NSG 530 EXAM 3 – WILKES ADVANCED
PATHOPHYSIOLOGY QUESTIONS AND
ANSWERS
1. A patient presents with a serum sodium of 120 mEq/L and high urine osmolality. Which
pathophysiological mechanism best describes SIADH?
A. Excessive production of ADH leading to water retention and dilutional hyponatremia
B. Deficiency of ADH leading to excessive water loss and hypernatremia
C. Resistance to ADH at the collecting duct level
D. Destruction of the posterior pituitary gland
Answer: A
Conceptual Explanation: Syndrome of Inappropriate Antidiuretic Hormone (SIADH) is
characterized by excessive ADH release, leading to water reabsorption in the kidneys,
which results in dilutional hyponatremia and concentrated urine.
2. Which of the following findings is most characteristic of Grave’s disease?
A. TSH-secreting pituitary adenoma
B. Destruction of thyroid follicles by T-cells
,C. Thyroid-stimulating immunoglobulins (TSI) binding to TSH receptors
D. Iodine deficiency leading to goiter
Answer: C
Conceptual Explanation: Grave’s disease is an autoimmune disorder where Type II
hypersensitivity involves TSI antibodies that mimic TSH, stimulating the thyroid gland to
overproduce thyroid hormones.
3. In the context of Chronic Kidney Disease (CKD), why do patients develop secondary
hyperparathyroidism?
A. Excessive vitamin D intake
B. Direct stimulation of the parathyroid gland by urea
C. Hypocalcemia resulting from hyperphosphatemia and decreased activated Vitamin D
D. Primary adenoma of the parathyroid gland
Answer: C
Conceptual Explanation: In CKD, the kidneys fail to excrete phosphate and produce 1,25-
dihydroxyvitamin D. The resulting hyperphosphatemia and hypocalcemia trigger the
parathyroid glands to release PTH.
4. Which cell type in the stomach is responsible for secreting intrinsic factor and hydrochloric
acid?
A. Chief cells
, B. G cells
C. Mucous cells
D. Parietal cells
Answer: D
Conceptual Explanation: Parietal cells secrete HCl (for digestion) and intrinsic factor
(required for Vitamin B12 absorption in the ileum).
5. A patient with cirrhosis develops hepatic encephalopathy. What is the primary neurotoxin
involved?
A. Bilirubin
B. Albumin
C. Ammonia
D. Lactate
Answer: C
Conceptual Explanation: Liver failure leads to the inability to convert ammonia (a
byproduct of protein metabolism) into urea, allowing ammonia to cross the blood-brain
barrier and cause neurologic dysfunction.
6. What is the hallmark clinical manifestation of nephrotic syndrome?
A. Gross hematuria and hypertension
B. Pyuria and flank pain
PATHOPHYSIOLOGY QUESTIONS AND
ANSWERS
1. A patient presents with a serum sodium of 120 mEq/L and high urine osmolality. Which
pathophysiological mechanism best describes SIADH?
A. Excessive production of ADH leading to water retention and dilutional hyponatremia
B. Deficiency of ADH leading to excessive water loss and hypernatremia
C. Resistance to ADH at the collecting duct level
D. Destruction of the posterior pituitary gland
Answer: A
Conceptual Explanation: Syndrome of Inappropriate Antidiuretic Hormone (SIADH) is
characterized by excessive ADH release, leading to water reabsorption in the kidneys,
which results in dilutional hyponatremia and concentrated urine.
2. Which of the following findings is most characteristic of Grave’s disease?
A. TSH-secreting pituitary adenoma
B. Destruction of thyroid follicles by T-cells
,C. Thyroid-stimulating immunoglobulins (TSI) binding to TSH receptors
D. Iodine deficiency leading to goiter
Answer: C
Conceptual Explanation: Grave’s disease is an autoimmune disorder where Type II
hypersensitivity involves TSI antibodies that mimic TSH, stimulating the thyroid gland to
overproduce thyroid hormones.
3. In the context of Chronic Kidney Disease (CKD), why do patients develop secondary
hyperparathyroidism?
A. Excessive vitamin D intake
B. Direct stimulation of the parathyroid gland by urea
C. Hypocalcemia resulting from hyperphosphatemia and decreased activated Vitamin D
D. Primary adenoma of the parathyroid gland
Answer: C
Conceptual Explanation: In CKD, the kidneys fail to excrete phosphate and produce 1,25-
dihydroxyvitamin D. The resulting hyperphosphatemia and hypocalcemia trigger the
parathyroid glands to release PTH.
4. Which cell type in the stomach is responsible for secreting intrinsic factor and hydrochloric
acid?
A. Chief cells
, B. G cells
C. Mucous cells
D. Parietal cells
Answer: D
Conceptual Explanation: Parietal cells secrete HCl (for digestion) and intrinsic factor
(required for Vitamin B12 absorption in the ileum).
5. A patient with cirrhosis develops hepatic encephalopathy. What is the primary neurotoxin
involved?
A. Bilirubin
B. Albumin
C. Ammonia
D. Lactate
Answer: C
Conceptual Explanation: Liver failure leads to the inability to convert ammonia (a
byproduct of protein metabolism) into urea, allowing ammonia to cross the blood-brain
barrier and cause neurologic dysfunction.
6. What is the hallmark clinical manifestation of nephrotic syndrome?
A. Gross hematuria and hypertension
B. Pyuria and flank pain
