NURS 5315 ADVANCED PATHOPHYSIOLOGY
TEST 1 ACTUAL EXAM PAPER 2026
QUESTIONS WITH ANSWERS GRADED A+
• What can Reactive Oxygen Species cause?.
Answer: Heart disease, Alzheimers, Parkinsons, Amyotrophic Lateral
Sclerosis (ALS), CV disease, HTN, HLD, DM, ischemic heart disease, HF,
OSA. Lipid perioxidation, damage proteins, fragment DNA, less *protein
synthesis*, chromatin destruction, damage mitochondria
• Atrophy P. Still functional; imbalance between protein synthesis and
degradation. Essentially there is an increase in the catabolism of intracellular
organelles, reducing structural components of cell Physiologic: thymus
gland in early childhood Pathological: disuse (muscle atrophy d/ decrease
workload, pressure, use, blood supply, nutrition, hormonal stimulation, or
nervous stimulation).
Answer: E. Cells decrease in size
• How are free radicals produced? 2. Absorption of extreme energy sources
(radiation, UV light) 3. Metabolism of exogenous chemicals, drugs, and
pesticides 4. Transition of metals 5. Nitric oxide acting like a chemical
mediator and a free radical.
Answer: 1. Normal cellular respiration
• Hyperplasia Phys: increased rate of division, increase in tissue mass after
damage or partial resection; may be compensatory, hormonal, or pathologic
Patho: abnormal proliferation of normal cells usually caused by increased
hormonal stimulation (endometrial). increase of production of local growth
factors Ex: removal of part of the liver lead to hyperplasia of hepatocytes.
uterine or mammary gland enlargement during pregnancy.
Answer: E: cells increase in number, mitosis (cell division) must occur, size
of cell does not change
,• Dysplasia P. caused by cell injury/irritation, characterized by disordered cell
growth. aka atypical hyperplasia or pre-cancer, a disorderly proliferation
Physiologic: N/A Pathologic: squamous dysplasia of cervix from HPV
shows up on pap smear, breast cancer development; pap smears often show
dysplastic cells of the cervix that must undergo laser/surgical tx.
Answer: E. Not true adaptation; Cells abnormal change in size, shape,
organization (classified as mild, moderate, severe)
• Metaplasia P: reversible; results from exposure of the cells to chronic
stressors, injury, or irritation; Cancer can arise from this area, stimulus
induces a reprogramming of stem cells under the influence of cytokines and
growth factors Ex: Patho: Columnar cells change to squamous cells in lungs
of smoker or normal ciliated epithelial cells of the bronchial linings are
replaced by stratified squamous epithelial cells.; Phys: Barrett Esophagus-
normal squamous cells change to columnar epithelial cells in response to
reflux, aka intestinal metaplasia.
Answer: E: reversible change, one type of cell changes to another type for
survival
• What is the body's defense against ROS?.
Answer: Antioxidants (Vitamin E, Vitamin C, cysteine, glutathione,
albumin, ceruloplasmin, transferrin)
• action potential.
Answer: Process of conducting an impulse. Activates the neuron --> the
neuron depolarizes --> then repolarizes
• Threshold potential.
Answer: Point at which depolarization must reach in order to initiate an
action potential
• Hypoxia injury P. decrease in mitochondrial function, decreased production
of ATP increases anaerobic metabolism. eventual cell death. C.M. hypoxia,
cyanosis, cognitive impairment, lethargy.
Answer: E. inadequate oxygenation of tissues
,• Hypokalemia and action potentials.
Answer: HYPERpolarized (more negative, ex. -100). Less excitable.
Decreased neuromuscular excitability: weakness, smooth muscle atony,
paresthesia, cardiac dysrhythmias
• Hyperkalemia and action potentials When resting membrane
potential=threshold potential, it is BAD = cardiac standstill, paresthesia,
paralysis.
Answer: HYPOpolarized (more positive, ex: closer to 0). More excitable.
Peaked T waves.
• Free radical and ROS P. lipid peroxidation, damage proteins, fragment DNA
C.M. development in Alzheimer's, heart disease, Parkinson's disease,
Amyotrophic Lateral Sclerosis.
Answer: E. normal byproduct of ATP production, will overwhelm the
mitochondria- exhaust intracellular antioxidants
• Ethanol P. metabolized by liver, generates free radicals C.M. CNS
depression, nutrient deficiencies-Mag, Vit B6, thiamine, PO4, inflammation
and fatty infiltration of liver, hepatomegaly, leads to liver failure
irreversible.
Answer: E. mood altering drug, long term effects on liver and nutritional
status
• Oncosis.
Answer: Na and H2O enter cell and cause swelling. Organ increases in
weight, becomes distended and pale. Associated with high fever,
hypocalcemia, certain infections
• Hypocalcemia and action potentials.
Answer: Increased permeability to Na+. More excitable. Tetany,
hyperreflexia, circumoral paresthesia, seizures, dysrhythmias.
• Fatty Infiltration liver fails to metabolize lipids. usually from ETOH or high
fat diet. can lead to cirrhosis.
Answer: intracellular accumulation of lipids in the liver
, • Hypercalcemia and action potentials.
Answer: Decreased permeability to Na+. Less excitable. Weakness,
hyporeflexia, fatigue, lethargy, confusion, encephalopathy, depressed T
waves
• Atrophy.
Answer: Occurs as a result of decrease in work load, pressure, use, blood
supply, nutrition, hormonal stimulation, or nervous stimulation. Once the
cell has decreased in size, it has now compensated for decreased blood
supply, nerve supply, nutrient supply, hormonal supply, and has achieved
new homeostasis. Cells are alive but have diminished function and may lead
to cellular death.
• Atrophy examples Disuse atrophy- someone that ends up being paralyzed.
Answer: Physiologic atrophy- shrinking of the thymus gland during
childhood.
• Hypertrophy.
Answer: Increase in SIZE of cells, which will lead to increase in size of
organ. Caused by hormonal stimulation or increased functional demand.
• Hypertrophy examples pathologic hypertrophy- cardiomegaly results from
an increased workload in hypertensive patients / *left ventricular
hypertrophy*.
Answer: physiologic hypertrophy- skeletal hypertrophy when a person does
heavy work or weight lifting / when a kidney is surgically removed, the
other kidney increases in size
• Hyperplasia.
Answer: Increase in NUMBER of cells. Results from increased rate of
mitosis. Can ONLY happen in cells that are capable of mitosis (cell
division).
• dystrophic calcification calcium salt clump and harden- interfere with
cellular structure and function r/t pulmonary TB, atherosclerosis, injured
heart valves, chronic pancreatitis.
TEST 1 ACTUAL EXAM PAPER 2026
QUESTIONS WITH ANSWERS GRADED A+
• What can Reactive Oxygen Species cause?.
Answer: Heart disease, Alzheimers, Parkinsons, Amyotrophic Lateral
Sclerosis (ALS), CV disease, HTN, HLD, DM, ischemic heart disease, HF,
OSA. Lipid perioxidation, damage proteins, fragment DNA, less *protein
synthesis*, chromatin destruction, damage mitochondria
• Atrophy P. Still functional; imbalance between protein synthesis and
degradation. Essentially there is an increase in the catabolism of intracellular
organelles, reducing structural components of cell Physiologic: thymus
gland in early childhood Pathological: disuse (muscle atrophy d/ decrease
workload, pressure, use, blood supply, nutrition, hormonal stimulation, or
nervous stimulation).
Answer: E. Cells decrease in size
• How are free radicals produced? 2. Absorption of extreme energy sources
(radiation, UV light) 3. Metabolism of exogenous chemicals, drugs, and
pesticides 4. Transition of metals 5. Nitric oxide acting like a chemical
mediator and a free radical.
Answer: 1. Normal cellular respiration
• Hyperplasia Phys: increased rate of division, increase in tissue mass after
damage or partial resection; may be compensatory, hormonal, or pathologic
Patho: abnormal proliferation of normal cells usually caused by increased
hormonal stimulation (endometrial). increase of production of local growth
factors Ex: removal of part of the liver lead to hyperplasia of hepatocytes.
uterine or mammary gland enlargement during pregnancy.
Answer: E: cells increase in number, mitosis (cell division) must occur, size
of cell does not change
,• Dysplasia P. caused by cell injury/irritation, characterized by disordered cell
growth. aka atypical hyperplasia or pre-cancer, a disorderly proliferation
Physiologic: N/A Pathologic: squamous dysplasia of cervix from HPV
shows up on pap smear, breast cancer development; pap smears often show
dysplastic cells of the cervix that must undergo laser/surgical tx.
Answer: E. Not true adaptation; Cells abnormal change in size, shape,
organization (classified as mild, moderate, severe)
• Metaplasia P: reversible; results from exposure of the cells to chronic
stressors, injury, or irritation; Cancer can arise from this area, stimulus
induces a reprogramming of stem cells under the influence of cytokines and
growth factors Ex: Patho: Columnar cells change to squamous cells in lungs
of smoker or normal ciliated epithelial cells of the bronchial linings are
replaced by stratified squamous epithelial cells.; Phys: Barrett Esophagus-
normal squamous cells change to columnar epithelial cells in response to
reflux, aka intestinal metaplasia.
Answer: E: reversible change, one type of cell changes to another type for
survival
• What is the body's defense against ROS?.
Answer: Antioxidants (Vitamin E, Vitamin C, cysteine, glutathione,
albumin, ceruloplasmin, transferrin)
• action potential.
Answer: Process of conducting an impulse. Activates the neuron --> the
neuron depolarizes --> then repolarizes
• Threshold potential.
Answer: Point at which depolarization must reach in order to initiate an
action potential
• Hypoxia injury P. decrease in mitochondrial function, decreased production
of ATP increases anaerobic metabolism. eventual cell death. C.M. hypoxia,
cyanosis, cognitive impairment, lethargy.
Answer: E. inadequate oxygenation of tissues
,• Hypokalemia and action potentials.
Answer: HYPERpolarized (more negative, ex. -100). Less excitable.
Decreased neuromuscular excitability: weakness, smooth muscle atony,
paresthesia, cardiac dysrhythmias
• Hyperkalemia and action potentials When resting membrane
potential=threshold potential, it is BAD = cardiac standstill, paresthesia,
paralysis.
Answer: HYPOpolarized (more positive, ex: closer to 0). More excitable.
Peaked T waves.
• Free radical and ROS P. lipid peroxidation, damage proteins, fragment DNA
C.M. development in Alzheimer's, heart disease, Parkinson's disease,
Amyotrophic Lateral Sclerosis.
Answer: E. normal byproduct of ATP production, will overwhelm the
mitochondria- exhaust intracellular antioxidants
• Ethanol P. metabolized by liver, generates free radicals C.M. CNS
depression, nutrient deficiencies-Mag, Vit B6, thiamine, PO4, inflammation
and fatty infiltration of liver, hepatomegaly, leads to liver failure
irreversible.
Answer: E. mood altering drug, long term effects on liver and nutritional
status
• Oncosis.
Answer: Na and H2O enter cell and cause swelling. Organ increases in
weight, becomes distended and pale. Associated with high fever,
hypocalcemia, certain infections
• Hypocalcemia and action potentials.
Answer: Increased permeability to Na+. More excitable. Tetany,
hyperreflexia, circumoral paresthesia, seizures, dysrhythmias.
• Fatty Infiltration liver fails to metabolize lipids. usually from ETOH or high
fat diet. can lead to cirrhosis.
Answer: intracellular accumulation of lipids in the liver
, • Hypercalcemia and action potentials.
Answer: Decreased permeability to Na+. Less excitable. Weakness,
hyporeflexia, fatigue, lethargy, confusion, encephalopathy, depressed T
waves
• Atrophy.
Answer: Occurs as a result of decrease in work load, pressure, use, blood
supply, nutrition, hormonal stimulation, or nervous stimulation. Once the
cell has decreased in size, it has now compensated for decreased blood
supply, nerve supply, nutrient supply, hormonal supply, and has achieved
new homeostasis. Cells are alive but have diminished function and may lead
to cellular death.
• Atrophy examples Disuse atrophy- someone that ends up being paralyzed.
Answer: Physiologic atrophy- shrinking of the thymus gland during
childhood.
• Hypertrophy.
Answer: Increase in SIZE of cells, which will lead to increase in size of
organ. Caused by hormonal stimulation or increased functional demand.
• Hypertrophy examples pathologic hypertrophy- cardiomegaly results from
an increased workload in hypertensive patients / *left ventricular
hypertrophy*.
Answer: physiologic hypertrophy- skeletal hypertrophy when a person does
heavy work or weight lifting / when a kidney is surgically removed, the
other kidney increases in size
• Hyperplasia.
Answer: Increase in NUMBER of cells. Results from increased rate of
mitosis. Can ONLY happen in cells that are capable of mitosis (cell
division).
• dystrophic calcification calcium salt clump and harden- interfere with
cellular structure and function r/t pulmonary TB, atherosclerosis, injured
heart valves, chronic pancreatitis.
