ADVANCED PATHOPHYSIOLOGY EXAM 1 ACTUAL 2026
TEST QUESTIONS AND ANSWERS
• Mr. Forbes is being prepared for open heart surgery when he suffers a myocardial
infarction in which a large part of his left ventricle has sufferedlethal cell injury.
Mr. Forbes' CPK-MB and LDH1, enzymes associated with myocardial cells, aresignificantly
elevated. What is the best explanation for this?
a. It is a sign that necrotic myocardial cells have released their cytoplasmiccontents into
the blood.
b. It is a sign of reversible fatty accumulation in the myocardial cells
c. It is a sign that the myocardial cells are undergoing hypertrophy.
d. None of the above.
ANS A
• If a tissue specimen of myocardial cells were obtained for examination fromMr. Forbes,
which of the following findings would indicate irreversible cell injury?
a. cellular swelling
b. decreased ATP production
c. decreased intracellular calcium
,d. dissolution of nuclear material
ANS D
• The accumulation of lactic acid that occurs with impaired energy produc-tion results
from which of the following?
a. increased intracellular glucose
b. increased anaerobic metabolism
c. decreased metabolic rate
d. increased oxidative phosphorylation
ANS B
• A mountain climber is stranded at 23,000 feet in the Swiss Alps and has lost all his
equipment and supplies in an avalanche. Subsequently, he sufferscell injury due to
impaired ATP production.The reason for the decrease in ATPis which of the following?
a. enzyme inhibition
,b. uncoupling
c. hypoxia
d. none of the above
ANS C
• An elderly patient develops an obstruction in his left middle cerebral artery. The
brain tissue supplied by this artery becomes hypoxic. The bestexplanation for this is
which of the following?
a. the obstruction results in decreased blood flow
b. the obstruction results in decreased hemoglobin in the blood
c. while blood flow stays the same, the obstruction reduces oxygen contentin the blood
d. none of the above explain the reason for the hypoxia
ANS A
• Increased mobilization and delivery of free fatty acids to liver cells can re- sult in fat
accumulation. Which of the following problems results in increased mobilization of free
fatty acids?
a. anemia
, b. hepatic toxins
c. starvation
d. hypoxia
ANS C
• Generalized hypoxia results in a switch to anaerobic metabolism in cells.Anaerobic
metabolism results in which of the following?
a. decreased lactic acid inside cells
b. decreased arterial pH
c. more effective ATP production
d. increased pH inside cells
ANS B
• There is a disease of the spleen, which results in an excessive destructionof RBCs. This
increase in RBC destruction can lead to which of the following?
a. hypoxia
b. hypobilirubinemia
c. an increase in platelets
d. all of the above
ANS A
TEST QUESTIONS AND ANSWERS
• Mr. Forbes is being prepared for open heart surgery when he suffers a myocardial
infarction in which a large part of his left ventricle has sufferedlethal cell injury.
Mr. Forbes' CPK-MB and LDH1, enzymes associated with myocardial cells, aresignificantly
elevated. What is the best explanation for this?
a. It is a sign that necrotic myocardial cells have released their cytoplasmiccontents into
the blood.
b. It is a sign of reversible fatty accumulation in the myocardial cells
c. It is a sign that the myocardial cells are undergoing hypertrophy.
d. None of the above.
ANS A
• If a tissue specimen of myocardial cells were obtained for examination fromMr. Forbes,
which of the following findings would indicate irreversible cell injury?
a. cellular swelling
b. decreased ATP production
c. decreased intracellular calcium
,d. dissolution of nuclear material
ANS D
• The accumulation of lactic acid that occurs with impaired energy produc-tion results
from which of the following?
a. increased intracellular glucose
b. increased anaerobic metabolism
c. decreased metabolic rate
d. increased oxidative phosphorylation
ANS B
• A mountain climber is stranded at 23,000 feet in the Swiss Alps and has lost all his
equipment and supplies in an avalanche. Subsequently, he sufferscell injury due to
impaired ATP production.The reason for the decrease in ATPis which of the following?
a. enzyme inhibition
,b. uncoupling
c. hypoxia
d. none of the above
ANS C
• An elderly patient develops an obstruction in his left middle cerebral artery. The
brain tissue supplied by this artery becomes hypoxic. The bestexplanation for this is
which of the following?
a. the obstruction results in decreased blood flow
b. the obstruction results in decreased hemoglobin in the blood
c. while blood flow stays the same, the obstruction reduces oxygen contentin the blood
d. none of the above explain the reason for the hypoxia
ANS A
• Increased mobilization and delivery of free fatty acids to liver cells can re- sult in fat
accumulation. Which of the following problems results in increased mobilization of free
fatty acids?
a. anemia
, b. hepatic toxins
c. starvation
d. hypoxia
ANS C
• Generalized hypoxia results in a switch to anaerobic metabolism in cells.Anaerobic
metabolism results in which of the following?
a. decreased lactic acid inside cells
b. decreased arterial pH
c. more effective ATP production
d. increased pH inside cells
ANS B
• There is a disease of the spleen, which results in an excessive destructionof RBCs. This
increase in RBC destruction can lead to which of the following?
a. hypoxia
b. hypobilirubinemia
c. an increase in platelets
d. all of the above
ANS A
