Cell injury and adaptation: metaplasia mechanism: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Cell injury and adaptation: metaplasia mechanism

Sample item

A 40-year-old with chronic reflux has columnar epithelium with goblet cells replacing the distal oesophageal squamous lining. What best explains this change?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Reprogramming of stem cells under chronic acid injury

Metaplasia is a reversible replacement of one adult cell type by another, caused by reprogramming of stem cells in response to chronic stress. Barrett oesophagus has a predisposition to adenocarcinoma through dysplasia.

Option by option

  • A. Hypertrophy of existing glandular cells

    Hypertrophy is enlargement of existing cells and does not alter their lineage.

  • B. Failure of apoptosis in basal cells

    Failure of apoptosis would increase cell numbers, not change the cell type.

  • C. Reprogramming of stem cells under chronic acid injury (correct)

    Correct. Stem cells differentiate along a new pathway as an adaptation to acid, which is metaplasia.

  • D. Mutation of tumour suppressor genes in squamous cells

    Tumour suppressor mutation drives dysplasia and cancer later, but not the original adaptive change.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is C, Reprogramming of stem cells under chronic acid injury. Metaplasia is a reversible replacement of one adult cell type by another, caused by reprogramming of stem cells in response to chronic stress.

Why is "Hypertrophy of existing glandular cells" not the answer?

Hypertrophy is enlargement of existing cells and does not alter their lineage.

Why is "Failure of apoptosis in basal cells" not the answer?

Failure of apoptosis would increase cell numbers, not change the cell type.

Why is "Mutation of tumour suppressor genes in squamous cells" not the answer?

Tumour suppressor mutation drives dysplasia and cancer later, but not the original adaptive change.

What concept does this question test?

It tests Cell injury and adaptation: metaplasia mechanism in Pathology. Barrett oesophagus has a predisposition to adenocarcinoma through dysplasia.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cell injury and adaptation: metaplasia mechanism?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.