South College NSG 5140 Advanced Pathophysiology
Midterm Exam
250 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 South College NSG 5140 Advanced Pathophysiology Midterm Exam
Page 1
,Q1
A patient with long-standing hypertension develops left ventricular hypertrophy. Which cellular
adaptation best explains this change?
A) Hyperplasia
B) Hypertrophy CORRECT
C) Metaplasia
D) Dysplasia
Rationale
Cardiac muscle cells cannot significantly divide after birth. In response to increased workload caused by
hypertension, existing myocardial cells enlarge, resulting in hypertrophy rather than hyperplasia.
Q2
A chronic smoker develops replacement of normal ciliated respiratory epithelium with stratified
squamous epithelium. This process is known as:
A) Hyperplasia
B) Hypertrophy
C) Metaplasia CORRECT
D) Dysplasia
Rationale
Metaplasia is a reversible substitution of one mature cell type with another that is better able to tolerate
chronic irritation. Persistent irritation may increase the risk of dysplasia and malignancy.
Q3
Which cellular adaptation is considered reversible after the removal of the stressor?
A) Dysplasia
B) Neoplasia
C) Atrophy CORRECT
D) Anaplasia
Page 2
,Rationale
Atrophy is a decrease in cell size due to reduced workload, diminished blood supply, aging, or loss of
stimulation. If the underlying cause is corrected, the tissue may regain normal size and function.
Q4
A pathologist examining a tissue sample notes "coagulative necrosis" in a kidney specimen. This
type of necrosis is most commonly associated with:
A) Ischemia CORRECT
B) Tuberculosis
C) Pancreatitis
D) Bacterial infection
Rationale
Coagulative necrosis is the most common type of necrosis and is typically caused by ischemia in solid
organs such as the kidney, heart, and liver. The tissue architecture is preserved for several days.
Q5
The irreversible marker of cell death on electron microscopy is:
A) Cellular swelling
B) Nuclear pyknosis
C) Mitochondrial amorphous (flocculent) densities CORRECT
D) Membrane blebbing
Rationale
Flocculent densities in the mitochondrial matrix are an irreversible marker of cell death, indicating severe
membrane damage. This is the "point of no return" where cell death is inevitable even if the stressor is
removed.
Q6
What is the earliest reversible morphologic sign of cell injury?
A) Nuclear fragmentation
Page 3
, B) Cellular swelling (hydropic change) CORRECT
C) Karyolysis
D) Fatty change
Rationale
Cellular swelling is the earliest reversible sign of cell injury, caused by ATP depletion leading to failure of
the Na⁺/K⁺ pump and subsequent water influx. This is followed by fatty change in some organs.
Q7
A patient with chronic alcoholism develops thiamine deficiency leading to Wernicke-Korsakoff
syndrome. The cellular injury in this condition is best described as:
A) Hypoxic injury
B) Nutritional injury CORRECT
C) Chemical injury
D) Physical injury
Rationale
Thiamine (vitamin B1) deficiency is a nutritional cause of cellular injury. Thiamine is an essential
coenzyme in carbohydrate metabolism, and its deficiency leads to impaired glucose utilization and ATP
production, particularly affecting neurons.
Q8
A patient with chronic liver disease develops cirrhosis. The liver tissue shows extensive scarring
and nodule formation. This is best described as:
A) Regeneration
B) Repair by fibrosis CORRECT
C) Resolution
D) Hyperplasia
Page 4
Midterm Exam
250 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 South College NSG 5140 Advanced Pathophysiology Midterm Exam
Page 1
,Q1
A patient with long-standing hypertension develops left ventricular hypertrophy. Which cellular
adaptation best explains this change?
A) Hyperplasia
B) Hypertrophy CORRECT
C) Metaplasia
D) Dysplasia
Rationale
Cardiac muscle cells cannot significantly divide after birth. In response to increased workload caused by
hypertension, existing myocardial cells enlarge, resulting in hypertrophy rather than hyperplasia.
Q2
A chronic smoker develops replacement of normal ciliated respiratory epithelium with stratified
squamous epithelium. This process is known as:
A) Hyperplasia
B) Hypertrophy
C) Metaplasia CORRECT
D) Dysplasia
Rationale
Metaplasia is a reversible substitution of one mature cell type with another that is better able to tolerate
chronic irritation. Persistent irritation may increase the risk of dysplasia and malignancy.
Q3
Which cellular adaptation is considered reversible after the removal of the stressor?
A) Dysplasia
B) Neoplasia
C) Atrophy CORRECT
D) Anaplasia
Page 2
,Rationale
Atrophy is a decrease in cell size due to reduced workload, diminished blood supply, aging, or loss of
stimulation. If the underlying cause is corrected, the tissue may regain normal size and function.
Q4
A pathologist examining a tissue sample notes "coagulative necrosis" in a kidney specimen. This
type of necrosis is most commonly associated with:
A) Ischemia CORRECT
B) Tuberculosis
C) Pancreatitis
D) Bacterial infection
Rationale
Coagulative necrosis is the most common type of necrosis and is typically caused by ischemia in solid
organs such as the kidney, heart, and liver. The tissue architecture is preserved for several days.
Q5
The irreversible marker of cell death on electron microscopy is:
A) Cellular swelling
B) Nuclear pyknosis
C) Mitochondrial amorphous (flocculent) densities CORRECT
D) Membrane blebbing
Rationale
Flocculent densities in the mitochondrial matrix are an irreversible marker of cell death, indicating severe
membrane damage. This is the "point of no return" where cell death is inevitable even if the stressor is
removed.
Q6
What is the earliest reversible morphologic sign of cell injury?
A) Nuclear fragmentation
Page 3
, B) Cellular swelling (hydropic change) CORRECT
C) Karyolysis
D) Fatty change
Rationale
Cellular swelling is the earliest reversible sign of cell injury, caused by ATP depletion leading to failure of
the Na⁺/K⁺ pump and subsequent water influx. This is followed by fatty change in some organs.
Q7
A patient with chronic alcoholism develops thiamine deficiency leading to Wernicke-Korsakoff
syndrome. The cellular injury in this condition is best described as:
A) Hypoxic injury
B) Nutritional injury CORRECT
C) Chemical injury
D) Physical injury
Rationale
Thiamine (vitamin B1) deficiency is a nutritional cause of cellular injury. Thiamine is an essential
coenzyme in carbohydrate metabolism, and its deficiency leads to impaired glucose utilization and ATP
production, particularly affecting neurons.
Q8
A patient with chronic liver disease develops cirrhosis. The liver tissue shows extensive scarring
and nodule formation. This is best described as:
A) Regeneration
B) Repair by fibrosis CORRECT
C) Resolution
D) Hyperplasia
Page 4
