WGU D115 Advanced Pathophysiology
Objective Assessment (OA) Exam 2026
Complete Unit 1-Unit 7 Practice Questions &
Study Guide
Key Content Areas Covered
• Unit 1: Cellular Adaptation, Injury, and Death
• Unit 2: Genetics and Congenital Disorders
• Unit 3: Inflammation and Immune Responses
• Unit 4: Fluid, Electrolyte, and Acid-Base Disorders
• Unit 5: Cardiovascular and Lymphatic Systems
• Unit 6: Respiratory, Renal, and Endocrine Systems
• Unit 7: Neurological, Gastrointestinal, and
Multisystem Disorders
, SECTION 1: CELLULAR ADAPTATION, INJURY, AND
DEATH (Questions 1-15)
1. A patient with chronic gastroesophageal reflux disease (GERD)
develops replacement of the normal stratified squamous
epithelium of the lower esophagus with columnar epithelium
containing goblet cells. This represents which type of cellular
adaptation?
A) Dysplasia
B) Metaplasia
C) Hyperplasia
D) Atrophy
Answer B: ) Metaplasia
Rationale: Metaplasia is the reversible replacement of one
differentiated cell type with another. In Barrett's esophagus, chronic
acid exposure causes the normal squamous epithelium to be replaced
by columnar epithelium with goblet cells, which is a precursor to
esophageal adenocarcinoma. Dysplasia involves disordered growth
with atypical cells, not replacement of one cell type with another. ---
2. A patient with prolonged hypoxia develops cellular swelling
characterized by membrane blebbing and dilation of the
endoplasmic reticulum. This represents which stage of cellular
injury?
A) Irreversible injury
B) Reversible injury
C) Necrosis
D) Apoptosis
,Answer B: ) Reversible injury
Rationale: Cellular swelling with ER dilation and membrane blebbing
indicates reversible injury, where mitochondrial function and ATP
production can potentially recover. If the insult continues, irreversible
injury and necrosis follow. ---
3. Which morphological feature distinguishes apoptosis from
necrosis?
A) Cellular swelling
B) Membrane lysis
C) Formation of apoptotic bodies
D) Inflammatory response
Answer C: ) Formation of apoptotic bodies
Rationale: Apoptosis features cell shrinkage, chromatin condensation,
and formation of membrane-bound apoptotic bodies that are
phagocytosed without triggering inflammation. Necrosis involves
cellular swelling, membrane lysis, and triggers an inflammatory
response. ---
4. A biopsy reveals poorly differentiated cells with
hyperchromatic nuclei and numerous mitotic figures. This
histologic appearance is best termed:
A) Metaplasia
B) Hypertrophy
C) Anaplasia
D) Dysplasia
Answer C: ) Anaplasia
, Rationale: Anaplasia is the hallmark of malignancy, characterized by
loss of cellular differentiation ("to form backward"), pleomorphism
(variation in size/shape), hyperchromatic nuclei, increased nuclear-to-
cytoplasmic ratio, atypical mitotic figures, and loss of normal tissue
architecture. ---
5. A 70-year-old woman with dementia shows brain tissue with
"tangles" of hyperphosphorylated tau protein and plaques of
amyloid-beta. These represent which type of intracellular
accumulation?
A) Glycogen storage
B) Lipofuscin accumulation
C) Protein aggregation
D) Lipid accumulation
Answer C: ) Protein aggregation
Rationale: Alzheimer's disease involves accumulation of abnormally
folded proteins: amyloid-beta plaques extracellularly and
hyperphosphorylated tau forming neurofibrillary tangles
intracellularly. ---
6. A patient with severe pancreatitis develops fat necrosis with
saponification. This is characterized by:
A) Preservation of cellular outlines
B) Formation of chalky white deposits
C) Liquefaction of tissue
D) Granuloma formation
Answer B: ) Formation of chalky white deposits
Objective Assessment (OA) Exam 2026
Complete Unit 1-Unit 7 Practice Questions &
Study Guide
Key Content Areas Covered
• Unit 1: Cellular Adaptation, Injury, and Death
• Unit 2: Genetics and Congenital Disorders
• Unit 3: Inflammation and Immune Responses
• Unit 4: Fluid, Electrolyte, and Acid-Base Disorders
• Unit 5: Cardiovascular and Lymphatic Systems
• Unit 6: Respiratory, Renal, and Endocrine Systems
• Unit 7: Neurological, Gastrointestinal, and
Multisystem Disorders
, SECTION 1: CELLULAR ADAPTATION, INJURY, AND
DEATH (Questions 1-15)
1. A patient with chronic gastroesophageal reflux disease (GERD)
develops replacement of the normal stratified squamous
epithelium of the lower esophagus with columnar epithelium
containing goblet cells. This represents which type of cellular
adaptation?
A) Dysplasia
B) Metaplasia
C) Hyperplasia
D) Atrophy
Answer B: ) Metaplasia
Rationale: Metaplasia is the reversible replacement of one
differentiated cell type with another. In Barrett's esophagus, chronic
acid exposure causes the normal squamous epithelium to be replaced
by columnar epithelium with goblet cells, which is a precursor to
esophageal adenocarcinoma. Dysplasia involves disordered growth
with atypical cells, not replacement of one cell type with another. ---
2. A patient with prolonged hypoxia develops cellular swelling
characterized by membrane blebbing and dilation of the
endoplasmic reticulum. This represents which stage of cellular
injury?
A) Irreversible injury
B) Reversible injury
C) Necrosis
D) Apoptosis
,Answer B: ) Reversible injury
Rationale: Cellular swelling with ER dilation and membrane blebbing
indicates reversible injury, where mitochondrial function and ATP
production can potentially recover. If the insult continues, irreversible
injury and necrosis follow. ---
3. Which morphological feature distinguishes apoptosis from
necrosis?
A) Cellular swelling
B) Membrane lysis
C) Formation of apoptotic bodies
D) Inflammatory response
Answer C: ) Formation of apoptotic bodies
Rationale: Apoptosis features cell shrinkage, chromatin condensation,
and formation of membrane-bound apoptotic bodies that are
phagocytosed without triggering inflammation. Necrosis involves
cellular swelling, membrane lysis, and triggers an inflammatory
response. ---
4. A biopsy reveals poorly differentiated cells with
hyperchromatic nuclei and numerous mitotic figures. This
histologic appearance is best termed:
A) Metaplasia
B) Hypertrophy
C) Anaplasia
D) Dysplasia
Answer C: ) Anaplasia
, Rationale: Anaplasia is the hallmark of malignancy, characterized by
loss of cellular differentiation ("to form backward"), pleomorphism
(variation in size/shape), hyperchromatic nuclei, increased nuclear-to-
cytoplasmic ratio, atypical mitotic figures, and loss of normal tissue
architecture. ---
5. A 70-year-old woman with dementia shows brain tissue with
"tangles" of hyperphosphorylated tau protein and plaques of
amyloid-beta. These represent which type of intracellular
accumulation?
A) Glycogen storage
B) Lipofuscin accumulation
C) Protein aggregation
D) Lipid accumulation
Answer C: ) Protein aggregation
Rationale: Alzheimer's disease involves accumulation of abnormally
folded proteins: amyloid-beta plaques extracellularly and
hyperphosphorylated tau forming neurofibrillary tangles
intracellularly. ---
6. A patient with severe pancreatitis develops fat necrosis with
saponification. This is characterized by:
A) Preservation of cellular outlines
B) Formation of chalky white deposits
C) Liquefaction of tissue
D) Granuloma formation
Answer B: ) Formation of chalky white deposits
