LC Cellular Response to Stress II Flashcards

1
Q

Which of the followings is NOT a recognized pathway to intracellular accumulations?

Inadequate removal of a normal substance secondary to defects in mechanisms of packaging and transport

Accumulation of an abnormal endogenous substance as a result of genetic or acquired defects in its folding, packaging, transport, or secretion

Failure to degrade a metabolite due to inherited enzyme deficiencies, resulting to abnormal storage

Accumulation of an abnormal exogenous substance when the cell is unable to degrade the substance nor the ability to transport it to other sites

Excessive production of proteins that interfer with proper degradation of exogenous and endogenous substance

A

Excessive production of proteins that interfer with proper degradation of exogenous and endogenous substance

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2
Q

A 50 year-old man with history of alcohol abuse and dependency was noted to have abnormal levels of liver enzymes. He underwent a biopsy of his liver (see below). Which of the followings explain the histological finding?

Abnormal metabolism with intracellular accumulation of endogenous substances

Accumulation of an abnormal endogenous substance as a result of genetic defects in its folding, packaging, transport, or secretion

Fai​lure to degrade a metabolite due to inherited enzyme deficiencies, resulting in abnormal storage

Acc​umulation of an abnormal exogenous substance when the cell is unable to degrade the substance nor the ability to transport it to other sites

A

Abnormal metabolism with intracellular accumulation of endogenous substances

Hepatocellular steatosis results from (1) shunting of normal substrates away from catabolism and toward lipid biosynthesis, as a result of increased generation of reduced nicotinamide adenine dinucleotide (NADH) by the two major enzymes of alcohol metabolism, alcohol dehydro­genase and acetaldehyde dehydrogenase; (2) impaired assembly and secretion of lipoproteins; and (3) increased peripheral catabolism of fat, thus releasing free fatty acids into the circulation.

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3
Q

A 37 year-old woman had her gastric mucosa biospsied. In the picture below, what do the abnormal histological findings represent?

Triglycerides in macrophages

Cholesterol in macrophages

Phospholipids in macrophages

Proteins in macrophages

A

Cholesterol in macrophages

The cellular mechanism is tightly regulated such that most cells use cholesterol for the synthesis of cell membranes without intracellular accumulation of cholesterol or cholesterol esters. This is a case of gastric xanrhoma where intracellular accumulation of cholesterol within macrophages (foamy cells) in the lamina propria.

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4
Q

A 32 year-old woman with excessive protein loss in the urine (proteinuria). Biopsy of her kidney revealed round eosinophlic droplets in the cytoplasm of renal tubule cells. Which of the followings explains the described histological finding?

Accumulation of a normal substance secondary to excess uptake and consequently inadequate catabolism

Accumulation of an abnormal endogenous substance as a result of genetic defects in its folding, packaging, transport, or secretion

Fai​lure to degrade a metabolite due to inherited enzyme deficiencies, resulting in abnormal storage

Acc​umulation of an abnormal exogenous substance when the cell is unable to degrade the substance nor the ability to transport it to other sites

A

Accumulation of a normal substance secondary to excess uptake and consequently inadequate catabolism

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5
Q

A 62 year-old man from Albuquerque was hospitalized because of pneumonia. The exact etiology was not evident to his physician. She ordered a lung biopsy, see below. Which of the followings explains the histological finding?

Inadequate removal of a normal substance secondary to defects in mechanisms of packaging and transport

Accumulation of an abnormal endogenous substance as a result of genetic or acquired defects in its folding, packaging, transport, or secretion

Fai​lure to degrade a metabolite due to inherited enzyme deficiencies, resulting in abnormal storage

Acc​umulation of an abnormal exogenous substance when the cell is unable to degrade the substance nor the ability to transport it to other sites

A

Acc​umulation of an abnormal exogenous substance when the cell is unable to degrade the substance nor the ability to transport it to other sites

Anthracotic pigment is a common incidental finding in surgical lung biopsy specimens and transbronchial biopsy specimens of patients in urban area because carbon (coal dust) is a ubiquitous air pollutant. A characteristic distribution is often discernible, with dust deposited along lymphatic routes in the pleura and bronchovascular sheaths. When inhaled it is picked up by macrophages within the alveoli and is then transported through lymphatic channels to the regional lymph nodes in the tracheobronchial region.

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6
Q

A 44 year-old woman uderwent breast biopsy for some unspecified radiographic abnormalities. In the biopsied tissue (shown below), identify the histological abnormalities.

A
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7
Q

A 52-year-old man presented to the dermatology clinic complaining of tightness in his legs. The pain was bilaterally symmetric and had not been progressing. Chronic renal failure was diagnosed 9 years ago, and the patient has been treated with hemodialysis since that time. His calcium is markedly elevated. A skin biopsy was performed to confirm the suspected diagnosis. The biopsy is shown below. Which of the followings is not a cause of hypercalcemia?

Increased secretion of parathyroid hormone (PTH) with subsequent bone resorption, as in hyperparathyroidism

Resorption of bone tissue secondary to primary tumors of bone marrow or cancer metastases

Renal failure which causes retention of phosphate, leading to secondary hyperparathyroidism

Vitamin D-related disordered including vitamin D insufficiency

A

Vitamin D-related disordered including vitamin D insufficiency

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8
Q

Which of the following statements is FALSE regarding dystrohic calcification?

It commonly develops in aging or damaged heart valves

It is almost always present in the atheromas of advanced atherosclerosis

It is encountered in areas of all types of necrosis, except in fat necrosis

The calcium salts appear macroscopically as fine, white gritty deposits

A

It is encountered in areas of all types of necrosis, except in fat necrosis

Dystrophic calcification is encountered in areas of necrosis, whether they are of coagulative, caseous, or liquefactive type, and in foci of enzymatic necrosis of fat.

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