Pathophysiology: The Complete 100-Question Master Prep
Section 1: Cellular Adaptation, Injury, and Death
1. A patient with long-standing hypertension shows an increase in the thickness of the left
ventricular wall. This is an example of:
A) Atrophy
B) Hypertrophy
C) Hyperplasia
D) Metaplasia
Elaboration: Hypertrophy is an increase in cell size in response to increased mechanical load
or stress. In the heart, the myocytes enlarge to pump against higher systemic pressure.
2. Which cellular adaptation is considered a "precancerous" change?
A) Metaplasia
B) Hypertrophy
C) Dysplasia
D) Atrophy
Elaboration: Dysplasia involves deranged cell growth resulting in varied size, shape, and
organization. It is often a precursor to neoplasia (cancer).
3. The transition of ciliated columnar epithelium to stratified squamous epithelium in the
airways of a chronic smoker is:
A) Metaplasia
B) Dysplasia
C) Anaplasia
D) Hyperplasia
Elaboration: Metaplasia is a reversible replacement of one mature cell type by another to
better withstand chronic irritation.
4. Which process involves the digestion of a cell's own components by its lysosomal
enzymes during starvation?
A) Apoptosis
, B) Autophagy
C) Necrosis
D) Oncosis
Elaboration: Autophagy is a survival mechanism where cells "self-eat" damaged organelles to
maintain nutrient homeostasis.
5. Calcification that occurs in dead or dying tissues in the presence of normal serum
calcium levels is:
A) Metastatic calcification
B) Dystrophic calcification
C) Pathologic ossification
D) Hypercalcemia
Elaboration: Dystrophic calcification occurs in injured or necrotic tissues (like damaged heart
valves) without systemic calcium imbalances.
6. What is the most common cause of hypoxia in clinical practice?
A) Anemia
B) Ischemia
C) High altitude
D) Carbon monoxide poisoning
Elaboration: Ischemia is the reduced blood supply to a tissue, which not only limits oxygen
but also the delivery of nutrients and removal of waste.
7. Free radical injury is caused by:
A) Unpaired electrons that damage cell membranes and DNA.
B) Excessive ATP production.
C) Low sodium levels.
D) Decreased lysosomal activity.
Elaboration: Reactive oxygen species (ROS) steal electrons from stable molecules, leading to
lipid peroxidation and protein fragmentation.
8. Which type of necrosis is characteristic of tuberculosis infections in the lungs?
A) Coagulative
, B) Liquefactive
C) Caseous
D) Fat
Elaboration: Caseous necrosis looks "cheese-like" and is a combination of coagulative and
liquefactive necrosis, often surrounded by a granuloma.
9. Programmed cell death that does not elicit an inflammatory response is:
A) Necrosis
B) Apoptosis
C) Gangrene
D) Infarction
Elaboration: Apoptosis is "clean" cell suicide where the cell breaks into fragments that are
neatly phagocytized.
10. Wet gangrene is usually the result of:
A) Liquefactive necrosis and bacterial infection.
B) Coagulative necrosis in the lower extremities.
C) Lack of blood supply without infection.
D) Excessive sun exposure.
Elaboration: Wet gangrene occurs when bacteria invade necrotic tissue, leading to a foul-
smelling, swollen, and black appearance.
Section 2: Inflammation and Immunity
11. Which cells arrive first at the site of an acute injury?
A) Monocytes
B) Macrophages
C) Neutrophils
D) Lymphocytes
Elaboration: Neutrophils are the "first responders" of the innate immune system, peaking
within 6-24 hours of injury.