NSG 5140 Midterm Exam Review – Advanced
Pathophysiology (South College) –Best Practice Questions
with Verified Answers & Detailed Rationales for NSG 5140
Advanced Pathophysiology Midterm Preparation – Instant
Download PDF
Complete Graduate-Level Study Guide Covering Cellular Adaptation & Injury, Inflammation
& Immunity, Genetics & Epigenetics, Fluids/Electrolytes/Acid–Base, Stress &
Neuroendocrine Responses, Hematology & Hemostasis, Cardiovascular Pathophysiology,
Respiratory Pathophysiology, and Renal & Acid–Base Regulation
Cellular Adaptation, Injury, & Death (Q1–20)
1. A 60-year-old man with long-standing hypertension has left ventricular
hypertrophy on echocardiogram. Which cellular adaptation best explains this
finding?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Hypertrophy = increased cell size in response to increased workload.
2. A chronic smoker’s bronchial epithelium changes from ciliated columnar to
stratified squamous. This is best described as:
A. Dysplasia
B. Metaplasia
C. Hyperplasia
D. Anaplasia
Metaplasia is a reversible change to a more resistant cell type under chronic stress.
,3. Which cellular adaptation is characterized by a decrease in cell size and function
due to decreased workload or loss of innervation?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
Atrophy = reduced cell size and function from disuse, denervation, ischemia, etc.
4. A Pap smear shows disordered epithelial cell growth with variation in size, shape,
and nuclear appearance, but the cells have not invaded the basement membrane.
This is best described as:
A. Metaplasia
B. Dysplasia
C. Hyperplasia
D. Anaplasia
Dysplasia = abnormal, potentially reversible growth with loss of uniformity.
5. Which mechanism is the primary cause of cellular swelling in early hypoxic injury?
A. Increased protein synthesis
B. Failure of the Na⁺/K⁺-ATPase pump due to ATP depletion
C. Increased fatty acid oxidation
D. Enhanced calcium efflux
ATP depletion impairs the pump, leading to intracellular Na⁺ and water accumulation.
6. Which of the following best distinguishes apoptosis from necrosis?
A. Apoptosis triggers intense inflammation; necrosis does not
B. Apoptosis is programmed, controlled cell death; necrosis is uncontrolled and
often inflammatory
C. Apoptosis affects large tissue areas; necrosis is always single cells
D. Apoptosis occurs only in cancer; necrosis only in infection
,Apoptosis is orderly and non-inflammatory; necrosis is disordered and pro-inflammatory.
7. A patient with frostbite has tissue death characterized by cell swelling, membrane
rupture, and inflammation. Which type of cell death is this?
A. Apoptosis
B. Necrosis
C. Autophagy
D. Senescence
Necrosis features swelling, rupture, and inflammatory response.
8. Which intracellular accumulation is most characteristic of chronic alcohol use in
hepatocytes?
A. Glycogen
B. Fat (steatosis)
C. Calcium
D. Hemosiderin
Fatty change (steatosis) is common in alcoholic liver disease.
9. A patient with hereditary hemochromatosis has excessive iron deposition in
multiple organs. Which pigment is primarily involved?
A. Bilirubin
B. Melanin
C. Hemosiderin
D. Lipofuscin
Hemosiderin is an iron-containing pigment that accumulates in iron overload.
10. Which of the following is a hallmark of reversible cell injury?
A. Nuclear fragmentation
B. Cellular swelling and fatty change
, C. Membrane rupture
D. Enzymatic digestion of cell contents
Swelling and fatty change are early, potentially reversible changes.
11. A patient with a myocardial infarction has coagulative necrosis in the affected
area. Which feature is most characteristic of this type of necrosis?
A. Complete digestion of tissue
B. Preservation of cell outlines with loss of nuclei
C. Cheese-like appearance
D. Formation of granulomas
Coagulative necrosis preserves basic cell architecture for a period.
12. Which of the following is the primary source of reactive oxygen species (ROS)
during reperfusion injury?
A. Nucleus
B. Mitochondria and activated neutrophils
C. Ribosomes
D. Golgi apparatus
Reperfusion increases ROS from mitochondria and inflammatory cells.
13. A patient with tuberculosis has areas of tissue death described as “cheese-like.”
Which type of necrosis is this?
A. Coagulative
B. Liquefactive
C. Caseous
D. Fat
Caseous necrosis is typical of TB and appears cheese-like.
14. Which enzyme is primarily responsible for the digestion of cellular components in
liquefactive necrosis?
Pathophysiology (South College) –Best Practice Questions
with Verified Answers & Detailed Rationales for NSG 5140
Advanced Pathophysiology Midterm Preparation – Instant
Download PDF
Complete Graduate-Level Study Guide Covering Cellular Adaptation & Injury, Inflammation
& Immunity, Genetics & Epigenetics, Fluids/Electrolytes/Acid–Base, Stress &
Neuroendocrine Responses, Hematology & Hemostasis, Cardiovascular Pathophysiology,
Respiratory Pathophysiology, and Renal & Acid–Base Regulation
Cellular Adaptation, Injury, & Death (Q1–20)
1. A 60-year-old man with long-standing hypertension has left ventricular
hypertrophy on echocardiogram. Which cellular adaptation best explains this
finding?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Hypertrophy = increased cell size in response to increased workload.
2. A chronic smoker’s bronchial epithelium changes from ciliated columnar to
stratified squamous. This is best described as:
A. Dysplasia
B. Metaplasia
C. Hyperplasia
D. Anaplasia
Metaplasia is a reversible change to a more resistant cell type under chronic stress.
,3. Which cellular adaptation is characterized by a decrease in cell size and function
due to decreased workload or loss of innervation?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
Atrophy = reduced cell size and function from disuse, denervation, ischemia, etc.
4. A Pap smear shows disordered epithelial cell growth with variation in size, shape,
and nuclear appearance, but the cells have not invaded the basement membrane.
This is best described as:
A. Metaplasia
B. Dysplasia
C. Hyperplasia
D. Anaplasia
Dysplasia = abnormal, potentially reversible growth with loss of uniformity.
5. Which mechanism is the primary cause of cellular swelling in early hypoxic injury?
A. Increased protein synthesis
B. Failure of the Na⁺/K⁺-ATPase pump due to ATP depletion
C. Increased fatty acid oxidation
D. Enhanced calcium efflux
ATP depletion impairs the pump, leading to intracellular Na⁺ and water accumulation.
6. Which of the following best distinguishes apoptosis from necrosis?
A. Apoptosis triggers intense inflammation; necrosis does not
B. Apoptosis is programmed, controlled cell death; necrosis is uncontrolled and
often inflammatory
C. Apoptosis affects large tissue areas; necrosis is always single cells
D. Apoptosis occurs only in cancer; necrosis only in infection
,Apoptosis is orderly and non-inflammatory; necrosis is disordered and pro-inflammatory.
7. A patient with frostbite has tissue death characterized by cell swelling, membrane
rupture, and inflammation. Which type of cell death is this?
A. Apoptosis
B. Necrosis
C. Autophagy
D. Senescence
Necrosis features swelling, rupture, and inflammatory response.
8. Which intracellular accumulation is most characteristic of chronic alcohol use in
hepatocytes?
A. Glycogen
B. Fat (steatosis)
C. Calcium
D. Hemosiderin
Fatty change (steatosis) is common in alcoholic liver disease.
9. A patient with hereditary hemochromatosis has excessive iron deposition in
multiple organs. Which pigment is primarily involved?
A. Bilirubin
B. Melanin
C. Hemosiderin
D. Lipofuscin
Hemosiderin is an iron-containing pigment that accumulates in iron overload.
10. Which of the following is a hallmark of reversible cell injury?
A. Nuclear fragmentation
B. Cellular swelling and fatty change
, C. Membrane rupture
D. Enzymatic digestion of cell contents
Swelling and fatty change are early, potentially reversible changes.
11. A patient with a myocardial infarction has coagulative necrosis in the affected
area. Which feature is most characteristic of this type of necrosis?
A. Complete digestion of tissue
B. Preservation of cell outlines with loss of nuclei
C. Cheese-like appearance
D. Formation of granulomas
Coagulative necrosis preserves basic cell architecture for a period.
12. Which of the following is the primary source of reactive oxygen species (ROS)
during reperfusion injury?
A. Nucleus
B. Mitochondria and activated neutrophils
C. Ribosomes
D. Golgi apparatus
Reperfusion increases ROS from mitochondria and inflammatory cells.
13. A patient with tuberculosis has areas of tissue death described as “cheese-like.”
Which type of necrosis is this?
A. Coagulative
B. Liquefactive
C. Caseous
D. Fat
Caseous necrosis is typical of TB and appears cheese-like.
14. Which enzyme is primarily responsible for the digestion of cellular components in
liquefactive necrosis?
