NUR 631/NUR631 Exam 3 V1 | Advanced
Physiology and Pathophysiology Q&A with
Rationale | Grand Canyon University
1. A patient presents with macrocytic-normochromic anemia. Which deficiency is most likely
responsible for this finding?
A. Iron deficiency
B. Vitamin C deficiency
C. Vitamin B12 or folate deficiency
D. Chronic blood loss
Correct Answer: C
Expert Explanation: Macrocytic-normochromic anemias are characterized by large red
blood cells and are typically caused by impaired DNA synthesis. The most common causes
are Vitamin B12 deficiency (pernicious anemia) and folate deficiency. Without these
nutrients, the red blood cells cannot divide correctly during maturation in the bone
marrow.
2. In Pernicious Anemia, what is the underlying pathophysiology regarding the stomach?
A. Overproduction of hydrochloric acid
B. Destruction of gastric parietal cells
C. Hypertrophy of the gastric mucosa
,D. Increased secretion of gastrin
Correct Answer: B
Expert Explanation: Pernicious anemia is an autoimmune condition where the body
attacks gastric parietal cells. These cells are responsible for secreting intrinsic factor, which
is essential for B12 absorption in the ileum. Without intrinsic factor, a B12 deficiency
develops, leading to neurological symptoms and anemia.
3. Which laboratory value is the most sensitive indicator for diagnosing iron deficiency
anemia?
A. Serum Ferritin
B. Hematocrit
C. Hemoglobin
D. Mean Corpuscular Volume (MCV)
Correct Answer: A
Expert Explanation: Serum ferritin levels reflect the body’s total iron stores and are the
most sensitive indicator for iron deficiency. Low ferritin levels occur early in the depletion
phase before hemoglobin levels begin to drop. This measurement helps clinicians
distinguish iron deficiency from other types of anemia.
4. A 25-year-old male is diagnosed with Polycythemia Vera. Which mutation is most
commonly associated with this condition?
A. JAK2 mutation
, B. Philadelphia chromosome
C. BRCA1 mutation
D. Factor V Leiden
Correct Answer: A
Expert Explanation: Polycythemia Vera is a myeloproliferative disorder characterized by
the overproduction of red blood cells. Over 95 percent of patients with this condition carry
the JAK2 V617F mutation. This mutation leads to erythropoietin-independent activation of
the JAK-STAT pathway, driving uncontrolled cell production.
5. What is the primary physiological consequence of a Sickle Cell crisis?
A. Excessive bleeding from the mucosa
B. Increased oxygen carrying capacity
C. Iron overload in the liver
D. Vaso-occlusion and tissue ischemia
Correct Answer: D
Expert Explanation: Sickle cell crisis occurs when deoxygenated Hemoglobin S causes red
blood cells to take on a rigid, sickle shape. These misshapen cells become trapped in small
capillaries, obstructing blood flow to tissues. This vaso-occlusion leads to severe pain,
tissue hypoxia, and potential organ infarction.
Physiology and Pathophysiology Q&A with
Rationale | Grand Canyon University
1. A patient presents with macrocytic-normochromic anemia. Which deficiency is most likely
responsible for this finding?
A. Iron deficiency
B. Vitamin C deficiency
C. Vitamin B12 or folate deficiency
D. Chronic blood loss
Correct Answer: C
Expert Explanation: Macrocytic-normochromic anemias are characterized by large red
blood cells and are typically caused by impaired DNA synthesis. The most common causes
are Vitamin B12 deficiency (pernicious anemia) and folate deficiency. Without these
nutrients, the red blood cells cannot divide correctly during maturation in the bone
marrow.
2. In Pernicious Anemia, what is the underlying pathophysiology regarding the stomach?
A. Overproduction of hydrochloric acid
B. Destruction of gastric parietal cells
C. Hypertrophy of the gastric mucosa
,D. Increased secretion of gastrin
Correct Answer: B
Expert Explanation: Pernicious anemia is an autoimmune condition where the body
attacks gastric parietal cells. These cells are responsible for secreting intrinsic factor, which
is essential for B12 absorption in the ileum. Without intrinsic factor, a B12 deficiency
develops, leading to neurological symptoms and anemia.
3. Which laboratory value is the most sensitive indicator for diagnosing iron deficiency
anemia?
A. Serum Ferritin
B. Hematocrit
C. Hemoglobin
D. Mean Corpuscular Volume (MCV)
Correct Answer: A
Expert Explanation: Serum ferritin levels reflect the body’s total iron stores and are the
most sensitive indicator for iron deficiency. Low ferritin levels occur early in the depletion
phase before hemoglobin levels begin to drop. This measurement helps clinicians
distinguish iron deficiency from other types of anemia.
4. A 25-year-old male is diagnosed with Polycythemia Vera. Which mutation is most
commonly associated with this condition?
A. JAK2 mutation
, B. Philadelphia chromosome
C. BRCA1 mutation
D. Factor V Leiden
Correct Answer: A
Expert Explanation: Polycythemia Vera is a myeloproliferative disorder characterized by
the overproduction of red blood cells. Over 95 percent of patients with this condition carry
the JAK2 V617F mutation. This mutation leads to erythropoietin-independent activation of
the JAK-STAT pathway, driving uncontrolled cell production.
5. What is the primary physiological consequence of a Sickle Cell crisis?
A. Excessive bleeding from the mucosa
B. Increased oxygen carrying capacity
C. Iron overload in the liver
D. Vaso-occlusion and tissue ischemia
Correct Answer: D
Expert Explanation: Sickle cell crisis occurs when deoxygenated Hemoglobin S causes red
blood cells to take on a rigid, sickle shape. These misshapen cells become trapped in small
capillaries, obstructing blood flow to tissues. This vaso-occlusion leads to severe pain,
tissue hypoxia, and potential organ infarction.
