1 | Page
NSG530 ADVANCED PATHOPHYSIOLOGY FINAL EXAM (2026) |
VERIFIED AND 100% CORRECT QUESTIONS & ANSWERS |
CHAMBERLAIN, ALREADY GRADED A+
1. Which of the following best describes the mechanism of cellular injury
caused by ischemia-reperfusion?
A) Decreased reactive oxygen species (ROS) generation
B) Mitochondrial calcium overload and oxidative stress
C) Reduced neutrophil activation
D) Enhanced DNA repair capacity
Correct Answer: B) Mitochondrial calcium overload and oxidative stress
Rationale:
During reperfusion, the sudden influx of oxygen leads to generation of reactive
oxygen species, mitochondrial permeability transition, calcium overload, and cell
membrane damage, exacerbating injury.
2. In the progression from acute inflammation to chronic inflammation,
which cell type becomes more prominent?
A) Neutrophils
B) Eosinophils
C) Macrophages and lymphocytes
D) Basophils
Correct Answer: C) Macrophages and lymphocytes
Rationale:
Acute inflammation is marked by neutrophils. In chronic inflammation,
macrophages, T and B lymphocytes, and sometimes plasma cells dominate the
cellular infiltrate.
3. Which gene mutation is most commonly associated with familial
hypercholesterolemia?
A) LDL receptor gene
,2 | Page
B) HMG-CoA reductase gene
C) Apolipoprotein C gene
D) PCSK9 loss-of-function
Correct Answer: A) LDL receptor gene
Rationale:
Familial hypercholesterolemia classically involves defective LDL receptor
function, leading to impaired hepatic uptake of LDL and elevated plasma LDL.
4. Which type of hypersensitivity reaction involves immune complexes
(antigen-antibody) depositing in vessel walls?
A) Type I
B) Type II
C) Type III
D) Type IV
Correct Answer: C) Type III
Rationale:
Type III hypersensitivity is mediated by deposition of antigen-antibody complexes
that trigger complement activation and inflammation (e.g., serum sickness, lupus
nephritis).
5. Which of the following best describes the pathophysiology of diabetic
ketoacidosis (DKA)?
A) Insulin excess leading to lipogenesis
B) Absolute insulin deficiency with increased lipolysis and ketogenesis
C) Hypoglycemia triggering production of ketone bodies
D) Renal failure causing accumulation of ketoacids
Correct Answer: B) Absolute insulin deficiency with increased lipolysis and
ketogenesis
Rationale:
In DKA, insufficient insulin leads to unopposed lipolysis, free fatty acid release,
hepatic ketone production, metabolic acidosis, and osmotic diuresis.
6. Which oncogene is most often mutated in many human cancers and
results in unregulated cell proliferation?
A) Rb
,3 | Page
B) p53
C) Ras
D) BRCA1
Correct Answer: C) Ras
Rationale:
Ras is a proto-oncogene; mutations lead to constitutive activation of downstream
signaling (MAPK/PI3K), causing uncontrolled cell proliferation.
7. Which of the following is characteristic of reversible cell injury?
A) Severe mitochondrial disruption
B) Nuclear karyolysis
C) Cellular swelling and membrane blebs
D) Loss of ribosomes
Correct Answer: C) Cellular swelling and membrane blebs
Rationale:
In reversible injury, cells often demonstrate swelling, blebbing, and detachment of
ribosomes, but nuclear integrity remains intact. When damage is severe,
irreversible changes follow.
8. Which electrolyte abnormality is most likely in the setting of tumor lysis
syndrome?
A) Hypokalemia
B) Hypophosphatemia
C) Hypocalcemia
D) Hyponatremia
Correct Answer: C) Hypocalcemia
Rationale:
Tumor lysis syndrome causes release of phosphate, which binds to calcium,
leading to hypocalcemia, along with hyperphosphatemia, hyperkalemia, and
hyperuricemia.
9. Which cytokine is primarily responsible for the acute phase response
and induction of fever?
A) IL-2
B) TNF-alpha
, 4 | Page
C) IL-6
D) IL-10
Correct Answer: C) IL-6
Rationale:
IL-6 stimulates hepatocytes to produce acute phase proteins (e.g., CRP) and
contributes to fever via acting on the hypothalamus.
10.In heart failure, activation of which compensatory mechanism
contributes to remodeling and worsened disease in the long run?
A) Natriuretic peptide release
B) Parasympathetic activation
C) Renin-angiotensin-aldosterone system (RAAS)
D) Increased insulin sensitivity
Correct Answer: C) Renin-angiotensin-aldosterone system (RAAS)
Rationale:
In heart failure, RAAS activation aims to maintain perfusion by vasoconstriction
and sodium retention, but chronically leads to remodeling, fibrosis, and worsening
heart failure.
11.Which process best describes metastasis of cancer cells to distant
organs?
A) Local invasion only
B) Intravasation, survival in circulation, extravasation, colonization
C) Direct extension through adjacent tissues
D) Clonal expansion within primary tumor
Correct Answer: B) Intravasation, survival in circulation, extravasation,
colonization
Rationale:
Metastasis involves tumor cells invading blood or lymph vessels (intravasation),
surviving in circulation, exiting (extravasation), and establishing growth at distant
sites.
12.Which of the following causes respiratory acidosis?
A) Hyperventilation
B) Pulmonary embolism
NSG530 ADVANCED PATHOPHYSIOLOGY FINAL EXAM (2026) |
VERIFIED AND 100% CORRECT QUESTIONS & ANSWERS |
CHAMBERLAIN, ALREADY GRADED A+
1. Which of the following best describes the mechanism of cellular injury
caused by ischemia-reperfusion?
A) Decreased reactive oxygen species (ROS) generation
B) Mitochondrial calcium overload and oxidative stress
C) Reduced neutrophil activation
D) Enhanced DNA repair capacity
Correct Answer: B) Mitochondrial calcium overload and oxidative stress
Rationale:
During reperfusion, the sudden influx of oxygen leads to generation of reactive
oxygen species, mitochondrial permeability transition, calcium overload, and cell
membrane damage, exacerbating injury.
2. In the progression from acute inflammation to chronic inflammation,
which cell type becomes more prominent?
A) Neutrophils
B) Eosinophils
C) Macrophages and lymphocytes
D) Basophils
Correct Answer: C) Macrophages and lymphocytes
Rationale:
Acute inflammation is marked by neutrophils. In chronic inflammation,
macrophages, T and B lymphocytes, and sometimes plasma cells dominate the
cellular infiltrate.
3. Which gene mutation is most commonly associated with familial
hypercholesterolemia?
A) LDL receptor gene
,2 | Page
B) HMG-CoA reductase gene
C) Apolipoprotein C gene
D) PCSK9 loss-of-function
Correct Answer: A) LDL receptor gene
Rationale:
Familial hypercholesterolemia classically involves defective LDL receptor
function, leading to impaired hepatic uptake of LDL and elevated plasma LDL.
4. Which type of hypersensitivity reaction involves immune complexes
(antigen-antibody) depositing in vessel walls?
A) Type I
B) Type II
C) Type III
D) Type IV
Correct Answer: C) Type III
Rationale:
Type III hypersensitivity is mediated by deposition of antigen-antibody complexes
that trigger complement activation and inflammation (e.g., serum sickness, lupus
nephritis).
5. Which of the following best describes the pathophysiology of diabetic
ketoacidosis (DKA)?
A) Insulin excess leading to lipogenesis
B) Absolute insulin deficiency with increased lipolysis and ketogenesis
C) Hypoglycemia triggering production of ketone bodies
D) Renal failure causing accumulation of ketoacids
Correct Answer: B) Absolute insulin deficiency with increased lipolysis and
ketogenesis
Rationale:
In DKA, insufficient insulin leads to unopposed lipolysis, free fatty acid release,
hepatic ketone production, metabolic acidosis, and osmotic diuresis.
6. Which oncogene is most often mutated in many human cancers and
results in unregulated cell proliferation?
A) Rb
,3 | Page
B) p53
C) Ras
D) BRCA1
Correct Answer: C) Ras
Rationale:
Ras is a proto-oncogene; mutations lead to constitutive activation of downstream
signaling (MAPK/PI3K), causing uncontrolled cell proliferation.
7. Which of the following is characteristic of reversible cell injury?
A) Severe mitochondrial disruption
B) Nuclear karyolysis
C) Cellular swelling and membrane blebs
D) Loss of ribosomes
Correct Answer: C) Cellular swelling and membrane blebs
Rationale:
In reversible injury, cells often demonstrate swelling, blebbing, and detachment of
ribosomes, but nuclear integrity remains intact. When damage is severe,
irreversible changes follow.
8. Which electrolyte abnormality is most likely in the setting of tumor lysis
syndrome?
A) Hypokalemia
B) Hypophosphatemia
C) Hypocalcemia
D) Hyponatremia
Correct Answer: C) Hypocalcemia
Rationale:
Tumor lysis syndrome causes release of phosphate, which binds to calcium,
leading to hypocalcemia, along with hyperphosphatemia, hyperkalemia, and
hyperuricemia.
9. Which cytokine is primarily responsible for the acute phase response
and induction of fever?
A) IL-2
B) TNF-alpha
, 4 | Page
C) IL-6
D) IL-10
Correct Answer: C) IL-6
Rationale:
IL-6 stimulates hepatocytes to produce acute phase proteins (e.g., CRP) and
contributes to fever via acting on the hypothalamus.
10.In heart failure, activation of which compensatory mechanism
contributes to remodeling and worsened disease in the long run?
A) Natriuretic peptide release
B) Parasympathetic activation
C) Renin-angiotensin-aldosterone system (RAAS)
D) Increased insulin sensitivity
Correct Answer: C) Renin-angiotensin-aldosterone system (RAAS)
Rationale:
In heart failure, RAAS activation aims to maintain perfusion by vasoconstriction
and sodium retention, but chronically leads to remodeling, fibrosis, and worsening
heart failure.
11.Which process best describes metastasis of cancer cells to distant
organs?
A) Local invasion only
B) Intravasation, survival in circulation, extravasation, colonization
C) Direct extension through adjacent tissues
D) Clonal expansion within primary tumor
Correct Answer: B) Intravasation, survival in circulation, extravasation,
colonization
Rationale:
Metastasis involves tumor cells invading blood or lymph vessels (intravasation),
surviving in circulation, exiting (extravasation), and establishing growth at distant
sites.
12.Which of the following causes respiratory acidosis?
A) Hyperventilation
B) Pulmonary embolism
