NSG 5140 WEEK 10 FINAL EXAM:
ADVANCED PATHOPHYSIOLOGY
QUESTIONS AND ANSWERS
1. Which compensatory mechanism is primarily responsible for the hypertrophy of the left
ventricle in a patient with chronic systemic hypertension?
A. Increased preload through venous return
B. Decreased myocardial oxygen demand
C. Increased afterload causing mechanical stress
D. Parasympathetic nervous system stimulation
Answer: C
Conceptual Explanation: Chronic hypertension increases systemic vascular resistance,
which is the afterload the left ventricle must pump against. This mechanical stress leads to
adaptive hypertrophy of the cardiac muscle.
2. In the context of the Renin-Angiotensin-Aldosterone System (RAAS), what is the direct
effect of Angiotensin II on the vascular system?
A. Systemic vasodilation
,B. Potent vasoconstriction
C. Inhibition of ADH secretion
D. Increased potassium excretion in the distal tubule
Answer: B
Conceptual Explanation: Angiotensin II is a potent vasoconstrictor that acts directly on
arterial smooth muscle to increase blood pressure.
3. Which type of hypersensitivity reaction is characterized by the formation of immune
complexes that deposit in vessel walls or extravascular tissues?
A. Type III (Immune Complex)
B. Type II (Cytotoxic)
C. Type I (IgE-mediated)
D. Type IV (Cell-mediated)
Answer: A
Conceptual Explanation: Type III hypersensitivity involves the deposition of antigen-
antibody complexes in tissues, leading to complement activation and inflammatory
response.
4. A patient presents with a plasma pH of 7.25, PaCO2 of 55 mmHg, and HCO3 of 26 mEq/L.
Which acid-base imbalance is occurring?
A. Metabolic Acidosis
, B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
Answer: D
Conceptual Explanation: The pH is acidic (<7.35) and the PaCO2 is elevated (>45 mmHg),
indicating that the primary cause of the acidosis is respiratory retention of CO2.
5. What is the primary underlying cause of the development of Multiple Sclerosis (MS)?
A. Autoimmune-mediated demyelination of the central nervous system
B. Degeneration of the dopamine-producing neurons in the substantia nigra
C. Excessive accumulation of amyloid-beta plaques
D. Deficiency of acetylcholine at the neuromuscular junction
Answer: A
Conceptual Explanation: Multiple Sclerosis is an autoimmune disease where the body’s
immune system attacks the myelin sheath surrounding nerve fibers in the brain and spinal
cord.
6. In Diabetic Ketoacidosis (DKA), why do the lungs initiate Kussmaul respirations?
A. To reduce carbon dioxide levels and increase pH
B. To compensate for metabolic alkalosis
ADVANCED PATHOPHYSIOLOGY
QUESTIONS AND ANSWERS
1. Which compensatory mechanism is primarily responsible for the hypertrophy of the left
ventricle in a patient with chronic systemic hypertension?
A. Increased preload through venous return
B. Decreased myocardial oxygen demand
C. Increased afterload causing mechanical stress
D. Parasympathetic nervous system stimulation
Answer: C
Conceptual Explanation: Chronic hypertension increases systemic vascular resistance,
which is the afterload the left ventricle must pump against. This mechanical stress leads to
adaptive hypertrophy of the cardiac muscle.
2. In the context of the Renin-Angiotensin-Aldosterone System (RAAS), what is the direct
effect of Angiotensin II on the vascular system?
A. Systemic vasodilation
,B. Potent vasoconstriction
C. Inhibition of ADH secretion
D. Increased potassium excretion in the distal tubule
Answer: B
Conceptual Explanation: Angiotensin II is a potent vasoconstrictor that acts directly on
arterial smooth muscle to increase blood pressure.
3. Which type of hypersensitivity reaction is characterized by the formation of immune
complexes that deposit in vessel walls or extravascular tissues?
A. Type III (Immune Complex)
B. Type II (Cytotoxic)
C. Type I (IgE-mediated)
D. Type IV (Cell-mediated)
Answer: A
Conceptual Explanation: Type III hypersensitivity involves the deposition of antigen-
antibody complexes in tissues, leading to complement activation and inflammatory
response.
4. A patient presents with a plasma pH of 7.25, PaCO2 of 55 mmHg, and HCO3 of 26 mEq/L.
Which acid-base imbalance is occurring?
A. Metabolic Acidosis
, B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
Answer: D
Conceptual Explanation: The pH is acidic (<7.35) and the PaCO2 is elevated (>45 mmHg),
indicating that the primary cause of the acidosis is respiratory retention of CO2.
5. What is the primary underlying cause of the development of Multiple Sclerosis (MS)?
A. Autoimmune-mediated demyelination of the central nervous system
B. Degeneration of the dopamine-producing neurons in the substantia nigra
C. Excessive accumulation of amyloid-beta plaques
D. Deficiency of acetylcholine at the neuromuscular junction
Answer: A
Conceptual Explanation: Multiple Sclerosis is an autoimmune disease where the body’s
immune system attacks the myelin sheath surrounding nerve fibers in the brain and spinal
cord.
6. In Diabetic Ketoacidosis (DKA), why do the lungs initiate Kussmaul respirations?
A. To reduce carbon dioxide levels and increase pH
B. To compensate for metabolic alkalosis
