2026-2027 WGU D236 Pathophysiology OA V2 –
Complete Practice Questions with Rationales
Question 1: A patient with chronic alcohol abuse develops liver cirrhosis.
The liver tissue shows extensive scarring and nodule formation. This is best
described as:
A) Regeneration
B) Repair by fibrosis
C) Resolution
D) Hyperplasia
Correct Answer: B) Repair by fibrosis
Rationale: Fibrosis is the replacement of damaged tissue with collagenous
scar tissue when regeneration is not possible. In cirrhosis, chronic liver injury
leads to extensive fibrosis and nodular regeneration. Resolution involves
complete restoration of normal tissue architecture, which does not occur in
cirrhosis.
Question 2: Which of the following cellular changes is considered an
adaptive response to chronic ischemia?
A) Atrophy
B) Necrosis
C) Apoptosis
D) Fatty change
Correct Answer: A) Atrophy
,Rationale: Atrophy is a decrease in cell size and function in response to
decreased workload, nutrition, or blood supply (ischemia). It is an adaptive
change that allows cells to survive under reduced oxygen and nutrient
conditions. Necrosis and apoptosis are forms of cell death, not adaptation.
Question 3: A patient's wound shows excessive granulation tissue that
extends above the wound edges. This is known as:
A) Hypertrophic scar
B) Keloid
C) Proud flesh
D) Contracture
Correct Answer: C) Proud flesh
Rationale: Proud flesh (exuberant granulation tissue) occurs when
granulation tissue grows excessively above the wound surface, preventing
epithelialization. Hypertrophic scars and keloids are excessive collagen
deposition during maturation. Contractures are scarring that leads to tissue
shortening and deformity.
Question 4: A patient with a parasitic infection has an elevated eosinophil
count. This is an example of:
A) Innate immunity
B) Humoral immunity
C) Cell-mediated immunity
D) Passive immunity
Correct Answer: A) Innate immunity
,Rationale: Eosinophilia in response to parasitic infections is part of the innate
immune response. Eosinophils release toxic granule proteins to kill parasites.
Humoral and cell-mediated immunity are components of adaptive immunity.
Passive immunity involves transfer of antibodies from another source.
Question 5: A patient develops a fever after receiving a blood transfusion.
This is most likely due to:
A) Type I hypersensitivity
B) Type II hypersensitivity
C) Type III hypersensitivity
D) Type IV hypersensitivity
Correct Answer: B) Type II hypersensitivity
Rationale: Transfusion reactions are Type II hypersensitivity reactions
mediated by antibodies (IgM or IgG) against RBC antigens, leading to
complement activation and hemolysis. Type I is IgE-mediated (anaphylaxis),
Type III is immune complex-mediated, and Type IV is T-cell mediated.
Question 6: A patient with a known allergy to penicillin develops hives and
wheezing after receiving the drug. This reaction is mediated by:
A) T lymphocytes
B) Macrophages
C) Mast cell degranulation
D) Complement activation
Correct Answer: C) Mast cell degranulation
Rationale: Penicillin allergy is a Type I hypersensitivity reaction. Penicillin-
specific IgE binds to mast cells, causing degranulation and release of
, histamine and other mediators, leading to hives, wheezing, and potentially
anaphylaxis. T cells, macrophages, and complement are involved in other
hypersensitivity types.
Question 7: A patient with tuberculosis develops a granuloma in the lung.
The granuloma is primarily composed of:
A) Neutrophils and lymphocytes
B) Epithelioid macrophages and multinucleated giant cells
C) Plasma cells and eosinophils
D) Basophils and mast cells
Correct Answer: B) Epithelioid macrophages and multinucleated giant
cells
Rationale: Granulomas are organized collections of epithelioid macrophages
(activated macrophages) and multinucleated giant cells (formed by fusion of
macrophages). They form in response to persistent pathogens like
Mycobacterium tuberculosis. Neutrophils are associated with acute
inflammation, eosinophils with parasitic infections.
Question 8: Which of the following cytokines is primarily responsible for
the recruitment of neutrophils to the site of infection?
A) Interleukin-4
B) Interleukin-8 (CXCL8)
C) Tumor necrosis factor-beta
D) Interferon-alpha
Correct Answer: B) Interleukin-8 (CXCL8)
Complete Practice Questions with Rationales
Question 1: A patient with chronic alcohol abuse develops liver cirrhosis.
The liver tissue shows extensive scarring and nodule formation. This is best
described as:
A) Regeneration
B) Repair by fibrosis
C) Resolution
D) Hyperplasia
Correct Answer: B) Repair by fibrosis
Rationale: Fibrosis is the replacement of damaged tissue with collagenous
scar tissue when regeneration is not possible. In cirrhosis, chronic liver injury
leads to extensive fibrosis and nodular regeneration. Resolution involves
complete restoration of normal tissue architecture, which does not occur in
cirrhosis.
Question 2: Which of the following cellular changes is considered an
adaptive response to chronic ischemia?
A) Atrophy
B) Necrosis
C) Apoptosis
D) Fatty change
Correct Answer: A) Atrophy
,Rationale: Atrophy is a decrease in cell size and function in response to
decreased workload, nutrition, or blood supply (ischemia). It is an adaptive
change that allows cells to survive under reduced oxygen and nutrient
conditions. Necrosis and apoptosis are forms of cell death, not adaptation.
Question 3: A patient's wound shows excessive granulation tissue that
extends above the wound edges. This is known as:
A) Hypertrophic scar
B) Keloid
C) Proud flesh
D) Contracture
Correct Answer: C) Proud flesh
Rationale: Proud flesh (exuberant granulation tissue) occurs when
granulation tissue grows excessively above the wound surface, preventing
epithelialization. Hypertrophic scars and keloids are excessive collagen
deposition during maturation. Contractures are scarring that leads to tissue
shortening and deformity.
Question 4: A patient with a parasitic infection has an elevated eosinophil
count. This is an example of:
A) Innate immunity
B) Humoral immunity
C) Cell-mediated immunity
D) Passive immunity
Correct Answer: A) Innate immunity
,Rationale: Eosinophilia in response to parasitic infections is part of the innate
immune response. Eosinophils release toxic granule proteins to kill parasites.
Humoral and cell-mediated immunity are components of adaptive immunity.
Passive immunity involves transfer of antibodies from another source.
Question 5: A patient develops a fever after receiving a blood transfusion.
This is most likely due to:
A) Type I hypersensitivity
B) Type II hypersensitivity
C) Type III hypersensitivity
D) Type IV hypersensitivity
Correct Answer: B) Type II hypersensitivity
Rationale: Transfusion reactions are Type II hypersensitivity reactions
mediated by antibodies (IgM or IgG) against RBC antigens, leading to
complement activation and hemolysis. Type I is IgE-mediated (anaphylaxis),
Type III is immune complex-mediated, and Type IV is T-cell mediated.
Question 6: A patient with a known allergy to penicillin develops hives and
wheezing after receiving the drug. This reaction is mediated by:
A) T lymphocytes
B) Macrophages
C) Mast cell degranulation
D) Complement activation
Correct Answer: C) Mast cell degranulation
Rationale: Penicillin allergy is a Type I hypersensitivity reaction. Penicillin-
specific IgE binds to mast cells, causing degranulation and release of
, histamine and other mediators, leading to hives, wheezing, and potentially
anaphylaxis. T cells, macrophages, and complement are involved in other
hypersensitivity types.
Question 7: A patient with tuberculosis develops a granuloma in the lung.
The granuloma is primarily composed of:
A) Neutrophils and lymphocytes
B) Epithelioid macrophages and multinucleated giant cells
C) Plasma cells and eosinophils
D) Basophils and mast cells
Correct Answer: B) Epithelioid macrophages and multinucleated giant
cells
Rationale: Granulomas are organized collections of epithelioid macrophages
(activated macrophages) and multinucleated giant cells (formed by fusion of
macrophages). They form in response to persistent pathogens like
Mycobacterium tuberculosis. Neutrophils are associated with acute
inflammation, eosinophils with parasitic infections.
Question 8: Which of the following cytokines is primarily responsible for
the recruitment of neutrophils to the site of infection?
A) Interleukin-4
B) Interleukin-8 (CXCL8)
C) Tumor necrosis factor-beta
D) Interferon-alpha
Correct Answer: B) Interleukin-8 (CXCL8)
