ACTUAL 2026/2027 WILKES EXAM 1 AND STUDY GUIDE CELLULAR
BIOLOGY , GENETICS & INFLAMMATION ACCURATE EXAM REAL
QUESTIONS AND CORRECT VERIFIED ANSWERS WITH DETAILED
RATIONALES (A NEW UPDATED VERSION 2026 EDITION)
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Question 1
A patient with chronic hypertension demonstrates left ventricular hypertrophy on
echocardiogram. Which cellular adaptation BEST explains this finding?
A) Hyperplasia
B) Metaplasia
C) Hypertrophy
D) Dysplasia
Correct Answer: C) Hypertrophy
Rationale: Hypertrophy is an increase in cell size in response to increased
workload or stress. In chronic hypertension, the left ventricle pumps against
increased afterload, causing myocardial cells to enlarge. This initially compensates
but eventually leads to decreased compliance if workload persists. Hyperplasia (A)
is an increase in cell number. Metaplasia (B) is replacement of one differentiated
cell type with another. Dysplasia (D) is abnormal cell growth with loss of
differentiation, often precancerous .
Question 2
A cell is exposed to a toxin that damages mitochondrial DNA. Which cellular
function will be most immediately impaired?
,A) Protein synthesis
B) ATP production
C) Lipid synthesis
D) DNA replication
Correct Answer: B) ATP production
Rationale: Mitochondria are the primary site of oxidative phosphorylation and
ATP production. Damage to mitochondrial DNA impairs the electron transport
chain, reducing ATP synthesis. Cells with high energy demands (neurons, cardiac
muscle) are most vulnerable. Protein synthesis occurs at ribosomes (A), lipid
synthesis in the smooth endoplasmic reticulum (C), and DNA replication in the
nucleus (D) .
Question 3
Which cellular change is considered a reversible response to injury?
A) Necrosis
B) Apoptosis
C) Cellular swelling
D) Karyolysis
Correct Answer: C) Cellular swelling
Rationale: Cellular swelling (hydropic change) is the earliest and most reversible
manifestation of cell injury. It results from failure of the Na+/K+ ATPase pump,
causing intracellular sodium and water accumulation. Necrosis (A) and karyolysis
,(D) are irreversible changes. Apoptosis (B) is programmed cell death, which is
generally irreversible .
Question 4
Which of the following is characteristic of irreversible cell injury?
A) Cellular swelling
B) Decreased ATP production
C) Mitochondrial dysfunction with amorphous densities and membrane damage
D) Detachment of ribosomes from endoplasmic reticulum
Correct Answer: C) Mitochondrial dysfunction with amorphous densities and
membrane damage
Rationale: Irreversible cell injury is marked by severe mitochondrial damage
(vacuolization, amorphous densities), profound membrane damage (plasma,
lysosomal, organellar), and nuclear changes (pyknosis, karyorrhexis, karyolysis).
Cellular swelling and decreased ATP are reversible changes that occur early in
injury .
Question 5
A patient with chronic GERD develops intestinal-type epithelium in the distal
esophagus. This is an example of:
A) Hypertrophy
B) Hyperplasia
C) Metaplasia
D) Dysplasia
, Correct Answer: C) Metaplasia
Rationale: Barrett's esophagus is a classic example of metaplasia—a reversible
change where one adult cell type (squamous epithelium) is replaced by another
(intestinal columnar epithelium) in response to chronic irritation from gastric acid.
It is a precursor to dysplasia and adenocarcinoma .
Question 6
Which gene mutation would most likely lead to uncontrolled cell proliferation?
A) Mutation in a tumor suppressor gene causing loss of function
B) Mutation in a structural protein gene
C) Mutation in a mitochondrial gene
D) Mutation in a hemoglobin gene
Correct Answer: A) Mutation in a tumor suppressor gene causing loss of
function
Rationale: Tumor suppressor genes (e.g., p53, RB, BRCA1/2) normally inhibit cell
division or promote apoptosis. Loss-of-function mutations remove these brakes on
cell proliferation. Oncogenes are the "accelerators"—gain-of-function mutations in
proto-oncogenes drive proliferation .
Question 7
A child is born with an autosomal recessive disorder. Which statement about the
parents is correct?