NR 507 ADVANCED PATHOPHYSIOLOGY –
MIDTERM EXAM PREP
NEWEST 2025/2026 ACTUAL EXAM
COMPLETE QUESTIONS & CORRECT
DETAILED ANSWERS (VERIFIED) WITH
RATIONALES | ALREADY GRADED A+ |
BRAND NEW VERSION!
Question 1
A 22-year-old develops wheezing, hypotension, and urticaria immediately after eating
peanuts. Which mechanism is responsible for this reaction?
a) IgG-mediated cytotoxicity
b) Immune complex deposition
c) IgE-mediated mast cell degranulation
d) T-cell mediated inflammation
Answer: c) IgE-mediated mast cell degranulation
Rationale: This is a Type I hypersensitivity reaction (anaphylaxis). IgE antibodies bind to mast
cells → degranulation → release of histamine, leukotrienes, prostaglandins →
bronchoconstriction, vasodilation, hypotension.
Question 2
A patient develops hemolysis after receiving the wrong blood type transfusion. What type of
hypersensitivity is this?
a) Type I
b) Type II
c) Type III
d) Type IV
Answer: b) Type II
Rationale: Type II hypersensitivity is cytotoxic and tissue-specific. IgG/IgM antibodies bind to
RBCs → complement activation → cell lysis → hemolytic transfusion reaction.
Question 3
,A patient with systemic lupus erythematosus presents with kidney damage due to immune
complex deposition. What type of hypersensitivity is this?
a) Type II
b) Type I
c) Type IV
d) Type III
Answer: d) Type III
Rationale: Type III reactions involve antigen-antibody complexes circulating and depositing in
tissues (kidneys, joints), leading to inflammation and organ damage.
Question 4
A nurse notes a rash localized only to the area where a patient touched poison ivy 3 days
ago. What type of reaction is this?
a) Type I
b) Type II
c) Type III
d) Type IV
Answer: d) Type IV
Rationale: Type IV hypersensitivity is delayed and T-cell mediated. Contact dermatitis appears
days after exposure and remains localized.
Question 5
Which treatment is most appropriate for a life-threatening Type I hypersensitivity reaction?
a) Antihistamines
b) Corticosteroids
c) Epinephrine
d) Antibiotics
Answer: c) Epinephrine
Rationale: Epinephrine reverses bronchoconstriction and hypotension in anaphylaxis.
Antihistamines are supportive but not first-line in emergencies.
Question 6
A patient with Graves' disease has antibodies stimulating thyroid receptors. What type of
hypersensitivity is this?
a) Type III
b) Type II
c) Type IV
d) Type I
Answer: b) Type II
,Rationale: Type II can alter function (not just destroy tissue). In Graves', antibodies stimulate
TSH receptors → hyperthyroidism.
Question 7
A patient presents with a malar rash, photosensitivity, and positive ANA. Which condition is
most likely?
a) Rheumatoid arthritis
b) Multiple sclerosis
c) Systemic lupus erythematosus
d) Sjogren's syndrome
Answer: c) Systemic lupus erythematosus
Rationale: Classic SLE findings include malar rash, photosensitivity, ANA positivity, and multi-
organ involvement due to immune complex deposition.
Question 8
A patient with contact dermatitis asks why antihistamines are not effective. What is the best
explanation?
a) No mast cells are involved
b) It is antibody mediated
c) It involves complement activation
d) It is caused by infection
Answer: a) No mast cells are involved
Rationale: Type IV reactions are T-cell mediated, not histamine-driven → antihistamines are
ineffective.
Question 9
A child is diagnosed with a genetic immune disorder affecting B cells. This is classified as:
a) Secondary immunodeficiency
b) Primary immunodeficiency
c) Autoimmune disorder
d) Alloimmunity
Answer: b) Primary immunodeficiency
Rationale: Primary immunodeficiencies are genetic defects affecting immune components like
B or T cells.
Question 10
A patient with HIV develops Pneumocystis pneumonia. This is an example of:
a) Primary immunodeficiency
b) Autoimmune disorder
c) Secondary immunodeficiency
d) Hypersensitivity
, Answer: c) Secondary immunodeficiency
Rationale: HIV causes acquired (secondary) immunodeficiency by destroying CD4+ T cells →
opportunistic infections like PCP.
Question 11
What cellular adaptation is characterized by an increase in cell size?
a) Hyperplasia
b) Atrophy
c) Hypertrophy
d) Metaplasia
Answer: c) Hypertrophy
Rationale: Hypertrophy = increase in cell SIZE (e.g., cardiac muscle in hypertension).
Hyperplasia = increase in cell NUMBER.
Question 12
Which process describes the replacement of one differentiated cell type by another?
a) Dysplasia
b) Anaplasia
c) Metaplasia
d) Hyperplasia
Answer: c) Metaplasia
Rationale: Metaplasia is reversible replacement (e.g., columnar to squamous epithelium in
smokers). Dysplasia = disordered growth; Anaplasia = loss of differentiation (cancer).
Question 13
A patient has ischemia leading to cellular injury. Which change occurs FIRST due to ATP
depletion?
a) DNA degradation
b) Failure of Na+/K+ pump
c) Ribosome detachment
d) Protein denaturation
Answer: b) Failure of Na+/K+ pump
Rationale: Ischemia → ↓ATP → Na+/K+-ATPase fails → sodium/water influx → cellular
swelling (hydropic change).
Question 14
Apoptosis differs from necrosis in which key way?
a) Apoptosis causes inflammation; necrosis does not
MIDTERM EXAM PREP
NEWEST 2025/2026 ACTUAL EXAM
COMPLETE QUESTIONS & CORRECT
DETAILED ANSWERS (VERIFIED) WITH
RATIONALES | ALREADY GRADED A+ |
BRAND NEW VERSION!
Question 1
A 22-year-old develops wheezing, hypotension, and urticaria immediately after eating
peanuts. Which mechanism is responsible for this reaction?
a) IgG-mediated cytotoxicity
b) Immune complex deposition
c) IgE-mediated mast cell degranulation
d) T-cell mediated inflammation
Answer: c) IgE-mediated mast cell degranulation
Rationale: This is a Type I hypersensitivity reaction (anaphylaxis). IgE antibodies bind to mast
cells → degranulation → release of histamine, leukotrienes, prostaglandins →
bronchoconstriction, vasodilation, hypotension.
Question 2
A patient develops hemolysis after receiving the wrong blood type transfusion. What type of
hypersensitivity is this?
a) Type I
b) Type II
c) Type III
d) Type IV
Answer: b) Type II
Rationale: Type II hypersensitivity is cytotoxic and tissue-specific. IgG/IgM antibodies bind to
RBCs → complement activation → cell lysis → hemolytic transfusion reaction.
Question 3
,A patient with systemic lupus erythematosus presents with kidney damage due to immune
complex deposition. What type of hypersensitivity is this?
a) Type II
b) Type I
c) Type IV
d) Type III
Answer: d) Type III
Rationale: Type III reactions involve antigen-antibody complexes circulating and depositing in
tissues (kidneys, joints), leading to inflammation and organ damage.
Question 4
A nurse notes a rash localized only to the area where a patient touched poison ivy 3 days
ago. What type of reaction is this?
a) Type I
b) Type II
c) Type III
d) Type IV
Answer: d) Type IV
Rationale: Type IV hypersensitivity is delayed and T-cell mediated. Contact dermatitis appears
days after exposure and remains localized.
Question 5
Which treatment is most appropriate for a life-threatening Type I hypersensitivity reaction?
a) Antihistamines
b) Corticosteroids
c) Epinephrine
d) Antibiotics
Answer: c) Epinephrine
Rationale: Epinephrine reverses bronchoconstriction and hypotension in anaphylaxis.
Antihistamines are supportive but not first-line in emergencies.
Question 6
A patient with Graves' disease has antibodies stimulating thyroid receptors. What type of
hypersensitivity is this?
a) Type III
b) Type II
c) Type IV
d) Type I
Answer: b) Type II
,Rationale: Type II can alter function (not just destroy tissue). In Graves', antibodies stimulate
TSH receptors → hyperthyroidism.
Question 7
A patient presents with a malar rash, photosensitivity, and positive ANA. Which condition is
most likely?
a) Rheumatoid arthritis
b) Multiple sclerosis
c) Systemic lupus erythematosus
d) Sjogren's syndrome
Answer: c) Systemic lupus erythematosus
Rationale: Classic SLE findings include malar rash, photosensitivity, ANA positivity, and multi-
organ involvement due to immune complex deposition.
Question 8
A patient with contact dermatitis asks why antihistamines are not effective. What is the best
explanation?
a) No mast cells are involved
b) It is antibody mediated
c) It involves complement activation
d) It is caused by infection
Answer: a) No mast cells are involved
Rationale: Type IV reactions are T-cell mediated, not histamine-driven → antihistamines are
ineffective.
Question 9
A child is diagnosed with a genetic immune disorder affecting B cells. This is classified as:
a) Secondary immunodeficiency
b) Primary immunodeficiency
c) Autoimmune disorder
d) Alloimmunity
Answer: b) Primary immunodeficiency
Rationale: Primary immunodeficiencies are genetic defects affecting immune components like
B or T cells.
Question 10
A patient with HIV develops Pneumocystis pneumonia. This is an example of:
a) Primary immunodeficiency
b) Autoimmune disorder
c) Secondary immunodeficiency
d) Hypersensitivity
, Answer: c) Secondary immunodeficiency
Rationale: HIV causes acquired (secondary) immunodeficiency by destroying CD4+ T cells →
opportunistic infections like PCP.
Question 11
What cellular adaptation is characterized by an increase in cell size?
a) Hyperplasia
b) Atrophy
c) Hypertrophy
d) Metaplasia
Answer: c) Hypertrophy
Rationale: Hypertrophy = increase in cell SIZE (e.g., cardiac muscle in hypertension).
Hyperplasia = increase in cell NUMBER.
Question 12
Which process describes the replacement of one differentiated cell type by another?
a) Dysplasia
b) Anaplasia
c) Metaplasia
d) Hyperplasia
Answer: c) Metaplasia
Rationale: Metaplasia is reversible replacement (e.g., columnar to squamous epithelium in
smokers). Dysplasia = disordered growth; Anaplasia = loss of differentiation (cancer).
Question 13
A patient has ischemia leading to cellular injury. Which change occurs FIRST due to ATP
depletion?
a) DNA degradation
b) Failure of Na+/K+ pump
c) Ribosome detachment
d) Protein denaturation
Answer: b) Failure of Na+/K+ pump
Rationale: Ischemia → ↓ATP → Na+/K+-ATPase fails → sodium/water influx → cellular
swelling (hydropic change).
Question 14
Apoptosis differs from necrosis in which key way?
a) Apoptosis causes inflammation; necrosis does not
