UNE Pathophysiology — Midterm Exam for
Nursing and Health Sciences – Questions and
Answers Study Guide.
QUESTION 1:
A 68-year-old male with a history of chronic hypertension presents with left ventricular
hypertrophy. Which type of cellular adaptation best describes this change?
A) Atrophy
B) Hyperplasia
C) Hypertrophy
D) Metaplasia
CORRECT ANSWER: C
RATIONALE: Hypertrophy refers to an increase in the size of individual cells, resulting in an
enlarged organ. In chronic hypertension, the left ventricle must pump against increased
afterload, causing individual cardiac muscle cells to increase in size to generate more force.
Unlike hyperplasia, which involves cell number increase, hypertrophy involves cell size
increase.
QUESTION 2:
A 55-year-old female with breast cancer undergoes radiation therapy. Three months later,
breast tissue shows replacement of normal glandular epithelium with fibrous connective
tissue. Which cellular adaptation has occurred?
A) Dysplasia
B) Metaplasia
C) Hyperplasia
D) Anaplasia
CORRECT ANSWER: B
RATIONALE: Metaplasia is the reversible replacement of one differentiated cell type with
another differentiated cell type, often in response to chronic irritation or injury. In this case,
,normal glandular epithelium has been replaced by fibrous connective tissue as an adaptive
response to radiation-induced damage.
QUESTION 3:
A pathologist examines cervical cells and observes disordered maturation, nuclear
pleomorphism, and increased mitotic figures. This is best classified as:
A) Hyperplasia
B) Metaplasia
C) Dysplasia
D) Hypertrophy
CORRECT ANSWER: C
RATIONALE: Dysplasia is characterized by disordered cell growth with loss of uniformity of
individual cells and loss of architectural orientation. It involves abnormal cell size, shape, and
organization, with increased mitotic activity. Dysplasia is considered a preneoplastic lesion
and may progress to carcinoma in situ if left untreated.
QUESTION 4:
A 72-year-old male with advanced prostate cancer has been bedridden for 6 months. On
examination, his quadriceps muscles appear significantly smaller than baseline. This change is
best described as:
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
CORRECT ANSWER: C
RATIONALE: Atrophy is a decrease in cell size, resulting in a reduction in organ size. Disuse
atrophy occurs when muscles are not used, leading to decreased protein synthesis and
increased protein degradation. In this bedridden patient, lack of weight-bearing activity and
mechanical loading causes skeletal muscle atrophy.
QUESTION 5:
,A 45-year-old woman with endometrial hyperplasia has an overgrowth of the endometrial
lining. Which cellular process is primarily responsible?
A) Hypertrophy
B) Hyperplasia
C) Metaplasia
D) Apoptosis
CORRECT ANSWER: B
RATIONALE: Hyperplasia is an increase in the number of cells in an organ or tissue, resulting in
increased tissue mass. Endometrial hyperplasia involves proliferation of endometrial glands
and stroma, typically due to unopposed estrogen stimulation. Unlike hypertrophy, hyperplasia
involves cell division and increased cell numbers.
QUESTION 6:
Coagulative necrosis is most commonly associated with which of the following conditions?
A) Cerebral infarction
B) Myocardial infarction
C) Pancreatitis
D) Meningococcemia
CORRECT ANSWER: B
RATIONALE: Coagulative necrosis is the most common pattern of ischemic injury in solid
organs except the brain. It is characterized by preservation of tissue architecture for several
days after cell death. Myocardial infarction is the classic example, where ischemia denatures
proteins and enzymes, preventing autolysis and maintaining tissue outlines.
QUESTION 7:
A patient presents with severe acute pancreatitis. The necrotic pancreatic tissue appears
chalky white due to enzymatic digestion of cell membranes and fat saponification. This type
of necrosis is called:
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
, D) Fat necrosis
CORRECT ANSWER: D
RATIONALE: Fat necrosis occurs when lipases break down triglycerides in adipose tissue,
releasing fatty acids that combine with calcium to form chalky white soaps (saponification).
This is characteristic of acute pancreatitis where pancreatic lipase leaks and digests
peripancreatic fat, creating chalky white deposits visible on imaging and gross examination.
QUESTION 8:
A 30-year-old patient with HIV develops Pneumocystis jirovecii pneumonia. The lung tissue
shows granulomatous inflammation with central amorphous, eosinophilic debris. This pattern
of necrosis is:
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
CORRECT ANSWER: C
RATIONALE: Caseous necrosis is a distinctive form of coagulative necrosis seen in
granulomatous inflammation, particularly tuberculosis and fungal infections. The necrotic
tissue appears soft, white, and cheese-like (caseous) on gross examination. Microscopically, it
appears as amorphous, eosinophilic debris without preserved tissue architecture.
QUESTION 9:
A 65-year-old male suffers an ischemic stroke. The brain tissue in the affected area shows
complete dissolution of dead tissue into a liquid mass. This pattern is:
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
CORRECT ANSWER: B
RATIONALE: Liquefactive necrosis occurs when enzymatic digestion of dead cells results in
transformation of tissue into a liquid viscous mass. The brain is particularly susceptible
Nursing and Health Sciences – Questions and
Answers Study Guide.
QUESTION 1:
A 68-year-old male with a history of chronic hypertension presents with left ventricular
hypertrophy. Which type of cellular adaptation best describes this change?
A) Atrophy
B) Hyperplasia
C) Hypertrophy
D) Metaplasia
CORRECT ANSWER: C
RATIONALE: Hypertrophy refers to an increase in the size of individual cells, resulting in an
enlarged organ. In chronic hypertension, the left ventricle must pump against increased
afterload, causing individual cardiac muscle cells to increase in size to generate more force.
Unlike hyperplasia, which involves cell number increase, hypertrophy involves cell size
increase.
QUESTION 2:
A 55-year-old female with breast cancer undergoes radiation therapy. Three months later,
breast tissue shows replacement of normal glandular epithelium with fibrous connective
tissue. Which cellular adaptation has occurred?
A) Dysplasia
B) Metaplasia
C) Hyperplasia
D) Anaplasia
CORRECT ANSWER: B
RATIONALE: Metaplasia is the reversible replacement of one differentiated cell type with
another differentiated cell type, often in response to chronic irritation or injury. In this case,
,normal glandular epithelium has been replaced by fibrous connective tissue as an adaptive
response to radiation-induced damage.
QUESTION 3:
A pathologist examines cervical cells and observes disordered maturation, nuclear
pleomorphism, and increased mitotic figures. This is best classified as:
A) Hyperplasia
B) Metaplasia
C) Dysplasia
D) Hypertrophy
CORRECT ANSWER: C
RATIONALE: Dysplasia is characterized by disordered cell growth with loss of uniformity of
individual cells and loss of architectural orientation. It involves abnormal cell size, shape, and
organization, with increased mitotic activity. Dysplasia is considered a preneoplastic lesion
and may progress to carcinoma in situ if left untreated.
QUESTION 4:
A 72-year-old male with advanced prostate cancer has been bedridden for 6 months. On
examination, his quadriceps muscles appear significantly smaller than baseline. This change is
best described as:
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
CORRECT ANSWER: C
RATIONALE: Atrophy is a decrease in cell size, resulting in a reduction in organ size. Disuse
atrophy occurs when muscles are not used, leading to decreased protein synthesis and
increased protein degradation. In this bedridden patient, lack of weight-bearing activity and
mechanical loading causes skeletal muscle atrophy.
QUESTION 5:
,A 45-year-old woman with endometrial hyperplasia has an overgrowth of the endometrial
lining. Which cellular process is primarily responsible?
A) Hypertrophy
B) Hyperplasia
C) Metaplasia
D) Apoptosis
CORRECT ANSWER: B
RATIONALE: Hyperplasia is an increase in the number of cells in an organ or tissue, resulting in
increased tissue mass. Endometrial hyperplasia involves proliferation of endometrial glands
and stroma, typically due to unopposed estrogen stimulation. Unlike hypertrophy, hyperplasia
involves cell division and increased cell numbers.
QUESTION 6:
Coagulative necrosis is most commonly associated with which of the following conditions?
A) Cerebral infarction
B) Myocardial infarction
C) Pancreatitis
D) Meningococcemia
CORRECT ANSWER: B
RATIONALE: Coagulative necrosis is the most common pattern of ischemic injury in solid
organs except the brain. It is characterized by preservation of tissue architecture for several
days after cell death. Myocardial infarction is the classic example, where ischemia denatures
proteins and enzymes, preventing autolysis and maintaining tissue outlines.
QUESTION 7:
A patient presents with severe acute pancreatitis. The necrotic pancreatic tissue appears
chalky white due to enzymatic digestion of cell membranes and fat saponification. This type
of necrosis is called:
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
, D) Fat necrosis
CORRECT ANSWER: D
RATIONALE: Fat necrosis occurs when lipases break down triglycerides in adipose tissue,
releasing fatty acids that combine with calcium to form chalky white soaps (saponification).
This is characteristic of acute pancreatitis where pancreatic lipase leaks and digests
peripancreatic fat, creating chalky white deposits visible on imaging and gross examination.
QUESTION 8:
A 30-year-old patient with HIV develops Pneumocystis jirovecii pneumonia. The lung tissue
shows granulomatous inflammation with central amorphous, eosinophilic debris. This pattern
of necrosis is:
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
CORRECT ANSWER: C
RATIONALE: Caseous necrosis is a distinctive form of coagulative necrosis seen in
granulomatous inflammation, particularly tuberculosis and fungal infections. The necrotic
tissue appears soft, white, and cheese-like (caseous) on gross examination. Microscopically, it
appears as amorphous, eosinophilic debris without preserved tissue architecture.
QUESTION 9:
A 65-year-old male suffers an ischemic stroke. The brain tissue in the affected area shows
complete dissolution of dead tissue into a liquid mass. This pattern is:
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
CORRECT ANSWER: B
RATIONALE: Liquefactive necrosis occurs when enzymatic digestion of dead cells results in
transformation of tissue into a liquid viscous mass. The brain is particularly susceptible
