NSG 5140 ADVANCED
PATHOPHYSIOLOGY — MIDTERM 2
1. Which mechanism is primarily responsible for edema
formation in congestive heart failure?
A. Increased plasma oncotic pressure
B. Decreased capillary hydrostatic pressure
C. Increased capillary hydrostatic pressure
D. Decreased interstitial fluid pressure
Correct answer: C. Increased capillary hydrostatic pressure
Rationale: In heart failure, reduced cardiac output leads to
venous congestion, increasing hydrostatic pressure in
capillaries. This drives fluid out of the vascular space into
interstitial tissues, producing edema.
2. Which electrolyte imbalance is most commonly associated
with metabolic alkalosis?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Correct answer: B. Hypokalemia
Rationale: Metabolic alkalosis causes hydrogen ions to shift out
of cells, leading potassium to shift into cells, resulting in
decreased serum potassium levels.
3. In type 1 diabetes mellitus, hyperglycemia results primarily
from:
A. Insulin resistance
, B. Excess glucagon secretion
C. Autoimmune destruction of beta cells
D. Increased hepatic glycogen storage
Correct answer: C. Autoimmune destruction of beta cells
Rationale: Type 1 diabetes is characterized by immune-
mediated destruction of pancreatic beta cells, resulting in
absolute insulin deficiency.
4. Which condition is characterized by decreased alveolar
surfactant production?
A. Asthma
B. COPD
C. Acute respiratory distress syndrome (ARDS)
D. Pulmonary embolism
Correct answer: C. Acute respiratory distress syndrome (ARDS)
Rationale: ARDS involves damage to type II pneumocytes,
reducing surfactant production and leading to alveolar collapse
and impaired gas exchange.
5. Which acid-base disorder is expected in chronic
obstructive pulmonary disease (COPD)?
A. Metabolic alkalosis
B. Respiratory alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
Correct answer: C. Respiratory acidosis
Rationale: COPD leads to chronic hypoventilation and CO₂
retention, resulting in respiratory acidosis.
, 6. A key feature of septic shock is:
A. Decreased cardiac output due to myocardial infarction
B. Peripheral vasoconstriction and increased SVR
C. Systemic vasodilation and capillary leakage
D. Isolated pulmonary hypertension
Correct answer: C. Systemic vasodilation and capillary leakage
Rationale: Septic shock is caused by inflammatory mediators
that lead to widespread vasodilation and increased capillary
permeability.
7. Which immune cell is primarily responsible for antibody
production?
A. T helper cells
B. B lymphocytes
C. Macrophages
D. Natural killer cells
Correct answer: B. B lymphocytes
Rationale: B cells differentiate into plasma cells, which produce
antigen-specific antibodies.
8. The primary cause of iron-deficiency anemia is:
A. Bone marrow suppression
B. Chronic hemolysis
C. Inadequate iron intake or chronic blood loss
D. Vitamin B12 deficiency
Correct answer: C. Inadequate iron intake or chronic blood
loss
Rationale: Iron deficiency impairs hemoglobin synthesis, most
commonly due to dietary deficiency or chronic bleeding.
, 9. Which hormone increases blood glucose during stress?
A. Insulin
B. Thyroxine
C. Cortisol
D. Aldosterone
Correct answer: C. Cortisol
Rationale: Cortisol promotes gluconeogenesis and insulin
resistance, raising blood glucose levels during stress.
10. Atherosclerosis primarily begins with:
A. Platelet aggregation
B. Endothelial injury
C. Smooth muscle hypertrophy
D. Thrombus formation
Correct answer: B. Endothelial injury
Rationale: Damage to the vascular endothelium triggers lipid
deposition and inflammatory processes that initiate
atherosclerosis.
11. Which condition is most associated with SIADH?
A. Hypernatremia
B. Hyponatremia
C. Hypercalcemia
D. Hypokalemia
Correct answer: B. Hyponatremia
Rationale: SIADH causes excessive water retention, diluting
serum sodium levels.
PATHOPHYSIOLOGY — MIDTERM 2
1. Which mechanism is primarily responsible for edema
formation in congestive heart failure?
A. Increased plasma oncotic pressure
B. Decreased capillary hydrostatic pressure
C. Increased capillary hydrostatic pressure
D. Decreased interstitial fluid pressure
Correct answer: C. Increased capillary hydrostatic pressure
Rationale: In heart failure, reduced cardiac output leads to
venous congestion, increasing hydrostatic pressure in
capillaries. This drives fluid out of the vascular space into
interstitial tissues, producing edema.
2. Which electrolyte imbalance is most commonly associated
with metabolic alkalosis?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Correct answer: B. Hypokalemia
Rationale: Metabolic alkalosis causes hydrogen ions to shift out
of cells, leading potassium to shift into cells, resulting in
decreased serum potassium levels.
3. In type 1 diabetes mellitus, hyperglycemia results primarily
from:
A. Insulin resistance
, B. Excess glucagon secretion
C. Autoimmune destruction of beta cells
D. Increased hepatic glycogen storage
Correct answer: C. Autoimmune destruction of beta cells
Rationale: Type 1 diabetes is characterized by immune-
mediated destruction of pancreatic beta cells, resulting in
absolute insulin deficiency.
4. Which condition is characterized by decreased alveolar
surfactant production?
A. Asthma
B. COPD
C. Acute respiratory distress syndrome (ARDS)
D. Pulmonary embolism
Correct answer: C. Acute respiratory distress syndrome (ARDS)
Rationale: ARDS involves damage to type II pneumocytes,
reducing surfactant production and leading to alveolar collapse
and impaired gas exchange.
5. Which acid-base disorder is expected in chronic
obstructive pulmonary disease (COPD)?
A. Metabolic alkalosis
B. Respiratory alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
Correct answer: C. Respiratory acidosis
Rationale: COPD leads to chronic hypoventilation and CO₂
retention, resulting in respiratory acidosis.
, 6. A key feature of septic shock is:
A. Decreased cardiac output due to myocardial infarction
B. Peripheral vasoconstriction and increased SVR
C. Systemic vasodilation and capillary leakage
D. Isolated pulmonary hypertension
Correct answer: C. Systemic vasodilation and capillary leakage
Rationale: Septic shock is caused by inflammatory mediators
that lead to widespread vasodilation and increased capillary
permeability.
7. Which immune cell is primarily responsible for antibody
production?
A. T helper cells
B. B lymphocytes
C. Macrophages
D. Natural killer cells
Correct answer: B. B lymphocytes
Rationale: B cells differentiate into plasma cells, which produce
antigen-specific antibodies.
8. The primary cause of iron-deficiency anemia is:
A. Bone marrow suppression
B. Chronic hemolysis
C. Inadequate iron intake or chronic blood loss
D. Vitamin B12 deficiency
Correct answer: C. Inadequate iron intake or chronic blood
loss
Rationale: Iron deficiency impairs hemoglobin synthesis, most
commonly due to dietary deficiency or chronic bleeding.
, 9. Which hormone increases blood glucose during stress?
A. Insulin
B. Thyroxine
C. Cortisol
D. Aldosterone
Correct answer: C. Cortisol
Rationale: Cortisol promotes gluconeogenesis and insulin
resistance, raising blood glucose levels during stress.
10. Atherosclerosis primarily begins with:
A. Platelet aggregation
B. Endothelial injury
C. Smooth muscle hypertrophy
D. Thrombus formation
Correct answer: B. Endothelial injury
Rationale: Damage to the vascular endothelium triggers lipid
deposition and inflammatory processes that initiate
atherosclerosis.
11. Which condition is most associated with SIADH?
A. Hypernatremia
B. Hyponatremia
C. Hypercalcemia
D. Hypokalemia
Correct answer: B. Hyponatremia
Rationale: SIADH causes excessive water retention, diluting
serum sodium levels.
