NSG5140 Week 10 Final Exam –Actual Questions Advanced
Pathophysiology – South College (2026 Update) latest update
this year instant pdf download
SECTION 1: CELLULAR ADAPTATION, INJURY & DEATH
1. A patient with long-standing hypertension develops left ventricular
hypertrophy (LVH). What is the primary pathophysiologic adaptation occurring
in the myocardium?
• A) Myocardial hyperplasia
• B) Eccentric dilation due to volume overload
• C) Concentric hypertrophy from pressure overload
• D) Myocardial apoptosis
Answer: C) Concentric hypertrophy from pressure overload
Rationale: Cardiac myocytes are terminally differentiated and cannot undergo
hyperplasia (increase in cell number). They respond to increased afterload
(pressure overload from hypertension) by increasing in size (hypertrophy) to
maintain wall tension and cardiac output.
2. Which organ is most susceptible to irreversible injury from ischemia?
• A) Kidney
• B) Brain
• C) Liver
• D) Skeletal muscle
Answer: B) Brain
Rationale: Neurons rely almost exclusively on aerobic metabolism and have
minimal glycogen stores. They can suffer irreversible injury within 4–6 minutes of
ischemia, making the brain the most vulnerable organ to hypoxic injury.
,3. What is the primary mechanism of cellular injury in hypoxia?
• A) Accumulation of lactic acid
• B) Disruption of protein synthesis
• C) ATP depletion
• D) Increased free radicals
Answer: C) ATP depletion
Rationale: In hypoxia, oxygen delivery to cells is reduced, impairing oxidative
phosphorylation in mitochondria. This leads to a rapid drop in ATP production,
which disrupts sodium-potassium pumps, protein synthesis, and cellular
homeostasis.
4. Which cellular change is characteristic of reversible cell injury?
• A) Nuclear pyknosis
• B) Mitochondrial swelling
• C) Myelin figures
• D) Karyorrhexis
Answer: B) Mitochondrial swelling
Rationale: Mitochondrial swelling and loss of microvilli are reversible changes.
Pyknosis (nuclear condensation), karyorrhexis (fragmentation), and myelin figures
are markers of irreversible injury/necrosis.
5. Which mechanism most directly leads to irreversible cell injury?
• A) Decreased ATP production
• B) Cellular swelling
• C) Mitochondrial membrane damage
• D) Ribosomal detachment
,Answer: C) Mitochondrial membrane damage
Rationale: Mitochondrial membrane damage is considered the "point of no
return" in cell injury, triggering either apoptosis or necrosis. It leads to loss of ATP
production, calcium influx, and release of cytochrome c.
6. Which statement best describes a characteristic of apoptosis?
• A) Apoptosis involves programmed cell death of scattered single cells
• B) Apoptosis is characterized by swelling of the nucleus and cytoplasm
• C) Apoptosis involves unpredictable patterns of cell death
• D) Apoptosis results in benign malignancies
Answer: A) Apoptosis involves programmed cell death of scattered single cells
Rationale: Apoptosis is programmed, controlled cell death that affects individual
cells without triggering inflammation. Unlike necrosis, apoptosis does not cause
cell swelling or inflammation.
7. Which of the following best describes necrosis?
• A) Programmed cell death
• B) Controlled cellular degradation
• C) Unregulated cell death due to injury
• D) Apoptotic cell signaling
Answer: C) Unregulated cell death due to injury
Rationale: Necrosis results from severe cell injury (hypoxia, toxins, infection) and
leads to unregulated cell death, inflammation, and tissue damage.
8. Which type of necrosis is most commonly associated with hypoxic injury to
the heart?
• A) Liquefactive necrosis
, • B) Caseous necrosis
• C) Fat necrosis
• D) Coagulative necrosis
Answer: D) Coagulative necrosis
Rationale: Coagulative necrosis results from protein denaturation, typically due to
ischemia in solid organs like the heart and kidneys. In myocardial infarction, tissue
architecture is initially preserved, with cells showing loss of nuclei and
eosinophilic cytoplasm.
9. A patient presents with a brain infarct following a stroke. What type of
necrosis is expected in the brain tissue?
• A) Coagulative necrosis
• B) Liquefactive necrosis
• C) Caseous necrosis
• D) Gangrenous necrosis
Answer: B) Liquefactive necrosis
Rationale: Liquefactive necrosis is characteristic of brain infarcts due to the high
lipid content and presence of hydrolytic enzymes in neural tissue, resulting in
tissue digestion and cyst formation.
10. Reperfusion injury primarily results from:
• A) ATP restoration
• B) Reactive oxygen species
• C) Reduced inflammation
• D) Decreased calcium influx
Answer: B) Reactive oxygen species
Rationale: Reintroduction of oxygen generates free radicals (reactive oxygen
Pathophysiology – South College (2026 Update) latest update
this year instant pdf download
SECTION 1: CELLULAR ADAPTATION, INJURY & DEATH
1. A patient with long-standing hypertension develops left ventricular
hypertrophy (LVH). What is the primary pathophysiologic adaptation occurring
in the myocardium?
• A) Myocardial hyperplasia
• B) Eccentric dilation due to volume overload
• C) Concentric hypertrophy from pressure overload
• D) Myocardial apoptosis
Answer: C) Concentric hypertrophy from pressure overload
Rationale: Cardiac myocytes are terminally differentiated and cannot undergo
hyperplasia (increase in cell number). They respond to increased afterload
(pressure overload from hypertension) by increasing in size (hypertrophy) to
maintain wall tension and cardiac output.
2. Which organ is most susceptible to irreversible injury from ischemia?
• A) Kidney
• B) Brain
• C) Liver
• D) Skeletal muscle
Answer: B) Brain
Rationale: Neurons rely almost exclusively on aerobic metabolism and have
minimal glycogen stores. They can suffer irreversible injury within 4–6 minutes of
ischemia, making the brain the most vulnerable organ to hypoxic injury.
,3. What is the primary mechanism of cellular injury in hypoxia?
• A) Accumulation of lactic acid
• B) Disruption of protein synthesis
• C) ATP depletion
• D) Increased free radicals
Answer: C) ATP depletion
Rationale: In hypoxia, oxygen delivery to cells is reduced, impairing oxidative
phosphorylation in mitochondria. This leads to a rapid drop in ATP production,
which disrupts sodium-potassium pumps, protein synthesis, and cellular
homeostasis.
4. Which cellular change is characteristic of reversible cell injury?
• A) Nuclear pyknosis
• B) Mitochondrial swelling
• C) Myelin figures
• D) Karyorrhexis
Answer: B) Mitochondrial swelling
Rationale: Mitochondrial swelling and loss of microvilli are reversible changes.
Pyknosis (nuclear condensation), karyorrhexis (fragmentation), and myelin figures
are markers of irreversible injury/necrosis.
5. Which mechanism most directly leads to irreversible cell injury?
• A) Decreased ATP production
• B) Cellular swelling
• C) Mitochondrial membrane damage
• D) Ribosomal detachment
,Answer: C) Mitochondrial membrane damage
Rationale: Mitochondrial membrane damage is considered the "point of no
return" in cell injury, triggering either apoptosis or necrosis. It leads to loss of ATP
production, calcium influx, and release of cytochrome c.
6. Which statement best describes a characteristic of apoptosis?
• A) Apoptosis involves programmed cell death of scattered single cells
• B) Apoptosis is characterized by swelling of the nucleus and cytoplasm
• C) Apoptosis involves unpredictable patterns of cell death
• D) Apoptosis results in benign malignancies
Answer: A) Apoptosis involves programmed cell death of scattered single cells
Rationale: Apoptosis is programmed, controlled cell death that affects individual
cells without triggering inflammation. Unlike necrosis, apoptosis does not cause
cell swelling or inflammation.
7. Which of the following best describes necrosis?
• A) Programmed cell death
• B) Controlled cellular degradation
• C) Unregulated cell death due to injury
• D) Apoptotic cell signaling
Answer: C) Unregulated cell death due to injury
Rationale: Necrosis results from severe cell injury (hypoxia, toxins, infection) and
leads to unregulated cell death, inflammation, and tissue damage.
8. Which type of necrosis is most commonly associated with hypoxic injury to
the heart?
• A) Liquefactive necrosis
, • B) Caseous necrosis
• C) Fat necrosis
• D) Coagulative necrosis
Answer: D) Coagulative necrosis
Rationale: Coagulative necrosis results from protein denaturation, typically due to
ischemia in solid organs like the heart and kidneys. In myocardial infarction, tissue
architecture is initially preserved, with cells showing loss of nuclei and
eosinophilic cytoplasm.
9. A patient presents with a brain infarct following a stroke. What type of
necrosis is expected in the brain tissue?
• A) Coagulative necrosis
• B) Liquefactive necrosis
• C) Caseous necrosis
• D) Gangrenous necrosis
Answer: B) Liquefactive necrosis
Rationale: Liquefactive necrosis is characteristic of brain infarcts due to the high
lipid content and presence of hydrolytic enzymes in neural tissue, resulting in
tissue digestion and cyst formation.
10. Reperfusion injury primarily results from:
• A) ATP restoration
• B) Reactive oxygen species
• C) Reduced inflammation
• D) Decreased calcium influx
Answer: B) Reactive oxygen species
Rationale: Reintroduction of oxygen generates free radicals (reactive oxygen
