NSG 5140 Advanced Pathophysiology | South College | 2026 Exam
Questions and Answers | 100% Pass Guaranteed | Graded A+ |
Graduate-Level Rationales
Question 1
A 65-year-old man presents with fatigue and dyspnea on exertion. Labs show hemoglobin 8.5
g/dL, MCV 72 fL, ferritin low. Most likely cause of anemia:
A) Vitamin B12 deficiency
B) Iron-deficiency anemia
C) Anemia of chronic disease
D) Hemolytic anemia
Answer: B
Rationale: Microcytic anemia (low MCV) with low ferritin indicates iron deficiency.
Question 2
A 55-year-old woman presents with polyuria and polydipsia. Labs: fasting glucose 180 mg/dL,
HbA1c 8.2%. Most likely diagnosis:
A) Type 1 diabetes mellitus
B) Type 2 diabetes mellitus
C) Diabetes insipidus
D) Secondary diabetes
Answer: B
Rationale: Adult-onset diabetes with hyperglycemia and classic symptoms suggests type 2
diabetes.
Question 3
A 48-year-old man presents with crushing chest pain radiating to his left arm. ECG shows ST
elevations in leads II, III, and aVF. Most likely diagnosis:
A) Anterior MI
B) Lateral MI
C) Inferior MI
D) Pericarditis
,Answer: C
Rationale: ST elevation in II, III, aVF indicates inferior wall myocardial infarction.
Question 4
A 25-year-old woman presents with chronic diarrhea, bloating, and iron-deficiency anemia.
Small bowel biopsy shows villous atrophy. Most likely diagnosis:
A) Crohn disease
B) Celiac disease
C) Ulcerative colitis
D) Lactose intolerance
Answer: B
Rationale: Villous atrophy with malabsorption indicates celiac disease.
Question 5
A 70-year-old man presents with sudden weakness of the right arm and slurred speech. CT scan
is negative for hemorrhage. Next best step:
A) Start aspirin
B) Evaluate for thrombolytic therapy
C) MRI of the spine
D) Lumbar puncture
Answer: B
Rationale: Ischemic stroke should be evaluated for thrombolytic therapy if within the window.
Question 6
A 60-year-old woman presents with fever, productive cough, and pleuritic chest pain. Chest X-
ray shows right lower lobe consolidation. Most appropriate initial therapy:
A) IV vancomycin
B) Oral amoxicillin-clavulanate
C) Oral azithromycin
D) Observation
Answer: C
Rationale: Outpatient community-acquired pneumonia in otherwise healthy adults is treated
with a macrolide.
,Question 7
A 45-year-old man presents with hematuria and flank pain. Ultrasound shows a solid renal mass.
Most likely diagnosis:
A) Kidney stone
B) Pyelonephritis
C) Renal cell carcinoma
D) Polycystic kidney disease
Answer: C
Rationale: Solid renal mass in adults presenting with hematuria suggests renal cell carcinoma.
Question 8
A 35-year-old man presents with sudden-onset shortness of breath and pleuritic chest pain after a
long flight. Exam: tachycardia, hypotension. Most likely diagnosis:
A) Pneumonia
B) Pulmonary embolism
C) Myocardial infarction
D) Asthma exacerbation
Answer: B
Rationale: Acute dyspnea and pleuritic pain following immobilization suggests pulmonary
embolism.
Question 9
A 50-year-old woman presents with fatigue, constipation, weight gain, and cold intolerance.
Labs: TSH elevated, free T4 low. Most likely diagnosis:
A) Hyperthyroidism
B) Primary hypothyroidism
C) Subclinical hypothyroidism
D) Secondary hypothyroidism
Answer: B
Rationale: Elevated TSH with low T4 indicates primary thyroid failure.
Question 10
, A 65-year-old man presents with resting tremor, rigidity, and shuffling gait. Most appropriate
pharmacologic therapy:
A) Beta-blocker
B) Levodopa-carbidopa
C) SSRI
D) Corticosteroids
Answer: B
Rationale: Dopaminergic therapy is first-line for Parkinson disease.
Question 11
A 30-year-old woman presents with palpitations, tremor, weight loss, and exophthalmos. Labs:
low TSH, high T4. Most likely diagnosis:
A) Hypothyroidism
B) Graves disease
C) Hashimoto thyroiditis
D) Subacute thyroiditis
Answer: B
Rationale: Hyperthyroidism with ophthalmopathy is indicative of Graves disease.
Question 12
A 28-year-old man presents with painless penile ulcer and non-tender inguinal
lymphadenopathy. Most likely diagnosis:
A) Herpes simplex virus
B) Chancroid
C) Primary syphilis
D) Gonorrhea
Answer: C
Rationale: Painless chancre with non-tender lymph nodes is characteristic of primary syphilis.
Question 13
A 60-year-old woman presents with headache, jaw claudication, and visual disturbances. ESR is
elevated. Most likely diagnosis:
A) Migraine
B) Tension headache
Questions and Answers | 100% Pass Guaranteed | Graded A+ |
Graduate-Level Rationales
Question 1
A 65-year-old man presents with fatigue and dyspnea on exertion. Labs show hemoglobin 8.5
g/dL, MCV 72 fL, ferritin low. Most likely cause of anemia:
A) Vitamin B12 deficiency
B) Iron-deficiency anemia
C) Anemia of chronic disease
D) Hemolytic anemia
Answer: B
Rationale: Microcytic anemia (low MCV) with low ferritin indicates iron deficiency.
Question 2
A 55-year-old woman presents with polyuria and polydipsia. Labs: fasting glucose 180 mg/dL,
HbA1c 8.2%. Most likely diagnosis:
A) Type 1 diabetes mellitus
B) Type 2 diabetes mellitus
C) Diabetes insipidus
D) Secondary diabetes
Answer: B
Rationale: Adult-onset diabetes with hyperglycemia and classic symptoms suggests type 2
diabetes.
Question 3
A 48-year-old man presents with crushing chest pain radiating to his left arm. ECG shows ST
elevations in leads II, III, and aVF. Most likely diagnosis:
A) Anterior MI
B) Lateral MI
C) Inferior MI
D) Pericarditis
,Answer: C
Rationale: ST elevation in II, III, aVF indicates inferior wall myocardial infarction.
Question 4
A 25-year-old woman presents with chronic diarrhea, bloating, and iron-deficiency anemia.
Small bowel biopsy shows villous atrophy. Most likely diagnosis:
A) Crohn disease
B) Celiac disease
C) Ulcerative colitis
D) Lactose intolerance
Answer: B
Rationale: Villous atrophy with malabsorption indicates celiac disease.
Question 5
A 70-year-old man presents with sudden weakness of the right arm and slurred speech. CT scan
is negative for hemorrhage. Next best step:
A) Start aspirin
B) Evaluate for thrombolytic therapy
C) MRI of the spine
D) Lumbar puncture
Answer: B
Rationale: Ischemic stroke should be evaluated for thrombolytic therapy if within the window.
Question 6
A 60-year-old woman presents with fever, productive cough, and pleuritic chest pain. Chest X-
ray shows right lower lobe consolidation. Most appropriate initial therapy:
A) IV vancomycin
B) Oral amoxicillin-clavulanate
C) Oral azithromycin
D) Observation
Answer: C
Rationale: Outpatient community-acquired pneumonia in otherwise healthy adults is treated
with a macrolide.
,Question 7
A 45-year-old man presents with hematuria and flank pain. Ultrasound shows a solid renal mass.
Most likely diagnosis:
A) Kidney stone
B) Pyelonephritis
C) Renal cell carcinoma
D) Polycystic kidney disease
Answer: C
Rationale: Solid renal mass in adults presenting with hematuria suggests renal cell carcinoma.
Question 8
A 35-year-old man presents with sudden-onset shortness of breath and pleuritic chest pain after a
long flight. Exam: tachycardia, hypotension. Most likely diagnosis:
A) Pneumonia
B) Pulmonary embolism
C) Myocardial infarction
D) Asthma exacerbation
Answer: B
Rationale: Acute dyspnea and pleuritic pain following immobilization suggests pulmonary
embolism.
Question 9
A 50-year-old woman presents with fatigue, constipation, weight gain, and cold intolerance.
Labs: TSH elevated, free T4 low. Most likely diagnosis:
A) Hyperthyroidism
B) Primary hypothyroidism
C) Subclinical hypothyroidism
D) Secondary hypothyroidism
Answer: B
Rationale: Elevated TSH with low T4 indicates primary thyroid failure.
Question 10
, A 65-year-old man presents with resting tremor, rigidity, and shuffling gait. Most appropriate
pharmacologic therapy:
A) Beta-blocker
B) Levodopa-carbidopa
C) SSRI
D) Corticosteroids
Answer: B
Rationale: Dopaminergic therapy is first-line for Parkinson disease.
Question 11
A 30-year-old woman presents with palpitations, tremor, weight loss, and exophthalmos. Labs:
low TSH, high T4. Most likely diagnosis:
A) Hypothyroidism
B) Graves disease
C) Hashimoto thyroiditis
D) Subacute thyroiditis
Answer: B
Rationale: Hyperthyroidism with ophthalmopathy is indicative of Graves disease.
Question 12
A 28-year-old man presents with painless penile ulcer and non-tender inguinal
lymphadenopathy. Most likely diagnosis:
A) Herpes simplex virus
B) Chancroid
C) Primary syphilis
D) Gonorrhea
Answer: C
Rationale: Painless chancre with non-tender lymph nodes is characteristic of primary syphilis.
Question 13
A 60-year-old woman presents with headache, jaw claudication, and visual disturbances. ESR is
elevated. Most likely diagnosis:
A) Migraine
B) Tension headache
