D) Heart

C) Lungs

What is a major risk factor for coronary artery disease?

A) Low sodium intake
B) Low LDL cholesterol
C) Smoking
D) High HDL cholesterol

C) Smoking

Which best describes transient myocardial ischemia?

A) Heart attack with irreversible damage
B) Temporary loss of blood flow to heart muscle
C) Complete coronary artery blockage
D) Inflammation of the pericardium

B) Temporary loss of blood flow to heart muscle

Myocardial infarction results after how many minutes of ischemia?

A) 5 minutes
B) 10 minutes
C) 20 minutes
D) 30 minutes

C) 20 minutes

Which disease causes sudden myocardial dysfunction without coronary artery disease, often triggered by emotional stress?

A) Rheumatic heart disease
B) Takotsubo cardiomyopathy
C) Infective endocarditis
D) Pericarditis

B) Takotsubo cardiomyopathy

What is the MOST common cause of left heart failure?

A) COPD
B) Pulmonary hypertension
C) Ischemic heart disease and hypertension
D) Infective endocarditis

C) Ischemic heart disease and hypertension

In right-sided heart failure, which symptom is most prominent?

A) Pulmonary edema
B) Crackles
C) Jugular venous distention
D) Dyspnea

D) Dyspnea

What ejection fraction percentage is typical of HFrEF?

A) Above 55%
B) 40-55%
C) Below 40%
D) Exactly 50%

C) Below 40%

Which describes a RESTRICTIVE lung disorder?

A) Decreased lung expansion
B) Increased airway resistance
C) Air trapping in alveoli
D) Barrel chest

A) Decreased lung expansion

Which of the following is an obstructive pulmonary disease?

A) Pulmonary fibrosis
B) Silicosis
C) COPD
D) Pneumonia

C) COPD

Which symptom is COMMON to many pulmonary diseases?

A) Hyperglycemia
B) Hypoxia
C) Anemia
D) Edema

B) Hypoxia

Which condition involves destruction of alveolar walls and results in barrel chest?

A) Chronic bronchitis
B) Emphysema
C) Pulmonary fibrosis
D) Silicosis

B) Emphysema

What is a major risk factor for lung cancer?

A) Alcohol use
B) Obesity
C) Cigarette smoking
D) Low HDL cholesterol

C) Cigarette smoking

What condition causes a collapsed lung due to air entering the pleural space?

A) Pneumonia
B) Pulmonary fibrosis
C) Pneumothorax
D) Asthma

C) Pneumothorax

Which structure is most commonly involved in aspiration pneumonia? A) Left lung
B) Right lung
C) Trachea
D) Pulmonary vein

B) Right lung

Pulmonary hypertension most commonly results from:

A) Right heart failure
B) Left heart failure
C) COPD
D) Smoking

B) Left heart failure

What is Cor Pulmonale?

A) Left ventricular enlargement
B) Right ventricular failure due to pulmonary hypertension
C) Alveolar fibrosis
D) Pulmonary edema

B) Right ventricular failure due to pulmonary hypertension

What is a primary symptom of detrusor hyper-reflexia?

A) Urine retention

B) Decreased urination frequency

C) Increased urgency and frequency

D) Blood in urine

C) Increased urgency and frequency

Detrusor/sphincter dyssynergia involves:

A) Underactive bladder

B) Overactive bladder without coordination issues

C) Simultaneous contraction of bladder and sphincter

D) Lack of bladder sensation

C) Simultaneous contraction of bladder and sphincter

Which of the following is TRUE about detrusor a-reflexia?

A) Causes urinary urgency

B) Leads to urine retention

C) Involves overactivity of bladder muscles

D) Caused by damage above the pontine center

B) Leads to urine retention

What is the most common site of urinary tract infection?

A) Kidneys

B) Bladder

C) Ureters

D) Urethra

B) Bladder

What physiological factor helps prevent UTIs?

A) Low urine potassium

B) Urinary secretions of acid

C) High blood sugar

D) Low bladder temperature

B) Urinary secretions of acid

Acute pyelonephritis typically presents with:

A) Chest pain and dyspnea

B) Flank pain, fever, and chills

C) Increased thirst and urination

D) Jaundice and fatigue

B) Flank pain, fever, and chills

A sudden onset of hematuria and mild proteinuria is typical of:

A) Chronic glomerulonephritis

B) Acute glomerulonephritis

C) Acute pyelonephritis

D) Nephrolithiasis

B) Acute glomerulonephritis

Which condition typically progresses over time with secondary causes like diabetes?

A) Acute kidney injury

B) Acute glomerulonephritis

C) Chronic glomerulonephritis

D) Cystitis

C) Chronic glomerulonephritis

Prerenal AKI is mainly caused by:

A) Decreased renal blood flow

B) Nephron damage

C) Obstruction to urine flow

D) Dehydration of glomerulus

A) Decreased renal blood flow

Intrarenal AKI is primarily caused by:

A) Obstruction outside the kidney

B) Systemic hypertension

C) Direct damage to nephron structures

D) Dehydration

C) Direct damage to nephron structures

What is a hallmark clinical finding of CKD (Chronic Kidney Disease)?

A) Increased serum creatinine

B) Decreased urine pH

C) Decreased white blood cell count

D) Increased lung compliance

A) Increased serum creatinine

In CKD, anemia occurs primarily due to:

A) Low blood iron levels

B) Deficiency of erythropoietin

C) Bone marrow fibrosis

D) Hyperkalemia

B) Deficiency of erythropoietin

Which symptom involves difficulty swallowing?

A) Dysphagia

B) Hematemesis

C) Retching

D) Ascites

A) Dysphagia

Projectile vomiting:

A) Is usually preceded by nausea

B) Occurs spontaneously

C) Only happens during seizures

D) Results in bloody vomitus

B) Occurs spontaneously

Osmotic diarrhea is caused by:

A) Increased intestinal motility

B) Excess chloride secretion

C) Non-absorbable substances drawing water into the intestine

D) Viral infection of the colon

C) Non-absorbable substances drawing water into the intestine

Motility diarrhea involves:

A) Increased time for fluid absorption

B) Decreased transit time

C) Decreased secretion of fluids

D) Hypersecretion of pepsin

B) Decreased transit time

GERD results primarily from:

A) Hypersecretion of mucus

B) Decreased tone of the lower esophageal sphincter

C) Inflammation of the pancreas

D) Loss of bile secretion

B) Decreased tone of the lower esophageal sphincter

Which condition involves necrosis of the intestinal wall due to vascular insufficiency?

A) Dumping syndrome

B) Acute mesenteric arterial insufficiency

C) Lactose intolerance

D) Eosinophilic esophagitis

B) Acute mesenteric arterial insufficiency

Which feature distinguishes Crohn’s disease from ulcerative colitis?

A) Continuous lesions from rectum

B) Involves only mucosal layer

C) Skip lesions throughout the GI tract

D) Rare formation of fistulas

C) Skip lesions throughout the GI tract

Which statement about ulcerative colitis is true?

A) Involves full-thickness intestinal wall

B) Rarely causes bloody diarrhea

C) Begins in the rectum and extends proximally

D) Commonly forms abscesses

C) Begins in the rectum and extends proximally

In alcoholic liver disease, what is the correct order of progression?

A) Steatohepatitis → Fatty liver → Cirrhosis

B) Cirrhosis → Fatty liver → Steatohepatitis

C) Fatty liver → Steatohepatitis → Cirrhosis

D) Hepatitis → Steatohepatitis → Fatty liver

C) Fatty liver → Steatohepatitis → Cirrhosis

Non-alcoholic fatty liver disease is most commonly associated with:

A) Chronic alcohol consumption

B) Viral hepatitis

C) Obesity and metabolic syndrome

D) Genetic liver disorders

C) Obesity and metabolic syndrome

What are common signs of shock?

A) Hypertension and increased cardiac output

B) Tachycardia and hypotension

C) Hyperkalemia and bradycardia

D) Decreased respiratory rate and edema

B) Tachycardia and hypotension

During shock, impaired oxygen use leads cells to shift to:

A) Increased aerobic metabolism

B) Anaerobic metabolism

C) Beta-oxidation of fats only

D) Decreased glycolysis

B) Anaerobic metabolism

In cellular impairment during shock, which electrolyte accumulates inside the cell?

A) Potassium

B) Calcium

C) Sodium

D) Chloride

C) Sodium

Cardiogenic shock is primarily caused by:

A) Blood loss

B) Inability of the heart to pump blood adequately

C) Vasodilation from spinal cord injury

D) Allergic reaction

B) Inability of the heart to pump blood adequately

A specific manifestation of cardiogenic shock includes:

A) High urine output

B) Crackles and pulmonary edema

C) Hives and pruritus

D) Fever and chills

B) Crackles and pulmonary edema

What is the primary problem in hypovolemic shock?

A) Decreased heart contractility

B) Increased vascular tone

C) Insufficient intravascular fluid volume

D) Cardiac arrhythmias

C) Insufficient intravascular fluid volume

A classic sign of hypovolemic shock includes:

A) Dry mucous membranes

B) Jugular venous distention

C) Pulmonary crackles

D) Wheezing

A) Dry mucous membranes

Neurogenic shock results from:

A) Excessive sympathetic stimulation

B) Loss of sympathetic nerve activity

C) Infection in the bloodstream

D) Acute heart failure

B) Loss of sympathetic nerve activity

Neurogenic shock causes what primary vascular change?

A) Widespread vasoconstriction

B) Increased systemic vascular resistance

C) Widespread vasodilation

D) Clot formation in large arteries

C) Widespread vasodilation

Anaphylactic shock is triggered by:

A) Severe dehydration

B) Massive bacterial infection

C) Severe allergic hypersensitivity reaction

D) Acute myocardial infarction

C) Severe allergic hypersensitivity reaction

Which is a specific symptom of anaphylactic shock?

A) Crackles

B) Flushed skin and angioedema

C) Hypertension

D) Cold, clammy skin

B) Flushed skin and angioedema

Septic shock is primarily caused by:

A) Loss of blood volume

B) Infection and systemic inflammation

C) Cardiac ischemia

D) Acute liver failure

B) Infection and systemic inflammation

A characteristic finding in septic shock is:

A) Very high systemic vascular resistance

B) Normal or increased cardiac output despite low blood pressure

C) Extremely low ejection fraction

D) Widespread vasoconstriction

B) Normal or increased cardiac output despite low blood pressure

MODS is defined as:

A) Heart and lung failure within 24 hours

B) Dysfunction of two or more organs after systemic inflammation

C) Failure of only the kidneys and lungs

D) Infection of multiple organs

B) Dysfunction of two or more organs after systemic inflammation

What is a key cellular player in MODS pathogenesis?

A) Red blood cells

B) Macrophages only

C) Neutrophils releasing damaging enzymes

D) Smooth muscle cells

C) Neutrophils releasing damaging enzymes

Secondary MODS typically occurs:

A) Immediately after trauma

B) Due to a second insult after the initial injury

C) Without any initial inflammatory insult

D) Only after viral infection

B) Due to a second insult after the initial injury

A second-degree burn is characterized by:

A) Damage limited to the epidermis

B) Immediate blistering and partial dermis destruction

C) Full-thickness skin and subcutaneous tissue destruction

D) White, painless appearance

B) Immediate blistering and partial dermis destruction

Third-degree burns are also called:

A) Partial-thickness burns

B) First-degree burns

C) Full-thickness burns

D) Surface burns

C) Full-thickness burns

Major burns lead to:

A) Decreased capillary permeability

B) Massive evaporative water loss and fluid shift

C) Immediate hypercoagulability

D) Increased bone marrow activity

B) Massive evaporative water loss and fluid shift

Without fluid resuscitation in major burns, what serious complication occurs?

A) Hyperglycemia

B) Irreversible hypovolemic shock and death

C) Pulmonary edema

D) Immune system hyperactivity

B) Irreversible hypovolemic shock and death