NR507 Advanced Pathophysiology
Midterm Exam – Chamberlain
Questions and Ansẉers
2026\2027 update
Part 1: Cellular Biology & Genetics (Questions 1–15)
1. A cell is deprived of oxygen. Which of the following is the most
likely immediate consequence?
A) Increased ATP production
B) Shift to anaerobic glycolysis
C) Rupture of the lysosomes
D) Immediate cellular necrosis
AnswerB) Shift to anaerobic glycolysis
Rationale: Without oxygen, the electron transport chain stops. The
cell must rely on anaerobic glycolysis to generate ATP, which
produces lactic acid as a byproduct. Necrosis (D) occurs later if the
deprivation is prolonged.
2. Which cellular adaptation is most likely to occur in the
myocardium of an athlete?
A) Atrophy
B) Hyperplasia
,C) Hypertrophy
D) Metaplasia
AnswerC) Hypertrophy
Rationale: Hypertrophy is an increase in cell size. Because cardiac
muscle cells (myocytes) cannot divide, the heart adapts to increased
workload (like athletic training) by increasing the size of existing
cells, not by making more (hyperplasia).
3. A patient presents with a chronic cough and a history of smoking.
A biopsy reveals squamous cells in the bronchial lining where
columnar cells normally reside. This is an example of:
A) Dysplasia
B) Metaplasia
C) Hyperplasia
D) Anaplasia
AnswerB) Metaplasia
Rationale: Metaplasia is the reversible replacement of one mature
cell type by another, often as an adaptive response to chronic
irritation (like cigarette smoke changing columnar ciliated cells to
squamous cells).
4. What is the primary difference between necrosis and apoptosis?
A) Necrosis is programmed; apoptosis is accidental.
B) Necrosis causes inflammation; apoptosis usually does not.
C) Apoptosis causes cellular swelling; necrosis causes cellular
shrinkage.
D) Necrosis only affects isolated cells; apoptosis affects patches of
cells.
,AnswerB) Necrosis causes inflammation; apoptosis usually does not.
Rationale: Necrosis is an uncontrolled, accidental cell death that
releases cellular contents into the extracellular space, triggering an
inflammatory response. Apoptosis is programmed cell death where
the cell fragments into apoptotic bodies that are quickly
phagocytosed without causing inflammation.
5. Which type of necrosis is most commonly associated with
ischemic injury in the heart or kidneys?
A) Liquefactive necrosis
B) Coagulative necrosis
C) Caseous necrosis
D) Fat necrosis
AnswerB) Coagulative necrosis
Rationale: Coagulative necrosis is caused by protein denaturation,
typically due to hypoxia/ischemia. The architecture of the dead
tissue is preserved for a few days. It is classic in myocardial
infarction and renal infarcts.
6. Free radicals cause cellular injury primarily by:
A) Activating endonucleases
B) Stealing electrons from other molecules, causing lipid
peroxidation
C) Inhibiting the Na+/K+ pump
D) Decreasing intracellular calcium levels
AnswerB) Stealing electrons from other molecules, causing lipid
peroxidation
, Rationale: Free radicals are highly unstable molecules with an
unpaired electron. They steal electrons from cell membranes (lipid
peroxidation), proteins, and DNA, causing severe structural damage.
7. A patient has an intracellular accumulation of triglycerides in the
liver. This condition is known as:
A) Steatosis
B) Melanosis
C) Hemosiderosis
D) Amyloidosis
AnswerA) Steatosis
Rationale: Steatosis (fatty change) is the abnormal accumulation of
triglycerides within parenchymal cells, most commonly in the liver
due to alcohol abuse, diabetes, or obesity.
8. Which statement is true regarding the sodium-potassium
(Na+/K+) pump?
A) It moves sodium into the cell and potassium out of the cell.
B) It requires ATP to function.
C) It is an example of passive transport.
D) It moves 3 K+ in for every 2 Na+ out.
AnswerB) It requires ATP to function.
Rationale: The Na+/K+ pump is primary active transport. It uses ATP
to move 3 Na+ out of the cell and 2 K+ into the cell against their
concentration gradients.
9. A child is born with an extra chromosome 21. This is an example
of which genetic disorder?
Midterm Exam – Chamberlain
Questions and Ansẉers
2026\2027 update
Part 1: Cellular Biology & Genetics (Questions 1–15)
1. A cell is deprived of oxygen. Which of the following is the most
likely immediate consequence?
A) Increased ATP production
B) Shift to anaerobic glycolysis
C) Rupture of the lysosomes
D) Immediate cellular necrosis
AnswerB) Shift to anaerobic glycolysis
Rationale: Without oxygen, the electron transport chain stops. The
cell must rely on anaerobic glycolysis to generate ATP, which
produces lactic acid as a byproduct. Necrosis (D) occurs later if the
deprivation is prolonged.
2. Which cellular adaptation is most likely to occur in the
myocardium of an athlete?
A) Atrophy
B) Hyperplasia
,C) Hypertrophy
D) Metaplasia
AnswerC) Hypertrophy
Rationale: Hypertrophy is an increase in cell size. Because cardiac
muscle cells (myocytes) cannot divide, the heart adapts to increased
workload (like athletic training) by increasing the size of existing
cells, not by making more (hyperplasia).
3. A patient presents with a chronic cough and a history of smoking.
A biopsy reveals squamous cells in the bronchial lining where
columnar cells normally reside. This is an example of:
A) Dysplasia
B) Metaplasia
C) Hyperplasia
D) Anaplasia
AnswerB) Metaplasia
Rationale: Metaplasia is the reversible replacement of one mature
cell type by another, often as an adaptive response to chronic
irritation (like cigarette smoke changing columnar ciliated cells to
squamous cells).
4. What is the primary difference between necrosis and apoptosis?
A) Necrosis is programmed; apoptosis is accidental.
B) Necrosis causes inflammation; apoptosis usually does not.
C) Apoptosis causes cellular swelling; necrosis causes cellular
shrinkage.
D) Necrosis only affects isolated cells; apoptosis affects patches of
cells.
,AnswerB) Necrosis causes inflammation; apoptosis usually does not.
Rationale: Necrosis is an uncontrolled, accidental cell death that
releases cellular contents into the extracellular space, triggering an
inflammatory response. Apoptosis is programmed cell death where
the cell fragments into apoptotic bodies that are quickly
phagocytosed without causing inflammation.
5. Which type of necrosis is most commonly associated with
ischemic injury in the heart or kidneys?
A) Liquefactive necrosis
B) Coagulative necrosis
C) Caseous necrosis
D) Fat necrosis
AnswerB) Coagulative necrosis
Rationale: Coagulative necrosis is caused by protein denaturation,
typically due to hypoxia/ischemia. The architecture of the dead
tissue is preserved for a few days. It is classic in myocardial
infarction and renal infarcts.
6. Free radicals cause cellular injury primarily by:
A) Activating endonucleases
B) Stealing electrons from other molecules, causing lipid
peroxidation
C) Inhibiting the Na+/K+ pump
D) Decreasing intracellular calcium levels
AnswerB) Stealing electrons from other molecules, causing lipid
peroxidation
, Rationale: Free radicals are highly unstable molecules with an
unpaired electron. They steal electrons from cell membranes (lipid
peroxidation), proteins, and DNA, causing severe structural damage.
7. A patient has an intracellular accumulation of triglycerides in the
liver. This condition is known as:
A) Steatosis
B) Melanosis
C) Hemosiderosis
D) Amyloidosis
AnswerA) Steatosis
Rationale: Steatosis (fatty change) is the abnormal accumulation of
triglycerides within parenchymal cells, most commonly in the liver
due to alcohol abuse, diabetes, or obesity.
8. Which statement is true regarding the sodium-potassium
(Na+/K+) pump?
A) It moves sodium into the cell and potassium out of the cell.
B) It requires ATP to function.
C) It is an example of passive transport.
D) It moves 3 K+ in for every 2 Na+ out.
AnswerB) It requires ATP to function.
Rationale: The Na+/K+ pump is primary active transport. It uses ATP
to move 3 Na+ out of the cell and 2 K+ into the cell against their
concentration gradients.
9. A child is born with an extra chromosome 21. This is an example
of which genetic disorder?
