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ADVANCED PATHOPHYSIOLOGY FINAL EXAM NEWEST 2025 ACTUAL EXAM COMPLETE 100
Do women or men more often have multiple sclerosis? - (answer) Women (2-3:1)
Which disease has the following risk factors:
-Epstein-barr virus (EBV)
-Live above the 37th parallel
-Caucasian
-Female
-Vitamin D deficiency: Decreased time between clinical isolated syndrome (CIS) and 2nd exacerbation
-Smoking - (answer) Multiple Sclerosis
What is the main pathophysiological theory for multiple sclerosis? - (answer) It's an
autoimmune/neurodegenerative disease:
-inflammation
-demyelination/remyelination
-permanent axonal damage
What are the Myelin forming cells of the CNS? - (answer) Oligodendrocytes
What do T-Helper cell types 1 & 17 do? - (answer) Pro-inflammatory
What does T-Helper cell type 2 do? - (answer) Anti-inflammatory
What is the pathophysiology of Multple Sclerosis? - (answer) 1. Autoreactive T cells express Very Late
Antegen-4 (VLA-4, aka α4-integrin) on their cell surface and secrete Matrix Metalloproteinases (MMP).
2. VLA-4 binds to Vascular Cell Adhesion Molecule (VCAM) receptors on the blood brain barrier (BBB)
and MMP results in dysregulation of the BBB, allowing cell entry into the CNS.
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ADVANCED PATHOPHYSIOLOGY FINAL EXAM NEWEST 2025 ACTUAL EXAM COMPLETE 100
3. Once in the CNS, pro-inflammatory cytokines (TNF-α, INF-γ, and Osteopontin [OP]) are secreted
resulting in inflammation and further T cell entry into the CNS.
4. T cells in the CNS interact with microglia, astrocytes, and macrophages to produce reactive oxygen
species and nitric oxide causing CNS damage.
5. B cells acts as ACPs, enter the CNS, and produce myelin-specific antibodies that form membrane
attack complexes with complement causing cell lysis.
Which disease presents in the following way:
**Visual changes, optic neuritis (Often the 1st sign/symptom)
-Paresthesias
-Gait issues/falls
-Foot drop
-Dysdiadochokinesia
-Fatigue
-Weakness
-Impaired coordination
-Cognitive changes
MRI:
***Gadolinium enhanced lesions
LUMBAR PUNCTURE TEST:
-Increased IgG
-Increased Myelin basic protein (MBP)
-Increased CSF protein - (answer) Multiple Sclerosis
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ADVANCED PATHOPHYSIOLOGY FINAL EXAM NEWEST 2025 ACTUAL EXAM COMPLETE 100
Which cognitive test is most commonly used to diagnose MS? - (answer) Symbol Digit Modalities Test
(SDMT)
What is the primary diagnostic test for MS? - (answer) MRI with or without contrast
What is the most common type of MS, which is involves episodes of acute worsening with some
recovery and no progression in between exacerbations? - (answer) Relapsing Remitting MS (RRMS)
What type of MS can develop from RRMS, have a steady progression of the disease in between
exacerbations, and present with more black holes and brain atrophy? - (answer) Secondary Progressive
MS (SPMS)
What type of MS is the least common, it doesn't develop from RRMS and is the progressive worsening of
the disease from the start, lacking recovery times? - (answer) Primary Progressive MS (PPMS)
What is the prognosis (good or bad) for someone with MS who is:
- under 40 years old
-Female
-First sign/symptom is optic neuritis/sensory issues
-Low exacerbation frequency
-RRMS
-Single lesion - (answer) Good prognosis
What is the prognosis (good or bad) for someone with MS who is:
- over 40 years old
-Male
-First sign/symptom is motor or cerebellar
-Multiple lesion locations
-PPMS - (answer) Bad prognosis
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ADVANCED PATHOPHYSIOLOGY FINAL EXAM NEWEST 2025 ACTUAL EXAM COMPLETE 100
What are the treatment goals for treating MS? - (answer) -Decrease attack/exacerbation rate
-Decrease annualized relapse rate (ARR)
-Slow progression of disease
-Prevent/limit ADRs
-Symptom management (fatigue, bladder dysfunction, cognitive dysfunction, constipation, depression)
When monitoring MS patients should follow-up with their neurologists every _________. Get an MRI
every ___________. - (answer) When monitoring MS patients should follow-up with their neurologists
every 6 months-1 year. Get an MRI every 1 year (based on need).
What is the difference between seizure and epilepsy? - (answer) Seizure: a discrete clinical event that
results in the abnormal synchronous discharge of a set of neurons in the brain.
Epilepsy: at least 2 unprovoked seizures occurring more than 24 hours apart.
What is Status Epilepticus? - (answer) Failure of the termination mechanisms for seizure leading to
abnormally prolonged seizures. Length of seizure beyond 5 minutes and duration beyond the risk of
long-term consequence (30 minutes).
Which part of the brain is responsible for visual memory, organizing sensory information, emotional
responses? - (answer) Temporal lobe
Which lobe of the brain is responsible for sensations (touch, feeling pain, spacial representation)? -
(answer) Parietal lobe
Which part of the brain is responsible for planning, abstract thinking, organizing, reward system,
pleasure? - (answer) Frontal Lobe
Which part of the brain is responsible for vision? - (answer) Occipital lobe
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ADVANCED PATHOPHYSIOLOGY FINAL EXAM NEWEST 2025 ACTUAL EXAM COMPLETE 100
Do women or men more often have multiple sclerosis? - (answer) Women (2-3:1)
Which disease has the following risk factors:
-Epstein-barr virus (EBV)
-Live above the 37th parallel
-Caucasian
-Female
-Vitamin D deficiency: Decreased time between clinical isolated syndrome (CIS) and 2nd exacerbation
-Smoking - (answer) Multiple Sclerosis
What is the main pathophysiological theory for multiple sclerosis? - (answer) It's an
autoimmune/neurodegenerative disease:
-inflammation
-demyelination/remyelination
-permanent axonal damage
What are the Myelin forming cells of the CNS? - (answer) Oligodendrocytes
What do T-Helper cell types 1 & 17 do? - (answer) Pro-inflammatory
What does T-Helper cell type 2 do? - (answer) Anti-inflammatory
What is the pathophysiology of Multple Sclerosis? - (answer) 1. Autoreactive T cells express Very Late
Antegen-4 (VLA-4, aka α4-integrin) on their cell surface and secrete Matrix Metalloproteinases (MMP).
2. VLA-4 binds to Vascular Cell Adhesion Molecule (VCAM) receptors on the blood brain barrier (BBB)
and MMP results in dysregulation of the BBB, allowing cell entry into the CNS.
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ADVANCED PATHOPHYSIOLOGY FINAL EXAM NEWEST 2025 ACTUAL EXAM COMPLETE 100
3. Once in the CNS, pro-inflammatory cytokines (TNF-α, INF-γ, and Osteopontin [OP]) are secreted
resulting in inflammation and further T cell entry into the CNS.
4. T cells in the CNS interact with microglia, astrocytes, and macrophages to produce reactive oxygen
species and nitric oxide causing CNS damage.
5. B cells acts as ACPs, enter the CNS, and produce myelin-specific antibodies that form membrane
attack complexes with complement causing cell lysis.
Which disease presents in the following way:
**Visual changes, optic neuritis (Often the 1st sign/symptom)
-Paresthesias
-Gait issues/falls
-Foot drop
-Dysdiadochokinesia
-Fatigue
-Weakness
-Impaired coordination
-Cognitive changes
MRI:
***Gadolinium enhanced lesions
LUMBAR PUNCTURE TEST:
-Increased IgG
-Increased Myelin basic protein (MBP)
-Increased CSF protein - (answer) Multiple Sclerosis
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ADVANCED PATHOPHYSIOLOGY FINAL EXAM NEWEST 2025 ACTUAL EXAM COMPLETE 100
Which cognitive test is most commonly used to diagnose MS? - (answer) Symbol Digit Modalities Test
(SDMT)
What is the primary diagnostic test for MS? - (answer) MRI with or without contrast
What is the most common type of MS, which is involves episodes of acute worsening with some
recovery and no progression in between exacerbations? - (answer) Relapsing Remitting MS (RRMS)
What type of MS can develop from RRMS, have a steady progression of the disease in between
exacerbations, and present with more black holes and brain atrophy? - (answer) Secondary Progressive
MS (SPMS)
What type of MS is the least common, it doesn't develop from RRMS and is the progressive worsening of
the disease from the start, lacking recovery times? - (answer) Primary Progressive MS (PPMS)
What is the prognosis (good or bad) for someone with MS who is:
- under 40 years old
-Female
-First sign/symptom is optic neuritis/sensory issues
-Low exacerbation frequency
-RRMS
-Single lesion - (answer) Good prognosis
What is the prognosis (good or bad) for someone with MS who is:
- over 40 years old
-Male
-First sign/symptom is motor or cerebellar
-Multiple lesion locations
-PPMS - (answer) Bad prognosis
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ADVANCED PATHOPHYSIOLOGY FINAL EXAM NEWEST 2025 ACTUAL EXAM COMPLETE 100
What are the treatment goals for treating MS? - (answer) -Decrease attack/exacerbation rate
-Decrease annualized relapse rate (ARR)
-Slow progression of disease
-Prevent/limit ADRs
-Symptom management (fatigue, bladder dysfunction, cognitive dysfunction, constipation, depression)
When monitoring MS patients should follow-up with their neurologists every _________. Get an MRI
every ___________. - (answer) When monitoring MS patients should follow-up with their neurologists
every 6 months-1 year. Get an MRI every 1 year (based on need).
What is the difference between seizure and epilepsy? - (answer) Seizure: a discrete clinical event that
results in the abnormal synchronous discharge of a set of neurons in the brain.
Epilepsy: at least 2 unprovoked seizures occurring more than 24 hours apart.
What is Status Epilepticus? - (answer) Failure of the termination mechanisms for seizure leading to
abnormally prolonged seizures. Length of seizure beyond 5 minutes and duration beyond the risk of
long-term consequence (30 minutes).
Which part of the brain is responsible for visual memory, organizing sensory information, emotional
responses? - (answer) Temporal lobe
Which lobe of the brain is responsible for sensations (touch, feeling pain, spacial representation)? -
(answer) Parietal lobe
Which part of the brain is responsible for planning, abstract thinking, organizing, reward system,
pleasure? - (answer) Frontal Lobe
Which part of the brain is responsible for vision? - (answer) Occipital lobe
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