EXAM, FINAL EXAM, PULMONARY & RESPIRATORY
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5315 ADVANCED PATHOPHYSIOLOGY WITH THIS
COMPREHENSIVE 2026–2027 ULTIMATE EXAM
SECTION 1: CELLULAR ADAPTATION & INJURY
1. A patient with prolonged hypertension develops left ventricular hypertrophy.
This is an example of which type of cellular adaptation?
• A) Atrophy
• B) Hyperplasia
• C) Hypertrophy
• D) Dysplasia
Answer: C
Hypertrophy is an increase in cell SIZE due to increased workload. The heart
muscle cells enlarge in response to chronic pressure overload from hypertension,
leading to ventricular wall thickening. This is a pathologic adaptation that can
eventually lead to heart failure .
2. A 72-year-old patient with immobility develops muscle wasting. This is an
example of:
• A) Physiologic atrophy
• B) Disuse atrophy
• C) Pathologic hypertrophy
, • D) Metaplasia
Answer: B
Disuse atrophy occurs when cells decrease in size due to reduced workload,
pressure, use, blood supply, or nervous stimulation. In immobile patients,
decreased muscle use leads to cell shrinkage and diminished function. The cells
remain alive but have reduced functional capacity .
3. Which of the following best describes the mechanism of injury caused by
reactive oxygen species (ROS)?
• A) Increased ATP production
• B) Lipid peroxidation and DNA damage
• C) Enhanced protein synthesis
• D) Cellular swelling only
Answer: B
Reactive oxygen species cause cellular injury through lipid peroxidation (damaging
cell membranes), protein damage, and DNA fragmentation. This mechanism is
implicated in the pathogenesis of Alzheimer's disease, Parkinson's disease,
atherosclerosis, and heart failure .
4. The body's primary defense against reactive oxygen species includes all of the
following EXCEPT:
• A) Vitamin E
• B) Glutathione
• C) Albumin
• D) Glucose
Answer: D
,Antioxidant defenses include Vitamin E, Vitamin C, cysteine, glutathione, albumin,
ceruloplasmin, and transferrin. Glucose is not considered an antioxidant defense
mechanism against ROS .
5. A patient with chronic alcoholism develops fatty infiltration of the liver. This
represents:
• A) Intracellular accumulation of lipids
• B) Dystrophic calcification
• C) Metastatic calcification
• D) Coagulative necrosis
Answer: A
Fatty infiltration (steatosis) is the intracellular accumulation of lipids in the liver
when the liver fails to metabolize lipids properly. Chronic alcohol use and high-fat
diets are common causes that can progress to cirrhosis .
6. Which type of necrosis is characterized by tissue that appears "clumped like
cheese" and is typically associated with tuberculosis?
• A) Coagulative necrosis
• B) Liquefactive necrosis
• C) Caseous necrosis
• D) Fat necrosis
Answer: C
Caseous necrosis is characteristic of tuberculosis and some fungal infections. The
tissue appears white, crumbly, and cheese-like due to the combination of
coagulative and liquefactive necrosis with granulomatous inflammation .
, 7. Dystrophic calcification occurs when:
• A) There is hypercalcemia from hyperparathyroidism
• B) Calcium accumulates in dead or dying tissues
• C) Calcium is deposited in normal tissue
• D) There is toxic levels of Vitamin D
Answer: B
Dystrophic calcification is the accumulation of calcium salts in dead or dying
tissues despite normal serum calcium levels. It is associated with pulmonary
tuberculosis, atherosclerosis, injured heart valves, and chronic pancreatitis .
8. Which suffix indicates a benign tumor?
• A) -carcinoma
• B) -sarcoma
• C) -oma
• D) -blastoma
Answer: C
The suffix "-oma" typically indicates a benign tumor (e.g., lipoma). "-carcinoma"
indicates malignant epithelial tumors, "-sarcoma" indicates malignant connective
tissue tumors, and "-blastoma" indicates tumors from immature or embryonic
tissue .
SECTION 2: FLUID & ELECTROLYTE BALANCE
9. Intracellular fluid (ICF) accounts for approximately what percentage of total
body water?
• A) 20%