Advanced Pathophysiology NRSG 605:
Comprehensive Exam Study Guide – Vascular,
Cardiac, and Hematologic Diseases
Chapter 1: Vascular Diseases (Q1–Q200)
Q1. Which of the following best describes the fundamental difference
between arteriosclerosis and atherosclerosis?
A. Arteriosclerosis is an inflammatory disease, while atherosclerosis is a
degenerative disease.
B. Arteriosclerosis is a generalized hardening of arteries, while
atherosclerosis is a specific form involving plaque buildup in large and
medium arteries.
C. Arteriosclerosis affects only small arterioles, while atherosclerosis affects
only veins.
D. Arteriosclerosis is reversible, while atherosclerosis is irreversible.
Answer: B
Explanation: Arteriosclerosis is a general term for the hardening and loss of
elasticity of arterial walls, often due to aging. Atherosclerosis is a specific
form of arteriosclerosis characterized by the buildup of fatty plaques
(atheromas) in the intima of large and medium-sized arteries, leading to
narrowing and reduced blood flow.
,Q2. In the response-to-injury hypothesis of atherosclerosis, what is the initial
triggering event?
A. Accumulation of LDL cholesterol in the intima.
B. Endothelial injury or dysfunction.
C. Proliferation of smooth muscle cells.
D. Infiltration of macrophages.
Answer: B
Explanation: The response-to-injury hypothesis posits that atherosclerosis
begins with endothelial injury or dysfunction. This injury leads to increased
permeability, allowing lipoproteins to enter the vessel wall, and triggers an
inflammatory response.
Q3. Which lipoprotein is considered the most atherogenic?
A. Chylomicrons
B. VLDL
C. LDL
D. HDL
Answer: C
Explanation: Elevated low-density lipoprotein cholesterol (LDL-C) is a major
risk factor for coronary heart disease. LDL particles can penetrate the
endothelium and become oxidized, triggering an inflammatory response and
foam cell formation, which are key steps in atherogenesis.
,Q4. A 55-year-old male presents with a pulsatile mass in his abdomen. He
has a history of hypertension and smoking. What is the most likely
diagnosis?
A. Abdominal aortic aneurysm (AAA)
B. Carotid artery stenosis
C. Peripheral artery disease
D. Renal artery stenosis
Answer: A
Explanation: A pulsatile abdominal mass is a classic clinical manifestation
of an abdominal aortic aneurysm (AAA). The aorta balloons out due to a
weakened wall, often associated with atherosclerosis and high blood
pressure.
Q5. Which of the following is NOT a major risk factor for the development of
atherosclerosis?
A. Elevated LDL-C
B. Hypertension
C. High HDL-C
D. Cigarette smoking
Answer: C
Explanation: High HDL-C (≥60 mg/dL) is considered a negative risk factor,
meaning it is protective and can subtract one risk factor from a patient's
total risk score. The major risk factors include elevated LDL-C, hypertension,
smoking, age, and family history.
, Q6. A patient with carotid artery disease is at the highest risk for which of
the following complications?
A. Myocardial infarction
B. Cerebral vascular accident (stroke)
C. Pulmonary embolism
D. Deep vein thrombosis
Answer: B
Explanation: Carotid artery disease, or carotid artery stenosis, occurs when
the carotid arteries become narrowed by plaque. This significantly increases
the risk of a stroke (cerebral vascular accident) due to reduced blood flow to
the brain.
Q7. What is the primary pathophysiologic outcome of a ruptured
atherosclerotic plaque?
A. Vasodilation and increased blood flow.
B. Formation of a thrombus (clot) and potential distal embolization.
C. Weakening of the vessel wall leading to aneurysm.
D. Hypertrophy of the tunica media.
Answer: B
Explanation: When an atherosclerotic plaque fissures or ruptures, it
exposes the underlying thrombogenic material to the blood. This triggers
platelet aggregation and the coagulation cascade, leading to the formation
Comprehensive Exam Study Guide – Vascular,
Cardiac, and Hematologic Diseases
Chapter 1: Vascular Diseases (Q1–Q200)
Q1. Which of the following best describes the fundamental difference
between arteriosclerosis and atherosclerosis?
A. Arteriosclerosis is an inflammatory disease, while atherosclerosis is a
degenerative disease.
B. Arteriosclerosis is a generalized hardening of arteries, while
atherosclerosis is a specific form involving plaque buildup in large and
medium arteries.
C. Arteriosclerosis affects only small arterioles, while atherosclerosis affects
only veins.
D. Arteriosclerosis is reversible, while atherosclerosis is irreversible.
Answer: B
Explanation: Arteriosclerosis is a general term for the hardening and loss of
elasticity of arterial walls, often due to aging. Atherosclerosis is a specific
form of arteriosclerosis characterized by the buildup of fatty plaques
(atheromas) in the intima of large and medium-sized arteries, leading to
narrowing and reduced blood flow.
,Q2. In the response-to-injury hypothesis of atherosclerosis, what is the initial
triggering event?
A. Accumulation of LDL cholesterol in the intima.
B. Endothelial injury or dysfunction.
C. Proliferation of smooth muscle cells.
D. Infiltration of macrophages.
Answer: B
Explanation: The response-to-injury hypothesis posits that atherosclerosis
begins with endothelial injury or dysfunction. This injury leads to increased
permeability, allowing lipoproteins to enter the vessel wall, and triggers an
inflammatory response.
Q3. Which lipoprotein is considered the most atherogenic?
A. Chylomicrons
B. VLDL
C. LDL
D. HDL
Answer: C
Explanation: Elevated low-density lipoprotein cholesterol (LDL-C) is a major
risk factor for coronary heart disease. LDL particles can penetrate the
endothelium and become oxidized, triggering an inflammatory response and
foam cell formation, which are key steps in atherogenesis.
,Q4. A 55-year-old male presents with a pulsatile mass in his abdomen. He
has a history of hypertension and smoking. What is the most likely
diagnosis?
A. Abdominal aortic aneurysm (AAA)
B. Carotid artery stenosis
C. Peripheral artery disease
D. Renal artery stenosis
Answer: A
Explanation: A pulsatile abdominal mass is a classic clinical manifestation
of an abdominal aortic aneurysm (AAA). The aorta balloons out due to a
weakened wall, often associated with atherosclerosis and high blood
pressure.
Q5. Which of the following is NOT a major risk factor for the development of
atherosclerosis?
A. Elevated LDL-C
B. Hypertension
C. High HDL-C
D. Cigarette smoking
Answer: C
Explanation: High HDL-C (≥60 mg/dL) is considered a negative risk factor,
meaning it is protective and can subtract one risk factor from a patient's
total risk score. The major risk factors include elevated LDL-C, hypertension,
smoking, age, and family history.
, Q6. A patient with carotid artery disease is at the highest risk for which of
the following complications?
A. Myocardial infarction
B. Cerebral vascular accident (stroke)
C. Pulmonary embolism
D. Deep vein thrombosis
Answer: B
Explanation: Carotid artery disease, or carotid artery stenosis, occurs when
the carotid arteries become narrowed by plaque. This significantly increases
the risk of a stroke (cerebral vascular accident) due to reduced blood flow to
the brain.
Q7. What is the primary pathophysiologic outcome of a ruptured
atherosclerotic plaque?
A. Vasodilation and increased blood flow.
B. Formation of a thrombus (clot) and potential distal embolization.
C. Weakening of the vessel wall leading to aneurysm.
D. Hypertrophy of the tunica media.
Answer: B
Explanation: When an atherosclerotic plaque fissures or ruptures, it
exposes the underlying thrombogenic material to the blood. This triggers
platelet aggregation and the coagulation cascade, leading to the formation
