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NR507 – Advanced Pathophysiology

Exam Study Guide – Final Study Guide

Exam Format: Cumulative
Question Type: Multiple Choice
Number of Questions: 100
Time Allotted: 120 minutes
Testing Timeframe: The final exam will only be available starting on Wednesday Week 8 at
12:01 am MT until Saturday Week 8 at 11:59 pm MT.


1. Exam CoverageContent Areas:

• Week 5: Gastrointestinal and Neurobiological Pathologies

• Week 6: Endocrine Pathologies

• Week 7: CNS Sensory and Motor Pathologies

• Week 8: Brain and Dermatological Pathologies

2. Key Concepts to Study

Gastrointestinal pathologies:

Pathophysiology of GERD

Gastroesophageal reflux disease (GERD) occurs when the lower esophageal sphincter (LES)
becomes weakened or relaxes inappropriately, allowing gastric acid to reflux into the esophagus.
Chronic exposure to acid causes mucosal inflammation, irritation, and possible erosion.

Signs and Symptoms of GERD

Common symptoms include heartburn, regurgitation, chest pain, dysphagia, chronic cough, and
hoarseness, particularly after meals or when lying down.

Pharmacologic Management of GERD

Treatment includes proton pump inhibitors (PPIs) such as omeprazole, H2 receptor antagonists
like famotidine, and antacids for symptomatic relief. Prokinetic agents may be used in selected
cases.

Risk Factors for Esophageal Stricture




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Chronic GERD, prolonged acid exposure, esophageal injury, radiation therapy, or ingestion of
caustic substances can lead to fibrosis and narrowing of the esophagus.

Hiatal Hernia Treatment

Treatment involves lifestyle modifications (weight loss, avoiding large meals), acid-suppressive
therapy, and surgical repair (e.g., Nissen fundoplication) in severe cases.

Pathophysiology of Appendicitis

Appendicitis results from obstruction of the appendix lumen, often by fecalith or lymphoid
hyperplasia, leading to increased pressure, bacterial overgrowth, ischemia, and inflammation.

Symptoms of Appendicitis

Patients typically experience right lower quadrant abdominal pain (McBurney’s point), nausea,
vomiting, fever, and rebound tenderness.

Diagnosing Appendicitis via Lab Work

Laboratory findings may show leukocytosis with a left shift (increased neutrophils), elevated
Creactive protein (CRP), and occasionally mild electrolyte disturbances.

Risks for Appendectomy in Adults

Risks include infection, bleeding, anesthesia complications, bowel obstruction, and, rarely,
incisional hernia.

Peptic Ulcer Disease (PUD) Pathophysiology

PUD involves mucosal erosion in the stomach or duodenum due to an imbalance between
mucosal defense and acid-peptic injury, often associated with Helicobacter pylori infection or
NSAID use.

Risk Factors for PUD

Risk factors include H. pylori infection, chronic NSAID use, smoking, alcohol use, and stress.

Compare Gastric and Duodenal Ulcers

• Gastric ulcers: Pain worsens with food; more likely associated with older age and
NSAIDs.
• Duodenal ulcers: Pain improves with food; often related to H. pylori infection and
increased acid production.

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