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SCI225 Pathophysiology Final Exam 2025 Latest Practical
Questions with Verified Answers
Which of the following types of anemia is a microcytic anemia? A. Pernicious anemia B. Iron deficiency anemia C. Folic acid deficiency anemia D. Sickle cell anemia B. Iron deficiency anemia Microcytic anemia is characterized by smaller-than-normal red blood cells (RBCs) with a reduced mean corpuscular volume (MCV). Among the given options, iron deficiency anemia is the most common cause of microcytic anemia. It occurs when there is insufficient iron available to produce hemoglobin, leading to smaller RBCs that carry less oxygen. Which of the following diseases increases the risk for abnormal bleeding? A. Von Willebrand disease B. Factor V Leiden C. Anemia D. Polycythemia Ver A. Von Willebrand Disease
Von Willebrand disease (vWD) is a bleeding disorder caused by a deficiency or dysfunction of von Willebrand factor (vWF), a protein that is critical for platelet adhesion and aggregation during the formation of a blood clot. Without sufficient or functional vWF, clot formation is impaired, leading to an increased risk of abnormal bleeding, including easy bruising, nosebleeds, prolonged bleeding after injury, or heavy menstrual bleeding. A 14-year-old girl presents with fatigue, pallor, and dizziness. She mentions heavy menstrual periods and a diet low in red meat and iron-rich foods. Laboratory tests reveal low hemoglobin, low hematocrit, and low serum ferritin levels. 1.What are the key causes of iron deficiency anemia in adolescents, and how does diet contribute? A. Excessive vitamin C intake B. Low dietary iron intake and menstrual blood loss C. Dehydration D. Chronic bacterial infections Iron loss from menstruation combined with inadequate dietary intake is the most common cause in this population A 55-year-old male complains of frequent headaches, dizziness, and a ruddy complexion. He recently experienced a deep vein thrombosis. Laboratory findings reveal elevated hemoglobin, hematocrit, and red blood cell counts. JAK2 mutation testing is positive How is polycythemia vera managed? A.Blood transfusions B.Therapeutic phlebotomy C.Corticosteroids Antibiotics Therapeutic phlebotomy reduces red blood cell mass, alleviating symptoms and lowering the risk of thrombosis. A 35-year-old postpartum female presents with uncontrolled bleeding from her IV site and oozing from surgical incisions. She shows signs of petechiae, hematuria, and low blood pressure. Laboratory results reveal prolonged prothrombin time (PT), thrombocytopenia, and elevated D-dimer levels. What does an elevated D-dimer indicate?
B. Right Heart Failure Pulmonary hypertension is a condition where the blood pressure in the pulmonary arteries becomes abnormally high. This increased pressure forces the right ventricle of the heart to work harder to pump blood through the lungs. Over time, this increased workload causes the right ventricle to enlarge (hypertrophy) and weaken, eventually leading to right heart failure, also known as cor pulmonale. A 65-year-old male with a history of left-sided heart failure presents to the emergency department with shortness of breath, pink frothy sputum, and crackles on auscultation. Chest X- ray reveals diffuse alveolar infiltrates. What is the most likely cause of pulmonary edema in this patient? A. Right-sided heart failure B. Left-sided heart failure C. Chronic bronchitis D. Pulmonary embolism Pulmonary edema commonly results from left-sided heart failure, which increases pulmonary venous pressure, leading to fluid leakage into the alveoli. A premature newborn, born at 28 weeks gestation, presents with signs of respiratory distress shortly after birth, including grunting, nasal flaring, intercostal retractions, and cyanosis. A chest X-ray reveals a ground-glass appearance, and blood gas analysis indicates hypoxemia. Which of the following is a major risk factor for RDS? A. Maternal smoking during pregnancy B. Low birth weight C. Premature birth D. Maternal alcohol consumption during pregnancy Premature birth is the primary risk factor for RDS as surfactant production is insufficient before 34 - 36 weeks of gestation
A 6 - month-old infant is brought to the emergency department with a history of rhinorrhea, fever, poor feeding, and lethargy. The infant has a cough, wheezing, and tachypnea. A nasal swab confirms respiratory syncytial virus (RSV) as the cause of illness. What symptom is commonly observed in bronchiolitis? A. Inspiratory stridor B. Expiratory wheezing C. Barking cough D. Cyanosis without respiratory effort Expiratory wheezing occurs due to obstruction and inflammation of the bronchioles A 26-year-old woman develops sudden onset of fever, malaise, and nausea. The physical examination findings were as follows: temperature, 38.3oC; pulse, 85/min; respirations, 18/min; and blood pressure, 140/90 mmHg. Urinalysis revealed 1+ proteinuria and 4+ hematuria without ketones or glucose. There were RBC casts on microscopic examination of the urine. A renal biopsy shows marked glomerular hypercellularity with neutrophils in glomerular capillary loops on light microscopy. On immunofluorescence microscopy there are granular deposits of IgG and C3 in the glomerular capillary basement membrane. Electron microscopy shows electron-dense subepithelial humps. Which of the following is the most likely diagnosis? A. diabetes mellitus B. Goodpasture syndrome C. membranous glomerulonephritis D. post-infectious glomerulonephritis E. systemic amyloidosis Post-infectious glomerulonephritis (PIGN) is a type of kidney disease that typically occurs after an infection, commonly a streptococcal throat or skin infection. The patient's clinical presentation, urinalysis findings, and biopsy results are classic for PIGN. An 8-year-old boy is recovering from impetigo and has a few honey-colored crusts remaining on his face. The crusts are removed and culture of the lesions grows group A Streptococcus pyogenes. He is treated with a course of penicillin. One week later, he develops malaise, nausea,
A) Staphylococcus aureusB) Streptococcus pyogenesC) Escherichia coliD) Pseudomonas aeruginosa Acute poststreptococcal glomerulonephritis (APSGN) is most commonly triggered by an infection with Streptococcus pyogenes (group A Streptococcus), often following a recent throat or skin infection. The body's immune response to the bacteria results in immune complex formation, which deposits in the kidneys, causing inflammation and damage to the glomeruli. A 6-year-old child presents with swelling in the legs and around the eyes, and a history of weight gain over the past few weeks. Physical examination reveals puffy eyelids, edema in the lower extremities, and a palpable, firm abdomen. Urinalysis shows 3+ proteinuria and a serum albumin level of 2.0 g/dL (normal 3.5-5.0 g/dL). Which of the following is the most likely assessment finding in this child? A) HematuriaB) HypoalbuminemiaC) HypercalcemiaD) Leukocytosis Nephrotic syndrome in children is characterized by edema, significant proteinuria, and hypoalbuminemia. The low serum albumin levels result from the loss of protein in the urine. Hematuria is typically seen in conditions like glomerulonephritis rather than nephrotic syndrome. Hypercalcemia and leukocytosis are not commonly associated with nephrotic syndrome in children. A 24-year-old man seeks medical evaluation for infertility. Despite trying to conceive for 4 years he and his wife have been unsuccessful. An evaluation of his wife has not revealed an etiology. On physical examination he has bilateral gynecomastia, the testes are small (<2 cm in the longest axis) and firm, and the penis is small. The pubic-to-floor height is greater than the crown-to-pubic height. Laboratory tests show low testosterone and elevated FSH levels. Notably, he has azoospermia. Which of the following is the most likely diagnosis? A. variant of Turner syndrome B. Klinefelter syndrome C. androgen insensitivity syndrome D. Down syndrome mosaic
E. 5 alpha-reductase deficiency Klinefelter syndrome is a genetic condition that occurs in males who have an extra X chromosome (47, XXY). It often causes infertility due to low testosterone levels and azoospermia (no sperm in the semen), along with physical signs like small, firm testes, gynecomastia (enlarged breast tissue), and a tall, slim body with long. The elevated FSH level happens because the testes are not producing enough testosterone, leading the body to try to "stimulate" them more. A 14-year-old girl is seen because she has not started menstruating and because of short- stature. On physical examination she is short 4’9” (145 cm). She has micrognathia, prominent low-set ears, and epicanthal folds. She has a broad chest, widely spaced nipples, and a short, webbed neck. She has had numerous episodes of otitis media. On abdominal MRI the ovaries are small and elongated. Which is the most likely diagnosis? A. DiGeorge syndrome B. Edwards syndrome C. Turner syndrome D. Klinefelter syndrome E. Down syndrome Turner syndrome is a genetic condition in females caused by a missing or partially missing X chromosome (45, X). Girls with Turner syndrome are typically short in stature and have distinctive physical features, such as a broad chest with widely spaced nipples, a short webbed neck, and certain facial traits like low-set ears and epicanthal folds. They also often have underdeveloped ovaries, which can lead to delayed or absent menstruation and infertility. The frequent ear infections (otitis media) and her specific physical traits make Turner syndrome the most likely diagnosis.
C. Intraductal Adenocarcinoma D. Decreased Prolactin level E. Pituitary tumor F. Inadequate treatment of Hashimoto's The most likely diagnosis for this patient is E. Pituitary tumor. This patient presents with a non- bloody, non-painful nipple discharge, which is often linked to hormonal imbalances. The pituitary gland, which produces prolactin, can sometimes develop a tumor leading to increased prolactin secretion and resulting in nipple discharge. A 27-year-old woman presents with irregular periods, acne, and excessive hair growth on her face. She is concerned about difficulty losing weight. On examination, her BMI is 30, and she has hirsutism on her upper lip and chin. Laboratory studies reveal the following:
- Elevated serum testosterone level
- Increased luteinizing hormone (LH) to follicle-stimulating hormone (FSH) ratio (LH:FSH >2:1)
- Elevated fasting insulin level
- Normal thyroid function tests Which of the following is the most likely diagnosis based on these lab findings? A. Polycystic ovary syndrome (PCOS)B. Congenital adrenal hyperplasiaC. HyperthyroidismD. Ovarian carcinomaE. Cushing's syndrome The most likely diagnosis is A. Polycystic ovary syndrome (PCOS). PCOS is commonly associated with:
- Elevated serum testosterone
- Abnormal LH:FSH ratios
- Insulin resistance (indicated by the elevated fasting insulin level).
These lab findings, combined with the patient's symptoms of irregular periods, hirsutism, and difficulty with weight loss, strongly point to PCOS. Which of the following is a typical sign of an upper GI bleed? A)Black, tarry stools (melena) B) Bright red blood in the stool C)Vomiting of clear fluid D) Abdominal distension with guarding A. Tarry Black Stool (Melena) An upper gastrointestinal (GI) bleed originates from the esophagus, stomach, or duodenum. A typical sign of an upper GI bleed is melena, which refers to black, tarry stools. This occurs because blood from an upper GI source is exposed to stomach acid and digestive enzymes as it passes through the gastrointestinal tract. The breakdown of hemoglobin in the blood produces compounds like hematin, which give the stool its characteristic dark color and sticky consistency. Which of the following is the most common cause of peptic ulcer disease (PUD)? A)Helicobacter pylori infection B)Stress C)Alcohol consumption D)Excessive aspirin use A)Helicobacter pylori infection. Peptic ulcer disease (PUD) involves the formation of ulcers in the lining of the stomach or duodenum, typically due to an imbalance between aggressive factors (like stomach acid) and protective factors (like the mucosal barrier). The most common cause of PUD is infection with the bacterium Helicobacter pylori (H. pylori), which is responsible for approximately 70-90% of cases worldwide. A 45-year-old man presents with progressive difficulty swallowing, first with solids and now with liquids. He reports regurgitation of undigested food and has lost 15 pounds over the past 3
In acute pancreatitis, hypocalcemia (low blood calcium) is a sign of severe disease. It happens because the inflamed pancreas releases fat-digesting enzymes, which break down fat in the surrounding tissue. This process creates fatty acids that bind to calcium, lowering the blood calcium level. Among the findings, hypocalcemia is a strong indicator of severity and potential complications, making it the best predictor in this case. A 2-week-old male newborn presents with delayed passage of meconium, abdominal distention, and bilious vomiting. Physical examination reveals a distended abdomen with visible peristalsis. Digital rectal examination causes explosive release of stool and gas. Barium enema shows a transitional zone at the rectosigmoid junction. Which of the following is the most likely diagnosis? A. Intestinal malrotation B. Necrotizing enterocolitis C. Hirschsprung disease D. Meconium ileus E. Intestinal atresia Hirschsprung disease is a condition where part of the colon lacks nerve cells, preventing it from relaxing and allowing stool to pass through. This causes delayed passage of meconium, abdominal swelling, and vomiting in newborns. The explosive release of stool during a rectal exam and the barium enema showing a "transitional zone" (narrowed segment of bowel near the rectum) are classic signs of Hirschsprung disease. These findings match the description and make it the most likely diagnosis. Hypertension increases the risk for which of the following? Check all that apply A. Lung Cancer B. Retinopathy C. Heart Attacks
D. Kidney disease Hypertension can damage the blood vessels over time, leading to complications in various organs. In the eyes, high blood pressure can cause retinopathy, damaging the retinal vessels, which can result in vision problems. In the heart, hypertension increases the risk of heart attacks by causing increased strain on the heart and promoting plaque buildup in the arteries. It can also lead to kidney disease by damaging the blood vessels in the kidneys, impairing their function. Lung cancer is not directly associated with hypertension. Coronary artery disease increases the risk for which of the following? A. Myocardial Infarction B. Diabetes C. Arrythmia D. Both A and C Coronary artery disease (CAD) increases the risk of a myocardial infarction (heart attack) due to reduced blood flow to the heart muscle, and it can also lead to arrhythmias because of the damage to the heart's electrical system from decreased oxygen supply. Both conditions are common complications of CAD. A 65-year-old female presents to the clinic with swelling and redness in her left lower leg. She reports that she recently returned from a 10-hour flight and has had mild pain in the leg since then. On examination, there is tenderness along the calf, and Doppler ultrasound confirms a deep vein thrombosis (DVT). What is the primary complication of untreated DVT? A. Stroke B. Pulmonary embolism C. Heart attack D. Kidney failure A clot can dislodge and travel to the lungs, causing a life-threatening pulmonary embolism.
Osteoarthritis typically causes hand pain and stiffness that worsens with use and improves with rest, along with bony enlargements in the DIP and PIP joints, while sparing the MCP joints. The X-ray findings of joint space narrowing and osteophytes (bony growths) are hallmark features of osteoarthritis, distinguishing it from inflammatory conditions like rheumatoid arthritis. A 65-year-old man presents with bone pain, hearing loss, and a warm sensation in his right tibia. Physical examination reveals bowing of the right tibia and an enlarged skull. Laboratory studies show elevated serum alkaline phosphatase with normal calcium and phosphate levels. X-rays show areas of both osteolysis and sclerosis with cortical thickening. Which of the following is the most likely diagnosis? A. Multiple myeloma B. Paget's disease C. Osteoporosis D. Osteogenesis imperfecta E. Bone metastases Paget's disease of bone causes abnormal bone remodeling, leading to areas of bone destruction (osteolysis) and thickening (sclerosis), which explains the symptoms of bone pain, enlarged skull, and bowing of the tibia. The elevated serum alkaline phosphatase, along with normal calcium and phosphate levels, supports the diagnosis of Paget's disease, which is characterized by abnormal bone turnover. A 6-year-old boy presents with a limp and knee pain. His mother reports he had strep throat two weeks ago. Physical examination reveals warm, swollen knees bilaterally. Laboratory studies show elevated ESR and positive antistreptolysin O titer. Which of the following is the most likely diagnosis? A. Juvenile idiopathic arthritis
B. Septic arthritis C. Acute rheumatic fever D. Lyme disease E. Legg-Calvé-Perthes disease Acute rheumatic fever often follows a recent strep throat infection and can cause symptoms like joint pain, warmth, and swelling, especially in the knees. The elevated ESR (indicating inflammation) and positive antistreptolysin O (ASO) titer confirm a recent streptococcal infection, making acute rheumatic fever the most likely diagnosis A 13-year-old male athlete presents with anterior knee pain that worsens with running and jumping. Physical examination reveals tenderness and swelling over the tibial tuberosity. X-rays show fragmentation of the tibial tubercle with soft tissue swelling. Which of the following is the most likely diagnosis? A. Juvenile rheumatoid arthritis B. Osgood-Schlatter disease C. Patellar tendinitis D. Septic arthritis E. Patellofemoral syndrome Osgood-Schlatter disease is a common cause of knee pain in active adolescents, particularly athletes, and is characterized by inflammation and pain at the tibial tuberosity, which is worsened by running and jumping. X-rays showing fragmentation of the tibial tubercle along with soft tissue swelling confirm this diagnosis, as it results from repetitive stress on the area where the patellar tendon attaches.
A 65-year-old man presents with a 1cm pearly nodule with central ulceration on his nose. The lesion has been slowly growing over the past year and occasionally bleeds. Which of the following is the most likely diagnosis? A. Squamous cell carcinoma B. Basal cell carcinoma C. Melanoma D. Seborrheic keratosis E. Actinic keratosis The description of a pearly nodule with central ulceration and slow growth is characteristic of basal cell carcinoma, the most common type of skin cancer. Basal cell carcinoma typically appears on sun-exposed areas like the nose and often has a tendency to ulcerate and bleed A 3-year-old child presents with multiple fluid-filled vesicles in various stages of healing, along with crusted lesions. The rash is predominantly on the trunk and extremities, and the child has a fever of 38.5°C. Several classmates have similar symptoms. Which of the following is the most likely diagnosis? A. Impetigo B. Varicella C. Hand-foot-mouth disease D. Scabies E. Contact dermatitis
The description of multiple fluid-filled vesicles in various stages of healing, along with crusted lesions, is characteristic of varicella (chickenpox). The rash often appears on the trunk and extremities and is commonly associated with a fever, as well as being highly contagious, as seen in the child’s classmates with similar symptoms. A 6-year-old girl presents with bright red facial rash described as "slapped cheeks" appearance, followed by a lacy reticular rash on her trunk and extremities. The mother reports the child had mild fever and cold-like symptoms a week ago. Several other children in her class have similar symptoms. Which of the following is the most likely diagnosis? A. Roseola infantum B. Erythema infectiosum C. Scarlet fever D. Measles E. Rubella The "slapped cheeks" appearance followed by a lacy reticular rash on the trunk and extremities is characteristic of erythema infectiosum, also known as fifth disease, caused by parvovirus B19. The mild fever and cold-like symptoms preceding the rash, along with the similar symptoms in classmates, further support this diagnosis. Leukemia is classified as: acute or chronic A patient has thrombosis. While reviewing the history, the nurse found the patient has atherosclerosis? To which component of the Virchow triad does the atherosclerosis correlate? Endothelial injury
