Cellular Responses to Stress, Inflammation and Repair, Hemodynamic Disorders

Question 1

The two (2) consistent features of
reversible cell injury

Answer 1

Cellular swelling,
Fatty change

Question 2

Increase in cell NUMBER due to
increased workload or
compensatory response

Answer 2

Hyperplasia

Question 3

Increase in cell SIZE due to
hormonal stimulation or
compensatory response

Answer 3

Hypertrophy

Question 4

Decrease in cell size and/or
number due to loss of
innervation, loss of blood
supply, etc.

Answer 4

Atrophy

Question 5

Differentiated cell type
replaced by another

Answer 5

metaplasia

Question 6

Most common type of metaplasia

Answer 6

Squamous metaplasia

Question 7

Type of metaplasia in Barrett’s
esophagus

Answer 7

Intestinal metaplasia

Question 8

Degradation of this molecule
causes increased cytoplasmic
eosinophilia in necrotic cells

Answer 8

Nucleic acids

Question 9

Decreased basophilia of
chromatin

Answer 9

Karyolysis

Question 10

Nuclear shrinkage with
increased basophilia

Answer 10

Pyknosis

Question 11

Fragmentation of pyknotic
nucleus

Answer 11

Karyorrhexis

Question 12

Pattern of necrosis in the setting of ischemia in most organs; (+) “ghost cells” - preserved cell architecture, loss of nucleus. Acidophilic tombstones

Answer 12

Coagulative necrosis

Question 13

All organs undergo coagulative
necrosis following ischemia,
except:

Answer 13

Brain

Question 14

Pattern of necrosis occurring in
bacterial infections and
ischemic necrosis of the brain;
due to neutrophilic enzymes;
(+) pus

Answer 14

Liquefactive necrosis

Question 15

Pattern of necrosis due to loss
of blood supply in a limb; can
be dry or wet (superimposed
with bacterial infection)

Answer 15

Gangrenous necrosis

Question 16

Pattern of necrosis
characterized by cheese-like
friable foci of necrosis and
structureless collection of lysed
cells and amorphous debris;
seen in tuberculous infections

Answer 16

Caseous necrosis

Question 17

Pattern of necrosis seen in
acute pancreatitis; (+) chalkywhite
areas of saponification,
(+) basophilic calcium deposits

Answer 17

Fat necrosis

Question 18

Pattern of necrosis
characterized by pink,
amorphous material in the
walls of arteries; due to
immune complex deposition

Answer 18

Fibrinoid necrosis

Question 19

Most characteristics feature of
apoptosis

Answer 19

Chromatin condensation

Question 20

Pathologic calcification that
occurs in necrotic tissue in the
setting of normal serum
calcium levels

Answer 20

Dystrophic calcification

Question 21

Sand-like lamellated dystrophic
calcifications seen in papillary
cancers

Answer 21

Psammoma bodies

Question 22

Pathologic calcification that
occurs in viable tissue in the
setting of hypercalcemia

Answer 22

Metastatic calcification

Question 23

Transmigration of leukocytes
across the endothelium i.e.
postcapillary venules

Answer 23

Diapedesis

Question 24

Movement of leukocytes
towards a chemotactic signal

Answer 24

Chemotaxis

Question 25

Most common exogenous chemotactic product

Answer 25

N-formylmethionine

Question 26

Endogenous chemotactic signals

Answer 26

IL-8, C5a, leukotriene B4

Question 27

Vasoactive amine that causes vasodilation and increased vascular permeability; produced by mast cells, platelets, and basophils

Answer 27

Histamine

Question 28

Vasoactive amine that causes vasoconstriction; produced by platelets and neuroendocrine cells

Answer 28

Serotonin

Question 29

Parent molecule of eicosanoids

Answer 29

Arachidonic Acid

Question 30

Vasodilating eicosanoids

Answer 30

PGI2 (Prostacyclin, PGE1, PGE2, PGD2

Question 31

Vasoconstricting eicosanoids

Answer 31

TXA2, LTC4, D4, E4

Question 32

Cytokine that has a significant role in fever

Answer 32

IL-1, TNF

Question 33

Complement system pathway activated by antibodies

Answer 33

Classical pathway

Question 34

Complement system pathway activated by microbial products

Answer 34

Alternative pathway

Question 35

Deficient complement proteins associated with increased risk to Neisseria infections

Answer 35

Late components or Membrane attack complex (C5b, C6-C9)

Question 36

Complement proteins acting as anaphylatoxins

Answer 36

C3a, C5a

Question 37

Most common complement deficiency

Answer 37

C2

Question 38

An autosomal dominant disease caused by deficiency in C1 inhibitor

Answer 38

Hereditary angioedema

Question 39

Hallmark of acute inflammation

Answer 39

Dilation of small blood vessels and accumulation of leukocytes and fluid in the extravascular tissue

Question 40

Cells involved in chronic inflammation

Answer 40

Macrophage, lymphocytes

Question 41

Pattern of inflammation in TB or foreign body deposition

Answer 41

Chronic granulomatous

Question 42

Hallmark of granuloma

Answer 42

Epithelioid cells

Question 43

Acute phase protein that causes red blood cells to form stacks (rouleaux)

Answer 43

Fibrinogen

Question 44

Reduces availability of iron to erythroid precursors in marrow; Causes anemia of chronic inflammation

Answer 44

Hepcidin

Question 45

Most important source of growth factors during repair

Answer 45

Macrophage

Question 46

Examples of stable tissues - quiescent but with limited capacity to proliferate in response to tissue injury and loss

Answer 46

Liver, Kidney, Pancreas, Endothelium, Fibroblasts, Smooth muscle

Question 47

Examples of permanent tissue - terminally differentiated and nonproliferative

Answer 47

Neurons, Cardiac and skeletal myocytes

Question 48

Hallmark of repair

Answer 48

Granulation tissue

Question 49

Scar tissue that does not grow beyond the boundaries of the original wound

Answer 49

Hypertrophic scar

Question 50

Scar tissue grows beyond the boundaries of the original wound; more common in African American

Answer 50

Keloid

Question 51

Mechanism of edema or effusion in heart failure

Answer 51

↑ Hydrostatic pressure

Question 52

Mechanism of edema or effusion in nephrotic syndrome or liver cirrhosis

Answer 52

↓ Oncotic pressure

Question 53

Mechanism of edema or effusion in burns or infections

Answer 53

↑ Vascular permeability

Question 54

Mechanism of edema or effusion in tumors, filariasis, post-radiation fibrosis, postlymphadenectomy in breast cancer

Answer 54

Lymphatic obstruction

Question 55

Type of effusion characterized by increased protein content, specific gravity, fibrin, and inflammatory cells

Answer 55

Exudate

Question 56

Increased in blood volume in tissues due to arteriolar dilation; an active process

Answer 56

Hyperemia

Question 57

Increased in blood volume in tissues due to reduced outflow; a passive process

Answer 57

Congestion

Question 58

Engorged alveolar capillaries, septal edema, and focal intraalveolar hemorrhage

Answer 58

Acute pulmonary congestion

Question 59

(+) Hemosiderin-laden macrophages (heart failure cells); fibrotic septa

Answer 59

Chronic pulmonary congestion

Question 60

Distended central vein and sinusoids, centrilobular ischemic necrosis, periportal fatty change

Answer 60

Acute hepatic congestion

Question 61

Nutmeg liver, (+) hemosiderin-laden macrophages, hepatocyte dropout and necrosis

Answer 61

Chronic hepatic congestion

Question 62

Initial step in hemostasis that occurs due to reflex neurogenic mechanisms and endothelin

Answer 62

Arteriolar vasoconstriction

Question 63

Vitamin K-dependent proteins that act together as anticoagulants

Answer 63

Protein C, Protein S

Question 64

Main factor of fibrin degradation

Answer 64

Plasmin

Question 65

Virchow triad of thrombosis

Answer 65

Endothelial injury, Abnormal blood flow, Hypercoagulability

Question 66

Most common inherited thrombophilia; FV becomes resistant to Protein C inactivation

Answer 66

Factor V Leiden

Question 67

Type of thrombosis that occurs due to turbulence/endothelial injury; retrograde propagation

Answer 67

Arterial thrombosis

Question 68

Common sites involved in arterial thrombosis

Answer 68

Coronary > Cerebral > Femoral

Question 69

Type of thrombosis that occurs due to stasis; anterograde propagation

Answer 69

Venous thrombosis

Question 70

Most common site involved in venous thrombosis

Answer 70

Lower extremity veins (90%)

Question 71

Detached intravascular mass that is carried by the blood from its point of origin to a distant site

Answer 71

Embolus

Question 72

Most common form of thromboembolic disease

Answer 72

Pulmonary embolism

Question 73

Most common source of pulmonary embolism

Answer 73

Deep venous thrombosis

Question 74

Type of pulmonary embolism that causes sudden death; located at the pulmonary artery bifurcation

Answer 74

Saddle embolus

Question 75

Most common source of systemic thromboembolism that results in end-organ ischemia

Answer 75

Mural thrombi

Question 76

Type of embolism associated with long bone fractures and soft tissue trauma

Answer 76

Fat embolism

Question 77

5th most common cause of maternal mortality worldwide, occurs in immediate postpartum

Answer 77

Amniotic fluid embolism

Question 78

Specific form of air embolism seen in divers who did rapid ascent; (+) bends and chokes

Answer 78

Decompression sickness

Question 79

Area of ischemic necrosis caused by vascular occlusion

Answer 79

Infarct

Question 80

Type of infarct in solid organs with end-arterial circulation

Answer 80

White infarct

Question 81

Type of infarct occurring due to venous occlusion in spongy tissues or organs with dual blood supply

Answer 81

Red infarct

Question 82

State in which diminished cardiac output or reduced effective circulating blood volume impairs tissue perfusion and leads to cellular hypoxia

Answer 82

Shock

Question 83

Type of shock seen in MI, arrhythmia, cardiac tamponade, tension pneumothorax

Answer 83

Cardiogenic shock

Question 84

Type of shock seen in hemorrhage, diarrhea

Answer 84

Hypovolemic shock

Question 85

Stage of shock where worsening circulatory and metabolic derangement (lactic acidosis) is observed

Answer 85

Progressive

Question 86

Stage of shock refractory to corrective measures

Answer 86

Irreversible