FPGEE Pathophysiology 3

Question 1

In rheumatoid arthritis, the chronic joint destruction is primarily mediated by:

Accepted Answer

Pannus formation driven by synovial fibroblasts and macrophages secreting destructive cytokines

Answer

RA pannus is a hyperplastic synovial tissue containing activated fibroblasts and macrophages that secrete TNF-α, IL-1, IL-6, and metalloproteinases that erode cartilage and bone.

Question 2

A patient with acute pancreatitis develops hypocalcemia. Which mechanism is most responsible?

Accepted Answer

Saponification of peripancreatic fat by lipases binding calcium

Answer

Released pancreatic lipases cleave peripancreatic fat into fatty acids, which bind calcium ions to form calcium soaps (saponification), sequestering calcium and lowering serum levels.

Question 3

Which pathophysiological event triggers the cascade of cellular injury in ischemia-reperfusion injury?

Accepted Answer

Rapid restoration of oxygen leading to reactive oxygen species generation and cellular damage

Answer

Paradoxically, reoxygenation after ischemia produces a burst of ROS from xanthine oxidase and mitochondria, activating proteases and causing endothelial and parenchymal cell damage.

Question 4

In nephrotic syndrome, the edema forms primarily because:

Accepted Answer

Massive proteinuria lowers plasma oncotic pressure, allowing fluid to shift into interstitial spaces

Answer

Heavy urinary protein loss (>3.5 g/day) depletes albumin, reducing intravascular oncotic pressure and allowing Starling forces to drive fluid out of capillaries into the interstitium.

Question 5

Pernicious anemia is caused by:

Accepted Answer

Autoimmune destruction of gastric parietal cells impairing intrinsic factor production

Answer

Pernicious anemia is an autoimmune condition with antibodies against parietal cells and/or intrinsic factor, leading to loss of IF and inability to absorb dietary vitamin B12 in the terminal ileum.

FPGEE Exam Practice Test

FPGEE Exam Practice Test

FPGEE Pathophysiology 3