NR 507 Week 8 Final Exams NR-507 Advanced
Pathophysiology Actual Week 8 Final Exam
Complete
Cellular Processes & Genetics
1. A 58-year-old man with a history of hypertension presents with sudden chest
pain radiating to his left arm. An ECG shows ST-segment elevation. At the cellular
level, what is the primary mechanism of myocardial injury in this patient?
A) Calcium overload triggering apoptosis
B) Hypoxic injury due to ischemia
C) Free radical damage from reperfusion
D) Direct chemical toxicity from catecholamines
Answer: B
Rationale: Myocardial infarction results from ischemia, which causes hypoxia.
Hypoxia halts aerobic ATP production, leading to failure of the Na⁺/K⁺ pump,
cellular swelling, calcium influx, and ultimately necrosis. While reperfusion can
cause additional injury, the primary insult is hypoxic/ischemic injury.
2. A newborn is noted to have a flat facial profile, upward-slanting palpebral
fissures, a single palmar crease, and a gap between the first and second toes.
Which chromosomal abnormality is most likely?
A) Monosomy X (Turner syndrome)
B) Trisomy 21 (Down syndrome)
C) Trisomy 18 (Edwards syndrome)
D) Deletion of chromosome 5 (Cri-du-chat syndrome)
, Answer: B
*Rationale: These findings are classic for Trisomy 21 (Down syndrome). Advanced
maternal age is the primary risk factor. Trisomy 18 presents with rocker-bottom
feet and clenched hands; Turner syndrome presents with webbed neck and short
stature; Cri-du-chat presents with cat-like cry and microcephaly.*
3. A 28-year-old male presents with infertility, tall stature, gynecomastia, and
small firm testes. His karyotype is most likely:
A) 46,XY
B) 47,XXY
C) 45,XO
D) 47,XYY
Answer: B
Rationale: Klinefelter syndrome (47,XXY) results from an extra X chromosome in a
phenotypic male. Clinical features include tall stature, gynecomastia, small testes,
infertility, and increased risk for breast cancer and osteoporosis.
Inflammation, Immunity & Hypersensitivity
4. A patient develops widespread urticaria, bronchospasm, and hypotension
within 5 minutes of receiving intravenous penicillin. Which type of hypersensitivity
reaction is occurring?
A) Type I (IgE-mediated)
B) Type II (Cytotoxic)
C) Type III (Immune complex)
D) Type IV (Delayed-type)
Answer: A
Rationale: This is anaphylaxis, a classic Type I hypersensitivity reaction mediated
by IgE binding to mast cells and basophils, causing histamine release and rapid
systemic effects. Type II involves antibodies against cell surfaces (e.g., autoimmune
Pathophysiology Actual Week 8 Final Exam
Complete
Cellular Processes & Genetics
1. A 58-year-old man with a history of hypertension presents with sudden chest
pain radiating to his left arm. An ECG shows ST-segment elevation. At the cellular
level, what is the primary mechanism of myocardial injury in this patient?
A) Calcium overload triggering apoptosis
B) Hypoxic injury due to ischemia
C) Free radical damage from reperfusion
D) Direct chemical toxicity from catecholamines
Answer: B
Rationale: Myocardial infarction results from ischemia, which causes hypoxia.
Hypoxia halts aerobic ATP production, leading to failure of the Na⁺/K⁺ pump,
cellular swelling, calcium influx, and ultimately necrosis. While reperfusion can
cause additional injury, the primary insult is hypoxic/ischemic injury.
2. A newborn is noted to have a flat facial profile, upward-slanting palpebral
fissures, a single palmar crease, and a gap between the first and second toes.
Which chromosomal abnormality is most likely?
A) Monosomy X (Turner syndrome)
B) Trisomy 21 (Down syndrome)
C) Trisomy 18 (Edwards syndrome)
D) Deletion of chromosome 5 (Cri-du-chat syndrome)
, Answer: B
*Rationale: These findings are classic for Trisomy 21 (Down syndrome). Advanced
maternal age is the primary risk factor. Trisomy 18 presents with rocker-bottom
feet and clenched hands; Turner syndrome presents with webbed neck and short
stature; Cri-du-chat presents with cat-like cry and microcephaly.*
3. A 28-year-old male presents with infertility, tall stature, gynecomastia, and
small firm testes. His karyotype is most likely:
A) 46,XY
B) 47,XXY
C) 45,XO
D) 47,XYY
Answer: B
Rationale: Klinefelter syndrome (47,XXY) results from an extra X chromosome in a
phenotypic male. Clinical features include tall stature, gynecomastia, small testes,
infertility, and increased risk for breast cancer and osteoporosis.
Inflammation, Immunity & Hypersensitivity
4. A patient develops widespread urticaria, bronchospasm, and hypotension
within 5 minutes of receiving intravenous penicillin. Which type of hypersensitivity
reaction is occurring?
A) Type I (IgE-mediated)
B) Type II (Cytotoxic)
C) Type III (Immune complex)
D) Type IV (Delayed-type)
Answer: A
Rationale: This is anaphylaxis, a classic Type I hypersensitivity reaction mediated
by IgE binding to mast cells and basophils, causing histamine release and rapid
systemic effects. Type II involves antibodies against cell surfaces (e.g., autoimmune
