pathophysiology exam questions - semmelweis...

Pathophysiology exam questions

Fall Semester

1. Pathophysiology of heart failurePre and afterload, contractility. Etiology of heart failure. Pressure andvolume overload. Characteristic energetic alterations and possiblecompensatory mechanisms of heart failure. Stepping across thecompensationdecompensation border. Left and right ventricularfailure.

2. Pathophysiology of cardiomyopathiesPathomechanism of congestive, hypertrophied, restrictive andobliterative cardiomyopathies. Myocarditis. Secondarymyocardiopathies: alcoholic, diabetic, peripartal and ischemic heartdisease.

3. Pathophysiology of coronary circulationCauses of insufficient oxygen supply of the myocardium. Anginapectoris syndrome. Pathomechanism of myocardial infarction. Typicalalterations in serum enzyme levels and ECGmorphology.Complications of myocardial infarction.

4. Pathophysiology of arrhythmiasMechanisms of the development of arrhythmias. Disturbances ofimpulse formation and conduction. Hemodynamic effects ofarrhythmias.

5. Disturbances of the regulation of respiration, the differentforms of tissue hypoxiaAbnormal ventilatory patterns. Sleep apnea. Abnormalities of centraland peripheral chemoreceptors. Forms of tissue hypoxia. Cyanosis.Pulmonal dyspnea.

01/12/2004 1/14 Exam questions


6. Pathophysiology of ventilatory disordersObstructive ventilatory disorder, causes and functional characteristics:compliance, resistance, lung volumes. Restrictive ventilatory disorder,causes and functional characteristics: compliance, resistance, lungvolumes. Pathophysiology of bronchial asthma.

7. Pathophysiology of alveolar ventilationAlveolar hypo and hyperventilation. Significance of ventilationperfusion mismatch. Disturbances of alveolar diffusion.

8. Pathophysiology of respiratory insufficiencyPartial and total respiratory failure. Compensatory mechanisms inrespiratory failure. Causes and pathomechanism of ARDS. Causes andoutcomes of alveolar hyperventilation.

9. Circulatory shock. Systemic reactionsDefinition and common etiological factors of circulatory shock.Characteristics of the major forms of shock. Reactions of the circulatoryand immune system. Pathomechanism of reperfusion. Role of adiposetissue in shock.

10. Local effects of circulatory shockReaction of the skeletal muscle in shock. Role of the liver in shock.Pathological events in the lung in shock. Intestine as shockorgan.Contribution of kidney in shock. Pathophysiological bases for shocktherapy.

11. Pathophysiology of essential hypertensionRole of heredity and environmental factors in the development ofessential hypertension. Role of vasoactive mediators and changes incardiac output in the pathophysiology of essential hypertension.Connection between obesity and hypertension.



12. Pathogenesis and hemodynamic characteristics of the differentforms of secondary hypertensionPathogenesis and hemodynamic characteristics of renovascular, renalparenchymal, and endocrine (Cushing's syndrome, primaryaldosteronism, acromegaly, pheochromocytoma) forms of hypertension.

13. Disturbances of carbohydrate metabolismCharacteristics of the metabolic disorder associated with diabetesmellitus. Classification of diabetes syndrome. Diagnostic criteria. Typesof hypoglycemia. Glycogen storage diseases and other enzymaticdisorders of carbohydrate metabolism.

14. Early and delayed sequelae of diabetes mellitusHypoglycemic, hyperglycemic ketoacidotic, and nonketotichyperosmolar coma. Micro and macroangiopathies, organmanifestations.

15. Pathogenesis of type I diabetes mellitusHeredity, environmental effects; pathogenetic concepts in the differentstages of the disease.

16. Pathogenesis of type II diabetes mellitusHeredity, environmental effects; pathogenetic concepts in the differentstages of the disease.

17. Causes of hepatic lesionsForms of viral hepatitis, differential diagnosis. Toxic lesions. Differentforms of alcohol induced hepatic disease: fatty liver, hepatitis, cirrhosis.Congenital hepatic diseases.

18. Forms of hepatic lesionsLiver cell injury. Forms of cholestasis. Classification and differentialdiagnosis of jaundice. Pathomechanism of cirrhosis. Liver dysfunctionassociated with heart failure. Forms and sequelae of portalhypertension.



19. Metabolic disorders accompanying hepatic failureDisorders of protein, carbohydrate and lipid metabolism accompanyinghepatic insufficiency. Detoxifying function in normal and pathologicstates: alcohol, bilirubin and ammonia. Development of hepatic coma.Pathomechanism of ascites production. Effect of hepatic failure on thewater and electrolyte balance.

20. Pathophysiology of starvationEnergy demand in pathological states. Feedingfasting cycle and itsregulation. Different stages of starvation. Differences in the metaboliccharacteristics of the short term and prolonged (adapted) starvation.

21. Pathophysiology of obesityCriteria of obesity. Indexes used to estimate obesity. Types,pathogenesis and outcomes of obesity.

22. Disturbances of protein and amino acid metabolismProtein deficiency. Proteincalorie undernutrition: clinical patterns,outcomes and diagnostic criteria. Secondary protein metabolismabnormalities. Disturbances of amino acid metabolism.

23. Pathophysiology of vitamin metabolism. Metabolism ofminerals. Nutritional diseasesHypo and hypervitaminoses. Abnormalities of trace mineralmetabolism. Role of food constituents in the pathogenesis of tumors.Impaired dietary habits.

24. Disturbances of gastric juice secretion. Peptic ulcerRole of defensive and aggressive factors in the pathomechanism of acidpeptic disease. Cytoprotection. Pathomechanism of gastric ulcer. Role ofheredity in the pathomechanism of duodenal ulcer. Pathophysiologicalcharacteristics of duodenal ulcer. The mucusbicarbonate barrier.Stressulcer.



25. Disturbances of gastrointestinal tract motilityDisturbances of mastication and swallowing. Gastroesophageal reflux.Achalasia esophagi. Alterations of gastric motility. Motility disorders ofsmall intestine. Duodenal reflux. The early dumping syndrome.Motility disorders of the colon. The spastic colon.

26. Malabsorption syndromeGastrointestinal and extragastrointestinal causes of malabsorption.Clinical features and outcomes of malabsorption syndrome. Whipple'sdisease. Crohn's disease. Irritable bowel syndrome. Colitis ulcerosa.

27. Disorders of the exocrine pancreas function. Inflammatory andneoplastic diseases of the pancreasHyposecretion of the pancreatic juice. Mucoviscidosis. Pancreatic juicehypersecretion. Etiology, clinical course and complications of acutepancreatitis. Etiology, pathomechanism and alterations in pancreaticfunction and laboratory findings in chronic pancreatitis. Pancreatictumors.

28. General characteristics of inflammation. Role of biogen amines,lipid mediators and cytokinesLocal signs, forms, endogenous and exogenous causes of inflammation.Alterations of microcirculation. Role of histamine, serotonin,prostaglandins, leukotriens, PAF in the inflammation.

29. Role of proteolytic systems in inflammationPlasma contact activating system and its regulation. Role ofcomplement system. Formation and regulation of cytokines ininflammation. Diseases of abnormal complement system function.



30. Inherited and acquired disorders of chemotaxis andphagocytosisMechanism of chemotaxis and chemokinesis. O2dependent and O2independent mechanisms of phagocytosis. Congenital and acquireddysfunction of phagocytes. Processes of chronic inflammation andwound healing.

31. Systemic reactions in inflammationMechanism of the development of fever, fever patterns. Endogenouspyrogens and cryogens. Biological significance of fever. Role ofleukocytosis and thrombocyte aggregation. Alterations in the synthesisof serum proteins, acute phase proteins.

32. Immunodeficiencies: causes and sequelae. ImmunosuppressionInherited and acquired disorders of the complement system.Classification of congenital immunodeficiencies, causes and clinicalfeatures of the certain diseases. Acquired immunodeficiencies. Possiblemethods for immunosuppression.

33. Hypersensitivity reactionsAnaphylaxis, allergy, atopic diseases. Types of hypersensitivityreactions, syndromes caused by them, their pathomechanisms. Role ofhypersensitivity reactions in autoimmune diseases.

34. Connections between malignancies and the immune system.ImmunotherapyPossible mechanisms of the protection of immune system againsttumors. Possibilities for tumors to escape. Significance oftumorantigens. Theories of immunotherapy.

35. ImmunotoleranceHumoral and cellular immunity. Natural and induced tolerance.Possible mechanisms of the development of tolerance, evidences.Significance of central and peripheral tolerance.



36. Autoimmune processes and their pathogenetic roleDefinition of autoimmunity, autoimmune reactions without pathologicconsequences. Classification of autoimmune diseases, their incidenceand aggravating factors. The MHC. Forms of contribution of humoraland cellular immune system in certain autoimmune diseases. Theoriesconcerning the development of autoimmune diseases.



Spring Semester

37. Pathophysiology of agingMolecular and cellular processes of aging. Alterations in the differentorgans with aging. Factors influencing aging. Important diseasesassociated with old age.

38. Sideropenic and sideroachrestic anemiasCauses and development of iron deficiency. Laboratory, hematologicaland clinical characteristics of iron deficiency anemia. Sideroachresticanemias.

39. Megaloblastic anemiasRole of vitamin B12 and folic acid in the nucleic acid metabolism of redblood cells. Causes of B12 or folic acid deficiency. Clinical symptoms ofmegaloblastic anemias. Polyglobulias.

40. Hemolytic anemiasSymptoms of hemolysis (acute, chronic). Forms of corpuscular andextracorpuscular hemolytic anemias. Hemoglobinopathies. Paroxysmalnocturnal hemoglobinuria.

41. Reactive alterations in the leukocyte count. Malignancies of thebone marrowGranulocytosis. Leukemoid reaction. General features of malignantcellproliferation. Acute nonlymphocytic leukemias. Malignanthyperplastic diseases of the bone marrow. Chronic myeloid leukemia,polycythemia vera, idiopathic myelofibrosis.



42. Reactive and malignant processes of the lymphoid system.Disorders of the pluripotent hemopoietic stem cellReactive alterations in the lymphoid system. Infectious mononucleosis.Hodgkin's lymphoma. Clonal diseases of the lymphoid system: acutelymphoblastic leukemia, nonHodgkin lymphomas. Aplastic anemia.Myelodysplasias.

43. Pathophysiology of hemorrhagic diatheses. CoagulopathiesForms of hemorrhagic diatheses. Laboratory differential diagnosis.Inherited and acquired coagulopathies.

44. Pathophysiology of thrombocytopathies and vasculopathiesBleeding disorders accompanying quantitative and qualitative defectsof thrombocytes, laboratory differential diagnosis. Vasculopathies.

45. Pathophysiology of thrombophilias and thromboemboliasFactors predisposing for thrombosis. Congenital thrombophilias.Differences and similarities between the pathomechanism of arterial,venous and intracardiac thrombus formation. DIC. Thromboticmicroangiopathies.

46. Pathophysiology of hypertriglyceridemias and hypolipidemiasClassification and composition of lipoproteins. Transport of exogenousand endogenous triglycerides. Classification of primaryhyperlipoproteinemias. Primary and secondary hypertriglyceridemias.Hypolipidemias.

47. Pathophysiology of hypercholesterolemias and lipid storagediseasesClassification and functions of apoproteins. Transport of exogenous andendogenous cholesterol. "Reverse" cholesteroltransport. Classificationof hyperlipoproteinemias. Primary and secondaryhypercholesterolemias. Lipid storage diseases.



48. Evolution of atherosclerosisProcess of the development of atherosclerosis. Organ manifestations.Chemical, experimental and epidemiological evidences of the connectionof atherosclerosis and cholesterol metabolism. Possible pathogeneticrole of atherogenic lipoproteins.

49. Lipid theory of atherosclerosisConnections between abnormal serum lipid concentrations andatherosclerosis. Possible connections between serum lipid levels anddiet. Lipid theory at "cellular level".

50. Nonlipid theories of atherosclerosisThrombogenic, mesenchymal and "response to injury" theories ofatherosclerosis.

51. Risk factors of atherosclerosis. Bases for the prevention ofcomplicationsMajor risk factors of atherosclerosis. Possibilities for screening andconcepts for prevention.

52. Disturbances of potassium metabolismCauses and outcomes of hypokalemia. Causes and outcomes ofhyperkalemia. Relationships between potassium metabolism and acidbase balance.

53. Acidbase disorders of respiratory originCauses and complications of respiratory acidosis. Diseases withrespiratory acidosis. Causes and complications of respiratory alkalosis.Diseases with respiratory alkalosis.

54. Pathophysiology of the diseases with metabolic acidosisCauses and significance of metabolic acidosis. Diseases with metabolicacidosis. The concept and use of anion gap. Renal tubular acidosis.



55. Pathophysiology of the diseases with metabolic alkalosisCauses and significance of metabolic alkalosis. Diseases with metabolicalkalosis. Compensatory mechanisms of acidbase disorders.

56. Pathophysiology of acute parenchymal renal failurePathomechanism of acute renal insufficiency of renal origin. Role ofvascular and tubular factors in GFR decrease. Role of thick ascendingsegment in the development of acute renal failure.

57. Pathophysiology of nonparenchymal acute renal failurePathomechanism of prerenal and postrenal acute failure. Sequelae ofacute renal insufficiency.

58. Pathophysiology of chronic renal failureAlterations in fluid, sodium, potassium and urea excretion and incalciumphosphate metabolism in chronic renal failure. Acidbaseimbalance in chronic renal insufficiency. Factors contributing to theprogression of renal disease.

59. Complications of chronic renal failure. UremiaAnemia, hemophilia, hypertension, hyperlipidemia and impairedglucose tolerance in chronic renal failure. Characteristics of uremia.Uremic toxins.

60. Disturbances in the function of hypophysisDefinition, etiology and pathophysiology of panhypopituitarism.Clinical forms of growth hormone hyposecretion. Laron dwarf, Pygmydwarf. Factors influencing prolactin secretion. Hyperprolactinemias.

61. Disturbances in thyroid functionPathophysiology and clinical symptoms of Grave's disease. Etiology andclinical forms of hypothyreosis. Cause and symptoms of Hashimoto'sthyroiditis.



62. Hypofunction of the adrenal cortex and medullaAcute and chronic forms of adrenal cortex hypofunction: WaterhouseFriderichsen syndrome, Addison's disease, iatrogenic causes.Adrenogenital syndrome. Hypofunction of the adrenal medulla.

63. Hyperfunction of the adrenal cortex and medullaDefinition of Cushing's syndrome, forms with low and high ACTHconcentration. Pathophysiology of Cushing's disease and ectopic ACTHsyndrome. Primary and secondary hyperaldosteronism. Clinical signsand diagnostic laboratory methods of pheochromocytoma.

64. Disturbances in female sexual functionDisturbances in sexual maturation. Menstruation abnormalities.Hormonal disturbances in pregnancy.

65. Disturbances in male sexual functionDisturbances in sexual differentiation. Precocious puberty. Forms ofhypogonadism (hypophysaer, testicular, peripheral).

66. Disturbances of calcium and phosphate metabolism.Pathophysiology of the diseases of skeletonDiseases with hyper and hypocalcemia. Tetany syndrome.Pathomechanism of renal and absorptive hypercalciurias.Pathomechanism of involutional osteoporosis. Secondary osteoporosis.Development of rickets and osteomalatia. Pathomechanism of renalosteodystrophy. Osteogenesis imperfecta. Paget's disease of bone.Osteopetrosis.

67. Qualitative and quantitative consciousness disordersClassification and differences between qualitative and quantitativedisorders of consciousness. Disturbances of vigility and contents."Short" consciousness disorders. Cerebral commotion. Pseudocomas.Pathogenetic classification of unconsciousness. Causes andclassification of diffuse consciousness disorders of metabolic origin,fundamentals of the diagnostic route.



68. Pathophysiology of motor disordersDisorders of voluntary motorium. Peripheral and central paresis.Apraxia. Pathomechanism of extrapyramidal movement disorders ofcerebellar and brainstem origin.

69. PainBiological significance of pain sensation. Theories concerning thedevelopment of pain. Local and systemic reactions associated with pain.Diagnostic significance of pain. Pain syndromes. Acute and chronicpain. Theoretical bases for pain relief.

70. Disturbances of the autonomic nervous systemChronic autonomic insufficiency and acute dysautonomy. Central,peripheral and local vegetative disorders.

71. Pathophysiology of CNS circulationGlobal and focal ischemia of the brain. Disturbances in theautoregulation of brain circulation. Development of ischemic nerve celldamage. Classification of cerebral hemorrhages. Classification ofcerebrovascular diseases according to their clinical course.

72. Pathophysiology of intracranial fluid spacesForms and characteristics of brain edema. Consequences of brainedema. Causes, most common forms and outcomes of the alterations incerebrospinal fluid dynamics.

73. Disturbances of water homeostasisCauses and outcomes of water depletion. Decreased intake andincreased excretion of water. Causes and outcomes of water retention.Increased intake and decreased excretion of water. SIADH.



74. Disturbances of sodium homeostasisCauses and complications of sodium depletion. Diseases with sodiumdepletion. Causes and complications of sodium retention. Sodiumretention with hypo and hypernatremia. Symptoms of sodiumretention.

75. Pathophysiology of thermoregulationHypo and hyperthermias. Effects of heat exposure on human organism.Pathomechanism of heatstroke.


pathophysiology exam questions - semmelweis...

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