WGU PATHOPHYSIOLOGY STUDY GUIDE: D236
PATHOPHYSIOLOGY EXAM QUESTIONS
COMPLETED WITH CORRECT ANSWERS
Cellular Adaptation, Injury & Death (Q1–25)
1. A 72-year-old client's left ventricular wall thickens in response to years of
uncontrolled hypertension. This is best described as:
A. Physiologic hyperplasia
B. Pathologic hypertrophy
C. Compensatory atrophy
D. Metaplasia
Answer: B. Chronic pressure overload forces cardiomyocytes to enlarge (hypertrophy).
Because it eventually decompensates, it is pathologic.
2. A woman's uterus enlarges during pregnancy. This is:
A. Pathologic hypertrophy
B. Physiologic hypertrophy and hyperplasia
C. Atrophy
D. Dysplasia
Answer: B. Estrogen and progesterone drive both cell enlargement and division — a
normal, reversible adaptation.
3. A client with a fractured femur is immobilized for 8 weeks. The quadriceps muscle
decreases in mass. This is:
A. Hypertrophy
B. Hyperplasia
C. Disuse atrophy
D. Metaplasia
Answer: C. Reduced workload → decreased protein synthesis → atrophy. Reversible with
rehabilitation.
,4. A biopsy of the uterine cervix shows cells with large, irregular nuclei and disordered
arrangement but no invasion through the basement membrane. This is:
A. Metaplasia
B. Dysplasia
C. Carcinoma in situ
D. Anaplasia
Answer: B. Dysplasia = disordered, atypical growth confined above the basement
membrane; potentially reversible.
5. Chronic acid reflux causes the distal esophagus to replace squamous epithelium with
intestinal-type columnar cells. This is:
A. Dysplasia
B. Anaplasia
C. Metaplasia
D. Hyperplasia
Answer: C. Barrett's esophagus is a classic metaplastic change; it raises adenocarcinoma
risk.
6. Which statement best describes anaplasia?
A. Reversible cell substitution
B. Loss of differentiation and structural organization, typical of malignancy
C. Increase in cell number
D. Programmed cell death
Answer: B. Anaplastic cells lack normal features and organization — a hallmark of
cancer.
7. The single most common cause of cellular injury is:
A. Radiation
B. Hypoxia/ischemia
C. Chemical toxins
D. Infectious agents
,Answer: B. Oxygen deprivation is the most common mechanism of cell injury across
disease states.
8. During ischemia, ATP falls and the Na⁺/K⁺-ATPase pump fails. The immediate cellular
consequence is:
A. Cellular shrinkage
B. Sodium and water influx causing cellular swelling
C. Increased intracellular potassium
D. Decreased intracellular calcium
Answer: B. Loss of pump function → Na⁺ and water enter → hydropic swelling.
9. Which finding indicates irreversible cell injury?
A. Cellular swelling
B. Fatty change
C. Membrane rupture with enzyme leakage
D. Decreased ATP
Answer: C. Loss of membrane integrity with leakage of intracellular enzymes (troponin,
CK, LDH) marks irreversible injury.
10. A client with an MI has elevated troponin. This reflects:
A. Apoptosis
B. Necrosis with sarcolemmal rupture
C. Hypertrophy
D. Metaplasia
Answer: B. Troponin is intracellular; it appears in blood only when the membrane
ruptures.
11. Which type of necrosis occurs in a cerebral infarct?
A. Coagulative
B. Liquefactive
C. Caseous
, D. Fat
Answer: B. Brain is enzyme- and lipid-rich → liquefactive necrosis.
12. Coagulative necrosis is most typical of ischemia in the:
A. Brain
B. Heart, kidney, spleen
C. Pancreas
D. Lung
Answer: B. These organs show coagulative necrosis after ischemia; architecture is
temporarily preserved.
13. Caseous necrosis with granuloma formation is most characteristic of:
A. Tuberculosis
B. Myocardial infarction
C. Pancreatitis
D. Gangrene
Answer: A. Caseous necrosis is classic for TB and some fungal infections.
14. Which best distinguishes apoptosis from necrosis?
A. Apoptosis causes inflammation; necrosis does not
B. Apoptosis is programmed and non-inflammatory; necrosis is unregulated and
inflammatory
C. Both rupture the membrane
D. Apoptosis is always pathologic
Answer: B. Apoptosis: ATP-dependent, cell shrinks, no inflammation.
15. Apoptosis is executed by:
A. Caspases
B. Complement proteins
C. Histamine
D. Bradykinin
PATHOPHYSIOLOGY EXAM QUESTIONS
COMPLETED WITH CORRECT ANSWERS
Cellular Adaptation, Injury & Death (Q1–25)
1. A 72-year-old client's left ventricular wall thickens in response to years of
uncontrolled hypertension. This is best described as:
A. Physiologic hyperplasia
B. Pathologic hypertrophy
C. Compensatory atrophy
D. Metaplasia
Answer: B. Chronic pressure overload forces cardiomyocytes to enlarge (hypertrophy).
Because it eventually decompensates, it is pathologic.
2. A woman's uterus enlarges during pregnancy. This is:
A. Pathologic hypertrophy
B. Physiologic hypertrophy and hyperplasia
C. Atrophy
D. Dysplasia
Answer: B. Estrogen and progesterone drive both cell enlargement and division — a
normal, reversible adaptation.
3. A client with a fractured femur is immobilized for 8 weeks. The quadriceps muscle
decreases in mass. This is:
A. Hypertrophy
B. Hyperplasia
C. Disuse atrophy
D. Metaplasia
Answer: C. Reduced workload → decreased protein synthesis → atrophy. Reversible with
rehabilitation.
,4. A biopsy of the uterine cervix shows cells with large, irregular nuclei and disordered
arrangement but no invasion through the basement membrane. This is:
A. Metaplasia
B. Dysplasia
C. Carcinoma in situ
D. Anaplasia
Answer: B. Dysplasia = disordered, atypical growth confined above the basement
membrane; potentially reversible.
5. Chronic acid reflux causes the distal esophagus to replace squamous epithelium with
intestinal-type columnar cells. This is:
A. Dysplasia
B. Anaplasia
C. Metaplasia
D. Hyperplasia
Answer: C. Barrett's esophagus is a classic metaplastic change; it raises adenocarcinoma
risk.
6. Which statement best describes anaplasia?
A. Reversible cell substitution
B. Loss of differentiation and structural organization, typical of malignancy
C. Increase in cell number
D. Programmed cell death
Answer: B. Anaplastic cells lack normal features and organization — a hallmark of
cancer.
7. The single most common cause of cellular injury is:
A. Radiation
B. Hypoxia/ischemia
C. Chemical toxins
D. Infectious agents
,Answer: B. Oxygen deprivation is the most common mechanism of cell injury across
disease states.
8. During ischemia, ATP falls and the Na⁺/K⁺-ATPase pump fails. The immediate cellular
consequence is:
A. Cellular shrinkage
B. Sodium and water influx causing cellular swelling
C. Increased intracellular potassium
D. Decreased intracellular calcium
Answer: B. Loss of pump function → Na⁺ and water enter → hydropic swelling.
9. Which finding indicates irreversible cell injury?
A. Cellular swelling
B. Fatty change
C. Membrane rupture with enzyme leakage
D. Decreased ATP
Answer: C. Loss of membrane integrity with leakage of intracellular enzymes (troponin,
CK, LDH) marks irreversible injury.
10. A client with an MI has elevated troponin. This reflects:
A. Apoptosis
B. Necrosis with sarcolemmal rupture
C. Hypertrophy
D. Metaplasia
Answer: B. Troponin is intracellular; it appears in blood only when the membrane
ruptures.
11. Which type of necrosis occurs in a cerebral infarct?
A. Coagulative
B. Liquefactive
C. Caseous
, D. Fat
Answer: B. Brain is enzyme- and lipid-rich → liquefactive necrosis.
12. Coagulative necrosis is most typical of ischemia in the:
A. Brain
B. Heart, kidney, spleen
C. Pancreas
D. Lung
Answer: B. These organs show coagulative necrosis after ischemia; architecture is
temporarily preserved.
13. Caseous necrosis with granuloma formation is most characteristic of:
A. Tuberculosis
B. Myocardial infarction
C. Pancreatitis
D. Gangrene
Answer: A. Caseous necrosis is classic for TB and some fungal infections.
14. Which best distinguishes apoptosis from necrosis?
A. Apoptosis causes inflammation; necrosis does not
B. Apoptosis is programmed and non-inflammatory; necrosis is unregulated and
inflammatory
C. Both rupture the membrane
D. Apoptosis is always pathologic
Answer: B. Apoptosis: ATP-dependent, cell shrinks, no inflammation.
15. Apoptosis is executed by:
A. Caspases
B. Complement proteins
C. Histamine
D. Bradykinin
