NR283 VCAS Final Exam: (Latest 2026/2027 Update)
Pathophysiology Comprehensive Review | Q&A | Grade A | 100%
Correct (Verified Answers)
PATHOPHYSIOLOGY FINAL EXAM | COMPLETE REVIEW
SUBJECT SOURCE
Pathophysiology - Comprehensive Final Exam NR283 VCAS Final Exam Study Guide 2026/2027
Review
Q1
What triggers autonomic dysreflexia in spinal cord injury patients (T-6 or higher)?
A Sustained stimuli at T-6 or below: restrictive clothing, full bladder or UTI, pressure areas, fecal
impaction
B Restrictive clothing only
C Full bladder only
D Fecal impaction only
CORRECT ANSWER A. Sustained stimuli at T-6 or below: restrictive clothing, full bladder or
UTI, pressure areas, fecal impaction
CLINICAL RATIONALE
Autonomic dysreflexia is a medical emergency in SCI patients with lesions at T6 or above. Any noxious
stimulus below the injury level triggers massive sympathetic discharge, causing severe hypertension,
bradycardia, headache, and flushing above the lesion.
,Q2
What are the signs and symptoms of autonomic dysreflexia above the level of injury?
A Higher BP (severe and rapid), flushed face, headache, distended neck veins, lower heart rate,
higher sweating
B Pale, cool, no sweating
C Bradycardia only
D Hypotension
CORRECT ANSWER A. Higher BP (severe and rapid), flushed face, headache, distended neck
veins, lower heart rate, higher sweating
CLINICAL RATIONALE
Above the lesion: vasodilation causes flushing, sweating, headache from hypertension (systolic often
>200 mmHg), and compensatory bradycardia via baroreceptor reflex.
Q3
What are the signs and symptoms of autonomic dysreflexia below the level of injury?
A Flushed face and headache
B Vasoconstriction below: pale, cool, no sweating
C Tachycardia and sweating
D Hypertension and bradycardia
CORRECT ANSWER B. Vasoconstriction below: pale, cool, no sweating
CLINICAL RATIONALE
Below the level of injury, sympathetic outflow causes vasoconstriction, leading to pale, cool, dry skin due
to unopposed sympathetic activity without descending inhibition.
,Q4
What is the pathologic diagnosis of emphysema (COPD)?
A Permanent enlargement and destruction of airspaces distal to the terminal bronchiole
B Chronic bronchitis with mucous hypersecretion
C Asthma with bronchospasm
D Pulmonary fibrosis
CORRECT ANSWER A. Permanent enlargement and destruction of airspaces distal to the
terminal bronchiole
CLINICAL RATIONALE
Emphysema is characterized by alveolar wall destruction and loss of elastic recoil, leading to air trapping,
hyperinflation, flattened diaphragms on X-ray, and "pink puffers" (thin, severe dyspnea, quiet chest).
Q5
What are common causes of anemia?
A Iron deficiency, vitamin deficiency, chronic diseases, bone marrow diseases, hemolytic anemia,
sickle cell anemia
B Only iron deficiency
C Only vitamin deficiency
D Only chronic diseases
CORRECT ANSWER A. Iron deficiency, vitamin deficiency, chronic diseases, bone marrow
diseases, hemolytic anemia, sickle cell anemia
CLINICAL RATIONALE
Anemia classification by mechanism: decreased production (iron/B12/folate deficiency, bone marrow
failure), increased destruction (hemolytic anemia, sickle cell), or blood loss (chronic bleeding).
, Q6
What is the mechanism of kidney stone formation (renal calculi)?
A Excess of crystal-forming substances that cannot be dissolved in urine (calcium oxalate, uric
acid, struvite, cystine)
B Dehydration only
C High calcium intake only
D Urinary tract infection only
CORRECT ANSWER A. Excess of crystal-forming substances that cannot be dissolved in urine
(calcium oxalate, uric acid, struvite, cystine)
CLINICAL RATIONALE
Contributing factors: low urine volume (dehydration), dietary factors (oxalates, purines), high calcium
excretion, and pH disturbances. Calcium oxalate stones are most common (~80%).
Q7
What are the manifestations of a stone in the ureter?
A Asymptomatic, no obstruction
B High pressure inside ureter, spasms of smooth muscle, distension of walls, renal colic,
nausea/vomiting
C Frequent/painful urination, chronic bladder discomfort
D Hydronephrosis only
CORRECT ANSWER B. High pressure inside ureter, spasms of smooth muscle, distension of
walls, renal colic, nausea/vomiting
CLINICAL RATIONALE
Ureteral stones cause severe, colicky flank pain (renal colic) that radiates to groin. Nausea/vomiting from
sympathetic activation. Treatment: NSAIDs, IV fluids, tamsulosin for medical expulsive therapy.
Pathophysiology Comprehensive Review | Q&A | Grade A | 100%
Correct (Verified Answers)
PATHOPHYSIOLOGY FINAL EXAM | COMPLETE REVIEW
SUBJECT SOURCE
Pathophysiology - Comprehensive Final Exam NR283 VCAS Final Exam Study Guide 2026/2027
Review
Q1
What triggers autonomic dysreflexia in spinal cord injury patients (T-6 or higher)?
A Sustained stimuli at T-6 or below: restrictive clothing, full bladder or UTI, pressure areas, fecal
impaction
B Restrictive clothing only
C Full bladder only
D Fecal impaction only
CORRECT ANSWER A. Sustained stimuli at T-6 or below: restrictive clothing, full bladder or
UTI, pressure areas, fecal impaction
CLINICAL RATIONALE
Autonomic dysreflexia is a medical emergency in SCI patients with lesions at T6 or above. Any noxious
stimulus below the injury level triggers massive sympathetic discharge, causing severe hypertension,
bradycardia, headache, and flushing above the lesion.
,Q2
What are the signs and symptoms of autonomic dysreflexia above the level of injury?
A Higher BP (severe and rapid), flushed face, headache, distended neck veins, lower heart rate,
higher sweating
B Pale, cool, no sweating
C Bradycardia only
D Hypotension
CORRECT ANSWER A. Higher BP (severe and rapid), flushed face, headache, distended neck
veins, lower heart rate, higher sweating
CLINICAL RATIONALE
Above the lesion: vasodilation causes flushing, sweating, headache from hypertension (systolic often
>200 mmHg), and compensatory bradycardia via baroreceptor reflex.
Q3
What are the signs and symptoms of autonomic dysreflexia below the level of injury?
A Flushed face and headache
B Vasoconstriction below: pale, cool, no sweating
C Tachycardia and sweating
D Hypertension and bradycardia
CORRECT ANSWER B. Vasoconstriction below: pale, cool, no sweating
CLINICAL RATIONALE
Below the level of injury, sympathetic outflow causes vasoconstriction, leading to pale, cool, dry skin due
to unopposed sympathetic activity without descending inhibition.
,Q4
What is the pathologic diagnosis of emphysema (COPD)?
A Permanent enlargement and destruction of airspaces distal to the terminal bronchiole
B Chronic bronchitis with mucous hypersecretion
C Asthma with bronchospasm
D Pulmonary fibrosis
CORRECT ANSWER A. Permanent enlargement and destruction of airspaces distal to the
terminal bronchiole
CLINICAL RATIONALE
Emphysema is characterized by alveolar wall destruction and loss of elastic recoil, leading to air trapping,
hyperinflation, flattened diaphragms on X-ray, and "pink puffers" (thin, severe dyspnea, quiet chest).
Q5
What are common causes of anemia?
A Iron deficiency, vitamin deficiency, chronic diseases, bone marrow diseases, hemolytic anemia,
sickle cell anemia
B Only iron deficiency
C Only vitamin deficiency
D Only chronic diseases
CORRECT ANSWER A. Iron deficiency, vitamin deficiency, chronic diseases, bone marrow
diseases, hemolytic anemia, sickle cell anemia
CLINICAL RATIONALE
Anemia classification by mechanism: decreased production (iron/B12/folate deficiency, bone marrow
failure), increased destruction (hemolytic anemia, sickle cell), or blood loss (chronic bleeding).
, Q6
What is the mechanism of kidney stone formation (renal calculi)?
A Excess of crystal-forming substances that cannot be dissolved in urine (calcium oxalate, uric
acid, struvite, cystine)
B Dehydration only
C High calcium intake only
D Urinary tract infection only
CORRECT ANSWER A. Excess of crystal-forming substances that cannot be dissolved in urine
(calcium oxalate, uric acid, struvite, cystine)
CLINICAL RATIONALE
Contributing factors: low urine volume (dehydration), dietary factors (oxalates, purines), high calcium
excretion, and pH disturbances. Calcium oxalate stones are most common (~80%).
Q7
What are the manifestations of a stone in the ureter?
A Asymptomatic, no obstruction
B High pressure inside ureter, spasms of smooth muscle, distension of walls, renal colic,
nausea/vomiting
C Frequent/painful urination, chronic bladder discomfort
D Hydronephrosis only
CORRECT ANSWER B. High pressure inside ureter, spasms of smooth muscle, distension of
walls, renal colic, nausea/vomiting
CLINICAL RATIONALE
Ureteral stones cause severe, colicky flank pain (renal colic) that radiates to groin. Nausea/vomiting from
sympathetic activation. Treatment: NSAIDs, IV fluids, tamsulosin for medical expulsive therapy.
