NR507 ADVANCED
PATHOPHYSIOLOGY MIDTERM EXAM
COMPREHENSIVE GUIDE
1. A patient presents with a chronic cough and a history of smoking. A biopsy of the bronchial
lining reveals that columnar ciliated epithelial cells have been replaced by stratified
squamous epithelial cells. Which cellular adaptation is this?
A. Atrophy
B. Hypertrophy
C. Metaplasia
D. Dysplasia
Answer: C
Conceptual Explanation: Metaplasia is the reversible replacement of one mature cell type
by another, often less differentiated, cell type to better withstand environmental stress.
2. In the context of cellular injury, what is the primary mechanism by which reactive oxygen
species (ROS) cause damage to the cell?
A. Lipid peroxidation of membranes
,B. Activation of sodium-potassium pumps
C. Inhibition of the Krebs cycle
D. Dilation of the endoplasmic reticulum
Answer: A
Conceptual Explanation: ROS cause cell injury via lipid peroxidation, which destroys
unsaturated fatty acids in cell membranes, as well as protein fragmentation and DNA
damage.
3. Which of the following electrolyte imbalances is most likely to cause a shortened QT
interval and shortened ST segment on an EKG?
A. Hyperkalemia
B. Hypocalcemia
C. Hypomagnesemia
D. Hypercalcemia
Answer: D
Conceptual Explanation: Hypercalcemia shortens the QT interval and the ST segment,
while hypocalcemia prolongs the QT interval.
4. What is the hallmark physiological finding in patients with Nephrotic Syndrome?
A. Hematuria with RBC casts
B. Proteinuria exceeding 3.5g per day
, C. Reduced serum cholesterol levels
D. Hypotension due to fluid loss
Answer: B
Conceptual Explanation: Nephrotic syndrome is characterized by massive proteinuria
(>3.5g/day), hypoalbuminemia, hyperlipidemia, and peripheral edema.
5. A 45-year-old male presents with severe chest pain that radiates to the left arm and jaw.
Lab tests show elevated Troponin I levels. What is the most likely underlying
pathophysiological process?
A. Stable angina due to fixed plaque
B. Pericarditis with effusion
C. Myocardial infarction due to coronary artery occlusion
D. Aortic stenosis
Answer: C
Conceptual Explanation: Troponin I is a highly specific marker for myocardial necrosis,
indicating a myocardial infarction typically caused by acute coronary occlusion.
6. Which type of hypersensitivity reaction is mediated by IgE and involves the degranulation
of mast cells?
A. Type IV
B. Type II
PATHOPHYSIOLOGY MIDTERM EXAM
COMPREHENSIVE GUIDE
1. A patient presents with a chronic cough and a history of smoking. A biopsy of the bronchial
lining reveals that columnar ciliated epithelial cells have been replaced by stratified
squamous epithelial cells. Which cellular adaptation is this?
A. Atrophy
B. Hypertrophy
C. Metaplasia
D. Dysplasia
Answer: C
Conceptual Explanation: Metaplasia is the reversible replacement of one mature cell type
by another, often less differentiated, cell type to better withstand environmental stress.
2. In the context of cellular injury, what is the primary mechanism by which reactive oxygen
species (ROS) cause damage to the cell?
A. Lipid peroxidation of membranes
,B. Activation of sodium-potassium pumps
C. Inhibition of the Krebs cycle
D. Dilation of the endoplasmic reticulum
Answer: A
Conceptual Explanation: ROS cause cell injury via lipid peroxidation, which destroys
unsaturated fatty acids in cell membranes, as well as protein fragmentation and DNA
damage.
3. Which of the following electrolyte imbalances is most likely to cause a shortened QT
interval and shortened ST segment on an EKG?
A. Hyperkalemia
B. Hypocalcemia
C. Hypomagnesemia
D. Hypercalcemia
Answer: D
Conceptual Explanation: Hypercalcemia shortens the QT interval and the ST segment,
while hypocalcemia prolongs the QT interval.
4. What is the hallmark physiological finding in patients with Nephrotic Syndrome?
A. Hematuria with RBC casts
B. Proteinuria exceeding 3.5g per day
, C. Reduced serum cholesterol levels
D. Hypotension due to fluid loss
Answer: B
Conceptual Explanation: Nephrotic syndrome is characterized by massive proteinuria
(>3.5g/day), hypoalbuminemia, hyperlipidemia, and peripheral edema.
5. A 45-year-old male presents with severe chest pain that radiates to the left arm and jaw.
Lab tests show elevated Troponin I levels. What is the most likely underlying
pathophysiological process?
A. Stable angina due to fixed plaque
B. Pericarditis with effusion
C. Myocardial infarction due to coronary artery occlusion
D. Aortic stenosis
Answer: C
Conceptual Explanation: Troponin I is a highly specific marker for myocardial necrosis,
indicating a myocardial infarction typically caused by acute coronary occlusion.
6. Which type of hypersensitivity reaction is mediated by IgE and involves the degranulation
of mast cells?
A. Type IV
B. Type II
