NSG 1520 PATHOPHYSIOLOGY EXAM 3
REVIEW QUESTIONS AND ANSWERS
1. Which clinical manifestation is most characteristic of Nephrotic Syndrome?
A. Gross hematuria and hypertension
B. Increased serum albumin levels
C. Oliguria and flank pain
D. Massive proteinuria exceeding 3.5g/day
Answer: D
Conceptual Explanation: Nephrotic syndrome is characterized by massive proteinuria
(>3.5g/day) due to increased glomerular permeability, leading to hypoalbuminemia and
generalized edema.
2. In the context of Chronic Kidney Disease (CKD), why does secondary hyperparathyroidism
occur?
A. Excessive excretion of calcium by the kidneys
B. Hypophosphatemia stimulating the parathyroid gland
C. Reduced Vitamin D activation leading to hypocalcemia
,D. Hypersecretion of aldosterone
Answer: C
Conceptual Explanation: In CKD, the kidneys fail to activate Vitamin D. Without active
Vitamin D, calcium absorption decreases (hypocalcemia), which triggers the parathyroid
glands to release PTH to compensate.
3. A patient presents with sudden onset of severe flank pain radiating to the groin and
hematuria. What is the most likely diagnosis?
A. Acute Pyelonephritis
B. Polycystic Kidney Disease
C. Nephrolithiasis
D. Cystitis
Answer: C
Conceptual Explanation: Renal calculi (nephrolithiasis) cause renal colic, characterized by
sudden, sharp, radiating pain and hematuria as the stone passes through the urinary tract.
4. What is the primary pathophysiological mechanism behind Gastroesophageal Reflux
Disease (GERD)?
A. Excessive production of gastrin
B. Inappropriate relaxation of the lower esophageal sphincter (LES)
C. Rapid gastric emptying
, D. Autoimmune destruction of parietal cells
Answer: B
Conceptual Explanation: GERD occurs when the LES relaxes inappropriately or is weak,
allowing acidic stomach contents to reflux into the esophagus.
5. Which of the following distinguishes Crohn’s Disease from Ulcerative Colitis?
A. Crohn’s involves only the mucosal layer
B. Ulcerative Colitis exhibits ‘skip lesions’
C. Ulcerative Colitis causes transmural inflammation
D. Crohn’s can affect any part of the GI tract from mouth to anus
Answer: D
Conceptual Explanation: Crohn’s disease is characterized by transmural inflammation
and skip lesions anywhere in the GI tract, whereas UC is limited to the colon and the
mucosal layer.
6. A patient with cirrhosis develops hepatic encephalopathy. What is the primary neurotoxin
responsible for this condition?
A. Bilirubin
B. Urea
C. Creatinine
D. Ammonia
REVIEW QUESTIONS AND ANSWERS
1. Which clinical manifestation is most characteristic of Nephrotic Syndrome?
A. Gross hematuria and hypertension
B. Increased serum albumin levels
C. Oliguria and flank pain
D. Massive proteinuria exceeding 3.5g/day
Answer: D
Conceptual Explanation: Nephrotic syndrome is characterized by massive proteinuria
(>3.5g/day) due to increased glomerular permeability, leading to hypoalbuminemia and
generalized edema.
2. In the context of Chronic Kidney Disease (CKD), why does secondary hyperparathyroidism
occur?
A. Excessive excretion of calcium by the kidneys
B. Hypophosphatemia stimulating the parathyroid gland
C. Reduced Vitamin D activation leading to hypocalcemia
,D. Hypersecretion of aldosterone
Answer: C
Conceptual Explanation: In CKD, the kidneys fail to activate Vitamin D. Without active
Vitamin D, calcium absorption decreases (hypocalcemia), which triggers the parathyroid
glands to release PTH to compensate.
3. A patient presents with sudden onset of severe flank pain radiating to the groin and
hematuria. What is the most likely diagnosis?
A. Acute Pyelonephritis
B. Polycystic Kidney Disease
C. Nephrolithiasis
D. Cystitis
Answer: C
Conceptual Explanation: Renal calculi (nephrolithiasis) cause renal colic, characterized by
sudden, sharp, radiating pain and hematuria as the stone passes through the urinary tract.
4. What is the primary pathophysiological mechanism behind Gastroesophageal Reflux
Disease (GERD)?
A. Excessive production of gastrin
B. Inappropriate relaxation of the lower esophageal sphincter (LES)
C. Rapid gastric emptying
, D. Autoimmune destruction of parietal cells
Answer: B
Conceptual Explanation: GERD occurs when the LES relaxes inappropriately or is weak,
allowing acidic stomach contents to reflux into the esophagus.
5. Which of the following distinguishes Crohn’s Disease from Ulcerative Colitis?
A. Crohn’s involves only the mucosal layer
B. Ulcerative Colitis exhibits ‘skip lesions’
C. Ulcerative Colitis causes transmural inflammation
D. Crohn’s can affect any part of the GI tract from mouth to anus
Answer: D
Conceptual Explanation: Crohn’s disease is characterized by transmural inflammation
and skip lesions anywhere in the GI tract, whereas UC is limited to the colon and the
mucosal layer.
6. A patient with cirrhosis develops hepatic encephalopathy. What is the primary neurotoxin
responsible for this condition?
A. Bilirubin
B. Urea
C. Creatinine
D. Ammonia
