Chamberlain NR 507 Advanced Pathophysiology
Final Exam Prep | Latest Update 2026/2027
200 Practice Questions & Detailed Answers |
Verified Answers with Rationales | A+ Graded
Section 1: Cellular Adaptation, Injury & Death (Questions 1–25)
1. A cell exhibits mitochondrial outer membrane permeabilization, cytochrome c release, caspase9
activation, and phosphatidylserine externalization without inflammation. Which pathway is most
precisely identified?
A. Extrinsic apoptotic pathway via TNF receptor
B. Intrinsic apoptotic pathway via BAX/BAK pore formation
C. Necroptosis via RIPK1/RIPK3/MLKL
D. Pyroptosis via NLRP3 inflammasome
Correct Answer: B
Rationale: Intrinsic apoptosis is triggered by intracellular stress, causing BAX/BAK mitochondrial pore
formation, cytochrome c release, apoptosome assembly, and caspase9 activation with
phosphatidylserine exposure but no inflammation. Extrinsic apoptosis uses caspase8; necroptosis and
pyroptosis are inflammatory lytic pathways.
2. Which type of cell death is genetically programmed, ATPdependent, and does not trigger an
inflammatory response?
A. Necrosis
B. Apoptosis
C. Coagulative necrosis
D. Liquefactive necrosis
Correct Answer: B
Rationale: Apoptosis is programmed cell death requiring ATP, characterized by cell shrinkage, chromatin
condensation, and apoptotic body formation without inflammation.
,3. Which finding is most consistent with necrosis rather than apoptosis?
A. Cell shrinkage without inflammation
B. Cell swelling with inflammation
C. Intact plasma membrane
D. Caspase9 activation
Correct Answer: B
Rationale: Necrosis involves cell swelling, membrane rupture, and inflammation, whereas apoptosis
involves cell shrinkage and no inflammation.
4. Coagulative necrosis is most characteristic of ischemic injury to which organs?
A. Brain and pancreas
B. Heart and kidney
C. Lung and liver
D. Intestine and spleen
Correct Answer: B
Rationale: Coagulative necrosis is typical of ischemic injury in solid organs such as the heart, kidney, and
spleen, where tissue architecture is preserved temporarily.
5. A cerebral infarct most commonly undergoes which type of necrosis?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis
Correct Answer: B
Rationale: The brain lacks structural supporting stroma and has high lipid content, so ischemic neuronal
death undergoes liquefactive necrosis.
6. Caseous necrosis is classically associated with:
A. Acute pancreatitis
,B. Tuberculosis
C. Myocardial infarction
D. Gangrenous appendicitis
Correct Answer: B
Rationale: Caseous necrosis ("cheeselike") is characteristic of tuberculosis and fungal infections,
reflecting a combination of coagulative and liquefactive necrosis.
7. A patient with chronic acid reflux develops columnar epithelium in the distal esophagus. This
adaptation is:
A. Atrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
Correct Answer: C
Rationale: Metaplasia is the reversible replacement of one mature cell type by another (squamous to
columnar in Barrett esophagus) as a protective response to chronic irritation.
8. Which cellular adaptation involves an increase in cell number?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
Correct Answer: B
Rationale: Hyperplasia is an increase in cell number in tissues capable of mitotic division, often in
response to hormonal stimulation or chronic irritation.
9. Left ventricular enlargement in chronic hypertension is an example of:
A. Physiological hyperplasia
B. Pathological hypertrophy
C. Metaplasia
, D. Dysplasia
Correct Answer: B
Rationale: Chronic pressure overload causes pathological hypertrophy of cardiac myocytes, which are
permanent cells unable to undergo hyperplasia.
10. Disuse atrophy of skeletal muscle is primarily mediated by:
A. Decreased protein degradation
B. Increased protein synthesis
C. Increased ubiquitinproteasome–mediated proteolysis and autophagy
D. Hyperplasia of myocytes
Correct Answer: C
Rationale: Immobilization increases proteolysis via the ubiquitinproteasome system and autophagy,
reducing muscle mass.
11. The earliest morphological sign of reversible cell injury is:
A. Nuclear fragmentation
B. Cellular swelling (hydropic change)
C. Membrane rupture
D. Dystrophic calcification
Correct Answer: B
Rationale: Failure of the Na⁺/K⁺ATPase pump causes water influx and cellular swelling, the earliest
reversible change.
12. Reperfusion injury following restoration of blood flow to ischemic tissue is primarily mediated by:
A. Sudden ATP restoration
B. Reactive oxygen species burst and calcium overload
C. Decreased inflammatory cell recruitment
D. Reduced mitochondrial permeability
Correct Answer: B
Final Exam Prep | Latest Update 2026/2027
200 Practice Questions & Detailed Answers |
Verified Answers with Rationales | A+ Graded
Section 1: Cellular Adaptation, Injury & Death (Questions 1–25)
1. A cell exhibits mitochondrial outer membrane permeabilization, cytochrome c release, caspase9
activation, and phosphatidylserine externalization without inflammation. Which pathway is most
precisely identified?
A. Extrinsic apoptotic pathway via TNF receptor
B. Intrinsic apoptotic pathway via BAX/BAK pore formation
C. Necroptosis via RIPK1/RIPK3/MLKL
D. Pyroptosis via NLRP3 inflammasome
Correct Answer: B
Rationale: Intrinsic apoptosis is triggered by intracellular stress, causing BAX/BAK mitochondrial pore
formation, cytochrome c release, apoptosome assembly, and caspase9 activation with
phosphatidylserine exposure but no inflammation. Extrinsic apoptosis uses caspase8; necroptosis and
pyroptosis are inflammatory lytic pathways.
2. Which type of cell death is genetically programmed, ATPdependent, and does not trigger an
inflammatory response?
A. Necrosis
B. Apoptosis
C. Coagulative necrosis
D. Liquefactive necrosis
Correct Answer: B
Rationale: Apoptosis is programmed cell death requiring ATP, characterized by cell shrinkage, chromatin
condensation, and apoptotic body formation without inflammation.
,3. Which finding is most consistent with necrosis rather than apoptosis?
A. Cell shrinkage without inflammation
B. Cell swelling with inflammation
C. Intact plasma membrane
D. Caspase9 activation
Correct Answer: B
Rationale: Necrosis involves cell swelling, membrane rupture, and inflammation, whereas apoptosis
involves cell shrinkage and no inflammation.
4. Coagulative necrosis is most characteristic of ischemic injury to which organs?
A. Brain and pancreas
B. Heart and kidney
C. Lung and liver
D. Intestine and spleen
Correct Answer: B
Rationale: Coagulative necrosis is typical of ischemic injury in solid organs such as the heart, kidney, and
spleen, where tissue architecture is preserved temporarily.
5. A cerebral infarct most commonly undergoes which type of necrosis?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis
Correct Answer: B
Rationale: The brain lacks structural supporting stroma and has high lipid content, so ischemic neuronal
death undergoes liquefactive necrosis.
6. Caseous necrosis is classically associated with:
A. Acute pancreatitis
,B. Tuberculosis
C. Myocardial infarction
D. Gangrenous appendicitis
Correct Answer: B
Rationale: Caseous necrosis ("cheeselike") is characteristic of tuberculosis and fungal infections,
reflecting a combination of coagulative and liquefactive necrosis.
7. A patient with chronic acid reflux develops columnar epithelium in the distal esophagus. This
adaptation is:
A. Atrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
Correct Answer: C
Rationale: Metaplasia is the reversible replacement of one mature cell type by another (squamous to
columnar in Barrett esophagus) as a protective response to chronic irritation.
8. Which cellular adaptation involves an increase in cell number?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
Correct Answer: B
Rationale: Hyperplasia is an increase in cell number in tissues capable of mitotic division, often in
response to hormonal stimulation or chronic irritation.
9. Left ventricular enlargement in chronic hypertension is an example of:
A. Physiological hyperplasia
B. Pathological hypertrophy
C. Metaplasia
, D. Dysplasia
Correct Answer: B
Rationale: Chronic pressure overload causes pathological hypertrophy of cardiac myocytes, which are
permanent cells unable to undergo hyperplasia.
10. Disuse atrophy of skeletal muscle is primarily mediated by:
A. Decreased protein degradation
B. Increased protein synthesis
C. Increased ubiquitinproteasome–mediated proteolysis and autophagy
D. Hyperplasia of myocytes
Correct Answer: C
Rationale: Immobilization increases proteolysis via the ubiquitinproteasome system and autophagy,
reducing muscle mass.
11. The earliest morphological sign of reversible cell injury is:
A. Nuclear fragmentation
B. Cellular swelling (hydropic change)
C. Membrane rupture
D. Dystrophic calcification
Correct Answer: B
Rationale: Failure of the Na⁺/K⁺ATPase pump causes water influx and cellular swelling, the earliest
reversible change.
12. Reperfusion injury following restoration of blood flow to ischemic tissue is primarily mediated by:
A. Sudden ATP restoration
B. Reactive oxygen species burst and calcium overload
C. Decreased inflammatory cell recruitment
D. Reduced mitochondrial permeability
Correct Answer: B
