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NUR2063 ESSENTIALS OF PATHOPHYSIOLOGY MIDTERM Original
Exam Questions with Answers and Rationales




Section 1: Cellular Injury, Adaptation, and Genetics
(Questions)
1. What is the first visible sign of reversible cellular injury?
A. Karyolysis
B. Cellular swelling (hydropic change)
C. Pyknosis
D. Karyorrhexis
Answer: B
Rationale: Cellular swelling is the earliest visible sign of
reversible cell injury, resulting from ATP depletion and
failure of the sodium-potassium pump, leading to sodium
and water accumulation.
2. What is the difference between necrosis and apoptosis?
A. Both are programmed cell death
B. Necrosis is uncontrolled cell death with inflammation;
apoptosis is programmed cell death without inflammation
C. Apoptosis is uncontrolled; necrosis is programmed
D. They are identical
Answer: B
Rationale: Necrosis is irreversible, uncontrolled cell death
causing cell lysis and inflammation. Apoptosis is a

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controlled, energy-dependent process of programmed
cell death without inflammatory response.
3. Which type of necrosis is most characteristic of myocardial
infarction?
A. Liquefactive necrosis
B. Coagulative necrosis
C. Caseous necrosis
D. Fat necrosis
Answer: B
Rationale: Coagulative necrosis occurs in most organs
(heart, kidney, liver) after ischemic injury, preserving
tissue architecture. Liquefactive occurs in brain; caseous
in tuberculosis; fat in pancreatitis.
4. What is "metaplasia"?
A. Increase in cell size
B. Reversible change where one mature cell type is
replaced by another
C. Increase in cell number
D. Uncontrolled cell growth
Answer: B
Rationale: Metaplasia is a reversible adaptive change
where one differentiated cell type is replaced by another
better suited to stress (e.g., squamous metaplasia in
smokers' airways).

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5. What is "dysplasia"?
A. Normal cell growth
B. Abnormal, disordered cell growth with potential to
become malignant
C. Decrease in cell size
D. Change in cell type only
Answer: B
Rationale: Dysplasia is disordered, abnormal cell growth
with variable size, shape, and organization—a
premalignant change (e.g., cervical dysplasia).
6. What is the most common cause of cellular injury?
A. Trauma
B. Hypoxia/ischemia
C. Infection
D. Chemical exposure
Answer: B
Rationale: Hypoxia (decreased oxygen) and ischemia
(decreased blood flow) are the most common causes of
cellular injury, leading to ATP depletion and cell
dysfunction.
7. What is "autosomal dominant" inheritance?
A. Both alleles must be affected
B. One affected allele is sufficient to cause disease, with
50% transmission risk

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C. Trait is on the X chromosome
D. Trait always skips generations
Answer: B
Rationale: Autosomal dominant disorders require only
one mutated allele. Affected parents have a 50% chance
of passing the trait to each child (e.g., Huntington
disease, Marfan syndrome).
8. What is "autosomal recessive" inheritance?
A. One affected allele is sufficient
B. Two copies of the mutated allele are required for
disease manifestation
C. Trait is on the Y chromosome
D. Trait is always lethal
Answer: B
Rationale: Autosomal recessive disorders (cystic fibrosis,
sickle cell disease) require two mutant alleles. Carriers
(one mutant allele) are typically asymptomatic.
9. What is "trisomy 21" (Down syndrome)?
A. Deletion of chromosome 21
B. Three copies of chromosome 21, causing intellectual
disability and characteristic features
C. One copy of chromosome 21
D. Translocation only
Answer: B

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