Test bank For Applied Pathophysiology
for the Advanced Practice Nurse 2nd
Edition by Lucie Dlugasch; Lachel Story
Chapter 1-14 | 9781284255614
Chapters 1–12: 7 questions each (84)
Chapters 13–14: 8 questions each (16)
Chapter 1 — Foundations of Applied Pathophysiology
(Questions 1–7)
1. A 68-year-old patient has chronic low-grade inflammation with elevated IL-6 and CRP.
Which long-term consequence is most likely?
A. Decreased risk of atherosclerosis
B. Increased bone formation
C. Cachexia and muscle wasting
D. Hypercoagulability with prolonged bleeding
Answer: C. Cachexia and muscle wasting.
Rationale: Chronic inflammatory cytokines (e.g., IL-6, TNF-α) promote catabolism,
leading to cachexia/muscle wasting.
2. Which statement best describes the difference between hypertrophy and hyperplasia?
A. Hypertrophy = increased cell number; hyperplasia = increased cell size.
B. Hypertrophy occurs only in cardiac muscle; hyperplasia occurs only in skin.
C. Hypertrophy = increased cell size; hyperplasia = increased cell number.
D. Both are always pathological.
Answer: C. Hypertrophy = increased cell size; hyperplasia = increased cell
number.
Rationale: Hypertrophy is enlargement of existing cells, hyperplasia is increased cell
proliferation — can be physiological or pathological.
3. A patient with chronic hypoxia upregulates HIF-1α leading to angiogenesis. What cellular
adaptation is this?
, A. Dysplasia
B. Metaplasia
C. Compensatory hyperplasia
D. Physiologic adaptation to hypoxia
Answer: D. Physiologic adaptation to hypoxia.
Rationale: HIF-1α mediated responses (angiogenesis, erythropoietin) are adaptive
responses to hypoxia.
4. Which process most directly produces reactive oxygen species (ROS) during
ischemia-reperfusion injury?
A. Increased lysosomal enzyme release
B. Mitochondrial electron transport chain dysfunction
C. Activation of caspases
D. DNA methylation changes
Answer: B. Mitochondrial electron transport chain dysfunction.
Rationale: Reperfusion restores oxygen to damaged mitochondria, causing electron
leak and ROS generation.
5. Which marker is most specific for myocardial cell necrosis?
A. CK-MB
B. Troponin I
C. CRP
D. AST
Answer: B. Troponin I.
Rationale: Cardiac troponins are highly specific and sensitive markers of myocardial
necrosis.
6. A reversible cell injury is characterized by:
A. Nuclear pyknosis
B. Plasma membrane rupture
C. Cellular swelling and detachment of ribosomes from RER
D. Karyorrhexis
Answer: C. Cellular swelling and detachment of ribosomes from RER.
Rationale: Early reversible injury shows cell swelling and ribosomal detachment;
nuclear changes indicate irreversible injury.
7. Which is the best example of pathologic apoptosis?
A. Regression of the corpus luteum
B. T-cell mediated killing of virally infected hepatocytes
C. Shedding of intestinal epithelium
D. Embryonic digit separation
Answer: B. T-cell mediated killing of virally infected hepatocytes.
Rationale: Immune-mediated apoptosis of infected cells is a pathologic apoptotic
, mechanism.
Chapter 2 — Cellular Injury & Death (Questions 8–14)
8. Which intracellular change is most characteristic of irreversible cell injury?
A. Glycogen depletion
B. Mitochondrial swelling with loss of cristae
C. Cellular swelling reversible with oxygenation
D. Chromatin clumping reversible with reperfusion
Answer: B. Mitochondrial swelling with loss of cristae.
Rationale: Severe mitochondrial damage and membrane rupture signal irreversible
injury.
9. Which type of necrosis is typically seen with enzymatic fat digestion in acute
pancreatitis?
A. Coagulative
B. Liquefactive
C. Fat necrosis
D. Caseous
Answer: C. Fat necrosis.
Rationale: Pancreatic lipases cause saponification of fat — fat necrosis.
10.A cell undergoing autophagy primarily:
A. Commits suicide with caspase activation
B. Engulfs neighboring cells extracellularly
C. Recycles its own organelles during nutrient deprivation
D. Undergoes necrosis due to ATP depletion
Answer: C. Recycles its own organelles during nutrient deprivation.
Rationale: Autophagy is a survival mechanism to degrade cell components for
nutrients.
11.Which lab pattern suggests hemolytic (intravascular) anemia from severe RBC
destruction?
A. Low LDH, low indirect bilirubin
B. High haptoglobin, low free hemoglobin
C. Elevated LDH, elevated indirect bilirubin, low haptoglobin
D. Elevated direct bilirubin with normal LDH
Answer: C. Elevated LDH, elevated indirect bilirubin, low haptoglobin.
Rationale: Intravascular hemolysis increases LDH and free Hb binds haptoglobin
(decreased); indirect bilirubin rises.
for the Advanced Practice Nurse 2nd
Edition by Lucie Dlugasch; Lachel Story
Chapter 1-14 | 9781284255614
Chapters 1–12: 7 questions each (84)
Chapters 13–14: 8 questions each (16)
Chapter 1 — Foundations of Applied Pathophysiology
(Questions 1–7)
1. A 68-year-old patient has chronic low-grade inflammation with elevated IL-6 and CRP.
Which long-term consequence is most likely?
A. Decreased risk of atherosclerosis
B. Increased bone formation
C. Cachexia and muscle wasting
D. Hypercoagulability with prolonged bleeding
Answer: C. Cachexia and muscle wasting.
Rationale: Chronic inflammatory cytokines (e.g., IL-6, TNF-α) promote catabolism,
leading to cachexia/muscle wasting.
2. Which statement best describes the difference between hypertrophy and hyperplasia?
A. Hypertrophy = increased cell number; hyperplasia = increased cell size.
B. Hypertrophy occurs only in cardiac muscle; hyperplasia occurs only in skin.
C. Hypertrophy = increased cell size; hyperplasia = increased cell number.
D. Both are always pathological.
Answer: C. Hypertrophy = increased cell size; hyperplasia = increased cell
number.
Rationale: Hypertrophy is enlargement of existing cells, hyperplasia is increased cell
proliferation — can be physiological or pathological.
3. A patient with chronic hypoxia upregulates HIF-1α leading to angiogenesis. What cellular
adaptation is this?
, A. Dysplasia
B. Metaplasia
C. Compensatory hyperplasia
D. Physiologic adaptation to hypoxia
Answer: D. Physiologic adaptation to hypoxia.
Rationale: HIF-1α mediated responses (angiogenesis, erythropoietin) are adaptive
responses to hypoxia.
4. Which process most directly produces reactive oxygen species (ROS) during
ischemia-reperfusion injury?
A. Increased lysosomal enzyme release
B. Mitochondrial electron transport chain dysfunction
C. Activation of caspases
D. DNA methylation changes
Answer: B. Mitochondrial electron transport chain dysfunction.
Rationale: Reperfusion restores oxygen to damaged mitochondria, causing electron
leak and ROS generation.
5. Which marker is most specific for myocardial cell necrosis?
A. CK-MB
B. Troponin I
C. CRP
D. AST
Answer: B. Troponin I.
Rationale: Cardiac troponins are highly specific and sensitive markers of myocardial
necrosis.
6. A reversible cell injury is characterized by:
A. Nuclear pyknosis
B. Plasma membrane rupture
C. Cellular swelling and detachment of ribosomes from RER
D. Karyorrhexis
Answer: C. Cellular swelling and detachment of ribosomes from RER.
Rationale: Early reversible injury shows cell swelling and ribosomal detachment;
nuclear changes indicate irreversible injury.
7. Which is the best example of pathologic apoptosis?
A. Regression of the corpus luteum
B. T-cell mediated killing of virally infected hepatocytes
C. Shedding of intestinal epithelium
D. Embryonic digit separation
Answer: B. T-cell mediated killing of virally infected hepatocytes.
Rationale: Immune-mediated apoptosis of infected cells is a pathologic apoptotic
, mechanism.
Chapter 2 — Cellular Injury & Death (Questions 8–14)
8. Which intracellular change is most characteristic of irreversible cell injury?
A. Glycogen depletion
B. Mitochondrial swelling with loss of cristae
C. Cellular swelling reversible with oxygenation
D. Chromatin clumping reversible with reperfusion
Answer: B. Mitochondrial swelling with loss of cristae.
Rationale: Severe mitochondrial damage and membrane rupture signal irreversible
injury.
9. Which type of necrosis is typically seen with enzymatic fat digestion in acute
pancreatitis?
A. Coagulative
B. Liquefactive
C. Fat necrosis
D. Caseous
Answer: C. Fat necrosis.
Rationale: Pancreatic lipases cause saponification of fat — fat necrosis.
10.A cell undergoing autophagy primarily:
A. Commits suicide with caspase activation
B. Engulfs neighboring cells extracellularly
C. Recycles its own organelles during nutrient deprivation
D. Undergoes necrosis due to ATP depletion
Answer: C. Recycles its own organelles during nutrient deprivation.
Rationale: Autophagy is a survival mechanism to degrade cell components for
nutrients.
11.Which lab pattern suggests hemolytic (intravascular) anemia from severe RBC
destruction?
A. Low LDH, low indirect bilirubin
B. High haptoglobin, low free hemoglobin
C. Elevated LDH, elevated indirect bilirubin, low haptoglobin
D. Elevated direct bilirubin with normal LDH
Answer: C. Elevated LDH, elevated indirect bilirubin, low haptoglobin.
Rationale: Intravascular hemolysis increases LDH and free Hb binds haptoglobin
(decreased); indirect bilirubin rises.
