NSG 1520 PATHOPHYSIOLOGY EXAM 3
- COMPREHENSIVE REVIEW
QUESTIONS AND ANSWERS
1. A patient presents with a fruity odor to their breath, Kussmaul respirations, and a blood
glucose level of 450 mg/dL. Which pathophysiological mechanism explains the acid-base
imbalance in this patient?
A. Excessive bicarbonate loss through the kidneys
B. Accumulation of ketone bodies from fatty acid oxidation
C. Increased production of lactic acid due to anaerobic metabolism
D. Retention of carbon dioxide due to hypoventilation
Answer: B
Conceptual Explanation: In Diabetic Ketoacidosis (DKA), a profound lack of insulin leads
the body to break down fats for energy, producing acidic ketone bodies (acetoacetate and
beta-hydroxybutyrate), leading to metabolic acidosis.
,2. In the development of Graves’ disease, what is the primary underlying mechanism of
hyperthyroidism?
A. Destruction of thyroid follicular cells by T-cells
B. Pituitary adenoma secreting excessive TSH
C. Production of antibodies that mimic Thyroid Stimulating Hormone (TSH)
D. Iodine deficiency leading to thyroid hyperplasia
Answer: C
Conceptual Explanation: Graves’ disease is an autoimmune disorder where Type II
hypersensitivity leads to the production of Thyroid-Stimulating Immunoglobulins (TSI)
that bind to and activate TSH receptors, causing excess thyroid hormone release.
3. Which of the following findings is most characteristic of a patient in the oliguric phase of
Acute Kidney Injury (AKI)?
A. Hypernatremia and hypokalemia
B. Metabolic alkalosis and hypovolemia
C. Decreased BUN and dilute urine
D. Increased serum creatinine and hyperkalemia
Answer: D
, Conceptual Explanation: During the oliguric phase, the GFR decreases significantly,
leading to the retention of nitrogenous wastes (increased BUN/Creatinine) and potassium,
as the kidneys cannot effectively excrete them.
4. A patient with chronic cirrhosis develops portal hypertension. Which complication is
directly related to the redirection of blood flow through collateral veins?
A. Asterixis
B. Hepatic encephalopathy
C. Hypoalbuminemia
D. Esophageal varices
Answer: D
Conceptual Explanation: Portal hypertension causes blood to back up into the systemic
circulation through collateral vessels, leading to enlarged, fragile veins in the esophagus
known as esophageal varices.
5. Cushing’s Syndrome is characterized by an excess of cortisol. Which clinical manifestation is
a result of cortisol’s effect on adipose tissue distribution?
A. Hyperpigmentation of the skin
B. Muscle wasting in the abdomen
C. Thinning of the hair on the scalp
D. Centripetal (truncal) obesity
- COMPREHENSIVE REVIEW
QUESTIONS AND ANSWERS
1. A patient presents with a fruity odor to their breath, Kussmaul respirations, and a blood
glucose level of 450 mg/dL. Which pathophysiological mechanism explains the acid-base
imbalance in this patient?
A. Excessive bicarbonate loss through the kidneys
B. Accumulation of ketone bodies from fatty acid oxidation
C. Increased production of lactic acid due to anaerobic metabolism
D. Retention of carbon dioxide due to hypoventilation
Answer: B
Conceptual Explanation: In Diabetic Ketoacidosis (DKA), a profound lack of insulin leads
the body to break down fats for energy, producing acidic ketone bodies (acetoacetate and
beta-hydroxybutyrate), leading to metabolic acidosis.
,2. In the development of Graves’ disease, what is the primary underlying mechanism of
hyperthyroidism?
A. Destruction of thyroid follicular cells by T-cells
B. Pituitary adenoma secreting excessive TSH
C. Production of antibodies that mimic Thyroid Stimulating Hormone (TSH)
D. Iodine deficiency leading to thyroid hyperplasia
Answer: C
Conceptual Explanation: Graves’ disease is an autoimmune disorder where Type II
hypersensitivity leads to the production of Thyroid-Stimulating Immunoglobulins (TSI)
that bind to and activate TSH receptors, causing excess thyroid hormone release.
3. Which of the following findings is most characteristic of a patient in the oliguric phase of
Acute Kidney Injury (AKI)?
A. Hypernatremia and hypokalemia
B. Metabolic alkalosis and hypovolemia
C. Decreased BUN and dilute urine
D. Increased serum creatinine and hyperkalemia
Answer: D
, Conceptual Explanation: During the oliguric phase, the GFR decreases significantly,
leading to the retention of nitrogenous wastes (increased BUN/Creatinine) and potassium,
as the kidneys cannot effectively excrete them.
4. A patient with chronic cirrhosis develops portal hypertension. Which complication is
directly related to the redirection of blood flow through collateral veins?
A. Asterixis
B. Hepatic encephalopathy
C. Hypoalbuminemia
D. Esophageal varices
Answer: D
Conceptual Explanation: Portal hypertension causes blood to back up into the systemic
circulation through collateral vessels, leading to enlarged, fragile veins in the esophagus
known as esophageal varices.
5. Cushing’s Syndrome is characterized by an excess of cortisol. Which clinical manifestation is
a result of cortisol’s effect on adipose tissue distribution?
A. Hyperpigmentation of the skin
B. Muscle wasting in the abdomen
C. Thinning of the hair on the scalp
D. Centripetal (truncal) obesity
