PATHOPHYSIOLOGY EXAM 1 QUESTIONS
AND CORRECT ANSWERS WITH
DETAILED RATIONALES
1. Which of the following best describes reversible cell injury?
A) Rupture of the plasma membrane
B) Swelling of the endoplasmic reticulum and mitochondria
C) Chromatin clumping and nuclear fragmentation
D) Release of lysosomal enzymes into the cytoplasm
Answer: B
Rationale: Reversible injury is characterized by cellular swelling (hydropic
change) and fatty change, with swelling of organelles like the ER and
mitochondria. Membrane rupture, nuclear fragmentation (karyorrhexis), and
lysosomal enzyme release are hallmarks of irreversible injury and necrosis.
2. A patient with chronic alcoholism develops liver disease. Liver biopsy
shows fat accumulation within hepatocytes. This is an example of:
A) Hydropic degeneration
B) Steatosis
C) Hypertrophy
D) Metaplasia
Answer: B
Rationale: Steatosis (fatty change) is the abnormal accumulation of
triglycerides within parenchymal cells, commonly seen in the liver due to
alcohol toxicity, diabetes, or obesity.
,3. Which of the following is a characteristic of apoptosis?
A) Swelling of the cell and organelles
B) Leakage of intracellular contents into the extracellular space
C) Fragmentation of the cell into apoptotic bodies
D) Significant inflammatory response
Answer: C
Rationale: Apoptosis is programmed cell death characterized by cell
shrinkage, chromatin condensation, and formation of apoptotic bodies that
are phagocytosed without triggering inflammation. Necrosis involves swelling
and inflammation.
4. Caseous necrosis is most commonly associated with which organism?
A) Streptococcus pneumoniae
B) Mycobacterium tuberculosis
C) Staphylococcus aureus
D) Escherichia coli
Answer: B
Rationale: Caseous necrosis is a distinctive form of coagulative necrosis seen
in tuberculous infections, characterized by a friable, cheese-like appearance
(granulomatous inflammation with central necrosis).
5. The process by which one adult cell type is replaced by another adult cell
type is termed:
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
,D) Dysplasia
Answer: C
Rationale: Metaplasia is a reversible change in which one differentiated cell
type is replaced by another, often in response to chronic irritation (e.g.,
Barrett's esophagus where squamous epithelium is replaced by columnar).
6. A patient experiences a myocardial infarction. The heart tissue undergoes
coagulative necrosis. What is the primary mechanism of cell death in this
scenario?
A) ATP depletion leading to failure of Na+/K+ pump
B) Activation of caspases
C) Direct membrane attack by complement
D) Osmotic lysis due to water influx
Answer: A
Rationale: Ischemic injury (MI) leads to hypoxia, causing ATP depletion. This
fails the Na+/K+ pump, leading to sodium influx, cell swelling, and eventual
coagulative necrosis. Caspase activation is for apoptosis.
7. Which of the following is a systemic effect of inflammation?
A) Rubor (redness)
B) Tumor (swelling)
C) Fever
D) Dolor (pain)
Answer: C
Rationale: Fever is a systemic (whole-body) effect of inflammation, mediated
by pyrogens (IL-1, TNF-α). Rubor, tumor, dolor, and calor are the four local
cardinal signs.
, 8. The predominant phagocyte in early (acute) inflammatory responses is the:
A) Macrophage
B) Lymphocyte
C) Neutrophil
D) Eosinophil
Answer: C
Rationale: Neutrophils (polymorphonuclear leukocytes) are the first
leukocytes to arrive at an inflammatory site (within minutes to hours) and are
the hallmark of acute inflammation.
9. Which cell type is primarily responsible for chronic inflammation and
granuloma formation?
A) Neutrophils
B) Mast cells
C) Macrophages
D) Platelets
Answer: C
Rationale: Macrophages are the dominant cells in chronic inflammation. They
can fuse to form multinucleated giant cells, a feature of granulomas
(organized collections of macrophages).
10. Histamine is released from mast cells and causes which of the following
vascular changes?
A) Vasoconstriction
B) Increased vascular permeability
C) Platelet aggregation
D) Bronchoconstriction only
AND CORRECT ANSWERS WITH
DETAILED RATIONALES
1. Which of the following best describes reversible cell injury?
A) Rupture of the plasma membrane
B) Swelling of the endoplasmic reticulum and mitochondria
C) Chromatin clumping and nuclear fragmentation
D) Release of lysosomal enzymes into the cytoplasm
Answer: B
Rationale: Reversible injury is characterized by cellular swelling (hydropic
change) and fatty change, with swelling of organelles like the ER and
mitochondria. Membrane rupture, nuclear fragmentation (karyorrhexis), and
lysosomal enzyme release are hallmarks of irreversible injury and necrosis.
2. A patient with chronic alcoholism develops liver disease. Liver biopsy
shows fat accumulation within hepatocytes. This is an example of:
A) Hydropic degeneration
B) Steatosis
C) Hypertrophy
D) Metaplasia
Answer: B
Rationale: Steatosis (fatty change) is the abnormal accumulation of
triglycerides within parenchymal cells, commonly seen in the liver due to
alcohol toxicity, diabetes, or obesity.
,3. Which of the following is a characteristic of apoptosis?
A) Swelling of the cell and organelles
B) Leakage of intracellular contents into the extracellular space
C) Fragmentation of the cell into apoptotic bodies
D) Significant inflammatory response
Answer: C
Rationale: Apoptosis is programmed cell death characterized by cell
shrinkage, chromatin condensation, and formation of apoptotic bodies that
are phagocytosed without triggering inflammation. Necrosis involves swelling
and inflammation.
4. Caseous necrosis is most commonly associated with which organism?
A) Streptococcus pneumoniae
B) Mycobacterium tuberculosis
C) Staphylococcus aureus
D) Escherichia coli
Answer: B
Rationale: Caseous necrosis is a distinctive form of coagulative necrosis seen
in tuberculous infections, characterized by a friable, cheese-like appearance
(granulomatous inflammation with central necrosis).
5. The process by which one adult cell type is replaced by another adult cell
type is termed:
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
,D) Dysplasia
Answer: C
Rationale: Metaplasia is a reversible change in which one differentiated cell
type is replaced by another, often in response to chronic irritation (e.g.,
Barrett's esophagus where squamous epithelium is replaced by columnar).
6. A patient experiences a myocardial infarction. The heart tissue undergoes
coagulative necrosis. What is the primary mechanism of cell death in this
scenario?
A) ATP depletion leading to failure of Na+/K+ pump
B) Activation of caspases
C) Direct membrane attack by complement
D) Osmotic lysis due to water influx
Answer: A
Rationale: Ischemic injury (MI) leads to hypoxia, causing ATP depletion. This
fails the Na+/K+ pump, leading to sodium influx, cell swelling, and eventual
coagulative necrosis. Caspase activation is for apoptosis.
7. Which of the following is a systemic effect of inflammation?
A) Rubor (redness)
B) Tumor (swelling)
C) Fever
D) Dolor (pain)
Answer: C
Rationale: Fever is a systemic (whole-body) effect of inflammation, mediated
by pyrogens (IL-1, TNF-α). Rubor, tumor, dolor, and calor are the four local
cardinal signs.
, 8. The predominant phagocyte in early (acute) inflammatory responses is the:
A) Macrophage
B) Lymphocyte
C) Neutrophil
D) Eosinophil
Answer: C
Rationale: Neutrophils (polymorphonuclear leukocytes) are the first
leukocytes to arrive at an inflammatory site (within minutes to hours) and are
the hallmark of acute inflammation.
9. Which cell type is primarily responsible for chronic inflammation and
granuloma formation?
A) Neutrophils
B) Mast cells
C) Macrophages
D) Platelets
Answer: C
Rationale: Macrophages are the dominant cells in chronic inflammation. They
can fuse to form multinucleated giant cells, a feature of granulomas
(organized collections of macrophages).
10. Histamine is released from mast cells and causes which of the following
vascular changes?
A) Vasoconstriction
B) Increased vascular permeability
C) Platelet aggregation
D) Bronchoconstriction only
