NR 507 Exam 1 Actual Exam V1 | NR 507 Advanced Pathophysiology
(NR507 Exam 1) [PDF] | Chamberlain University
1. A 62-year-old male with a history of chronic hypertension presents to the clinic. An
echocardiogram reveals increased thickness of the left ventricular wall. Which cellular
adaptation has occurred?
A. Hyperplasia
B. Metaplasia
C. Atrophy
D. Hypertrophy
Answer: D
Rationale: The increase in cardiac muscle mass in response to increased workload from
hypertension is a classic example of hypertrophy. Hypertrophy involves an increase in the
size of individual cells rather than an increase in the number of cells. This adaptation is
common in permanent cell populations like the myocardium that cannot undergo mitosis.
2. A 45-year-old female undergoes a routine pap smear which reveals abnormal changes in
the size and shape of cervical epithelial cells. This condition is best described as:
A. Dysplasia
B. Hyperplasia
C. Metaplasia
D. Anaplasia
Answer: A
Rationale: Dysplasia refers to abnormal changes in the size, shape, and organization of
mature cells. It is often considered a precancerous condition but is not synonymous with
cancer. If the inciting stimulus is removed, dysplastic changes are frequently reversible.
3. During myocardial ischemia, the lack of oxygen leads to a decrease in ATP production.
What is the immediate consequence of the failure of the sodium-potassium pump?
A. Intracellular dehydration
B. Intracellular sodium and water accumulation
C. Extracellular potassium decrease
D. Increased mitochondrial respiration
Answer: B
,Rationale: The failure of the ATP-dependent Na+/K+ pump leads to an accumulation of
sodium inside the cell. Because water follows sodium osmotically, the cell experiences
swelling, known as oncosis. This is one of the earliest signs of cell injury due to hypoxia.
4. A patient presents with a large area of tissue death in the brain following an ischemic
stroke. The pathologist notes that the tissue has become soft and liquefied. This is an
example of:
A. Coagulative necrosis
B. Caseous necrosis
C. Liquefactive necrosis
D. Fat necrosis
Answer: C
Rationale: Liquefactive necrosis is characteristic of ischemic injury to the central nervous
system. This occurs because brain cells are rich in digestive hydrolytic enzymes and lipids.
As the cells are digested by their own enzymes, the tissue becomes soft and liquid.
5. A 30-year-old patient is diagnosed with pulmonary tuberculosis. A lung biopsy reveals a
cheese-like appearance of the necrotic tissue. What type of necrosis is this?
A. Fat necrosis
B. Gangrenous necrosis
C. Coagulative necrosis
D. Caseous necrosis
Answer: D
Rationale: Caseous necrosis is typically found in lung tissue infected by Mycobacterium
tuberculosis. It is a combination of coagulative and liquefactive necrosis where the dead
cells disintegrate but are not completely digested. This results in a soft, granular, and
friable appearance resembling clumped cheese.
6. Which of the following is a characteristic feature of apoptosis that distinguishes it from
necrosis?
A. Presence of inflammation
B. Cell swelling and lysis
C. Passive process due to external injury
D. Programmed cell death involving caspase activation
Answer: D
, Rationale: Apoptosis is an active, programmed process of cellular self-destruction that
involves the activation of enzymes called caspases. Unlike necrosis, apoptosis does not
typically trigger an inflammatory response because the cell fragments into apoptotic bodies
that are quietly phagocytized. It is a critical mechanism for maintaining homeostasis and
removing damaged or unnecessary cells.
7. A patient is exposed to high levels of ionizing radiation. This leads to the formation of
reactive oxygen species (ROS). How do ROS cause cellular injury?
A. By increasing intracellular pH
B. By damaging lipids, proteins, and DNA through oxidative stress
C. By promoting ATP synthesis
D. By stabilizing the mitochondrial membrane
Answer: B
Rationale: Reactive oxygen species cause injury via oxidative stress, which involves the
peroxidation of lipids, alteration of proteins, and breaking of DNA strands. These molecules
are highly unstable and seek to steal electrons from surrounding structures. The resulting
damage can lead to cell death or mutations.
8. In the context of the inflammatory response, what is the primary function of histamine
released from mast cells?
A. To induce vasoconstriction
B. To cause vasodilation and increase vascular permeability
C. To inhibit the movement of leukocytes
D. To decrease the production of exudate
Answer: B
Rationale: Histamine is a potent vasoactive amine that triggers rapid vasodilation and
increases the permeability of capillaries. This allow fluids, proteins, and white blood cells to
migrate from the blood into the interstitial space. It is one of the first mediators released
during an acute inflammatory response.
9. A 10-year-old child presents with a high fever and an elevated white blood cell count.
These systemic manifestations of inflammation are primarily mediated by:
A. Histamine and Serotonin
B. Nitric Oxide and Bradykinin
C. IL-1, IL-6, and TNF-alpha
D. Leukotrienes and Prostaglandins
(NR507 Exam 1) [PDF] | Chamberlain University
1. A 62-year-old male with a history of chronic hypertension presents to the clinic. An
echocardiogram reveals increased thickness of the left ventricular wall. Which cellular
adaptation has occurred?
A. Hyperplasia
B. Metaplasia
C. Atrophy
D. Hypertrophy
Answer: D
Rationale: The increase in cardiac muscle mass in response to increased workload from
hypertension is a classic example of hypertrophy. Hypertrophy involves an increase in the
size of individual cells rather than an increase in the number of cells. This adaptation is
common in permanent cell populations like the myocardium that cannot undergo mitosis.
2. A 45-year-old female undergoes a routine pap smear which reveals abnormal changes in
the size and shape of cervical epithelial cells. This condition is best described as:
A. Dysplasia
B. Hyperplasia
C. Metaplasia
D. Anaplasia
Answer: A
Rationale: Dysplasia refers to abnormal changes in the size, shape, and organization of
mature cells. It is often considered a precancerous condition but is not synonymous with
cancer. If the inciting stimulus is removed, dysplastic changes are frequently reversible.
3. During myocardial ischemia, the lack of oxygen leads to a decrease in ATP production.
What is the immediate consequence of the failure of the sodium-potassium pump?
A. Intracellular dehydration
B. Intracellular sodium and water accumulation
C. Extracellular potassium decrease
D. Increased mitochondrial respiration
Answer: B
,Rationale: The failure of the ATP-dependent Na+/K+ pump leads to an accumulation of
sodium inside the cell. Because water follows sodium osmotically, the cell experiences
swelling, known as oncosis. This is one of the earliest signs of cell injury due to hypoxia.
4. A patient presents with a large area of tissue death in the brain following an ischemic
stroke. The pathologist notes that the tissue has become soft and liquefied. This is an
example of:
A. Coagulative necrosis
B. Caseous necrosis
C. Liquefactive necrosis
D. Fat necrosis
Answer: C
Rationale: Liquefactive necrosis is characteristic of ischemic injury to the central nervous
system. This occurs because brain cells are rich in digestive hydrolytic enzymes and lipids.
As the cells are digested by their own enzymes, the tissue becomes soft and liquid.
5. A 30-year-old patient is diagnosed with pulmonary tuberculosis. A lung biopsy reveals a
cheese-like appearance of the necrotic tissue. What type of necrosis is this?
A. Fat necrosis
B. Gangrenous necrosis
C. Coagulative necrosis
D. Caseous necrosis
Answer: D
Rationale: Caseous necrosis is typically found in lung tissue infected by Mycobacterium
tuberculosis. It is a combination of coagulative and liquefactive necrosis where the dead
cells disintegrate but are not completely digested. This results in a soft, granular, and
friable appearance resembling clumped cheese.
6. Which of the following is a characteristic feature of apoptosis that distinguishes it from
necrosis?
A. Presence of inflammation
B. Cell swelling and lysis
C. Passive process due to external injury
D. Programmed cell death involving caspase activation
Answer: D
, Rationale: Apoptosis is an active, programmed process of cellular self-destruction that
involves the activation of enzymes called caspases. Unlike necrosis, apoptosis does not
typically trigger an inflammatory response because the cell fragments into apoptotic bodies
that are quietly phagocytized. It is a critical mechanism for maintaining homeostasis and
removing damaged or unnecessary cells.
7. A patient is exposed to high levels of ionizing radiation. This leads to the formation of
reactive oxygen species (ROS). How do ROS cause cellular injury?
A. By increasing intracellular pH
B. By damaging lipids, proteins, and DNA through oxidative stress
C. By promoting ATP synthesis
D. By stabilizing the mitochondrial membrane
Answer: B
Rationale: Reactive oxygen species cause injury via oxidative stress, which involves the
peroxidation of lipids, alteration of proteins, and breaking of DNA strands. These molecules
are highly unstable and seek to steal electrons from surrounding structures. The resulting
damage can lead to cell death or mutations.
8. In the context of the inflammatory response, what is the primary function of histamine
released from mast cells?
A. To induce vasoconstriction
B. To cause vasodilation and increase vascular permeability
C. To inhibit the movement of leukocytes
D. To decrease the production of exudate
Answer: B
Rationale: Histamine is a potent vasoactive amine that triggers rapid vasodilation and
increases the permeability of capillaries. This allow fluids, proteins, and white blood cells to
migrate from the blood into the interstitial space. It is one of the first mediators released
during an acute inflammatory response.
9. A 10-year-old child presents with a high fever and an elevated white blood cell count.
These systemic manifestations of inflammation are primarily mediated by:
A. Histamine and Serotonin
B. Nitric Oxide and Bradykinin
C. IL-1, IL-6, and TNF-alpha
D. Leukotrienes and Prostaglandins
