NSG 5140 ADVANCED PATHOPHYSIOLOGY MIDTERM EXAM
REVIEW 2 SOUTH COLLEGE QUESTIONS WITH VERIFIED
ANSWERS & DETAILED RATIONALES
2026-2027 UPDATE
SECTION 1: CELLULAR ADAPTATION AND INJURY (Questions 1-30)
Q1. A 60-year-old man with long-standing hypertension has left ventricular
hypertrophy on echocardiogram. Which cellular adaptation best explains this
finding?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Correct Answer: B
Rationale: Hypertrophy is an increase in individual cell size due to increased
workload, as seen in myocardial cells responding to chronic pressure overload
from hypertension. Cardiac myocytes are terminally differentiated and cannot
undergo hyperplasia.
Q2. A chronic smoker's bronchial epithelium changes from ciliated columnar to
stratified squamous. This is best described as:
A. Dysplasia
B. Metaplasia
C. Hyperplasia
D. Anaplasia
Correct Answer: B
Rationale: Metaplasia is a reversible change where one differentiated cell type
is replaced by another more resistant cell type. In smokers, the normal
pseudostratified ciliated columnar epithelium is replaced by stratified squamous
1
,epithelium as a protective adaptation.
Q3. Which cellular adaptation is characterized by a decrease in cell size and
function due to decreased workload or loss of innervation?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
Correct Answer: C
Rationale: Atrophy is a reduction in cell size and function resulting from
disuse, denervation, ischemia, malnutrition, or decreased hormonal stimulation.
Q4. A Pap smear shows disordered epithelial cell growth with variation in size,
shape, and nuclear appearance, but cells have not invaded the basement
membrane.
This is best described as:
A. Metaplasia
B. Dysplasia
C. Hyperplasia
D. Neoplasia
Correct Answer: B
Rationale: Dysplasia is characterized by disordered cellular growth with
pleomorphism (variation in size and shape), hyperchromatic nuclei, and loss of
normal architectural organization. It is potentially reversible but may
progress to carcinoma in situ.
Q5. Which type of cellular adaptation involves an increase in the number of
cells in an organ or tissue?
2
,A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
Correct Answer: B
Rationale: Hyperplasia is an increase in cell number resulting from increased
mitotic division. It can be physiologic (e.g., breast tissue during pregnancy)
or pathologic (e.g., endometrial hyperplasia).
Q6. What is the most common cause of irreversible cell injury leading to necrosis?
A. Hypoxia
B. Infection
C. Physical trauma
D. Genetic mutations
Correct Answer: A
Rationale: Hypoxia/ischemia is the most common cause of irreversible cell
injury. It leads to ATP depletion, failure of Na+/K+ pumps, cellular swelling,
and ultimately cell death.
Q7. A patient with a myocardial infarction shows coagulative necrosis. Which
characteristic describes coagulative necrosis?
A. Tissue becomes soft and liquified
B. Cells become pale and cheesy
C. Tissue architecture is preserved but cells are dead
D. Fat saponification occurs
Correct Answer: C
Rationale: Coagulative necrosis is characteristic of ischemic injury in solid
organs (heart, kidney). The tissue architecture is preserved for several days
3
, while the cells are dead, with eosinophilic cytoplasm and loss of nuclei.
Q8. Caseous necrosis is most commonly associated with which condition?
A. Myocardial infarction
B. Tuberculosis
C. Pancreatitis
D. Stroke
Correct Answer: B
Rationale: Caseous necrosis is characteristic of tuberculosis. It appears as a
soft, white, cheese-like material with granuloma formation, containing
Langhans giant cells.
Q9. Which type of necrosis occurs in the brain following a stroke?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis
Correct Answer: B
Rationale: Liquefactive necrosis occurs in the brain because the tissue has
high lipid content and lacks a supportive framework. The dead tissue becomes
soft and liquefied due to enzymatic digestion.
Q10. Fat necrosis is most commonly associated with which condition?
A. Stroke
B. Acute pancreatitis
C. Myocardial infarction
D. Tuberculosis
4
REVIEW 2 SOUTH COLLEGE QUESTIONS WITH VERIFIED
ANSWERS & DETAILED RATIONALES
2026-2027 UPDATE
SECTION 1: CELLULAR ADAPTATION AND INJURY (Questions 1-30)
Q1. A 60-year-old man with long-standing hypertension has left ventricular
hypertrophy on echocardiogram. Which cellular adaptation best explains this
finding?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Correct Answer: B
Rationale: Hypertrophy is an increase in individual cell size due to increased
workload, as seen in myocardial cells responding to chronic pressure overload
from hypertension. Cardiac myocytes are terminally differentiated and cannot
undergo hyperplasia.
Q2. A chronic smoker's bronchial epithelium changes from ciliated columnar to
stratified squamous. This is best described as:
A. Dysplasia
B. Metaplasia
C. Hyperplasia
D. Anaplasia
Correct Answer: B
Rationale: Metaplasia is a reversible change where one differentiated cell type
is replaced by another more resistant cell type. In smokers, the normal
pseudostratified ciliated columnar epithelium is replaced by stratified squamous
1
,epithelium as a protective adaptation.
Q3. Which cellular adaptation is characterized by a decrease in cell size and
function due to decreased workload or loss of innervation?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
Correct Answer: C
Rationale: Atrophy is a reduction in cell size and function resulting from
disuse, denervation, ischemia, malnutrition, or decreased hormonal stimulation.
Q4. A Pap smear shows disordered epithelial cell growth with variation in size,
shape, and nuclear appearance, but cells have not invaded the basement
membrane.
This is best described as:
A. Metaplasia
B. Dysplasia
C. Hyperplasia
D. Neoplasia
Correct Answer: B
Rationale: Dysplasia is characterized by disordered cellular growth with
pleomorphism (variation in size and shape), hyperchromatic nuclei, and loss of
normal architectural organization. It is potentially reversible but may
progress to carcinoma in situ.
Q5. Which type of cellular adaptation involves an increase in the number of
cells in an organ or tissue?
2
,A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
Correct Answer: B
Rationale: Hyperplasia is an increase in cell number resulting from increased
mitotic division. It can be physiologic (e.g., breast tissue during pregnancy)
or pathologic (e.g., endometrial hyperplasia).
Q6. What is the most common cause of irreversible cell injury leading to necrosis?
A. Hypoxia
B. Infection
C. Physical trauma
D. Genetic mutations
Correct Answer: A
Rationale: Hypoxia/ischemia is the most common cause of irreversible cell
injury. It leads to ATP depletion, failure of Na+/K+ pumps, cellular swelling,
and ultimately cell death.
Q7. A patient with a myocardial infarction shows coagulative necrosis. Which
characteristic describes coagulative necrosis?
A. Tissue becomes soft and liquified
B. Cells become pale and cheesy
C. Tissue architecture is preserved but cells are dead
D. Fat saponification occurs
Correct Answer: C
Rationale: Coagulative necrosis is characteristic of ischemic injury in solid
organs (heart, kidney). The tissue architecture is preserved for several days
3
, while the cells are dead, with eosinophilic cytoplasm and loss of nuclei.
Q8. Caseous necrosis is most commonly associated with which condition?
A. Myocardial infarction
B. Tuberculosis
C. Pancreatitis
D. Stroke
Correct Answer: B
Rationale: Caseous necrosis is characteristic of tuberculosis. It appears as a
soft, white, cheese-like material with granuloma formation, containing
Langhans giant cells.
Q9. Which type of necrosis occurs in the brain following a stroke?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis
Correct Answer: B
Rationale: Liquefactive necrosis occurs in the brain because the tissue has
high lipid content and lacks a supportive framework. The dead tissue becomes
soft and liquefied due to enzymatic digestion.
Q10. Fat necrosis is most commonly associated with which condition?
A. Stroke
B. Acute pancreatitis
C. Myocardial infarction
D. Tuberculosis
4
