Morphology of cell injury MCQs With Answer

Morphology of cell injury MCQs With Answer

The morphology of cell injury is a core topic for B. Pharm students, covering structural and biochemical changes that occur during reversible and irreversible cell damage. This introduction explains key concepts such as cellular swelling, fatty change, mitochondrial dysfunction, oxidative stress, apoptosis, necrosis, and patterns of tissue response. Emphasis on histological features, ultrastructural alterations, and relevant biomarkers helps link pathology with pharmacology and toxicology. SEO keywords included: Morphology of cell injury, MCQs, B. Pharm students, cell injury mechanisms, necrosis, apoptosis, free radicals, and cellular adaptations. Now let’s test your knowledge with 50 MCQs on this topic.

Q1. What is the earliest visible light microscopic change in reversible cell injury?

• Fatty change
• Cellular swelling
• Pyknosis
• Karyorrhexis

Correct Answer: Cellular swelling

Q2. Which of the following is a hallmark of irreversible cell injury?

• Membrane blebbing
• Reversible mitochondrial swelling
• Loss of membrane integrity with enzyme leakage
• Chromatin clumping

Correct Answer: Loss of membrane integrity with enzyme leakage

Q3. Which organelle’s dysfunction is most critical for determining cell death versus recovery?

• Golgi apparatus
• Mitochondrion
• Lysosome
• Peroxisome

Correct Answer: Mitochondrion

Q4. During apoptosis, which nuclear feature is characteristic?

• Cell swelling and lysis
• Karyolysis
• Pyknosis followed by karyorrhexis
• Extensive inflammation

Correct Answer: Pyknosis followed by karyorrhexis

Q5. Lipid peroxidation primarily damages which cellular component?

• DNA in nucleus
• Plasma membrane phospholipids
• Ribosomal RNA
• Cytoskeletal proteins

Correct Answer: Plasma membrane phospholipids

Q6. What is the main source of reactive oxygen species (ROS) during oxidative stress?

• Mitochondrial electron transport chain
• Golgi complex
• Extracellular matrix
• Lysosomal hydrolases

Correct Answer: Mitochondrial electron transport chain

Q7. Which enzyme system detoxifies hydrogen peroxide in cells?

• Cyclooxygenase
• Glutathione peroxidase
• Proteasome
• RNA polymerase

Correct Answer: Glutathione peroxidase

Q8. Fatty change (steatosis) in the liver is primarily due to disturbance in:

• Glycogen synthesis
• VLDL export and lipid metabolism
• Cholesterol esterification
• Lysosomal storage

Correct Answer: VLDL export and lipid metabolism

Q9. Which type of necrosis is typically seen in ischemic infarction of the kidney?

• Coagulative necrosis
• Caseous necrosis
• Fat necrosis

Correct Answer: Coagulative necrosis

Q10. Liquefactive necrosis is most characteristic of which of the following?

• Myocardial infarction
• Pyogenic bacterial abscess in brain
• Caseating granuloma in tuberculosis
• Acute pancreatitis fat necrosis

Correct Answer: Pyogenic bacterial abscess in brain

Q11. Caseous necrosis is classically associated with:

• Staphylococcal skin infection
• Tuberculosis
• Ischemic limb gangrene
• Acute alcoholic hepatitis

Correct Answer: Tuberculosis

Q12. Which intracellular ion overload is a critical mediator of cell injury?

• Potassium
• Sodium
• Calcium
• Magnesium

Correct Answer: Calcium

Q13. Activation of which enzyme by increased intracellular calcium contributes to cell membrane damage?

• Protein kinase A
• Phospholipase A2
• DNA ligase
• Glucokinase

Correct Answer: Phospholipase A2

Q14. Which process describes selective removal of damaged organelles or proteins to protect cells?

• Necrosis
• Autophagy
• Apoptosis
• Oncosis

Correct Answer: Autophagy

Q15. Which marker is most specific for myocardial cell necrosis?

• ALT
• CK-MB
• Troponin I
• Alkaline phosphatase

Correct Answer: Troponin I

Q16. What histologic change indicates irreversible nuclear damage in necrosis?

• Chromatin clumping
• Pyknosis progressing to karyorrhexis and karyolysis
• Margination of chromatin only
• Nucleolar enlargement

Correct Answer: Pyknosis progressing to karyorrhexis and karyolysis

Q17. Which pathway is central to intrinsic (mitochondrial) apoptosis?

• Death receptor-FADD-caspase 8
• Bax/Bak-mediated cytochrome c release and caspase 9
• NF-κB activation
• mTOR activation

Correct Answer: Bax/Bak-mediated cytochrome c release and caspase 9

Q18. Extrinsic apoptosis is initiated by:

• Mitochondrial permeability transition
• Death receptors such as Fas binding ligand
• Oxidative phosphorylation
• Proteasomal degradation

Correct Answer: Death receptors such as Fas binding ligand

Q19. Which cellular adaptation is characterized by an increase in cell size without cell number change?

• Hyperplasia
• Hypertrophy
• Atrophy
• Metaplasia

Correct Answer: Hypertrophy

Q20. Metaplasia involves:

• Transformation of one differentiated cell type to another
• Uncontrolled cell division
• Cell shrinkage due to proteasomal loss
• Programmed cell death

Correct Answer: Transformation of one differentiated cell type to another

Q21. Persistent hypoxia typically causes which primary biochemical alteration?

• Increased oxidative phosphorylation
• Decreased ATP generation
• Enhanced proteasome activity
• Stabilization of lysosomal membranes

Correct Answer: Decreased ATP generation

Q22. Ischemia-reperfusion injury primarily worsens damage by:

• Reducing calcium influx
• Generating reactive oxygen species upon reperfusion
• Decreasing neutrophil infiltration
• Stabilizing mitochondrial membranes

Correct Answer: Generating reactive oxygen species upon reperfusion

Q23. Which laboratory change indicates hepatocellular necrosis?

• Elevated serum amylase
• Elevated AST and ALT
• Increased hemoglobin
• High creatinine clearance

Correct Answer: Elevated AST and ALT

Q24. Which of the following is a damage-associated molecular pattern (DAMP) released by necrotic cells?

• Interleukin-10
• HMGB1 protein
• Insulin
• Histamine

Correct Answer: HMGB1 protein

Q25. Ferroptosis is a regulated form of cell death driven by:

• Excessive caspase activation
• Lipid peroxidation dependent on iron
• Nuclear DNA fragmentation only
• Mitochondrial ATP overproduction

Correct Answer: Lipid peroxidation dependent on iron

Q26. Which histologic feature best distinguishes apoptosis from necrosis?

• Large inflammatory infiltrate
• Cell shrinkage with intact plasma membrane and phagocytosis of apoptotic bodies
• Complete dissolution of tissue architecture
• Massive cell lysis and enzyme release

Correct Answer: Cell shrinkage with intact plasma membrane and phagocytosis of apoptotic bodies

Q27. On electron microscopy, mitochondrial swelling and loss of cristae indicate:

• Cellular recovery
• Severe and often irreversible cell injury
• Normal variation
• Increased protein synthesis

Correct Answer: Severe and often irreversible cell injury

Q28. Which pharmacologic agent is known to cause centrilobular hepatic necrosis via toxic metabolite formation?

• Ibuprofen
• Acetaminophen (paracetamol)
• Amoxicillin
• Metformin

Correct Answer: Acetaminophen (paracetamol)

Q29. Which molecular event is central to ER stress leading to cell injury?

• Accumulation of misfolded proteins activating the unfolded protein response
• Enhanced DNA replication
• Activation of cytosolic ribonucleases
• Increased glycolysis only

Correct Answer: Accumulation of misfolded proteins activating the unfolded protein response

Q30. Which antioxidant is a key intracellular defense against ROS and is consumed during acetaminophen toxicity?

• Vitamin C
• Reduced glutathione (GSH)
• Vitamin K
• Coenzyme Q10

Correct Answer: Reduced glutathione (GSH)

Q31. Which cell death pathway involves receptor-interacting protein kinases (RIPK) and is caspase-independent?

• Apoptosis
• Necroptosis
• Autophagy
• Senescence

Correct Answer: Necroptosis

Q32. In chronic cell injury, persistent cell loss with replacement by connective tissue is called:

• Regeneration
• Fibrosis
• Apoptosis
• Steatosis

Correct Answer: Fibrosis

Q33. Which of the following best explains hydropic change in cells?

• Glycogen accumulation
• ATP depletion leading to failure of Na+/K+ ATPase and intracellular sodium accumulation
• Excessive protein synthesis
• Increased lipid peroxidation only

Correct Answer: ATP depletion leading to failure of Na+/K+ ATPase and intracellular sodium accumulation

Q34. Which caspase is typically the executioner caspase that cleaves cellular substrates during apoptosis?

• Caspase 8
• Caspase 9
• Caspase 3
• Caspase 1

Correct Answer: Caspase 3

Q35. Which morphological change is a sign of irreversible nuclear dissolution?

• Karyolysis
• Chromatin margination
• Nucleolar prominence
• Cellular swelling only

Correct Answer: Karyolysis

Q36. Which process describes a decrease in cell size and metabolic activity due to reduced workload or trophic signals?

• Hypertrophy
• Metaplasia
• Atrophy
• Hyperplasia

Correct Answer: Atrophy

Q37. Which of the following is a common trigger of apoptosis during development and tissue homeostasis?

• ATP surge
• Growth factor withdrawal
• Excessive mitochondrial fusion
• Phospholipid synthesis

Correct Answer: Growth factor withdrawal

Q38. What morphological change in necrosis makes it proinflammatory compared to apoptosis?

• Sequestration of cellular debris in apoptotic bodies
• Release of intracellular contents and DAMPs into extracellular space
• Rapid phagocytosis with no inflammation
• Only subtle nuclear condensation

Correct Answer: Release of intracellular contents and DAMPs into extracellular space

Q39. Which lipid accumulation pattern is most commonly seen in hepatocytes in alcoholic liver disease?

• Microvesicular steatosis
• Glycogen vacuolation
• Macrovesicular steatosis
• Proteinaceous inclusion bodies

Correct Answer: Macrovesicular steatosis

Q40. Which biomarker rises earliest after myocardial injury?

• Troponin I immediately at 5 minutes
• CK-MB at about 4-6 hours
• Troponin I within 3-4 hours
• ALT within 1 hour

Correct Answer: Troponin I within 3-4 hours

Q41. Which event is most associated with lysosomal rupture in necrosis?

• Activation of apoptotic caspases only
• Release of acid hydrolases that digest cell components
• Formation of autophagosomes exclusively
• Enhanced DNA repair

Correct Answer: Release of acid hydrolases that digest cell components

Q42. In coagulative necrosis, tissue architecture is preserved initially because:

• Proteolytic enzyme activity is increased
• Denaturation of structural proteins and enzymes delays proteolysis
• Immediate dissolution by neutrophils occurs
• Lipid membranes are rapidly broken down

Correct Answer: Denaturation of structural proteins and enzymes delays proteolysis

Q43. Which intracellular signaling molecule promotes survival and inhibits apoptosis via PI3K pathway?

• p53
• AKT (protein kinase B)
• Bax
• Caspase 9

Correct Answer: AKT (protein kinase B)

Q44. Which process contributes to fatty change by increasing delivery of free fatty acids to the liver?

• Starvation
• Enhanced VLDL synthesis
• Hyperinsulinemia only
• Increased mitochondrial β-oxidation exclusively

Correct Answer: Starvation

Q45. Which drug class can impair mitochondrial function and cause lactic acidosis as a manifestation of cell injury?

• Statins
• Biguanides (metformin)
• Beta-blockers
• ACE inhibitors

Correct Answer: Biguanides (metformin)

Q46. Which of the following best characterizes cellular senescence relative to cell injury?

• Acute programmed death with apoptosis markers
• Permanent cell cycle arrest with altered function and secretory phenotype
• Immediate necrotic lysis
• Rapid regeneration of tissue

Correct Answer: Permanent cell cycle arrest with altered function and secretory phenotype

Q47. Which reactive species formation is linked to nitric oxide reacting with superoxide?

• Hydroxyl radical
• Peroxynitrite (ONOO−)
• Hydrogen peroxide only
• Singlet oxygen

Correct Answer: Peroxynitrite (ONOO−)

Q48. Which histochemical stain is useful to detect neutral fat in tissue sections for assessing steatosis?

• PAS stain
• Oil Red O stain
• Hematoxylin and eosin only
• Silver stain

Correct Answer: Oil Red O stain

Q49. Which process is primarily responsible for removal of apoptotic bodies without inducing inflammation?

• Release of DAMPs
• Phagocytosis by macrophages via recognition of exposed phosphatidylserine
• Complement-mediated lysis
• Neutrophil extracellular trap formation

Correct Answer: Phagocytosis by macrophages via recognition of exposed phosphatidylserine

Q50. Which of the following best links toxic injury to DNA damage and possible carcinogenesis?

• Reversible mitochondrial swelling only
• Formation of DNA adducts and failure of repair mechanisms
• Immediate apoptosis without mutation
• Increased glycogen storage

Correct Answer: Formation of DNA adducts and failure of repair mechanisms

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.

Mail- Sachin@pharmacyfreak.com