NSG 5140 Advanced Pathophysiology Final Exam: South
College NSG 5140 Final Exam – 100 Verified Pathophysiology
Questions| PDF
Cellular Function, Injury, & Adaptation
Question 1
A patient with chronic hypertension develops left ventricular wall thickening. Which
mechanism best explains this adaptation?
A. Increased myocyte number due to cell division
B. Increased myocyte size due to increased workload
C. Replacement of cardiac cells with fibrous tissue
D. Transformation of cardiac cells into smooth muscle
Answer: B – Increased myocyte size due to increased workload
Rationale: Cardiac myocytes are terminally differentiated and respond to increased
workload primarily through hypertrophy (increase in individual cell size), not hyperplasia
(increase in cell number) .
Question 2
Which cellular adaptation is characterized by an increase in cell size and organ size in
response to increased workload?
A. Hyperplasia
B. Metaplasia
C. Hypertrophy
D. Dysplasia
Answer: C – Hypertrophy
,Rationale: Hypertrophy refers to an increase in cell size, which leads to enlargement of the
organ. This occurs in response to increased workload or mechanical stress, such as in
hypertension or heart valve disease .
Question 3
A patient with chronic gastroesophageal reflux disease develops replacement of normal
stratified squamous epithelium in the lower esophagus with columnar epithelium. This
change is known as:
A. Anaplasia
B. Metaplasia
C. Hyperplasia
D. Neoplasia
Answer: B – Metaplasia
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with
another. In GERD, chronic acid exposure causes the esophageal squamous epithelium to
transform into columnar epithelium (Barrett esophagus) as an adaptive response .
Question 4
What is the primary mechanism of cellular injury in hypoxic conditions?
A. DNA mutation
B. ATP depletion leading to loss of ion homeostasis
C. Free radical formation
D. Protein misfolding
Answer: B – ATP depletion leading to loss of ion homeostasis
Rationale: Hypoxia impairs oxidative phosphorylation in mitochondria, causing rapid ATP
depletion. This disrupts the sodium-potassium pump, leading to sodium and water influx,
cellular swelling, and ultimately cell death .
,Question 5
Which type of necrosis is classically associated with tuberculosis and is characterized by a
cheese-like appearance?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Fat necrosis
D. Caseous necrosis
Answer: D – Caseous necrosis
Rationale: Caseous necrosis is a distinct form of necrosis seen in tuberculosis. It results in
a soft, friable, "cheese-like" material due to the combination of coagulative and liquefactive
necrosis with granulomatous inflammation .
Question 6
During ischemic injury, loss of adenosine triphosphate (ATP) most directly leads to:
A. Increased oxidative phosphorylation
B. Failure of the sodium-potassium pump
C. Increased protein synthesis
D. Mitochondrial membrane stabilization
Answer: B – Failure of the sodium-potassium pump
Rationale: ATP is required for the Na⁺/K⁺ ATPase pump function. ATP depletion causes
pump failure, leading to sodium and water influx into the cell, which results in cellular
swelling—a key event in the pathway to cell death .
Question 7
Which organ is most susceptible to irreversible damage from ischemia?
A. Kidney
B. Liver
C. Brain
D. Skeletal muscle
, Answer: C – Brain
Rationale: Neurons rely almost exclusively on aerobic metabolism and have minimal
glycogen stores. They can suffer irreversible injury within just 4–6 minutes of complete
ischemia, making the brain the most vulnerable organ .
Question 8
Which type of cell death is a programmed, energy-dependent process that does NOT trigger
inflammation?
A. Necrosis
B. Apoptosis
C. Autolysis
D. Gangrene
Answer: B – Apoptosis
Rationale: Apoptosis is "programmed cell death" that is ATP-dependent and tightly
regulated. It eliminates unwanted or damaged cells without releasing cellular contents, thus
avoiding an inflammatory response .
Inflammation & Immunity
Question 9
The hallmark of acute inflammation is the presence of:
A. Fibrosis
B. Granuloma formation
C. Neutrophil infiltration
D. Lymphocyte predominance
Answer: C – Neutrophil infiltration
College NSG 5140 Final Exam – 100 Verified Pathophysiology
Questions| PDF
Cellular Function, Injury, & Adaptation
Question 1
A patient with chronic hypertension develops left ventricular wall thickening. Which
mechanism best explains this adaptation?
A. Increased myocyte number due to cell division
B. Increased myocyte size due to increased workload
C. Replacement of cardiac cells with fibrous tissue
D. Transformation of cardiac cells into smooth muscle
Answer: B – Increased myocyte size due to increased workload
Rationale: Cardiac myocytes are terminally differentiated and respond to increased
workload primarily through hypertrophy (increase in individual cell size), not hyperplasia
(increase in cell number) .
Question 2
Which cellular adaptation is characterized by an increase in cell size and organ size in
response to increased workload?
A. Hyperplasia
B. Metaplasia
C. Hypertrophy
D. Dysplasia
Answer: C – Hypertrophy
,Rationale: Hypertrophy refers to an increase in cell size, which leads to enlargement of the
organ. This occurs in response to increased workload or mechanical stress, such as in
hypertension or heart valve disease .
Question 3
A patient with chronic gastroesophageal reflux disease develops replacement of normal
stratified squamous epithelium in the lower esophagus with columnar epithelium. This
change is known as:
A. Anaplasia
B. Metaplasia
C. Hyperplasia
D. Neoplasia
Answer: B – Metaplasia
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with
another. In GERD, chronic acid exposure causes the esophageal squamous epithelium to
transform into columnar epithelium (Barrett esophagus) as an adaptive response .
Question 4
What is the primary mechanism of cellular injury in hypoxic conditions?
A. DNA mutation
B. ATP depletion leading to loss of ion homeostasis
C. Free radical formation
D. Protein misfolding
Answer: B – ATP depletion leading to loss of ion homeostasis
Rationale: Hypoxia impairs oxidative phosphorylation in mitochondria, causing rapid ATP
depletion. This disrupts the sodium-potassium pump, leading to sodium and water influx,
cellular swelling, and ultimately cell death .
,Question 5
Which type of necrosis is classically associated with tuberculosis and is characterized by a
cheese-like appearance?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Fat necrosis
D. Caseous necrosis
Answer: D – Caseous necrosis
Rationale: Caseous necrosis is a distinct form of necrosis seen in tuberculosis. It results in
a soft, friable, "cheese-like" material due to the combination of coagulative and liquefactive
necrosis with granulomatous inflammation .
Question 6
During ischemic injury, loss of adenosine triphosphate (ATP) most directly leads to:
A. Increased oxidative phosphorylation
B. Failure of the sodium-potassium pump
C. Increased protein synthesis
D. Mitochondrial membrane stabilization
Answer: B – Failure of the sodium-potassium pump
Rationale: ATP is required for the Na⁺/K⁺ ATPase pump function. ATP depletion causes
pump failure, leading to sodium and water influx into the cell, which results in cellular
swelling—a key event in the pathway to cell death .
Question 7
Which organ is most susceptible to irreversible damage from ischemia?
A. Kidney
B. Liver
C. Brain
D. Skeletal muscle
, Answer: C – Brain
Rationale: Neurons rely almost exclusively on aerobic metabolism and have minimal
glycogen stores. They can suffer irreversible injury within just 4–6 minutes of complete
ischemia, making the brain the most vulnerable organ .
Question 8
Which type of cell death is a programmed, energy-dependent process that does NOT trigger
inflammation?
A. Necrosis
B. Apoptosis
C. Autolysis
D. Gangrene
Answer: B – Apoptosis
Rationale: Apoptosis is "programmed cell death" that is ATP-dependent and tightly
regulated. It eliminates unwanted or damaged cells without releasing cellular contents, thus
avoiding an inflammatory response .
Inflammation & Immunity
Question 9
The hallmark of acute inflammation is the presence of:
A. Fibrosis
B. Granuloma formation
C. Neutrophil infiltration
D. Lymphocyte predominance
Answer: C – Neutrophil infiltration
