2025 Advanced Pathophysiology
QUESTIONS AND ANSWERS EXAM - ACTUAL EXAM
WITH A STUDY GUIDE AND PRACTICE EXAM |
GUARANTEED PASS | LATEST UPDATE
A student asks the healthcare professional to describe exotoxins. Which statement by
the professional is best?
a. Exotoxins are contained in cell walls of gram-negative bacteria.
b. Exotoxins are released during the lysis of bacteria.
c. Exotoxins are able to initiate the complement and coagulation cascades.
d. Exotoxins are released during bacterial growth. - CORRECT ANSWER D.
Exotoxins are proteins released during bacterial growth. Exotoxins are not contained in
cell walls of gram-negative bacteria, released during lysis of bacterial, or able to initiate
the complement and coagulation cascades.
A healthcare professional student is learning about fungal infections. What information
should the student use to help another student understand?
a. Fungal infections occur only on skin, hair, and nails.
b. Phagocytes and T lymphocytes control fungal infections.
c. Fungal infections release endotoxins.
d. Vaccines prevent fungal infections. - CORRECT ANSWER B. The host defense
against fungal infection includes the fungistatic properties of neutrophils and
macrophages. T lymphocytes are crucial in limiting the extent of infection and producing
cytokines to further activate macrophages. Fungi infect other tissue types such as
vaginal or gastrointestinal. Fungi do not release endotoxins; they reside in the cell walls
of gram-negative bacteria. Fungal infections are not prevented by current vaccines.
Cytokines are thought to cause fevers by stimulating the synthesis of which chemical
mediator?
a. Leukotriene
b. Histamine
c. Prostaglandin
d. Bradykinin - CORRECT ANSWER C. Cytokines seem to raise the
thermoregulatory set point through stimulation of prostaglandin synthesis and turnover
in thermoregulatory (brain) and nonthermoregulatory (peripheral) tissues. Leukotrienes,
histamine, and bradykinin are not directly related to fever production
After sexual transmission of HIV, how soon can lab results detect the infection?
a. 1 to 2 days
,b. 4 to 10 days
c. 4 to 8 weeks
d. 2 to 4 months - CORRECT ANSWER B. HIV RNA may be detected in the
plasma by about 4 to 10 days after an acute infection and HIV.
Which cells are primary targets for HIV?
a. CD4+ Th cells only
b. CD4+ Th cells, macrophages, and dendritic cells
c. CD8-positive cytotoxic T (Tc) cells and plasma cells
d. CD8-positive Tc cells only - CORRECT ANSWER B. The primary cellular targets
for HIV include CD4+ Th cells, macrophages, and dendritic cells. The other cell types
are not the primary target cells of HIV.
Which hormone prompts increased anxiety, vigilance, and arousal during a stress
response?
a. Norepinephrine
b. Epinephrine
c. Cortisol
d. Adrenocorticotropic hormone (ACTH) - CORRECT ANSWER A. The release of
norepinephrine promotes arousal, increased vigilance, increased anxiety, and other
protective emotional responses. Epinephrine's effects are primarily on the
cardiovascular system. Cortisol's chief effects involve metabolic processes. By inhibiting
the use of metabolic substances while promoting their formation, cortisol mobilizes
glucose, amino acids, lipids, and fatty acids and delivers them to the bloodstream.
ACTH binds with specific receptors on the adrenal glands which causes the release of
the glucocorticoids.
A student asks the healthcare professional how immunity is decreased by stress. The
professional responds that during a stress response, the helper T (Th) 1 response is
suppressed by which hormone?
a. ACTH
b. Cortisol
c. Prolactin
d. Growth hormone - CORRECT ANSWER B. Cortisol acts to suppress the activity
of Th1 cells, which leads to a decrease in innate immunity and the proinflammatory
response. Cortisol also stimulates the activity of Th2 cells, which increases adaptive
immunity and the antiinflammatory response. ACTH binds with specific receptors on the
adrenal glands which causes the release of the glucocorticoids. Prolactin is secreted in
response to a variety of stressful stimuli and acts as a second messenger for IL-2 and
has a positive influence on B-cell activation and differentiation. Growth hormone affects
protein, lipid, and carbohydrate metabolism; counters effects of insulin; and is involved
in tissue repair.
Stress-induced sympathetic stimulation of the adrenal medulla causes the secretion of
what?
,a. Epinephrine and aldosterone b. Norepinephrine and cortisol c. Epinephrine and
norepinephrine
d. Acetylcholine and cortisol - CORRECT ANSWER C. The sympathetic nervous
system is aroused during the stress response and causes the medulla of the adrenal
gland to release catecholamines (80% epinephrine and 20% norepinephrine) into the
bloodstream. Sympathetic stimulation of the adrenal medulla does not cause the
secretion of aldosterone, cortisol, or acetylcholine.
A severely stressed patient has cold, clammy skin. The healthcare professional quizzes
the student about this effect. The student correctly answers that this effect is directly
from which action?
a. Epinephrine dilating blood vessels leading to the vital organs
b. Norepinephrine constricting blood vessels in the skin
c. Dilating the airways to increased oxygenation of the tissues
d. Dysfunctional temperature regulation from cortisol secretion - CORRECT
ANSWER B. In a stress response, the actions of norepinephrine and epinephrine are
complementary. While epinephrine dilates blood vessels to the vital organs (among
other things), norepinephrine constricts blood vessels in the viscera and skin, providing
more blood supply for those vital organs. The clinical result is cold, clammy skin.
Epinephrine can also dilate airways, but this does not produce the skin changes as
described. Temperature dysregulation is not the cause of the cold, clammy skin.
Released stress-induced cortisol results in the stimulation of gluconeogenesis by
affecting which structure?
a. Adrenal cortex
b. Pancreas
c. Liver
d. Anterior pituitary - CORRECT ANSWER C. One of the primary effects of cortisol
is the stimulation of gluconeogenesis through stimulation of the liver. The adrenal
cortex, pancreas, and anterior pituitary do not produce stimulation of gluconeogenesis
when exposed to cortisol.
What effect do androgens have on lymphocytes?
a. Suppression of B-cell responses and enhancement of T-cell responses
b. Suppression of T-cell responses and enhancement of B-cell responses
c. Suppression of B- and T-cell responses
d. Enhancement of B- and T-cell responses - CORRECT ANSWER C. Androgens
suppress T- and B-cell responses. Androgens do not enhance either B- or T-cell
responses
Which statement is true concerning the differences between stress-induced hormonal
alterations of men and women? a. After injury, women produce more proinflammatory
cytokines than men, a profile that is associated with poor outcomes.
b. Androgens appear to induce a greater degree of immune cell apoptosis after injury,
creating greater immunosuppression in injured men than in injured women.
, c. Psychologic stress associated with some types of competition decreases both
testosterone and cortisol, especially in athletes older than 45 years of age.
d. After stressful stimuli, estrogen is increased in women, but testosterone is decreased
in men. - CORRECT ANSWER B. Androgens appear to induce a greater degree of
immune cell apoptosis after injury, a mechanism that may elicit a greater
immunosuppression in injured men vs. injured women. Men produce more
proinflammatory cytokines. Competitive stress increases testosterone and cortisol.
Estrogen is not increased in women after stressful stimuli.
A reduction in an individual's number of natural killer (NK) cells appears to correlate with
an increased risk for the development of what?
a. Depression
b. Type 1 diabetes
c. Obsessive compulsive disorder (OCD)
d. Gastroesophageal reflux disorder (GERD) - CORRECT ANSWER A. A meta-
analysis of studies shows a relationship between depression and the reduction in
lymphocyte proliferation and natural killer cell activity. Currently, no research supports
correlations between the number of NK cells and type 1 diabetes, OCD, or GERD.
Which cancer originates from connective tissue?
a. Osteogenic sarcoma
b. Basal cell carcinoma
c. Multiple myeloma
d. Adenocarcinoma - CORRECT ANSWER A. Cancers arising from connective
tissue usually have the suffix -sarcoma. Carcinomas arise in epithelial tissue. Myeloma
arises in the bone marrow.
Carcinoma refers to abnormal cell proliferation originating from which tissue origin?
a. Blood vessels
b. Epithelial cells
c. Connective tissue
d. Glandular tissue - CORRECT ANSWER B. Only cancers arising from epithelial
cells are called carcinomas. Connective tissue cancers are called sarcomas. Glandular
tissue cancers are named adenocarcinomas. Malignant cancers can invade blood
vessels.
Carcinoma in situ is characterized by which changes?
a. Cells have broken through the local basement membrane.
b. Cells have invaded immediate surrounding tissue.
c. Cells remain localized in the glandular or squamous cells.
d. Cellular and tissue alterations indicate dysplasia. - CORRECT ANSWER C.
Carcinoma in situ (CIS) refers to preinvasive epithelial malignant tumors of glandular or
squamous cell origin. These early stage cancers are localized to the epithelium and
have not broken through the local basement membrane or invaded the surrounding
tissue. Dysplasia refers to changes in mature cell structure.
QUESTIONS AND ANSWERS EXAM - ACTUAL EXAM
WITH A STUDY GUIDE AND PRACTICE EXAM |
GUARANTEED PASS | LATEST UPDATE
A student asks the healthcare professional to describe exotoxins. Which statement by
the professional is best?
a. Exotoxins are contained in cell walls of gram-negative bacteria.
b. Exotoxins are released during the lysis of bacteria.
c. Exotoxins are able to initiate the complement and coagulation cascades.
d. Exotoxins are released during bacterial growth. - CORRECT ANSWER D.
Exotoxins are proteins released during bacterial growth. Exotoxins are not contained in
cell walls of gram-negative bacteria, released during lysis of bacterial, or able to initiate
the complement and coagulation cascades.
A healthcare professional student is learning about fungal infections. What information
should the student use to help another student understand?
a. Fungal infections occur only on skin, hair, and nails.
b. Phagocytes and T lymphocytes control fungal infections.
c. Fungal infections release endotoxins.
d. Vaccines prevent fungal infections. - CORRECT ANSWER B. The host defense
against fungal infection includes the fungistatic properties of neutrophils and
macrophages. T lymphocytes are crucial in limiting the extent of infection and producing
cytokines to further activate macrophages. Fungi infect other tissue types such as
vaginal or gastrointestinal. Fungi do not release endotoxins; they reside in the cell walls
of gram-negative bacteria. Fungal infections are not prevented by current vaccines.
Cytokines are thought to cause fevers by stimulating the synthesis of which chemical
mediator?
a. Leukotriene
b. Histamine
c. Prostaglandin
d. Bradykinin - CORRECT ANSWER C. Cytokines seem to raise the
thermoregulatory set point through stimulation of prostaglandin synthesis and turnover
in thermoregulatory (brain) and nonthermoregulatory (peripheral) tissues. Leukotrienes,
histamine, and bradykinin are not directly related to fever production
After sexual transmission of HIV, how soon can lab results detect the infection?
a. 1 to 2 days
,b. 4 to 10 days
c. 4 to 8 weeks
d. 2 to 4 months - CORRECT ANSWER B. HIV RNA may be detected in the
plasma by about 4 to 10 days after an acute infection and HIV.
Which cells are primary targets for HIV?
a. CD4+ Th cells only
b. CD4+ Th cells, macrophages, and dendritic cells
c. CD8-positive cytotoxic T (Tc) cells and plasma cells
d. CD8-positive Tc cells only - CORRECT ANSWER B. The primary cellular targets
for HIV include CD4+ Th cells, macrophages, and dendritic cells. The other cell types
are not the primary target cells of HIV.
Which hormone prompts increased anxiety, vigilance, and arousal during a stress
response?
a. Norepinephrine
b. Epinephrine
c. Cortisol
d. Adrenocorticotropic hormone (ACTH) - CORRECT ANSWER A. The release of
norepinephrine promotes arousal, increased vigilance, increased anxiety, and other
protective emotional responses. Epinephrine's effects are primarily on the
cardiovascular system. Cortisol's chief effects involve metabolic processes. By inhibiting
the use of metabolic substances while promoting their formation, cortisol mobilizes
glucose, amino acids, lipids, and fatty acids and delivers them to the bloodstream.
ACTH binds with specific receptors on the adrenal glands which causes the release of
the glucocorticoids.
A student asks the healthcare professional how immunity is decreased by stress. The
professional responds that during a stress response, the helper T (Th) 1 response is
suppressed by which hormone?
a. ACTH
b. Cortisol
c. Prolactin
d. Growth hormone - CORRECT ANSWER B. Cortisol acts to suppress the activity
of Th1 cells, which leads to a decrease in innate immunity and the proinflammatory
response. Cortisol also stimulates the activity of Th2 cells, which increases adaptive
immunity and the antiinflammatory response. ACTH binds with specific receptors on the
adrenal glands which causes the release of the glucocorticoids. Prolactin is secreted in
response to a variety of stressful stimuli and acts as a second messenger for IL-2 and
has a positive influence on B-cell activation and differentiation. Growth hormone affects
protein, lipid, and carbohydrate metabolism; counters effects of insulin; and is involved
in tissue repair.
Stress-induced sympathetic stimulation of the adrenal medulla causes the secretion of
what?
,a. Epinephrine and aldosterone b. Norepinephrine and cortisol c. Epinephrine and
norepinephrine
d. Acetylcholine and cortisol - CORRECT ANSWER C. The sympathetic nervous
system is aroused during the stress response and causes the medulla of the adrenal
gland to release catecholamines (80% epinephrine and 20% norepinephrine) into the
bloodstream. Sympathetic stimulation of the adrenal medulla does not cause the
secretion of aldosterone, cortisol, or acetylcholine.
A severely stressed patient has cold, clammy skin. The healthcare professional quizzes
the student about this effect. The student correctly answers that this effect is directly
from which action?
a. Epinephrine dilating blood vessels leading to the vital organs
b. Norepinephrine constricting blood vessels in the skin
c. Dilating the airways to increased oxygenation of the tissues
d. Dysfunctional temperature regulation from cortisol secretion - CORRECT
ANSWER B. In a stress response, the actions of norepinephrine and epinephrine are
complementary. While epinephrine dilates blood vessels to the vital organs (among
other things), norepinephrine constricts blood vessels in the viscera and skin, providing
more blood supply for those vital organs. The clinical result is cold, clammy skin.
Epinephrine can also dilate airways, but this does not produce the skin changes as
described. Temperature dysregulation is not the cause of the cold, clammy skin.
Released stress-induced cortisol results in the stimulation of gluconeogenesis by
affecting which structure?
a. Adrenal cortex
b. Pancreas
c. Liver
d. Anterior pituitary - CORRECT ANSWER C. One of the primary effects of cortisol
is the stimulation of gluconeogenesis through stimulation of the liver. The adrenal
cortex, pancreas, and anterior pituitary do not produce stimulation of gluconeogenesis
when exposed to cortisol.
What effect do androgens have on lymphocytes?
a. Suppression of B-cell responses and enhancement of T-cell responses
b. Suppression of T-cell responses and enhancement of B-cell responses
c. Suppression of B- and T-cell responses
d. Enhancement of B- and T-cell responses - CORRECT ANSWER C. Androgens
suppress T- and B-cell responses. Androgens do not enhance either B- or T-cell
responses
Which statement is true concerning the differences between stress-induced hormonal
alterations of men and women? a. After injury, women produce more proinflammatory
cytokines than men, a profile that is associated with poor outcomes.
b. Androgens appear to induce a greater degree of immune cell apoptosis after injury,
creating greater immunosuppression in injured men than in injured women.
, c. Psychologic stress associated with some types of competition decreases both
testosterone and cortisol, especially in athletes older than 45 years of age.
d. After stressful stimuli, estrogen is increased in women, but testosterone is decreased
in men. - CORRECT ANSWER B. Androgens appear to induce a greater degree of
immune cell apoptosis after injury, a mechanism that may elicit a greater
immunosuppression in injured men vs. injured women. Men produce more
proinflammatory cytokines. Competitive stress increases testosterone and cortisol.
Estrogen is not increased in women after stressful stimuli.
A reduction in an individual's number of natural killer (NK) cells appears to correlate with
an increased risk for the development of what?
a. Depression
b. Type 1 diabetes
c. Obsessive compulsive disorder (OCD)
d. Gastroesophageal reflux disorder (GERD) - CORRECT ANSWER A. A meta-
analysis of studies shows a relationship between depression and the reduction in
lymphocyte proliferation and natural killer cell activity. Currently, no research supports
correlations between the number of NK cells and type 1 diabetes, OCD, or GERD.
Which cancer originates from connective tissue?
a. Osteogenic sarcoma
b. Basal cell carcinoma
c. Multiple myeloma
d. Adenocarcinoma - CORRECT ANSWER A. Cancers arising from connective
tissue usually have the suffix -sarcoma. Carcinomas arise in epithelial tissue. Myeloma
arises in the bone marrow.
Carcinoma refers to abnormal cell proliferation originating from which tissue origin?
a. Blood vessels
b. Epithelial cells
c. Connective tissue
d. Glandular tissue - CORRECT ANSWER B. Only cancers arising from epithelial
cells are called carcinomas. Connective tissue cancers are called sarcomas. Glandular
tissue cancers are named adenocarcinomas. Malignant cancers can invade blood
vessels.
Carcinoma in situ is characterized by which changes?
a. Cells have broken through the local basement membrane.
b. Cells have invaded immediate surrounding tissue.
c. Cells remain localized in the glandular or squamous cells.
d. Cellular and tissue alterations indicate dysplasia. - CORRECT ANSWER C.
Carcinoma in situ (CIS) refers to preinvasive epithelial malignant tumors of glandular or
squamous cell origin. These early stage cancers are localized to the epithelium and
have not broken through the local basement membrane or invaded the surrounding
tissue. Dysplasia refers to changes in mature cell structure.
