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PORTAGE LEARNING NURS 231 PATHOPHYSIOLOGY ALL
EXAMS 2026/2027 | Complete Compilation | Latest Update |
Verified Answers | Pass Guaranteed - A+ Graded
MODULE 1 EXAM: Cellular Function & Genetics (Q1-20)
Q1. A 58-year-old male with a 40 pack-year smoking history presents with chronic
cough and hemoptysis. Biopsy reveals squamous cell carcinoma of the lung. Which
cellular adaptation most likely preceded the malignant transformation in his
bronchial epithelium?
A. Metaplasia
B. Hypertrophy
C. Hyperplasia
D. Dysplasia
D. Dysplasia [CORRECT]
Rationale: Dysplasia is disordered, dysfunctional epithelial cell growth representing a
premalignant alteration; in smokers, bronchial epithelium progresses through
metaplasia to dysplasia before carcinoma. Metaplasia (A) is reversible replacement of
one cell type by another but not necessarily premalignant. Hypertrophy (B) is
increased cell size, and hyperplasia (C) is increased cell number—neither implies
disordered maturation.
Correct Answer: D
Q2. A patient suffers an acute myocardial infarction. Within 24 hours, the myocardial
tissue demonstrates preserved tissue architecture with loss of nuclei and eosinophilic
cytoplasm. This represents which type of necrosis?
A. Liquefactive necrosis
B. Caseous necrosis
,2
C. Coagulative necrosis
D. Fat necrosis
C. Coagulative necrosis [CORRECT]
Rationale: Coagulative necrosis is characteristic of ischemic injury in solid organs
(heart, kidney, spleen) where architectural outlines are preserved due to denaturation
of structural proteins. Liquefactive necrosis (A) occurs in brain infarcts and abscesses.
Caseous necrosis (B) is seen in tuberculosis. Fat necrosis (D) occurs in pancreatic
injury or breast trauma.
Correct Answer: C
Q3. A 45-year-old woman presents with jaundice, dark urine, and RUQ pain. CT
shows a gallstone obstructing the common bile duct. The elevated bilirubin and liver
enzyme elevation represent which category of cell injury?
A. Hypoxic injury
B. Chemical injury
C. Reperfusion injury
D. Infectious injury
B. Chemical injury [CORRECT]
Rationale: Bile acids are potent chemical detergents that cause direct membrane
damage and hepatocyte injury when retained due to obstruction. This is classified as
chemical injury rather than hypoxic (A), which requires oxygen deprivation.
Reperfusion (C) involves ROS generation after restoration of blood flow. Infectious
(D) requires a pathogen.
Correct Answer: B
Q4. A 6-year-old boy is diagnosed with Duchenne muscular dystrophy. Genetic
testing reveals a deletion in the DMD gene on Xp21. Which inheritance pattern does
this disorder follow?
,3
A. Autosomal dominant
B. Autosomal recessive
C. X-linked recessive
D. X-linked dominant
C. X-linked recessive [CORRECT]
Rationale: Duchenne muscular dystrophy is caused by mutations in the dystrophin
gene located on the X chromosome and follows X-linked recessive inheritance,
primarily affecting males. Females are typically carriers. It is not autosomal (A, B) or
X-linked dominant (D), which would affect males and females more equally.
Correct Answer: C
Q5. During apoptosis, which cellular event is the defining characteristic that
distinguishes it from necrosis?
A. Cell swelling and membrane rupture
B. Chromatin condensation and caspase activation
C. Inflammatory infiltrate surrounding the cell
D. Mitochondrial swelling and calcium overload
B. Chromatin condensation and caspase activation [CORRECT]
Rationale: Apoptosis is programmed cell death characterized by chromatin
condensation, cell shrinkage, membrane blebbing, and caspase cascade activation
without inflammation. Necrosis (A, C, D) involves cell swelling, membrane rupture,
release of cellular contents, and inflammatory response.
Correct Answer: B
Q6. A pathologist examines a liver biopsy and notes Mallory-Denk bodies, fatty
change, and hepatocyte ballooning. These findings represent which pattern of cell
injury?
, 4
A. Hydropic change
B. Fatty change (steatosis) with alcoholic hepatitis
C. Amyloid deposition
D. Pigment accumulation
B. Fatty change (steatosis) with alcoholic hepatitis [CORRECT]
Rationale: Mallory-Denk bodies (cytokeratin aggregates), steatosis, and ballooning
degeneration are the classic histologic triad of alcoholic hepatitis. Hydropic change
(A) is reversible cell swelling from water influx but lacks these specific inclusions.
Amyloid (C) and pigment (D) are unrelated.
Correct Answer: B
Q7. A patient with chronic emphysema has destruction of alveolar walls and loss of
elastic recoil. At the cellular level, which enzyme is primarily responsible for the tissue
destruction?
A. Collagenase
B. Elastase
C. Hyaluronidase
D. Protease inhibitor
B. Elastase [CORRECT]
Rationale: Neutrophil-derived elastase destroys elastin fibers in alveolar walls,
causing loss of elastic recoil in emphysema. Normally inhibited by alpha-1
antitrypsin, deficiency or inactivation (by smoking) permits elastase-mediated
destruction. Collagenase (A) affects collagen; hyaluronidase (C) breaks down ground
substance. Protease inhibitor (D) prevents, not causes, destruction.
Correct Answer: B
Q8. A 35-year-old woman has a breast lump biopsy showing well-circumscribed,
encapsulated proliferation of ductal epithelium with uniform cells, low mitotic rate,
and no invasion. This best describes:
PORTAGE LEARNING NURS 231 PATHOPHYSIOLOGY ALL
EXAMS 2026/2027 | Complete Compilation | Latest Update |
Verified Answers | Pass Guaranteed - A+ Graded
MODULE 1 EXAM: Cellular Function & Genetics (Q1-20)
Q1. A 58-year-old male with a 40 pack-year smoking history presents with chronic
cough and hemoptysis. Biopsy reveals squamous cell carcinoma of the lung. Which
cellular adaptation most likely preceded the malignant transformation in his
bronchial epithelium?
A. Metaplasia
B. Hypertrophy
C. Hyperplasia
D. Dysplasia
D. Dysplasia [CORRECT]
Rationale: Dysplasia is disordered, dysfunctional epithelial cell growth representing a
premalignant alteration; in smokers, bronchial epithelium progresses through
metaplasia to dysplasia before carcinoma. Metaplasia (A) is reversible replacement of
one cell type by another but not necessarily premalignant. Hypertrophy (B) is
increased cell size, and hyperplasia (C) is increased cell number—neither implies
disordered maturation.
Correct Answer: D
Q2. A patient suffers an acute myocardial infarction. Within 24 hours, the myocardial
tissue demonstrates preserved tissue architecture with loss of nuclei and eosinophilic
cytoplasm. This represents which type of necrosis?
A. Liquefactive necrosis
B. Caseous necrosis
,2
C. Coagulative necrosis
D. Fat necrosis
C. Coagulative necrosis [CORRECT]
Rationale: Coagulative necrosis is characteristic of ischemic injury in solid organs
(heart, kidney, spleen) where architectural outlines are preserved due to denaturation
of structural proteins. Liquefactive necrosis (A) occurs in brain infarcts and abscesses.
Caseous necrosis (B) is seen in tuberculosis. Fat necrosis (D) occurs in pancreatic
injury or breast trauma.
Correct Answer: C
Q3. A 45-year-old woman presents with jaundice, dark urine, and RUQ pain. CT
shows a gallstone obstructing the common bile duct. The elevated bilirubin and liver
enzyme elevation represent which category of cell injury?
A. Hypoxic injury
B. Chemical injury
C. Reperfusion injury
D. Infectious injury
B. Chemical injury [CORRECT]
Rationale: Bile acids are potent chemical detergents that cause direct membrane
damage and hepatocyte injury when retained due to obstruction. This is classified as
chemical injury rather than hypoxic (A), which requires oxygen deprivation.
Reperfusion (C) involves ROS generation after restoration of blood flow. Infectious
(D) requires a pathogen.
Correct Answer: B
Q4. A 6-year-old boy is diagnosed with Duchenne muscular dystrophy. Genetic
testing reveals a deletion in the DMD gene on Xp21. Which inheritance pattern does
this disorder follow?
,3
A. Autosomal dominant
B. Autosomal recessive
C. X-linked recessive
D. X-linked dominant
C. X-linked recessive [CORRECT]
Rationale: Duchenne muscular dystrophy is caused by mutations in the dystrophin
gene located on the X chromosome and follows X-linked recessive inheritance,
primarily affecting males. Females are typically carriers. It is not autosomal (A, B) or
X-linked dominant (D), which would affect males and females more equally.
Correct Answer: C
Q5. During apoptosis, which cellular event is the defining characteristic that
distinguishes it from necrosis?
A. Cell swelling and membrane rupture
B. Chromatin condensation and caspase activation
C. Inflammatory infiltrate surrounding the cell
D. Mitochondrial swelling and calcium overload
B. Chromatin condensation and caspase activation [CORRECT]
Rationale: Apoptosis is programmed cell death characterized by chromatin
condensation, cell shrinkage, membrane blebbing, and caspase cascade activation
without inflammation. Necrosis (A, C, D) involves cell swelling, membrane rupture,
release of cellular contents, and inflammatory response.
Correct Answer: B
Q6. A pathologist examines a liver biopsy and notes Mallory-Denk bodies, fatty
change, and hepatocyte ballooning. These findings represent which pattern of cell
injury?
, 4
A. Hydropic change
B. Fatty change (steatosis) with alcoholic hepatitis
C. Amyloid deposition
D. Pigment accumulation
B. Fatty change (steatosis) with alcoholic hepatitis [CORRECT]
Rationale: Mallory-Denk bodies (cytokeratin aggregates), steatosis, and ballooning
degeneration are the classic histologic triad of alcoholic hepatitis. Hydropic change
(A) is reversible cell swelling from water influx but lacks these specific inclusions.
Amyloid (C) and pigment (D) are unrelated.
Correct Answer: B
Q7. A patient with chronic emphysema has destruction of alveolar walls and loss of
elastic recoil. At the cellular level, which enzyme is primarily responsible for the tissue
destruction?
A. Collagenase
B. Elastase
C. Hyaluronidase
D. Protease inhibitor
B. Elastase [CORRECT]
Rationale: Neutrophil-derived elastase destroys elastin fibers in alveolar walls,
causing loss of elastic recoil in emphysema. Normally inhibited by alpha-1
antitrypsin, deficiency or inactivation (by smoking) permits elastase-mediated
destruction. Collagenase (A) affects collagen; hyaluronidase (C) breaks down ground
substance. Protease inhibitor (D) prevents, not causes, destruction.
Correct Answer: B
Q8. A 35-year-old woman has a breast lump biopsy showing well-circumscribed,
encapsulated proliferation of ductal epithelium with uniform cells, low mitotic rate,
and no invasion. This best describes:
