NSG 5140 Midterm and Final Exam Review Adv
Pathophysiology South College NSG 5140 Advanced
Pathophysiology Exam Questions and Answers | 100%
Pass Guaranteed | Graded A+ | This content is
designed to reflect graduate-level material and exam
standards
Question 1
A 65-year-old male with chronic heart failure presents with worsening dyspnea
and peripheral edema. Which cellular adaptation is most likely occurring in his
myocardial tissue in response to prolonged pressure overload?
A. Hyperplasia
B. Atrophy
C. Metaplasia
D. Hypertrophy
Correct Answer: D. Hypertrophy
Rationale: Hypertrophy is an increase in individual cell size due to increased workload,
as seen in myocardial cells responding to chronic pressure overload from hypertension
or valve disease. Hyperplasia is increased cell number, which is rare in cardiac muscle.
Atrophy is decreased cell size from disuse. Metaplasia is replacement of one
differentiated cell type with another.
Question 2
A patient with chronic hypoxia from COPD develops increased red blood cell
production. This cellular response is best described as:
A. Physiologic hyperplasia
B. Pathologic hyperplasia
C. Compensatory hypertrophy
D. Metaplasia
,Correct Answer: A. Physiologic hyperplasia
Rationale: Physiologic hyperplasia is an increase in cell number in response to a
physiologic need. Chronic hypoxia stimulates erythropoietin production, leading to
increased red blood cell production (polycythemia) as a compensatory mechanism. This
is physiologic because it serves a protective function.
Question 3
The sodium-potassium pump moves which ions in which direction to maintain the
electrochemical gradient essential for membrane potential?
A. 2 Na⁺ out, 3 K⁺ in
B. 3 Na⁺ out, 2 K⁺ in
C. 1 Na⁺ out, 1 K⁺ in
D. 3 Na⁺ in, 2 K⁺ out
Correct Answer: B. 3 Na⁺ out, 2 K⁺ in
Rationale: The sodium-potassium pump actively transports 3 sodium ions out of the
cell and 2 potassium ions into the cell, consuming ATP in the process. This creates an
electrochemical gradient essential for membrane potential, nerve impulse transmission,
and secondary active transport.
Question 4
A patient experiences an ischemic stroke. The brain tissue undergoes which type of
necrosis?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis
Correct Answer: B. Liquefactive necrosis
Rationale: In the brain, ischemic injury leads to enzymatic digestion of dead cells,
resulting in liquefactive necrosis. The brain has high levels of proteolytic enzymes (from
,microglia and neutrophils) and high lipid content, which contribute to liquefaction and
cyst formation.
Question 5
A pathologist examines a biopsy from the bronchial epithelium of a chronic
smoker. The normal pseudostratified ciliated columnar epithelium is replaced by
stratified squamous epithelium. This cellular change is best described as:
A. Dysplasia
B. Metaplasia
C. Hyperplasia
D. Anaplasia
Correct Answer: B. Metaplasia
Rationale: Metaplasia is the reversible replacement of one mature cell type by another,
here pseudostratified ciliated columnar to stratified squamous epithelium. This occurs as
an adaptive response to chronic irritation but predisposes to dysplasia and cancer.
Dysplasia is disordered growth, often precancerous.
Question 6
In a patient with prolonged ischemia due to renal artery stenosis, proximal tubular
epithelial cells exhibit swelling of mitochondria and dilation of the endoplasmic
reticulum on electron microscopy. This morphology represents:
A. Irreversible injury; massive calcium influx into mitochondria
B. Reversible injury; depletion of ATP leading to failure of ion pumps
C. Necroptosis; activation of receptor-interacting protein kinases
D. Apoptosis; cytochrome c release from mitochondria
Correct Answer: B. Reversible injury; depletion of ATP leading to failure of ion pumps
Rationale: Cellular swelling with mitochondrial and ER changes is characteristic of
reversible injury, primarily due to ATP depletion causing failure of Na⁺/K⁺ ATPase and
, subsequent intracellular edema. Calcium influx and mitochondrial damage are features
of irreversible injury.
Question 7
A researcher studying pressure overload in cardiac myocytes observes that
sustained mechanical stretch leads to increased protein synthesis and cell
enlargement without cell division. Which intracellular signaling pathway is most
directly responsible for this adaptive response?
A. Activation of the PI3K/Akt/mTOR pathway leading to increased translation
B. Induction of p53-mediated cell cycle arrest and senescence
C. Upregulation of caspases and initiation of apoptosis
D. Activation of the unfolded protein response (UPR) due to ER stress
Correct Answer: A. Activation of the PI3K/Akt/mTOR pathway leading to increased
translation
Rationale: Cardiac myocytes respond to increased workload by undergoing
hypertrophy, which is driven by the PI3K/Akt/mTOR pathway that enhances protein
synthesis. p53 activation would promote apoptosis or senescence, not hypertrophy.
Caspase activation leads to apoptosis.
Question 8
Which of the following is the hallmark of reversible cellular injury?
A. Nuclear pyknosis
B. Cellular swelling
C. Karyorrhexis
D. Apoptosis
Correct Answer: B. Cellular swelling
Rationale: Reversible injury often involves failure of ion pumps leading to water influx
and cell swelling. This occurs before irreversible changes like nuclear pyknosis
(condensation) or karyorrhexis (fragmentation).
Pathophysiology South College NSG 5140 Advanced
Pathophysiology Exam Questions and Answers | 100%
Pass Guaranteed | Graded A+ | This content is
designed to reflect graduate-level material and exam
standards
Question 1
A 65-year-old male with chronic heart failure presents with worsening dyspnea
and peripheral edema. Which cellular adaptation is most likely occurring in his
myocardial tissue in response to prolonged pressure overload?
A. Hyperplasia
B. Atrophy
C. Metaplasia
D. Hypertrophy
Correct Answer: D. Hypertrophy
Rationale: Hypertrophy is an increase in individual cell size due to increased workload,
as seen in myocardial cells responding to chronic pressure overload from hypertension
or valve disease. Hyperplasia is increased cell number, which is rare in cardiac muscle.
Atrophy is decreased cell size from disuse. Metaplasia is replacement of one
differentiated cell type with another.
Question 2
A patient with chronic hypoxia from COPD develops increased red blood cell
production. This cellular response is best described as:
A. Physiologic hyperplasia
B. Pathologic hyperplasia
C. Compensatory hypertrophy
D. Metaplasia
,Correct Answer: A. Physiologic hyperplasia
Rationale: Physiologic hyperplasia is an increase in cell number in response to a
physiologic need. Chronic hypoxia stimulates erythropoietin production, leading to
increased red blood cell production (polycythemia) as a compensatory mechanism. This
is physiologic because it serves a protective function.
Question 3
The sodium-potassium pump moves which ions in which direction to maintain the
electrochemical gradient essential for membrane potential?
A. 2 Na⁺ out, 3 K⁺ in
B. 3 Na⁺ out, 2 K⁺ in
C. 1 Na⁺ out, 1 K⁺ in
D. 3 Na⁺ in, 2 K⁺ out
Correct Answer: B. 3 Na⁺ out, 2 K⁺ in
Rationale: The sodium-potassium pump actively transports 3 sodium ions out of the
cell and 2 potassium ions into the cell, consuming ATP in the process. This creates an
electrochemical gradient essential for membrane potential, nerve impulse transmission,
and secondary active transport.
Question 4
A patient experiences an ischemic stroke. The brain tissue undergoes which type of
necrosis?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis
Correct Answer: B. Liquefactive necrosis
Rationale: In the brain, ischemic injury leads to enzymatic digestion of dead cells,
resulting in liquefactive necrosis. The brain has high levels of proteolytic enzymes (from
,microglia and neutrophils) and high lipid content, which contribute to liquefaction and
cyst formation.
Question 5
A pathologist examines a biopsy from the bronchial epithelium of a chronic
smoker. The normal pseudostratified ciliated columnar epithelium is replaced by
stratified squamous epithelium. This cellular change is best described as:
A. Dysplasia
B. Metaplasia
C. Hyperplasia
D. Anaplasia
Correct Answer: B. Metaplasia
Rationale: Metaplasia is the reversible replacement of one mature cell type by another,
here pseudostratified ciliated columnar to stratified squamous epithelium. This occurs as
an adaptive response to chronic irritation but predisposes to dysplasia and cancer.
Dysplasia is disordered growth, often precancerous.
Question 6
In a patient with prolonged ischemia due to renal artery stenosis, proximal tubular
epithelial cells exhibit swelling of mitochondria and dilation of the endoplasmic
reticulum on electron microscopy. This morphology represents:
A. Irreversible injury; massive calcium influx into mitochondria
B. Reversible injury; depletion of ATP leading to failure of ion pumps
C. Necroptosis; activation of receptor-interacting protein kinases
D. Apoptosis; cytochrome c release from mitochondria
Correct Answer: B. Reversible injury; depletion of ATP leading to failure of ion pumps
Rationale: Cellular swelling with mitochondrial and ER changes is characteristic of
reversible injury, primarily due to ATP depletion causing failure of Na⁺/K⁺ ATPase and
, subsequent intracellular edema. Calcium influx and mitochondrial damage are features
of irreversible injury.
Question 7
A researcher studying pressure overload in cardiac myocytes observes that
sustained mechanical stretch leads to increased protein synthesis and cell
enlargement without cell division. Which intracellular signaling pathway is most
directly responsible for this adaptive response?
A. Activation of the PI3K/Akt/mTOR pathway leading to increased translation
B. Induction of p53-mediated cell cycle arrest and senescence
C. Upregulation of caspases and initiation of apoptosis
D. Activation of the unfolded protein response (UPR) due to ER stress
Correct Answer: A. Activation of the PI3K/Akt/mTOR pathway leading to increased
translation
Rationale: Cardiac myocytes respond to increased workload by undergoing
hypertrophy, which is driven by the PI3K/Akt/mTOR pathway that enhances protein
synthesis. p53 activation would promote apoptosis or senescence, not hypertrophy.
Caspase activation leads to apoptosis.
Question 8
Which of the following is the hallmark of reversible cellular injury?
A. Nuclear pyknosis
B. Cellular swelling
C. Karyorrhexis
D. Apoptosis
Correct Answer: B. Cellular swelling
Rationale: Reversible injury often involves failure of ion pumps leading to water influx
and cell swelling. This occurs before irreversible changes like nuclear pyknosis
(condensation) or karyorrhexis (fragmentation).
