NURS 5315 ADVANCED PATHOPHYSIOLOGY
TEST 1 PRACTICE EXAMINATION 2026
QUESTIONS WITH ANSWERS GRADED A+
• What can Reactive Oxygen Species cause?.
Answer: Heart disease, Alzheimers, Parkinsons, Amyotrophic Lateral
Sclerosis (ALS), CV disease, HTN, HLD, DM, ischemic heart disease, HF,
OSA. Lipid perioxidation, damage proteins, fragment DNA, less *protein
synthesis*, chromatin destruction, damage mitochondria
• Atrophy P. Still functional; imbalance between protein synthesis and
degradation. Essentially there is an increase in the catabolism of intracellular
organelles, reducing structural components of cell Physiologic: thymus
gland in early childhood Pathological: disuse (muscle atrophy d/ decrease
workload, pressure, use, blood supply, nutrition, hormonal stimulation, or
nervous stimulation).
Answer: E. Cells decrease in size
• Hyperplasia Phys: increased rate of division, increase in tissue mass after
damage or partial resection; may be compensatory, hormonal, or pathologic
Patho: abnormal proliferation of normal cells usually caused by increased
hormonal stimulation (endometrial). increase of production of local growth
factors Ex: removal of part of the liver lead to hyperplasia of hepatocytes.
uterine or mammary gland enlargement during pregnancy.
Answer: E: cells increase in number, mitosis (cell division) must occur, size
of cell does not change
• Dysplasia P. caused by cell injury/irritation, characterized by disordered cell
growth. aka atypical hyperplasia or pre-cancer, a disorderly proliferation
Physiologic: N/A Pathologic: squamous dysplasia of cervix from HPV
shows up on pap smear, breast cancer development; pap smears often show
dysplastic cells of the cervix that must undergo laser/surgical tx.
Answer: E. Not true adaptation; Cells abnormal change in size, shape,
, organization (classified as mild, moderate, severe)
• Metaplasia P: reversible; results from exposure of the cells to chronic
stressors, injury, or irritation; Cancer can arise from this area, stimulus
induces a reprogramming of stem cells under the influence of cytokines and
growth factors Ex: Patho: Columnar cells change to squamous cells in lungs
of smoker or normal ciliated epithelial cells of the bronchial linings are
replaced by stratified squamous epithelial cells.; Phys: Barrett Esophagus-
normal squamous cells change to columnar epithelial cells in response to
reflux, aka intestinal metaplasia.
Answer: E: reversible change, one type of cell changes to another type for
survival
• Hypoxia injury P. decrease in mitochondrial function, decreased production
of ATP increases anaerobic metabolism. eventual cell death. C.M. hypoxia,
cyanosis, cognitive impairment, lethargy.
Answer: E. inadequate oxygenation of tissues
• Free radical and ROS P. lipid peroxidation, damage proteins, fragment DNA
C.M. development in Alzheimer's, heart disease, Parkinson's disease,
Amyotrophic Lateral Sclerosis.
Answer: E. normal byproduct of ATP production, will overwhelm the
mitochondria- exhaust intracellular antioxidants
• Ethanol P. metabolized by liver, generates free radicals C.M. CNS
depression, nutrient deficiencies-Mag, Vit B6, thiamine, PO4, inflammation
and fatty infiltration of liver, hepatomegaly, leads to liver failure
irreversible.
Answer: E. mood altering drug, long term effects on liver and nutritional
status
• How are free radicals produced? 2. Absorption of extreme energy sources
(radiation, UV light) 3. Metabolism of exogenous chemicals, drugs, and
pesticides 4. Transition of metals 5. Nitric oxide acting like a chemical
mediator and a free radical.
Answer: 1. Normal cellular respiration
,• Oncosis.
Answer: Na and H2O enter cell and cause swelling. Organ increases in
weight, becomes distended and pale. Associated with high fever,
hypocalcemia, certain infections
• What is the body's defense against ROS?.
Answer: Antioxidants (Vitamin E, Vitamin C, cysteine, glutathione,
albumin, ceruloplasmin, transferrin)
• Fatty Infiltration liver fails to metabolize lipids. usually from ETOH or high
fat diet. can lead to cirrhosis.
Answer: intracellular accumulation of lipids in the liver
• dystrophic calcification calcium salt clump and harden- interfere with
cellular structure and function r/t pulmonary TB, atherosclerosis, injured
heart valves, chronic pancreatitis.
Answer: accumulation of Ca in dead or dying tissues
• action potential.
Answer: Process of conducting an impulse. Activates the neuron --> the
neuron depolarizes --> then repolarizes
• metastatic calcification result of hypercalcemia r/t hyperparathyroidism,
hyperthyroidism, toxic levels of Vit D. Can also r/t hyperphosphatemia in
renal failure.
Answer: accumulation of Ca in normal tissue
• Threshold potential.
Answer: Point at which depolarization must reach in order to initiate an
action potential
• urate accumulation.
Answer: sodium urate crystals are deposited in tissues- group of disorders
collectively called gout- acute arthritis, chronic gouty arthritis, tophus,
nephritis
• Coagulative Necrosis.
, Answer: kidneys, heart, adrenals- secondary to hypoxia
• Liquefactive Necrosis.
Answer: nerve cells- brain- accumulation of pus
• Hypokalemia and action potentials.
Answer: HYPERpolarized (more negative, ex. -100). Less excitable.
Decreased neuromuscular excitability: weakness, smooth muscle atony,
paresthesia, cardiac dysrhythmias
• Caseous Necrosis.
Answer: lung disease- usually TB- tissue looks like clumped cheese
• Fat Necrosis.
Answer: breast, pancreas, abdominal structures- creates soaps
• Gangrenous Necrosis Wet- internal organs- can lead to death Gas- from
clostridium- antitoxins and hyperbaric therapy.
Answer: Dry- dark shriveled skin
• Gout P. uric acid is deposited in the tissues of kidney, heart, earlobes, and
joints. C.M. inflammation, painful joints. result of diuretic use or diet high
in cream sauces, red wine, or red meat.
Answer: E. disturbances in serum urate levels. uncommon for < 30 years
old.
• Hyperkalemia and action potentials When resting membrane
potential=threshold potential, it is BAD = cardiac standstill, paresthesia,
paralysis.
Answer: HYPOpolarized (more positive, ex: closer to 0). More excitable.
Peaked T waves.
• Hypocalcemia and action potentials.
Answer: Increased permeability to Na+. More excitable. Tetany,
hyperreflexia, circumoral paresthesia, seizures, dysrhythmias.
• Rhabdomyolysis P. hypoxia to cell causes failure of the Na-K pump,
causing accumulation of intracellular sodium, oncosis, and eventual cell
TEST 1 PRACTICE EXAMINATION 2026
QUESTIONS WITH ANSWERS GRADED A+
• What can Reactive Oxygen Species cause?.
Answer: Heart disease, Alzheimers, Parkinsons, Amyotrophic Lateral
Sclerosis (ALS), CV disease, HTN, HLD, DM, ischemic heart disease, HF,
OSA. Lipid perioxidation, damage proteins, fragment DNA, less *protein
synthesis*, chromatin destruction, damage mitochondria
• Atrophy P. Still functional; imbalance between protein synthesis and
degradation. Essentially there is an increase in the catabolism of intracellular
organelles, reducing structural components of cell Physiologic: thymus
gland in early childhood Pathological: disuse (muscle atrophy d/ decrease
workload, pressure, use, blood supply, nutrition, hormonal stimulation, or
nervous stimulation).
Answer: E. Cells decrease in size
• Hyperplasia Phys: increased rate of division, increase in tissue mass after
damage or partial resection; may be compensatory, hormonal, or pathologic
Patho: abnormal proliferation of normal cells usually caused by increased
hormonal stimulation (endometrial). increase of production of local growth
factors Ex: removal of part of the liver lead to hyperplasia of hepatocytes.
uterine or mammary gland enlargement during pregnancy.
Answer: E: cells increase in number, mitosis (cell division) must occur, size
of cell does not change
• Dysplasia P. caused by cell injury/irritation, characterized by disordered cell
growth. aka atypical hyperplasia or pre-cancer, a disorderly proliferation
Physiologic: N/A Pathologic: squamous dysplasia of cervix from HPV
shows up on pap smear, breast cancer development; pap smears often show
dysplastic cells of the cervix that must undergo laser/surgical tx.
Answer: E. Not true adaptation; Cells abnormal change in size, shape,
, organization (classified as mild, moderate, severe)
• Metaplasia P: reversible; results from exposure of the cells to chronic
stressors, injury, or irritation; Cancer can arise from this area, stimulus
induces a reprogramming of stem cells under the influence of cytokines and
growth factors Ex: Patho: Columnar cells change to squamous cells in lungs
of smoker or normal ciliated epithelial cells of the bronchial linings are
replaced by stratified squamous epithelial cells.; Phys: Barrett Esophagus-
normal squamous cells change to columnar epithelial cells in response to
reflux, aka intestinal metaplasia.
Answer: E: reversible change, one type of cell changes to another type for
survival
• Hypoxia injury P. decrease in mitochondrial function, decreased production
of ATP increases anaerobic metabolism. eventual cell death. C.M. hypoxia,
cyanosis, cognitive impairment, lethargy.
Answer: E. inadequate oxygenation of tissues
• Free radical and ROS P. lipid peroxidation, damage proteins, fragment DNA
C.M. development in Alzheimer's, heart disease, Parkinson's disease,
Amyotrophic Lateral Sclerosis.
Answer: E. normal byproduct of ATP production, will overwhelm the
mitochondria- exhaust intracellular antioxidants
• Ethanol P. metabolized by liver, generates free radicals C.M. CNS
depression, nutrient deficiencies-Mag, Vit B6, thiamine, PO4, inflammation
and fatty infiltration of liver, hepatomegaly, leads to liver failure
irreversible.
Answer: E. mood altering drug, long term effects on liver and nutritional
status
• How are free radicals produced? 2. Absorption of extreme energy sources
(radiation, UV light) 3. Metabolism of exogenous chemicals, drugs, and
pesticides 4. Transition of metals 5. Nitric oxide acting like a chemical
mediator and a free radical.
Answer: 1. Normal cellular respiration
,• Oncosis.
Answer: Na and H2O enter cell and cause swelling. Organ increases in
weight, becomes distended and pale. Associated with high fever,
hypocalcemia, certain infections
• What is the body's defense against ROS?.
Answer: Antioxidants (Vitamin E, Vitamin C, cysteine, glutathione,
albumin, ceruloplasmin, transferrin)
• Fatty Infiltration liver fails to metabolize lipids. usually from ETOH or high
fat diet. can lead to cirrhosis.
Answer: intracellular accumulation of lipids in the liver
• dystrophic calcification calcium salt clump and harden- interfere with
cellular structure and function r/t pulmonary TB, atherosclerosis, injured
heart valves, chronic pancreatitis.
Answer: accumulation of Ca in dead or dying tissues
• action potential.
Answer: Process of conducting an impulse. Activates the neuron --> the
neuron depolarizes --> then repolarizes
• metastatic calcification result of hypercalcemia r/t hyperparathyroidism,
hyperthyroidism, toxic levels of Vit D. Can also r/t hyperphosphatemia in
renal failure.
Answer: accumulation of Ca in normal tissue
• Threshold potential.
Answer: Point at which depolarization must reach in order to initiate an
action potential
• urate accumulation.
Answer: sodium urate crystals are deposited in tissues- group of disorders
collectively called gout- acute arthritis, chronic gouty arthritis, tophus,
nephritis
• Coagulative Necrosis.
, Answer: kidneys, heart, adrenals- secondary to hypoxia
• Liquefactive Necrosis.
Answer: nerve cells- brain- accumulation of pus
• Hypokalemia and action potentials.
Answer: HYPERpolarized (more negative, ex. -100). Less excitable.
Decreased neuromuscular excitability: weakness, smooth muscle atony,
paresthesia, cardiac dysrhythmias
• Caseous Necrosis.
Answer: lung disease- usually TB- tissue looks like clumped cheese
• Fat Necrosis.
Answer: breast, pancreas, abdominal structures- creates soaps
• Gangrenous Necrosis Wet- internal organs- can lead to death Gas- from
clostridium- antitoxins and hyperbaric therapy.
Answer: Dry- dark shriveled skin
• Gout P. uric acid is deposited in the tissues of kidney, heart, earlobes, and
joints. C.M. inflammation, painful joints. result of diuretic use or diet high
in cream sauces, red wine, or red meat.
Answer: E. disturbances in serum urate levels. uncommon for < 30 years
old.
• Hyperkalemia and action potentials When resting membrane
potential=threshold potential, it is BAD = cardiac standstill, paresthesia,
paralysis.
Answer: HYPOpolarized (more positive, ex: closer to 0). More excitable.
Peaked T waves.
• Hypocalcemia and action potentials.
Answer: Increased permeability to Na+. More excitable. Tetany,
hyperreflexia, circumoral paresthesia, seizures, dysrhythmias.
• Rhabdomyolysis P. hypoxia to cell causes failure of the Na-K pump,
causing accumulation of intracellular sodium, oncosis, and eventual cell
