NURS6501 Advanced Pathophysiology Final Exam
Bundle 2025/2026 - 300 Questions
VERSION 1 – SYSTEMIC INTEGRATION FOCUS
Multi-System Interactions • Advanced Cellular & Molecular Mechanisms • Complex
Disease States
1. Cardio-Renal Syndrome (SATA)
Select mechanisms that simultaneously worsen both cardiac output and GFR in
type 4 CRS. (Choose 3)
☐ A. Renal afferent arteriole vasodilation
☐ B. Sympathetic over-activity
☐ C. RAAS continuous activation
☐ D. ADH-mediated water retention
☐ E. ANP suppression
Answer: B, C, D – Key: Sympathetic & RAAS vasoconstrict glomerular efferent ↑ filtration
fraction but ↓ renal plasma flow; ADH ↑ preload but causes hyponatremia and further
neuro-hormonal activation.
2. Molecular 2026
Which micro-RNA cluster is up-regulated in human hypertrophied myocardium
and promotes fibroblast collagen synthesis via TGF-β1 post-transcriptional
enhancement?
A. miR-21
B. miR-1
C. miR-133
D. miR-208b
Answer: A – Key: 2025 Nature Cardiology multi-omics; anti-miR-21 antisense in Phase-II
trials.
, 3. Calculation – Pressure Gradient
Given LAP 18 mmHg, PAP 70/30 mmHg, PCWP 20 mmHg, calculate diastolic
pressure gradient (DPG) across pulmonary circulation.
DPG = diastolic PAP – PCWP = 30 – 20 = 10 mmHg
Answer: 10 mmHg (precapillary component)
4. Autoimmune Demyelination (SATA)
In MS, which processes are antigen-specific? (Choose 2)
☐ A. Epitope spreading to MOG
☐ B. Bystander microglial activation
☐ C. Molecular mimicry to EBV EBNA-1
☐ D. Nitric-oxide mediated axonal injury
☐ E. Complement-mediated plaque formation
Answer: A, C – Key: Specific T/B-cell epitopes; others are innate/inflammatory.
5. Cancer Cachexia Pathway
Continuous IL-6 secretion by tumor leads to STAT3 activation in liver causing:
A. Up-regulation of albumin synthesis
B. Increased hepcidin → functional iron deficiency
C. Glycogenolysis inhibition
D. LDL-receptor degradation
Answer: B – Key: Hepcidin-ferroportin internalization → hypoferremia & cachexia-related
anemia.
… 70 more V1 items …
VERSION 2 – ORGAN SYSTEM SPECIALIZATION
Cardiovascular • Neurological/Psych • Endocrine/Metabolic
6. Advanced HF Mechanism
In HFrEF with reduced ejection fraction, sarcomere-length-dependent increase in
Ca²⁺ sensitivity is termed:
A. Laplace law
B. Anrep effect
Bundle 2025/2026 - 300 Questions
VERSION 1 – SYSTEMIC INTEGRATION FOCUS
Multi-System Interactions • Advanced Cellular & Molecular Mechanisms • Complex
Disease States
1. Cardio-Renal Syndrome (SATA)
Select mechanisms that simultaneously worsen both cardiac output and GFR in
type 4 CRS. (Choose 3)
☐ A. Renal afferent arteriole vasodilation
☐ B. Sympathetic over-activity
☐ C. RAAS continuous activation
☐ D. ADH-mediated water retention
☐ E. ANP suppression
Answer: B, C, D – Key: Sympathetic & RAAS vasoconstrict glomerular efferent ↑ filtration
fraction but ↓ renal plasma flow; ADH ↑ preload but causes hyponatremia and further
neuro-hormonal activation.
2. Molecular 2026
Which micro-RNA cluster is up-regulated in human hypertrophied myocardium
and promotes fibroblast collagen synthesis via TGF-β1 post-transcriptional
enhancement?
A. miR-21
B. miR-1
C. miR-133
D. miR-208b
Answer: A – Key: 2025 Nature Cardiology multi-omics; anti-miR-21 antisense in Phase-II
trials.
, 3. Calculation – Pressure Gradient
Given LAP 18 mmHg, PAP 70/30 mmHg, PCWP 20 mmHg, calculate diastolic
pressure gradient (DPG) across pulmonary circulation.
DPG = diastolic PAP – PCWP = 30 – 20 = 10 mmHg
Answer: 10 mmHg (precapillary component)
4. Autoimmune Demyelination (SATA)
In MS, which processes are antigen-specific? (Choose 2)
☐ A. Epitope spreading to MOG
☐ B. Bystander microglial activation
☐ C. Molecular mimicry to EBV EBNA-1
☐ D. Nitric-oxide mediated axonal injury
☐ E. Complement-mediated plaque formation
Answer: A, C – Key: Specific T/B-cell epitopes; others are innate/inflammatory.
5. Cancer Cachexia Pathway
Continuous IL-6 secretion by tumor leads to STAT3 activation in liver causing:
A. Up-regulation of albumin synthesis
B. Increased hepcidin → functional iron deficiency
C. Glycogenolysis inhibition
D. LDL-receptor degradation
Answer: B – Key: Hepcidin-ferroportin internalization → hypoferremia & cachexia-related
anemia.
… 70 more V1 items …
VERSION 2 – ORGAN SYSTEM SPECIALIZATION
Cardiovascular • Neurological/Psych • Endocrine/Metabolic
6. Advanced HF Mechanism
In HFrEF with reduced ejection fraction, sarcomere-length-dependent increase in
Ca²⁺ sensitivity is termed:
A. Laplace law
B. Anrep effect
