NUR-641E FINAL EXAM PREP:
ADVANCED PATHOPHYSIOLOGY 2026
QUESTIONS AND ANSWERS
1. Which epigenetic mechanism involves the addition of a methyl group to the cytosine base
of DNA, typically leading to gene silencing?
A. Histone acetylation
B. Protein phosphorylation
C. RNA interference
D. DNA methylation
Answer: D
Conceptual Explanation: DNA methylation involves the addition of a methyl group to
cytosine, which often prevents transcription factors from binding, thus silencing the gene.
2. In the context of cellular injury, what is the primary difference between necrosis and
apoptosis?
A. Necrosis is programmed cell death, while apoptosis is accidental.
B. Necrosis results in cell swelling and membrane rupture, while apoptosis involves cell
shrinkage and fragmentation.
,C. Apoptosis involves inflammation, while necrosis does not.
D. Apoptosis only occurs in cancerous cells.
Answer: B
Conceptual Explanation: Necrosis is passive, accidental death characterized by swelling
and lysis leading to inflammation; apoptosis is an active, programmed process where the
cell shrinks and fragments without inducing an inflammatory response.
3. A patient with chronic hypertension develops thickening of the left ventricular wall. This
cellular adaptation is best described as:
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Metaplasia
Answer: B
Conceptual Explanation: Hypertrophy is an increase in the size of cells (and the organ) in
response to increased workload, common in cardiac muscle under hypertensive stress.
4. Which of the following describes the role of ‘foam cells’ in the progression of
atherosclerosis?
A. They are macrophages that have ingested oxidized LDL cholesterol.
B. They are smooth muscle cells that have migrated to the adventitia.
, C. They are endothelial cells that have become calcified.
D. They are platelets that have aggregated at the site of injury.
Answer: A
Conceptual Explanation: Foam cells are formed when macrophages ingest oxidized LDL
within the arterial wall, serving as a hallmark of early atherosclerotic plaques.
5. Type II hypersensitivity reactions are primarily mediated by:
A. Antibodies (IgG/IgM) reacting with cell-surface antigens
B. Immune complexes (IgG/IgM)
C. IgE and mast cells
D. Cytotoxic T-lymphocytes
Answer: A
Conceptual Explanation: Type II reactions involve IgG or IgM antibodies binding to
specific antigens on cell surfaces or tissues, leading to cell destruction or dysfunction.
6. Which mediator is primarily responsible for the systemic effects of sepsis, including fever
and hypotension?
A. Tumor Necrosis Factor-alpha (TNF-α)
B. Interleukin-10
C. Histamine
ADVANCED PATHOPHYSIOLOGY 2026
QUESTIONS AND ANSWERS
1. Which epigenetic mechanism involves the addition of a methyl group to the cytosine base
of DNA, typically leading to gene silencing?
A. Histone acetylation
B. Protein phosphorylation
C. RNA interference
D. DNA methylation
Answer: D
Conceptual Explanation: DNA methylation involves the addition of a methyl group to
cytosine, which often prevents transcription factors from binding, thus silencing the gene.
2. In the context of cellular injury, what is the primary difference between necrosis and
apoptosis?
A. Necrosis is programmed cell death, while apoptosis is accidental.
B. Necrosis results in cell swelling and membrane rupture, while apoptosis involves cell
shrinkage and fragmentation.
,C. Apoptosis involves inflammation, while necrosis does not.
D. Apoptosis only occurs in cancerous cells.
Answer: B
Conceptual Explanation: Necrosis is passive, accidental death characterized by swelling
and lysis leading to inflammation; apoptosis is an active, programmed process where the
cell shrinks and fragments without inducing an inflammatory response.
3. A patient with chronic hypertension develops thickening of the left ventricular wall. This
cellular adaptation is best described as:
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Metaplasia
Answer: B
Conceptual Explanation: Hypertrophy is an increase in the size of cells (and the organ) in
response to increased workload, common in cardiac muscle under hypertensive stress.
4. Which of the following describes the role of ‘foam cells’ in the progression of
atherosclerosis?
A. They are macrophages that have ingested oxidized LDL cholesterol.
B. They are smooth muscle cells that have migrated to the adventitia.
, C. They are endothelial cells that have become calcified.
D. They are platelets that have aggregated at the site of injury.
Answer: A
Conceptual Explanation: Foam cells are formed when macrophages ingest oxidized LDL
within the arterial wall, serving as a hallmark of early atherosclerotic plaques.
5. Type II hypersensitivity reactions are primarily mediated by:
A. Antibodies (IgG/IgM) reacting with cell-surface antigens
B. Immune complexes (IgG/IgM)
C. IgE and mast cells
D. Cytotoxic T-lymphocytes
Answer: A
Conceptual Explanation: Type II reactions involve IgG or IgM antibodies binding to
specific antigens on cell surfaces or tissues, leading to cell destruction or dysfunction.
6. Which mediator is primarily responsible for the systemic effects of sepsis, including fever
and hypotension?
A. Tumor Necrosis Factor-alpha (TNF-α)
B. Interleukin-10
C. Histamine
