Page 1 of 178
# TABLE OF CONTENTS
| Section | Topic | Question Numbers |
|---------|-------|------------------|
| **I** | **Cellular Adaptation & Injury** | 1–25 |
| **II** | **Fluid, Electrolyte & Acid-Base Disorders** | 26–50 |
| **III** | **Inflammation & Tissue Repair** | 51–70 |
| **IV** | **Genetics & Genetic Disorders** | 71–90 |
| **V** | **Immunology & Hypersensitivity** | 91–115 |
| **VI** | **Oncology & Neoplasia** | 116–135 |
| **VII** | **Hematologic Disorders** | 136–160 |
| **VIII** | **Cardiovascular Disorders** | 161–185 |
| **IX** | **Respiratory Disorders** | 186–205 |
| **X** | **Renal & Urinary Disorders** | 206–225 |
| **XI** | **Gastrointestinal Disorders** | 226–245 |
| **XII** | **Endocrine Disorders** | 246–260 |
| **XIII** | **Neurological & Sensory Disorders** | 261–280 |
| **XIV** | **Reproductive & Musculoskeletal Disorders** | 281–300 |
,Page 2 of 178
SECTION I: CELLULAR ADAPTATION & INJURY
**Question 1**
A 55-year-old male with a history of chronic gastroesophageal reflux disease undergoes an upper
endoscopy. Biopsy results reveal that the normal squamous epithelium of the lower esophagus
has been replaced by columnar epithelium resembling that of the stomach. Which cellular
adaptation best describes this finding?
A) Hyperplasia
B) Dysplasia
C) Metaplasia
D) Atrophy
**Correct Answer: C) Metaplasia**
**Rationale:** Metaplasia is a reversible adaptive change in which one differentiated cell type is
replaced by another mature cell type better suited to withstand environmental stress or chronic
irritation. In Barrett's esophagus, chronic acid exposure causes the normal stratified squamous
epithelium to undergo metaplastic transformation to columnar epithelium, which is more
resistant to acid injury. Hyperplasia (A) is an increase in cell number; dysplasia (B) is disordered
cellular growth with atypia; atrophy (D) is a decrease in cell size or number.
---
**Question 2**
A patient's skeletal muscle cells demonstrate an increase in both cell size and the number of
myofibrils following a consistent weight-training program. This adaptation is best classified as:
A) Hyperplasia
B) Hypertrophy
,Page 3 of 178
C) Metaplasia
D) Dysplasia
**Correct Answer: B) Hypertrophy**
**Rationale:** Hypertrophy is an increase in cell size resulting from increased synthesis of
structural proteins and organelles. Skeletal muscle cells, which are terminally differentiated and
cannot undergo mitosis, respond to increased workload through hypertrophy. Hyperplasia (A)
involves an increase in cell number; metaplasia (C) is replacement of one cell type with another;
dysplasia (D) is abnormal cellular growth.
---
**Question 3**
A 45-year-old female with a history of chronic iron deficiency anemia presents with spoon-
shaped nails and fatigue. Laboratory evaluation reveals microcytic, hypochromic anemia. The
bone marrow biopsy would most likely show:
A) Decreased erythropoiesis
B) Hyperplastic erythroid precursors
C) Megaloblastic changes
D) Aplastic marrow
**Correct Answer: B) Hyperplastic erythroid precursors**
**Rationale:** In iron deficiency anemia, the bone marrow responds to decreased hemoglobin
production by increasing erythroid precursor proliferation (erythroid hyperplasia). This is a
compensatory hyperplasia in response to erythropoietin stimulation. Decreased erythropoiesis
(A) would be seen in aplastic anemia; megaloblastic changes (C) are seen in B12/folate
deficiency; aplastic marrow (D) is seen in aplastic anemia.
, Page 4 of 178
**Question 4**
A 60-year-old male with a history of benign prostatic hyperplasia develops acute urinary
retention. The bladder wall shows thickening and increased muscle mass. This represents which
type of cellular adaptation?
A) Physiologic hypertrophy
B) Pathologic hypertrophy
C) Physiologic hyperplasia
D) Pathologic metaplasia
**Correct Answer: B) Pathologic hypertrophy**
**Rationale:** Pathologic hypertrophy occurs in response to increased workload or stress that is
disease-related. The bladder smooth muscle undergoes hypertrophy in response to increased
resistance from prostatic obstruction. Physiologic hypertrophy (A) occurs in response to normal
stimuli (e.g., exercise). Hyperplasia (C) would be an increase in cell number, which is not the
primary response in this scenario. Metaplasia (D) is replacement of one cell type with another.
---
**Question 5**
Which cellular adaptation is characterized by the replacement of one mature cell type by another
mature cell type and is considered reversible upon removal of the irritating stimulus?
A) Atrophy
B) Hyperplasia
C) Metaplasia
D) Dysplasia
# TABLE OF CONTENTS
| Section | Topic | Question Numbers |
|---------|-------|------------------|
| **I** | **Cellular Adaptation & Injury** | 1–25 |
| **II** | **Fluid, Electrolyte & Acid-Base Disorders** | 26–50 |
| **III** | **Inflammation & Tissue Repair** | 51–70 |
| **IV** | **Genetics & Genetic Disorders** | 71–90 |
| **V** | **Immunology & Hypersensitivity** | 91–115 |
| **VI** | **Oncology & Neoplasia** | 116–135 |
| **VII** | **Hematologic Disorders** | 136–160 |
| **VIII** | **Cardiovascular Disorders** | 161–185 |
| **IX** | **Respiratory Disorders** | 186–205 |
| **X** | **Renal & Urinary Disorders** | 206–225 |
| **XI** | **Gastrointestinal Disorders** | 226–245 |
| **XII** | **Endocrine Disorders** | 246–260 |
| **XIII** | **Neurological & Sensory Disorders** | 261–280 |
| **XIV** | **Reproductive & Musculoskeletal Disorders** | 281–300 |
,Page 2 of 178
SECTION I: CELLULAR ADAPTATION & INJURY
**Question 1**
A 55-year-old male with a history of chronic gastroesophageal reflux disease undergoes an upper
endoscopy. Biopsy results reveal that the normal squamous epithelium of the lower esophagus
has been replaced by columnar epithelium resembling that of the stomach. Which cellular
adaptation best describes this finding?
A) Hyperplasia
B) Dysplasia
C) Metaplasia
D) Atrophy
**Correct Answer: C) Metaplasia**
**Rationale:** Metaplasia is a reversible adaptive change in which one differentiated cell type is
replaced by another mature cell type better suited to withstand environmental stress or chronic
irritation. In Barrett's esophagus, chronic acid exposure causes the normal stratified squamous
epithelium to undergo metaplastic transformation to columnar epithelium, which is more
resistant to acid injury. Hyperplasia (A) is an increase in cell number; dysplasia (B) is disordered
cellular growth with atypia; atrophy (D) is a decrease in cell size or number.
---
**Question 2**
A patient's skeletal muscle cells demonstrate an increase in both cell size and the number of
myofibrils following a consistent weight-training program. This adaptation is best classified as:
A) Hyperplasia
B) Hypertrophy
,Page 3 of 178
C) Metaplasia
D) Dysplasia
**Correct Answer: B) Hypertrophy**
**Rationale:** Hypertrophy is an increase in cell size resulting from increased synthesis of
structural proteins and organelles. Skeletal muscle cells, which are terminally differentiated and
cannot undergo mitosis, respond to increased workload through hypertrophy. Hyperplasia (A)
involves an increase in cell number; metaplasia (C) is replacement of one cell type with another;
dysplasia (D) is abnormal cellular growth.
---
**Question 3**
A 45-year-old female with a history of chronic iron deficiency anemia presents with spoon-
shaped nails and fatigue. Laboratory evaluation reveals microcytic, hypochromic anemia. The
bone marrow biopsy would most likely show:
A) Decreased erythropoiesis
B) Hyperplastic erythroid precursors
C) Megaloblastic changes
D) Aplastic marrow
**Correct Answer: B) Hyperplastic erythroid precursors**
**Rationale:** In iron deficiency anemia, the bone marrow responds to decreased hemoglobin
production by increasing erythroid precursor proliferation (erythroid hyperplasia). This is a
compensatory hyperplasia in response to erythropoietin stimulation. Decreased erythropoiesis
(A) would be seen in aplastic anemia; megaloblastic changes (C) are seen in B12/folate
deficiency; aplastic marrow (D) is seen in aplastic anemia.
, Page 4 of 178
**Question 4**
A 60-year-old male with a history of benign prostatic hyperplasia develops acute urinary
retention. The bladder wall shows thickening and increased muscle mass. This represents which
type of cellular adaptation?
A) Physiologic hypertrophy
B) Pathologic hypertrophy
C) Physiologic hyperplasia
D) Pathologic metaplasia
**Correct Answer: B) Pathologic hypertrophy**
**Rationale:** Pathologic hypertrophy occurs in response to increased workload or stress that is
disease-related. The bladder smooth muscle undergoes hypertrophy in response to increased
resistance from prostatic obstruction. Physiologic hypertrophy (A) occurs in response to normal
stimuli (e.g., exercise). Hyperplasia (C) would be an increase in cell number, which is not the
primary response in this scenario. Metaplasia (D) is replacement of one cell type with another.
---
**Question 5**
Which cellular adaptation is characterized by the replacement of one mature cell type by another
mature cell type and is considered reversible upon removal of the irritating stimulus?
A) Atrophy
B) Hyperplasia
C) Metaplasia
D) Dysplasia
