FPGEE Pathophysiology

Question 1

Which pathophysiological mechanism primarily underlies the development of type 2 diabetes mellitus?

Accepted Answer

Insulin resistance combined with progressive beta-cell dysfunction

Answer

Autoimmune destruction of beta cells

Answer

Absolute insulin deficiency due to pancreatectomy

Answer

Excessive glucagon secretion without insulin resistance

Question 2

In heart failure with reduced ejection fraction (HFrEF), which compensatory mechanism initially helps maintain cardiac output but ultimately worsens cardiac remodeling?

Accepted Answer

Activation of the renin-angiotensin-aldosterone system (RAAS)

Answer

Decreased renin release

Answer

Parasympathetic nervous system activation

Answer

Decreased antidiuretic hormone secretion

Question 3

A patient with chronic kidney disease develops anemia. What is the primary pathophysiological reason?

Accepted Answer

Decreased erythropoietin production by the diseased kidneys

Answer

Iron deficiency due to poor dietary intake

Answer

Hemolysis caused by uremic toxins primarily

Answer

Vitamin B12 malabsorption secondary to renal tubular damage

Question 4

Which of the following best describes the pathophysiology of asthma?

Accepted Answer

Reversible airway inflammation and bronchospasm driven by Th2-mediated hypersensitivity

Answer

Irreversible destruction of alveolar walls leading to air trapping

Answer

Neutrophilic inflammation causing permanent airway remodeling

Answer

Mucus plug obstruction without underlying inflammation

Question 5

In atherosclerosis, which event is considered the earliest pathological change in the arterial wall?

Accepted Answer

Accumulation of oxidized LDL and foam cell formation in the intima

Answer

Calcification of the tunica media

Answer

Smooth muscle cell proliferation into the lumen

Answer

Thrombosis over a ruptured plaque

Question 6

A patient presents with polyuria, polydipsia, and hyponatremia. MRI shows a pituitary tumor. Which pathophysiological defect best explains the polyuria?

Accepted Answer

Deficient ADH secretion leading to inability to concentrate urine

Answer

Excess ADH production causing water retention and dilutional hyponatremia

Answer

Primary polydipsia resetting the osmotic threshold

Answer

Aldosterone excess causing potassium wasting and water loss

Question 7

Which mechanism explains the hypercalcemia seen in primary hyperparathyroidism?

Accepted Answer

Excess PTH stimulating osteoclast activity, renal calcium reabsorption, and calcitriol synthesis

Answer

Decreased calcitonin secretion by thyroid C-cells

Answer

Vitamin D toxicity causing excessive intestinal calcium absorption

Answer

Thiazide diuretic-induced reduction of renal calcium excretion