MSN 570 — Advanced Pathophysiology (United
States University) Final Exam — 70 questions with
correct answers and detailed rationales.
1. Which cellular adaptation is characterized by an increase in cell number
in tissues capable of mitosis?
A. Hypertrophy
B. Hyperplasia
C. Metaplasia
D. Atrophy
Correct answer: B — Hyperplasia
Rationale: Hyperplasia = increased cell number through mitotic activity (e.g.,
endometrial hyperplasia, benign prostatic hyperplasia). Hypertrophy =
increased cell size (e.g., cardiac hypertrophy). Metaplasia = reversible change
of one adult cell type to another. Atrophy = decrease in cell size/number.
2. Early reversible cellular injury is characterized by: (Select all that apply)
A. Cellular swelling
B. Mitochondrial vacuolization progressing to rupture
C. Membrane blebbing
D. Nuclear karyolysis
Correct answers: A, C
Rationale: Reversible injury: cellular (hydropic) swelling, membrane blebs,
and ribosomal detachment. Mitochondrial vacuolization can occur but
rupture indicates irreversible injury; nuclear karyolysis is an irreversible
nuclear change.
,3. Which mediators are primarily responsible for the fever response?
(Select all that apply)
A. IL-1
B. IL-6
C. Prostaglandin E₂ (PGE₂)
D. IL-10
Correct answers: A, B, C
Rationale: IL-1 and IL-6 stimulate the hypothalamus to increase PGE₂
production, which raises the thermoregulatory set point. IL-10 is anti-
inflammatory and does not cause fever.
4. A patient with SIADH will most likely have: (Select all that apply)
A. Hyponatremia
B. Low urine osmolality
C. Concentrated urine
D. Euvolemic or mild volume expansion
Correct answers: A, C, D
Rationale: SIADH = excess ADH → water retention → dilutional
hyponatremia, concentrated urine (high urine osmolality), typically
euvolemic clinically due to natriuresis.
5. Which processes describe Type II hypersensitivity?
A. Immune complex deposition in tissues
B. Antibody binding to cell-surface antigens leading to complement
activation
C. IgE mediated mast cell degranulation
D. T-cell mediated cytotoxicity
, Correct answer: B
Rationale: Type II hypersensitivity = IgG/IgM antibodies directed at cell-
surface or extracellular matrix antigens causing complement activation or
ADCC (e.g., autoimmune hemolytic anemia, Goodpasture). Type III =
immune complexes; Type I = IgE; Type IV = T-cell mediated.
6. Which clinical features are typical of nephrotic syndrome? (Select all
that apply)
A. Massive proteinuria (>3.5 g/day)
B. Hypoalbuminemia
C. Hematuria as dominant feature
D. Generalized edema (anasarca)
Correct answers: A, B, D
Rationale: Nephrotic syndrome: heavy proteinuria, hypoalbuminemia,
hyperlipidemia, and edema. Hematuria and RBC casts are more nephritic.
7. Which lab pattern is most consistent with metabolic acidosis with
respiratory compensation?
A. pH 7.25, HCO₃⁻ 12 mEq/L, PaCO₂ 30 mmHg
B. pH 7.50, HCO₃⁻ 36 mEq/L, PaCO₂ 48 mmHg
C. pH 7.35, HCO₃⁻ 22 mEq/L, PaCO₂ 40 mmHg
D. pH 7.60, HCO₃⁻ 30 mEq/L, PaCO₂ 20 mmHg
Correct answer: A
Rationale: Low pH, low HCO₃⁻ indicate metabolic acidosis; respiratory
compensation lowers PaCO₂ (hyperventilation) — PaCO₂ around 30 is
reasonable for compensation.
States University) Final Exam — 70 questions with
correct answers and detailed rationales.
1. Which cellular adaptation is characterized by an increase in cell number
in tissues capable of mitosis?
A. Hypertrophy
B. Hyperplasia
C. Metaplasia
D. Atrophy
Correct answer: B — Hyperplasia
Rationale: Hyperplasia = increased cell number through mitotic activity (e.g.,
endometrial hyperplasia, benign prostatic hyperplasia). Hypertrophy =
increased cell size (e.g., cardiac hypertrophy). Metaplasia = reversible change
of one adult cell type to another. Atrophy = decrease in cell size/number.
2. Early reversible cellular injury is characterized by: (Select all that apply)
A. Cellular swelling
B. Mitochondrial vacuolization progressing to rupture
C. Membrane blebbing
D. Nuclear karyolysis
Correct answers: A, C
Rationale: Reversible injury: cellular (hydropic) swelling, membrane blebs,
and ribosomal detachment. Mitochondrial vacuolization can occur but
rupture indicates irreversible injury; nuclear karyolysis is an irreversible
nuclear change.
,3. Which mediators are primarily responsible for the fever response?
(Select all that apply)
A. IL-1
B. IL-6
C. Prostaglandin E₂ (PGE₂)
D. IL-10
Correct answers: A, B, C
Rationale: IL-1 and IL-6 stimulate the hypothalamus to increase PGE₂
production, which raises the thermoregulatory set point. IL-10 is anti-
inflammatory and does not cause fever.
4. A patient with SIADH will most likely have: (Select all that apply)
A. Hyponatremia
B. Low urine osmolality
C. Concentrated urine
D. Euvolemic or mild volume expansion
Correct answers: A, C, D
Rationale: SIADH = excess ADH → water retention → dilutional
hyponatremia, concentrated urine (high urine osmolality), typically
euvolemic clinically due to natriuresis.
5. Which processes describe Type II hypersensitivity?
A. Immune complex deposition in tissues
B. Antibody binding to cell-surface antigens leading to complement
activation
C. IgE mediated mast cell degranulation
D. T-cell mediated cytotoxicity
, Correct answer: B
Rationale: Type II hypersensitivity = IgG/IgM antibodies directed at cell-
surface or extracellular matrix antigens causing complement activation or
ADCC (e.g., autoimmune hemolytic anemia, Goodpasture). Type III =
immune complexes; Type I = IgE; Type IV = T-cell mediated.
6. Which clinical features are typical of nephrotic syndrome? (Select all
that apply)
A. Massive proteinuria (>3.5 g/day)
B. Hypoalbuminemia
C. Hematuria as dominant feature
D. Generalized edema (anasarca)
Correct answers: A, B, D
Rationale: Nephrotic syndrome: heavy proteinuria, hypoalbuminemia,
hyperlipidemia, and edema. Hematuria and RBC casts are more nephritic.
7. Which lab pattern is most consistent with metabolic acidosis with
respiratory compensation?
A. pH 7.25, HCO₃⁻ 12 mEq/L, PaCO₂ 30 mmHg
B. pH 7.50, HCO₃⁻ 36 mEq/L, PaCO₂ 48 mmHg
C. pH 7.35, HCO₃⁻ 22 mEq/L, PaCO₂ 40 mmHg
D. pH 7.60, HCO₃⁻ 30 mEq/L, PaCO₂ 20 mmHg
Correct answer: A
Rationale: Low pH, low HCO₃⁻ indicate metabolic acidosis; respiratory
compensation lowers PaCO₂ (hyperventilation) — PaCO₂ around 30 is
reasonable for compensation.
