Which is an example of a reversible morphological change?

Appeared in: RRB Nsg. Superintendent - 29 April 2025 (Shift-3rd)

Explanation

Cellular swelling, also known as hydropic change or vacuolar degeneration, is the first and most common manifestation of reversible cell injury.
It occurs due to the failure of the energy-dependent Na+-K+ ATPase pump in the cell membrane, which is often caused by hypoxia or metabolic injury.
This pump failure leads to an intracellular accumulation of sodium, which in turn causes an osmotic influx of water, making the cell swell.
If the injurious stimulus is removed, the cell can restore its normal ion and fluid balance, making the swelling a reversible process.

Option A: Fibrosis is the formation of excess fibrous connective tissue (scarring) in an organ. It is a result of chronic inflammation or tissue repair and is generally considered a permanent or irreversible change.
Option B: Atrophy is a decrease in cell size and is classified as a cellular adaptation to stress, not a direct morphological change from acute injury. While it can be reversible, cellular swelling is the more precise answer for an early, acute reversible injury.
Option C: Necrosis is a form of cell death that is, by definition, irreversible. It occurs after severe or prolonged injury, leading to membrane rupture, enzymatic digestion of the cell, and inflammation.

Visual 1: Diagram: A visual comparison showing a normal cell, a cell undergoing reversible injury (swelling, membrane blebbing), and a cell undergoing irreversible injury (membrane rupture, nuclear changes like pyknosis).
Visual 2: Micrograph: A histology slide showing hydropic change (cellular swelling) in renal tubular cells, highlighting the pale, swollen cytoplasm and compressed microvasculature.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Reversible vs. Irreversible Cell Injury as background academic context rather than a clinical decision trigger.
Understanding the difference between reversible and irreversible cell injury is fundamental for diagnosing diseases and predicting patient outcomes. Early intervention can reverse cellular damage and prevent permanent organ dysfunction.
In clinical practice, elevated serum enzymes like AST, ALT, or troponins indicate irreversible cell injury (necrosis), as these enzymes leak out from dead cells.
What if? If the injurious stimulus (e.g., lack of oxygen to heart muscle) persists, the reversible cellular swelling will progress to irreversible injury (necrosis), resulting in a myocardial infarction (heart attack).

How to Approach the Question

First, identify the key terms in the question: 'reversible' and 'morphological change'. This directs you to the topic of cellular responses to injury.
Recall the main types of cellular injury: reversible and irreversible.
Evaluate each option based on these categories.
Fibrosis is a permanent repair process (irreversible).
Necrosis is cell death (irreversible).
Atrophy is an adaptation, not a direct injury response in the same way as swelling. While it can be reversible, it's a different category of cellular response.

Concept Tested & Keywords

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Practise the full RRB Nsg. Superintendent - 29 April 2025 (Shift-3rd)

Attempt every question from this paper in a timed mock, then review the full solution for each one.