GNRS 610 Advanced Pathophysiology Exam 1 –
APU — Master Review & Preparation Guide
2025/2026 <Latest Version>
Section 1: Cellular Biology, Adaptation, Injury, and Death (Questions 1-30)
1. What is the primary purpose of cellular adaptation?
a) To return the cell to a normal state
b) To initiate immediate cell death
c) To achieve a new steady state and preserve viability ✓
d) To signal the immune system for help
2. Which of the following is a reversible change where one adult cell type is replaced by
another?
a) Hyperplasia
b) Dysplasia
c) Metaplasia ✓
d) Anaplasia
3. A patient with a long-standing history of cigarette smoking has bronchial cells change from
columnar to stratified squamous epithelium. This is an example of:
a) Neoplasia
b) Hyperplasia
c) Metaplasia ✓
d) Dysplasia
4. The increase in the size of the uterus during pregnancy is primarily due to:
a) Hypertrophy and hyperplasia ✓
b) Metaplasia and dysplasia
c) Atrophy and necrosis
d) Neoplasia and anaplasia
5. A reduction in cell size and functional capacity due to decreased workload or adverse
conditions is termed:
a) Hypertrophy
b) Hyperplasia
,c) Atrophy ✓
d) Metaplasia
6. Which of the following is a hallmark of irreversible cell injury?
a) Cellular swelling
b) Ribosomal detachment
c) Mitochondrial vacuolization
d) Nuclear pyknosis, karyorrhexis, or karyolysis ✓
7. The most common cause of cellular injury is:
a) Chemical toxicity
b) Infectious agents
c) Hypoxia ✓
d) Genetic mutations
8. Ischemia-reperfusion injury causes additional damage primarily due to:
a) Restoration of ATP levels
b) Inflammatory response and oxidative stress from reactive oxygen species (ROS) ✓
c) Immediate normalization of pH
d) Prevention of apoptosis
9. Coagulative necrosis is characterized by:
a) Tissue that becomes soft and liquefied
b) Preservation of tissue architecture with denatured proteins ✓
c) Chalky-white appearance from calcium deposits
d) A cheese-like appearance, typically in the lungs
10. Liquefactive necrosis is most commonly associated with infections in which organ?
a) Heart
b) Brain ✓
c) Kidney
d) Liver
11. Caseous necrosis is a hallmark of which disease?
a) Tuberculosis ✓
b) Myocardial infarction
c) Acute pancreatitis
d) Gangrene
12. Apoptosis is best described as:
a) Unregulated cell death causing inflammation
, b) Programmed, energy-dependent cell death ✓
c) Always a pathological process
d) The same as coagulative necrosis
13. Fatty change (steatosis) is most often seen in which organ?
a) Heart
b) Brain
c) Liver ✓
d) Skeletal muscle
14. The accumulation of lipofuscin, an aging pigment, in a cell is an example of:
a) Pathologic calcification
b) Intracellular accumulation ✓
c) Hyaline degeneration
d) Metastatic calcification
15. Dystrophic calcification occurs in:
a) Normal serum calcium levels, but in damaged tissues ✓
b) Hypercalcemic states, in normal tissues
c) Only in the vascular system
d) The renal tubules
16. The primary cellular site where reactive oxygen species (ROS) are generated is the:
a) Nucleus
b) Golgi apparatus
c) Lysosome
d) Mitochondria ✓
17. Which antioxidant enzyme system is the most critical for converting hydrogen peroxide to
water?
a) Superoxide dismutase (SOD)
b) Glutathione peroxidase ✓
c) Catalase
d) Cytochrome P-450
18. Cellular swelling is a sign of reversible injury and is due to failure of:
a) The sodium-potassium (Na+/K+) ATPase pump ✓
b) The calcium pump
c) Protein synthesis
d) DNA transcription
APU — Master Review & Preparation Guide
2025/2026 <Latest Version>
Section 1: Cellular Biology, Adaptation, Injury, and Death (Questions 1-30)
1. What is the primary purpose of cellular adaptation?
a) To return the cell to a normal state
b) To initiate immediate cell death
c) To achieve a new steady state and preserve viability ✓
d) To signal the immune system for help
2. Which of the following is a reversible change where one adult cell type is replaced by
another?
a) Hyperplasia
b) Dysplasia
c) Metaplasia ✓
d) Anaplasia
3. A patient with a long-standing history of cigarette smoking has bronchial cells change from
columnar to stratified squamous epithelium. This is an example of:
a) Neoplasia
b) Hyperplasia
c) Metaplasia ✓
d) Dysplasia
4. The increase in the size of the uterus during pregnancy is primarily due to:
a) Hypertrophy and hyperplasia ✓
b) Metaplasia and dysplasia
c) Atrophy and necrosis
d) Neoplasia and anaplasia
5. A reduction in cell size and functional capacity due to decreased workload or adverse
conditions is termed:
a) Hypertrophy
b) Hyperplasia
,c) Atrophy ✓
d) Metaplasia
6. Which of the following is a hallmark of irreversible cell injury?
a) Cellular swelling
b) Ribosomal detachment
c) Mitochondrial vacuolization
d) Nuclear pyknosis, karyorrhexis, or karyolysis ✓
7. The most common cause of cellular injury is:
a) Chemical toxicity
b) Infectious agents
c) Hypoxia ✓
d) Genetic mutations
8. Ischemia-reperfusion injury causes additional damage primarily due to:
a) Restoration of ATP levels
b) Inflammatory response and oxidative stress from reactive oxygen species (ROS) ✓
c) Immediate normalization of pH
d) Prevention of apoptosis
9. Coagulative necrosis is characterized by:
a) Tissue that becomes soft and liquefied
b) Preservation of tissue architecture with denatured proteins ✓
c) Chalky-white appearance from calcium deposits
d) A cheese-like appearance, typically in the lungs
10. Liquefactive necrosis is most commonly associated with infections in which organ?
a) Heart
b) Brain ✓
c) Kidney
d) Liver
11. Caseous necrosis is a hallmark of which disease?
a) Tuberculosis ✓
b) Myocardial infarction
c) Acute pancreatitis
d) Gangrene
12. Apoptosis is best described as:
a) Unregulated cell death causing inflammation
, b) Programmed, energy-dependent cell death ✓
c) Always a pathological process
d) The same as coagulative necrosis
13. Fatty change (steatosis) is most often seen in which organ?
a) Heart
b) Brain
c) Liver ✓
d) Skeletal muscle
14. The accumulation of lipofuscin, an aging pigment, in a cell is an example of:
a) Pathologic calcification
b) Intracellular accumulation ✓
c) Hyaline degeneration
d) Metastatic calcification
15. Dystrophic calcification occurs in:
a) Normal serum calcium levels, but in damaged tissues ✓
b) Hypercalcemic states, in normal tissues
c) Only in the vascular system
d) The renal tubules
16. The primary cellular site where reactive oxygen species (ROS) are generated is the:
a) Nucleus
b) Golgi apparatus
c) Lysosome
d) Mitochondria ✓
17. Which antioxidant enzyme system is the most critical for converting hydrogen peroxide to
water?
a) Superoxide dismutase (SOD)
b) Glutathione peroxidase ✓
c) Catalase
d) Cytochrome P-450
18. Cellular swelling is a sign of reversible injury and is due to failure of:
a) The sodium-potassium (Na+/K+) ATPase pump ✓
b) The calcium pump
c) Protein synthesis
d) DNA transcription