PATHO 370 Midterm Study Guide West Coast University
Actual Exam 2026/2027 – Complete Assessment with
Detailed Rationales | 100% Verified | Pass Guaranteed – A+
Graded
Section A: Cellular Adaptation, Injury & Death (Q1–Q12)
Q1: Which term describes an increase in the size of individual cells, resulting in
enlargement of an organ or tissue in response to increased workload?
A. Hyperplasia
B. Hypertrophy [CORRECT]
C. Metaplasia
D. Atrophy
Correct Answer: B
Rationale: Hypertrophy is an increase in cell SIZE from increased workload (e.g., cardiac
and skeletal muscle). Hyperplasia increases cell number, metaplasia replaces one
mature cell type with another, and atrophy is decreased cell size.
Q2: During pregnancy, rising estrogen and progesterone stimulate proliferation of
glandular epithelial cells in the breast. This adaptive change is best classified as:
A. Atrophy
B. Metaplasia
C. Hyperplasia [CORRECT]
D. Dysplasia
Correct Answer: C
Rationale: A hormone-driven increase in the NUMBER of cells is physiologic hyperplasia.
Atrophy is shrinkage, metaplasia is cell-type replacement, and dysplasia is disordered,
atypical growth.
Q3: Biopsy of the bronchus of a long-term smoker shows normal ciliated columnar
epithelium replaced by stratified squamous epithelium better able to withstand
irritation. This change is:
A. Metaplasia [CORRECT]
B. Neoplasia
C. Atrophy
,D. Hypertrophy
Correct Answer: A
Rationale: Metaplasia is a reversible replacement of one mature cell type by another
better suited to chronic stress; it may revert if smoking stops but can progress to
dysplasia. Neoplasia is uncontrolled new growth, not an adaptive replacement.
Q4: A Pap smear reveals disordered growth with marked variation in cell size and shape
and hyperchromatic nuclei, confined to the epithelial surface. This finding is best
described as:
A. Dysplasia [CORRECT]
B. Metaplasia
C. Apoptosis
D. Coagulative necrosis
Correct Answer: A
Rationale: Dysplasia is deranged, atypical cell growth that may be premalignant and is
often reversible if the stimulus is removed. Metaplasia is cell-type replacement, and
apoptosis/necrosis are forms of cell death.
Q5: A patient in hemorrhagic shock develops severe tissue hypoxia. The earliest cellular
change expected is:
A. Nuclear pyknosis
B. Lysosomal rupture
C. Mitochondrial calcification
D. Cellular swelling from failure of the Na+/K+ ATPase pump [CORRECT]
Correct Answer: D
Rationale: Hypoxia depletes ATP, so the Na+/K+ pump fails and sodium and water enter
the cell, causing swelling—the first reversible change. Pyknosis, lysosomal rupture, and
mitochondrial calcification are late, irreversible events.
Q6: Which finding marks the transition from reversible to irreversible cell injury?
A. Reversible cellular swelling
B. Lysosomal membrane rupture with release of hydrolytic enzymes [CORRECT]
C. Detachment of ribosomes from rough endoplasmic reticulum
D. Reversible clumping of nuclear chromatin
Correct Answer: B
Rationale: Lysosomal membrane rupture allows hydrolytic enzymes to autodigest the
cell, which is irreversible. Swelling, ribosomal detachment, and chromatin clumping are
reversible changes.
, Q7: A patient with pulmonary tuberculosis has necrotic areas that grossly resemble
clumped, cheesy debris. This necrosis is:
A. Liquefactive necrosis
B. Fat necrosis
C. Caseous necrosis [CORRECT]
D. Coagulative necrosis
Correct Answer: C
Rationale: Caseous ("cheese-like") necrosis is characteristic of granulomatous
tuberculosis. Coagulative necrosis follows ischemia, liquefactive occurs in brain and
abscesses, and fat necrosis occurs in pancreatitis.
Q8: Which feature best distinguishes apoptosis from necrosis?
A. Cell swelling with rupture and inflammation
B. Affects groups of contiguous cells
C. Energy-dependent death of single cells without inflammation [CORRECT]
D. Always a pathologic process
Correct Answer: C
Rationale: Apoptosis is programmed, energy-requiring death of single cells with
membrane blebbing and no inflammation, and it occurs physiologically. Necrosis
produces swelling, lysis, inflammation, and is always pathologic.
Q9: Two hours after complete coronary artery occlusion, the affected myocardium
shows preserved cellular outlines with protein denaturation. This is:
A. Coagulative necrosis [CORRECT]
B. Liquefactive necrosis
C. Caseous necrosis
D. Gangrenous necrosis
Correct Answer: A
Rationale: Ischemic death of heart, kidney, spleen, and liver tissue produces coagulative
necrosis with preserved architecture. Liquefactive necrosis is typical of brain and
abscesses, and gangrene involves severe ischemia plus bacterial invasion.
Q10: In acute pancreatitis, leaked lipases digest adipose tissue, and calcium complexes
with released fatty acids to form chalky white soaps. This is:
A. Caseous necrosis
B. Liquefactive necrosis
C. Coagulative necrosis
D. Fat necrosis [CORRECT]
Correct Answer: D
Actual Exam 2026/2027 – Complete Assessment with
Detailed Rationales | 100% Verified | Pass Guaranteed – A+
Graded
Section A: Cellular Adaptation, Injury & Death (Q1–Q12)
Q1: Which term describes an increase in the size of individual cells, resulting in
enlargement of an organ or tissue in response to increased workload?
A. Hyperplasia
B. Hypertrophy [CORRECT]
C. Metaplasia
D. Atrophy
Correct Answer: B
Rationale: Hypertrophy is an increase in cell SIZE from increased workload (e.g., cardiac
and skeletal muscle). Hyperplasia increases cell number, metaplasia replaces one
mature cell type with another, and atrophy is decreased cell size.
Q2: During pregnancy, rising estrogen and progesterone stimulate proliferation of
glandular epithelial cells in the breast. This adaptive change is best classified as:
A. Atrophy
B. Metaplasia
C. Hyperplasia [CORRECT]
D. Dysplasia
Correct Answer: C
Rationale: A hormone-driven increase in the NUMBER of cells is physiologic hyperplasia.
Atrophy is shrinkage, metaplasia is cell-type replacement, and dysplasia is disordered,
atypical growth.
Q3: Biopsy of the bronchus of a long-term smoker shows normal ciliated columnar
epithelium replaced by stratified squamous epithelium better able to withstand
irritation. This change is:
A. Metaplasia [CORRECT]
B. Neoplasia
C. Atrophy
,D. Hypertrophy
Correct Answer: A
Rationale: Metaplasia is a reversible replacement of one mature cell type by another
better suited to chronic stress; it may revert if smoking stops but can progress to
dysplasia. Neoplasia is uncontrolled new growth, not an adaptive replacement.
Q4: A Pap smear reveals disordered growth with marked variation in cell size and shape
and hyperchromatic nuclei, confined to the epithelial surface. This finding is best
described as:
A. Dysplasia [CORRECT]
B. Metaplasia
C. Apoptosis
D. Coagulative necrosis
Correct Answer: A
Rationale: Dysplasia is deranged, atypical cell growth that may be premalignant and is
often reversible if the stimulus is removed. Metaplasia is cell-type replacement, and
apoptosis/necrosis are forms of cell death.
Q5: A patient in hemorrhagic shock develops severe tissue hypoxia. The earliest cellular
change expected is:
A. Nuclear pyknosis
B. Lysosomal rupture
C. Mitochondrial calcification
D. Cellular swelling from failure of the Na+/K+ ATPase pump [CORRECT]
Correct Answer: D
Rationale: Hypoxia depletes ATP, so the Na+/K+ pump fails and sodium and water enter
the cell, causing swelling—the first reversible change. Pyknosis, lysosomal rupture, and
mitochondrial calcification are late, irreversible events.
Q6: Which finding marks the transition from reversible to irreversible cell injury?
A. Reversible cellular swelling
B. Lysosomal membrane rupture with release of hydrolytic enzymes [CORRECT]
C. Detachment of ribosomes from rough endoplasmic reticulum
D. Reversible clumping of nuclear chromatin
Correct Answer: B
Rationale: Lysosomal membrane rupture allows hydrolytic enzymes to autodigest the
cell, which is irreversible. Swelling, ribosomal detachment, and chromatin clumping are
reversible changes.
, Q7: A patient with pulmonary tuberculosis has necrotic areas that grossly resemble
clumped, cheesy debris. This necrosis is:
A. Liquefactive necrosis
B. Fat necrosis
C. Caseous necrosis [CORRECT]
D. Coagulative necrosis
Correct Answer: C
Rationale: Caseous ("cheese-like") necrosis is characteristic of granulomatous
tuberculosis. Coagulative necrosis follows ischemia, liquefactive occurs in brain and
abscesses, and fat necrosis occurs in pancreatitis.
Q8: Which feature best distinguishes apoptosis from necrosis?
A. Cell swelling with rupture and inflammation
B. Affects groups of contiguous cells
C. Energy-dependent death of single cells without inflammation [CORRECT]
D. Always a pathologic process
Correct Answer: C
Rationale: Apoptosis is programmed, energy-requiring death of single cells with
membrane blebbing and no inflammation, and it occurs physiologically. Necrosis
produces swelling, lysis, inflammation, and is always pathologic.
Q9: Two hours after complete coronary artery occlusion, the affected myocardium
shows preserved cellular outlines with protein denaturation. This is:
A. Coagulative necrosis [CORRECT]
B. Liquefactive necrosis
C. Caseous necrosis
D. Gangrenous necrosis
Correct Answer: A
Rationale: Ischemic death of heart, kidney, spleen, and liver tissue produces coagulative
necrosis with preserved architecture. Liquefactive necrosis is typical of brain and
abscesses, and gangrene involves severe ischemia plus bacterial invasion.
Q10: In acute pancreatitis, leaked lipases digest adipose tissue, and calcium complexes
with released fatty acids to form chalky white soaps. This is:
A. Caseous necrosis
B. Liquefactive necrosis
C. Coagulative necrosis
D. Fat necrosis [CORRECT]
Correct Answer: D
