NUR 546/NUR546 Exam 2 V1 | Advanced
Pathophysiology Q&A with Rationale |
William Paterson University
1. A patient with Grave’s disease is likely to have which of the following pathophysiological
findings?
A. Decreased thyroid-stimulating immunoglobulins
B. Autoimmune destruction of the thyroid follicles
C. High levels of TSH with low levels of T4
D. Thyroid-stimulating antibodies binding to TSH receptors
Answer: D
Rationale: Graves disease is an autoimmune disorder where the body produces antibodies
that mimic TSH. These thyroid-stimulating immunoglobulins bind to TSH receptors on the
thyroid gland, causing excessive production of T3 and T4. This leads to the characteristic
hypermetabolic state and potential exophthalmos seen in patients.
2. Which of the following describes the pathophysiology of Type 1 Diabetes Mellitus?
A. Autoimmune destruction of pancreatic beta cells
B. Insulin resistance in peripheral tissues
C. Overproduction of glucagon by alpha cells
D. Decreased glucose absorption in the GI tract
,Answer: A
Rationale: Type 1 Diabetes Mellitus is characterized by an absolute insulin deficiency due
to the destruction of beta cells in the islets of Langerhans. This process is typically
mediated by a T-cell-directed autoimmune attack against beta-cell antigens. Without
insulin, glucose cannot enter cells, leading to hyperglycemia and metabolic derangements
such as ketosis.
3. A patient presents with ‘moon face’, ‘buffalo hump’, and central obesity. What is the most
likely underlying cause?
A. Deficiency of aldosterone
B. Excessive secretion of cortisol
C. Hypersecretion of catecholamines
D. Inadequate levels of growth hormone
Answer: B
Rationale: These clinical features are classic signs of Cushing’s syndrome, which results
from chronic exposure to excessive levels of cortisol. The redistribution of adipose tissue
leads to the characteristic truncal obesity and facial rounding. Additionally, patients may
experience skin thinning, easy bruising, and glucose intolerance.
4. In the context of Acute Kidney Injury (AKI), which condition would be classified as
prerenal?
A. Hypovolemia due to severe hemorrhage
, B. Obstruction of the ureters by a stone
C. Acute tubular necrosis from contrast dye
D. Glomerulonephritis following a strep infection
Answer: A
Rationale: Prerenal AKI occurs when there is a significant reduction in blood flow to the
kidneys without direct damage to the renal parenchyma. Hypovolemia from hemorrhage
reduces renal perfusion pressure, leading to a drop in the glomerular filtration rate. If the
underlying cause of decreased perfusion is corrected quickly, the kidney function often
returns to baseline.
5. What is the hallmark physiological finding in Nephrotic Syndrome?
A. Gross hematuria and hypertension
B. Excretion of more than 3.5 grams of protein in the urine per day
C. Elevated white blood cell count in urine
D. Painful urination and flank pain
Answer: B
Rationale: Nephrotic syndrome involves damage to the glomerular filtration barrier,
allowing large amounts of protein to leak into the urine. This massive proteinuria leads to
hypoalbuminemia, which reduces plasma oncotic pressure and causes systemic edema. It is
distinguished from nephritic syndrome, which is more focused on inflammation and blood
in the urine.
Pathophysiology Q&A with Rationale |
William Paterson University
1. A patient with Grave’s disease is likely to have which of the following pathophysiological
findings?
A. Decreased thyroid-stimulating immunoglobulins
B. Autoimmune destruction of the thyroid follicles
C. High levels of TSH with low levels of T4
D. Thyroid-stimulating antibodies binding to TSH receptors
Answer: D
Rationale: Graves disease is an autoimmune disorder where the body produces antibodies
that mimic TSH. These thyroid-stimulating immunoglobulins bind to TSH receptors on the
thyroid gland, causing excessive production of T3 and T4. This leads to the characteristic
hypermetabolic state and potential exophthalmos seen in patients.
2. Which of the following describes the pathophysiology of Type 1 Diabetes Mellitus?
A. Autoimmune destruction of pancreatic beta cells
B. Insulin resistance in peripheral tissues
C. Overproduction of glucagon by alpha cells
D. Decreased glucose absorption in the GI tract
,Answer: A
Rationale: Type 1 Diabetes Mellitus is characterized by an absolute insulin deficiency due
to the destruction of beta cells in the islets of Langerhans. This process is typically
mediated by a T-cell-directed autoimmune attack against beta-cell antigens. Without
insulin, glucose cannot enter cells, leading to hyperglycemia and metabolic derangements
such as ketosis.
3. A patient presents with ‘moon face’, ‘buffalo hump’, and central obesity. What is the most
likely underlying cause?
A. Deficiency of aldosterone
B. Excessive secretion of cortisol
C. Hypersecretion of catecholamines
D. Inadequate levels of growth hormone
Answer: B
Rationale: These clinical features are classic signs of Cushing’s syndrome, which results
from chronic exposure to excessive levels of cortisol. The redistribution of adipose tissue
leads to the characteristic truncal obesity and facial rounding. Additionally, patients may
experience skin thinning, easy bruising, and glucose intolerance.
4. In the context of Acute Kidney Injury (AKI), which condition would be classified as
prerenal?
A. Hypovolemia due to severe hemorrhage
, B. Obstruction of the ureters by a stone
C. Acute tubular necrosis from contrast dye
D. Glomerulonephritis following a strep infection
Answer: A
Rationale: Prerenal AKI occurs when there is a significant reduction in blood flow to the
kidneys without direct damage to the renal parenchyma. Hypovolemia from hemorrhage
reduces renal perfusion pressure, leading to a drop in the glomerular filtration rate. If the
underlying cause of decreased perfusion is corrected quickly, the kidney function often
returns to baseline.
5. What is the hallmark physiological finding in Nephrotic Syndrome?
A. Gross hematuria and hypertension
B. Excretion of more than 3.5 grams of protein in the urine per day
C. Elevated white blood cell count in urine
D. Painful urination and flank pain
Answer: B
Rationale: Nephrotic syndrome involves damage to the glomerular filtration barrier,
allowing large amounts of protein to leak into the urine. This massive proteinuria leads to
hypoalbuminemia, which reduces plasma oncotic pressure and causes systemic edema. It is
distinguished from nephritic syndrome, which is more focused on inflammation and blood
in the urine.
