NR507 / NR 507 Midterm Exam (New
2026/2027 Update) Advanced
Pathophysiology – Chamberlain
SECTION 1: CELLULAR BIOLOGY & TISSUE RESPONSE
(Questions 1-20)
Question 1
A 58-year-old patient with long-standing hypertension
develops concentric left ventricular hypertrophy. Which
mechanism primarily drives this structural change?
A) Increased preload from volume overload
B) Chronic pressure overload leading to myocardial fiber
thickening
C) Decreased afterload resulting in chamber dilation
D) Increased sympathetic stimulation causing myocyte
apoptosis
Answer: B
Rationale: Chronic pressure overload, such as that caused by
long-standing hypertension, increases left ventricular wall stress.
To compensate, cardiomyocytes thicken (increase in sarcomeres
,added in parallel), resulting in concentric hypertrophy, which
helps normalize wall stress.
Question 2
Which cellular adaptation is characterized by an increase in the
number of cells in response to a stimulus?
A) Hypertrophy
B) Hyperplasia
C) Metaplasia
D) Dysplasia
Answer: B
Rationale: Hyperplasia is an increase in the number of cells in a
tissue or organ in response to a stimulus. It can be physiologic
(e.g., endometrial hyperplasia during the menstrual cycle) or
pathologic (e.g., benign prostatic hyperplasia).
Question 3
A decrease in cell size due to decreased workload, denervation,
or reduced blood supply is called:
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
,Answer: C
Rationale: Atrophy is a decrease in cell size that can result from
decreased workload (disuse), loss of innervation (denervation),
diminished blood supply (ischemia), inadequate nutrition, or
aging.
Question 4
What is the primary difference between apoptosis and necrosis?
A) Apoptosis is always pathologic; necrosis is always physiologic
B) Apoptosis is programmed cell death; necrosis is unregulated
cell death due to injury
C) Both are forms of unregulated cell death
D) Necrosis is programmed; apoptosis is unregulated
Answer: B
Rationale: Apoptosis is programmed cell death that is tightly
regulated and often physiologic, while necrosis is unregulated cell
death that occurs in response to injury, ischemia, or toxins,
typically eliciting an inflammatory response.
Question 5
A patient with Klinefelter syndrome has which chromosomal
abnormality?
, A) Trisomy 21
B) 47, XXY
C) 45, X
D) 47, XYY
Answer: B
Rationale: Klinefelter syndrome is characterized by a 47, XXY
karyotype. Affected individuals are male with an extra X
chromosome, leading to hypogonadism, infertility, and
gynecomastia.
Question 6
What is the pattern of inheritance for Hemophilia A?
A) Autosomal dominant
B) Autosomal recessive
C) X-linked recessive
D) Mitochondrial inheritance
Answer: C
Rationale: Hemophilia A is an X-linked recessive disorder.
Affected males inherit the mutated gene from their carrier
mothers, while females are typically carriers.
Question 7
A patient presents with a mutation in the CFTR gene leading to
2026/2027 Update) Advanced
Pathophysiology – Chamberlain
SECTION 1: CELLULAR BIOLOGY & TISSUE RESPONSE
(Questions 1-20)
Question 1
A 58-year-old patient with long-standing hypertension
develops concentric left ventricular hypertrophy. Which
mechanism primarily drives this structural change?
A) Increased preload from volume overload
B) Chronic pressure overload leading to myocardial fiber
thickening
C) Decreased afterload resulting in chamber dilation
D) Increased sympathetic stimulation causing myocyte
apoptosis
Answer: B
Rationale: Chronic pressure overload, such as that caused by
long-standing hypertension, increases left ventricular wall stress.
To compensate, cardiomyocytes thicken (increase in sarcomeres
,added in parallel), resulting in concentric hypertrophy, which
helps normalize wall stress.
Question 2
Which cellular adaptation is characterized by an increase in the
number of cells in response to a stimulus?
A) Hypertrophy
B) Hyperplasia
C) Metaplasia
D) Dysplasia
Answer: B
Rationale: Hyperplasia is an increase in the number of cells in a
tissue or organ in response to a stimulus. It can be physiologic
(e.g., endometrial hyperplasia during the menstrual cycle) or
pathologic (e.g., benign prostatic hyperplasia).
Question 3
A decrease in cell size due to decreased workload, denervation,
or reduced blood supply is called:
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
,Answer: C
Rationale: Atrophy is a decrease in cell size that can result from
decreased workload (disuse), loss of innervation (denervation),
diminished blood supply (ischemia), inadequate nutrition, or
aging.
Question 4
What is the primary difference between apoptosis and necrosis?
A) Apoptosis is always pathologic; necrosis is always physiologic
B) Apoptosis is programmed cell death; necrosis is unregulated
cell death due to injury
C) Both are forms of unregulated cell death
D) Necrosis is programmed; apoptosis is unregulated
Answer: B
Rationale: Apoptosis is programmed cell death that is tightly
regulated and often physiologic, while necrosis is unregulated cell
death that occurs in response to injury, ischemia, or toxins,
typically eliciting an inflammatory response.
Question 5
A patient with Klinefelter syndrome has which chromosomal
abnormality?
, A) Trisomy 21
B) 47, XXY
C) 45, X
D) 47, XYY
Answer: B
Rationale: Klinefelter syndrome is characterized by a 47, XXY
karyotype. Affected individuals are male with an extra X
chromosome, leading to hypogonadism, infertility, and
gynecomastia.
Question 6
What is the pattern of inheritance for Hemophilia A?
A) Autosomal dominant
B) Autosomal recessive
C) X-linked recessive
D) Mitochondrial inheritance
Answer: C
Rationale: Hemophilia A is an X-linked recessive disorder.
Affected males inherit the mutated gene from their carrier
mothers, while females are typically carriers.
Question 7
A patient presents with a mutation in the CFTR gene leading to
