PATHO 370 MIDTERM STUDY GUIDE
2026/2027 – WEST COAST UNIVERSITY |
PRACTICE QUESTIONS, CORRECT ANSWERS
& DETAILED RATIONALES |
PATHOPHYSIOLOGY EXAM PREP | JUST
RELEASED PDF
PATHO 370 MIDTERM STUDY GUIDE 2026/2027 – WEST COAST UNIVERSITY
PRACTICE QUESTIONS, CORRECT ANSWERS & DETAILED RATIONALES
PATHOPHYSIOLOGY EXAM PREP
═══════════════════════════════════════════════════════
════════════════════════
DOCUMENT OVERVIEW
• This study guide contains 200 comprehensive multiple-choice questions designed
to test your mastery of all core pathophysiology concepts covered in PATHO 370,
with detailed rationales for every correct answer to deepen understanding.
• Use this material by working through questions systematically, reviewing incorrect
answers thoroughly, and focusing on detailed rationales to identify knowledge gaps
and reinforce foundational concepts before your midterm exam.
═══════════════════════════════════════════════════════
════════════════════════
QUESTIONS 1-20: CELLULAR INJURY AND ADAPTATION
═══════════════════════════════════════════════════════
════════════════════════
QUESTION 1: Which of the following represents the initial reversible stage of
cellular injury?
A) Coagulation necrosis
B) Hydropic swelling of organelles
C) Liquefactive necrosis
D) Fatty infiltration of hepatocytes
,E) Enzymatic dissolution of cell membranes
CORRECT ANSWER: B) Hydropic swelling of organelles
RATIONALE: Hydropic swelling (also called hydropic degeneration) is the earliest
reversible change observed during cellular injury. It results from ATP depletion
causing failure of the Na+/K+ ATPase pump, leading to sodium and water
accumulation within the cell and its organelles. The cell becomes enlarged and pale.
This stage is completely reversible if the injurious stimulus is removed. Necrosis
represents irreversible cell death, and fatty infiltration and enzymatic dissolution
occur in more advanced stages of injury.
───────────────────────────────────────────────────────
────────────────────────
QUESTION 2: A 58-year-old man with severe hypoxia is brought to the
emergency department. Which organelle dysfunction will be the most critical
in determining whether the cell survives?
A) Rough endoplasmic reticulum damage
B) Mitochondrial dysfunction and ATP depletion
C) Golgi apparatus fragmentation
D) Lysosomal membrane disruption
E) Ribosomal degradation
CORRECT ANSWER: B) Mitochondrial dysfunction and ATP depletion
RATIONALE: The mitochondrion is the "powerhouse" of the cell and is responsible
for ATP production through oxidative phosphorylation. Severe hypoxia impairs
mitochondrial function, leading to rapid ATP depletion. Since ATP is essential for
maintaining the Na+/K+ ATPase pump, calcium pumps, and other vital cellular
functions, mitochondrial failure triggers the transition from reversible to
irreversible cell injury. Without ATP restoration, the cell cannot recover. The other
organelles are important but not the primary determinant of cell survival in acute
hypoxic injury.
,───────────────────────────────────────────────────────
────────────────────────
QUESTION 3: Which type of necrosis occurs in the brain following an ischemic
stroke?
A) Coagulation necrosis
B) Liquefactive necrosis
C) Fibrinoid necrosis
D) Gangrenous necrosis
E) Caseous necrosis
CORRECT ANSWER: B) Liquefactive necrosis
RATIONALE: The brain has minimal structural proteins and a high lipid content, with
abundant hydrolytic enzymes released from microglial cells and neutrophils during
ischemic injury. These enzymes digest the necrotic tissue, creating a liquid-filled
cavity or cyst. This results in liquefactive necrosis, which is the characteristic pattern
in brain infarction. Coagulation necrosis occurs in most organs, caseous necrosis is
typical of tuberculosis, fibrinoid necrosis occurs in malignant hypertension, and
gangrenous necrosis is a descriptive term for tissue necrosis with putrefaction.
───────────────────────────────────────────────────────
────────────────────────
QUESTION 4: A 45-year-old woman presents with progressive muscle
weakness and elevated creatine kinase. Muscle biopsy shows muscle fiber
atrophy. Which adaptive response is occurring?
A) Hyperplasia
B) Metaplasia
C) Hypertrophy
D) Atrophy
E) Dysplasia
CORRECT ANSWER: D) Atrophy
, RATIONALE: Atrophy is a decrease in cell size resulting from loss of cell substance. It
occurs in response to decreased demand (disuse), loss of innervation, decreased
blood supply, or nutritional deficiency. The muscle fibers are smaller due to loss of
myofilaments and mitochondria. Elevated creatine kinase indicates muscle fiber
injury and breakdown. Hypertrophy would show increased size, hyperplasia would
show increased number of cells, metaplasia would involve transformation to a
different cell type, and dysplasia would show abnormal cellular organization.
───────────────────────────────────────────────────────
────────────────────────
QUESTION 5: Which cellular adaptation occurs when columnar epithelium in
the stomach undergoes transformation to stratified squamous epithelium?
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Anaplasia
E) Differentiation
CORRECT ANSWER: C) Metaplasia
RATIONALE: Metaplasia is the reversible transformation of one differentiated cell
type into another differentiated cell type. Chronic irritation (such as chronic reflux
or smoking) can cause gastric mucosa to change from columnar epithelium to
squamous epithelium. Barrett's esophagus is another classic example where
esophageal squamous epithelium transforms to columnar (intestinal-type)
epithelium. Metaplasia is generally adaptive, replacing vulnerable cells with more
resistant ones, but it can be a precursor to dysplasia and malignancy if the stimulus
persists. Anaplasia represents loss of differentiation seen in cancer.
───────────────────────────────────────────────────────
────────────────────────
QUESTION 6: A 72-year-old man has had chronic cigarette smoking for 50
years. His epithelial cells show increased nuclear size, coarse chromatin, and
increased mitotic figures. This represents which pathologic process?
2026/2027 – WEST COAST UNIVERSITY |
PRACTICE QUESTIONS, CORRECT ANSWERS
& DETAILED RATIONALES |
PATHOPHYSIOLOGY EXAM PREP | JUST
RELEASED PDF
PATHO 370 MIDTERM STUDY GUIDE 2026/2027 – WEST COAST UNIVERSITY
PRACTICE QUESTIONS, CORRECT ANSWERS & DETAILED RATIONALES
PATHOPHYSIOLOGY EXAM PREP
═══════════════════════════════════════════════════════
════════════════════════
DOCUMENT OVERVIEW
• This study guide contains 200 comprehensive multiple-choice questions designed
to test your mastery of all core pathophysiology concepts covered in PATHO 370,
with detailed rationales for every correct answer to deepen understanding.
• Use this material by working through questions systematically, reviewing incorrect
answers thoroughly, and focusing on detailed rationales to identify knowledge gaps
and reinforce foundational concepts before your midterm exam.
═══════════════════════════════════════════════════════
════════════════════════
QUESTIONS 1-20: CELLULAR INJURY AND ADAPTATION
═══════════════════════════════════════════════════════
════════════════════════
QUESTION 1: Which of the following represents the initial reversible stage of
cellular injury?
A) Coagulation necrosis
B) Hydropic swelling of organelles
C) Liquefactive necrosis
D) Fatty infiltration of hepatocytes
,E) Enzymatic dissolution of cell membranes
CORRECT ANSWER: B) Hydropic swelling of organelles
RATIONALE: Hydropic swelling (also called hydropic degeneration) is the earliest
reversible change observed during cellular injury. It results from ATP depletion
causing failure of the Na+/K+ ATPase pump, leading to sodium and water
accumulation within the cell and its organelles. The cell becomes enlarged and pale.
This stage is completely reversible if the injurious stimulus is removed. Necrosis
represents irreversible cell death, and fatty infiltration and enzymatic dissolution
occur in more advanced stages of injury.
───────────────────────────────────────────────────────
────────────────────────
QUESTION 2: A 58-year-old man with severe hypoxia is brought to the
emergency department. Which organelle dysfunction will be the most critical
in determining whether the cell survives?
A) Rough endoplasmic reticulum damage
B) Mitochondrial dysfunction and ATP depletion
C) Golgi apparatus fragmentation
D) Lysosomal membrane disruption
E) Ribosomal degradation
CORRECT ANSWER: B) Mitochondrial dysfunction and ATP depletion
RATIONALE: The mitochondrion is the "powerhouse" of the cell and is responsible
for ATP production through oxidative phosphorylation. Severe hypoxia impairs
mitochondrial function, leading to rapid ATP depletion. Since ATP is essential for
maintaining the Na+/K+ ATPase pump, calcium pumps, and other vital cellular
functions, mitochondrial failure triggers the transition from reversible to
irreversible cell injury. Without ATP restoration, the cell cannot recover. The other
organelles are important but not the primary determinant of cell survival in acute
hypoxic injury.
,───────────────────────────────────────────────────────
────────────────────────
QUESTION 3: Which type of necrosis occurs in the brain following an ischemic
stroke?
A) Coagulation necrosis
B) Liquefactive necrosis
C) Fibrinoid necrosis
D) Gangrenous necrosis
E) Caseous necrosis
CORRECT ANSWER: B) Liquefactive necrosis
RATIONALE: The brain has minimal structural proteins and a high lipid content, with
abundant hydrolytic enzymes released from microglial cells and neutrophils during
ischemic injury. These enzymes digest the necrotic tissue, creating a liquid-filled
cavity or cyst. This results in liquefactive necrosis, which is the characteristic pattern
in brain infarction. Coagulation necrosis occurs in most organs, caseous necrosis is
typical of tuberculosis, fibrinoid necrosis occurs in malignant hypertension, and
gangrenous necrosis is a descriptive term for tissue necrosis with putrefaction.
───────────────────────────────────────────────────────
────────────────────────
QUESTION 4: A 45-year-old woman presents with progressive muscle
weakness and elevated creatine kinase. Muscle biopsy shows muscle fiber
atrophy. Which adaptive response is occurring?
A) Hyperplasia
B) Metaplasia
C) Hypertrophy
D) Atrophy
E) Dysplasia
CORRECT ANSWER: D) Atrophy
, RATIONALE: Atrophy is a decrease in cell size resulting from loss of cell substance. It
occurs in response to decreased demand (disuse), loss of innervation, decreased
blood supply, or nutritional deficiency. The muscle fibers are smaller due to loss of
myofilaments and mitochondria. Elevated creatine kinase indicates muscle fiber
injury and breakdown. Hypertrophy would show increased size, hyperplasia would
show increased number of cells, metaplasia would involve transformation to a
different cell type, and dysplasia would show abnormal cellular organization.
───────────────────────────────────────────────────────
────────────────────────
QUESTION 5: Which cellular adaptation occurs when columnar epithelium in
the stomach undergoes transformation to stratified squamous epithelium?
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Anaplasia
E) Differentiation
CORRECT ANSWER: C) Metaplasia
RATIONALE: Metaplasia is the reversible transformation of one differentiated cell
type into another differentiated cell type. Chronic irritation (such as chronic reflux
or smoking) can cause gastric mucosa to change from columnar epithelium to
squamous epithelium. Barrett's esophagus is another classic example where
esophageal squamous epithelium transforms to columnar (intestinal-type)
epithelium. Metaplasia is generally adaptive, replacing vulnerable cells with more
resistant ones, but it can be a precursor to dysplasia and malignancy if the stimulus
persists. Anaplasia represents loss of differentiation seen in cancer.
───────────────────────────────────────────────────────
────────────────────────
QUESTION 6: A 72-year-old man has had chronic cigarette smoking for 50
years. His epithelial cells show increased nuclear size, coarse chromatin, and
increased mitotic figures. This represents which pathologic process?
