D236 OA V2 – Pathophysiology –
Western Governors University:
2026/2027 Academic Year | 200
PRACTICE QUESTIONS WITH DETAILED
RATIONALES ACROSS ALL CORE
DOMAINS
SECTION ONE: CELLULAR AND TISSUE ADAPTATION,
INJURY, AND DEATH (Questions 1–30)
Question 1
A patient with a history of chronic smoking has bronchial epithelial cells that have
changed from normal ciliated columnar epithelium to stratified squamous
epithelium. This cellular adaptation is known as:
A. Dysplasia
B. Metaplasia
C. Hyperplasia
D. Anaplasia
Correct answer: B. Metaplasia
Rationale: Metaplasia is the reversible replacement of one mature cell type by
another, often as an adaptive response to chronic irritation or stress, such as the
change seen in the bronchial lining of smokers. Dysplasia involves disordered growth
,with cellular atypia. Hyperplasia is an increase in the number of cells. Anaplasia
describes the loss of differentiation characteristic of malignancy.
Question 2
Which cellular adaptation is characterized by a decrease in cell size and function?
A. Hypertrophy
B. Atrophy
C. Metaplasia
D. Dysplasia
Correct answer: B. Atrophy
Rationale: Atrophy is a decrease in cell size and function, often due to disuse,
denervation, ischemia, malnutrition, or aging. Hypertrophy is an increase in cell size.
Metaplasia is the replacement of one cell type by another. Dysplasia is disordered
cellular growth.
Question 3
An increase in the number of cells in an organ or tissue, which may be compensatory
or hormonal, is called:
A. Neoplasia
B. Dysplasia
C. Hypertrophy
D. Hyperplasia
Correct answer: D. Hyperplasia
,Rationale: Hyperplasia is an increase in the number of cells in an organ or tissue,
which may be compensatory (e.g., liver regeneration) or hormonal (e.g., endometrial
hyperplasia). Neoplasia is abnormal, uncontrolled growth. Dysplasia is disordered
growth. Hypertrophy is an increase in cell size.
Question 4
Abnormal changes in the size, shape, and organization of mature cells, often
considered a precursor to cancer, is:
A. Metaplasia
B. Atrophy
C. Dysplasia
D. Hypertrophy
Correct answer: C. Dysplasia
Rationale: Dysplasia refers to abnormal, disorganized cellular growth often due to
chronic injury and may precede cancer. It is characterized by variation in cell size,
shape, and nuclear appearance. Metaplasia is the replacement of one cell type with
another, atrophy is a decrease in cell size, and hypertrophy is an increase in cell size.
Question 5
Which type of necrosis is most common in the heart and kidneys following hypoxic
injury?
A. Coagulative
B. Caseous
C. Fat
D. Liquefactive
, Correct answer: A. Coagulative
Rationale: Coagulative necrosis results from protein denaturation and is
characteristic of hypoxic injury in solid organs like the heart and kidney. Caseous
necrosis is seen in tuberculosis. Fat necrosis occurs in pancreatitis. Liquefactive
necrosis is typical of brain tissue.
Question 6
Which process is characterized by programmed cell death that does not trigger an
inflammatory response?
A. Necrosis
B. Apoptosis
C. Coagulative necrosis
D. Caseous necrosis
Correct answer: B. Apoptosis
Rationale: Apoptosis is a controlled, energy-dependent process of programmed cell
death that does not trigger inflammation. Necrosis is unregulated cell death that
releases cellular contents and triggers an inflammatory response. Coagulative and
caseous necrosis are specific types of necrosis.
Question 7
Which finding indicates reversible cell injury rather than necrosis?
A. Nuclear fragmentation
B. Cellular swelling
Western Governors University:
2026/2027 Academic Year | 200
PRACTICE QUESTIONS WITH DETAILED
RATIONALES ACROSS ALL CORE
DOMAINS
SECTION ONE: CELLULAR AND TISSUE ADAPTATION,
INJURY, AND DEATH (Questions 1–30)
Question 1
A patient with a history of chronic smoking has bronchial epithelial cells that have
changed from normal ciliated columnar epithelium to stratified squamous
epithelium. This cellular adaptation is known as:
A. Dysplasia
B. Metaplasia
C. Hyperplasia
D. Anaplasia
Correct answer: B. Metaplasia
Rationale: Metaplasia is the reversible replacement of one mature cell type by
another, often as an adaptive response to chronic irritation or stress, such as the
change seen in the bronchial lining of smokers. Dysplasia involves disordered growth
,with cellular atypia. Hyperplasia is an increase in the number of cells. Anaplasia
describes the loss of differentiation characteristic of malignancy.
Question 2
Which cellular adaptation is characterized by a decrease in cell size and function?
A. Hypertrophy
B. Atrophy
C. Metaplasia
D. Dysplasia
Correct answer: B. Atrophy
Rationale: Atrophy is a decrease in cell size and function, often due to disuse,
denervation, ischemia, malnutrition, or aging. Hypertrophy is an increase in cell size.
Metaplasia is the replacement of one cell type by another. Dysplasia is disordered
cellular growth.
Question 3
An increase in the number of cells in an organ or tissue, which may be compensatory
or hormonal, is called:
A. Neoplasia
B. Dysplasia
C. Hypertrophy
D. Hyperplasia
Correct answer: D. Hyperplasia
,Rationale: Hyperplasia is an increase in the number of cells in an organ or tissue,
which may be compensatory (e.g., liver regeneration) or hormonal (e.g., endometrial
hyperplasia). Neoplasia is abnormal, uncontrolled growth. Dysplasia is disordered
growth. Hypertrophy is an increase in cell size.
Question 4
Abnormal changes in the size, shape, and organization of mature cells, often
considered a precursor to cancer, is:
A. Metaplasia
B. Atrophy
C. Dysplasia
D. Hypertrophy
Correct answer: C. Dysplasia
Rationale: Dysplasia refers to abnormal, disorganized cellular growth often due to
chronic injury and may precede cancer. It is characterized by variation in cell size,
shape, and nuclear appearance. Metaplasia is the replacement of one cell type with
another, atrophy is a decrease in cell size, and hypertrophy is an increase in cell size.
Question 5
Which type of necrosis is most common in the heart and kidneys following hypoxic
injury?
A. Coagulative
B. Caseous
C. Fat
D. Liquefactive
, Correct answer: A. Coagulative
Rationale: Coagulative necrosis results from protein denaturation and is
characteristic of hypoxic injury in solid organs like the heart and kidney. Caseous
necrosis is seen in tuberculosis. Fat necrosis occurs in pancreatitis. Liquefactive
necrosis is typical of brain tissue.
Question 6
Which process is characterized by programmed cell death that does not trigger an
inflammatory response?
A. Necrosis
B. Apoptosis
C. Coagulative necrosis
D. Caseous necrosis
Correct answer: B. Apoptosis
Rationale: Apoptosis is a controlled, energy-dependent process of programmed cell
death that does not trigger inflammation. Necrosis is unregulated cell death that
releases cellular contents and triggers an inflammatory response. Coagulative and
caseous necrosis are specific types of necrosis.
Question 7
Which finding indicates reversible cell injury rather than necrosis?
A. Nuclear fragmentation
B. Cellular swelling
