NURS6202 (CU-AGPCNP) Advanced
Pathophysiology Midterm Exam
(Qns and Ans) 2026.
Question 1
Under anaerobic conditions, what process provides energy for the cell?
A) Oxidative phosphorylation
B) Glycolysis
C) Krebs cycle
D) Beta-oxidation
Answer: B) Glycolysis
Rationale: Glycolysis is the anaerobic pathway that produces ATP without oxygen.
It yields only 2 ATP per glucose molecule compared to 36 ATP with aerobic
metabolism. This pathway becomes critical during ischemia or hypoxia when
oxidative phosphorylation cannot occur.
Question 2
What is the result of lipid peroxidation?
A) Increased ATP production
B) Cell membrane damage
,C) Enhanced protein synthesis
D) DNA repair activation
Answer: B) Cell membrane damage
Rationale: Lipid peroxidation is a free radical-mediated chain reaction that
damages cell membranes by oxidizing polyunsaturated fatty acids. This leads to
increased membrane permeability, loss of membrane integrity, and eventual cell
death.
Question 3
How do free radicals cause cell damage?
A) Accepting electrons from cell membranes
B) Giving up an electron, which causes injury to the chemical bonds of the cell
membrane
C) Increasing intracellular calcium
D) Activating apoptosis
Answer: B) Giving up an electron, which causes injury to the chemical bonds of
the cell membrane
Rationale: Free radicals are highly reactive molecules with unpaired electrons.
They damage cells by "stealing" electrons from other molecules, initiating chain
reactions that damage cell membranes, proteins, and DNA.
Question 4
A patient develops cardiac arrest. CPR is initiated, and capnography attached to
,the endotracheal tube demonstrates end-tidal CO₂ is 12 mmHg. After 10 minutes
of resuscitation, the EtCO₂ rapidly increases to 37 mmHg. What does this change
indicate?
A) Poor quality compressions
B) Pneumothorax due to compressions
C) Right mainstem intubation
D) Return of spontaneous circulation (ROSC)
Answer: D) Return of spontaneous circulation (ROSC)
Rationale: A sudden rise in EtCO₂ is often the earliest indicator of ROSC, occurring
even before a palpable pulse is detected. This reflects restoration of pulmonary
blood flow and ventilation.
Question 5
Apoptotic cell death is characterized by:
A) Cell swelling and lysis
B) Inflammation and tissue damage
C) Cell shrinkage, membrane blebbing, and caspase activation
D) Necrosis and nuclear dissolution
Answer: C) Cell shrinkage, membrane blebbing, and caspase activation
Rationale: Apoptosis is programmed cell death characterized by cell shrinkage,
chromatin condensation, membrane blebbing, and caspase cascade activation.
Unlike necrosis, apoptosis does not trigger inflammation.
, Question 6
Which of the following is a common cause of cellular injury?
A) Hypoxia
B) Genetic mutations
C) Free radicals
D) All of the above
Answer: D) All of the above
Rationale: Cellular injury can result from multiple causes including hypoxia (oxygen
deprivation), genetic mutations, free radical damage, physical agents, chemical
toxins, infectious agents, and nutritional imbalances.
Question 7
The Hayflick limit refers to:
A) The number of cell divisions before senescence
B) The maximum size a cell can achieve
C) The limit of DNA repair capacity
D) The maximum rate of cellular metabolism
Answer: A) The number of cell divisions before senescence
Rationale: The Hayflick limit describes the finite number of times a normal human
cell can divide before entering senescence. Cancer cells bypass this limit through
telomerase activation, allowing unlimited replication.
Pathophysiology Midterm Exam
(Qns and Ans) 2026.
Question 1
Under anaerobic conditions, what process provides energy for the cell?
A) Oxidative phosphorylation
B) Glycolysis
C) Krebs cycle
D) Beta-oxidation
Answer: B) Glycolysis
Rationale: Glycolysis is the anaerobic pathway that produces ATP without oxygen.
It yields only 2 ATP per glucose molecule compared to 36 ATP with aerobic
metabolism. This pathway becomes critical during ischemia or hypoxia when
oxidative phosphorylation cannot occur.
Question 2
What is the result of lipid peroxidation?
A) Increased ATP production
B) Cell membrane damage
,C) Enhanced protein synthesis
D) DNA repair activation
Answer: B) Cell membrane damage
Rationale: Lipid peroxidation is a free radical-mediated chain reaction that
damages cell membranes by oxidizing polyunsaturated fatty acids. This leads to
increased membrane permeability, loss of membrane integrity, and eventual cell
death.
Question 3
How do free radicals cause cell damage?
A) Accepting electrons from cell membranes
B) Giving up an electron, which causes injury to the chemical bonds of the cell
membrane
C) Increasing intracellular calcium
D) Activating apoptosis
Answer: B) Giving up an electron, which causes injury to the chemical bonds of
the cell membrane
Rationale: Free radicals are highly reactive molecules with unpaired electrons.
They damage cells by "stealing" electrons from other molecules, initiating chain
reactions that damage cell membranes, proteins, and DNA.
Question 4
A patient develops cardiac arrest. CPR is initiated, and capnography attached to
,the endotracheal tube demonstrates end-tidal CO₂ is 12 mmHg. After 10 minutes
of resuscitation, the EtCO₂ rapidly increases to 37 mmHg. What does this change
indicate?
A) Poor quality compressions
B) Pneumothorax due to compressions
C) Right mainstem intubation
D) Return of spontaneous circulation (ROSC)
Answer: D) Return of spontaneous circulation (ROSC)
Rationale: A sudden rise in EtCO₂ is often the earliest indicator of ROSC, occurring
even before a palpable pulse is detected. This reflects restoration of pulmonary
blood flow and ventilation.
Question 5
Apoptotic cell death is characterized by:
A) Cell swelling and lysis
B) Inflammation and tissue damage
C) Cell shrinkage, membrane blebbing, and caspase activation
D) Necrosis and nuclear dissolution
Answer: C) Cell shrinkage, membrane blebbing, and caspase activation
Rationale: Apoptosis is programmed cell death characterized by cell shrinkage,
chromatin condensation, membrane blebbing, and caspase cascade activation.
Unlike necrosis, apoptosis does not trigger inflammation.
, Question 6
Which of the following is a common cause of cellular injury?
A) Hypoxia
B) Genetic mutations
C) Free radicals
D) All of the above
Answer: D) All of the above
Rationale: Cellular injury can result from multiple causes including hypoxia (oxygen
deprivation), genetic mutations, free radical damage, physical agents, chemical
toxins, infectious agents, and nutritional imbalances.
Question 7
The Hayflick limit refers to:
A) The number of cell divisions before senescence
B) The maximum size a cell can achieve
C) The limit of DNA repair capacity
D) The maximum rate of cellular metabolism
Answer: A) The number of cell divisions before senescence
Rationale: The Hayflick limit describes the finite number of times a normal human
cell can divide before entering senescence. Cancer cells bypass this limit through
telomerase activation, allowing unlimited replication.
