,NR 507 Final Exam | Advanced Pathophysiology (2026)
Actual Q&A PDF | Chamberlain
1. In cellular adaptation, which change involves an increase in the number of cells rather
than cell size?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Correct Answer: Hyperplasia
Rationale: Hyperplasia is an increase in cell number in response to hormonal or
functional demand. Hypertrophy increases cell size, atrophy reduces cell size, and
metaplasia replaces one mature cell type with another. This distinction is essential when
interpreting tissue responses to stress.
2. A 72-year-old male with chronic obstructive pulmonary disease develops right
ventricular enlargement. Which mechanism best explains this finding?
A) Left ventricular pressure overload
B) Pulmonary hypertension causing right ventricular hypertrophy
C) Systemic hypertension causing left atrial dilation
D) Aortic stenosis reducing coronary perfusion
,Correct Answer: Pulmonary hypertension causing right ventricular hypertrophy
Rationale: Chronic hypoxemia from COPD causes pulmonary vasoconstriction and
pulmonary hypertension. The right ventricle must generate higher pressure, leading to
hypertrophy and eventually cor pulmonale. Left-sided and systemic causes do not
directly produce this pattern.
3. Which type of necrosis is most characteristic of ischemic injury in the brain?
A) Coagulative necrosis
B) Fat necrosis
C) Liquefactive necrosis
D) Caseous necrosis
Correct Answer: Liquefactive necrosis
Rationale: Brain tissue lacks significant structural support and undergoes enzymatic
digestion after ischemia, producing liquefactive necrosis. Coagulative necrosis
predominates in heart and kidney, fat necrosis occurs in pancreas or breast, and caseous
necrosis is seen in tuberculosis. This distinction helps localize injury patterns.
4. During reperfusion after myocardial ischemia, which event most directly worsens cell
injury?
A) Reduced intracellular sodium
, B) Decreased calcium influx
C) Increased oxygen-derived free radicals
D) Enhanced mitochondrial ATP production
Correct Answer: Increased oxygen-derived free radicals
Rationale: Reperfusion restores oxygen but also generates reactive oxygen species
that damage membranes, proteins, and DNA. Calcium overload and inflammation
further amplify injury. Reduced sodium, decreased calcium, and improved ATP would be
protective rather than harmful.
5. A 58-year-old female has a biopsy showing orderly increase in cell size without atypia
in the endometrium. Which term best describes this finding?
A) Physiologic hypertrophy
B) Pathologic hyperplasia
C) Dysplasia
D) Anaplasia
Correct Answer: Pathologic hyperplasia
Rationale: Hyperplasia can be physiologic or pathologic; endometrial hyperplasia
from unopposed estrogen is pathologic. Dysplasia involves disordered growth and
atypia, while anaplasia indicates loss of differentiation. The orderly increase without
atypia favors hyperplasia.
Actual Q&A PDF | Chamberlain
1. In cellular adaptation, which change involves an increase in the number of cells rather
than cell size?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Correct Answer: Hyperplasia
Rationale: Hyperplasia is an increase in cell number in response to hormonal or
functional demand. Hypertrophy increases cell size, atrophy reduces cell size, and
metaplasia replaces one mature cell type with another. This distinction is essential when
interpreting tissue responses to stress.
2. A 72-year-old male with chronic obstructive pulmonary disease develops right
ventricular enlargement. Which mechanism best explains this finding?
A) Left ventricular pressure overload
B) Pulmonary hypertension causing right ventricular hypertrophy
C) Systemic hypertension causing left atrial dilation
D) Aortic stenosis reducing coronary perfusion
,Correct Answer: Pulmonary hypertension causing right ventricular hypertrophy
Rationale: Chronic hypoxemia from COPD causes pulmonary vasoconstriction and
pulmonary hypertension. The right ventricle must generate higher pressure, leading to
hypertrophy and eventually cor pulmonale. Left-sided and systemic causes do not
directly produce this pattern.
3. Which type of necrosis is most characteristic of ischemic injury in the brain?
A) Coagulative necrosis
B) Fat necrosis
C) Liquefactive necrosis
D) Caseous necrosis
Correct Answer: Liquefactive necrosis
Rationale: Brain tissue lacks significant structural support and undergoes enzymatic
digestion after ischemia, producing liquefactive necrosis. Coagulative necrosis
predominates in heart and kidney, fat necrosis occurs in pancreas or breast, and caseous
necrosis is seen in tuberculosis. This distinction helps localize injury patterns.
4. During reperfusion after myocardial ischemia, which event most directly worsens cell
injury?
A) Reduced intracellular sodium
, B) Decreased calcium influx
C) Increased oxygen-derived free radicals
D) Enhanced mitochondrial ATP production
Correct Answer: Increased oxygen-derived free radicals
Rationale: Reperfusion restores oxygen but also generates reactive oxygen species
that damage membranes, proteins, and DNA. Calcium overload and inflammation
further amplify injury. Reduced sodium, decreased calcium, and improved ATP would be
protective rather than harmful.
5. A 58-year-old female has a biopsy showing orderly increase in cell size without atypia
in the endometrium. Which term best describes this finding?
A) Physiologic hypertrophy
B) Pathologic hyperplasia
C) Dysplasia
D) Anaplasia
Correct Answer: Pathologic hyperplasia
Rationale: Hyperplasia can be physiologic or pathologic; endometrial hyperplasia
from unopposed estrogen is pathologic. Dysplasia involves disordered growth and
atypia, while anaplasia indicates loss of differentiation. The orderly increase without
atypia favors hyperplasia.
