EXAM 2 NR545/NR545 ADVANCED PATHOPHYSIOLOGY – EXAM 2:
COMPREHENSIVE ASSESSMENT OF DISEASE MECHANISMS, LAB
INTERPRETATION, AND CLINICAL PATHOPHYSIOLOGY QUESTIONS
WITH ANSWERS & RATIONALES
1. Which of the following best describes the primary mechanism of acute kidney injury
(AKI)?
A. Sudden reduction in renal perfusion, tubular injury, or obstruction
B. Gradual decrease in kidney size exclusively
C. Chronic autoimmune damage only
D. Hypernatremia exclusively
Answer: A. Sudden reduction in renal perfusion, tubular injury, or obstruction
Rationale: AKI results from prerenal, intrinsic, or postrenal causes leading to rapid loss of
kidney function.
2. Which lab finding is most characteristic of nephritic syndrome?
A. Hematuria, mild proteinuria, hypertension, and azotemia
B. Massive proteinuria only
C. Hypokalemia exclusively
D. Hypercalcemia only
Answer: A. Hematuria, mild proteinuria, hypertension, and azotemia
Rationale: Glomerular inflammation allows blood cells to leak into urine and often elevates
blood pressure.
3. Which of the following best describes the pathophysiology of heart failure with reduced
ejection fraction (HFrEF)?
A. Impaired contractility leading to decreased cardiac output
B. Purely diastolic dysfunction only
C. Pulmonary embolism exclusively
D. Arrhythmia only
Answer: A. Impaired contractility leading to decreased cardiac output
Rationale: HFrEF involves systolic dysfunction, commonly due to myocardial infarction or
cardiomyopathy.
4. Which of the following is true regarding type 1 diabetes mellitus?
A. Autoimmune destruction of pancreatic beta cells causing absolute insulin deficiency
,B. Insulin resistance exclusively
C. Hyperthyroidism only
D. Glucagon deficiency only
Answer: A. Autoimmune destruction of pancreatic beta cells causing absolute insulin
deficiency
Rationale: Type 1 DM leads to hyperglycemia due to lack of insulin.
5. Which of the following lab findings is characteristic of hypothyroidism?
A. Low T4, high TSH, bradycardia, and fatigue
B. High T4 exclusively
C. Hypernatremia only
D. Hypocalcemia only
Answer: A. Low T4, high TSH, bradycardia, and fatigue
Rationale: Primary hypothyroidism leads to low thyroid hormone, prompting pituitary TSH
elevation.
6. Which of the following best describes the mechanism of chronic liver failure?
A. Progressive hepatocyte loss and fibrosis leading to portal hypertension, coagulopathy, and
jaundice
B. Acute viral infection only
C. Gallbladder obstruction exclusively
D. Kidney disease only
Answer: A. Progressive hepatocyte loss and fibrosis leading to portal hypertension,
coagulopathy, and jaundice
Rationale: Chronic insults (e.g., hepatitis, alcohol) damage liver structure and function over
time.
7. Which of the following is true regarding chronic obstructive pulmonary disease
(COPD)?
A. Persistent airflow limitation due to chronic bronchitis and/or emphysema, usually caused by
smoking
B. Reversible airway obstruction only
C. Pulmonary edema exclusively
D. Pneumothorax only
, Answer: A. Persistent airflow limitation due to chronic bronchitis and/or emphysema,
usually caused by smoking
Rationale: COPD is progressive, characterized by irreversible airflow limitation.
8. Which of the following lab findings is most indicative of iron-deficiency anemia?
A. Microcytic, hypochromic RBCs with low serum ferritin
B. Macrocytic anemia exclusively
C. Hemolytic markers only
D. Hypernatremia only
Answer: A. Microcytic, hypochromic RBCs with low serum ferritin
Rationale: Iron deficiency impairs hemoglobin production, producing small, pale red blood
cells.
9. Which of the following best describes the pathophysiology of cirrhosis-related ascites?
A. Portal hypertension and hypoalbuminemia causing fluid accumulation in the peritoneal cavity
B. Renal failure exclusively
C. Hypercalcemia only
D. Pulmonary edema only
Answer: A. Portal hypertension and hypoalbuminemia causing fluid accumulation in the
peritoneal cavity
Rationale: Increased hydrostatic pressure and low oncotic pressure lead to fluid leakage into the
abdomen.
10. Which of the following is true regarding systemic inflammatory response syndrome
(SIRS)?
A. Widespread inflammation caused by infection, trauma, or other insults leading to fever,
tachycardia, tachypnea, and leukocytosis
B. Autoimmune disease only
C. Chronic heart failure exclusively
D. Pulmonary embolism only
Answer: A. Widespread inflammation caused by infection, trauma, or other insults leading
to fever, tachycardia, tachypnea, and leukocytosis
Rationale: SIRS is a systemic inflammatory state that may progress to sepsis if infection is
present.
COMPREHENSIVE ASSESSMENT OF DISEASE MECHANISMS, LAB
INTERPRETATION, AND CLINICAL PATHOPHYSIOLOGY QUESTIONS
WITH ANSWERS & RATIONALES
1. Which of the following best describes the primary mechanism of acute kidney injury
(AKI)?
A. Sudden reduction in renal perfusion, tubular injury, or obstruction
B. Gradual decrease in kidney size exclusively
C. Chronic autoimmune damage only
D. Hypernatremia exclusively
Answer: A. Sudden reduction in renal perfusion, tubular injury, or obstruction
Rationale: AKI results from prerenal, intrinsic, or postrenal causes leading to rapid loss of
kidney function.
2. Which lab finding is most characteristic of nephritic syndrome?
A. Hematuria, mild proteinuria, hypertension, and azotemia
B. Massive proteinuria only
C. Hypokalemia exclusively
D. Hypercalcemia only
Answer: A. Hematuria, mild proteinuria, hypertension, and azotemia
Rationale: Glomerular inflammation allows blood cells to leak into urine and often elevates
blood pressure.
3. Which of the following best describes the pathophysiology of heart failure with reduced
ejection fraction (HFrEF)?
A. Impaired contractility leading to decreased cardiac output
B. Purely diastolic dysfunction only
C. Pulmonary embolism exclusively
D. Arrhythmia only
Answer: A. Impaired contractility leading to decreased cardiac output
Rationale: HFrEF involves systolic dysfunction, commonly due to myocardial infarction or
cardiomyopathy.
4. Which of the following is true regarding type 1 diabetes mellitus?
A. Autoimmune destruction of pancreatic beta cells causing absolute insulin deficiency
,B. Insulin resistance exclusively
C. Hyperthyroidism only
D. Glucagon deficiency only
Answer: A. Autoimmune destruction of pancreatic beta cells causing absolute insulin
deficiency
Rationale: Type 1 DM leads to hyperglycemia due to lack of insulin.
5. Which of the following lab findings is characteristic of hypothyroidism?
A. Low T4, high TSH, bradycardia, and fatigue
B. High T4 exclusively
C. Hypernatremia only
D. Hypocalcemia only
Answer: A. Low T4, high TSH, bradycardia, and fatigue
Rationale: Primary hypothyroidism leads to low thyroid hormone, prompting pituitary TSH
elevation.
6. Which of the following best describes the mechanism of chronic liver failure?
A. Progressive hepatocyte loss and fibrosis leading to portal hypertension, coagulopathy, and
jaundice
B. Acute viral infection only
C. Gallbladder obstruction exclusively
D. Kidney disease only
Answer: A. Progressive hepatocyte loss and fibrosis leading to portal hypertension,
coagulopathy, and jaundice
Rationale: Chronic insults (e.g., hepatitis, alcohol) damage liver structure and function over
time.
7. Which of the following is true regarding chronic obstructive pulmonary disease
(COPD)?
A. Persistent airflow limitation due to chronic bronchitis and/or emphysema, usually caused by
smoking
B. Reversible airway obstruction only
C. Pulmonary edema exclusively
D. Pneumothorax only
, Answer: A. Persistent airflow limitation due to chronic bronchitis and/or emphysema,
usually caused by smoking
Rationale: COPD is progressive, characterized by irreversible airflow limitation.
8. Which of the following lab findings is most indicative of iron-deficiency anemia?
A. Microcytic, hypochromic RBCs with low serum ferritin
B. Macrocytic anemia exclusively
C. Hemolytic markers only
D. Hypernatremia only
Answer: A. Microcytic, hypochromic RBCs with low serum ferritin
Rationale: Iron deficiency impairs hemoglobin production, producing small, pale red blood
cells.
9. Which of the following best describes the pathophysiology of cirrhosis-related ascites?
A. Portal hypertension and hypoalbuminemia causing fluid accumulation in the peritoneal cavity
B. Renal failure exclusively
C. Hypercalcemia only
D. Pulmonary edema only
Answer: A. Portal hypertension and hypoalbuminemia causing fluid accumulation in the
peritoneal cavity
Rationale: Increased hydrostatic pressure and low oncotic pressure lead to fluid leakage into the
abdomen.
10. Which of the following is true regarding systemic inflammatory response syndrome
(SIRS)?
A. Widespread inflammation caused by infection, trauma, or other insults leading to fever,
tachycardia, tachypnea, and leukocytosis
B. Autoimmune disease only
C. Chronic heart failure exclusively
D. Pulmonary embolism only
Answer: A. Widespread inflammation caused by infection, trauma, or other insults leading
to fever, tachycardia, tachypnea, and leukocytosis
Rationale: SIRS is a systemic inflammatory state that may progress to sepsis if infection is
present.
