NSG 1520 PATHOPHYSIOLOGY EXAM 3
- COMPREHENSIVE REVIEW
QUESTIONS AND ANSWERS
1. A patient presents with polyuria, polydipsia, and a urine specific gravity of 1.002. Which
pathophysiological process is most likely occurring?
A. Excessive secretion of antidiuretic hormone (ADH)
B. Insulin resistance leading to osmotic diuresis
C. Deficiency in the synthesis or release of antidiuretic hormone (ADH)
D. Hyperaldosteronism causing sodium retention
Answer: C
Conceptual Explanation: Diabetes Insipidus is characterized by a deficiency of ADH,
leading to the inability of the kidneys to reabsorb water, resulting in dilute urine with low
specific gravity.
2. Which clinical manifestation is a hallmark of Grave’s disease due to the stimulation of
retro-orbital connective tissue?
A. Myxedema
B. Exophthalmos
,C. Goiter
D. Acanthosis nigricans
Answer: B
Conceptual Explanation: Exophthalmos (bulging eyes) in Grave’s disease results from
autoimmune-mediated inflammation and accumulation of glycosaminoglycans in the
extraocular muscles and retro-orbital fat.
3. In the pathogenesis of Type 2 Diabetes Mellitus, what is the primary cellular defect?
A. Autoimmune destruction of pancreatic beta cells
B. Absolute deficiency of insulin production
C. Decreased sensitivity of peripheral tissues to insulin
D. Excessive glucagon secretion from alpha cells
Answer: C
Conceptual Explanation: Type 2 DM is primarily characterized by insulin resistance,
where target tissues fail to respond appropriately to insulin, often coupled with a relative
rather than absolute insulin deficiency.
4. A patient with chronic kidney disease (CKD) develops secondary hyperparathyroidism.
What is the initiating factor?
A. Hypocalcemia due to hyperphosphatemia and decreased Vitamin D activation
B. Direct stimulation of the parathyroid gland by urea
, C. Metabolic alkalosis inhibiting calcium ionization
D. Hypernatremia triggering hormonal release
Answer: A
Conceptual Explanation: In CKD, kidneys cannot excrete phosphorus or activate Vitamin
D. High phosphorus binds calcium, and low Vitamin D reduces calcium absorption, leading
to hypocalcemia, which stimulates PTH release.
5. Which acid-base imbalance is most commonly associated with early stages of Acute Kidney
Injury (AKI) or Chronic Kidney Disease?
A. Respiratory Alkalosis
B. Respiratory Acidosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
Answer: C
Conceptual Explanation: Kidneys are responsible for excreting hydrogen ions and
regenerating bicarbonate. Failure to do so in renal impairment results in metabolic
acidosis.
6. What is the primary mechanism of injury in Intrarenal Acute Kidney Injury (AKI) caused by
nephrotoxic drugs?
A. Decreased renal perfusion pressure
- COMPREHENSIVE REVIEW
QUESTIONS AND ANSWERS
1. A patient presents with polyuria, polydipsia, and a urine specific gravity of 1.002. Which
pathophysiological process is most likely occurring?
A. Excessive secretion of antidiuretic hormone (ADH)
B. Insulin resistance leading to osmotic diuresis
C. Deficiency in the synthesis or release of antidiuretic hormone (ADH)
D. Hyperaldosteronism causing sodium retention
Answer: C
Conceptual Explanation: Diabetes Insipidus is characterized by a deficiency of ADH,
leading to the inability of the kidneys to reabsorb water, resulting in dilute urine with low
specific gravity.
2. Which clinical manifestation is a hallmark of Grave’s disease due to the stimulation of
retro-orbital connective tissue?
A. Myxedema
B. Exophthalmos
,C. Goiter
D. Acanthosis nigricans
Answer: B
Conceptual Explanation: Exophthalmos (bulging eyes) in Grave’s disease results from
autoimmune-mediated inflammation and accumulation of glycosaminoglycans in the
extraocular muscles and retro-orbital fat.
3. In the pathogenesis of Type 2 Diabetes Mellitus, what is the primary cellular defect?
A. Autoimmune destruction of pancreatic beta cells
B. Absolute deficiency of insulin production
C. Decreased sensitivity of peripheral tissues to insulin
D. Excessive glucagon secretion from alpha cells
Answer: C
Conceptual Explanation: Type 2 DM is primarily characterized by insulin resistance,
where target tissues fail to respond appropriately to insulin, often coupled with a relative
rather than absolute insulin deficiency.
4. A patient with chronic kidney disease (CKD) develops secondary hyperparathyroidism.
What is the initiating factor?
A. Hypocalcemia due to hyperphosphatemia and decreased Vitamin D activation
B. Direct stimulation of the parathyroid gland by urea
, C. Metabolic alkalosis inhibiting calcium ionization
D. Hypernatremia triggering hormonal release
Answer: A
Conceptual Explanation: In CKD, kidneys cannot excrete phosphorus or activate Vitamin
D. High phosphorus binds calcium, and low Vitamin D reduces calcium absorption, leading
to hypocalcemia, which stimulates PTH release.
5. Which acid-base imbalance is most commonly associated with early stages of Acute Kidney
Injury (AKI) or Chronic Kidney Disease?
A. Respiratory Alkalosis
B. Respiratory Acidosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
Answer: C
Conceptual Explanation: Kidneys are responsible for excreting hydrogen ions and
regenerating bicarbonate. Failure to do so in renal impairment results in metabolic
acidosis.
6. What is the primary mechanism of injury in Intrarenal Acute Kidney Injury (AKI) caused by
nephrotoxic drugs?
A. Decreased renal perfusion pressure
