ADVANCED PATHOPHYSIOLOGY MIDTERM 6501 WALDEN UNIVERSITY EXAM QUESTIONS AND VERIFIED ANSWERS |ALL GRADED A+

Ace the Advanced Pathophysiology Midterm (NUR 6501) at Walden University with the most comprehensive exam preparation guide available. This resource contains 200+ actual exam questions with verified answers (all graded A+) covering every topic tested in this core nurse practitioner course. What's Inside: Cellular Biology & Pathophysiology: Anaerobic glycolysis – facilitates continued muscle performance when oxygen is depleted. Action potential initiation – sodium gates open, sodium rushes into cell, changing membrane potential from negative to positive. Sodium and water accumulation in injured cell – decreased ATP production. Potassium diffusion across cell membrane – resting plasma membrane is more permeable to potassium. Sodium/potassium transport – by adenosine triphosphate enzyme (ATPase). Predominant extracellular cation – sodium. Early endoplasmic reticulum swelling – reduced protein synthesis. Oncotic pressure (colloid osmotic pressure) – determined by plasma proteins. Symport transport – Na+ and Ca2+ moving simultaneously in same direction. Distinguishing aging from disease – difficult because both result from cell injury. Genetics & Chromosomal Disorders: Klinefelter syndrome – karyotype XXY. Turner syndrome – absent homologous X chromosome (single X); features: short stature, widely spaced nipples, reduced carrying angle, sparse body hair. Down syndrome – most common cause: maternal nondisjunction; risk factor: pregnancy in women over age 35. Tetraploidy – 92 chromosomes (stillborn fetus). Cystic fibrosis – caused by autosomal recessive gene. Huntington disease – delayed age of onset. Neurofibromatosis – varying degrees of disease = expressivity. Proband – person first diagnosed with a genetic disease (on pedigree chart). DNA replication in eukaryotic cell – most genetic information contained in nucleolus. Cytokines role in cell reproduction – provide growth factor for tissue growth and development. Albinism – inability to convert tyrosine to DOPA. Endocrine Disorders: Hypothyroidism – decreased T3/T4, elevated TSH; everything slows: metabolism, sympathetic nervous system (drowsy, lethargic), constipation, weight gain, decreased body temp. Hyperthyroidism – increased T3/T4, decreased TSH; weight loss, heat intolerance, diarrhea, increased HR/BP. Thyroid hormones (T3, T4) – regulate metabolism, temperature, growth and development; require iodine. TSH produced by anterior pituitary gland. Cushing's disease (internal) vs. Cushing's syndrome (external – e.g., steroid treatment). Cushing's symptoms: "UP, UP, UP, DOWN, UP" – hypernatremia, hypertension, increased blood volume, hypokalemia, hyperglycemia; truncal obesity, moon face, buffalo hump, striae, excessive hair. Addison's disease – autoimmune disorder attacking adrenal cortex; decreased cortisol and aldosterone; symptoms: hyperpigmentation, hyponatremia, hyperkalemia, hypoglycemia, low BP, vascular collapse risk. Adrenal cortex – secretes cortisol, aldosterone, sex hormones. Aldosterone – retains sodium/water, secretes potassium; regulates BP. Cortisol – stress hormone; increases blood glucose, breaks down fats/proteins/carbs. Negative feedback loop: Hypothalamus (CRH) → Pituitary (ACTH) → Adrenal cortex (cortisol). SIADH – increased antidiuretic hormone (ADH) production. Diabetes Insipidus – decreased ADH production. ADH (vasopressin) – made by hypothalamus, stored in posterior pituitary; regulates water conservation. Pheochromocytoma – benign adrenal medulla tumor secreting catecholamines (epinephrine, norepinephrine); causes hypertension, headache, sweating, panic attack symptoms. Cardiovascular Disorders: Hypertension – BP 130; BP = cardiac output × total peripheral vascular resistance. Left-sided heart failure – dyspnea, crackles, oliguria, frothy sputum, displaced apical pulse (hypertrophy). Right-sided heart failure – jugular vein distention, ascending dependent edema, weight gain, hepatomegaly. Coronary artery disease – dyslipidemia (abnormal serum lipoproteins); increased LDL = coronary risk. Stable angina – chest pain relieved by nitrates; sensation described as "clenching fist over left sternal border." Myocardial infarction (MI) – death of myocardial tissue from coronary artery occlusion; chest/upper body pain, SOB, diaphoresis, nausea. Pericarditis – inflammation of pericardium, often with pericardial effusion. Cardiac tamponade – fluid accumulation compressing heart → impairs cardiac filling → low cardiac output. Infective endocarditis – inflammation of endothelium lining heart and valves (most commonly mitral valve, then aortic, tricuspid). Myocarditis – inflammation of myocardium with necrosis of cardiac myocytes; inflammatory infiltrate on biopsy. Aortic stenosis – calcification of aortic valve cusps restricting forward flow during systole. Aortic regurgitation (insufficiency) – backward flow from aorta into left ventricle during diastole. Mitral stenosis – narrowing of mitral valve orifice impeding flow from left atrium to left ventricle. Mitral regurgitation – incompetent mitral valve allowing backflow from left ventricle to left atrium during systole. Mitral valve prolapse – billowing of mitral valve leaflets into left atrium during systole. Pulmonic stenosis – narrowing of pulmonary outflow tract obstructing flow from right ventricle to pulmonary artery during systole. Pulmonic regurgitation – backflow from pulmonary artery into right ventricle during diastole. Tricuspid regurgitation – holosystolic murmur loudest at tricuspid area; enhanced by inspiration. Deep vein thrombosis (DVT) – blood clot in lower limb from impaired venous return, endothelial injury, or hypercoagulability; thrombi consist of thrombin, fibrin, RBCs (few platelets). Peripheral artery disease (PAD) – atherosclerotic disease of arteries perfusing limbs (especially lower extremities); can cause intermittent claudication. Pulmonary Disorders: Ventilation – movement of air in/out of lungs; controlled by parasympathetic and sympathetic nervous system. Gas exchange in lungs – via diffusion (O2 into blood, CO2 out of blood). Lung compliance – determined by adequate surfactant production and elastic recoil. Airway resistance – increases as airway diameter decreases. Spirometer – measures volume of air inhaled/exhaled and time per breath. Dyspnea – shortness of breath. Orthopnea – difficulty breathing when lying down. Paroxysmal nocturnal dyspnea – awakening from sleep with SOB, needing to be upright. Aspiration – breathing fluid, food, vomitus, or object into lungs. Atelectasis – collapsed lung; incomplete expansion of alveoli. Bronchiectasis – dilation of bronchi secondary to infection or chronic inflammation. Bronchiolitis – inflammation of bronchioles; usually in children 2 years; often caused by RSV. Pulmonary edema – fluid accumulation in lungs; common cause = left heart failure. ARDS (Acute Respiratory Distress Syndrome) – respiratory insufficiency marked by progressive hypoxia. Asthma – chronic allergic disorder with episodes of breathing difficulty, coughing, wheezing. COPD (Chronic Obstructive Pulmonary Disease) – group of lung diseases blocking airflow (bronchitis and emphysema). Chronic bronchitis – chronic bronchial inflammation causing airway obstruction from smooth muscle hypertrophy. Emphysema – damaged/enlarged air sacs causing breathlessness. Renal & Urinary Disorders: Kidney function – filter blood and produce urine. Renal blood flow – mL/min. GFR (Glomerular Filtration Rate) – 90-120 mL/min. Nephron function – regulate water and soluble substances; filter blood, reabsorb needed, excrete rest. Proximal convoluted tubule – reabsorbs 60-70% of filtered sodium and water. Distal tubules – transport, reabsorb, and secrete glomerular filtrate. Creatinine – 0.6-1.2 mg/dL. BUN (Blood Urea Nitrogen) – 10-20 mg/dL; indicator of hydration status. UTI (Urinary Tract Infection) – presence of organism in urinary tract. Pyelonephritis – inflammation of renal pelvis and kidney. Acute glomerulonephritis (AGN) – immune disease after strep infection; decreases GFR; symptoms: oliguria, edema, hematuria ("tea-colored"), mild HTN, proteinuria; usually follows strep infection by 10 days. Lupus erythematosus – autoimmune disease; butterfly-shaped rash over nose and cheeks; can affect heart, lungs, kidneys (SLE). Acute Kidney Injury (AKI) – abrupt loss of kidney function. Prerenal – decreased renal blood flow (hypotension, hypoperfusion). Intrarenal – injury to renal tissue from toxins/ischemia (edema, glomerulonephritis). Postrenal – obstruction of urine flow. Oliguric phase – 500 mL urine output in 24 hours. Chronic Kidney Disease (CKD) – staged 1 (mild) to 5 (ESRD requiring dialysis or transplant). Gastrointestinal & Hepatobiliary Disorders: Duodenum – chemical digestion of carbs, proteins, and lipids. Bile – bitter greenish-brown alkaline fluid; secreted by liver, stored in gallbladder. Liver functions – metabolism of fats/proteins/carbohydrates; bilirubin excretion; enzyme activation; glycogen/vitamin/mineral storage; plasma protein synthesis (albumin, clotting factors); blood detoxification; bile production. Hepatic portal vein – connects intestinal capillaries to liver capillaries. Bilirubin – orange-yellow pigment formed from hemoglobin breakdown; excreted in bile. Gallbladder – stores and concentrates bile. Pancreas – exocrine (digestive enzymes, bicarbonate) and endocrine (insulin, glucagon). Anorexia – loss of appetite. Vomiting (emesis) – expelling stomach contents. Primary constipation – lifestyle factors (inactivity, inadequate fiber/fluid, ignoring urge). Diarrhea causes – bacteria (E. coli), viruses, toxins, drugs, laxative abuse, malabsorption, IBD, stress, anxiety. GI bleeding symptoms – abdominal pain, hematemesis, hematochezia, melena, altered LOC, signs of shock, tachycardia. Peptic Ulcer Disease (PUD) – break in mucosal lining of lower esophagus, stomach, or duodenum. Duodenal ulcer – increased parietal cells, increased gastric levels, rapid gastric emptying. Gastric ulcer – persistent upper abdominal burning pain, relieved by bland foods, hematemesis or melena. Zollinger-Ellison syndrome – hypersecretion of gastric acid from non-beta-cell pancreatic islet tumor. Stress ulcers – gastric mucosal lesions in critically ill patients (trauma, shock, hemorrhage, sepsis, burns, ARDS, major surgery). Cushing ulcer – increased vagus nerve stimulation from increased ICP → increased acid production. Dumping syndrome – increase fat/protein, small frequent meals, lie down after meals. Ulcerative colitis – chronic inflammation of rectum and large intestine with ulcers and irritation. Crohn's disease – chronic inflammatory bowel disease affecting lining of digestive tract. Irritable Bowel Syndrome (IBS) – intermittent cramping, abdominal pain, bloating, constipation, diarrhea. Diverticulitis – inflammation of diverticula. Appendicitis – inflammation of appendix. Portal hypertension – liver damage from chronic alcoholism; obstructs venous flow; causes vein engorgement around umbilicus. Splenomegaly – enlargement of spleen. Ascites – excess fluid in peritoneal cavity. Hepatic encephalopathy – impaired ammonia metabolism causing cerebral edema; symptoms: change in LOC, memory loss, asterixis (flapping tremor), hyperventilation with respiratory alkalosis; treatment: lactulose, low protein. Hepatitis – inflammation of liver (viral, fever, loss of appetite, jaundice, fatigue). Hepatitis B – transmitted through any body fluid (vaginal secretions, semen, blood). Hepatitis C – bloodborne (blood exposure, sharing needles, mother to infant); rarely sexual contact. Hepatitis D – only exists with hepatitis B; HBV vaccine offers protection. Viral hepatitis symptoms – fatigue, myalgia/arthralgia, mild fever, N/V, abdominal pain, aversion to smoking, hepatosplenomegaly, dark urine, jaundice. Cirrhosis causes – alcoholism (most common), nutritional deprivation, hepatitis. Cholecystitis – inflammation of gallbladder (usually with gallstones). Chronic pancreatitis – caused by ETOH (adults), cystic fibrosis (children). LDL cholesterol – "bad" cholesterol; delivers plaque to arterial walls (100 mg/dL). HDL cholesterol – "good" cholesterol; high protein, low fat. GERD (Gastroesophageal Reflux Disease) – stomach acid or bile irritates food pipe lining. Diabetes & Metabolism: Type 1 diabetes – pancreatic cells fail to produce insulin; autoimmune destruction. Type 2 diabetes – insulin resistance with impaired insulin utilization; often in obese adults. Three P's of diabetes – Polyuria (excessive urination), Polydipsia (excessive thirst), Polyphagia (excessive hunger). DKA (Diabetic Ketoacidosis) – hyperglycemia, hyperketonemia, metabolic acidosis; occurs mostly in type 1 diabetes; causes nausea, vomiting, abdominal pain; can progress to cerebral edema, coma, death. DKA pathophysiology – hyperglycemia from insulin deficiency causes osmotic diuresis; urinary ketones cause sodium and potassium loss. Why This Guide is Different: 200+ Actual Exam Questions – real NUR 6501 midterm content. Verified Correct Answers (ANS....) – all answers A+ graded. Walden University Specific – tailored to this exact course. Quick Reference – perfect for last-minute review before exam day.