NU606 | NU606 Advanced Pathophysiology Exam 1
Version 2 | Questions with Correct Answers and
Expert Explanation for Each Question | Regis
1. Which cellular adaptation is characterized by the replacement of one mature cell
type by another, often as a response to chronic irritation?
A. Atrophy
B. Metaplasia
C. Hypertrophy
D. Dysplasia
Correct Answer: B
Expert Explanation: Metaplasia is a reversible change in which one adult cell type
is replaced by another adult cell type to better withstand adverse environmental
conditions. A classic example is the change in the respiratory epithelium of smokers
where ciliated columnar cells are replaced by stratified squamous cells. Although
the new cells are more rugged, the loss of cilia and mucus secretion can predispose
the individual to infection.
2. A patient with chronic hypertension exhibits an increase in the size of left
ventricular myocardial cells. This is an example of:
A. Hyperplasia
,B. Metaplasia
C. Hypertrophy
D. Neoplasia
Correct Answer: C
Expert Explanation: Hypertrophy involves an increase in the size of individual
cells, which consequently increases the size of the affected organ. In the case of the
heart, myocardial cells cannot divide, so they adapt to increased workload by
increasing protein synthesis and organelle size. This differs from hyperplasia, which
involves an increase in the actual number of cells through division.
3. Which process is considered a programmed cell death that does not typically trigger
an inflammatory response?
A. Necrosis
B. Autophagy
C. Infarction
D. Apoptosis
Correct Answer: D
Expert Explanation: Apoptosis is a highly regulated form of cell death used to
eliminate unwanted or damaged cells without leaking cellular contents. Because the
,cell membrane remains intact while the cell fragments into apoptotic bodies, there
is no release of pro-inflammatory signals. In contrast, necrosis involves cell swelling
and membrane rupture, which triggers a significant inflammatory response.
4. What is the primary mechanism of cellular injury caused by hypoxia?
A. Increased ATP production
B. Intracellular alkalosis
C. Decreased intracellular calcium levels
D. Failure of the sodium-potassium pump
Correct Answer: D
Expert Explanation: Hypoxia leads to a decrease in mitochondrial oxidative
phosphorylation, which severely reduces ATP production. Without sufficient ATP,
the energy-dependent sodium-potassium pump fails, leading to an accumulation of
sodium inside the cell. This causes water to enter the cell by osmosis, resulting in
cellular swelling and potential membrane damage.
5. In the context of fluid and electrolyte balance, which hormone is primarily
responsible for the reabsorption of water independently of sodium in the collecting
ducts?
A. Aldosterone
B. Antidiuretic Hormone (ADH)
, C. Atrial Natriuretic Peptide (ANP)
D. Renin
Correct Answer: B
Expert Explanation: Antidiuretic Hormone (ADH), also known as vasopressin, acts
on the V2 receptors in the renal collecting ducts to increase water permeability. It
facilitates the insertion of aquaporin channels, allowing water to be reabsorbed
back into the blood based on the osmotic gradient. This process regulates plasma
osmolality and is distinct from aldosterone, which primarily regulates sodium
reabsorption.
6. A patient presents with a serum sodium level of 120 mEq/L. Which clinical
manifestation is most likely to occur due to cerebral edema?
A. Confusion and seizures
B. Hypotension
C. Thirst
D. Muscle tetany
Correct Answer: A
Expert Explanation: Hyponatremia causes an osmotic shift where water moves
from the extracellular fluid into the intracellular compartment of brain cells. This
Version 2 | Questions with Correct Answers and
Expert Explanation for Each Question | Regis
1. Which cellular adaptation is characterized by the replacement of one mature cell
type by another, often as a response to chronic irritation?
A. Atrophy
B. Metaplasia
C. Hypertrophy
D. Dysplasia
Correct Answer: B
Expert Explanation: Metaplasia is a reversible change in which one adult cell type
is replaced by another adult cell type to better withstand adverse environmental
conditions. A classic example is the change in the respiratory epithelium of smokers
where ciliated columnar cells are replaced by stratified squamous cells. Although
the new cells are more rugged, the loss of cilia and mucus secretion can predispose
the individual to infection.
2. A patient with chronic hypertension exhibits an increase in the size of left
ventricular myocardial cells. This is an example of:
A. Hyperplasia
,B. Metaplasia
C. Hypertrophy
D. Neoplasia
Correct Answer: C
Expert Explanation: Hypertrophy involves an increase in the size of individual
cells, which consequently increases the size of the affected organ. In the case of the
heart, myocardial cells cannot divide, so they adapt to increased workload by
increasing protein synthesis and organelle size. This differs from hyperplasia, which
involves an increase in the actual number of cells through division.
3. Which process is considered a programmed cell death that does not typically trigger
an inflammatory response?
A. Necrosis
B. Autophagy
C. Infarction
D. Apoptosis
Correct Answer: D
Expert Explanation: Apoptosis is a highly regulated form of cell death used to
eliminate unwanted or damaged cells without leaking cellular contents. Because the
,cell membrane remains intact while the cell fragments into apoptotic bodies, there
is no release of pro-inflammatory signals. In contrast, necrosis involves cell swelling
and membrane rupture, which triggers a significant inflammatory response.
4. What is the primary mechanism of cellular injury caused by hypoxia?
A. Increased ATP production
B. Intracellular alkalosis
C. Decreased intracellular calcium levels
D. Failure of the sodium-potassium pump
Correct Answer: D
Expert Explanation: Hypoxia leads to a decrease in mitochondrial oxidative
phosphorylation, which severely reduces ATP production. Without sufficient ATP,
the energy-dependent sodium-potassium pump fails, leading to an accumulation of
sodium inside the cell. This causes water to enter the cell by osmosis, resulting in
cellular swelling and potential membrane damage.
5. In the context of fluid and electrolyte balance, which hormone is primarily
responsible for the reabsorption of water independently of sodium in the collecting
ducts?
A. Aldosterone
B. Antidiuretic Hormone (ADH)
, C. Atrial Natriuretic Peptide (ANP)
D. Renin
Correct Answer: B
Expert Explanation: Antidiuretic Hormone (ADH), also known as vasopressin, acts
on the V2 receptors in the renal collecting ducts to increase water permeability. It
facilitates the insertion of aquaporin channels, allowing water to be reabsorbed
back into the blood based on the osmotic gradient. This process regulates plasma
osmolality and is distinct from aldosterone, which primarily regulates sodium
reabsorption.
6. A patient presents with a serum sodium level of 120 mEq/L. Which clinical
manifestation is most likely to occur due to cerebral edema?
A. Confusion and seizures
B. Hypotension
C. Thirst
D. Muscle tetany
Correct Answer: A
Expert Explanation: Hyponatremia causes an osmotic shift where water moves
from the extracellular fluid into the intracellular compartment of brain cells. This
