,NSG 530 Exam 4 Advanced Pathophysiology Questions And Answers
2026/2027 Wilkes University
Q1. Reduced tissue oxygen delivery stimulates renal production of
erythropoietin. What response should subsequently occur in
functioning bone marrow?
A) Increased platelet destruction
B) Increased erythrocyte production
C) Reduced reticulocyte release
D) Suppression of hemoglobin synthesis
Correct Answer: B) Increased erythrocyte production
Rationale: Renal cells respond to tissue hypoxia by increasing
erythropoietin secretion. Erythropoietin stimulates erythroid progenitor
survival, proliferation, and maturation in bone marrow, increasing production
of red blood cells and improving oxygen-carrying capacity.
Q2. Which laboratory pattern most strongly supports iron-deficiency
anemia?
A) High ferritin, low TIBC, and macrocytosis
B) High serum iron, low ferritin, and leukocytosis
C) Low ferritin, low serum iron, and increased total iron-binding capacity
D) Normal ferritin, high serum iron, and increased MCV
Correct Answer: C) Low ferritin, low serum iron, and increased total iron-
binding capacity
Rationale: Iron deficiency depletes iron stores, causing low ferritin and
serum iron. Transferrin production generally increases, resulting in elevated
total iron-binding capacity. Reduced hemoglobin synthesis eventually
produces microcytic, hypochromic erythrocytes.
Q3. Why does iron deficiency eventually produce microcytic
erythrocytes?
A) Reduced hemoglobin synthesis limits normal erythrocyte development
B) DNA replication accelerates excessively
C) Erythrocyte membranes accumulate excessive cholesterol
, D) Bone marrow produces excess intrinsic factor
Correct Answer: A) Reduced hemoglobin synthesis limits normal
erythrocyte development
Rationale: Iron is necessary for heme synthesis. Inadequate iron limits
hemoglobin formation, causing developing erythrocytes to undergo
additional cell divisions before reaching an adequate intracellular
hemoglobin concentration, producing smaller cells with reduced hemoglobin
content.
Q4. Pernicious anemia results from impaired absorption of vitamin
B12 because of deficiency of which substance?
A) Transferrin
B) Erythropoietin
C) Hepcidin
D) Intrinsic factor
Correct Answer: D) Intrinsic factor
Rationale: Intrinsic factor is produced by gastric parietal cells and is
required for efficient vitamin B12 absorption in the terminal ileum.
Autoimmune destruction of parietal cells or intrinsic factor can therefore
cause vitamin B12 deficiency and pernicious anemia.
Q5. Neurologic abnormalities are more characteristic of vitamin B12
deficiency than folate deficiency because vitamin B12 is essential
for what process?
A) Maintenance of normal myelin and neurologic function
B) Platelet aggregation
C) Conversion of fibrinogen to fibrin
D) Renal erythropoietin secretion
Correct Answer: A) Maintenance of normal myelin and neurologic function
Rationale: Vitamin B12 participates in biochemical reactions important for
neurologic integrity. Deficiency can damage myelin and produce
paresthesias, impaired proprioception, gait abnormalities, or cognitive
changes in addition to megaloblastic anemia.
2026/2027 Wilkes University
Q1. Reduced tissue oxygen delivery stimulates renal production of
erythropoietin. What response should subsequently occur in
functioning bone marrow?
A) Increased platelet destruction
B) Increased erythrocyte production
C) Reduced reticulocyte release
D) Suppression of hemoglobin synthesis
Correct Answer: B) Increased erythrocyte production
Rationale: Renal cells respond to tissue hypoxia by increasing
erythropoietin secretion. Erythropoietin stimulates erythroid progenitor
survival, proliferation, and maturation in bone marrow, increasing production
of red blood cells and improving oxygen-carrying capacity.
Q2. Which laboratory pattern most strongly supports iron-deficiency
anemia?
A) High ferritin, low TIBC, and macrocytosis
B) High serum iron, low ferritin, and leukocytosis
C) Low ferritin, low serum iron, and increased total iron-binding capacity
D) Normal ferritin, high serum iron, and increased MCV
Correct Answer: C) Low ferritin, low serum iron, and increased total iron-
binding capacity
Rationale: Iron deficiency depletes iron stores, causing low ferritin and
serum iron. Transferrin production generally increases, resulting in elevated
total iron-binding capacity. Reduced hemoglobin synthesis eventually
produces microcytic, hypochromic erythrocytes.
Q3. Why does iron deficiency eventually produce microcytic
erythrocytes?
A) Reduced hemoglobin synthesis limits normal erythrocyte development
B) DNA replication accelerates excessively
C) Erythrocyte membranes accumulate excessive cholesterol
, D) Bone marrow produces excess intrinsic factor
Correct Answer: A) Reduced hemoglobin synthesis limits normal
erythrocyte development
Rationale: Iron is necessary for heme synthesis. Inadequate iron limits
hemoglobin formation, causing developing erythrocytes to undergo
additional cell divisions before reaching an adequate intracellular
hemoglobin concentration, producing smaller cells with reduced hemoglobin
content.
Q4. Pernicious anemia results from impaired absorption of vitamin
B12 because of deficiency of which substance?
A) Transferrin
B) Erythropoietin
C) Hepcidin
D) Intrinsic factor
Correct Answer: D) Intrinsic factor
Rationale: Intrinsic factor is produced by gastric parietal cells and is
required for efficient vitamin B12 absorption in the terminal ileum.
Autoimmune destruction of parietal cells or intrinsic factor can therefore
cause vitamin B12 deficiency and pernicious anemia.
Q5. Neurologic abnormalities are more characteristic of vitamin B12
deficiency than folate deficiency because vitamin B12 is essential
for what process?
A) Maintenance of normal myelin and neurologic function
B) Platelet aggregation
C) Conversion of fibrinogen to fibrin
D) Renal erythropoietin secretion
Correct Answer: A) Maintenance of normal myelin and neurologic function
Rationale: Vitamin B12 participates in biochemical reactions important for
neurologic integrity. Deficiency can damage myelin and produce
paresthesias, impaired proprioception, gait abnormalities, or cognitive
changes in addition to megaloblastic anemia.
