West Coast University PathoPhysiology MidterM
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SECTION 1: CELLULAR INJURY, ADAPTATION, AND DEATH (Questions 1-10)
**Question 1**
A patient with chronic alcoholism develops liver damage characterized by enlarged,
yellowish liver with fat accumulation. This type of cellular adaptation is called:
A) Hyperplasia
B) Metaplasia
C) Fatty change (steatosis)
D) Dysplasia
**Answer:** C) Fatty change (steatosis)
**Rationale:** Fatty change (steatosis) is the accumulation of triglycerides within
parenchymal cells, most commonly in the liver. It is caused by toxins (including
alcohol), diabetes, obesity, and malnutrition. The liver becomes enlarged, yellow, and
greasy. This is a reversible injury if the causative agent is removed.
---
**Question 2**
,A 65-year-old smoker develops a cough producing blood-tinged sputum. A bronchial
biopsy reveals that normal ciliated columnar epithelial cells have been replaced by
stratified squamous epithelial cells. This change is known as:
A) Dysplasia
B) Metaplasia
C) Anaplasia
D) Hyperplasia
**Answer:** B) Metaplasia
**Rationale:** Metaplasia is the reversible replacement of one differentiated cell type
with another. In the respiratory tract of smokers, the normal ciliated columnar
epithelium is replaced by stratified squamous epithelium (squamous metaplasia). While
this change is protective against smoke irritation, it loses ciliary function and can
progress to dysplasia and carcinoma.
---
**Question 3**
A patient with prolonged ischemia to the heart experiences irreversible cell injury
characterized by nuclear dissolution (karyolysis), nuclear fragmentation (karyorrhexis),
and protein denaturation. This type of cell death is called:
A) Apoptosis
B) Necrosis
C) Autophagy
D) Pyroptosis
**Answer:** B) Necrosis
, **Rationale:** Necrosis is pathological cell death resulting from irreversible injury
(ischemia, toxins, infection). It is characterized by cell swelling, membrane disruption,
and nuclear changes (pyknosis, karyorrhexis, karyolysis). Necrosis always elicits an
inflammatory response. Apoptosis is programmed, regulated cell death without
inflammation.
---
**Question 4**
A pathologist examining a myocardial infarction (heart attack) specimen notes that the
dead cardiac muscle cells appear to have undergone enzymatic digestion and have
been removed by phagocytes. This process is characteristic of which type of necrosis?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
**Answer:** A) Coagulative necrosis
**Rationale:** Coagulative necrosis is the most common type of necrosis, typically
seen in solid organs (heart, kidney, liver) following ischemia. Cell outlines are
preserved initially, with protein denaturation. Over time, dead cells are removed by
phagocytes and replaced by scar tissue. Liquefactive necrosis (brain, abscesses)
results in liquid viscous mass.
---
**Question 5**
A 45-year-old woman with breast cancer is undergoing chemotherapy. She notices
significant hair loss. This is due to chemotherapy affecting rapidly dividing cells in hair
follicles, leading to:
exaM||verified exaM!!!||, West Coast University College of
nUrsing, 2026/2027 |||qUestions and ansWers With
rationales/graded a+/2026 UPdate/100% CorreCt /instant
doWnload
SECTION 1: CELLULAR INJURY, ADAPTATION, AND DEATH (Questions 1-10)
**Question 1**
A patient with chronic alcoholism develops liver damage characterized by enlarged,
yellowish liver with fat accumulation. This type of cellular adaptation is called:
A) Hyperplasia
B) Metaplasia
C) Fatty change (steatosis)
D) Dysplasia
**Answer:** C) Fatty change (steatosis)
**Rationale:** Fatty change (steatosis) is the accumulation of triglycerides within
parenchymal cells, most commonly in the liver. It is caused by toxins (including
alcohol), diabetes, obesity, and malnutrition. The liver becomes enlarged, yellow, and
greasy. This is a reversible injury if the causative agent is removed.
---
**Question 2**
,A 65-year-old smoker develops a cough producing blood-tinged sputum. A bronchial
biopsy reveals that normal ciliated columnar epithelial cells have been replaced by
stratified squamous epithelial cells. This change is known as:
A) Dysplasia
B) Metaplasia
C) Anaplasia
D) Hyperplasia
**Answer:** B) Metaplasia
**Rationale:** Metaplasia is the reversible replacement of one differentiated cell type
with another. In the respiratory tract of smokers, the normal ciliated columnar
epithelium is replaced by stratified squamous epithelium (squamous metaplasia). While
this change is protective against smoke irritation, it loses ciliary function and can
progress to dysplasia and carcinoma.
---
**Question 3**
A patient with prolonged ischemia to the heart experiences irreversible cell injury
characterized by nuclear dissolution (karyolysis), nuclear fragmentation (karyorrhexis),
and protein denaturation. This type of cell death is called:
A) Apoptosis
B) Necrosis
C) Autophagy
D) Pyroptosis
**Answer:** B) Necrosis
, **Rationale:** Necrosis is pathological cell death resulting from irreversible injury
(ischemia, toxins, infection). It is characterized by cell swelling, membrane disruption,
and nuclear changes (pyknosis, karyorrhexis, karyolysis). Necrosis always elicits an
inflammatory response. Apoptosis is programmed, regulated cell death without
inflammation.
---
**Question 4**
A pathologist examining a myocardial infarction (heart attack) specimen notes that the
dead cardiac muscle cells appear to have undergone enzymatic digestion and have
been removed by phagocytes. This process is characteristic of which type of necrosis?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
**Answer:** A) Coagulative necrosis
**Rationale:** Coagulative necrosis is the most common type of necrosis, typically
seen in solid organs (heart, kidney, liver) following ischemia. Cell outlines are
preserved initially, with protein denaturation. Over time, dead cells are removed by
phagocytes and replaced by scar tissue. Liquefactive necrosis (brain, abscesses)
results in liquid viscous mass.
---
**Question 5**
A 45-year-old woman with breast cancer is undergoing chemotherapy. She notices
significant hair loss. This is due to chemotherapy affecting rapidly dividing cells in hair
follicles, leading to:
