NSG530 / NSG 530 Exam 1 (Latest 2024 /
2026): Advanced Pathophysiology |
Questions and Verified Answers | 100%
Correct | Grade A - Wilkes
1. A 62-year-old patient with chronic hypertension develops left
ventricular hypertrophy. This cellular change is best described as:
A. Hyperplasia
B. Metaplasia
C. Hypertrophy
D. Dysplasia
Correct ,,,answer,,,,: C
Rationale: Hypertrophy is an increase in cell size due to increased
synthesis of structural proteins. In hypertension, increased afterload
causes myocardial hypertrophy. Hyperplasia is increased cell
number; metaplasia is change from one differentiated cell type to
another; dysplasia is disordered growth.
2. Which of the following is an example of pathologic hyperplasia?
A. Uterine enlargement during pregnancy
B. Breast tissue enlargement during lactation
C. Endometrial hyperplasia due to unopposed estrogen
D. Liver regeneration after partial hepatectomy
Correct ,,,answer,,,,: C
Rationale: Pathologic hyperplasia results from abnormal hormonal
stimulation or chronic irritation, such as endometrial hyperplasia
,from unopposed estrogen, which can progress to neoplasia. The
others are physiologic adaptations.
3. A patient with chronic gastroesophageal reflux disease (GERD)
has biopsy of the distal esophagus showing replacement of
squamous epithelium with columnar epithelium. This is termed:
A. Dysplasia
B. Anaplasia
C. Metaplasia
D. Neoplasia
Correct ,,,answer,,,,: C
Rationale: Metaplasia is the reversible substitution of one
differentiated cell type for another, often due to chronic irritation
(e.g., Barrett’s esophagus). Dysplasia is disordered growth;
anaplasia is loss of differentiation in malignancy.
4. During reversible cell injury, which intracellular event occurs
first?
A. Lysosomal rupture
B. Nuclear pyknosis
C. Cellular swelling due to Na+/K+ pump failure
D. Formation of apoptotic bodies
Correct ,,,answer,,,,: C
Rationale: ATP depletion leads to failure of the Na+/K+ ATPase
pump, causing sodium accumulation and water influx (cellular
swelling/hydropic change). This is reversible if oxygen is restored.
Lysosomal rupture and nuclear changes indicate irreversible injury.
5. Which type of necrosis is most characteristic of ischemic injury to
the brain?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis
,Correct ,,,answer,,,,: B
Rationale: Brain infarction results in liquefactive necrosis due to
release of digestive enzymes from microglia and neutrophils,
forming a cystic cavity. Coagulative necrosis occurs in solid organs
(heart, kidney, liver).
6. A patient with a myocardial infarction has cell death due to
prolonged ischemia. This type of necrosis is:
A. Coagulative
B. Liquefactive
C. Caseous
D. Gangrenous
Correct ,,,answer,,,,: A
Rationale: Coagulative necrosis is characteristic of hypoxic death in
all solid organs except the brain. Tissue architecture is preserved for
days. Dry gangrene is coagulative necrosis with superadded
infection.
7. Which of the following is a hallmark of apoptosis?
A. Inflammation of surrounding tissue
B. Cell swelling and lysis
C. Formation of apoptotic bodies with intact cell membranes
D. Random DNA fragmentation
Correct ,,,answer,,,,: C
Rationale: Apoptosis is programmed cell death characterized by cell
shrinkage, chromatin condensation, and formation of membrane-
bound apoptotic bodies that are phagocytosed without
inflammation. Necrosis causes inflammation.
8. A precancerous cervical biopsy shows disordered cellular growth,
loss of nuclear polarity, and variation in cell size and shape. This is
called:
A. Hyperplasia
B. Metaplasia
, C. Dysplasia
D. Anaplasia
Correct ,,,answer,,,,: C
Rationale: Dysplasia is disordered cell growth with loss of
uniformity and architectural orientation. It is often premalignant.
Anaplasia refers to the lack of differentiation in malignant tumors
(severe dysplasia).
9. Ischemia-reperfusion injury is primarily mediated by:
A. Prolonged ATP depletion
B. Restoration of oxygen leading to reactive oxygen species (ROS)
and calcium overload
C. Activation of apoptosis without necrosis
D. Loss of growth factor signaling
Correct ,,,answer,,,,: B
Rationale: Reperfusion after ischemia paradoxically causes
additional injury via generation of ROS, mitochondrial calcium
overload, and inflammatory response (complement, neutrophils).
This is why reperfusion strategies may cause reperfusion injury.
10. Which cellular change is associated with atrophy?
A. Increased cell number
B. Increased cell size
C. Decreased cell size with reduced protein synthesis
D. Replacement with another cell type
Correct ,,,answer,,,,: C
Rationale: Atrophy is a decrease in cell size due to reduced protein
synthesis and increased protein degradation. Causes include disuse,
denervation, ischemia, and hormonal loss.
11. A patient with chronic renal failure has a kidney biopsy showing
shrinkage of glomeruli and tubules. This is best described as:
A. Physiologic atrophy
2026): Advanced Pathophysiology |
Questions and Verified Answers | 100%
Correct | Grade A - Wilkes
1. A 62-year-old patient with chronic hypertension develops left
ventricular hypertrophy. This cellular change is best described as:
A. Hyperplasia
B. Metaplasia
C. Hypertrophy
D. Dysplasia
Correct ,,,answer,,,,: C
Rationale: Hypertrophy is an increase in cell size due to increased
synthesis of structural proteins. In hypertension, increased afterload
causes myocardial hypertrophy. Hyperplasia is increased cell
number; metaplasia is change from one differentiated cell type to
another; dysplasia is disordered growth.
2. Which of the following is an example of pathologic hyperplasia?
A. Uterine enlargement during pregnancy
B. Breast tissue enlargement during lactation
C. Endometrial hyperplasia due to unopposed estrogen
D. Liver regeneration after partial hepatectomy
Correct ,,,answer,,,,: C
Rationale: Pathologic hyperplasia results from abnormal hormonal
stimulation or chronic irritation, such as endometrial hyperplasia
,from unopposed estrogen, which can progress to neoplasia. The
others are physiologic adaptations.
3. A patient with chronic gastroesophageal reflux disease (GERD)
has biopsy of the distal esophagus showing replacement of
squamous epithelium with columnar epithelium. This is termed:
A. Dysplasia
B. Anaplasia
C. Metaplasia
D. Neoplasia
Correct ,,,answer,,,,: C
Rationale: Metaplasia is the reversible substitution of one
differentiated cell type for another, often due to chronic irritation
(e.g., Barrett’s esophagus). Dysplasia is disordered growth;
anaplasia is loss of differentiation in malignancy.
4. During reversible cell injury, which intracellular event occurs
first?
A. Lysosomal rupture
B. Nuclear pyknosis
C. Cellular swelling due to Na+/K+ pump failure
D. Formation of apoptotic bodies
Correct ,,,answer,,,,: C
Rationale: ATP depletion leads to failure of the Na+/K+ ATPase
pump, causing sodium accumulation and water influx (cellular
swelling/hydropic change). This is reversible if oxygen is restored.
Lysosomal rupture and nuclear changes indicate irreversible injury.
5. Which type of necrosis is most characteristic of ischemic injury to
the brain?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis
,Correct ,,,answer,,,,: B
Rationale: Brain infarction results in liquefactive necrosis due to
release of digestive enzymes from microglia and neutrophils,
forming a cystic cavity. Coagulative necrosis occurs in solid organs
(heart, kidney, liver).
6. A patient with a myocardial infarction has cell death due to
prolonged ischemia. This type of necrosis is:
A. Coagulative
B. Liquefactive
C. Caseous
D. Gangrenous
Correct ,,,answer,,,,: A
Rationale: Coagulative necrosis is characteristic of hypoxic death in
all solid organs except the brain. Tissue architecture is preserved for
days. Dry gangrene is coagulative necrosis with superadded
infection.
7. Which of the following is a hallmark of apoptosis?
A. Inflammation of surrounding tissue
B. Cell swelling and lysis
C. Formation of apoptotic bodies with intact cell membranes
D. Random DNA fragmentation
Correct ,,,answer,,,,: C
Rationale: Apoptosis is programmed cell death characterized by cell
shrinkage, chromatin condensation, and formation of membrane-
bound apoptotic bodies that are phagocytosed without
inflammation. Necrosis causes inflammation.
8. A precancerous cervical biopsy shows disordered cellular growth,
loss of nuclear polarity, and variation in cell size and shape. This is
called:
A. Hyperplasia
B. Metaplasia
, C. Dysplasia
D. Anaplasia
Correct ,,,answer,,,,: C
Rationale: Dysplasia is disordered cell growth with loss of
uniformity and architectural orientation. It is often premalignant.
Anaplasia refers to the lack of differentiation in malignant tumors
(severe dysplasia).
9. Ischemia-reperfusion injury is primarily mediated by:
A. Prolonged ATP depletion
B. Restoration of oxygen leading to reactive oxygen species (ROS)
and calcium overload
C. Activation of apoptosis without necrosis
D. Loss of growth factor signaling
Correct ,,,answer,,,,: B
Rationale: Reperfusion after ischemia paradoxically causes
additional injury via generation of ROS, mitochondrial calcium
overload, and inflammatory response (complement, neutrophils).
This is why reperfusion strategies may cause reperfusion injury.
10. Which cellular change is associated with atrophy?
A. Increased cell number
B. Increased cell size
C. Decreased cell size with reduced protein synthesis
D. Replacement with another cell type
Correct ,,,answer,,,,: C
Rationale: Atrophy is a decrease in cell size due to reduced protein
synthesis and increased protein degradation. Causes include disuse,
denervation, ischemia, and hormonal loss.
11. A patient with chronic renal failure has a kidney biopsy showing
shrinkage of glomeruli and tubules. This is best described as:
A. Physiologic atrophy
