Chamberlain NR283 Pathophysiology –
Exam 2 Actual Exam Questions &
Answers with Rationales 2026/2027 100%
Correct | Pass Guaranteed | Grade A
Q01 A patient presents with fatigue, weight gain, cold intolerance, dry skin, and bradycardia.
Labs show TSH 18.2 mIU/L (elevated) and free T4 0.4 ng/dL (low). What is the most likely
diagnosis?
Answer: Primary hypothyroidism
Rationale: Elevated TSH with low free T4 is the classic pattern for primary thyroid gland failure
(most commonly Hashimoto thyroiditis in adults).
Q02 Which autoantibody is most specific for Hashimoto thyroiditis?
Answer: Anti-thyroid peroxidase (anti-TPO) antibody
Rationale: Anti-TPO antibodies are present in >90% of Hashimoto cases and indicate
autoimmune destruction of thyroid tissue.
Q03 A 34-year-old female has palpitations, unintentional weight loss, heat intolerance, tremor,
and exophthalmos. TSH is <0.01 mIU/L, free T4 is elevated, and TSH receptor antibodies are
positive. What is the diagnosis?
Answer: Graves disease
Rationale: Low TSH + high free T4 + positive TSH receptor antibodies (TRAb) is diagnostic of
Graves disease (autoimmune hyperthyroidism).
Q04 A patient with Graves disease is started on methimazole. Which serious adverse effect
requires monitoring of the CBC?
, Answer: Agranulocytosis
Rationale: Methimazole (and PTU) carry a rare but potentially fatal risk of agranulocytosis;
CBC monitoring is recommended, especially in the first 3 months.
Q05 Which hormone is primarily responsible for increasing blood calcium levels by stimulating
osteoclast activity and renal calcium reabsorption?
Answer: Parathyroid hormone (PTH)
Rationale: PTH is secreted when serum calcium is low; it mobilizes calcium from bone,
increases renal reabsorption, and promotes vitamin D activation.
Q06 A patient with chronic kidney disease stage 4 has secondary hyperparathyroidism. Which
lab pattern is expected?
Answer: High PTH, low calcium, high phosphorus
Rationale: Damaged kidneys cannot excrete phosphate → hyperphosphatemia → hypocalcemia
→ compensatory PTH elevation.
Q07 A 55-year-old male has fatigue, erectile dysfunction, decreased libido, and depression.
Morning total testosterone is 180 ng/dL (low). Next step?
Answer: Repeat morning total testosterone + obtain LH and FSH
Rationale: Confirm hypogonadism with repeat morning level and evaluate the hypothalamic-
pituitary-gonadal axis (primary vs secondary hypogonadism).
Q08 A 28-year-old female presents with polyuria, polydipsia, unintentional weight loss, and
random plasma glucose 380 mg/dL. What is the most likely diagnosis?
Answer: Type 1 diabetes mellitus
Rationale: Acute onset, classic symptoms, and high glucose in a young adult strongly suggest
type 1 DM (autoimmune beta-cell destruction).
Exam 2 Actual Exam Questions &
Answers with Rationales 2026/2027 100%
Correct | Pass Guaranteed | Grade A
Q01 A patient presents with fatigue, weight gain, cold intolerance, dry skin, and bradycardia.
Labs show TSH 18.2 mIU/L (elevated) and free T4 0.4 ng/dL (low). What is the most likely
diagnosis?
Answer: Primary hypothyroidism
Rationale: Elevated TSH with low free T4 is the classic pattern for primary thyroid gland failure
(most commonly Hashimoto thyroiditis in adults).
Q02 Which autoantibody is most specific for Hashimoto thyroiditis?
Answer: Anti-thyroid peroxidase (anti-TPO) antibody
Rationale: Anti-TPO antibodies are present in >90% of Hashimoto cases and indicate
autoimmune destruction of thyroid tissue.
Q03 A 34-year-old female has palpitations, unintentional weight loss, heat intolerance, tremor,
and exophthalmos. TSH is <0.01 mIU/L, free T4 is elevated, and TSH receptor antibodies are
positive. What is the diagnosis?
Answer: Graves disease
Rationale: Low TSH + high free T4 + positive TSH receptor antibodies (TRAb) is diagnostic of
Graves disease (autoimmune hyperthyroidism).
Q04 A patient with Graves disease is started on methimazole. Which serious adverse effect
requires monitoring of the CBC?
, Answer: Agranulocytosis
Rationale: Methimazole (and PTU) carry a rare but potentially fatal risk of agranulocytosis;
CBC monitoring is recommended, especially in the first 3 months.
Q05 Which hormone is primarily responsible for increasing blood calcium levels by stimulating
osteoclast activity and renal calcium reabsorption?
Answer: Parathyroid hormone (PTH)
Rationale: PTH is secreted when serum calcium is low; it mobilizes calcium from bone,
increases renal reabsorption, and promotes vitamin D activation.
Q06 A patient with chronic kidney disease stage 4 has secondary hyperparathyroidism. Which
lab pattern is expected?
Answer: High PTH, low calcium, high phosphorus
Rationale: Damaged kidneys cannot excrete phosphate → hyperphosphatemia → hypocalcemia
→ compensatory PTH elevation.
Q07 A 55-year-old male has fatigue, erectile dysfunction, decreased libido, and depression.
Morning total testosterone is 180 ng/dL (low). Next step?
Answer: Repeat morning total testosterone + obtain LH and FSH
Rationale: Confirm hypogonadism with repeat morning level and evaluate the hypothalamic-
pituitary-gonadal axis (primary vs secondary hypogonadism).
Q08 A 28-year-old female presents with polyuria, polydipsia, unintentional weight loss, and
random plasma glucose 380 mg/dL. What is the most likely diagnosis?
Answer: Type 1 diabetes mellitus
Rationale: Acute onset, classic symptoms, and high glucose in a young adult strongly suggest
type 1 DM (autoimmune beta-cell destruction).
