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D236 – PATHOPHYSIOLOGY OBJECTIVE
ASSESSMENT (OA) SAMPLE EXAM
2026-27 VERSION
100 Questions | Answers & Rationales
SECTION I: Cellular Dysfunction (Q1–20)
1. Which cellular adaptation occurs when cells decrease in size
due to reduced workload?
A. Hypertrophy
B. Atrophy
C. Hyperplasia
D. Dysplasia
Answer: B
Rationale: Atrophy is the reduction in cell size due to decreased
workload, nutrition, or stimulation.
2. Which adaptation increases cell size in response to
increased demand?
A. Atrophy
B. Hyperplasia
C. Hypertrophy
D. Metaplasia
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Answer: C
Rationale: Hypertrophy is an increase in cell size, often seen in
cardiac or skeletal muscle cells under stress.
3. Metaplasia is best described as:
A. Abnormal cell growth
B. Replacement of one mature cell type by another
C. Increased cell number
D. Cell death
Answer: B
Rationale: Metaplasia is reversible replacement of one
differentiated cell type with another, often due to chronic
irritation.
4. Dysplasia refers to:
A. Normal growth
B. Increased cell size
C. Abnormal changes in size, shape, or organization
D. Cell death
Answer: C
Rationale: Dysplasia is disorganized growth that may precede
malignancy.
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5. Hypoxia causes cellular injury primarily by:
A. Excess calcium
B. ATP depletion
C. Free radical formation
D. Protein denaturation
Answer: B
Rationale: Low oxygen reduces ATP production, impairing
cellular processes.
6. Oxidative stress injures cells via:
A. Hypoxia
B. Free radical damage
C. Sodium retention
D. Necrosis
Answer: B
Rationale: Free radicals cause lipid peroxidation, protein and
DNA damage.
7. Intracellular accumulation of lipids may indicate:
A. Glycogen storage
B. Fatty liver disease
C. Protein deficiency
D. Cellular apoptosis
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Answer: B
8. Cellular apoptosis is best defined as:
A. Necrotic cell death
B. Programmed cell death
C. Swelling and rupture
D. Uncontrolled injury
Answer: B
9. Necrosis differs from apoptosis because it:
A. Is programmed
B. Induces inflammation
C. Occurs normally
D. Has no effect on neighboring cells
Answer: B
10. Which ion imbalance is common in cell injury?
A. Hypermagnesemia
B. Increased intracellular calcium
C. Hypernatremia
D. Hypokalemia
Answer: B
D236 – PATHOPHYSIOLOGY OBJECTIVE
ASSESSMENT (OA) SAMPLE EXAM
2026-27 VERSION
100 Questions | Answers & Rationales
SECTION I: Cellular Dysfunction (Q1–20)
1. Which cellular adaptation occurs when cells decrease in size
due to reduced workload?
A. Hypertrophy
B. Atrophy
C. Hyperplasia
D. Dysplasia
Answer: B
Rationale: Atrophy is the reduction in cell size due to decreased
workload, nutrition, or stimulation.
2. Which adaptation increases cell size in response to
increased demand?
A. Atrophy
B. Hyperplasia
C. Hypertrophy
D. Metaplasia
,2
Answer: C
Rationale: Hypertrophy is an increase in cell size, often seen in
cardiac or skeletal muscle cells under stress.
3. Metaplasia is best described as:
A. Abnormal cell growth
B. Replacement of one mature cell type by another
C. Increased cell number
D. Cell death
Answer: B
Rationale: Metaplasia is reversible replacement of one
differentiated cell type with another, often due to chronic
irritation.
4. Dysplasia refers to:
A. Normal growth
B. Increased cell size
C. Abnormal changes in size, shape, or organization
D. Cell death
Answer: C
Rationale: Dysplasia is disorganized growth that may precede
malignancy.
,3
5. Hypoxia causes cellular injury primarily by:
A. Excess calcium
B. ATP depletion
C. Free radical formation
D. Protein denaturation
Answer: B
Rationale: Low oxygen reduces ATP production, impairing
cellular processes.
6. Oxidative stress injures cells via:
A. Hypoxia
B. Free radical damage
C. Sodium retention
D. Necrosis
Answer: B
Rationale: Free radicals cause lipid peroxidation, protein and
DNA damage.
7. Intracellular accumulation of lipids may indicate:
A. Glycogen storage
B. Fatty liver disease
C. Protein deficiency
D. Cellular apoptosis
, 4
Answer: B
8. Cellular apoptosis is best defined as:
A. Necrotic cell death
B. Programmed cell death
C. Swelling and rupture
D. Uncontrolled injury
Answer: B
9. Necrosis differs from apoptosis because it:
A. Is programmed
B. Induces inflammation
C. Occurs normally
D. Has no effect on neighboring cells
Answer: B
10. Which ion imbalance is common in cell injury?
A. Hypermagnesemia
B. Increased intracellular calcium
C. Hypernatremia
D. Hypokalemia
Answer: B
