NR507 Advanced Pathophysiology
midterm exam Practice questions
with answers/ NR 507 Advanced
Pathophysiology Week 4 Practice
Test.
A client presents with enlargement of the left ventricle due to long-
standing hypertension. This cellular adaptation is best described as:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Correct 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 undergo
hyperplasia (cell division) .
A client who smokes has a change in the bronchial epithelium from
ciliated columnar to stratified squamous. This change is termed:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Correct Answer: D) Metaplasia
Rationale: Metaplasia is the reversible replacement of one differentiated
cell type with another mature cell type, often in response to chronic
irritation such as cigarette smoke .
,Which characteristic is typical of reversible cell injury?
A) Nuclear fragmentation
B) Cellular swelling and fatty change
C) Lysosomal rupture
D) Plasma membrane disruption
Correct Answer: B) Cellular swelling and fatty change
Rationale: Reversible cell injury causes cellular swelling (due to impaired
Na+/K+ pump function) and fatty change (due to lipid accumulation).
Nuclear fragmentation and membrane disruption indicate irreversible
injury .
Which of the following is an irreversible change in cell injury?
A) Cellular swelling
B) Fatty change
C) Pyknosis (nuclear shrinkage)
D) Loss of microvilli
Correct Answer: C) Pyknosis (nuclear shrinkage)
Rationale: Pyknosis (nuclear shrinkage), karyorrhexis (nuclear
fragmentation), and karyolysis (nuclear dissolution) are irreversible
nuclear changes indicating cell death .
Coagulative necrosis is most commonly seen in which organ?
A) Brain
B) Lung
C) Heart (myocardial infarction)
D) Pancreas
Correct Answer: C) Heart (myocardial infarction)
,Rationale: Coagulative necrosis is characteristic of ischemic injury in solid
organs such as the heart, kidney, and liver. The tissue architecture is
preserved but cells are dead, with denatured proteins preventing
enzymatic digestion .
Liquefactive necrosis is characteristic of:
A) Myocardial infarction
B) Brain infarction (stroke)
C) Tuberculosis
D) Ischemic injury to the kidney
Correct Answer: B) Brain infarction (stroke)
Rationale: Liquefactive necrosis occurs in the brain due to enzymatic
digestion of necrotic tissue, forming a cystic space. The brain's high lipid
content and lack of supporting stroma contribute to this pattern .
Caseous necrosis is characteristic of which condition?
A) Tuberculosis
B) Myocardial infarction
C) Stroke
D) Acute pancreatitis
Correct Answer: A) Tuberculosis
Rationale: Caseous necrosis is a distinct form of necrosis seen in
tuberculosis, characterized by a soft, cheese-like appearance with
granuloma formation and contains both necrotic cells and immune cells .
Which cellular organelle plays a critical role in the "point of no return" in
cellular injury?
A) Endoplasmic reticulum
B) Golgi apparatus
, C) Mitochondria
D) Lysosomes
Correct Answer: C) Mitochondria
Rationale: Mitochondria are the primary site of ATP production through
oxidative phosphorylation. When mitochondrial damage reaches the
"point of no return," ATP production ceases entirely, leading to
irreversible membrane and DNA damage .
Ischemia-reperfusion injury causes additional cellular damage primarily
due to:
A) Immediate restoration of ATP levels
B) Influx of calcium and generation of oxygen-free radicals
C) Rapid normalization of pH
D) Prevention of inflammatory cell infiltration
Correct Answer: B) Influx of calcium and generation of oxygen-free
radicals
Rationale: When blood flow returns (reperfusion), it brings oxygen which
leads to a burst of free radical production and an influx of calcium,
exacerbating the injury caused by the initial ischemia .
Which molecule is a classic "danger signal" released from necrotic cells?
A) Cytochrome C
B) High-mobility group box 1 (HMGB1)
C) Calcium ions
D) Potassium ions
Correct Answer: B) High-mobility group box 1 (HMGB1)
Rationale: HMGB1 is a nuclear protein released from necrotic cells that
acts as a damage-associated molecular pattern (DAMP), triggering an
inflammatory response .
midterm exam Practice questions
with answers/ NR 507 Advanced
Pathophysiology Week 4 Practice
Test.
A client presents with enlargement of the left ventricle due to long-
standing hypertension. This cellular adaptation is best described as:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Correct 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 undergo
hyperplasia (cell division) .
A client who smokes has a change in the bronchial epithelium from
ciliated columnar to stratified squamous. This change is termed:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Correct Answer: D) Metaplasia
Rationale: Metaplasia is the reversible replacement of one differentiated
cell type with another mature cell type, often in response to chronic
irritation such as cigarette smoke .
,Which characteristic is typical of reversible cell injury?
A) Nuclear fragmentation
B) Cellular swelling and fatty change
C) Lysosomal rupture
D) Plasma membrane disruption
Correct Answer: B) Cellular swelling and fatty change
Rationale: Reversible cell injury causes cellular swelling (due to impaired
Na+/K+ pump function) and fatty change (due to lipid accumulation).
Nuclear fragmentation and membrane disruption indicate irreversible
injury .
Which of the following is an irreversible change in cell injury?
A) Cellular swelling
B) Fatty change
C) Pyknosis (nuclear shrinkage)
D) Loss of microvilli
Correct Answer: C) Pyknosis (nuclear shrinkage)
Rationale: Pyknosis (nuclear shrinkage), karyorrhexis (nuclear
fragmentation), and karyolysis (nuclear dissolution) are irreversible
nuclear changes indicating cell death .
Coagulative necrosis is most commonly seen in which organ?
A) Brain
B) Lung
C) Heart (myocardial infarction)
D) Pancreas
Correct Answer: C) Heart (myocardial infarction)
,Rationale: Coagulative necrosis is characteristic of ischemic injury in solid
organs such as the heart, kidney, and liver. The tissue architecture is
preserved but cells are dead, with denatured proteins preventing
enzymatic digestion .
Liquefactive necrosis is characteristic of:
A) Myocardial infarction
B) Brain infarction (stroke)
C) Tuberculosis
D) Ischemic injury to the kidney
Correct Answer: B) Brain infarction (stroke)
Rationale: Liquefactive necrosis occurs in the brain due to enzymatic
digestion of necrotic tissue, forming a cystic space. The brain's high lipid
content and lack of supporting stroma contribute to this pattern .
Caseous necrosis is characteristic of which condition?
A) Tuberculosis
B) Myocardial infarction
C) Stroke
D) Acute pancreatitis
Correct Answer: A) Tuberculosis
Rationale: Caseous necrosis is a distinct form of necrosis seen in
tuberculosis, characterized by a soft, cheese-like appearance with
granuloma formation and contains both necrotic cells and immune cells .
Which cellular organelle plays a critical role in the "point of no return" in
cellular injury?
A) Endoplasmic reticulum
B) Golgi apparatus
, C) Mitochondria
D) Lysosomes
Correct Answer: C) Mitochondria
Rationale: Mitochondria are the primary site of ATP production through
oxidative phosphorylation. When mitochondrial damage reaches the
"point of no return," ATP production ceases entirely, leading to
irreversible membrane and DNA damage .
Ischemia-reperfusion injury causes additional cellular damage primarily
due to:
A) Immediate restoration of ATP levels
B) Influx of calcium and generation of oxygen-free radicals
C) Rapid normalization of pH
D) Prevention of inflammatory cell infiltration
Correct Answer: B) Influx of calcium and generation of oxygen-free
radicals
Rationale: When blood flow returns (reperfusion), it brings oxygen which
leads to a burst of free radical production and an influx of calcium,
exacerbating the injury caused by the initial ischemia .
Which molecule is a classic "danger signal" released from necrotic cells?
A) Cytochrome C
B) High-mobility group box 1 (HMGB1)
C) Calcium ions
D) Potassium ions
Correct Answer: B) High-mobility group box 1 (HMGB1)
Rationale: HMGB1 is a nuclear protein released from necrotic cells that
acts as a damage-associated molecular pattern (DAMP), triggering an
inflammatory response .
