BIO 322 Exam 4 V1 | BIO 322 Applied
Pathophysiology | Actual Q&A with Rationale
(BIO322 Exam 4) | Grand Canyon University
1. A patient presents with a glomerular filtration rate (GFR) of 25 mL/min/1.73 m². Which
stage of chronic kidney disease (CKD) does this reflect?
A. Stage 2
B. Stage 3
C. Stage 5
D. Stage 4
Correct Answer: D
Explanation: Stage 4 chronic kidney disease is characterized by a severely decreased GFR
ranging from 15 to 29 mL/min/1.73 m². This stage indicates significant kidney damage and
necessitates preparation for potential renal replacement therapy. The clinician must
monitor for complications such as anemia, hypertension, and bone disease which become
more prevalent at this level of dysfunction.
2. Which of the following clinical findings are consistent with a diagnosis of Diabetic
Ketoacidosis (DKA)? (Select All That Apply)
A. Blood glucose > 250 mg/dL
B. Presence of ketones in the urine
,C. Arterial pH < 7.30
D. Bicarbonate level > 18 mEq/L
E. Kussmaul respirations
F. Fruity-smelling breath
Correct Answer: A,B,C,E,F
Explanation: DKA is characterized by hyperglycemia, metabolic acidosis, and ketonemia,
which leads to the respiratory compensation known as Kussmaul breathing. A bicarbonate
level in DKA is typically low (below 18 mEq/L), not high, as it is consumed to buffer the
metabolic acids. The patient’s fruity breath is a direct result of acetone production during
the breakdown of fatty acids for energy.
3. In the context of liver cirrhosis, which mechanism primarily contributes to the
development of esophageal varices?
A. Decreased production of albumin
B. Hyperbilirubinemia
C. Reduced clotting factor synthesis
D. Portal hypertension
Correct Answer: D
Explanation: Portal hypertension occurs when blood flow through the liver is obstructed,
causing increased pressure in the portal venous system. This pressure forces blood into
,collateral vessels, such as those in the esophagus, causing them to become dilated and
fragile. If these varices rupture, it results in a life-threatening medical emergency due to
massive upper gastrointestinal bleeding.
4. A patient with hyperthyroidism is experiencing a ‘thyroid storm.’ Which symptom is a
characteristic hallmark of this life-threatening condition?
A. Bradycardia
B. Hyperthermia
C. Weight gain
D. Hypotension
Correct Answer: B
Explanation: Thyroid storm is an extreme state of thyrotoxicosis characterized by severe
hypermetabolism, often triggered by stress or infection. Hyperthermia, often exceeding
104 degrees Fahrenheit, is a critical sign along with severe tachycardia and agitation. This
condition requires immediate intervention to block thyroid hormone synthesis and
manage the systemic effects of the excess hormones.
5. What is the primary pathophysiological defect in Type 1 Diabetes Mellitus?
A. Insulin resistance in peripheral tissues
B. Increased glucose absorption in the gut
C. Excessive glucagon secretion
, D. Autoimmune destruction of pancreatic beta cells
Correct Answer: D
Explanation: Type 1 Diabetes Mellitus involves a T-cell mediated autoimmune attack on
the insulin-producing beta cells in the Islets of Langerhans. This leads to an absolute insulin
deficiency, requiring exogenous insulin for survival and metabolic control. Unlike Type 2
diabetes, which involves resistance, Type 1 is fundamentally a problem of production
failure.
6. Which hormone is inappropriately elevated in a patient with Cushing Syndrome?
A. Cortisol
B. Aldosterone
C. Epinephrine
D. Thyroxine
Correct Answer: A
Explanation: Cushing Syndrome results from chronic exposure to excessive levels of
cortisol, whether from endogenous overproduction or exogenous administration of
corticosteroids. High cortisol levels lead to metabolic disturbances such as hyperglycemia,
fat redistribution (buffalo hump), and muscle wasting. Management focuses on identifying
the source of the excess and reducing cortisol levels to a physiological range.
Pathophysiology | Actual Q&A with Rationale
(BIO322 Exam 4) | Grand Canyon University
1. A patient presents with a glomerular filtration rate (GFR) of 25 mL/min/1.73 m². Which
stage of chronic kidney disease (CKD) does this reflect?
A. Stage 2
B. Stage 3
C. Stage 5
D. Stage 4
Correct Answer: D
Explanation: Stage 4 chronic kidney disease is characterized by a severely decreased GFR
ranging from 15 to 29 mL/min/1.73 m². This stage indicates significant kidney damage and
necessitates preparation for potential renal replacement therapy. The clinician must
monitor for complications such as anemia, hypertension, and bone disease which become
more prevalent at this level of dysfunction.
2. Which of the following clinical findings are consistent with a diagnosis of Diabetic
Ketoacidosis (DKA)? (Select All That Apply)
A. Blood glucose > 250 mg/dL
B. Presence of ketones in the urine
,C. Arterial pH < 7.30
D. Bicarbonate level > 18 mEq/L
E. Kussmaul respirations
F. Fruity-smelling breath
Correct Answer: A,B,C,E,F
Explanation: DKA is characterized by hyperglycemia, metabolic acidosis, and ketonemia,
which leads to the respiratory compensation known as Kussmaul breathing. A bicarbonate
level in DKA is typically low (below 18 mEq/L), not high, as it is consumed to buffer the
metabolic acids. The patient’s fruity breath is a direct result of acetone production during
the breakdown of fatty acids for energy.
3. In the context of liver cirrhosis, which mechanism primarily contributes to the
development of esophageal varices?
A. Decreased production of albumin
B. Hyperbilirubinemia
C. Reduced clotting factor synthesis
D. Portal hypertension
Correct Answer: D
Explanation: Portal hypertension occurs when blood flow through the liver is obstructed,
causing increased pressure in the portal venous system. This pressure forces blood into
,collateral vessels, such as those in the esophagus, causing them to become dilated and
fragile. If these varices rupture, it results in a life-threatening medical emergency due to
massive upper gastrointestinal bleeding.
4. A patient with hyperthyroidism is experiencing a ‘thyroid storm.’ Which symptom is a
characteristic hallmark of this life-threatening condition?
A. Bradycardia
B. Hyperthermia
C. Weight gain
D. Hypotension
Correct Answer: B
Explanation: Thyroid storm is an extreme state of thyrotoxicosis characterized by severe
hypermetabolism, often triggered by stress or infection. Hyperthermia, often exceeding
104 degrees Fahrenheit, is a critical sign along with severe tachycardia and agitation. This
condition requires immediate intervention to block thyroid hormone synthesis and
manage the systemic effects of the excess hormones.
5. What is the primary pathophysiological defect in Type 1 Diabetes Mellitus?
A. Insulin resistance in peripheral tissues
B. Increased glucose absorption in the gut
C. Excessive glucagon secretion
, D. Autoimmune destruction of pancreatic beta cells
Correct Answer: D
Explanation: Type 1 Diabetes Mellitus involves a T-cell mediated autoimmune attack on
the insulin-producing beta cells in the Islets of Langerhans. This leads to an absolute insulin
deficiency, requiring exogenous insulin for survival and metabolic control. Unlike Type 2
diabetes, which involves resistance, Type 1 is fundamentally a problem of production
failure.
6. Which hormone is inappropriately elevated in a patient with Cushing Syndrome?
A. Cortisol
B. Aldosterone
C. Epinephrine
D. Thyroxine
Correct Answer: A
Explanation: Cushing Syndrome results from chronic exposure to excessive levels of
cortisol, whether from endogenous overproduction or exogenous administration of
corticosteroids. High cortisol levels lead to metabolic disturbances such as hyperglycemia,
fat redistribution (buffalo hump), and muscle wasting. Management focuses on identifying
the source of the excess and reducing cortisol levels to a physiological range.
