HSC 4558 Exam 2 V1 | HSC 4558 Pathophysiology II | Actual Q&A with
Rationale (HSC4558 Exam 2) | University of Central Florida
1. A patient presents with a serum sodium of 120 mEq/L and high urine osmolality. Which
condition is most consistent with these findings?
A. Diabetes Insipidus
B. Conn Syndrome
C. Addison Disease
D. SIADH
Answer: D
Explanation: SIADH involves the excessive secretion of antidiuretic hormone leading to
water retention. This physiological process results in dilutional hyponatremia and
concentrated urine despite fluid volume expansion. It is often associated with ectopic
hormone production from tumors or central nervous system disorders.
2. Which clinical manifestation is a hallmark sign of Grave’s disease?
A. Cold intolerance
B. Weight gain
C. Bradycardia
D. Exophthalmos
Answer: D
Explanation: Graves’ disease is an autoimmune disorder characterized by the production
of thyroid-stimulating immunoglobulins. These antibodies cause hyperthyroidism and
inflammatory changes in the retro-orbital tissues leading to protrusion of the eyes. This
specific ocular symptom distinguishes it from other forms of hyperthyroidism.
3. In the context of chronic kidney disease, why does anemia typically develop?
A. Iron deficiency from diet
B. Decreased erythropoietin production
C. Increased destruction of leukocytes
D. Vitamin B12 malabsorption
Answer: B
,Explanation: The kidneys are the primary site for the synthesis of erythropoietin, which
stimulates red blood cell production in the bone marrow. As renal function declines in
chronic kidney disease, the production of this hormone significantly decreases.
Consequently, the patient develops a normocytic, normochromic anemia due to reduced
marrow stimulation.
4. A patient with Type 1 Diabetes Mellitus presents with Kussmaul respirations and fruity
breath. What is the primary cause of these symptoms?
A. Lactic acidosis
B. Respiratory alkalosis
C. Hypoglycemic shock
D. Metabolic acidosis due to ketosis
Answer: D
Explanation: Diabetic ketoacidosis occurs when an absolute lack of insulin forces the body
to metabolize fats for energy, producing acidic ketone bodies. The accumulation of these
ketones leads to a decrease in serum pH, triggering respiratory compensation via deep,
rapid breaths. This compensatory mechanism aims to expel carbon dioxide and mitigate
the acid-base imbalance.
5. What is the pathophysiological mechanism behind the development of ascites in liver
cirrhosis?
A. Portal hypertension and hypoalbuminemia
B. Increased serum albumin
C. Decreased capillary permeability
D. Reduced renin secretion
Answer: A
Explanation: Liver cirrhosis leads to structural changes that increase resistance to blood
flow in the portal vein, causing hypertension. Simultaneously, the failing liver produces less
albumin, which reduces the colloid osmotic pressure in the blood vessels. This combination
promotes the leakage of fluid into the peritoneal cavity, manifesting as ascites.
6. Which of the following is characteristic of Cushing syndrome?
A. Moon face and truncal obesity
B. Hyperkalemia
C. Hypoglycemia
D. Hypotension
, Answer: A
Explanation: Cushing syndrome results from prolonged exposure to high levels of
glucocorticoids, most notably cortisol. This hormone excess causes a redistribution of
adipose tissue to the face, neck, and trunk while wasting peripheral muscles. The metabolic
changes also commonly lead to hyperglycemia and secondary hypertension.
7. What is the most common cause of acute pyelonephritis?
A. Ascending urinary tract infection
B. Viral infection
C. Glomerular damage
D. Autoimmune response
Answer: A
Explanation: Acute pyelonephritis is a bacterial infection of the renal pelvis and kidney
interstitium. Most cases result from microorganisms, particularly E. coli, ascending from
the lower urinary tract via the ureters. Clinical signs include fever, chills, and significant
costovertebral angle tenderness.
8. A patient is diagnosed with Hashimoto thyroiditis. What would you expect to see on their
lab report?
A. High T3 and T4 levels
B. Low TSH levels
C. High TSH and low T4 levels
D. Increased radioactive iodine uptake
Answer: C
Explanation: Hashimoto thyroiditis is an autoimmune condition where antibodies attack
the thyroid gland, leading to primary hypothyroidism. As the thyroid fails to produce
adequate T4, the pituitary gland increases TSH secretion through the negative feedback
loop. This endocrine imbalance results in a characteristic pattern of elevated TSH and
depressed thyroid hormone levels.
9. Which hormone deficiency is responsible for Diabetes Insipidus?
A. Antidiuretic Hormone (ADH)
B. Aldosterone
C. Insulin
D. Oxytocin
Answer: A
Rationale (HSC4558 Exam 2) | University of Central Florida
1. A patient presents with a serum sodium of 120 mEq/L and high urine osmolality. Which
condition is most consistent with these findings?
A. Diabetes Insipidus
B. Conn Syndrome
C. Addison Disease
D. SIADH
Answer: D
Explanation: SIADH involves the excessive secretion of antidiuretic hormone leading to
water retention. This physiological process results in dilutional hyponatremia and
concentrated urine despite fluid volume expansion. It is often associated with ectopic
hormone production from tumors or central nervous system disorders.
2. Which clinical manifestation is a hallmark sign of Grave’s disease?
A. Cold intolerance
B. Weight gain
C. Bradycardia
D. Exophthalmos
Answer: D
Explanation: Graves’ disease is an autoimmune disorder characterized by the production
of thyroid-stimulating immunoglobulins. These antibodies cause hyperthyroidism and
inflammatory changes in the retro-orbital tissues leading to protrusion of the eyes. This
specific ocular symptom distinguishes it from other forms of hyperthyroidism.
3. In the context of chronic kidney disease, why does anemia typically develop?
A. Iron deficiency from diet
B. Decreased erythropoietin production
C. Increased destruction of leukocytes
D. Vitamin B12 malabsorption
Answer: B
,Explanation: The kidneys are the primary site for the synthesis of erythropoietin, which
stimulates red blood cell production in the bone marrow. As renal function declines in
chronic kidney disease, the production of this hormone significantly decreases.
Consequently, the patient develops a normocytic, normochromic anemia due to reduced
marrow stimulation.
4. A patient with Type 1 Diabetes Mellitus presents with Kussmaul respirations and fruity
breath. What is the primary cause of these symptoms?
A. Lactic acidosis
B. Respiratory alkalosis
C. Hypoglycemic shock
D. Metabolic acidosis due to ketosis
Answer: D
Explanation: Diabetic ketoacidosis occurs when an absolute lack of insulin forces the body
to metabolize fats for energy, producing acidic ketone bodies. The accumulation of these
ketones leads to a decrease in serum pH, triggering respiratory compensation via deep,
rapid breaths. This compensatory mechanism aims to expel carbon dioxide and mitigate
the acid-base imbalance.
5. What is the pathophysiological mechanism behind the development of ascites in liver
cirrhosis?
A. Portal hypertension and hypoalbuminemia
B. Increased serum albumin
C. Decreased capillary permeability
D. Reduced renin secretion
Answer: A
Explanation: Liver cirrhosis leads to structural changes that increase resistance to blood
flow in the portal vein, causing hypertension. Simultaneously, the failing liver produces less
albumin, which reduces the colloid osmotic pressure in the blood vessels. This combination
promotes the leakage of fluid into the peritoneal cavity, manifesting as ascites.
6. Which of the following is characteristic of Cushing syndrome?
A. Moon face and truncal obesity
B. Hyperkalemia
C. Hypoglycemia
D. Hypotension
, Answer: A
Explanation: Cushing syndrome results from prolonged exposure to high levels of
glucocorticoids, most notably cortisol. This hormone excess causes a redistribution of
adipose tissue to the face, neck, and trunk while wasting peripheral muscles. The metabolic
changes also commonly lead to hyperglycemia and secondary hypertension.
7. What is the most common cause of acute pyelonephritis?
A. Ascending urinary tract infection
B. Viral infection
C. Glomerular damage
D. Autoimmune response
Answer: A
Explanation: Acute pyelonephritis is a bacterial infection of the renal pelvis and kidney
interstitium. Most cases result from microorganisms, particularly E. coli, ascending from
the lower urinary tract via the ureters. Clinical signs include fever, chills, and significant
costovertebral angle tenderness.
8. A patient is diagnosed with Hashimoto thyroiditis. What would you expect to see on their
lab report?
A. High T3 and T4 levels
B. Low TSH levels
C. High TSH and low T4 levels
D. Increased radioactive iodine uptake
Answer: C
Explanation: Hashimoto thyroiditis is an autoimmune condition where antibodies attack
the thyroid gland, leading to primary hypothyroidism. As the thyroid fails to produce
adequate T4, the pituitary gland increases TSH secretion through the negative feedback
loop. This endocrine imbalance results in a characteristic pattern of elevated TSH and
depressed thyroid hormone levels.
9. Which hormone deficiency is responsible for Diabetes Insipidus?
A. Antidiuretic Hormone (ADH)
B. Aldosterone
C. Insulin
D. Oxytocin
Answer: A
