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MSN 570 Advanced Pathophysiology Final 2024
1. Which of the following statements describes an active cellular membrane exchange process?
- A. Sodium moving out of cells and potassium moving into cells
- B. The movement of water from an area of low solute concentration to an area of high solute concentration
- C. The movement of insulin using a protein to travel across the cell membrane
- D. Oxygen moving across the pulmonary capillaries to an area of high carbon dioxide
Correct answer: A
Rationale: The correct answer is A. In active transport, energy is expended to move substances against their concentration gradient. Sodium moving out of cells and potassium moving into cells is an example of active transport because it requires energy to pump these ions across the cell membrane against their concentration gradients. Choices B, C, and D describe passive processes where substances move along their concentration gradients without the input of energy.
2. A 30-year-old has poorly controlled asthma and is taking prednisone 10 mg by mouth once a day. He has been on this regimen for 6 weeks. Abrupt withdrawal or discontinuation of this medication can cause:
- A. adrenal crisis
- B. hypercortisolism
- C. ACTH stimulation
- D. thyroid crisis
Correct answer: A
Rationale: Abrupt withdrawal or discontinuation of prednisone, a corticosteroid, can lead to adrenal crisis. This occurs due to the suppression of the adrenal glands' natural cortisol production caused by prolonged exogenous steroid administration. Adrenal crisis presents with symptoms such as weakness, fatigue, abdominal pain, and hypotension. Hypercortisolism (Cushing syndrome) results from chronic excessive exposure to cortisol, not abrupt withdrawal. ACTH stimulation would be expected in response to low cortisol levels, not as a direct consequence of prednisone withdrawal. Thyroid crisis (thyroid storm) is associated with severe hyperthyroidism and is not directly related to corticosteroid withdrawal.
3. Which of the following birthmarks usually fade or regress as the child gets older?
- A. Hemangiomas
- B. Congenital dermal melanocytosis (i.e., Mongolian spots)
- C. Macular stains
- D. Hemangiomas, congenital dermal melanocytosis (i.e., Mongolian spots), and macular stains
Correct answer: D
Rationale: The correct answer is Hemangiomas, congenital dermal melanocytosis (i.e., Mongolian spots), and macular stains. These three types of birthmarks are known to fade or regress as the child gets older. Hemangiomas are vascular birthmarks that often shrink and disappear over time. Congenital dermal melanocytosis, commonly known as Mongolian spots, usually fade by adolescence. Macular stains, also called salmon patches, tend to lighten and fade as a child grows. The other choices are incorrect because they do not typically fade or regress with age.
4. 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.
5. Which of the following eye disorders manifests with red eye, pain, and visual acuity changes?
- A. Bacterial conjunctivitis
- B. Acute closed-angle glaucoma
- C. Chronic open-angle glaucoma
- D. Blepharitis
Correct answer: B
Rationale: Acute closed-angle glaucoma presents with symptoms such as a red eye, severe pain, and rapid visual acuity changes due to increased intraocular pressure. This condition is considered an ophthalmologic emergency. Bacterial conjunctivitis typically presents with redness, discharge, and irritation but is not associated with severe pain or visual changes. Chronic open-angle glaucoma is usually asymptomatic until advanced stages and does not typically present with acute pain. Blepharitis involves inflammation of the eyelid margins and is characterized by redness and irritation, but it does not cause severe pain or acute visual changes.
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