NURS 5315 Final Exam V3 | NURS 5315
Advanced Pathophysiology | Actual Q&A
with Rationale (NURS5315 Final Exam) |
The University of Texas at Arlington
1. A patient is diagnosed with myocardial infarction. Which cellular process primarily drives
the transition from reversible to irreversible cell injury?
A. Decreased production of reactive oxygen species
B. Intracellular accumulation of potassium ions
C. Significant depletion of ATP leading to mitochondrial failure and membrane damage
D. Increased pH due to lactic acid accumulation
Answer: C
Rationale: Ischemic injury leads to a rapid decline in ATP production as the cell shifts to
anaerobic metabolism. The lack of ATP impairs the sodium-potassium pump, leading to
cellular swelling and the activation of proteolytic enzymes. Eventually, irreversible damage
occurs when mitochondrial membranes and the plasma membrane lose structural
integrity.
2. Which epigenetic mechanism is commonly associated with the silencing of tumor
suppressor genes in various cancers?
A. DNA hypermethylation in the promoter region
,B. Histone acetylation
C. Upregulation of transcription factors
D. Chromosomal translocation
Answer: A
Rationale: Epigenetic silencing involves chemical modifications to DNA without changing
the genetic sequence. Hypermethylation of CpG islands in the promoter region of tumor
suppressor genes effectively prevents gene transcription. This loss of tumor suppression
allows for unregulated cell growth and is a hallmark of many malignancies.
3. A patient presents with signs of systemic inflammation. Which cytokine is primarily
responsible for inducing the acute-phase response and fever in the hypothalamus?
A. Interleukin-10
B. Interleukin-1 (IL-1) and TNF-alpha
C. Transforming growth factor beta
D. Interferon gamma
Answer: B
Rationale: IL-1 and Tumor Necrosis Factor-alpha act as endogenous pyrogens by
stimulating the hypothalamus to increase the set-point temperature. They also stimulate
the liver to produce acute-phase reactants like C-reactive protein. These cytokines are
critical mediators of the systemic inflammatory response syndrome (SIRS).
, 4. Why do cancer cells often exhibit ‘immortality’ or the ability to divide indefinitely?
A. Continuous shortening of telomeres
B. Upregulation of the enzyme telomerase
C. Increased sensitivity to apoptotic signals
D. Arrest in the G1 phase of the cell cycle
Answer: B
Rationale: In normal somatic cells, telomeres shorten with each division until the cell
reaches senescence. Cancer cells often reactivate telomerase, an enzyme that maintains
telomere length and prevents chromosomal instability. This allows the malignant cells to
bypass normal replicative limits and achieve immortality.
5. Which pathophysiological finding is characteristic of Alzheimer’s disease in the central
nervous system?
A. Demyelination of peripheral nerves
B. Accumulation of amyloid-beta plaques and neurofibrillary tangles of tau protein
C. Depletion of dopamine in the substantia nigra
D. Hypertrophy of the cerebral cortex
Answer: B
Rationale: Alzheimer’s disease is characterized by the extracellular accumulation of
amyloid-beta peptides into plaques. Intracellularly, tau proteins become
Advanced Pathophysiology | Actual Q&A
with Rationale (NURS5315 Final Exam) |
The University of Texas at Arlington
1. A patient is diagnosed with myocardial infarction. Which cellular process primarily drives
the transition from reversible to irreversible cell injury?
A. Decreased production of reactive oxygen species
B. Intracellular accumulation of potassium ions
C. Significant depletion of ATP leading to mitochondrial failure and membrane damage
D. Increased pH due to lactic acid accumulation
Answer: C
Rationale: Ischemic injury leads to a rapid decline in ATP production as the cell shifts to
anaerobic metabolism. The lack of ATP impairs the sodium-potassium pump, leading to
cellular swelling and the activation of proteolytic enzymes. Eventually, irreversible damage
occurs when mitochondrial membranes and the plasma membrane lose structural
integrity.
2. Which epigenetic mechanism is commonly associated with the silencing of tumor
suppressor genes in various cancers?
A. DNA hypermethylation in the promoter region
,B. Histone acetylation
C. Upregulation of transcription factors
D. Chromosomal translocation
Answer: A
Rationale: Epigenetic silencing involves chemical modifications to DNA without changing
the genetic sequence. Hypermethylation of CpG islands in the promoter region of tumor
suppressor genes effectively prevents gene transcription. This loss of tumor suppression
allows for unregulated cell growth and is a hallmark of many malignancies.
3. A patient presents with signs of systemic inflammation. Which cytokine is primarily
responsible for inducing the acute-phase response and fever in the hypothalamus?
A. Interleukin-10
B. Interleukin-1 (IL-1) and TNF-alpha
C. Transforming growth factor beta
D. Interferon gamma
Answer: B
Rationale: IL-1 and Tumor Necrosis Factor-alpha act as endogenous pyrogens by
stimulating the hypothalamus to increase the set-point temperature. They also stimulate
the liver to produce acute-phase reactants like C-reactive protein. These cytokines are
critical mediators of the systemic inflammatory response syndrome (SIRS).
, 4. Why do cancer cells often exhibit ‘immortality’ or the ability to divide indefinitely?
A. Continuous shortening of telomeres
B. Upregulation of the enzyme telomerase
C. Increased sensitivity to apoptotic signals
D. Arrest in the G1 phase of the cell cycle
Answer: B
Rationale: In normal somatic cells, telomeres shorten with each division until the cell
reaches senescence. Cancer cells often reactivate telomerase, an enzyme that maintains
telomere length and prevents chromosomal instability. This allows the malignant cells to
bypass normal replicative limits and achieve immortality.
5. Which pathophysiological finding is characteristic of Alzheimer’s disease in the central
nervous system?
A. Demyelination of peripheral nerves
B. Accumulation of amyloid-beta plaques and neurofibrillary tangles of tau protein
C. Depletion of dopamine in the substantia nigra
D. Hypertrophy of the cerebral cortex
Answer: B
Rationale: Alzheimer’s disease is characterized by the extracellular accumulation of
amyloid-beta peptides into plaques. Intracellularly, tau proteins become
