Pathophysiology Practice Questions

Correct Answer: C

Rationale: In a 60-year-old man presenting with painless hematuria, the next step in the evaluation should be cystoscopy. Cystoscopy is recommended to assess the cause of hematuria, particularly to rule out bladder cancer, which is more common in older individuals. Urinalysis (Choice A) can provide initial information but may not definitively diagnose the underlying cause. Renal ultrasound (Choice B) and intravenous pyelogram (Choice D) are imaging studies that may be considered later in the evaluation process but are not the initial step for painless hematuria.

Correct Answer: B

Rationale: The correct answer is B: 'History of the parent having been abused as a child.' Research shows that a history of being abused as a child is a significant risk factor for child abuse. This cycle of abuse can sometimes continue from one generation to the next. Choices A, C, and D are incorrect. Flexible role functioning between parents, a single-parent home situation, and the presence of parental mental illness are important factors to consider in various contexts but may not specifically indicate a higher likelihood of child abuse in this case.

Correct Answer: B

Rationale: The correct answer is B because sudden onset of behavioral changes is a typical symptom of delirium. Delirium is characterized by an acute and fluctuating disturbance in attention, awareness, and cognition. Choice A is incorrect because delirium is not a normal part of aging. Choice C describes memory issues, which can be seen in delirium but are less specific than sudden behavioral changes. Choice D, while it mentions the patient's independence, does not directly support the diagnosis of delirium.

Correct Answer: D

Rationale: The correct answer is D, Colon cancer. Colon cancer commonly presents with blood in the stool due to bleeding from the tumor. Gastroesophageal reflux (Choice A) is associated with heartburn and regurgitation of stomach contents into the esophagus. Crohn's disease (Choice B) is a type of inflammatory bowel disease that can cause symptoms like abdominal pain, diarrhea, and weight loss, but it does not typically present with blood in the stool as a primary symptom. Irritable bowel syndrome (Choice C) is a functional gastrointestinal disorder characterized by symptoms such as abdominal pain, bloating, and changes in bowel habits, but it does not usually involve blood in the stool as a prominent feature.

Correct Answer: C

Rationale: The correct answer is C, aortic dissection. Aortic dissection is characterized by sudden, severe chest pain that can radiate to the back. The discrepancy in blood pressure between the arms (higher in the right arm) is known as a 'pulse deficit' and is a classic finding in aortic dissection. This condition involves a tear in the inner layer of the aorta, leading to the abnormal flow of blood within the aortic wall. Acute myocardial infarction (choice A) presents with chest pain but typically does not cause discrepancies in blood pressure between arms. Pulmonary embolism (choice B) usually presents with chest pain and difficulty breathing but does not cause unequal blood pressures in the arms. Pericarditis (choice D) can cause chest pain exacerbated by breathing or lying down, but it does not typically lead to differences in blood pressure between arms.