ACTUAL EXAM 2026/2027 Units 2-7 |
Advanced Pathophysiology | Verified Q&A |
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UNIT 2: Cellular Function & Genetics (30 Questions)
Cellular Adaptation & Injury (12 Questions)
Q1: A 45-year-old male with a history of hypertension presents with left ventricular hypertrophy. This
cellular adaptation is best described as:
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Metaplasia
Correct Answer: B
Rationale: Hypertrophy is an increase in cell size resulting in enlarged tissue mass. The heart muscle
cells increase in size in response to chronic pressure overload from hypertension, increasing contractile
strength to overcome elevated systemic vascular resistance.
Q2: A postmenopausal woman experiences uterine shrinkage due to estrogen deficiency. This process is
an example of:
A. Physiologic hypertrophy
B. Pathologic atrophy
C. Physiologic atrophy
D. Metaplasia
Correct Answer: C
Rationale: Physiologic atrophy is a normal, programmed reduction in tissue size due to decreased
hormonal stimulation. Postmenopausal uterine atrophy is an expected, age-related change rather than
pathologic atrophy from disease or disuse.
,Q3: [Select All That Apply] Which are reversible cellular injuries?
A. Cellular swelling
B. Fatty change
C. Nuclear pyknosis
D. Karyorrhexis
E. Karyolysis
Correct Answer: A, B
Rationale: Cellular swelling and fatty change are reversible injuries if the injurious stimulus is removed.
Nuclear changes (pyknosis, karyorrhexis, karyolysis) indicate irreversible injury and cell death.
Q4: A patient with chronic gastroesophageal reflux develops Barrett's esophagus. This is an example of:
A. Dysplasia
B. Metaplasia
C. Hyperplasia
D. Anaplasia
Correct Answer: B
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with another. In
Barrett's esophagus, chronic acid exposure causes squamous epithelium to transform into columnar
epithelium, which is more resistant to acid but increases cancer risk.
Q5: Coagulative necrosis is most characteristic of which condition?
A. Cerebral infarction
B. Myocardial infarction
C. Pancreatitis
D. Pyogenic abscess
Correct Answer: B
Rationale: Coagulative necrosis preserves tissue architecture and is characteristic of ischemia in solid
organs (heart, kidney, spleen). Myocardial infarction results from coronary artery occlusion causing
coagulative necrosis of cardiac muscle.
Q6: Liquefactive necrosis is most commonly seen in:
A. Myocardial infarction
B. Cerebral infarction
,C. Renal infarction
D. Limb gangrene
Correct Answer: B
Rationale: Liquefactive necrosis occurs when enzymatic digestion predominates, characteristic of brain
infarcts due to high lipid content and abundant hydrolytic enzymes. The brain tissue softens and
liquefies rather than maintaining architecture.
Q7: Caseous necrosis is the hallmark of:
A. Tuberculosis
B. Syphilis
C. Amebiasis
D. Histoplasmosis
Correct Answer: A
Rationale: Caseous necrosis appears as soft, friable, "cheese-like" white material and is pathognomonic
for tuberculosis. It represents a combination of coagulative and liquefactive necrosis with
granulomatous inflammation.
Q8: A patient with severe trauma develops fat necrosis in subcutaneous tissue. The pathognomonic
finding is:
A. Calcium deposits appearing as white chalky deposits
B. Liquefied tissue with pus formation
C. Green-black discoloration of tissue
D. Caseous granulomas
Correct Answer: A
Rationale: Fat necrosis occurs when lipases break down triglycerides into fatty acids, which combine
with calcium to form insoluble soaps, appearing as chalky white deposits. This is seen in acute
pancreatitis and traumatic fat necrosis.
Q9: Dry gangrene differs from wet gangrene primarily by:
A. Presence of bacterial infection
B. Preservation of tissue demarcation without significant bacterial putrefaction
C. Rapid progression and systemic toxicity
D. Liquefactive necrosis pattern
, Correct Answer: B
Rationale: Dry gangrene results from coagulative necrosis with ischemia but without significant bacterial
infection, allowing a clear line of demarcation to form between viable and necrotic tissue. Wet gangrene
involves bacterial infection and liquefactive necrosis.
Q10: Apoptosis differs from necrosis in that apoptosis:
A. Always causes inflammation
B. Is a programmed, energy-dependent process without inflammation
C. Results from acute injury only
D. Affects groups of cells rather than single cells
Correct Answer: B
Rationale: Apoptosis is programmed cell death characterized by cell shrinkage, chromatin condensation,
and formation of apoptotic bodies without inflammation. It requires ATP and is regulated by caspases,
unlike necrosis which is accidental and inflammatory.
Q11: A 55-year-old smoker develops squamous metaplasia in the bronchi. The primary significance of
this finding is:
A. It is a benign change with no clinical importance
B. It increases risk for malignant transformation
C. It improves mucociliary clearance
D. It indicates resolved inflammation
Correct Answer: B
Rationale: While metaplasia is initially adaptive, persistent injury (smoking) can cause dysplastic
changes. Squamous metaplasia in the respiratory tract is a premalignant condition that may progress to
squamous cell carcinoma if the irritant continues.
Q12: Cellular swelling (hydropic change) is caused by:
A. Decreased intracellular water
B. Impaired Na+/K+-ATPase pump function leading to water influx
C. Increased protein synthesis
D. Decreased membrane permeability
Correct Answer: B
Rationale: Cellular swelling results from ATP depletion causing Na+/K+-ATPase pump failure. Sodium