Cell pathology , necrosis , apoptosis
40. A 48-year-old male with a history of chronic alcoholism who is continuing to perform adequately on the job will most often have which of the following findings in liver: a. Cholestasis b. Fatty change c. Hemochromatosis d. Hypertrophy of smooth endoplasmic reticulum e. Coagulative necrosis
b
45. The light brown perinuclear pigment seen on H&E staining of the cardiac muscle fibers in the heart of an 80 year old male is: a. Hemosiderin resulting from iron overload b. Lipochrome from "wear and tear" c. Glycogen resulting from a storage disease d. Cholesterol as a consequence of atherosclerosis e. Calcium deposition following necrosis
b
8. Which of the following are potentially reversible cellular responses? a. Necrosis b. Metaplasia c. Atrophy d. Hyperplasia e. Apoptosis
b
84. Which of the following processes is reversible? a. Apoptosis b. Mucoid intumescence c. Hyalinosis d. Amyloidosis e. Fibrinoid changes
b
86. Heart valves hyalinosis is typical of: a. Congenital heart disease b. Rheumatic fever c. Alcoholism d. Hypertensive disease e. Cardiomyopathy
b
112. Prehepatic jaundice causes are: a. Acute hepatitis b. Hemolytic poisons c. Isoimmune and autoimmune conflicts d. Tumors of duodenal papilla e. Liver cirrhosis
bc
90. Characterize which of the following statement of heart lipomatosis in obesity is true: a. Lipids are deposited udder the endocardium b. Lipids are deposited udder the pericardium c. Lipids are deposited in myocardial stroma d. Lipids are deposited in the cell cytoplasm e. All of the listed
bc
103. Mechanical jaundice is typical for: a. Acute hepatitis b. Cholelithiasis c. Biliary atresia d. Hypoplasia of the bile ducts e. Hemolytic disease
bcd
114. Which of the following are the causes of infarction? a. Calcification b. Angiospasm c. Thrombosis d. Embolism e. Necrosis
bcd
63. Cellular cytoplasm undergoes the following changes: a. Karyolysis b. Protein denaturation c. Protein coagulation d. Plasmorexis e. Nucleic acids polymerization
bcd
101. Connective tissue hyalinosis is characterized by: a. Flabby consistence b. Dense consistence c. White ± gray color d. Black color e. Semi transparency
bce
36. Which of the following would NOT be associated with metastatic calcification? a. Increased secretion of parathyroid hormone (PTH) b. Atherocalcinosis c. Gallbladder lithiasis d. Renal failure e. Aortic stenosis
bce
39. Langhans giant cells a. Are the antigen presenting cells in the skin b. Have a peripheral ring of nuclei with central clearing c. Are characteristically seen in tuberculosis d. Have nuclei scattered randomly through the cytoplasm e. Are derived from macrophage
bce
66. Which of the following are necrosis microscopic features: a. Karyokinesis b. Karyorexis c. Karyolysis d. Karyomitosis e. Karyopiknosis
bce
72. Varieties of cell injury are: a. Metaplasia b. Degeneration c. Apoptosis d. Necrosis e. Sclerosis
bd
108. The followings are the causes of parenchymal jaundice: a. Acute inflammation of the common bile duct b. Hepatocytes injury c. Hemolysis of erythrocytes d. Acute hepatitis e. Liver cirrhosis
bde
38. Apoptosis a. Occurs following acute deprivation of blood b. Occurs during embryogenesis c. Leads to damage to neighboring cells d. Follows activation of caspase 3 e. Is triggered when there is irreversible damage to cellular DNA
bde
55. Which of the following can be myocardial infarction cases: a. Ossification b. Angiospasm c. Petrification d. Thrombosis e. Embolism
bde
57. Which of the following are morphological necrosis types? a. Paranecrosis b. Fat necrosis c. Protein necrosis d. Coagulative necrosis e. Caseous necrosis
bde
58. Which of the following processes are characteristic of cellular necrosis? a. Hemochromatosis b. Karyopyknosis c. Hyalinosis d. Cytolysis e. Plasmolysis
bde
59. Which of the following are etiologic types of necrosis? a. Allergic type b. Vascular type c. Focal type d. Toxic type e. Biologic type
bde
64. Etiologic types of necrosis are: a. Parenchymatous type b. Traumatic type c. Allergic type d. Caseous type e. Infectious type
be
111. Dystrophic calcification is referred to: a. Accumulation of calcium salts into unmodified gastric mucosa b. Calcareous metastases in the kidneys c. Necrosis foci calcification d. Accumulation of calcium salts into unmodified lungs e. Accumulation of calcium salts into myocardium in condition of hypercalcemia
c
118. Unfavorable outcomes of necrosis include: a. Organization b. Calcification c. Purulent fusion d. Bordering inflammation e. Sepsis
c
119. The localization of gangrene is: a. Kidney b. Myocardium c. Soft tissues of the lower extremities d. Brain e. All of the listed
c
16. Most forms of pathologic hyperplasia are caused by excessive hormonal stimulation or growth factors acting on target cells. If a patient had hyperplasia of the endometrium, which of the following is the most likely? a. Increased risk of miscarriage b. Decreased risk of miscarriage c. Increased risk of endometrial cancer d. Decreased risk of endometrial cancer e. Increased risk of neurologic disease
c
18. Which of the following describes hypertrophy? a. Increase in the number of cells (mitosis) in an organ or tissue b. Decrease in the number of cells (mitosis) in an organ or tissue c. Increase in individual cell size in an organ or tissue d. Decrease in individual cell size in an organ or tissue e. Reversible change in which one adult cell is replaced by another adult cell type
c
19. Which of the following types of atrophy is involved in ischemia? a. Decreased workload b. Loss of innervation c. Diminished blood supply d. Inadequate nutrition (protein-calorie) e. Loss of endocrine stimulation
c
21. Atrophy may be accompanied by residual bodies, such as lipofuscin granules, which can turn tissue what color? a. Yellow b. Blue c. Brown d. White e. Red
c
23. Which of the following is the most common stem cell reprogramming change involved in respiratory tract cancer? a. Squamous to columnar b. Squamous to cuboidal c. Columnar to squamous d. Columnar to cuboidal e. Cuboidal to squamous
c
30. Which of the following has a cheesy, yellow-white appearance at the area of necrosis and is encountered most often in foci of tuberculous infection? a. Coagulative necrosis b. Liquefactive necrosis c. Caseous necrosis d. Fat necrosis e. Gangrenous necrosis
c
34. Hemosiderin is a hemoglobin-derived, golden yellow-to-brown, granular or crystalline pigment that can indicate a local excess of which of the following? A. Oxygen B. CO2 C. Iron D. Macrophages E. Ca
c
4. Necrotic death of brain tissue usually produces what type of necrosis? a. Coagulative b. Caseous c. Liquefactive d. Fat e. Gangrene
c
41. A 53-year-old male who is developing an acute myocardial infarction from coronary occlusion has an irreversible injury to the myocardium when: a. Glycogen is depleted b. Cytoplasmic sodium increases c. Nuclei undergo karyorrhexis d. Intracellular pH diminishes e. Blebs form on cell membranes
c
46. Karyorrhexis refers to: a. Disintegration of the cell cytoplasm b. Cell membrane lysis c. Disintegration of the cell nucleus d. Mitochondrial swelling and lysis e. Oxygen toxicity
c
78. Myocardial fatty degeneration can be detected by the following stain: a. Hematoxilin-Eosin b. Picrofuchsin c. Sudan-3 d. Toluidine blue e. Kongo-red
c
79. Clinical evidence of parenchymal lipidic degeneration of myocardium is: a. Increased contractility b. Hypertension c. Decreased contractility d. Rupture of heart e. Hyperemia
c
81. Parenchymal myocardial degeneration develops in the following cases: a. Hypertension b. Avitaminosis c. Diphtheria d. Diabetes mellitus e. Protein starvation
c
91. Which of the following is amyloid specific stain? a. Hematoxylin-eosin b. Picrofuchsin c. Kongo-red d. Toluidine e. Sudan-3
c
98. Which of the followings are etiologic types of amyloidosis: a. Localized type b. Generalized type c. Primary type d. Secondary type e. Hereditary type
cde
14. Which of the following is NOT characteristic of reversible cell injury? a. Reduced oxidative phosphorylation b. ATP depletion c. Cellular shrinking d. Changes in ion concentrations e. Caryolysis
ce
61. Which of the following are microscopic features of necrosis: a. Meiosis b. Mitosis c. Plasmorexis d. Plasmochinesis e. Plasmolysis
ce
62. Necrosis unfavorable outcomes include: a. Organization b. Petrification c. Purulent fusion d. Inflammation ream e. Sepsis
ce
77. Which of the following are fatty liver causes? a. Increased blood inflow b. Rheumatic fever c. Hypoxia d. Hypertension e. Decreased blood outflow
ce
1. Hydropic swelling results from: a. Membrane rupture b. ATP accumulation c. Oncogene activation d. Na/K pump dysfunction e. Cytoplasm lisis
d
20. Which of the following is associated with cachexia, seen in patients with chronic inflammatory diseases and cancer? a. Decreased workload b. Loss of innervation c. Diminished blood supply d. Inadequate nutrition (protein-calorie) e. Loss of endocrine stimulation
d
26. Which of the following is NOT associated with cell death? a. Nuclear condensation (pyknosis) b. Nuclear fragmentation (karyorrhexis) c. Dissolution of the nucleus (karyolysis) d. Decrease in intracellular Ca e. Amorphous mitochondrial densities
d
35. Bilirubin is hemoglobin-derived and the normal major pigment found in bile. If found in excess, what color does it change the skin? a. Black b. White c. Red d. Yellow e. Blue
d
48. A 3500 gm liver from a 35-year-old female has a yellow, greasy cut surface. This appearance most likely resulted from: a. Galactosemia b. Iron accumulation c. Mycobacterium tuberculosis infection d. Alcoholism e. Hypoxia
d
5. Which of the following cellular responses is indicative of injury due to faulty metabolism? a. Hydropic swelling b. Lactate production c. Metaplasia d. Intracellular accumulations e. Hypertrophy
d
52. Physical examination of a 42-year-old female reveals scleral icterus. Which of the following underlying conditions is most likely to contribute to this finding: a. Hypercholesterolemia b. Thrombocytopenia c. Metastatic carcinoma d. Hepatitis e. Diabetes mellitus
d
6. A high serum lactate level (lactic acidosis) usually indicates the presence of: a. Liver failure b. Hypoglycemia c. Immunologic injury d. Cellular hypoxia e. Hypocalcemia
d
76. Fatty liver is characterized by: a. Decreased liver size b. Dense consistency c. Rough surface d. Lipids in hepatocytes e. Absence of nuclei
d
104. Brown induration of lungs is characterized by accumulation of: a. Hydrochloric hematin b. Lipofuscin c. Bilirubin d. Coal dust e. Hemosiderin
e
113. Necrosis is caused by: a. Biologic factors b. Blood flow disturbances c. Allergic factors d. Chemicals e. All of the listed
e
116. Which of the following disorders is manifested by humid necrosis? a. Tuberculosis of lung b. Rheumatic pericarditis c. Myocardial infarction d. Spleen infarction e. Ischemic infarction of brain
e
13. You're most likely to see caseous necrosis in: a. Calcified fat around a wounded pancreas b. Gangrenous diabetic foot c. Infarcted myocardium d. Pus in a boil e. Tuberculous lung
e
22. Which of the following describes metaplasia? a. Increase in the number of cells (mitosis) in an organ or tissue b. Decrease in the number of cells (mitosis) in an organ or tissue c. Increase in individual cell size in an organ or tissue d. Decrease in individual cell size in an organ or tissue e. Reversible change in which one adult cell is replaced by another adult cell type
e
25. Which of the following is associated with cell death and NOT specifically with reversible cell injury? a. Membrane blebs b. Clumping of chromatin c. Swelling of ER d. Swelling of mitochondria e. Myelin figures
e
32. Chemically induced cell injury from carbon tetrachloride (CCl4) and acetaminophen (Tylenol) affect which organ? a. Brain b. Kidneys c. Pancreas d. Spleen e. Liver
e
33. Which of the following diseases would most likely show glycogen abnormalities if tissues, such as the descending loop of Henle and liver cells, are stained with periodic acid shift (PAS)? a. Chronic hypertension b. Congestive heart failure c. Abdominal aortic aneurysm d. Rheumatoid arthritis e. Diabetes mellitus
e
43. The presence of squamous epithelium in the lower trachea of a 42-year-old female with a history of smoking is called: a. Dysplasia b. Aplasia c. Anaplasia d. Hyperplasia e. Metaplasia
e
83. Accumulation of lipids in the wall of the large arteries is typical of: a. Inflammation b. Cachexia c. Aneurism d. Obesity e. Atherosclerosis
e
87. Systemic arteriolar hyalinosis is typical of: a. Atherosclerosis b. Tuberculosis c. Alcoholism d. Syphilis e. Hypertensive disease
e
88. The following structures are subject to hyaline changes: a. Renal stones b. Bone tissue c. Amyloid d. Cartilaginous tissue e. Fibrous tissue
e
89. Amyloid is a protein that deposits in: a. Cells b. Foci of necrosis c. Nuclei of cells d. Foci of calcification e. Interstitial tissue
e
92. Amyloidosis is a complication of: a. Pneumonia b. Hypertensive disease c. Dysentery d. Aterosclerosis e. Bronchiectasis
e
99. Generalized obesity contributes to: a. Brown atrophy of the heart b. Acute pancreatitis c. Myocarditis d. Goiter e. Ischemic heart disease
e
74. The types of degeneration depending on their locations are: a. Parenchymatous type b. Mesenchymal type c. Mixed type d. Proteic type e. Lipidic type
abc
75. The types of degeneration depending on metabolic disturbances are: a. Carbohydrate degeneration b. Protein degeneration c. Fat degeneration d. Parenchymatous degeneration e. Mesenchymal degeneration
abc
95. Small arteries hyalinosis is typical for: a. Essential hypertension b. Secondary hypertension c. Diabetic microangiopathy d. Diabetic macroangiopathy e. Atherosclerosis
abc
67. Relatively favorable necrosis outcomes include: a. Organization b. Petrification c. Malignisasion d. Purulent fusion e. Incapsulation
abe
68. Which of the following are nuclear changes characteristic of necrosis? a. Chromatin condensation b. Nucleic acids depolimerization c. Glycogen synthesis d. Kariokinesis e. Karyopyknosis
abe
107. Which of the following statements regarding dystrophic calcification is true: a. It is predominantly local process b. It is predominantly generalized process c. It forms petrifications d. Calcium salts accumulates due to hyperkalemia e. It makes gouty tophi
ac
28. Which of the following would NOT cause mitochondrial damage? a. Increase in cytosolic Ca b. Oxidative stress c. Retention of cytochrome c d. Breakdown of phospholipids through the phospholipase A2 and sphingomyelin pathways e. Lipid breakdown products (e.g. free fatty acids and ceramide)
ac
109. According to the mechanism of development jaundice is classified into: a. Hemolytic jaundice b. Hypostatic jaundice c. Mechanical jaundice d. Parenchymatous jaundice e. Biliary jaundice
acd
3. Apoptosis is a process that results in: a. Cellular atrophy b. Cellular death c. Cellular proliferation d. Cellular mutation e. Cellular dysplasia
b
100. Amyloid cardiomegaly is characterized by deposition of abnormal protein: a. Under the endocardium b. In the cardiomyocytes cytoplasm c. Into the vascular stroma d. In the Nerves e. Along the epicardial vessels
ace
105. Metastatic calcification affects the following organs: a. Lungs b. Pancreas c. Stomach d. Veins e. Heart
ace
37. Reperfusion cellular injury is caused by a. High intracellular concentrations of Calcium b. High intracellular concentrations of Potassium c. Free radical release d. Vitamin E e. Nitric oxide
ace
94. The followings is referred to preotic mesenchymal degeneration: a. Mucoid intumescence b. Plasmatic impregnation c. Fibrinoid intumescence d. Amyloidosis e. Hemosiderosis
ace
49. The marked enlargement of the uterus that occurs with pregnancy is accompanied by histopathologic evidence for an increase in: a. Myometrial cell numbers b. Nuclear anaplasia c. Cellular DNA content d. Myometrial cell size e. Fibroblasts and collagen
ad
70. Which of the following is of crucial importance in myocardial infarction: a. Plasmorexix b. Plasmorrhagia c. Karyokinesis d. Karyolysis e. Cytolysis
ade
71. In the myocardial infarction the crucial roles play: a. Arterial thrombosis b. Hypofunction of the organ c. Allergy d. Functional overload e. Insufficient collateral circulation
ade
11. Which of the following are NOT evidence of irreversible cell injury? a. Acute cell swelling ("cellular edema") b. Calcium chunks in the mitochondria c. Nuclear pyknosis d. Rupture of the lysosomes e. Lipidic degeneration
ae
29. Which of the following would NOT be an ultrastructural change seen in a reversibly injured cell? a. Apoptosis b. Microvilli distortion c. Myelin figured d. Amorphous densities e. Cell shrinking
ae
2. Coagulative necrosis: a. Resemble crumbly cheese b. Can result from interrupted blood supply c. Is reversible if promptly and aggressively managed d. Remains functional for 5-7 days e. Affects only extremities
b
106. Which pigment appears in the area of hemorrhage? a. Adrenochrome b. Hemosiderin c. Melanin d. Lipofuscin e. Lipochrome
b
53. In which of the following settings is fat necrosis most often seen? a. A 31 year old male has an acute abdomen with marked abdominal pain and an elevated serum amylase b. A 66 year old female with chronic alcoholism has an elevated serum AST c. A 23 year old female with a decreased total serum complement has a history of systemic lupus erythematosus d. A 70 year old female with adenocarcinoma of the colon and metastases to liver has an elevated LDH e. A 49 year old male with sudden onset of chest pain has an elevated serum creatine kinase
a
60. Dry gangrene is characterized by: a. Mummification b. Proliferation c. Hydration d. Encephalomalacia e. Myomalacia
a
7. Ischemic death of tissue in visceral organs, such as the heart, typically produces: a. Coagulative necrosis b. Liquefactive necrosis c. Caseous necrosis d. Fat necrosis e. Preotic necrosis
a
80. Liver steatosis is caused by: a. Alcoholism b. Viral hepatitis B c. Hypertension d. Viral hepatitis A e. All of the listed
a
82. Liver steatosis is usually followed by: a. Recovery of structures b. Massive necrosis c. Transformation in protein degeneration d. Transformation into liver cirrhosis e. Falls lobule appearance
a
96. Secondary amyloidosis can be a complication of: a. Tuberculosis b. Atherosclerosis c. Diabetes mellitus d. Hepatitis e. Hypertension
a
110. Metastatic calcification occurs in: a. Destruction of bone by tumors b. Parathormone excess c. Calcitonin excess d. Hypocalcemia e. All of the listed
ab
54. Melting of dead tissue is observed in: a. Myomalacia b. Encephalomalacia c. Mummification d. Coagulation e. Ossification
ab
65. Which of the following are the gangrene types? a. Wet b. Dry c. Aerobic d. Anabolic e. Caseous
ab
69. In tuberculosis caseous necrosis is: a. Coagulative b. Direct c. Indirect d. Wet e. Fibrinoid
ab
85. Which of the following structures predominantly is renal amyloid deposited in? a. Vascular wall b. Capillary loops and mesangium of glomeruli c. Cytoplasm of nephrothelium d. Vascular lumen e. All of the listed
ab
93. Which of the following is referred to the macroscopic diagnosis of amyloidosis: a. Virchow reaction b. Lugol solution c. 10% Hydrochloric acid d. 10% Osmic acid e. Toluidine blue ?
ab
44. A 59-year-old female had a cerebral infarction. Months later, a computed tomographic (CT) scan shows a cystic area in her cerebral cortex. The CT finding is a lesion that is the consequence of resolution from: a. Liquefactive necrosis b. Atrophy c. Coagulative necrosis d. Caseous necrosis e. Apoptosis
a
73. Degeneration causes are: a. Decomposition b Dysfunction of transport systems c. Endocrine dysfunction d. Autoregulatory system of cell disturbances e. Fanerosis
abc
47. The spleen at autopsy on sectioning shows a tan to white, wedge-shaped lesion with base on the capsule. This most likely represents the result of: a. Coagulative necrosis b. Abscess formation c. Metaplasia d. Caseous necrosis e. Liquefactive necrosis
a
50. A 73-year-old male suffers a "stroke" with loss of blood supply to cerebral cortex in the distribution of the middle cerebral artery. The most likely consequence of this is: a. Infarction with liquefactive necrosis b. Pale infarction with coagulative necrosis c. Predominant loss of glial cells d. Recovery of damaged neurons if the vascular supply is reestablished e. Wet gangrene with secondary bacterial infection
a
102. Pigments are substances that: a. Are collared b. May accumulate color c. Are of preotic nature d. Care dissolved in lipids e. All of the listed
a
115. Humid gangrene is found in: a. Intestine b. Brain c. Kidney d. Myocardium e. Liver
a
117. Which of the following disorders is manifested by caseous necrosis? a. Milliary tuberculosis of lung b. Myocardial infarction c. Dysentery d. Typhoid fever e. Gangrene
a
12. Which ion is blamed for "reperfusion injury"? a. Calcium b. Magnesium c. Phosphate d. Potassium e. Sodium
a
15. Which of the following describes hyperplasia? a. Increase in the number of cells (mitosis) in an organ or tissue b. Decrease in the number of cells (mitosis) in an organ or tissue c. Increase in individual cell size in an organ or tissue d. Decrease in individual cell size in an organ or tissue e. Reversible change in which one adult cell is replaced by another adult cell type
a
17. Infection from which of the following is associated with hyperplasia? a. Papillomavirus b. Enterobacteria c. Staphylococci d. Streptococci e. Hook worms
a
24. In Barrett esophagus, metaplasia occurs as a result of refluxed gastric acid. Which of the following changes occurs? a. Squamous to columnar b. Squamous to cuboidal c. Columnar to squamous d. Columnar to cuboidal e. Cuboidal to squamous
a
42. After years of breathing dirty city air, your lungs have accumulated: a. Anthracotic pigment b. Lipofuscin c. Melanin d. Hemosiderin e. Biliverdin
a
