,NSG530/NSG 530 Exam 1 Advanced
Pathophysiology | Wilkes University | Q&A|
1. A cell is exposed to a toxin that damages mitochondrial DNA. Which cellular function will be most
immediately impaired?
A) Protein synthesis
B) ATP production
C) Lipid biosynthesis
D) DNA replication
Correct Answer: ATP production
Rationale: Mitochondria are the primary site of oxidative phosphorylation and ATP generation
through the electron transport chain. Damage to mitochondrial DNA disrupts the encoding of
essential proteins for this process, leading to immediate impairment of ATP production. Protein
synthesis occurs primarily on ribosomes in the cytoplasm and rough endoplasmic reticulum, while
lipid biosynthesis takes place in the smooth endoplasmic reticulum, and DNA replication occurs in the
nucleus.
2. During prolonged hypoxia, a cell shifts from aerobic to anaerobic metabolism. What is the primary
consequence of this metabolic switch?
A) Increased production of reactive oxygen species
B) Accumulation of intracellular lactic acid
C) Enhanced mitochondrial ATP synthesis
D) Activation of the sodium-potassium pump
Correct Answer: Accumulation of intracellular lactic acid
Rationale: Anaerobic metabolism produces ATP through glycolysis with pyruvate converted to lactate,
resulting in lactic acid accumulation and decreased intracellular pH. This acidosis impairs enzymatic
function and can lead to cellular injury. Reactive oxygen species production is more associated with
reperfusion injury rather than hypoxia itself. Mitochondrial ATP synthesis actually decreases under
anaerobic conditions.
3. A researcher observes cells with enlarged nuclei, prominent nucleoli, and increased cytoplasmic
RNA content. Which cellular adaptation is most consistent with these findings?
A) Atrophy
,B) Hypertrophy
C) Hyperplasia
D) Dysplasia
Correct Answer: Hypertrophy
Rationale: Hypertrophy involves an increase in cell size accompanied by increased synthesis of
structural proteins and organelles, reflected in enlarged nuclei, prominent nucleoli, and elevated RNA
content for protein production. Atrophy involves cellular shrinkage and reduced function. Hyperplasia
is an increase in cell number, not size. Dysplasia involves abnormal cellular maturation and
organization rather than 单纯 size increase.
4. What distinguishes apoptosis from necrosis at the biochemical level?
A) Apoptosis triggers an inflammatory response, whereas necrosis does not
B) Apoptosis requires ATP-dependent caspase activation, whereas necrosis does not
C) Necrosis involves programmed cell death, whereas apoptosis is accidental
D) Apoptosis causes cellular swelling, whereas necrosis causes cellular shrinkage
Correct Answer: Apoptosis requires ATP-dependent caspase activation, whereas necrosis does not
Rationale: Apoptosis is an energy-dependent process requiring ATP for caspase activation and orderly
cellular dismantling. Necrosis is passive, ATP-independent cell death resulting from catastrophic
injury. Apoptosis does not trigger inflammation, whereas necrosis does. Necrosis involves cellular
swelling and membrane rupture, while apoptosis features cellular shrinkage and membrane blebbing.
5. A patient with chronic alcohol use disorder develops liver enlargement due to accumulation of fat
and proteins within hepatocytes. This cellular change is best classified as:
A) Metaplasia
B) Hypertrophy
C) Intracellular accumulation
D) Dysplasia
Correct Answer: Intracellular accumulation
Rationale: Alcoholic liver disease leads to accumulation of triglycerides (steatosis) and abnormal
proteins (Mallory bodies) within hepatocytes, representing intracellular accumulation of endogenous
substances. Metaplasia involves replacement of one cell type with another. Hypertrophy is an
increase in cell size without abnormal accumulations. Dysplasia involves disordered cellular growth
and maturation.
, 6. In reversible cellular injury, which event occurs earliest following ischemia?
A) Loss of membrane integrity
B) ATP depletion
C) Nuclear pyknosis
D) Lysosomal rupture
Correct Answer: ATP depletion
Rationale: ATP depletion is the earliest and most critical event in reversible cellular injury following
ischemia, as oxygen deprivation halts oxidative phosphorylation. This precedes loss of membrane
integrity, which occurs later with irreversible injury. Nuclear pyknosis and lysosomal rupture are
features of irreversible injury and necrosis.
7. Which statement accurately describes the role of p53 in cellular response to DNA damage?
A) p53 promotes cell cycle progression to facilitate DNA repair
B) p53 activates DNA repair mechanisms and can induce apoptosis if damage is irreparable
C) p53 inhibits apoptosis to preserve damaged cells
D) p53 functions exclusively as an oncogene
Correct Answer: p53 activates DNA repair mechanisms and can induce apoptosis if damage is
irreparable
Rationale: p53 is a tumor suppressor protein that functions as a transcription factor, activating genes
involved in DNA repair and cell cycle arrest. When DNA damage is beyond repair, p53 triggers
apoptosis to eliminate potentially malignant cells. p53 does not promote cell cycle progression; it
arrests the cell cycle. It is not an oncogene but rather a tumor suppressor.
8. A tissue sample reveals cells with dark, condensed nuclei and eosinophilic cytoplasm, with
surrounding inflammation. This histologic appearance is characteristic of:
A) Apoptosis
B) Coagulative necrosis
C) Caseous necrosis
D) Liquefactive necrosis
Correct Answer: Coagulative necrosis
Pathophysiology | Wilkes University | Q&A|
1. A cell is exposed to a toxin that damages mitochondrial DNA. Which cellular function will be most
immediately impaired?
A) Protein synthesis
B) ATP production
C) Lipid biosynthesis
D) DNA replication
Correct Answer: ATP production
Rationale: Mitochondria are the primary site of oxidative phosphorylation and ATP generation
through the electron transport chain. Damage to mitochondrial DNA disrupts the encoding of
essential proteins for this process, leading to immediate impairment of ATP production. Protein
synthesis occurs primarily on ribosomes in the cytoplasm and rough endoplasmic reticulum, while
lipid biosynthesis takes place in the smooth endoplasmic reticulum, and DNA replication occurs in the
nucleus.
2. During prolonged hypoxia, a cell shifts from aerobic to anaerobic metabolism. What is the primary
consequence of this metabolic switch?
A) Increased production of reactive oxygen species
B) Accumulation of intracellular lactic acid
C) Enhanced mitochondrial ATP synthesis
D) Activation of the sodium-potassium pump
Correct Answer: Accumulation of intracellular lactic acid
Rationale: Anaerobic metabolism produces ATP through glycolysis with pyruvate converted to lactate,
resulting in lactic acid accumulation and decreased intracellular pH. This acidosis impairs enzymatic
function and can lead to cellular injury. Reactive oxygen species production is more associated with
reperfusion injury rather than hypoxia itself. Mitochondrial ATP synthesis actually decreases under
anaerobic conditions.
3. A researcher observes cells with enlarged nuclei, prominent nucleoli, and increased cytoplasmic
RNA content. Which cellular adaptation is most consistent with these findings?
A) Atrophy
,B) Hypertrophy
C) Hyperplasia
D) Dysplasia
Correct Answer: Hypertrophy
Rationale: Hypertrophy involves an increase in cell size accompanied by increased synthesis of
structural proteins and organelles, reflected in enlarged nuclei, prominent nucleoli, and elevated RNA
content for protein production. Atrophy involves cellular shrinkage and reduced function. Hyperplasia
is an increase in cell number, not size. Dysplasia involves abnormal cellular maturation and
organization rather than 单纯 size increase.
4. What distinguishes apoptosis from necrosis at the biochemical level?
A) Apoptosis triggers an inflammatory response, whereas necrosis does not
B) Apoptosis requires ATP-dependent caspase activation, whereas necrosis does not
C) Necrosis involves programmed cell death, whereas apoptosis is accidental
D) Apoptosis causes cellular swelling, whereas necrosis causes cellular shrinkage
Correct Answer: Apoptosis requires ATP-dependent caspase activation, whereas necrosis does not
Rationale: Apoptosis is an energy-dependent process requiring ATP for caspase activation and orderly
cellular dismantling. Necrosis is passive, ATP-independent cell death resulting from catastrophic
injury. Apoptosis does not trigger inflammation, whereas necrosis does. Necrosis involves cellular
swelling and membrane rupture, while apoptosis features cellular shrinkage and membrane blebbing.
5. A patient with chronic alcohol use disorder develops liver enlargement due to accumulation of fat
and proteins within hepatocytes. This cellular change is best classified as:
A) Metaplasia
B) Hypertrophy
C) Intracellular accumulation
D) Dysplasia
Correct Answer: Intracellular accumulation
Rationale: Alcoholic liver disease leads to accumulation of triglycerides (steatosis) and abnormal
proteins (Mallory bodies) within hepatocytes, representing intracellular accumulation of endogenous
substances. Metaplasia involves replacement of one cell type with another. Hypertrophy is an
increase in cell size without abnormal accumulations. Dysplasia involves disordered cellular growth
and maturation.
, 6. In reversible cellular injury, which event occurs earliest following ischemia?
A) Loss of membrane integrity
B) ATP depletion
C) Nuclear pyknosis
D) Lysosomal rupture
Correct Answer: ATP depletion
Rationale: ATP depletion is the earliest and most critical event in reversible cellular injury following
ischemia, as oxygen deprivation halts oxidative phosphorylation. This precedes loss of membrane
integrity, which occurs later with irreversible injury. Nuclear pyknosis and lysosomal rupture are
features of irreversible injury and necrosis.
7. Which statement accurately describes the role of p53 in cellular response to DNA damage?
A) p53 promotes cell cycle progression to facilitate DNA repair
B) p53 activates DNA repair mechanisms and can induce apoptosis if damage is irreparable
C) p53 inhibits apoptosis to preserve damaged cells
D) p53 functions exclusively as an oncogene
Correct Answer: p53 activates DNA repair mechanisms and can induce apoptosis if damage is
irreparable
Rationale: p53 is a tumor suppressor protein that functions as a transcription factor, activating genes
involved in DNA repair and cell cycle arrest. When DNA damage is beyond repair, p53 triggers
apoptosis to eliminate potentially malignant cells. p53 does not promote cell cycle progression; it
arrests the cell cycle. It is not an oncogene but rather a tumor suppressor.
8. A tissue sample reveals cells with dark, condensed nuclei and eosinophilic cytoplasm, with
surrounding inflammation. This histologic appearance is characteristic of:
A) Apoptosis
B) Coagulative necrosis
C) Caseous necrosis
D) Liquefactive necrosis
Correct Answer: Coagulative necrosis
