GOULD'S PATHOPHYSIOLOGY FOR THE
HEALTH PROFESSIONS
7TH EDITION
• AUTHOR(S)KARIN C. VANMETER;
ROBERT J. HUBERT
TEST BANK
1.
Reference
Ch. 1 — Introduction to Pathophysiology — Cellular adaptation:
atrophy
Stem
A 68-year-old man with long-standing reduced blood flow to his
lower limb presents with a gradually decreasing muscle bulk
and reduced strength in the affected leg. Describe the most
likely cellular adaptation and the primary mechanistic driver
linking decreased workload and reduced cell size.
Options
A. Hypertrophy due to increased protein synthesis.
,B. Atrophy due to decreased protein synthesis and increased
proteasomal degradation.
C. Hyperplasia caused by increased mitotic activity.
D. Metaplasia due to replacement by a different cell type.
Correct answer
B
Rationales
Correct (B): The clinical picture shows decreased muscle mass
from reduced workload and perfusion; atrophy is the adaptive
decrease in cell size caused by reduced protein synthesis and
increased degradation (ubiquitin–proteasome pathway),
consistent with mechanisms described in Chapter 1. This
reduces cellular energy demand and preserves viability under
stress.
Incorrect (A): Hypertrophy is enlargement from increased
protein synthesis and is inappropriate here because the cells
are shrinking, not enlarging.
Incorrect (C): Hyperplasia is increased cell number via mitosis
and does not explain reduced muscle bulk in postmitotic
myocytes.
Incorrect (D): Metaplasia is replacement of one differentiated
cell type by another; it does not produce decreased muscle
fiber size from disuse.
Teaching point
Atrophy: decreased workload → reduced protein synthesis +
increased proteasomal degradation.
,Citation
VanMeter, K. C., & Hubert, R. J. (2024). Gould’s Pathophysiology
for the Health Professions (7th ed.). Ch. 1.
2.
Reference
Ch. 1 — Introduction to Pathophysiology — Hypertrophy vs.
hyperplasia
Stem
A 35-year-old female athlete uses resistance training for months
and develops increased skeletal muscle mass. In contrast, her
uterus enlarges during pregnancy due to both cell enlargement
and increased cell number. Explain the differing adaptive
mechanisms for skeletal muscle and uterine changes.
Options
A. Skeletal muscle hypertrophy occurs via hyperplasia of
myocytes; uterine growth is hypertrophy only.
B. Skeletal muscle hypertrophy occurs via increased protein
synthesis in postmitotic cells; uterine growth combines
hypertrophy and hyperplasia under hormonal stimulation.
C. Both tissues enlarge only by fluid accumulation in
intracellular compartments.
D. Uterine enlargement is metaplasia; skeletal muscle enlarges
by apoptosis of inhibitory cells.
, Correct answer
B
Rationales
Correct (B): Skeletal muscle fibers are largely postmitotic and
increase in size by upregulating protein synthesis and organelle
content (hypertrophy). Uterine smooth muscle undergoes both
hypertrophy and hyperplasia driven by pregnancy hormones —
a classic contrast explained in Chapter 1.
Incorrect (A): Skeletal muscle rarely undergoes hyperplasia of
myocytes; the statement reverses the mechanisms.
Incorrect (C): Enlargement by fluid accumulation (edema) is not
the primary mechanism for physiologic hypertrophy.
Incorrect (D): Metaplasia is wrong for uterine growth; apoptosis
of inhibitory cells is not the mechanism described.
Teaching point
Hypertrophy = increased cell size (protein synthesis);
hyperplasia = increased cell number (mitosis), often hormonal.
Citation
VanMeter, K. C., & Hubert, R. J. (2024). Gould’s Pathophysiology
for the Health Professions (7th ed.). Ch. 1.
3.
Reference
Ch. 1 — Introduction to Pathophysiology — Cellular injury:
reversible vs irreversible
HEALTH PROFESSIONS
7TH EDITION
• AUTHOR(S)KARIN C. VANMETER;
ROBERT J. HUBERT
TEST BANK
1.
Reference
Ch. 1 — Introduction to Pathophysiology — Cellular adaptation:
atrophy
Stem
A 68-year-old man with long-standing reduced blood flow to his
lower limb presents with a gradually decreasing muscle bulk
and reduced strength in the affected leg. Describe the most
likely cellular adaptation and the primary mechanistic driver
linking decreased workload and reduced cell size.
Options
A. Hypertrophy due to increased protein synthesis.
,B. Atrophy due to decreased protein synthesis and increased
proteasomal degradation.
C. Hyperplasia caused by increased mitotic activity.
D. Metaplasia due to replacement by a different cell type.
Correct answer
B
Rationales
Correct (B): The clinical picture shows decreased muscle mass
from reduced workload and perfusion; atrophy is the adaptive
decrease in cell size caused by reduced protein synthesis and
increased degradation (ubiquitin–proteasome pathway),
consistent with mechanisms described in Chapter 1. This
reduces cellular energy demand and preserves viability under
stress.
Incorrect (A): Hypertrophy is enlargement from increased
protein synthesis and is inappropriate here because the cells
are shrinking, not enlarging.
Incorrect (C): Hyperplasia is increased cell number via mitosis
and does not explain reduced muscle bulk in postmitotic
myocytes.
Incorrect (D): Metaplasia is replacement of one differentiated
cell type by another; it does not produce decreased muscle
fiber size from disuse.
Teaching point
Atrophy: decreased workload → reduced protein synthesis +
increased proteasomal degradation.
,Citation
VanMeter, K. C., & Hubert, R. J. (2024). Gould’s Pathophysiology
for the Health Professions (7th ed.). Ch. 1.
2.
Reference
Ch. 1 — Introduction to Pathophysiology — Hypertrophy vs.
hyperplasia
Stem
A 35-year-old female athlete uses resistance training for months
and develops increased skeletal muscle mass. In contrast, her
uterus enlarges during pregnancy due to both cell enlargement
and increased cell number. Explain the differing adaptive
mechanisms for skeletal muscle and uterine changes.
Options
A. Skeletal muscle hypertrophy occurs via hyperplasia of
myocytes; uterine growth is hypertrophy only.
B. Skeletal muscle hypertrophy occurs via increased protein
synthesis in postmitotic cells; uterine growth combines
hypertrophy and hyperplasia under hormonal stimulation.
C. Both tissues enlarge only by fluid accumulation in
intracellular compartments.
D. Uterine enlargement is metaplasia; skeletal muscle enlarges
by apoptosis of inhibitory cells.
, Correct answer
B
Rationales
Correct (B): Skeletal muscle fibers are largely postmitotic and
increase in size by upregulating protein synthesis and organelle
content (hypertrophy). Uterine smooth muscle undergoes both
hypertrophy and hyperplasia driven by pregnancy hormones —
a classic contrast explained in Chapter 1.
Incorrect (A): Skeletal muscle rarely undergoes hyperplasia of
myocytes; the statement reverses the mechanisms.
Incorrect (C): Enlargement by fluid accumulation (edema) is not
the primary mechanism for physiologic hypertrophy.
Incorrect (D): Metaplasia is wrong for uterine growth; apoptosis
of inhibitory cells is not the mechanism described.
Teaching point
Hypertrophy = increased cell size (protein synthesis);
hyperplasia = increased cell number (mitosis), often hormonal.
Citation
VanMeter, K. C., & Hubert, R. J. (2024). Gould’s Pathophysiology
for the Health Professions (7th ed.). Ch. 1.
3.
Reference
Ch. 1 — Introduction to Pathophysiology — Cellular injury:
reversible vs irreversible
