GOULD'S PATHOPHYSIOLOGY FOR THE
HEALTH PROFESSIONS
7TH EDITION
• AUTHOR(S)KARIN C. VANMETER;
ROBERT J. HUBERT
TEST BANK
1
Reference
Ch. 1 — Introduction to Pathophysiology — Cellular Adaptation
(Atrophy)
Stem
A 72-year-old man develops progressive skeletal muscle
weakness after several months of limited mobility following a
hip fracture. Muscle biopsy shows decreased cell size with
reduced organelle content. Which cellular mechanism best
explains the decreased muscle mass in this patient?
A. Increased apoptosis due to caspase activation.
B. Reduced protein synthesis with proteasome-mediated
,protein degradation.
C. Increased cellular hydration causing reversible swelling.
D. Metaplastic replacement of myocytes with fibroblasts.
Correct Answer
B
Rationales
Correct (B): Atrophy from disuse occurs when protein synthesis
falls and proteasome pathways increase degradation of
contractile proteins, reducing cell size and organelle number—
consistent with disuse atrophy described in the chapter.
A: Apoptosis removes whole cells; disuse atrophy is primarily
cell shrinkage, not increased programmed cell death.
C: Cellular swelling indicates reversible injury, not the regulated
reduction in cell size seen with atrophy.
D: Metaplasia is replacement of one mature cell type by
another (e.g., epithelium), not fibroblast replacement of
myocytes in disuse-related atrophy.
Teaching Point
Disuse atrophy: decreased synthesis + increased proteasome
degradation → smaller cells.
Citation
VanMeter, K. C., & Hubert, R. J. (2024). Gould’s Pathophysiology
for the Health Professions (7th ed.). Ch. 1.
2
,Reference
Ch. 1 — Introduction to Pathophysiology — Cellular Adaptation
(Hypertrophy)
Stem
A weightlifter begins an intensified resistance program and
notes increased muscle bulk after 8 weeks. At the cellular level,
which process most directly accounts for the increase in muscle
fiber size?
A. Increased number of nuclei per myocyte via mitosis.
B. Upregulation of protein synthesis and assembly of contractile
elements.
C. Increased interstitial fluid accumulation causing sarcoplasmic
expansion.
D. Conversion of satellite cells into adipocytes.
Correct Answer
B
Rationales
Correct (B): Hypertrophy of skeletal muscle results from
increased synthesis of structural proteins (actin, myosin) and
organelles—driven by growth factors and mechanical
signaling—leading to larger cell size.
A: Skeletal myocytes are postmitotic; hypertrophy involves
enlargement, not mitotic increase in cell number.
C: Fluid accumulation causes swelling, not true hypertrophic
increase in contractile proteins.
, D: Satellite cells can fuse to repair/grow muscle but do not
convert into adipocytes to cause hypertrophy.
Teaching Point
Hypertrophy = increased functional proteins/organelles within
cells, not cell division.
Citation
VanMeter, K. C., & Hubert, R. J. (2024). Gould’s Pathophysiology
for the Health Professions (7th ed.). Ch. 1.
3
Reference
Ch. 1 — Introduction to Pathophysiology — Cellular Adaptation
(Hyperplasia)
Stem
A woman taking estrogen therapy develops a thickened
endometrium. Histology shows increased numbers of
endometrial glandular epithelial cells. Which mechanism best
explains this tissue change?
A. Persistent cellular hypertrophy through increased organelle
content.
B. Increased mitotic activity driven by hormonal stimulation.
C. Irreversible cell injury with necrosis and scarring.
D. Metaplastic transformation to a more resilient epithelium.
HEALTH PROFESSIONS
7TH EDITION
• AUTHOR(S)KARIN C. VANMETER;
ROBERT J. HUBERT
TEST BANK
1
Reference
Ch. 1 — Introduction to Pathophysiology — Cellular Adaptation
(Atrophy)
Stem
A 72-year-old man develops progressive skeletal muscle
weakness after several months of limited mobility following a
hip fracture. Muscle biopsy shows decreased cell size with
reduced organelle content. Which cellular mechanism best
explains the decreased muscle mass in this patient?
A. Increased apoptosis due to caspase activation.
B. Reduced protein synthesis with proteasome-mediated
,protein degradation.
C. Increased cellular hydration causing reversible swelling.
D. Metaplastic replacement of myocytes with fibroblasts.
Correct Answer
B
Rationales
Correct (B): Atrophy from disuse occurs when protein synthesis
falls and proteasome pathways increase degradation of
contractile proteins, reducing cell size and organelle number—
consistent with disuse atrophy described in the chapter.
A: Apoptosis removes whole cells; disuse atrophy is primarily
cell shrinkage, not increased programmed cell death.
C: Cellular swelling indicates reversible injury, not the regulated
reduction in cell size seen with atrophy.
D: Metaplasia is replacement of one mature cell type by
another (e.g., epithelium), not fibroblast replacement of
myocytes in disuse-related atrophy.
Teaching Point
Disuse atrophy: decreased synthesis + increased proteasome
degradation → smaller cells.
Citation
VanMeter, K. C., & Hubert, R. J. (2024). Gould’s Pathophysiology
for the Health Professions (7th ed.). Ch. 1.
2
,Reference
Ch. 1 — Introduction to Pathophysiology — Cellular Adaptation
(Hypertrophy)
Stem
A weightlifter begins an intensified resistance program and
notes increased muscle bulk after 8 weeks. At the cellular level,
which process most directly accounts for the increase in muscle
fiber size?
A. Increased number of nuclei per myocyte via mitosis.
B. Upregulation of protein synthesis and assembly of contractile
elements.
C. Increased interstitial fluid accumulation causing sarcoplasmic
expansion.
D. Conversion of satellite cells into adipocytes.
Correct Answer
B
Rationales
Correct (B): Hypertrophy of skeletal muscle results from
increased synthesis of structural proteins (actin, myosin) and
organelles—driven by growth factors and mechanical
signaling—leading to larger cell size.
A: Skeletal myocytes are postmitotic; hypertrophy involves
enlargement, not mitotic increase in cell number.
C: Fluid accumulation causes swelling, not true hypertrophic
increase in contractile proteins.
, D: Satellite cells can fuse to repair/grow muscle but do not
convert into adipocytes to cause hypertrophy.
Teaching Point
Hypertrophy = increased functional proteins/organelles within
cells, not cell division.
Citation
VanMeter, K. C., & Hubert, R. J. (2024). Gould’s Pathophysiology
for the Health Professions (7th ed.). Ch. 1.
3
Reference
Ch. 1 — Introduction to Pathophysiology — Cellular Adaptation
(Hyperplasia)
Stem
A woman taking estrogen therapy develops a thickened
endometrium. Histology shows increased numbers of
endometrial glandular epithelial cells. Which mechanism best
explains this tissue change?
A. Persistent cellular hypertrophy through increased organelle
content.
B. Increased mitotic activity driven by hormonal stimulation.
C. Irreversible cell injury with necrosis and scarring.
D. Metaplastic transformation to a more resilient epithelium.
