Pathophysiology Midterm Examination 2026/2027 |
Questions and Answers
Table of Contents
1. Chapter 1: Introduction to Pathophysiology (Q1 - Q15)
o Concepts of Health, Disease, and Homeostasis
o Cellular Adaptation, Injury, and Death
o Inflammation and Healing
o Genetics and Genetic Diseases
2. Chapter 2: Disorders of Fluid, Electrolyte, and Acid-Base Balance (Q16 - Q30)
o Fluid Compartments and Shifts
o Electrolyte Imbalances (Sodium, Potassium, Calcium)
o Acid-Base Disorders (Respiratory and Metabolic)
3. Chapter 3: Disorders of the Immune System (Q31 - Q45)
o Innate and Adaptive Immunity
o Hypersensitivity Reactions
o Immunodeficiency and Autoimmune Diseases
4. Chapter 4: Disorders of the Hematologic System (Q46 - Q60)
o Anemias (Microcytic, Macrocytic, Normocytic)
o Coagulation Disorders
o Leukemias and Lymphomas
5. Chapter 5: Disorders of the Cardiovascular System (Q61 - Q75)
o Atherosclerosis and Hypertension
o Ischemic Heart Disease and Heart Failure
o Arrhythmias and Valvular Disorders
6. Chapter 6: Disorders of the Respiratory System (Q76 - Q90)
o Obstructive and Restrictive Lung Diseases
o Gas Exchange Abnormalities and Pulmonary Vascular Disorders
7. Chapter 7: Disorders of the Renal System (Q91 - Q105)
o Acute Kidney Injury and Chronic Kidney Disease
o Glomerular and Tubular Disorders
8. Chapter 8: Disorders of the Neurological System (Q106 - Q120)
o Acute Brain Injury and Neurodegenerative Diseases
o Seizures and Neuromuscular Disorders
9. Chapter 9: Disorders of the Endocrine System (Q121 - Q135)
o Pituitary, Thyroid, and Adrenal Disorders
, o Diabetes Mellitus and Metabolic Syndrome
10. Chapter 10: Disorders of the Gastrointestinal and Hepatobiliary Systems
(Q136 - Q150)
o Gastroesophageal, Peptic, and Intestinal Disorders
o Liver, Gallbladder, and Pancreatic Disorders
11. Chapter 11: Disorders of the Musculoskeletal System (Q151 - Q160)
o Osteoporosis, Osteoarthritis, and Rheumatoid Arthritis
o Muscle Disorders and Bone Tumors
12. Chapter 12: Disorders of the Reproductive System (Q161 - Q170)
o Male and Female Reproductive Disorders
o Sexually Transmitted Infections and Pregnancy-Related Conditions
13. Chapter 13: Multisystem and Integrative Concepts (Q171 - Q180)
o Shock
o Sepsis and Multiple Organ Dysfunction Syndrome (MODS)
o Burns
Chapter 1: Introduction to Pathophysiology
Question 1
A 62-year-old male with a 40-year history of smoking presents with a chronic cough and
shortness of breath. A lung biopsy reveals that the normal ciliated pseudostratified
columnar epithelium of his bronchi has been replaced by stratified squamous
epithelium. Which of the following terms best describes this cellular adaptation?
A. Dysplasia
B. Metaplasia
C. Hyperplasia
D. Hypertrophy
Answer: B
Rationale:
• B. Metaplasia is a reversible change in which one adult cell type is replaced by
another adult cell type that is better able to survive the adverse environment. In
this case, the columnar epithelium is replaced by more robust squamous
epithelium due to chronic irritation from smoking.
• A. Dysplasia refers to disordered growth and is a precursor to malignancy,
characterized by variation in cell size, shape, and organization.
• C. Hyperplasia is an increase in the number of cells in an organ or tissue.
• D. Hypertrophy is an increase in the size of cells.
,Question 2
A 19-year-old male is brought to the emergency department after a motor vehicle
accident. He has a fractured femur and significant blood loss. A blood transfusion is
initiated. His red blood cells are noted to have a decreased life span, and they are
removed from circulation by macrophages in the spleen. Which of the following
processes is most directly responsible for the removal of these aged red blood cells?
A. Oncosis
B. Necrosis
C. Apoptosis
D. Autophagy
Answer: C
Rationale:
• C. Apoptosis is programmed cell death, a normal physiological process that
removes aged or damaged cells without inciting an inflammatory response. The
removal of senescent red blood cells by splenic macrophages is a classic example
of apoptosis.
• A. Oncosis is a form of cell death characterized by cell swelling, often a precursor
to necrosis.
• B. Necrosis is a pathological process of cell death caused by severe injury,
leading to cell swelling, rupture, and inflammation.
• D. Autophagy is a process of self-digestion of cellular components, often a
survival mechanism during nutrient deprivation.
Question 3
A 5-year-old boy presents with recurrent, severe bacterial infections. Genetic testing
reveals a defect in the gene responsible for the NADPH oxidase complex in his
neutrophils. This defect impairs the ability of his phagocytes to produce superoxide
radicals. Which of the following conditions is most likely?
A. Severe Combined Immunodeficiency (SCID)
B. Chronic Granulomatous Disease (CGD)
C. Leukocyte Adhesion Deficiency (LAD)
D. DiGeorge Syndrome
Answer: B
Rationale:
• B. Chronic Granulomatous Disease (CGD) is an inherited immunodeficiency
disorder caused by a defect in the NADPH oxidase complex, which is essential for
the respiratory burst and the production of reactive oxygen species (ROS) to kill
ingested bacteria and fungi.
• A. SCID is characterized by a profound defect in both B and T cell function.
• C. LAD is a defect in leukocyte adhesion and migration.
, • D. DiGeorge Syndrome is a developmental defect of the thymus and
parathyroid glands, leading to T-cell deficiency.
Question 4
A 45-year-old female presents with a firm, fixed, and painless lump in her right breast. A
biopsy reveals malignant cells that have broken through the basement membrane and
are invading the surrounding stromal tissue. Which of the following terms best describes
this stage of the tumor?
A. Carcinoma in situ
B. Benign neoplasm
C. Invasive carcinoma
D. Dysplastic nevus
Answer: C
Rationale:
• C. Invasive carcinoma (or infiltrating carcinoma) is a cancer that has grown
beyond the basement membrane of the epithelium and is invading the
surrounding tissue.
• A. Carcinoma in situ refers to pre-invasive cancer that is confined to the
epithelium.
• B. Benign neoplasm is a non-cancerous growth that does not invade or
metastasize.
• D. Dysplastic nevus is a benign mole with atypical cells, not an invasive
carcinoma.
Question 5
An autopsy on an 80-year-old patient reveals significant atrophy of the brain. The brain
weight is 20% below the expected normal for his age, with widened sulci and narrowed
gyri. Which of the following cellular mechanisms is the primary cause of this tissue
shrinkage?
A. Apoptosis
B. Necrosis
C. Autophagy
D. Increased ubiquitin-proteasome activity
Answer: A
Rationale:
• A. Apoptosis is the primary mechanism of programmed cell death that occurs in
aging and neurodegenerative diseases like Alzheimer's, contributing to the
gradual loss of neurons and tissue atrophy.
• B. Necrosis is a pathological, inflammatory process, not the orderly cell loss seen
in aging.
Questions and Answers
Table of Contents
1. Chapter 1: Introduction to Pathophysiology (Q1 - Q15)
o Concepts of Health, Disease, and Homeostasis
o Cellular Adaptation, Injury, and Death
o Inflammation and Healing
o Genetics and Genetic Diseases
2. Chapter 2: Disorders of Fluid, Electrolyte, and Acid-Base Balance (Q16 - Q30)
o Fluid Compartments and Shifts
o Electrolyte Imbalances (Sodium, Potassium, Calcium)
o Acid-Base Disorders (Respiratory and Metabolic)
3. Chapter 3: Disorders of the Immune System (Q31 - Q45)
o Innate and Adaptive Immunity
o Hypersensitivity Reactions
o Immunodeficiency and Autoimmune Diseases
4. Chapter 4: Disorders of the Hematologic System (Q46 - Q60)
o Anemias (Microcytic, Macrocytic, Normocytic)
o Coagulation Disorders
o Leukemias and Lymphomas
5. Chapter 5: Disorders of the Cardiovascular System (Q61 - Q75)
o Atherosclerosis and Hypertension
o Ischemic Heart Disease and Heart Failure
o Arrhythmias and Valvular Disorders
6. Chapter 6: Disorders of the Respiratory System (Q76 - Q90)
o Obstructive and Restrictive Lung Diseases
o Gas Exchange Abnormalities and Pulmonary Vascular Disorders
7. Chapter 7: Disorders of the Renal System (Q91 - Q105)
o Acute Kidney Injury and Chronic Kidney Disease
o Glomerular and Tubular Disorders
8. Chapter 8: Disorders of the Neurological System (Q106 - Q120)
o Acute Brain Injury and Neurodegenerative Diseases
o Seizures and Neuromuscular Disorders
9. Chapter 9: Disorders of the Endocrine System (Q121 - Q135)
o Pituitary, Thyroid, and Adrenal Disorders
, o Diabetes Mellitus and Metabolic Syndrome
10. Chapter 10: Disorders of the Gastrointestinal and Hepatobiliary Systems
(Q136 - Q150)
o Gastroesophageal, Peptic, and Intestinal Disorders
o Liver, Gallbladder, and Pancreatic Disorders
11. Chapter 11: Disorders of the Musculoskeletal System (Q151 - Q160)
o Osteoporosis, Osteoarthritis, and Rheumatoid Arthritis
o Muscle Disorders and Bone Tumors
12. Chapter 12: Disorders of the Reproductive System (Q161 - Q170)
o Male and Female Reproductive Disorders
o Sexually Transmitted Infections and Pregnancy-Related Conditions
13. Chapter 13: Multisystem and Integrative Concepts (Q171 - Q180)
o Shock
o Sepsis and Multiple Organ Dysfunction Syndrome (MODS)
o Burns
Chapter 1: Introduction to Pathophysiology
Question 1
A 62-year-old male with a 40-year history of smoking presents with a chronic cough and
shortness of breath. A lung biopsy reveals that the normal ciliated pseudostratified
columnar epithelium of his bronchi has been replaced by stratified squamous
epithelium. Which of the following terms best describes this cellular adaptation?
A. Dysplasia
B. Metaplasia
C. Hyperplasia
D. Hypertrophy
Answer: B
Rationale:
• B. Metaplasia is a reversible change in which one adult cell type is replaced by
another adult cell type that is better able to survive the adverse environment. In
this case, the columnar epithelium is replaced by more robust squamous
epithelium due to chronic irritation from smoking.
• A. Dysplasia refers to disordered growth and is a precursor to malignancy,
characterized by variation in cell size, shape, and organization.
• C. Hyperplasia is an increase in the number of cells in an organ or tissue.
• D. Hypertrophy is an increase in the size of cells.
,Question 2
A 19-year-old male is brought to the emergency department after a motor vehicle
accident. He has a fractured femur and significant blood loss. A blood transfusion is
initiated. His red blood cells are noted to have a decreased life span, and they are
removed from circulation by macrophages in the spleen. Which of the following
processes is most directly responsible for the removal of these aged red blood cells?
A. Oncosis
B. Necrosis
C. Apoptosis
D. Autophagy
Answer: C
Rationale:
• C. Apoptosis is programmed cell death, a normal physiological process that
removes aged or damaged cells without inciting an inflammatory response. The
removal of senescent red blood cells by splenic macrophages is a classic example
of apoptosis.
• A. Oncosis is a form of cell death characterized by cell swelling, often a precursor
to necrosis.
• B. Necrosis is a pathological process of cell death caused by severe injury,
leading to cell swelling, rupture, and inflammation.
• D. Autophagy is a process of self-digestion of cellular components, often a
survival mechanism during nutrient deprivation.
Question 3
A 5-year-old boy presents with recurrent, severe bacterial infections. Genetic testing
reveals a defect in the gene responsible for the NADPH oxidase complex in his
neutrophils. This defect impairs the ability of his phagocytes to produce superoxide
radicals. Which of the following conditions is most likely?
A. Severe Combined Immunodeficiency (SCID)
B. Chronic Granulomatous Disease (CGD)
C. Leukocyte Adhesion Deficiency (LAD)
D. DiGeorge Syndrome
Answer: B
Rationale:
• B. Chronic Granulomatous Disease (CGD) is an inherited immunodeficiency
disorder caused by a defect in the NADPH oxidase complex, which is essential for
the respiratory burst and the production of reactive oxygen species (ROS) to kill
ingested bacteria and fungi.
• A. SCID is characterized by a profound defect in both B and T cell function.
• C. LAD is a defect in leukocyte adhesion and migration.
, • D. DiGeorge Syndrome is a developmental defect of the thymus and
parathyroid glands, leading to T-cell deficiency.
Question 4
A 45-year-old female presents with a firm, fixed, and painless lump in her right breast. A
biopsy reveals malignant cells that have broken through the basement membrane and
are invading the surrounding stromal tissue. Which of the following terms best describes
this stage of the tumor?
A. Carcinoma in situ
B. Benign neoplasm
C. Invasive carcinoma
D. Dysplastic nevus
Answer: C
Rationale:
• C. Invasive carcinoma (or infiltrating carcinoma) is a cancer that has grown
beyond the basement membrane of the epithelium and is invading the
surrounding tissue.
• A. Carcinoma in situ refers to pre-invasive cancer that is confined to the
epithelium.
• B. Benign neoplasm is a non-cancerous growth that does not invade or
metastasize.
• D. Dysplastic nevus is a benign mole with atypical cells, not an invasive
carcinoma.
Question 5
An autopsy on an 80-year-old patient reveals significant atrophy of the brain. The brain
weight is 20% below the expected normal for his age, with widened sulci and narrowed
gyri. Which of the following cellular mechanisms is the primary cause of this tissue
shrinkage?
A. Apoptosis
B. Necrosis
C. Autophagy
D. Increased ubiquitin-proteasome activity
Answer: A
Rationale:
• A. Apoptosis is the primary mechanism of programmed cell death that occurs in
aging and neurodegenerative diseases like Alzheimer's, contributing to the
gradual loss of neurons and tissue atrophy.
• B. Necrosis is a pathological, inflammatory process, not the orderly cell loss seen
in aging.
