WGU D236 PATHOPHYSIOLOGY CORE EXAMS SET 2026-
2027 QUESTIONS AND ANSWERS RATED A+
✔✔compensatory Physiologic hyperplasia - ✔✔is an adaptive mechanism that enables
certain organs to regenerate. Occurs in skin, intestines, hepatocytes, bone marrow, and
fibroblasts. Ex. Is when skin gets callus in response to mechanical stimulus.
✔✔Hormonal physiologic hyperplasia - ✔✔Hormonal occurs mainly from estrogen
dependent organs such as uterus and breasts.Ex- after ovulation estrogen stimulates
endometrium to grow/thicken for fertilized ovum.
✔✔Pathologic hyperplasia - ✔✔he abnormal proliferation of normal cells and can occur
as a response to excessive hormonal stimulation or the effects of growth factors on
target cells. These cells have enlargement of the nucleus, clumping of chromatin
(package and protect DNA), and the presence of one or more large nucleoli. Ex. Benign
prostatic hyperplasia (BPH) and endometriosis-both the result of hormonal imbalance.
✔✔Metaplasia - ✔✔reversible replacement of one mature cell type (epithelial or
mesenchymal) by another, sometimes less differentiated, cell type.
✔✔Cause of metaplasia - ✔✔develops from reprogramming of stem cells. Found in
association with tissue damage, repair, and regeneration.
✔✔pathophysiology of metaplasia - ✔✔Adaptive replacement cell may be more suitable
to the changed conditions in the surrounding environment. Ex. GERD damages
squamous epithelium of the esophagus, cells are replaced by glandular epithelium
which may tolerate the acid better. Not always beneficial. Ex. Smoking causes changes
in bronchi cells, which don't have cilia or secrete mucus, causing loss of protective
mechanism.
✔✔What is the significance of metaplasia - ✔✔Can be reversed if stimulus is removed.
If continues, can cause malignant transformation.
✔✔Dysplasia - ✔✔abnormal changes in the size, shape, and organization of mature
cells. mostly found in epithelia
✔✔Significance of dysplasia - ✔✔can be reversed if it does not involve the entire
epithelium. When dysplastic changes penetrate the basement membrane it is
considered a preinvasive neoplasm (carcinoma in situ)
✔✔mechanisms of cell injury - ✔✔ATP depletion, mitochondrial damage, accumulation
of oxygen and oxygen-derived free radicals
membrane damage
protein folding defects
DNA damage defects
,calcium level alterations
✔✔reperfusion injury - ✔✔injury to tissue that occurs after blood flow is restored
restoration of needed oxygen is accompanied by oxidative stress with the generation of
toxic oxygen radicals which damage cellular membranes and mitochndria
✔✔What helps reperfusion injury? - ✔✔antioxidants and anti-inflammatory drugs
✔✔examples of cell injury - ✔✔ischemic and hypoxic injury
ischemia-reperfusion injury
oxidative stress or accumulation of oxygen-derived free radicals induced injury
chemical injury
✔✔Cell injury: ATP depletion - ✔✔loss of mitochondrial ATP and decreased ATP
synthesis
results include:
cellular swelling
decreased protein synthesis
decreased membrane transport
lipogenesis
all changes that contribute to loss of integrity of the plasma membrane
✔✔Cell injury: Oxygen and oxygen-derived free radicals - ✔✔lack of oxygen is key in
progression of cell injury in ischemia (reduced blood supply)
activated oxygen species (free radicals) cause destruction of cell membranes and cell
structure
✔✔Cell Injury: Intracellular calcium and loss of calcium steady state - ✔✔Normally
intracellular cytosolic calcium concentrations are very low; ischemia and certain
chemicals can cause an increase in cytosolic Ca concentrations
sustained levels of Ca continue to increase with damage to plasma membrane
Ca causes intracellular damage by activating enzymes
✔✔Cellular events that occur with ischemia-hypoxic injury - ✔✔-Decrease in oxygen
reaching the cell
-decrease in ATP production within mitochondria
-failed NA+/K pump
-Na, Ca enter cell, K leaves
-organelle swelling
-protein synthesis stops
-ATP via oxidative phosphorylation declines, glycolysis increases
-glycogen stores depleated
-lactic acid produced
-decrease in intracellular Ph declines
-rupture of lysosomes
, -autodigestion of the cell contents and membrane
✔✔Deleterious effects of free radicals on cells - ✔✔-unstable compounds with an
unpaired electron in outer ring
-anxious to "mate" with other substances
affinity for lipid substances
(there is a phospholipid bilayer membrane around cell)
-combine avidly with cell and organelle membranes
-lipid peroxidation - dissolution of the membrane
-"drills a hole"
✔✔examples o diseases linked to oxygen-derived free radicals - ✔✔aging
atherosclerosis
brain disorders
Cancer
Cardiac myopathy
Diabetes
Eye disorders
inflammatory disorders
iron overload
emphysema
radiation injury
reperfusion injury
rheumatoid arthritis
sleep apnea
Burns
✔✔Most types of cellular accumulations occur as a result of what 4 mechanisms - ✔✔1
- insufficient removal of normal substance because of altered packaging/transport
2-abnormal substance (result of mutated gene) accumulated because of deficits in
protein folding, transport, or abnormal degredation
3 - endogenous substance not effectively catabolized because of lack of vital lysosomal
enzyme
4 - harmful exogenous materials such as heavy metals, dusts, microorganisms that
accumulate because of inhalation, ingestion, or infection
✔✔normal substances that cause cell accumulation - ✔✔water
protein
lipid
carbs
✔✔abnormal substances that cause cell accumulation - ✔✔-endogenous: product of
abnormal metabolism synthesis
-exogenous: infectious agent or material
2027 QUESTIONS AND ANSWERS RATED A+
✔✔compensatory Physiologic hyperplasia - ✔✔is an adaptive mechanism that enables
certain organs to regenerate. Occurs in skin, intestines, hepatocytes, bone marrow, and
fibroblasts. Ex. Is when skin gets callus in response to mechanical stimulus.
✔✔Hormonal physiologic hyperplasia - ✔✔Hormonal occurs mainly from estrogen
dependent organs such as uterus and breasts.Ex- after ovulation estrogen stimulates
endometrium to grow/thicken for fertilized ovum.
✔✔Pathologic hyperplasia - ✔✔he abnormal proliferation of normal cells and can occur
as a response to excessive hormonal stimulation or the effects of growth factors on
target cells. These cells have enlargement of the nucleus, clumping of chromatin
(package and protect DNA), and the presence of one or more large nucleoli. Ex. Benign
prostatic hyperplasia (BPH) and endometriosis-both the result of hormonal imbalance.
✔✔Metaplasia - ✔✔reversible replacement of one mature cell type (epithelial or
mesenchymal) by another, sometimes less differentiated, cell type.
✔✔Cause of metaplasia - ✔✔develops from reprogramming of stem cells. Found in
association with tissue damage, repair, and regeneration.
✔✔pathophysiology of metaplasia - ✔✔Adaptive replacement cell may be more suitable
to the changed conditions in the surrounding environment. Ex. GERD damages
squamous epithelium of the esophagus, cells are replaced by glandular epithelium
which may tolerate the acid better. Not always beneficial. Ex. Smoking causes changes
in bronchi cells, which don't have cilia or secrete mucus, causing loss of protective
mechanism.
✔✔What is the significance of metaplasia - ✔✔Can be reversed if stimulus is removed.
If continues, can cause malignant transformation.
✔✔Dysplasia - ✔✔abnormal changes in the size, shape, and organization of mature
cells. mostly found in epithelia
✔✔Significance of dysplasia - ✔✔can be reversed if it does not involve the entire
epithelium. When dysplastic changes penetrate the basement membrane it is
considered a preinvasive neoplasm (carcinoma in situ)
✔✔mechanisms of cell injury - ✔✔ATP depletion, mitochondrial damage, accumulation
of oxygen and oxygen-derived free radicals
membrane damage
protein folding defects
DNA damage defects
,calcium level alterations
✔✔reperfusion injury - ✔✔injury to tissue that occurs after blood flow is restored
restoration of needed oxygen is accompanied by oxidative stress with the generation of
toxic oxygen radicals which damage cellular membranes and mitochndria
✔✔What helps reperfusion injury? - ✔✔antioxidants and anti-inflammatory drugs
✔✔examples of cell injury - ✔✔ischemic and hypoxic injury
ischemia-reperfusion injury
oxidative stress or accumulation of oxygen-derived free radicals induced injury
chemical injury
✔✔Cell injury: ATP depletion - ✔✔loss of mitochondrial ATP and decreased ATP
synthesis
results include:
cellular swelling
decreased protein synthesis
decreased membrane transport
lipogenesis
all changes that contribute to loss of integrity of the plasma membrane
✔✔Cell injury: Oxygen and oxygen-derived free radicals - ✔✔lack of oxygen is key in
progression of cell injury in ischemia (reduced blood supply)
activated oxygen species (free radicals) cause destruction of cell membranes and cell
structure
✔✔Cell Injury: Intracellular calcium and loss of calcium steady state - ✔✔Normally
intracellular cytosolic calcium concentrations are very low; ischemia and certain
chemicals can cause an increase in cytosolic Ca concentrations
sustained levels of Ca continue to increase with damage to plasma membrane
Ca causes intracellular damage by activating enzymes
✔✔Cellular events that occur with ischemia-hypoxic injury - ✔✔-Decrease in oxygen
reaching the cell
-decrease in ATP production within mitochondria
-failed NA+/K pump
-Na, Ca enter cell, K leaves
-organelle swelling
-protein synthesis stops
-ATP via oxidative phosphorylation declines, glycolysis increases
-glycogen stores depleated
-lactic acid produced
-decrease in intracellular Ph declines
-rupture of lysosomes
, -autodigestion of the cell contents and membrane
✔✔Deleterious effects of free radicals on cells - ✔✔-unstable compounds with an
unpaired electron in outer ring
-anxious to "mate" with other substances
affinity for lipid substances
(there is a phospholipid bilayer membrane around cell)
-combine avidly with cell and organelle membranes
-lipid peroxidation - dissolution of the membrane
-"drills a hole"
✔✔examples o diseases linked to oxygen-derived free radicals - ✔✔aging
atherosclerosis
brain disorders
Cancer
Cardiac myopathy
Diabetes
Eye disorders
inflammatory disorders
iron overload
emphysema
radiation injury
reperfusion injury
rheumatoid arthritis
sleep apnea
Burns
✔✔Most types of cellular accumulations occur as a result of what 4 mechanisms - ✔✔1
- insufficient removal of normal substance because of altered packaging/transport
2-abnormal substance (result of mutated gene) accumulated because of deficits in
protein folding, transport, or abnormal degredation
3 - endogenous substance not effectively catabolized because of lack of vital lysosomal
enzyme
4 - harmful exogenous materials such as heavy metals, dusts, microorganisms that
accumulate because of inhalation, ingestion, or infection
✔✔normal substances that cause cell accumulation - ✔✔water
protein
lipid
carbs
✔✔abnormal substances that cause cell accumulation - ✔✔-endogenous: product of
abnormal metabolism synthesis
-exogenous: infectious agent or material
