NSG 520 Pathophysiology & Pharmacology
--- --- --- --- ---
Final Exam --- ---
200 Practice Questions with Rationales |
--- --- --- --- --- ---
2026/2027 Edition --- ---
--
-
SECTION 1: CELLULAR PATHOPHYSIOLOGY & ADAPTATION (Q1-
--- --- --- --- --- ---
20)---
Q1. Which cellular change is most characteristic of irreversible cell injury?
--- --- --- --- --- --- --- --- --- --- ---
A. Swelling of mitochondria --- --- ---
B. Nuclear pyknosis --- ---
C. Loss of plasma membrane integrity
--- --- --- --- ---
D. Ribosome detachment --- ---
Correct Answer: C. Loss of plasma membrane integrity
--- --- --- --- --- --- --- ---
Rationale: Loss of plasma membrane integrity is irreversible because it leads to
--- --- --- --- --- --- --- --- --- --- --- ---
uncontrolled ion influx and enzyme leakage. Ribosome detachment and
--- --- --- --- --- --- --- --- ---
mitochondrial swelling are reversible changes that occur early in cell injury.
--- --- --- --- --- --- --- --- --- --- ---
Pyknosis (nuclear condensation) can occur before the point of no return.
--- --- --- --- --- --- --- --- --- --- ------
--
-
Q2. A patient with chronic alcoholism develops hepatic necrosis with
--- --- --- --- --- --- --- --- --- ---
preserved tissue architecture. This is an example of:
--- --- --- --- --- --- --- ---
A. Apoptosis ---
B. Coagulative necrosis --- ---
C. Liquefactive necrosis --- ---
D. Caseous necrosis --- ---
,Correct Answer: B. Coagulative necrosis
--- --- --- --- ---
Rationale: Coagulative necrosis, typically from ischemia or toxins like alcohol,
--- --- --- --- --- --- --- --- --- ---
preserves tissue outlines for days. Liquefactive necrosis occurs in the brain,
--- --- --- --- --- --- --- --- --- --- ---
caseous necrosis is characteristic of tuberculosis, and apoptosis is programmed
--- --- --- --- --- --- --- --- --- ---
cell death without inflammation.
--- --- --- ------
--
-
Q3. Which cytokine is primarily responsible for fever in systemic
--- --- --- --- --- --- --- --- --- ---
inflammation? ---
A. IL-4 ---
B. IL-10 ---
C. TNF-α ---
D. IL-1 and IL-6 --- --- ---
Correct Answer: D. IL-1 and IL-6
--- --- --- --- --- ---
Rationale: IL-1 and IL-6 act on the hypothalamic thermoregulatory center to
--- --- --- --- --- --- --- --- --- --- ---
produce prostaglandin E2, causing fever. TNF-α contributes to inflammation but
--- --- --- --- --- --- --- --- --- ---
is not the primary pyrogen.
--- --- --- --- ------
--
-
Q4. A patient with chronic hypertension develops concentric left ventricular
--- --- --- --- --- --- --- --- --- -
hypertrophy. This is an example of:
-- --- --- --- --- --- ---
A. Pressure overload adaptation --- --- ---
B. Volume overload adaptation --- --- ---
C. Apoptosis ---
D. Atrophic remodeling --- ---
Correct Answer: A. Pressure overload adaptation
--- --- --- --- --- ---
Rationale: Pressure overload (hypertension, aortic stenosis) causes parallel
--- --- --- --- --- --- --- ---
sarcomere addition → concentric hypertrophy. Volume overload (as in valvular
--- --- --- --- --- --- --- --- --- ---
regurgitation) causes eccentric hypertrophy with sarcomeres added in series.
--- --- --- --- --- --- --- --- ------
--
-
,Q5. The irreversible point in cell injury is marked by:
--- --- --- --- --- --- --- --- --- ---
A. ATP depletion --- ---
B. Cellular swelling --- ---
C. Loss of plasma membrane integrity
--- --- --- --- ---
D. Ribosomal detachment --- ---
Correct Answer: C. Loss of plasma membrane integrity
--- --- --- --- --- --- --- ---
Rationale: Loss of plasma membrane integrity is the point of no return. ATP
--- --- --- --- --- --- --- --- --- --- --- --- ---
depletion, cellular swelling, and ribosomal detachment are reversible changes if
--- --- --- --- --- --- --- --- --- ---
oxygenation and energy production are restored. --- --- --- --- --- ------
--
-
Q6. Which type of necrosis is most commonly seen in the brain after a
--- --- --- --- --- --- --- --- --- --- --- --- --- ---
stroke? ---
A. Coagulative necrosis --- ---
B. Liquefactive necrosis --- ---
C. Caseous necrosis --- ---
D. Fat necrosis--- ---
Correct Answer: B. Liquefactive necrosis
--- --- --- --- ---
Rationale: Liquefactive necrosis occurs in the brain due to the high lipid
--- --- --- --- --- --- --- --- --- --- --- ---
content and enzymatic breakdown of tissue. Coagulative necrosis is typical in
--- --- --- --- --- --- --- --- --- --- ---
myocardial infarction, caseous in tuberculosis, and fat necrosis in pancreatitis.
--- --- --- --- --- --- --- --- --- ------
--
-
Q7. A patient with tuberculosis develops a lung lesion with central
--- --- --- --- --- --- --- --- --- --- ---
caseation. ---
This is which type of necrosis?
--- --- --- --- --- ---
A. Coagulative ---
B. Liquefactive ---
C. Caseous ---
D. Fat necrosis--- ---
, Correct Answer: C. Caseous necrosis
--- --- --- --- ---
Rationale: Caseous necrosis (cheese-like appearance) is characteristic of
--- --- --- --- --- --- --- ---
tuberculosis and some fungal infections; it contains macrophages and
--- --- --- --- --- --- --- --- ---
lymphocytes forming granulomas. --- --- ------
--
-
Q8. A patient with acute pancreatitis develops chalky white spots in the
--- --- --- --- --- --- --- --- --- --- --- ---
peritoneum. This is: --- --- ---
A. Coagulative necrosis --- ---
B. Fat necrosis--- ---
C. Caseous necrosis --- ---
D. Fibrinoid necrosis --- ---
Correct Answer: B. Fat necrosis
--- --- --- --- ---
Rationale: Fat necrosis occurs when pancreatic enzymes (lipases) break down
--- --- --- --- --- --- --- --- --- ---
triglycerides into fatty acids, which bind calcium to form chalky white deposits
--- --- --- --- --- --- --- --- --- --- --- ---
(saponification). ------
--
-
Q9. A patient with chronic GERD develops replacement of esophageal
--- --- --- --- --- --- --- --- --- ---
squamous epithelium with columnar epithelium. This adaptation is known
--- --- --- --- --- --- --- --- ---
as: ---
A. Dysplasia ---
B. Metaplasia ---
C. Hyperplasia ---
D. Necrosis ---
Correct Answer: B. Metaplasia
--- --- --- ---
Rationale: Metaplasia involves replacement of one mature cell type by another
--- --- --- --- --- --- --- --- --- --- ---
in response to chronic irritation. Barrett's esophagus is a classic example.
--- --- --- --- --- --- --- --- --- --- ---
Dysplasia involves disordered cellular growth and is considered pre-neoplastic.
--- --- --- --- --- --- --- --- ------
--
-
--- --- --- --- ---
Final Exam --- ---
200 Practice Questions with Rationales |
--- --- --- --- --- ---
2026/2027 Edition --- ---
--
-
SECTION 1: CELLULAR PATHOPHYSIOLOGY & ADAPTATION (Q1-
--- --- --- --- --- ---
20)---
Q1. Which cellular change is most characteristic of irreversible cell injury?
--- --- --- --- --- --- --- --- --- --- ---
A. Swelling of mitochondria --- --- ---
B. Nuclear pyknosis --- ---
C. Loss of plasma membrane integrity
--- --- --- --- ---
D. Ribosome detachment --- ---
Correct Answer: C. Loss of plasma membrane integrity
--- --- --- --- --- --- --- ---
Rationale: Loss of plasma membrane integrity is irreversible because it leads to
--- --- --- --- --- --- --- --- --- --- --- ---
uncontrolled ion influx and enzyme leakage. Ribosome detachment and
--- --- --- --- --- --- --- --- ---
mitochondrial swelling are reversible changes that occur early in cell injury.
--- --- --- --- --- --- --- --- --- --- ---
Pyknosis (nuclear condensation) can occur before the point of no return.
--- --- --- --- --- --- --- --- --- --- ------
--
-
Q2. A patient with chronic alcoholism develops hepatic necrosis with
--- --- --- --- --- --- --- --- --- ---
preserved tissue architecture. This is an example of:
--- --- --- --- --- --- --- ---
A. Apoptosis ---
B. Coagulative necrosis --- ---
C. Liquefactive necrosis --- ---
D. Caseous necrosis --- ---
,Correct Answer: B. Coagulative necrosis
--- --- --- --- ---
Rationale: Coagulative necrosis, typically from ischemia or toxins like alcohol,
--- --- --- --- --- --- --- --- --- ---
preserves tissue outlines for days. Liquefactive necrosis occurs in the brain,
--- --- --- --- --- --- --- --- --- --- ---
caseous necrosis is characteristic of tuberculosis, and apoptosis is programmed
--- --- --- --- --- --- --- --- --- ---
cell death without inflammation.
--- --- --- ------
--
-
Q3. Which cytokine is primarily responsible for fever in systemic
--- --- --- --- --- --- --- --- --- ---
inflammation? ---
A. IL-4 ---
B. IL-10 ---
C. TNF-α ---
D. IL-1 and IL-6 --- --- ---
Correct Answer: D. IL-1 and IL-6
--- --- --- --- --- ---
Rationale: IL-1 and IL-6 act on the hypothalamic thermoregulatory center to
--- --- --- --- --- --- --- --- --- --- ---
produce prostaglandin E2, causing fever. TNF-α contributes to inflammation but
--- --- --- --- --- --- --- --- --- ---
is not the primary pyrogen.
--- --- --- --- ------
--
-
Q4. A patient with chronic hypertension develops concentric left ventricular
--- --- --- --- --- --- --- --- --- -
hypertrophy. This is an example of:
-- --- --- --- --- --- ---
A. Pressure overload adaptation --- --- ---
B. Volume overload adaptation --- --- ---
C. Apoptosis ---
D. Atrophic remodeling --- ---
Correct Answer: A. Pressure overload adaptation
--- --- --- --- --- ---
Rationale: Pressure overload (hypertension, aortic stenosis) causes parallel
--- --- --- --- --- --- --- ---
sarcomere addition → concentric hypertrophy. Volume overload (as in valvular
--- --- --- --- --- --- --- --- --- ---
regurgitation) causes eccentric hypertrophy with sarcomeres added in series.
--- --- --- --- --- --- --- --- ------
--
-
,Q5. The irreversible point in cell injury is marked by:
--- --- --- --- --- --- --- --- --- ---
A. ATP depletion --- ---
B. Cellular swelling --- ---
C. Loss of plasma membrane integrity
--- --- --- --- ---
D. Ribosomal detachment --- ---
Correct Answer: C. Loss of plasma membrane integrity
--- --- --- --- --- --- --- ---
Rationale: Loss of plasma membrane integrity is the point of no return. ATP
--- --- --- --- --- --- --- --- --- --- --- --- ---
depletion, cellular swelling, and ribosomal detachment are reversible changes if
--- --- --- --- --- --- --- --- --- ---
oxygenation and energy production are restored. --- --- --- --- --- ------
--
-
Q6. Which type of necrosis is most commonly seen in the brain after a
--- --- --- --- --- --- --- --- --- --- --- --- --- ---
stroke? ---
A. Coagulative necrosis --- ---
B. Liquefactive necrosis --- ---
C. Caseous necrosis --- ---
D. Fat necrosis--- ---
Correct Answer: B. Liquefactive necrosis
--- --- --- --- ---
Rationale: Liquefactive necrosis occurs in the brain due to the high lipid
--- --- --- --- --- --- --- --- --- --- --- ---
content and enzymatic breakdown of tissue. Coagulative necrosis is typical in
--- --- --- --- --- --- --- --- --- --- ---
myocardial infarction, caseous in tuberculosis, and fat necrosis in pancreatitis.
--- --- --- --- --- --- --- --- --- ------
--
-
Q7. A patient with tuberculosis develops a lung lesion with central
--- --- --- --- --- --- --- --- --- --- ---
caseation. ---
This is which type of necrosis?
--- --- --- --- --- ---
A. Coagulative ---
B. Liquefactive ---
C. Caseous ---
D. Fat necrosis--- ---
, Correct Answer: C. Caseous necrosis
--- --- --- --- ---
Rationale: Caseous necrosis (cheese-like appearance) is characteristic of
--- --- --- --- --- --- --- ---
tuberculosis and some fungal infections; it contains macrophages and
--- --- --- --- --- --- --- --- ---
lymphocytes forming granulomas. --- --- ------
--
-
Q8. A patient with acute pancreatitis develops chalky white spots in the
--- --- --- --- --- --- --- --- --- --- --- ---
peritoneum. This is: --- --- ---
A. Coagulative necrosis --- ---
B. Fat necrosis--- ---
C. Caseous necrosis --- ---
D. Fibrinoid necrosis --- ---
Correct Answer: B. Fat necrosis
--- --- --- --- ---
Rationale: Fat necrosis occurs when pancreatic enzymes (lipases) break down
--- --- --- --- --- --- --- --- --- ---
triglycerides into fatty acids, which bind calcium to form chalky white deposits
--- --- --- --- --- --- --- --- --- --- --- ---
(saponification). ------
--
-
Q9. A patient with chronic GERD develops replacement of esophageal
--- --- --- --- --- --- --- --- --- ---
squamous epithelium with columnar epithelium. This adaptation is known
--- --- --- --- --- --- --- --- ---
as: ---
A. Dysplasia ---
B. Metaplasia ---
C. Hyperplasia ---
D. Necrosis ---
Correct Answer: B. Metaplasia
--- --- --- ---
Rationale: Metaplasia involves replacement of one mature cell type by another
--- --- --- --- --- --- --- --- --- --- ---
in response to chronic irritation. Barrett's esophagus is a classic example.
--- --- --- --- --- --- --- --- --- --- ---
Dysplasia involves disordered cellular growth and is considered pre-neoplastic.
--- --- --- --- --- --- --- --- ------
--
-
