South College NSG 5140 Final Exam | Advanced Pathophysiology | Questions and Correct Answers plus
Rationale | New 2026/2027 Update
Number of Questions: 250
Section 1: Cellular Adaptation, Injury, and Cell Death
Question 1
A patient with chronic hypertension develops left ventricular hypertrophy. Which cellular
adaptation best explains this change?
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Dysplasia
Answer
Answer: B
Rationale
Cardiac muscle cells are terminally differentiated and respond to increased workload by increasing in
size (hypertrophy), not number (hyperplasia). Metaplasia is the replacement of one cell type with
another, and dysplasia is disordered growth.
Question 2
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
D) Dysplasia
Answer
Answer: C
Rationale
Metaplasia is the reversible replacement of one mature cell type with another better able to tolerate
chronic irritation. Persistent irritation may progress to dysplasia and malignancy.
,Question 3
Which cellular adaptation is considered reversible after removal of the stressor?
A) Dysplasia
B) Neoplasia
C) Atrophy
D) Anaplasia
Answer
Answer: C
Rationale
Atrophy is a decrease in cell size due to reduced workload, diminished blood supply, aging, or loss of
stimulation. If the cause is corrected, the tissue may regain normal size and function.
Question 4
A pathologist examining a kidney specimen notes coagulative necrosis. This type of necrosis
is most commonly associated with:
A) Ischemia
B) Tuberculosis
C) Pancreatitis
D) Bacterial infection
Answer
Answer: A
Rationale
Coagulative necrosis is the most common type and is typically caused by ischemia in solid organs
such as the kidney, heart, and liver. Tissue architecture is preserved initially.
Question 5
The irreversible marker of cell death on electron microscopy is:
A) Cellular swelling
,B) Nuclear pyknosis
C) Mitochondrial amorphous densities
D) Membrane blebbing
Answer
Answer: C
Rationale
Flocculent densities in the mitochondrial matrix are an irreversible marker of cell death, indicating
severe membrane damage and the "point of no return."
Question 6
What is the earliest reversible morphologic sign of cell injury?
A) Nuclear fragmentation
B) Cellular swelling (hydropic change)
C) Karyolysis
D) Fatty change
Answer
Answer: B
Rationale
Cellular swelling is the earliest reversible sign of cell injury, caused by ATP depletion leading to failure
of the Na⁺/K⁺ pump and water influx.
Question 7
A patient with chronic alcoholism develops thiamine deficiency leading to Wernicke-Korsakoff
syndrome. The cellular injury is best described as:
A) Hypoxic injury
B) Nutritional injury
C) Chemical injury
D) Physical injury
Answer
, Answer: B
Rationale
Thiamine deficiency is a nutritional cause of cellular injury. Thiamine is an essential coenzyme in
carbohydrate metabolism; its deficiency impairs ATP production, particularly affecting neurons.
Question 8
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
C) Resolution
D) Hyperplasia
Answer
Answer: B
Rationale
Fibrosis replaces damaged tissue with collagenous scar tissue when regeneration is not possible. In
cirrhosis, chronic injury leads to extensive fibrosis and nodular regeneration.
Question 9
Which process requires energy to move sodium out of the cell?
A) Diffusion
B) Osmosis
C) Sodium-potassium ATPase pump
D) Facilitated diffusion
Answer
Answer: C
Rationale
The sodium-potassium ATPase pump actively transports sodium out of the cell and potassium into the
Rationale | New 2026/2027 Update
Number of Questions: 250
Section 1: Cellular Adaptation, Injury, and Cell Death
Question 1
A patient with chronic hypertension develops left ventricular hypertrophy. Which cellular
adaptation best explains this change?
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Dysplasia
Answer
Answer: B
Rationale
Cardiac muscle cells are terminally differentiated and respond to increased workload by increasing in
size (hypertrophy), not number (hyperplasia). Metaplasia is the replacement of one cell type with
another, and dysplasia is disordered growth.
Question 2
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
D) Dysplasia
Answer
Answer: C
Rationale
Metaplasia is the reversible replacement of one mature cell type with another better able to tolerate
chronic irritation. Persistent irritation may progress to dysplasia and malignancy.
,Question 3
Which cellular adaptation is considered reversible after removal of the stressor?
A) Dysplasia
B) Neoplasia
C) Atrophy
D) Anaplasia
Answer
Answer: C
Rationale
Atrophy is a decrease in cell size due to reduced workload, diminished blood supply, aging, or loss of
stimulation. If the cause is corrected, the tissue may regain normal size and function.
Question 4
A pathologist examining a kidney specimen notes coagulative necrosis. This type of necrosis
is most commonly associated with:
A) Ischemia
B) Tuberculosis
C) Pancreatitis
D) Bacterial infection
Answer
Answer: A
Rationale
Coagulative necrosis is the most common type and is typically caused by ischemia in solid organs
such as the kidney, heart, and liver. Tissue architecture is preserved initially.
Question 5
The irreversible marker of cell death on electron microscopy is:
A) Cellular swelling
,B) Nuclear pyknosis
C) Mitochondrial amorphous densities
D) Membrane blebbing
Answer
Answer: C
Rationale
Flocculent densities in the mitochondrial matrix are an irreversible marker of cell death, indicating
severe membrane damage and the "point of no return."
Question 6
What is the earliest reversible morphologic sign of cell injury?
A) Nuclear fragmentation
B) Cellular swelling (hydropic change)
C) Karyolysis
D) Fatty change
Answer
Answer: B
Rationale
Cellular swelling is the earliest reversible sign of cell injury, caused by ATP depletion leading to failure
of the Na⁺/K⁺ pump and water influx.
Question 7
A patient with chronic alcoholism develops thiamine deficiency leading to Wernicke-Korsakoff
syndrome. The cellular injury is best described as:
A) Hypoxic injury
B) Nutritional injury
C) Chemical injury
D) Physical injury
Answer
, Answer: B
Rationale
Thiamine deficiency is a nutritional cause of cellular injury. Thiamine is an essential coenzyme in
carbohydrate metabolism; its deficiency impairs ATP production, particularly affecting neurons.
Question 8
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
C) Resolution
D) Hyperplasia
Answer
Answer: B
Rationale
Fibrosis replaces damaged tissue with collagenous scar tissue when regeneration is not possible. In
cirrhosis, chronic injury leads to extensive fibrosis and nodular regeneration.
Question 9
Which process requires energy to move sodium out of the cell?
A) Diffusion
B) Osmosis
C) Sodium-potassium ATPase pump
D) Facilitated diffusion
Answer
Answer: C
Rationale
The sodium-potassium ATPase pump actively transports sodium out of the cell and potassium into the
