PATHO 370 MIDTERM EXAM QUESTIONS AND ANSWERS WEST COAST UNIVERSITY
SECTION 1: CELLULAR FUNCTION AND ADAPTATION (Questions 1–35)
1. A patient with chronic hypertension develops thickening of the left ventricular wall due to
increased workload. This cellular adaptation is best classified as:
A. Hyperplasia
B. Metaplasia
C. Hypertrophy
D. Dysplasia
Answer: C
Rationale: Hypertrophy is an increase in cell size in response to increased functional
demand. Cardiac myocytes are permanent cells and cannot divide, so they enlarge to
compensate for increased afterload in chronic hypertension .
2. The cervical epithelium of a long-term smoker undergoes replacement of normal
columnar cells with stratified squamous cells. This adaptation is:
A. Dysplasia
B. Metaplasia
C. Hyperplasia
D. Anaplasia
Answer: B
Rationale: Metaplasia is the reversible replacement of one mature cell type with another as
a protective response to chronic irritation, such as smoking .
3. Which change is considered a reversible cellular adaptation?
A. Coagulative necrosis
B. Fatty change in the liver
,C. Liquefactive necrosis
D. Caseous necrosis
Answer: B
Rationale: Fatty change (steatosis) is reversible if the injurious agent, such as alcohol, is
removed. Necrosis is always irreversible .
4. Brain tissue deprived of blood supply undergoes which type of necrosis?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Gangrenous necrosis
D. Caseous necrosis
Answer: B
Rationale: Brain tissue undergoes liquefactive necrosis due to abundant lysosomes and
lipids, forming a cystic cavity .
5. A patient with tuberculosis has a lung lesion with a cheese-like appearance. This type of
necrosis is:
A. Coagulative
B. Liquefactive
C. Caseous
D. Fat necrosis
Answer: C
Rationale: Caseous necrosis is characteristic of tuberculosis, with a friable, yellow-white
appearance due to combined coagulative and liquefactive necrosis .
6. Which type of necrosis is associated with pancreatic enzyme leakage?
A. Coagulative
B. Liquefactive
C. Caseous
D. Fat necrosis
Answer: D
Rationale: Fat necrosis occurs when pancreatic lipases break down triglycerides into fatty
acids that bind calcium, forming soapy deposits .
7. Apoptosis is characterized by:
A. Cell swelling and lysis
B. Inflammation
,C. Programmed cell death without inflammation
D. Ischemic injury
Answer: C
Rationale: Apoptosis is programmed cell death that does not trigger an inflammatory
response, unlike necrosis.
8. Free radical injury causes cell damage primarily by:
A. Activating caspases
B. Lipid peroxidation of membranes
C. Blocking protein synthesis
D. Inhibiting sodium channels
Answer: B
Rationale: Free radicals attack polyunsaturated fatty acids in cell membranes, causing
lipid peroxidation and membrane damage .
9. Reperfusion injury after ischemia is mediated by:
A. Hypoxia-inducible factor
B. Oxygen free radicals
C. Lactic acid accumulation
D. ATP depletion
Answer: B
Rationale: Sudden reintroduction of oxygen during reperfusion generates reactive oxygen
species, causing further cell damage .
10. A patient with carbon monoxide poisoning has hypoxia due to:
A. Decreased oxygen-carrying capacity
B. Cyanide inhibition of cytochrome oxidase
C. Pulmonary edema
D. Anemia
Answer: A
Rationale: CO binds hemoglobin with 200 times greater affinity than oxygen, reducing
oxygen-carrying capacity .
11. Lead poisoning causes anemia by:
A. Hemolysis
B. Inhibiting heme synthesis enzymes
C. Bone marrow hypoplasia
D. Vitamin B12 deficiency
, Answer: B
Rationale: Lead inhibits aminolevulinic acid dehydratase and ferrochelatase, blocking
heme synthesis .
12. Which cellular change is most characteristic of dysplasia?
A. Increased cell size
B. Disorganized cell growth with nuclear atypia
C. Replacement of cell type
D. Decreased cell number
Answer: B
Rationale: Dysplasia involves disordered growth with nuclear atypia and is considered a
precancerous change.
13. Atrophy is defined as:
A. Increase in cell size
B. Increase in cell number
C. Decrease in cell size
D. Change in cell type
Answer: C
Rationale: Atrophy is a decrease in cell size due to reduced workload, hormonal
stimulation, or nutrient supply .
14. Hyperplasia involves:
A. Increase in cell size
B. Increase in cell number
C. Change in cell type
D. Disorganized growth
Answer: B
Rationale: Hyperplasia is an increase in the number of cells in a tissue or organ .
15. Cellular hypoxia results in:
A. Increased pH
B. Enhanced ATP activity
C. Loss of intracellular calcium
D. Failure of the sodium-potassium pump
Answer: D
Rationale: Hypoxia depletes ATP, causing failure of the sodium-potassium pump and
cellular swelling .
SECTION 1: CELLULAR FUNCTION AND ADAPTATION (Questions 1–35)
1. A patient with chronic hypertension develops thickening of the left ventricular wall due to
increased workload. This cellular adaptation is best classified as:
A. Hyperplasia
B. Metaplasia
C. Hypertrophy
D. Dysplasia
Answer: C
Rationale: Hypertrophy is an increase in cell size in response to increased functional
demand. Cardiac myocytes are permanent cells and cannot divide, so they enlarge to
compensate for increased afterload in chronic hypertension .
2. The cervical epithelium of a long-term smoker undergoes replacement of normal
columnar cells with stratified squamous cells. This adaptation is:
A. Dysplasia
B. Metaplasia
C. Hyperplasia
D. Anaplasia
Answer: B
Rationale: Metaplasia is the reversible replacement of one mature cell type with another as
a protective response to chronic irritation, such as smoking .
3. Which change is considered a reversible cellular adaptation?
A. Coagulative necrosis
B. Fatty change in the liver
,C. Liquefactive necrosis
D. Caseous necrosis
Answer: B
Rationale: Fatty change (steatosis) is reversible if the injurious agent, such as alcohol, is
removed. Necrosis is always irreversible .
4. Brain tissue deprived of blood supply undergoes which type of necrosis?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Gangrenous necrosis
D. Caseous necrosis
Answer: B
Rationale: Brain tissue undergoes liquefactive necrosis due to abundant lysosomes and
lipids, forming a cystic cavity .
5. A patient with tuberculosis has a lung lesion with a cheese-like appearance. This type of
necrosis is:
A. Coagulative
B. Liquefactive
C. Caseous
D. Fat necrosis
Answer: C
Rationale: Caseous necrosis is characteristic of tuberculosis, with a friable, yellow-white
appearance due to combined coagulative and liquefactive necrosis .
6. Which type of necrosis is associated with pancreatic enzyme leakage?
A. Coagulative
B. Liquefactive
C. Caseous
D. Fat necrosis
Answer: D
Rationale: Fat necrosis occurs when pancreatic lipases break down triglycerides into fatty
acids that bind calcium, forming soapy deposits .
7. Apoptosis is characterized by:
A. Cell swelling and lysis
B. Inflammation
,C. Programmed cell death without inflammation
D. Ischemic injury
Answer: C
Rationale: Apoptosis is programmed cell death that does not trigger an inflammatory
response, unlike necrosis.
8. Free radical injury causes cell damage primarily by:
A. Activating caspases
B. Lipid peroxidation of membranes
C. Blocking protein synthesis
D. Inhibiting sodium channels
Answer: B
Rationale: Free radicals attack polyunsaturated fatty acids in cell membranes, causing
lipid peroxidation and membrane damage .
9. Reperfusion injury after ischemia is mediated by:
A. Hypoxia-inducible factor
B. Oxygen free radicals
C. Lactic acid accumulation
D. ATP depletion
Answer: B
Rationale: Sudden reintroduction of oxygen during reperfusion generates reactive oxygen
species, causing further cell damage .
10. A patient with carbon monoxide poisoning has hypoxia due to:
A. Decreased oxygen-carrying capacity
B. Cyanide inhibition of cytochrome oxidase
C. Pulmonary edema
D. Anemia
Answer: A
Rationale: CO binds hemoglobin with 200 times greater affinity than oxygen, reducing
oxygen-carrying capacity .
11. Lead poisoning causes anemia by:
A. Hemolysis
B. Inhibiting heme synthesis enzymes
C. Bone marrow hypoplasia
D. Vitamin B12 deficiency
, Answer: B
Rationale: Lead inhibits aminolevulinic acid dehydratase and ferrochelatase, blocking
heme synthesis .
12. Which cellular change is most characteristic of dysplasia?
A. Increased cell size
B. Disorganized cell growth with nuclear atypia
C. Replacement of cell type
D. Decreased cell number
Answer: B
Rationale: Dysplasia involves disordered growth with nuclear atypia and is considered a
precancerous change.
13. Atrophy is defined as:
A. Increase in cell size
B. Increase in cell number
C. Decrease in cell size
D. Change in cell type
Answer: C
Rationale: Atrophy is a decrease in cell size due to reduced workload, hormonal
stimulation, or nutrient supply .
14. Hyperplasia involves:
A. Increase in cell size
B. Increase in cell number
C. Change in cell type
D. Disorganized growth
Answer: B
Rationale: Hyperplasia is an increase in the number of cells in a tissue or organ .
15. Cellular hypoxia results in:
A. Increased pH
B. Enhanced ATP activity
C. Loss of intracellular calcium
D. Failure of the sodium-potassium pump
Answer: D
Rationale: Hypoxia depletes ATP, causing failure of the sodium-potassium pump and
cellular swelling .
