SCI 225
Pathophysiology — Midterm Exam
Nightingale College
100 Questions with Correct Answers & Rationales
Instructions: Choose the single best answer (A, B, C, or D) for each question. The correct answer and rationale are
shown in blue.
Cellular Adaptation, Injury, and Death (Q1–15)
1. What is 'hypertrophy,' as a cellular adaptation?
A) An increase in the number of cells
B) An increase in the size of individual cells
C) A decrease in cell size
D) A change from one mature cell type to another
Rationale: Hypertrophy is an increase in individual cell size, often in response to increased workload (e.g.,
cardiac muscle hypertrophy in hypertension).
2. What is 'hyperplasia,' as a cellular adaptation?
A) An increase in the number of cells in a tissue
B) An increase in cell size only
C) A decrease in cell size
D) Cell death
Rationale: Hyperplasia refers to an increase in the number of cells, which can be a normal or pathologic
response to a stimulus.
3. What is 'atrophy'?
A) A decrease in cell size and function due to decreased workload, disuse, or reduced stimulation
B) An increase in cell number
C) A conversion of one cell type to another
D) Programmed cell death
Rationale: Atrophy is a reduction in cell size and function, commonly resulting from disuse, decreased blood
supply, or reduced hormonal stimulation.
4. What is 'metaplasia'?
A) The reversible replacement of one mature cell type with another mature cell type
B) Irreversible cell death
C) An increase in cell size
D) A benign tumor formation
Rationale: Metaplasia is an adaptive, generally reversible change in which one differentiated cell type is
replaced by another, often in response to chronic irritation.
5. What is the key difference between reversible and irreversible cell injury?
A) Reversible injury allows the cell to recover once the stressor is removed; irreversible injury leads to
cell death
B) There is no meaningful difference between the two
, C) Irreversible injury always resolves spontaneously
D) Reversible injury always leads to necrosis
Rationale: Reversible cell injury involves functional/structural changes that can be resolved if the injurious
stimulus is removed, whereas irreversible injury progresses to cell death.
6. What is 'necrosis'?
A) Uncontrolled, pathologic cell death that triggers an inflammatory response
B) A normal, programmed process of cell death
C) An adaptive increase in cell size
D) A benign growth
Rationale: Necrosis is unregulated cell death resulting from injury, characterized by cell swelling, membrane
rupture, and an associated inflammatory response.
7. What is 'apoptosis'?
A) Programmed, regulated cell death that does not typically provoke inflammation
B) An accidental, uncontrolled form of cell death
C) A type of cellular hypertrophy
D) A benign tumor
Rationale: Apoptosis is a genetically programmed, energy-dependent process of cell death that removes
damaged or unneeded cells in an orderly fashion without triggering significant inflammation.
8. What is the most common cause of reversible and irreversible cell injury in clinical practice?
A) Hypoxia (oxygen deprivation)
B) Excess vitamin intake
C) Increased physical activity
D) Normal aging alone
Rationale: Hypoxia, often resulting from ischemia (reduced blood flow), is one of the most common causes of
cell injury, as cells depend on oxygen for ATP production.
9. What is 'ischemia'?
A) A reduction in blood supply to a tissue, leading to oxygen and nutrient deprivation
B) An increase in blood supply to a tissue
C) A type of programmed cell death
D) A benign neoplasm
Rationale: Ischemia refers to inadequate blood flow to a tissue, which deprives cells of oxygen and nutrients
and can lead to cell injury or death if prolonged.
10. What type of necrosis is characteristic of ischemic injury in solid organs such as the kidney or heart?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
Rationale: Coagulative necrosis, in which the tissue architecture is preserved for a time despite cell death, is
classic for ischemic injury in solid organs like the heart and kidney.
11. What type of necrosis is characteristic of brain tissue injury (e.g., stroke)?
A) Liquefactive necrosis
B) Coagulative necrosis
C) Fat necrosis
D) Gangrenous necrosis
, Rationale: Liquefactive necrosis, involving digestion of dead cells into a liquid viscous mass, is characteristic
of brain tissue injury due to its high lipid content and enzyme activity.
12. What is a 'free radical,' and how does it contribute to cell injury?
A) A highly reactive molecule with an unpaired electron that can damage cell membranes, proteins, and
DNA
B) A stable, inert molecule with no clinical significance
C) A type of hormone
D) A type of white blood cell
Rationale: Free radicals are unstable, highly reactive molecules that can cause oxidative damage to lipids,
proteins, and DNA, contributing to cell injury.
13. What is the role of antioxidants (e.g., vitamins C and E) in relation to free radical injury?
A) They help neutralize free radicals and reduce oxidative cell damage
B) They increase free radical production
C) They have no biological effect on free radicals
D) They cause cell injury directly
Rationale: Antioxidants help neutralize free radicals, reducing the oxidative damage they can cause to cellular
structures.
14. What intracellular change is an early, reversible sign of hypoxic cell injury?
A) Cellular swelling due to failure of the ATP-dependent sodium-potassium pump
B) Complete nuclear dissolution
C) Permanent membrane rupture
D) Irreversible mitochondrial destruction
Rationale: Early hypoxic injury impairs ATP production, causing the sodium-potassium pump to fail, leading
to intracellular sodium and water accumulation (cellular swelling), which is reversible if oxygen is restored.
15. What is 'gangrene,' and what are its two primary types?
A) Tissue necrosis with superimposed putrefaction, classified as dry (coagulative) or wet (with bacterial
infection/liquefaction)
B) A type of benign tumor
C) A reversible form of cell injury
D) A normal healing process
Rationale: Gangrene refers to extensive tissue necrosis, often from ischemia; dry gangrene involves
coagulative necrosis, while wet gangrene involves superimposed bacterial infection and liquefaction.
Genetics and Genetic Disorders (Q16–25)
16. What is the difference between a genotype and a phenotype?
A) Genotype is an individual's genetic makeup; phenotype is the observable expression of that genetic
makeup
B) Genotype and phenotype are identical concepts
C) Phenotype refers only to genetic makeup
D) Genotype refers only to physical traits
Rationale: Genotype is the specific genetic constitution of an individual, while phenotype is the observable
physical or biochemical expression resulting from that genotype (and environmental interaction).
17. What inheritance pattern requires only one copy of a mutated gene from either parent to cause the disorder?
A) Autosomal dominant
B) Autosomal recessive
Pathophysiology — Midterm Exam
Nightingale College
100 Questions with Correct Answers & Rationales
Instructions: Choose the single best answer (A, B, C, or D) for each question. The correct answer and rationale are
shown in blue.
Cellular Adaptation, Injury, and Death (Q1–15)
1. What is 'hypertrophy,' as a cellular adaptation?
A) An increase in the number of cells
B) An increase in the size of individual cells
C) A decrease in cell size
D) A change from one mature cell type to another
Rationale: Hypertrophy is an increase in individual cell size, often in response to increased workload (e.g.,
cardiac muscle hypertrophy in hypertension).
2. What is 'hyperplasia,' as a cellular adaptation?
A) An increase in the number of cells in a tissue
B) An increase in cell size only
C) A decrease in cell size
D) Cell death
Rationale: Hyperplasia refers to an increase in the number of cells, which can be a normal or pathologic
response to a stimulus.
3. What is 'atrophy'?
A) A decrease in cell size and function due to decreased workload, disuse, or reduced stimulation
B) An increase in cell number
C) A conversion of one cell type to another
D) Programmed cell death
Rationale: Atrophy is a reduction in cell size and function, commonly resulting from disuse, decreased blood
supply, or reduced hormonal stimulation.
4. What is 'metaplasia'?
A) The reversible replacement of one mature cell type with another mature cell type
B) Irreversible cell death
C) An increase in cell size
D) A benign tumor formation
Rationale: Metaplasia is an adaptive, generally reversible change in which one differentiated cell type is
replaced by another, often in response to chronic irritation.
5. What is the key difference between reversible and irreversible cell injury?
A) Reversible injury allows the cell to recover once the stressor is removed; irreversible injury leads to
cell death
B) There is no meaningful difference between the two
, C) Irreversible injury always resolves spontaneously
D) Reversible injury always leads to necrosis
Rationale: Reversible cell injury involves functional/structural changes that can be resolved if the injurious
stimulus is removed, whereas irreversible injury progresses to cell death.
6. What is 'necrosis'?
A) Uncontrolled, pathologic cell death that triggers an inflammatory response
B) A normal, programmed process of cell death
C) An adaptive increase in cell size
D) A benign growth
Rationale: Necrosis is unregulated cell death resulting from injury, characterized by cell swelling, membrane
rupture, and an associated inflammatory response.
7. What is 'apoptosis'?
A) Programmed, regulated cell death that does not typically provoke inflammation
B) An accidental, uncontrolled form of cell death
C) A type of cellular hypertrophy
D) A benign tumor
Rationale: Apoptosis is a genetically programmed, energy-dependent process of cell death that removes
damaged or unneeded cells in an orderly fashion without triggering significant inflammation.
8. What is the most common cause of reversible and irreversible cell injury in clinical practice?
A) Hypoxia (oxygen deprivation)
B) Excess vitamin intake
C) Increased physical activity
D) Normal aging alone
Rationale: Hypoxia, often resulting from ischemia (reduced blood flow), is one of the most common causes of
cell injury, as cells depend on oxygen for ATP production.
9. What is 'ischemia'?
A) A reduction in blood supply to a tissue, leading to oxygen and nutrient deprivation
B) An increase in blood supply to a tissue
C) A type of programmed cell death
D) A benign neoplasm
Rationale: Ischemia refers to inadequate blood flow to a tissue, which deprives cells of oxygen and nutrients
and can lead to cell injury or death if prolonged.
10. What type of necrosis is characteristic of ischemic injury in solid organs such as the kidney or heart?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
Rationale: Coagulative necrosis, in which the tissue architecture is preserved for a time despite cell death, is
classic for ischemic injury in solid organs like the heart and kidney.
11. What type of necrosis is characteristic of brain tissue injury (e.g., stroke)?
A) Liquefactive necrosis
B) Coagulative necrosis
C) Fat necrosis
D) Gangrenous necrosis
, Rationale: Liquefactive necrosis, involving digestion of dead cells into a liquid viscous mass, is characteristic
of brain tissue injury due to its high lipid content and enzyme activity.
12. What is a 'free radical,' and how does it contribute to cell injury?
A) A highly reactive molecule with an unpaired electron that can damage cell membranes, proteins, and
DNA
B) A stable, inert molecule with no clinical significance
C) A type of hormone
D) A type of white blood cell
Rationale: Free radicals are unstable, highly reactive molecules that can cause oxidative damage to lipids,
proteins, and DNA, contributing to cell injury.
13. What is the role of antioxidants (e.g., vitamins C and E) in relation to free radical injury?
A) They help neutralize free radicals and reduce oxidative cell damage
B) They increase free radical production
C) They have no biological effect on free radicals
D) They cause cell injury directly
Rationale: Antioxidants help neutralize free radicals, reducing the oxidative damage they can cause to cellular
structures.
14. What intracellular change is an early, reversible sign of hypoxic cell injury?
A) Cellular swelling due to failure of the ATP-dependent sodium-potassium pump
B) Complete nuclear dissolution
C) Permanent membrane rupture
D) Irreversible mitochondrial destruction
Rationale: Early hypoxic injury impairs ATP production, causing the sodium-potassium pump to fail, leading
to intracellular sodium and water accumulation (cellular swelling), which is reversible if oxygen is restored.
15. What is 'gangrene,' and what are its two primary types?
A) Tissue necrosis with superimposed putrefaction, classified as dry (coagulative) or wet (with bacterial
infection/liquefaction)
B) A type of benign tumor
C) A reversible form of cell injury
D) A normal healing process
Rationale: Gangrene refers to extensive tissue necrosis, often from ischemia; dry gangrene involves
coagulative necrosis, while wet gangrene involves superimposed bacterial infection and liquefaction.
Genetics and Genetic Disorders (Q16–25)
16. What is the difference between a genotype and a phenotype?
A) Genotype is an individual's genetic makeup; phenotype is the observable expression of that genetic
makeup
B) Genotype and phenotype are identical concepts
C) Phenotype refers only to genetic makeup
D) Genotype refers only to physical traits
Rationale: Genotype is the specific genetic constitution of an individual, while phenotype is the observable
physical or biochemical expression resulting from that genotype (and environmental interaction).
17. What inheritance pattern requires only one copy of a mutated gene from either parent to cause the disorder?
A) Autosomal dominant
B) Autosomal recessive
