Portage Pathophysiology Module 1 to 10 Exam | 200 Practice
Questions & Detailed Answers | NURS 231 / BIOD 331
Complete Q&A Guide | A+ Graded
MODULE 1: INTRODUCTION TO PATHOPHYSIOLOGY AND CELLULAR INJURY
1. What is the primary difference between apoptosis and necrosis?
A) Apoptosis triggers inflammation; necrosis does not
B) Apoptosis is programmed, energydependent cell death; necrosis is uncontrolled, accidental cell death
C) Apoptosis causes cell swelling; necrosis causes cell shrinkage
D) Both are identical forms of cell death
Correct Answer: B
Explanation: Apoptosis is programmed, energydependent cell death that does not trigger an
inflammatory response because the cell membrane remains intact and cellular debris is phagocytized.
Necrosis is uncontrolled, accidental cell death caused by severe injury, which causes cell swelling,
membrane rupture, and leakage of cellular contents, triggering a severe inflammatory response.
2. A patient has chronic GERD. The esophageal cells change from stratified squamous to columnar
epithelium. What is this cellular adaptation called?
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Dysplasia
,Correct Answer: C
Explanation: Metaplasia is the reversible replacement of one fully differentiated adult cell type with
another adult cell type to better withstand a stressful environment. In chronic GERD, the esophageal
epithelium changes to columnar epithelium (Barrett's esophagus) to better tolerate the acidic
environment.
3. A bodybuilder increases the size of their biceps through weightlifting. What cellular adaptation is
occurring?
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Atrophy
Correct Answer: B
Explanation: Hypertrophy is an increase in the physical size of existing cells without an increase in the
number of cells, caused by increased workload. This can be physiologic, such as muscle growth from
exercise, or pathologic, as in cardiac hypertrophy from hypertension.
4. A patient suffers a myocardial infarction. The ischemic cells show cellular swelling, blebbing, and the
influx of sodium and water. What is this specific manifestation of cellular injury called?
A) Apoptosis
B) Karyolysis
C) Hydropic swelling (oncosis)
,D) Fatty change
Correct Answer: C
Explanation: Hydropic swelling (also known as oncosis) occurs because the lack of ATP causes the
sodiumpotassium pump to fail, allowing water to rush into the cell. This is an early manifestation of
cellular injury seen in ischemic conditions like myocardial infarction.
5. Which cellular organelle is most susceptible to injury from ischemia and contains enzymes that, if
leaked, cause autodigestion of the cell?
A) Mitochondria
B) Ribosome
C) Lysosome
D) Golgi apparatus
Correct Answer: C
Explanation: The lysosome contains powerful acid hydrolases. If the lysosomal membrane ruptures,
these enzymes are released into the cytoplasm and digest the cell (autodigestion). Lysosomes are
particularly susceptible to injury from ischemia.
6. What role do reactive oxygen species (free radicals) play in cellular injury?
A) They promote cellular repair
B) They stabilize cell membranes
, C) They cause injury by stealing electrons from lipids, proteins, and DNA
D) They enhance ATP production
Correct Answer: C
Explanation: Free radicals are highly unstable molecules with an unpaired electron. They cause cellular
injury by stealing electrons from lipids (causing lipid peroxidation of cell membranes), proteins, and
DNA, leading to severe cellular dysfunction and death.
7. A patient has an enlarged uterus due to pregnancy. This is an example of what cellular adaptation?
A) Hypertrophy
B) Metaplasia
C) Atrophy
D) Hyperplasia
Correct Answer: D
Explanation: Hyperplasia is an increase in the number of cells in an organ or tissue, usually stimulated by
hormones or growth factors. The uterine enlargement during pregnancy is due to both hyperplasia and
hypertrophy of smooth muscle cells.
8. When a cell is deprived of oxygen, what is the first metabolic pathway it switches to, and what is the
byproduct?
A) Oxidative phosphorylation; water
Questions & Detailed Answers | NURS 231 / BIOD 331
Complete Q&A Guide | A+ Graded
MODULE 1: INTRODUCTION TO PATHOPHYSIOLOGY AND CELLULAR INJURY
1. What is the primary difference between apoptosis and necrosis?
A) Apoptosis triggers inflammation; necrosis does not
B) Apoptosis is programmed, energydependent cell death; necrosis is uncontrolled, accidental cell death
C) Apoptosis causes cell swelling; necrosis causes cell shrinkage
D) Both are identical forms of cell death
Correct Answer: B
Explanation: Apoptosis is programmed, energydependent cell death that does not trigger an
inflammatory response because the cell membrane remains intact and cellular debris is phagocytized.
Necrosis is uncontrolled, accidental cell death caused by severe injury, which causes cell swelling,
membrane rupture, and leakage of cellular contents, triggering a severe inflammatory response.
2. A patient has chronic GERD. The esophageal cells change from stratified squamous to columnar
epithelium. What is this cellular adaptation called?
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Dysplasia
,Correct Answer: C
Explanation: Metaplasia is the reversible replacement of one fully differentiated adult cell type with
another adult cell type to better withstand a stressful environment. In chronic GERD, the esophageal
epithelium changes to columnar epithelium (Barrett's esophagus) to better tolerate the acidic
environment.
3. A bodybuilder increases the size of their biceps through weightlifting. What cellular adaptation is
occurring?
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Atrophy
Correct Answer: B
Explanation: Hypertrophy is an increase in the physical size of existing cells without an increase in the
number of cells, caused by increased workload. This can be physiologic, such as muscle growth from
exercise, or pathologic, as in cardiac hypertrophy from hypertension.
4. A patient suffers a myocardial infarction. The ischemic cells show cellular swelling, blebbing, and the
influx of sodium and water. What is this specific manifestation of cellular injury called?
A) Apoptosis
B) Karyolysis
C) Hydropic swelling (oncosis)
,D) Fatty change
Correct Answer: C
Explanation: Hydropic swelling (also known as oncosis) occurs because the lack of ATP causes the
sodiumpotassium pump to fail, allowing water to rush into the cell. This is an early manifestation of
cellular injury seen in ischemic conditions like myocardial infarction.
5. Which cellular organelle is most susceptible to injury from ischemia and contains enzymes that, if
leaked, cause autodigestion of the cell?
A) Mitochondria
B) Ribosome
C) Lysosome
D) Golgi apparatus
Correct Answer: C
Explanation: The lysosome contains powerful acid hydrolases. If the lysosomal membrane ruptures,
these enzymes are released into the cytoplasm and digest the cell (autodigestion). Lysosomes are
particularly susceptible to injury from ischemia.
6. What role do reactive oxygen species (free radicals) play in cellular injury?
A) They promote cellular repair
B) They stabilize cell membranes
, C) They cause injury by stealing electrons from lipids, proteins, and DNA
D) They enhance ATP production
Correct Answer: C
Explanation: Free radicals are highly unstable molecules with an unpaired electron. They cause cellular
injury by stealing electrons from lipids (causing lipid peroxidation of cell membranes), proteins, and
DNA, leading to severe cellular dysfunction and death.
7. A patient has an enlarged uterus due to pregnancy. This is an example of what cellular adaptation?
A) Hypertrophy
B) Metaplasia
C) Atrophy
D) Hyperplasia
Correct Answer: D
Explanation: Hyperplasia is an increase in the number of cells in an organ or tissue, usually stimulated by
hormones or growth factors. The uterine enlargement during pregnancy is due to both hyperplasia and
hypertrophy of smooth muscle cells.
8. When a cell is deprived of oxygen, what is the first metabolic pathway it switches to, and what is the
byproduct?
A) Oxidative phosphorylation; water
