ADVANCED PATHOPHYSIOLOGY EXAM 4
2026 COMPREHENSIVE REVIEW
QUESTIONS AND SOLUTIONS MASTER
STUDY GUIDE
◉ Lambert-Eaton - Clinical Manifestations
Answer: *Strong link to lung cancer
*Muscle weakness that IMPROVES with repetitive stimulation
*Do not respond to cholinesterase inhibitors
◉ Spinal cord trauma - patho
Answer: *Microscopic hemorrhages in central grey matter
*Axonal edema in white matter --> ischemia --> injury and
degeneration
*Release inflammatory mediators -->necrosis and scar tissue
formation
,*Injury is maximal at injury site and two cord segments above and
below it
◉ Spinal cord trauma - Clinical manifestations
Answer: *Spinal shock (normal activity of the spinal cord stops at
and below level of injury. Loss of spinal reflexes.)
*Paraplegia, quadriplegia
*Autonomic dysreflexia
◉ Brown-Sequard Syndrome
Answer: Occurs when there is trauma or lesion that affects one half
of the spinal cord. Typically occurs in the cervical region.
◉ Brown-Sequard Syndrome - Clinical Manifestations
Answer: *Loss of proprioception on the SAME side as the lesion
*Loss of voluntary motor function from the corticospinal tract on the
SAME side as the lesion
*Loss of pain and temperature on the OPPOSITE side of the lesion
,◉ Syringomyelia
Answer: The presence of a cavity in the spinal cord. Usually caused
by a tumor, cyst, or trauma.
◉ Syringomyelia -Clinical Manifestations
Answer: Loss of pain and temperature sensation on both sides at the
level of the lesion (Due to the crossing of the lateral spinothalamic
tract)
◉ Stroke - Types
Answer: *Ischemic (embolic, thrombolic)
*Hemorrhagic
◉ Atherosclerosis
Answer: Most common cause of thrombotic stroke
◉ Internal carotid, middle cerebral, posterior cerebral, and basilar
artery
Answer: Common sites of thrombotic stroke
◉ Lacunar stroke
, Answer: Microinfarcts that involve small cerebral arteries that
penetrate the brainstem and thalamus. May be clinically silent or
produce motor and/or sensory deficits
◉ Embolic stroke
Answer: Emboli traveling through the heart, aorta, and carotic
arteries occlude the middle cerebral artery.
Emboli traveling the vertebral and basilar arteries occlude the apex
of the basilar artery
◉ Ischemic stroke - pathogenesis
Answer: *Nerve cells within the ischemic focus are damaged and
killed by energy deprivation
*Neurons die at the edge of the ischemic region due to excessive
stimulation of glutamate receptors (neuronal excitotoxicity)
◉ Neuronal excitotoxicity
Answer: *Depletion of ATP -->inhibits NA+K+ ATPase -->loss of
normal ion gradient --> increased extracellular glutamate levels
*Increased glutamate levels--> increased stimulation on
postsynaptic cells --> influx of Ca+ into neuronal cells --> cell death
2026 COMPREHENSIVE REVIEW
QUESTIONS AND SOLUTIONS MASTER
STUDY GUIDE
◉ Lambert-Eaton - Clinical Manifestations
Answer: *Strong link to lung cancer
*Muscle weakness that IMPROVES with repetitive stimulation
*Do not respond to cholinesterase inhibitors
◉ Spinal cord trauma - patho
Answer: *Microscopic hemorrhages in central grey matter
*Axonal edema in white matter --> ischemia --> injury and
degeneration
*Release inflammatory mediators -->necrosis and scar tissue
formation
,*Injury is maximal at injury site and two cord segments above and
below it
◉ Spinal cord trauma - Clinical manifestations
Answer: *Spinal shock (normal activity of the spinal cord stops at
and below level of injury. Loss of spinal reflexes.)
*Paraplegia, quadriplegia
*Autonomic dysreflexia
◉ Brown-Sequard Syndrome
Answer: Occurs when there is trauma or lesion that affects one half
of the spinal cord. Typically occurs in the cervical region.
◉ Brown-Sequard Syndrome - Clinical Manifestations
Answer: *Loss of proprioception on the SAME side as the lesion
*Loss of voluntary motor function from the corticospinal tract on the
SAME side as the lesion
*Loss of pain and temperature on the OPPOSITE side of the lesion
,◉ Syringomyelia
Answer: The presence of a cavity in the spinal cord. Usually caused
by a tumor, cyst, or trauma.
◉ Syringomyelia -Clinical Manifestations
Answer: Loss of pain and temperature sensation on both sides at the
level of the lesion (Due to the crossing of the lateral spinothalamic
tract)
◉ Stroke - Types
Answer: *Ischemic (embolic, thrombolic)
*Hemorrhagic
◉ Atherosclerosis
Answer: Most common cause of thrombotic stroke
◉ Internal carotid, middle cerebral, posterior cerebral, and basilar
artery
Answer: Common sites of thrombotic stroke
◉ Lacunar stroke
, Answer: Microinfarcts that involve small cerebral arteries that
penetrate the brainstem and thalamus. May be clinically silent or
produce motor and/or sensory deficits
◉ Embolic stroke
Answer: Emboli traveling through the heart, aorta, and carotic
arteries occlude the middle cerebral artery.
Emboli traveling the vertebral and basilar arteries occlude the apex
of the basilar artery
◉ Ischemic stroke - pathogenesis
Answer: *Nerve cells within the ischemic focus are damaged and
killed by energy deprivation
*Neurons die at the edge of the ischemic region due to excessive
stimulation of glutamate receptors (neuronal excitotoxicity)
◉ Neuronal excitotoxicity
Answer: *Depletion of ATP -->inhibits NA+K+ ATPase -->loss of
normal ion gradient --> increased extracellular glutamate levels
*Increased glutamate levels--> increased stimulation on
postsynaptic cells --> influx of Ca+ into neuronal cells --> cell death
