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NR 412 EXAM 1: PATHOPHYSIOLOGY V3 Regis University – New Original
Questions with Answers & Rationales
SECTION 1: CELLULAR BIOLOGY, INJURY, AND ADAPTATION
1. A patient with chronic kidney disease has elevated serum
phosphate and low calcium. The parathyroid glands respond by
increasing PTH secretion, causing parathyroid hyperplasia. This
is an example of:
A) Pathologic hyperplasia
B) Physiologic hyperplasia (compensatory hormonal response)
C) Metaplasia
D) Dysplasia only
Answer: B
Rationale: Parathyroid hyperplasia in response to hypocalcemia
is physiologic compensatory hyperplasia—the body adapting to
a metabolic derangement, not a primary pathologic process.
2. Which of the following is an example of pathologic
hypertrophy?
A) Skeletal muscle growth from weight training
B) Left ventricular hypertrophy from hypertension
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C) Uterine enlargement during pregnancy
D) Breast development during puberty only
Answer: B
Rationale: LVH from chronic hypertension is pathologic—an
adaptive response that ultimately impairs function. Muscle
growth from exercise and pregnancy changes are physiologic.
3. A patient with chronic GERD develops Barrett's esophagus.
This represents:
A) Hyperplasia
B) Metaplasia (squamous → columnar epithelium)
C) Dysplasia
D) Hypertrophy only
Answer: B
Rationale: Barrett's esophagus: replacement of squamous
epithelium with columnar (intestinal) epithelium due to chronic
acid exposure—metaplasia.
4. Barrett's esophagus increases the risk of:
A) Gastric lymphoma
B) Esophageal adenocarcinoma
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C) Squamous cell carcinoma of the esophagus
D) No cancer risk only
Answer: B
Rationale: Barrett's metaplasia is a precursor to esophageal
adenocarcinoma.
5. Which of the following is a reversible form of cell injury?
A) Necrosis
B) Cellular swelling and fatty change
C) Apoptosis
D) Gangrene only
Answer: B
Rationale: Cellular swelling (hydropic change) and fatty change
are reversible if the injurious stimulus is removed.
6. Cellular swelling results from:
A) Increased Na+/K+ pump activity
B) Failure of the Na+/K+ pump with sodium and water
accumulation
C) Increased protein synthesis
D) Decreased intracellular sodium only
Answer: B
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Rationale: ATP depletion impairs the Na+/K+ pump →
intracellular sodium and water increase → cellular swelling.
7. Which type of necrosis is characterized by a combination of
coagulative and liquefactive necrosis with a cheesy
appearance?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis only
Answer: C
Rationale: Caseous necrosis (TB, fungal infections): cheesy,
granular debris—a mix of coagulative and liquefactive patterns.
8. Fat necrosis is associated with:
A) Myocardial infarction
B) Acute pancreatitis (lipase-mediated fat saponification)
C) Stroke
D) Liver failure only
Answer: B
Rationale: Pancreatic lipases digest peripancreatic fat, forming
chalky calcium soaps (saponification).
NR 412 EXAM 1: PATHOPHYSIOLOGY V3 Regis University – New Original
Questions with Answers & Rationales
SECTION 1: CELLULAR BIOLOGY, INJURY, AND ADAPTATION
1. A patient with chronic kidney disease has elevated serum
phosphate and low calcium. The parathyroid glands respond by
increasing PTH secretion, causing parathyroid hyperplasia. This
is an example of:
A) Pathologic hyperplasia
B) Physiologic hyperplasia (compensatory hormonal response)
C) Metaplasia
D) Dysplasia only
Answer: B
Rationale: Parathyroid hyperplasia in response to hypocalcemia
is physiologic compensatory hyperplasia—the body adapting to
a metabolic derangement, not a primary pathologic process.
2. Which of the following is an example of pathologic
hypertrophy?
A) Skeletal muscle growth from weight training
B) Left ventricular hypertrophy from hypertension
, Page |2
C) Uterine enlargement during pregnancy
D) Breast development during puberty only
Answer: B
Rationale: LVH from chronic hypertension is pathologic—an
adaptive response that ultimately impairs function. Muscle
growth from exercise and pregnancy changes are physiologic.
3. A patient with chronic GERD develops Barrett's esophagus.
This represents:
A) Hyperplasia
B) Metaplasia (squamous → columnar epithelium)
C) Dysplasia
D) Hypertrophy only
Answer: B
Rationale: Barrett's esophagus: replacement of squamous
epithelium with columnar (intestinal) epithelium due to chronic
acid exposure—metaplasia.
4. Barrett's esophagus increases the risk of:
A) Gastric lymphoma
B) Esophageal adenocarcinoma
, Page |3
C) Squamous cell carcinoma of the esophagus
D) No cancer risk only
Answer: B
Rationale: Barrett's metaplasia is a precursor to esophageal
adenocarcinoma.
5. Which of the following is a reversible form of cell injury?
A) Necrosis
B) Cellular swelling and fatty change
C) Apoptosis
D) Gangrene only
Answer: B
Rationale: Cellular swelling (hydropic change) and fatty change
are reversible if the injurious stimulus is removed.
6. Cellular swelling results from:
A) Increased Na+/K+ pump activity
B) Failure of the Na+/K+ pump with sodium and water
accumulation
C) Increased protein synthesis
D) Decreased intracellular sodium only
Answer: B
, Page |4
Rationale: ATP depletion impairs the Na+/K+ pump →
intracellular sodium and water increase → cellular swelling.
7. Which type of necrosis is characterized by a combination of
coagulative and liquefactive necrosis with a cheesy
appearance?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis only
Answer: C
Rationale: Caseous necrosis (TB, fungal infections): cheesy,
granular debris—a mix of coagulative and liquefactive patterns.
8. Fat necrosis is associated with:
A) Myocardial infarction
B) Acute pancreatitis (lipase-mediated fat saponification)
C) Stroke
D) Liver failure only
Answer: B
Rationale: Pancreatic lipases digest peripancreatic fat, forming
chalky calcium soaps (saponification).
