507 Adv Pathophysiology Actual Week 1-
4 Midterm Exam Complete 1-100 Exam
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Question 1
A patient with chronic hypertension has an enlarged heart. This increase
in muscle mass is primarily due to which cellular adaptation?
A) Hyperplasia
B) Metaplasia
C) Hypertrophy
D) Dysplasia
Correct Answer: C
Rationale: Hypertrophy is an increase in the size of cells, leading to an
enlarged organ. Cardiac muscle cells are terminally differentiated and
cannot divide, so they adapt to increased workload through hypertrophy,
not hyperplasia (increase in cell number). This is the primary mechanism
by which the heart compensates for chronic pressure overload in
hypertension.
,Question 2
The irreversible point in cellular injury where cell death is inevitable, even
if the stressor is removed, is known as the:
A) Point of no return
B) Cellular apoptosis threshold
C) Necrotic point
D) Ischemic threshold
Correct Answer: A
Rationale: The "point of no return" is a key concept in cellular injury
where mitochondrial damage becomes so severe that ATP production
ceases entirely, leading to irreversible membrane and DNA damage.
Once this point is reached, cell death is inevitable regardless of
intervention.
Question 3
Which of the following is a characteristic feature of apoptosis?
A) Elicits a significant inflammatory response
B) Results in cellular swelling and rupture
C) Involves organized cell shrinkage and fragmentation
D) Affects large groups of contiguous cells
Correct Answer: C
Rationale: Apoptosis is programmed cell death characterized by
organized cell shrinkage, chromatin condensation, and fragmentation
into apoptotic bodies. Unlike necrosis, apoptosis does not elicit a
,significant inflammatory response and typically affects individual cells
rather than large groups.
Question 4
Carcinoma in situ (CIS) refers to:
A) Malignant cells that have metastasized to distant sites
B) Cells that have invaded immediate surrounding tissue
C) Cells that remain localized in the epithelial layer without breaching the
basement membrane
D) Cellular and tissue alterations that indicate severe dysplasia
Correct Answer: C
Rationale: Carcinoma in situ (CIS) refers to preinvasive epithelial
malignant tumors of glandular or squamous cell origin. These early-stage
cancers are localized to the epithelium and have NOT broken through the
local basement membrane or invaded surrounding tissue.
Question 5
Cachexia in cancer is primarily mediated by which cytokine?
A) Interleukin-2 (IL-2)
B) Tumor Necrosis Factor-alpha (TNF-α)
C) Interferon-gamma (IFN-γ)
D) Transforming Growth Factor-beta (TGF-β)
Correct Answer: B
, Rationale: Cachexia in cancer is primarily mediated by Tumor Necrosis
Factor-alpha (TNF-α), which was formerly called cachectin. This
cytokine promotes wasting of muscle and adipose tissue, leading to the
profound weight loss and muscle wasting seen in cancer patients.
Question 6
A 60-year-old smoker presents with a lung mass. Biopsy reveals cells
that appear abnormal but are confined to the epithelial layer without
invasion. This is classified as:
A) Squamous cell carcinoma
B) Adenocarcinoma
C) Carcinoma in situ
D) Small cell carcinoma
Correct Answer: C
Rationale: Carcinoma in situ is characterized by abnormal cells that
have not invaded through the basement membrane. This represents the
earliest stage of cancer and is potentially curable with complete
excision.
Question 7
Metaplasia is best described as:
A) An increase in cell size
B) A reversible replacement of one mature cell type by another