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NURS 231/BIOD 331 Pathophysiology – Module 10
Exam – Portage Learning – Latest 2026-2027
Updated & Verified
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QUESTION 1
Each of the following statements correctly describes the pathophysiology of
gout EXCEPT:
A. Hyperuricemia promotes monosodium urate crystal formation
B. Uric acid is poorly soluble in synovial fluid
C. Acute gout attacks involve intense inflammation and pain
D. Uric acid readily dissolves in cooler peripheral joints
Correct Answer: D
Verified Explanation:
Gout develops due to elevated serum uric acid levels that exceed the solubility
threshold of uric acid in body fluids. Uric acid is poorly soluble, particularly in
synovial fluid and in cooler peripheral joints such as the first
metatarsophalangeal joint. This reduced solubility promotes precipitation of
monosodium urate crystals, which trigger a strong inflammatory response when
phagocytized by immune cells. Acute gout attacks are therefore characterized
by redness, swelling, warmth, and severe pain. Any statement suggesting that
uric acid readily dissolves in synovial fluid or peripheral joints contradicts the
fundamental mechanism of gout and is incorrect.
QUESTION 2
Which mechanism best explains joint destruction in rheumatoid arthritis?
A. Mechanical wear and tear of cartilage
B. Autoimmune-mediated synovial inflammation
C. Deposition of calcium salts in cartilage
D. Reduced estrogen levels
Correct Answer: B
Verified Explanation:
Rheumatoid arthritis is a chronic autoimmune disease in which the immune
system mistakenly attacks the synovial membrane lining the joints. This
immune-mediated inflammation leads to synovial hyperplasia, formation of
pannus tissue, and progressive erosion of cartilage and bone. Over time, this
inflammatory process causes joint deformity and loss of function. Unlike
osteoarthritis, which is primarily due to mechanical degeneration, rheumatoid
arthritis is driven by systemic immune dysregulation, often accompanied by
systemic symptoms such as fatigue and fever.
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QUESTION 3
Which factor most significantly increases the risk for developing osteoporosis?
A. Increased physical activity
B. Long-term corticosteroid therapy
C. Elevated estrogen levels
D. High dietary calcium intake
Correct Answer: B
Verified Explanation:
Osteoporosis is characterized by decreased bone mass and deterioration of bone
microarchitecture, leading to increased fracture risk. Long-term corticosteroid
use is a major secondary cause of osteoporosis because corticosteroids suppress
osteoblast activity while increasing osteoclast-mediated bone resorption. This
imbalance disrupts normal bone remodeling and accelerates bone loss. Although
adequate calcium intake and physical activity are protective factors, prolonged
exposure to corticosteroids significantly compromises bone integrity and
predisposes individuals to fractures.
QUESTION 4
Which clinical feature best differentiates osteoarthritis from rheumatoid
arthritis?
A. Presence of joint pain
B. Symmetrical joint involvement
C. Pain that worsens with activity
D. Chronic synovial inflammation
Correct Answer: C
Verified Explanation:
Osteoarthritis is a degenerative joint disease primarily caused by mechanical
stress and cartilage breakdown. As a result, joint pain in osteoarthritis typically
worsens with activity and improves with rest. Rheumatoid arthritis, in contrast,
is an inflammatory autoimmune condition characterized by prolonged morning
stiffness, symmetrical joint involvement, and persistent synovial inflammation.
While both conditions cause joint pain, the activity-related worsening of
symptoms is more characteristic of osteoarthritis.
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QUESTION 5
Which cell type is responsible for bone resorption during normal bone
remodeling?
A. Osteoblast
B. Osteocyte
C. Osteoclast
D. Chondrocyte
Correct Answer: C
Verified Explanation:
Bone remodeling is a continuous process that maintains skeletal integrity
through a balance of bone formation and bone resorption. Osteoclasts are
specialized multinucleated cells that break down bone tissue by secreting acids
and proteolytic enzymes, allowing minerals to be released into the bloodstream.
Osteoblasts, in contrast, are responsible for bone formation. When osteoclast
activity exceeds osteoblast activity, as seen in osteoporosis, net bone loss
occurs.
QUESTION 6
A patient presents with localized bone pain, fever, and swelling. Which
condition best explains these findings?
A. Osteoporosis
B. Osteoarthritis
C. Osteomyelitis
D. Gout
Correct Answer: C
Verified Explanation:
Osteomyelitis is an infection of bone tissue, most commonly caused by bacterial
pathogens. The infection triggers an inflammatory response that results in
localized bone pain, swelling, warmth, and systemic signs such as fever. If
untreated, osteomyelitis can compromise blood supply to the bone, leading to
necrosis. Osteoporosis and osteoarthritis are noninfectious conditions and do not
produce fever, while gout primarily affects joints rather than bone tissue itself.
NURS 231/BIOD 331 Pathophysiology – Module 10
Exam – Portage Learning – Latest 2026-2027
Updated & Verified
,2|Page
QUESTION 1
Each of the following statements correctly describes the pathophysiology of
gout EXCEPT:
A. Hyperuricemia promotes monosodium urate crystal formation
B. Uric acid is poorly soluble in synovial fluid
C. Acute gout attacks involve intense inflammation and pain
D. Uric acid readily dissolves in cooler peripheral joints
Correct Answer: D
Verified Explanation:
Gout develops due to elevated serum uric acid levels that exceed the solubility
threshold of uric acid in body fluids. Uric acid is poorly soluble, particularly in
synovial fluid and in cooler peripheral joints such as the first
metatarsophalangeal joint. This reduced solubility promotes precipitation of
monosodium urate crystals, which trigger a strong inflammatory response when
phagocytized by immune cells. Acute gout attacks are therefore characterized
by redness, swelling, warmth, and severe pain. Any statement suggesting that
uric acid readily dissolves in synovial fluid or peripheral joints contradicts the
fundamental mechanism of gout and is incorrect.
QUESTION 2
Which mechanism best explains joint destruction in rheumatoid arthritis?
A. Mechanical wear and tear of cartilage
B. Autoimmune-mediated synovial inflammation
C. Deposition of calcium salts in cartilage
D. Reduced estrogen levels
Correct Answer: B
Verified Explanation:
Rheumatoid arthritis is a chronic autoimmune disease in which the immune
system mistakenly attacks the synovial membrane lining the joints. This
immune-mediated inflammation leads to synovial hyperplasia, formation of
pannus tissue, and progressive erosion of cartilage and bone. Over time, this
inflammatory process causes joint deformity and loss of function. Unlike
osteoarthritis, which is primarily due to mechanical degeneration, rheumatoid
arthritis is driven by systemic immune dysregulation, often accompanied by
systemic symptoms such as fatigue and fever.
,3|Page
QUESTION 3
Which factor most significantly increases the risk for developing osteoporosis?
A. Increased physical activity
B. Long-term corticosteroid therapy
C. Elevated estrogen levels
D. High dietary calcium intake
Correct Answer: B
Verified Explanation:
Osteoporosis is characterized by decreased bone mass and deterioration of bone
microarchitecture, leading to increased fracture risk. Long-term corticosteroid
use is a major secondary cause of osteoporosis because corticosteroids suppress
osteoblast activity while increasing osteoclast-mediated bone resorption. This
imbalance disrupts normal bone remodeling and accelerates bone loss. Although
adequate calcium intake and physical activity are protective factors, prolonged
exposure to corticosteroids significantly compromises bone integrity and
predisposes individuals to fractures.
QUESTION 4
Which clinical feature best differentiates osteoarthritis from rheumatoid
arthritis?
A. Presence of joint pain
B. Symmetrical joint involvement
C. Pain that worsens with activity
D. Chronic synovial inflammation
Correct Answer: C
Verified Explanation:
Osteoarthritis is a degenerative joint disease primarily caused by mechanical
stress and cartilage breakdown. As a result, joint pain in osteoarthritis typically
worsens with activity and improves with rest. Rheumatoid arthritis, in contrast,
is an inflammatory autoimmune condition characterized by prolonged morning
stiffness, symmetrical joint involvement, and persistent synovial inflammation.
While both conditions cause joint pain, the activity-related worsening of
symptoms is more characteristic of osteoarthritis.
, 4|Page
QUESTION 5
Which cell type is responsible for bone resorption during normal bone
remodeling?
A. Osteoblast
B. Osteocyte
C. Osteoclast
D. Chondrocyte
Correct Answer: C
Verified Explanation:
Bone remodeling is a continuous process that maintains skeletal integrity
through a balance of bone formation and bone resorption. Osteoclasts are
specialized multinucleated cells that break down bone tissue by secreting acids
and proteolytic enzymes, allowing minerals to be released into the bloodstream.
Osteoblasts, in contrast, are responsible for bone formation. When osteoclast
activity exceeds osteoblast activity, as seen in osteoporosis, net bone loss
occurs.
QUESTION 6
A patient presents with localized bone pain, fever, and swelling. Which
condition best explains these findings?
A. Osteoporosis
B. Osteoarthritis
C. Osteomyelitis
D. Gout
Correct Answer: C
Verified Explanation:
Osteomyelitis is an infection of bone tissue, most commonly caused by bacterial
pathogens. The infection triggers an inflammatory response that results in
localized bone pain, swelling, warmth, and systemic signs such as fever. If
untreated, osteomyelitis can compromise blood supply to the bone, leading to
necrosis. Osteoporosis and osteoarthritis are noninfectious conditions and do not
produce fever, while gout primarily affects joints rather than bone tissue itself.
