NSG 5140 Advanced Pathophysiology —
Midterm Exam Review
Questions and Answers with Rationales| South College
NSG 5140 Advanced Pathophysiology – Midterm Ptaicgee 1
, 1. Cellular hypertrophy is best defined as:
A. An increase in the number of cells in a tissue
B. An increase in the size of individual cells, leading to increased tissue
mass
C. A decrease in cell size due to loss of cellular substance
D. The replacement of one differentiated cell type with another
Answer: B — An increase in the size of individual cells, leading to
increased tissue mass
Rationale: Hypertrophy refers to an increase in individual cell size (e.g.,
cardiac myocyte enlargement in response to increased workload), distinct
from hyperplasia (increased cell number).
2. Hyperplasia differs from hypertrophy in that hyperplasia involves:
A. An increase in cell number due to increased cell division
B. An increase in individual cell size only
C. Programmed cell death
D. A change from one mature cell type to another
Answer: A — An increase in cell number due to increased cell division
Rationale: Hyperplasia is an increase in the number of cells in a tissue or
organ, resulting from increased cellular proliferation, and can occur
alongside or independent of hypertrophy.
3. Atrophy is a cellular adaptation characterized by:
A. Increased cell size and function
B. A decrease in cell size and function due to disuse, decreased workload,
or reduced blood/nutrient/hormonal supply
C. Malignant transformation of cells
D. Replacement of one cell type by another
Answer: B — A decrease in cell size and function due to disuse,
decreased workload, or reduced blood/nutrient/hormonal supply
NSG 5140 Advanced Pathophysiology – Midterm Ptaicgee 2
, Rationale: Atrophy involves a reduction in cell size and function as an
adaptive response to conditions like disuse, denervation, or diminished
blood supply.
4. Metaplasia refers to:
A. The reversible replacement of one differentiated cell type by another,
often in response to chronic irritation or injury
B. An irreversible cellular adaptation always leading to cancer
C. A decrease in cell number
D. An increase in cell size only
Answer: A — The reversible replacement of one differentiated cell type
by another, often in response to chronic irritation or injury
Rationale: Metaplasia is a reversible adaptive change in which one mature
cell type is replaced by another, often better suited to withstand a chronic
stressor (e.g., squamous metaplasia of the bronchial epithelium in smokers).
5. Which of the following best distinguishes reversible from irreversible
cell injury?
A. Reversible injury always involves cell death; irreversible injury does not
B. Irreversible injury involves severe mitochondrial damage and loss of
membrane integrity that prevent the cell from recovering
C. Reversible injury cannot be caused by hypoxia
D. Irreversible injury is always caused by genetic mutation
Answer: B — Irreversible injury involves severe mitochondrial damage
and loss of membrane integrity that prevent the cell from recovering
Rationale: Irreversible cell injury is marked by severe mitochondrial
dysfunction and loss of plasma membrane integrity, points beyond which the
cell cannot recover, ultimately leading to cell death.
6. Hypoxia causes cell injury primarily by:
A. Directly damaging DNA
NSG 5140 Advanced Pathophysiology – Midterm Ptaicgee 3
, B. Impairing aerobic respiration and ATP production, disrupting cellular
processes dependent on energy
C. Increasing intracellular oxygen levels excessively
D. Causing immediate cell lysis in all cases
Answer: B — Impairing aerobic respiration and ATP production,
disrupting cellular processes dependent on energy
Rationale: Hypoxia reduces oxidative phosphorylation, decreasing ATP
production, which impairs energy-dependent cellular functions such as ion
pumps, leading to cellular injury if prolonged.
7. Free radical-mediated cell injury involves damage to cellular
components primarily through:
A. Direct enzymatic digestion
B. Oxidative damage to lipids, proteins, and DNA caused by unstable,
reactive molecules
C. Osmotic lysis only
D. Immediate apoptosis without any biochemical damage
Answer: B — Oxidative damage to lipids, proteins, and DNA caused by
unstable, reactive molecules
Rationale: Free radicals are highly reactive molecules that damage lipids
(lipid peroxidation), proteins, and DNA, contributing to cellular injury and
dysfunction.
8. Apoptosis differs from necrosis in that apoptosis is:
A. An unregulated, passive process triggered only by severe injury
B. A regulated, energy-dependent programmed cell death process that
typically does not provoke inflammation
C. Always pathological, never physiological
D. Characterized by cell swelling and membrane rupture
Answer: B — A regulated, energy-dependent programmed cell death
process that typically does not provoke inflammation
NSG 5140 Advanced Pathophysiology – Midterm Ptaicgee 4
Midterm Exam Review
Questions and Answers with Rationales| South College
NSG 5140 Advanced Pathophysiology – Midterm Ptaicgee 1
, 1. Cellular hypertrophy is best defined as:
A. An increase in the number of cells in a tissue
B. An increase in the size of individual cells, leading to increased tissue
mass
C. A decrease in cell size due to loss of cellular substance
D. The replacement of one differentiated cell type with another
Answer: B — An increase in the size of individual cells, leading to
increased tissue mass
Rationale: Hypertrophy refers to an increase in individual cell size (e.g.,
cardiac myocyte enlargement in response to increased workload), distinct
from hyperplasia (increased cell number).
2. Hyperplasia differs from hypertrophy in that hyperplasia involves:
A. An increase in cell number due to increased cell division
B. An increase in individual cell size only
C. Programmed cell death
D. A change from one mature cell type to another
Answer: A — An increase in cell number due to increased cell division
Rationale: Hyperplasia is an increase in the number of cells in a tissue or
organ, resulting from increased cellular proliferation, and can occur
alongside or independent of hypertrophy.
3. Atrophy is a cellular adaptation characterized by:
A. Increased cell size and function
B. A decrease in cell size and function due to disuse, decreased workload,
or reduced blood/nutrient/hormonal supply
C. Malignant transformation of cells
D. Replacement of one cell type by another
Answer: B — A decrease in cell size and function due to disuse,
decreased workload, or reduced blood/nutrient/hormonal supply
NSG 5140 Advanced Pathophysiology – Midterm Ptaicgee 2
, Rationale: Atrophy involves a reduction in cell size and function as an
adaptive response to conditions like disuse, denervation, or diminished
blood supply.
4. Metaplasia refers to:
A. The reversible replacement of one differentiated cell type by another,
often in response to chronic irritation or injury
B. An irreversible cellular adaptation always leading to cancer
C. A decrease in cell number
D. An increase in cell size only
Answer: A — The reversible replacement of one differentiated cell type
by another, often in response to chronic irritation or injury
Rationale: Metaplasia is a reversible adaptive change in which one mature
cell type is replaced by another, often better suited to withstand a chronic
stressor (e.g., squamous metaplasia of the bronchial epithelium in smokers).
5. Which of the following best distinguishes reversible from irreversible
cell injury?
A. Reversible injury always involves cell death; irreversible injury does not
B. Irreversible injury involves severe mitochondrial damage and loss of
membrane integrity that prevent the cell from recovering
C. Reversible injury cannot be caused by hypoxia
D. Irreversible injury is always caused by genetic mutation
Answer: B — Irreversible injury involves severe mitochondrial damage
and loss of membrane integrity that prevent the cell from recovering
Rationale: Irreversible cell injury is marked by severe mitochondrial
dysfunction and loss of plasma membrane integrity, points beyond which the
cell cannot recover, ultimately leading to cell death.
6. Hypoxia causes cell injury primarily by:
A. Directly damaging DNA
NSG 5140 Advanced Pathophysiology – Midterm Ptaicgee 3
, B. Impairing aerobic respiration and ATP production, disrupting cellular
processes dependent on energy
C. Increasing intracellular oxygen levels excessively
D. Causing immediate cell lysis in all cases
Answer: B — Impairing aerobic respiration and ATP production,
disrupting cellular processes dependent on energy
Rationale: Hypoxia reduces oxidative phosphorylation, decreasing ATP
production, which impairs energy-dependent cellular functions such as ion
pumps, leading to cellular injury if prolonged.
7. Free radical-mediated cell injury involves damage to cellular
components primarily through:
A. Direct enzymatic digestion
B. Oxidative damage to lipids, proteins, and DNA caused by unstable,
reactive molecules
C. Osmotic lysis only
D. Immediate apoptosis without any biochemical damage
Answer: B — Oxidative damage to lipids, proteins, and DNA caused by
unstable, reactive molecules
Rationale: Free radicals are highly reactive molecules that damage lipids
(lipid peroxidation), proteins, and DNA, contributing to cellular injury and
dysfunction.
8. Apoptosis differs from necrosis in that apoptosis is:
A. An unregulated, passive process triggered only by severe injury
B. A regulated, energy-dependent programmed cell death process that
typically does not provoke inflammation
C. Always pathological, never physiological
D. Characterized by cell swelling and membrane rupture
Answer: B — A regulated, energy-dependent programmed cell death
process that typically does not provoke inflammation
NSG 5140 Advanced Pathophysiology – Midterm Ptaicgee 4
