NR 507 Advanced Pathophysiology
ACTUAL EXAM | Weeks 1-4 Midterm
Exam Practice Set | 100 Questions |
Correct Answers and Rationales |
Verified Q&A | Pass Guaranteed - A+
Graded
SECTION 1: CELLULAR ADAPTATION, INJURY, AND DEATH
(Questions 1-15)
1. A 68-year-old male with chronic obstructive pulmonary disease (COPD) has reduced muscle
mass in his lower extremities due to decreased physical activity. What type of cellular adaptation is
this?
● A) Hypertrophy
● B) Hyperplasia
● C) Atrophy
● D) Metaplasia
Correct Answer: C) Atrophy
,Rationale: Atrophy is a decrease in cell size due to disuse, denervation, ischemia, or malnutrition.
In this case, disuse atrophy occurs from decreased physical activity.
2. A weightlifter develops increased skeletal muscle mass. This represents which cellular
adaptation?
● A) Hypertrophy
● B) Hyperplasia
● C) Metaplasia
● D) Dysplasia
Correct Answer: A) Hypertrophy
Rationale: Hypertrophy is an increase in cell SIZE (not number) in response to increased workload,
such as weightlifting. The cardiac muscle also undergoes hypertrophy in response to hypertension.
3. A patient with chronic gastroesophageal reflux disease (GERD) has biopsy showing replacement
of normal squamous epithelium with columnar epithelium. This is an example of:
● A) Dysplasia
● B) Metaplasia
● C) Hyperplasia
● D) Anaplasia
Correct Answer: B) Metaplasia
Rationale: Metaplasia is the replacement of one differentiated cell type with another. Barrett's
esophagus (squamous → columnar) is a classic example, often caused by chronic acid exposure.
4. Which of the following is the most common cause of cellular injury?
● A) Chemical toxins
● B) Hypoxia/ischemia
● C) Physical trauma
● D) Infectious agents
Correct Answer: B) Hypoxia/ischemia
,Rationale: Hypoxia/ischemia is the most common cause of cellular injury. It leads to ATP depletion,
anaerobic metabolism, lactic acidosis, loss of Na+/K+ pump function, and cellular swelling.
5. During ischemia, the switch to anaerobic metabolism results in:
● A) Increased ATP production
● B) Lactic acidosis
● C) Decreased calcium influx
● D) Improved cellular function
Correct Answer: B) Lactic acidosis
Rationale: Without oxygen, cells switch to anaerobic metabolism, producing lactic acid from
pyruvate. This causes intracellular pH to drop, leading to enzyme dysfunction and cellular damage.
6. Free radical injury causes cellular damage through all of the following EXCEPT:
● A) Lipid peroxidation of cell membranes
● B) Protein oxidation
● C) DNA damage
● D) Increased ATP synthesis
Correct Answer: D) Increased ATP synthesis
Rationale: Free radicals cause oxidative stress through lipid peroxidation, protein oxidation, and
DNA damage. They do NOT increase ATP synthesis; in fact, they damage mitochondria and
decrease ATP production.
7. Which enzyme is responsible for converting superoxide to hydrogen peroxide as part of the
cellular defense against free radicals?
● A) Catalase
● B) Superoxide dismutase
● C) Glutathione peroxidase
● D) Xanthine oxidase
Correct Answer: B) Superoxide dismutase
, Rationale: Superoxide dismutase (SOD) converts superoxide (O₂⁻) to hydrogen peroxide (H₂O₂).
Catalase then converts H₂O₂ to water and oxygen. Glutathione peroxidase also neutralizes H₂O₂.
8. Ischemia-reperfusion injury is characterized by paradoxical worsening of cellular damage upon
restoration of blood flow due to:
● A) Decreased oxygen delivery
● B) Oxidative stress and free radical generation
● C) Reduced calcium influx
● D) Decreased neutrophil recruitment
Correct Answer: B) Oxidative stress and free radical generation
Rationale: Reperfusion generates free radicals from xanthine oxidase, mitochondrial dysfunction,
and NADPH oxidase. Calcium overload and neutrophil recruitment also contribute to the injury.
9. Coagulative necrosis is most commonly associated with:
● A) Brain infarction
● B) Ischemia of solid organs (heart, kidney, spleen)
● C) Bacterial infections
● D) Tuberculosis
Correct Answer: B) Ischemia of solid organs (heart, kidney, spleen)
Rationale: Coagulative necrosis results from ischemia in solid organs except the brain. Protein
denaturation occurs, but tissue architecture is preserved. The brain undergoes liquefactive
necrosis.
10. Liquefactive necrosis is characteristic of:
● A) Myocardial infarction
● B) Cerebral infarction and bacterial abscesses
● C) Tuberculosis
● D) Acute pancreatitis
Correct Answer: B) Cerebral infarction and bacterial abscesses
ACTUAL EXAM | Weeks 1-4 Midterm
Exam Practice Set | 100 Questions |
Correct Answers and Rationales |
Verified Q&A | Pass Guaranteed - A+
Graded
SECTION 1: CELLULAR ADAPTATION, INJURY, AND DEATH
(Questions 1-15)
1. A 68-year-old male with chronic obstructive pulmonary disease (COPD) has reduced muscle
mass in his lower extremities due to decreased physical activity. What type of cellular adaptation is
this?
● A) Hypertrophy
● B) Hyperplasia
● C) Atrophy
● D) Metaplasia
Correct Answer: C) Atrophy
,Rationale: Atrophy is a decrease in cell size due to disuse, denervation, ischemia, or malnutrition.
In this case, disuse atrophy occurs from decreased physical activity.
2. A weightlifter develops increased skeletal muscle mass. This represents which cellular
adaptation?
● A) Hypertrophy
● B) Hyperplasia
● C) Metaplasia
● D) Dysplasia
Correct Answer: A) Hypertrophy
Rationale: Hypertrophy is an increase in cell SIZE (not number) in response to increased workload,
such as weightlifting. The cardiac muscle also undergoes hypertrophy in response to hypertension.
3. A patient with chronic gastroesophageal reflux disease (GERD) has biopsy showing replacement
of normal squamous epithelium with columnar epithelium. This is an example of:
● A) Dysplasia
● B) Metaplasia
● C) Hyperplasia
● D) Anaplasia
Correct Answer: B) Metaplasia
Rationale: Metaplasia is the replacement of one differentiated cell type with another. Barrett's
esophagus (squamous → columnar) is a classic example, often caused by chronic acid exposure.
4. Which of the following is the most common cause of cellular injury?
● A) Chemical toxins
● B) Hypoxia/ischemia
● C) Physical trauma
● D) Infectious agents
Correct Answer: B) Hypoxia/ischemia
,Rationale: Hypoxia/ischemia is the most common cause of cellular injury. It leads to ATP depletion,
anaerobic metabolism, lactic acidosis, loss of Na+/K+ pump function, and cellular swelling.
5. During ischemia, the switch to anaerobic metabolism results in:
● A) Increased ATP production
● B) Lactic acidosis
● C) Decreased calcium influx
● D) Improved cellular function
Correct Answer: B) Lactic acidosis
Rationale: Without oxygen, cells switch to anaerobic metabolism, producing lactic acid from
pyruvate. This causes intracellular pH to drop, leading to enzyme dysfunction and cellular damage.
6. Free radical injury causes cellular damage through all of the following EXCEPT:
● A) Lipid peroxidation of cell membranes
● B) Protein oxidation
● C) DNA damage
● D) Increased ATP synthesis
Correct Answer: D) Increased ATP synthesis
Rationale: Free radicals cause oxidative stress through lipid peroxidation, protein oxidation, and
DNA damage. They do NOT increase ATP synthesis; in fact, they damage mitochondria and
decrease ATP production.
7. Which enzyme is responsible for converting superoxide to hydrogen peroxide as part of the
cellular defense against free radicals?
● A) Catalase
● B) Superoxide dismutase
● C) Glutathione peroxidase
● D) Xanthine oxidase
Correct Answer: B) Superoxide dismutase
, Rationale: Superoxide dismutase (SOD) converts superoxide (O₂⁻) to hydrogen peroxide (H₂O₂).
Catalase then converts H₂O₂ to water and oxygen. Glutathione peroxidase also neutralizes H₂O₂.
8. Ischemia-reperfusion injury is characterized by paradoxical worsening of cellular damage upon
restoration of blood flow due to:
● A) Decreased oxygen delivery
● B) Oxidative stress and free radical generation
● C) Reduced calcium influx
● D) Decreased neutrophil recruitment
Correct Answer: B) Oxidative stress and free radical generation
Rationale: Reperfusion generates free radicals from xanthine oxidase, mitochondrial dysfunction,
and NADPH oxidase. Calcium overload and neutrophil recruitment also contribute to the injury.
9. Coagulative necrosis is most commonly associated with:
● A) Brain infarction
● B) Ischemia of solid organs (heart, kidney, spleen)
● C) Bacterial infections
● D) Tuberculosis
Correct Answer: B) Ischemia of solid organs (heart, kidney, spleen)
Rationale: Coagulative necrosis results from ischemia in solid organs except the brain. Protein
denaturation occurs, but tissue architecture is preserved. The brain undergoes liquefactive
necrosis.
10. Liquefactive necrosis is characteristic of:
● A) Myocardial infarction
● B) Cerebral infarction and bacterial abscesses
● C) Tuberculosis
● D) Acute pancreatitis
Correct Answer: B) Cerebral infarction and bacterial abscesses
