NSG 5003 Advanced Pathophysiology COMPLETED EXAM 2026/2027 (19pages)

1. What is the difference between primary and secondary hemostasis? How do they relate to the formation of a blood clot? - Primary hemostasis is the initial response to vascular injury, involving platelet activation, adhesion, and aggregation. Secondary hemostasis is the activation of the coagulation cascade, resulting in the generation of thrombin and fibrin. Both processes are essential for the formation of a stable blood clot that can seal the damaged vessel and prevent excessive bleeding. - Rationale: This question tests the students' understanding of the basic mechanisms of hemostasis and their role in clotting. 2. What are the main causes and consequences of acute respiratory distress syndrome (ARDS)? How is it diagnosed and treated? - ARDS is a life-threatening condition characterized by severe hypoxemia, pulmonary edema, and inflammation. The main causes of ARDS are direct or indirect lung injury, such as pneumonia, sepsis, trauma, or aspiration. The consequences of ARDS include impaired gas exchange, respiratory failure, multiple organ dysfunction, and high mortality. ARDS is diagnosed based on clinical criteria, such as acute onset, bilateral infiltrates on chest imaging, PaO2/FiO2 ratio less than 300 mmHg, and absence of cardiac failure. The treatment of ARDS involves supportive care, such as mechanical ventilation, fluid management, infection control, and nutritional support. - Rationale: This question tests the students' knowledge of the pathophysiology, etiology, diagnosis, and management of ARDS. 3. What are the main types and features of shock? How are they differentiated and managed? - Shock is a state of inadequate tissue perfusion that leads to cellular hypoxia and organ dysfunction. The main types of shock are hypovolemic, cardiogenic, obstructive, and distributive. Hypovolemic shock is caused by loss of blood or fluid volume. Cardiogenic shock is caused by impaired cardiac function or contractility. Obstructive shock is caused by obstruction of blood flow in the heart or great vessels. Distributive shock is caused by widespread vasodilation and increased capillary permeability. The features of shock include hypotension, tachycardia, oliguria, altered mental status, and metabolic acidosis. The differentiation of shock types is based on clinical presentation, hemodynamic parameters, and diagnostic tests. The management of shock involves restoring tissue perfusion, correcting the underlying cause, and providing organ support. - Rationale: This question tests the students' ability to recognize, classify, and treat different forms of shock