WGU D236 Pathophysiology OA V2 | 200 Practice
Questions & Detailed Answers | 3 Set Exams with
Rationales | A+ Graded
SET 1: Cellular Adaptation, Injury, Inflammation, Neoplasia, Genetics, Immunity, Hemodynamics
Question 1: Which cellular adaptation is characterized by an increase in the number of cells in an organ
or tissue?
A) Atrophy
B) Hypertrophy
C) Metaplasia
D) Hyperplasia
Correct Answer: D) Hyperplasia
Rationale: Hyperplasia is an increase in the number of cells resulting from an increased rate of cellular
division. This can be physiologic (e.g., breast development during puberty) or pathologic (e.g.,
endometrial hyperplasia). Atrophy is a decrease in cell size, hypertrophy is an increase in cell size, and
metaplasia is the replacement of one mature cell type by another.
Question 2: A patient with longstanding uncontrolled hypertension develops an enlarged left ventricle
on echocardiogram. Which cellular adaptation explains this finding?
A) Atrophy
B) Hypertrophy
C) Hyperplasia
,D) Metaplasia
Correct Answer: B) Hypertrophy
Rationale: Chronic pressure overload increases myocyte size (cardiac cells cannot divide), enlarging the
ventricle. This is a compensatory mechanism to meet increased workload demands. Hyperplasia
(increase in cell number) does not occur in adult myocardium.
Question 3: A chronic smoker's esophageal biopsy shows columnar epithelium replacing normal
squamous epithelium (Barrett esophagus). This change is best described as:
A) Dysplasia
B) Metaplasia
C) Hyperplasia
D) Anaplasia
Correct Answer: B) Metaplasia
Rationale: Metaplasia is the reversible substitution of a stresstolerant cell type (columnar) for squamous
epithelium under acid injury. Dysplasia is disordered, premalignant growth; anaplasia indicates lack of
differentiation characteristic of malignancy.
Question 4: Which finding indicates REVERSIBLE cell injury rather than necrosis?
A) Karyolysis
B) Pyknosis
,C) Cellular swelling
D) Karyorrhexis
Correct Answer: C) Cellular swelling
Rationale: Cellular swelling (hydropic change) from ATP depletion and Na⁺/K⁺ pump failure is reversible
if the insult resolves. Karyolysis, pyknosis, and karyorrhexis are all nuclear changes associated with
irreversible injury and cell death.
Question 5: Form of osmotic pressure exerted by proteins is called:
A) Hydrostatic pressure
B) Oncotic pressure
C) Diffusion pressure
D) Osmotic gradient
Correct Answer: B) Oncotic pressure
Rationale: Oncotic pressure (colloid osmotic pressure) is the form of osmotic pressure exerted by
proteins, primarily albumin, in the blood plasma.
Question 6: What is the effect of reduced blood supply on tissue metabolism?
A) Increased aerobic metabolism
B) Increased ATP production
C) Shift to anaerobic metabolism with increased lactate production
, D) No change in metabolic pathways
Correct Answer: C) Shift to anaerobic metabolism with increased lactate production
Rationale: When tissue perfusion is inadequate, the cell's metabolism shifts from aerobic to anaerobic,
leading to increased lactate formation, a fall in pH, and a drastic reduction in ATP production.
Question 7: A patient with prolonged tissue ischemia demonstrates severe cellular swelling, membrane
rupture, and release of intracellular enzymes into the circulation. Which mechanism most directly
explains the irreversible nature of this injury?
A) Persistent depletion of ATP leading to failure of membrane integrity
B) Increased glycolysis with preserved mitochondrial function
C) Enhanced autophagy preventing lysosomal rupture
D) Activation of adaptive hypertrophy
Correct Answer: A) Persistent depletion of ATP leading to failure of membrane integrity
Rationale: Irreversible cell injury occurs when ATP depletion becomes severe enough to disrupt
membrane integrity, allowing leakage of intracellular enzymes and ultimately resulting in necrosis.
Question 8: Which plasma protein is most responsible for maintaining plasma oncotic pressure?
A) Fibrinogen
B) Albumin
C) Globulin
Questions & Detailed Answers | 3 Set Exams with
Rationales | A+ Graded
SET 1: Cellular Adaptation, Injury, Inflammation, Neoplasia, Genetics, Immunity, Hemodynamics
Question 1: Which cellular adaptation is characterized by an increase in the number of cells in an organ
or tissue?
A) Atrophy
B) Hypertrophy
C) Metaplasia
D) Hyperplasia
Correct Answer: D) Hyperplasia
Rationale: Hyperplasia is an increase in the number of cells resulting from an increased rate of cellular
division. This can be physiologic (e.g., breast development during puberty) or pathologic (e.g.,
endometrial hyperplasia). Atrophy is a decrease in cell size, hypertrophy is an increase in cell size, and
metaplasia is the replacement of one mature cell type by another.
Question 2: A patient with longstanding uncontrolled hypertension develops an enlarged left ventricle
on echocardiogram. Which cellular adaptation explains this finding?
A) Atrophy
B) Hypertrophy
C) Hyperplasia
,D) Metaplasia
Correct Answer: B) Hypertrophy
Rationale: Chronic pressure overload increases myocyte size (cardiac cells cannot divide), enlarging the
ventricle. This is a compensatory mechanism to meet increased workload demands. Hyperplasia
(increase in cell number) does not occur in adult myocardium.
Question 3: A chronic smoker's esophageal biopsy shows columnar epithelium replacing normal
squamous epithelium (Barrett esophagus). This change is best described as:
A) Dysplasia
B) Metaplasia
C) Hyperplasia
D) Anaplasia
Correct Answer: B) Metaplasia
Rationale: Metaplasia is the reversible substitution of a stresstolerant cell type (columnar) for squamous
epithelium under acid injury. Dysplasia is disordered, premalignant growth; anaplasia indicates lack of
differentiation characteristic of malignancy.
Question 4: Which finding indicates REVERSIBLE cell injury rather than necrosis?
A) Karyolysis
B) Pyknosis
,C) Cellular swelling
D) Karyorrhexis
Correct Answer: C) Cellular swelling
Rationale: Cellular swelling (hydropic change) from ATP depletion and Na⁺/K⁺ pump failure is reversible
if the insult resolves. Karyolysis, pyknosis, and karyorrhexis are all nuclear changes associated with
irreversible injury and cell death.
Question 5: Form of osmotic pressure exerted by proteins is called:
A) Hydrostatic pressure
B) Oncotic pressure
C) Diffusion pressure
D) Osmotic gradient
Correct Answer: B) Oncotic pressure
Rationale: Oncotic pressure (colloid osmotic pressure) is the form of osmotic pressure exerted by
proteins, primarily albumin, in the blood plasma.
Question 6: What is the effect of reduced blood supply on tissue metabolism?
A) Increased aerobic metabolism
B) Increased ATP production
C) Shift to anaerobic metabolism with increased lactate production
, D) No change in metabolic pathways
Correct Answer: C) Shift to anaerobic metabolism with increased lactate production
Rationale: When tissue perfusion is inadequate, the cell's metabolism shifts from aerobic to anaerobic,
leading to increased lactate formation, a fall in pH, and a drastic reduction in ATP production.
Question 7: A patient with prolonged tissue ischemia demonstrates severe cellular swelling, membrane
rupture, and release of intracellular enzymes into the circulation. Which mechanism most directly
explains the irreversible nature of this injury?
A) Persistent depletion of ATP leading to failure of membrane integrity
B) Increased glycolysis with preserved mitochondrial function
C) Enhanced autophagy preventing lysosomal rupture
D) Activation of adaptive hypertrophy
Correct Answer: A) Persistent depletion of ATP leading to failure of membrane integrity
Rationale: Irreversible cell injury occurs when ATP depletion becomes severe enough to disrupt
membrane integrity, allowing leakage of intracellular enzymes and ultimately resulting in necrosis.
Question 8: Which plasma protein is most responsible for maintaining plasma oncotic pressure?
A) Fibrinogen
B) Albumin
C) Globulin
