NSG 5140 Midterm Exam : Advanced Pathophysiology- Questions with CORRECT Answers 2026 Latest update-South College

Sodium-Potassium Pump

The sodium-potassium pump moves 3 Na⁺ ions out and 2 K⁺ ions into the cell, creating an electrochemical gradient essential for membrane potential.

Mitochondria

Mitochondria are known as the 'powerhouse' of the cell due to their role in oxidative phosphorylation and ATP generation.

Metabolic Acidosis Lab Values

In metabolic acidosis, there is a loss of bicarbonate or accumulation of acids, lowering both bicarbonate and pH.

B Lymphocytes

B cells differentiate into plasma cells which produce antibodies, central to humoral immunity.

Hallmark of Reversible Cellular Injury

Reversible injury often involves failure of ion pumps leading to water influx and cell swelling.

Interleukin-1 (IL-1)

IL-1 acts on the hypothalamus to raise the body temperature set point, causing fever.

Type 1 Diabetes Mellitus

Type 1 DM is an autoimmune condition where T-cells destroy insulin-producing beta cells in the pancreas.

Cardinal Sign of Acute Inflammation

Redness (rubor) results from vasodilation and increased blood flow to the inflamed area.

Down Syndrome

Trisomy 21 leads to Down syndrome, characterized by developmental delays and distinct facial features.

Liquefactive Necrosis

In the brain, ischemic injury leads to enzymatic digestion of dead cells resulting in liquefactive necrosis.

IgM

IgM is the first antibody produced and is effective in agglutination and complement activation.

Oncogene

Oncogenes are mutated proto-oncogenes that drive unregulated cell proliferation.

Hypokalemia

Low potassium levels disturb the cardiac action potential, increasing the risk of arrhythmias.

Type III Hypersensitivity

SLE involves immune complex deposition (Type III), leading to widespread inflammation and tissue damage.

Frontal Lobe

The primary motor cortex, located in the frontal lobe, initiates voluntary movement.

Impaired tissue perfusion

Shock results in inadequate delivery of oxygen and nutrients to tissues, causing cellular dysfunction.

Bronchoconstriction and mucus production

Asthma involves hyperresponsiveness, smooth muscle constriction, and increased mucus, narrowing the airway.

Apoptosis

Apoptosis is an orderly process for removing damaged or unneeded cells without inflammation.

Atherosclerotic plaque rupture

Plaque rupture leads to thrombus formation, blocking coronary arteries and causing infarction.

Serum creatinine

Creatinine is a waste product filtered by the kidneys; elevated levels suggest impaired renal function.

Aldosterone

Aldosterone promotes Na⁺ reabsorption and K⁺ loss in the distal nephron to increase blood volume.

Hypovolemic shock

Hypovolemic shock occurs when blood or fluid loss reduces preload and cardiac output.

Frank-Starling law of the heart

Stretching of myocardial fibers improves contractile force, increasing output.

Elevated LDL cholesterol

LDL contributes to plaque formation in arterial walls, promoting atherosclerosis.

Pulmonary edema

Left-sided failure backs up blood into the lungs, causing fluid accumulation and respiratory symptoms.

Parathyroid hormone (PTH)

PTH increases serum calcium by acting on bones, kidneys, and intestines.

Demyelination of CNS neurons

MS involves immune-mediated destruction of myelin in the CNS, impairing nerve conduction.

Parkinson's disease

Parkinson's results from degeneration of dopaminergic neurons, affecting movement.

Decreased erythropoietin production

Kidneys fail to produce erythropoietin, reducing RBC synthesis in the bone marrow.

Air trapping and hyperinflation

COPD causes loss of elastic recoil and obstruction, leading to air retention and barrel chest.

Helicobacter pylori infection

H. pylori disrupts the mucosal barrier and induces inflammation, promoting ulcer formation.

Hepatitis A

Hepatitis A spreads via contaminated food/water and typically causes acute, self-limited illness.

Fibrosis and nodular regeneration of liver tissue

Chronic liver damage leads to scarring and nodules, impairing liver function and circulation.

Moon face and central obesity

Excess cortisol leads to characteristic fat distribution and other systemic effects.

Antidiuretic hormone (ADH)

ADH deficiency causes large volumes of dilute urine and risk of dehydration.

Grave's disease lab finding

Elevated T3/T4 and suppressed TSH.

Grave's disease

An autoimmune hyperthyroidism; thyroid hormone is high, and feedback suppresses TSH.

Electrolyte imbalance in Addison's disease

Hyponatremia and hyperkalemia.

Aldosterone in Addison's

Low aldosterone in Addison's leads to sodium loss and potassium retention.

Hallmark of nephrotic syndrome

Massive proteinuria.

Nephrotic syndrome features

Increased glomerular permeability, leading to protein loss in urine.

Acid-base imbalance from vomiting

Metabolic alkalosis.

Cause of metabolic alkalosis

Loss of gastric acid from vomiting increases bicarbonate concentration.

Most common type of renal stone

Calcium oxalate.

Calcium oxalate stones formation

Calcium oxalate stones form due to high calcium and oxalate levels in the urine.

Characteristic finding of glomerulonephritis

Hematuria.

Cause of post-renal acute kidney injury

Urinary tract obstruction.

Effect of obstruction on kidneys

Obstruction (e.g., stone or tumor) increases pressure upstream, impairing kidney function.

Neurotransmitter deficient in Alzheimer's disease

Acetylcholine.

Major complication of untreated hypertension

End-organ damage.

Effect of prolonged high BP

Damages vessels and organs, including kidneys, eyes, heart, and brain.

Common feature of benign tumors

Encapsulation and non-invasiveness.

Characteristics of benign tumors

Benign tumors grow slowly, are well-differentiated, and do not invade surrounding tissues.

Primary characteristic of cancer cells

Uncontrolled proliferation.

Tumor suppressor genes significance

They inhibit cell growth and division.

Effect of loss or mutation of tumor suppressor genes

Removes growth regulation and can lead to cancer.

Type of edema with low plasma protein levels

Oncotic (hypoalbuminemic) edema.

Cause of oncotic edema

Reduced albumin decreases oncotic pressure, leading to fluid movement into interstitial spaces.

First step in hemostasis

Vasoconstriction.

Role of vasoconstriction in hemostasis

Reduces blood flow and initiates clot formation following vessel injury.

Role of surfactant in the lungs

Reduce surface tension in alveoli.

Function of surfactant

Prevents alveolar collapse by decreasing surface tension, crucial for effective gas exchange.

Condition leading to increased intracranial pressure (ICP)

Traumatic brain injury.

Hallmark sign of increased ICP

Papilledema.

Cause of papilledema

Swelling of the optic disc results from pressure transmitted to the optic nerve sheath.

Most common cause of community-acquired pneumonia

Streptococcus pneumoniae.

Trigger for renin-angiotensin-aldosterone system (RAAS)

Decreased renal perfusion.

Effect of low renal perfusion

Stimulates renin release, activating RAAS to increase BP and volume.

Expected lab abnormality in hyperparathyroidism

Hypercalcemia.

Effect of excess PTH

Increases calcium reabsorption from bone and kidneys, raising serum calcium.

Secondary hypertension

The most common cause is renal artery stenosis, where reduced renal perfusion from artery narrowing stimulates RAAS, raising BP.

Hypoxemia in pulmonary embolism

The major mechanism is ventilation-perfusion (V/Q) mismatch, where a PE blocks perfusion to ventilated alveoli, causing high V/Q and impaired gas exchange.

Wheezing sound in asthma

Caused by airway narrowing due to bronchospasm, where tightened airways from inflammation and muscle constriction create a whistling sound during breathing.

Structural abnormality in emphysema

Destruction of alveolar walls, where loss of alveolar septa reduces surface area for gas exchange and causes hyperinflation.

Condition from prolonged hypoxemia

Cor pulmonale, which results from chronic lung disease causing pulmonary hypertension, straining the right heart.

Lab finding consistent with dehydration

Elevated hematocrit, where plasma volume decreases, concentrating RBCs and raising hematocrit.

Lung volume in obstructive lung diseases

Residual volume increases due to air trapping preventing full exhalation.

Electrolyte imbalance with Chvostek's sign

Hypocalcemia, where low calcium increases neuromuscular excitability, producing facial muscle twitching.

Primary regulator of blood pH

Kidneys, which regulate pH by reabsorbing or excreting bicarbonate and hydrogen ions.

Clinical sign of left ventricular failure

Dyspnea on exertion, where pulmonary congestion from left-sided failure impairs gas exchange during activity.

Major complication of atrial fibrillation

Thromboembolism, where irregular atrial activity promotes clot formation, increasing stroke risk.

Disorder with autoimmune destruction of ACh receptors

Myasthenia gravis, where antibodies attack ACh receptors at neuromuscular junctions, causing weakness.

Finding consistent with hyperthyroidism

Weight loss despite increased appetite, where elevated thyroid hormone accelerates metabolism, leading to weight loss.

WBC type increasing in parasitic infections

Eosinophils, which defend against parasites and mediate allergic reactions.

Most common cause of bacterial meningitis in adults

Streptococcus pneumoniae, which invades the CNS and causes inflammation of the meninges.

Disorder with decreased dopamine and increased acetylcholine

Parkinson's disease, where the imbalance leads to tremors, rigidity, and bradykinesia.

Characteristic of rheumatoid arthritis

Symmetrical joint inflammation, where RA is an autoimmune disease that affects joints bilaterally.

Type of mutation with a change in a single nucleotide

Point mutation, which can alter protein function or be silent depending on the codon change.

Fluid compartment with majority of body water

Intracellular, where approximately two-thirds of total body water is inside cells.

Pathophysiological mechanism of GERD

Incompetent lower esophageal sphincter, where a weak LES allows acid to reflux into the esophagus, causing symptoms.

Hormone for uterine contractions during labor

Oxytocin, which stimulates myometrial contractions and is used clinically to induce labor.

Lab value elevated in pancreatitis

Serum lipase, which is more specific than amylase for pancreatic inflammation.

Type of anemia caused by vitamin B12 deficiency

(Definition not provided in the notes)

Megaloblastic anemia

B12 deficiency leads to impaired DNA synthesis, causing large, immature RBCs.

Common clinical manifestation in anemia

Fatigue

Reduced oxygen-carrying capacity

Results in decreased tissue oxygenation.

Most specific cardiac enzyme for myocardial infarction

Troponin I

Troponin rise after MI

Troponin rises within hours of MI and is highly specific for cardiac muscle damage.

Typical ECG change in hyperkalemia

Peaked T waves

Effect of elevated potassium on ECG

Elevated potassium alters repolarization, producing tall, peaked T waves.