NSG 530 ADVANCED
PATHOPHYSIOLOGY - EXAM 4
COMPREHENSIVE ASSESSMENT
QUESTIONS AND VERIFIED ANSWERS |
100% CORRECT | GRADE A+ - WILKES
1. A patient presents with fasting hypoglycemia despite high insulin levels and low C-peptide
levels. What is the most likely cause of this presentation?
A. Insulinoma (beta cell tumor)
B. Exogenous insulin administration
C. Sulfonylurea overdose
D. Somogyi effect
Answer: B
Conceptual Explanation: C-peptide is a byproduct of endogenous insulin production. High
insulin with low C-peptide indicates that the insulin is originating from an external source
(exogenous). An insulinoma would result in high C-peptide levels.
2. Which mechanism best describes the development of the Somogyi effect in a patient with
Type 1 Diabetes?
A. Hypoglycemia-induced counter-regulatory hormone release causing rebound
hyperglycemia
,B. Early morning surge of growth hormone and cortisol
C. Decreased peripheral insulin sensitivity due to nocturnal cytokine release
D. Excessive glucagon secretion due to pancreatic alpha-cell hypertrophy
Answer: A
Conceptual Explanation: The Somogyi effect occurs when nocturnal hypoglycemia
triggers the release of counter-regulatory hormones (epinephrine, cortisol, GH, glucagon),
leading to hyperglycemia by morning.
3. A patient with syndrome of inappropriate antidiuretic hormone (SIADH) is at risk for which
electrolyte imbalance?
A. Hypernatremia due to water loss
B. Hypokalemia due to renal excretion
C. Dilutional hyponatremia
D. Hypercalcemia due to bone resorption
Answer: C
Conceptual Explanation: SIADH involves excessive ADH, which causes the kidneys to
reabsorb too much water, diluting the serum sodium and causing hyponatremia.
4. In the pathophysiology of Diabetes Insipidus (DI), what is the primary cause of polyuria?
A. Osmotic diuresis from hyperglycemia
B. Increased glomerular filtration rate
, C. Insufficient ADH production or renal resistance to ADH
D. Failure of the loop of Henle to concentrate urea
Answer: C
Conceptual Explanation: DI is characterized by a deficiency of ADH (neurogenic) or a lack
of response to it (nephrogenic), preventing the collecting ducts from reabsorbing water.
5. Which finding is characteristic of Graves’ disease but not other forms of hyperthyroidism?
A. Tachycardia and palpitations
B. Exophthalmos (pretibial myxedema)
C. Increased basal metabolic rate
D. Heat intolerance
Answer: B
Conceptual Explanation: Exophthalmos is caused by autoimmune-mediated inflammation
of the extraocular muscles and orbital fat, which is specific to the autoimmune nature of
Graves’ disease.
6. What is the primary pathophysiological defect in Hashimoto thyroiditis?
A. Iodine deficiency leading to goiter
B. Excessive production of Reverse T3
C. Pituitary failure to produce Thyroid Stimulating Hormone (TSH)
PATHOPHYSIOLOGY - EXAM 4
COMPREHENSIVE ASSESSMENT
QUESTIONS AND VERIFIED ANSWERS |
100% CORRECT | GRADE A+ - WILKES
1. A patient presents with fasting hypoglycemia despite high insulin levels and low C-peptide
levels. What is the most likely cause of this presentation?
A. Insulinoma (beta cell tumor)
B. Exogenous insulin administration
C. Sulfonylurea overdose
D. Somogyi effect
Answer: B
Conceptual Explanation: C-peptide is a byproduct of endogenous insulin production. High
insulin with low C-peptide indicates that the insulin is originating from an external source
(exogenous). An insulinoma would result in high C-peptide levels.
2. Which mechanism best describes the development of the Somogyi effect in a patient with
Type 1 Diabetes?
A. Hypoglycemia-induced counter-regulatory hormone release causing rebound
hyperglycemia
,B. Early morning surge of growth hormone and cortisol
C. Decreased peripheral insulin sensitivity due to nocturnal cytokine release
D. Excessive glucagon secretion due to pancreatic alpha-cell hypertrophy
Answer: A
Conceptual Explanation: The Somogyi effect occurs when nocturnal hypoglycemia
triggers the release of counter-regulatory hormones (epinephrine, cortisol, GH, glucagon),
leading to hyperglycemia by morning.
3. A patient with syndrome of inappropriate antidiuretic hormone (SIADH) is at risk for which
electrolyte imbalance?
A. Hypernatremia due to water loss
B. Hypokalemia due to renal excretion
C. Dilutional hyponatremia
D. Hypercalcemia due to bone resorption
Answer: C
Conceptual Explanation: SIADH involves excessive ADH, which causes the kidneys to
reabsorb too much water, diluting the serum sodium and causing hyponatremia.
4. In the pathophysiology of Diabetes Insipidus (DI), what is the primary cause of polyuria?
A. Osmotic diuresis from hyperglycemia
B. Increased glomerular filtration rate
, C. Insufficient ADH production or renal resistance to ADH
D. Failure of the loop of Henle to concentrate urea
Answer: C
Conceptual Explanation: DI is characterized by a deficiency of ADH (neurogenic) or a lack
of response to it (nephrogenic), preventing the collecting ducts from reabsorbing water.
5. Which finding is characteristic of Graves’ disease but not other forms of hyperthyroidism?
A. Tachycardia and palpitations
B. Exophthalmos (pretibial myxedema)
C. Increased basal metabolic rate
D. Heat intolerance
Answer: B
Conceptual Explanation: Exophthalmos is caused by autoimmune-mediated inflammation
of the extraocular muscles and orbital fat, which is specific to the autoimmune nature of
Graves’ disease.
6. What is the primary pathophysiological defect in Hashimoto thyroiditis?
A. Iodine deficiency leading to goiter
B. Excessive production of Reverse T3
C. Pituitary failure to produce Thyroid Stimulating Hormone (TSH)
