NURS 5315 ADVANCED PATHOPHYSIOLOGY
EXAMS 1-5 Verified Questions with Answers and
Rationales | 2026/2027 Edition | UTA Updated
Question 1
A 58-year-old patient with long-standing hypertension presents with left
ventricular wall thickening on echocardiogram. This cellular adaptation is called:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Rationale: Hypertrophy is an increase in cell SIZE, leading to an increase in organ
size. It is caused by hormonal stimulation or increased functional demand. In
hypertension, the heart works harder to pump blood, causing pathologic
hypertrophy. Hyperplasia is an increase in cell NUMBER and can only occur in
cells capable of mitosis.
Question 2
A biopsy of a patient's breast tissue shows replacement of normal endothelial cells
with malignant cells. This is an example of:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Rationale: Metaplasia is the reversible replacement of one differentiated cell type
with another. In smokers, the normal ciliated columnar epithelium of the trachea is
replaced by stratified squamous epithelium in response to cigarette irritation. The
question describes malignant transformation which is neoplasia, but metaplasia is
the replacement of one cell type with another.
Question 3
,Which of the following are mechanisms of reversible cell injury? (Select all that
apply)
A) Decreased ATP production
B) Cellular swelling
C) Nuclear pyknosis
D) Fatty change in liver
E) Rupture of lysosomal membranes
Rationale: Decreased ATP production, cellular swelling (hydropic change), and
fatty change are reversible. Nuclear pyknosis (nuclear shrinkage) and rupture of
lysosomal membranes are signs of irreversible injury.
Question 4
A patient with chronic alcoholism presents with an enlarged, fatty liver. This is an
example of:
A) Hypertrophy
B) Hyperplasia
C) Fatty change (steatosis)
D) Metaplasia
Rationale: Fatty change (steatosis) is the accumulation of triglycerides in
parenchymal cells, commonly seen in the liver of chronic alcoholics. It is a
reversible form of cellular injury.
Question 5
Which of the following is a characteristic of irreversible cell injury?
A) Cellular swelling
B) Nuclear dissolution (karyolysis)
C) Fatty change
D) Decreased ATP production
Rationale: Nuclear dissolution (karyolysis) is a sign of irreversible cell injury.
Cellular swelling, fatty change, and decreased ATP production are reversible
changes.
,Question 6
The increase in the number of cells in an organ or tissue is called:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Rationale: Hyperplasia is an increase in cell NUMBER, leading to an increase in
organ size. It can only occur in cells capable of mitosis (e.g., epithelial cells,
hepatocytes).
Question 7
Which type of necrosis is most commonly associated with tuberculosis?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
Rationale: Caseous necrosis is characteristic of tuberculosis. It has a cheese-like
appearance and is a combination of coagulative and liquefactive necrosis.
Question 8
Programmed cell death characterized by cell shrinkage, chromatin condensation,
and formation of apoptotic bodies is called:
A) Necrosis
B) Apoptosis
C) Autophagy
D) Pyroptosis
Rationale: Apoptosis is programmed cell death that is genetically regulated and
does not trigger an inflammatory response. It is characterized by cell shrinkage,
chromatin condensation, and formation of apoptotic bodies.
, Question 9
Which of the following cellular changes is LEAST likely to be reversible?
A) Cellular swelling
B) Nuclear fragmentation
C) Fatty change
D) Loss of microvilli
Rationale: Nuclear fragmentation (karyorrhexis) is a sign of irreversible cell
injury. Cellular swelling, fatty change, and loss of microvilli can be reversible if
the injurious stimulus is removed.
Question 10
The shrinkage of cells due to loss of cell volume and decreased cell size is called:
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
Rationale: Atrophy is a decrease in cell SIZE, leading to a decrease in organ size.
It can be caused by decreased workload, loss of innervation, diminished blood
supply, inadequate nutrition, or loss of endocrine stimulation.
Question 11
A patient with benign prostatic hyperplasia has an increase in the number of
prostate cells. This is an example of:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Rationale: Benign prostatic hyperplasia involves an increase in the NUMBER of
prostate cells. This is a classic example of pathologic hyperplasia.
EXAMS 1-5 Verified Questions with Answers and
Rationales | 2026/2027 Edition | UTA Updated
Question 1
A 58-year-old patient with long-standing hypertension presents with left
ventricular wall thickening on echocardiogram. This cellular adaptation is called:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Rationale: Hypertrophy is an increase in cell SIZE, leading to an increase in organ
size. It is caused by hormonal stimulation or increased functional demand. In
hypertension, the heart works harder to pump blood, causing pathologic
hypertrophy. Hyperplasia is an increase in cell NUMBER and can only occur in
cells capable of mitosis.
Question 2
A biopsy of a patient's breast tissue shows replacement of normal endothelial cells
with malignant cells. This is an example of:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Rationale: Metaplasia is the reversible replacement of one differentiated cell type
with another. In smokers, the normal ciliated columnar epithelium of the trachea is
replaced by stratified squamous epithelium in response to cigarette irritation. The
question describes malignant transformation which is neoplasia, but metaplasia is
the replacement of one cell type with another.
Question 3
,Which of the following are mechanisms of reversible cell injury? (Select all that
apply)
A) Decreased ATP production
B) Cellular swelling
C) Nuclear pyknosis
D) Fatty change in liver
E) Rupture of lysosomal membranes
Rationale: Decreased ATP production, cellular swelling (hydropic change), and
fatty change are reversible. Nuclear pyknosis (nuclear shrinkage) and rupture of
lysosomal membranes are signs of irreversible injury.
Question 4
A patient with chronic alcoholism presents with an enlarged, fatty liver. This is an
example of:
A) Hypertrophy
B) Hyperplasia
C) Fatty change (steatosis)
D) Metaplasia
Rationale: Fatty change (steatosis) is the accumulation of triglycerides in
parenchymal cells, commonly seen in the liver of chronic alcoholics. It is a
reversible form of cellular injury.
Question 5
Which of the following is a characteristic of irreversible cell injury?
A) Cellular swelling
B) Nuclear dissolution (karyolysis)
C) Fatty change
D) Decreased ATP production
Rationale: Nuclear dissolution (karyolysis) is a sign of irreversible cell injury.
Cellular swelling, fatty change, and decreased ATP production are reversible
changes.
,Question 6
The increase in the number of cells in an organ or tissue is called:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Rationale: Hyperplasia is an increase in cell NUMBER, leading to an increase in
organ size. It can only occur in cells capable of mitosis (e.g., epithelial cells,
hepatocytes).
Question 7
Which type of necrosis is most commonly associated with tuberculosis?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
Rationale: Caseous necrosis is characteristic of tuberculosis. It has a cheese-like
appearance and is a combination of coagulative and liquefactive necrosis.
Question 8
Programmed cell death characterized by cell shrinkage, chromatin condensation,
and formation of apoptotic bodies is called:
A) Necrosis
B) Apoptosis
C) Autophagy
D) Pyroptosis
Rationale: Apoptosis is programmed cell death that is genetically regulated and
does not trigger an inflammatory response. It is characterized by cell shrinkage,
chromatin condensation, and formation of apoptotic bodies.
, Question 9
Which of the following cellular changes is LEAST likely to be reversible?
A) Cellular swelling
B) Nuclear fragmentation
C) Fatty change
D) Loss of microvilli
Rationale: Nuclear fragmentation (karyorrhexis) is a sign of irreversible cell
injury. Cellular swelling, fatty change, and loss of microvilli can be reversible if
the injurious stimulus is removed.
Question 10
The shrinkage of cells due to loss of cell volume and decreased cell size is called:
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
Rationale: Atrophy is a decrease in cell SIZE, leading to a decrease in organ size.
It can be caused by decreased workload, loss of innervation, diminished blood
supply, inadequate nutrition, or loss of endocrine stimulation.
Question 11
A patient with benign prostatic hyperplasia has an increase in the number of
prostate cells. This is an example of:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Rationale: Benign prostatic hyperplasia involves an increase in the NUMBER of
prostate cells. This is a classic example of pathologic hyperplasia.
