These AGACNP practice questions target pathology — including Berlin Criteria, Global Definition, ATN, Acute Tubular Necrosis. The complete AGACNP deck holds 1020 flashcards, 30 of them dedicated to this topic. Study the free samples below, then unlock the whole collection for a one-time $7.
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A 72-year-old with COPD presents with RR 28, pH 7.28, PaCO2 62 mmHg, and PaO2 54 mmHg. Which classification of respiratory failure is this, and what is the immediate gold-standard intervention?
Show answer →This is Type II (Hypercapnic) Respiratory Failure, defined by PaCO2 >45 mmHg with associated acidemia (pH <7.35). In the context of a COPD exacerbation, Non-invasive Ventilation (NIV/BiPAP) is the gold standard (Level A evidence). It reduces intubation rates, hospital stay, and mortality. Exam strategy: ANCC emphasizes recognizing that Type II failure is a pump problem (ventilatory failure), whereas Type I is a lung problem (oxygenation failure). Distinguish from Type I (Hypoxemic), which is PaO2 <60 mmHg with a normal or low PaCO2.
In the 2024-2026 updated ARDS guidelines (Berlin Criteria/Global Definition), what is the PaO2/FiO2 ratio threshold for Moderate ARDS, and what PEEP setting is required for diagnosis?
Show answer →Moderate ARDS is defined by a P/F ratio of 100-200 mmHg. The diagnosis requires a minimum PEEP of 5 cmH2O (or CPAP). Note: Recent updates allow for the use of High-Flow Nasal Cannula (HFNC) with a flow of >=30L/min to meet the PEEP requirement for diagnosis in resource-limited settings or early ARDS. Exam Strategy: Always calculate the P/F ratio by dividing PaO2 by the decimal FiO2 (e.g., 80 / 0.4 = 200).
An 82-year-old patient with bilateral renal artery stenosis is started on an ACE inhibitor for hypertension. Within 72 hours, the Cr rises by 50%. What is the hemodynamic mechanism?
Show answer →ACE inhibitors block the production of Angiotensin II, which normally provides compensatory vasoconstriction of the efferent arteriole to maintain glomerular filtration pressure when renal perfusion is low (as in renal artery stenosis). Losing this efferent squeeze causes a sharp drop in intraglomerular pressure and GFR. **Exam Strategy:** ANCC frequently tests this specific drug-disease interaction. A rise in Cr >30% after starting an ACEI/ARB should raise immediate suspicion for undiagnosed renal artery stenosis.
Differentiate the urine sediment and biochemical markers of Prerenal AKI from Acute Tubular Necrosis (ATN) in a 2026 clinical context.
Show answer →**Prerenal:** Urine Sodium <20 mEq/L, FENa <1%, Urine Osmolality >500 mOsm/kg, and sediment showing only hyaline casts or bland sediment. **ATN:** Urine Sodium >40 mEq/L, FENa >2%, Urine Osmolality <350 mOsm/kg, and sediment showing muddy brown granular casts and renal tubular epithelial cells. **Advanced Concept:** Novel biomarkers like NGAL and KIM-1 (now more common in 2026) will be elevated in ATN but remain low in pure prerenal AKI, helping to distinguish functional vs. structural damage earlier than creatinine.
A patient found down for 12 hours has a CK of 45,000 U/L. The UA is positive for blood on dipstick, but microscopy shows 0-2 RBCs/hpf. What is the pathophysiology of the resulting AKI?
Show answer →Pigment-induced ATN (Rhabdomyolysis). Myoglobin is released from damaged muscle. Pathophysiology: 1) Intrarenal vasoconstriction, 2) Direct tubular toxicity from heme-protein, and 3) Tubular obstruction by myoglobin precipitates (especially in acidic urine). The dipstick-microscopy mismatch (positive blood, no RBCs) indicates myoglobinuria. Management: Aggressive fluid resuscitation (goal UOP 200-300 mL/hr). ANCC Pearl: Alkalinization of urine (pH >6.5) is sometimes used but volume expansion is the priority.
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Try 30 free AGACNP cards firstThe full AGACNP deck contains 1020 flashcards, and 30 of them focus on pathology. This page shows 5 free samples.
Our AGACNP deck dedicates 30 of 1020 cards (3%) to pathology — always cross-check the official ANCC exam outline for the current blueprint weighting.
Yes — the samples on this page are free, and the AGACNP preview page has 30 more free cards. Full access to all 1020 cards is a one-time $7.
Assessment
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Basics
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Diagnostics
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Management
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Pharmacology
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