NUR 611 ADVANCED
PATHOPHYSIOLOGY EXAM REVIEW
1. A patient is diagnosed with atrophy of the quadriceps muscles following prolonged
immobilization. Which cellular process best describes this adaptation?
A. Increased protein synthesis and organelle duplication
B. Programmed cell death regulated by the p53 gene
C. Replacement of one mature cell type by another less mature cell type
D. Decreased protein synthesis and increased protein degradation via the ubiquitin-
proteasome pathway
Answer: D
Conceptual Explanation: Atrophy results from decreased protein synthesis, increased
protein catabolism, or both. The ubiquitin-proteasome pathway is the primary mechanism
for protein degradation in muscle atrophy.
2. In the context of hypoxia, what is the primary cause of cellular swelling (oncosis)?
A. Failure of the Na+/K+ ATPase pump due to ATP depletion
B. Activation of lysosomal enzymes
C. Accumulation of calcium in the mitochondria
,D. Increased anaerobic glycolysis leading to lactic acidosis
Answer: A
Conceptual Explanation: Hypoxia leads to ATP depletion, which causes the failure of the
sodium-potassium pump. Sodium accumulates inside the cell, creating an osmotic gradient
that pulls water in, resulting in cellular swelling.
3. Which type of necrosis is most commonly associated with hypoxic injury in the brain?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis
Answer: B
Conceptual Explanation: Liquefactive necrosis occurs in the brain because brain cells are
rich in digestive hydrolytic enzymes and lipids; the tissue becomes soft and liquefied.
4. A 45-year-old male with chronic hypertension shows increased left ventricular wall
thickness. This is an example of:
A. Pathologic hypertrophy
B. Physiologic hypertrophy
C. Compensatory hyperplasia
D. Dysplasia
, Answer: A
Conceptual Explanation: Pathologic hypertrophy occurs in response to chronic
hemodynamic overload, such as hypertension, where the heart muscle enlarges to handle
the increased afterload.
5. Which electrolyte imbalance is a common complication of respiratory acidosis?
A. Hypokalemia
B. Hypercalcemia
C. Hyponatremia
D. Hyperkalemia
Answer: D
Conceptual Explanation: In acidosis, excess hydrogen ions (H+) move into the cells. To
maintain electroneutrality, potassium ions (K+) move out of the cells into the extracellular
fluid, potentially leading to hyperkalemia.
6. Anion gap is most useful in differentiating the causes of which acid-base disturbance?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
Answer: D
PATHOPHYSIOLOGY EXAM REVIEW
1. A patient is diagnosed with atrophy of the quadriceps muscles following prolonged
immobilization. Which cellular process best describes this adaptation?
A. Increased protein synthesis and organelle duplication
B. Programmed cell death regulated by the p53 gene
C. Replacement of one mature cell type by another less mature cell type
D. Decreased protein synthesis and increased protein degradation via the ubiquitin-
proteasome pathway
Answer: D
Conceptual Explanation: Atrophy results from decreased protein synthesis, increased
protein catabolism, or both. The ubiquitin-proteasome pathway is the primary mechanism
for protein degradation in muscle atrophy.
2. In the context of hypoxia, what is the primary cause of cellular swelling (oncosis)?
A. Failure of the Na+/K+ ATPase pump due to ATP depletion
B. Activation of lysosomal enzymes
C. Accumulation of calcium in the mitochondria
,D. Increased anaerobic glycolysis leading to lactic acidosis
Answer: A
Conceptual Explanation: Hypoxia leads to ATP depletion, which causes the failure of the
sodium-potassium pump. Sodium accumulates inside the cell, creating an osmotic gradient
that pulls water in, resulting in cellular swelling.
3. Which type of necrosis is most commonly associated with hypoxic injury in the brain?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis
Answer: B
Conceptual Explanation: Liquefactive necrosis occurs in the brain because brain cells are
rich in digestive hydrolytic enzymes and lipids; the tissue becomes soft and liquefied.
4. A 45-year-old male with chronic hypertension shows increased left ventricular wall
thickness. This is an example of:
A. Pathologic hypertrophy
B. Physiologic hypertrophy
C. Compensatory hyperplasia
D. Dysplasia
, Answer: A
Conceptual Explanation: Pathologic hypertrophy occurs in response to chronic
hemodynamic overload, such as hypertension, where the heart muscle enlarges to handle
the increased afterload.
5. Which electrolyte imbalance is a common complication of respiratory acidosis?
A. Hypokalemia
B. Hypercalcemia
C. Hyponatremia
D. Hyperkalemia
Answer: D
Conceptual Explanation: In acidosis, excess hydrogen ions (H+) move into the cells. To
maintain electroneutrality, potassium ions (K+) move out of the cells into the extracellular
fluid, potentially leading to hyperkalemia.
6. Anion gap is most useful in differentiating the causes of which acid-base disturbance?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
Answer: D
