NR 507 Advanced Pathophysiology Week 8 Final Exam
Actual Exam 2026/2027 | Questions with Verified
Answers | 100% Correct | Pass Guaranteed
SECTION 1: Cellular Foundations & Genetic Disorders (15 Questions)
Q1: A 45-year-old alcoholic has ballooned hepatocytes on biopsy. Electron microscopy
shows a proliferated smooth endoplasmic reticulum. This adaptation is:
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Metaplasia
Correct Answer: C
Rationale: Chronic ethanol → CYP2E1 induction → SER hyperplasia (↑ organelle number
= ↑ cell number). Clinical: Tolerance to anesthetic agents; guides peri-operative dosing.
Distractors: hypertrophy = ↑ cell size; atrophy = ↓ size; metaplasia = phenotype switch.
Q2: Which disorder shows autosomal-dominant, 100 % penetrance?
A. Cystic fibrosis
B. Sickle-cell disease
,C. Huntington disease
D. Phenylketonuria
Correct Answer: C
Rationale: HD = CAG-repeat expansion; every individual with ≥ 40 repeats manifests
chorea. NP role: 50 % offspring risk; genetic counseling mandatory. CF & PKU are AR;
sickle-cell AR with variable expression.
Q3: A BRCA1 mutation carrier asks why her cancer risk is high. The primary molecular
mechanism is:
A. Defective DNA mismatch repair
B. Impaired homologous recombination double-strand break repair
C. Activated RAS oncogene
D. Telomerase over-expression
Correct Answer: B
Rationale: BRCA1 repairs DNA double-strand breaks via HR; loss → genomic instability
→ triple-negative breast/ovarian cancers. Therapy: PARP inhibitors exploit synthetic
lethality. Mismatch repair (A) causes Lynch syndrome; RAS (C) drives proliferation;
telomerase (D) immortalizes but doesn’t initiate.
Q4: The earliest reversible change in acute hypoxic cell injury is:
A. Lysosomal rupture
B. Ribosomal detachment
,C. Decreased ATP → Na⁺/K⁺ pump failure → cellular swelling
D. Nuclear pyknosis
Correct Answer: C
Rationale: O₂ lack → oxidative phosphorylation stops → ATP ↓ → pump fails → Na⁺ &
water influx → hydropic change (reversible). Clinical correlate: AST/ALT rise before
irreversible necrosis. Lysosomal rupture & pyknosis signal irreversible damage.
Q5: A smoker’s bronchial biopsy shows stratified squamous epithelium replacing
pseudostratified columnar. This is:
A. Dysplasia
B. Metaplasia
C. Hyperplasia
D. Anaplasia
Correct Answer: B
Rationale: Chronic irritation (cigarette smoke) → protective switch to more durable
squamous phenotype. Risk: precursor to dysplasia/cancer; smoking cessation can
reverse. Dysplasia = disordered growth; anaplasia = malignant undifferentiation.
Q6: Which proto-oncogene conversion creates the Philadelphia chromosome in CML?
A. BCL2
B. ABL1
, C. MYC
D. RAS
Correct Answer: B
Rationale: t(9;22) BCR-ABL → constitutive tyrosine-kinase activity → uncontrolled
granulocyte proliferation. Targeted therapy: Imatinib inhibits kinase ATP pocket. MYC
(Burkitt), RAS (many solid tumors), BCL2 (follicular lymphoma).
Q7: A child with xeroderma pigmentosum cannot:
A. Repair UV-induced thymine dimers
B. Synthesize melanin
C. Undergo meiosis
D. Perform nucleotide-excision repair
Correct Answer: D
Rationale: NER pathway defect → thymine dimers persist → basal-cell & squamous-cell
cancers by age 10. NP advice: strict sun avoidance, dermatology q3-6 mo. Melanin
synthesis (B) normal; meiosis (C) unaffected.
Q8: The Warburg effect in cancer cells describes:
A. Increased oxidative phosphorylation
B. Aerobic glycolysis with lactate production
C. Gluconeogenesis activation
Actual Exam 2026/2027 | Questions with Verified
Answers | 100% Correct | Pass Guaranteed
SECTION 1: Cellular Foundations & Genetic Disorders (15 Questions)
Q1: A 45-year-old alcoholic has ballooned hepatocytes on biopsy. Electron microscopy
shows a proliferated smooth endoplasmic reticulum. This adaptation is:
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Metaplasia
Correct Answer: C
Rationale: Chronic ethanol → CYP2E1 induction → SER hyperplasia (↑ organelle number
= ↑ cell number). Clinical: Tolerance to anesthetic agents; guides peri-operative dosing.
Distractors: hypertrophy = ↑ cell size; atrophy = ↓ size; metaplasia = phenotype switch.
Q2: Which disorder shows autosomal-dominant, 100 % penetrance?
A. Cystic fibrosis
B. Sickle-cell disease
,C. Huntington disease
D. Phenylketonuria
Correct Answer: C
Rationale: HD = CAG-repeat expansion; every individual with ≥ 40 repeats manifests
chorea. NP role: 50 % offspring risk; genetic counseling mandatory. CF & PKU are AR;
sickle-cell AR with variable expression.
Q3: A BRCA1 mutation carrier asks why her cancer risk is high. The primary molecular
mechanism is:
A. Defective DNA mismatch repair
B. Impaired homologous recombination double-strand break repair
C. Activated RAS oncogene
D. Telomerase over-expression
Correct Answer: B
Rationale: BRCA1 repairs DNA double-strand breaks via HR; loss → genomic instability
→ triple-negative breast/ovarian cancers. Therapy: PARP inhibitors exploit synthetic
lethality. Mismatch repair (A) causes Lynch syndrome; RAS (C) drives proliferation;
telomerase (D) immortalizes but doesn’t initiate.
Q4: The earliest reversible change in acute hypoxic cell injury is:
A. Lysosomal rupture
B. Ribosomal detachment
,C. Decreased ATP → Na⁺/K⁺ pump failure → cellular swelling
D. Nuclear pyknosis
Correct Answer: C
Rationale: O₂ lack → oxidative phosphorylation stops → ATP ↓ → pump fails → Na⁺ &
water influx → hydropic change (reversible). Clinical correlate: AST/ALT rise before
irreversible necrosis. Lysosomal rupture & pyknosis signal irreversible damage.
Q5: A smoker’s bronchial biopsy shows stratified squamous epithelium replacing
pseudostratified columnar. This is:
A. Dysplasia
B. Metaplasia
C. Hyperplasia
D. Anaplasia
Correct Answer: B
Rationale: Chronic irritation (cigarette smoke) → protective switch to more durable
squamous phenotype. Risk: precursor to dysplasia/cancer; smoking cessation can
reverse. Dysplasia = disordered growth; anaplasia = malignant undifferentiation.
Q6: Which proto-oncogene conversion creates the Philadelphia chromosome in CML?
A. BCL2
B. ABL1
, C. MYC
D. RAS
Correct Answer: B
Rationale: t(9;22) BCR-ABL → constitutive tyrosine-kinase activity → uncontrolled
granulocyte proliferation. Targeted therapy: Imatinib inhibits kinase ATP pocket. MYC
(Burkitt), RAS (many solid tumors), BCL2 (follicular lymphoma).
Q7: A child with xeroderma pigmentosum cannot:
A. Repair UV-induced thymine dimers
B. Synthesize melanin
C. Undergo meiosis
D. Perform nucleotide-excision repair
Correct Answer: D
Rationale: NER pathway defect → thymine dimers persist → basal-cell & squamous-cell
cancers by age 10. NP advice: strict sun avoidance, dermatology q3-6 mo. Melanin
synthesis (B) normal; meiosis (C) unaffected.
Q8: The Warburg effect in cancer cells describes:
A. Increased oxidative phosphorylation
B. Aerobic glycolysis with lactate production
C. Gluconeogenesis activation
