NR507 ADVANCED PATHOPHYSIOLOGY MIDTERM EXAM: 200
QUESTIONS WITH ANSWERS AND RATIONALES
(COVERS CELLULAR ADAPTATION, INFLAMMATION, IMMUNITY,
NEOPLASIA, HEMATOLOGY, RESPIRATORY, RENAL, ENDOCRINE, AND
ACID-BASE DISORDERS)
1. A patient with chronic hypertension develops an enlarged left
ventricle. This represents which type of cellular adaptation?
A) Hyperplasia
B) Metaplasia
C) Hypertrophy
D) Dysplasia
Correct Answer: C. Hypertrophy is an increase in cell size, leading to an
increase in organ size, often in response to increased workload such as
chronic hypertension. The other options describe different cellular
changes: hyperplasia is an increase in cell number, metaplasia is a
change in cell type, and dysplasia is disordered cell growth .
2. A chronic smoker develops a change in bronchial epithelium from
ciliated columnar to stratified squamous cells. This process is termed:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Correct Answer: D. Metaplasia is a reversible change where one
differentiated cell type is replaced by another adult cell type better
,suited to withstand environmental stress or chronic irritation, such as in
a smoker's airways .
3. Which of the following is the primary mechanism of cellular injury in
a patient experiencing a myocardial infarction?
A) Free radical formation
B) Hypoxic injury due to ischemia
C) Chemical toxicity
D) Accumulation of calcium
Correct Answer: B. A myocardial infarction (heart attack) is caused by
ischemia (lack of blood flow), which leads to hypoxic injury and cell
death. The other options are other mechanisms of injury but are not
the primary cause in this scenario .
4. The earliest reversible morphologic sign of cell injury is:
A) Nuclear pyknosis
B) Cellular swelling (hydropic change)
C) Membrane blebbing
D) Mitochondrial dense bodies
Correct Answer: B. Cellular swelling, or hydropic change, is the first sign
of reversible cell injury and is caused by failure of the sodium-potassium
pump. The other changes occur with more severe or irreversible injury .
5. A biopsy shows a tumor with cells that resemble cartilage but are
malignant. This is a:
A) Carcinoma
B) Sarcoma
C) Chondrosarcoma
D) Lipoma
Correct Answer: C. A chondrosarcoma is a malignant tumor of
,mesenchymal origin that produces cartilage. Carcinomas arise from
epithelial tissue, sarcomas from connective tissue, and lipomas are
benign fatty tumors .
6. Which of the following is a characteristic feature of malignant
tumors?
A) Encapsulation
B) Well-differentiated cells
C) Slow growth
D) Invasion and metastasis
Correct Answer: D. Invasion into surrounding tissues and metastasis
(spread to distant sites) are key hallmarks of malignancy. Benign tumors
are typically encapsulated, well-differentiated, and slow-growing .
7. Which term describes a muscle cell showing a reduced ability to
function due to a decrease in cell size?
A) Dysplasia
B) Atrophy
C) Metaplasia
D) Hypertrophy
Correct Answer: B. Atrophy is a decrease in the size of cells, leading to a
reduced tissue or organ mass and function. This can result from disuse,
denervation, or decreased blood supply .
8. The function of proto-oncogenes is to:
A) Suppress tumor growth
B) Promote normal cell growth and division
C) Initiate apoptosis
D) Repair DNA damage
Correct Answer: B. Proto-oncogenes are normal genes that regulate cell
, growth and division. When mutated or overexpressed, they become
oncogenes that can drive uncontrolled cell proliferation .
9. Which of the following is a characteristic of benign tumors?
A) Anaplasia
B) High mitotic rate
C) Encapsulation
D) Metastasis
Correct Answer: C. Benign tumors are typically well-differentiated,
slow-growing, and encapsulated, meaning they are confined to a
defined capsule and do not invade surrounding tissues. Anaplasia, high
mitotic rates, and metastasis are features of malignant tumors .
10. Anaplasia in malignant tumors refers to:
A) Well-differentiated cells resembling tissue of origin
B) Lack of differentiation and loss of cellular characteristics
C) Encapsulated growth without invasion
D) Slow growth and localized spread
Correct Answer: B. Anaplasia is a hallmark of malignancy and refers to a
lack of differentiation, meaning the cells have lost the structural and
functional characteristics of their tissue of origin .
11. The "two-hit hypothesis" in cancer genetics applies to which type of
gene?
A) Proto-oncogenes
B) Tumor suppressor genes
C) Oncogenes
D) Apoptosis genes
Correct Answer: B. The two-hit hypothesis states that both alleles of a
tumor suppressor gene must be inactivated (mutated) for tumor
QUESTIONS WITH ANSWERS AND RATIONALES
(COVERS CELLULAR ADAPTATION, INFLAMMATION, IMMUNITY,
NEOPLASIA, HEMATOLOGY, RESPIRATORY, RENAL, ENDOCRINE, AND
ACID-BASE DISORDERS)
1. A patient with chronic hypertension develops an enlarged left
ventricle. This represents which type of cellular adaptation?
A) Hyperplasia
B) Metaplasia
C) Hypertrophy
D) Dysplasia
Correct Answer: C. Hypertrophy is an increase in cell size, leading to an
increase in organ size, often in response to increased workload such as
chronic hypertension. The other options describe different cellular
changes: hyperplasia is an increase in cell number, metaplasia is a
change in cell type, and dysplasia is disordered cell growth .
2. A chronic smoker develops a change in bronchial epithelium from
ciliated columnar to stratified squamous cells. This process is termed:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Correct Answer: D. Metaplasia is a reversible change where one
differentiated cell type is replaced by another adult cell type better
,suited to withstand environmental stress or chronic irritation, such as in
a smoker's airways .
3. Which of the following is the primary mechanism of cellular injury in
a patient experiencing a myocardial infarction?
A) Free radical formation
B) Hypoxic injury due to ischemia
C) Chemical toxicity
D) Accumulation of calcium
Correct Answer: B. A myocardial infarction (heart attack) is caused by
ischemia (lack of blood flow), which leads to hypoxic injury and cell
death. The other options are other mechanisms of injury but are not
the primary cause in this scenario .
4. The earliest reversible morphologic sign of cell injury is:
A) Nuclear pyknosis
B) Cellular swelling (hydropic change)
C) Membrane blebbing
D) Mitochondrial dense bodies
Correct Answer: B. Cellular swelling, or hydropic change, is the first sign
of reversible cell injury and is caused by failure of the sodium-potassium
pump. The other changes occur with more severe or irreversible injury .
5. A biopsy shows a tumor with cells that resemble cartilage but are
malignant. This is a:
A) Carcinoma
B) Sarcoma
C) Chondrosarcoma
D) Lipoma
Correct Answer: C. A chondrosarcoma is a malignant tumor of
,mesenchymal origin that produces cartilage. Carcinomas arise from
epithelial tissue, sarcomas from connective tissue, and lipomas are
benign fatty tumors .
6. Which of the following is a characteristic feature of malignant
tumors?
A) Encapsulation
B) Well-differentiated cells
C) Slow growth
D) Invasion and metastasis
Correct Answer: D. Invasion into surrounding tissues and metastasis
(spread to distant sites) are key hallmarks of malignancy. Benign tumors
are typically encapsulated, well-differentiated, and slow-growing .
7. Which term describes a muscle cell showing a reduced ability to
function due to a decrease in cell size?
A) Dysplasia
B) Atrophy
C) Metaplasia
D) Hypertrophy
Correct Answer: B. Atrophy is a decrease in the size of cells, leading to a
reduced tissue or organ mass and function. This can result from disuse,
denervation, or decreased blood supply .
8. The function of proto-oncogenes is to:
A) Suppress tumor growth
B) Promote normal cell growth and division
C) Initiate apoptosis
D) Repair DNA damage
Correct Answer: B. Proto-oncogenes are normal genes that regulate cell
, growth and division. When mutated or overexpressed, they become
oncogenes that can drive uncontrolled cell proliferation .
9. Which of the following is a characteristic of benign tumors?
A) Anaplasia
B) High mitotic rate
C) Encapsulation
D) Metastasis
Correct Answer: C. Benign tumors are typically well-differentiated,
slow-growing, and encapsulated, meaning they are confined to a
defined capsule and do not invade surrounding tissues. Anaplasia, high
mitotic rates, and metastasis are features of malignant tumors .
10. Anaplasia in malignant tumors refers to:
A) Well-differentiated cells resembling tissue of origin
B) Lack of differentiation and loss of cellular characteristics
C) Encapsulated growth without invasion
D) Slow growth and localized spread
Correct Answer: B. Anaplasia is a hallmark of malignancy and refers to a
lack of differentiation, meaning the cells have lost the structural and
functional characteristics of their tissue of origin .
11. The "two-hit hypothesis" in cancer genetics applies to which type of
gene?
A) Proto-oncogenes
B) Tumor suppressor genes
C) Oncogenes
D) Apoptosis genes
Correct Answer: B. The two-hit hypothesis states that both alleles of a
tumor suppressor gene must be inactivated (mutated) for tumor
