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NURS 5315 Advanced
Pathophysiology UTA Exam 1
Questions and Answers
1. Atrophy is characterized by:
E) Cells decrease in size (Correct)
Explanation: Atrophy involves a reduction in cell size due
to decreased workload, blood supply, nutrition, hormonal, or nervous stimulation. It still retains some function, but the cell shrinks. Physiologic atrophy: Thymus gland in early childhood Pathologic atrophy: Disuse, immobilization, or chronic illness
2. Hyperplasia is defined as: E) Cells increase in number; mitosis occurs; cell size
does not change (Correct)
Explanation: Hyperplasia involves an increase in cell
number due to increased mitotic activity, often as a response to injury or hormonal stimulation. Examples: Liver regeneration after partial removal, uterine or mammary gland enlargement during pregnancy.
3. Dysplasia is characterized by: E) Disordered cell growth, abnormal change in size,
shape, and organization (Correct)
Explanation: Dysplasia is considered a pre-cancerous
change, often caused by cell injury or irritation, and involves atypical hyperplasia. It is not a normal adaptive process. Examples: Cervical squamous dysplasia from HPV, abnormal breast cell growth.
4. Metaplasia is: E) Reversible change where one cell type transforms
into another for survival (Correct)
Explanation: Metaplasia results from chronic stress or
irritation, reprogramming stem cells to produce different cell types, which can be a precursor to dysplasia or cancer. Examples: Columnar to squamous cells in the lungs of smokers; Barrett’s esophagus (squamous to columnar in response to reflux).
5. Hypoxia injury is characterized by:
E) Inadequate oxygenation of tissues (Correct)
Explanation: Hypoxia causes decreased mitochondrial
function, reduced ATP, and eventually cell death. It can result from ischemia or low oxygen supply.
Lipids accumulate intracellularly, often due to alcohol
or high-fat diet (Correct)
Explanation: The liver’s inability to metabolize lipids leads
to steatosis, which can progress to cirrhosis.
10. Dystrophic calcification is: Accumulation of calcium salts in dead or dying
tissues (Correct)
Explanation: It interferes with tissue function, seen in
injured heart valves, atherosclerosis, or chronic infections.
11. Metastatic calcification involves: Calcium deposits in normal tissues due to
hypercalcemia (Correct)
Explanation: Conditions like hyperparathyroidism or
vitamin D toxicity lead to calcium depositing in tissues like lungs, kidneys, and gastric mucosa.
12. Urate accumulation causes: Gout, characterized by sodium urate crystal deposits
in joints and tissues (Correct)
Explanation: Elevated serum uric acid leads to crystal
formation, causing inflammation and joint pain.
13. Coagulative necrosis is typically seen in: Kidneys, heart, adrenal glands (hypoxic
injury) (Correct)
Explanation: Characterized by preserved cell outlines with
loss of nuclei; common in ischemic injury.
14. Liquefactive necrosis occurs in:
Brain tissue, resulting in pus formation (Correct)
Explanation: Enzymatic digestion leads to tissue
liquefaction, typical in brain infarcts or abscesses.
15. Caseous necrosis is typically associated with: Tuberculosis in the lungs, where tissue appears
cheese-like (Correct)
Explanation: It involves granulomatous inflammation with
necrotic tissue resembling cheese.
16. Fat necrosis is common in: Breast, pancreas, and abdominal structures, creating
soap-like deposits (Correct)
Explanation: Lipid breakdown leads to saponification,
forming soap deposits.
17. Gangrenous necrosis can be:
22. Prostate-specific antigen (PSA) is associated with:
Prostate cancer (Correct)
Use: Screening and monitoring treatment response.
23. Carcino- refers to: Epithelial tissue origin, such as in renal cell
carcinoma (Correct)
Sarco- refers to: Connective tissue origin, such as in
chondrosarcoma (Correct)
24. Carcinoma in situ is: A pre-invasive malignant epithelial tumor, often in
the cervix (Correct)
Note: It has not invaded beyond the basement
membrane.
25. Common sites of metastasis include: Lung, liver, bone, brain, depending on tumor
type (Correct)
Examples: Lung cancer spreads to brain, liver, bones.
26. The TNM staging system evaluates: Tumor size (T), lymph node involvement (N), and
metastasis (M) (Correct)
27. The intravascular fluid compartment accounts for:
Approximately 20% of total body water (Correct)
28. Osmolality measures: Solute concentration in fluid, normal range 280-
mOsm/kg (Correct)
29. The interstitial fluid compartment surrounds cells and accounts for:
About 20% of total body water (Correct)
30. The intracellular fluid compartment makes up:
Approximately 40% of total body water (Correct)
31. Osmosis is: Passive movement of water from low to high solute
concentration (Correct)
32. Osmotic pressure is:
Released by the heart, oppose RAAS, promote Na
and water excretion (Correct)
38. Fluid volume deficit (dehydration) manifests as: Poor skin turgor, dry mucous membranes, sunken
eyes, decreased urine output, fatigue (Correct)
39. Fluid volume excess presents with: Edema, rales, hypertension, weight gain, bounding
pulses, JVD (Correct)
40. Edema is: Fluid accumulation in interstitial space, can be
localized or generalized (Correct)
41. Euvolemic hypernatremia is characterized by: Total body water loss with normal or slightly elevated
serum sodium (Correct); often from diabetes
insipidus.
42. Hypovolemic hypernatremia results from: Water loss via GI or diuretics with volume
depletion (Correct)
43. Hypervolemic hypernatremia occurs with:
Excess administration of hypertonic saline (Correct)
44. Mild hyponatremia (Na 125-135) presents with: Anorexia, apathy, restlessness, nausea, lethargy,
muscle cramps (Correct)
45. Moderate hyponatremia (Na 120-125) causes:
Confusion, agitation, headache (Correct)
46. Severe hyponatremia (<120) can lead to:
Seizures, coma, incontinence, death (Correct)
47. Isotonic hyponatremia (mOsm 280-295) is caused by: Elevated triglycerides or proteins, not true
hyponatremia (Correct)
48. Hypertonic hyponatremia (mOsm >295) occurs due to: Excess solutes other than Na, causing water shift out
of cells (Correct)
49. Hypotonic hyponatremia (mOsm <280) with urine Na >100 indicates:
Potassium via excretion and reabsorption in
tubules (Correct)
56. Magnesium inhibits K+ exit from cells; low magnesium leads to:
Increased K+ exit and renal excretion (Correct)
57. Metabolic acidosis features: Increased acid, decreased bicarbonate, renal hydrogen retention, hyperventilation, headache,
nausea, dehydration, hypotension (Correct)
pH: <7.4, HCO3: <
58. Metabolic alkalosis occurs due to: GI loss, diuretics; manifests as slow respirations,
irritability, twitching (Correct)
pH: >7.4, HCO3: >
59. Respiratory acidosis results from: CNS depression, airway obstruction; manifests as
restlessness, confusion, seizures (Correct)
pH: <7.4, PaCO2: >
60. Respiratory alkalosis is caused by:
Anxiety, PE, CHF, salicylate OD; presents with light-
headedness, tetany (Correct)
pH: >7.4, PaCO2: <
61. An allele is:
Paired genes on autosomal chromosomes (Correct)
62. A locus is: The specific position of a gene on a
chromosome (Correct)
63. Phenotype is: The outward appearance or expressed
traits (Correct)
64. Genotype is: The genetic makeup or specific gene
composition (Correct)
65. Polymorphic refers to: Two or more alleles occurring at appreciable
frequency in a population (Correct)
66. Homozygous means:
73. Sex-linked chromosomes:
The 23rd pair, determining sex (X or Y) (Correct)
74. Hypertrophy is:
An increase in cell size (Correct)
Examples: Skeletal muscle growth, compensatory
hypertrophy in remaining kidney. Physiologic hypertrophy: Due to increased demand or hormonal stimulation Pathologic hypertrophy: Due to disease, e.g., V hypertrophy from hypertension
75. Hypoxic injury causes: Ischemia leading to decreased oxygen, decreased
H/H, cell energy failure (Correct)
Clinical markers: Elevated enzymes like CK, LDH, AST,
ALT, troponin
76. CK enzymes are: Released by muscle cells, including cardiac
muscle (Correct)
LDH: Found in liver, muscle, heart, RBCs, brain (Correct)
AST: Present in liver, heart, muscle (Correct)
ALT: Liver-specific enzyme (Correct)
Troponin: Cardiac-specific marker (Correct)
77. Pathophysiology of hypoxic injury involves: Decreased mitochondrial ATP, increased anaerobic metabolism, cell swelling, ribosomal dysfunction,
eventual cell death (Correct)
78. Free radicals are molecules with: Unpaired electrons, making them unstable and highly
reactive (Correct)
79. Reactive oxygen species (ROS) are: Byproducts of mitochondrial ATP production that can
cause oxidative damage (Correct)
80. The mechanism of cellular hypertrophy involves: An increase in cell size due to hormonal stimulation
or increased functional demand (Correct)
Explanation: Hypertrophy results from increased
synthesis of cellular components, often in response to workload or hormonal signals.
81. The primary cause of cellular injury in ischemia is:
85. Which type of necrosis is most commonly associated with tuberculosis?
Caseous necrosis (Correct)
Explanation: Caseous necrosis appears as cheese-like,
friable tissue, typical in TB infections.
86. Fat necrosis is most often observed in:
Pancreatic tissue or breast tissue (Correct)
Explanation: Lipase activity in these tissues leads to fat
destruction and saponification.
87. Which of the following is a hallmark of liquefactive necrosis? Pus formation and tissue liquefaction, especially in
brain tissue (Correct)
Explanation: Enzymatic digestion causes tissue to liquefy,
forming abscesses or brain infarcts.
88. The process of metastasis involves: Tumor cells invading local tissues, entering blood or lymphatic vessels, surviving circulation, and
establishing new tumors (Correct)
Explanation: Metastasis is a complex, multi-step process
involving invasion, circulation, and colonization.
89. Which of the following tumor markers is most specific for prostate cancer?
Prostate-specific antigen (PSA) (Correct)
Explanation: PSA is used to screen and monitor prostate
cancer.
90. The TNM system staging assesses: Tumor size (T), lymph node involvement (N), and
presence of metastasis (M) (Correct)
Explanation: It helps determine cancer stage and
prognosis.
91. Intravascular fluid makes up approximately:
20% of total body water (Correct)
Explanation: The intravascular compartment includes
plasma and blood volume.
92. Osmolality measures: Solute concentration in body fluids, with a normal
range of 280-295 mOsm/kg (Correct)
Explanation: It reflects the concentration of particles like
sodium, glucose, and urea.
93. The interstitial fluid compartment accounts for:
