cell pathology Theme options Mcq

Question 1

Question 1

A 43-year-old man has complained of mild burning epigastric pain following meals for the past 3 years. Upper GI endoscopy is performed, and biopsies are taken of an erythematous area of the lower oesophageal mucous 3 cm above the gastroesophageal junction. There is no mass lesion, no ulceration, and no haemorrhage note. The biopsies demonstrate the presence of columnar epithelium with goblet cells. Which alteration is most likely represented by these findings?

Answer 1

Answer: Metaplasia

Question 2

Question 2

A 59-year-old woman experienced loss of consciousness that persisted for over an hour. Subsequently, she could not speak, and she could not move her right arm or leg. A cerebral angiogram revealed an occlusion to her left middle cerebral artery. Months later, a computed tomographic (CT) scan shows a large 5 cm cystic area in her left parietal lobe cortex. This CT finding most likely demonstrates a lesion that is the consequence of resolution form which of the following events?

Answer 2

Answer: Liquefactive necrosis

Question 3

Question 3

A 26-year-old female presented with ‘feeling something hard’ in her left cheek for several years. History was unremarkable except for having trauma to her face when about 5 years old. Physical examination revealed nothing unusual except for several small (<1cm) moveable nodules that could be palpated in her cheek. A CT scan of this area revealed radiopaque masses in the muscle tissue. Laboratory findings showed her serum calcium was 9.4mg/dl and serum phosphorus was 3.9mg/dL. Which pattern of cellular or tissue alteration is likely to be responsible for this?

Answer 3

Answer: Dystrophic calcification

Question 4

Question 4

A 26-year-old female of African- American ethnicity complains of a swelling on her right ear lobe. The patient had ear piercings at age 3 and again at age 23. The swelling arose after the second piercing and has continued to grow. The swelling was firm, non-tender, dumbbell-shaped, measuring 3cm in diameter. Histopathology (Movat stain) findings showed thick, eosinophilic, hyalinised collagen bundles. IHC was positive for aSMA and negative for desmin. Which pattern of cellular or tissue alteration is likely to be responsible for this?

Answer 4

Answer: Keloids

Question 5

Question 5

A 52-year-old female visiting Sudan, is admitted with abdominal pain. Physical examination revealed massive hepatosplenomegaly and portal hypertension. FBC indicated a pancytopenia and there was elevation of liver ALT and AS. An ultrasound fibroscan result of 10kPa was found. Viral screening was negative. Kato-Katz examination of a stool sample was positive. Which pattern of cellular or tissue alteration is likely to be responsible for this?

Answer 5

Answer: Fibrosis

Question 6

Question 6

A 53-year-old African man who emigrated from Mali 25 years ago complained of skin nodules in the periumbilical area which were present ‘intermittently’ for the past 5 years. Physical examination was positive for two 0.5cm diameter subcutaneous nodule. FBC indicated an eosinophilia and serology for anti-strongyloidiasis IgG was positive. The patient responded to treatment with ivermectin. Which pattern of cellular or tissue alteration is likely to be responsible for this?

Answer 6

Answer: Chronic inflammation

Question 7

20-year-old woman, primigravida at 36 weeks of gestation, presents with some recent nausea, right upper quadrant pain and jaundice. Laboratory findings show ALT 665 U/L, AST 367 U/L, and total bilirubin 8 mg/dL. A liver ultrasound was ordered. Which pattern of cellular or tissue alteration in his liver is most likely to be present?

Answer 7

Answer: Microvesicular Steatosis

Question 8

A 56-year-old woman complains of painless lump in her left breast of 10 days duration. She noticed it following a road traffic accident when the steering wheel hit her breast at the site of the lump. On examination, there is a hard lump deep to the nipple with an overlying bruise.
What is the possible diagnosis?

Answer 8

Answer: Fat Necrosis

Question 9

A 65-year-old man suffered a massive myocardial infarction that was complicated by shock and prolonged hypotension. On arrival in the emergency department, he was found to have focal neurological signs in addition to features consistent with low-output cardiac failure. Despite the best efforts of the medical team, he died the next day. At autopsy, the most likely change you would expect to see in a brain biopsy would be:

Answer 9

Answer: Liquefactive Necrosis

Question 10

Question 8

A 45-year-old woman with a chronic infective lesion on her leg underwent a full-thickness biopsy of the lesion. During histological examination of this lesion a rim of multinuclear giant cells is seen. The central region is most likely to show:

Answer 10

Answer: Caseous necrosis

Question 11

25-year-old woman breastfed her first baby for almost 1 year with no difficulties and no
complications. Which of the following cellular processes that occurred in the breast during
pregnancy allowed her to nurse the infant for this period of time?

Answer 11

Lobular hyperplasia

Question 12

An 80-year-old woman was found dead in her room in a nursing home one morning. An
autopsy was carried out and her death was reported as being secondary to old age. At
autopsy, her heart was small (250 g) and dark brown in colour on section. Microscopically,
there was light-brown perinuclear pigment seen after haematoxylin and eosin (H&E)
staining of the cardiac muscle fibres. Which of the following substances is most likely to be
increased in the myocardial fibres to produce this cardiac appearance?

Answer 12

Lipochrome, from ‘wear and tear (lipofuscin)

Question 13

Karyorrhexis

Answer 13

A histopathologist reviewing a slide noticed a disease process which has led to scattered
loss of individual cells, with the microscopic appearance of karyorrhexis and cell
fragmentation. The overall tissue structure, however, has remained intact. This process is
most typical of which of the following diseases?

A Barbiturate overdose
B Brown atrophy of the heart
C Chronic alcoholic liver disease
D Renal transplant rejection
E Viral hepatitis

Question 14

A 21-year-old woman sustains a fractured left femur in a road traffic accident (RTA). She requires traction and is bed-bound for several weeks. On removal of the traction, the left leg is weak and the left quadriceps is visibly wasted.

Answer 14

Atrophy

Question 15

A 40-year-old woman has a cervical biopsy following an abnormal cervical smear. The biopsy shows lack of maturation throughout the whole thickness of the epithelium.

Answer 15

Answer: Dysplasia

Question 16

A 45-year-old man presents with ‘acid heartburn’. An endoscopy is performed at which the lower oesophageal mucosa appears red and velvety. A biopsy taken from this area shows glandular epithelium.

Answer 16

Answer: Metaplasia

Question 17

A 75-year-old man presents with symptoms of urinary outflow obstruction. Investigations show an enlarged prostate gland.

Answer 17

Hyperplasia

Question 18

A 65-year-old man with long-standing hypertension develops cardiac failure. A chest radiograph shows enlargement of the heart, and an echocardiogram shows a thickened left ventricular free wall

Answer 18

Answer: Hypertrophy

Question 19

A 56-year-old woman complains of painless lump in her left breast of 10 days duration. She noticed it following a road traffic accident when the steering wheel hit her breast at the site of the lump. On examination, there is a hard lump deep to the nipple with an overlying bruise.
What is the possible diagnosis?

Answer 19

Answer: Fat Necrosis

Question 20

Which of the following histopathological findings are most likely to be found in the
cerebrum of a 75-year-old woman who suffered a cerebral infarction 1 week ago?

Answer 20

Liquefactive necrosis

Question 21

A 46-year-old woman with chronic renal insufficiency has hyperphosphataemia. Which of
the following is the most likely complication of hyperphosphataemia?

Answer 21

Metastatic calcification

Question 22

A 28-year-old Asian woman with cervical lymphadenopathy is seen in a surgical outpatient
clinic. An excision biopsy of one of the nodes is performed and sent for histopathology.
This shows granulomatous inflammation. Which of the following histopathological features
is most diagnostic for tuberculosis?

Answer 22

Caseation necrosis

Question 23

You are looking at a histopathology slide that shows changes associated with cell injury.
Which of the following cell changes associated with injury is most likely to be accompanied
by disruption of the cell membrane?

Answer 23

Coagulative necrosis

Question 24

A 42-year-old man was seen in the emergency department complaining of a worsening
headache for the past week, along with fever and increasing obtundation. A computed
tomographic scan of the head revealed a solitary, 4-cm-diameter lesion with ring
enhancement in the right parietal lobe. A stereotactic biopsy was performed and a frozen
section showed granulation tissue with adjacent collagenisation, gliosis and oedema.
Which of the following is the most probable diagnosis?

Answer 24

Chronic brain abscess

Question 25

A 16-year-old boy with a 1-day history of sore throat was seen by his GP. On physical
examination, the most prominent finding was a pharyngeal purulent exudate. Which of the
following types of inflammation does this boy have?

Answer 25

Acute inflammation

Question 26

Which of the following provides an example of concomitant hyperplasia and hypertrophy?

Answer 26

Uterine growth during pregnancy

Question 27

Which of the following findings will be most striking in a microscopic slide showing atrophy
of an organ?

Answer 27

A greater number of autophagic vacuoles

Question 28

Accumulation of which of the following substances indicates ageing at a cellular level in a biopsy taken from an elderly person?

Answer 28

Lipofuscin

Question 29

Metaplasia is a reversible change in which one adult cell type (epithelial or mesenchymal)
is replaced by another adult cell type. In which of the following situations is the process of
epithelial metaplasia most likely to have occurred?

Answer 29

Vitamin A deficiency

Question 30

A 73-year-old woman with long-standing hypertension and aortic stenosis died suddenly
one morning. An autopsy was performed on her body. At autopsy, her heart weighed 540 g.
The size of her heart is most likely to be the result of which of the following processes
involving the myocardial fibres?

Answer 30

Hypertrophy

Question 31

A healthy 26-year-old man fractured his right tibia in a road traffic accident. His right leg
was immobilised in a plaster cast. The cast was removed from his leg after 8 weeks of
immobilisation. Which of the following changes is most likely to have taken place in his
gastrocnemius muscle after this time?

Answer 31

Decrease in the number of muscle fibres (Atrophy)

Question 32

A histopathologist reports fat necrosis after examining a slide. Fat necrosis might be found
in which one of the following situations?

Answer 32

Trauma to the breast

Question 33

Hypertrophy can be physiological or pathological and is caused by increased functional
demand or by specific hormonal stimulation. Hypertrophy can be best described as:

Answer 33

Increase in cell size and in its organelles

Question 34

A 35-year-old man is a habitual smoker. If a biopsy is taken from the respiratory tract in
this man, the epithelium of respiratory tract is most likely to show:

Answer 34

Stratified squamous metaplasia

Question 35

An 80-year-old woman was found dead in her room in a nursing home one morning. An
autopsy was carried out and her death was reported as being secondary to old age. At
autopsy, her heart was small (250 g) and dark brown in colour on section. Microscopically,
there was light-brown perinuclear pigment seen after haematoxylin and eosin (H&E)
staining of the cardiac muscle fibres. Which of the following substances is most likely to be
increased in the myocardial fibres to produce this cardiac appearance?

Answer 35

Lipochrome, from ‘wear and tear (lipofuscin)

Question 36

A 42-year-old woman has complained of mild, burning, substernal or epigastric pain
following meals for the past 3 years. Upper gastrointestinal endoscopy is performed and
biopsies are taken of an erythematous area of the lower oesophageal mucosa 3 cm above
the gastro-oesophageal junction. There is no mass lesion, no ulceration, and no
haemorrhage is noted. The biopsies demonstrate the presence of columnar epithelium with
goblet cells. Which of the following mucosal alterations is most likely to be represented by
these findings?

Answer 36

Metaplasia

Question 37

A 45-year-old woman with a chronic infective lesion on her leg underwent a full-thickness
biopsy of the lesion. During histological examination of this lesion a rim of multinuclear
giant cells is seen. The central region is most likely to show:

Answer 37

Caseous necrosis

Question 38

A 65-year-old man suffered a massive myocardial infarction that was complicated by
shock and prolonged hypotension. On arrival in the emergency department, he was found
to have focal neurological signs in addition to features consistent with low-output cardiac
failure. Despite the best efforts of the medical team, he died the next day. At autopsy, the
most likely change you would expect to see in a brain biopsy would be:

Answer 38

Liquefactive necrosis

Question 39

A skin biopsy from an anorexic 16-year-old girl showed cellular atrophy. During atrophy:

Answer 39

Cell size decreases

Question 40

A 25-year-old woman breastfed her first baby for almost 1 year with no difficulties and no complications. Which of the following cellular processes that occurred in the breast during pregnancy allowed her to nurse the infant for this period of time?

Answer 40

Hyperplasia (Lobular)

Question 41

A 73-year-old woman with long-standing hypertension and aortic stenosis died suddenly one morning. An autopsy was performed on her body. At autopsy, her heart weighed 540 g. The size of her heart is most likely to be the result of which of the following processes involving the myocardial fibres?

Answer 41

Hypertrophy

Question 42

A 45-year-old woman with a chronic infective lesion on her leg underwent a full-thickness biopsy of the lesion. During histological examination of this lesion a rim of multinuclear giant cells is seen. The central region is most likely to show:

Answer 42

Caseous necrosis