NR 507 ADVANCED PATHOPHYSIOLOGY
FINAL EXAM COMPREHENSIVE GUIDE
2026/27 EDITION Questions And Answers
,1. Which cellular adaptation is characterized by a reversible
change in which one differentiated cell type is replaced by
another differentiated cell type?
A. Hypertrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
Correct Answer: C
Explanation: Metaplasia is the reversible replacement of
one differentiated cell type with another, often in response
to chronic irritation (e.g., squamous metaplasia in
smokers). Hypertrophy is increased cell size, hyperplasia is
increased cell number, and dysplasia is disordered growth
with atypia.
2. A patient with chronic heart failure demonstrates left
ventricular thickening. Which type of cellular adaptation is
this?
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Metaplasia
Correct Answer: B
Explanation: Hypertrophy is an increase in cell/organ size
due to increased workload, common in cardiac muscle with
hypertension or heart failure. Atrophy is decreased size,
hyperplasia is increased cell number, and metaplasia is cell
type replacement.
,3. Which mediator is primarily responsible for vasodilation and
increased vascular permeability in acute inflammation?
A. Histamine
B. Leukotriene B4
C. Thromboxane A2
D. Platelet-activating factor
Correct Answer: A
Explanation: Histamine causes immediate transient
vasodilation and increased permeability in acute
inflammation. Leukotriene B4 is a chemotactic agent,
thromboxane A2 causes vasoconstriction and platelet
aggregation, and PAF has multiple effects but histamine is
the primary early mediator.
4. In the pathogenesis of atherosclerosis, which event occurs
FIRST?
A. Foam cell formation
B. Endothelial injury/dysfunction
C. Plaque rupture
D. Smooth muscle cell proliferation
Correct Answer: B
Explanation: Endothelial injury is the initiating event in
atherosclerosis, leading to increased permeability,
leukocyte adhesion, and subsequent lipid accumulation.
Foam cell formation, smooth muscle proliferation, and
plaque rupture occur later.
5. A patient presents with left-sided heart failure. Which
symptom is MOST directly related to pulmonary congestion?
, A. Peripheral edema
B. Jugular vein distention
C. Pulmonary crackles
D. Hepatomegaly
Correct Answer: C
Explanation: Left-sided heart failure causes pulmonary
congestion leading to crackles (rales) on auscultation.
Peripheral edema, JVD, and hepatomegaly are signs of
right-sided heart failure.
6. Which type of shock is characterized by decreased systemic
vascular resistance and warm, flushed skin in early stages?
A. Hypovolemic shock
B. Cardiogenic shock
C. Septic (distributive) shock
D. Obstructive shock
Correct Answer: C
Explanation: Septic shock is a distributive shock with
vasodilation causing decreased SVR and warm skin
initially. Hypovolemic and cardiogenic shock present with
cold, clammy skin due to vasoconstriction.
7. In COPD, which pathophysiological change is MOST
characteristic of emphysema?
A. Excessive mucus production
B. Destruction of alveolar walls
C. Bronchial smooth muscle hypertrophy
D. Airway edema
Correct Answer: B
FINAL EXAM COMPREHENSIVE GUIDE
2026/27 EDITION Questions And Answers
,1. Which cellular adaptation is characterized by a reversible
change in which one differentiated cell type is replaced by
another differentiated cell type?
A. Hypertrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
Correct Answer: C
Explanation: Metaplasia is the reversible replacement of
one differentiated cell type with another, often in response
to chronic irritation (e.g., squamous metaplasia in
smokers). Hypertrophy is increased cell size, hyperplasia is
increased cell number, and dysplasia is disordered growth
with atypia.
2. A patient with chronic heart failure demonstrates left
ventricular thickening. Which type of cellular adaptation is
this?
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Metaplasia
Correct Answer: B
Explanation: Hypertrophy is an increase in cell/organ size
due to increased workload, common in cardiac muscle with
hypertension or heart failure. Atrophy is decreased size,
hyperplasia is increased cell number, and metaplasia is cell
type replacement.
,3. Which mediator is primarily responsible for vasodilation and
increased vascular permeability in acute inflammation?
A. Histamine
B. Leukotriene B4
C. Thromboxane A2
D. Platelet-activating factor
Correct Answer: A
Explanation: Histamine causes immediate transient
vasodilation and increased permeability in acute
inflammation. Leukotriene B4 is a chemotactic agent,
thromboxane A2 causes vasoconstriction and platelet
aggregation, and PAF has multiple effects but histamine is
the primary early mediator.
4. In the pathogenesis of atherosclerosis, which event occurs
FIRST?
A. Foam cell formation
B. Endothelial injury/dysfunction
C. Plaque rupture
D. Smooth muscle cell proliferation
Correct Answer: B
Explanation: Endothelial injury is the initiating event in
atherosclerosis, leading to increased permeability,
leukocyte adhesion, and subsequent lipid accumulation.
Foam cell formation, smooth muscle proliferation, and
plaque rupture occur later.
5. A patient presents with left-sided heart failure. Which
symptom is MOST directly related to pulmonary congestion?
, A. Peripheral edema
B. Jugular vein distention
C. Pulmonary crackles
D. Hepatomegaly
Correct Answer: C
Explanation: Left-sided heart failure causes pulmonary
congestion leading to crackles (rales) on auscultation.
Peripheral edema, JVD, and hepatomegaly are signs of
right-sided heart failure.
6. Which type of shock is characterized by decreased systemic
vascular resistance and warm, flushed skin in early stages?
A. Hypovolemic shock
B. Cardiogenic shock
C. Septic (distributive) shock
D. Obstructive shock
Correct Answer: C
Explanation: Septic shock is a distributive shock with
vasodilation causing decreased SVR and warm skin
initially. Hypovolemic and cardiogenic shock present with
cold, clammy skin due to vasoconstriction.
7. In COPD, which pathophysiological change is MOST
characteristic of emphysema?
A. Excessive mucus production
B. Destruction of alveolar walls
C. Bronchial smooth muscle hypertrophy
D. Airway edema
Correct Answer: B
