MSN 570 Advanced Pathophysiology Final 2024

MSN 570 Advanced Pathophysiology Final 2024 Related

Review MSN 570 Advanced Pathophysiology Final 2024 related questions and content

What is the pathophysiologic process responsible for the decreased glomerular filtration rate in a patient with acute glomerulonephritis?

  • A. Decreased renal-induced constriction of the renal arteries
  • B. Immune complex deposition, increased capillary permeability, and cellular proliferation
  • C. Necrosis of 70% or more of the nephrons secondary to increased kidney interstitial hydrostatic pressure
  • D. Scar tissue formation throughout the proximal convoluted tubule secondary to toxin-induced collagen synthesis
Correct Answer: B

Rationale: The correct answer is B: Immune complex deposition, increased capillary permeability, and cellular proliferation. Acute glomerulonephritis is characterized by inflammation of the glomeruli in the kidneys. This inflammation leads to the deposition of immune complexes, increased capillary permeability, and cellular proliferation, which collectively contribute to a decreased glomerular filtration rate. Choice A is incorrect as decreased renal-induced constriction of the renal arteries would not directly result in decreased glomerular filtration rate. Choice C is incorrect as necrosis of nephrons due to increased kidney interstitial hydrostatic pressure would affect kidney function differently. Choice D is incorrect as scar tissue formation in the proximal convoluted tubule due to toxin-induced collagen synthesis is not a typical feature of acute glomerulonephritis.

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Which of the following is a common cause of mechanical small intestine obstruction?

  • A. Infection
  • B. Postoperative adhesions
  • C. Tumors
  • D. Foreign body
Correct Answer: B

Rationale: Postoperative adhesions are a common cause of mechanical small intestine obstruction. Adhesions can form after abdominal surgery, causing bands of scar tissue that may twist or pull the intestines, leading to obstruction. This is a more common cause compared to infection, tumors, or foreign bodies. Infection may lead to inflammation but is not a typical cause of mechanical obstruction. Tumors and foreign bodies can cause blockages but are less common than postoperative adhesions.

In which of the following cases is dehydration more likely to occur?

  • A. A 50-year-old woman who is a bodybuilder
  • B. A 50-year-old man who is morbidly obese
  • C. A 10-year-old child who is thin
  • D. A 30-year-old with multiple sclerosis
Correct Answer: B

Rationale: Dehydration is more likely to occur in a 50-year-old man who is morbidly obese due to the increased risk of conditions like diabetes and heart disease that can lead to fluid imbalances. Being morbidly obese can also strain the body's systems, increasing the need for water. The other choices are less likely to experience dehydration as a primary concern. While being a bodybuilder may require strict hydration practices, dehydration is more prevalent in individuals with conditions like obesity.

A 65-year-old man is admitted to the intensive care unit from the operating room after a triple coronary artery bypass graft. He is intubated and on a ventilator. Lactic acid levels were normal postoperatively, but now they are rising. The increased level could be an indication of:

  • A. excessive sedation
  • B. bowel ischemia
  • C. excessive volume infusion in the operating room
  • D. mild hypothermia postoperatively
Correct Answer: B

Rationale: In this scenario, the rising lactic acid levels in a 65-year-old man after a coronary artery bypass graft could indicate bowel ischemia. Bowel ischemia can lead to anaerobic metabolism, causing an increase in lactic acid levels. Excessive sedation may cause respiratory depression but would not directly lead to rising lactic acid levels. Excessive volume infusion in the operating room might cause fluid overload but would not typically result in rising lactic acid levels. Mild hypothermia postoperatively could lead to shivering and increased oxygen consumption, but it is less likely to be the primary cause of rising lactic acid levels in this context.

Which of the following clinical findings in a 51-year-old woman is consistent with Graves disease?

  • A. Thin hair, exophthalmos, hyperreflexia, and pretibial edema.
  • B. Thin hair, exophthalmos, weight gain, and constipation.
  • C. Thick hair, bradycardia, weight loss, and dry skin.
  • D. Thick hair, bradycardia, weight gain, and constipation.
Correct Answer: A

Rationale: The clinical findings of thin hair, exophthalmos (bulging eyes), hyperreflexia, and pretibial edema are classic manifestations of Graves disease, an autoimmune condition that results in hyperthyroidism. Choice B is incorrect because weight gain and constipation are more indicative of hypothyroidism, not hyperthyroidism seen in Graves disease. Choice C is incorrect as the symptoms described are more characteristic of hypothyroidism, not hyperthyroidism. Choice D is also incorrect as the symptoms listed are not consistent with Graves disease but rather suggest hypothyroidism.

When does pain in the lower extremities due to peripheral artery disease usually worsen?

  • A. with rest because blood flow decreases.
  • B. with elevation of the extremity because blood is diverted away.
  • C. when the leg is in a dependent position because blood pools.
  • D. when the leg is touched or massaged because cytokines are released.
Correct Answer: B

Rationale: Pain in the lower extremities due to peripheral artery disease usually worsens with elevation of the extremity because blood is diverted away from the affected area, leading to decreased perfusion and exacerbation of symptoms. Choices A, C, and D are incorrect because resting, dependent position, and touch/massage do not typically worsen the pain associated with peripheral artery disease.

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