NUR 616 ADVANCED
PATHOPHYSIOLOGY EXAM
QUESTIONS AND ANSWERS
1. A patient exhibits a change in the cellular phenotype from one mature cell type to another
in response to chronic irritation. This is best described as:
A. Dysplasia
B. Metaplasia
C. Hyperplasia
D. Anaplasia
Answer: B
Conceptual Explanation: Metaplasia is the reversible replacement of one mature cell type
by another mature cell type, often due to chronic irritation, such as in the respiratory tract
of smokers.
2. In the intrinsic pathway of apoptosis, which organelle plays a central role by releasing
cytochrome c into the cytosol?
A. Lysosome
B. Mitochondria
,C. Endoplasmic reticulum
D. Golgi apparatus
Answer: B
Conceptual Explanation: The intrinsic pathway of apoptosis involves mitochondrial outer
membrane permeabilization and the subsequent release of cytochrome c, which activates
the caspase cascade.
3. Which of the following describes the mechanism of Type II hypersensitivity reactions?
A. Antibody-mediated cell destruction or dysfunction
B. IgE-mediated mast cell degranulation
C. Immune complex deposition in tissues
D. T-cell mediated cytotoxicity
Answer: A
Conceptual Explanation: Type II hypersensitivities are tissue-specific reactions involving
IgG or IgM antibodies directed against antigens on the surface of specific cells or tissues.
4. A patient with chronic kidney disease presents with secondary hyperparathyroidism. What
is the primary pathophysiology behind this?
A. Decreased renal excretion of calcium
B. Increased renal production of Vitamin D3
C. Primary adenoma of the parathyroid gland
, D. Hyperphosphatemia and decreased activation of Vitamin D
Answer: D
Conceptual Explanation: In CKD, phosphate retention and reduced 1,25-
dihydroxyvitamin D production lead to hypocalcemia, which chronically stimulates the
parathyroid glands.
5. What is the primary driver of the ‘cytokine storm’ observed in severe systemic
inflammatory response syndrome (SIRS)?
A. Excessive production of anti-inflammatory IL-10
B. Depletion of B-lymphocytes
C. Uncontrolled release of pro-inflammatory mediators like IL-1, IL-6, and TNF-alpha
D. Hyper-activation of the parasympathetic nervous system
Answer: C
Conceptual Explanation: A cytokine storm is characterized by a massive, uncontrolled
release of pro-inflammatory cytokines, leading to multi-organ failure and vascular collapse.
6. In the context of cancer biology, the Warburg effect refers to:
A. The preference for aerobic glycolysis even in the presence of oxygen
B. The preference for oxidative phosphorylation over glycolysis
C. The ability of cancer cells to survive without glucose
D. The rapid mutation rate of tumor suppressor genes
PATHOPHYSIOLOGY EXAM
QUESTIONS AND ANSWERS
1. A patient exhibits a change in the cellular phenotype from one mature cell type to another
in response to chronic irritation. This is best described as:
A. Dysplasia
B. Metaplasia
C. Hyperplasia
D. Anaplasia
Answer: B
Conceptual Explanation: Metaplasia is the reversible replacement of one mature cell type
by another mature cell type, often due to chronic irritation, such as in the respiratory tract
of smokers.
2. In the intrinsic pathway of apoptosis, which organelle plays a central role by releasing
cytochrome c into the cytosol?
A. Lysosome
B. Mitochondria
,C. Endoplasmic reticulum
D. Golgi apparatus
Answer: B
Conceptual Explanation: The intrinsic pathway of apoptosis involves mitochondrial outer
membrane permeabilization and the subsequent release of cytochrome c, which activates
the caspase cascade.
3. Which of the following describes the mechanism of Type II hypersensitivity reactions?
A. Antibody-mediated cell destruction or dysfunction
B. IgE-mediated mast cell degranulation
C. Immune complex deposition in tissues
D. T-cell mediated cytotoxicity
Answer: A
Conceptual Explanation: Type II hypersensitivities are tissue-specific reactions involving
IgG or IgM antibodies directed against antigens on the surface of specific cells or tissues.
4. A patient with chronic kidney disease presents with secondary hyperparathyroidism. What
is the primary pathophysiology behind this?
A. Decreased renal excretion of calcium
B. Increased renal production of Vitamin D3
C. Primary adenoma of the parathyroid gland
, D. Hyperphosphatemia and decreased activation of Vitamin D
Answer: D
Conceptual Explanation: In CKD, phosphate retention and reduced 1,25-
dihydroxyvitamin D production lead to hypocalcemia, which chronically stimulates the
parathyroid glands.
5. What is the primary driver of the ‘cytokine storm’ observed in severe systemic
inflammatory response syndrome (SIRS)?
A. Excessive production of anti-inflammatory IL-10
B. Depletion of B-lymphocytes
C. Uncontrolled release of pro-inflammatory mediators like IL-1, IL-6, and TNF-alpha
D. Hyper-activation of the parasympathetic nervous system
Answer: C
Conceptual Explanation: A cytokine storm is characterized by a massive, uncontrolled
release of pro-inflammatory cytokines, leading to multi-organ failure and vascular collapse.
6. In the context of cancer biology, the Warburg effect refers to:
A. The preference for aerobic glycolysis even in the presence of oxygen
B. The preference for oxidative phosphorylation over glycolysis
C. The ability of cancer cells to survive without glucose
D. The rapid mutation rate of tumor suppressor genes
