NR507 Advanced Pathophysiology: Week 4 Midterm Practice Question Bank – 250 High-Yield Questions with Answers (Chamberlain University Version A Aligned)

NR507 Advanced Pathophysiology: Week 4 Midterm Practice Question Bank – 250 High-Yield Questions with Answers (Chamberlain University Version A Aligned) 1. A 68-year-old male with long-standing hypertension has an echocardiogram demonstrating increased left ventricular wall thickness. Which cellular adaptation best explains this finding, and what is the underlying mechanism? A. Dysplasia, because the cardiac cells demonstrate disordered growth and abnormal organization B. Hypertrophy, because cardiac muscle cells cannot divide and instead increase in cell size in response to increased workload C. Hyperplasia, because cardiac muscle cells divide to increase cell number under increased workload D. Metaplasia, because cardiac muscle cells transform into a more resistant cell type Answer: B. Hypertrophy, because cardiac muscle cells cannot divide and instead increase in cell size in response to increased workload 2. A 55-year-old chronic smoker undergoes bronchoscopy with biopsy of the bronchial epithelium. Histology reveals that the normal ciliated pseudostratified columnar epithelium has been replaced by stratified squamous epithelium. Which cellular adaptation is this, and what is its significance? A. Atrophy, the bronchial cells have decreased in size due to chronic irritation B. Metaplasia, the change is a reversible substitution of one differentiated cell type for another that better tolerates stress, though it may predispose to malignant transformation with ongoing injury C. Hyperplasia, the bronchial cells have increased in number due to chronic inflammation D. Dysplasia, the change is disordered growth that is irreversible and already malignant Answer: B. Metaplasia, the change is a reversible substitution of one differentiated cell type for another that better tolerates stress, though it may predispose to malignant transformation with ongoing injury 3. A 30-year-old female with menorrhagia has an endometrial biopsy showing increased number of endometrial glands due to unopposed estrogen stimulation. Which cellular adaptation is occurring? A. Hyperplasia, because there is an increase in cell number in response to hormonal stimulation B. Hypertrophy, because the endometrial cells have increased in size C. Dysplasia, because the cells show disordered growth and atypia D. Metaplasia, because one cell type has replaced another Answer: A. Hyperplasia, because there is an increase in cell number in response to hormonal stimulation 4. A cervical biopsy in a 35-year-old female shows disordered cellular growth with abnormal size, shape, and organization of squamous epithelial cells that has not broken through the basement membrane. Which term best describes this finding? A. Carcinoma with metastasis, because the cells have invaded surrounding tissues B. Hyperplasia, because there is an increased number of normal cells C. Metaplasia, because one cell type has been replaced by another D. Dysplasia that may be reversible but can progress to carcinoma in situ if the insult continues Answer: D. Dysplasia that may be reversible but can progress to carcinoma in situ if the insult continues 5. A 60-year-old male with a cast on his leg for 6 weeks has noticeable decrease in muscle mass of the affected limb when the cast is removed. Which cellular adaptation explains this finding, and what is its likely mechanism? A. Metaplasia due to chronic irritation from the cast material B. Atrophy due to decreased workload, denervation, ischemia, malnutrition, or aging C. Hypertrophy due to increased workload from the cast D. Apoptosis due to programmed cell death from cast pressure Answer: B. Atrophy due to decreased workload, denervation, ischemia, malnutrition, or aging 6. A pathologist examining a tissue specimen from an acutely ischemic myocardium notes cellular swelling and fatty change. These findings are most characteristic of which stage of cellular injury? A. Apoptosis with chromatin condensation and apoptotic body formation B. Coagulative necrosis with preserved tissue architecture C. Irreversible injury with nuclear pyknosis and karyorrhexis D. Reversible injury characterized by impaired Na+/K+ ATPase activity and accumulation of lipids Answer: D. Reversible injury characterized by impaired Na+/K+ ATPase activity and accumulation of lipids 7. Histologic examination of a myocardial infarction at 24 hours demonstrates preserved cellular outlines with loss of nuclei and eosinophilic cytoplasm. Which type of necrosis is this? A. Caseous necrosis, characteristic of tuberculosis B. Gangrenous necrosis, characteristic of lower extremity ischemia C. Coagulative necrosis, characteristic of ischemic injury in solid organs such as the heart, kidney, and liver D. Liquefactive necrosis, characteristic of brain infarction Answer: C. Coagulative necrosis, characteristic of ischemic injury in solid organs such as the heart, kidney, and liver 8. A 72-year-old male suffers an ischemic stroke. CT scan days later shows an area of tissue liquefaction in the cerebral cortex. Which type of necrosis explains this finding? A. Fat necrosis, characteristic of acute pancreatic enzyme release B. Coagulative necrosis, because neurons lack connective tissue C. Caseous necrosis, characteristic of central nervous system tuberculosis D. Liquefactive necrosis, characteristic of brain infarction due to enzymatic digestion of tissue by lysosomal enzymes Answer: D. Liquefactive necrosis, characteristic of brain infarction due to enzymatic digestion of tissue by lysosomal enzymes 9. A 45-year-old female undergoes a routine Pap smear. The cytology report indicates the presence of dysplastic cells that are confined to the epithelial layer and do not invade the basement membrane. Which of the following is the most accurate description of this finding? A. Invasive carcinoma B. Dysplasia C. Metaplasia D. Anaplasia Answer: B. Dysplasia 10. A 50-year-old male with a history of chronic gastroesophageal reflux disease (GERD) undergoes an endoscopy. Biopsy of the distal esophagus reveals columnar epithelium with goblet cells, replacing the normal stratified squamous epithelium. This adaptation is known as: A. Barrett's esophagus, a form of metaplasia B. Esophageal dysplasia C. Esophageal hyperplasia D. Esophageal hypertrophy Answer: A. Barrett's esophagus, a form of metaplasia