NR-507 MIDTERM EXAM ADVANCED PATHOPHYSIOLOGY
QUESTIONS AND VERIFIED ANSWERS 2024
1. Which of the following best describes the mechanism of hypoxia in
high-altitude environments?
A) Decreased atmospheric pressure leading to reduced oxygen
diffusion
B) Increased erythropoiesis in the bone marrow
C) Enhanced cardiac output due to low oxygen availability
D) Increased hemoglobin binding capacity at low oxygen levels
Answer: A) Decreased atmospheric pressure leading to reduced oxygen
diffusion
Rationale: At high altitudes, the lower atmospheric pressure decreases
the partial pressure of oxygen, which reduces the diffusion of oxygen
into the bloodstream, leading to hypoxia. The body attempts to
compensate for this by increasing erythropoiesis over time and
adjusting cardiac output.
2. In the pathogenesis of atherosclerosis, which of the following
processes is most responsible for the development of a fibrous
plaque?
A) Endothelial injury and increased vascular permeability
B) Increased cholesterol absorption from the intestines
C) Activation of peroxisome proliferator-activated receptor (PPAR)
D) Impaired production of nitric oxide by endothelial cells
Answer: A) Endothelial injury and increased vascular permeability
Rationale: Endothelial injury leads to increased vascular permeability,
allowing lipoproteins, especially LDL, to enter the vessel wall. The
,accumulation of lipids within the intima triggers an inflammatory
response, resulting in the formation of a fibrous plaque.
3. Which of the following is a key feature of diabetic nephropathy?
A) Increased glomerular filtration rate (GFR) early in the disease
B) Decreased albuminuria
C) Hypertension due to hyperkalemia
D) Progressive loss of glomerular filtration capacity
Answer: D) Progressive loss of glomerular filtration capacity
Rationale: Diabetic nephropathy leads to progressive damage to the
glomeruli, ultimately resulting in a decline in glomerular filtration rate
(GFR). Early stages often involve hyperfiltration and increased
albuminuria, but the disease progresses to renal failure as the filtration
capacity declines.
4. Which of the following is the primary cause of pulmonary edema in
left-sided heart failure?
A) Decreased pulmonary capillary permeability
B) Increased blood flow to the lungs
C) Increased left atrial pressure leading to pulmonary venous
congestion
D) Loss of the surfactant layer in the alveoli
Answer: C) Increased left atrial pressure leading to pulmonary venous
congestion
Rationale: In left-sided heart failure, the left ventricle is unable to
efficiently pump blood, leading to increased pressure in the left atrium.
This increased pressure is transmitted backward to the pulmonary
circulation, causing fluid to accumulate in the alveoli, resulting in
pulmonary edema.
5. Which of the following factors most directly contributes to the
development of aortic aneurysms?
, A) Hypertension-induced vascular remodeling
B) Decreased levels of collagen in the vessel wall
C) Increased levels of vasodilators such as nitric oxide
D) Decreased systemic vascular resistance
Answer: A) Hypertension-induced vascular remodeling
Rationale: Chronic hypertension increases the stress on the walls of
large arteries like the aorta, leading to vascular remodeling and
weakening of the vessel wall. This causes the aorta to dilate and form
an aneurysm over time.
6. What is the pathophysiological mechanism behind acute
pancreatitis?
A) Obstruction of the bile duct leading to pancreatic enzyme activation
B) Inflammation of the pancreas due to autoimmune destruction of
pancreatic cells
C) Ductal hypertension and premature activation of digestive
enzymes within the pancreas
D) Fibrosis and scarring of pancreatic tissue due to chronic alcohol
consumption
Answer: C) Ductal hypertension and premature activation of digestive
enzymes within the pancreas
Rationale: Acute pancreatitis is often caused by the obstruction of
pancreatic ducts (e.g., due to gallstones or alcohol consumption),
leading to ductal hypertension. This hypertension causes premature
activation of digestive enzymes, which then digest pancreatic tissue,
leading to inflammation and injury.
7. Which of the following electrolyte imbalances is most commonly
observed in patients with chronic kidney disease (CKD)?
QUESTIONS AND VERIFIED ANSWERS 2024
1. Which of the following best describes the mechanism of hypoxia in
high-altitude environments?
A) Decreased atmospheric pressure leading to reduced oxygen
diffusion
B) Increased erythropoiesis in the bone marrow
C) Enhanced cardiac output due to low oxygen availability
D) Increased hemoglobin binding capacity at low oxygen levels
Answer: A) Decreased atmospheric pressure leading to reduced oxygen
diffusion
Rationale: At high altitudes, the lower atmospheric pressure decreases
the partial pressure of oxygen, which reduces the diffusion of oxygen
into the bloodstream, leading to hypoxia. The body attempts to
compensate for this by increasing erythropoiesis over time and
adjusting cardiac output.
2. In the pathogenesis of atherosclerosis, which of the following
processes is most responsible for the development of a fibrous
plaque?
A) Endothelial injury and increased vascular permeability
B) Increased cholesterol absorption from the intestines
C) Activation of peroxisome proliferator-activated receptor (PPAR)
D) Impaired production of nitric oxide by endothelial cells
Answer: A) Endothelial injury and increased vascular permeability
Rationale: Endothelial injury leads to increased vascular permeability,
allowing lipoproteins, especially LDL, to enter the vessel wall. The
,accumulation of lipids within the intima triggers an inflammatory
response, resulting in the formation of a fibrous plaque.
3. Which of the following is a key feature of diabetic nephropathy?
A) Increased glomerular filtration rate (GFR) early in the disease
B) Decreased albuminuria
C) Hypertension due to hyperkalemia
D) Progressive loss of glomerular filtration capacity
Answer: D) Progressive loss of glomerular filtration capacity
Rationale: Diabetic nephropathy leads to progressive damage to the
glomeruli, ultimately resulting in a decline in glomerular filtration rate
(GFR). Early stages often involve hyperfiltration and increased
albuminuria, but the disease progresses to renal failure as the filtration
capacity declines.
4. Which of the following is the primary cause of pulmonary edema in
left-sided heart failure?
A) Decreased pulmonary capillary permeability
B) Increased blood flow to the lungs
C) Increased left atrial pressure leading to pulmonary venous
congestion
D) Loss of the surfactant layer in the alveoli
Answer: C) Increased left atrial pressure leading to pulmonary venous
congestion
Rationale: In left-sided heart failure, the left ventricle is unable to
efficiently pump blood, leading to increased pressure in the left atrium.
This increased pressure is transmitted backward to the pulmonary
circulation, causing fluid to accumulate in the alveoli, resulting in
pulmonary edema.
5. Which of the following factors most directly contributes to the
development of aortic aneurysms?
, A) Hypertension-induced vascular remodeling
B) Decreased levels of collagen in the vessel wall
C) Increased levels of vasodilators such as nitric oxide
D) Decreased systemic vascular resistance
Answer: A) Hypertension-induced vascular remodeling
Rationale: Chronic hypertension increases the stress on the walls of
large arteries like the aorta, leading to vascular remodeling and
weakening of the vessel wall. This causes the aorta to dilate and form
an aneurysm over time.
6. What is the pathophysiological mechanism behind acute
pancreatitis?
A) Obstruction of the bile duct leading to pancreatic enzyme activation
B) Inflammation of the pancreas due to autoimmune destruction of
pancreatic cells
C) Ductal hypertension and premature activation of digestive
enzymes within the pancreas
D) Fibrosis and scarring of pancreatic tissue due to chronic alcohol
consumption
Answer: C) Ductal hypertension and premature activation of digestive
enzymes within the pancreas
Rationale: Acute pancreatitis is often caused by the obstruction of
pancreatic ducts (e.g., due to gallstones or alcohol consumption),
leading to ductal hypertension. This hypertension causes premature
activation of digestive enzymes, which then digest pancreatic tissue,
leading to inflammation and injury.
7. Which of the following electrolyte imbalances is most commonly
observed in patients with chronic kidney disease (CKD)?
