UT Tyler FNP – NURS 5350 Advanced
Pathophysiology Practice Exam 1
Questions, Correct Answers, Detailed
Rationales Latest Version
Question 1
A 58-year-old man with long-standing hypertension develops left ventricular hypertrophy
(LVH). Which pathophysiologic mechanism initially causes myocardial hypertrophy?
A. Increased apoptosis of cardiac myocytes
B. Increased synthesis of contractile proteins in response to pressure overload
C. Fibrosis replacing damaged myocardium
D. Hyperplasia of cardiac muscle cells
Correct Answer: B
Rationale
Pressure overload caused by hypertension increases afterload. Cardiac myocytes respond by
enlarging (hypertrophy), increasing synthesis of sarcomeres and contractile proteins.
• A: Apoptosis contributes later to heart failure.
• B: Correct. Adult cardiac muscle adapts through hypertrophy rather than hyperplasia.
• C: Fibrosis occurs later with chronic remodeling.
• D: Adult cardiac myocytes cannot significantly divide.
Key Point: Adult myocardium adapts by hypertrophy, not hyperplasia.
Question 2
,Which cytokine is primarily responsible for stimulating hepatic production of C-reactive protein
(CRP) during the acute inflammatory response?
A. IL-2
B. IL-6
C. IL-10
D. Interferon-gamma
Correct Answer: B
Rationale
IL-6 stimulates hepatocytes to produce acute-phase proteins including CRP, fibrinogen, and
serum amyloid A.
• A: IL-2 stimulates T-cell proliferation.
• B: Correct.
• C: IL-10 is anti-inflammatory.
• D: IFN-γ activates macrophages.
Clinical Pearl: Elevated CRP reflects systemic inflammation but is nonspecific.
Question 3
A patient with chronic kidney disease develops normocytic normochromic anemia. Which
mechanism best explains this finding?
A. Iron deficiency
B. Folate deficiency
C. Decreased erythropoietin production
D. Increased hemolysis
Correct Answer: C
Rationale
The kidneys produce erythropoietin (EPO), which stimulates bone marrow erythropoiesis. CKD
reduces EPO production, resulting in anemia.
, • A: Produces microcytic anemia.
• B: Produces macrocytic anemia.
• C: Correct.
• D: Not the primary cause.
Key Point: CKD anemia is treated with erythropoiesis-stimulating agents after evaluating iron
status.
Question 4
Which receptor is primarily responsible for insulin-mediated glucose uptake into skeletal
muscle?
A. GLUT-1
B. GLUT-2
C. GLUT-4
D. GLUT-5
Correct Answer: C
Rationale
GLUT-4 is insulin dependent and found primarily in skeletal muscle and adipose tissue.
• A: Basal glucose uptake.
• B: Liver and pancreatic beta cells.
• C: Correct.
• D: Fructose transporter.
Clinical Pearl: Type 2 diabetes involves impaired GLUT-4 translocation due to insulin
resistance.
Question 5
A patient with septic shock develops widespread activation of coagulation pathways. Which
disorder is most likely occurring?
A. Hemophilia A
, B. Disseminated intravascular coagulation (DIC)
C. von Willebrand disease
D. Idiopathic thrombocytopenic purpura
Correct Answer: B
Rationale
Sepsis commonly triggers DIC through systemic tissue factor activation, causing microvascular
thrombosis and subsequent bleeding due to consumption of platelets and clotting factors.
• A: Factor VIII deficiency.
• B: Correct.
• C: Platelet adhesion defect.
• D: Autoimmune platelet destruction.
Classic Laboratory Findings
• Elevated PT/PTT
• Low fibrinogen
• Elevated D-dimer
• Thrombocytopenia
Question 6
Which electrolyte abnormality is expected in untreated primary hyperaldosteronism?
A. Hyperkalemia
B. Hyponatremia
C. Hypokalemia
D. Hypercalcemia
Correct Answer: C
Rationale
Excess aldosterone increases sodium reabsorption while promoting potassium and hydrogen ion
excretion.
Pathophysiology Practice Exam 1
Questions, Correct Answers, Detailed
Rationales Latest Version
Question 1
A 58-year-old man with long-standing hypertension develops left ventricular hypertrophy
(LVH). Which pathophysiologic mechanism initially causes myocardial hypertrophy?
A. Increased apoptosis of cardiac myocytes
B. Increased synthesis of contractile proteins in response to pressure overload
C. Fibrosis replacing damaged myocardium
D. Hyperplasia of cardiac muscle cells
Correct Answer: B
Rationale
Pressure overload caused by hypertension increases afterload. Cardiac myocytes respond by
enlarging (hypertrophy), increasing synthesis of sarcomeres and contractile proteins.
• A: Apoptosis contributes later to heart failure.
• B: Correct. Adult cardiac muscle adapts through hypertrophy rather than hyperplasia.
• C: Fibrosis occurs later with chronic remodeling.
• D: Adult cardiac myocytes cannot significantly divide.
Key Point: Adult myocardium adapts by hypertrophy, not hyperplasia.
Question 2
,Which cytokine is primarily responsible for stimulating hepatic production of C-reactive protein
(CRP) during the acute inflammatory response?
A. IL-2
B. IL-6
C. IL-10
D. Interferon-gamma
Correct Answer: B
Rationale
IL-6 stimulates hepatocytes to produce acute-phase proteins including CRP, fibrinogen, and
serum amyloid A.
• A: IL-2 stimulates T-cell proliferation.
• B: Correct.
• C: IL-10 is anti-inflammatory.
• D: IFN-γ activates macrophages.
Clinical Pearl: Elevated CRP reflects systemic inflammation but is nonspecific.
Question 3
A patient with chronic kidney disease develops normocytic normochromic anemia. Which
mechanism best explains this finding?
A. Iron deficiency
B. Folate deficiency
C. Decreased erythropoietin production
D. Increased hemolysis
Correct Answer: C
Rationale
The kidneys produce erythropoietin (EPO), which stimulates bone marrow erythropoiesis. CKD
reduces EPO production, resulting in anemia.
, • A: Produces microcytic anemia.
• B: Produces macrocytic anemia.
• C: Correct.
• D: Not the primary cause.
Key Point: CKD anemia is treated with erythropoiesis-stimulating agents after evaluating iron
status.
Question 4
Which receptor is primarily responsible for insulin-mediated glucose uptake into skeletal
muscle?
A. GLUT-1
B. GLUT-2
C. GLUT-4
D. GLUT-5
Correct Answer: C
Rationale
GLUT-4 is insulin dependent and found primarily in skeletal muscle and adipose tissue.
• A: Basal glucose uptake.
• B: Liver and pancreatic beta cells.
• C: Correct.
• D: Fructose transporter.
Clinical Pearl: Type 2 diabetes involves impaired GLUT-4 translocation due to insulin
resistance.
Question 5
A patient with septic shock develops widespread activation of coagulation pathways. Which
disorder is most likely occurring?
A. Hemophilia A
, B. Disseminated intravascular coagulation (DIC)
C. von Willebrand disease
D. Idiopathic thrombocytopenic purpura
Correct Answer: B
Rationale
Sepsis commonly triggers DIC through systemic tissue factor activation, causing microvascular
thrombosis and subsequent bleeding due to consumption of platelets and clotting factors.
• A: Factor VIII deficiency.
• B: Correct.
• C: Platelet adhesion defect.
• D: Autoimmune platelet destruction.
Classic Laboratory Findings
• Elevated PT/PTT
• Low fibrinogen
• Elevated D-dimer
• Thrombocytopenia
Question 6
Which electrolyte abnormality is expected in untreated primary hyperaldosteronism?
A. Hyperkalemia
B. Hyponatremia
C. Hypokalemia
D. Hypercalcemia
Correct Answer: C
Rationale
Excess aldosterone increases sodium reabsorption while promoting potassium and hydrogen ion
excretion.
