MSN570
Advanced Pathophysiology Across
the Lifespan
Final Exam Review
(Questions & Solutions)
2025
1
, I. Multiple Choice Questions (10 Questions)
Question 1
Case Scenario: A 28‐week gestation preterm infant develops respiratory
distress shortly after birth. The chest radiograph reveals a ground‑glass
appearance with air bronchograms.
Question: Which pathophysiologic mechanism is most responsible for
the infant’s condition?
- A) Surfactant deficiency
- B) Neonatal pneumonia
- C) Patent ductus arteriosus
- D) Meconium aspiration
Correct ANS: A
Rationale: In preterm infants, underdeveloped type II pneumocytes
result in insufficient surfactant production, leading to alveolar collapse
(atelectasis) and the classic “ground‑glass” appearance on imaging.
---
Question 2
Case Scenario: A 2‑month-old infant is noted to have a continuous
murmur on cardiovascular exam. Echocardiography confirms a patent
ductus arteriosus (PDA).
Question: Which factor primarily contributes to the persistence of the
ductus arteriosus in this neonate?
- A) Excessive prostaglandin production
- B) Maternal hyperglycemia
- C) Fetal hypoxia
- D) Overactivity of the sympathetic nervous system
Correct ANS: A
2
, Rationale: Elevated prostaglandin levels in the immediate postnatal
period can delay closure of the ductus arteriosus. In many cases, failure
of the normal drop in prostaglandins after birth is the primary
mechanism for PDA.
---
Question 3
Case Scenario: An 8‑year-old child with a history of atopy presents with
wheezing and shortness of breath on exposure to allergens.
Question: Which mediator is most critical in the bronchoconstriction
seen in allergic asthma?
- A) Histamine
- B) Bradykinin
- C) Angiotensin II
- D) Prostaglandin E₂
Correct ANS: A
Rationale: In allergic asthma, mast cell degranulation releases
histamine, which is a potent mediator of bronchoconstriction, increased
mucus secretion, and inflammation.
---
Question 4
Case Scenario: A 15‑year‑old with a recent onset of polyuria, polydipsia,
and unintentional weight loss is diagnosed with type 1 diabetes mellitus.
Question: What is the primary pathophysiologic process underlying this
condition?
- A) Autoimmune destruction of pancreatic beta‑cells
- B) Peripheral insulin resistance
- C) Beta‑cell hyperactivity
- D) Increased hepatic glucose production
Correct ANS: A
3
, Rationale: Type 1 diabetes mellitus is characterized by autoimmune
destruction of pancreatic beta‑cells, resulting in absolute insulin
deficiency.
---
Question 5
Case Scenario: A 35‑year‑old man presents to the emergency
department with severe chest pain and ST elevations on his ECG.
Question: Which pathophysiologic event most likely precipitated his
myocardial infarction?
- A) Atherosclerotic plaque rupture followed by thrombus formation
- B) Coronary artery spasm due to cocaine abuse
- C) Infective endocarditis with septic emboli
- D) A congenital coronary artery anomaly
Correct ANS: A
Rationale: In the majority of myocardial infarctions, rupture of an
atherosclerotic plaque exposes the subendothelial matrix, initiating
platelet aggregation and thrombus formation that occlude coronary
blood flow.
---
Question 6
Case Scenario: A 60‑year‑old male with a history of dilated
cardiomyopathy presents with signs of fluid overload and reduced
ejection fraction.
Question: Which neurohormonal mechanism is most instrumental in
exacerbating his heart failure?
- A) Activation of the renin‑angiotensin‑aldosterone system (RAAS)
- B) Decreased production of antidiuretic hormone
- C) Enhanced parasympathetic tone
- D) Inhibition of sympathetic nervous system activity
4
Advanced Pathophysiology Across
the Lifespan
Final Exam Review
(Questions & Solutions)
2025
1
, I. Multiple Choice Questions (10 Questions)
Question 1
Case Scenario: A 28‐week gestation preterm infant develops respiratory
distress shortly after birth. The chest radiograph reveals a ground‑glass
appearance with air bronchograms.
Question: Which pathophysiologic mechanism is most responsible for
the infant’s condition?
- A) Surfactant deficiency
- B) Neonatal pneumonia
- C) Patent ductus arteriosus
- D) Meconium aspiration
Correct ANS: A
Rationale: In preterm infants, underdeveloped type II pneumocytes
result in insufficient surfactant production, leading to alveolar collapse
(atelectasis) and the classic “ground‑glass” appearance on imaging.
---
Question 2
Case Scenario: A 2‑month-old infant is noted to have a continuous
murmur on cardiovascular exam. Echocardiography confirms a patent
ductus arteriosus (PDA).
Question: Which factor primarily contributes to the persistence of the
ductus arteriosus in this neonate?
- A) Excessive prostaglandin production
- B) Maternal hyperglycemia
- C) Fetal hypoxia
- D) Overactivity of the sympathetic nervous system
Correct ANS: A
2
, Rationale: Elevated prostaglandin levels in the immediate postnatal
period can delay closure of the ductus arteriosus. In many cases, failure
of the normal drop in prostaglandins after birth is the primary
mechanism for PDA.
---
Question 3
Case Scenario: An 8‑year-old child with a history of atopy presents with
wheezing and shortness of breath on exposure to allergens.
Question: Which mediator is most critical in the bronchoconstriction
seen in allergic asthma?
- A) Histamine
- B) Bradykinin
- C) Angiotensin II
- D) Prostaglandin E₂
Correct ANS: A
Rationale: In allergic asthma, mast cell degranulation releases
histamine, which is a potent mediator of bronchoconstriction, increased
mucus secretion, and inflammation.
---
Question 4
Case Scenario: A 15‑year‑old with a recent onset of polyuria, polydipsia,
and unintentional weight loss is diagnosed with type 1 diabetes mellitus.
Question: What is the primary pathophysiologic process underlying this
condition?
- A) Autoimmune destruction of pancreatic beta‑cells
- B) Peripheral insulin resistance
- C) Beta‑cell hyperactivity
- D) Increased hepatic glucose production
Correct ANS: A
3
, Rationale: Type 1 diabetes mellitus is characterized by autoimmune
destruction of pancreatic beta‑cells, resulting in absolute insulin
deficiency.
---
Question 5
Case Scenario: A 35‑year‑old man presents to the emergency
department with severe chest pain and ST elevations on his ECG.
Question: Which pathophysiologic event most likely precipitated his
myocardial infarction?
- A) Atherosclerotic plaque rupture followed by thrombus formation
- B) Coronary artery spasm due to cocaine abuse
- C) Infective endocarditis with septic emboli
- D) A congenital coronary artery anomaly
Correct ANS: A
Rationale: In the majority of myocardial infarctions, rupture of an
atherosclerotic plaque exposes the subendothelial matrix, initiating
platelet aggregation and thrombus formation that occlude coronary
blood flow.
---
Question 6
Case Scenario: A 60‑year‑old male with a history of dilated
cardiomyopathy presents with signs of fluid overload and reduced
ejection fraction.
Question: Which neurohormonal mechanism is most instrumental in
exacerbating his heart failure?
- A) Activation of the renin‑angiotensin‑aldosterone system (RAAS)
- B) Decreased production of antidiuretic hormone
- C) Enhanced parasympathetic tone
- D) Inhibition of sympathetic nervous system activity
4
