NR 507 – Advanced Pathophysiology
(Chamberlain University, 2025/2026) –
Midterm Exam with Verified Answers
Midterm Exam – 100% Verified Answers | Graded A+ 100 Questions – Answers in red –
Full Expert Rationales
CELLULAR INJURY & ADAPTATION (1–10)
1. The most common cause of cellular injury is: Hypoxia
Rationale: Hypoxia disrupts ATP production → Na⁺/K⁺ pump failure → cell swelling,
membrane damage. Causes: ischemia, hypoxemia, anemia.
2. Reversible cell injury is characterized by: Cell swelling and fatty change
Rationale: Early: hydropic swelling (endoplasmic reticulum dilation), blebbing. ATP ↓ →
anaerobic glycolysis → lactic acid → pH ↓.
3. Irreversible injury is marked by: Mitochondrial vacuolization and nuclear pyknosis
Rationale: Point of no return: membrane rupture, lysosomal enzyme release,
karyorrhexis/karyolysis.
4. Atrophy is defined as: Decrease in cell size
Rationale: Reduced protein synthesis, ↑ autophagy. Causes: disuse, denervation, ischemia.
5. Metaplasia is: Reversible change from one differentiated cell type to another
Rationale: Adaptive response to chronic irritation (e.g., squamous metaplasia in smokers).
Precancerous if dysplastic.
, 6. The hallmark of apoptosis is: Cell shrinkage and DNA fragmentation
Rationale: Intrinsic (mitochondrial) or extrinsic (death receptor) pathway → caspase activation
→ orderly cell death.
7. Free radicals cause injury by: Lipid peroxidation of membranes
Rationale: ROS (O₂⁻, OH⁻, H₂O₂) → chain reaction → membrane damage, protein denaturation.
8. Necrosis is characterized by: Uncontrolled cell death with inflammation
Rationale: Types: coagulative (ischemia), liquefactive (brain/abscess), caseous (TB), fat
(pancreatitis).
9. Hyperplasia is: Increase in cell number
Rationale: Physiologic (hormonal, e.g., endometrial) or pathologic (chronic irritation). Can
predispose to cancer.
10. The primary source of ATP in cells is: Oxidative phosphorylation in mitochondria
Rationale: 1 glucose → 32 ATP via ETC. Anaerobic glycolysis → 2 ATP.
INFLAMMATION & IMMUNITY (11–20)
11. The first vascular response in acute inflammation is: Transient vasoconstriction followed
by vasodilation
Rationale: Histamine, prostaglandins → ↑ blood flow → redness, warmth.
12. The cardinal sign of inflammation mediated by histamine is: Increased vascular
permeability
(Chamberlain University, 2025/2026) –
Midterm Exam with Verified Answers
Midterm Exam – 100% Verified Answers | Graded A+ 100 Questions – Answers in red –
Full Expert Rationales
CELLULAR INJURY & ADAPTATION (1–10)
1. The most common cause of cellular injury is: Hypoxia
Rationale: Hypoxia disrupts ATP production → Na⁺/K⁺ pump failure → cell swelling,
membrane damage. Causes: ischemia, hypoxemia, anemia.
2. Reversible cell injury is characterized by: Cell swelling and fatty change
Rationale: Early: hydropic swelling (endoplasmic reticulum dilation), blebbing. ATP ↓ →
anaerobic glycolysis → lactic acid → pH ↓.
3. Irreversible injury is marked by: Mitochondrial vacuolization and nuclear pyknosis
Rationale: Point of no return: membrane rupture, lysosomal enzyme release,
karyorrhexis/karyolysis.
4. Atrophy is defined as: Decrease in cell size
Rationale: Reduced protein synthesis, ↑ autophagy. Causes: disuse, denervation, ischemia.
5. Metaplasia is: Reversible change from one differentiated cell type to another
Rationale: Adaptive response to chronic irritation (e.g., squamous metaplasia in smokers).
Precancerous if dysplastic.
, 6. The hallmark of apoptosis is: Cell shrinkage and DNA fragmentation
Rationale: Intrinsic (mitochondrial) or extrinsic (death receptor) pathway → caspase activation
→ orderly cell death.
7. Free radicals cause injury by: Lipid peroxidation of membranes
Rationale: ROS (O₂⁻, OH⁻, H₂O₂) → chain reaction → membrane damage, protein denaturation.
8. Necrosis is characterized by: Uncontrolled cell death with inflammation
Rationale: Types: coagulative (ischemia), liquefactive (brain/abscess), caseous (TB), fat
(pancreatitis).
9. Hyperplasia is: Increase in cell number
Rationale: Physiologic (hormonal, e.g., endometrial) or pathologic (chronic irritation). Can
predispose to cancer.
10. The primary source of ATP in cells is: Oxidative phosphorylation in mitochondria
Rationale: 1 glucose → 32 ATP via ETC. Anaerobic glycolysis → 2 ATP.
INFLAMMATION & IMMUNITY (11–20)
11. The first vascular response in acute inflammation is: Transient vasoconstriction followed
by vasodilation
Rationale: Histamine, prostaglandins → ↑ blood flow → redness, warmth.
12. The cardinal sign of inflammation mediated by histamine is: Increased vascular
permeability
