NSG 520 (HU) Pathophysiology & Pharmacology Final
Exam | Herzing University | 207+ Questions With
Verified Answers | Instant Pdf Download
Section 1: Cellular Pathophysiology & Inflammation (Q1–15)
1. Which cellular change is most characteristic of irreversible cell injury?
a) Swelling of mitochondria
b) Nuclear pyknosis
c) Loss of plasma membrane integrity
d) Ribosome detachment
Rationale: Loss of plasma membrane integrity is irreversible because it leads to
uncontrolled ion influx and enzyme leakage. Ribosome detachment is reversible.
Mitochondrial swelling and pyknosis can occur before the point of no return.
2. A patient with chronic alcoholism develops hepatic necrosis with preserved
tissue architecture. This is an example of:
a) Apoptosis
b) Coagulative necrosis
c) Liquefactive necrosis
d) Caseous necrosis
Rationale: Coagulative necrosis, typically from ischemia or toxins like alcohol,
preserves tissue outlines for days. Liquefactive occurs in brain; caseous in TB;
apoptosis is programmed cell death.
3. Which cytokine is primarily responsible for fever in systemic inflammation?
a) IL-4
b) IL-10
c) TNF-α
d) IL-1 and IL-6
,*Rationale: IL-1 and IL-6 act on the hypothalamic thermoregulatory center to produce
prostaglandin E2, causing fever. TNF-α contributes but is not primary.*
4. A patient with septic shock has widespread vasodilation and capillary leakage.
This is primarily due to:
a) Histamine
b) Nitric oxide
c) Leukotrienes
d) Platelet-activating factor
Rationale: Nitric oxide (from iNOS in sepsis) causes profound vasodilation and
increased capillary permeability. Histamine acts locally in allergic reactions.
5. Which finding indicates the transition from acute to systemic inflammation
(SIRS)?
a) Localized redness and swelling
b) Fever, tachycardia, tachypnea, and leukocytosis
c) Elevated CRP only
d) Bradycardia and hypotension
*Rationale: SIRS requires ≥2 of: fever/hypothermia, tachycardia, tachypnea,
leukocytosis/leukopenia. Localized findings are not systemic.*
6. A patient with a myocardial infarction develops fever and leukocytosis 2 days
later. This is most likely due to:
a) Bacterial endocarditis
b) Acute inflammation from necrotic tissue
c) A drug reaction
d) Viral pericarditis
*Rationale: Post-MI inflammatory response (acute phase reaction) is sterile and peaks
at 48–72 hours.*
7. Which cell type is the first to arrive at an acute inflammatory site?
a) Neutrophils
,b) Macrophages
c) Lymphocytes
d) Eosinophils
*Rationale: Neutrophils (polymorphonuclear leukocytes) arrive within minutes to hours
due to chemotaxis via IL-8 and leukotriene B4.*
8. Chronic inflammation is characterized by:
a) Predominant neutrophil infiltration
b) Lymphocytes, macrophages, and fibrosis
c) Exudative fluid
d) Rapid resolution
Rationale: Chronic inflammation features mononuclear cells (lymphocytes,
macrophages), tissue destruction, and attempted repair with fibrosis.
9. Which of the following is an endogenous pyrogen?
a) IL-1
b) Histamine
c) Bradykinin
d) Serotonin
*Rationale: IL-1, IL-6, and TNF-α are endogenous pyrogens that reset the hypothalamic
set point.*
10. A patient with rheumatoid arthritis has pannus formation. Pannus is:
a) Fibrotic lung tissue
b) Proliferating synovial tissue that erodes cartilage
c) Necrotic muscle
d) Granulomatous inflammation
Rationale: Pannus is inflamed, thickened synovium with invasive granulation
tissue that destroys cartilage and bone in RA.
11. Which of the following is a hallmark of apoptosis?
a) Cell swelling
, b) Inflammation
c) Chromatin condensation and fragmentation
d) Loss of ATP
Rationale: Apoptosis shows nuclear fragmentation, cell shrinkage, and no
inflammation (cell membrane remains intact until phagocytosis).
12. A patient with tuberculosis develops a lung lesion with central caseation. This
is which type of necrosis?
a) Coagulative
b) Liquefactive
c) Caseous
d) Fat necrosis
Rationale: Caseous necrosis (cheese-like) is characteristic of TB and some fungal
infections; contains macrophages and lymphocytes.
13. Which lab value best indicates systemic inflammation?
a) Low albumin
b) Elevated C-reactive protein (CRP)
c) Elevated BUN
d) Low platelets
*Rationale: CRP, produced by the liver under IL-6 stimulation, rises rapidly and is a
sensitive acute-phase reactant.*
14. Ischemia-reperfusion injury is primarily caused by:
a) Lack of ATP
b) Lysosomal rupture
c) Reactive oxygen species (ROS) upon reoxygenation
d) Hyperkalemia
Rationale: ROS (superoxide, hydrogen peroxide, hydroxyl radical) form during
reoxygenation, causing further membrane damage.
Exam | Herzing University | 207+ Questions With
Verified Answers | Instant Pdf Download
Section 1: Cellular Pathophysiology & Inflammation (Q1–15)
1. Which cellular change is most characteristic of irreversible cell injury?
a) Swelling of mitochondria
b) Nuclear pyknosis
c) Loss of plasma membrane integrity
d) Ribosome detachment
Rationale: Loss of plasma membrane integrity is irreversible because it leads to
uncontrolled ion influx and enzyme leakage. Ribosome detachment is reversible.
Mitochondrial swelling and pyknosis can occur before the point of no return.
2. A patient with chronic alcoholism develops hepatic necrosis with preserved
tissue architecture. This is an example of:
a) Apoptosis
b) Coagulative necrosis
c) Liquefactive necrosis
d) Caseous necrosis
Rationale: Coagulative necrosis, typically from ischemia or toxins like alcohol,
preserves tissue outlines for days. Liquefactive occurs in brain; caseous in TB;
apoptosis is programmed cell death.
3. Which cytokine is primarily responsible for fever in systemic inflammation?
a) IL-4
b) IL-10
c) TNF-α
d) IL-1 and IL-6
,*Rationale: IL-1 and IL-6 act on the hypothalamic thermoregulatory center to produce
prostaglandin E2, causing fever. TNF-α contributes but is not primary.*
4. A patient with septic shock has widespread vasodilation and capillary leakage.
This is primarily due to:
a) Histamine
b) Nitric oxide
c) Leukotrienes
d) Platelet-activating factor
Rationale: Nitric oxide (from iNOS in sepsis) causes profound vasodilation and
increased capillary permeability. Histamine acts locally in allergic reactions.
5. Which finding indicates the transition from acute to systemic inflammation
(SIRS)?
a) Localized redness and swelling
b) Fever, tachycardia, tachypnea, and leukocytosis
c) Elevated CRP only
d) Bradycardia and hypotension
*Rationale: SIRS requires ≥2 of: fever/hypothermia, tachycardia, tachypnea,
leukocytosis/leukopenia. Localized findings are not systemic.*
6. A patient with a myocardial infarction develops fever and leukocytosis 2 days
later. This is most likely due to:
a) Bacterial endocarditis
b) Acute inflammation from necrotic tissue
c) A drug reaction
d) Viral pericarditis
*Rationale: Post-MI inflammatory response (acute phase reaction) is sterile and peaks
at 48–72 hours.*
7. Which cell type is the first to arrive at an acute inflammatory site?
a) Neutrophils
,b) Macrophages
c) Lymphocytes
d) Eosinophils
*Rationale: Neutrophils (polymorphonuclear leukocytes) arrive within minutes to hours
due to chemotaxis via IL-8 and leukotriene B4.*
8. Chronic inflammation is characterized by:
a) Predominant neutrophil infiltration
b) Lymphocytes, macrophages, and fibrosis
c) Exudative fluid
d) Rapid resolution
Rationale: Chronic inflammation features mononuclear cells (lymphocytes,
macrophages), tissue destruction, and attempted repair with fibrosis.
9. Which of the following is an endogenous pyrogen?
a) IL-1
b) Histamine
c) Bradykinin
d) Serotonin
*Rationale: IL-1, IL-6, and TNF-α are endogenous pyrogens that reset the hypothalamic
set point.*
10. A patient with rheumatoid arthritis has pannus formation. Pannus is:
a) Fibrotic lung tissue
b) Proliferating synovial tissue that erodes cartilage
c) Necrotic muscle
d) Granulomatous inflammation
Rationale: Pannus is inflamed, thickened synovium with invasive granulation
tissue that destroys cartilage and bone in RA.
11. Which of the following is a hallmark of apoptosis?
a) Cell swelling
, b) Inflammation
c) Chromatin condensation and fragmentation
d) Loss of ATP
Rationale: Apoptosis shows nuclear fragmentation, cell shrinkage, and no
inflammation (cell membrane remains intact until phagocytosis).
12. A patient with tuberculosis develops a lung lesion with central caseation. This
is which type of necrosis?
a) Coagulative
b) Liquefactive
c) Caseous
d) Fat necrosis
Rationale: Caseous necrosis (cheese-like) is characteristic of TB and some fungal
infections; contains macrophages and lymphocytes.
13. Which lab value best indicates systemic inflammation?
a) Low albumin
b) Elevated C-reactive protein (CRP)
c) Elevated BUN
d) Low platelets
*Rationale: CRP, produced by the liver under IL-6 stimulation, rises rapidly and is a
sensitive acute-phase reactant.*
14. Ischemia-reperfusion injury is primarily caused by:
a) Lack of ATP
b) Lysosomal rupture
c) Reactive oxygen species (ROS) upon reoxygenation
d) Hyperkalemia
Rationale: ROS (superoxide, hydrogen peroxide, hydroxyl radical) form during
reoxygenation, causing further membrane damage.
