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Advanced Pathophysiology Exam 3 – Final Mastery
Test | A+ Graded | 2025/2026 Updated Edition |
Guaranteed Pass
A patient with chronic obstructive pulmonary disease presents with progressive
shortness of breath, cyanosis, and digital clubbing. Arterial blood gases show
elevated PaCO₂ and decreased PaO₂. Which mechanism best explains the
hypoxemia in advanced COPD?
A. Alveolar hyperventilation producing excessive oxygen uptake
B. Ventilation-perfusion mismatch due to obstructed airways and destroyed alveoli
C. Increased diffusion capacity across the alveolar-capillary membrane
D. Decreased oxygen consumption at the cellular level
Answer: B
A 58-year-old man develops severe chest pain radiating to the back, with sudden
hemodynamic collapse. Imaging confirms a thoracic aortic dissection. Which
pathophysiological event initiates the formation of an aortic dissection?
A. Progressive calcification of the aortic valve
B. Tearing of the intimal layer allowing blood to track between vessel layers
C. Complete obstruction of the coronary arteries by atherosclerotic plaque
D. Sudden rupture of the pulmonary artery
Answer: B
A patient with advanced HIV infection presents with chronic diarrhea, weight loss,
and multiple opportunistic infections. What is the underlying pathophysiologic
mechanism leading to immunosuppression in this disease?
A. Destruction of CD4+ T lymphocytes by viral replication
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B. Overactivation of natural killer cells causing immune exhaustion
C. Excess antibody production leading to autoimmunity
D. Impaired neutrophil chemotaxis due to viral proteins
Answer: A
A 66-year-old man with a long history of smoking is diagnosed with small cell
lung carcinoma. He develops muscle weakness, confusion, and severe
hyponatremia. Which mechanism explains the paraneoplastic syndrome seen in
this case?
A. Ectopic production of parathyroid hormone by tumor cells
B. Tumor secretion of antidiuretic hormone causing water retention
C. Autoimmune destruction of adrenal cortex triggered by tumor antigens
D. Excess cortisol secretion directly from malignant lung tissue
Answer: B
A patient with chronic hypertension presents with a sudden severe headache, visual
disturbances, and elevated blood pressure readings of 220/120 mmHg. Which
pathophysiologic event best explains the end-organ damage associated with
malignant hypertension?
A. Widespread vasodilation and decreased systemic vascular resistance
B. Fibrinoid necrosis and hyperplastic arteriolosclerosis in small vessels
C. Enhanced vagal tone suppressing cardiac output
D. Depletion of plasma renin activity and aldosterone
Answer: B
A young woman develops generalized tonic-clonic seizures followed by confusion
and tongue biting. Which pathophysiologic process is the most common
underlying cause of epilepsy?
A. Excess inhibition of cortical neurons by GABA
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B. Abnormal synchronous neuronal discharges due to altered ion channel activity
C. Autoimmune destruction of myelin in the spinal cord
D. Impaired cerebral perfusion caused by carotid artery stenosis
Answer: B
A patient develops jaundice, dark urine, and pale stools following gallstone
obstruction of the common bile duct. Which mechanism best explains the
laboratory finding of conjugated hyperbilirubinemia in this patient?
A. Increased breakdown of red blood cells leading to excess unconjugated bilirubin
B. Obstruction of bile flow preventing excretion of conjugated bilirubin into
intestines
C. Impaired conjugation of bilirubin in the hepatocytes due to enzyme deficiency
D. Decreased albumin binding capacity leading to free bilirubin circulation
Answer: B
A man with severe head trauma develops persistent hypernatremia despite
adequate fluid replacement. Laboratory findings confirm diabetes insipidus. What
is the primary pathophysiologic cause of this condition?
A. Renal resistance to the action of antidiuretic hormone
B. Excessive aldosterone secretion increasing sodium retention
C. Inadequate secretion of ADH due to hypothalamic or pituitary injury
D. Increased thirst mechanism causing water loss
Answer: C
A 12-year-old boy with a history of recurrent respiratory infections and failure to
thrive is diagnosed with cystic fibrosis. Which mechanism best explains the disease
manifestations?
A. Defective chloride transport leading to thickened secretions in lungs and
pancreas
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B. Autoimmune attack on the alveolar epithelial cells
C. Inhibition of surfactant synthesis impairing alveolar stability
D. Increased immunoglobulin deposition in respiratory tract
Answer: A
A 47-year-old man develops persistent chest pain and ECG findings consistent
with pericarditis. Which mechanism is most responsible for the chest pain
associated with acute pericarditis?
A. Ischemia of the coronary arteries supplying the epicardium
B. Inflammation and friction involving the parietal pericardium innervated by the
phrenic nerve
C. Compression of the myocardium due to fibrotic thickening
D. Microthrombi formation in the pericardial vessels
Answer: B
A patient with polycystic kidney disease develops hypertension, hematuria, and
progressive decline in renal function. What is the main pathophysiologic
mechanism contributing to kidney enlargement and damage in this disease?
A. Uncontrolled proliferation of mesangial cells
B. Formation of multiple fluid-filled cysts causing compression of renal
parenchyma
C. Overproduction of renin leading to hypertensive nephrosclerosis
D. Fibrosis of glomerular basement membrane from immune complex deposition
Answer: B
A 70-year-old man with a long-standing smoking history develops hemoptysis and
weight loss. Biopsy reveals squamous cell carcinoma of the lung. Which
pathophysiologic process is most directly related to the malignant transformation
in this patient?
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Advanced Pathophysiology Exam 3 – Final Mastery
Test | A+ Graded | 2025/2026 Updated Edition |
Guaranteed Pass
A patient with chronic obstructive pulmonary disease presents with progressive
shortness of breath, cyanosis, and digital clubbing. Arterial blood gases show
elevated PaCO₂ and decreased PaO₂. Which mechanism best explains the
hypoxemia in advanced COPD?
A. Alveolar hyperventilation producing excessive oxygen uptake
B. Ventilation-perfusion mismatch due to obstructed airways and destroyed alveoli
C. Increased diffusion capacity across the alveolar-capillary membrane
D. Decreased oxygen consumption at the cellular level
Answer: B
A 58-year-old man develops severe chest pain radiating to the back, with sudden
hemodynamic collapse. Imaging confirms a thoracic aortic dissection. Which
pathophysiological event initiates the formation of an aortic dissection?
A. Progressive calcification of the aortic valve
B. Tearing of the intimal layer allowing blood to track between vessel layers
C. Complete obstruction of the coronary arteries by atherosclerotic plaque
D. Sudden rupture of the pulmonary artery
Answer: B
A patient with advanced HIV infection presents with chronic diarrhea, weight loss,
and multiple opportunistic infections. What is the underlying pathophysiologic
mechanism leading to immunosuppression in this disease?
A. Destruction of CD4+ T lymphocytes by viral replication
1|Page
,2|Page
B. Overactivation of natural killer cells causing immune exhaustion
C. Excess antibody production leading to autoimmunity
D. Impaired neutrophil chemotaxis due to viral proteins
Answer: A
A 66-year-old man with a long history of smoking is diagnosed with small cell
lung carcinoma. He develops muscle weakness, confusion, and severe
hyponatremia. Which mechanism explains the paraneoplastic syndrome seen in
this case?
A. Ectopic production of parathyroid hormone by tumor cells
B. Tumor secretion of antidiuretic hormone causing water retention
C. Autoimmune destruction of adrenal cortex triggered by tumor antigens
D. Excess cortisol secretion directly from malignant lung tissue
Answer: B
A patient with chronic hypertension presents with a sudden severe headache, visual
disturbances, and elevated blood pressure readings of 220/120 mmHg. Which
pathophysiologic event best explains the end-organ damage associated with
malignant hypertension?
A. Widespread vasodilation and decreased systemic vascular resistance
B. Fibrinoid necrosis and hyperplastic arteriolosclerosis in small vessels
C. Enhanced vagal tone suppressing cardiac output
D. Depletion of plasma renin activity and aldosterone
Answer: B
A young woman develops generalized tonic-clonic seizures followed by confusion
and tongue biting. Which pathophysiologic process is the most common
underlying cause of epilepsy?
A. Excess inhibition of cortical neurons by GABA
2|Page
,3|Page
B. Abnormal synchronous neuronal discharges due to altered ion channel activity
C. Autoimmune destruction of myelin in the spinal cord
D. Impaired cerebral perfusion caused by carotid artery stenosis
Answer: B
A patient develops jaundice, dark urine, and pale stools following gallstone
obstruction of the common bile duct. Which mechanism best explains the
laboratory finding of conjugated hyperbilirubinemia in this patient?
A. Increased breakdown of red blood cells leading to excess unconjugated bilirubin
B. Obstruction of bile flow preventing excretion of conjugated bilirubin into
intestines
C. Impaired conjugation of bilirubin in the hepatocytes due to enzyme deficiency
D. Decreased albumin binding capacity leading to free bilirubin circulation
Answer: B
A man with severe head trauma develops persistent hypernatremia despite
adequate fluid replacement. Laboratory findings confirm diabetes insipidus. What
is the primary pathophysiologic cause of this condition?
A. Renal resistance to the action of antidiuretic hormone
B. Excessive aldosterone secretion increasing sodium retention
C. Inadequate secretion of ADH due to hypothalamic or pituitary injury
D. Increased thirst mechanism causing water loss
Answer: C
A 12-year-old boy with a history of recurrent respiratory infections and failure to
thrive is diagnosed with cystic fibrosis. Which mechanism best explains the disease
manifestations?
A. Defective chloride transport leading to thickened secretions in lungs and
pancreas
3|Page
, 4|Page
B. Autoimmune attack on the alveolar epithelial cells
C. Inhibition of surfactant synthesis impairing alveolar stability
D. Increased immunoglobulin deposition in respiratory tract
Answer: A
A 47-year-old man develops persistent chest pain and ECG findings consistent
with pericarditis. Which mechanism is most responsible for the chest pain
associated with acute pericarditis?
A. Ischemia of the coronary arteries supplying the epicardium
B. Inflammation and friction involving the parietal pericardium innervated by the
phrenic nerve
C. Compression of the myocardium due to fibrotic thickening
D. Microthrombi formation in the pericardial vessels
Answer: B
A patient with polycystic kidney disease develops hypertension, hematuria, and
progressive decline in renal function. What is the main pathophysiologic
mechanism contributing to kidney enlargement and damage in this disease?
A. Uncontrolled proliferation of mesangial cells
B. Formation of multiple fluid-filled cysts causing compression of renal
parenchyma
C. Overproduction of renin leading to hypertensive nephrosclerosis
D. Fibrosis of glomerular basement membrane from immune complex deposition
Answer: B
A 70-year-old man with a long-standing smoking history develops hemoptysis and
weight loss. Biopsy reveals squamous cell carcinoma of the lung. Which
pathophysiologic process is most directly related to the malignant transformation
in this patient?
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