Objective Assessment (OA) Actual Exam Practice Test
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QUESTIONS 2026 CARRICULUM BASSED VERRIFIED TEST INSTANT PDF
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1. A patient with chronic anemia develops atrophy of the bone marrow. Which cellular adaptation
best describes this process?
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
Answer: C) Atrophy
Rationale: Atrophy is a decrease in cell size due to reduced workload, decreased blood supply
(ischemia), or inadequate nutrition. In chronic anemia, decreased oxygen delivery leads to reduced
cellular activity and subsequent atrophy. Hypertrophy involves cell enlargement, hyperplasia involves
increased cell number, and metaplasia involves one cell type replacing another .
2. A 55-year-old smoker presents with chronic bronchitis. The bronchial epithelium has changed from
ciliated columnar to stratified squamous cells. This change is an example of:
A) Dysplasia
B) Metaplasia
,C) Anaplasia
D) Neoplasia
Answer: B) Metaplasia
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with another in
response to chronic irritation. The change from columnar to squamous epithelium in smokers is a
protective response to chronic irritation. Dysplasia refers to abnormal cell growth, anaplasia refers to
loss of differentiation in cancer cells, and neoplasia is new, uncontrolled growth .
3. Which type of necrosis is most commonly associated with tuberculosis infections?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
Answer: C) Caseous necrosis
Rationale: Caseous necrosis is characteristic of tuberculosis infections, resulting in a cheese-like, white
appearance. Coagulative necrosis occurs from ischemia (e.g., myocardial infarction), liquefactive
necrosis occurs in the brain from ischemia, and fat necrosis occurs in breast and pancreatic tissue .
4. A patient suffers a myocardial infarction. The type of necrosis seen in the affected cardiac tissue is:
,A) Liquefactive necrosis
B) Coagulative necrosis
C) Caseous necrosis
D) Gangrenous necrosis
Answer: B) Coagulative necrosis
Rationale: Coagulative necrosis is the characteristic pattern of cell death in hypoxic/ischemic injury,
particularly in solid organs like the heart, kidney, and spleen. The tissue architecture is preserved for
several days due to protein denaturation. Liquefactive necrosis occurs in the brain, caseous in
tuberculosis, and gangrenous is a combination of ischemic necrosis and bacterial infection .
5. Apoptosis is best described as:
A) Uncontrolled cell death due to injury
B) Programmed cell death without inflammation
C) Cell death causing significant inflammation
D) Death of cells due to hypoxia
Answer: B) Programmed cell death without inflammation
Rationale: Apoptosis is a regulated, energy-dependent process of programmed cell death that
eliminates unwanted or damaged cells without triggering an inflammatory response. It is distinct from
necrosis, which is uncontrolled and causes inflammation. Apoptosis is essential for normal
development and tissue homeostasis .
, 6. A patient is found to have dysplastic cells on a cervical Pap smear. The healthcare provider should
interpret this finding as:
A) Malignant tumor
B) Precancerous cellular changes
C) Normal cellular variation
D) Metastatic disease
Answer: B) Precancerous cellular changes
Rationale: Dysplasia involves abnormal cell growth and differentiation and is considered a
precancerous condition. It can be graded as mild, moderate, or severe and may progress to carcinoma
in situ and invasive cancer. It does not indicate a definitive malignancy but warrants monitoring and
possible intervention .
7. Which cellular change involves an increase in cell size and organ size due to increased workload?
A) Atrophy
B) Hypertrophy
C) Hyperplasia
D) Metaplasia
Answer: B) Hypertrophy