NU 208 Pathophysiology
Final Assessment Review
Questions & Solutions
2025
©2025
, Question 1 (MC)
Case Scenario: A 65‑year‑old male with a history of coronary artery
disease presents with crushing chest pain. An electrocardiogram and
elevated troponin levels confirm an acute myocardial infarction.
Histologic examination of the infarcted area reveals an area of cell
death with preservation of the cellular outlines.
Question: Which description best characterizes the type of cell death
occurring in the myocardium?
A. Apoptosis with formation of apoptotic bodies
B. Coagulative necrosis with preservation of cellular architecture
C. Liquefactive necrosis with complete enzymatic digestion
D. Fat necrosis resulting from enzymatic digestion of adipocytes
Correct ANS: B
Rationale: Myocardial infarction typically causes coagulative necrosis.
This process preserves the basic outline of dead cells despite the loss of
nuclear detail, distinguishing it from liquefactive or apoptotic forms of
cell death.
---
Question 2 (MC)
Case Scenario: A 45‑year‑old female with an acute ischemic stroke is
administered thrombolytic therapy. Subsequent imaging, however,
reveals additional tissue damage in the reperfused area.
Question: Which mediator is primarily responsible for the exacerbation
of tissue injury during reperfusion?
A. Lactic acid accumulation
B. Reactive oxygen species
C. Activated caspases
D. Intracellular calcium overload
©2025
, Correct ANS: B
Rationale: Reperfusion injury is principally mediated by reactive oxygen
species (ROS) that are generated when oxygen is reintroduced, leading to
oxidative damage of cellular membranes, proteins, and DNA.
---
Question 3 (MC)
Case Scenario: A 52‑year‑old male in septic shock displays fever,
hypotension, and multi‑organ dysfunction. Blood tests show markedly
elevated cytokine levels.
Question: Which cytokine is most directly implicated in driving the
systemic inflammatory response seen in sepsis?
A. Interleukin‑10
B. Tumor necrosis factor‑alpha
C. Interferon‑alpha
D. Interleukin‑4
Correct ANS: B
Rationale: Tumor necrosis factor‑alpha (TNF‑alpha) is a key mediator in
sepsis, contributing to fever, shock, and organ dysfunction by triggering a
cascade of inflammatory responses.
---
Question 4 (MC)
Case Scenario: A 50‑year‑old patient with non‑small cell lung cancer is
started on an epidermal growth factor receptor (EGFR) inhibitor.
Question: Which signal transduction pathway is primarily disrupted by
inhibition of EGFR in this patient?
A. Mitogen‑activated protein kinase (MAPK)/ERK pathway
B. Janus kinase (JAK)/STAT pathway
C. Wnt/β‑catenin pathway
D. Notch signaling pathway
©2025
, Correct ANS: A
Rationale: EGFR normally activates the MAPK/ERK pathway to promote
cell proliferation. Inhibition of EGFR reduces downstream MAPK/ERK
signaling, thereby tempering tumor cell proliferation.
---
Question 5 (MC)
Case Scenario: A biopsy from inflamed tissue reveals cell death with
nuclear condensation, cell shrinkage, and membrane blebbing but
without a significant inflammatory infiltrate.
Question: Which molecular event best distinguishes this process from
necrosis?
A. Activation of caspases
B. Disruption of plasma membrane integrity
C. Uncontrolled cell swelling
D. Robust inflammatory cell infiltration
Correct ANS: A
Rationale: The activation of caspases is a hallmark of apoptosis, a
regulated form of cell death that occurs with minimal inflammation—
unlike the uncontrolled cell swelling and membrane rupture seen in
necrosis.
---
Question 6 (MC)
Case Scenario: A patient with Alzheimer’s disease is found to have
neuronal aggregates and enlarged autophagic vacuoles on microscopic
examination.
Question: Which process best describes the mechanism by which cells
attempt to remove damaged proteins and organelles under stress?
A. Uncontrolled cell death due to toxin exposure
B. Autophagy via lysosomal degradation
C. Apoptosis mediated by caspase activation
©2025
Final Assessment Review
Questions & Solutions
2025
©2025
, Question 1 (MC)
Case Scenario: A 65‑year‑old male with a history of coronary artery
disease presents with crushing chest pain. An electrocardiogram and
elevated troponin levels confirm an acute myocardial infarction.
Histologic examination of the infarcted area reveals an area of cell
death with preservation of the cellular outlines.
Question: Which description best characterizes the type of cell death
occurring in the myocardium?
A. Apoptosis with formation of apoptotic bodies
B. Coagulative necrosis with preservation of cellular architecture
C. Liquefactive necrosis with complete enzymatic digestion
D. Fat necrosis resulting from enzymatic digestion of adipocytes
Correct ANS: B
Rationale: Myocardial infarction typically causes coagulative necrosis.
This process preserves the basic outline of dead cells despite the loss of
nuclear detail, distinguishing it from liquefactive or apoptotic forms of
cell death.
---
Question 2 (MC)
Case Scenario: A 45‑year‑old female with an acute ischemic stroke is
administered thrombolytic therapy. Subsequent imaging, however,
reveals additional tissue damage in the reperfused area.
Question: Which mediator is primarily responsible for the exacerbation
of tissue injury during reperfusion?
A. Lactic acid accumulation
B. Reactive oxygen species
C. Activated caspases
D. Intracellular calcium overload
©2025
, Correct ANS: B
Rationale: Reperfusion injury is principally mediated by reactive oxygen
species (ROS) that are generated when oxygen is reintroduced, leading to
oxidative damage of cellular membranes, proteins, and DNA.
---
Question 3 (MC)
Case Scenario: A 52‑year‑old male in septic shock displays fever,
hypotension, and multi‑organ dysfunction. Blood tests show markedly
elevated cytokine levels.
Question: Which cytokine is most directly implicated in driving the
systemic inflammatory response seen in sepsis?
A. Interleukin‑10
B. Tumor necrosis factor‑alpha
C. Interferon‑alpha
D. Interleukin‑4
Correct ANS: B
Rationale: Tumor necrosis factor‑alpha (TNF‑alpha) is a key mediator in
sepsis, contributing to fever, shock, and organ dysfunction by triggering a
cascade of inflammatory responses.
---
Question 4 (MC)
Case Scenario: A 50‑year‑old patient with non‑small cell lung cancer is
started on an epidermal growth factor receptor (EGFR) inhibitor.
Question: Which signal transduction pathway is primarily disrupted by
inhibition of EGFR in this patient?
A. Mitogen‑activated protein kinase (MAPK)/ERK pathway
B. Janus kinase (JAK)/STAT pathway
C. Wnt/β‑catenin pathway
D. Notch signaling pathway
©2025
, Correct ANS: A
Rationale: EGFR normally activates the MAPK/ERK pathway to promote
cell proliferation. Inhibition of EGFR reduces downstream MAPK/ERK
signaling, thereby tempering tumor cell proliferation.
---
Question 5 (MC)
Case Scenario: A biopsy from inflamed tissue reveals cell death with
nuclear condensation, cell shrinkage, and membrane blebbing but
without a significant inflammatory infiltrate.
Question: Which molecular event best distinguishes this process from
necrosis?
A. Activation of caspases
B. Disruption of plasma membrane integrity
C. Uncontrolled cell swelling
D. Robust inflammatory cell infiltration
Correct ANS: A
Rationale: The activation of caspases is a hallmark of apoptosis, a
regulated form of cell death that occurs with minimal inflammation—
unlike the uncontrolled cell swelling and membrane rupture seen in
necrosis.
---
Question 6 (MC)
Case Scenario: A patient with Alzheimer’s disease is found to have
neuronal aggregates and enlarged autophagic vacuoles on microscopic
examination.
Question: Which process best describes the mechanism by which cells
attempt to remove damaged proteins and organelles under stress?
A. Uncontrolled cell death due to toxin exposure
B. Autophagy via lysosomal degradation
C. Apoptosis mediated by caspase activation
©2025
