NSG 500 ADVANCED
PATHOPHYSIOLOGY EXAM 3
QUESTIONS AND ANSWERS
1. A patient presents with exophthalmos, heat intolerance, and a diffuse goiter. Which
mechanism best explains the underlying pathology of Graves’ disease?
A. Autoantibodies stimulate the TSH receptor, leading to excessive thyroid hormone
production.
B. Destruction of the thyroid follicular cells by cytotoxic T cells.
C. Pituitary adenoma secreting excessive amounts of Thyroid Stimulating Hormone.
D. Iodine deficiency resulting in compensatory thyroid hypertrophy.
Answer: A
Conceptual Explanation: Graves’ disease is an autoimmune disorder where Type II
hypersensitivity involves thyroid-stimulating immunoglobulins (TSI) that bind to and
activate the TSH receptor, leading to hyperthyroidism.
,2. In a patient with Syndrome of Inappropriate Antidiuretic Hormone (SIADH), which
electrolyte imbalance is the primary clinical concern?
A. Hyperkalemia
B. Hypernatremia
C. Hypocalcemia
D. Hyponatremia
Answer: D
Conceptual Explanation: SIADH involves excessive ADH release, leading to water
retention and dilutional hyponatremia, which can cause cerebral edema and neurological
symptoms.
3. A patient with Diabetes Insipidus (DI) is likely to exhibit which of the following laboratory
findings?
A. Low urine specific gravity and low serum sodium.
B. High urine osmolality and low serum osmolality.
C. Low urine osmolality and high serum osmolality.
D. High urine specific gravity and high serum sodium.
Answer: C
, Conceptual Explanation: Diabetes Insipidus is characterized by a lack of ADH (or
response to it), resulting in the excretion of large volumes of dilute urine (low osmolality)
and concentration of the blood (high serum osmolality).
4. Which clinical finding is most indicative of Cushing’s Syndrome rather than Cushing’s
Disease?
A. Hypercortisolism resulting from an ectopic ACTH-secreting tumor.
B. Hypercortisolism resulting from a pituitary adenoma.
C. Elevated ACTH levels with a positive dexamethasone suppression test.
D. Hypercortisolism caused by long-term exogenous glucocorticoid use.
Answer: D
Conceptual Explanation: Cushing’s Syndrome is the broad term for hypercortisolism.
Exogenous steroid use is the most common cause of the syndrome, whereas Cushing’s
Disease specifically refers to a pituitary source of ACTH.
5. A patient with Addison’s disease is at high risk for an adrenal crisis during periods of stress.
What is the physiological cause of this crisis?
A. Excessive production of mineralocorticoids.
B. Hypersecretion of epinephrine from the adrenal medulla.
C. Inadequate secretion of cortisol and aldosterone.
D. Autoimmune destruction of the posterior pituitary gland.
PATHOPHYSIOLOGY EXAM 3
QUESTIONS AND ANSWERS
1. A patient presents with exophthalmos, heat intolerance, and a diffuse goiter. Which
mechanism best explains the underlying pathology of Graves’ disease?
A. Autoantibodies stimulate the TSH receptor, leading to excessive thyroid hormone
production.
B. Destruction of the thyroid follicular cells by cytotoxic T cells.
C. Pituitary adenoma secreting excessive amounts of Thyroid Stimulating Hormone.
D. Iodine deficiency resulting in compensatory thyroid hypertrophy.
Answer: A
Conceptual Explanation: Graves’ disease is an autoimmune disorder where Type II
hypersensitivity involves thyroid-stimulating immunoglobulins (TSI) that bind to and
activate the TSH receptor, leading to hyperthyroidism.
,2. In a patient with Syndrome of Inappropriate Antidiuretic Hormone (SIADH), which
electrolyte imbalance is the primary clinical concern?
A. Hyperkalemia
B. Hypernatremia
C. Hypocalcemia
D. Hyponatremia
Answer: D
Conceptual Explanation: SIADH involves excessive ADH release, leading to water
retention and dilutional hyponatremia, which can cause cerebral edema and neurological
symptoms.
3. A patient with Diabetes Insipidus (DI) is likely to exhibit which of the following laboratory
findings?
A. Low urine specific gravity and low serum sodium.
B. High urine osmolality and low serum osmolality.
C. Low urine osmolality and high serum osmolality.
D. High urine specific gravity and high serum sodium.
Answer: C
, Conceptual Explanation: Diabetes Insipidus is characterized by a lack of ADH (or
response to it), resulting in the excretion of large volumes of dilute urine (low osmolality)
and concentration of the blood (high serum osmolality).
4. Which clinical finding is most indicative of Cushing’s Syndrome rather than Cushing’s
Disease?
A. Hypercortisolism resulting from an ectopic ACTH-secreting tumor.
B. Hypercortisolism resulting from a pituitary adenoma.
C. Elevated ACTH levels with a positive dexamethasone suppression test.
D. Hypercortisolism caused by long-term exogenous glucocorticoid use.
Answer: D
Conceptual Explanation: Cushing’s Syndrome is the broad term for hypercortisolism.
Exogenous steroid use is the most common cause of the syndrome, whereas Cushing’s
Disease specifically refers to a pituitary source of ACTH.
5. A patient with Addison’s disease is at high risk for an adrenal crisis during periods of stress.
What is the physiological cause of this crisis?
A. Excessive production of mineralocorticoids.
B. Hypersecretion of epinephrine from the adrenal medulla.
C. Inadequate secretion of cortisol and aldosterone.
D. Autoimmune destruction of the posterior pituitary gland.
