, NR 507 Midterm Exam Study Guide
Advanced Pathophysiology
1. Which cellular organelle is responsible for ATP production through oxidative
phosphorylation?
a) Ribosome
b) Golgi apparatus
c) Mitochondrion
d) Endoplasmic reticulum
Answer: c) Mitochondrion
Rationale: The mitochondrion is the primary site of oxidative phosphorylation, where the
electron transport chain generates approximately 36 ATP molecules per glucose molecule.
It contains its own DNA and is essential for cellular energy metabolism. Dysfunction of
mitochondria is implicated in numerous disease processes .
2. A client presents with enlargement of the left ventricle due to long-standing
hypertension. This is an example of which type of cellular adaptation?
a) Hyperplasia
b) Hypertrophy
c) Atrophy
d) Metaplasia
Answer: b) Hypertrophy
Rationale: Hypertrophy is an increase in cell size leading to organ enlargement. The left
ventricle enlarges in response to increased workload (hypertension) because cardiac
muscle cells cannot divide (hyperplasia). This adaptation allows the heart to generate
more force to overcome elevated afterload .
,3. A client who smokes has a change in the bronchial epithelium from ciliated
columnar to stratified squamous. This is an example of:
a) Hyperplasia
b) Hypertrophy
c) Atrophy
d) Metaplasia
Answer: d) Metaplasia
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with
another in response to chronic irritation or injury. In smokers, the normal respiratory
epithelium is replaced by stratified squamous epithelium to withstand irritation. This is a
protective mechanism but increases the risk for dysplasia and cancer .
4. Which of the following is a characteristic feature of apoptosis?
a) Uncontrolled cell death
b) Involves organized cell shrinkage and fragmentation
c) Causes an inflammatory response
d) Results from severe injury
Answer: b) Involves organized cell shrinkage and fragmentation
Rationale: Apoptosis is a highly regulated, energy-dependent process of programmed cell
death. It is essential for normal development and tissue homeostasis and does not trigger
an inflammatory response, unlike necrosis .
5. Coagulative necrosis is most commonly seen in which organ?
a) Brain
b) Lung
c) Heart (myocardial infarction)
d) Pancreas
Answer: c) Heart (myocardial infarction)
, Rationale: Coagulative necrosis is characteristic of ischemic injury in solid organs such as
the heart (myocardial infarction), kidney, and liver, where cell architecture is preserved for
a while. Brain typically undergoes liquefactive necrosis .
6. Liquefactive necrosis is characteristic of:
a) Myocardial infarction
b) Brain infarction (stroke)
c) Tuberculosis
d) Ischemic injury to the kidney
Answer: b) Brain infarction (stroke)
Rationale: Liquefactive necrosis occurs in the brain due to enzymatic digestion of necrotic
tissue, forming a cystic space. It also occurs in bacterial abscesses .
7. Caseous necrosis is characteristic of which condition?
a) Tuberculosis
b) Myocardial infarction
c) Pancreatitis
d) Gangrene
Answer: a) Tuberculosis
Rationale: Caseous necrosis (cheese-like) is characteristic of tuberculosis. It represents a
combination of coagulative and liquefactive necrosis with a granulomatous inflammatory
response .
8. Reversible cell injury is characterized by:
a) Nuclear fragmentation
b) Cellular swelling and fatty change
c) Lysosomal rupture
d) Plasma membrane disruption
Answer: b) Cellular swelling and fatty change
Advanced Pathophysiology
1. Which cellular organelle is responsible for ATP production through oxidative
phosphorylation?
a) Ribosome
b) Golgi apparatus
c) Mitochondrion
d) Endoplasmic reticulum
Answer: c) Mitochondrion
Rationale: The mitochondrion is the primary site of oxidative phosphorylation, where the
electron transport chain generates approximately 36 ATP molecules per glucose molecule.
It contains its own DNA and is essential for cellular energy metabolism. Dysfunction of
mitochondria is implicated in numerous disease processes .
2. A client presents with enlargement of the left ventricle due to long-standing
hypertension. This is an example of which type of cellular adaptation?
a) Hyperplasia
b) Hypertrophy
c) Atrophy
d) Metaplasia
Answer: b) Hypertrophy
Rationale: Hypertrophy is an increase in cell size leading to organ enlargement. The left
ventricle enlarges in response to increased workload (hypertension) because cardiac
muscle cells cannot divide (hyperplasia). This adaptation allows the heart to generate
more force to overcome elevated afterload .
,3. A client who smokes has a change in the bronchial epithelium from ciliated
columnar to stratified squamous. This is an example of:
a) Hyperplasia
b) Hypertrophy
c) Atrophy
d) Metaplasia
Answer: d) Metaplasia
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with
another in response to chronic irritation or injury. In smokers, the normal respiratory
epithelium is replaced by stratified squamous epithelium to withstand irritation. This is a
protective mechanism but increases the risk for dysplasia and cancer .
4. Which of the following is a characteristic feature of apoptosis?
a) Uncontrolled cell death
b) Involves organized cell shrinkage and fragmentation
c) Causes an inflammatory response
d) Results from severe injury
Answer: b) Involves organized cell shrinkage and fragmentation
Rationale: Apoptosis is a highly regulated, energy-dependent process of programmed cell
death. It is essential for normal development and tissue homeostasis and does not trigger
an inflammatory response, unlike necrosis .
5. Coagulative necrosis is most commonly seen in which organ?
a) Brain
b) Lung
c) Heart (myocardial infarction)
d) Pancreas
Answer: c) Heart (myocardial infarction)
, Rationale: Coagulative necrosis is characteristic of ischemic injury in solid organs such as
the heart (myocardial infarction), kidney, and liver, where cell architecture is preserved for
a while. Brain typically undergoes liquefactive necrosis .
6. Liquefactive necrosis is characteristic of:
a) Myocardial infarction
b) Brain infarction (stroke)
c) Tuberculosis
d) Ischemic injury to the kidney
Answer: b) Brain infarction (stroke)
Rationale: Liquefactive necrosis occurs in the brain due to enzymatic digestion of necrotic
tissue, forming a cystic space. It also occurs in bacterial abscesses .
7. Caseous necrosis is characteristic of which condition?
a) Tuberculosis
b) Myocardial infarction
c) Pancreatitis
d) Gangrene
Answer: a) Tuberculosis
Rationale: Caseous necrosis (cheese-like) is characteristic of tuberculosis. It represents a
combination of coagulative and liquefactive necrosis with a granulomatous inflammatory
response .
8. Reversible cell injury is characterized by:
a) Nuclear fragmentation
b) Cellular swelling and fatty change
c) Lysosomal rupture
d) Plasma membrane disruption
Answer: b) Cellular swelling and fatty change
