ADVANCED PATHOPHYSIOLOGY (NUR-
641E) FINAL EXAMINATION
COMPREHENSIVE REVIEW
1. Which cellular adaptation process is characterized by the replacement of one mature cell
type by another, often less differentiated, cell type?
A. Metaplasia
B. Hyperplasia
C. Dysplasia
D. Anaplasia
Answer: A
Conceptual Explanation: Metaplasia is the reversible replacement of one mature cell type
by another, frequently occurring in response to chronic irritation or inflammation, such as
in the respiratory tract of smokers.
2. In the context of ischemia-reperfusion injury, what is the primary mechanism by which
reactive oxygen species (ROS) cause cellular damage?
A. Induction of sodium-potassium pump failure
B. Activation of lysosomal enzymes
,C. Direct inhibition of ATP synthesis
D. Membrane lipid peroxidation and mitochondrial stress
Answer: D
Conceptual Explanation: ROS cause damage primarily through lipid peroxidation of
membranes, protein carbonylation, and DNA damage, which significantly exacerbates
cellular injury once blood flow is restored.
3. A patient presents with a plasma pH of 7.25, PaCO2 of 55 mmHg, and HCO3- of 28 mEq/L.
What is the most likely acid-base imbalance?
A. Metabolic Acidosis with partial compensation
B. Respiratory Acidosis with partial compensation
C. Metabolic Alkalosis with no compensation
D. Respiratory Alkalosis with full compensation
Answer: B
Conceptual Explanation: The pH is acidic (<7.35). The PaCO2 is elevated (>45), indicating
a respiratory cause. The HCO3- is slightly elevated (>26), indicating the kidneys are
attempting to compensate, but the pH is not yet normal, so it is partial compensation.
4. Which genetic concept explains why individuals with the same genotype for
Neurofibromatosis type 1 exhibit varying degrees of clinical severity?
A. Variable expressivity
, B. Genomic imprinting
C. Incomplete penetrance
D. Anticipation
Answer: A
Conceptual Explanation: Variable expressivity refers to the range of signs and symptoms
that can occur in different people with the same genetic condition.
5. During the inflammatory response, which mediator is primarily responsible for inducing
pain and increasing vascular permeability via the arachidonic acid pathway?
A. Histamine
B. Complement C3b
C. Interferon-gamma
D. Prostaglandins
Answer: D
Conceptual Explanation: Prostaglandins are produced via the cyclooxygenase pathway of
arachidonic acid metabolism and are key mediators of pain and vasodilation.
6. A 65-year-old male with chronic hypertension develops left ventricular hypertrophy. This
change is primarily mediated by which signaling pathway?
A. Increased apoptosis due to ischemia
B. Atrophy of the endocardium
641E) FINAL EXAMINATION
COMPREHENSIVE REVIEW
1. Which cellular adaptation process is characterized by the replacement of one mature cell
type by another, often less differentiated, cell type?
A. Metaplasia
B. Hyperplasia
C. Dysplasia
D. Anaplasia
Answer: A
Conceptual Explanation: Metaplasia is the reversible replacement of one mature cell type
by another, frequently occurring in response to chronic irritation or inflammation, such as
in the respiratory tract of smokers.
2. In the context of ischemia-reperfusion injury, what is the primary mechanism by which
reactive oxygen species (ROS) cause cellular damage?
A. Induction of sodium-potassium pump failure
B. Activation of lysosomal enzymes
,C. Direct inhibition of ATP synthesis
D. Membrane lipid peroxidation and mitochondrial stress
Answer: D
Conceptual Explanation: ROS cause damage primarily through lipid peroxidation of
membranes, protein carbonylation, and DNA damage, which significantly exacerbates
cellular injury once blood flow is restored.
3. A patient presents with a plasma pH of 7.25, PaCO2 of 55 mmHg, and HCO3- of 28 mEq/L.
What is the most likely acid-base imbalance?
A. Metabolic Acidosis with partial compensation
B. Respiratory Acidosis with partial compensation
C. Metabolic Alkalosis with no compensation
D. Respiratory Alkalosis with full compensation
Answer: B
Conceptual Explanation: The pH is acidic (<7.35). The PaCO2 is elevated (>45), indicating
a respiratory cause. The HCO3- is slightly elevated (>26), indicating the kidneys are
attempting to compensate, but the pH is not yet normal, so it is partial compensation.
4. Which genetic concept explains why individuals with the same genotype for
Neurofibromatosis type 1 exhibit varying degrees of clinical severity?
A. Variable expressivity
, B. Genomic imprinting
C. Incomplete penetrance
D. Anticipation
Answer: A
Conceptual Explanation: Variable expressivity refers to the range of signs and symptoms
that can occur in different people with the same genetic condition.
5. During the inflammatory response, which mediator is primarily responsible for inducing
pain and increasing vascular permeability via the arachidonic acid pathway?
A. Histamine
B. Complement C3b
C. Interferon-gamma
D. Prostaglandins
Answer: D
Conceptual Explanation: Prostaglandins are produced via the cyclooxygenase pathway of
arachidonic acid metabolism and are key mediators of pain and vasodilation.
6. A 65-year-old male with chronic hypertension develops left ventricular hypertrophy. This
change is primarily mediated by which signaling pathway?
A. Increased apoptosis due to ischemia
B. Atrophy of the endocardium
