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WALDEN UNIVERSITY ADVANCED
PATHOPHYSIOLOGY MIDTERM EXAM 1
(235 QUESTIONS AND ANSWERS) 2025
UPDATE GRADE 100% PASS
What is the probable cause of cellular swelling in the early stages of cell injury? - Solution Na-K pump fails to remove intracellular Na+ The mechanism for liver damage related to chronic alcoholism is:
- Solution Oxidative stress. Free radicals cause damage by: - Solution Giving up on electron, which cause injury to the chemical bonds of the cell membrane. The loss of adenosine triphosphate (ATP) during ischemia causes cells to: - Solution Swell because of the influx of sodium chloride. During cellular injury, when the membrane becomes damaged, what is the mechanism of cell injury? - Solution Loss of permeability. When a person experiences a myocardial infarction, how long before anaerobic metabolism ceases? - Solution 3-4 minutes. Left calf being smaller than right calf when a cast is removed is an example of: - Solution Atrophy. A young female becomes agitated and apprehensive, and she eventually loses consciousness. At the hospital ER, the following lab values were obtained: -Plasma Sodium 137
-Plasma Potassium 5. -pH 7. -Serum Co2 22 -Plasma Bicarb 24 What is her immediate diagnosis? - Solution Respiratory alkalosis. What would not shift blood toward pH alkalosis? -Hydrogen ion secretion into urine -Exhalation of carbon dioxide -All of the above would -None of the above would - Solution All of the above. A 76 y/o man was brought to an urgent care facility when he fell after sitting for prolonged period of time. He is slow to answer questions, has muscle weakness and cramping, and constipated. He had diarrhea for three weeks. On exam: neck veins flat, BP low in supine, HR 110, pulse weak + regular, resps 20 but deep. Labs: Na+ 142, K 2.8. -What fluid imbalance does he have and why? - Solution Isotonic fluid deficit. (Diarrhea x 3 weeks, orthostatic hypotension, tachycardia, weak pulse and low BP on supine. A 76 y/o man was brought to an urgent care facility when he fell after sitting for prolonged period of time. He is slow to answer questions, has muscle weakness and cramping, and constipated. He had diarrhea for three weeks. On exam: neck veins flat, BP low in supine, HR 110, pulse weak + regular, resps 20 but deep. Labs: Na+ 142, K 2.8. -What imbalance is indicated based on lab results? What clinical manifestations are noted based on this imbalance? - Solution Hypokalemia. (Muscle weakness and constipation).
What tissue type is involved in liquefactive necrosis? - Solution Brain. What tissue type is involved with caseous necrosis? - Solution Lungs (ex: TB). What tissue type is involved in fatty necrosis? - Solution Breasts, pancreas, abdomen. True or false: The human neonate initially has poor production of IgG. - Solution True. Type 1 hypersensitivity - Solution IgE mediated Type 2 hypersensitivity - Solution Tissue-specfic Type 3 hypersensitivty - Solution immune-complex mediated. Type 4 hypersensitivity - Solution Cell-mediated. True or false: inappropriate immune responses against the host's own tissues is termed alloimmunity. - Solution False. Colonization, invasion, multiplication and spread are: - Solution the process of infection. Clinical infection stages: - Solution Incubation period, prodromal state, invasion period and convalescence. Hallmark of most infectious disease: - Solution fever. Polycythemia vera is a chronic condition that occurs when there is a _______________ of RBCs, and causes splenomegaly. - Solution Overproduction.
True or false: Hemolytic disease of the fetus and newborn resulting from Rh incompatibility is more sever than that stemming from ABO incompatibility. - Solution True. a 62 y/o woman comes into the clinic complaining of being tired. Upon exam, you notice she is pale, has sores in the corners of her mouth accompanied by a red tongue and has concave funerals. Which type of anemia do you suspect? - Solution Iron deficiency. Within how many hours should RhoGAM be given to an Rh- negative mother's exposure to Rh-positive fetal blood? - Solution
What is a lifelong treatment plan for a patient who has had gastric bypass diagnosed with pernicious anemia? - Solution Vitamin B12. Your patient has developed hemolytic anemia related to the antibiotic PCN. What is the first line of therapy? - Solution Corticosteroid administration. What treatment prevents the development of kernicterius in an infant born with hemolytic newborn disease (HDN)? - Solution Replacement transfusion of new Rh-positive blood that is not contaminated with anti-Rh antibodies. What vitamin improves the absorption of oral iron in children and should be recommended as part of the treatment for iron- deficiency anemia? - Solution Vitamin C. What is the fundamental physiologic mechanism of anemia? - Solution Hypoxia.
What type of anemia is pernicious anemia? - Solution macryocytic normochromic What type of anemia is post-hemorrhagic? - Solution normocytic chromocytic What type of anemia is folate-deficiency? - Solution microcytic normochromic Anemias associated with impaired erythrocyte function: - Solution iron-deficiency, pernicious anemia, folate-deficiency Anemia associated with increased erythrocyte function: - Solution sick cell anemia Is chronic ITP (immune thrombocytopenic purpura). more common in men or women? - Solution Women The APRN assesses a client with inspiratory and expiratory wheezing, dyspepsia, nonproductive cough, increased use of accessory muscles and tachypnea. The client is afebrile. Which condition should the APRN suspect? - Solution Asthma The APRN suspects asthma in a client with a history of significant environmental allergies. When considering the pathophysiology of asthma, which immunoglobulin may contribute to the triggering of asthmatic symptoms in this client? - Solution IgE The APRN is assessing an 8 y/o client suspected of asthma. Which criterion should the APRN use to confirm a diagnosis of asthma in this client? - Solution Reduced expiratory flow rate confirmed by spirometry testing. Why is nasal congestion a serious threat to young infants? - Solution Infants are obligatory nose breathers.
The APRN assesses a 2 y/o child brought to the clinic for a "cold that keeps getting worse". Which clinical manifestations would cause the APRN to suspect croup? - Solution -low grade fever -sore throat -barking cough What is the most common predisposing factor for OSA in children? - Solution Adenotonsillar hypertrophy The parents of a 2 y/o child are concern because their child has recurrent respiratory infections and "problems with digestion". The child was born at home and did not receive any newborn screenings but has since been caught up on required immunizations. What test should the APRN run to rule out cystic fibrosis? - Solution Serum immunoreactive trypsinogen What is the chief predisposing factor for respiratory distress syndrome (RDS) of the newborn? - Solution Premature birth. bronchiolitis tends to occur during the first year of life and is most often caused by what type of infection? - Solution RSV (respiratory syncytial virus) In chronic bronchitis, goblet cells undergo: - Solution hyperplasia and hypertrophy Diminished respiratory flow rates in emphysema are ultimately caused by what? - Solution Alveolar wall destruction. Which diagnostic test is required to confirm COPD? - Solution Pulmonary function test. -often caused by RSV -a seal like or barking cough is common
What other condition connect to atopic dermatitis? - Solution Asthma What is true regarding scabies? - Solution -Transmission occurs through personal contact and infected clothing and bedding -it is a contagious disease caused by the itch mite, sarcoptes scabiei -the rash is marked by burrows, papule and vesicular lesions True or false: allergic contact dermatitis is a common form of t-cell mediated or delayed hypersensitivity type IV - Solution true __________ involves high contagious parasites that survive by sucking blood while secreting toxic saliva. - Solution pediculosis Tinea capitis: - Solution fungal infection of the scalp Tinea pedis: - Solution Athlete's foot Tinea corporis: - Solution Ringworm Tinea cruris: - Solution groin, jock itch Tinea unguium (onychomycosis) - Solution fungal infection of the nail True or false: malignant (cutaneous) melanoma is a tumor of the skin originating from keratinocytes: - Solution False What is true regarding herpes zoster (shingles)? - Solution - Caused by VSV (varicella zoster virus) -Pain and paresthesia localized to the dermatome -Adults can develop shingles of they've already had chickenpox What form of psoriasis is the most common? - Solution Plaque.
Complications of psoriasis: - Solution -Cardiovascular complications -Chronic inflammation -linked to other autoimmune deficiencies Tick bites cause: - Solution -larger rash in bullseye pattern -lyme disease -Rocky Mountain spotted fever What disease can lead to meningitis and inflammation of the cardiac tissue? - Solution Lyme disease True or false: erysipelas is a deeper form of cellulitis: - Solution False. Erysipelas is a common bacterial infection of the superficial layer of the skin extending to lymphatic vessels. Where is Candida found? - Solution -skin -GI tract -vagina What is true regarding yeast infections? - Solution -Breastfeeding babies or bottle feeding can get yeast in their mouths -Use of Abx can be a risk factor -Diabetics are prone to yeast infections Phases of bone repair in order: - Solution 1-inflammatory 2-repair 3-remodeling Malunion and delayed union occur when: - Solution there is failure of the bone ends to grow together after a fracture. What is the primary difference between arthritis, bursitis and tendonitis? - Solution Source of inflammation.
Osteomyelitis causes: - Solution -Staph infection -Bloodborne or exogenous source Most common primary malignant bone tumor? - Solution Osteosarcoma Which gender is at highest risk for osteoporosis? - Solution Women Can osteoporosis be genetic? - Solution Yes Other term for osteoarthritis - Solution DJD New bone formation: - Solution involucrum Bronchitis definition: - Solution chronic inflammation of the bronchi that causes airway obstructs. Bronchitis patho: - Solution -Results from bronchial smooth muscle hypertrophy -Increased in size and number of epithelial mucous glands and goblet cells -increased production of thick, tenacious mucous Chronic bronchitis/COPD: - Solution -hyper secretion of mucous -chronic productive cough (3 months, two consecutive years) Patho of COPD: - Solution -Inspired irritants increase mucous production, size and number of mucous glands, bronchial edema and thicker than normal mucous. -Decreased luminal airways d/t edema/inflammation -Results in impaired airflow -Causes hypertrophied bronchial smooth muscle and hypoxemia/HCAP -Airways collapse early in expiration, traps gas in lungs.
COPD clinical manifestations: - Solution -Decreased exercise tolerance -Decreased FEV -Polcythemia (increased RBCs = thicker blood) -Productive cough ("smoker's cough") -Wheezing and SOB Acute bronchitis - Solution -Infection or inflammation of the large airways or bronchi -usually self limiting, caused by virus Acute bronchitis patho: - Solution -Follows viral illness (flu, rhinovirus, adenovirus) -bronchial lining becomes irritated and airways narrow d/t inflammatory process -Edema, capillary dilation, exudates What is the major extracellular cation that plays a pivotal role in the maintenance of extracellular fluid volume and perfusion of vital organs and capillary beds? - Solution Sodium. How is the kidney able to concentrate or dilute urine? - Solution Response to vasopressin, and ability to deploy aquaporins to the luminal membrane. What dose the nephron tubule require for reabsorptive tasks? - Solution energy and active transport. What is the number one cause of chronic kidney failure in the nation? - Solution Diabetes. What is true regarding hypertension: - Solution -A majority have CKD -Many are unaware
Bladder exstrophy - Solution characterized by urinary bladder and part of the intestines/GI tract and or spine is outside of the body at the time of birth. Symptoms of nephrotic syndrome in children: - Solution -diarrhea -anorexia -poor absorption -HLD -Diminished/frothy/foamy urine output When does the GFR match adult range? - Solution Two years When do kidneys reach adult size? - Solution Teen years Risk factors for developing Crohn's disease: - Solution -Genetic history -NSAID use Smoking Symptoms associated with colon cancer: - Solution -Abd Px -Change in bowel habits -Blood in stool Hallmark of ulcerative colitis: - Solution bloody diarrhea True or false: acute pancreatitis is typically caused by viral pathogens: - Solution false Hallmark of pyloric stenosis: - Solution projectile vomiting Risk factors for peptic ulcer disease: - Solution -H.pylori infection -Habitual use of NSAIDs -Excessive ETOH/smoking
Appendicitis symptoms: - Solution -N/V -Fever and leukocytosis -Sudden pain relief indicates rupture Leading cause of acute liver failure: - Solution acetaminophen overdose Gallstone risk factors: - Solution -High fat diet -Pregnancy -Female Phase of liver failure marked by patient seeking care after jaundice, hyperbilirubinemia, and pain? - Solution icteric phase Diagnostic marker for acute pancreatitis: - Solution serum lipase What dose repeated exacerbations of acute pancreatitis lead to? - Solution Destruction of acing cells and islets of Langerhans cells. Environment risk factors for stomach cancer: - Solution -Tobacco use -Infection with h.pylori w/ CagA gene -Use of pickled foods Location of highest colon cancer incidence: - Solution Ascending colon Cleft lip/palate: - Solution -Difficulty with breast latch -Risk factors include maternal ETOH use -SLP may be needed Pediatric diarrhea: - Solution -Most often caused by acute gastroenteritis -Lack of tears when crying indicates dehydration
-Overproduction of mucous in respiratory tract, reproductive tract and digestive tract -Changes cells that produce mucous, sweat, saliva and digestive secretions -increases number of goblet cells, causes thick mucous -secretions block airway ducts -Abnormally elevated sodium and chloride concentrations in sweat Major manifestations of CF: - Solution -Digestive -Pancreatic insufficiency Most common cause of CF deaths - Solution Respiratory failure Number of Americans with fault CF gene - Solution 10 million/ in 31 Clinical manifestations of CF: - Solution -Persistent cough/wheeze -Sputum production -Frequent respiratory infections -Dyspnea -Fatigue -Recurrent/severe PNA -Salty-tasting skin -Activity intolerance -Digital clubbing -Rhonchi -Chronic sinus infections -Nasal polyps -Steatorrhea -Fat soluble vitamin deficiency -Unable to maintain weight -Delayed/impaired growth
Evaluation of CF: - Solution Newborn screening, IRT blood and sweat test CF treatment - Solution -Incurable -Chest PT (oscillation vest) -PEP devices -Aerosol therapies (bronchodilators, nebulizer deoxyribonuclease, inhaled hypertonic saline -IV Abx, azithro, Motrin, corticosteroids -Nutritional support Childhood asthma: - Solution -inflammatory disorder of bronchial mucousa -100+ familial genes -diagnosed more often in boys Asthma Pathophysiology - Solution -Characterized by bronchospasm, airway hyperactivity and inflammation with antigen response -Patients experience episodic attacks of bronchospasm, bronchial inflammation, mucous edema and increased mucous production Antigen inflamed with asthma: - Solution Eosinophilia with influx of activated t cells What is PEF (peak expiratory flow rate) based on? - Solution Height, age, gender--HAG Early asthmatic response: - Solution -Bronchospasm/bronchoconstriction usually signaled by coughing -Peak phase is 30 minutes - three hours -IgE causes mast cell degranulation and relates inflammatory mediators
