NR283 Exam 4 Actual Exam Style V1 | NR
283 Pathophysiology | Chamberlain
1. A patient presents with massive proteinuria, hypoalbuminemia, and generalized edema.
Which condition is most likely responsible for these clinical manifestations?
A. Nephrotic Syndrome
B. Nephritic Syndrome
C. Acute Tubular Necrosis
D. Pyelonephritis
Answer: A
Rationale: Nephrotic syndrome is characterized by increased glomerular permeability,
leading to the loss of large amounts of protein in the urine. This loss of albumin reduces the
oncotic pressure in the blood vessels, causing fluid to leak into the interstitial spaces and
result in edema. Unlike nephritic syndrome, it is primarily associated with non-
inflammatory damage to the glomerular basement membrane.
2. Which clinical finding is characteristic of a patient in the oliguric phase of acute kidney
injury (AKI)?
A. Metabolic alkalosis
B. Hypokalemia
C. Increased urine output
,D. Elevated BUN and Creatinine
Answer: D
Rationale: The oliguric phase of AKI is marked by a significant decrease in glomerular
filtration rate, resulting in the retention of nitrogenous wastes. This leads to an elevation of
blood urea nitrogen (BUN) and serum creatinine levels. During this phase, patients also
commonly experience metabolic acidosis and hyperkalemia due to impaired renal
excretion.
3. A patient is diagnosed with Type 1 Diabetes Mellitus. What is the primary
pathophysiological mechanism of this disease?
A. Insulin resistance in peripheral tissues
B. Excessive glucagon secretion by alpha cells
C. Autoimmune destruction of pancreatic beta cells
D. Chronic inflammation of the exocrine pancreas
Answer: C
Rationale: Type 1 Diabetes Mellitus is an autoimmune disorder where the immune system
attacks and destroys the insulin-producing beta cells in the Islets of Langerhans. This
results in an absolute deficiency of insulin, making the patient dependent on exogenous
insulin for survival. It is distinct from Type 2 Diabetes, which primarily involves insulin
resistance and relative insulin deficiency.
, 4. What is the hallmark characteristic of Crohn’s disease that distinguishes it from Ulcerative
Colitis?
A. Skip lesions and transmural inflammation
B. Continuous lesions starting in the rectum
C. Involvement only of the mucosal layer
D. High risk of toxic megacolon
Answer: A
Rationale: Crohn’s disease is characterized by ‘skip lesions,’ which are healthy areas of the
bowel interspersed with diseased segments. The inflammation is transmural, meaning it
affects all layers of the intestinal wall, which can lead to fistula formation and strictures. In
contrast, ulcerative colitis typically presents with continuous inflammation restricted to
the mucosal layer of the colon and rectum.
5. A patient with chronic liver failure exhibits confusion and a flapping tremor of the hands
(asterixis). What is the most likely cause of these symptoms?
A. Accumulation of bilirubin
B. Decreased albumin synthesis
C. Elevated serum ammonia levels
D. Hyponatremia
Answer: C
283 Pathophysiology | Chamberlain
1. A patient presents with massive proteinuria, hypoalbuminemia, and generalized edema.
Which condition is most likely responsible for these clinical manifestations?
A. Nephrotic Syndrome
B. Nephritic Syndrome
C. Acute Tubular Necrosis
D. Pyelonephritis
Answer: A
Rationale: Nephrotic syndrome is characterized by increased glomerular permeability,
leading to the loss of large amounts of protein in the urine. This loss of albumin reduces the
oncotic pressure in the blood vessels, causing fluid to leak into the interstitial spaces and
result in edema. Unlike nephritic syndrome, it is primarily associated with non-
inflammatory damage to the glomerular basement membrane.
2. Which clinical finding is characteristic of a patient in the oliguric phase of acute kidney
injury (AKI)?
A. Metabolic alkalosis
B. Hypokalemia
C. Increased urine output
,D. Elevated BUN and Creatinine
Answer: D
Rationale: The oliguric phase of AKI is marked by a significant decrease in glomerular
filtration rate, resulting in the retention of nitrogenous wastes. This leads to an elevation of
blood urea nitrogen (BUN) and serum creatinine levels. During this phase, patients also
commonly experience metabolic acidosis and hyperkalemia due to impaired renal
excretion.
3. A patient is diagnosed with Type 1 Diabetes Mellitus. What is the primary
pathophysiological mechanism of this disease?
A. Insulin resistance in peripheral tissues
B. Excessive glucagon secretion by alpha cells
C. Autoimmune destruction of pancreatic beta cells
D. Chronic inflammation of the exocrine pancreas
Answer: C
Rationale: Type 1 Diabetes Mellitus is an autoimmune disorder where the immune system
attacks and destroys the insulin-producing beta cells in the Islets of Langerhans. This
results in an absolute deficiency of insulin, making the patient dependent on exogenous
insulin for survival. It is distinct from Type 2 Diabetes, which primarily involves insulin
resistance and relative insulin deficiency.
, 4. What is the hallmark characteristic of Crohn’s disease that distinguishes it from Ulcerative
Colitis?
A. Skip lesions and transmural inflammation
B. Continuous lesions starting in the rectum
C. Involvement only of the mucosal layer
D. High risk of toxic megacolon
Answer: A
Rationale: Crohn’s disease is characterized by ‘skip lesions,’ which are healthy areas of the
bowel interspersed with diseased segments. The inflammation is transmural, meaning it
affects all layers of the intestinal wall, which can lead to fistula formation and strictures. In
contrast, ulcerative colitis typically presents with continuous inflammation restricted to
the mucosal layer of the colon and rectum.
5. A patient with chronic liver failure exhibits confusion and a flapping tremor of the hands
(asterixis). What is the most likely cause of these symptoms?
A. Accumulation of bilirubin
B. Decreased albumin synthesis
C. Elevated serum ammonia levels
D. Hyponatremia
Answer: C
