,NR 507 Final Exam | Advanced Pathophysiology |
Chamberlain University | Q & A | 2026/2027
Edition (PDF)
1. A 52-year-old man with chronic hypertension develops left ventricular hypertrophy. This adaptive
change is best described as which of the following?
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Dysplasia
Correct Answer: Hypertrophy
Rationale: Hypertrophy is an increase in cell size due to increased workload, such as the increased
afterload from hypertension. Cardiac myocytes cannot divide, so they undergo hypertrophy rather
than hyperplasia. This is a compensatory mechanism that can eventually become maladaptive,
leading to heart failure.
2. A patient with chronic gastroesophageal reflux disease (GERD) develops squamous metaplasia of
the lower esophagus (Barrett's esophagus). This is an example of which of the following?
A) Atrophy
B) Hypertrophy
C) Hyperplasia
D) Metaplasia
Correct Answer: Metaplasia
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with another, often
due to chronic irritation. Barrett's esophagus occurs when the normal squamous epithelium of the
esophagus is replaced by columnar epithelium in response to chronic acid exposure. This condition
increases the risk for esophageal adenocarcinoma.
,3. Which of the following best describes the mechanism of cellular injury in ischemia-reperfusion
injury?
A) Direct mechanical disruption of the cell membrane
B) Generation of reactive oxygen species upon restoration of blood flow
C) Inhibition of protein synthesis by bacterial toxins
D) Activation of apoptosis via the extrinsic pathway
Correct Answer: Generation of reactive oxygen species upon restoration of blood flow
Rationale: Ischemia-reperfusion injury occurs when blood supply returns to tissue after a period of
ischemia. The reintroduction of oxygen leads to the generation of reactive oxygen species (ROS),
which cause further cellular damage through lipid peroxidation, protein oxidation, and DNA damage.
This can paradoxically worsen the injury caused by the initial ischemia.
4. A patient has a biopsy showing cells with enlarged, hyperchromatic nuclei and loss of normal tissue
architecture. These findings are most consistent with which of the following?
A) Benign hyperplasia
B) Dysplasia
C) Metaplasia
D) Atrophy
Correct Answer: Dysplasia
Rationale: Dysplasia is characterized by abnormal cellular changes including enlarged, hyperchromatic
nuclei, increased nuclear-to-cytoplasmic ratio, and loss of normal tissue architecture. While dysplasia
is not cancer, it represents a precancerous condition that may progress to malignancy if the
underlying cause is not removed.
5. A patient with chronic obstructive pulmonary disease (COPD) has been smoking for 40 years. Which
cellular adaptation is most likely occurring in the respiratory epithelium?
A) Squamous metaplasia
, B) Hyperplasia
C) Hypertrophy
D) Atrophy
Correct Answer: Squamous metaplasia
Rationale: Chronic irritation from cigarette smoke causes the normal ciliated pseudostratified
columnar epithelium of the respiratory tract to undergo squamous metaplasia. The squamous
epithelium is more resilient to irritation but loses the protective mucus-clearing function of cilia,
increasing infection risk and potentially progressing to dysplasia or carcinoma.
6. A child is diagnosed with cystic fibrosis. Which of the following best describes the underlying
pathophysiology of this disorder?
A) Deletion of a single amino acid in the CFTR protein leading to defective chloride transport
B) Excessive production of mucus due to goblet cell hyperplasia
C) Autoimmune destruction of pancreatic cells
D) Deficiency of alpha-1 antitrypsin leading to elastase activity
Correct Answer: Deletion of a single amino acid in the CFTR protein leading to defective chloride
transport
Rationale: Cystic fibrosis is caused by a mutation in the CFTR gene on chromosome 7, most commonly
a deletion of phenylalanine at position 508 (ΔF508). This results in defective chloride transport across
epithelial cell membranes, leading to thick, dehydrated secretions in the lungs, pancreas, and other
organs.
7. A patient with heart failure is found to have pulmonary congestion, peripheral edema, and jugular
venous distention. Which type of heart failure is most consistent with these findings?
A) Left-sided heart failure
B) Right-sided heart failure
C) Systolic heart failure
D) High-output heart failure
Chamberlain University | Q & A | 2026/2027
Edition (PDF)
1. A 52-year-old man with chronic hypertension develops left ventricular hypertrophy. This adaptive
change is best described as which of the following?
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Dysplasia
Correct Answer: Hypertrophy
Rationale: Hypertrophy is an increase in cell size due to increased workload, such as the increased
afterload from hypertension. Cardiac myocytes cannot divide, so they undergo hypertrophy rather
than hyperplasia. This is a compensatory mechanism that can eventually become maladaptive,
leading to heart failure.
2. A patient with chronic gastroesophageal reflux disease (GERD) develops squamous metaplasia of
the lower esophagus (Barrett's esophagus). This is an example of which of the following?
A) Atrophy
B) Hypertrophy
C) Hyperplasia
D) Metaplasia
Correct Answer: Metaplasia
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with another, often
due to chronic irritation. Barrett's esophagus occurs when the normal squamous epithelium of the
esophagus is replaced by columnar epithelium in response to chronic acid exposure. This condition
increases the risk for esophageal adenocarcinoma.
,3. Which of the following best describes the mechanism of cellular injury in ischemia-reperfusion
injury?
A) Direct mechanical disruption of the cell membrane
B) Generation of reactive oxygen species upon restoration of blood flow
C) Inhibition of protein synthesis by bacterial toxins
D) Activation of apoptosis via the extrinsic pathway
Correct Answer: Generation of reactive oxygen species upon restoration of blood flow
Rationale: Ischemia-reperfusion injury occurs when blood supply returns to tissue after a period of
ischemia. The reintroduction of oxygen leads to the generation of reactive oxygen species (ROS),
which cause further cellular damage through lipid peroxidation, protein oxidation, and DNA damage.
This can paradoxically worsen the injury caused by the initial ischemia.
4. A patient has a biopsy showing cells with enlarged, hyperchromatic nuclei and loss of normal tissue
architecture. These findings are most consistent with which of the following?
A) Benign hyperplasia
B) Dysplasia
C) Metaplasia
D) Atrophy
Correct Answer: Dysplasia
Rationale: Dysplasia is characterized by abnormal cellular changes including enlarged, hyperchromatic
nuclei, increased nuclear-to-cytoplasmic ratio, and loss of normal tissue architecture. While dysplasia
is not cancer, it represents a precancerous condition that may progress to malignancy if the
underlying cause is not removed.
5. A patient with chronic obstructive pulmonary disease (COPD) has been smoking for 40 years. Which
cellular adaptation is most likely occurring in the respiratory epithelium?
A) Squamous metaplasia
, B) Hyperplasia
C) Hypertrophy
D) Atrophy
Correct Answer: Squamous metaplasia
Rationale: Chronic irritation from cigarette smoke causes the normal ciliated pseudostratified
columnar epithelium of the respiratory tract to undergo squamous metaplasia. The squamous
epithelium is more resilient to irritation but loses the protective mucus-clearing function of cilia,
increasing infection risk and potentially progressing to dysplasia or carcinoma.
6. A child is diagnosed with cystic fibrosis. Which of the following best describes the underlying
pathophysiology of this disorder?
A) Deletion of a single amino acid in the CFTR protein leading to defective chloride transport
B) Excessive production of mucus due to goblet cell hyperplasia
C) Autoimmune destruction of pancreatic cells
D) Deficiency of alpha-1 antitrypsin leading to elastase activity
Correct Answer: Deletion of a single amino acid in the CFTR protein leading to defective chloride
transport
Rationale: Cystic fibrosis is caused by a mutation in the CFTR gene on chromosome 7, most commonly
a deletion of phenylalanine at position 508 (ΔF508). This results in defective chloride transport across
epithelial cell membranes, leading to thick, dehydrated secretions in the lungs, pancreas, and other
organs.
7. A patient with heart failure is found to have pulmonary congestion, peripheral edema, and jugular
venous distention. Which type of heart failure is most consistent with these findings?
A) Left-sided heart failure
B) Right-sided heart failure
C) Systolic heart failure
D) High-output heart failure
