HSC 4558 Exam 3 V3 | HSC 4558 Pathophysiology II | Actual Q&A with
Rationale (HSC4558 Exam 3) | University of Central Florida
1. A patient presents with extreme thirst, frequent urination, and a blood glucose level of 650
mg/dL without the presence of ketones in the urine. Which condition is most likely?
A. Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)
B. Diabetic Ketoacidosis (DKA)
C. Hypoglycemic Shock
D. Type 1 Diabetes Mellitus
Answer: A
Explanation: HHNS is characterized by extreme hyperglycemia and dehydration without
significant ketosis. This occurs primarily in Type 2 diabetics who have enough insulin to
prevent lipolysis but not enough to control glucose levels. The absence of ketones
distinguishes this from DKA, which is common in Type 1 diabetics.
2. Which clinical manifestation is a hallmark sign of Graves’ disease, a form of
hyperthyroidism?
A. Weight gain and bradycardia
B. Cold intolerance and lethargy
C. Exophthalmos (bulging eyes)
D. Myxedema
Answer: C
Explanation: Exophthalmos is caused by the accumulation of connective tissue and fat
behind the eyeballs in patients with Graves’ disease. It is an autoimmune manifestation
specific to this condition and results from orbital edema. Other signs include tachycardia,
heat intolerance, and weight loss due to an increased metabolic rate.
3. What is the primary pathophysiology underlying Addison’s disease?
A. Excessive production of cortisol
B. Tumor of the pituitary gland causing high ACTH
C. Overproduction of Growth Hormone
D. Adrenal insufficiency resulting in low cortisol and aldosterone
Answer: D
,Explanation: Addison’s disease involves the destruction of the adrenal cortex, leading to a
deficiency of mineralocorticoids and glucocorticoids. Patients typically present with
hyperpigmentation, hypotension, and electrolyte imbalances such as hyperkalemia.
Treatment requires lifelong hormone replacement therapy to prevent adrenal crisis.
4. A 55-year-old male reports difficulty initiating urination and a weak stream. Digital rectal
exam reveals a smooth, enlarged prostate. What is the most likely diagnosis?
A. Benign Prostatic Hyperplasia (BPH)
B. Prostate Cancer
C. Prostatitis
D. Urethral stricture
Answer: A
Explanation: BPH is a common condition in aging men where the prostate gland enlarges,
compressing the urethra. Symptoms include hesitancy, frequency, and nocturia. Unlike
prostate cancer, BPH involves a smooth enlargement rather than hard, irregular nodules.
5. Which hormone is responsible for the release of calcium from the bone into the
bloodstream?
A. Calcitonin
B. Insulin
C. Thyroid Stimulating Hormone (TSH)
D. Parathyroid Hormone (PTH)
Answer: D
Explanation: PTH is secreted by the parathyroid glands in response to low serum calcium
levels. It stimulates osteoclast activity, which breaks down bone matrix to release calcium.
Conversely, calcitonin is produced by the thyroid to lower serum calcium by inhibiting
osteoclasts.
6. Which type of fracture involves the bone breaking into several fragments?
A. Greenstick fracture
B. Stress fracture
C. Comminuted fracture
D. Spiral fracture
Answer: C
, Explanation: A comminuted fracture occurs when the bone is splintered or crushed into
multiple pieces. This usually occurs following high-impact trauma. Proper surgical
intervention is often required to realign the fragments for healing.
7. What is the primary cause of Rheumatoid Arthritis (RA)?
A. Wear and tear of the articular cartilage
B. Uric acid crystal deposition in the joint
C. Autoimmune destruction of the synovial membrane
D. Bacterial infection within the joint space
Answer: C
Explanation: RA is a systemic autoimmune disease characterized by chronic inflammation
of the synovium. This leads to the formation of a pannus, which eventually destroys
cartilage and bone within the joint. Patients often experience symmetrical joint pain and
morning stiffness lasting more than one hour.
8. Which skin cancer is characterized by a ‘pearly’ appearance and is the most common form
of skin cancer?
A. Melanoma
B. Squamous Cell Carcinoma
C. Basal Cell Carcinoma
D. Kaposi Sarcoma
Answer: C
Explanation: Basal Cell Carcinoma typically appears as a slow-growing, pearly or waxy
bump on sun-exposed areas. It rarely metastasizes but can be locally invasive if left
untreated. Chronic UV exposure is the leading risk factor for its development.
9. A patient with a T-score of -2.8 on a DEXA scan is diagnosed with which condition?
A. Osteopenia
B. Osteomalacia
C. Osteoporosis
D. Osteoarthritis
Answer: C
Explanation: Osteoporosis is defined by the WHO as a T-score of -2.5 or lower. This
indicates a significant loss of bone mineral density, increasing the risk of fragility fractures.
A score between -1.0 and -2.5 is categorized as osteopenia.
Rationale (HSC4558 Exam 3) | University of Central Florida
1. A patient presents with extreme thirst, frequent urination, and a blood glucose level of 650
mg/dL without the presence of ketones in the urine. Which condition is most likely?
A. Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)
B. Diabetic Ketoacidosis (DKA)
C. Hypoglycemic Shock
D. Type 1 Diabetes Mellitus
Answer: A
Explanation: HHNS is characterized by extreme hyperglycemia and dehydration without
significant ketosis. This occurs primarily in Type 2 diabetics who have enough insulin to
prevent lipolysis but not enough to control glucose levels. The absence of ketones
distinguishes this from DKA, which is common in Type 1 diabetics.
2. Which clinical manifestation is a hallmark sign of Graves’ disease, a form of
hyperthyroidism?
A. Weight gain and bradycardia
B. Cold intolerance and lethargy
C. Exophthalmos (bulging eyes)
D. Myxedema
Answer: C
Explanation: Exophthalmos is caused by the accumulation of connective tissue and fat
behind the eyeballs in patients with Graves’ disease. It is an autoimmune manifestation
specific to this condition and results from orbital edema. Other signs include tachycardia,
heat intolerance, and weight loss due to an increased metabolic rate.
3. What is the primary pathophysiology underlying Addison’s disease?
A. Excessive production of cortisol
B. Tumor of the pituitary gland causing high ACTH
C. Overproduction of Growth Hormone
D. Adrenal insufficiency resulting in low cortisol and aldosterone
Answer: D
,Explanation: Addison’s disease involves the destruction of the adrenal cortex, leading to a
deficiency of mineralocorticoids and glucocorticoids. Patients typically present with
hyperpigmentation, hypotension, and electrolyte imbalances such as hyperkalemia.
Treatment requires lifelong hormone replacement therapy to prevent adrenal crisis.
4. A 55-year-old male reports difficulty initiating urination and a weak stream. Digital rectal
exam reveals a smooth, enlarged prostate. What is the most likely diagnosis?
A. Benign Prostatic Hyperplasia (BPH)
B. Prostate Cancer
C. Prostatitis
D. Urethral stricture
Answer: A
Explanation: BPH is a common condition in aging men where the prostate gland enlarges,
compressing the urethra. Symptoms include hesitancy, frequency, and nocturia. Unlike
prostate cancer, BPH involves a smooth enlargement rather than hard, irregular nodules.
5. Which hormone is responsible for the release of calcium from the bone into the
bloodstream?
A. Calcitonin
B. Insulin
C. Thyroid Stimulating Hormone (TSH)
D. Parathyroid Hormone (PTH)
Answer: D
Explanation: PTH is secreted by the parathyroid glands in response to low serum calcium
levels. It stimulates osteoclast activity, which breaks down bone matrix to release calcium.
Conversely, calcitonin is produced by the thyroid to lower serum calcium by inhibiting
osteoclasts.
6. Which type of fracture involves the bone breaking into several fragments?
A. Greenstick fracture
B. Stress fracture
C. Comminuted fracture
D. Spiral fracture
Answer: C
, Explanation: A comminuted fracture occurs when the bone is splintered or crushed into
multiple pieces. This usually occurs following high-impact trauma. Proper surgical
intervention is often required to realign the fragments for healing.
7. What is the primary cause of Rheumatoid Arthritis (RA)?
A. Wear and tear of the articular cartilage
B. Uric acid crystal deposition in the joint
C. Autoimmune destruction of the synovial membrane
D. Bacterial infection within the joint space
Answer: C
Explanation: RA is a systemic autoimmune disease characterized by chronic inflammation
of the synovium. This leads to the formation of a pannus, which eventually destroys
cartilage and bone within the joint. Patients often experience symmetrical joint pain and
morning stiffness lasting more than one hour.
8. Which skin cancer is characterized by a ‘pearly’ appearance and is the most common form
of skin cancer?
A. Melanoma
B. Squamous Cell Carcinoma
C. Basal Cell Carcinoma
D. Kaposi Sarcoma
Answer: C
Explanation: Basal Cell Carcinoma typically appears as a slow-growing, pearly or waxy
bump on sun-exposed areas. It rarely metastasizes but can be locally invasive if left
untreated. Chronic UV exposure is the leading risk factor for its development.
9. A patient with a T-score of -2.8 on a DEXA scan is diagnosed with which condition?
A. Osteopenia
B. Osteomalacia
C. Osteoporosis
D. Osteoarthritis
Answer: C
Explanation: Osteoporosis is defined by the WHO as a T-score of -2.5 or lower. This
indicates a significant loss of bone mineral density, increasing the risk of fragility fractures.
A score between -1.0 and -2.5 is categorized as osteopenia.
