NRS-455
Pathophysiology
Midterm Prep
(With Solutions)
2026
1
,1. Case: A 58-year-old male presents with exertional chest pain.
Question: Which cellular mechanism underlies myocardial ischemia?
- A. Increased ATP synthesis
- B. Anaerobic glycolysis with lactic acid accumulation
- C. Enhanced oxidative phosphorylation
- D. Increased fatty acid oxidation
Answer: B
Rationale: Ischemia reduces oxygen supply, forcing anaerobic
metabolism and lactic acid buildup.
---
2. Case: A patient with COPD develops chronic hypoxemia.
Question: Which adaptation occurs in response?
- A. Decreased erythropoietin
- B. Polycythemia
- C. Reduced hematocrit
- D. Decreased hemoglobin affinity for oxygen
Answer: B
Rationale: Chronic hypoxemia stimulates erythropoietin →
polycythemia.
---
3. Case: A patient with cirrhosis develops ascites.
Question: Which mechanism contributes most?
- A. Increased plasma oncotic pressure
- B. Portal hypertension and hypoalbuminemia
- C. Decreased capillary hydrostatic pressure
- D. Increased lymphatic drainage
Answer: B
2
, Rationale: Portal hypertension and low albumin drive fluid into
peritoneum.
---
4. Case: A patient with sepsis develops hypotension.
Question: Which mediator is primarily responsible?
- A. Histamine
- B. Nitric oxide
- C. Endothelin
- D. Angiotensin II
Answer: B
Rationale: Sepsis induces NO release → vasodilation and hypotension.
---
5. Case: A patient with chronic kidney disease develops anemia.
Question: Which pathophysiologic mechanism is most responsible?
- A. Iron deficiency
- B. Reduced erythropoietin production
- C. Vitamin B12 deficiency
- D. Hemolysis
Answer: B
Rationale: CKD impairs erythropoietin synthesis.
---
6. Case: A patient with asthma presents with wheezing.
Question: Which mechanism explains airway obstruction?
- A. Loss of alveolar elasticity
- B. Bronchial smooth muscle constriction and mucus hypersecretion
- C. Alveolar destruction
- D. Pulmonary fibrosis
Answer: B
3
Pathophysiology
Midterm Prep
(With Solutions)
2026
1
,1. Case: A 58-year-old male presents with exertional chest pain.
Question: Which cellular mechanism underlies myocardial ischemia?
- A. Increased ATP synthesis
- B. Anaerobic glycolysis with lactic acid accumulation
- C. Enhanced oxidative phosphorylation
- D. Increased fatty acid oxidation
Answer: B
Rationale: Ischemia reduces oxygen supply, forcing anaerobic
metabolism and lactic acid buildup.
---
2. Case: A patient with COPD develops chronic hypoxemia.
Question: Which adaptation occurs in response?
- A. Decreased erythropoietin
- B. Polycythemia
- C. Reduced hematocrit
- D. Decreased hemoglobin affinity for oxygen
Answer: B
Rationale: Chronic hypoxemia stimulates erythropoietin →
polycythemia.
---
3. Case: A patient with cirrhosis develops ascites.
Question: Which mechanism contributes most?
- A. Increased plasma oncotic pressure
- B. Portal hypertension and hypoalbuminemia
- C. Decreased capillary hydrostatic pressure
- D. Increased lymphatic drainage
Answer: B
2
, Rationale: Portal hypertension and low albumin drive fluid into
peritoneum.
---
4. Case: A patient with sepsis develops hypotension.
Question: Which mediator is primarily responsible?
- A. Histamine
- B. Nitric oxide
- C. Endothelin
- D. Angiotensin II
Answer: B
Rationale: Sepsis induces NO release → vasodilation and hypotension.
---
5. Case: A patient with chronic kidney disease develops anemia.
Question: Which pathophysiologic mechanism is most responsible?
- A. Iron deficiency
- B. Reduced erythropoietin production
- C. Vitamin B12 deficiency
- D. Hemolysis
Answer: B
Rationale: CKD impairs erythropoietin synthesis.
---
6. Case: A patient with asthma presents with wheezing.
Question: Which mechanism explains airway obstruction?
- A. Loss of alveolar elasticity
- B. Bronchial smooth muscle constriction and mucus hypersecretion
- C. Alveolar destruction
- D. Pulmonary fibrosis
Answer: B
3
