NU 621
Advanced Pathophysiology
Final Exam Review
(Questions & Solutions)
2025
1
,1. A 28-year-old man presents with muscle weakness, fatigue, and ptosis
that worsens throughout the day. What is the underlying
pathophysiological mechanism?
a) Increased acetylcholine release
b) Destruction of acetylcholine receptors by autoantibodies
c) Excess dopamine in the synaptic cleft
d) Hypoglycemia-induced neuromuscular blockade
ANS: b
Rationale: Myasthenia gravis involves autoantibody-mediated
destruction of acetylcholine receptors at the neuromuscular junction,
impairing synaptic transmission.
2. A 52-year-old woman with a history of chronic hypertension develops
left ventricular hypertrophy. This is an example of:
a) Atrophy
b) Hyperplasia
c) Hypertrophy
d) Metaplasia
ANS: c
Rationale: Chronic increased workload leads to hypertrophy
(enlargement of cells), particularly in cardiac muscle.
3. In acute tubular necrosis (ATN), the most likely initial mechanism is:
a) Glomerular basement membrane thickening
b) Tubular epithelial cell injury
c) Mesangial cell proliferation
d) Bowman's capsule fibrosis
ANS: b
Rationale: ATN is most often caused by direct injury to the tubular
epithelial cells, disrupting filtration and reabsorption.
4. Which finding is most consistent with early compensated shock?
a) Hypotension
2
, b) Warm, flushed skin
c) Tachycardia
d) Marked oliguria
ANS: c
Rationale: The early compensatory response to shock is to increase heart
rate to maintain perfusion.
5. A 33-year-old woman is diagnosed with systemic lupus erythematosus
(SLE). The pathophysiological basis is best described as:
a) Bacterial infection
b) Delayed hypersensitivity
c) Immune complex deposition and systemic autoimmunity
d) Cell-mediated hypersensitivity
ANS: c
Rationale: SLE involves immune complex (antigen-antibody) deposition
causing multisystemic inflammation.
6. A patient has severe mitral regurgitation. This leads to:
a) Increased left ventricular afterload
b) Decreased left atrial pressure
c) Increased left atrial volume and pressure
d) Decreased pulmonary pressures
ANS: c
Rationale: Mitral regurgitation results in backflow into the left atrium,
increasing its pressure and volume.
7. In diabetic ketoacidosis, which of the following is most likely present?
a) Hyperchloremic metabolic alkalosis
b) Respiratory acidosis
c) High anion gap metabolic acidosis
d) Hypokalemia
ANS: c
Rationale: DKA is defined by high anion gap metabolic acidosis due to
ketone body accumulation.
3
Advanced Pathophysiology
Final Exam Review
(Questions & Solutions)
2025
1
,1. A 28-year-old man presents with muscle weakness, fatigue, and ptosis
that worsens throughout the day. What is the underlying
pathophysiological mechanism?
a) Increased acetylcholine release
b) Destruction of acetylcholine receptors by autoantibodies
c) Excess dopamine in the synaptic cleft
d) Hypoglycemia-induced neuromuscular blockade
ANS: b
Rationale: Myasthenia gravis involves autoantibody-mediated
destruction of acetylcholine receptors at the neuromuscular junction,
impairing synaptic transmission.
2. A 52-year-old woman with a history of chronic hypertension develops
left ventricular hypertrophy. This is an example of:
a) Atrophy
b) Hyperplasia
c) Hypertrophy
d) Metaplasia
ANS: c
Rationale: Chronic increased workload leads to hypertrophy
(enlargement of cells), particularly in cardiac muscle.
3. In acute tubular necrosis (ATN), the most likely initial mechanism is:
a) Glomerular basement membrane thickening
b) Tubular epithelial cell injury
c) Mesangial cell proliferation
d) Bowman's capsule fibrosis
ANS: b
Rationale: ATN is most often caused by direct injury to the tubular
epithelial cells, disrupting filtration and reabsorption.
4. Which finding is most consistent with early compensated shock?
a) Hypotension
2
, b) Warm, flushed skin
c) Tachycardia
d) Marked oliguria
ANS: c
Rationale: The early compensatory response to shock is to increase heart
rate to maintain perfusion.
5. A 33-year-old woman is diagnosed with systemic lupus erythematosus
(SLE). The pathophysiological basis is best described as:
a) Bacterial infection
b) Delayed hypersensitivity
c) Immune complex deposition and systemic autoimmunity
d) Cell-mediated hypersensitivity
ANS: c
Rationale: SLE involves immune complex (antigen-antibody) deposition
causing multisystemic inflammation.
6. A patient has severe mitral regurgitation. This leads to:
a) Increased left ventricular afterload
b) Decreased left atrial pressure
c) Increased left atrial volume and pressure
d) Decreased pulmonary pressures
ANS: c
Rationale: Mitral regurgitation results in backflow into the left atrium,
increasing its pressure and volume.
7. In diabetic ketoacidosis, which of the following is most likely present?
a) Hyperchloremic metabolic alkalosis
b) Respiratory acidosis
c) High anion gap metabolic acidosis
d) Hypokalemia
ANS: c
Rationale: DKA is defined by high anion gap metabolic acidosis due to
ketone body accumulation.
3
