NU 606 Advanced
Pathophysiology ActualFinal Exam
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Questions and Verified Answers |
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Cellular Adaptation, Injury & Death (Advanced Concepts) – 10 questions
Q1: A bodybuilder engages in intensive weightlifting, resulting in an increase in the size
of his skeletal muscle fibers. Which cellular signaling pathway is primarily responsible
for this physiological hypertrophy?
A. The ubiquitin-proteasome pathway.
B. The mTOR (mammalian target of rapamycin) pathway.
C. The caspase-dependent extrinsic pathway.
D. The hypoxia-inducible factor (HIF) pathway.
Correct Answer: B
Rationale: The best answer is the mTOR pathway because it integrates signals from
growth factors, nutrients, and energy status to stimulate protein synthesis and inhibit
autophagy, leading to an increase in cell size (hypertrophy). The ubiquitin-proteasome
pathway is associated with atrophy, while HIF is activated in hypoxia.
Q2: A patient with a broken leg is immobilized in a cast for several weeks. The resulting
decrease in muscle mass in the affected leg is best described by which cellular
process?
A. Dysplasia.
B. Hyperplasia.
C. Atrophy via the ubiquitin-proteasome pathway.
D. Metaplasia.
Correct Answer: C
Rationale: This choice is correct because disuse atrophy involves the degradation of
structural proteins; this is primarily mediated by the ubiquitin-proteasome system, which
tags damaged or unneeded proteins for destruction by the proteasome. Dysplasia refers
,to disordered cellular growth, hyperplasia is an increase in cell number, and metaplasia
is a change in cell type.
Q3: During a myocardial infarction, cardiac myocytes undergo ischemic injury. Which
sequence of events occurs at the cellular level immediately following the onset of
hypoxia?
A. Mitochondrial swelling, followed by ATP depletion, and finally failure of the
sodium-potassium pump.
B. ATP depletion, leading to failure of the sodium-potassium pump, causing cellular
swelling and mitochondrial injury.
C. Anaerobic glycolysis cessation, leading to lactic acidosis and cellular necrosis.
D. Influx of calcium, activating endonucleases before ATP stores are exhausted.
Correct Answer: B
Rationale: This aligns with the pathophysiology of hypoxic injury because the lack of
oxygen forces the cell to switch to anaerobic metabolism, quickly depleting ATP. Without
ATP, the Na/K ATPase pump fails, allowing sodium and water to enter the cell (swelling)
and calcium to influx, ultimately leading to mitochondrial damage and membrane
rupture.
Q4: A pathologist examines a brain biopsy from a patient who suffered a stroke. The
tissue shows soft, liquefied necrosis with cystic spaces. This morphological pattern of
necrosis is most characteristic of which organ or etiology?
A. Myocardial infarction (coagulative necrosis).
B. Tuberculosis infection (caseous necrosis).
C. Acute pancreatitis (fat necrosis).
D. The central nervous system (liquefactive necrosis).
Correct Answer: D
Rationale: The best answer is the central nervous system because brain tissue is rich in
lysosomal enzymes and lipids; when ischemia occurs, the autolysis of cells leads to
liquefactive necrosis, creating a soft, liquid-filled space. Coagulative necrosis is typical
of the heart and kidney, caseous for TB, and fat necrosis for the pancreas.
Q5: A patient with diabetes mellitus develops a non-healing ulcer on the foot. A biopsy
of the wound edge shows tissue that is dry, shriveled, and dark black. This type of
necrosis is best described as:
A. Coagulative necrosis.
B. Liquefactive necrosis.
C. Caseous necrosis.
D. Dry gangrene.
Correct Answer: D
, Rationale: This choice is correct because dry gangrene typically occurs in the
extremities due to chronic ischemia (often from diabetes or atherosclerosis); the tissue
becomes desiccated and mummified due to slow coagulative necrosis with little
bacterial invasion. Liquefactive involves liquefaction, caseous has a "cheese-like"
appearance, and standard coagulative necrosis implies a solid organ infarct without the
mummification seen in gangrene.
Q6: A 45-year-old woman presents with fatigue and spontaneous bruising. Lab work
reveals pancytopenia, and a bone marrow biopsy shows hypocellularity. The physician
explains that her hematopoietic stem cells are undergoing excessive programmed cell
death. This process is primarily driven by:
A. The extrinsic pathway involving death receptors like Fas.
B. The intrinsic pathway involving mitochondrial cytochrome c release.
C. The release of histones from neutrophils.
D. Pyroptosis mediated by caspase-1.
Correct Answer: B
Rationale: This aligns with the pathophysiology of aplastic anemia where internal
cellular stress, such as DNA damage or oxidative stress, triggers the intrinsic
(mitochondrial) pathway of apoptosis. While the extrinsic pathway can occur, aplastic
anemia is often driven by an intrinsic loss of self-tolerance or direct stem cell damage
leading to mitochondrial permeabilization.
Q7: A researcher is studying the effects of reactive oxygen species (ROS) on
endothelial cells. What is the primary mechanism by which ROS cause cellular injury?
A. Inhibition of the Na/K pump.
B. Lipid peroxidation of the cell membrane.
C. Activation of the mTOR pathway.
D. Upregulation of telomerase.
Correct Answer: B
Rationale: This choice is correct because free radicals (ROS) are highly unstable and
react with polyunsaturated fatty acids in the cell membrane, stealing electrons and
causing lipid peroxidation. This chain reaction damages the membrane structure and
integrity, leading to cell lysis or dysfunction.
Q8: In the context of cellular adaptation, which scenario describes metaplasia?
A. The thickening of the bladder wall due to urinary obstruction.
B. The change of ciliated columnar epithelium to stratified squamous epithelium in a
smoker's trachea.
C. The enlargement of the left ventricle due to hypertension.
D. The formation of dysplastic cells in the cervix.
Correct Answer: B
Pathophysiology ActualFinal Exam
Review - Regis College | Complete
Questions and Verified Answers |
Pass Guaranteed - A+ Graded
Cellular Adaptation, Injury & Death (Advanced Concepts) – 10 questions
Q1: A bodybuilder engages in intensive weightlifting, resulting in an increase in the size
of his skeletal muscle fibers. Which cellular signaling pathway is primarily responsible
for this physiological hypertrophy?
A. The ubiquitin-proteasome pathway.
B. The mTOR (mammalian target of rapamycin) pathway.
C. The caspase-dependent extrinsic pathway.
D. The hypoxia-inducible factor (HIF) pathway.
Correct Answer: B
Rationale: The best answer is the mTOR pathway because it integrates signals from
growth factors, nutrients, and energy status to stimulate protein synthesis and inhibit
autophagy, leading to an increase in cell size (hypertrophy). The ubiquitin-proteasome
pathway is associated with atrophy, while HIF is activated in hypoxia.
Q2: A patient with a broken leg is immobilized in a cast for several weeks. The resulting
decrease in muscle mass in the affected leg is best described by which cellular
process?
A. Dysplasia.
B. Hyperplasia.
C. Atrophy via the ubiquitin-proteasome pathway.
D. Metaplasia.
Correct Answer: C
Rationale: This choice is correct because disuse atrophy involves the degradation of
structural proteins; this is primarily mediated by the ubiquitin-proteasome system, which
tags damaged or unneeded proteins for destruction by the proteasome. Dysplasia refers
,to disordered cellular growth, hyperplasia is an increase in cell number, and metaplasia
is a change in cell type.
Q3: During a myocardial infarction, cardiac myocytes undergo ischemic injury. Which
sequence of events occurs at the cellular level immediately following the onset of
hypoxia?
A. Mitochondrial swelling, followed by ATP depletion, and finally failure of the
sodium-potassium pump.
B. ATP depletion, leading to failure of the sodium-potassium pump, causing cellular
swelling and mitochondrial injury.
C. Anaerobic glycolysis cessation, leading to lactic acidosis and cellular necrosis.
D. Influx of calcium, activating endonucleases before ATP stores are exhausted.
Correct Answer: B
Rationale: This aligns with the pathophysiology of hypoxic injury because the lack of
oxygen forces the cell to switch to anaerobic metabolism, quickly depleting ATP. Without
ATP, the Na/K ATPase pump fails, allowing sodium and water to enter the cell (swelling)
and calcium to influx, ultimately leading to mitochondrial damage and membrane
rupture.
Q4: A pathologist examines a brain biopsy from a patient who suffered a stroke. The
tissue shows soft, liquefied necrosis with cystic spaces. This morphological pattern of
necrosis is most characteristic of which organ or etiology?
A. Myocardial infarction (coagulative necrosis).
B. Tuberculosis infection (caseous necrosis).
C. Acute pancreatitis (fat necrosis).
D. The central nervous system (liquefactive necrosis).
Correct Answer: D
Rationale: The best answer is the central nervous system because brain tissue is rich in
lysosomal enzymes and lipids; when ischemia occurs, the autolysis of cells leads to
liquefactive necrosis, creating a soft, liquid-filled space. Coagulative necrosis is typical
of the heart and kidney, caseous for TB, and fat necrosis for the pancreas.
Q5: A patient with diabetes mellitus develops a non-healing ulcer on the foot. A biopsy
of the wound edge shows tissue that is dry, shriveled, and dark black. This type of
necrosis is best described as:
A. Coagulative necrosis.
B. Liquefactive necrosis.
C. Caseous necrosis.
D. Dry gangrene.
Correct Answer: D
, Rationale: This choice is correct because dry gangrene typically occurs in the
extremities due to chronic ischemia (often from diabetes or atherosclerosis); the tissue
becomes desiccated and mummified due to slow coagulative necrosis with little
bacterial invasion. Liquefactive involves liquefaction, caseous has a "cheese-like"
appearance, and standard coagulative necrosis implies a solid organ infarct without the
mummification seen in gangrene.
Q6: A 45-year-old woman presents with fatigue and spontaneous bruising. Lab work
reveals pancytopenia, and a bone marrow biopsy shows hypocellularity. The physician
explains that her hematopoietic stem cells are undergoing excessive programmed cell
death. This process is primarily driven by:
A. The extrinsic pathway involving death receptors like Fas.
B. The intrinsic pathway involving mitochondrial cytochrome c release.
C. The release of histones from neutrophils.
D. Pyroptosis mediated by caspase-1.
Correct Answer: B
Rationale: This aligns with the pathophysiology of aplastic anemia where internal
cellular stress, such as DNA damage or oxidative stress, triggers the intrinsic
(mitochondrial) pathway of apoptosis. While the extrinsic pathway can occur, aplastic
anemia is often driven by an intrinsic loss of self-tolerance or direct stem cell damage
leading to mitochondrial permeabilization.
Q7: A researcher is studying the effects of reactive oxygen species (ROS) on
endothelial cells. What is the primary mechanism by which ROS cause cellular injury?
A. Inhibition of the Na/K pump.
B. Lipid peroxidation of the cell membrane.
C. Activation of the mTOR pathway.
D. Upregulation of telomerase.
Correct Answer: B
Rationale: This choice is correct because free radicals (ROS) are highly unstable and
react with polyunsaturated fatty acids in the cell membrane, stealing electrons and
causing lipid peroxidation. This chain reaction damages the membrane structure and
integrity, leading to cell lysis or dysfunction.
Q8: In the context of cellular adaptation, which scenario describes metaplasia?
A. The thickening of the bladder wall due to urinary obstruction.
B. The change of ciliated columnar epithelium to stratified squamous epithelium in a
smoker's trachea.
C. The enlargement of the left ventricle due to hypertension.
D. The formation of dysplastic cells in the cervix.
Correct Answer: B
