,South University NSG 5003 Week 7 Knowledge Check Quiz
| Adv Pathophysiology (2026) Q&A
1. Which pathophysiologic mechanism best explains the chronic hyperglycemia in
type 2 diabetes mellitus?
A) Autoimmune destruction of pancreatic beta cells
B) Insulin resistance and progressive beta-cell dysfunction
C) Excessive glucagon-like peptide-1 secretion
D) Increased insulin receptor sensitivity
Correct Answer: Insulin resistance and progressive beta-cell dysfunction
Rationale: Type 2 diabetes is characterized by insulin resistance in peripheral
tissues and a progressive decline in pancreatic beta-cell function, leading to
insufficient insulin secretion to maintain euglycemia. Autoimmune destruction of
beta cells defines type 1 diabetes, and increased insulin sensitivity or excessive
GLP-1 would lower glucose, not raise it.
2. A 28-year-old patient presents with polydipsia, polyuria, and weight loss over
three weeks. Fasting glucose is 286 mg/dL, and urine ketones are positive. Which
diagnosis is most likely?
A) Type 1 diabetes mellitus
B) Type 2 diabetes mellitus
C) Diabetes insipidus
D) Metabolic syndrome
,Correct Answer: Type 1 diabetes mellitus
Rationale: The classic triad of polydipsia, polyuria, and weight loss with
ketonuria and severe hyperglycemia in a young patient is characteristic of type 1
diabetes mellitus. Type 2 diabetes typically presents insidiously in older, obese
patients without ketosis, diabetes insipidus causes polyuria without
hyperglycemia, and metabolic syndrome does not cause ketonuria.
3. A patient with type 1 diabetes is found unresponsive with a blood glucose of 42
mg/dL. Which counter-regulatory hormone is primarily responsible for the
immediate glucose-elevating response?
A) Insulin
B) Glucagon
C) Aldosterone
D) Cortisol
Correct Answer: Glucagon
Rationale: Glucagon is the primary counter-regulatory hormone that stimulates
hepatic glycogenolysis and gluconeogenesis within minutes of hypoglycemia.
Insulin lowers glucose and would worsen the condition, aldosterone regulates
sodium and potassium, and cortisol has a slower, more sustained effect on glucose.
4. A patient with type 2 diabetes on metformin presents with fatigue and a serum
creatinine of 2.8 mg/dL. Which complication is most concerning?
, A) Lactic acidosis
B) Hypoglycemia
C) Diabetic ketoacidosis
D) Hyperosmolar hyperglycemic state
Correct Answer: Lactic acidosis
Rationale: Metformin is contraindicated in renal insufficiency because impaired
clearance leads to drug accumulation and risk of lactic acidosis, a life-threatening
complication. Metformin does not typically cause hypoglycemia when used alone,
diabetic ketoacidosis is more common in type 1 diabetes, and hyperosmolar
hyperglycemic state is associated with severe hyperglycemia without metformin as
the primary trigger.
5. A patient with diabetic ketoacidosis has a pH of 7.18 and a bicarbonate of 10
mEq/L. Which compensatory mechanism is expected?
A) Hyperventilation with decreased PaCO2
B) Hypoventilation with increased PaCO2
C) Renal retention of hydrogen ions
D) Increased renal bicarbonate excretion
Correct Answer: Hyperventilation with decreased PaCO2
Rationale: In metabolic acidosis, the respiratory system compensates by
hyperventilating to blow off carbon dioxide, decreasing PaCO2 and raising pH.
Hypoventilation would worsen acidosis, and renal retention of hydrogen ions or
increased bicarbonate excretion would also worsen the acid-base disturbance.
| Adv Pathophysiology (2026) Q&A
1. Which pathophysiologic mechanism best explains the chronic hyperglycemia in
type 2 diabetes mellitus?
A) Autoimmune destruction of pancreatic beta cells
B) Insulin resistance and progressive beta-cell dysfunction
C) Excessive glucagon-like peptide-1 secretion
D) Increased insulin receptor sensitivity
Correct Answer: Insulin resistance and progressive beta-cell dysfunction
Rationale: Type 2 diabetes is characterized by insulin resistance in peripheral
tissues and a progressive decline in pancreatic beta-cell function, leading to
insufficient insulin secretion to maintain euglycemia. Autoimmune destruction of
beta cells defines type 1 diabetes, and increased insulin sensitivity or excessive
GLP-1 would lower glucose, not raise it.
2. A 28-year-old patient presents with polydipsia, polyuria, and weight loss over
three weeks. Fasting glucose is 286 mg/dL, and urine ketones are positive. Which
diagnosis is most likely?
A) Type 1 diabetes mellitus
B) Type 2 diabetes mellitus
C) Diabetes insipidus
D) Metabolic syndrome
,Correct Answer: Type 1 diabetes mellitus
Rationale: The classic triad of polydipsia, polyuria, and weight loss with
ketonuria and severe hyperglycemia in a young patient is characteristic of type 1
diabetes mellitus. Type 2 diabetes typically presents insidiously in older, obese
patients without ketosis, diabetes insipidus causes polyuria without
hyperglycemia, and metabolic syndrome does not cause ketonuria.
3. A patient with type 1 diabetes is found unresponsive with a blood glucose of 42
mg/dL. Which counter-regulatory hormone is primarily responsible for the
immediate glucose-elevating response?
A) Insulin
B) Glucagon
C) Aldosterone
D) Cortisol
Correct Answer: Glucagon
Rationale: Glucagon is the primary counter-regulatory hormone that stimulates
hepatic glycogenolysis and gluconeogenesis within minutes of hypoglycemia.
Insulin lowers glucose and would worsen the condition, aldosterone regulates
sodium and potassium, and cortisol has a slower, more sustained effect on glucose.
4. A patient with type 2 diabetes on metformin presents with fatigue and a serum
creatinine of 2.8 mg/dL. Which complication is most concerning?
, A) Lactic acidosis
B) Hypoglycemia
C) Diabetic ketoacidosis
D) Hyperosmolar hyperglycemic state
Correct Answer: Lactic acidosis
Rationale: Metformin is contraindicated in renal insufficiency because impaired
clearance leads to drug accumulation and risk of lactic acidosis, a life-threatening
complication. Metformin does not typically cause hypoglycemia when used alone,
diabetic ketoacidosis is more common in type 1 diabetes, and hyperosmolar
hyperglycemic state is associated with severe hyperglycemia without metformin as
the primary trigger.
5. A patient with diabetic ketoacidosis has a pH of 7.18 and a bicarbonate of 10
mEq/L. Which compensatory mechanism is expected?
A) Hyperventilation with decreased PaCO2
B) Hypoventilation with increased PaCO2
C) Renal retention of hydrogen ions
D) Increased renal bicarbonate excretion
Correct Answer: Hyperventilation with decreased PaCO2
Rationale: In metabolic acidosis, the respiratory system compensates by
hyperventilating to blow off carbon dioxide, decreasing PaCO2 and raising pH.
Hypoventilation would worsen acidosis, and renal retention of hydrogen ions or
increased bicarbonate excretion would also worsen the acid-base disturbance.
