Questions and correct answers with rationales 2026/2027
UNIT 1: CELLULAR ADAPTATION, INJURY, AND GENETICS
1. Which cellular adaptation is most likely to occur in the left ventricle due
to chronic hypertension?
A) Atrophy
B) Hypertrophy
C) Hyperplasia
D) Metaplasia
Answer: B) Hypertrophy
Rationale: Hypertrophy is an increase in cell size in response to increased
workload. Chronic hypertension increases the workload on the left
ventricle, causing myocardial cells to hypertrophy to meet the increased
demand. Cardiac muscle cells have limited ability to undergo hyperplasia .
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2. A patient with chronic obstructive pulmonary disease (COPD) develops
squamous metaplasia in the bronchial epithelium. Which best describes
this cellular change?
A) An increase in cell size
B) A reversible replacement of one differentiated cell type with another
,C) An increase in the number of cells
D) A decrease in cell size
Answer: B) A reversible replacement of one differentiated cell type with
another
Rationale: Metaplasia is a reversible change in which one differentiated cell
type is replaced by another. In COPD, normal ciliated columnar epithelium
is replaced by stratified squamous epithelium due to chronic irritation from
smoking .
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3. A patient with gastroesophageal reflux disease develops Barrett's
esophagus. This is an example of which cellular adaptation?
A) Hypertrophy
B) Hyperplasia
C) Metaplasia
D) Dysplasia
Answer: C) Metaplasia
Rationale: Barrett's esophagus is a metaplastic change in which normal
squamous epithelium is replaced by columnar epithelium similar to that of
the stomach or intestines in response to chronic acid exposure .
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,4. Which chromosomal abnormality is present in a child born with an extra
chromosome 21?
A) Turner syndrome (45, X)
B) Klinefelter syndrome (47, XXY)
C) Down syndrome (Trisomy 21)
D) Edwards syndrome (Trisomy 18)
Answer: C) Down syndrome (Trisomy 21)
Rationale: Down syndrome is caused by the presence of an extra copy of
chromosome 21, typically due to maternal nondisjunction during meiosis .
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5. A patient experiences prolonged myocardial ischemia resulting in
irreversible injury and cell membrane rupture. Which type of cellular death
has most likely occurred?
A) Apoptosis
B) Necrosis
C) Atrophy
D) Autophagy
Answer: B) Necrosis
, Rationale: Necrosis results from irreversible cellular injury and is
characterized by cell swelling, membrane rupture, and inflammation. This is
in contrast to apoptosis, which is programmed cell death without
inflammation .
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6. What is the genetic composition of genes?
A) RNA molecules
B) DNA segments that encode proteins
C) Lipid bilayers
D) Carbohydrate chains
Answer: B) DNA segments that encode proteins
Rationale: Genes are composed of DNA (deoxyribonucleic acid)—
segments of DNA that encode proteins .
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7. Which syndrome is characterized by a DNA deletion on chromosome 5,
presenting with a cat-like cry, microcephaly, and low birth weight?
A) Down syndrome
B) Turner syndrome
C) Cri du chat syndrome