NURS65401 ADVANCED
PATHOPHYSIOLOGY FINAL EXAM
QUESTIONS AND ANSWERS
1. Which of the following describes the epigenetic mechanism where a methyl group is
attached to a cytosine base, typically leading to gene silencing?
A. Histone acetylation
B. DNA methylation
C. RNA interference
D. Chromatin remodeling
Answer: B
Conceptual Explanation: DNA methylation involves the addition of a methyl group to the
carbon-5 position of the cytosine pyrimidine ring, which generally reduces gene
expression.
2. In Type III hypersensitivity reactions, what is the primary cause of tissue damage?
A. Deposition of immune complexes in vessel walls
B. Direct T-cell mediated cytotoxicity
,C. IgE-mediated mast cell degranulation
D. Antibody-dependent cell-mediated cytotoxicity (ADCC)
Answer: A
Conceptual Explanation: Type III hypersensitivity is caused by the formation of antigen-
antibody (immune) complexes that deposit in tissues, activating complement and
attracting neutrophils.
3. A patient with severe COPD presents with a pH of 7.32, PaCO2 of 58 mmHg, and HCO3 of
30 mEq/L. Which acid-base imbalance is occurring?
A. Partially Compensated Respiratory Acidosis
B. Uncompensated Respiratory Acidosis
C. Compensated Metabolic Alkalosis
D. Partially Compensated Metabolic Acidosis
Answer: A
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is elevated (indicating the kidneys are attempting to compensate).
4. Angiotensin II contributes to the development of heart failure through which of the
following mechanisms?
A. Inducing vasodilation and reducing afterload
B. Promoting ventricular remodeling and hypertrophy
, C. Increasing sodium excretion in the distal tubule
D. Inhibiting the release of norepinephrine
Answer: B
Conceptual Explanation: Angiotensin II is a potent vasoconstrictor but also acts as a
growth factor that promotes pathological remodeling and fibrosis of the myocardium.
5. Which biomarker is most specific for myocardial injury in the setting of an acute coronary
syndrome?
A. Troponin I
B. Myoglobin
C. Creatine Kinase (CK-MB)
D. Lactate dehydrogenase (LDH)
Answer: A
Conceptual Explanation: Cardiac troponins (I and T) are highly specific to cardiac muscle
and remain the gold standard for diagnosing myocardial infarction.
6. What is the primary pathophysiology behind the development of pulmonary edema in left-
sided heart failure?
A. Increased pulmonary capillary oncotic pressure
B. Decreased pulmonary capillary hydrostatic pressure
C. Obstruction of lymphatic drainage in the lungs
PATHOPHYSIOLOGY FINAL EXAM
QUESTIONS AND ANSWERS
1. Which of the following describes the epigenetic mechanism where a methyl group is
attached to a cytosine base, typically leading to gene silencing?
A. Histone acetylation
B. DNA methylation
C. RNA interference
D. Chromatin remodeling
Answer: B
Conceptual Explanation: DNA methylation involves the addition of a methyl group to the
carbon-5 position of the cytosine pyrimidine ring, which generally reduces gene
expression.
2. In Type III hypersensitivity reactions, what is the primary cause of tissue damage?
A. Deposition of immune complexes in vessel walls
B. Direct T-cell mediated cytotoxicity
,C. IgE-mediated mast cell degranulation
D. Antibody-dependent cell-mediated cytotoxicity (ADCC)
Answer: A
Conceptual Explanation: Type III hypersensitivity is caused by the formation of antigen-
antibody (immune) complexes that deposit in tissues, activating complement and
attracting neutrophils.
3. A patient with severe COPD presents with a pH of 7.32, PaCO2 of 58 mmHg, and HCO3 of
30 mEq/L. Which acid-base imbalance is occurring?
A. Partially Compensated Respiratory Acidosis
B. Uncompensated Respiratory Acidosis
C. Compensated Metabolic Alkalosis
D. Partially Compensated Metabolic Acidosis
Answer: A
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is elevated (indicating the kidneys are attempting to compensate).
4. Angiotensin II contributes to the development of heart failure through which of the
following mechanisms?
A. Inducing vasodilation and reducing afterload
B. Promoting ventricular remodeling and hypertrophy
, C. Increasing sodium excretion in the distal tubule
D. Inhibiting the release of norepinephrine
Answer: B
Conceptual Explanation: Angiotensin II is a potent vasoconstrictor but also acts as a
growth factor that promotes pathological remodeling and fibrosis of the myocardium.
5. Which biomarker is most specific for myocardial injury in the setting of an acute coronary
syndrome?
A. Troponin I
B. Myoglobin
C. Creatine Kinase (CK-MB)
D. Lactate dehydrogenase (LDH)
Answer: A
Conceptual Explanation: Cardiac troponins (I and T) are highly specific to cardiac muscle
and remain the gold standard for diagnosing myocardial infarction.
6. What is the primary pathophysiology behind the development of pulmonary edema in left-
sided heart failure?
A. Increased pulmonary capillary oncotic pressure
B. Decreased pulmonary capillary hydrostatic pressure
C. Obstruction of lymphatic drainage in the lungs
