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D236 PATHOPHYSIOLOGY Questions with further explained answers 2025 new update Western Governors University

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D236 PATHOPHYSIOLOGY Questions with further explained
answers 2025 new update Western Governors University




• A patient with a viral illness and severe vomiting has an elevated
CO2 level and a blood pH of 7.53. She is breathing slowly.

What condition does the patient have?

Respiratory
acidosis
Respiratory
alkalosis. Metabolic
acidosis Metabolic
alkalosis Answer
Correct:
The patient's pH and CO2 level are both elevating (moving in the same
direction). This indicates metabolic alkalosis. The CO 2 level is high because
her respiratory system is attempting to compensate for the high pH by
exhaling less and retaining more CO 2


• What happens in a dehydrated patient?

ADH levels decrease and the RAAS is

,activated. ADH levels decrease and the
RAAS is inactivated. ADH levels increase and
the RAAS is inactivated. ADH levels increase
and the RAAS is activated.
Answer
Correct:
Osmoreceptors will stimulate the secretion of ADH from the posterior
pituitary. In addition, low circulation stimulates the kidney to make renin, and
the RAAS will increase blood volume and blood pressure by promoting the
reabsorption of water and sodium in the kidney and through vasoconstriction.

• ACE (angiotensin converting enzymes) inhibitors are used to treat
abnormal blood pressure. They prevent the conversion of angiotensin I
to angiotensin II.

Which explains how ACE inhibitors work?

The decrease in the production of angiotensin II keeps blood vessels more dilated. This
raises blood pressure.
The decrease in the production of angiotensin II constricts blood vessels. This raises
blood pressure.
The decrease in the production of angiotensin II constricts blood vessels. This lowers
blood pressure.

,The decrease in the production of angiotensin II keeps blood vessels more dilated. This
lowers blood pressure.
Answer
Correct:
Normally, the RAAS is activated in response to low blood pressure, and its
actions help to raise blood pressure. As part of this response, angiotensin II is
produced and causes vasoconstriction. Vasoconstriction increases blood
pressure. Sometimes individuals with high blood pressure are prescribed ACE
inhibitors. Because ACE inhibitors prevent the production of angiotensin II,
blood vessels will remain more dilated, lowering blood pressure.

• In diabetic ketoacidosis, what happens to the
anion gap? Because HCO3- is consumed, the anion gap
increases. Because HCO3- is consumed, the anion gap
decreases. Because extra HCO3- is produced, the anion
gap decreases. Because extra HCO3- is produced, the
anion gap increases. Answer
Correct:
The anion gap is the difference between measured cations (Na+ and K+)
and measured anions (Cl- and HCO3-). The body should have an equal
number of cations and anions in order to maintain electrochemical balance. If
the measured ions were the only ones contributing to this balance, the
difference between the cations and anions should be zero. However, in
practice, the difference is not zero due to the presence of unmeasured anions.
The level of unmeasured anions is the anion gap. In diabetic ketoacidosis,
HCO3- is consumed by the additional keto acids present in the bloodstream.
Because it is one of the measured anions, its consumption increases the
anion gap. This is well-illustrated in Figure 8-4 of Capriotti.

• Patients with end stage renal disease are not able to maintain
homeostatic levels of potassium, and the increased level of potassium
in their bloodstream can impair cardiac function.

To remove potassium from the blood during dialysis, what should the
dialysate do?

It should have a higher concentration of potassium than that of the bloodstream.
It should have a lower concentration of potassium than that of the bloodstream.
It should have a concentration of potassium that is equal to that of the
bloodstream. It should not contain potassium.
Answer

, Correct:
Dialysis relies on diffusion to remove solutes, including waste and potassium,
from the blood. Solutes move from areas of high concentration to areas of
low concentration. When the amount of potassium is lower in the dialysate
than in the bloodstream, potassium will diffuse from the bloodstream into the
dialysate. This removes excess potassium, decreasing the chances the
patient will have a cardiac arrhythmias or arrest.

• An ultrasound reveals that a woman's baby is a boy.

If she is a carrier for hemophilia, what is the probability her son will have
hemophilia?

75%
50%
25%
100%
Answer
Correct:
The woman has two copies of the X chromosome. One of the woman's X
chromosomes has the allele that causes hemophilia, and one has a
healthy allele. Therefore, she is expected to pass on the disease-causing
allele 50% of the time. Since her son only inherits one X chromosome,
inheriting one allele that causes hemophilia would give him the disease.

• Noah, who has sickle cell anemia, is encouraged by recent gene
therapy studies. Rather than fixing the defective gene, the treatment
tells the body to begin making a fetal form of hemoglobin.

How does sickle cell anemia affect the body?

Individuals with sickle cell anemia are heterozygous for the sickle cell gene and
possess one good copy of the sickle cell gene.
In individuals with sickle cell anemia, the gene for the fetal form of hemoglobin does not
have a sickle cell mutation.
In individuals with sickle cell anemia, the genes for both fetal hemoglobin and the adult
form of hemoglobin have mutations that cause the disease.
Individuals with sickle cell anemia lack the gene for the fetal form of hemoglobin.
Answer
Correct:
Individuals who have sickle cell anemia have normal copies of the gene for
the fetal form of hemoglobin. Prompting this gene to make hemoglobin in

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