NUR 546/NUR546 Exam 1 V2 | Advanced
Pathophysiology Q&A with Rationale |
William Paterson University
1. A patient who has had a cast on their left leg for six weeks notices the leg is significantly
smaller than the right leg upon removal. Which cellular adaptation has occurred?
A. Hypertrophy
B. Hyperplasia
C. Metaplasia
D. Atrophy
Correct Answer: D
Expert Explanation: Atrophy is a decrease in cellular size caused by aging, disuse, or
reduced blood supply. In this scenario, the lack of muscle use while the leg was in a cast led
to disuse atrophy of the skeletal muscle. This adaptation allows the cells to survive in a
state of decreased metabolic demand.
2. Which process is primarily responsible for the cellular swelling seen during hypoxic injury?
A. Excessive production of ATP
B. Increased protein synthesis
C. Activation of the complement system
D. Failure of the sodium-potassium pump
,Correct Answer: D
Expert Explanation: Hypoxia leads to a decrease in ATP production because the
mitochondria cannot perform oxidative phosphorylation. Without ATP, the sodium-
potassium pump fails, leading to an accumulation of sodium inside the cell. Water follows
sodium into the cell via osmosis, resulting in acute cellular swelling.
3. A 55-year-old male with a history of heavy smoking has a biopsy of his bronchial lining
showing a change from ciliated columnar epithelium to stratified squamous epithelium. This
is an example of:
A. Dysplasia
B. Metaplasia
C. Anaplasia
D. Neoplasia
Correct Answer: B
Expert Explanation: Metaplasia is the reversible replacement of one mature cell type by
another mature cell type. This typically occurs in response to chronic irritation, such as
cigarette smoke in the lungs. While the new cells are more resilient, they often lose critical
functions like cilia and mucus secretion.
4. Which type of necrosis is most commonly associated with hypoxic injury in the brain?
A. Coagulative necrosis
B. Caseous necrosis
, C. Liquefactive necrosis
D. Fat necrosis
Correct Answer: C
Expert Explanation: Liquefactive necrosis occurs in the brain because brain cells are rich
in digestive hydrolytic enzymes and lipids. As the cells die, these enzymes digest the tissue
into a soft, liquid mass. This process is distinct from coagulative necrosis, which is more
common in the heart and kidneys.
5. Programmed cell death that is a normal part of development and homeostasis is known as:
A. Necrosis
B. Apoptosis
C. Autophagy
D. Pyreptosis
Correct Answer: B
Expert Explanation: Apoptosis is an active process of cellular self-destruction, often
referred to as programmed cell death. It occurs in both normal and pathologic states to
remove redundant or damaged cells without triggering an inflammatory response. Unlike
necrosis, apoptosis involves cell shrinkage rather than swelling.
Pathophysiology Q&A with Rationale |
William Paterson University
1. A patient who has had a cast on their left leg for six weeks notices the leg is significantly
smaller than the right leg upon removal. Which cellular adaptation has occurred?
A. Hypertrophy
B. Hyperplasia
C. Metaplasia
D. Atrophy
Correct Answer: D
Expert Explanation: Atrophy is a decrease in cellular size caused by aging, disuse, or
reduced blood supply. In this scenario, the lack of muscle use while the leg was in a cast led
to disuse atrophy of the skeletal muscle. This adaptation allows the cells to survive in a
state of decreased metabolic demand.
2. Which process is primarily responsible for the cellular swelling seen during hypoxic injury?
A. Excessive production of ATP
B. Increased protein synthesis
C. Activation of the complement system
D. Failure of the sodium-potassium pump
,Correct Answer: D
Expert Explanation: Hypoxia leads to a decrease in ATP production because the
mitochondria cannot perform oxidative phosphorylation. Without ATP, the sodium-
potassium pump fails, leading to an accumulation of sodium inside the cell. Water follows
sodium into the cell via osmosis, resulting in acute cellular swelling.
3. A 55-year-old male with a history of heavy smoking has a biopsy of his bronchial lining
showing a change from ciliated columnar epithelium to stratified squamous epithelium. This
is an example of:
A. Dysplasia
B. Metaplasia
C. Anaplasia
D. Neoplasia
Correct Answer: B
Expert Explanation: Metaplasia is the reversible replacement of one mature cell type by
another mature cell type. This typically occurs in response to chronic irritation, such as
cigarette smoke in the lungs. While the new cells are more resilient, they often lose critical
functions like cilia and mucus secretion.
4. Which type of necrosis is most commonly associated with hypoxic injury in the brain?
A. Coagulative necrosis
B. Caseous necrosis
, C. Liquefactive necrosis
D. Fat necrosis
Correct Answer: C
Expert Explanation: Liquefactive necrosis occurs in the brain because brain cells are rich
in digestive hydrolytic enzymes and lipids. As the cells die, these enzymes digest the tissue
into a soft, liquid mass. This process is distinct from coagulative necrosis, which is more
common in the heart and kidneys.
5. Programmed cell death that is a normal part of development and homeostasis is known as:
A. Necrosis
B. Apoptosis
C. Autophagy
D. Pyreptosis
Correct Answer: B
Expert Explanation: Apoptosis is an active process of cellular self-destruction, often
referred to as programmed cell death. It occurs in both normal and pathologic states to
remove redundant or damaged cells without triggering an inflammatory response. Unlike
necrosis, apoptosis involves cell shrinkage rather than swelling.
