NRMS 5190 Advanced Pathophysiology Exam 2
Study Guide | 2026/27 Update with complete
solutions - SUNY Downstate Medical Center.
NRMS 5190 Advanced Pathophysiology Exam 2 Study Guide | 2026/27 Update
with Complete Solutions - SUNY Downstate Medical Center
SECTION 1: Cell Injury, Adaptation, and Death
1. A student is studying the rotation of the phospholipid molecules in the cell
membrane during cellular injury. Which of the following is the earliest reversible
manifestation of cellular injury?
A) Cellular swelling
B) Nuclear dissolution
C) Membrane rupture
D) Mitochondrial calcification
Correct Answer: A
Rationale: The rotation of the phospholipid molecules in the cell membrane during
cellular injury: cellular swelling (hydropic degeneration) is the earliest reversible
manifestation of cellular injury due to failure of the sodium-potassium pump and
accumulation of water. Nuclear dissolution, membrane rupture, and
mitochondrial calcification are irreversible changes.
2. A cell that has undergone metaplasia has:
,A) Replaced one mature cell type with another mature cell type
B) Increased in size
C) Increased in number
D) Undergone malignant transformation
Correct Answer: A
Rationale: Metaplasia is the reversible replacement of one mature cell type with
another mature cell type (e.g., columnar to squamous epithelium in smokers).
Hypertrophy is increased cell size, hyperplasia is increased cell number, and
dysplasia is disordered growth that may progress to malignancy.
3. A student is studying the rotation of the ATP synthase in a cell undergoing
hypoxia. Which of the following is the primary consequence of ATP depletion?
A) Failure of the sodium-potassium pump
B) Increased protein synthesis
C) Enhanced DNA repair
D) Increased oxidative phosphorylation
Correct Answer: A
Rationale: The rotation of the ATP synthase in a cell undergoing hypoxia: ATP
depletion causes failure of the sodium-potassium pump, leading to intracellular
accumulation of sodium and water (cellular swelling). Protein synthesis and DNA
repair decrease during ATP depletion.
4. Which of the following is an example of programmed cell death?
A) Necrosis
B) Apoptosis
C) Autolysis
D) Coagulative necrosis
Correct Answer: B
Rationale: Apoptosis is programmed cell death that occurs under normal
,physiologic and pathologic conditions. It is energy-dependent and does not cause
inflammation. Necrosis, autolysis, and coagulative necrosis are forms of
unregulated cell death.
5. A student is studying the rotation of the mitochondria during reperfusion
injury. Which of the following is the primary mechanism of reperfusion injury?
A) Production of reactive oxygen species
B) Decreased calcium influx
C) Reduced inflammatory response
D) Enhanced ATP production
Correct Answer: A
Rationale: The rotation of the mitochondria during reperfusion injury: reperfusion
injury is primarily caused by the production of reactive oxygen species (ROS) and
calcium overload, leading to further cellular damage. Inflammatory response is
increased, not reduced.
6. Which of the following types of necrosis is characteristic of ischemic injury in
the heart?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
Correct Answer: A
Rationale: Coagulative necrosis is characteristic of ischemic injury in the heart,
kidney, and spleen. Liquefactive necrosis occurs in the brain and abscesses.
Caseous necrosis occurs in tuberculosis. Fat necrosis occurs in the pancreas and
breast.
, 7. A student is studying the rotation of the ribosomes during cellular stress.
Which of the following is a consequence of ribosome detachment from the
endoplasmic reticulum?
A) Decreased protein synthesis
B) Increased protein synthesis
C) Enhanced cell repair
D) Increased ATP production
Correct Answer: A
Rationale: The rotation of the ribosomes during cellular stress: detachment of
ribosomes from the rough endoplasmic reticulum leads to decreased protein
synthesis, impairing cellular repair and function.
8. Which of the following is an example of physiologic hyperplasia?
A) Breast enlargement during pregnancy
B) Cardiac hypertrophy from hypertension
C) Squamous metaplasia in smokers
D) Dysplasia in cervical epithelium
Correct Answer: A
Rationale: Physiologic hyperplasia occurs in response to normal hormonal
stimulation, such as breast enlargement during pregnancy. Cardiac hypertrophy is
pathologic hypertrophy. Squamous metaplasia is pathologic metaplasia. Dysplasia
is disordered growth.
9. A student is studying the rotation of the lysosomes during cellular injury.
Which of the following is the consequence of lysosomal enzyme release?
A) Autodigestion of cellular components
B) Enhanced cell repair
C) Increased ATP production
D) Decreased inflammation
Study Guide | 2026/27 Update with complete
solutions - SUNY Downstate Medical Center.
NRMS 5190 Advanced Pathophysiology Exam 2 Study Guide | 2026/27 Update
with Complete Solutions - SUNY Downstate Medical Center
SECTION 1: Cell Injury, Adaptation, and Death
1. A student is studying the rotation of the phospholipid molecules in the cell
membrane during cellular injury. Which of the following is the earliest reversible
manifestation of cellular injury?
A) Cellular swelling
B) Nuclear dissolution
C) Membrane rupture
D) Mitochondrial calcification
Correct Answer: A
Rationale: The rotation of the phospholipid molecules in the cell membrane during
cellular injury: cellular swelling (hydropic degeneration) is the earliest reversible
manifestation of cellular injury due to failure of the sodium-potassium pump and
accumulation of water. Nuclear dissolution, membrane rupture, and
mitochondrial calcification are irreversible changes.
2. A cell that has undergone metaplasia has:
,A) Replaced one mature cell type with another mature cell type
B) Increased in size
C) Increased in number
D) Undergone malignant transformation
Correct Answer: A
Rationale: Metaplasia is the reversible replacement of one mature cell type with
another mature cell type (e.g., columnar to squamous epithelium in smokers).
Hypertrophy is increased cell size, hyperplasia is increased cell number, and
dysplasia is disordered growth that may progress to malignancy.
3. A student is studying the rotation of the ATP synthase in a cell undergoing
hypoxia. Which of the following is the primary consequence of ATP depletion?
A) Failure of the sodium-potassium pump
B) Increased protein synthesis
C) Enhanced DNA repair
D) Increased oxidative phosphorylation
Correct Answer: A
Rationale: The rotation of the ATP synthase in a cell undergoing hypoxia: ATP
depletion causes failure of the sodium-potassium pump, leading to intracellular
accumulation of sodium and water (cellular swelling). Protein synthesis and DNA
repair decrease during ATP depletion.
4. Which of the following is an example of programmed cell death?
A) Necrosis
B) Apoptosis
C) Autolysis
D) Coagulative necrosis
Correct Answer: B
Rationale: Apoptosis is programmed cell death that occurs under normal
,physiologic and pathologic conditions. It is energy-dependent and does not cause
inflammation. Necrosis, autolysis, and coagulative necrosis are forms of
unregulated cell death.
5. A student is studying the rotation of the mitochondria during reperfusion
injury. Which of the following is the primary mechanism of reperfusion injury?
A) Production of reactive oxygen species
B) Decreased calcium influx
C) Reduced inflammatory response
D) Enhanced ATP production
Correct Answer: A
Rationale: The rotation of the mitochondria during reperfusion injury: reperfusion
injury is primarily caused by the production of reactive oxygen species (ROS) and
calcium overload, leading to further cellular damage. Inflammatory response is
increased, not reduced.
6. Which of the following types of necrosis is characteristic of ischemic injury in
the heart?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
Correct Answer: A
Rationale: Coagulative necrosis is characteristic of ischemic injury in the heart,
kidney, and spleen. Liquefactive necrosis occurs in the brain and abscesses.
Caseous necrosis occurs in tuberculosis. Fat necrosis occurs in the pancreas and
breast.
, 7. A student is studying the rotation of the ribosomes during cellular stress.
Which of the following is a consequence of ribosome detachment from the
endoplasmic reticulum?
A) Decreased protein synthesis
B) Increased protein synthesis
C) Enhanced cell repair
D) Increased ATP production
Correct Answer: A
Rationale: The rotation of the ribosomes during cellular stress: detachment of
ribosomes from the rough endoplasmic reticulum leads to decreased protein
synthesis, impairing cellular repair and function.
8. Which of the following is an example of physiologic hyperplasia?
A) Breast enlargement during pregnancy
B) Cardiac hypertrophy from hypertension
C) Squamous metaplasia in smokers
D) Dysplasia in cervical epithelium
Correct Answer: A
Rationale: Physiologic hyperplasia occurs in response to normal hormonal
stimulation, such as breast enlargement during pregnancy. Cardiac hypertrophy is
pathologic hypertrophy. Squamous metaplasia is pathologic metaplasia. Dysplasia
is disordered growth.
9. A student is studying the rotation of the lysosomes during cellular injury.
Which of the following is the consequence of lysosomal enzyme release?
A) Autodigestion of cellular components
B) Enhanced cell repair
C) Increased ATP production
D) Decreased inflammation
