NRMS 5190 ADVANCED PATHOPHYSIOLOGY EXAM 1 REVIEW
QUESTIONS AND ANSWERS WITH RATIONALES | 2026/27
UPDATE | 100% CORRECT -SUNY DOWNSTATE MEDICAL
CENTER
148 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
NRMS 5190 ADVANCED PATHOPHYSIOLOGY EXAM 1 REVIEW QUESTIONS AND ANSWERS WITH
RATIONALES | 2026/27 UPDATE | 100% CORRECT -SUNY DOWNSTATE MEDICAL CENTER. It contains 148
carefully selected questions that reflect the most current exam content and testing strategies. Each question is
accompanied by a correct answer and a detailed rationale that explains the underlying pathophysiology,
pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 148 Questions
Foundations - Application - NRMS 5190 Advanced Pathophysiology 1 Review AND WITH Rationales
2026/27 Update 100 Correct -suny Downstate Medical Center Advanced Pathophysiology Graduate
Msn/dnp-level Advanced Pathophysiology
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Cellular Injury Adaptation 1-25 Explains, Mechanism, Acute, Change, Pathophysiologic
AND Death
Inflammation AND Wound 26-50 Mechanism, Explains, Finding, Directly, Response
Healing
Immunity AND Immune 51-75 Mechanism, Explains, Disease, Diabetes Mellitus, Anemia
Disorders
Genetics AND Genetic 76-100 Explains, Mechanism, Directly, Chronic, Acute
Disorders
Fluid Electrolyte AND 101-125 Mechanism, Explains, Likely, Tumor, Chronic
Acid-base Imbalances
Neoplasia AND Cancer 126-148 Explains, Describes, Directly, Mechanism, Pathophysiology
Pathophysiology
TOTAL 148 All questions include answers and detailed rationales
,Section A - Cellular Injury Adaptation AND Death
Q1.
A cell exposed to prolonged hypoxia shows swelling, reduced ATP, and increased
anaerobic glycolysis. Which mechanism best explains the resulting intracellular
accumulation of Na+ and Ca2+?
A. Increased activity of the Na+/K+-ATPase B. Failure of ATP-dependent ion pumps with
pump membrane permeability changes
C. Enhanced lysosomal enzyme release into D. Upregulation of aquaporin channels
the cytosol causing water efflux
Correct: B - Failure of ATP-dependent ion pumps with membrane permeability changes
Rationale:Hypoxia reduces oxidative phosphorylation and ATP production, causing failure of
the Na+/K+-ATPase and Ca2+ pumps; the resulting ion gradients dissipate, allowing Na+ and
Ca2+ influx and cell swelling. Lysosomal enzyme release occurs later in irreversible injury,
and aquaporins do not cause ion accumulation.
Why the other answers are wrong:
A. ATP depletion decreases, not increases, Na+/K+-ATPase activity.
C. Lysosomal enzyme release is a later event in irreversible injury, not the primary cause of
early ion shifts.
D. Aquaporins facilitate water movement, not the accumulation of Na+ and Ca2+.
Reference: Kumar, V., Abbas, A.K., Aster, J.C. (2025). Robbins & Cotran Pathologic Basis of Disease,
11th Ed., Ch. 1.
Q2.
Which statement accurately distinguishes type II from type III hypersensitivity reactions?
A. Type II is mediated by IgE; type III by IgG B. Type II involves antibody binding to fixed
tissue antigens; type III involves circulating
immune complex deposition
C. Type II is T-cell mediated; type III is D. Type II occurs within minutes; type III is
complement independent delayed 24-72 hours
Correct: B - Type II involves antibody binding to fixed tissue antigens; type III involves
circulating immune complex deposition
Rationale:Type II hypersensitivity is caused by IgG/IgM antibodies directed against antigens
fixed on cell surfaces or extracellular matrix, leading to cell destruction or dysfunction. Type III
results from deposition of circulating antigen-antibody complexes in tissues, activating
complement and causing inflammation.
Why the other answers are wrong:
Page 3
, Section A - Cellular Injury Adaptation AND Death
A. IgE mediates type I, not type II; type III is typically IgG-mediated.
C. Type II is antibody-mediated, not T-cell mediated; type III is complement-dependent.
D. Type III is not a delayed-type (type IV) reaction; timing does not distinguish II from III.
Reference: Abbas, A.K., Lichtman, A.H., Pillai, S. (2024). Cellular and Molecular Immunology, 11th Ed.,
Ch. 19.
Q3.
A patient with severe vomiting has an arterial blood gas showing pH 7.48, PaCO2 46 mm
Hg, and HCO3- 34 mEq/L. Which acid-base disturbance is present?
A. Metabolic alkalosis with compensatory B. Respiratory alkalosis with metabolic
hypoventilation compensation
C. Metabolic acidosis with respiratory D. Respiratory acidosis with metabolic
compensation alkalosis
Correct: A - Metabolic alkalosis with compensatory hypoventilation
Rationale:The elevated pH and HCO3- indicate metabolic alkalosis; the elevated PaCO2
reflects compensatory hypoventilation. In respiratory alkalosis, pH would be high but HCO3-
would be low or normal, and PaCO2 would be low.
Why the other answers are wrong:
B. Respiratory alkalosis would show decreased PaCO2 and compensatory decreased HCO3-.
C. Metabolic acidosis would show decreased pH and HCO3-.
D. Primary respiratory acidosis would show decreased pH with elevated PaCO2.
Reference: Norris, T.L. (2025). Porth's Pathophysiology: Concepts of Altered Health States, 11th Ed., Ch.
30.
Q4.
In autosomal dominant disorders, which phenomenon explains why some individuals
carrying the mutation show no clinical features?
A. Anticipation B. Incomplete penetrance
C. Genomic imprinting D. Mosaicism
Correct: B - Incomplete penetrance
Rationale:Incomplete penetrance means that not all individuals with a disease-causing
genotype express the phenotype. Anticipation refers to earlier onset/severe disease in
successive generations; imprinting and mosaicism do not explain absence of features in
carriers.
Why the other answers are wrong:
A. Anticipation involves increasing severity or earlier onset in later generations, not absence of
phenotype.
Page 4
QUESTIONS AND ANSWERS WITH RATIONALES | 2026/27
UPDATE | 100% CORRECT -SUNY DOWNSTATE MEDICAL
CENTER
148 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
NRMS 5190 ADVANCED PATHOPHYSIOLOGY EXAM 1 REVIEW QUESTIONS AND ANSWERS WITH
RATIONALES | 2026/27 UPDATE | 100% CORRECT -SUNY DOWNSTATE MEDICAL CENTER. It contains 148
carefully selected questions that reflect the most current exam content and testing strategies. Each question is
accompanied by a correct answer and a detailed rationale that explains the underlying pathophysiology,
pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 148 Questions
Foundations - Application - NRMS 5190 Advanced Pathophysiology 1 Review AND WITH Rationales
2026/27 Update 100 Correct -suny Downstate Medical Center Advanced Pathophysiology Graduate
Msn/dnp-level Advanced Pathophysiology
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Cellular Injury Adaptation 1-25 Explains, Mechanism, Acute, Change, Pathophysiologic
AND Death
Inflammation AND Wound 26-50 Mechanism, Explains, Finding, Directly, Response
Healing
Immunity AND Immune 51-75 Mechanism, Explains, Disease, Diabetes Mellitus, Anemia
Disorders
Genetics AND Genetic 76-100 Explains, Mechanism, Directly, Chronic, Acute
Disorders
Fluid Electrolyte AND 101-125 Mechanism, Explains, Likely, Tumor, Chronic
Acid-base Imbalances
Neoplasia AND Cancer 126-148 Explains, Describes, Directly, Mechanism, Pathophysiology
Pathophysiology
TOTAL 148 All questions include answers and detailed rationales
,Section A - Cellular Injury Adaptation AND Death
Q1.
A cell exposed to prolonged hypoxia shows swelling, reduced ATP, and increased
anaerobic glycolysis. Which mechanism best explains the resulting intracellular
accumulation of Na+ and Ca2+?
A. Increased activity of the Na+/K+-ATPase B. Failure of ATP-dependent ion pumps with
pump membrane permeability changes
C. Enhanced lysosomal enzyme release into D. Upregulation of aquaporin channels
the cytosol causing water efflux
Correct: B - Failure of ATP-dependent ion pumps with membrane permeability changes
Rationale:Hypoxia reduces oxidative phosphorylation and ATP production, causing failure of
the Na+/K+-ATPase and Ca2+ pumps; the resulting ion gradients dissipate, allowing Na+ and
Ca2+ influx and cell swelling. Lysosomal enzyme release occurs later in irreversible injury,
and aquaporins do not cause ion accumulation.
Why the other answers are wrong:
A. ATP depletion decreases, not increases, Na+/K+-ATPase activity.
C. Lysosomal enzyme release is a later event in irreversible injury, not the primary cause of
early ion shifts.
D. Aquaporins facilitate water movement, not the accumulation of Na+ and Ca2+.
Reference: Kumar, V., Abbas, A.K., Aster, J.C. (2025). Robbins & Cotran Pathologic Basis of Disease,
11th Ed., Ch. 1.
Q2.
Which statement accurately distinguishes type II from type III hypersensitivity reactions?
A. Type II is mediated by IgE; type III by IgG B. Type II involves antibody binding to fixed
tissue antigens; type III involves circulating
immune complex deposition
C. Type II is T-cell mediated; type III is D. Type II occurs within minutes; type III is
complement independent delayed 24-72 hours
Correct: B - Type II involves antibody binding to fixed tissue antigens; type III involves
circulating immune complex deposition
Rationale:Type II hypersensitivity is caused by IgG/IgM antibodies directed against antigens
fixed on cell surfaces or extracellular matrix, leading to cell destruction or dysfunction. Type III
results from deposition of circulating antigen-antibody complexes in tissues, activating
complement and causing inflammation.
Why the other answers are wrong:
Page 3
, Section A - Cellular Injury Adaptation AND Death
A. IgE mediates type I, not type II; type III is typically IgG-mediated.
C. Type II is antibody-mediated, not T-cell mediated; type III is complement-dependent.
D. Type III is not a delayed-type (type IV) reaction; timing does not distinguish II from III.
Reference: Abbas, A.K., Lichtman, A.H., Pillai, S. (2024). Cellular and Molecular Immunology, 11th Ed.,
Ch. 19.
Q3.
A patient with severe vomiting has an arterial blood gas showing pH 7.48, PaCO2 46 mm
Hg, and HCO3- 34 mEq/L. Which acid-base disturbance is present?
A. Metabolic alkalosis with compensatory B. Respiratory alkalosis with metabolic
hypoventilation compensation
C. Metabolic acidosis with respiratory D. Respiratory acidosis with metabolic
compensation alkalosis
Correct: A - Metabolic alkalosis with compensatory hypoventilation
Rationale:The elevated pH and HCO3- indicate metabolic alkalosis; the elevated PaCO2
reflects compensatory hypoventilation. In respiratory alkalosis, pH would be high but HCO3-
would be low or normal, and PaCO2 would be low.
Why the other answers are wrong:
B. Respiratory alkalosis would show decreased PaCO2 and compensatory decreased HCO3-.
C. Metabolic acidosis would show decreased pH and HCO3-.
D. Primary respiratory acidosis would show decreased pH with elevated PaCO2.
Reference: Norris, T.L. (2025). Porth's Pathophysiology: Concepts of Altered Health States, 11th Ed., Ch.
30.
Q4.
In autosomal dominant disorders, which phenomenon explains why some individuals
carrying the mutation show no clinical features?
A. Anticipation B. Incomplete penetrance
C. Genomic imprinting D. Mosaicism
Correct: B - Incomplete penetrance
Rationale:Incomplete penetrance means that not all individuals with a disease-causing
genotype express the phenotype. Anticipation refers to earlier onset/severe disease in
successive generations; imprinting and mosaicism do not explain absence of features in
carriers.
Why the other answers are wrong:
A. Anticipation involves increasing severity or earlier onset in later generations, not absence of
phenotype.
Page 4
