NSG 530 Exam 1 Actual Exam V1 | NSG 530 Advanced
Pathophysiology (NSG530 Exam 1) [PDF] | Wilkes University
1. A 65-year-old male with a history of chronic untreated hypertension presents for a routine
check-up. An echocardiogram reveals increased thickness of the left ventricular wall. Which
cellular process best explains this finding?
A. Hypertrophy
B. Atrophy
C. Hyperplasia
D. Metaplasia
Answer: A
Rationale: Hypertrophy is an increase in the size of cells in response to mechanical load or
stress, which results in an increase in the size of the organ. In cardiac tissue, cells are
unable to divide (post-mitotic), so they adapt to increased afterload by increasing protein
synthesis. This results in the thickening of the ventricular wall to compensate for the higher
pressure required to pump blood.
2. During a biopsy of the bronchial lining in a long-term smoker, the pathologist notes that
the normal ciliated columnar epithelium has been replaced by stratified squamous
epithelium. This is an example of:
A. Dysplasia
B. Metaplasia
C. Anaplasia
D. Hyperplasia
Answer: B
Rationale: Metaplasia is a reversible replacement of one mature cell type by another
mature cell type that is better able to tolerate environmental stress. In smokers, the fragile
columnar cells of the airway change into tougher squamous cells to survive the irritation of
smoke. While this provides protection, the loss of cilia and mucus secretion impairs the
lung’s defense mechanisms.
3. A patient experiences a myocardial infarction due to a blocked coronary artery. Which of
the following is the primary mechanism leading to cellular swelling in the affected
myocardium?
A. Increased protein synthesis
B. Decreased intracellular sodium levels
,C. Failure of the Na+/K+ ATPase pump
D. Activation of the complement system
Answer: C
Rationale: Hypoxia leads to a decrease in mitochondrial ATP production, which is
necessary for the function of the Na+/K+ ATPase pump. When this pump fails, sodium
accumulates inside the cell, creating an osmotic gradient that pulls water into the
cytoplasm. This results in acute cellular swelling, also known as oncosis or hydropic
degeneration.
4. Which process involves the programmed cell death of a cell without triggering an
inflammatory response in the surrounding tissue?
A. Liquefactive necrosis
B. Autolysis
C. Coagulative necrosis
D. Apoptosis
Answer: D
Rationale: Apoptosis is a highly regulated form of cell suicide that allows for the removal
of damaged or unnecessary cells. Unlike necrosis, apoptosis causes the cell to shrink and
fragment into membrane-bound bodies that are phagocytized by neighbors. Because the
cell membrane remains intact until the end, cellular contents do not leak out to trigger
inflammation.
5. A 30-year-old female presents with signs of systemic lupus erythematosus (SLE). The
pathophysiology involves the deposition of immune complexes in various tissues. This
represents which type of hypersensitivity?
A. Type III
B. Type II
C. Type I
D. Type IV
Answer: A
Rationale: Type III hypersensitivity is mediated by the formation of antigen-antibody
complexes that circulate in the blood and deposit in vessel walls or tissues. Once deposited,
these complexes activate the complement system, which recruits neutrophils and leads to
tissue damage. SLE is a classic example of this mechanism, often affecting the kidneys,
joints, and skin.
, 6. What is the primary role of histone acetylation in the context of epigenetic regulation?
A. Increasing gene expression by relaxing chromatin
B. Promoting DNA degradation
C. Silencing genes by tightening DNA coils
D. Causing point mutations in the genetic code
Answer: A
Rationale: Histone acetylation involves the addition of an acetyl group to the tails of
histone proteins, which decreases their positive charge. This reduces the affinity between
histones and the negatively charged DNA, leading to a more open chromatin structure
(euchromatin). As a result, transcription factors can more easily access the DNA, thereby
increasing gene expression.
7. Which substance is primarily responsible for the redness (rubor) and heat (calor) observed
during acute inflammation?
A. Histamine
B. Leukotrienes
C. Complement C5a
D. Interleukin-10
Answer: A
Rationale: Histamine is released by mast cells during the early stages of the inflammatory
response. It causes significant vasodilation of the arterioles and increases the permeability
of venules. The resulting increase in blood flow to the injured area produces the
characteristic redness and localized warmth associated with inflammation.
8. In the process of wound healing, what is the significance of granulation tissue?
A. It signifies the end of the inflammatory phase
B. It provides a vascular framework for tissue repair
C. It is indicative of permanent scar formation
D. It is a sign of chronic infection
Answer: B
Rationale: Granulation tissue is a hallmark of the proliferative phase of wound healing,
appearing pink and granular. It consists of new capillary sprouts (angiogenesis) and
fibroblasts that produce collagen to fill the wound gap. This tissue serves as a temporary
scaffold that supports the migration of cells and the eventual maturation of the scar.
Pathophysiology (NSG530 Exam 1) [PDF] | Wilkes University
1. A 65-year-old male with a history of chronic untreated hypertension presents for a routine
check-up. An echocardiogram reveals increased thickness of the left ventricular wall. Which
cellular process best explains this finding?
A. Hypertrophy
B. Atrophy
C. Hyperplasia
D. Metaplasia
Answer: A
Rationale: Hypertrophy is an increase in the size of cells in response to mechanical load or
stress, which results in an increase in the size of the organ. In cardiac tissue, cells are
unable to divide (post-mitotic), so they adapt to increased afterload by increasing protein
synthesis. This results in the thickening of the ventricular wall to compensate for the higher
pressure required to pump blood.
2. During a biopsy of the bronchial lining in a long-term smoker, the pathologist notes that
the normal ciliated columnar epithelium has been replaced by stratified squamous
epithelium. This is an example of:
A. Dysplasia
B. Metaplasia
C. Anaplasia
D. Hyperplasia
Answer: B
Rationale: Metaplasia is a reversible replacement of one mature cell type by another
mature cell type that is better able to tolerate environmental stress. In smokers, the fragile
columnar cells of the airway change into tougher squamous cells to survive the irritation of
smoke. While this provides protection, the loss of cilia and mucus secretion impairs the
lung’s defense mechanisms.
3. A patient experiences a myocardial infarction due to a blocked coronary artery. Which of
the following is the primary mechanism leading to cellular swelling in the affected
myocardium?
A. Increased protein synthesis
B. Decreased intracellular sodium levels
,C. Failure of the Na+/K+ ATPase pump
D. Activation of the complement system
Answer: C
Rationale: Hypoxia leads to a decrease in mitochondrial ATP production, which is
necessary for the function of the Na+/K+ ATPase pump. When this pump fails, sodium
accumulates inside the cell, creating an osmotic gradient that pulls water into the
cytoplasm. This results in acute cellular swelling, also known as oncosis or hydropic
degeneration.
4. Which process involves the programmed cell death of a cell without triggering an
inflammatory response in the surrounding tissue?
A. Liquefactive necrosis
B. Autolysis
C. Coagulative necrosis
D. Apoptosis
Answer: D
Rationale: Apoptosis is a highly regulated form of cell suicide that allows for the removal
of damaged or unnecessary cells. Unlike necrosis, apoptosis causes the cell to shrink and
fragment into membrane-bound bodies that are phagocytized by neighbors. Because the
cell membrane remains intact until the end, cellular contents do not leak out to trigger
inflammation.
5. A 30-year-old female presents with signs of systemic lupus erythematosus (SLE). The
pathophysiology involves the deposition of immune complexes in various tissues. This
represents which type of hypersensitivity?
A. Type III
B. Type II
C. Type I
D. Type IV
Answer: A
Rationale: Type III hypersensitivity is mediated by the formation of antigen-antibody
complexes that circulate in the blood and deposit in vessel walls or tissues. Once deposited,
these complexes activate the complement system, which recruits neutrophils and leads to
tissue damage. SLE is a classic example of this mechanism, often affecting the kidneys,
joints, and skin.
, 6. What is the primary role of histone acetylation in the context of epigenetic regulation?
A. Increasing gene expression by relaxing chromatin
B. Promoting DNA degradation
C. Silencing genes by tightening DNA coils
D. Causing point mutations in the genetic code
Answer: A
Rationale: Histone acetylation involves the addition of an acetyl group to the tails of
histone proteins, which decreases their positive charge. This reduces the affinity between
histones and the negatively charged DNA, leading to a more open chromatin structure
(euchromatin). As a result, transcription factors can more easily access the DNA, thereby
increasing gene expression.
7. Which substance is primarily responsible for the redness (rubor) and heat (calor) observed
during acute inflammation?
A. Histamine
B. Leukotrienes
C. Complement C5a
D. Interleukin-10
Answer: A
Rationale: Histamine is released by mast cells during the early stages of the inflammatory
response. It causes significant vasodilation of the arterioles and increases the permeability
of venules. The resulting increase in blood flow to the injured area produces the
characteristic redness and localized warmth associated with inflammation.
8. In the process of wound healing, what is the significance of granulation tissue?
A. It signifies the end of the inflammatory phase
B. It provides a vascular framework for tissue repair
C. It is indicative of permanent scar formation
D. It is a sign of chronic infection
Answer: B
Rationale: Granulation tissue is a hallmark of the proliferative phase of wound healing,
appearing pink and granular. It consists of new capillary sprouts (angiogenesis) and
fibroblasts that produce collagen to fill the wound gap. This tissue serves as a temporary
scaffold that supports the migration of cells and the eventual maturation of the scar.
