NSG 5140 Advanced Pathophysiology
Final Exam Review 2025 | 200 Practice
Questions & Answers with Rationales
South College.
Unit 1: Cellular Adaptation, Injury & Necrosis
Q1. Which type of cellular adaptation involves an increase in the size of existing
cells?
a) Hyperplasia
b) Hypertrophy
c) Atrophy
d) Metaplasia
Answer: b) Hypertrophy
Rationale: Hypertrophy refers to the increase in cell size, often in response to increased
workload. Hyperplasia refers to an increase in cell number, atrophy is a decrease in cell
size or number, and metaplasia is the replacement of one cell type by another .
Q2. A patient with chronic hypertension is found to have left ventricular
enlargement. This is an example of:
a) Hyperplasia
b) Hypertrophy
c) Dysplasia
d) Metaplasia
Answer: b) Hypertrophy
Rationale: Chronic increased workload on the heart causes myocardial cells to enlarge,
resulting in hypertrophy, particularly in the left ventricle .
,Q3. Which process is characterized by a reversible change where one adult cell
type is replaced by another adult cell type?
a) Dysplasia
b) Metaplasia
c) Atrophy
d) Hypertrophy
Answer: b) Metaplasia
Rationale: Metaplasia is the reversible replacement of one mature cell type with another,
often as an adaptive response to chronic irritation .
Q4. The most common cause of reversible cell injury is:
a) DNA fragmentation
b) ATP depletion
c) Lysosomal rupture
d) Mitochondrial calcification
Answer: b) ATP depletion
Rationale: Loss of ATP impairs membrane pumps, causing cell swelling and dysfunction
before irreversible damage occurs .
Q5. Which type of necrosis preserves tissue architecture and is most commonly
associated with ischemic injury in the heart and kidneys?
a) Coagulative
b) Liquefactive
c) Caseous
d) Fat
Answer: a) Coagulative
Rationale: Coagulative necrosis preserves the basic tissue architecture and is most
commonly associated with ischemic injury, particularly in the heart and kidneys .
Q6. Liquefactive necrosis is characteristically seen in:
a) Myocardial infarction
b) Brain infarction
c) Tuberculosis
d) Adipose tissue injury
Answer: b) Brain infarction
Rationale: In the brain, ischemic injury causes enzymatic digestion of tissue, producing a
liquid, viscous mass, known as liquefactive necrosis .
,Q7. Caseous necrosis is most commonly associated with:
a) Myocardial infarction
b) Tuberculosis
c) Stroke
d) Trauma
Answer: b) Tuberculosis
Rationale: Caseous necrosis, resembling crumbly cheese, is typical of granulomatous
infections like tuberculosis .
Q8. Which organ is most susceptible to irreversible damage from ischemia?
a) Kidney
b) Liver
c) Brain
d) Skeletal muscle
Answer: c) Brain
Rationale: Neurons rely almost exclusively on aerobic metabolism and have minimal
glycogen stores. They can suffer irreversible injury within just 4–6 minutes of complete
ischemia .
Q9. Which of the following is a hallmark of reversible cellular injury?
a) Nuclear fragmentation
b) Cellular swelling
c) Karyolysis
d) Mitochondrial rupture
Answer: b) Cellular swelling
Rationale: Reversible injury often presents with hydropic change (cellular swelling) due to
ATP depletion and sodium-potassium pump failure .
Q10. Which type of cell death is a programmed, energy-dependent process that
does not trigger inflammation?
a) Necrosis
b) Apoptosis
c) Autolysis
d) Gangrene
Answer: b) Apoptosis
Rationale: Apoptosis is an energy-dependent, genetically regulated process of cell death
that eliminates damaged or unnecessary cells without causing inflammation .
, Unit 2: Inflammation & Immunity
Q11. Which cell type is the first responder in acute inflammation?
a) Macrophage
b) Lymphocyte
c) Neutrophil
d) Eosinophil
Answer: c) Neutrophil
Rationale: Neutrophils are the first leukocytes to arrive at the site of acute inflammation,
typically within hours .
Q12. Which mediator is primarily responsible for early vasodilation in acute
inflammation?
a) Leukotrienes
b) Histamine
c) Prostaglandins
d) Tumor necrosis factor-α (TNF-α)
Answer: b) Histamine
Rationale: Histamine is released immediately from mast cells in response to injury, causing
rapid vasodilation (redness, heat) and increased vascular permeability .
Q13. Which cytokine plays a central role in the systemic inflammatory response
seen in sepsis and is primarily responsible for fever?
a) Interleukin-2
b) Tumor necrosis factor–alpha (TNF-α)
c) Interleukin-10
d) Interferon-gamma
Answer: b) Tumor necrosis factor–alpha (TNF-α)
*Rationale: TNF-α is a primary mediator of the septic response, responsible for
vasodilation, capillary leak, and fever. Endogenous pyrogens (IL-1, IL-6, TNF-α) act on
the hypothalamus to increase the thermoregulatory set point* .
Q14. Which type of hypersensitivity is IgE-mediated?
a) Type I
b) Type II
Final Exam Review 2025 | 200 Practice
Questions & Answers with Rationales
South College.
Unit 1: Cellular Adaptation, Injury & Necrosis
Q1. Which type of cellular adaptation involves an increase in the size of existing
cells?
a) Hyperplasia
b) Hypertrophy
c) Atrophy
d) Metaplasia
Answer: b) Hypertrophy
Rationale: Hypertrophy refers to the increase in cell size, often in response to increased
workload. Hyperplasia refers to an increase in cell number, atrophy is a decrease in cell
size or number, and metaplasia is the replacement of one cell type by another .
Q2. A patient with chronic hypertension is found to have left ventricular
enlargement. This is an example of:
a) Hyperplasia
b) Hypertrophy
c) Dysplasia
d) Metaplasia
Answer: b) Hypertrophy
Rationale: Chronic increased workload on the heart causes myocardial cells to enlarge,
resulting in hypertrophy, particularly in the left ventricle .
,Q3. Which process is characterized by a reversible change where one adult cell
type is replaced by another adult cell type?
a) Dysplasia
b) Metaplasia
c) Atrophy
d) Hypertrophy
Answer: b) Metaplasia
Rationale: Metaplasia is the reversible replacement of one mature cell type with another,
often as an adaptive response to chronic irritation .
Q4. The most common cause of reversible cell injury is:
a) DNA fragmentation
b) ATP depletion
c) Lysosomal rupture
d) Mitochondrial calcification
Answer: b) ATP depletion
Rationale: Loss of ATP impairs membrane pumps, causing cell swelling and dysfunction
before irreversible damage occurs .
Q5. Which type of necrosis preserves tissue architecture and is most commonly
associated with ischemic injury in the heart and kidneys?
a) Coagulative
b) Liquefactive
c) Caseous
d) Fat
Answer: a) Coagulative
Rationale: Coagulative necrosis preserves the basic tissue architecture and is most
commonly associated with ischemic injury, particularly in the heart and kidneys .
Q6. Liquefactive necrosis is characteristically seen in:
a) Myocardial infarction
b) Brain infarction
c) Tuberculosis
d) Adipose tissue injury
Answer: b) Brain infarction
Rationale: In the brain, ischemic injury causes enzymatic digestion of tissue, producing a
liquid, viscous mass, known as liquefactive necrosis .
,Q7. Caseous necrosis is most commonly associated with:
a) Myocardial infarction
b) Tuberculosis
c) Stroke
d) Trauma
Answer: b) Tuberculosis
Rationale: Caseous necrosis, resembling crumbly cheese, is typical of granulomatous
infections like tuberculosis .
Q8. Which organ is most susceptible to irreversible damage from ischemia?
a) Kidney
b) Liver
c) Brain
d) Skeletal muscle
Answer: c) Brain
Rationale: Neurons rely almost exclusively on aerobic metabolism and have minimal
glycogen stores. They can suffer irreversible injury within just 4–6 minutes of complete
ischemia .
Q9. Which of the following is a hallmark of reversible cellular injury?
a) Nuclear fragmentation
b) Cellular swelling
c) Karyolysis
d) Mitochondrial rupture
Answer: b) Cellular swelling
Rationale: Reversible injury often presents with hydropic change (cellular swelling) due to
ATP depletion and sodium-potassium pump failure .
Q10. Which type of cell death is a programmed, energy-dependent process that
does not trigger inflammation?
a) Necrosis
b) Apoptosis
c) Autolysis
d) Gangrene
Answer: b) Apoptosis
Rationale: Apoptosis is an energy-dependent, genetically regulated process of cell death
that eliminates damaged or unnecessary cells without causing inflammation .
, Unit 2: Inflammation & Immunity
Q11. Which cell type is the first responder in acute inflammation?
a) Macrophage
b) Lymphocyte
c) Neutrophil
d) Eosinophil
Answer: c) Neutrophil
Rationale: Neutrophils are the first leukocytes to arrive at the site of acute inflammation,
typically within hours .
Q12. Which mediator is primarily responsible for early vasodilation in acute
inflammation?
a) Leukotrienes
b) Histamine
c) Prostaglandins
d) Tumor necrosis factor-α (TNF-α)
Answer: b) Histamine
Rationale: Histamine is released immediately from mast cells in response to injury, causing
rapid vasodilation (redness, heat) and increased vascular permeability .
Q13. Which cytokine plays a central role in the systemic inflammatory response
seen in sepsis and is primarily responsible for fever?
a) Interleukin-2
b) Tumor necrosis factor–alpha (TNF-α)
c) Interleukin-10
d) Interferon-gamma
Answer: b) Tumor necrosis factor–alpha (TNF-α)
*Rationale: TNF-α is a primary mediator of the septic response, responsible for
vasodilation, capillary leak, and fever. Endogenous pyrogens (IL-1, IL-6, TNF-α) act on
the hypothalamus to increase the thermoregulatory set point* .
Q14. Which type of hypersensitivity is IgE-mediated?
a) Type I
b) Type II
