WGU D115 ADVANCED PATHOPHYSIOLOGY OA
EXAM QUESTIONS AND CORRECT ANSWERS
WITH DETAILED RATIONALES
CELLULAR PATHOPHYSIOLOGY & ADAPTATION (Questions 1–50)
1. Which mechanism is primarily responsible for cellular swelling in early
hypoxic injury?
A. Increased ATP production
B. Failure of Na⁺/K⁺ ATPase pump
C. Increased protein synthesis
D. Mitochondrial DNA replication
Answer: B
Rationale: Hypoxia decreases ATP production, leading to failure of the Na⁺/K⁺
ATPase pump. Sodium accumulates inside the cell, water follows, causing
cellular swelling (hydropic change).
2. Which cellular adaptation is most likely to occur in the left ventricle due to
chronic hypertension?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
,D. Metaplasia
Answer: B
Rationale: Hypertrophy is the increase in cell size seen in cardiac muscle as it
works harder against high afterload from hypertension. Cardiac myocytes
cannot significantly divide, so the heart compensates by increasing cell size
rather than cell number.
3. A patient with COPD develops rightsided heart failure. Which cellular
adaptation most likely occurred in the right ventricle?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Answer: B
Rationale: The right ventricle undergoes hypertrophy in response to
increased workload from pulmonary hypertension caused by COPD. The
increased pressure in the pulmonary vasculature forces the right ventricle to
work harder, leading to an increase in myocardial cell size.
4. Which best describes the difference between necrosis and apoptosis?
A. Necrosis is programmed cell death; apoptosis is unprogrammed
,B. Necrosis involves cell shrinkage; apoptosis involves cell swelling
C. Necrosis is always pathological; apoptosis is always physiological
D. Necrosis causes inflammation; apoptosis does not typically cause
inflammation
Answer: D
Rationale: Necrosis is unprogrammed cell death resulting from injury, causing
cellular swelling, membrane rupture, and inflammation. Apoptosis is
programmed cell death with cell shrinkage, membrane blebbing, and
phagocytosis without inflammation.
5. Which type of cellular adaptation involves the replacement of one mature
cell type with another?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Answer: D
Rationale: Metaplasia is the reversible replacement of one differentiated cell
type with another mature cell type, often in response to chronic irritation or
inflammation.
, 6. What is the most common cause of cellular injury leading to hypoxia?
A. Bacterial infection
B. Ischemia
C. Genetic mutation
D. Autoimmune response
Answer: B
Rationale: Ischemia (reduced blood flow) is the most common cause of
hypoxia and cellular injury, depriving cells of oxygen and nutrients needed for
ATP production.
7. Reperfusion injury is caused by which mechanism?
A. Increased ATP production
B. Generation of reactive oxygen species
C. Decreased intracellular calcium
D. Activation of DNA repair enzymes
Answer: B
Rationale: Upon restoration of blood flow, reactive oxygen species (free
radicals) are generated, causing additional cellular damage beyond the initial
ischemic injury.
EXAM QUESTIONS AND CORRECT ANSWERS
WITH DETAILED RATIONALES
CELLULAR PATHOPHYSIOLOGY & ADAPTATION (Questions 1–50)
1. Which mechanism is primarily responsible for cellular swelling in early
hypoxic injury?
A. Increased ATP production
B. Failure of Na⁺/K⁺ ATPase pump
C. Increased protein synthesis
D. Mitochondrial DNA replication
Answer: B
Rationale: Hypoxia decreases ATP production, leading to failure of the Na⁺/K⁺
ATPase pump. Sodium accumulates inside the cell, water follows, causing
cellular swelling (hydropic change).
2. Which cellular adaptation is most likely to occur in the left ventricle due to
chronic hypertension?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
,D. Metaplasia
Answer: B
Rationale: Hypertrophy is the increase in cell size seen in cardiac muscle as it
works harder against high afterload from hypertension. Cardiac myocytes
cannot significantly divide, so the heart compensates by increasing cell size
rather than cell number.
3. A patient with COPD develops rightsided heart failure. Which cellular
adaptation most likely occurred in the right ventricle?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Answer: B
Rationale: The right ventricle undergoes hypertrophy in response to
increased workload from pulmonary hypertension caused by COPD. The
increased pressure in the pulmonary vasculature forces the right ventricle to
work harder, leading to an increase in myocardial cell size.
4. Which best describes the difference between necrosis and apoptosis?
A. Necrosis is programmed cell death; apoptosis is unprogrammed
,B. Necrosis involves cell shrinkage; apoptosis involves cell swelling
C. Necrosis is always pathological; apoptosis is always physiological
D. Necrosis causes inflammation; apoptosis does not typically cause
inflammation
Answer: D
Rationale: Necrosis is unprogrammed cell death resulting from injury, causing
cellular swelling, membrane rupture, and inflammation. Apoptosis is
programmed cell death with cell shrinkage, membrane blebbing, and
phagocytosis without inflammation.
5. Which type of cellular adaptation involves the replacement of one mature
cell type with another?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Answer: D
Rationale: Metaplasia is the reversible replacement of one differentiated cell
type with another mature cell type, often in response to chronic irritation or
inflammation.
, 6. What is the most common cause of cellular injury leading to hypoxia?
A. Bacterial infection
B. Ischemia
C. Genetic mutation
D. Autoimmune response
Answer: B
Rationale: Ischemia (reduced blood flow) is the most common cause of
hypoxia and cellular injury, depriving cells of oxygen and nutrients needed for
ATP production.
7. Reperfusion injury is caused by which mechanism?
A. Increased ATP production
B. Generation of reactive oxygen species
C. Decreased intracellular calcium
D. Activation of DNA repair enzymes
Answer: B
Rationale: Upon restoration of blood flow, reactive oxygen species (free
radicals) are generated, causing additional cellular damage beyond the initial
ischemic injury.
