ADVANCED PATHOPHYSIOLOGY
COMPREHENSIVE EXAM - NUR 616
QUESTIONS AND ANSWERS
1. A 55-year-old male presents with severe chest pain and is diagnosed with an acute
myocardial infarction. Which intracellular change occurs first due to the lack of oxygen?
A. Decreased mitochondrial oxidative phosphorylation
B. Release of lysosomal enzymes into the cytoplasm
C. Dilation of the endoplasmic reticulum
D. Increased intracellular pH
Answer: A
Conceptual Explanation: The initial response to ischemia is the failure of mitochondrial
oxidative phosphorylation, leading to a decrease in ATP production.
2. In the context of cellular injury, what is the primary consequence of the failure of the
Na+/K+ ATPase pump?
A. Intracellular accumulation of potassium
B. Cellular shrinkage
C. Decreased osmotic pressure within the cell
,D. Intracellular accumulation of sodium and water
Answer: D
Conceptual Explanation: Failure of the Na+/K+ pump leads to sodium accumulation
inside the cell, which draws water in by osmosis, causing hydropic swelling.
3. Which type of necrosis is most commonly associated with ischemic injury to the brain?
A. Coagulative necrosis
B. Caseous necrosis
C. Liquefactive necrosis
D. Fat necrosis
Answer: C
Conceptual Explanation: In the brain, ischemic injury results in liquefactive necrosis
because of the high lipid and water content and the release of hydrolytic enzymes.
4. A patient is found to have a mutation in a tumor suppressor gene. How does this typically
contribute to carcinogenesis?
A. It causes a gain of function that promotes cell growth
B. It requires only one allele to be mutated to lose function
C. It prevents the activation of oncogenes
D. It results in a loss of function, removing ‘brakes’ on the cell cycle
, Answer: D
Conceptual Explanation: Tumor suppressor genes (like p53) normally regulate the cell
cycle; their loss of function allows unregulated cell proliferation.
5. Which of the following is a characteristic feature of apoptosis compared to necrosis?
A. Significant inflammatory response
B. Activation of caspases and DNA fragmentation
C. Cellular swelling and membrane rupture
D. Passive process not requiring energy
Answer: B
Conceptual Explanation: Apoptosis is a programmed, energy-dependent process
characterized by caspase activation and DNA laddering without inflammation.
6. What is the primary mechanism behind Type I hypersensitivity reactions?
A. IgG-mediated cytotoxic response
B. Immune complex deposition
C. IgE-mediated mast cell degranulation
D. T-cell mediated delayed hypersensitivity
Answer: C
COMPREHENSIVE EXAM - NUR 616
QUESTIONS AND ANSWERS
1. A 55-year-old male presents with severe chest pain and is diagnosed with an acute
myocardial infarction. Which intracellular change occurs first due to the lack of oxygen?
A. Decreased mitochondrial oxidative phosphorylation
B. Release of lysosomal enzymes into the cytoplasm
C. Dilation of the endoplasmic reticulum
D. Increased intracellular pH
Answer: A
Conceptual Explanation: The initial response to ischemia is the failure of mitochondrial
oxidative phosphorylation, leading to a decrease in ATP production.
2. In the context of cellular injury, what is the primary consequence of the failure of the
Na+/K+ ATPase pump?
A. Intracellular accumulation of potassium
B. Cellular shrinkage
C. Decreased osmotic pressure within the cell
,D. Intracellular accumulation of sodium and water
Answer: D
Conceptual Explanation: Failure of the Na+/K+ pump leads to sodium accumulation
inside the cell, which draws water in by osmosis, causing hydropic swelling.
3. Which type of necrosis is most commonly associated with ischemic injury to the brain?
A. Coagulative necrosis
B. Caseous necrosis
C. Liquefactive necrosis
D. Fat necrosis
Answer: C
Conceptual Explanation: In the brain, ischemic injury results in liquefactive necrosis
because of the high lipid and water content and the release of hydrolytic enzymes.
4. A patient is found to have a mutation in a tumor suppressor gene. How does this typically
contribute to carcinogenesis?
A. It causes a gain of function that promotes cell growth
B. It requires only one allele to be mutated to lose function
C. It prevents the activation of oncogenes
D. It results in a loss of function, removing ‘brakes’ on the cell cycle
, Answer: D
Conceptual Explanation: Tumor suppressor genes (like p53) normally regulate the cell
cycle; their loss of function allows unregulated cell proliferation.
5. Which of the following is a characteristic feature of apoptosis compared to necrosis?
A. Significant inflammatory response
B. Activation of caspases and DNA fragmentation
C. Cellular swelling and membrane rupture
D. Passive process not requiring energy
Answer: B
Conceptual Explanation: Apoptosis is a programmed, energy-dependent process
characterized by caspase activation and DNA laddering without inflammation.
6. What is the primary mechanism behind Type I hypersensitivity reactions?
A. IgG-mediated cytotoxic response
B. Immune complex deposition
C. IgE-mediated mast cell degranulation
D. T-cell mediated delayed hypersensitivity
Answer: C
