NR-507: Advanced Pathophysiology |
Advanced Disease Processes Comprehensive
Examination Practice Questions with
Answers & Rationales
Question 1
A patient with chronic hypertension develops left ventricular hypertrophy. This
represents which type of cellular adaptation?
A) Hyperplasia
B) Metaplasia
C) Hypertrophy
D) Dysplasia
Answer: C
Rationale: Hypertrophy is an increase in cell size that occurs in response to
increased workload. The cardiac muscle cells increase in size to compensate for the
increased afterload from hypertension. This adaptation increases the contractile
force of the myocardium. Hyperplasia is an increase in cell number, metaplasia is a
change from one cell type to another, and dysplasia is abnormal cellular growth.
Question 2
A woman experiences endometrial hyperplasia during her reproductive years. This
adaptation is best described as:
A) Pathologic hyperplasia
B) Physiologic hyperplasia
C) Compensatory hyperplasia
D) Dysplastic hyperplasia
Answer: B
Rationale: Physiologic hyperplasia occurs in response to normal hormonal
stimulation and is a controlled process. Endometrial hyperplasia during the
menstrual cycle is a normal physiologic response to estrogen stimulation.
,Pathologic hyperplasia occurs in response to abnormal stimuli. Compensatory
hyperplasia occurs in response to tissue loss.
Question 3
A pathologist notes that a patient's esophageal tissue has changed from stratified
squamous epithelium to columnar epithelium. This change is called:
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Dysplasia
Answer: C
Rationale: Metaplasia is the reversible replacement of one differentiated cell type
with another. In the esophagus, chronic acid reflux (GERD) causes the squamous
epithelium to be replaced by columnar epithelium (Barrett's esophagus), which is
more resistant to acid. This is a protective response but increases cancer risk.
Question 4
The process of cellular atrophy is most commonly caused by:
A) Increased workload
B) Decreased workload or loss of stimulation
C) Chronic inflammation
D) Genetic mutations
Answer: B
Rationale: Atrophy is a decrease in cell size due to decreased workload, loss of
innervation, decreased blood supply, or inadequate nutrition. Disuse atrophy of
muscles from immobilization is a classic example. Increased workload causes
hypertrophy, not atrophy.
Question 5
A patient presents with a tumor that is well-differentiated and resembles the tissue
of origin. This is most likely:
,A) Anaplastic carcinoma
B) Benign neoplasm
C) Malignant sarcoma
D) Metastatic adenocarcinoma
Answer: B
Rationale: Benign neoplasms are typically well-differentiated, resembling the
tissue of origin. They grow slowly, are encapsulated, and do not metastasize.
Malignant tumors are poorly differentiated (anaplastic), invasive, and can
metastasize.
Question 6
Which cellular change is reversible?
A) Necrosis
B) Apoptosis
C) Hydropic swelling
D) Coagulative necrosis
Answer: C
Rationale: Hydropic swelling (cellular edema) is the earliest manifestation of
reversible cell injury. It occurs when the cell's sodium-potassium pump fails,
leading to accumulation of intracellular fluid. If the injury is corrected, the cell can
return to normal. Necrosis and apoptosis are forms of irreversible cell death.
Question 7
Irreversible cell injury is characterized by:
A) Cell swelling and fatty change
B) Loss of plasma membrane integrity and nuclear changes
C) Preservation of mitochondrial function
D) Reversal of cellular changes
Answer: B
Rationale: Irreversible cell injury is marked by loss of plasma membrane integrity
(allowing enzymes to leak out) and nuclear changes including pyknosis (nuclear
shrinkage), karyorrhexis (nuclear fragmentation), and karyolysis (nuclear
dissolution). These changes indicate cell death that cannot be reversed.
, Question 8
A patient with a prolonged fever develops fever-related cellular injury. This type of
injury is classified as:
A) Hypoxic injury
B) Chemical injury
C) Physical injury
D) Free radical injury
Answer: C
Rationale: Fever represents a physical form of cellular injury from thermal
extremes. Physical agents causing cell injury include mechanical trauma,
temperature extremes (heat and cold), radiation, and electrical forces. Hypoxia is
oxygen deprivation, chemical injury involves toxins, and free radical injury
involves oxidative stress.
Question 9
A middle-aged adult who smokes heavily develops squamous cell carcinoma of the
lung. This represents a form of cellular adaptation related to:
A) Metaplasia progressing to dysplasia and neoplasia
B) Hypertrophy
C) Physiologic hyperplasia
D) Cellular atrophy
Answer: A
Rationale: Chronic irritation from cigarette smoke causes the normal columnar
epithelium of the bronchi to undergo squamous metaplasia. This metaplastic
epithelium can progress to dysplasia (abnormal cellular growth) and eventually to
carcinoma in situ and invasive squamous cell carcinoma. This represents the
metaplasia-dysplasia-neoplasia sequence.
Question 10
Which statement best describes the difference between necrosis and apoptosis?
Advanced Disease Processes Comprehensive
Examination Practice Questions with
Answers & Rationales
Question 1
A patient with chronic hypertension develops left ventricular hypertrophy. This
represents which type of cellular adaptation?
A) Hyperplasia
B) Metaplasia
C) Hypertrophy
D) Dysplasia
Answer: C
Rationale: Hypertrophy is an increase in cell size that occurs in response to
increased workload. The cardiac muscle cells increase in size to compensate for the
increased afterload from hypertension. This adaptation increases the contractile
force of the myocardium. Hyperplasia is an increase in cell number, metaplasia is a
change from one cell type to another, and dysplasia is abnormal cellular growth.
Question 2
A woman experiences endometrial hyperplasia during her reproductive years. This
adaptation is best described as:
A) Pathologic hyperplasia
B) Physiologic hyperplasia
C) Compensatory hyperplasia
D) Dysplastic hyperplasia
Answer: B
Rationale: Physiologic hyperplasia occurs in response to normal hormonal
stimulation and is a controlled process. Endometrial hyperplasia during the
menstrual cycle is a normal physiologic response to estrogen stimulation.
,Pathologic hyperplasia occurs in response to abnormal stimuli. Compensatory
hyperplasia occurs in response to tissue loss.
Question 3
A pathologist notes that a patient's esophageal tissue has changed from stratified
squamous epithelium to columnar epithelium. This change is called:
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Dysplasia
Answer: C
Rationale: Metaplasia is the reversible replacement of one differentiated cell type
with another. In the esophagus, chronic acid reflux (GERD) causes the squamous
epithelium to be replaced by columnar epithelium (Barrett's esophagus), which is
more resistant to acid. This is a protective response but increases cancer risk.
Question 4
The process of cellular atrophy is most commonly caused by:
A) Increased workload
B) Decreased workload or loss of stimulation
C) Chronic inflammation
D) Genetic mutations
Answer: B
Rationale: Atrophy is a decrease in cell size due to decreased workload, loss of
innervation, decreased blood supply, or inadequate nutrition. Disuse atrophy of
muscles from immobilization is a classic example. Increased workload causes
hypertrophy, not atrophy.
Question 5
A patient presents with a tumor that is well-differentiated and resembles the tissue
of origin. This is most likely:
,A) Anaplastic carcinoma
B) Benign neoplasm
C) Malignant sarcoma
D) Metastatic adenocarcinoma
Answer: B
Rationale: Benign neoplasms are typically well-differentiated, resembling the
tissue of origin. They grow slowly, are encapsulated, and do not metastasize.
Malignant tumors are poorly differentiated (anaplastic), invasive, and can
metastasize.
Question 6
Which cellular change is reversible?
A) Necrosis
B) Apoptosis
C) Hydropic swelling
D) Coagulative necrosis
Answer: C
Rationale: Hydropic swelling (cellular edema) is the earliest manifestation of
reversible cell injury. It occurs when the cell's sodium-potassium pump fails,
leading to accumulation of intracellular fluid. If the injury is corrected, the cell can
return to normal. Necrosis and apoptosis are forms of irreversible cell death.
Question 7
Irreversible cell injury is characterized by:
A) Cell swelling and fatty change
B) Loss of plasma membrane integrity and nuclear changes
C) Preservation of mitochondrial function
D) Reversal of cellular changes
Answer: B
Rationale: Irreversible cell injury is marked by loss of plasma membrane integrity
(allowing enzymes to leak out) and nuclear changes including pyknosis (nuclear
shrinkage), karyorrhexis (nuclear fragmentation), and karyolysis (nuclear
dissolution). These changes indicate cell death that cannot be reversed.
, Question 8
A patient with a prolonged fever develops fever-related cellular injury. This type of
injury is classified as:
A) Hypoxic injury
B) Chemical injury
C) Physical injury
D) Free radical injury
Answer: C
Rationale: Fever represents a physical form of cellular injury from thermal
extremes. Physical agents causing cell injury include mechanical trauma,
temperature extremes (heat and cold), radiation, and electrical forces. Hypoxia is
oxygen deprivation, chemical injury involves toxins, and free radical injury
involves oxidative stress.
Question 9
A middle-aged adult who smokes heavily develops squamous cell carcinoma of the
lung. This represents a form of cellular adaptation related to:
A) Metaplasia progressing to dysplasia and neoplasia
B) Hypertrophy
C) Physiologic hyperplasia
D) Cellular atrophy
Answer: A
Rationale: Chronic irritation from cigarette smoke causes the normal columnar
epithelium of the bronchi to undergo squamous metaplasia. This metaplastic
epithelium can progress to dysplasia (abnormal cellular growth) and eventually to
carcinoma in situ and invasive squamous cell carcinoma. This represents the
metaplasia-dysplasia-neoplasia sequence.
Question 10
Which statement best describes the difference between necrosis and apoptosis?
