NURS 6501
Advanced Pathophysiology — Midterm Exam
Questions and Answers| Latest Update
Page 1 of 71
, Section 1: Cellular Function, Genetics,
Immunity, Inflammation/Infection, Fluid-
Electrolyte & Acid-Base
Question 1. A cell exposed to prolonged hypoxia switches to
anaerobic glycolysis. Which of the following is the most immediate
consequence of this metabolic shift?
A. Increased ATP production
B. Accumulation of lactic acid and intracellular acidosis
C. Enhanced protein synthesis
D. Decreased sodium influx
Answer: B. Accumulation of lactic acid and intracellular acidosis
Rationale: Anaerobic glycolysis produces far less ATP than
oxidative phosphorylation and generates lactic acid as an end
product, lowering intracellular pH. This acidosis further impairs
enzyme function and accelerates cell injury if hypoxia persists.
Page 2 of 71
,Question 2. Which cellular adaptation is characterized by an increase
in the number of cells in an organ or tissue, often seen in the liver after
partial resection?
A. Hypertrophy
B. Atrophy
C. Hyperplasia
D. Metaplasia
Answer: C. Hyperplasia
Rationale: Hyperplasia is an increase in cell number resulting
from increased mitotic activity, a normal compensatory response in
tissues capable of division, such as the liver.
Question 3. Reversible replacement of one differentiated cell type with
another, such as bronchial epithelium changing from ciliated columnar
to stratified squamous in a chronic smoker, is termed:
A. Dysplasia
B. Metaplasia
C. Anaplasia
D. Hyperplasia
Answer: B. Metaplasia
Page 3 of 71
, Rationale: Metaplasia is a reversible adaptive substitution of one
adult cell type for another, typically in response to chronic irritation;
it may progress to dysplasia if the stimulus continues.
Question 4. Free radical-mediated cell injury primarily damages cells
by:
A. Directly inhibiting the Na+/K+-ATPase pump
B. Peroxidation of membrane lipids and damage to DNA and
proteins
C. Blocking glycolysis exclusively
D. Increasing lysosomal membrane stability
Answer: B. Peroxidation of membrane lipids and damage to DNA
and proteins
Rationale: Free radicals are highly reactive molecules with
unpaired electrons that cause lipid peroxidation of cell membranes
and oxidative damage to proteins and nucleic acids, leading to
structural and functional cell injury.
Question 5. Coagulative necrosis is most characteristic of injury to
which tissue?
Page 4 of 71
Advanced Pathophysiology — Midterm Exam
Questions and Answers| Latest Update
Page 1 of 71
, Section 1: Cellular Function, Genetics,
Immunity, Inflammation/Infection, Fluid-
Electrolyte & Acid-Base
Question 1. A cell exposed to prolonged hypoxia switches to
anaerobic glycolysis. Which of the following is the most immediate
consequence of this metabolic shift?
A. Increased ATP production
B. Accumulation of lactic acid and intracellular acidosis
C. Enhanced protein synthesis
D. Decreased sodium influx
Answer: B. Accumulation of lactic acid and intracellular acidosis
Rationale: Anaerobic glycolysis produces far less ATP than
oxidative phosphorylation and generates lactic acid as an end
product, lowering intracellular pH. This acidosis further impairs
enzyme function and accelerates cell injury if hypoxia persists.
Page 2 of 71
,Question 2. Which cellular adaptation is characterized by an increase
in the number of cells in an organ or tissue, often seen in the liver after
partial resection?
A. Hypertrophy
B. Atrophy
C. Hyperplasia
D. Metaplasia
Answer: C. Hyperplasia
Rationale: Hyperplasia is an increase in cell number resulting
from increased mitotic activity, a normal compensatory response in
tissues capable of division, such as the liver.
Question 3. Reversible replacement of one differentiated cell type with
another, such as bronchial epithelium changing from ciliated columnar
to stratified squamous in a chronic smoker, is termed:
A. Dysplasia
B. Metaplasia
C. Anaplasia
D. Hyperplasia
Answer: B. Metaplasia
Page 3 of 71
, Rationale: Metaplasia is a reversible adaptive substitution of one
adult cell type for another, typically in response to chronic irritation;
it may progress to dysplasia if the stimulus continues.
Question 4. Free radical-mediated cell injury primarily damages cells
by:
A. Directly inhibiting the Na+/K+-ATPase pump
B. Peroxidation of membrane lipids and damage to DNA and
proteins
C. Blocking glycolysis exclusively
D. Increasing lysosomal membrane stability
Answer: B. Peroxidation of membrane lipids and damage to DNA
and proteins
Rationale: Free radicals are highly reactive molecules with
unpaired electrons that cause lipid peroxidation of cell membranes
and oxidative damage to proteins and nucleic acids, leading to
structural and functional cell injury.
Question 5. Coagulative necrosis is most characteristic of injury to
which tissue?
Page 4 of 71
