NR507 MIDTERM EXAM ADVANCED
PATHOPHYSIOLOGY REVIEW CHAMBERLAIN
ACTUAL EXAM QUESTIONS AND VERIFIED
ANSWERS WITH RATIONALES GRADED A+ LATEST
Question 1
A 55-year-old male presents with crushing chest pain radiating to the left arm.
ECG shows ST-segment elevation in leads II, III, and aVF. Which coronary artery
is most likely affected?
A. Left anterior descending artery
B. Right coronary artery
C. Left circumflex artery
D. Posterior descending artery
Answer: B. Right coronary artery
Rationale: ST elevation in II, III, and aVF indicates an inferior myocardial
infarction, typically supplied by the right coronary artery.
Question 2
A patient presents with fatigue, pallor, and spoon-shaped nails. Labs show
microcytic, hypochromic anemia and low ferritin. What is the most likely cause?
A. Iron deficiency anemia
B. Thalassemia
C. Vitamin B12 deficiency
D. Anemia of chronic disease
Answer: A. Iron deficiency anemia
Rationale: Microcytic, hypochromic anemia with low ferritin is characteristic of
iron deficiency anemia, commonly due to chronic blood loss or malabsorption.
,Question 3
A patient with diabetes reports excessive thirst, frequent urination, and blurred
vision. Labs reveal hyperglycemia and ketones in the urine. What is the most likely
diagnosis?
A. Hyperosmolar hyperglycemic state
B. Type 2 diabetes mellitus
C. Diabetic ketoacidosis
D. SIADH
Answer: C. Diabetic ketoacidosis
Rationale: DKA presents with hyperglycemia, ketonuria, polyuria, polydipsia, and
metabolic acidosis, typically in type 1 diabetes patients.
Question 4
A patient presents with fatigue, jaundice, and splenomegaly. Labs show indirect
hyperbilirubinemia, elevated LDH, and spherocytes. What is the most likely
diagnosis?
A. Vitamin B12 deficiency
B. Iron deficiency anemia
C. Hemolytic anemia
D. Aplastic anemia
Answer: C. Hemolytic anemia
Rationale: Spherocytes, indirect hyperbilirubinemia, and elevated LDH suggest
extravascular hemolysis, as seen in autoimmune hemolytic anemia.
,Question 5
A patient presents with sudden-onset dyspnea, pleuritic chest pain, and hemoptysis.
CT pulmonary angiogram shows multiple filling defects in the pulmonary arteries.
What is the underlying pathophysiology?
A. Alveolar hypoventilation
B. Pulmonary embolism causing V/Q mismatch
C. Pulmonary edema
D. Pneumothorax
Answer: B. Pulmonary embolism causing V/Q mismatch
Rationale: Pulmonary embolism obstructs pulmonary blood flow, causing
ventilation without perfusion, resulting in hypoxemia (V/Q mismatch).
Question 6
A patient presents with fatigue and pallor. Labs reveal macrocytic anemia, elevated
homocysteine, and low vitamin B12. Which neurologic pathway is most affected?
A. Corticospinal tract
B. Dorsal columns
C. Spinothalamic tract
D. Peripheral nerves
Answer: B. Dorsal columns
Rationale: Vitamin B12 deficiency causes demyelination of the dorsal columns,
affecting vibration and proprioception.
, Question 7
A patient presents with polyuria, polydipsia, and hypernatremia. Urine osmolality
is low, and ADH is absent. Which condition is most likely?
A. Central diabetes insipidus
B. Nephrogenic diabetes insipidus
C. SIADH
D. Primary polydipsia
Answer: A. Central diabetes insipidus
Rationale: Central DI results from deficient ADH secretion, causing polyuria,
hypernatremia, and dilute urine.
Question 8
A patient presents with fatigue and pallor. Labs reveal normocytic anemia, low
reticulocyte count, and low erythropoietin. Which type of anemia is most likely?
A. Iron deficiency anemia
B. Anemia of chronic kidney disease
C. Hemolytic anemia
D. Vitamin B12 deficiency
Answer: B. Anemia of chronic kidney disease
Rationale: CKD reduces erythropoietin production, leading to normocytic,
normochromic anemia with low reticulocytes.
Question 9
A patient presents with fever, cough, and lobar consolidation on chest X-ray.
Which pathogen is most commonly responsible?
A. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
C. Staphylococcus aureus
D. Pseudomonas aeruginosa
PATHOPHYSIOLOGY REVIEW CHAMBERLAIN
ACTUAL EXAM QUESTIONS AND VERIFIED
ANSWERS WITH RATIONALES GRADED A+ LATEST
Question 1
A 55-year-old male presents with crushing chest pain radiating to the left arm.
ECG shows ST-segment elevation in leads II, III, and aVF. Which coronary artery
is most likely affected?
A. Left anterior descending artery
B. Right coronary artery
C. Left circumflex artery
D. Posterior descending artery
Answer: B. Right coronary artery
Rationale: ST elevation in II, III, and aVF indicates an inferior myocardial
infarction, typically supplied by the right coronary artery.
Question 2
A patient presents with fatigue, pallor, and spoon-shaped nails. Labs show
microcytic, hypochromic anemia and low ferritin. What is the most likely cause?
A. Iron deficiency anemia
B. Thalassemia
C. Vitamin B12 deficiency
D. Anemia of chronic disease
Answer: A. Iron deficiency anemia
Rationale: Microcytic, hypochromic anemia with low ferritin is characteristic of
iron deficiency anemia, commonly due to chronic blood loss or malabsorption.
,Question 3
A patient with diabetes reports excessive thirst, frequent urination, and blurred
vision. Labs reveal hyperglycemia and ketones in the urine. What is the most likely
diagnosis?
A. Hyperosmolar hyperglycemic state
B. Type 2 diabetes mellitus
C. Diabetic ketoacidosis
D. SIADH
Answer: C. Diabetic ketoacidosis
Rationale: DKA presents with hyperglycemia, ketonuria, polyuria, polydipsia, and
metabolic acidosis, typically in type 1 diabetes patients.
Question 4
A patient presents with fatigue, jaundice, and splenomegaly. Labs show indirect
hyperbilirubinemia, elevated LDH, and spherocytes. What is the most likely
diagnosis?
A. Vitamin B12 deficiency
B. Iron deficiency anemia
C. Hemolytic anemia
D. Aplastic anemia
Answer: C. Hemolytic anemia
Rationale: Spherocytes, indirect hyperbilirubinemia, and elevated LDH suggest
extravascular hemolysis, as seen in autoimmune hemolytic anemia.
,Question 5
A patient presents with sudden-onset dyspnea, pleuritic chest pain, and hemoptysis.
CT pulmonary angiogram shows multiple filling defects in the pulmonary arteries.
What is the underlying pathophysiology?
A. Alveolar hypoventilation
B. Pulmonary embolism causing V/Q mismatch
C. Pulmonary edema
D. Pneumothorax
Answer: B. Pulmonary embolism causing V/Q mismatch
Rationale: Pulmonary embolism obstructs pulmonary blood flow, causing
ventilation without perfusion, resulting in hypoxemia (V/Q mismatch).
Question 6
A patient presents with fatigue and pallor. Labs reveal macrocytic anemia, elevated
homocysteine, and low vitamin B12. Which neurologic pathway is most affected?
A. Corticospinal tract
B. Dorsal columns
C. Spinothalamic tract
D. Peripheral nerves
Answer: B. Dorsal columns
Rationale: Vitamin B12 deficiency causes demyelination of the dorsal columns,
affecting vibration and proprioception.
, Question 7
A patient presents with polyuria, polydipsia, and hypernatremia. Urine osmolality
is low, and ADH is absent. Which condition is most likely?
A. Central diabetes insipidus
B. Nephrogenic diabetes insipidus
C. SIADH
D. Primary polydipsia
Answer: A. Central diabetes insipidus
Rationale: Central DI results from deficient ADH secretion, causing polyuria,
hypernatremia, and dilute urine.
Question 8
A patient presents with fatigue and pallor. Labs reveal normocytic anemia, low
reticulocyte count, and low erythropoietin. Which type of anemia is most likely?
A. Iron deficiency anemia
B. Anemia of chronic kidney disease
C. Hemolytic anemia
D. Vitamin B12 deficiency
Answer: B. Anemia of chronic kidney disease
Rationale: CKD reduces erythropoietin production, leading to normocytic,
normochromic anemia with low reticulocytes.
Question 9
A patient presents with fever, cough, and lobar consolidation on chest X-ray.
Which pathogen is most commonly responsible?
A. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
C. Staphylococcus aureus
D. Pseudomonas aeruginosa
