Pathophysiology Midterm Exam Nightingale College Utah
2026/2027 – Verified Questions with Answers and Detailed
Rationales | Comprehensive Study Guide
1. Scenario: A patient has prolonged hypoxia. Which cellular change is most likely
to occur first?
A. Necrosis
B. Apoptosis
C. Cellular swelling
D. Calcification
Answer: C
Rationale: Hypoxia impairs ATP production, leading to Na⁺/K⁺ pump failure and
cellular swelling (hydropic change) before irreversible injury occurs.
2. Which type of necrosis is typical in myocardial infarction?
A. Coagulative
B. Liquefactive
C. Caseous
D. Fat
Answer: A
Rationale: Coagulative necrosis preserves tissue architecture initially, commonly
seen in ischemic injury to solid organs like the heart.
3. Scenario: A patient presents with TB. Which necrosis pattern is expected?
A. Coagulative
B. Liquefactive
,C. Caseous
D. Fat
Answer: C
Rationale: Caseous necrosis (“cheese-like”) is characteristic of tuberculosis
infection.
4. Which cellular adaptation occurs due to chronic hypertension in the heart?
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Metaplasia
Answer: B
Rationale: Chronic pressure overload causes myocardial cells to enlarge
(hypertrophy) to increase contractile force.
5. Scenario: A patient with chronic acid reflux develops esophageal squamous
epithelium changing to columnar epithelium. What is this adaptation?
A. Hyperplasia
B. Metaplasia
C. Dysplasia
D. Atrophy
Answer: B
Rationale: Metaplasia is reversible replacement of one mature cell type with
another due to chronic stress.
6. Which lab marker indicates acute myocardial injury?
A. AST
B. CK-MB
C. ALT
D. LDH only
Answer: B
Rationale: CK-MB is specific for cardiac muscle injury; troponin is also highly
specific.
, 7. Scenario: A patient presents with jaundice, hepatomegaly, and elevated
AST/ALT. Likely mechanism?
A. Apoptosis
B. Coagulative necrosis
C. Fatty change and cell injury
D. Liquefactive necrosis
Answer: C
Rationale: Hepatocytes under stress accumulate fat (steatosis), causing
hepatomegaly and enzyme elevation.
8. Which cell type mediates acute inflammation first?
A. Lymphocytes
B. Neutrophils
C. Macrophages
D. Eosinophils
Answer: B
Rationale: Neutrophils are the first responders in acute inflammation.
9. Scenario: A patient has a chronic inflammatory disease. Which cell
predominates?
A. Neutrophils
B. Macrophages and lymphocytes
C. Basophils
D. Erythrocytes
Answer: B
Rationale: Chronic inflammation involves macrophages, lymphocytes, and plasma
cells rather than neutrophils.
10. Which mediator increases vascular permeability during inflammation?
A. Histamine
B. Dopamine
2026/2027 – Verified Questions with Answers and Detailed
Rationales | Comprehensive Study Guide
1. Scenario: A patient has prolonged hypoxia. Which cellular change is most likely
to occur first?
A. Necrosis
B. Apoptosis
C. Cellular swelling
D. Calcification
Answer: C
Rationale: Hypoxia impairs ATP production, leading to Na⁺/K⁺ pump failure and
cellular swelling (hydropic change) before irreversible injury occurs.
2. Which type of necrosis is typical in myocardial infarction?
A. Coagulative
B. Liquefactive
C. Caseous
D. Fat
Answer: A
Rationale: Coagulative necrosis preserves tissue architecture initially, commonly
seen in ischemic injury to solid organs like the heart.
3. Scenario: A patient presents with TB. Which necrosis pattern is expected?
A. Coagulative
B. Liquefactive
,C. Caseous
D. Fat
Answer: C
Rationale: Caseous necrosis (“cheese-like”) is characteristic of tuberculosis
infection.
4. Which cellular adaptation occurs due to chronic hypertension in the heart?
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Metaplasia
Answer: B
Rationale: Chronic pressure overload causes myocardial cells to enlarge
(hypertrophy) to increase contractile force.
5. Scenario: A patient with chronic acid reflux develops esophageal squamous
epithelium changing to columnar epithelium. What is this adaptation?
A. Hyperplasia
B. Metaplasia
C. Dysplasia
D. Atrophy
Answer: B
Rationale: Metaplasia is reversible replacement of one mature cell type with
another due to chronic stress.
6. Which lab marker indicates acute myocardial injury?
A. AST
B. CK-MB
C. ALT
D. LDH only
Answer: B
Rationale: CK-MB is specific for cardiac muscle injury; troponin is also highly
specific.
, 7. Scenario: A patient presents with jaundice, hepatomegaly, and elevated
AST/ALT. Likely mechanism?
A. Apoptosis
B. Coagulative necrosis
C. Fatty change and cell injury
D. Liquefactive necrosis
Answer: C
Rationale: Hepatocytes under stress accumulate fat (steatosis), causing
hepatomegaly and enzyme elevation.
8. Which cell type mediates acute inflammation first?
A. Lymphocytes
B. Neutrophils
C. Macrophages
D. Eosinophils
Answer: B
Rationale: Neutrophils are the first responders in acute inflammation.
9. Scenario: A patient has a chronic inflammatory disease. Which cell
predominates?
A. Neutrophils
B. Macrophages and lymphocytes
C. Basophils
D. Erythrocytes
Answer: B
Rationale: Chronic inflammation involves macrophages, lymphocytes, and plasma
cells rather than neutrophils.
10. Which mediator increases vascular permeability during inflammation?
A. Histamine
B. Dopamine
