WGU D115 OA ADVANCED PATHOPHYSIOLOGY EXAM 2 VERSIONS 2025/2026
BANK ACTUAL QUESTIONS WITH DETAILED ANSWERS AND OA READINESS
PRACTICE EXAM TEST BANK WITH STUDY GUIDE EXPERT VERIFIED FOR
GUARANTEED PASS/ALREADY GRADED A+
1. A 55-year-old male with a long history of hypertension presents to the clinic with
complaints of worsening headache and blurred vision. Funduscopic examination reveals
arteriovenous nicking and cotton-wool spots. Which underlying pathophysiological
process is primarily responsible for these ocular findings?
A. Retinal artery occlusion
B. Increased vascular permeability and ischemia
C. Central retinal vein blockage
D. Lens sclerosis due to hyperglycemia
Answer: B.
Increased vascular permeability and ischemia. This patient's findings are classic for
hypertensive retinopathy. Persistent hypertension causes vascular damage.
Arteriovenous nicking occurs due to sclerotic thickening of the arteriolar walls,
compressing the venules at crossing points. Cotton-wool spots are microinfarcts of the
nerve fiber layer caused by ischemia from precapillary arteriole occlusion. Flame-
shaped hemorrhages (not listed but often present) occur due to increased vascular
permeability. While retinal artery occlusion (A) and central vein blockage (C) are specific
vascular events, they do not describe the generalized microvascular changes of chronic
hypertension. Lens sclerosis (D) is related to diabetes or aging, not hypertension.
2. A 10-year-old girl is brought to the emergency department with a 2-day history of a
progressively painful sore throat, high fever, and difficulty swallowing. On physical
exam, the pharynx is red and edematous with a yellow-gray exudate on the tonsils.
Cervical lymph nodes are tender and enlarged. The causative pathogen is a gram-positive
coccus that forms chains. Which complication is this patient most at risk for if the
infection is not adequately treated?
A. Rheumatic fever
B. Otitis media
C. Glomerulonephritis
D. Both A and C
, Answer: D. Both A and C
The presentation is highly suggestive of Streptococcal pharyngitis (caused by
Streptococcus pyogenes, a gram-positive coccus in chains). The two major non-
suppurative (distant) complications of group A strep pharyngitis is Acute Rheumatic
Fever (A), an inflammatory disease affecting the heart, joints, and CNS, and Post-
streptococcal Glomerulonephritis (C). While otitis media (B) can be a suppurative
complication, it is not the most serious long-term risk. Therefore, the correct answer is
the one that includes both of the major non-suppurative complications.
3. A 45-year-old female presents with muscle weakness, fatigue, weight gain, and cold
intolerance. Physical exam reveals bradycardia, periorbital edema, and dry skin. Lab tests
show an elevated TSH and a low free T4. What is the most likely diagnosis?
A. Graves' disease
B. Hashimoto's thyroiditis
C. Subacute thyroiditis
D. Pituitary adenoma
Answer: B. Hashimoto's thyroiditis
The clinical picture (weakness, fatigue, weight gain, cold intolerance, bradycardia, dry
skin) and lab findings (elevated TSH, low T4) are diagnostic of primary
hypothyroidism. Hashimoto's thyroiditis (B) is an autoimmune disorder and the most
common cause of hypothyroidism in iodine-sufficient areas. Graves' disease (A) causes
hyperthyroidism (low TSH, high T4). Subacute thyroiditis (C) often presents with a
painful thyroid and a transient hyperthyroid phase. A pituitary adenoma (D) could cause
secondary hypothyroidism, but it would typically present with low TSH and low T4, and
often other hormone deficiencies.
4. A 60-year-old male with a 40-pack-year smoking history presents with clubbing of his
fingers and a new diagnosis of non-small cell lung cancer. Which paraneoplastic
syndrome is most directly associated with the finding of digital clubbing?
A. Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
B. Hypercalcemia
C. Cushing's Syndrome
D. Hypertrophic Osteoarthropathy
BANK ACTUAL QUESTIONS WITH DETAILED ANSWERS AND OA READINESS
PRACTICE EXAM TEST BANK WITH STUDY GUIDE EXPERT VERIFIED FOR
GUARANTEED PASS/ALREADY GRADED A+
1. A 55-year-old male with a long history of hypertension presents to the clinic with
complaints of worsening headache and blurred vision. Funduscopic examination reveals
arteriovenous nicking and cotton-wool spots. Which underlying pathophysiological
process is primarily responsible for these ocular findings?
A. Retinal artery occlusion
B. Increased vascular permeability and ischemia
C. Central retinal vein blockage
D. Lens sclerosis due to hyperglycemia
Answer: B.
Increased vascular permeability and ischemia. This patient's findings are classic for
hypertensive retinopathy. Persistent hypertension causes vascular damage.
Arteriovenous nicking occurs due to sclerotic thickening of the arteriolar walls,
compressing the venules at crossing points. Cotton-wool spots are microinfarcts of the
nerve fiber layer caused by ischemia from precapillary arteriole occlusion. Flame-
shaped hemorrhages (not listed but often present) occur due to increased vascular
permeability. While retinal artery occlusion (A) and central vein blockage (C) are specific
vascular events, they do not describe the generalized microvascular changes of chronic
hypertension. Lens sclerosis (D) is related to diabetes or aging, not hypertension.
2. A 10-year-old girl is brought to the emergency department with a 2-day history of a
progressively painful sore throat, high fever, and difficulty swallowing. On physical
exam, the pharynx is red and edematous with a yellow-gray exudate on the tonsils.
Cervical lymph nodes are tender and enlarged. The causative pathogen is a gram-positive
coccus that forms chains. Which complication is this patient most at risk for if the
infection is not adequately treated?
A. Rheumatic fever
B. Otitis media
C. Glomerulonephritis
D. Both A and C
, Answer: D. Both A and C
The presentation is highly suggestive of Streptococcal pharyngitis (caused by
Streptococcus pyogenes, a gram-positive coccus in chains). The two major non-
suppurative (distant) complications of group A strep pharyngitis is Acute Rheumatic
Fever (A), an inflammatory disease affecting the heart, joints, and CNS, and Post-
streptococcal Glomerulonephritis (C). While otitis media (B) can be a suppurative
complication, it is not the most serious long-term risk. Therefore, the correct answer is
the one that includes both of the major non-suppurative complications.
3. A 45-year-old female presents with muscle weakness, fatigue, weight gain, and cold
intolerance. Physical exam reveals bradycardia, periorbital edema, and dry skin. Lab tests
show an elevated TSH and a low free T4. What is the most likely diagnosis?
A. Graves' disease
B. Hashimoto's thyroiditis
C. Subacute thyroiditis
D. Pituitary adenoma
Answer: B. Hashimoto's thyroiditis
The clinical picture (weakness, fatigue, weight gain, cold intolerance, bradycardia, dry
skin) and lab findings (elevated TSH, low T4) are diagnostic of primary
hypothyroidism. Hashimoto's thyroiditis (B) is an autoimmune disorder and the most
common cause of hypothyroidism in iodine-sufficient areas. Graves' disease (A) causes
hyperthyroidism (low TSH, high T4). Subacute thyroiditis (C) often presents with a
painful thyroid and a transient hyperthyroid phase. A pituitary adenoma (D) could cause
secondary hypothyroidism, but it would typically present with low TSH and low T4, and
often other hormone deficiencies.
4. A 60-year-old male with a 40-pack-year smoking history presents with clubbing of his
fingers and a new diagnosis of non-small cell lung cancer. Which paraneoplastic
syndrome is most directly associated with the finding of digital clubbing?
A. Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
B. Hypercalcemia
C. Cushing's Syndrome
D. Hypertrophic Osteoarthropathy
