NR507 FINAL EXAM STUDY GUIDE NR 507
WEEK 5 - 8 ADVANCED PATHOPHYSIOLOGY
QUESTIONS AND ANSWERS (2026)
(VERIFIED ANSWERS)- CHAMBERLAIN
1. Body's process for adapting to high hormone levels
Question: To adapt to high levels of hormones, cells can decrease the number of
receptors for that hormone. What is this process called?
A. Up-regulation
B. Down-regulation
C. Hormone resistance
D. Receptor desensitization
Answer: B. Down-regulation
Rationale: Down-regulation occurs when cells reduce the number of receptors in
response to high hormone levels, decreasing sensitivity to the hormone. This is a
protective mechanism to prevent overstimulation and maintain homeostasis. For
example, prolonged high insulin levels can cause insulin receptor down-regulation,
leading to insulin resistance.
2. Cushing's Syndrome
Question: Which of the following most commonly causes Cushing’s syndrome?
A. Autoimmune destruction of adrenal cortex
B. Excessive ACTH from adrenal or non-pituitary adenomas
C. Hypopituitarism
D. Chronic hypothyroidism
Answer: B. Excessive ACTH from adrenal or non-pituitary adenomas
Rationale: Cushing’s syndrome is characterized by excessive cortisol due to elevated
ACTH. Non-pituitary tumors, such as small-cell lung cancer, can secrete ectopic ACTH.
Clinical signs include weight gain, hyperpigmentation, moon face, and central obesity.
,3. Lab results indicating primary hypothyroidism
Question: Which lab results are consistent with primary hypothyroidism?
A. High T3/T4, high TSH
B. Low T3/T4, high TSH
C. Low T3/T4, low TSH
D. High T3/T4, low TSH
Answer: B. Low T3/T4, high TSH
Rationale: Primary hypothyroidism originates in the thyroid gland, causing low T3
and T4 levels. The pituitary responds by increasing TSH to stimulate the thyroid.
Autoimmune thyroiditis (Hashimoto’s) is the most common cause.
4. Common causes of hypoparathyroidism
Question: Hypoparathyroidism is most commonly caused by:
A. Parathyroid adenoma
B. Vitamin D deficiency
C. Parathyroid gland injury or removal
D. Chronic renal failure
Answer: C. Parathyroid gland injury or removal
Rationale: Surgical removal or accidental damage to the parathyroid glands is the
most common cause. This leads to decreased PTH, causing hypocalcemia and
hyperphosphatemia, which can manifest as tetany, paresthesia, and seizures.
5. Pathophysiology of thyroid storm
Question: Thyroid storm is precipitated by high levels of thyroid hormone combined
with:
,A. Hypothyroidism
B. Stress hormones
C. Vitamin D deficiency
D. Low cortisol
Answer: B. Stress hormones
Rationale: Thyroid storm is an acute, life-threatening exacerbation of
hyperthyroidism. High thyroid hormone levels plus stress hormones cause fever,
tachycardia, arrhythmias, and potentially high-output heart failure. Immediate
intervention is required to prevent death.
6. Signs of thyrotoxicosis
Question: Which of the following are common signs of thyrotoxicosis?
A. Weight gain and lethargy
B. Weight loss and enlarged thyroid
C. Bradycardia and cold intolerance
D. Hypotension and edema
Answer: B. Weight loss and enlarged thyroid
Rationale: Thyrotoxicosis results from excess thyroid hormone. Clinical
manifestations include weight loss despite normal appetite, goiter, heat intolerance,
palpitations, and tremors. The metabolic rate is markedly increased.
7. Diet and prevention of prostate cancer
Question: Which dietary approach is suggested to potentially prevent prostate
cancer?
A. High-fat, high-dairy diet
B. Low-fat, low-dairy, high fruits and vegetables
C. High-protein, low-vegetable diet
D. High-sugar, high-carb diet
Answer: B. Low-fat, low-dairy, high fruits and vegetables
, Rationale: Evidence suggests that reducing fat and dairy intake and increasing fruit
and vegetable consumption may decrease prostate cancer risk. Antioxidants and
phytochemicals in plant foods may inhibit tumor growth.
8. Impact of Benign Prostatic Hypertrophy (BPH) on the urinary system
Question: BPH primarily affects the urinary system by:
A. Causing kidney failure directly
B. Blocking urine flow through the urethra
C. Increasing bladder compliance
D. Decreasing prostate size
Answer: B. Blocking urine flow through the urethra
Rationale: Enlarged prostate tissue compresses the urethra, leading to urinary
retention, incomplete bladder emptying, increased risk of urinary tract infections, and
potential kidney damage from chronic obstruction.
9. Dermatomes
Question: Dermatomes are defined as:
A. Muscles supplied by a single spinal nerve
B. Areas of skin supplied by a single spinal nerve root
C. Groups of bones in the vertebral column
D. Regions of the brain controlling sensation
Answer: B. Areas of skin supplied by a single spinal nerve root
Rationale: Each spinal nerve innervates a specific skin area called a dermatome.
Overlapping innervation occurs between adjacent dermatomes. Clinically, dermatomal
mapping helps localize nerve injuries or herniated discs.
WEEK 5 - 8 ADVANCED PATHOPHYSIOLOGY
QUESTIONS AND ANSWERS (2026)
(VERIFIED ANSWERS)- CHAMBERLAIN
1. Body's process for adapting to high hormone levels
Question: To adapt to high levels of hormones, cells can decrease the number of
receptors for that hormone. What is this process called?
A. Up-regulation
B. Down-regulation
C. Hormone resistance
D. Receptor desensitization
Answer: B. Down-regulation
Rationale: Down-regulation occurs when cells reduce the number of receptors in
response to high hormone levels, decreasing sensitivity to the hormone. This is a
protective mechanism to prevent overstimulation and maintain homeostasis. For
example, prolonged high insulin levels can cause insulin receptor down-regulation,
leading to insulin resistance.
2. Cushing's Syndrome
Question: Which of the following most commonly causes Cushing’s syndrome?
A. Autoimmune destruction of adrenal cortex
B. Excessive ACTH from adrenal or non-pituitary adenomas
C. Hypopituitarism
D. Chronic hypothyroidism
Answer: B. Excessive ACTH from adrenal or non-pituitary adenomas
Rationale: Cushing’s syndrome is characterized by excessive cortisol due to elevated
ACTH. Non-pituitary tumors, such as small-cell lung cancer, can secrete ectopic ACTH.
Clinical signs include weight gain, hyperpigmentation, moon face, and central obesity.
,3. Lab results indicating primary hypothyroidism
Question: Which lab results are consistent with primary hypothyroidism?
A. High T3/T4, high TSH
B. Low T3/T4, high TSH
C. Low T3/T4, low TSH
D. High T3/T4, low TSH
Answer: B. Low T3/T4, high TSH
Rationale: Primary hypothyroidism originates in the thyroid gland, causing low T3
and T4 levels. The pituitary responds by increasing TSH to stimulate the thyroid.
Autoimmune thyroiditis (Hashimoto’s) is the most common cause.
4. Common causes of hypoparathyroidism
Question: Hypoparathyroidism is most commonly caused by:
A. Parathyroid adenoma
B. Vitamin D deficiency
C. Parathyroid gland injury or removal
D. Chronic renal failure
Answer: C. Parathyroid gland injury or removal
Rationale: Surgical removal or accidental damage to the parathyroid glands is the
most common cause. This leads to decreased PTH, causing hypocalcemia and
hyperphosphatemia, which can manifest as tetany, paresthesia, and seizures.
5. Pathophysiology of thyroid storm
Question: Thyroid storm is precipitated by high levels of thyroid hormone combined
with:
,A. Hypothyroidism
B. Stress hormones
C. Vitamin D deficiency
D. Low cortisol
Answer: B. Stress hormones
Rationale: Thyroid storm is an acute, life-threatening exacerbation of
hyperthyroidism. High thyroid hormone levels plus stress hormones cause fever,
tachycardia, arrhythmias, and potentially high-output heart failure. Immediate
intervention is required to prevent death.
6. Signs of thyrotoxicosis
Question: Which of the following are common signs of thyrotoxicosis?
A. Weight gain and lethargy
B. Weight loss and enlarged thyroid
C. Bradycardia and cold intolerance
D. Hypotension and edema
Answer: B. Weight loss and enlarged thyroid
Rationale: Thyrotoxicosis results from excess thyroid hormone. Clinical
manifestations include weight loss despite normal appetite, goiter, heat intolerance,
palpitations, and tremors. The metabolic rate is markedly increased.
7. Diet and prevention of prostate cancer
Question: Which dietary approach is suggested to potentially prevent prostate
cancer?
A. High-fat, high-dairy diet
B. Low-fat, low-dairy, high fruits and vegetables
C. High-protein, low-vegetable diet
D. High-sugar, high-carb diet
Answer: B. Low-fat, low-dairy, high fruits and vegetables
, Rationale: Evidence suggests that reducing fat and dairy intake and increasing fruit
and vegetable consumption may decrease prostate cancer risk. Antioxidants and
phytochemicals in plant foods may inhibit tumor growth.
8. Impact of Benign Prostatic Hypertrophy (BPH) on the urinary system
Question: BPH primarily affects the urinary system by:
A. Causing kidney failure directly
B. Blocking urine flow through the urethra
C. Increasing bladder compliance
D. Decreasing prostate size
Answer: B. Blocking urine flow through the urethra
Rationale: Enlarged prostate tissue compresses the urethra, leading to urinary
retention, incomplete bladder emptying, increased risk of urinary tract infections, and
potential kidney damage from chronic obstruction.
9. Dermatomes
Question: Dermatomes are defined as:
A. Muscles supplied by a single spinal nerve
B. Areas of skin supplied by a single spinal nerve root
C. Groups of bones in the vertebral column
D. Regions of the brain controlling sensation
Answer: B. Areas of skin supplied by a single spinal nerve root
Rationale: Each spinal nerve innervates a specific skin area called a dermatome.
Overlapping innervation occurs between adjacent dermatomes. Clinically, dermatomal
mapping helps localize nerve injuries or herniated discs.
