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Pathology > Cell responses to stress and toxic insults: adaptation, injury and death > Flashcards

Cell responses to stress and toxic insults: adaptation, injury and death Flashcards

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1
Q

City dwellers’ adaptation to air pollutants.

a) Squamous metoplasia
b) Glandular metoplasia
c) Osseous metoplasia
d) Bronchial mucous hyperplasia

A

A

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2
Q

In hypoxemia, the following are the cellular happening:

a) Decrease cytocelic gly
b) Increase cellular pH
c) Increase transnational problem
d) Increase cellular impermeability

A

B

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3
Q

Free readicals most commonly destroy the:

a) smooth ER
b) rough ER
c) nucleus
d) phospholipid bilayer membrane

A

D

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4
Q

Which of the following is an example of an ultrastructure finding in reversible cell injury?

a) Pyknosis
b) lysosomal rupture
c) blebbing
d) mitochondrial vacuolization

A

C

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5
Q

Which of the following is an irreversible ultrastructural change?

a) Lysosomal rupture
b) autophagy
c) chromatin clumping
d) endoplasmic reticulum swelling

A

A

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6
Q

What’s the right sequence of cell change during
injury/death?

a) Function retains until cell death
b) Function loss occurs RIGHT after cell death
c) Cell death precede all functional & histologic change
d) Ultrastructural changes antedate eosinophilic changes

A

D

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7
Q

Not true of hypoxic injury:

a) Hydropic degeneration
b) Anaerobic respiratory mechanisms terminated
c) Protein synthesis, transport and packaging deranged
d) Reactive oxygen species produced

A

B

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8
Q

True of saponification in enzymatic fat necrosis:

a) Release of enzymes in hypercalcemic milieu
b) Release of fatty acids despite of normal calcium levels
c) Neutrophile digestion and calcium deposition
d) Release of fatty acids. The process of saponification

A

B

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9
Q

Preservation of cellular outline but with loss of cellular detail is due to:

a) Protein denaturation
b) autolysis
c) autophagy
d) infarction

A

A

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10
Q

The pattern of necrosis in myocardial infarction is:

a) coagulation necrosis
b) fat necrosis
c) liquetactive necrosis
d) cafeation necrosis

A

A

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11
Q

Refers to focal accumulation of carbon pigment lader macrophages is the connective tissues of lung parenchyma

a) steatosis
b) xanthoma
c) cholesterolosis
d) anthracosis

A

D

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12
Q

The first manifestation of almost all cell injury

a) Fat accumulation
b) Dystrophic calcification
c) Hyaline
d) Cellular swelling

A

D

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13
Q

In this type of cellular adaptation, there’s a marked increase in number of autophagosomes accompanied by a decrease in number of myofilaments, ER, and mitochondria

a) hypertrophy
b) hyperplasia
c) atrophy
d) metaplasia

A

D

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14
Q

A reversible change or alteration in adult cells characterized by variation in size, shape and orientation:

a) metaplasia
b) dysplasia
c) hyperplasia
d) atrophy

A

B

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15
Q

Increased hormonal stimulation may cause cells to undergo

a) Metaplasia
b) Hyperplasia
c) Dysplasia
d) Atrophy

A

B

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16
Q

Morphological characteristics of cellular aging?

a. Hemosiderin
b. Abnormal pleiomorphic vacuolated ribosomes
c. Abnormally lobed nucleus
d. Abnormally folded golgi

A

C

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17
Q

In this solid tissue hypoxia-induced necrosis is due to autolysis rather than protein denaturation.

a. Kidney
b. Spleen
c. Brain
d. Liver

A

C

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18
Q

Why is there no inflammation during apoptosis?

a. Rapid phagocytosis of apoptotic bodies
b. No enzymes in apoptotic bodies
c. No proteins inside apoptotic bodies
d. None of the choices

A

A

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19
Q

Irreversible nuclear change is seen morphologically as fragmentation

a. Karyolysis
b. Pyknosis
c. Karyorrhexis
d. NOTA

A

C

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20
Q

Which mechanism is believed to be mainly responsible for the aging process?

A. Telomere shortening
B. Heterophagy
C. ATP depletion
D. CTL apoptosis

A

A

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21
Q

Alcoholic injury to the liver causes accumulation of

A. triglycerides
B. lipofuscin
C. hemosiderin
D. melanin

A

A

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22
Q

Metastatic calcification is exemplified in:

A. Atherosclerosis
B. Hyperparathyroidism
C. Serocalcific TB
D. Fibrocalcific TB

A

B

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23
Q

Carbon dust in tissues

A. Orthosia
B. Hematosia
C. Anthracosis
D. Cacoprosia

A

C

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24
Q

In vasculitis involving autoimmune inflammatory diseases, the type of necrosis is

A. Caseation
B. Fibrinoid
C. Enzymatic fat
D. Coagulation

A

B

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25
Q

Induction of smooth endoplasmic reticulum is associated with:

A. barbiturates use
B. lipofuscin accumulation
C. epidermolysis bullosa
D. α1-antitrypsin deficiency

A

A

From Robbins: Although hypertrophy usually refers to increase in size of cells or tissues, sometimes a subcellular
organelle may undergo selective hypertrophy. For instance, individuals treated with drugs such as barbiturates show hypertrophy of the smooth endoplamic reticulum (ER) in hepatocytes, which is an adaptive response that increases the amount of enzymes (cytochrome P-450 mixed function oxidases) available to detoxify the drugs. Over time, the patients respond less to the drug because of this adaptation.

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26
Q

Caseation necrosis is commonly seen in

A. viral infection
B. mycobacterium infection
C. vascular disorders
D. autoimmune disorders

A

B

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27
Q

The chalky deposits present during fat necrosis are due to…

A. Steatosis
B. Necrosis
C. Saponification

A

C

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28
Q

This disorder is associated with increased Apoptosis and Cell Death

A. Breast Cancer
B. Prostate Cancer
C. Thymic Involution
D. AIDS

A

D

HIV (human immunodeficiency virus) invades CD4+ T cells, and one might assume that it this infection by HIV that causes the great dying-off of these cells. However, that appears not to the main culprit. Fewer than 1 in 100,000
CD4+ T cells in the blood of AIDS patients are actually infected with the virus. So what kills so many uninfected CD4+ cells? The answer is clear: apoptosis.

29
Q

Generalized atrophy occurs due to

A. Tumor pressure
B. Denervation
C. Ischemia
D. Aging

A

D

30
Q

The major mechanism of apoptosis in humans

A. Mitochondrial pathway
B. Reduction-oxidation reaction
C. Death-receptor pathway
D. Peroxidase

A

A

31
Q

The protein, when released from an organelle to the cytoplasm, causes apoptosis?

A. Fas ligand
B. TNF
C. cytochrome c
D. Bcl-2

A

C

32
Q

Free radicals are generated by:

A. Glutathione peroxidation
B. UV-radiation
C. Oxidative protein modification
D. DNA cross-linking

A

B

33
Q

Localized area of coagulation necrosis

A. abscess
B. infarct
C. gangrene
D. pus

A

B

34
Q

An adaptive mechanism which involves increase in the number of cells:

a. hyperplasia
b. induction
c. hypertrophy
d. metaplasia

A

A

35
Q

An adaptive mechanism that results in a decrease of cytoplasmic volume and no. of organelles:

a. dysplasia
b. neoplasia
c. atrophy
d. agenesis

A

C

36
Q

An adaptive mechanism which involves an in cell size and girth:

a. hyperplasia
b. hypertrophy
c. increase n/c ratio
d. none of the above

A

B

37
Q

An adaptive mechanism which transformation of multipotential stem cells into cells not native to the injured cell:

a. dysplasia
b. anaplasia
c. metaplasia
d. hyperplasia

A

C

38
Q

Clinical example of metaplastic phenomenon:

a. cardiomegaly
b. endometrial
c. liver regeneration
d. reflux in esophagus

A

D

39
Q

Clinical example of a hyperplastic

a. Barret’s esophagus
b. prolapsed ectocervix
c. gastric adenocarcinoma
d. hypertension

A

D

40
Q

Clinical example of hypertrophic

a. Barret’s esophagus
b. myocardial infarct
c. tuberculoma
d. hypertensive cardiomegaly

A

D

41
Q

Clinical example of an atrophic

a. Alzheimer’s disease
b. endometrial hyperesteremia
c. tuberculoma
d. splenic infarct

A

A

42
Q

Common sequelae of metaplastic phenomenon:

a. pulmonary failure
b. adrenocortical carcinoma
c. endometrial carcinoma
d. gastric carcinoma

A

D

43
Q

Common sequelae of hypertrophy:

a. pulmonary failure
b. cardiac failure
c. hematopoietic failure
d. esophageal adenocarcinoma

A

B

44
Q

Liquefactive necrosis is expected in:

A. Cerebral infarct
B. Splenic infarction
C. Myocardial infarction
D. Hydrocephalous vacuole

A

A

45
Q

Gangrenous necrosis can be expected in:

A. diabetic foot
B. diabetic granuloma
C. diabetic neuropathy
D. mucocele of appendix

A

A

46
Q

Caseation necrosis can be expected in:

A. filariasis
B. sarcoidosis
C. histoplasma
D. scrofula

A

C

47
Q

Coagulation necrosis can be expected in:

A. pulmonary infarct
B. intestinal infarct
C. cerebral infarct
D. splenic infarct

A

D

48
Q

Which of the following is true:

A. gangrene refers to tissue necrosis with or without infection
B. acute inflammation does not occur around necrotic tissues
C. apoptosis usually does not cause inflammation
D. The blood vessels surrounding acutely inflamed
tissues usually show progressive dilation from the time of injury

A

C

49
Q

Necrosis is a characteristic of chronic inflammation:

A. leptospirosis
B. gummatous inflammation
C. plasmacytosis
D. tuberculosis

A

D

50
Q

A 40y.o. patient having a lymphoma involving the lymph nodes in the paraaortic areas. Treated with chemotherapy results to loss of individual neoplastic cells through fragmentation of individual nucleus and cytoplasm. Over the weeks, lymphoma decreased in size as documented by abdominal CT scan. By which of the following mechanisms did the neoplasm
primarily respond to the therapy?

A. coagulative necrosis
B. phagocytosis
C. autolysis
D. apoptosis

A

D

51
Q

A 43y.o. man has complained of mild burning substernal or epigastric pain following meals for the past 3 years. Upper GI endoscopy was performed and biopsies were taken of an erythematous area of the lower esophageal mucosa 3cm above the gastroesophageal junction. There is no mass lesion, no ulceration, and no hemorrhage noted. The biopsies demonstrated the presence of columnar epithelium with goblet cells. Which of the ff. mucosal
alteration is most likely represented by these findings?

A. agenesis
B. hypertrophy
C. adenocarcinoma
D. metaplasia

A

D

52
Q

A 59y.o. woman lost consciousness for an hour. Upon arousal she was unable to speak or move her right arm and leg. Angiography showed an occlusion in her left cerebral artery. Months later, a CT scan
revealed a 5cm cystic mass on her left parietal lobe. This is a result of the resolution of a previous:

A. liquefactive necrosis
B. Coagulation necrosis
C. Fat necrosis

A

A

53
Q

A 19-year old recently gave birth to her first child. She started breastfeeding and continued for 2 years. Which of the following cellular processes that occurred during pregnancy which allowed her to do this?

A. Stromal hypertrophy
B. Epithelial dysplasia
C. Ductal epithelial metaplasia
D. Lobular hyperplasia

A

D

54
Q

A 80 y/o man dies from complications of Alzheimer’s disease. At autopsy his heart is small (250g) and dark brown on sectioning. Microscopically
there is a light brown perinuclear pigment with H&E staining of the cardiac muscle fibers. Which of the following substances is most likely increased in the myocardial fibers to produce this appearance in the heart?

a. hemosiderin from reabsorbed hemorrhages
b. lipochrome from “wear and tear”
c. dystrophic calcifications
d. carbon pigments from anthracosis

A

B

55
Q

A 20- year old woman had Goodpasture syndrome which progressed to chronic renal failure. She was 165 cm tall, weighed 55kg and had a blood
pressure of 150/90 – 180/110 but she did not take regular medications. Lab studies showed her BUN over 100 mg /dl. She required chronic dialysis. She died from heart failure. At autopsy her height weighed 540g. the size of the heart is the result of:

a. hypertrophy
b. amyloid infiltration
c. post-infarct myocyte hyperplasia
d. fatty change

A

A

56
Q

A 26- year old man had destruction of the aortic valve by Staphylococcus aureus. Autopsy of the spleen reveals presence of tan to white wedge-shaped 1.5 x 3 cm lesion with base on capsule. What is the possible pathogenesis?

a. coagulation necrosis
b. gangrenous necrosis
c. lymphoreticular hyperplasia
d. sinusoidal hypertrophy

A

A

57
Q

A 20-year old man is involved in a motor vehicle accident, which resulted in multiple blunt trauma with laceration to his lower extremities. The left femoral
artery is lacerated and he incurs extensive blood loss and remains hypotensive for hours during transport to the emergency department. On admission hematocrit is 12%. Which of the following tissue is most likely to withstand impact of the events with least damage?

a. Skeletal muscle
b. Small intestine epithelium
c. Retina
d. Myocardium

A

A

58
Q

A 35- year old woman developed icterus over the last week of her life. Lab studies show her to be hyperammonemia. She is found at autopsy to have 3500g liver with uniform, yellow, greasy cut surface. No necrosis of hepatocytes. Which of the following would cause the see condition in the patient?

a. galactosemia
b. hemochromatosis
c. TB
d. malnutrition

A

D

59
Q

A 55- year old man has a 30 year history of poorly managed DM. His right foot had black discoloration and softness, with areas of yellow exudates. Upon
amputation, what pathological process is expected?

a. enzymatic necrosis
b. gangrenous necrosis
c. coagulative necrosis
d. abscess formation

A

B

60
Q

A 45- year old man has traumatic injury to his forearms and incurs extensive blood loss. BP is 70/30. Which represents irreversible cell injury as a result of this injury?

a. cytoplasmic membrane blebbing
b. mitochondrial swelling
c. karyolysis
d. induction of ER

A

C

61
Q

A 21-year old woman has a routine pap smear perform for a health screening exam. The pathology report indicates that some cells are found to cytologically have larger, more irregular nuclei. A follow- up cervical biopsy microscopically
demonstrates disordered maturation of the squamous
epithelium with hyper chromatic and peiomorphic nuclei extending nearly the full thickness of the epithelial surface. No inflammatory cells are present.

Which of the following descriptive terms is best applied in these pap smear and biopsy findings?

a. dysplasia
b. metaplasia
c. anaplasia
d. hyperplasia

A

A

62
Q

Clinical manifestation of hyperplasia

A. Gastric adenocarcinoma
B. Barrett’s esophagus
C. Proccidentia uteri
D. Dysfunctional uterine bleeding

A

D

63
Q

Fibrinoid necrosis can be expected in:

A. Diabetes mellitus
B. Amyloidosis
C. Systemic lupus erythematosus
D. Fibrinous pericarditis

A

C

64
Q

Liquefactive necrosis can be expected in:

A. Chronic sequelae of a cardiovascular intraparenchymal hemorrhage
B. Alzheimer’s disease
C. Hydrocephalus ex vacuo
D. Hypoxic-ischemic encephalopathy

A

D

65
Q

Gangrenous necrosis can be expected in:

A. Acute suppurative appendicitis
B. Ap. carcinoid**
C. Lymphoid hypertrophy ap.**
D. Mucocoele ap.**

A

A

66
Q

Caseation necrosis can be expected in:

A. Fungal infection
B. Schistosomiasis
C. Sarcoidosis
D. Frontal lobe tuberculosis

A

D

67
Q

Coagulation necrosis can be expected in:

A. Hepatic infarct
B. Intestinal infarct
C. Placental infarct
D. Pulmonary infarct

A

A

68
Q

Which among the following shows evidence of reversible cell injury on light microscopy?

A. Organellar swelling
B. Endoplasmic reticulum induction
C. Cellular swelling
D. Cell membrane blebbing

A

C

Pathology (6 decks)

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