Page 1 of 81
D115 - ADVANCED PATHOPHYSIOLOGY-
PRACTICE QUESTIONS WITH RADICLE
RATIONALES
Nursing
Exam coverage :
• Section 1 (Q1–25): Cellular adaptation, necrosis,
neoplasia, and aging.
• Section 2 (Q26–50): Genetics, immunity,
hypersensitivity, and inflammation.
• Section 3 (Q51–75): Fluid/electrolyte balance, acid-base
disorders, and renal pathophysiology.
• Section 4 (Q76–100): Cardiovascular (ischemia, failure,
valves) and pulmonary (obstruction, embolism, ARDS).
• Section 5 (Q101–125): Endocrine disorders – thyroid,
adrenal, diabetes, pituitary, and calcium metabolism.
• Section 6 (Q126–150): Neurological (stroke, Parkinson's,
MS), musculoskeletal (disc, osteoporosis), and
hematologic (anemias, coagulation, myeloproliferative).
Section 1: Cellular Pathophysiology & Adaptation (Questions
1–25)
, Page 2 of 81
Question 1
A 68-year-old male with chronic alcohol use presents with
peripheral edema and jaundice. Liver biopsy shows hepatocyte
swelling with intracellular fat droplets and Mallory bodies.
Which cellular adaptation best explains the initial stage of this
pathological process?
A. Hyperplasia
B. Metaplasia
C. Steatosis
D. Dystrophic calcification
CORRECT ANSWER: C. Steatosis
RATIONALE: Steatosis (fatty change) is the reversible
accumulation of triglycerides within parenchymal cells,
commonly induced by alcohol toxicity. It represents an adaptive
response to cellular stress before irreversible injury occurs.
Question 2
A researcher studies a cell line that exhibits uncontrolled
proliferation, loss of contact inhibition, and ability to invade
adjacent tissues. These cells are most likely characterized by
which genetic alteration?
A. Activation of tumor suppressor genes
B. Overexpression of proto-oncogenes converting to oncogenes
C. Increased activity of DNA repair enzymes
D. Downregulation of telomerase activity
CORRECT ANSWER: B. Overexpression of proto-oncogenes
converting to oncogenes
, Page 3 of 81
RATIONALE: Proto-oncogenes regulate normal cell growth;
when mutated or overexpressed, they become oncogenes that
drive malignant transformation, leading to uncontrolled
proliferation and invasion.
Question 3
A 52-year-old female is found to have a BRCA1 gene mutation
during routine screening. This mutation increases her risk for
breast and ovarian cancer because BRCA1 normally functions
in which critical cellular process?
A. Apoptosis regulation
B. Homologous recombination DNA repair
C. Cell cycle checkpoint activation at G1/S
D. Angiogenesis inhibition
CORRECT ANSWER: B. Homologous recombination DNA repair
RATIONALE: BRCA1 is essential for homologous recombination
repair of double-strand DNA breaks. Loss of this function leads
to genomic instability and increased cancer susceptibility.
Question 4
A pathologist examines a tissue section and notes cells with
enlarged, hyperchromatic nuclei, prominent nucleoli, and a high
nuclear-to-cytoplasmic ratio. These microscopic features are
most consistent with which diagnosis?
A. Benign adenoma
B. Dysplasia
C. Necrosis
D. Malignant neoplasia
, Page 4 of 81
CORRECT ANSWER: D. Malignant neoplasia
RATIONALE: Malignant cells exhibit anaplasia – pleomorphism,
hyperchromasia, prominent nucleoli, and high N/C ratio –
distinguishing them from benign or dysplastic cells.
Question 5
Which of the following best describes the mechanism by which
p53 functions as a tumor suppressor in response to DNA
damage?
A. It promotes DNA replication to repair the damage quickly
B. It induces cell cycle arrest at G1/S and activates DNA repair
or triggers apoptosis
C. It inhibits the expression of pro-apoptotic BAX proteins
D. It enhances telomerase activity to prevent chromosomal
shortening
CORRECT ANSWER: B. It induces cell cycle arrest at G1/S and
activates DNA repair or triggers apoptosis
RATIONALE: The p53 protein acts as a transcription factor that
upregulates p21 (causing G1 arrest) and pro-apoptotic genes
(BAX, PUMA), allowing repair or elimination of damaged cells.
Question 6
A 45-year-old male with a family history of colorectal cancer is
found to have an APC gene mutation. The loss of APC function
most directly leads to carcinogenesis through which pathway?
A. Activation of the RAS-MAPK signaling cascade
B. Stabilization and accumulation of β-catenin in the nucleus
C. Inhibition of transforming growth factor-β (TGF-β) signaling
D115 - ADVANCED PATHOPHYSIOLOGY-
PRACTICE QUESTIONS WITH RADICLE
RATIONALES
Nursing
Exam coverage :
• Section 1 (Q1–25): Cellular adaptation, necrosis,
neoplasia, and aging.
• Section 2 (Q26–50): Genetics, immunity,
hypersensitivity, and inflammation.
• Section 3 (Q51–75): Fluid/electrolyte balance, acid-base
disorders, and renal pathophysiology.
• Section 4 (Q76–100): Cardiovascular (ischemia, failure,
valves) and pulmonary (obstruction, embolism, ARDS).
• Section 5 (Q101–125): Endocrine disorders – thyroid,
adrenal, diabetes, pituitary, and calcium metabolism.
• Section 6 (Q126–150): Neurological (stroke, Parkinson's,
MS), musculoskeletal (disc, osteoporosis), and
hematologic (anemias, coagulation, myeloproliferative).
Section 1: Cellular Pathophysiology & Adaptation (Questions
1–25)
, Page 2 of 81
Question 1
A 68-year-old male with chronic alcohol use presents with
peripheral edema and jaundice. Liver biopsy shows hepatocyte
swelling with intracellular fat droplets and Mallory bodies.
Which cellular adaptation best explains the initial stage of this
pathological process?
A. Hyperplasia
B. Metaplasia
C. Steatosis
D. Dystrophic calcification
CORRECT ANSWER: C. Steatosis
RATIONALE: Steatosis (fatty change) is the reversible
accumulation of triglycerides within parenchymal cells,
commonly induced by alcohol toxicity. It represents an adaptive
response to cellular stress before irreversible injury occurs.
Question 2
A researcher studies a cell line that exhibits uncontrolled
proliferation, loss of contact inhibition, and ability to invade
adjacent tissues. These cells are most likely characterized by
which genetic alteration?
A. Activation of tumor suppressor genes
B. Overexpression of proto-oncogenes converting to oncogenes
C. Increased activity of DNA repair enzymes
D. Downregulation of telomerase activity
CORRECT ANSWER: B. Overexpression of proto-oncogenes
converting to oncogenes
, Page 3 of 81
RATIONALE: Proto-oncogenes regulate normal cell growth;
when mutated or overexpressed, they become oncogenes that
drive malignant transformation, leading to uncontrolled
proliferation and invasion.
Question 3
A 52-year-old female is found to have a BRCA1 gene mutation
during routine screening. This mutation increases her risk for
breast and ovarian cancer because BRCA1 normally functions
in which critical cellular process?
A. Apoptosis regulation
B. Homologous recombination DNA repair
C. Cell cycle checkpoint activation at G1/S
D. Angiogenesis inhibition
CORRECT ANSWER: B. Homologous recombination DNA repair
RATIONALE: BRCA1 is essential for homologous recombination
repair of double-strand DNA breaks. Loss of this function leads
to genomic instability and increased cancer susceptibility.
Question 4
A pathologist examines a tissue section and notes cells with
enlarged, hyperchromatic nuclei, prominent nucleoli, and a high
nuclear-to-cytoplasmic ratio. These microscopic features are
most consistent with which diagnosis?
A. Benign adenoma
B. Dysplasia
C. Necrosis
D. Malignant neoplasia
, Page 4 of 81
CORRECT ANSWER: D. Malignant neoplasia
RATIONALE: Malignant cells exhibit anaplasia – pleomorphism,
hyperchromasia, prominent nucleoli, and high N/C ratio –
distinguishing them from benign or dysplastic cells.
Question 5
Which of the following best describes the mechanism by which
p53 functions as a tumor suppressor in response to DNA
damage?
A. It promotes DNA replication to repair the damage quickly
B. It induces cell cycle arrest at G1/S and activates DNA repair
or triggers apoptosis
C. It inhibits the expression of pro-apoptotic BAX proteins
D. It enhances telomerase activity to prevent chromosomal
shortening
CORRECT ANSWER: B. It induces cell cycle arrest at G1/S and
activates DNA repair or triggers apoptosis
RATIONALE: The p53 protein acts as a transcription factor that
upregulates p21 (causing G1 arrest) and pro-apoptotic genes
(BAX, PUMA), allowing repair or elimination of damaged cells.
Question 6
A 45-year-old male with a family history of colorectal cancer is
found to have an APC gene mutation. The loss of APC function
most directly leads to carcinogenesis through which pathway?
A. Activation of the RAS-MAPK signaling cascade
B. Stabilization and accumulation of β-catenin in the nucleus
C. Inhibition of transforming growth factor-β (TGF-β) signaling
