NURS 6501 Advanced Pathophysiology Exam
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Mr. Forbes complains of "indigestion" and becomes sweaty and pale. His wife takes him to the Emergency
Department at Northwestern Memorial Hospital. A cardiac catheterization 2 days later shows partial blockage of
his right coronary artery (RCA).
Blockage of the right coronary artery can lead to myocardial cell injury because it results in which of the
following?
a. bilirubin accumulation in myocardial cells
b. alteration in the genetic material of myocardial cells
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c. reduced energy production in myocardial cells
d. activation of the complement system - Correct Answer :C
When myocardial cells are injured, the function of the Na-K membrane pump may be impaired. Which of the
following may then result?
a.intracellular sodium will increase
b. extracellular potassium will decrease
c. cell volume will decrease
d. all of the above - Correct Answer :A
Mr. Forbes is being prepared for open heart surgery when he suffers a myocardial infarction in which a large part
of his left ventricle has suffered lethal cell injury.
Mr. Forbes' CPK-MB and LDH1, enzymes associated with myocardial cells, are significantly elevated. What is the
best explanation for this?
a. It is a sign that necrotic myocardial cells have released their cytoplasmic contents into the blood.
b. It is a sign of reversible fatty accumulation in the myocardial cells
c. It is a sign that the myocardial cells are undergoing hypertrophy.
d. None of the above. - Correct Answer :A
If a tissue specimen of myocardial cells were obtained for examination from Mr. Forbes, which of the following
findings would indicate irreversible cell injury?
a. cellular swelling
b. decreased ATP production
c. decreased intracellular calcium
d. dissolution of nuclear material - Correct Answer :D
The accumulation of lactic acid that occurs with impaired energy production results from which of the following?
a. increased intracellular glucose
b. increased anaerobic metabolism
c. decreased metabolic rate
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d. increased oxidative phosphorylation - Correct Answer :B
A mountain climber is stranded at 23,000 feet in the Swiss Alps and has lost all his equipment and supplies in an
avalanche. Subsequently, he suffers cell injury due to impaired ATP production. The reason for the decrease in
ATP is which of the following?
a. enzyme inhibition
b. uncoupling
c. hypoxia
d. none of the above - Correct Answer :C
An elderly patient develops an obstruction in his left middle cerebral artery. The brain tissue supplied by this
artery becomes hypoxic. The best explanation for this is which of the following?
a. the obstruction results in decreased blood flow
b. the obstruction results in decreased hemoglobin in the blood
c. while blood flow stays the same, the obstruction reduces oxygen content in the blood
d. none of the above explain the reason for the hypoxia - Correct Answer :A
Increased mobilization and delivery of free fatty acids to liver cells can result in fat accumulation. Which of the
following problems results in increased mobilization of free fatty acids?
a. anemia
b. hepatic toxins
c. starvation
d. hypoxia - Correct Answer :C
Generalized hypoxia results in a switch to anaerobic metabolism in cells. Anaerobic metabolism results in which
of the following?
a. decreased lactic acid inside cells
b. decreased arterial pH
c. more effective ATP production
d. increased pH inside cells - Correct Answer :B
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There is a disease of the spleen, which results in an excessive destruction of RBCs. This increase in RBC
destruction can lead to which of the following?
a. hypoxia
b. hypobilirubinemia
c. an increase in platelets
d. all of the above - Correct Answer :A
Your body has developed an increased demand for thyroid hormones. This will lead to ____________ of the
thyroid gland.
a. atrophy
b. hypertrophy
c. dysplasia
d. metaplasia - Correct Answer :B
You palpate a gangrenous leg and note the presence of crepitus. Crepitus is associated with which of the
following?
a. wet gangrene
b. dry gangrene
c. gas gangrene
d. all of the above - Correct Answer :C
Direct cell membrane destruction may result from which of the following?
a. complement activation
b. bacterial enzymes
c. free radicals
d. all of the above - Correct Answer :D
Which of the following is true regarding apoptosis?
a. It occurrence may be physiological or pathological.
b. It does not stimulate the inflammatory process.
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