NSG 5140 ADVANCED PATHOPHYSIOLOGY –
MIDTERM EXAM (2026/2027 SUMMER QUATER) |
QUESTIONS AND ANSWERS | VERIFIED ANSWERS
WITH RATIONALES | LATEST EXAM UPDATE
1. Which of the following best describes the pathophysiology of Type 1
Diabetes Mellitus?
A. Insulin resistance in peripheral tissues
B. Autoimmune destruction of pancreatic beta cells
C. Excess hepatic glucose production
D. Impaired insulin receptor function
>CORRECT ANS>> B. Autoimmune destruction of pancreatic beta cells
>EXPLANATION>> Type 1 diabetes is caused by autoimmune-mediated
destruction of pancreatic beta cells, leading to absolute insulin deficiency.
2. Which electrolyte imbalance is most commonly associated with chronic
kidney disease?
A. Hypokalemia
B. Hyperkalemia
C. Hypernatremia
D. Hypocalcemia
>CORRECT ANS>> B. Hyperkalemia
>EXPLANATION>> CKD reduces potassium excretion, leading to
hyperkalemia, which can cause cardiac arrhythmias.
3. A patient presents with severe diarrhea. Which acid-base disturbance
is most likely?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
,D. Respiratory alkalosis
>CORRECT ANS>> A. Metabolic acidosis
>EXPLANATION>> Loss of bicarbonate in diarrhea leads to metabolic
acidosis.
4. In heart failure, activation of the renin-angiotensin-aldosterone system
(RAAS) primarily causes:
A. Vasodilation and decreased blood pressure
B. Sodium and water retention
C. Increased diuresis
D. Bradycardia
>CORRECT ANS>> B. Sodium and water retention
>EXPLANATION>> RAAS activation increases sodium and water reabsorption
to maintain perfusion, which can worsen fluid overload in heart failure.
5. Which of the following best describes the pathophysiology of multiple
sclerosis?
A. Autoimmune destruction of myelin in the CNS
B. Degeneration of peripheral nerves
C. Accumulation of amyloid plaques in the brain
D. Inflammation of the neuromuscular junction
>CORRECT ANS>> A. Autoimmune destruction of myelin in the CNS
>EXPLANATION>> MS is an autoimmune demyelinating disorder affecting the
central nervous system, leading to conduction deficits.
6. Which condition is characterized by excessive cortisol secretion?
A. Addison’s disease
B. Cushing’s syndrome
C. Hypothyroidism
D. Pheochromocytoma
>CORRECT ANS>> B. Cushing’s syndrome
,>EXPLANATION>> Cushing’s syndrome results from chronic cortisol excess,
causing hyperglycaemia, hypertension, and central obesity.
7. What is the primary mechanism of tissue injury in hypovolemic shock?
A. Direct cytotoxicity
B. Decreased tissue perfusion leading to hypoxia
C. Autoimmune attack on organs
D. Overactivation of coagulation cascade
>CORRECT ANS>> B. Decreased tissue perfusion leading to hypoxia
>EXPLANATION>> Hypovolemic shock reduces circulating blood volume,
decreasing tissue oxygen delivery and causing cellular injury.
8. Which lab finding is consistent with iron-deficiency anemia?
A. High MCV and low ferritin
B. Low MCV and low ferritin
C. Normal MCV and high ferritin
D. Low MCV and high ferritin
>CORRECT ANS>> B. Low MCV and low ferritin
>EXPLANATION>> Iron-deficiency anaemia causes microcytic (low MCV),
hypochromic red cells with depleted iron stores (low ferritin).
9. Which pathogenetic mechanism underlies rheumatoid arthritis?
A. Autoimmune-mediated joint inflammation
B. Degeneration of articular cartilage due to wear and tear
C. Deposition of uric acid crystals
D. Infectious joint inflammation
>CORRECT ANS>> A. Autoimmune-mediated joint inflammation
>EXPLANATION>> RA involves autoimmune attack on synovial membranes,
leading to chronic joint inflammation and destruction.
10. A patient with COPD is most likely to have which blood gas
abnormality?
, A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
>CORRECT ANS>> C. Respiratory acidosis
>EXPLANATION>> COPD leads to hypoventilation and CO2 retention, causing
chronic respiratory acidosis.
11. The primary pathophysiologic change in myocardial infarction is:
A. Reversible ischemia of myocardial cells
B. Necrosis due to prolonged ischemia
C. Infection of the myocardium
D. Fibrosis without cell death
>CORRECT ANS>> B. Necrosis due to prolonged ischemia
>EXPLANATION>> MI occurs when coronary blood flow is blocked, leading to
irreversible necrosis of myocardial tissue.
12. Which hormone imbalance is most responsible for hyperthyroidism?
A. Excess TSH
B. Excess T3/T4
C. Low TSH
D. Low cortisol
>CORRECT ANS>> B. Excess T3/T4
>EXPLANATION>> Hyperthyroidism is caused by elevated thyroid hormones
(T3 and T4), which increase metabolic rate and sympathetic activity.
13. In cirrhosis, portal hypertension is primarily caused by:
A. Increased cardiac output
B. Fibrosis and vascular resistance in the liver
C. Dehydration
MIDTERM EXAM (2026/2027 SUMMER QUATER) |
QUESTIONS AND ANSWERS | VERIFIED ANSWERS
WITH RATIONALES | LATEST EXAM UPDATE
1. Which of the following best describes the pathophysiology of Type 1
Diabetes Mellitus?
A. Insulin resistance in peripheral tissues
B. Autoimmune destruction of pancreatic beta cells
C. Excess hepatic glucose production
D. Impaired insulin receptor function
>CORRECT ANS>> B. Autoimmune destruction of pancreatic beta cells
>EXPLANATION>> Type 1 diabetes is caused by autoimmune-mediated
destruction of pancreatic beta cells, leading to absolute insulin deficiency.
2. Which electrolyte imbalance is most commonly associated with chronic
kidney disease?
A. Hypokalemia
B. Hyperkalemia
C. Hypernatremia
D. Hypocalcemia
>CORRECT ANS>> B. Hyperkalemia
>EXPLANATION>> CKD reduces potassium excretion, leading to
hyperkalemia, which can cause cardiac arrhythmias.
3. A patient presents with severe diarrhea. Which acid-base disturbance
is most likely?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
,D. Respiratory alkalosis
>CORRECT ANS>> A. Metabolic acidosis
>EXPLANATION>> Loss of bicarbonate in diarrhea leads to metabolic
acidosis.
4. In heart failure, activation of the renin-angiotensin-aldosterone system
(RAAS) primarily causes:
A. Vasodilation and decreased blood pressure
B. Sodium and water retention
C. Increased diuresis
D. Bradycardia
>CORRECT ANS>> B. Sodium and water retention
>EXPLANATION>> RAAS activation increases sodium and water reabsorption
to maintain perfusion, which can worsen fluid overload in heart failure.
5. Which of the following best describes the pathophysiology of multiple
sclerosis?
A. Autoimmune destruction of myelin in the CNS
B. Degeneration of peripheral nerves
C. Accumulation of amyloid plaques in the brain
D. Inflammation of the neuromuscular junction
>CORRECT ANS>> A. Autoimmune destruction of myelin in the CNS
>EXPLANATION>> MS is an autoimmune demyelinating disorder affecting the
central nervous system, leading to conduction deficits.
6. Which condition is characterized by excessive cortisol secretion?
A. Addison’s disease
B. Cushing’s syndrome
C. Hypothyroidism
D. Pheochromocytoma
>CORRECT ANS>> B. Cushing’s syndrome
,>EXPLANATION>> Cushing’s syndrome results from chronic cortisol excess,
causing hyperglycaemia, hypertension, and central obesity.
7. What is the primary mechanism of tissue injury in hypovolemic shock?
A. Direct cytotoxicity
B. Decreased tissue perfusion leading to hypoxia
C. Autoimmune attack on organs
D. Overactivation of coagulation cascade
>CORRECT ANS>> B. Decreased tissue perfusion leading to hypoxia
>EXPLANATION>> Hypovolemic shock reduces circulating blood volume,
decreasing tissue oxygen delivery and causing cellular injury.
8. Which lab finding is consistent with iron-deficiency anemia?
A. High MCV and low ferritin
B. Low MCV and low ferritin
C. Normal MCV and high ferritin
D. Low MCV and high ferritin
>CORRECT ANS>> B. Low MCV and low ferritin
>EXPLANATION>> Iron-deficiency anaemia causes microcytic (low MCV),
hypochromic red cells with depleted iron stores (low ferritin).
9. Which pathogenetic mechanism underlies rheumatoid arthritis?
A. Autoimmune-mediated joint inflammation
B. Degeneration of articular cartilage due to wear and tear
C. Deposition of uric acid crystals
D. Infectious joint inflammation
>CORRECT ANS>> A. Autoimmune-mediated joint inflammation
>EXPLANATION>> RA involves autoimmune attack on synovial membranes,
leading to chronic joint inflammation and destruction.
10. A patient with COPD is most likely to have which blood gas
abnormality?
, A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
>CORRECT ANS>> C. Respiratory acidosis
>EXPLANATION>> COPD leads to hypoventilation and CO2 retention, causing
chronic respiratory acidosis.
11. The primary pathophysiologic change in myocardial infarction is:
A. Reversible ischemia of myocardial cells
B. Necrosis due to prolonged ischemia
C. Infection of the myocardium
D. Fibrosis without cell death
>CORRECT ANS>> B. Necrosis due to prolonged ischemia
>EXPLANATION>> MI occurs when coronary blood flow is blocked, leading to
irreversible necrosis of myocardial tissue.
12. Which hormone imbalance is most responsible for hyperthyroidism?
A. Excess TSH
B. Excess T3/T4
C. Low TSH
D. Low cortisol
>CORRECT ANS>> B. Excess T3/T4
>EXPLANATION>> Hyperthyroidism is caused by elevated thyroid hormones
(T3 and T4), which increase metabolic rate and sympathetic activity.
13. In cirrhosis, portal hypertension is primarily caused by:
A. Increased cardiac output
B. Fibrosis and vascular resistance in the liver
C. Dehydration
