HESI EXIT PATHOPHYSIOLOGY QUESTIONS WITH ANSWERS
2025/2026 GRADED A+
Type III: Immune Complex - *ex:* Arthus reaction; Serum Sickness; SLE; Acute
Glomerulonephritis.
*P:* Inflammation d/t immune complex blockage
*C:* Antigen-antibody complexes
Type IV: Cell-mediated, delayed - *ex:* Tuberculosis, Contact dermatitis, Transplant
rejection
*P:* Lymphokine release
*C:* Sensitized T-Cells
Systemic Lupus Erythematosus (SLE) - Autoimmune - *P:* Autoantibodies against
nucleic acids, and other immune cells and cell products. Causes inflammatory lesions in
organs (brain, heart, kidneys, etc)
*R/F:* Women; Black; 20-40 yrs; Hydralazine
*S/S:* Arthralgias; vasculitis; rash; renal disease; anemia
Incubation Period - Initial exposure
Colonization
Asymptomatic
Prodromal Period - Initial Ambiguous Symptoms
Invasion Period - Invasion
Specific Symptoms
Convalescence - Successful removal of infectious agents
Decline of symptoms
Septic Shock (Endotoxic Shock) - Leading cause of death in ICUs
*C:* gram (-) bacteria, some gram (+) and fungi
*S/S:* vasodilation, hypoxia, cardiovascular shock
Human immunodeficiency virus (HIV) - Blood Borne (blood, vaginal fluids, semen,
breast milk)
*P:* Retrovirus converts its own RNA to DNA, Decreases in helper T cells. Serologically
4-7 weeks can be up to years.
*S/S:* Weight Loss; Annorexia; Kaposi sarcoma; Vesicular and ulcerative lesions
perianal; loss of vision
Paraneoplastic Syndrome - When tumor markers such as alpha fetoprotein (AFP) and
prostate specific antigens (PSA) cause symptoms
5 Categories of Neuro function that are critical in the evaluation process: - 1) Level of
Consciousness
, 2) Pattern of Breathing
3) Pupillary Changes
4) Oculomotor Responses
5) Motor Responses
Lethargy - Limited spontaneous movement or speech
*Easy arousal with normal speech or touch*
May not be oriented time, place, or person
Stupor - A condition of deep sleep or unresponsiveness, can only be aroused with
vigorous and repeated stimulation.
Response is often withdrawal or grabbing at stimulus
Obtundation - Mild or moderate reduction in arousal (awakeness) with limited response
to the environment
Falls asleep unless stimulated verbally or tactiley
Answers questions with minimum response
Posthyperventilation apnea - Respirations stop after hyperventilation has lowered Pco2
levels below normal.
Rhythmic breathing returns when the Pco2 levels return to normal.
Cheyne-Stokes Respirations - Breathing pattern has a smooth increase in rate and
depth which peaks and then a smooth decrease in rate and depth of breathing to the
point of apnea.
Apneusis - Prolonged inspiratory cramp (a pause at full inspiration) occurs. A common
variant of this is a brief end-inspiratory pause of 2 or 3 seconds, often alternating with
an end expiratory pause.
*C:* hypoglycemia, anoxia, meningitis
Drugs that Dilate Pupils - Atropine
Scopolamine
Amphetamines
Mydriatics
Cycloplegics
Drugs that cause pinhole pupils - Opiates
Barbiturates
Pontine Damage
Exemptions from "Brain Death" - Depressant drugs
Alcohol poisoning
Neuromuscular blockage
Hypothermia
2025/2026 GRADED A+
Type III: Immune Complex - *ex:* Arthus reaction; Serum Sickness; SLE; Acute
Glomerulonephritis.
*P:* Inflammation d/t immune complex blockage
*C:* Antigen-antibody complexes
Type IV: Cell-mediated, delayed - *ex:* Tuberculosis, Contact dermatitis, Transplant
rejection
*P:* Lymphokine release
*C:* Sensitized T-Cells
Systemic Lupus Erythematosus (SLE) - Autoimmune - *P:* Autoantibodies against
nucleic acids, and other immune cells and cell products. Causes inflammatory lesions in
organs (brain, heart, kidneys, etc)
*R/F:* Women; Black; 20-40 yrs; Hydralazine
*S/S:* Arthralgias; vasculitis; rash; renal disease; anemia
Incubation Period - Initial exposure
Colonization
Asymptomatic
Prodromal Period - Initial Ambiguous Symptoms
Invasion Period - Invasion
Specific Symptoms
Convalescence - Successful removal of infectious agents
Decline of symptoms
Septic Shock (Endotoxic Shock) - Leading cause of death in ICUs
*C:* gram (-) bacteria, some gram (+) and fungi
*S/S:* vasodilation, hypoxia, cardiovascular shock
Human immunodeficiency virus (HIV) - Blood Borne (blood, vaginal fluids, semen,
breast milk)
*P:* Retrovirus converts its own RNA to DNA, Decreases in helper T cells. Serologically
4-7 weeks can be up to years.
*S/S:* Weight Loss; Annorexia; Kaposi sarcoma; Vesicular and ulcerative lesions
perianal; loss of vision
Paraneoplastic Syndrome - When tumor markers such as alpha fetoprotein (AFP) and
prostate specific antigens (PSA) cause symptoms
5 Categories of Neuro function that are critical in the evaluation process: - 1) Level of
Consciousness
, 2) Pattern of Breathing
3) Pupillary Changes
4) Oculomotor Responses
5) Motor Responses
Lethargy - Limited spontaneous movement or speech
*Easy arousal with normal speech or touch*
May not be oriented time, place, or person
Stupor - A condition of deep sleep or unresponsiveness, can only be aroused with
vigorous and repeated stimulation.
Response is often withdrawal or grabbing at stimulus
Obtundation - Mild or moderate reduction in arousal (awakeness) with limited response
to the environment
Falls asleep unless stimulated verbally or tactiley
Answers questions with minimum response
Posthyperventilation apnea - Respirations stop after hyperventilation has lowered Pco2
levels below normal.
Rhythmic breathing returns when the Pco2 levels return to normal.
Cheyne-Stokes Respirations - Breathing pattern has a smooth increase in rate and
depth which peaks and then a smooth decrease in rate and depth of breathing to the
point of apnea.
Apneusis - Prolonged inspiratory cramp (a pause at full inspiration) occurs. A common
variant of this is a brief end-inspiratory pause of 2 or 3 seconds, often alternating with
an end expiratory pause.
*C:* hypoglycemia, anoxia, meningitis
Drugs that Dilate Pupils - Atropine
Scopolamine
Amphetamines
Mydriatics
Cycloplegics
Drugs that cause pinhole pupils - Opiates
Barbiturates
Pontine Damage
Exemptions from "Brain Death" - Depressant drugs
Alcohol poisoning
Neuromuscular blockage
Hypothermia
