NU606 | NU606 Advanced Pathophysiology Exam 3
Version 1 | Questions with Correct Answers and
Expert Explanation for Each Question | Regis
1. A patient with Syndrome of Inappropriate Antidiuretic Hormone (SIADH) would
most likely exhibit which electrolyte abnormality?
A. Hypernatremia
B. Hyperkalemia
C. Hyponatremia
D. Hypocalcemia
Correct Answer: C
Expert Explanation: SIADH involves the excessive release of antidiuretic hormone,
which causes the kidneys to reabsorb too much water. This excess water dilutes the
blood, leading to dilutional hyponatremia. The condition is characterized by low
serum sodium levels and high urine osmolality.
2. Which pathophysiological mechanism is primary in the development of Type 1
Diabetes Mellitus?
A. Insulin resistance in peripheral tissues
B. Decreased glucose production by the liver
C. Autoimmune destruction of pancreatic beta cells
,D. Excessive secretion of glucagon by alpha cells
Correct Answer: C
Expert Explanation: Type 1 Diabetes Mellitus is primarily an autoimmune disease
where T-cells attack and destroy the insulin-producing beta cells in the islets of
Langerhans. This leads to an absolute deficiency of insulin, necessitating lifelong
exogenous insulin therapy. Unlike Type 2 DM, this process is not initially
characterized by insulin resistance.
3. A patient presents with a ‘moon face,’ central obesity, and purple striae on the
abdomen. Which condition is most consistent with these findings?
A. Addison’s Disease
B. Cushing’s Syndrome
C. Pheochromocytoma
D. Hashimoto’s Thyroiditis
Correct Answer: B
Expert Explanation: Cushing’s syndrome results from chronic exposure to
excessive levels of cortisol, either from endogenous overproduction or exogenous
administration. The classic physical features include fat redistribution to the face
and trunk, along with skin thinning that leads to purple striae. Cortisol also
promotes gluconeogenesis, often leading to secondary hyperglycemia.
,4. In the development of Chronic Kidney Disease (CKD), why does secondary
hyperparathyroidism occur?
A. Decreased activation of Vitamin D and hyperphosphatemia
B. Hypophosphatemia causing calcium release
C. Direct stimulation of the parathyroid gland by urea
D. Increased renal excretion of parathyroid hormone
Correct Answer: A
Expert Explanation: As kidney function declines, the kidneys lose the ability to
excrete phosphate and activate Vitamin D. The resulting hyperphosphatemia and
low levels of active Vitamin D (calcitriol) lead to hypocalcemia. In response, the
parathyroid glands overproduce PTH to try and restore calcium levels, which can
lead to bone demineralization.
5. Which of the following is a classic cause of prerenal acute kidney injury (AKI)?
A. Aminoglycoside toxicity
B. Severe dehydration and hypovolemia
C. Benign Prostatic Hyperplasia (BPH)
D. Acute glomerulonephritis
Correct Answer: B
, Expert Explanation: Prerenal AKI is caused by factors that reduce blood flow to the
kidneys without damaging the kidney tissue itself. Severe dehydration reduces the
effective circulating volume, leading to decreased renal perfusion and a drop in GFR.
If the underlying cause is corrected quickly, renal function can typically be restored
without permanent damage.
6. Nephrotic syndrome is primarily characterized by which of the following clinical
findings?
A. Proteinuria exceeding 3.5 grams per day
B. Gross hematuria and hypertension
C. Pyuria and flank pain
D. Elevated serum creatinine with normal protein excretion
Correct Answer: A
Expert Explanation: Nephrotic syndrome is defined by massive proteinuria
resulting from increased permeability of the glomerular basement membrane. This
loss of protein leads to hypoalbuminemia and generalized edema due to decreased
plasma oncotic pressure. In contrast, nephritic syndrome is more commonly
associated with hematuria and inflammatory changes.
7. What is the underlying cause of Graves’ disease?
A. Pituitary adenoma secreting excessive TSH
Version 1 | Questions with Correct Answers and
Expert Explanation for Each Question | Regis
1. A patient with Syndrome of Inappropriate Antidiuretic Hormone (SIADH) would
most likely exhibit which electrolyte abnormality?
A. Hypernatremia
B. Hyperkalemia
C. Hyponatremia
D. Hypocalcemia
Correct Answer: C
Expert Explanation: SIADH involves the excessive release of antidiuretic hormone,
which causes the kidneys to reabsorb too much water. This excess water dilutes the
blood, leading to dilutional hyponatremia. The condition is characterized by low
serum sodium levels and high urine osmolality.
2. Which pathophysiological mechanism is primary in the development of Type 1
Diabetes Mellitus?
A. Insulin resistance in peripheral tissues
B. Decreased glucose production by the liver
C. Autoimmune destruction of pancreatic beta cells
,D. Excessive secretion of glucagon by alpha cells
Correct Answer: C
Expert Explanation: Type 1 Diabetes Mellitus is primarily an autoimmune disease
where T-cells attack and destroy the insulin-producing beta cells in the islets of
Langerhans. This leads to an absolute deficiency of insulin, necessitating lifelong
exogenous insulin therapy. Unlike Type 2 DM, this process is not initially
characterized by insulin resistance.
3. A patient presents with a ‘moon face,’ central obesity, and purple striae on the
abdomen. Which condition is most consistent with these findings?
A. Addison’s Disease
B. Cushing’s Syndrome
C. Pheochromocytoma
D. Hashimoto’s Thyroiditis
Correct Answer: B
Expert Explanation: Cushing’s syndrome results from chronic exposure to
excessive levels of cortisol, either from endogenous overproduction or exogenous
administration. The classic physical features include fat redistribution to the face
and trunk, along with skin thinning that leads to purple striae. Cortisol also
promotes gluconeogenesis, often leading to secondary hyperglycemia.
,4. In the development of Chronic Kidney Disease (CKD), why does secondary
hyperparathyroidism occur?
A. Decreased activation of Vitamin D and hyperphosphatemia
B. Hypophosphatemia causing calcium release
C. Direct stimulation of the parathyroid gland by urea
D. Increased renal excretion of parathyroid hormone
Correct Answer: A
Expert Explanation: As kidney function declines, the kidneys lose the ability to
excrete phosphate and activate Vitamin D. The resulting hyperphosphatemia and
low levels of active Vitamin D (calcitriol) lead to hypocalcemia. In response, the
parathyroid glands overproduce PTH to try and restore calcium levels, which can
lead to bone demineralization.
5. Which of the following is a classic cause of prerenal acute kidney injury (AKI)?
A. Aminoglycoside toxicity
B. Severe dehydration and hypovolemia
C. Benign Prostatic Hyperplasia (BPH)
D. Acute glomerulonephritis
Correct Answer: B
, Expert Explanation: Prerenal AKI is caused by factors that reduce blood flow to the
kidneys without damaging the kidney tissue itself. Severe dehydration reduces the
effective circulating volume, leading to decreased renal perfusion and a drop in GFR.
If the underlying cause is corrected quickly, renal function can typically be restored
without permanent damage.
6. Nephrotic syndrome is primarily characterized by which of the following clinical
findings?
A. Proteinuria exceeding 3.5 grams per day
B. Gross hematuria and hypertension
C. Pyuria and flank pain
D. Elevated serum creatinine with normal protein excretion
Correct Answer: A
Expert Explanation: Nephrotic syndrome is defined by massive proteinuria
resulting from increased permeability of the glomerular basement membrane. This
loss of protein leads to hypoalbuminemia and generalized edema due to decreased
plasma oncotic pressure. In contrast, nephritic syndrome is more commonly
associated with hematuria and inflammatory changes.
7. What is the underlying cause of Graves’ disease?
A. Pituitary adenoma secreting excessive TSH
