WGU D236
Pathophysiology
OA V2 EXAM
Actual Questions with Verified Answers
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➢70 OA Exam Questions w/ Answers
➢ (Megan/Shay’s Study Guides)
➢ Casey's WGU NY01 Patho Note
➢ Expert Rationales included.
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Table of Contents
D236 OA – V2 Exam .............................................................. 2
D236 Patho - Megan/Shay’s Study Guides ......................... 37
Casey's WGU NY01 Patho Notes....................................... 100
D236 OA – V2 Exam
1. A patient record documents headaches with memory defects. The patient's
color and temperature are unusual, and the patient reports pain at night. Which
condition is described?
a. Angina pectoris
b. Atherosclerosis
c. Myocardial infarction
d. Thrombophlebitis
Correct Answer: d. Thrombophlebitis
Expert Rationale:
Thrombophlebitis involves inflammation and thrombus formation in a superficial
or deep vein. Clinical manifestations include localized warmth, erythema (color
change), tenderness, and pain that may worsen at night or with palpation. While
the memory defects and headaches are atypical, the combination of
color/temperature changes with nocturnal limb pain strongly suggests venous
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inflammation. Angina and MI present with chest pain; atherosclerosis is typically
asymptomatic until complications arise.
2. A patient record indicates a type of hypertension that is typically above
180/120 and can cause serious damage to organ tissue. It was treated as a
medical emergency. Which type of hypertension did this patient have?
a. Pulmonary
b. Malignant
c. Essential
d. Renal
Correct Answer: b. Malignant
Expert Rationale:
Malignant hypertension is defined by severe hypertension (systolic >180 mmHg or
diastolic >120-130 mmHg) accompanied by papilledema and/or acute target-
organ damage (encephalopathy, acute kidney injury, heart failure). It requires
immediate intervention to prevent irreversible organ damage. Essential
hypertension is chronic and asymptomatic; pulmonary hypertension affects
pulmonary arteries; renal hypertension is secondary to kidney disease but does
not inherently imply emergency status.
3. A patient presents with fatigue, fever, and night sweats. An echocardiogram
showed vegetations. Which disease is described?
a. Stenosis
b. Pericarditis
c. Myocarditis
d. Endocarditis
Correct Answer: d. Endocarditis
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Expert Rationale:
Infective endocarditis is characterized by the triad of fever, constitutional
symptoms (fatigue, night sweats, weight loss), and vegetation formation on heart
valves visualized by echocardiography (transesophageal echo is most sensitive).
Vegetations are masses of platelets, fibrin, microorganisms, and inflammatory
cells. Stenosis is a valvular narrowing; pericarditis involves the pericardial sac;
myocarditis involves myocardial inflammation without valvular vegetations.
4. Which type of anemia is characterized by insufficient or totally absent RBC
production and results in a patient having an inability to fight infection and
having a tendency to bleed?
a. Aplastic anemia
b. Folic acid deficiency anemia
c. Pernicious anemia
d. Iron deficiency anemia
Correct Answer: a. Aplastic anemia
Expert Rationale:
Aplastic anemia is a bone marrow failure syndrome characterized by pancytopenia
(deficiency of all blood cell lines) due to destruction or suppression of
hematopoietic stem cells. The absence of leukocytes causes infection
susceptibility; thrombocytopenia causes bleeding tendencies. Folic acid deficiency,
pernicious anemia (B12 deficiency), and iron deficiency anemia are specific
maturation or hemoglobin synthesis defects that do not typically cause complete
bone marrow failure.
5. A patient record document reports fatigue, shortness of breath, and vomiting.
The patient was given medication for crushing chest pain that radiated to the
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a. Infectious mononucleosis
b. Respiratory mycoses
c. Acute laryngitis
d. Pulmonary tuberculosis
Correct Answer: b. Respiratory mycoses; d. Pulmonary tuberculosis
Expert Rationale:
Lower respiratory tract infections involve the bronchi, bronchioles, and lung
parenchyma. Pulmonary tuberculosis (Mycobacterium tuberculosis) and
respiratory mycoses (fungal infections such as histoplasmosis, coccidioidomycosis)
directly infect lung tissue. Infectious mononucleosis is a systemic viral illness
caused by EBV, and acute laryngitis is an upper airway inflammation of the larynx.
15. Which symptom is associated with Systemic lupus erythematosus (SLE)?
a. Arthralgias
b. Dark urine
c. Koilonychia
d. Tachycardia
Correct Answer: a. Arthralgias
Expert Rationale:
SLE is a chronic autoimmune disease with multi-system involvement. Arthralgias
and arthritis are among the most common presenting symptoms, affecting
approximately 90% of patients. While dark urine may occur with lupus nephritis,
and tachycardia may result from inflammation or anemia, arthralgias are the most
characteristic and frequently reported symptom. Koilonychia (spoon-shaped nails)
is associated with iron deficiency anemia, not SLE.
16. What is a symptom of malaria?
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inhalation of beryllium dust, occurring in aerospace, nuclear, and electronics
industries. It mimics sarcoidosis with non-caseating granulomas, interstitial
pneumonitis, and restrictive lung disease. The occupational exposure history in a
nuclear power plant is the critical clue. TB causes caseating granulomas and
cavitary lesions; bronchiectasis and asthma have distinct radiographic and clinical
features.
62. A patient presents with fatigue, fever, and night sweats. An echocardiogram
shows vegetations. Which disease is described?
a. Pericarditis
b. Stenosis
c. Myocarditis
d. Endocarditis
Correct Answer: d. Endocarditis
Expert Rationale:
This question reinforces the diagnostic criteria for infective endocarditis: Duke
criteria include positive blood cultures for typical organisms and
echocardiographic evidence of vegetations, plus clinical manifestations (fever,
constitutional symptoms, murmur). Endocarditis involves the endocardial surface
and valves. Pericarditis causes friction rub and chest pain; myocarditis causes
arrhythmias and heart failure without vegetations; stenosis is a structural valvular
narrowing.
63. Which condition allows blood to flow back into the left atrium from the left
ventricle?
a. Mitral valve insufficiency
b. Aortic valve insufficiency
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c. Aortic valve stenosis
d. Mitral valve stenosis
Correct Answer: a. Mitral valve insufficiency
Expert Rationale:
Mitral (bicuspid) valve insufficiency (regurgitation) occurs when the valve leaflets
fail to coapt during systole, permitting retrograde blood flow from the high-
pressure left ventricle into the left atrium. This causes left atrial volume overload,
pulmonary congestion, and eventually left ventricular dilation. Aortic insufficiency
causes diastolic backflow into the LV; aortic stenosis causes obstructed outflow;
mitral stenosis causes obstructed inflow from LA to LV.
64. A primary care physician documented the following symptoms and history in
a patient's record: persistent abdominal pain radiating to the back, anorexia,
jaundice, and weight loss. The laboratory report showed glycosuria and
hyperglycemia. An endoscopic retrograde cholangiopancreatography was
conclusive and revealed the patient had which condition?
a. Colorectal cancer
b. Liver cancer
c. Gastrointestinal cancer
d. Pancreatic cancer
Correct Answer: d. Pancreatic cancer
Expert Rationale:
Pancreatic adenocarcinoma (particularly head of pancreas) presents with painless
or persistent epigastric pain radiating to the back, obstructive jaundice, weight
loss, anorexia, and new-onset diabetes (destruction of islet cells causing glycosuria
and hyperglycemia). ERCP is both diagnostic and therapeutic, revealing the
"double duct sign" (biliary and pancreatic duct obstruction). Colorectal cancer
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pulmonary circulation if there is an obstructive lung disease)
Valve problems
What are the compensatory mechanisms of heart failure?
#Renin and aldosterone secretion (vasoconstriction and blood volume is
increased)
#SNS response (increases heart rate/vasoconstriction - epinephrine and
norepinephrine)
#Cardiac hypertrophy (increased size of the heart)
What are complications of heart failure?
#Cardiogenic shock
#Acute pulmonary edema
#Organ failure
What lab test is an indication of heart failure?
B-Type Natriuretic Peptide (BNP) - a hormone produced by the heart. BNP > 500
are considered indicative of heart failure.
What are causes of left sided heart failure?
#MI
#Valve stenosis
#HTN (has to push after the afterload)
What is the RAAS system?
Renin-angiotensin-aldosterone system - a major mechanism in the regulation of
arterial blood pressure. It is a compensatory mechanism that raises blood
pressure and increases blood volume in response to decreased renal perfusion.
What is the patho of left sided heart failure?
Decreased cardiac output and pulmonary congestion
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#Fatigue
#Diarrhea, constipation, bloating or nausea (especially during menstrual periods)
What is ovarian cancer? What are the causes?
What markers indicate ovarian cancer? Pick 2
CEA
TP53
PSA
AFP
HE4
TP53 / HE4
Cancer of the ovaries
#Genetic causes, especially TP53 activation
#HE4 biomarker: protein that is produced by most epithelial ovarian cancer cells
What is pelvic inflammatory disease (PID) and what are s/sx?
Inflammation and infection of organs in the pelvic region, most often occurs when
sexually transmitted bacteria spread from your vagina to your uterus, fallopian
tubes, or ovaries. (Gonorrhea or chlamydia are the most common)
Symptoms:
#Can be nonexistent or mild, may not even notice symptoms until trouble getting
pregnant
#Mild to severe abdominal or pelvic pain
#Abnormal or heavy vaginal discharge with odor