NUR 631/NUR631 Exam 2 V1 | Advanced
Physiology and Pathophysiology Q&A with
Rationale | Grand Canyon University
1. A patient is diagnosed with pernicious anemia. Which of the following is the primary
pathophysiological mechanism behind this condition?
A. Deficiency of intrinsic factor
B. Lack of dietary iron intake
C. Autoimmune destruction of platelets
D. Chronic blood loss from the GI tract
Correct Answer: A
Expert Explanation: Pernicious anemia is caused by a lack of intrinsic factor, which is
secreted by the parietal cells of the stomach. Intrinsic factor is essential for the absorption
of Vitamin B12 in the terminal ileum. This deficiency leads to macrocytic-normochromic
anemia and can cause significant neurological impairments if left untreated.
2. Which type of anemia is characterized by red blood cells that are microcytic and
hypochromic?
A. Aplastic anemia
B. Folate deficiency anemia
C. Iron deficiency anemia
,D. Pernicious anemia
Correct Answer: C
Expert Explanation: Iron deficiency anemia results in small, pale red blood cells because
iron is a necessary component for hemoglobin synthesis. When iron stores are depleted,
the body cannot produce enough hemoglobin to fill the RBCs properly. This condition is the
most common nutritional disorder worldwide and often results from chronic occult
bleeding.
3. In sickle cell anemia, what is the primary cause of the ‘sickling’ of red blood cells?
A. Exposure to high altitudes and alkalosis
B. Excessive intake of iron supplements
C. Deoxygenation and dehydration
D. Bacterial infection in the bone marrow
Correct Answer: C
Expert Explanation: Sickling occurs when hemoglobin S (HbS) polymerizes into long
chains upon deoxygenation or dehydration, distorting the cell shape. These rigid cells can
then clog small capillaries, leading to tissue ischemia and severe pain. The process is
initially reversible with reoxygenation, but repeated sickling eventually damages the cell
membrane permanently.
4. What is the hallmark diagnostic finding in a patient with Hodgkin Lymphoma?
A. Reed-Sternberg cells in the lymph nodes
, B. Philadelphia chromosome in the blood
C. Bence Jones proteins in the urine
D. Auer rods in the cytoplasm of blasts
Correct Answer: A
Expert Explanation: Reed-Sternberg cells are large, multinucleated B cells that are
characteristic of Hodgkin lymphoma. These cells release cytokines that attract a variety of
inflammatory cells to the tumor site. Their presence is essential for distinguishing Hodgkin
from non-Hodgkin lymphoma during histological examination.
5. A patient with Multiple Myeloma is likely to present with which of the following clinical
features?
A. Hypocalcemia and increased bone density
B. Profound leukocytosis with lymphadenopathy
C. Hypercalcemia and lytic bone lesions
D. Thrombocytosis and increased clotting risks
Correct Answer: C
Expert Explanation: Multiple Myeloma is a malignancy of plasma cells that infiltrate the
bone marrow and cause extensive skeletal destruction. The malignant cells produce
osteoclast-activating factors, which lead to hypercalcemia and the formation of ‘punched-
Physiology and Pathophysiology Q&A with
Rationale | Grand Canyon University
1. A patient is diagnosed with pernicious anemia. Which of the following is the primary
pathophysiological mechanism behind this condition?
A. Deficiency of intrinsic factor
B. Lack of dietary iron intake
C. Autoimmune destruction of platelets
D. Chronic blood loss from the GI tract
Correct Answer: A
Expert Explanation: Pernicious anemia is caused by a lack of intrinsic factor, which is
secreted by the parietal cells of the stomach. Intrinsic factor is essential for the absorption
of Vitamin B12 in the terminal ileum. This deficiency leads to macrocytic-normochromic
anemia and can cause significant neurological impairments if left untreated.
2. Which type of anemia is characterized by red blood cells that are microcytic and
hypochromic?
A. Aplastic anemia
B. Folate deficiency anemia
C. Iron deficiency anemia
,D. Pernicious anemia
Correct Answer: C
Expert Explanation: Iron deficiency anemia results in small, pale red blood cells because
iron is a necessary component for hemoglobin synthesis. When iron stores are depleted,
the body cannot produce enough hemoglobin to fill the RBCs properly. This condition is the
most common nutritional disorder worldwide and often results from chronic occult
bleeding.
3. In sickle cell anemia, what is the primary cause of the ‘sickling’ of red blood cells?
A. Exposure to high altitudes and alkalosis
B. Excessive intake of iron supplements
C. Deoxygenation and dehydration
D. Bacterial infection in the bone marrow
Correct Answer: C
Expert Explanation: Sickling occurs when hemoglobin S (HbS) polymerizes into long
chains upon deoxygenation or dehydration, distorting the cell shape. These rigid cells can
then clog small capillaries, leading to tissue ischemia and severe pain. The process is
initially reversible with reoxygenation, but repeated sickling eventually damages the cell
membrane permanently.
4. What is the hallmark diagnostic finding in a patient with Hodgkin Lymphoma?
A. Reed-Sternberg cells in the lymph nodes
, B. Philadelphia chromosome in the blood
C. Bence Jones proteins in the urine
D. Auer rods in the cytoplasm of blasts
Correct Answer: A
Expert Explanation: Reed-Sternberg cells are large, multinucleated B cells that are
characteristic of Hodgkin lymphoma. These cells release cytokines that attract a variety of
inflammatory cells to the tumor site. Their presence is essential for distinguishing Hodgkin
from non-Hodgkin lymphoma during histological examination.
5. A patient with Multiple Myeloma is likely to present with which of the following clinical
features?
A. Hypocalcemia and increased bone density
B. Profound leukocytosis with lymphadenopathy
C. Hypercalcemia and lytic bone lesions
D. Thrombocytosis and increased clotting risks
Correct Answer: C
Expert Explanation: Multiple Myeloma is a malignancy of plasma cells that infiltrate the
bone marrow and cause extensive skeletal destruction. The malignant cells produce
osteoclast-activating factors, which lead to hypercalcemia and the formation of ‘punched-
