NR507 | NR507 Advanced Pathophysiology
Midterm v1 | Questions with Correct Answers and
Expert Explanation for Each Question |
Chamberlain
1. A 55-year-old male with a long history of smoking presents with a change in the cellular
structure of his bronchial lining from ciliated columnar epithelium to stratified squamous
epithelium. Which term best describes this process?
A. Atrophy
B. Metaplasia
C. Hypertrophy
D. Dysplasia
Correct Answer: B
Expert Explanation: Metaplasia is the reversible replacement of one mature cell type by
another mature cell type. In this case, the bronchial lining adapts to the irritation of smoke
by changing into a more rugged squamous cell. This process is a protective mechanism but
can lead to a loss of specialized functions like mucus secretion.
2. Which cellular adaptation is characterized by an increase in the size of cells and
consequently the size of the organ?
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Atrophy
Correct Answer: B
Expert Explanation: Hypertrophy involves an increase in the size of cells, not the number
of cells. This typically occurs in response to increased mechanical load or stress, such as in
the heart during chronic hypertension. Unlike hyperplasia, hypertrophy does not involve
new cell formation but rather the synthesis of more structural proteins.
3. A patient’s biopsy shows cells that vary in size and shape with large nuclei and an increased
rate of mitosis. This is referred to as:
A. Metaplasia
B. Atrophy
C. Anaplasia
,D. Dysplasia
Correct Answer: D
Expert Explanation: Dysplasia refers to abnormal changes in the size, shape, and
organization of mature cells. It is often considered a precursor to cancer, although it does
not always progress to malignancy. Pathologists look for these disorganized growth
patterns to grade the severity of potential precancerous lesions.
4. What is the most common cause of cellular injury?
A. Hypoxia
B. Chemical agents
C. Free radicals
D. Genetic factors
Correct Answer: A
Expert Explanation: Hypoxia, or a lack of sufficient oxygen, is the single most common
cause of cellular injury. It results from a decrease in oxygen in the air, loss of hemoglobin,
or decreased blood flow (ischemia). Without oxygen, the cell cannot produce adequate
ATP, leading to failure of vital metabolic processes.
5. During hypoxic injury, why does the cell swell?
A. Failure of the sodium-potassium pump
B. Increase in ATP production
C. Increased protein synthesis
D. Efflux of water out of the cell
Correct Answer: A
Expert Explanation: When ATP levels drop due to hypoxia, the Na+/K+ ATPase pump
fails. This leads to an accumulation of sodium inside the cell, which creates an osmotic
gradient that pulls water into the cytoplasm. This process is known as cellular swelling or
oncosis and is one of the earliest signs of cell injury.
6. Which type of necrosis is typically seen in the brain following hypoxic injury?
A. Coagulative necrosis
B. Fat necrosis
C. Caseous necrosis
D. Liquefactive necrosis
Correct Answer: D
, Expert Explanation: Liquefactive necrosis is common in the brain because brain cells are
rich in digestive hydrolytic enzymes and lipids. As the cells die, these enzymes liquefy the
tissue, creating a soft, liquid-filled cyst. This differs from coagulative necrosis, which is
more common in the heart or kidneys.
7. Apoptosis is best defined as:
A. Programmed cell death or ‘cellular suicide’
B. Accidental cell death due to injury
C. Cell death followed by an inflammatory response
D. Death of cells in a large geographic area
Correct Answer: A
Expert Explanation: Apoptosis is a highly regulated, programmed process of cellular self-
destruction. It allows the body to eliminate old, damaged, or unnecessary cells without
triggering a significant inflammatory response. This is distinct from necrosis, which is
always pathological and involves cell swelling and lysis.
8. What is the primary mechanism of Down Syndrome?
A. Monosomy of chromosome 21
B. Nondisjunction during meiosis
C. Translocation of chromosome 14
D. Deletion of the short arm of chromosome 5
Correct Answer: B
Expert Explanation: Down Syndrome, or Trisomy 21, is most commonly caused by
chromosomal nondisjunction during the formation of reproductive cells. This results in an
individual having three copies of chromosome 21 instead of the usual two. The risk of this
occurring increases significantly with maternal age.
9. A person who is a carrier for an autosomal recessive disorder:
A. Does not have the disease but can pass the gene to offspring
B. Has the disease and shows symptoms
C. Will pass the disease to all their children
D. Has two copies of the abnormal gene
Correct Answer: A
Expert Explanation: Carriers of autosomal recessive disorders have one normal allele and
one mutated allele (heterozygous). They do not manifest the clinical signs of the disease
Midterm v1 | Questions with Correct Answers and
Expert Explanation for Each Question |
Chamberlain
1. A 55-year-old male with a long history of smoking presents with a change in the cellular
structure of his bronchial lining from ciliated columnar epithelium to stratified squamous
epithelium. Which term best describes this process?
A. Atrophy
B. Metaplasia
C. Hypertrophy
D. Dysplasia
Correct Answer: B
Expert Explanation: Metaplasia is the reversible replacement of one mature cell type by
another mature cell type. In this case, the bronchial lining adapts to the irritation of smoke
by changing into a more rugged squamous cell. This process is a protective mechanism but
can lead to a loss of specialized functions like mucus secretion.
2. Which cellular adaptation is characterized by an increase in the size of cells and
consequently the size of the organ?
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Atrophy
Correct Answer: B
Expert Explanation: Hypertrophy involves an increase in the size of cells, not the number
of cells. This typically occurs in response to increased mechanical load or stress, such as in
the heart during chronic hypertension. Unlike hyperplasia, hypertrophy does not involve
new cell formation but rather the synthesis of more structural proteins.
3. A patient’s biopsy shows cells that vary in size and shape with large nuclei and an increased
rate of mitosis. This is referred to as:
A. Metaplasia
B. Atrophy
C. Anaplasia
,D. Dysplasia
Correct Answer: D
Expert Explanation: Dysplasia refers to abnormal changes in the size, shape, and
organization of mature cells. It is often considered a precursor to cancer, although it does
not always progress to malignancy. Pathologists look for these disorganized growth
patterns to grade the severity of potential precancerous lesions.
4. What is the most common cause of cellular injury?
A. Hypoxia
B. Chemical agents
C. Free radicals
D. Genetic factors
Correct Answer: A
Expert Explanation: Hypoxia, or a lack of sufficient oxygen, is the single most common
cause of cellular injury. It results from a decrease in oxygen in the air, loss of hemoglobin,
or decreased blood flow (ischemia). Without oxygen, the cell cannot produce adequate
ATP, leading to failure of vital metabolic processes.
5. During hypoxic injury, why does the cell swell?
A. Failure of the sodium-potassium pump
B. Increase in ATP production
C. Increased protein synthesis
D. Efflux of water out of the cell
Correct Answer: A
Expert Explanation: When ATP levels drop due to hypoxia, the Na+/K+ ATPase pump
fails. This leads to an accumulation of sodium inside the cell, which creates an osmotic
gradient that pulls water into the cytoplasm. This process is known as cellular swelling or
oncosis and is one of the earliest signs of cell injury.
6. Which type of necrosis is typically seen in the brain following hypoxic injury?
A. Coagulative necrosis
B. Fat necrosis
C. Caseous necrosis
D. Liquefactive necrosis
Correct Answer: D
, Expert Explanation: Liquefactive necrosis is common in the brain because brain cells are
rich in digestive hydrolytic enzymes and lipids. As the cells die, these enzymes liquefy the
tissue, creating a soft, liquid-filled cyst. This differs from coagulative necrosis, which is
more common in the heart or kidneys.
7. Apoptosis is best defined as:
A. Programmed cell death or ‘cellular suicide’
B. Accidental cell death due to injury
C. Cell death followed by an inflammatory response
D. Death of cells in a large geographic area
Correct Answer: A
Expert Explanation: Apoptosis is a highly regulated, programmed process of cellular self-
destruction. It allows the body to eliminate old, damaged, or unnecessary cells without
triggering a significant inflammatory response. This is distinct from necrosis, which is
always pathological and involves cell swelling and lysis.
8. What is the primary mechanism of Down Syndrome?
A. Monosomy of chromosome 21
B. Nondisjunction during meiosis
C. Translocation of chromosome 14
D. Deletion of the short arm of chromosome 5
Correct Answer: B
Expert Explanation: Down Syndrome, or Trisomy 21, is most commonly caused by
chromosomal nondisjunction during the formation of reproductive cells. This results in an
individual having three copies of chromosome 21 instead of the usual two. The risk of this
occurring increases significantly with maternal age.
9. A person who is a carrier for an autosomal recessive disorder:
A. Does not have the disease but can pass the gene to offspring
B. Has the disease and shows symptoms
C. Will pass the disease to all their children
D. Has two copies of the abnormal gene
Correct Answer: A
Expert Explanation: Carriers of autosomal recessive disorders have one normal allele and
one mutated allele (heterozygous). They do not manifest the clinical signs of the disease
