NSG 5003 ADVANCED
PATHOPHYSIOLOGY EXAM 3
QUESTIONS WITH COMPLETE
SOLUTION GUARANTEED SUCCESS.
1. Which mechanism best explains the development of edema in a patient with nephrotic
syndrome?
A. Increased capillary hydrostatic pressure
B. Decreased capillary permeability
C. Decreased plasma oncotic pressure due to albuminuria
D. Obstruction of the lymphatic flow
Answer: C
Conceptual Explanation: Nephrotic syndrome is characterized by heavy proteinuria
(albuminuria), which leads to hypoalbuminemia. This decrease in plasma albumin lowers
the plasma oncotic pressure, allowing fluid to escape from the intravascular space into the
interstitium, resulting in edema.
2. In the pathophysiology of Type 2 Diabetes Mellitus, what is the primary defect associated
with the ‘incretin effect’?
A. Overproduction of glucagon-like peptide-1 (GLP-1)
,B. Reduced secretion or sensitivity to GLP-1 and GIP
C. Increased renal glucose reabsorption via SGLT2
D. Enhanced insulin sensitivity in peripheral tissues
Answer: B
Conceptual Explanation: The incretin effect is significantly blunted in T2DM. This
involves a reduced secretion of GLP-1 and a diminished response to Glucose-dependent
Insulinotropic Polypeptide (GIP), leading to inadequate insulin secretion following oral
glucose intake.
3. A patient presents with a TSH of 12.5 mIU/L (High) and a Free T4 of 0.5 ng/dL (Low). Which
condition is most likely?
A. Secondary Hypothyroidism
B. Graves’ Disease
C. Primary Hypothyroidism
D. Thyroid Storm
Answer: C
Conceptual Explanation: Primary hypothyroidism is characterized by a high TSH as the
pituitary attempts to stimulate a failing thyroid gland, resulting in low levels of peripheral
thyroid hormones like Free T4.
, 4. Which of the following describes the pathophysiology of the ‘Somogyi Effect’?
A. Hyperglycemia in the morning due to growth hormone release
B. Nocturnal hypoglycemia followed by rebound hyperglycemia
C. Insulin resistance caused by excessive dietary fat intake
D. Hypoglycemia caused by excessive exercise in the evening
Answer: B
Conceptual Explanation: The Somogyi effect occurs when a patient receives too much
insulin at night, causing hypoglycemia, which triggers a counter-regulatory hormonal
response (epinephrine, cortisol) leading to rebound hyperglycemia by morning.
5. What is the hallmark physiological finding in patients with Acute Respiratory Distress
Syndrome (ARDS)?
A. Hypoxemia refractory to oxygen supplementation
B. Increased lung compliance
C. Decreased pulmonary artery pressure
D. Respiratory alkalosis due to hypoventilation
Answer: A
Conceptual Explanation: ARDS is characterized by diffuse alveolar damage and surfactant
depletion, leading to severe V/Q mismatch and shunting, resulting in hypoxemia that does
not significantly improve with high concentrations of oxygen (refractory hypoxemia).
PATHOPHYSIOLOGY EXAM 3
QUESTIONS WITH COMPLETE
SOLUTION GUARANTEED SUCCESS.
1. Which mechanism best explains the development of edema in a patient with nephrotic
syndrome?
A. Increased capillary hydrostatic pressure
B. Decreased capillary permeability
C. Decreased plasma oncotic pressure due to albuminuria
D. Obstruction of the lymphatic flow
Answer: C
Conceptual Explanation: Nephrotic syndrome is characterized by heavy proteinuria
(albuminuria), which leads to hypoalbuminemia. This decrease in plasma albumin lowers
the plasma oncotic pressure, allowing fluid to escape from the intravascular space into the
interstitium, resulting in edema.
2. In the pathophysiology of Type 2 Diabetes Mellitus, what is the primary defect associated
with the ‘incretin effect’?
A. Overproduction of glucagon-like peptide-1 (GLP-1)
,B. Reduced secretion or sensitivity to GLP-1 and GIP
C. Increased renal glucose reabsorption via SGLT2
D. Enhanced insulin sensitivity in peripheral tissues
Answer: B
Conceptual Explanation: The incretin effect is significantly blunted in T2DM. This
involves a reduced secretion of GLP-1 and a diminished response to Glucose-dependent
Insulinotropic Polypeptide (GIP), leading to inadequate insulin secretion following oral
glucose intake.
3. A patient presents with a TSH of 12.5 mIU/L (High) and a Free T4 of 0.5 ng/dL (Low). Which
condition is most likely?
A. Secondary Hypothyroidism
B. Graves’ Disease
C. Primary Hypothyroidism
D. Thyroid Storm
Answer: C
Conceptual Explanation: Primary hypothyroidism is characterized by a high TSH as the
pituitary attempts to stimulate a failing thyroid gland, resulting in low levels of peripheral
thyroid hormones like Free T4.
, 4. Which of the following describes the pathophysiology of the ‘Somogyi Effect’?
A. Hyperglycemia in the morning due to growth hormone release
B. Nocturnal hypoglycemia followed by rebound hyperglycemia
C. Insulin resistance caused by excessive dietary fat intake
D. Hypoglycemia caused by excessive exercise in the evening
Answer: B
Conceptual Explanation: The Somogyi effect occurs when a patient receives too much
insulin at night, causing hypoglycemia, which triggers a counter-regulatory hormonal
response (epinephrine, cortisol) leading to rebound hyperglycemia by morning.
5. What is the hallmark physiological finding in patients with Acute Respiratory Distress
Syndrome (ARDS)?
A. Hypoxemia refractory to oxygen supplementation
B. Increased lung compliance
C. Decreased pulmonary artery pressure
D. Respiratory alkalosis due to hypoventilation
Answer: A
Conceptual Explanation: ARDS is characterized by diffuse alveolar damage and surfactant
depletion, leading to severe V/Q mismatch and shunting, resulting in hypoxemia that does
not significantly improve with high concentrations of oxygen (refractory hypoxemia).
