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NURS 5315 Advanced Pathophysiology
UTA Exam 1 Actual Exam 2026/2027 |
Questions and Answers Latest | Verified
Answers | A+ Graded
SECTION 1: CELLULAR ADAPTATION, INJURY, AND DEATH (Questions 1-15)
Q1: A 65-year-old male with a history of smoking presents with a chronic cough. A bronchial
biopsy reveals that the normal ciliated pseudostratified columnar epithelial cells have been
replaced by stratified squamous epithelial cells. This change is best described as:
A. Hyperplasia
B. Metaplasia [CORRECT]
C. Dysplasia
D. Anaplasia
Correct Answer: B
Rationale: Metaplasia is a reversible change in which one differentiated cell type is replaced by
another cell type better able to withstand environmental stress. In smokers, the normal ciliated
columnar epithelium of the airways undergoes metaplasia to stratified squamous epithelium (B).
Hyperplasia (A) is increased cell number. Dysplasia (C) is abnormal cell growth and
differentiation. Anaplasia (D) is loss of differentiation seen in cancer.
Q2: A 45-year-old female with breast cancer undergoes mastectomy and lymph node dissection.
Six months post-surgery, she notices progressive weakness and decreased muscle mass in her
dominant arm. This cellular change represents:
A. Hypertrophy
B. Hyperplasia
C. Atrophy [CORRECT]
D. Metaplasia
,2
Correct Answer: C
Rationale: Atrophy is a decrease in cell size resulting in reduced tissue mass. Disuse atrophy
occurs from decreased workload, such as when lymph node dissection impairs lymphatic
drainage and limits arm mobility (C). Hypertrophy (A) is increased cell size. Hyperplasia (B) is
increased cell number. Metaplasia (D) involves cell type replacement, not size reduction.
Q3: A weightlifter develops significantly enlarged skeletal muscle fibers after 6 months of
intensive training. This adaptation is classified as:
A. Physiologic hypertrophy [CORRECT]
B. Pathologic hypertrophy
C. Compensatory hyperplasia
D. Dysplasia
Correct Answer: A
Rationale: Physiologic hypertrophy is an adaptive increase in cell size in response to normal
stimulation, such as exercise-induced skeletal muscle enlargement (A). Pathologic hypertrophy
(B) occurs in disease states like cardiac hypertrophy from hypertension. Hyperplasia (C)
involves increased cell number, not size. Dysplasia (D) represents disordered growth, not
adaptive change.
Q4: A 58-year-old male with chronic hypertension presents with left ventricular wall thickening
on echocardiogram. The myocardial cells demonstrate:
A. Hyperplasia
B. Physiologic hypertrophy
C. Pathologic hypertrophy [CORRECT]
D. Metaplasia
Correct Answer: C
Rationale: Pathologic hypertrophy occurs when cells enlarge in response to pathologic stressors.
In systemic hypertension, increased afterload causes compensatory enlargement of cardiac
myocytes (C). Cardiac myocytes cannot undergo hyperplasia (A) in adults. This is not
physiologic (B) as it results from disease. Metaplasia (D) involves cell type change, not
enlargement.
Q5: A patient with chronic gastroesophageal reflux disease undergoes endoscopy showing
columnar epithelium replacing the normal squamous epithelium of the distal esophagus (Barrett's
esophagus). This represents:
, 3
A. Dysplasia
B. Metaplasia [CORRECT]
C. Hyperplasia
D. Neoplasia
Correct Answer: B
Rationale: Barrett's esophagus is classic metaplasia where chronic acid exposure causes
replacement of squamous epithelium with acid-resistant columnar epithelium (B). While this is a
precancerous condition, the change itself is metaplastic. Dysplasia (A) would show abnormal
cellular architecture. Hyperplasia (C) is increased cell number. Neoplasia (D) indicates
uncontrolled new growth.
Q6: A 72-year-old male with peripheral arterial disease develops dry gangrene of the toes.
Microscopic examination would most likely reveal:
A. Liquefactive necrosis
B. Coagulative necrosis [CORRECT]
C. Caseous necrosis
D. Fat necrosis
Correct Answer: B
Rationale: Coagulative necrosis results from ischemia that denatures proteins and enzymes,
preserving tissue architecture temporarily. Dry gangrene in peripheral arterial disease represents
coagulative necrosis (B). Liquefactive necrosis (A) occurs in brain infarcts or abscesses. Caseous
necrosis (C) is seen in tuberculosis. Fat necrosis (D) occurs in pancreatic or breast tissue.
Q7: A 35-year-old female presents with acute severe abdominal pain. CT scan reveals pancreatic
inflammation with areas of chalky white deposits. The pathologic process occurring is:
A. Coagulative necrosis
B. Liquefactive necrosis
C. Fat necrosis [CORRECT]
D. Caseous necrosis
Correct Answer: C
Rationale: Acute pancreatitis causes release of pancreatic lipases that break down fat cells,
releasing fatty acids that combine with calcium to form chalky white soaps (fat necrosis) (C).
Coagulative necrosis (A) preserves architecture. Liquefactive necrosis (B) involves enzymatic
digestion forming liquid. Caseous necrosis (D) is cheese-like necrosis seen in TB.
NURS 5315 Advanced Pathophysiology
UTA Exam 1 Actual Exam 2026/2027 |
Questions and Answers Latest | Verified
Answers | A+ Graded
SECTION 1: CELLULAR ADAPTATION, INJURY, AND DEATH (Questions 1-15)
Q1: A 65-year-old male with a history of smoking presents with a chronic cough. A bronchial
biopsy reveals that the normal ciliated pseudostratified columnar epithelial cells have been
replaced by stratified squamous epithelial cells. This change is best described as:
A. Hyperplasia
B. Metaplasia [CORRECT]
C. Dysplasia
D. Anaplasia
Correct Answer: B
Rationale: Metaplasia is a reversible change in which one differentiated cell type is replaced by
another cell type better able to withstand environmental stress. In smokers, the normal ciliated
columnar epithelium of the airways undergoes metaplasia to stratified squamous epithelium (B).
Hyperplasia (A) is increased cell number. Dysplasia (C) is abnormal cell growth and
differentiation. Anaplasia (D) is loss of differentiation seen in cancer.
Q2: A 45-year-old female with breast cancer undergoes mastectomy and lymph node dissection.
Six months post-surgery, she notices progressive weakness and decreased muscle mass in her
dominant arm. This cellular change represents:
A. Hypertrophy
B. Hyperplasia
C. Atrophy [CORRECT]
D. Metaplasia
,2
Correct Answer: C
Rationale: Atrophy is a decrease in cell size resulting in reduced tissue mass. Disuse atrophy
occurs from decreased workload, such as when lymph node dissection impairs lymphatic
drainage and limits arm mobility (C). Hypertrophy (A) is increased cell size. Hyperplasia (B) is
increased cell number. Metaplasia (D) involves cell type replacement, not size reduction.
Q3: A weightlifter develops significantly enlarged skeletal muscle fibers after 6 months of
intensive training. This adaptation is classified as:
A. Physiologic hypertrophy [CORRECT]
B. Pathologic hypertrophy
C. Compensatory hyperplasia
D. Dysplasia
Correct Answer: A
Rationale: Physiologic hypertrophy is an adaptive increase in cell size in response to normal
stimulation, such as exercise-induced skeletal muscle enlargement (A). Pathologic hypertrophy
(B) occurs in disease states like cardiac hypertrophy from hypertension. Hyperplasia (C)
involves increased cell number, not size. Dysplasia (D) represents disordered growth, not
adaptive change.
Q4: A 58-year-old male with chronic hypertension presents with left ventricular wall thickening
on echocardiogram. The myocardial cells demonstrate:
A. Hyperplasia
B. Physiologic hypertrophy
C. Pathologic hypertrophy [CORRECT]
D. Metaplasia
Correct Answer: C
Rationale: Pathologic hypertrophy occurs when cells enlarge in response to pathologic stressors.
In systemic hypertension, increased afterload causes compensatory enlargement of cardiac
myocytes (C). Cardiac myocytes cannot undergo hyperplasia (A) in adults. This is not
physiologic (B) as it results from disease. Metaplasia (D) involves cell type change, not
enlargement.
Q5: A patient with chronic gastroesophageal reflux disease undergoes endoscopy showing
columnar epithelium replacing the normal squamous epithelium of the distal esophagus (Barrett's
esophagus). This represents:
, 3
A. Dysplasia
B. Metaplasia [CORRECT]
C. Hyperplasia
D. Neoplasia
Correct Answer: B
Rationale: Barrett's esophagus is classic metaplasia where chronic acid exposure causes
replacement of squamous epithelium with acid-resistant columnar epithelium (B). While this is a
precancerous condition, the change itself is metaplastic. Dysplasia (A) would show abnormal
cellular architecture. Hyperplasia (C) is increased cell number. Neoplasia (D) indicates
uncontrolled new growth.
Q6: A 72-year-old male with peripheral arterial disease develops dry gangrene of the toes.
Microscopic examination would most likely reveal:
A. Liquefactive necrosis
B. Coagulative necrosis [CORRECT]
C. Caseous necrosis
D. Fat necrosis
Correct Answer: B
Rationale: Coagulative necrosis results from ischemia that denatures proteins and enzymes,
preserving tissue architecture temporarily. Dry gangrene in peripheral arterial disease represents
coagulative necrosis (B). Liquefactive necrosis (A) occurs in brain infarcts or abscesses. Caseous
necrosis (C) is seen in tuberculosis. Fat necrosis (D) occurs in pancreatic or breast tissue.
Q7: A 35-year-old female presents with acute severe abdominal pain. CT scan reveals pancreatic
inflammation with areas of chalky white deposits. The pathologic process occurring is:
A. Coagulative necrosis
B. Liquefactive necrosis
C. Fat necrosis [CORRECT]
D. Caseous necrosis
Correct Answer: C
Rationale: Acute pancreatitis causes release of pancreatic lipases that break down fat cells,
releasing fatty acids that combine with calcium to form chalky white soaps (fat necrosis) (C).
Coagulative necrosis (A) preserves architecture. Liquefactive necrosis (B) involves enzymatic
digestion forming liquid. Caseous necrosis (D) is cheese-like necrosis seen in TB.
