NR507 Advanced Pathophysiology Midterm Exam –
Chamberlain (2025–2026) with Answers.
E X AM
**1. A patient with chronic anemia develops an enlarged heart. This is
an example of which type of cellular adaptation?**
A) Atrophy
B) Hypertrophy
C) Hyperplasia
D) Metaplasia
**Answer: B) Hypertrophy**
**Rationale:** Hypertrophy is an increase in cell size, which leads to an
increase in organ size. In chronic anemia, the heart must work harder to
pump oxygenated blood, causing cardiac myocytes to increase in size to
meet this increased workload. This represents a physiologic adaptation
that becomes pathologic if sustained .
---
**2. Which statement best describes the mechanism of cellular injury
from hypoxia?**
,A) Direct damage to the cell membrane
B) ATP depletion leading to failure of the sodium-potassium pump
C) Activation of inflammatory mediators
D) DNA fragmentation and apoptosis
**Answer: B) ATP depletion leading to failure of the sodium-potassium
pump**
**Rationale:** Hypoxia impairs oxidative phosphorylation, reducing
ATP production. Without ATP, the Na⁺/K⁺ pump fails, causing sodium to
accumulate intracellularly, water to follow, and cellular swelling. This is
a hallmark of reversible cellular injury that can progress to irreversible
damage if oxygen delivery is not restored .
---
**3. What is the primary function of the spleen in the body's immune
system?**
A) Production of antibodies
B) Immune surveillance and response in blood
C) Filtration of lymph fluid
D) Production of B lymphocytes
,**Answer: B) Immune surveillance and response in blood**
**Rationale:** The spleen serves as a critical immune organ that
collects antigens from the blood, initiates immune responses, and
removes old and damaged erythrocytes through phagocytosis. Unlike
lymph nodes, which filter lymph, the spleen filters blood .
---
**4. Which type of cellular adaptation is characterized by the
replacement of one differentiated cell type with another?**
A) Dysplasia
B) Hyperplasia
C) Metaplasia
D) Anaplasia
**Answer: C) Metaplasia**
**Rationale:** Metaplasia is the reversible replacement of one mature
cell type with another, often in response to chronic irritation. For
example, in chronic smokers, the normal pseudostratified columnar
epithelium of the respiratory tract may undergo squamous metaplasia
, as an adaptive response, which can increase cancer risk if the stimulus
persists .
---
**5. A patient has a genetic disorder affecting the CFTR gene. Which
cellular dysfunction is most likely?**
A) Impaired sodium transport
B) Defective chloride channel function
C) Abnormal calcium signaling
D) Mitochondrial dysfunction
**Answer: B) Defective chloride channel function**
**Rationale:** Cystic fibrosis results from mutations in the CFTR gene,
which encodes a chloride channel protein. This leads to defective
chloride transport across epithelial cell membranes, causing thick
mucus secretions in the lungs, pancreas, and other organs. This is an
inherited autosomal recessive disorder .
---
Chamberlain (2025–2026) with Answers.
E X AM
**1. A patient with chronic anemia develops an enlarged heart. This is
an example of which type of cellular adaptation?**
A) Atrophy
B) Hypertrophy
C) Hyperplasia
D) Metaplasia
**Answer: B) Hypertrophy**
**Rationale:** Hypertrophy is an increase in cell size, which leads to an
increase in organ size. In chronic anemia, the heart must work harder to
pump oxygenated blood, causing cardiac myocytes to increase in size to
meet this increased workload. This represents a physiologic adaptation
that becomes pathologic if sustained .
---
**2. Which statement best describes the mechanism of cellular injury
from hypoxia?**
,A) Direct damage to the cell membrane
B) ATP depletion leading to failure of the sodium-potassium pump
C) Activation of inflammatory mediators
D) DNA fragmentation and apoptosis
**Answer: B) ATP depletion leading to failure of the sodium-potassium
pump**
**Rationale:** Hypoxia impairs oxidative phosphorylation, reducing
ATP production. Without ATP, the Na⁺/K⁺ pump fails, causing sodium to
accumulate intracellularly, water to follow, and cellular swelling. This is
a hallmark of reversible cellular injury that can progress to irreversible
damage if oxygen delivery is not restored .
---
**3. What is the primary function of the spleen in the body's immune
system?**
A) Production of antibodies
B) Immune surveillance and response in blood
C) Filtration of lymph fluid
D) Production of B lymphocytes
,**Answer: B) Immune surveillance and response in blood**
**Rationale:** The spleen serves as a critical immune organ that
collects antigens from the blood, initiates immune responses, and
removes old and damaged erythrocytes through phagocytosis. Unlike
lymph nodes, which filter lymph, the spleen filters blood .
---
**4. Which type of cellular adaptation is characterized by the
replacement of one differentiated cell type with another?**
A) Dysplasia
B) Hyperplasia
C) Metaplasia
D) Anaplasia
**Answer: C) Metaplasia**
**Rationale:** Metaplasia is the reversible replacement of one mature
cell type with another, often in response to chronic irritation. For
example, in chronic smokers, the normal pseudostratified columnar
epithelium of the respiratory tract may undergo squamous metaplasia
, as an adaptive response, which can increase cancer risk if the stimulus
persists .
---
**5. A patient has a genetic disorder affecting the CFTR gene. Which
cellular dysfunction is most likely?**
A) Impaired sodium transport
B) Defective chloride channel function
C) Abnormal calcium signaling
D) Mitochondrial dysfunction
**Answer: B) Defective chloride channel function**
**Rationale:** Cystic fibrosis results from mutations in the CFTR gene,
which encodes a chloride channel protein. This leads to defective
chloride transport across epithelial cell membranes, causing thick
mucus secretions in the lungs, pancreas, and other organs. This is an
inherited autosomal recessive disorder .
---
