NURS 5315 ADVANCED PATHOPHYSIOLOGY
EXAM 1 ACTUAL TEST SCRIPT 2026
COMPLETE QUESTIONS AND ANSWERS
GRADED A+
◉ Hyperplasia. Answer: E: cells increase in number, mitosis (cell
division) must occur, size of cell does not change
Phys: increased rate of division, increase in tissue mass after damage
or partial resection; may be compensatory, hormonal, or pathologic
Patho: abnormal proliferation of normal cells usually caused by
increased hormonal stimulation (endometrial). increase of
production of local growth factors
Ex: removal of part of the liver lead to hyperplasia of hepatocytes.
uterine or mammary gland enlargement during pregnancy
◉ Dysplasia. Answer: E. Not true adaptation; Cells abnormal change
in size, shape, organization (classified as mild, moderate, severe)
P. caused by cell injury/irritation, characterized by disordered cell
growth. aka atypical hyperplasia or pre-cancer, a disorderly
proliferation
Physiologic: N/A
Pathologic: squamous dysplasia of cervix from HPV shows up on pap
smear, breast cancer development; pap smears often show
dysplastic cells of the cervix that must undergo laser/surgical tx
,◉ Metaplasia. Answer: E: reversible change, one type of cell changes
to another type for survival
P: reversible; results from exposure of the cells to chronic stressors,
injury, or irritation; Cancer can arise from this area, stimulus
induces a reprogramming of stem cells under the influence of
cytokines and growth factors
Ex: Patho: Columnar cells change to squamous cells in lungs of
smoker or normal ciliated epithelial cells of the bronchial linings are
replaced by stratified squamous epithelial cells.; Phys: Barrett
Esophagus- normal squamous cells change to columnar epithelial
cells in response to reflux, aka intestinal metaplasia
◉ Hypoxia injury. Answer: E. inadequate oxygenation of tissues
P. decrease in mitochondrial function, decreased production of ATP
increases anaerobic metabolism. eventual cell death.
C.M. hypoxia, cyanosis, cognitive impairment, lethargy
◉ Free radical and ROS. Answer: E. normal byproduct of ATP
production, will overwhelm the mitochondria- exhaust intracellular
antioxidants
P. lipid peroxidation, damage proteins, fragment DNA
C.M. development in Alzheimer's, heart disease, Parkinson's disease,
Amyotrophic Lateral Sclerosis
,◉ Ethanol. Answer: E. mood altering drug, long term effects on liver
and nutritional status
P. metabolized by liver, generates free radicals
C.M. CNS depression, nutrient deficiencies-Mag, Vit B6, thiamine,
PO4, inflammation and fatty infiltration of liver, hepatomegaly, leads
to liver failure irreversible
◉ Oncosis. Answer: Na and H2O enter cell and cause swelling. Organ
increases in weight, becomes distended and pale. Associated with
high fever, hypocalcemia, certain infections
◉ Fatty Infiltration. Answer: intracellular accumulation of lipids in
the liver
liver fails to metabolize lipids. usually from ETOH or high fat diet.
can lead to cirrhosis
◉ dystrophic calcification. Answer: accumulation of Ca in dead or
dying tissues
calcium salt clump and harden- interfere with cellular structure and
function
r/t pulmonary TB, atherosclerosis, injured heart valves, chronic
pancreatitis
◉ metastatic calcification. Answer: accumulation of Ca in normal
tissue
, result of hypercalcemia r/t hyperparathyroidism, hyperthyroidism,
toxic levels of Vit D. Can also r/t hyperphosphatemia in renal failure
◉ urate accumulation. Answer: sodium urate crystals are deposited
in tissues- group of disorders collectively called gout- acute arthritis,
chronic gouty arthritis, tophus, nephritis
◉ Coagulative Necrosis. Answer: kidneys, heart, adrenals- secondary
to hypoxia
◉ Liquefactive Necrosis. Answer: nerve cells- brain- accumulation of
pus
◉ Caseous Necrosis. Answer: lung disease- usually TB- tissue looks
like clumped cheese
◉ Fat Necrosis. Answer: breast, pancreas, abdominal structures-
creates soaps
◉ Gangrenous Necrosis. Answer: Dry- dark shriveled skin
Wet- internal organs- can lead to death
Gas- from clostridium- antitoxins and hyperbaric therapy
EXAM 1 ACTUAL TEST SCRIPT 2026
COMPLETE QUESTIONS AND ANSWERS
GRADED A+
◉ Hyperplasia. Answer: E: cells increase in number, mitosis (cell
division) must occur, size of cell does not change
Phys: increased rate of division, increase in tissue mass after damage
or partial resection; may be compensatory, hormonal, or pathologic
Patho: abnormal proliferation of normal cells usually caused by
increased hormonal stimulation (endometrial). increase of
production of local growth factors
Ex: removal of part of the liver lead to hyperplasia of hepatocytes.
uterine or mammary gland enlargement during pregnancy
◉ Dysplasia. Answer: E. Not true adaptation; Cells abnormal change
in size, shape, organization (classified as mild, moderate, severe)
P. caused by cell injury/irritation, characterized by disordered cell
growth. aka atypical hyperplasia or pre-cancer, a disorderly
proliferation
Physiologic: N/A
Pathologic: squamous dysplasia of cervix from HPV shows up on pap
smear, breast cancer development; pap smears often show
dysplastic cells of the cervix that must undergo laser/surgical tx
,◉ Metaplasia. Answer: E: reversible change, one type of cell changes
to another type for survival
P: reversible; results from exposure of the cells to chronic stressors,
injury, or irritation; Cancer can arise from this area, stimulus
induces a reprogramming of stem cells under the influence of
cytokines and growth factors
Ex: Patho: Columnar cells change to squamous cells in lungs of
smoker or normal ciliated epithelial cells of the bronchial linings are
replaced by stratified squamous epithelial cells.; Phys: Barrett
Esophagus- normal squamous cells change to columnar epithelial
cells in response to reflux, aka intestinal metaplasia
◉ Hypoxia injury. Answer: E. inadequate oxygenation of tissues
P. decrease in mitochondrial function, decreased production of ATP
increases anaerobic metabolism. eventual cell death.
C.M. hypoxia, cyanosis, cognitive impairment, lethargy
◉ Free radical and ROS. Answer: E. normal byproduct of ATP
production, will overwhelm the mitochondria- exhaust intracellular
antioxidants
P. lipid peroxidation, damage proteins, fragment DNA
C.M. development in Alzheimer's, heart disease, Parkinson's disease,
Amyotrophic Lateral Sclerosis
,◉ Ethanol. Answer: E. mood altering drug, long term effects on liver
and nutritional status
P. metabolized by liver, generates free radicals
C.M. CNS depression, nutrient deficiencies-Mag, Vit B6, thiamine,
PO4, inflammation and fatty infiltration of liver, hepatomegaly, leads
to liver failure irreversible
◉ Oncosis. Answer: Na and H2O enter cell and cause swelling. Organ
increases in weight, becomes distended and pale. Associated with
high fever, hypocalcemia, certain infections
◉ Fatty Infiltration. Answer: intracellular accumulation of lipids in
the liver
liver fails to metabolize lipids. usually from ETOH or high fat diet.
can lead to cirrhosis
◉ dystrophic calcification. Answer: accumulation of Ca in dead or
dying tissues
calcium salt clump and harden- interfere with cellular structure and
function
r/t pulmonary TB, atherosclerosis, injured heart valves, chronic
pancreatitis
◉ metastatic calcification. Answer: accumulation of Ca in normal
tissue
, result of hypercalcemia r/t hyperparathyroidism, hyperthyroidism,
toxic levels of Vit D. Can also r/t hyperphosphatemia in renal failure
◉ urate accumulation. Answer: sodium urate crystals are deposited
in tissues- group of disorders collectively called gout- acute arthritis,
chronic gouty arthritis, tophus, nephritis
◉ Coagulative Necrosis. Answer: kidneys, heart, adrenals- secondary
to hypoxia
◉ Liquefactive Necrosis. Answer: nerve cells- brain- accumulation of
pus
◉ Caseous Necrosis. Answer: lung disease- usually TB- tissue looks
like clumped cheese
◉ Fat Necrosis. Answer: breast, pancreas, abdominal structures-
creates soaps
◉ Gangrenous Necrosis. Answer: Dry- dark shriveled skin
Wet- internal organs- can lead to death
Gas- from clostridium- antitoxins and hyperbaric therapy
