,NSG3280/NSG 3280 Exam 4 | Pathophysiology |
Galen College | 26/27 Updated (PDF)
1. A sexually active young adult presents with dysuria and purulent urethral discharge. Which
pathophysiologic process is most consistent with gonorrhea?
A) Viral latency in sensory ganglia
B) Gram-negative diplococci invading columnar epithelium
C) Fungal overgrowth in vaginal mucosa
D) Spirochete-mediated destruction of large joints
Correct Answer: Gram-negative diplococci invading columnar epithelium
Rationale: Gonorrhea is caused by Neisseria gonorrhoeae, a gram-negative diplococcus that attaches
to and penetrates columnar epithelium, triggering an inflammatory response with neutrophil
infiltration. This process results in purulent exudate, dysuria, and urethritis.
2. Which complication best reflects the long-term pathogenesis of untreated gonorrhea in females?
A) Bone marrow suppression
B) Scarring of reproductive structures
C) Demyelination of peripheral nerves
D) Loss of lens elasticity
Correct Answer: Scarring of reproductive structures
Rationale: Untreated gonorrhea in females can ascend from the cervix to the upper genital tract,
causing salpingitis and pelvic inflammatory disease. The resulting scarring and adhesions of the
fallopian tubes can lead to tubal factor infertility and increased risk of ectopic pregnancy.
3. A 25-year-old male presents with a painless, indurated ulcer on the shaft of his penis and nontender
inguinal lymphadenopathy. Which stage of syphilis is the patient most likely experiencing?
A) Secondary syphilis
,B) Latent syphilis
C) Primary syphilis
D) Tertiary syphilis
Correct Answer: Primary syphilis
Rationale: Primary syphilis is characterized by a chancre—a painless, indurated ulcerated lesion at the
site of inoculation—appearing 10 to 90 days after exposure. Regional lymphadenopathy is often
present. Secondary syphilis involves systemic rash, latent syphilis has no symptoms, and tertiary
syphilis involves gummas and neurosyphilis.
4. In secondary syphilis, which finding is most characteristic?
A) Gummatus lesions of the skin and bone
B) Generalized maculopapular rash, including palms and soles, and condylomata lata
C) Painless chancre at the site of inoculation
D) Aortic aneurysm and tabes dorsalis
Correct Answer: Generalized maculopapular rash, including palms and soles, and condylomata lata
Rationale: Secondary syphilis occurs 4 to 10 weeks after the primary chancre, with systemic
dissemination causing a diffuse maculopapular rash often on the palms and soles, mucous patches,
and condylomata lata (moist, wart-like lesions). Gummas and aortic aneurysms are characteristic of
tertiary syphilis.
5. A 22-year-old female with Chlamydia trachomatis cervicitis is at greatest risk for which
complication?
A) Bartholin cyst
B) Pelvic inflammatory disease and subsequent tubal factor infertility
C) Uterine fibroids
D) Ovarian torsion
, Correct Answer: Pelvic inflammatory disease and subsequent tubal factor infertility
Rationale: Chlamydia trachomatis ascends from the cervix to the upper genital tract, causing
salpingitis, scarring, and adhesions that lead to tubal factor infertility and ectopic pregnancy. Bartholin
cysts are duct obstructions, fibroids are benign tumors, and ovarian torsion is a surgical emergency
unrelated to infection.
6. A mother asks how her newborn contracted ophthalmia neonatorum. Which organisms are most
likely responsible for transmission during birth?
A) Treponema pallidum or HPV
B) Neisseria gonorrhoeae or Chlamydia trachomatis
C) Herpes simplex virus or Candida albicans
D) Group B streptococcus or Escherichia coli
Correct Answer: Neisseria gonorrhoeae or Chlamydia trachomatis
Rationale: Both gonorrhea and chlamydia can be vertically transmitted during delivery, causing
neonatal conjunctivitis (ophthalmia neonatorum). Prophylactic erythromycin eye ointment is
routinely given to all newborns to prevent this infection.
7. A patient is diagnosed with herpes simplex virus type 2 (HSV-2) infection. Which pathophysiologic
process is responsible for the recurrent nature of this infection?
A) Gram-negative bacterial invasion of epithelial cells
B) Spirochete-mediated tissue destruction
C) Viral latency in sensory ganglia and reactivation
D) Fungal overgrowth in warm, moist environments
Correct Answer: Viral latency in sensory ganglia and reactivation
Rationale: Herpes simplex virus establishes latency in sensory nerve ganglia after primary infection.
Various triggers such as stress, illness, or immunosuppression can reactivate the virus, causing it to
travel down the nerve to the skin or mucosa and produce recurrent vesicular lesions.
Galen College | 26/27 Updated (PDF)
1. A sexually active young adult presents with dysuria and purulent urethral discharge. Which
pathophysiologic process is most consistent with gonorrhea?
A) Viral latency in sensory ganglia
B) Gram-negative diplococci invading columnar epithelium
C) Fungal overgrowth in vaginal mucosa
D) Spirochete-mediated destruction of large joints
Correct Answer: Gram-negative diplococci invading columnar epithelium
Rationale: Gonorrhea is caused by Neisseria gonorrhoeae, a gram-negative diplococcus that attaches
to and penetrates columnar epithelium, triggering an inflammatory response with neutrophil
infiltration. This process results in purulent exudate, dysuria, and urethritis.
2. Which complication best reflects the long-term pathogenesis of untreated gonorrhea in females?
A) Bone marrow suppression
B) Scarring of reproductive structures
C) Demyelination of peripheral nerves
D) Loss of lens elasticity
Correct Answer: Scarring of reproductive structures
Rationale: Untreated gonorrhea in females can ascend from the cervix to the upper genital tract,
causing salpingitis and pelvic inflammatory disease. The resulting scarring and adhesions of the
fallopian tubes can lead to tubal factor infertility and increased risk of ectopic pregnancy.
3. A 25-year-old male presents with a painless, indurated ulcer on the shaft of his penis and nontender
inguinal lymphadenopathy. Which stage of syphilis is the patient most likely experiencing?
A) Secondary syphilis
,B) Latent syphilis
C) Primary syphilis
D) Tertiary syphilis
Correct Answer: Primary syphilis
Rationale: Primary syphilis is characterized by a chancre—a painless, indurated ulcerated lesion at the
site of inoculation—appearing 10 to 90 days after exposure. Regional lymphadenopathy is often
present. Secondary syphilis involves systemic rash, latent syphilis has no symptoms, and tertiary
syphilis involves gummas and neurosyphilis.
4. In secondary syphilis, which finding is most characteristic?
A) Gummatus lesions of the skin and bone
B) Generalized maculopapular rash, including palms and soles, and condylomata lata
C) Painless chancre at the site of inoculation
D) Aortic aneurysm and tabes dorsalis
Correct Answer: Generalized maculopapular rash, including palms and soles, and condylomata lata
Rationale: Secondary syphilis occurs 4 to 10 weeks after the primary chancre, with systemic
dissemination causing a diffuse maculopapular rash often on the palms and soles, mucous patches,
and condylomata lata (moist, wart-like lesions). Gummas and aortic aneurysms are characteristic of
tertiary syphilis.
5. A 22-year-old female with Chlamydia trachomatis cervicitis is at greatest risk for which
complication?
A) Bartholin cyst
B) Pelvic inflammatory disease and subsequent tubal factor infertility
C) Uterine fibroids
D) Ovarian torsion
, Correct Answer: Pelvic inflammatory disease and subsequent tubal factor infertility
Rationale: Chlamydia trachomatis ascends from the cervix to the upper genital tract, causing
salpingitis, scarring, and adhesions that lead to tubal factor infertility and ectopic pregnancy. Bartholin
cysts are duct obstructions, fibroids are benign tumors, and ovarian torsion is a surgical emergency
unrelated to infection.
6. A mother asks how her newborn contracted ophthalmia neonatorum. Which organisms are most
likely responsible for transmission during birth?
A) Treponema pallidum or HPV
B) Neisseria gonorrhoeae or Chlamydia trachomatis
C) Herpes simplex virus or Candida albicans
D) Group B streptococcus or Escherichia coli
Correct Answer: Neisseria gonorrhoeae or Chlamydia trachomatis
Rationale: Both gonorrhea and chlamydia can be vertically transmitted during delivery, causing
neonatal conjunctivitis (ophthalmia neonatorum). Prophylactic erythromycin eye ointment is
routinely given to all newborns to prevent this infection.
7. A patient is diagnosed with herpes simplex virus type 2 (HSV-2) infection. Which pathophysiologic
process is responsible for the recurrent nature of this infection?
A) Gram-negative bacterial invasion of epithelial cells
B) Spirochete-mediated tissue destruction
C) Viral latency in sensory ganglia and reactivation
D) Fungal overgrowth in warm, moist environments
Correct Answer: Viral latency in sensory ganglia and reactivation
Rationale: Herpes simplex virus establishes latency in sensory nerve ganglia after primary infection.
Various triggers such as stress, illness, or immunosuppression can reactivate the virus, causing it to
travel down the nerve to the skin or mucosa and produce recurrent vesicular lesions.
