APEA PATHOPHYSIOLOGY ACTUAL
EXAM REVIEW 2026
180 Questions with Correct Answers &
Detailed Rationales
EXAM OVERVIEW
The APEA Pathophysiology Exam covers the following content areas:
Content Area Key Topics
Cellular Cell injury,
Pathophysiology adaptation,
inflammation,
neoplasia
Hematologic Anemias, clotting
System disorders, blood
dyscrasias
Cardiovascular Heart failure,
System hypertension,
coronary artery
disease, shock
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Respiratory System COPD, asthma,
pneumonia, pulmonary
embolism
Neurologic System Stroke, seizures, head
injury,
neurodegenerative
disorders
Gastrointestinal System Liver disease,
pancreatitis,
inflammatory bowel
disease
Renal System Acute kidney injury,
chronic kidney disease,
glomerular disorders
Endocrine System Diabetes, thyroid
disorders, adrenal
disorders
Musculoskeletal System Osteoporosis,
fractures, arthritis
Reproductive System STIs, pregnancy
complications,
reproductive cancers
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Immunologic System Autoimmune disorders,
immunodeficiencies,
hypersensitivity
Infectious Diseases Bacterial, viral,
fungal, parasitic
infections
SECTION 1: CELLULAR PATHOPHYSIOLOGY
(Questions 1-15)
Q1. A 68-year-old male with chronic heart failure presents with progressive
dyspnea and fatigue. A chest x-ray shows cardiomegaly. Which cellular
adaptation is most likely occurring in the cardiac myocytes?
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Dysplasia
Correct Answer: B
Rationale: Hypertrophy is an increase in cell size resulting in increased organ
size. Cardiac myocytes respond to increased workload (such as in
hypertension or valvular disease) by hypertrophy. This increases the cell's
ability to perform work. Hyperplasia (increased cell number) occurs in tissues
capable of mitosis (cardiac myocytes cannot divide). Metaplasia is
replacement of one cell type with another. Dysplasia is disordered cell
growth.
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Q2.-A-patient-with-chronic-gastroesophageal-reflux-disease-develops-Barrett-
esophagus.-This-is-an-example-of-which-cellular-adaptation?
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Dysplasia-
Correct-Answer:-C
Rationale:-Metaplasia-is-the-reversible-replacement-of-one-differentiated-cell-
type-with-another.-In-Barrett-esophagus,-the-normal-stratified-squamous-
epithelium-of-the-esophagus-is-replaced-by-intestinal-type-columnar-
epithelium-in-response-to-chronic-acid-exposure.-This-is-an-adaptive-response-
but-predisposes-to-adenocarcinoma.
Q3.-A-pathologist-notes-that-a-tissue-specimen-shows-cells-with-enlarged,-
hyperchromatic-nuclei-and-increased-mitotic-figures.-This-finding-is-most-
characteristic-of:
A) Atrophy
B) Hypertrophy
C) Dysplasia
D) Metaplasia-
Correct-Answer:-C
Rationale:-Dysplasia-is-characterized-by-disordered-cellular-growth-with-
atypical-changes-including-enlarged-nuclei-(nuclear-enlargement),-
hyperchromasia-(dark-staining),-and-increased-mitotic-figures.
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