ADVANCED
PATHOPHYSIOLOGY
MIDTERM 6501
1. Which cellular adaptation is most likely to occur in the cardiac muscle of a patient
with long-standing hypertension?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Dysplasia
Answer: B. Hypertrophy
,Rationale: Chronic hypertension increases the workload of the heart, leading to
hypertrophy (increase in cell size) of cardiac muscle cells.
2. What is the primary cause of cellular injury during hypoxia?
A. Lactic acid accumulation
B. ATP depletion
C. Increased mitochondrial activity
D. Calcium influx
Answer: B. ATP depletion
Rationale: Hypoxia reduces oxygen delivery to cells, impairing oxidative
phosphorylation and resulting in decreased ATP production.
3. Which cytokine is primarily responsible for mediating fever during inflammation?
A. IL-1
B. IL-6
C. TNF-α
D. IL-10
Answer: A. IL-1
Rationale: IL-1 acts on the hypothalamus to raise the set point for body temperature,
producing fever.
4. A patient with chronic obstructive pulmonary disease (COPD) develops
polycythemia. What is the most likely mechanism?
A. Hypoxia-induced erythropoietin production
B. Bone marrow hyperplasia
C. Dehydration
D. Elevated hematocrit due to plasma loss
Answer: A. Hypoxia-induced erythropoietin production
,Rationale: Chronic hypoxia stimulates the kidney to release erythropoietin,
increasing RBC production.
5. What is the most common cause of myocardial infarction?
A. Coronary artery spasm
B. Atherosclerotic plaque rupture with thrombosis
C. Embolism from the left atrium
D. Vasculitis
Answer: B. Atherosclerotic plaque rupture with thrombosis
Rationale: Rupture of an unstable atherosclerotic plaque leads to thrombus
formation, causing ischemia and infarction.
6. Which electrolyte imbalance is most associated with cardiac arrhythmias?
A. Hypokalemia
B. Hypocalcemia
C. Hypernatremia
D. Hypomagnesemia
Answer: A. Hypokalemia
Rationale: Low serum potassium levels alter cardiac conduction and increase the risk
of dysrhythmias.
7. Which type of hypersensitivity reaction is mediated by IgE antibodies?
A. Type I
B. Type II
C. Type III
D. Type IV
Answer: A. Type I
Rationale: Type I hypersensitivity involves IgE and mast cell degranulation, leading to
allergic reactions.
, 8. In Type II diabetes mellitus, insulin resistance occurs primarily at which cellular
site?
A. Insulin receptor
B. Glucose transporter (GLUT-4)
C. Pancreatic β-cells
D. Hepatic enzymes
Answer: A. Insulin receptor
Rationale: Insulin resistance is caused by defects in insulin receptor signaling,
reducing glucose uptake.
9. What is the main pathological change in emphysema?
A. Alveolar wall destruction and loss of elasticity
B. Fibrosis of alveolar walls
C. Bronchial hyperreactivity
D. Accumulation of surfactant
Answer: A. Alveolar wall destruction and loss of elasticity
Rationale: Emphysema involves the breakdown of alveolar septa, causing air
trapping and reduced recoil.
10. Which renal mechanism compensates for metabolic acidosis?
A. Secretion of bicarbonate
B. Reabsorption of hydrogen ions
C. Excretion of hydrogen ions and reabsorption of bicarbonate
D. Increased ammonia excretion
Answer: C. Excretion of hydrogen ions and reabsorption of bicarbonate
Rationale: The kidneys maintain acid-base balance by excreting H⁺ and reabsorbing
HCO₃⁻.
PATHOPHYSIOLOGY
MIDTERM 6501
1. Which cellular adaptation is most likely to occur in the cardiac muscle of a patient
with long-standing hypertension?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Dysplasia
Answer: B. Hypertrophy
,Rationale: Chronic hypertension increases the workload of the heart, leading to
hypertrophy (increase in cell size) of cardiac muscle cells.
2. What is the primary cause of cellular injury during hypoxia?
A. Lactic acid accumulation
B. ATP depletion
C. Increased mitochondrial activity
D. Calcium influx
Answer: B. ATP depletion
Rationale: Hypoxia reduces oxygen delivery to cells, impairing oxidative
phosphorylation and resulting in decreased ATP production.
3. Which cytokine is primarily responsible for mediating fever during inflammation?
A. IL-1
B. IL-6
C. TNF-α
D. IL-10
Answer: A. IL-1
Rationale: IL-1 acts on the hypothalamus to raise the set point for body temperature,
producing fever.
4. A patient with chronic obstructive pulmonary disease (COPD) develops
polycythemia. What is the most likely mechanism?
A. Hypoxia-induced erythropoietin production
B. Bone marrow hyperplasia
C. Dehydration
D. Elevated hematocrit due to plasma loss
Answer: A. Hypoxia-induced erythropoietin production
,Rationale: Chronic hypoxia stimulates the kidney to release erythropoietin,
increasing RBC production.
5. What is the most common cause of myocardial infarction?
A. Coronary artery spasm
B. Atherosclerotic plaque rupture with thrombosis
C. Embolism from the left atrium
D. Vasculitis
Answer: B. Atherosclerotic plaque rupture with thrombosis
Rationale: Rupture of an unstable atherosclerotic plaque leads to thrombus
formation, causing ischemia and infarction.
6. Which electrolyte imbalance is most associated with cardiac arrhythmias?
A. Hypokalemia
B. Hypocalcemia
C. Hypernatremia
D. Hypomagnesemia
Answer: A. Hypokalemia
Rationale: Low serum potassium levels alter cardiac conduction and increase the risk
of dysrhythmias.
7. Which type of hypersensitivity reaction is mediated by IgE antibodies?
A. Type I
B. Type II
C. Type III
D. Type IV
Answer: A. Type I
Rationale: Type I hypersensitivity involves IgE and mast cell degranulation, leading to
allergic reactions.
, 8. In Type II diabetes mellitus, insulin resistance occurs primarily at which cellular
site?
A. Insulin receptor
B. Glucose transporter (GLUT-4)
C. Pancreatic β-cells
D. Hepatic enzymes
Answer: A. Insulin receptor
Rationale: Insulin resistance is caused by defects in insulin receptor signaling,
reducing glucose uptake.
9. What is the main pathological change in emphysema?
A. Alveolar wall destruction and loss of elasticity
B. Fibrosis of alveolar walls
C. Bronchial hyperreactivity
D. Accumulation of surfactant
Answer: A. Alveolar wall destruction and loss of elasticity
Rationale: Emphysema involves the breakdown of alveolar septa, causing air
trapping and reduced recoil.
10. Which renal mechanism compensates for metabolic acidosis?
A. Secretion of bicarbonate
B. Reabsorption of hydrogen ions
C. Excretion of hydrogen ions and reabsorption of bicarbonate
D. Increased ammonia excretion
Answer: C. Excretion of hydrogen ions and reabsorption of bicarbonate
Rationale: The kidneys maintain acid-base balance by excreting H⁺ and reabsorbing
HCO₃⁻.
