,NR 507 midterm Exam | Advanced
Pathophysiology | Chamberlain University | Q & A
| 2026/2027 Edition (PDF)
1. A 52-year-old male presents with fatigue and weakness. Laboratory results show a hemoglobin of
8.2 g/dL. A bone marrow biopsy reveals megaloblastic changes. Which vitamin deficiency is most
likely the cause?
A) Vitamin B6
B) Vitamin B12
C) Vitamin C
D) Vitamin K
Correct Answer: Vitamin B12
Rationale: Megaloblastic anemia results from impaired DNA synthesis due to vitamin B12 or folate
deficiency. Vitamin B12 deficiency causes megaloblastic changes in bone marrow precursors, leading
to ineffective erythropoiesis. Vitamin B6 deficiency is associated with sideroblastic anemia, while
vitamin C and K deficiencies do not cause megaloblastic changes.
2. Which cellular adaptation is characterized by an increase in cell size and function in response to
increased workload?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Correct Answer: Hypertrophy
Rationale: Hypertrophy is an increase in cell size and functional capacity in response to increased
demand. It occurs in cells that cannot divide, such as cardiac and skeletal muscle. Hyperplasia involves
an increase in cell number, atrophy involves a decrease in cell size, and metaplasia is the replacement
of one cell type with another.
,3. A patient with chronic gastroesophageal reflux disease (GERD) develops Barrett esophagus. This
represents which type of cellular adaptation?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Correct Answer: Metaplasia
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with another. In
Barrett esophagus, the normal squamous epithelium of the esophagus is replaced by columnar
epithelium in response to chronic acid reflux. This is a protective adaptation that also increases the
risk of esophageal adenocarcinoma.
4. A 45-year-old female smoker presents with a persistent cough. A lung biopsy shows squamous
metaplasia of the bronchial epithelium. This change is best described as:
A) An irreversible malignant change
B) A reversible adaptive change
C) A type III hypersensitivity reaction
D) A type IV hypersensitivity reaction
Correct Answer: A reversible adaptive change
Rationale: Squamous metaplasia of the bronchial epithelium is a reversible adaptive change in
response to chronic irritation from cigarette smoke. While it is a protective response, it can progress
to dysplasia and carcinoma if the irritant is not removed. It is not a hypersensitivity reaction.
5. Which cellular organelle is responsible for ATP production and is often damaged in hypoxic injury?
A) Ribosome
B) Golgi apparatus
, C) Mitochondrion
D) Endoplasmic reticulum
Correct Answer: Mitochondrion
Rationale: Mitochondria are the powerhouses of the cell, producing ATP through oxidative
phosphorylation. Hypoxia and ischemia cause mitochondrial swelling and dysfunction, leading to ATP
depletion and cell injury. Ribosomes are involved in protein synthesis, the Golgi apparatus in protein
modification, and the endoplasmic reticulum in protein folding and lipid synthesis.
6. A patient with chronic alcoholism develops cirrhosis. Which type of cell death is most characteristic
of this condition?
A) Apoptosis
B) Necrosis
C) Coagulative necrosis
D) Steatosis with subsequent necrosis
Correct Answer: Steatosis with subsequent necrosis
Rationale: Chronic alcoholism leads to fatty liver (steatosis) due to impaired lipid metabolism.
Continued alcohol exposure causes hepatocellular injury and necrosis, leading to inflammation and
fibrosis, ultimately resulting in cirrhosis. While apoptosis and necrosis occur, steatosis is the hallmark
initial change.
7. A patient presents with enlargement of the left ventricle due to long-standing hypertension. This is
an example of which type of cellular adaptation?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Correct Answer: Hypertrophy
Pathophysiology | Chamberlain University | Q & A
| 2026/2027 Edition (PDF)
1. A 52-year-old male presents with fatigue and weakness. Laboratory results show a hemoglobin of
8.2 g/dL. A bone marrow biopsy reveals megaloblastic changes. Which vitamin deficiency is most
likely the cause?
A) Vitamin B6
B) Vitamin B12
C) Vitamin C
D) Vitamin K
Correct Answer: Vitamin B12
Rationale: Megaloblastic anemia results from impaired DNA synthesis due to vitamin B12 or folate
deficiency. Vitamin B12 deficiency causes megaloblastic changes in bone marrow precursors, leading
to ineffective erythropoiesis. Vitamin B6 deficiency is associated with sideroblastic anemia, while
vitamin C and K deficiencies do not cause megaloblastic changes.
2. Which cellular adaptation is characterized by an increase in cell size and function in response to
increased workload?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Correct Answer: Hypertrophy
Rationale: Hypertrophy is an increase in cell size and functional capacity in response to increased
demand. It occurs in cells that cannot divide, such as cardiac and skeletal muscle. Hyperplasia involves
an increase in cell number, atrophy involves a decrease in cell size, and metaplasia is the replacement
of one cell type with another.
,3. A patient with chronic gastroesophageal reflux disease (GERD) develops Barrett esophagus. This
represents which type of cellular adaptation?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Correct Answer: Metaplasia
Rationale: Metaplasia is the reversible replacement of one differentiated cell type with another. In
Barrett esophagus, the normal squamous epithelium of the esophagus is replaced by columnar
epithelium in response to chronic acid reflux. This is a protective adaptation that also increases the
risk of esophageal adenocarcinoma.
4. A 45-year-old female smoker presents with a persistent cough. A lung biopsy shows squamous
metaplasia of the bronchial epithelium. This change is best described as:
A) An irreversible malignant change
B) A reversible adaptive change
C) A type III hypersensitivity reaction
D) A type IV hypersensitivity reaction
Correct Answer: A reversible adaptive change
Rationale: Squamous metaplasia of the bronchial epithelium is a reversible adaptive change in
response to chronic irritation from cigarette smoke. While it is a protective response, it can progress
to dysplasia and carcinoma if the irritant is not removed. It is not a hypersensitivity reaction.
5. Which cellular organelle is responsible for ATP production and is often damaged in hypoxic injury?
A) Ribosome
B) Golgi apparatus
, C) Mitochondrion
D) Endoplasmic reticulum
Correct Answer: Mitochondrion
Rationale: Mitochondria are the powerhouses of the cell, producing ATP through oxidative
phosphorylation. Hypoxia and ischemia cause mitochondrial swelling and dysfunction, leading to ATP
depletion and cell injury. Ribosomes are involved in protein synthesis, the Golgi apparatus in protein
modification, and the endoplasmic reticulum in protein folding and lipid synthesis.
6. A patient with chronic alcoholism develops cirrhosis. Which type of cell death is most characteristic
of this condition?
A) Apoptosis
B) Necrosis
C) Coagulative necrosis
D) Steatosis with subsequent necrosis
Correct Answer: Steatosis with subsequent necrosis
Rationale: Chronic alcoholism leads to fatty liver (steatosis) due to impaired lipid metabolism.
Continued alcohol exposure causes hepatocellular injury and necrosis, leading to inflammation and
fibrosis, ultimately resulting in cirrhosis. While apoptosis and necrosis occur, steatosis is the hallmark
initial change.
7. A patient presents with enlargement of the left ventricle due to long-standing hypertension. This is
an example of which type of cellular adaptation?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Correct Answer: Hypertrophy
