HERZING UNIVERSITY NSG 120 PATHOPHYSIOLOGY EXAM 1: QUESTIONS & CORRECT ANSWERS

HERZING UNIVERSITY NSG 120 PATHOPHYSIOLOGY
EXAM 1: QUESTIONS & CORRECT ANSWERS




Section I: Cellular Adaptation & Injury (Questions 1–20)

1. A patient with chronic anemia develops enlarged heart muscle fibers. This is
an example of:

 A) Hyperplasia

 B) Hypertrophy

 C) Atrophy

 D) Metaplasia

Answer: B) Hypertrophy
Rationale: Hypertrophy is an increase in cell size, leading to organ enlargement
(e.g., heart in anemia due to increased workload). Hyperplasia = increased cell
number; atrophy = decreased size; metaplasia = one cell type replaces another.

2. Barrett esophagus, where esophageal squamous cells change to columnar
cells, is an example of:

 A) Dysplasia

 B) Hyperplasia

 C) Metaplasia

 D) Neoplasia

, Answer: C) Metaplasia
Rationale: Metaplasia is reversible replacement of one differentiated cell type by
another, often due to chronic irritation (e.g., GERD).

3. Which cellular change is considered a precursor to cancer?

 A) Physiologic hyperplasia

 B) Compensatory hypertrophy

 C) Dysplasia

 D) Atrophy

Answer: C) Dysplasia
Rationale: Dysplasia = disordered cell growth, shape, and size. Severe dysplasia is
often pre-neoplastic.

4. Irreversible cell injury is characterized by:

 A) Loss of ATP production

 B) Plasma membrane rupture

 C) Cellular swelling

 D) Increased protein synthesis

Answer: B) Plasma membrane rupture
Rationale: Loss of membrane integrity is a hallmark of irreversible injury. ATP loss,
swelling occur earlier but may be reversible.

5. Ischemic cell death in the brain is most often due to:

 A) Apoptosis

 B) Necrosis – liquefactive

 C) Necrosis – coagulative

,  D) Caseous necrosis

Answer: B) Necrosis – liquefactive
Rationale: Brain ischemia leads to liquefactive necrosis due to enzymatic
breakdown of neural tissue. Coagulative necrosis is typical in heart/kidney.

6. A patient with tuberculosis has lung lesions with cheese-like appearance. This
is:

 A) Fat necrosis

 B) Gangrenous necrosis

 C) Caseous necrosis

 D) Fibrinoid necrosis

Answer: C) Caseous necrosis
Rationale: Caseous necrosis (e.g., TB) combines coagulative and liquefactive
necrosis with a friable, cheese-like appearance.

7. Reperfusion injury occurs due to:

 A) Restoration of blood flow after ischemia

 B) Prolonged hypoxia without reflow

 C) Reduced oxygen demand

 D) Increased glycolysis

Answer: A) Restoration of blood flow after ischemia
Rationale: Reperfusion injury involves oxidative stress from free radicals and
inflammation upon reoxygenation.

8. Which is an example of physiologic apoptosis?

 A) Liver cirrhosis

 B) Menstrual shedding of endometrium

,  C) Myocardial infarction

 D) Skin burn

Answer: B) Menstrual shedding of endometrium
Rationale: Apoptosis is programmed cell death. Menstruation involves hormone-
driven apoptosis; others are necrosis.

9. Coagulative necrosis is most characteristic of:

 A) Brain infarction

 B) Myocardial infarction

 C) Acute pancreatitis

 D) Tuberculosis

Answer: B) Myocardial infarction
Rationale: Coagulative necrosis preserves tissue architecture for days (e.g., heart,
kidney). Pancreatitis = fat necrosis.

10. Hypoxia most directly impairs:

 A) DNA synthesis

 B) Aerobic ATP production

 C) Ribosome function

 D) Cell membrane lipids

Answer: B) Aerobic ATP production
Rationale: Hypoxia reduces oxidative phosphorylation, shifting to less efficient
anaerobic glycolysis.

11. Cellular swelling (hydropic change) is due to:

 A) Failure of Na+/K+ ATPase