NSG 5140 Week 5 Midterm Exam Prep | Complete 200
Question Bank & Detailed Rationales
Complete Actual Exam Questions 1-200
Advanced Pathophysiology | South College
Due: 30th September
SECTION A: CELLULAR ADAPTATION & INJURY
1. A patient with chronic hypertension develops left ventricular wall thickening.
Which mechanism best explains this adaptation?
A. Increased myocyte number due to cell division
B. Increased myocyte size due to increased workload
C. Replacement of cardiac cells with fibrous tissue
D. Transformation of cardiac cells into smooth muscle
Answer: B. Increased myocyte size due to increased workload
Rationale: Cardiac myocytes are terminally differentiated cells that cannot undergo
hyperplasia (increased cell number). They respond to increased workload, such as chronic
hypertension, by undergoing hypertrophy (increased cell size). This adaptation increases
contractile force but eventually becomes maladaptive, leading to heart failure .
,2. During ischemic injury, loss of ATP most directly leads to:
A. Increased oxidative phosphorylation
B. Failure of the sodium-potassium pump
C. Increased protein synthesis
D. Mitochondrial membrane stabilization
Answer: B. Failure of the sodium-potassium pump
Rationale: ATP depletion causes failure of the Na⁺/K⁺ ATPase pump, which requires ATP to
maintain ion gradients. This leads to intracellular sodium accumulation, water influx, and
cellular swelling. This is the hallmark of hypoxic cellular injury and a key feature of
reversible injury .
3. Which of the following is a hallmark of reversible cellular injury?
A. Nuclear pyknosis
B. Failure of ion pumps leading to cell swelling
C. Membrane rupture
D. Lysosomal enzyme release
Answer: B. Failure of ion pumps leading to cell swelling
Rationale: Reversible injury is characterized by cellular swelling due to ion pump failure. If
the insult is removed, the cell can recover. Irreversible injury involves membrane damage,
nuclear changes such as pyknosis, and lysosomal enzyme release .
4. What is the primary function of the sodium-potassium pump (Na⁺/K⁺ ATPase) in
maintaining cellular homeostasis?
A. Maintain resting membrane potential
B. Produce ATP
C. Synthesize proteins
D. Transport glucose into cells
, Answer: A. Maintain resting membrane potential
Rationale: The sodium-potassium pump moves 3 Na⁺ ions out of the cell and 2 K⁺ ions
into the cell, creating an electrochemical gradient essential for maintaining the resting
membrane potential. This gradient is critical for nerve impulse transmission and other
cellular functions .
5. What is a consequence of plasma membrane damage to the mitochondria?
A. Enzymatic digestion halts DNA synthesis
B. Influx of calcium ions halts ATP production
C. Edema from sodium influx causes reduction in ATP production
D. Potassium shifts out of the mitochondria, destroying infrastructure
Answer: B. Influx of calcium ions halts ATP production
Rationale: Plasma membrane damage allows calcium to enter the cell and accumulate in
mitochondria. Excess calcium disrupts oxidative phosphorylation and ATP production,
leading to cell injury and potential apoptosis. This is a critical step in the progression from
reversible to irreversible injury .
6. A researcher observes that sustained mechanical stretch of cardiac myocytes
leads to increased protein synthesis and cell enlargement. Which intracellular
signaling pathway is most directly responsible for this adaptive response?
A. Activation of the PI3K/Akt/mTOR pathway leading to increased translation
B. Induction of p53-mediated cell cycle arrest and senescence
C. Upregulation of caspases and initiation of apoptosis
D. Activation of the unfolded protein response (UPR) due to ER stress
Answer: A. Activation of the PI3K/Akt/mTOR pathway leading to increased
translation
Rationale: Cardiac myocytes respond to increased workload by undergoing hypertrophy,
driven by the PI3K/Akt/mTOR pathway that enhances protein synthesis. This pathway
Question Bank & Detailed Rationales
Complete Actual Exam Questions 1-200
Advanced Pathophysiology | South College
Due: 30th September
SECTION A: CELLULAR ADAPTATION & INJURY
1. A patient with chronic hypertension develops left ventricular wall thickening.
Which mechanism best explains this adaptation?
A. Increased myocyte number due to cell division
B. Increased myocyte size due to increased workload
C. Replacement of cardiac cells with fibrous tissue
D. Transformation of cardiac cells into smooth muscle
Answer: B. Increased myocyte size due to increased workload
Rationale: Cardiac myocytes are terminally differentiated cells that cannot undergo
hyperplasia (increased cell number). They respond to increased workload, such as chronic
hypertension, by undergoing hypertrophy (increased cell size). This adaptation increases
contractile force but eventually becomes maladaptive, leading to heart failure .
,2. During ischemic injury, loss of ATP most directly leads to:
A. Increased oxidative phosphorylation
B. Failure of the sodium-potassium pump
C. Increased protein synthesis
D. Mitochondrial membrane stabilization
Answer: B. Failure of the sodium-potassium pump
Rationale: ATP depletion causes failure of the Na⁺/K⁺ ATPase pump, which requires ATP to
maintain ion gradients. This leads to intracellular sodium accumulation, water influx, and
cellular swelling. This is the hallmark of hypoxic cellular injury and a key feature of
reversible injury .
3. Which of the following is a hallmark of reversible cellular injury?
A. Nuclear pyknosis
B. Failure of ion pumps leading to cell swelling
C. Membrane rupture
D. Lysosomal enzyme release
Answer: B. Failure of ion pumps leading to cell swelling
Rationale: Reversible injury is characterized by cellular swelling due to ion pump failure. If
the insult is removed, the cell can recover. Irreversible injury involves membrane damage,
nuclear changes such as pyknosis, and lysosomal enzyme release .
4. What is the primary function of the sodium-potassium pump (Na⁺/K⁺ ATPase) in
maintaining cellular homeostasis?
A. Maintain resting membrane potential
B. Produce ATP
C. Synthesize proteins
D. Transport glucose into cells
, Answer: A. Maintain resting membrane potential
Rationale: The sodium-potassium pump moves 3 Na⁺ ions out of the cell and 2 K⁺ ions
into the cell, creating an electrochemical gradient essential for maintaining the resting
membrane potential. This gradient is critical for nerve impulse transmission and other
cellular functions .
5. What is a consequence of plasma membrane damage to the mitochondria?
A. Enzymatic digestion halts DNA synthesis
B. Influx of calcium ions halts ATP production
C. Edema from sodium influx causes reduction in ATP production
D. Potassium shifts out of the mitochondria, destroying infrastructure
Answer: B. Influx of calcium ions halts ATP production
Rationale: Plasma membrane damage allows calcium to enter the cell and accumulate in
mitochondria. Excess calcium disrupts oxidative phosphorylation and ATP production,
leading to cell injury and potential apoptosis. This is a critical step in the progression from
reversible to irreversible injury .
6. A researcher observes that sustained mechanical stretch of cardiac myocytes
leads to increased protein synthesis and cell enlargement. Which intracellular
signaling pathway is most directly responsible for this adaptive response?
A. Activation of the PI3K/Akt/mTOR pathway leading to increased translation
B. Induction of p53-mediated cell cycle arrest and senescence
C. Upregulation of caspases and initiation of apoptosis
D. Activation of the unfolded protein response (UPR) due to ER stress
Answer: A. Activation of the PI3K/Akt/mTOR pathway leading to increased
translation
Rationale: Cardiac myocytes respond to increased workload by undergoing hypertrophy,
driven by the PI3K/Akt/mTOR pathway that enhances protein synthesis. This pathway
