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Pathophysiology Final Exam

Please answer the following questions as completely as possible. Please do not solicit help from your peers, supervisors or classmates Any student that breaks the honor code will receive a failing grade. Each question is worth 25 points for a total of 200 points. I have read and understand the conditions of this take-home exam. __________________.


1. Answer as completely as possible parts a-e (20 points)

a. Describe the difference in mechanism of emphysema, asthma and cystic fibrosis.

  1. Describe how the lack of chlorine channels in cystic fibrosis patients account for the major respiratory symptoms
  2. Gene therapy has been proposed and even tested for cystic fibrosis. Describe the pros and cons of this treatment.
  3. People who hyperventilate are told to breathe into a paper bag. Describe how this technique relieves the hypocapnia and stops the hyperventilation.
  4. Living in high altitudes and deep sea diving both have an effect on oxygenation of the blood. Describe the conditions and treatments associated with these two activities.

2. Answer the following questions on prostate cancer.

    1. Why is the use of PSA as a mass screening tool controversial?
    2. What has been proposed to help account for the lack of specificity of PSA as a detection tool?
    3. Why is staging so important and what tools have been developed to help clinicians in the staging of a prostate tumor?
    4. Propose a hypothesis why men with prostate tumors exhibit increased free/bound ratios of PSA.
    5. What are the advantages/disadvantages of the treatment methods of radation and hormonal therapy?

3. Answer as completely as possible parts a-e

    1. Estrogen has an effect at multiple tissues. What are the primary tissues affected and how does estrogen affect each of these tissues?
    2. What are the options available to menopausal women for estrogen replacement?
    3. Describe the pros and cons of each of the treatment options from part b.
    4. What is the advantages/disadvantages of tamoxifen?
    5. Where is the current research heading?
  1. Mr. Smith is a 40 year old who presents with respiratory difficulty, fever and productive cough. He has a history of asthma as well as cigarette smoking. He has also worked in asbestos manufacturing. Examination reveals a gentleman with respiratory difficulty, rapid respiratory rate and low arterial oxygen. He has enlarged lymph nodes in this axilla and neck. Chest exam reveals bilateral expiratory wheezing with crackles in the left lower lobe.
    1. What possible conditions is Mr. Smith suffering from?
    2. What course of action should be taken to treat his immediate symptoms?
    3. A chest X-ray reveals a mass in the lower left lung. What is Mr. Smith suffering from?
    4. What is the prognosis and treatment course for the condition in part c?
    5. What is the rationale for the use of a barometric chamber for a patient with smoke inhalation as opposed to the treatment for the bends?


5. Answer as completely as possible parts a-d

    1. Why is the course of action different in viral and bacterial meningitis?
    2. Explain the susceptibility of AIDS patients to this type of infection. What other types of resistant bacterial infections are AIDS patients particularly prone to?
    3. Describe how the AIDS virus is being attack at the cellular, chemical, genetic and immune levels.
    4. Describe some of the problems associated with these new treatments


6. Answer as completely as possible parts a-c

    1. You are exposed to hepatitis. You want to determine if you have had a great enough exposure to begin an immune response. Explain the following serological findings.

i. An increase in IgM, no detectable levels of IgG

ii. Increased levels of IgG

iii. no detectable levels of IgM or IgG

    1. Describe the unique danger associated with bone marrow transplants (be sure to explain how & why this occurs
    2. Describe four parameters used to assess donor/recipient compatibility. (be sure to describe what each parameter tests.
  1. Cathy has just given birth to a little girl. When the nurses take the infant back to the nursery and try to feed her, she becomes cyanotic. The episode passes, but when the infant is bathed, she becomes cyanotic again. Blood gas levels are taken, and they show the arterial blood is only 60% saturated.
    1. What could the possible causes of the decrease in blood oxygen levels?
    2. Physical examination indicates that there are no structural deformities involving the respiratory or digestive systems. What possibilities can you eliminate from part a.
    3. An echocardiograph shows a heart defect. What is the specific cause of the defect?
    4. Explain how this defect caused the cyanosis?
    5. What is the treatment for this defect?
  1. Vicki has a tumor that causes her to release excess amounts of ADH.
    1. Describe the effect this will have on the following:
    2. blood volume and blood pressure

      peripheral vasoconstriction and cardiac output

      RBC count and WBC count

    3. Vicki has a cholesterol panel done and finds out that her cholesterol and LDL levels are well above normal. What problems will this present?
    4. What will Vicki be advised to do? What are her treatment options?
    5. How could part a and b lead to CHF?