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 with chronic alcohol use develops hepatomegaly. Liver biopsy shows
enlarged hepatocytes with proliferated smooth endoplasmic reticulum. This cellular
adaptation is:
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Metaplasia
Correct Answer: C
Rationale: Chronic ethanol → induces CYP2E1 enzymes → proliferative response of
smooth ER (increase in organelle NUMBER per cell) = hyperplasia. Hypertrophy would
be increased cell size without numeric increase in organelles. Clinical correlate: explains
tolerance and drug interactions in substance users.
Q2: Which genetic disorder demonstrates autosomal dominant inheritance with
essentially complete penetrance?
,A. Cystic fibrosis
B. Sickle cell disease
C. Huntington disease
D. Phenylketonuria
Correct Answer: C
Rationale: Huntington = expanded CAG trinucleotide repeat, AD, 100 % penetrance by
mid-adult life. CF & PKU = AR; sickle cell = AR with variable expression. NP role: 50 %
recurrence risk for each child; presymptomatic genetic testing available.
Q3: A tumor suppressor gene mutation causes loss of “checkpoint” control in the G1/S
phase. Which gene is most likely mutated?
A. K-ras
B. p53
C. HER2
D. BCR-ABL
Correct Answer: B
Rationale: p53 arrests cell cycle at G1/S after DNA damage, permitting repair or
apoptosis. Loss-of-function mutations remove brake = uncontrolled proliferation. K-ras
& BCR-ABL are oncogenes; HER2 is receptor tyrosine kinase amplified in breast cancer.
Q4: A child presents with recurrent infections, eczema, and thrombocytopenia.
Peripheral smear shows small platelets. The underlying defect is in:
,A. Neutrophil oxidative burst
B. WASp protein cytoskeletal regulation
C. Complement C3 deficiency
D. Bruton tyrosine kinase
Correct Answer: B
Rationale: Wiskott-Aldrich syndrome = X-linked mutation in WASp → defective actin
polymerization → impaired immune synapse & platelet formation → triad of eczema,
infections, micro-thrombocytopenia. Btk defect = XLA (no eczema/thrombocytopenia).
Q5: Which form of necrosis is most characteristic of cerebral infarction?
A. Coagulative
B. Liquefactive
C. Caseous
D. Fat
Correct Answer: B
Rationale: Brain is rich in lipids & hydrolytic enzymes → ischemia → autolysis →
liquefactive necrosis (soft, cystic cavity). Coagulative = heart/kidney; caseous = TB; fat
= breast/pancreas.
Q6: A 30-year-old woman has bilateral breast cancer, a family history of ovarian cancer,
and triple-negative tumor phenotype. Which mutation confers the highest lifetime risk?
, A. BRCA1
B. BRCA2
C. p53
D. PTEN
Correct Answer: A
Rationale: BRCA1 → 60-70 % breast, 40-50 % ovarian; strongly associated with
triple-negative breast cancers. BRCA2 risks lower and more hormone-receptor positive.
p53 = Li-Fraumeni (multiple early cancers); PTEN = Cowden.
Q7: During ischemia-reperfusion injury, which reactive oxygen species is first generated
by the mitochondrial electron-transport chain?
A. Hydrogen peroxide
B. Superoxide anion
C. Hydroxyl radical
D. Hypochlorous acid
Correct Answer: B
Rationale: Ischemia → ↓O₂ → buildup of reducing equivalents; reperfusion supplies O₂
→ complex I/III leak electrons → superoxide (O₂⁻) formed first, then converted to H₂O₂
and •OH. Hypochlorous acid = myeloperoxidase product in neutrophils.
Q8: A 55-year-old man has 1000+ colonic adenomatous polyps and osteomas. Genetic
testing shows APC mutation. Which signaling pathway is dysregulated?
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 with chronic alcohol use develops hepatomegaly. Liver biopsy shows
enlarged hepatocytes with proliferated smooth endoplasmic reticulum. This cellular
adaptation is:
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Metaplasia
Correct Answer: C
Rationale: Chronic ethanol → induces CYP2E1 enzymes → proliferative response of
smooth ER (increase in organelle NUMBER per cell) = hyperplasia. Hypertrophy would
be increased cell size without numeric increase in organelles. Clinical correlate: explains
tolerance and drug interactions in substance users.
Q2: Which genetic disorder demonstrates autosomal dominant inheritance with
essentially complete penetrance?
,A. Cystic fibrosis
B. Sickle cell disease
C. Huntington disease
D. Phenylketonuria
Correct Answer: C
Rationale: Huntington = expanded CAG trinucleotide repeat, AD, 100 % penetrance by
mid-adult life. CF & PKU = AR; sickle cell = AR with variable expression. NP role: 50 %
recurrence risk for each child; presymptomatic genetic testing available.
Q3: A tumor suppressor gene mutation causes loss of “checkpoint” control in the G1/S
phase. Which gene is most likely mutated?
A. K-ras
B. p53
C. HER2
D. BCR-ABL
Correct Answer: B
Rationale: p53 arrests cell cycle at G1/S after DNA damage, permitting repair or
apoptosis. Loss-of-function mutations remove brake = uncontrolled proliferation. K-ras
& BCR-ABL are oncogenes; HER2 is receptor tyrosine kinase amplified in breast cancer.
Q4: A child presents with recurrent infections, eczema, and thrombocytopenia.
Peripheral smear shows small platelets. The underlying defect is in:
,A. Neutrophil oxidative burst
B. WASp protein cytoskeletal regulation
C. Complement C3 deficiency
D. Bruton tyrosine kinase
Correct Answer: B
Rationale: Wiskott-Aldrich syndrome = X-linked mutation in WASp → defective actin
polymerization → impaired immune synapse & platelet formation → triad of eczema,
infections, micro-thrombocytopenia. Btk defect = XLA (no eczema/thrombocytopenia).
Q5: Which form of necrosis is most characteristic of cerebral infarction?
A. Coagulative
B. Liquefactive
C. Caseous
D. Fat
Correct Answer: B
Rationale: Brain is rich in lipids & hydrolytic enzymes → ischemia → autolysis →
liquefactive necrosis (soft, cystic cavity). Coagulative = heart/kidney; caseous = TB; fat
= breast/pancreas.
Q6: A 30-year-old woman has bilateral breast cancer, a family history of ovarian cancer,
and triple-negative tumor phenotype. Which mutation confers the highest lifetime risk?
, A. BRCA1
B. BRCA2
C. p53
D. PTEN
Correct Answer: A
Rationale: BRCA1 → 60-70 % breast, 40-50 % ovarian; strongly associated with
triple-negative breast cancers. BRCA2 risks lower and more hormone-receptor positive.
p53 = Li-Fraumeni (multiple early cancers); PTEN = Cowden.
Q7: During ischemia-reperfusion injury, which reactive oxygen species is first generated
by the mitochondrial electron-transport chain?
A. Hydrogen peroxide
B. Superoxide anion
C. Hydroxyl radical
D. Hypochlorous acid
Correct Answer: B
Rationale: Ischemia → ↓O₂ → buildup of reducing equivalents; reperfusion supplies O₂
→ complex I/III leak electrons → superoxide (O₂⁻) formed first, then converted to H₂O₂
and •OH. Hypochlorous acid = myeloperoxidase product in neutrophils.
Q8: A 55-year-old man has 1000+ colonic adenomatous polyps and osteomas. Genetic
testing shows APC mutation. Which signaling pathway is dysregulated?
