NR507 Advanced Pathophysiology – Final Exam
Week 8 Questions and Rationalized Answers
(Verified) – Guarantee passing score Questions
for 2025/2026
1. A 45-year-old woman presents with fatigue, weight gain, and cold
intolerance. Lab results show TSH 25 mIU/L, free T4 low, and positive anti-
thyroperoxidase antibodies. Which diagnosis is most likely?
A. Graves disease
B. Subacute thyroiditis
C. Hashimoto thyroiditis
D. Toxic multinodular goiter
Ans>> C. Hashimoto thyroiditis
*Rationale: Elevated TSH, low free T4, and anti-TPO antibodies are
diagnostic of autoimmune hypothyroidism (Hashimoto thyroiditis).*
2. A 68-year-old man with a 50-pack-year smoking history presents with
hemoptysis and weight loss. CT shows a cavitary lesion in the right upper
lobe. Which organism is most likely to cause secondary infection in this
cavity?
A. Streptococcus pneumoniae
B. Aspergillus fumigatus
C. Haemophilus influenzae
D. Mycoplasma pneumoniae
Ans>> B. Aspergillus fumigatus
Rationale: Pre-existing lung cavities (e.g., from tuberculosis, cancer,
sarcoidosis) can become colonized by Aspergillus, forming an aspergilloma.
3. Which of the following is true regarding a complicated urinary tract
infection?
A. It is usually asymptomatic
B. Bacteria are located mostly in the lower urinary tract
C. Can be caused by a structural urinary tract disorder
D. Is associated with young adults
Ans>> C. Can be caused by a structural urinary tract disorder
, Rationale: Complicated UTIs occur in patients with anatomic or functional
abnormalities (e.g., calculi, obstruction, indwelling catheters).
4. Which of the following is a risk factor for the development of a urinary tract
infection in a woman of reproductive age?
A. Menopause
B. Pregnancy
C. Regular exercise
D. Low estrogen states
Ans>> B. Pregnancy
Rationale: Pregnancy causes ureteral dilation and urinary stasis, increasing
UTI risk.
5. Which of the following interventions can help prevent recurrent urinary tract
infections?
A. Douching to prevent bacterial growth
B. Increasing water consumption
C. Taking more vitamin D
D. Using spermicides during intercourse
Ans>> B. Increasing water consumption
Rationale: Increased hydration dilutes bacteria and promotes frequent
voiding, reducing UTI risk.
6. Why are women at higher risk for UTIs compared to men?
A. Longer urethra
B. Shorter urethra
C. Higher urine pH
D. Increased bladder capacity
Ans>> B. Shorter urethra
Rationale: The female urethra is shorter and closer to the anus, allowing
easier bacterial ascent.
7. A symptom of a lower urinary tract infection (cystitis) includes:
A. Decreased urination
B. Fever
C. Flank pain
D. Urgency
Ans>> D. Urgency
Rationale: Lower UTI symptoms include dysuria, frequency, urgency, and
, suprapubic discomfort; fever and flank pain suggest upper tract
involvement.
8. Which of the following best defines an uncomplicated UTI?
A. UTI in a pregnant woman with hydronephrosis
B. Simple cystitis in a non-pregnant woman without underlying
abnormalities
C. UTI associated with an indwelling catheter
D. UTI with fever and chills
Ans>> B. Simple cystitis in a non-pregnant woman without underlying
abnormalities
Rationale: Uncomplicated UTI occurs in a structurally and functionally
normal urinary tract, typically in young, non-pregnant women.
9. A complicated UTI is most likely to be seen in which patient population?
A. Healthy young male
B. Non-pregnant woman with no past UTI
C. Older adult with a urinary catheter
D. Child with no known renal anomalies
Ans>> C. Older adult with a urinary catheter
Rationale: Complicated UTIs occur in patients with indwelling catheters,
obstruction, calculi, or neurogenic bladder.
10.Which of the following urinalysis findings is most consistent with a
complicated UTI?
A. No leukocyte esterase, no nitrites
B. Protein negative, WBCs <5/hpf
C. Leukocyte esterase positive, nitrites positive, WBC casts present
D. Only RBCs present without WBCs
Ans>> C. Leukocyte esterase positive, nitrites positive, WBC casts
present
Rationale: Complicated UTIs often involve the upper tract; WBC casts
indicate pyelonephritis.
11.The presence of red blood cells (RBCs) in a urinalysis is considered
abnormal when:
A. 0-2 RBCs per high-power field
B. >2 RBCs per high-power field
C. Any RBCs are always normal
, D. RBCs are only significant if dysmorphic
Ans>> B. >2 RBCs per high-power field
*Rationale: Normal urine contains 0-2 RBCs/hpf; >2 is hematuria and
requires evaluation.*
12.Which urinary cast is most suggestive of glomerulonephritis?
A. Hyaline casts
B. Granular casts
C. RBC casts
D. WBC casts
Ans>> C. RBC casts
Rationale: RBC casts are pathognomonic for glomerulonephritis (e.g., IgA
nephropathy, poststreptococcal GN).
13.WBC casts in the urine are most consistent with:
A. Cystitis
B. Acute tubular necrosis
C. Pyelonephritis
D. Nephrotic syndrome
Ans>> C. Pyelonephritis
Rationale: WBC casts indicate inflammation or infection of the renal
parenchyma, such as pyelonephritis.
14.A 25-year-old female presents with burning and frequency for 3 days. She
denies fever or flank pain. Urinalysis shows RBCs, nitrites, and WBCs but
no casts. What is the most likely diagnosis?
A. Upper UTI
B. Cystitis
C. Pyelonephritis
D. Complicated UTI
Ans>> B. Cystitis
Rationale: Absence of fever, flank pain, and casts with positive
nitrites/WBCs indicates uncomplicated cystitis.
15.An 80-year-old man with confusion and a fall is found to be dehydrated.
Urinalysis shows pyuria, bacteriuria, and positive nitrites. Two days after
placement of an indwelling catheter, he spikes a fever of 102°F with shaking
chills and flank tenderness. What is the most likely diagnosis?
A. Urinary obstruction
Week 8 Questions and Rationalized Answers
(Verified) – Guarantee passing score Questions
for 2025/2026
1. A 45-year-old woman presents with fatigue, weight gain, and cold
intolerance. Lab results show TSH 25 mIU/L, free T4 low, and positive anti-
thyroperoxidase antibodies. Which diagnosis is most likely?
A. Graves disease
B. Subacute thyroiditis
C. Hashimoto thyroiditis
D. Toxic multinodular goiter
Ans>> C. Hashimoto thyroiditis
*Rationale: Elevated TSH, low free T4, and anti-TPO antibodies are
diagnostic of autoimmune hypothyroidism (Hashimoto thyroiditis).*
2. A 68-year-old man with a 50-pack-year smoking history presents with
hemoptysis and weight loss. CT shows a cavitary lesion in the right upper
lobe. Which organism is most likely to cause secondary infection in this
cavity?
A. Streptococcus pneumoniae
B. Aspergillus fumigatus
C. Haemophilus influenzae
D. Mycoplasma pneumoniae
Ans>> B. Aspergillus fumigatus
Rationale: Pre-existing lung cavities (e.g., from tuberculosis, cancer,
sarcoidosis) can become colonized by Aspergillus, forming an aspergilloma.
3. Which of the following is true regarding a complicated urinary tract
infection?
A. It is usually asymptomatic
B. Bacteria are located mostly in the lower urinary tract
C. Can be caused by a structural urinary tract disorder
D. Is associated with young adults
Ans>> C. Can be caused by a structural urinary tract disorder
, Rationale: Complicated UTIs occur in patients with anatomic or functional
abnormalities (e.g., calculi, obstruction, indwelling catheters).
4. Which of the following is a risk factor for the development of a urinary tract
infection in a woman of reproductive age?
A. Menopause
B. Pregnancy
C. Regular exercise
D. Low estrogen states
Ans>> B. Pregnancy
Rationale: Pregnancy causes ureteral dilation and urinary stasis, increasing
UTI risk.
5. Which of the following interventions can help prevent recurrent urinary tract
infections?
A. Douching to prevent bacterial growth
B. Increasing water consumption
C. Taking more vitamin D
D. Using spermicides during intercourse
Ans>> B. Increasing water consumption
Rationale: Increased hydration dilutes bacteria and promotes frequent
voiding, reducing UTI risk.
6. Why are women at higher risk for UTIs compared to men?
A. Longer urethra
B. Shorter urethra
C. Higher urine pH
D. Increased bladder capacity
Ans>> B. Shorter urethra
Rationale: The female urethra is shorter and closer to the anus, allowing
easier bacterial ascent.
7. A symptom of a lower urinary tract infection (cystitis) includes:
A. Decreased urination
B. Fever
C. Flank pain
D. Urgency
Ans>> D. Urgency
Rationale: Lower UTI symptoms include dysuria, frequency, urgency, and
, suprapubic discomfort; fever and flank pain suggest upper tract
involvement.
8. Which of the following best defines an uncomplicated UTI?
A. UTI in a pregnant woman with hydronephrosis
B. Simple cystitis in a non-pregnant woman without underlying
abnormalities
C. UTI associated with an indwelling catheter
D. UTI with fever and chills
Ans>> B. Simple cystitis in a non-pregnant woman without underlying
abnormalities
Rationale: Uncomplicated UTI occurs in a structurally and functionally
normal urinary tract, typically in young, non-pregnant women.
9. A complicated UTI is most likely to be seen in which patient population?
A. Healthy young male
B. Non-pregnant woman with no past UTI
C. Older adult with a urinary catheter
D. Child with no known renal anomalies
Ans>> C. Older adult with a urinary catheter
Rationale: Complicated UTIs occur in patients with indwelling catheters,
obstruction, calculi, or neurogenic bladder.
10.Which of the following urinalysis findings is most consistent with a
complicated UTI?
A. No leukocyte esterase, no nitrites
B. Protein negative, WBCs <5/hpf
C. Leukocyte esterase positive, nitrites positive, WBC casts present
D. Only RBCs present without WBCs
Ans>> C. Leukocyte esterase positive, nitrites positive, WBC casts
present
Rationale: Complicated UTIs often involve the upper tract; WBC casts
indicate pyelonephritis.
11.The presence of red blood cells (RBCs) in a urinalysis is considered
abnormal when:
A. 0-2 RBCs per high-power field
B. >2 RBCs per high-power field
C. Any RBCs are always normal
, D. RBCs are only significant if dysmorphic
Ans>> B. >2 RBCs per high-power field
*Rationale: Normal urine contains 0-2 RBCs/hpf; >2 is hematuria and
requires evaluation.*
12.Which urinary cast is most suggestive of glomerulonephritis?
A. Hyaline casts
B. Granular casts
C. RBC casts
D. WBC casts
Ans>> C. RBC casts
Rationale: RBC casts are pathognomonic for glomerulonephritis (e.g., IgA
nephropathy, poststreptococcal GN).
13.WBC casts in the urine are most consistent with:
A. Cystitis
B. Acute tubular necrosis
C. Pyelonephritis
D. Nephrotic syndrome
Ans>> C. Pyelonephritis
Rationale: WBC casts indicate inflammation or infection of the renal
parenchyma, such as pyelonephritis.
14.A 25-year-old female presents with burning and frequency for 3 days. She
denies fever or flank pain. Urinalysis shows RBCs, nitrites, and WBCs but
no casts. What is the most likely diagnosis?
A. Upper UTI
B. Cystitis
C. Pyelonephritis
D. Complicated UTI
Ans>> B. Cystitis
Rationale: Absence of fever, flank pain, and casts with positive
nitrites/WBCs indicates uncomplicated cystitis.
15.An 80-year-old man with confusion and a fall is found to be dehydrated.
Urinalysis shows pyuria, bacteriuria, and positive nitrites. Two days after
placement of an indwelling catheter, he spikes a fever of 102°F with shaking
chills and flank tenderness. What is the most likely diagnosis?
A. Urinary obstruction
