Adaptive changes – hypertrophy MCQs With Answer

Adaptive changes – hypertrophy MCQs With Answer

Understanding adaptive changes like cellular hypertrophy is essential for B.Pharm students studying pharmacology, pathophysiology, and therapeutics. This keyword-rich introduction covers cellular mechanisms, signaling pathways (mTOR, PI3K/Akt, calcineurin), examples such as skeletal and cardiac hypertrophy, and clinical implications for drug action and adverse effects. Learn how mechanotransduction, growth factors (IGF-1), and inhibitors (rapamycin, myostatin modulators) influence protein synthesis, degradation, and organ remodeling. These concise, exam-focused MCQs emphasize pharmacologic modulation, diagnostic markers, histology, and experimental models relevant to pharmacy practice and research. Now let’s test your knowledge with 50 MCQs on this topic.

Q1. Which cellular process primarily drives hypertrophy in skeletal muscle?

• Sarcomere addition and increased protein synthesis
• Satellite cell hyperplasia without protein synthesis
• Apoptosis of muscle fibers
• Decreased mitochondrial biogenesis

Correct Answer: Sarcomere addition and increased protein synthesis

Q2. Which signaling pathway is most directly associated with regulating cell size and protein synthesis in hypertrophy?

• mTOR/PI3K/Akt pathway
• JAK/STAT pathway
• Notch signaling
• Wnt/β-catenin pathway

Correct Answer: mTOR/PI3K/Akt pathway

Q3. Physiological hypertrophy of the heart, as seen in athletes, is typically characterized by which feature?

• Proportionate increase in chamber size and wall thickness (eccentric hypertrophy)
• Concentric hypertrophy with reduced chamber volume and fibrosis
• Extensive cell death and scar formation
• Immediate progression to heart failure

Correct Answer: Proportionate increase in chamber size and wall thickness (eccentric hypertrophy)

Q4. Pathological cardiac hypertrophy often involves which maladaptive change?

• Interstitial fibrosis and re-expression of fetal genes
• Increased oxidative phosphorylation efficiency
• Reduced collagen deposition
• Decreased natriuretic peptide release

Correct Answer: Interstitial fibrosis and re-expression of fetal genes

Q5. Which growth factor is most commonly linked to skeletal muscle growth and hypertrophy?

• Insulin-like growth factor 1 (IGF-1)
• Tumor necrosis factor-alpha (TNF-α)
• Interleukin-6 (IL-6)
• Interferon-gamma (IFN-γ)

Correct Answer: Insulin-like growth factor 1 (IGF-1)

Q6. Myostatin primarily exerts what effect on muscle?

• Inhibits muscle growth and hypertrophy
• Stimulates muscle protein synthesis
• Causes immediate muscle necrosis
• Enhances satellite cell fusion

Correct Answer: Inhibits muscle growth and hypertrophy

Q7. Rapamycin (sirolimus) inhibits hypertrophy by targeting which molecule?

• mTOR complex 1
• Calcineurin phosphatase
• Myostatin receptor
• Beta-adrenergic receptor

Correct Answer: mTOR complex 1

Q8. Concentric cardiac hypertrophy is most commonly caused by which physiological challenge?

• Pressure overload such as hypertension or aortic stenosis
• Volume overload such as valvular regurgitation
• Increased parasympathetic tone
• Physical endurance training

Correct Answer: Pressure overload such as hypertension or aortic stenosis

Q9. Which molecular marker is often upregulated in pathological cardiac hypertrophy and used clinically?

• B-type natriuretic peptide (BNP)
• Hemoglobin A1c
• C-reactive protein (CRP)
• Creatine kinase-MB

Correct Answer: B-type natriuretic peptide (BNP)

Q10. Mechanotransduction in hypertrophy refers to what process?

• Conversion of mechanical stress into biochemical signals
• Direct DNA mutation from mechanical force
• Immediate apoptosis due to strain
• Passive diffusion of growth factors

Correct Answer: Conversion of mechanical stress into biochemical signals

Q11. Which drug class can attenuate pathological cardiac hypertrophy via neurohormonal blockade?

• ACE inhibitors and angiotensin receptor blockers
• Beta-2 agonists
• Calcium channel blockers that increase afterload
• Systemic corticosteroids

Correct Answer: ACE inhibitors and angiotensin receptor blockers

Q12. Satellite cells contribute to muscle hypertrophy by which mechanism?

• Fusing with existing myofibers to donate nuclei
• Triggering necrosis of myocytes
• Inhibiting protein synthesis
• Reducing capillary density

Correct Answer: Fusing with existing myofibers to donate nuclei

Q13. Which intracellular system is responsible for targeted protein degradation that affects hypertrophy?

• Ubiquitin-proteasome system
• Glycolytic pathway
• Lipid peroxidation cascade
• Electron transport chain

Correct Answer: Ubiquitin-proteasome system

Q14. Which experimental model is commonly used to induce cardiac hypertrophy in research?

• Transverse aortic constriction (TAC) in rodents
• High-fat diet alone without hemodynamic change
• Neonatal hypoxia chamber
• Direct injection of BNP into myocardium

Correct Answer: Transverse aortic constriction (TAC) in rodents

Q15. Eccentric hypertrophy is typically associated with which adaptation?

• Volume overload and sarcomeres added in series
• Pressure overload with sarcomeres in parallel
• Immediate cell shrinkage
• Loss of myocardial contractile proteins

Correct Answer: Volume overload and sarcomeres added in series

Q16. Which pathway mediates calcineurin-dependent cardiac hypertrophy?

• Calcineurin activates NFAT transcription factors
• Calcineurin inhibits MAPK cascade
• Calcineurin degrades mTOR
• Calcineurin phosphorylates Akt directly

Correct Answer: Calcineurin activates NFAT transcription factors

Q17. Which histological change is typical in hypertrophied muscle cells?

• Enlarged cell size with increased myofibrils
• Reduced cell nucleus size without organelle change
• Diffuse necrosis with inflammatory infiltration only
• Loss of sarcomeres and cell fragmentation

Correct Answer: Enlarged cell size with increased myofibrils

Q18. In the context of liver adaptive hypertrophy, which stimulus commonly triggers hepatocyte enlargement?

• Partial hepatectomy leading to compensatory growth
• Acute viral infection only
• Prolonged fasting
• Renal failure without hepatic insult

Correct Answer: Partial hepatectomy leading to compensatory growth

Q19. What distinguishes hypertrophy from hyperplasia?

• Hypertrophy is increase in cell size; hyperplasia is increase in cell number
• Hypertrophy is irreversible; hyperplasia is always reversible
• Hypertrophy requires mitosis; hyperplasia does not
• They are identical processes with different names

Correct Answer: Hypertrophy is increase in cell size; hyperplasia is increase in cell number

Q20. Which biomarker increases with myocardial wall stress and is useful to assess hypertrophy-related dysfunction?

• BNP (B-type natriuretic peptide)
• Troponin I in stable hypertrophy
• Alkaline phosphatase
• Ceruloplasmin

Correct Answer: BNP (B-type natriuretic peptide)

Q21. Which pharmacologic agent can paradoxically cause skeletal muscle hypertrophy when abused?

• Anabolic-androgenic steroids
• ACE inhibitors
• Beta-blockers
• Statins at therapeutic doses

Correct Answer: Anabolic-androgenic steroids

Q22. Which transcriptional program is often reactivated in pathological cardiac hypertrophy?

• Fetal gene program (e.g., ANP, BNP, β-MHC)
• Adult metabolic gene program only
• Neuronal differentiation genes
• Hepatic gluconeogenesis genes

Correct Answer: Fetal gene program (e.g., ANP, BNP, β-MHC)

Q23. Which imaging modality best quantifies left ventricular mass in research and clinical practice?

• Cardiac magnetic resonance imaging (MRI)
• Plain chest X-ray
• Electrocardiography (ECG)
• Ultrasound of the abdomen

Correct Answer: Cardiac magnetic resonance imaging (MRI)

Q24. Autophagy’s role in hypertrophy is primarily to:

• Recycle damaged organelles and regulate protein turnover
• Directly synthesize new sarcomeres
• Trigger immediate necrosis
• Increase extracellular matrix deposition only

Correct Answer: Recycle damaged organelles and regulate protein turnover

Q25. Which endocrine factor contributes to cardiac hypertrophy through Gq-coupled receptor signaling?

• Angiotensin II
• Insulin solely via metabolic pathways
• Thyroid hormone exclusively
• Erythropoietin without receptor signaling

Correct Answer: Angiotensin II

Q26. Which experimental readout is commonly used to assess skeletal muscle hypertrophy in animal studies?

• Muscle fiber cross-sectional area measurement
• Serum creatinine only
• Bone mineral density
• Hepatic enzyme levels

Correct Answer: Muscle fiber cross-sectional area measurement

Q27. In pharmacology, blocking which receptor can reduce pathological cardiac hypertrophy mediated by catecholamines?

• β-adrenergic receptors (beta-blockers)
• Muscarinic M2 receptors
• Opioid receptors
• Histamine H1 receptors

Correct Answer: β-adrenergic receptors (beta-blockers)

Q28. Which is a hallmark of compensatory renal hypertrophy after unilateral nephrectomy?

• Increase in remaining nephron size and function
• Proliferation of nephron number only
• Immediate renal fibrosis without adaptation
• Global reduction in glomerular filtration rate

Correct Answer: Increase in remaining nephron size and function

Q29. Which MAP kinase is frequently implicated in stress-induced hypertrophic signaling?

• ERK1/2 (Extracellular signal-regulated kinases)
• Hexokinase
• ATP synthase
• Acetylcholinesterase

Correct Answer: ERK1/2 (Extracellular signal-regulated kinases)

Q30. Long-term pathological hypertrophy often predisposes to which clinical outcome?

• Progression to heart failure
• Enhanced lifelong cardiac reserve without risk
• Immediate resolution without treatment
• Protection from ischemic injury always

Correct Answer: Progression to heart failure

Q31. Which nutritional intervention supports skeletal muscle hypertrophy in conjunction with resistance training?

• High-quality protein intake with essential amino acids (e.g., leucine)
• Complete fasting
• High-sugar low-protein diets
• Exclusive fat supplementation without protein

Correct Answer: High-quality protein intake with essential amino acids (e.g., leucine)

Q32. Which enzyme complex senses cellular energy status and can inhibit hypertrophic growth when activated?

• AMP-activated protein kinase (AMPK)
• Pyruvate kinase
• DNA polymerase
• Lipase A2

Correct Answer: AMP-activated protein kinase (AMPK)

Q33. In smooth muscle hypertrophy (e.g., airway), which mediator commonly contributes to remodeling?

• Transforming growth factor-beta (TGF-β)
• Insulin-independent glucose uptake
• Albumin extravasation only
• Decreased extracellular matrix production

Correct Answer: Transforming growth factor-beta (TGF-β)

Q34. Which genetic mutation is classically associated with familial hypertrophic cardiomyopathy?

• Mutations in sarcomeric proteins such as β-myosin heavy chain
• Mutations in hemoglobin synthesis
• Mutations in insulin receptor only
• Mutations in collagen exclusively

Correct Answer: Mutations in sarcomeric proteins such as β-myosin heavy chain

Q35. Which drug may blunt exercise-induced skeletal muscle hypertrophy if taken chronically?

• Chronic high-dose corticosteroids
• Vitamin D supplementation
• Moderate caffeine intake
• Daily low-dose aspirin

Correct Answer: Chronic high-dose corticosteroids

Q36. Which intracellular change accompanies hypertrophy to support increased protein synthesis?

• Enhanced ribosomal biogenesis and mRNA translation
• Loss of rough endoplasmic reticulum
• Depletion of tRNA pools only
• Reduced ATP production exclusively

Correct Answer: Enhanced ribosomal biogenesis and mRNA translation

Q37. Which therapeutic strategy targets the mTOR pathway to control pathological hypertrophy?

• Use of mTOR inhibitors such as rapamycin
• Administration of anabolic steroids
• High-dose insulin infusion to stimulate mTOR
• Chronic beta-agonist therapy

Correct Answer: Use of mTOR inhibitors such as rapamycin

Q38. Hypertrophy in endocrine organs, like thyroid enlargement due to increased workload, is an example of:

• Adaptive hypertrophy in response to functional demand
• Primary neoplastic hyperplasia only
• Autoimmune destruction leading to cell shrinkage
• Irreversible necrosis

Correct Answer: Adaptive hypertrophy in response to functional demand

Q39. Which cellular event is least associated with hypertrophy?

• Massive increase in mitotic activity of terminally differentiated cells
• Increase in organelle content to meet metabolic demand
• Upregulation of anabolic pathways
• Enhanced protein synthesis

Correct Answer: Massive increase in mitotic activity of terminally differentiated cells

Q40. Which molecule negatively regulates muscle growth and is a therapeutic target for enhancing hypertrophy?

• Myostatin (GDF-8)
• IGF-1 receptor agonist
• mTOR activator
• Akt overexpression

Correct Answer: Myostatin (GDF-8)

Q41. During pathological hypertrophy, metabolic remodeling often shifts cardiomyocytes toward:

• Greater reliance on glucose metabolism over fatty acid oxidation
• Exclusive ketone utilization with no glucose use
• Only fatty acid oxidation with improved efficiency
• Complete anaerobic metabolism permanently

Correct Answer: Greater reliance on glucose metabolism over fatty acid oxidation

Q42. Measurement of protein synthesis rate in hypertrophy studies commonly uses which tracer technique?

• Stable isotope-labeled amino acids (e.g., 13C-leucine)
• Radioactive glucose uptake only
• Urine creatinine clearance exclusively
• Serum electrolyte measurement

Correct Answer: Stable isotope-labeled amino acids (e.g., 13C-leucine)

Q43. Which factor can predispose to pathological hypertrophy and is targeted by antihypertensive therapy?

• Chronic systemic hypertension
• Occasional light exercise
• Intermittent fasting
• Low-salt diet always

Correct Answer: Chronic systemic hypertension

Q44. Which cellular organelle expansion supports increased protein folding and secretion during hypertrophy?

• Rough endoplasmic reticulum
• Peroxisomes only
• Mitochondrial cristae reduction
• Golgi fragmentation exclusively

Correct Answer: Rough endoplasmic reticulum

Q45. Which clinical sign might suggest left ventricular hypertrophy on ECG?

• Increased QRS voltage and repolarization abnormalities
• Low-voltage QRS in all leads without change
• Isoelectric baseline throughout
• Isolated PR prolongation only

Correct Answer: Increased QRS voltage and repolarization abnormalities

Q46. In the context of cardiomyocyte hypertrophy, which process contributes to maladaptive remodeling?

• Excessive extracellular matrix deposition and fibrosis
• Balanced angiogenesis matching myocyte growth
• Complete removal of fibrotic tissue
• Normalization of fetal gene expression

Correct Answer: Excessive extracellular matrix deposition and fibrosis

Q47. Which therapeutic approach has been investigated to enhance muscle hypertrophy in wasting conditions?

• Myostatin inhibitors or antibodies
• Chronic high-dose glucocorticoids
• Long-term immobilization
• High-dose loop diuretics

Correct Answer: Myostatin inhibitors or antibodies

Q48. Which cellular event is required for hypertrophy in non-dividing cells like cardiomyocytes?

• Increased synthesis of contractile proteins and addition of sarcomeres
• Entry into cell cycle and mitosis
• Loss of nuclear DNA
• Complete shutdown of transcription

Correct Answer: Increased synthesis of contractile proteins and addition of sarcomeres

Q49. Which laboratory change might indicate pathological cardiac stress associated with hypertrophy?

• Elevated plasma BNP levels
• Reduced serum albumin only
• Marked leukopenia exclusively
• High serum lipase without symptoms

Correct Answer: Elevated plasma BNP levels

Q50. For a B.Pharm student, understanding hypertrophy is important primarily because:

• It informs pharmacologic strategies to modulate organ remodeling and drug responses
• It only affects veterinary medicine and not human pharmacology
• It has no relevance to drug toxicology or therapeutics
• It solely determines hair growth patterns

Correct Answer: It informs pharmacologic strategies to modulate organ remodeling and drug responses

G S Sachin

I am a Registered Pharmacist under the Pharmacy Act, 1948, and the founder of PharmacyFreak.com. I hold a Bachelor of Pharmacy degree from Rungta College of Pharmaceutical Science and Research. With a strong academic foundation and practical knowledge, I am committed to providing accurate, easy-to-understand content to support pharmacy students and professionals. My aim is to make complex pharmaceutical concepts accessible and useful for real-world application.

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