Chapter 2- Cell injury and adaptation Multiple choice

Question 1 of 5 Which of the following is incorrectly matched? Metaplasia - increase in cell number Hypertrophy - increase in cell size Atrophy - decrease in cell size Neoplasia - uncontrolled cell growth Apoptosis - programmed cell death

Metaplasia - increase in cell number

Question 3 of 5 Biopsy results of the airways of a long-term smoker reveal squamous epithelium have replaced pseudostratified columnar cells. This is an example of _______________. dysplasia pathological hypertrophy neoplasia metaplasia atrophy

metaplasia

Question 11 of 13 Walter, age 62, had to undergo an endoscopic examination of his esophagus due to his complaint of frequent "heartburn" after most meals. Examination of the cells shows that rather than normal squamous cells lining the esophagus, Walter had columnar cells. The physician explained to Walter that this change in cell shape likely occurred in response to harmful stomach acid in the esophagus, resulting in the "burning" sensation. Make the Connection. Drag and drop the proper term for the cellular change or injury that is best exemplified by the case scenario. apoptosis, atrophy, benign neoplasia, dysplasia, gangrene, hyperplasia, intracellular accumulation, malignant neoplasia, metaplasia, necrosis, pathological hypertrophy, physiological hypertrophy, pathologic calcification

metaplasia CORRECT. Metaplasia is the replacement of one type of cell within another type of cell. In Walter's case, squamous cells were replaced with columnar cells. Normally, such cellular changes are brought on by injury or insult to the cells. The change in cell type is the body's attempt to create cells better capable of withstanding the insult or injury.

Question 5 of 13 Miguel, a retired warehouse supervisor, had a myocardial infarction. Further evaluation revealed he had significant blockage in his left descending coronary artery. The blockage resulted in ischemia and cell death for those cells served by the artery. Make the Connection. Drag and drop the proper term for the cellular change or injury that is best exemplified by the case scenario. apoptosis, atrophy, benign neoplasia, dysplasia, gangrene, hyperplasia, intracellular accumulation, malignant neoplasia, metaplasia, necrosis, pathological hypertrophy, physiological hypertrophy, pathologic calcification

necrosis CORRECT. Necrosis is premature cell death caused by cell injury. Necrosis differs from apoptosis, in that the cellular destruction results from some form of trauma, rather than genetic programming. In Miguel's case, ischemia, which is a lack of oxygen delivery to the cells, caused metabolic processes to fail, leading to death of the cell.

Question 13 of 13 Cardiac catheterization results for Beatrice, a 54-year-old patient, show plaque build-up, appearing as hardened areas in the coronary arteries. Beatrice, who is overweight and leads a sedentary lifestyle, has several risk factors for arteriosclerosis. A coronary calcium scan is conducted to help analyze the state of the arterial plaques. Make the Connection. Drag and drop the proper term for the cellular change or injury that is best exemplified by the case scenario. apoptosis, atrophy, benign neoplasia, dysplasia, gangrene, hyperplasia, intracellular accumulation, malignant neoplasia, metaplasia, necrosis, pathological hypertrophy, physiological hypertrophy, pathologic calcification

pathologic calcification CORRECT. Pathologic calcification is, as the name implies, calcification of tissues that does not occur normally, but rather as part of the diseases process. Atherosclerotic plaques are the result of endothelial injury within the vessel, cholesterol accumulation, and foam cell formation. At times, muscle tissue near the borders of the plaques becomes calcified due to the deposition of extracellular calcium. A coronary calcium scan helps to determine the extent of calcification.

Question 4 of 5 Cardiac troponin (a protein in heart cells) levels often elevate following a myocardial infarction. This is related to which of the following disrupted cellular processes? Disruption of calcium transporters. Increased extracellular potassium. Decreased membrane potential. Increased intracellular accumulations. Loss of ATP production.

Loss of ATP production.

Question 2 of 5 In pathological hypertrophy, cells are poorly differentiated with an increased risk of metastasis. an increase in tissue size is not matched by an increase in supportive structures. cell number increases in mitotically active tissues. programmed cell death occurs at an accelerated rate. one cell type is replaced by another.

an increase in tissue size is not matched by an increase in supportive structures.

Question 2 of 13 Karen was infected with HIV (human immunodeficiency virus) 5 years ago. As the virus attacks important cells of her immune system, known as CD4 cells, Karen is at an increased risk for infection. Recently, Karen learned that not only does HIV directly attack CD4 cells, but the presence of the virus seems to activate pathways responsible for programmed cell death in CD4 cells. Thus, infection of HIV appears to increase the rate of "suicide" for CD4 cells. Make the Connection. Drag and drop the proper term for the cellular change or injury that is best exemplified by the case scenario. apoptosis, atrophy, benign neoplasia, dysplasia, gangrene, hyperplasia, intracellular accumulation, malignant neoplasia, metaplasia, necrosis, pathological hypertrophy, physiological hypertrophy, pathologic calcification

apoptosis CORRECT. Apoptosis is programmed cell death. Apoptosis is a regulated pathway by which damaged or unneeded cells begin the death process. As this is a genetically regulated process, it is controlled and predictable. Necrosis, on the other hand, is cellular death induced by damage to the cell, which the cell cannot withstand. In Karen's case, HIV appears to be activating the pathways of CD4 apoptosis.

Question 12 of 13 Vern, a 65-year-old male, was diagnosed with amyotrophic lateral sclerosis (ALS), or Lou Gehrig's disease. This disease damages the upper and lower motor neurons, eventually preventing neural signals from reaching the muscles. In response to the lack of signaling, the muscles become weaker and smaller. Make the connection. Drag and drop the proper term for the cellular change or injury that is best exemplified by the case scenario. apoptosis, atrophy, benign neoplasia, dysplasia, gangrene, hyperplasia, intracellular accumulation, malignant neoplasia, metaplasia, necrosis, pathological hypertrophy, physiological hypertrophy, pathologic calcification

atrophy CORRECT. Atrophy is the partial or complete degeneration of cells or tissues in the body, most commonly due to lack of use. In this case, Vern's muscle began to shrink, as the body was unable to signal the muscles to move. Similar reductions in muscle size due to lack of use can be observed as a result of the casting of an injured limb.

Question 4 of 13 A biopsy of a skin lesion is conducted on Leann, a 48-year-old Caucasian woman. Biopsy results revealed proliferating cells that were well-differentiated and resembled surrounding cells. The cells were contained within a well-defined area. Make the Connection. Drag and drop the proper term for the cellular change or injury that is best exemplified by the case scenario. apoptosis, atrophy, benign neoplasia, dysplasia, gangrene, hyperplasia, intracellular accumulation, malignant neoplasia,metaplasia, necrosis, pathological hypertrophy, physiological hypertrophy, pathologic calcification

benign neoplasia

Question 3 of 13 Ruth, age 52, needs to have a follow-up Pap smear. While counseling Ruth, the nurse explains that the last Pap smear results revealed cells that looked abnormal. The cells were not uniform in size and shape, and had an altered appearance when compared to normal, healthy cell. Make the Connection. Drag and drop the proper term for the cellular change or injury that is best exemplified by the case scenario. apoptosis, atrophy, benign neoplasia, dysplasia, gangrene, hyperplasia, intracellular accumulation, malignant neoplasia, metaplasia, necrosis, pathological hypertrophy, physiological hypertrophy, pathologic calcification

dysplasia CORRECT. Feedback: Dysplasia occurs when cells take on an abnormal appearance. Compared to normal cells, cells demonstrating dysplasia are atypical in size and shape. Dysplasia does not mean the cells are cancerous. However, some screening tests, such as the Pap smear, examine tissues to determine if any cellular changes are taking place. Any changes in the cells can then be monitored over time.

Question 8 of 13 At a construction site, a support fell and crushed the patient's left ankle. Surgical repair was necessary. Now, upon entering the room, you smell a foul odor and see significant discoloration of the injured area. You are concerned a specific bacterial infection may be present. Make the Connection. Drag and drop the proper term for the cellular change or injury that is best exemplified by the case scenario. apoptosis, atrophy, benign neoplasia, dysplasia, gangrene, hyperplasia, intracellular accumulation, malignant neoplasia, metaplasia, necrosis, pathological hypertrophy, physiological hypertrophy, pathologic calcification

gangrene CORRECT. Gangrene can exist in several forms and it occurs when the blood supply to tissue is disrupted. In this scenario, a specific form of gangrene, known as gas gangrene, is present. Gas gangrene is the result of infection with Clostridium perfringens. This infection begins deep in the body in traumatized tissues. An exotoxin produced by the bacteria causes the destruction of healthy muscle tissue and produces a foul odor

Janae experienced a frightening ATV accident, in which her ATV flipped over and she ended up catching a portion of her upper arm on a barbed wire fence. Although Janae's injuries healed fully, enlarged, keloid scar formations remain at the injury site. Make the Connection. Drag and drop the proper term for the cellular change or injury that is best exemplified by the case scenario. apoptosis, atrophy, benign neoplasia, dysplasia, gangrene, hyperplasia, intracellular accumulation, malignant neoplasia, metaplasia, necrosis, pathological hypertrophy, physiological hypertrophy, pathologic calcification

hyperplasia

Question 6 of 13 Julianne, who suffers from familial hypercholesterolemia, presents with xanthomas. Xanthomas are excess cholesterol deposits, which appear as yellow skin lesions. Make the Connection. Drag and drop the proper term for the cellular change or injury that is best exemplified by the case scenario. apoptosis, atrophy, benign neoplasia, dysplasia, gangrene, hyperplasia, intracellular accumulation, malignant neoplasia, metaplasia, necrosis, pathological hypertrophy, physiological hypertrophy, pathologic calcification

intracellular accumulation CORRECT. Some disease processes stimulate intracellular accumulations of particles, such as calcium, cholesterol, and triglycerides, among other substances. In familial hypercholesterolemia, a genetic defect causes decreased cellular uptake of cholesterol, resulting in high serum cholesterol levels. Cholesterol deposits, known as xanthomas, may appear to form under the skin.

Question 5 of 5 Apoptosis _____________. is cell death that results from injury. results in irreversible damage to tissues. is genetically programmed cell death. is a rare occurrence in a healthy individual. should be prevented with medical interventions.

is genetically programmed cell death.

Question 10 of 13 Andy has undergone a colonoscopy because his family has a history of colon cancer. Biopsy of the colon reveals poorly differentiated cells in the samples. Cells were abnormally organized, with distorted borders. Infiltration of the abnormal cells occurred throughout several samples. Make the Connection. Drag and drop the proper term for the cellular change or injury that is best exemplified by the case scenario. apoptosis, atrophy, benign neoplasia, dysplasia, gangrene, hyperplasia, intracellular accumulation, malignant neoplasia, metaplasia, necrosis, pathological hypertrophy, physiological hypertrophy, pathologic calcification

malignant neoplasia CORRECT. Neoplasia is uncontrolled, unregulated cell growth. Malignancy, when applied to neoplasm, indicates the cancerous cells are likely to infiltrate other tissues and spread. The appearance of malignant cells is far from normal. Such cells are poorly differentiated and appear to have a random organization. Biopsy samples of malignant neoplasia reveal cells moving beyond the borders or edges of the growth.

Question 9 of 13 Miles, a 62-year-old African American male, has been treated for hypertension for 15 years. He is currently complaining of wheezing during exercise. Chest palpitation reveals displacement of the point of maximal impact of the heart. Echocardiogram confirms enlargement of the heart. Make the Connection. Drag and drop the proper term for the cellular change or injury that is best exemplified by the case scenario. apoptosis, atrophy, benign neoplasia, dysplasia, gangrene, hyperplasia, intracellular accumulation, malignant neoplasia, metaplasia, necrosis, pathological hypertrophy, physiological hypertrophy, pathologic calcification

pathological hypertrophy CORRECT. In this scenario, the echocardiogram reveals enlargement of the heart, which indicates hypertrophy. This increase in heart size, though, is due to a disease process, Miles' hypertension, which is causing the heart to grow in order to pump against the higher pressure. Because it is a response to a disease process, the hypertrophy is considered pathological. The increase in heart size is not met with an equal increase in support structures.

Brian, age 28, began an aerobic exercise program 2 years ago. Brian now competes in long-distance cycling events and considers himself to be an endurance athlete who is in the "best shape of his life." An echocardiogram reveals a slightly enlarged left ventricle. Make the Connection. Drag and drop the proper term for the cellular change or injury that is best exemplified by the case scenario. apoptosis, atrophy, benign neoplasia, dysplasia gangrene, hyperplasia, intracellular accumulation, malignant neoplasia, metaplasia, necros, pathological hypertrophy, physiological hypertrophy, pathologic calcification

physiological hypertrophy CORRECT. In this scenario, Brian's heart demonstrated physiological hypertrophy, which is a natural increase in an organ's size in order to meet increased demands. In Brian's case, the left ventricle enlarged in response to the increased work output required for Brian's training and competition. Unlike pathological hypertrophy, support structures also increas