Page 1 of 132
# TABLE OF CONTENTS
| Section | Topic | Questions |
|---------|-------|-----------|
| **I** | **Cellular Adaptation & Injury** | 1–30 |
| **II** | **Genetics & Developmental Disorders** | 31–50 |
| **III** | **Inflammation & Tissue Repair** | 51–70 |
| **IV** | **Immunity & Hypersensitivity Reactions** | 71–95 |
| **V** | **Fluid, Electrolyte & Acid-Base Balance** | 96–115 |
| **VI** | **Hematologic Disorders** | 116–135 |
| **VII** | **Cardiovascular Pathophysiology** | 136–160 |
| **VIII** | **Respiratory Pathophysiology** | 161–180 |
| **IX** | **Renal & Urinary System Pathologies** | 181–200 |
| **X** | **Endocrine & Metabolic Disorders** | 201–215 |
,Page 2 of 132
# SECTION I: CELLULAR ADAPTATION & INJURY
## Questions 1–30
### Question 1
A patient with long-standing uncontrolled hypertension presents with left ventricular
enlargement on echocardiogram. This represents which type of cellular adaptation?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
**Correct Answer: B) Hypertrophy**
**Rationale:** Hypertrophy is an increase in cell size leading to organ enlargement. Cardiac
muscle cells are terminally differentiated and cannot divide (hyperplasia), so they respond to
increased workload from hypertension through hypertrophy. This adaptation allows the ventricle
to generate greater contractile force to overcome the elevated afterload. The other options are
incorrect because hyperplasia involves an increase in cell number, atrophy is a decrease in cell
size, and metaplasia is the replacement of one cell type with another.
---
### Question 2
A chronic smoker develops a change in bronchial epithelium from ciliated columnar to stratified
squamous cells. This is an example of:
A) Hyperplasia
B) Hypertrophy
,Page 3 of 132
C) Atrophy
D) Metaplasia
**Correct Answer: D) Metaplasia**
**Rationale:** Metaplasia is a reversible change where one differentiated cell type is replaced
by another. The bronchial epithelium undergoes squamous metaplasia in response to chronic
irritation from cigarette smoke. This replacement provides increased protection against the
irritant but impairs mucociliary clearance. The other options do not describe a change from one
cell type to another.
---
### Question 3
Which cellular change is the earliest indicator of reversible hypoxic cell injury?
A) Nuclear fragmentation (karyorrhexis)
B) Cellular swelling (hydropic change)
C) Lysosomal rupture
D) Plasma membrane disruption
**Correct Answer: B) Cellular swelling (hydropic change)**
**Rationale:** Cellular swelling is the earliest reversible morphologic sign of cell injury.
Hypoxia impairs oxidative phosphorylation, reducing ATP available to the Na⁺/K⁺-ATPase pump.
Sodium and water accumulate intracellularly, causing swelling. Nuclear fragmentation,
lysosomal rupture, and membrane disruption are hallmarks of irreversible injury.
---
, Page 4 of 132
### Question 4
Which form of necrosis is most commonly seen following myocardial infarction?
A) Liquefactive necrosis
B) Coagulative necrosis
C) Caseous necrosis
D) Fat necrosis
**Correct Answer: B) Coagulative necrosis**
**Rationale:** Coagulative necrosis is the most common type of necrosis and occurs primarily
in solid organs such as the heart, kidney, and adrenal glands following ischemia. In myocardial
infarction, the hypoxic tissue maintains its basic structural outline for several days due to protein
denaturation, which preserves cell architecture. Liquefactive necrosis is seen in the brain,
caseous necrosis in tuberculosis, and fat necrosis in breast or pancreatic tissue.
---
### Question 5
A pathologist examining brain tissue from a patient who died of a stroke finds liquefied tissue
with a fluid-filled cavity. This occurred because:
A) The brain has high protein content that denatures during ischemia
B) The brain has high lipid content and abundant hydrolytic enzymes that completely digest
necrotic tissue
C) Bacterial infection caused enzymatic dissolution
D) Caseous material accumulated due to granulomatous inflammation
# TABLE OF CONTENTS
| Section | Topic | Questions |
|---------|-------|-----------|
| **I** | **Cellular Adaptation & Injury** | 1–30 |
| **II** | **Genetics & Developmental Disorders** | 31–50 |
| **III** | **Inflammation & Tissue Repair** | 51–70 |
| **IV** | **Immunity & Hypersensitivity Reactions** | 71–95 |
| **V** | **Fluid, Electrolyte & Acid-Base Balance** | 96–115 |
| **VI** | **Hematologic Disorders** | 116–135 |
| **VII** | **Cardiovascular Pathophysiology** | 136–160 |
| **VIII** | **Respiratory Pathophysiology** | 161–180 |
| **IX** | **Renal & Urinary System Pathologies** | 181–200 |
| **X** | **Endocrine & Metabolic Disorders** | 201–215 |
,Page 2 of 132
# SECTION I: CELLULAR ADAPTATION & INJURY
## Questions 1–30
### Question 1
A patient with long-standing uncontrolled hypertension presents with left ventricular
enlargement on echocardiogram. This represents which type of cellular adaptation?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
**Correct Answer: B) Hypertrophy**
**Rationale:** Hypertrophy is an increase in cell size leading to organ enlargement. Cardiac
muscle cells are terminally differentiated and cannot divide (hyperplasia), so they respond to
increased workload from hypertension through hypertrophy. This adaptation allows the ventricle
to generate greater contractile force to overcome the elevated afterload. The other options are
incorrect because hyperplasia involves an increase in cell number, atrophy is a decrease in cell
size, and metaplasia is the replacement of one cell type with another.
---
### Question 2
A chronic smoker develops a change in bronchial epithelium from ciliated columnar to stratified
squamous cells. This is an example of:
A) Hyperplasia
B) Hypertrophy
,Page 3 of 132
C) Atrophy
D) Metaplasia
**Correct Answer: D) Metaplasia**
**Rationale:** Metaplasia is a reversible change where one differentiated cell type is replaced
by another. The bronchial epithelium undergoes squamous metaplasia in response to chronic
irritation from cigarette smoke. This replacement provides increased protection against the
irritant but impairs mucociliary clearance. The other options do not describe a change from one
cell type to another.
---
### Question 3
Which cellular change is the earliest indicator of reversible hypoxic cell injury?
A) Nuclear fragmentation (karyorrhexis)
B) Cellular swelling (hydropic change)
C) Lysosomal rupture
D) Plasma membrane disruption
**Correct Answer: B) Cellular swelling (hydropic change)**
**Rationale:** Cellular swelling is the earliest reversible morphologic sign of cell injury.
Hypoxia impairs oxidative phosphorylation, reducing ATP available to the Na⁺/K⁺-ATPase pump.
Sodium and water accumulate intracellularly, causing swelling. Nuclear fragmentation,
lysosomal rupture, and membrane disruption are hallmarks of irreversible injury.
---
, Page 4 of 132
### Question 4
Which form of necrosis is most commonly seen following myocardial infarction?
A) Liquefactive necrosis
B) Coagulative necrosis
C) Caseous necrosis
D) Fat necrosis
**Correct Answer: B) Coagulative necrosis**
**Rationale:** Coagulative necrosis is the most common type of necrosis and occurs primarily
in solid organs such as the heart, kidney, and adrenal glands following ischemia. In myocardial
infarction, the hypoxic tissue maintains its basic structural outline for several days due to protein
denaturation, which preserves cell architecture. Liquefactive necrosis is seen in the brain,
caseous necrosis in tuberculosis, and fat necrosis in breast or pancreatic tissue.
---
### Question 5
A pathologist examining brain tissue from a patient who died of a stroke finds liquefied tissue
with a fluid-filled cavity. This occurred because:
A) The brain has high protein content that denatures during ischemia
B) The brain has high lipid content and abundant hydrolytic enzymes that completely digest
necrotic tissue
C) Bacterial infection caused enzymatic dissolution
D) Caseous material accumulated due to granulomatous inflammation
