NSG 5140 ADVANCED PATHOPHYSIOLOGY –
MIDTERM 1 EXAM QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES GRADED A+
LATEST
1. Which of the following is the primary mechanism of cellular injury in
hypoxic conditions?
A. DNA mutation
B. ATP depletion leading to loss of ion homeostasis
C. Free radical formation
D. Protein misfolding
Answer: B
Rationale: Hypoxia limits oxidative phosphorylation → decreased ATP → Na⁺/K⁺
pump failure → cell swelling and injury.
2. A patient presents with edema due to heart failure. Which mechanism is
primarily responsible?
A. Increased plasma oncotic pressure
B. Increased hydrostatic pressure in capillaries
C. Decreased capillary permeability
D. Lymphatic obstruction
Answer: B
Rationale: Elevated hydrostatic pressure pushes fluid into interstitial spaces,
causing edema in CHF.
3. Which electrolyte imbalance is most likely in a patient with Addison’s
disease?
A. Hypernatremia, hypokalemia
B. Hypercalcemia, hypermagnesemia
,C. Hyponatremia, hyperkalemia f
D. Hypokalemia, hypernatremia f
Answer: C f
Rationale: Addison’s disease causes aldosterone deficiency → Na⁺ loss (hyponatremia) a
f f f f f f f f f f
nd K⁺ retention (hyperkalemia).
f f f
4. The hallmark of acute inflammation is:
f f f f f
A. Fibrosis
B. Vasodilationand increased vascular permeability
f f f f
C. Neoplasia
D. Autoantibody formation f
Answer: B f
Rationale:Acute inflammation triggers redness, heat, swelling, and pain through vascula
f f f f f f f f f f
r changes.
f
5. Which intracellular signaling pathway is most directly involved in ap
f f f f f f f f f
optosis?
A. MAPK
B. Caspase cascade f
C. JAK/STAT
D. PI3K/Akt
Answer: B f
Rationale:Caspases mediate programmed cell death by cleaving cellular substrates.
f f f f f f f f f
6. In a patient with chronic liver disease, whichlab value best reflects im
f f f f f f f f f f f f
paired synthetic function?
f f
A. AST
B. ALT
C. Albumin
D. Bilirubin
,Answer: C f
Rationale:Albumin productionis reduced in liver dysfunction; low albumin indicate
f f f f f f f f f f
s impaired synthetic capacity.
f f f
7. Which type of shock is causedby severe allergic reactions?
f f f f f f f f f
A. Cardiogenic
B. Hypovolemic
C. Distributive (anaphylactic) f
D. Obstructive
Answer: C f
Rationale:Anaphylaxis causes vasodilation and capillary leak → distributive shock.
f f f f f f f f f
8. A patient with type 1 diabetes presents with hyperglycemia, ketonuria, and aci
f f f f f f f f f f f
dosis. This is indicative of:
f f f f
A. HHNS
B. DKA (Diabetic Ketoacidosis)
f f
C. Hypoglycemia
D. Metabolic alkalosis f
Answer: B f
Rationale:DKA occurs in insulin deficiency → hyperglycemia, lipolysis, ketone product
f f f f f f f f f f
ion, and metabolic acidosis.
f f f
9. Which type of hypersensitivity reactionis mediated by IgE?
f f f f f f f f
A. Type I f
B. Type II f
C. Type I f
D. Type IV f
Answer: C f
Rationale:Type I hypersensitivity involves IgE binding to mast cells → histamine release
f f f f f f f f f f f f f
→ allergic reactions.
f f
, 10. The most common cause ofprimary hyperthyroidism is:
f f f f f f f
A. Pituitary adenoma f
B. Thyroid carcinoma f
C. Graves’ disease f
D. Iodine deficiency f
Answer: C f
Rationale:Graves’ disease is an autoimmune disorder causing thyroid hormone overprod
f f f f f f f f f f
uction.
11. Which of the following best describes metabolic acidosis?
f f f f f f f
A. Increased HCO₃⁻, decreased H⁺ f f f
B. Decreased HCO₃⁻, decreased pH f f f
C. Increased HCO₃⁻, increased pH f f f
D. Decreased H⁺, increased pH f f f
Answer: B f
Rationale:Metabolic acidosis is caused by a primary loss of bicarbonate or accumulation
f f f f f f f f f f f f f
of acids → low pH.
f f f f
12. A patient with cirrhosis has ascites.Whichmechanism primarily co
f f f f f f f f f
ntributes?
A. High plasma oncotic pressure
f f f
B. Portalhypertension and hypoalbuminemia
f f f
C. Renal sodium loss
f f
D. Hyperkalemia
Answer: B f
Rationale:Increased hydrostatic pressurein portal circulation and low albumin redu
f f f f f f f f f f
ce plasma oncotic pressure → fluid accumulation.
f f f f f f
MIDTERM 1 EXAM QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES GRADED A+
LATEST
1. Which of the following is the primary mechanism of cellular injury in
hypoxic conditions?
A. DNA mutation
B. ATP depletion leading to loss of ion homeostasis
C. Free radical formation
D. Protein misfolding
Answer: B
Rationale: Hypoxia limits oxidative phosphorylation → decreased ATP → Na⁺/K⁺
pump failure → cell swelling and injury.
2. A patient presents with edema due to heart failure. Which mechanism is
primarily responsible?
A. Increased plasma oncotic pressure
B. Increased hydrostatic pressure in capillaries
C. Decreased capillary permeability
D. Lymphatic obstruction
Answer: B
Rationale: Elevated hydrostatic pressure pushes fluid into interstitial spaces,
causing edema in CHF.
3. Which electrolyte imbalance is most likely in a patient with Addison’s
disease?
A. Hypernatremia, hypokalemia
B. Hypercalcemia, hypermagnesemia
,C. Hyponatremia, hyperkalemia f
D. Hypokalemia, hypernatremia f
Answer: C f
Rationale: Addison’s disease causes aldosterone deficiency → Na⁺ loss (hyponatremia) a
f f f f f f f f f f
nd K⁺ retention (hyperkalemia).
f f f
4. The hallmark of acute inflammation is:
f f f f f
A. Fibrosis
B. Vasodilationand increased vascular permeability
f f f f
C. Neoplasia
D. Autoantibody formation f
Answer: B f
Rationale:Acute inflammation triggers redness, heat, swelling, and pain through vascula
f f f f f f f f f f
r changes.
f
5. Which intracellular signaling pathway is most directly involved in ap
f f f f f f f f f
optosis?
A. MAPK
B. Caspase cascade f
C. JAK/STAT
D. PI3K/Akt
Answer: B f
Rationale:Caspases mediate programmed cell death by cleaving cellular substrates.
f f f f f f f f f
6. In a patient with chronic liver disease, whichlab value best reflects im
f f f f f f f f f f f f
paired synthetic function?
f f
A. AST
B. ALT
C. Albumin
D. Bilirubin
,Answer: C f
Rationale:Albumin productionis reduced in liver dysfunction; low albumin indicate
f f f f f f f f f f
s impaired synthetic capacity.
f f f
7. Which type of shock is causedby severe allergic reactions?
f f f f f f f f f
A. Cardiogenic
B. Hypovolemic
C. Distributive (anaphylactic) f
D. Obstructive
Answer: C f
Rationale:Anaphylaxis causes vasodilation and capillary leak → distributive shock.
f f f f f f f f f
8. A patient with type 1 diabetes presents with hyperglycemia, ketonuria, and aci
f f f f f f f f f f f
dosis. This is indicative of:
f f f f
A. HHNS
B. DKA (Diabetic Ketoacidosis)
f f
C. Hypoglycemia
D. Metabolic alkalosis f
Answer: B f
Rationale:DKA occurs in insulin deficiency → hyperglycemia, lipolysis, ketone product
f f f f f f f f f f
ion, and metabolic acidosis.
f f f
9. Which type of hypersensitivity reactionis mediated by IgE?
f f f f f f f f
A. Type I f
B. Type II f
C. Type I f
D. Type IV f
Answer: C f
Rationale:Type I hypersensitivity involves IgE binding to mast cells → histamine release
f f f f f f f f f f f f f
→ allergic reactions.
f f
, 10. The most common cause ofprimary hyperthyroidism is:
f f f f f f f
A. Pituitary adenoma f
B. Thyroid carcinoma f
C. Graves’ disease f
D. Iodine deficiency f
Answer: C f
Rationale:Graves’ disease is an autoimmune disorder causing thyroid hormone overprod
f f f f f f f f f f
uction.
11. Which of the following best describes metabolic acidosis?
f f f f f f f
A. Increased HCO₃⁻, decreased H⁺ f f f
B. Decreased HCO₃⁻, decreased pH f f f
C. Increased HCO₃⁻, increased pH f f f
D. Decreased H⁺, increased pH f f f
Answer: B f
Rationale:Metabolic acidosis is caused by a primary loss of bicarbonate or accumulation
f f f f f f f f f f f f f
of acids → low pH.
f f f f
12. A patient with cirrhosis has ascites.Whichmechanism primarily co
f f f f f f f f f
ntributes?
A. High plasma oncotic pressure
f f f
B. Portalhypertension and hypoalbuminemia
f f f
C. Renal sodium loss
f f
D. Hyperkalemia
Answer: B f
Rationale:Increased hydrostatic pressurein portal circulation and low albumin redu
f f f f f f f f f f
ce plasma oncotic pressure → fluid accumulation.
f f f f f f
