NURS6202 (CU-AGPCNP) Advanced Pathophysiology
Midterm Exam Qns and ANSWER 2026 ACTUAL
SECTION 1: CELLULAR BIOLOGY AND GENETICS
Question 1
Which of the following is the primary cause of chronic obstructive pulmonary disease (COPD)?
A. Genetic predisposition
B. Air pollution
C. Smoking
D. Occupational exposure
ANSWER: C. Smoking
Rationale for C (Correct): Smoking is the leading cause of COPD, as it damages the airways and alveoli,
leading to airflow obstruction and respiratory symptoms. Cigarette smoke contains toxic chemicals that
cause chronic inflammation, destruction of lung tissue, and impaired ciliary function.
Rationale for A (Incorrect): While genetic predisposition (particularly alpha-1 antitrypsin deficiency) can
contribute to COPD, it accounts for only 1-2% of cases and is not the primary cause.
Rationale for B (Incorrect): Air pollution can exacerbate COPD and contribute to its development, but it
is a secondary risk factor compared to smoking.
Rationale for D (Incorrect): Occupational exposure to dust, chemicals, and fumes can increase COPD risk,
but it is not the primary cause in most cases.
Question 2
What is the primary pathophysiological mechanism of type 2 diabetes mellitus?
A. Autoimmune destruction of beta cells
B. Insulin resistance
C. Genetic mutations
D. Viral infection
ANSWER: B. Insulin resistance
,Rationale for B (Correct): Type 2 diabetes mellitus is primarily caused by insulin resistance, where the
body's cells do not respond effectively to insulin, leading to elevated blood glucose levels. This is often
accompanied by relative insulin deficiency over time.
Rationale for A (Incorrect): Autoimmune destruction of beta cells is the primary mechanism of type 1
diabetes mellitus, not type 2 diabetes.
Rationale for C (Incorrect): While genetic factors contribute to type 2 diabetes susceptibility, genetic
mutations alone are not the primary pathophysiological mechanism.
Rationale for D (Incorrect): Viral infections may trigger type 1 diabetes in genetically susceptible
individuals but are not the primary mechanism of type 2 diabetes.
Question 3
Which of the following is a common complication of hypertension?
A. Osteoporosis
B. Chronic kidney disease
C. Asthma
D. Rheumatoid arthritis
ANSWER: B. Chronic kidney disease
Rationale for B (Correct): Chronic hypertension damages the blood vessels in the kidneys, leading to
nephrosclerosis and chronic kidney disease. The kidneys are particularly vulnerable to hypertensive
damage due to their rich vascular supply.
Rationale for A (Incorrect): Osteoporosis is not a direct complication of hypertension; it is more
commonly associated with aging, hormonal changes, and calcium/vitamin D deficiency.
Rationale for C (Incorrect): Asthma is a chronic respiratory condition unrelated to hypertension as a
complication.
Rationale for D (Incorrect): Rheumatoid arthritis is an autoimmune disorder and is not caused by
hypertension.
Question 4
What is the primary function of the sodium-potassium pump in cellular physiology?
A. To generate ATP for cellular energy
B. To maintain the resting membrane potential
C. To facilitate protein synthesis
D. To promote cell division
ANSWER: B. To maintain the resting membrane potential
,Rationale for B (Correct): The sodium-potassium pump (Na+/K+ ATPase) actively trANSWERports 3
sodium ions out of the cell and 2 potassium ions into the cell, maintaining the electrochemical gradient
essential for the resting membrane potential and cellular excitability.
Rationale for A (Incorrect): The sodium-potassium pump actually consumes ATP rather than generating
it; it requires energy to function.
Rationale for C (Incorrect): Protein synthesis occurs at ribosomes and is not directly related to the
sodium-potassium pump function.
Rationale for D (Incorrect): Cell division is regulated by various growth factors and cell cycle proteins,
not by the sodium-potassium pump.
Question 5
Which cellular adaptation occurs when cells increase in size in response to increased workload?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
ANSWER: B. Hypertrophy
Rationale for B (Correct): Hypertrophy is an increase in cell size (not number) in response to increased
demand or workload. Examples include cardiac muscle hypertrophy in hypertension and skeletal muscle
hypertrophy with exercise.
Rationale for A (Incorrect): Hyperplasia is an increase in the number of cells, not cell size. It occurs in
tissues capable of cell division.
Rationale for C (Incorrect): Atrophy is a decrease in cell size and function, typically due to decreased
workload, loss of innervation, or decreased blood supply.
Rationale for D (Incorrect): Metaplasia is the reversible replacement of one mature cell type with
another mature cell type, usually in response to chronic irritation.
Question 6
What is the primary mechanism of cell injury in ischemic conditions?
A. Increased protein synthesis
B. ATP depletion
C. Enhanced DNA repair
D. Increased cellular metabolism
ANSWER: B. ATP depletion
, Rationale for B (Correct): Ischemia reduces oxygen delivery to tissues, impairing oxidative
phosphorylation in mitochondria and leading to ATP depletion. This disrupts energy-dependent cellular
processes, including the sodium-potassium pump, leading to cellular swelling and injury.
Rationale for A (Incorrect): Ischemia actually decreases protein synthesis due to ATP depletion and
ribosomal detachment from the rough endoplasmic reticulum.
Rationale for C (Incorrect): DNA repair mechanisms are impaired during ischemia due to energy
depletion, not enhanced.
Rationale for D (Incorrect): Cellular metabolism decreases during ischemia due to lack of oxygen, not
increases.
Question 7
Which type of necrosis is characteristic of myocardial infarction?
A. Caseous necrosis
B. Coagulative necrosis
C. Liquefactive necrosis
D. Fat necrosis
ANSWER: B. Coagulative necrosis
Rationale for B (Correct): Coagulative necrosis is characteristic of ischemic injury in most solid
orgANSWER, including the heart. The basic cellular outline is preserved for several days as denatured
proteins form a gel-like substance.
Rationale for A (Incorrect): Caseous necrosis is characteristic of tuberculosis, appearing as a cheese-like
appearance in affected tissues.
Rationale for C (Incorrect): Liquefactive necrosis is characteristic of bacterial infections and hypoxic
injury in the central nervous system.
Rationale for D (Incorrect): Fat necrosis occurs in acute pancreatitis and breast tissue trauma, not in
myocardial infarction.
Question 8
What is the role of apoptosis in normal physiology?
A. To cause inflammation in damaged tissues
B. To eliminate damaged or unnecessary cells in a controlled manner
C. To promote rapid cell proliferation
D. To increase cellular metabolism
ANSWER: B. To eliminate damaged or unnecessary cells in a controlled manner
Midterm Exam Qns and ANSWER 2026 ACTUAL
SECTION 1: CELLULAR BIOLOGY AND GENETICS
Question 1
Which of the following is the primary cause of chronic obstructive pulmonary disease (COPD)?
A. Genetic predisposition
B. Air pollution
C. Smoking
D. Occupational exposure
ANSWER: C. Smoking
Rationale for C (Correct): Smoking is the leading cause of COPD, as it damages the airways and alveoli,
leading to airflow obstruction and respiratory symptoms. Cigarette smoke contains toxic chemicals that
cause chronic inflammation, destruction of lung tissue, and impaired ciliary function.
Rationale for A (Incorrect): While genetic predisposition (particularly alpha-1 antitrypsin deficiency) can
contribute to COPD, it accounts for only 1-2% of cases and is not the primary cause.
Rationale for B (Incorrect): Air pollution can exacerbate COPD and contribute to its development, but it
is a secondary risk factor compared to smoking.
Rationale for D (Incorrect): Occupational exposure to dust, chemicals, and fumes can increase COPD risk,
but it is not the primary cause in most cases.
Question 2
What is the primary pathophysiological mechanism of type 2 diabetes mellitus?
A. Autoimmune destruction of beta cells
B. Insulin resistance
C. Genetic mutations
D. Viral infection
ANSWER: B. Insulin resistance
,Rationale for B (Correct): Type 2 diabetes mellitus is primarily caused by insulin resistance, where the
body's cells do not respond effectively to insulin, leading to elevated blood glucose levels. This is often
accompanied by relative insulin deficiency over time.
Rationale for A (Incorrect): Autoimmune destruction of beta cells is the primary mechanism of type 1
diabetes mellitus, not type 2 diabetes.
Rationale for C (Incorrect): While genetic factors contribute to type 2 diabetes susceptibility, genetic
mutations alone are not the primary pathophysiological mechanism.
Rationale for D (Incorrect): Viral infections may trigger type 1 diabetes in genetically susceptible
individuals but are not the primary mechanism of type 2 diabetes.
Question 3
Which of the following is a common complication of hypertension?
A. Osteoporosis
B. Chronic kidney disease
C. Asthma
D. Rheumatoid arthritis
ANSWER: B. Chronic kidney disease
Rationale for B (Correct): Chronic hypertension damages the blood vessels in the kidneys, leading to
nephrosclerosis and chronic kidney disease. The kidneys are particularly vulnerable to hypertensive
damage due to their rich vascular supply.
Rationale for A (Incorrect): Osteoporosis is not a direct complication of hypertension; it is more
commonly associated with aging, hormonal changes, and calcium/vitamin D deficiency.
Rationale for C (Incorrect): Asthma is a chronic respiratory condition unrelated to hypertension as a
complication.
Rationale for D (Incorrect): Rheumatoid arthritis is an autoimmune disorder and is not caused by
hypertension.
Question 4
What is the primary function of the sodium-potassium pump in cellular physiology?
A. To generate ATP for cellular energy
B. To maintain the resting membrane potential
C. To facilitate protein synthesis
D. To promote cell division
ANSWER: B. To maintain the resting membrane potential
,Rationale for B (Correct): The sodium-potassium pump (Na+/K+ ATPase) actively trANSWERports 3
sodium ions out of the cell and 2 potassium ions into the cell, maintaining the electrochemical gradient
essential for the resting membrane potential and cellular excitability.
Rationale for A (Incorrect): The sodium-potassium pump actually consumes ATP rather than generating
it; it requires energy to function.
Rationale for C (Incorrect): Protein synthesis occurs at ribosomes and is not directly related to the
sodium-potassium pump function.
Rationale for D (Incorrect): Cell division is regulated by various growth factors and cell cycle proteins,
not by the sodium-potassium pump.
Question 5
Which cellular adaptation occurs when cells increase in size in response to increased workload?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
ANSWER: B. Hypertrophy
Rationale for B (Correct): Hypertrophy is an increase in cell size (not number) in response to increased
demand or workload. Examples include cardiac muscle hypertrophy in hypertension and skeletal muscle
hypertrophy with exercise.
Rationale for A (Incorrect): Hyperplasia is an increase in the number of cells, not cell size. It occurs in
tissues capable of cell division.
Rationale for C (Incorrect): Atrophy is a decrease in cell size and function, typically due to decreased
workload, loss of innervation, or decreased blood supply.
Rationale for D (Incorrect): Metaplasia is the reversible replacement of one mature cell type with
another mature cell type, usually in response to chronic irritation.
Question 6
What is the primary mechanism of cell injury in ischemic conditions?
A. Increased protein synthesis
B. ATP depletion
C. Enhanced DNA repair
D. Increased cellular metabolism
ANSWER: B. ATP depletion
, Rationale for B (Correct): Ischemia reduces oxygen delivery to tissues, impairing oxidative
phosphorylation in mitochondria and leading to ATP depletion. This disrupts energy-dependent cellular
processes, including the sodium-potassium pump, leading to cellular swelling and injury.
Rationale for A (Incorrect): Ischemia actually decreases protein synthesis due to ATP depletion and
ribosomal detachment from the rough endoplasmic reticulum.
Rationale for C (Incorrect): DNA repair mechanisms are impaired during ischemia due to energy
depletion, not enhanced.
Rationale for D (Incorrect): Cellular metabolism decreases during ischemia due to lack of oxygen, not
increases.
Question 7
Which type of necrosis is characteristic of myocardial infarction?
A. Caseous necrosis
B. Coagulative necrosis
C. Liquefactive necrosis
D. Fat necrosis
ANSWER: B. Coagulative necrosis
Rationale for B (Correct): Coagulative necrosis is characteristic of ischemic injury in most solid
orgANSWER, including the heart. The basic cellular outline is preserved for several days as denatured
proteins form a gel-like substance.
Rationale for A (Incorrect): Caseous necrosis is characteristic of tuberculosis, appearing as a cheese-like
appearance in affected tissues.
Rationale for C (Incorrect): Liquefactive necrosis is characteristic of bacterial infections and hypoxic
injury in the central nervous system.
Rationale for D (Incorrect): Fat necrosis occurs in acute pancreatitis and breast tissue trauma, not in
myocardial infarction.
Question 8
What is the role of apoptosis in normal physiology?
A. To cause inflammation in damaged tissues
B. To eliminate damaged or unnecessary cells in a controlled manner
C. To promote rapid cell proliferation
D. To increase cellular metabolism
ANSWER: B. To eliminate damaged or unnecessary cells in a controlled manner
