WGU D115 — Advanced Pathophysiology
250 OA Practice MCQs with Answers &
Rationales
EXAM SUMMARY — TOPICS COVERED
All 250 questions cover the major WGU D115 competency areas:
Cellular Pathophysiology & Genetics (Q1–15)
Immunity & Inflammation (Q16–25)
Fluid, Electrolyte & Acid-Base (Q26–35)
Cardiovascular (Q36–50)
Respiratory (Q51–60)
Neurological (Q61–70)
Endocrine (Q71–80)
Musculoskeletal (Q81–87)
Hematological (Q88–95)
Renal (Q96–100)
GI (Q101–110)
Oncology (Q111–116)
Shock & Hemodynamics (Q117–121)
Reproductive (Q122–127)
Integumentary & Wound Healing (Q128–132)
Diagnostics & Pharmacology (Q133–135)
Advanced Mixed Clinical (Q136–250)
UNIT 1 — FOUNDATIONS: CELLULAR PATHOPHYSIOLOGY &
GENETICS
1. How is transcription best defined?
,A. DNA is replicated from an RNA template B. mRNA leaves the nucleus and enters the
cytoplasm C. RNA is synthesized from a DNA template (correct answer) D. Ribosomes
translate codons into amino acids
Rationale: Transcription is the process by which RNA polymerase synthesizes mRNA using
a DNA strand as a template. Translation (not transcription) involves ribosomes reading
mRNA to synthesize proteins.
2. How is translation best defined?
A. DNA is copied into a complementary RNA strand B. A gene is expressed through chromatin
remodeling C. mRNA directs the synthesis of a polypeptide at the ribosome (correct
answer) D. tRNA copies genetic information from the nucleus
Rationale: Translation occurs after transcription. mRNA exits the nucleus, binds to
ribosomes, and tRNA anticodons match with mRNA codons to assemble amino acids into a
protein.
3. An amniocentesis indicates a neural tube defect when there is an increase in which protein?
A. Alpha-fetoprotein (correct answer) B. Beta-hCG C. Albumin D. Fibronectin
Rationale: Alpha-fetoprotein (AFP) is produced by the fetal liver and yolk sac. Elevated
AFP in amniotic fluid is a marker for open neural tube defects such as spina bifida and
anencephaly, because the protein leaks from exposed neural tissue.
4. Which cellular adaptation involves an increase in cell SIZE?
A. Hyperplasia B. Hypertrophy (correct answer) C. Atrophy D. Metaplasia
Rationale: Hypertrophy refers to an increase in cell size without an increase in cell
number, commonly seen in cardiac muscle under conditions of increased workload such as
hypertension.
5. Which cellular adaptation involves an increase in cell NUMBER?
A. Hyperplasia (correct answer) B. Hypertrophy C. Dysplasia D. Atrophy
,Rationale: Hyperplasia involves an increase in the number of cells in a tissue or organ. It
can be physiological (e.g., breast tissue during pregnancy) or pathological (e.g., endometrial
hyperplasia).
6. Metaplasia is best described as:
A. Decrease in cell number due to apoptosis B. Increase in cell size due to stress C.
Replacement of one mature cell type with another (correct answer) D. Abnormal cell growth
indicating malignancy
Rationale: Metaplasia is a reversible change where one differentiated cell type is replaced
by another. A classic example is Barrett's esophagus, where squamous epithelium is
replaced by columnar epithelium due to chronic acid exposure.
7. Apoptosis is best defined as:
A. Uncontrolled cell death due to injury B. Cell death caused by ischemia C. Programmed,
orderly cell death (correct answer) D. Necrosis initiated by bacterial toxins
Rationale: Apoptosis is a genetically programmed, energy-dependent process of cell death
that does not cause inflammation. It serves normal physiological functions such as tissue
remodeling and immune cell deletion.
8. Which type of necrosis is most commonly associated with myocardial infarction?
A. Coagulative necrosis (correct answer) B. Liquefactive necrosis C. Caseous necrosis D. Fat
necrosis
Rationale: Coagulative necrosis preserves cell outlines due to protein denaturation, and is
the hallmark of ischemic injury in solid organs like the heart. The infarcted tissue takes on
a firm, pale appearance.
9. Liquefactive necrosis is most often associated with:
A. Myocardial infarction B. Tuberculosis C. Brain infarction and bacterial infections (correct
answer) D. Pancreatic injury
, Rationale: Liquefactive necrosis results in complete digestion of dead cells, forming a liquid
mass. It occurs in the brain (due to abundant lipids and enzymatic activity) and in bacterial
abscesses where neutrophil enzymes liquefy tissue.
10. Caseous necrosis is the hallmark of which disease?
A. Staphylococcal pneumonia B. Myocardial infarction C. Tuberculosis (correct answer) D.
Pancreatitis
Rationale: Caseous necrosis appears grossly as a cheese-like, white material. It is a
combination of coagulative and liquefactive necrosis with lipid deposition, and is
pathognomonic of granulomatous infections such as tuberculosis.
11. Which of the following represents an autosomal dominant inheritance pattern?
A. Cystic fibrosis B. Sickle cell disease C. Huntington's disease (correct answer) D.
Phenylketonuria
Rationale: Huntington's disease is autosomal dominant — only one mutated allele is
needed for disease expression. Cystic fibrosis, sickle cell disease, and PKU are all autosomal
recessive conditions requiring two mutant alleles.
12. Cystic fibrosis follows which inheritance pattern?
A. Autosomal dominant B. Autosomal recessive (correct answer) C. X-linked dominant D.
Mitochondrial
Rationale: Cystic fibrosis results from mutations in the CFTR gene on chromosome 7. Both
copies of the gene must be defective for the disease to manifest, making it autosomal
recessive.
13. Which of the following is an X-linked recessive disorder?
A. Turner syndrome B. Down syndrome C. Hemophilia A (correct answer) D. Marfan
syndrome
250 OA Practice MCQs with Answers &
Rationales
EXAM SUMMARY — TOPICS COVERED
All 250 questions cover the major WGU D115 competency areas:
Cellular Pathophysiology & Genetics (Q1–15)
Immunity & Inflammation (Q16–25)
Fluid, Electrolyte & Acid-Base (Q26–35)
Cardiovascular (Q36–50)
Respiratory (Q51–60)
Neurological (Q61–70)
Endocrine (Q71–80)
Musculoskeletal (Q81–87)
Hematological (Q88–95)
Renal (Q96–100)
GI (Q101–110)
Oncology (Q111–116)
Shock & Hemodynamics (Q117–121)
Reproductive (Q122–127)
Integumentary & Wound Healing (Q128–132)
Diagnostics & Pharmacology (Q133–135)
Advanced Mixed Clinical (Q136–250)
UNIT 1 — FOUNDATIONS: CELLULAR PATHOPHYSIOLOGY &
GENETICS
1. How is transcription best defined?
,A. DNA is replicated from an RNA template B. mRNA leaves the nucleus and enters the
cytoplasm C. RNA is synthesized from a DNA template (correct answer) D. Ribosomes
translate codons into amino acids
Rationale: Transcription is the process by which RNA polymerase synthesizes mRNA using
a DNA strand as a template. Translation (not transcription) involves ribosomes reading
mRNA to synthesize proteins.
2. How is translation best defined?
A. DNA is copied into a complementary RNA strand B. A gene is expressed through chromatin
remodeling C. mRNA directs the synthesis of a polypeptide at the ribosome (correct
answer) D. tRNA copies genetic information from the nucleus
Rationale: Translation occurs after transcription. mRNA exits the nucleus, binds to
ribosomes, and tRNA anticodons match with mRNA codons to assemble amino acids into a
protein.
3. An amniocentesis indicates a neural tube defect when there is an increase in which protein?
A. Alpha-fetoprotein (correct answer) B. Beta-hCG C. Albumin D. Fibronectin
Rationale: Alpha-fetoprotein (AFP) is produced by the fetal liver and yolk sac. Elevated
AFP in amniotic fluid is a marker for open neural tube defects such as spina bifida and
anencephaly, because the protein leaks from exposed neural tissue.
4. Which cellular adaptation involves an increase in cell SIZE?
A. Hyperplasia B. Hypertrophy (correct answer) C. Atrophy D. Metaplasia
Rationale: Hypertrophy refers to an increase in cell size without an increase in cell
number, commonly seen in cardiac muscle under conditions of increased workload such as
hypertension.
5. Which cellular adaptation involves an increase in cell NUMBER?
A. Hyperplasia (correct answer) B. Hypertrophy C. Dysplasia D. Atrophy
,Rationale: Hyperplasia involves an increase in the number of cells in a tissue or organ. It
can be physiological (e.g., breast tissue during pregnancy) or pathological (e.g., endometrial
hyperplasia).
6. Metaplasia is best described as:
A. Decrease in cell number due to apoptosis B. Increase in cell size due to stress C.
Replacement of one mature cell type with another (correct answer) D. Abnormal cell growth
indicating malignancy
Rationale: Metaplasia is a reversible change where one differentiated cell type is replaced
by another. A classic example is Barrett's esophagus, where squamous epithelium is
replaced by columnar epithelium due to chronic acid exposure.
7. Apoptosis is best defined as:
A. Uncontrolled cell death due to injury B. Cell death caused by ischemia C. Programmed,
orderly cell death (correct answer) D. Necrosis initiated by bacterial toxins
Rationale: Apoptosis is a genetically programmed, energy-dependent process of cell death
that does not cause inflammation. It serves normal physiological functions such as tissue
remodeling and immune cell deletion.
8. Which type of necrosis is most commonly associated with myocardial infarction?
A. Coagulative necrosis (correct answer) B. Liquefactive necrosis C. Caseous necrosis D. Fat
necrosis
Rationale: Coagulative necrosis preserves cell outlines due to protein denaturation, and is
the hallmark of ischemic injury in solid organs like the heart. The infarcted tissue takes on
a firm, pale appearance.
9. Liquefactive necrosis is most often associated with:
A. Myocardial infarction B. Tuberculosis C. Brain infarction and bacterial infections (correct
answer) D. Pancreatic injury
, Rationale: Liquefactive necrosis results in complete digestion of dead cells, forming a liquid
mass. It occurs in the brain (due to abundant lipids and enzymatic activity) and in bacterial
abscesses where neutrophil enzymes liquefy tissue.
10. Caseous necrosis is the hallmark of which disease?
A. Staphylococcal pneumonia B. Myocardial infarction C. Tuberculosis (correct answer) D.
Pancreatitis
Rationale: Caseous necrosis appears grossly as a cheese-like, white material. It is a
combination of coagulative and liquefactive necrosis with lipid deposition, and is
pathognomonic of granulomatous infections such as tuberculosis.
11. Which of the following represents an autosomal dominant inheritance pattern?
A. Cystic fibrosis B. Sickle cell disease C. Huntington's disease (correct answer) D.
Phenylketonuria
Rationale: Huntington's disease is autosomal dominant — only one mutated allele is
needed for disease expression. Cystic fibrosis, sickle cell disease, and PKU are all autosomal
recessive conditions requiring two mutant alleles.
12. Cystic fibrosis follows which inheritance pattern?
A. Autosomal dominant B. Autosomal recessive (correct answer) C. X-linked dominant D.
Mitochondrial
Rationale: Cystic fibrosis results from mutations in the CFTR gene on chromosome 7. Both
copies of the gene must be defective for the disease to manifest, making it autosomal
recessive.
13. Which of the following is an X-linked recessive disorder?
A. Turner syndrome B. Down syndrome C. Hemophilia A (correct answer) D. Marfan
syndrome
