NURS 611 Advanced Pathophysiology Week 3: Hematologic and
Cardiovascular Systems 2026 |Maryville
1. A 55-year-old patient presents with fatigue and paresthesia in the fingers. Lab
results reveal a macrocytic, normochromic anemia. Which of the following is the
most likely underlying mechanism?
A. Deficiency of dietary iron intake
B. Chronic blood loss from the gastrointestinal tract
C. Lack of intrinsic factor leading to Vitamin B12 malabsorption
D. Inherited mutation in the hemoglobin beta chain
Answer: C
Rationale: Pernicious anemia is a macrocytic-normochromic anemia caused by a lack of
intrinsic factor, which is required for Vitamin B12 absorption. Neurological symptoms like
paresthesia are specific to B12 deficiency but not folate deficiency.
2. In the progression of atherosclerosis, what is the significance of ‘foam cells’?
A. They are macrophages that have engulfed oxidized LDL cholesterol
B. They are smooth muscle cells that have migrated to the adventitia
C. They are neutrophils that have released reactive oxygen species
D. They are endothelial cells that have become apoptotic
Answer: A
Rationale: Foam cells are formed when macrophages ingest oxidized LDL in the arterial
wall. Their accumulation leads to the formation of a fatty streak, the earliest visible lesion
of atherosclerosis.
,3. Which chromosome abnormality is characteristically associated with Chronic
Myeloid Leukemia (CML)?
A. Translocation of chromosomes 8 and 14
B. Deletion of the short arm of chromosome 5
C. Translocation of chromosomes 9 and 22
D. Trisomy 21
Answer: C
Rationale: The Philadelphia chromosome (Ph1) is a translocation between chromosomes
9 and 22, resulting in the BCR-ABL fusion protein with constitutive tyrosine kinase activity,
a hallmark of CML.
4. A patient diagnosed with Polycythemia Vera is found to have a mutation in
which gene?
A. BRCA1
B. p53
C. JAK2
D. VHL
Answer: C
Rationale: Over 95% of patients with Polycythemia Vera have a mutation in the Janus
kinase 2 (JAK2) gene, which leads to erythropoietin-independent proliferation of red blood
cells.
5. Which type of anemia is characterized by the presence of ringed sideroblasts
in the bone marrow?
A. Iron deficiency anemia
B. Sideroblastic anemia
C. Aplastic anemia
D. Hemolytic anemia
Answer: B
, Rationale: Sideroblastic anemia is characterized by the failure to incorporate iron into
hemoglobin, leading to iron sequestration in the mitochondria of erythroid precursors,
forming a ring around the nucleus.
6. A 10-year-old boy presents with pallor, bruising, and bone pain. Blood smear
shows a high number of lymphoblasts. What is the most likely diagnosis?
A. Acute Myeloid Leukemia (AML)
B. Chronic Lymphocytic Leukemia (CLL)
C. Hodgkin Lymphoma
D. Acute Lymphocytic Leukemia (ALL)
Answer: D
Rationale: ALL is the most common malignancy in children. It is characterized by the
overproduction of immature lymphoblasts in the bone marrow.
7. Which clinical finding is pathognomonic for Hodgkin Lymphoma?
A. Bence-Jones proteins in the urine
B. Smudge cells on peripheral smear
C. Auer rods in myeloid blasts
D. Reed-Sternberg cells in the lymph nodes
Answer: D
Rationale: Reed-Sternberg cells are large, multinucleated B-cells (often described as
having ‘owl-eye’ nuclei) that are the diagnostic hallmark of Hodgkin Lymphoma.
8. Multiple Myeloma is characterized by the malignant proliferation of which
cell type?
A. Plasma cells
B. T-helper cells
C. Natural Killer cells
D. Erythrocytes
Answer: A
Cardiovascular Systems 2026 |Maryville
1. A 55-year-old patient presents with fatigue and paresthesia in the fingers. Lab
results reveal a macrocytic, normochromic anemia. Which of the following is the
most likely underlying mechanism?
A. Deficiency of dietary iron intake
B. Chronic blood loss from the gastrointestinal tract
C. Lack of intrinsic factor leading to Vitamin B12 malabsorption
D. Inherited mutation in the hemoglobin beta chain
Answer: C
Rationale: Pernicious anemia is a macrocytic-normochromic anemia caused by a lack of
intrinsic factor, which is required for Vitamin B12 absorption. Neurological symptoms like
paresthesia are specific to B12 deficiency but not folate deficiency.
2. In the progression of atherosclerosis, what is the significance of ‘foam cells’?
A. They are macrophages that have engulfed oxidized LDL cholesterol
B. They are smooth muscle cells that have migrated to the adventitia
C. They are neutrophils that have released reactive oxygen species
D. They are endothelial cells that have become apoptotic
Answer: A
Rationale: Foam cells are formed when macrophages ingest oxidized LDL in the arterial
wall. Their accumulation leads to the formation of a fatty streak, the earliest visible lesion
of atherosclerosis.
,3. Which chromosome abnormality is characteristically associated with Chronic
Myeloid Leukemia (CML)?
A. Translocation of chromosomes 8 and 14
B. Deletion of the short arm of chromosome 5
C. Translocation of chromosomes 9 and 22
D. Trisomy 21
Answer: C
Rationale: The Philadelphia chromosome (Ph1) is a translocation between chromosomes
9 and 22, resulting in the BCR-ABL fusion protein with constitutive tyrosine kinase activity,
a hallmark of CML.
4. A patient diagnosed with Polycythemia Vera is found to have a mutation in
which gene?
A. BRCA1
B. p53
C. JAK2
D. VHL
Answer: C
Rationale: Over 95% of patients with Polycythemia Vera have a mutation in the Janus
kinase 2 (JAK2) gene, which leads to erythropoietin-independent proliferation of red blood
cells.
5. Which type of anemia is characterized by the presence of ringed sideroblasts
in the bone marrow?
A. Iron deficiency anemia
B. Sideroblastic anemia
C. Aplastic anemia
D. Hemolytic anemia
Answer: B
, Rationale: Sideroblastic anemia is characterized by the failure to incorporate iron into
hemoglobin, leading to iron sequestration in the mitochondria of erythroid precursors,
forming a ring around the nucleus.
6. A 10-year-old boy presents with pallor, bruising, and bone pain. Blood smear
shows a high number of lymphoblasts. What is the most likely diagnosis?
A. Acute Myeloid Leukemia (AML)
B. Chronic Lymphocytic Leukemia (CLL)
C. Hodgkin Lymphoma
D. Acute Lymphocytic Leukemia (ALL)
Answer: D
Rationale: ALL is the most common malignancy in children. It is characterized by the
overproduction of immature lymphoblasts in the bone marrow.
7. Which clinical finding is pathognomonic for Hodgkin Lymphoma?
A. Bence-Jones proteins in the urine
B. Smudge cells on peripheral smear
C. Auer rods in myeloid blasts
D. Reed-Sternberg cells in the lymph nodes
Answer: D
Rationale: Reed-Sternberg cells are large, multinucleated B-cells (often described as
having ‘owl-eye’ nuclei) that are the diagnostic hallmark of Hodgkin Lymphoma.
8. Multiple Myeloma is characterized by the malignant proliferation of which
cell type?
A. Plasma cells
B. T-helper cells
C. Natural Killer cells
D. Erythrocytes
Answer: A
