NSG 530 (Exams 1 – 4) Wilkes Advanced
Pathophysiology Take and pass the
Exam
EXAM 1: CELLULAR BIOLOGY, INFLAMMATION, GENETICS
& IMMUNITY
Cellular Injury & Adaptation
1. Hypoxic injury is best defined as:
A) Injury caused by physical trauma to cells
B) Lack of sufficient oxygen within cells, the single most common cause of cellular
injury
C) Damage resulting from free radical accumulation
D) Injury caused by genetic mutations
Rationale: Hypoxic injury occurs when cells are deprived of adequate oxygen. This is the
most frequent mechanism of cellular injury because oxygen is essential for aerobic
metabolism and ATP production. Without sufficient oxygen, cellular functions fail,
leading to injury or death .
2. Which term describes a deficiency in the amount of oxygen reaching tissues?
A) Ischemia
B) Anoxia
,C) Hypoxia
D) Necrosis
Rationale: Hypoxia refers specifically to reduced oxygen availability at the tissue level. It
can result from decreased oxygen in the air, reduced hemoglobin efficacy, decreased
red blood cells, or disease states. Hypoxia plays a role in cell differentiation,
angiogenesis, proliferation, and inflammation .
3. What is the primary cause of ischemia?
A) Reduced oxygen in inspired air
B) Reduced blood supply to tissues
C) Anemia
D) Carbon monoxide poisoning
Rationale: Ischemia is defined as reduced blood supply to tissues, most commonly
caused by narrowing of arteries (arteriosclerosis) or blockage by blood clots. Ischemia is
the most common cause of hypoxia .
4. What is reperfusion injury?
A) Injury caused by lack of blood flow
B) Injury that occurs when oxygen is reintroduced to ischemic tissue
C) Injury from bacterial toxins
D) Injury caused by physical trauma
Rationale: Reperfusion injury occurs when oxygen is restored to tissues after a period of
ischemia. The sudden reintroduction of oxygen leads to the formation of reactive
oxygen species, causing additional cellular damage beyond that caused by the initial
ischemia .
5. A patient develops hypertrophy of the cardiac muscle. What is the underlying
cellular mechanism?
,A) Increase in cell number
B) Increase in cell size
C) Decrease in cell size
D) Abnormal change in cell shape
Rationale: Hypertrophy is an increase in cell size, often seen in cardiac and skeletal
muscle in response to increased workload. Chronic hypertension increases afterload,
forcing the left ventricle to work harder, resulting in compensatory hypertrophy .
6. Which type of necrosis is characteristic of ischemic injury to the brain?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fatty necrosis
Rationale: Liquefactive necrosis occurs in the brain because of the lack of substantial
connective tissue and the high lipid/enzyme content. Ischemic injury to the brain leads
to liquefactive necrosis due to the breakdown of neural tissue .
7. Which cellular organelle is responsible for the synthesis of proteins destined for
secretion?
A) Smooth endoplasmic reticulum
B) Rough endoplasmic reticulum
C) Golgi apparatus
D) Lysosome
Rationale: The rough ER contains ribosomes, which are the sites of protein synthesis.
Proteins destined for secretion are synthesized in the rough ER and then transported to
the Golgi apparatus for processing and packaging .
8. The nucleus, which is essential for function and survival of the cell:
, A) Is the site of protein synthesis
B) Contains the genetic code
C) Transforms cellular energy
D) Initiates aerobic metabolism
Rationale: The nucleus contains the genetic code (DNA) and is essential for cell function
and survival. It regulates gene expression and controls cellular activities .
9. What is the primary mechanism of cellular injury in hypoxia?
A) Increased oxidative phosphorylation
B) Depletion of ATP
C) Excessive calcium release
D) Activation of lysosomal enzymes
Rationale: Hypoxia impairs oxidative phosphorylation, leading to ATP depletion, which
disrupts cellular functions like ion pumps, causing swelling and injury .
10. What is the hallmark histological feature of apoptosis?
A) Cell swelling and rupture
B) Inflammatory response
C) Chromatin condensation and DNA fragmentation
D) Mitochondrial swelling
Rationale: Apoptosis is programmed cell death characterized by cell shrinkage,
chromatin condensation, and DNA fragmentation without inflammation. This is distinct
from necrosis, which involves cell swelling and inflammation .
11. During the cellular injury process, why does intracellular calcium increase?
A) The sodium-potassium pump fails entirely
B) Ischemia causes direct calcium channel opening
Pathophysiology Take and pass the
Exam
EXAM 1: CELLULAR BIOLOGY, INFLAMMATION, GENETICS
& IMMUNITY
Cellular Injury & Adaptation
1. Hypoxic injury is best defined as:
A) Injury caused by physical trauma to cells
B) Lack of sufficient oxygen within cells, the single most common cause of cellular
injury
C) Damage resulting from free radical accumulation
D) Injury caused by genetic mutations
Rationale: Hypoxic injury occurs when cells are deprived of adequate oxygen. This is the
most frequent mechanism of cellular injury because oxygen is essential for aerobic
metabolism and ATP production. Without sufficient oxygen, cellular functions fail,
leading to injury or death .
2. Which term describes a deficiency in the amount of oxygen reaching tissues?
A) Ischemia
B) Anoxia
,C) Hypoxia
D) Necrosis
Rationale: Hypoxia refers specifically to reduced oxygen availability at the tissue level. It
can result from decreased oxygen in the air, reduced hemoglobin efficacy, decreased
red blood cells, or disease states. Hypoxia plays a role in cell differentiation,
angiogenesis, proliferation, and inflammation .
3. What is the primary cause of ischemia?
A) Reduced oxygen in inspired air
B) Reduced blood supply to tissues
C) Anemia
D) Carbon monoxide poisoning
Rationale: Ischemia is defined as reduced blood supply to tissues, most commonly
caused by narrowing of arteries (arteriosclerosis) or blockage by blood clots. Ischemia is
the most common cause of hypoxia .
4. What is reperfusion injury?
A) Injury caused by lack of blood flow
B) Injury that occurs when oxygen is reintroduced to ischemic tissue
C) Injury from bacterial toxins
D) Injury caused by physical trauma
Rationale: Reperfusion injury occurs when oxygen is restored to tissues after a period of
ischemia. The sudden reintroduction of oxygen leads to the formation of reactive
oxygen species, causing additional cellular damage beyond that caused by the initial
ischemia .
5. A patient develops hypertrophy of the cardiac muscle. What is the underlying
cellular mechanism?
,A) Increase in cell number
B) Increase in cell size
C) Decrease in cell size
D) Abnormal change in cell shape
Rationale: Hypertrophy is an increase in cell size, often seen in cardiac and skeletal
muscle in response to increased workload. Chronic hypertension increases afterload,
forcing the left ventricle to work harder, resulting in compensatory hypertrophy .
6. Which type of necrosis is characteristic of ischemic injury to the brain?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fatty necrosis
Rationale: Liquefactive necrosis occurs in the brain because of the lack of substantial
connective tissue and the high lipid/enzyme content. Ischemic injury to the brain leads
to liquefactive necrosis due to the breakdown of neural tissue .
7. Which cellular organelle is responsible for the synthesis of proteins destined for
secretion?
A) Smooth endoplasmic reticulum
B) Rough endoplasmic reticulum
C) Golgi apparatus
D) Lysosome
Rationale: The rough ER contains ribosomes, which are the sites of protein synthesis.
Proteins destined for secretion are synthesized in the rough ER and then transported to
the Golgi apparatus for processing and packaging .
8. The nucleus, which is essential for function and survival of the cell:
, A) Is the site of protein synthesis
B) Contains the genetic code
C) Transforms cellular energy
D) Initiates aerobic metabolism
Rationale: The nucleus contains the genetic code (DNA) and is essential for cell function
and survival. It regulates gene expression and controls cellular activities .
9. What is the primary mechanism of cellular injury in hypoxia?
A) Increased oxidative phosphorylation
B) Depletion of ATP
C) Excessive calcium release
D) Activation of lysosomal enzymes
Rationale: Hypoxia impairs oxidative phosphorylation, leading to ATP depletion, which
disrupts cellular functions like ion pumps, causing swelling and injury .
10. What is the hallmark histological feature of apoptosis?
A) Cell swelling and rupture
B) Inflammatory response
C) Chromatin condensation and DNA fragmentation
D) Mitochondrial swelling
Rationale: Apoptosis is programmed cell death characterized by cell shrinkage,
chromatin condensation, and DNA fragmentation without inflammation. This is distinct
from necrosis, which involves cell swelling and inflammation .
11. During the cellular injury process, why does intracellular calcium increase?
A) The sodium-potassium pump fails entirely
B) Ischemia causes direct calcium channel opening
