WITH RATIONALES MIDTERM QUESTIONS AND CORRECT ANSWERS
Question 1
Which cellular adaptation is characterized by a decrease in cell size and number, often due to
disuse or decreased workload?
A) Hyperplasia
B) Metaplasia
C) Atrophy
D) Dysplasia
E) Hypertrophy
Correct Answer: C) Atrophy
Rationale: Atrophy is a decrease in cell size and/or number, leading to reduced organ size,
often caused by decreased workload, denervation, ischemia, or malnutrition.
Question 2
A 60-year-old chronic smoker develops columnar epithelial cells in his bronchi, replacing the
normal ciliated pseudostratified columnar epithelium. This reversible change is termed:
A) Hyperplasia
B) Metaplasia
C) Dysplasia
D) Anaplasia
E) Neoplasia
Correct Answer: B) Metaplasia
Rationale: Metaplasia is a reversible process where one differentiated cell type is replaced by
another differentiated cell type, commonly seen in the respiratory tract of smokers adapting to
chronic irritation.
Question 3
Which of the following is the most common and fundamental cause of cellular injury?
A) Exposure to chemical toxins
B) Physical trauma
C) Hypoxia
D) Viral infections
E) Nutritional deficiencies
Correct Answer: C) Hypoxia
Rationale: Hypoxia, a reduction in oxygen supply to tissues, is the most common cause of cell
injury because it directly impairs aerobic respiration and ATP production, leading to widespread
cellular dysfunction.
,Question 4
Which type of cellular necrosis is characterized by protein denaturation, preserving the cellular
architectural outline for a period, typically seen in myocardial infarction?
A) Liquefactive
B) Caseous
C) Fat
D) Fibrinoid
E) Coagulative
Correct Answer: E) Coagulative
Rationale: Coagulative necrosis occurs due to ischemia or hypoxia, causing protein
denaturation and enzyme inactivation, which preserves the cell outline for days before
complete degradation.
Question 5
A client with acute inflammation exhibits local signs of redness, heat, swelling, pain, and loss of
function. Which chemical mediator is primarily responsible for the redness (rubor) and heat
(calor)?
A) Leukotrienes
B) Prostaglandins
C) Histamine
D) Bradykinin
E) Complement proteins
Correct Answer: C) Histamine
Rationale: Histamine, released by mast cells, causes vasodilation and increased blood flow,
leading to the redness (rubor) and heat (calor) characteristic of inflammation.
Question 6
Which genetic disorder is characterized by a trinucleotide repeat expansion (CAG) and
manifests as progressive neurodegeneration with chorea and cognitive decline, typically
inherited in an autosomal dominant pattern?
A) Cystic Fibrosis
B) Fragile X Syndrome
C) Huntington's Disease
D) Phenylketonuria
E) Tay-Sachs Disease
Correct Answer: C) Huntington's Disease
,Rationale: Huntington's Disease is an autosomal dominant neurodegenerative disorder caused
by an expanded CAG trinucleotide repeat in the huntingtin gene.
Question 7
A client with an arterial blood gas (ABG) of pH 7.30, PaCO2 50 mmHg, HCO3- 24 mEq/L
indicates:
A) Metabolic acidosis, uncompensated
B) Respiratory acidosis, uncompensated
C) Metabolic alkalosis, uncompensated
D) Respiratory alkalosis, uncompensated
E) Respiratory acidosis, partially compensated
Correct Answer: B) Respiratory acidosis, uncompensated
Rationale: The pH is acidic, the PaCO2 is high (indicating a primary respiratory problem), and
the HCO3- is within normal limits, signifying uncompensated respiratory acidosis.
Question 8
Which fluid compartment holds approximately two-thirds of the body's total water?
A) Intravascular fluid
B) Interstitial fluid
C) Intracellular fluid
D) Transcellular fluid
E) Extracellular fluid
Correct Answer: C) Intracellular fluid
Rationale: Intracellular fluid (ICF) accounts for about two-thirds of the total body water,
located within the cells.
Question 9
A client with severe burns is experiencing "third spacing." This refers to fluid accumulation in
which space?
A) Intracellular compartment
B) Intravascular compartment
C) Functionally unavailable interstitial space
D) Cerebrospinal fluid
E) Lymphatic system
Correct Answer: C) Functionally unavailable interstitial space
, Rationale: Third-spacing is the accumulation of fluid in areas that are not easily exchanged
with the intravascular or intracellular compartments, such as the peritoneal cavity (ascites) or in
burned tissue, leading to an effective circulating volume deficit.
Question 10
Which electrolyte plays a critical role in maintaining resting membrane potential, nerve impulse
transmission, and muscle contraction, and is the major intracellular cation?
A) Sodium
B) Calcium
C) Potassium
D) Magnesium
E) Chloride
Correct Answer: C) Potassium
Rationale: Potassium is the predominant intracellular cation and is essential for maintaining the
cell's resting membrane potential, crucial for nerve and muscle excitability.
Question 11
A client presents with a pH of 7.50, PaCO2 of 30 mmHg, HCO3- of 25 mEq/L. This ABG
indicates:
A) Metabolic acidosis
B) Respiratory alkalosis
C) Metabolic alkalosis
D) Respiratory acidosis
E) Mixed acid-base disorder
Correct Answer: B) Respiratory alkalosis
Rationale: The pH is alkaline, the PaCO2 is low (indicating a primary respiratory problem),
and the HCO3- is within normal limits, consistent with uncompensated respiratory alkalosis.
Question 12
Which type of hypersensitivity reaction is mediated by IgE antibodies and involves mast cell
degranulation, leading to rapid onset of symptoms like hives, angioedema, and bronchospasm?
A) Type I (Immediate)
B) Type II (Cytotoxic)
C) Type III (Immune Complex)
D) Type IV (Delayed)
E) Type V (Stimulating)
Correct Answer: A) Type I (Immediate)