SUNY Downstate Medical Center NRMS 5190 Advanced
Pathophysiology Final Exam | 150 Questions and Correct
Answers plus Rationale | New Update 2026-2027
1. Which pathway in the study guide carries pain, thermal sensation, crude
touch, and pressure?
A. Extrapyramidal system
B. Discriminative pathway
C. Pyramidal motor system
D. Anterolateral pathway
Correct Answer: D. Anterolateral pathway
Verified Rationale: The anterolateral/spinothalamic pathway carries pain,
temperature, crude touch, and pressure.
2. A patient can identify a screwdriver placed in the hand without looking at it.
Which sensory ability is being demonstrated?
A. Avolition
B. Stereognosis
C. Bradykinesia
D. Allodynia
Correct Answer: B. Stereognosis
Verified Rationale: Stereognosis is the ability to recognize objects by touch
without visual cues.
3. Which pain fibers are associated with fast pain?
A. Oligodendrocytes
B. C fibers
C. Schwann cells
D. A-delta fibers
,Correct Answer: D. A-delta fibers
Verified Rationale: A-delta fibers are myelinated and transmit fast, sharp pain.
4. Which tract is associated with sharp, stabbing pain?
A. Pyramidal tract
B. Nigrostriatal pathway
C. Neospinothalamic tract
D. Paleospinothalamic tract
Correct Answer: C. Neospinothalamic tract
Verified Rationale: The neospinothalamic tract carries fast, sharp, localized pain.
5. Which description best matches visceral pain?
A. Sharp burning pain originating in skin and subcutaneous tissue
B. Pain limited to a ligament after abnormal joint movement
C. A painless sensory deficit confined to one peripheral nerve
D. Diffuse, poorly defined pain originating in visceral organs
Correct Answer: D. Diffuse, poorly defined pain originating in visceral organs
Verified Rationale: Visceral pain is diffuse, poorly localized, and originates from
internal organs.
6. A sprained ankle is used in the study guide as an example of which type of
pain?
A. Cutaneous pain
B. Deep somatic pain
C. Referred pain
D. Visceral pain
Correct Answer: B. Deep somatic pain
Verified Rationale: Sprained ankle pain arises from musculoskeletal structures,
representing deep somatic pain.
,7. A patient has recurrent sharp, stabbing facial pain without numbness. Which
disorder is most consistent with the study guide?
A. Trigeminal neuralgia
B. Phantom limb pain
C. Complex regional pain syndrome
D. Postherpetic neuralgia
Correct Answer: A. Trigeminal neuralgia
Verified Rationale: Trigeminal neuralgia causes recurrent sharp, stabbing facial
pain without sensory loss.
8. Trigeminal neuralgia primarily involves which cranial nerve according to the
notes?
A. Cranial nerve VII
B. Cranial nerve X
C. Cranial nerve V
D. Cranial nerve II
Correct Answer: C. Cranial nerve V
Verified Rationale: Trigeminal neuralgia affects cranial nerve V.
9. Myasthenia gravis in the study guide is caused by which mechanism?
A. Progressive destruction of the nigrostriatal pathway
B. Antibody-mediated loss of acetylcholine receptors at the neuromuscular
junction
C. A single recessive gene defect transmitted from mother to male offspring
D. Autoimmune destruction of oligodendrocytes in the CNS
Correct Answer: B. Antibody-mediated loss of acetylcholine receptors at the
neuromuscular junction
Verified Rationale: Myasthenia gravis is caused by autoantibodies against
acetylcholine receptors.
, 10. Which symptom pattern is most characteristic of myasthenia gravis in the
uploaded material?
A. Resting tremor disappears as the day proceeds
B. Weakness is least evident in the morning and worsens with effort as the day
proceeds
C. Symptoms are limited to sensory loss without muscle fatigue
D. Weakness begins rapidly with loss of tendon reflexes and then resolves with
activity
Correct Answer: B. Weakness is least evident in the morning and worsens with
effort as the day proceeds
Verified Rationale: Myasthenia gravis causes fatigable weakness that worsens
later in the day.
11. Guillain-Barre syndrome is described as which type of disorder?
A. Autoimmune destruction of CNS oligodendrocytes with remissions and
exacerbations
B. Degenerative basal ganglia disorder with resting tremor
C. Acute immune-mediated polyneuropathy with rapid limb weakness and loss of
tendon reflexes
D. Inherited muscular dystrophy affecting boys at age 2-3 years
Correct Answer: C. Acute immune-mediated polyneuropathy with rapid limb
weakness and loss of tendon reflexes
Verified Rationale: Guillain-Barré is an acute immune-mediated polyneuropathy
causing ascending weakness and areflexia.
12. Which pathophysiologic change is central to Parkinson disease in the study
guide?
A. Progressive destruction of the nigrostriatal pathway with reduced striatal
dopamine
B. Loss of acetylcholine receptors at the neuromuscular junction
C. Demyelination of cranial nerve V
D. Autoimmune destruction of oligodendrocytes
Pathophysiology Final Exam | 150 Questions and Correct
Answers plus Rationale | New Update 2026-2027
1. Which pathway in the study guide carries pain, thermal sensation, crude
touch, and pressure?
A. Extrapyramidal system
B. Discriminative pathway
C. Pyramidal motor system
D. Anterolateral pathway
Correct Answer: D. Anterolateral pathway
Verified Rationale: The anterolateral/spinothalamic pathway carries pain,
temperature, crude touch, and pressure.
2. A patient can identify a screwdriver placed in the hand without looking at it.
Which sensory ability is being demonstrated?
A. Avolition
B. Stereognosis
C. Bradykinesia
D. Allodynia
Correct Answer: B. Stereognosis
Verified Rationale: Stereognosis is the ability to recognize objects by touch
without visual cues.
3. Which pain fibers are associated with fast pain?
A. Oligodendrocytes
B. C fibers
C. Schwann cells
D. A-delta fibers
,Correct Answer: D. A-delta fibers
Verified Rationale: A-delta fibers are myelinated and transmit fast, sharp pain.
4. Which tract is associated with sharp, stabbing pain?
A. Pyramidal tract
B. Nigrostriatal pathway
C. Neospinothalamic tract
D. Paleospinothalamic tract
Correct Answer: C. Neospinothalamic tract
Verified Rationale: The neospinothalamic tract carries fast, sharp, localized pain.
5. Which description best matches visceral pain?
A. Sharp burning pain originating in skin and subcutaneous tissue
B. Pain limited to a ligament after abnormal joint movement
C. A painless sensory deficit confined to one peripheral nerve
D. Diffuse, poorly defined pain originating in visceral organs
Correct Answer: D. Diffuse, poorly defined pain originating in visceral organs
Verified Rationale: Visceral pain is diffuse, poorly localized, and originates from
internal organs.
6. A sprained ankle is used in the study guide as an example of which type of
pain?
A. Cutaneous pain
B. Deep somatic pain
C. Referred pain
D. Visceral pain
Correct Answer: B. Deep somatic pain
Verified Rationale: Sprained ankle pain arises from musculoskeletal structures,
representing deep somatic pain.
,7. A patient has recurrent sharp, stabbing facial pain without numbness. Which
disorder is most consistent with the study guide?
A. Trigeminal neuralgia
B. Phantom limb pain
C. Complex regional pain syndrome
D. Postherpetic neuralgia
Correct Answer: A. Trigeminal neuralgia
Verified Rationale: Trigeminal neuralgia causes recurrent sharp, stabbing facial
pain without sensory loss.
8. Trigeminal neuralgia primarily involves which cranial nerve according to the
notes?
A. Cranial nerve VII
B. Cranial nerve X
C. Cranial nerve V
D. Cranial nerve II
Correct Answer: C. Cranial nerve V
Verified Rationale: Trigeminal neuralgia affects cranial nerve V.
9. Myasthenia gravis in the study guide is caused by which mechanism?
A. Progressive destruction of the nigrostriatal pathway
B. Antibody-mediated loss of acetylcholine receptors at the neuromuscular
junction
C. A single recessive gene defect transmitted from mother to male offspring
D. Autoimmune destruction of oligodendrocytes in the CNS
Correct Answer: B. Antibody-mediated loss of acetylcholine receptors at the
neuromuscular junction
Verified Rationale: Myasthenia gravis is caused by autoantibodies against
acetylcholine receptors.
, 10. Which symptom pattern is most characteristic of myasthenia gravis in the
uploaded material?
A. Resting tremor disappears as the day proceeds
B. Weakness is least evident in the morning and worsens with effort as the day
proceeds
C. Symptoms are limited to sensory loss without muscle fatigue
D. Weakness begins rapidly with loss of tendon reflexes and then resolves with
activity
Correct Answer: B. Weakness is least evident in the morning and worsens with
effort as the day proceeds
Verified Rationale: Myasthenia gravis causes fatigable weakness that worsens
later in the day.
11. Guillain-Barre syndrome is described as which type of disorder?
A. Autoimmune destruction of CNS oligodendrocytes with remissions and
exacerbations
B. Degenerative basal ganglia disorder with resting tremor
C. Acute immune-mediated polyneuropathy with rapid limb weakness and loss of
tendon reflexes
D. Inherited muscular dystrophy affecting boys at age 2-3 years
Correct Answer: C. Acute immune-mediated polyneuropathy with rapid limb
weakness and loss of tendon reflexes
Verified Rationale: Guillain-Barré is an acute immune-mediated polyneuropathy
causing ascending weakness and areflexia.
12. Which pathophysiologic change is central to Parkinson disease in the study
guide?
A. Progressive destruction of the nigrostriatal pathway with reduced striatal
dopamine
B. Loss of acetylcholine receptors at the neuromuscular junction
C. Demyelination of cranial nerve V
D. Autoimmune destruction of oligodendrocytes
