D236 Pathophysiology Week 2 Study Guide Comprehensive Exam
2026 |WGU
1. Which cellular adaptation is characterized by a decrease in cell size, leading to
reduced organ size?
A. Hypertrophy
B. Metaplasia
C. Atrophy
D. Dysplasia
Answer: C
Rationale: Atrophy is the shrinkage in cell size. If it occurs in a sufficient number of cells,
the entire organ shrinks.
2. What is the primary difference between hypertrophy and hyperplasia?
A. Hypertrophy involves an increase in cell number, while hyperplasia involves cell size.
B. Hypertrophy involves an increase in cell size, while hyperplasia involves cell number.
C. Hypertrophy is always pathological, while hyperplasia is always physiological.
D. There is no difference; the terms are interchangeable.
Answer: B
Rationale: Hypertrophy is an increase in the size of cells, whereas hyperplasia is an
increase in the number of cells resulting from an increased rate of cellular division.
,3. A patient who has smoked for 20 years shows a change in the bronchial lining
from ciliated columnar epithelium to stratified squamous epithelium. This is an
example of:
A. Dysplasia
B. Metaplasia
C. Atrophy
D. Anaplasia
Answer: B
Rationale: Metaplasia is the reversible replacement of one mature cell type by another,
often as a response to chronic irritation like smoking.
4. Which cellular change is most closely associated with the development of
cancer, though it is not yet cancerous itself?
A. Physiological Hyperplasia
B. Dysplasia
C. Metaplasia
D. Autophagy
Answer: B
Rationale: Dysplasia, often called ‘atypical hyperplasia,’ refers to abnormal changes in size,
shape, and organization of mature cells and is frequently a precursor to cancer.
5. What is the most common cause of cellular injury?
A. Chemical agents
B. Hypoxia
C. Free radicals
D. Genetic factors
Answer: B
Rationale: Hypoxia, or lack of sufficient oxygen, is the single most common cause of
cellular injury.
, 6. Ischemia leads to cellular injury primarily by reducing the production of:
A. Glucose
B. Sodium
C. Carbon dioxide
D. ATP
Answer: D
Rationale: Ischemia reduces mitochondrial oxygenation, which inhibits the production of
ATP, leading to failure of the sodium-potassium pump.
7. During reperfusion injury, what substances are produced that cause further
membrane damage and mitochondrial calcium overload?
A. Lactic acid
B. Reactive oxygen species (Free radicals)
C. Endorphins
D. Bicarbonate ions
Answer: B
Rationale: Reperfusion injury occurs when oxygen is restored to ischemic tissues, leading
to the generation of highly reactive oxygen species (oxidative stress).
8. Which type of necrosis is typically seen in the brain as a result of ischemic
injury?
A. Liquefactive necrosis
B. Coagulative necrosis
C. Caseous necrosis
D. Fat necrosis
Answer: A
Rationale: Liquefactive necrosis is common in the brain because brain cells are rich in
digestive hydrolytic enzymes and lipids.
2026 |WGU
1. Which cellular adaptation is characterized by a decrease in cell size, leading to
reduced organ size?
A. Hypertrophy
B. Metaplasia
C. Atrophy
D. Dysplasia
Answer: C
Rationale: Atrophy is the shrinkage in cell size. If it occurs in a sufficient number of cells,
the entire organ shrinks.
2. What is the primary difference between hypertrophy and hyperplasia?
A. Hypertrophy involves an increase in cell number, while hyperplasia involves cell size.
B. Hypertrophy involves an increase in cell size, while hyperplasia involves cell number.
C. Hypertrophy is always pathological, while hyperplasia is always physiological.
D. There is no difference; the terms are interchangeable.
Answer: B
Rationale: Hypertrophy is an increase in the size of cells, whereas hyperplasia is an
increase in the number of cells resulting from an increased rate of cellular division.
,3. A patient who has smoked for 20 years shows a change in the bronchial lining
from ciliated columnar epithelium to stratified squamous epithelium. This is an
example of:
A. Dysplasia
B. Metaplasia
C. Atrophy
D. Anaplasia
Answer: B
Rationale: Metaplasia is the reversible replacement of one mature cell type by another,
often as a response to chronic irritation like smoking.
4. Which cellular change is most closely associated with the development of
cancer, though it is not yet cancerous itself?
A. Physiological Hyperplasia
B. Dysplasia
C. Metaplasia
D. Autophagy
Answer: B
Rationale: Dysplasia, often called ‘atypical hyperplasia,’ refers to abnormal changes in size,
shape, and organization of mature cells and is frequently a precursor to cancer.
5. What is the most common cause of cellular injury?
A. Chemical agents
B. Hypoxia
C. Free radicals
D. Genetic factors
Answer: B
Rationale: Hypoxia, or lack of sufficient oxygen, is the single most common cause of
cellular injury.
, 6. Ischemia leads to cellular injury primarily by reducing the production of:
A. Glucose
B. Sodium
C. Carbon dioxide
D. ATP
Answer: D
Rationale: Ischemia reduces mitochondrial oxygenation, which inhibits the production of
ATP, leading to failure of the sodium-potassium pump.
7. During reperfusion injury, what substances are produced that cause further
membrane damage and mitochondrial calcium overload?
A. Lactic acid
B. Reactive oxygen species (Free radicals)
C. Endorphins
D. Bicarbonate ions
Answer: B
Rationale: Reperfusion injury occurs when oxygen is restored to ischemic tissues, leading
to the generation of highly reactive oxygen species (oxidative stress).
8. Which type of necrosis is typically seen in the brain as a result of ischemic
injury?
A. Liquefactive necrosis
B. Coagulative necrosis
C. Caseous necrosis
D. Fat necrosis
Answer: A
Rationale: Liquefactive necrosis is common in the brain because brain cells are rich in
digestive hydrolytic enzymes and lipids.
