ANP 650 MIDTERM EXAM
LATEST ACTUAL EXAM
TEST BANK 2025
1.
2. Question:
Explain the role of the renin-angiotensin-aldosterone system (RAAS) in blood pressure
regulation. Include the physiological mechanisms and the impact of pharmacological
inhibitors such as ACE inhibitors and ARBs.
Answer:
The RAAS regulates blood pressure and fluid balance. When blood pressure drops, the
kidneys release renin, which converts angiotensinogen (produced in the liver) to
angiotensin I. Angiotensin I is then converted to angiotensin II by angiotensin-converting
enzyme (ACE). Angiotensin II causes vasoconstriction and stimulates aldosterone
release from the adrenal glands, leading to sodium and water retention.
ACE inhibitors block the conversion of angiotensin I to angiotensin II, reducing
vasoconstriction and blood pressure. ARBs (angiotensin II receptor blockers) prevent
angiotensin II from binding to its receptors, offering a similar therapeutic effect.
2. Question:
Differentiate between Type 1 and Type 2 diabetes mellitus, focusing on pathophysiology,
clinical presentation, and management strategies.
Answer:
Type 1 Diabetes Mellitus (T1DM):
○ Pathophysiology: Autoimmune destruction of pancreatic beta cells, leading to
absolute insulin deficiency.
○ Clinical Presentation: Polyuria, polydipsia, weight loss, ketoacidosis.
○ Management: Lifelong insulin therapy, blood glucose monitoring, diet, and
exercise.
3. Type 2 Diabetes Mellitus (T2DM):
○ Pathophysiology: Insulin resistance combined with progressive beta-cell
dysfunction.
○ Clinical Presentation: Often asymptomatic initially, or presents with fatigue,
recurrent infections, or blurred vision.
○ Management: Lifestyle modification, oral antidiabetic agents (e.g., metformin),
and insulin if needed.
, 3. Question:
A 52-year-old male patient presents with crushing substernal chest pain radiating to the
left arm. ECG reveals ST-segment elevation in leads II, III, and aVF. What is the most
likely diagnosis, and what initial management steps should be taken?
Answer:
Diagnosis: Acute inferior myocardial infarction (STEMI).
Initial Management:
○ Administer oxygen if hypoxic.
○ Give aspirin (325 mg) and a P2Y12 inhibitor (e.g., clopidogrel).
○ Start nitroglycerin (sublingual or IV) for chest pain relief, unless contraindicated
(e.g., hypotension).
○ Administer heparin or enoxaparin as an anticoagulant.
○ Immediate reperfusion therapy (PCI or thrombolytics if PCI unavailable).
○ Beta-blockers can be started if no contraindications (e.g., bradycardia, heart
failure).
4. Question:
Discuss the pathophysiology of asthma and the pharmacological rationale for using
corticosteroids and beta-2 agonists in its treatment.
Answer:
Pathophysiology: Asthma is a chronic inflammatory disorder of the airways
characterized by bronchoconstriction, airway hyperresponsiveness, and mucus
hypersecretion. Triggers lead to mast cell degranulation and release of inflammatory
mediators like histamine and leukotrienes.
Pharmacological Rationale:
○ Corticosteroids (e.g., inhaled fluticasone): Reduce airway inflammation by
inhibiting cytokine production and inflammatory cell infiltration.
○ Beta-2 agonists (e.g., albuterol): Act on beta-2 adrenergic receptors to relax
bronchial smooth muscle, providing rapid relief of bronchospasm.
5. Question:
A 68-year-old female presents with symptoms of fatigue, pallor, and shortness of breath.
Laboratory tests reveal hemoglobin of 9 g/dL, MCV of 70 fL, and serum ferritin of 8
ng/mL. What is the most likely diagnosis, and how should it be managed?
Answer:
Diagnosis: Iron-deficiency anemia.
Management:
○ Identify and treat the underlying cause (e.g., gastrointestinal blood loss).
○ Oral iron supplementation (e.g., ferrous sulfate 325 mg TID) with advice to take
with vitamin C to enhance absorption.
○ Monitor hemoglobin and ferritin levels for response.
○ Parenteral iron may be used in cases of malabsorption or intolerance to oral iron.
LATEST ACTUAL EXAM
TEST BANK 2025
1.
2. Question:
Explain the role of the renin-angiotensin-aldosterone system (RAAS) in blood pressure
regulation. Include the physiological mechanisms and the impact of pharmacological
inhibitors such as ACE inhibitors and ARBs.
Answer:
The RAAS regulates blood pressure and fluid balance. When blood pressure drops, the
kidneys release renin, which converts angiotensinogen (produced in the liver) to
angiotensin I. Angiotensin I is then converted to angiotensin II by angiotensin-converting
enzyme (ACE). Angiotensin II causes vasoconstriction and stimulates aldosterone
release from the adrenal glands, leading to sodium and water retention.
ACE inhibitors block the conversion of angiotensin I to angiotensin II, reducing
vasoconstriction and blood pressure. ARBs (angiotensin II receptor blockers) prevent
angiotensin II from binding to its receptors, offering a similar therapeutic effect.
2. Question:
Differentiate between Type 1 and Type 2 diabetes mellitus, focusing on pathophysiology,
clinical presentation, and management strategies.
Answer:
Type 1 Diabetes Mellitus (T1DM):
○ Pathophysiology: Autoimmune destruction of pancreatic beta cells, leading to
absolute insulin deficiency.
○ Clinical Presentation: Polyuria, polydipsia, weight loss, ketoacidosis.
○ Management: Lifelong insulin therapy, blood glucose monitoring, diet, and
exercise.
3. Type 2 Diabetes Mellitus (T2DM):
○ Pathophysiology: Insulin resistance combined with progressive beta-cell
dysfunction.
○ Clinical Presentation: Often asymptomatic initially, or presents with fatigue,
recurrent infections, or blurred vision.
○ Management: Lifestyle modification, oral antidiabetic agents (e.g., metformin),
and insulin if needed.
, 3. Question:
A 52-year-old male patient presents with crushing substernal chest pain radiating to the
left arm. ECG reveals ST-segment elevation in leads II, III, and aVF. What is the most
likely diagnosis, and what initial management steps should be taken?
Answer:
Diagnosis: Acute inferior myocardial infarction (STEMI).
Initial Management:
○ Administer oxygen if hypoxic.
○ Give aspirin (325 mg) and a P2Y12 inhibitor (e.g., clopidogrel).
○ Start nitroglycerin (sublingual or IV) for chest pain relief, unless contraindicated
(e.g., hypotension).
○ Administer heparin or enoxaparin as an anticoagulant.
○ Immediate reperfusion therapy (PCI or thrombolytics if PCI unavailable).
○ Beta-blockers can be started if no contraindications (e.g., bradycardia, heart
failure).
4. Question:
Discuss the pathophysiology of asthma and the pharmacological rationale for using
corticosteroids and beta-2 agonists in its treatment.
Answer:
Pathophysiology: Asthma is a chronic inflammatory disorder of the airways
characterized by bronchoconstriction, airway hyperresponsiveness, and mucus
hypersecretion. Triggers lead to mast cell degranulation and release of inflammatory
mediators like histamine and leukotrienes.
Pharmacological Rationale:
○ Corticosteroids (e.g., inhaled fluticasone): Reduce airway inflammation by
inhibiting cytokine production and inflammatory cell infiltration.
○ Beta-2 agonists (e.g., albuterol): Act on beta-2 adrenergic receptors to relax
bronchial smooth muscle, providing rapid relief of bronchospasm.
5. Question:
A 68-year-old female presents with symptoms of fatigue, pallor, and shortness of breath.
Laboratory tests reveal hemoglobin of 9 g/dL, MCV of 70 fL, and serum ferritin of 8
ng/mL. What is the most likely diagnosis, and how should it be managed?
Answer:
Diagnosis: Iron-deficiency anemia.
Management:
○ Identify and treat the underlying cause (e.g., gastrointestinal blood loss).
○ Oral iron supplementation (e.g., ferrous sulfate 325 mg TID) with advice to take
with vitamin C to enhance absorption.
○ Monitor hemoglobin and ferritin levels for response.
○ Parenteral iron may be used in cases of malabsorption or intolerance to oral iron.
