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,SG3850/NSG 3850 Exam 1 | Advanced
1. A cell placed in a hypertonic solution will undergo which of the following volume changes as a
direct result of osmotic forces?
A) Swelling and eventual lysis
B) No net change in volume
C) Shrinkage due to water efflux
D) Rapid, uncontrolled division
Correct Answer: C) Shrinkage due to water efflux
Rationale: In a hypertonic solution, the extracellular fluid has a higher solute concentration than the
intracellular fluid. Water moves out of the cell across the semipermeable membrane via osmosis to
equalize concentrations, causing the cell to shrink (crenation). Swelling (A) occurs in hypotonic
solutions. No net change (B) occurs in isotonic solutions. Rapid division (D) is not an osmotic response.
2. A prolonged period of ischemia to cardiac muscle tissue will most directly lead to irreversible cell
death through which primary mechanism?
A) Accumulation of lipofuscin pigment
B) Failure of the sodium-potassium pump due to ATP depletion
C) Activation of oncogenes promoting uncontrolled division
D) Increased synthesis of structural proteins
Correct Answer: B) Failure of the sodium-potassium pump due to ATP depletion
Rationale: Ischemia deprives cells of oxygen, halting oxidative phosphorylation and ATP production.
Without ATP, the sodium-potassium pump fails, leading to intracellular sodium accumulation, water
influx, cellular swelling, and ultimately irreversible injury. Lipofuscin accumulation (A) is a sign of
aging, not acute ischemia. Uncontrolled division (C) and increased protein synthesis (D) are not
characteristic of ischemic injury.
,3. In reversible cellular injury, the earliest and most critical ultrastructural change observed is which of
the following?
A) Rupture of the lysosomal membrane
B) Nuclear fragmentation into irregular pieces
C) Swelling of the endoplasmic reticulum and mitochondria
D) Formation of amorphous densities in the mitochondrial matrix
Correct Answer: C) Swelling of the endoplasmic reticulum and mitochondria
Rationale: Reversible injury is characterized by cellular swelling and fatty change. The earliest
ultrastructural changes include swelling of the endoplasmic reticulum and mitochondria due to
impaired ion and fluid regulation. Lysosomal rupture (A) and nuclear fragmentation (B) are hallmarks
of irreversible injury and necrosis. Amorphous densities (D) are associated with irreversible
mitochondrial damage.
4. Which cellular adaptation is characterized by a decrease in cell size and metabolic activity in
response to decreased workload or nutrient supply?
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
Correct Answer: C) Atrophy
Rationale: Atrophy is a reduction in cell size and function that occurs when cells are subjected to
decreased workload, denervation, diminished blood supply, or inadequate nutrition. Hypertrophy (A)
is an increase in cell size. Hyperplasia (B) is an increase in cell number. Metaplasia (D) is the
replacement of one differentiated cell type with another.
5. Programmed cell death that eliminates damaged or unwanted cells without triggering an
inflammatory response is termed which of the following?
A) Necrosis
, B) Autophagy
C) Apoptosis
D) Pyroptosis
Correct Answer: C) Apoptosis
Rationale: Apoptosis is a highly regulated, energy-dependent form of cell death that removes cells
without releasing intracellular contents, thus avoiding an inflammatory response. Necrosis (A) is
unregulated and always triggers inflammation. Autophagy (B) is a process of cellular recycling, not cell
death. Pyroptosis (D) is a form of programmed cell death that is highly inflammatory.
6. When comparing necrosis and apoptosis, which of the following features is uniquely characteristic
of necrosis?
A) Cell shrinkage with preservation of organelles
B) Activation of caspase cascades
C) Disruption of the plasma membrane with leakage of cellular contents
D) Formation of apoptotic bodies that are phagocytosed
Correct Answer: C) Disruption of the plasma membrane with leakage of cellular contents
Rationale: Necrosis is characterized by loss of membrane integrity, cellular swelling, and leakage of
intracellular contents into the extracellular space, which triggers an inflammatory response. Cell
shrinkage (A), caspase activation (B), and apoptotic body formation (D) are all hallmark features of
apoptosis, not necrosis.
7. Reperfusion of ischemic tissue can paradoxically worsen cellular injury through which primary
mechanism?
A) Reduction of intracellular calcium levels
B) Generation of reactive oxygen species upon reoxygenation
C) Inhibition of the inflammatory cascade
D) Restoration of normal mitochondrial function
,SG3850/NSG 3850 Exam 1 | Advanced
1. A cell placed in a hypertonic solution will undergo which of the following volume changes as a
direct result of osmotic forces?
A) Swelling and eventual lysis
B) No net change in volume
C) Shrinkage due to water efflux
D) Rapid, uncontrolled division
Correct Answer: C) Shrinkage due to water efflux
Rationale: In a hypertonic solution, the extracellular fluid has a higher solute concentration than the
intracellular fluid. Water moves out of the cell across the semipermeable membrane via osmosis to
equalize concentrations, causing the cell to shrink (crenation). Swelling (A) occurs in hypotonic
solutions. No net change (B) occurs in isotonic solutions. Rapid division (D) is not an osmotic response.
2. A prolonged period of ischemia to cardiac muscle tissue will most directly lead to irreversible cell
death through which primary mechanism?
A) Accumulation of lipofuscin pigment
B) Failure of the sodium-potassium pump due to ATP depletion
C) Activation of oncogenes promoting uncontrolled division
D) Increased synthesis of structural proteins
Correct Answer: B) Failure of the sodium-potassium pump due to ATP depletion
Rationale: Ischemia deprives cells of oxygen, halting oxidative phosphorylation and ATP production.
Without ATP, the sodium-potassium pump fails, leading to intracellular sodium accumulation, water
influx, cellular swelling, and ultimately irreversible injury. Lipofuscin accumulation (A) is a sign of
aging, not acute ischemia. Uncontrolled division (C) and increased protein synthesis (D) are not
characteristic of ischemic injury.
,3. In reversible cellular injury, the earliest and most critical ultrastructural change observed is which of
the following?
A) Rupture of the lysosomal membrane
B) Nuclear fragmentation into irregular pieces
C) Swelling of the endoplasmic reticulum and mitochondria
D) Formation of amorphous densities in the mitochondrial matrix
Correct Answer: C) Swelling of the endoplasmic reticulum and mitochondria
Rationale: Reversible injury is characterized by cellular swelling and fatty change. The earliest
ultrastructural changes include swelling of the endoplasmic reticulum and mitochondria due to
impaired ion and fluid regulation. Lysosomal rupture (A) and nuclear fragmentation (B) are hallmarks
of irreversible injury and necrosis. Amorphous densities (D) are associated with irreversible
mitochondrial damage.
4. Which cellular adaptation is characterized by a decrease in cell size and metabolic activity in
response to decreased workload or nutrient supply?
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
Correct Answer: C) Atrophy
Rationale: Atrophy is a reduction in cell size and function that occurs when cells are subjected to
decreased workload, denervation, diminished blood supply, or inadequate nutrition. Hypertrophy (A)
is an increase in cell size. Hyperplasia (B) is an increase in cell number. Metaplasia (D) is the
replacement of one differentiated cell type with another.
5. Programmed cell death that eliminates damaged or unwanted cells without triggering an
inflammatory response is termed which of the following?
A) Necrosis
, B) Autophagy
C) Apoptosis
D) Pyroptosis
Correct Answer: C) Apoptosis
Rationale: Apoptosis is a highly regulated, energy-dependent form of cell death that removes cells
without releasing intracellular contents, thus avoiding an inflammatory response. Necrosis (A) is
unregulated and always triggers inflammation. Autophagy (B) is a process of cellular recycling, not cell
death. Pyroptosis (D) is a form of programmed cell death that is highly inflammatory.
6. When comparing necrosis and apoptosis, which of the following features is uniquely characteristic
of necrosis?
A) Cell shrinkage with preservation of organelles
B) Activation of caspase cascades
C) Disruption of the plasma membrane with leakage of cellular contents
D) Formation of apoptotic bodies that are phagocytosed
Correct Answer: C) Disruption of the plasma membrane with leakage of cellular contents
Rationale: Necrosis is characterized by loss of membrane integrity, cellular swelling, and leakage of
intracellular contents into the extracellular space, which triggers an inflammatory response. Cell
shrinkage (A), caspase activation (B), and apoptotic body formation (D) are all hallmark features of
apoptosis, not necrosis.
7. Reperfusion of ischemic tissue can paradoxically worsen cellular injury through which primary
mechanism?
A) Reduction of intracellular calcium levels
B) Generation of reactive oxygen species upon reoxygenation
C) Inhibition of the inflammatory cascade
D) Restoration of normal mitochondrial function
