NUR 3125 Pathophysiology
Across the Lifespan |
2025/2026 Verified 100%
Correct Questions & Answers
Section 1: Cardiovascular Pathophysiology (Questions
1–30)
1. In a 6-month-old infant, tetralogy of Fallot presents with cyanosis due to: A.
Left ventricular hypertrophy B. Right-to-left shunting through VSD C. Aortic
coarctation D. Patent ductus arteriosus
Rationale: Tetralogy of Fallot in pediatrics involves VSD, pulmonary stenosis,
overriding aorta, and RVH, causing right-to-left shunting and cyanosis exacerbated
by "tet spells" (Kumar 2025); surgical repair by 6–12 months prevents hypoxia-
related complications.
2. An 80-year-old adult with aortic stenosis develops syncope during exertion.
The primary pathophysiological mechanism is: A. Increased preload B. Fixed
cardiac output unable to meet demand C. Hyperdynamic circulation D. Reduced
afterload
Rationale: Aortic stenosis in geriatrics restricts LV outflow, leading to fixed
stroke volume and exertional syncope from cerebral hypoperfusion (Robbins
2025); calcification of valve common, requiring TAVR in high-risk elderly.
3. A 25-year-old pregnant woman at 28 weeks develops peripartum
cardiomyopathy. The pathophysiology involves: A. Coronary artery spasm B.
Myocardial inflammation and dilation C. Valvular incompetence D. Endocardial
fibrosis
Rationale: Peripartum cardiomyopathy (PPCM) in young adults is an idiopathic
dilated cardiomyopathy with inflammation and eccentric hypertrophy, peaking in
third trimester/postpartum (Kumar 2025); EF <45%, treat with ACEI post-delivery.
,4. A 12-year-old child with Kawasaki disease is at risk for: A. Mitral valve
prolapse B. Coronary artery aneurysms C. Atrial septal defect D. Pulmonary
hypertension
Rationale: Kawasaki disease in pediatrics causes immune-mediated vasculitis,
with 25% risk of coronary aneurysms if untreated (Robbins 2025); IVIG within 10
days prevents, with echo follow-up.
5. A 65-year-old with chronic hypertension develops left ventricular
hypertrophy. The cellular mechanism is: A. Decreased myofilament sensitivity
to Ca2+ B. Increased sarcomere addition in parallel C. Reduced actin-myosin
cross-bridges D. Mitochondrial dysfunction only
Rationale: Hypertrophy in adult HTN involves parallel sarcomere addition,
increasing wall thickness to normalize wall stress (Kumar 2025); leads to diastolic
dysfunction, risk for HFpEF.
6. An infant with congenital heart block due to maternal lupus has: A.
Tachycardia B. Complete AV dissociation C. Ventricular tachycardia D.
Supraventricular tachycardia
Rationale: Neonatal lupus causes congenital AV block via anti-Ro/La antibodies
(Robbins 2025); permanent pacemaker often needed, as HR <50 bpm risks
bradycardia.
7. A 75-year-old with amyloidosis develops restrictive cardiomyopathy.
Pathophysiology: A. Dilated chambers B. Infiltrative myocardial stiffening C.
Hypertrophic walls D. Valvular calcification
Rationale: Amyloid deposition in geriatric cardiomyopathy impairs diastolic
filling (Kumar 2025); low voltage ECG, echo for speckled pattern.
8. A 10-year-old with rheumatic fever develops carditis. The mechanism is: A.
Direct viral invasion B. Molecular mimicry with streptococcal antigens C.
Autoimmune vasculitis D. Ischemic necrosis
Rationale: Group A strep triggers cross-reactive antibodies against myocardium
(Robbins 2025); prophylaxis with penicillin to prevent recurrence.
,9. A 30-year-old with peripartum cardiomyopathy has EF 20%. Cellular
change: A. Concentric hypertrophy B. Eccentric hypertrophy with myocyte
slippage C. Fibrotic replacement D. Apoptotic loss only
Rationale: PPCM causes eccentric dilation from myocyte slippage and apoptosis
(Kumar 2025); bromocriptine trial in Europe, ACEI/BB in US.
10. A 60-year-old with HTN and DM develops diabetic cardiomyopathy. Key
pathophys: A. Coronary atherosclerosis only B. Microangiopathy and fibrosis C.
Valvular degeneration D. Arrhythmogenic right ventricular
Rationale: Hyperglycemia induces fibrosis and microvascular rarefaction
(Robbins 2025); early diastolic dysfunction, SGLT2i protective.
11. A newborn with hypoplastic left heart syndrome has: A. Right ventricular
outflow obstruction B. Underdeveloped left ventricle and ascending aorta C.
Complete AV canal defect D. Transposition of great arteries
Rationale: HLHS in neonates causes systemic hypoperfusion (Kumar 2025);
Norwood procedure stage 1.
12. A 85-year-old with calcific aortic stenosis has: A. Bicuspid valve B.
Degenerative calcification C. Rheumatic scarring D. Infective endocarditis
Rationale: Age-related dystrophic calcification stiffens leaflets (Robbins 2025);
TAVR for high-risk elderly.
13. A 28-year-old postpartum with cardiomyopathy has: A. Constrictive
physiology B. Dilated, inflammatory C. Restrictive amyloid D. Hypertrophic
Rationale: PPCM is dilated with inflammation (Kumar 2025); 50% recover EF
>50% with bromocriptine.
14. A 8-year-old with viral myocarditis develops: A. Conduction block B.
Ventricular dilation and dysfunction C. Pericardial effusion D. Coronary dilation
Rationale: Enterovirus causes myocyte necrosis (Robbins 2025); supportive care,
ECMO if EF <30%.
, 15. A 50-year-old with chronic HTN has concentric LVH. Mechanism: A.
Eccentric dilation B. Sarcomere addition in parallel C. Myocyte loss D. Fibrosis
only
Rationale: Pressure overload adds sarcomeres in parallel (Tortora 2025); diastolic
stiffening.
16. A newborn with maternal lupus has: A. VSD B. Congenital AV block C.
PDA D. Coarctation
Rationale: Anti-Ro/La transplacental (Kumar 2025); pacemaker 90%.
17. A 80-year-old with senile amyloidosis has: A. AL type B. Wild-type ATTR
C. AA type D. Familial
Rationale: ATTRwt infiltrates myocardium (Robbins 2025); tafamidis treatment.
18. A 12-year-old with rheumatic carditis has: A. Mitral stenosis acute B. Mitral
regurgitation C. Aortic dilation D. Tricuspid stenosis
Rationale: Strep mimicry (Kumar 2025); penicillin prophylaxis.
19. A 35-year-old with peripartum cardiomyopathy has: A. Concentric B.
Eccentric hypertrophy C. Restrictive D. Hypertrophic
Rationale: Inflammatory dilation (Robbins 2025); EF recovery 50%.
20. A 65-year-old with diabetic cardiomyopathy has: A. Ischemia only B.
Microvascular fibrosis C. Valvular D. Arrhythmogenic
Rationale: Hyperglycemia fibrosis (Kumar 2025); diastolic first.
21. A newborn with coarctation of aorta has: A. Preductal hypertension B.
Lower body hypoperfusion C. PDA closure late D. VSD always
Rationale: Postductal coarct (Robbins 2025); surgery.
22. A 90-year-old with aortic sclerosis has: A. Regurgitation B. Asymptomatic
thickening C. Stenosis severe D. Bicuspid
Rationale: Age-related (Kumar 2025); monitor, no intervention if no gradient.
Across the Lifespan |
2025/2026 Verified 100%
Correct Questions & Answers
Section 1: Cardiovascular Pathophysiology (Questions
1–30)
1. In a 6-month-old infant, tetralogy of Fallot presents with cyanosis due to: A.
Left ventricular hypertrophy B. Right-to-left shunting through VSD C. Aortic
coarctation D. Patent ductus arteriosus
Rationale: Tetralogy of Fallot in pediatrics involves VSD, pulmonary stenosis,
overriding aorta, and RVH, causing right-to-left shunting and cyanosis exacerbated
by "tet spells" (Kumar 2025); surgical repair by 6–12 months prevents hypoxia-
related complications.
2. An 80-year-old adult with aortic stenosis develops syncope during exertion.
The primary pathophysiological mechanism is: A. Increased preload B. Fixed
cardiac output unable to meet demand C. Hyperdynamic circulation D. Reduced
afterload
Rationale: Aortic stenosis in geriatrics restricts LV outflow, leading to fixed
stroke volume and exertional syncope from cerebral hypoperfusion (Robbins
2025); calcification of valve common, requiring TAVR in high-risk elderly.
3. A 25-year-old pregnant woman at 28 weeks develops peripartum
cardiomyopathy. The pathophysiology involves: A. Coronary artery spasm B.
Myocardial inflammation and dilation C. Valvular incompetence D. Endocardial
fibrosis
Rationale: Peripartum cardiomyopathy (PPCM) in young adults is an idiopathic
dilated cardiomyopathy with inflammation and eccentric hypertrophy, peaking in
third trimester/postpartum (Kumar 2025); EF <45%, treat with ACEI post-delivery.
,4. A 12-year-old child with Kawasaki disease is at risk for: A. Mitral valve
prolapse B. Coronary artery aneurysms C. Atrial septal defect D. Pulmonary
hypertension
Rationale: Kawasaki disease in pediatrics causes immune-mediated vasculitis,
with 25% risk of coronary aneurysms if untreated (Robbins 2025); IVIG within 10
days prevents, with echo follow-up.
5. A 65-year-old with chronic hypertension develops left ventricular
hypertrophy. The cellular mechanism is: A. Decreased myofilament sensitivity
to Ca2+ B. Increased sarcomere addition in parallel C. Reduced actin-myosin
cross-bridges D. Mitochondrial dysfunction only
Rationale: Hypertrophy in adult HTN involves parallel sarcomere addition,
increasing wall thickness to normalize wall stress (Kumar 2025); leads to diastolic
dysfunction, risk for HFpEF.
6. An infant with congenital heart block due to maternal lupus has: A.
Tachycardia B. Complete AV dissociation C. Ventricular tachycardia D.
Supraventricular tachycardia
Rationale: Neonatal lupus causes congenital AV block via anti-Ro/La antibodies
(Robbins 2025); permanent pacemaker often needed, as HR <50 bpm risks
bradycardia.
7. A 75-year-old with amyloidosis develops restrictive cardiomyopathy.
Pathophysiology: A. Dilated chambers B. Infiltrative myocardial stiffening C.
Hypertrophic walls D. Valvular calcification
Rationale: Amyloid deposition in geriatric cardiomyopathy impairs diastolic
filling (Kumar 2025); low voltage ECG, echo for speckled pattern.
8. A 10-year-old with rheumatic fever develops carditis. The mechanism is: A.
Direct viral invasion B. Molecular mimicry with streptococcal antigens C.
Autoimmune vasculitis D. Ischemic necrosis
Rationale: Group A strep triggers cross-reactive antibodies against myocardium
(Robbins 2025); prophylaxis with penicillin to prevent recurrence.
,9. A 30-year-old with peripartum cardiomyopathy has EF 20%. Cellular
change: A. Concentric hypertrophy B. Eccentric hypertrophy with myocyte
slippage C. Fibrotic replacement D. Apoptotic loss only
Rationale: PPCM causes eccentric dilation from myocyte slippage and apoptosis
(Kumar 2025); bromocriptine trial in Europe, ACEI/BB in US.
10. A 60-year-old with HTN and DM develops diabetic cardiomyopathy. Key
pathophys: A. Coronary atherosclerosis only B. Microangiopathy and fibrosis C.
Valvular degeneration D. Arrhythmogenic right ventricular
Rationale: Hyperglycemia induces fibrosis and microvascular rarefaction
(Robbins 2025); early diastolic dysfunction, SGLT2i protective.
11. A newborn with hypoplastic left heart syndrome has: A. Right ventricular
outflow obstruction B. Underdeveloped left ventricle and ascending aorta C.
Complete AV canal defect D. Transposition of great arteries
Rationale: HLHS in neonates causes systemic hypoperfusion (Kumar 2025);
Norwood procedure stage 1.
12. A 85-year-old with calcific aortic stenosis has: A. Bicuspid valve B.
Degenerative calcification C. Rheumatic scarring D. Infective endocarditis
Rationale: Age-related dystrophic calcification stiffens leaflets (Robbins 2025);
TAVR for high-risk elderly.
13. A 28-year-old postpartum with cardiomyopathy has: A. Constrictive
physiology B. Dilated, inflammatory C. Restrictive amyloid D. Hypertrophic
Rationale: PPCM is dilated with inflammation (Kumar 2025); 50% recover EF
>50% with bromocriptine.
14. A 8-year-old with viral myocarditis develops: A. Conduction block B.
Ventricular dilation and dysfunction C. Pericardial effusion D. Coronary dilation
Rationale: Enterovirus causes myocyte necrosis (Robbins 2025); supportive care,
ECMO if EF <30%.
, 15. A 50-year-old with chronic HTN has concentric LVH. Mechanism: A.
Eccentric dilation B. Sarcomere addition in parallel C. Myocyte loss D. Fibrosis
only
Rationale: Pressure overload adds sarcomeres in parallel (Tortora 2025); diastolic
stiffening.
16. A newborn with maternal lupus has: A. VSD B. Congenital AV block C.
PDA D. Coarctation
Rationale: Anti-Ro/La transplacental (Kumar 2025); pacemaker 90%.
17. A 80-year-old with senile amyloidosis has: A. AL type B. Wild-type ATTR
C. AA type D. Familial
Rationale: ATTRwt infiltrates myocardium (Robbins 2025); tafamidis treatment.
18. A 12-year-old with rheumatic carditis has: A. Mitral stenosis acute B. Mitral
regurgitation C. Aortic dilation D. Tricuspid stenosis
Rationale: Strep mimicry (Kumar 2025); penicillin prophylaxis.
19. A 35-year-old with peripartum cardiomyopathy has: A. Concentric B.
Eccentric hypertrophy C. Restrictive D. Hypertrophic
Rationale: Inflammatory dilation (Robbins 2025); EF recovery 50%.
20. A 65-year-old with diabetic cardiomyopathy has: A. Ischemia only B.
Microvascular fibrosis C. Valvular D. Arrhythmogenic
Rationale: Hyperglycemia fibrosis (Kumar 2025); diastolic first.
21. A newborn with coarctation of aorta has: A. Preductal hypertension B.
Lower body hypoperfusion C. PDA closure late D. VSD always
Rationale: Postductal coarct (Robbins 2025); surgery.
22. A 90-year-old with aortic sclerosis has: A. Regurgitation B. Asymptomatic
thickening C. Stenosis severe D. Bicuspid
Rationale: Age-related (Kumar 2025); monitor, no intervention if no gradient.
