May HY review

Question 1

What is the cause of a hyperacute transplant rejection?

Answer 1

Preformed recipient antibodies against the graft antigens

Question 2

What are the morphologic findings of a hyperacute transplant rejection?

Answer 2

Gross mottling and cyanosis

Arterial fibrinoid necrosis and capillary thrombotic occlusion

Question 3

What is the cause of an acute transplant rejection?

Answer 3

Exposure to donor antigens activates naive immune cells

Cell mediated

Question 4

What are the cellular changes that occur in an acute transplant rejection?

Answer 4

Lymphocytic interstitial infiltrate and endotheliitis

Question 5

What are the humoral changes that occur in acute transplant rejection?

Answer 5

C4d deposition, neutrophilic infiltrate, necrotizing vasculitis

Question 6

What are the causes of a chronic transplant rejection?

Answer 6

Chronic low grade response refractory to immunosuppression

MIXED cell mediated and humoral responses

Question 7

What are the morphologic changes that occurs in chronic transplant rejection?

Answer 7

Vascular wall thickening and interstitial fibrosis and parenchymal atrophy

Question 8

What are the changes in the cardiac muscle from 4-24 hours post-MI?

Answer 8

Digestion of cytoplasmic organelles, denaturation of proteins, and loss of RNA becomes visible

Wavy, hypereosinophilic myocytes with shrunken nuclei that occurs mainly in the center of the infarct

Question 9

What are the changes that occur in the cardiac muscle 1-3 days post MI?

Answer 9

NEUTROPHILS come in along the border of the injured tissue and make their way to the center of the infarct. They clean up the dead myocytes and release lysosomal enzymes, ROS, and cytokines that protect from pathogens. Also aids in wound healing

Question 10

What are the changes that occur in the cardiac muscle 3-10 days post MI?

Answer 10

MACROPHAGES come in and clean up any remaining dead myocytes and neutrophils

Start to form granulation tissue by releasing cytokines and growth factors

Question 11

What are the changes that occur in the cardiac muscle 10-14 days post-MI?

Answer 11

There is prominent fibroblast proliferation, collagen deposition, and neovascularization of granular tissue

Question 12

What are the changes that occur in the cardiac muscle 2 weeks- 2 months post-MI?

Answer 12

Collagen remodels and fibroblasts differentiate into myofibroblasts and form scar tissue

Question 13

What is the embryological event that is most likely behind tetraology of Fallot?

Answer 13

Deviation of the infundibular septum

Question 14

What are the 4 distinct abnormalities of Tetralogy of Fallot?

Answer 14

1. VSD
2. Overriding aorta over the R and L ventricles
3. Right ventricular outflow tract obstruction
4. Right ventricular hypertrophy

Question 15

What is the cranial nerve and vessels that come from the first pharyngeal and aortic arch?

Answer 15

Trigeminal Nerve (V)

Maxillary artery

Question 16

What is the cranial nerve and vessels that come from the second pharyngeal and aortic arch?

Answer 16

Facial nerve (VII)

Stapedial artery (regresses)

Question 17

What is the cranial nerve and vessels that come from the third pharyngeal and aortic arch?

Answer 17

Glossopharyngeal (IX)

Common carotid artery
proximal internal carotid artery

Question 18

What is the cranial nerve and vessels that come from the fourth pharyngeal and aortic arch?

Answer 18

Superior laryngeal branch of the vagus (X)

True aortic arch and subclavian arteries

Question 19

What is the cranial nerve and vessels that come from the sixth pharyngeal and aortic arch?

Answer 19

Recurrent laryngeal branch (X)

Pulmonary arteries and ductus arteriosus

Question 20

What two anatomical areas/ vessels have the greatest difference in blood oxygen content?

Answer 20

The aorta and the coronary sinus

Question 21

What stage of HepB is shown here?
HBsAg detectable

HBeAg

anti-HBc IgM

anti-HBc IgG

Answer 21

Acute infection

Question 22

What stage of HepB is seen here?

Anti-HBs

Anti-HBe

Answer 22

Cleared infection

Question 23

What immunoglobulin demonstrates the window phase of HepB?

Answer 23

Anti-HBc IgM

Question 24

What does the marker Anti-HBe indicate?

Answer 24

Decreased viral replication and infectivity

3-6 months after the initial infection

Question 25

What provides protective immunity from Hep B in the future?

Answer 25

Anti-HBsAg

Question 26

A newborn baby is being evaluated in the nursery. His head is normal size, his hips show no clicking. both of his feet are plantar flexed and adducted with the soles pointing medially. There is resistance to range of motion assessment in both feet. Muscle tone is normal and newborn reflexes are intact. The abnormal findings on this examination is most likely representative of what pathology? What is the cause of this pathology?

Answer 26

Talipes Equinovarus

A deformation anomaly from extrinsic forces on the developing fetus causing an underdevelopment of the talus bone

Question 27

A ________ refers to destruction of a structure that was previously developing normally. Examples include amniotic bands, constriction rings, hypoplasia, or amputation of the distal extremity.

Answer 27

Disruption

Question 28

_______ is the proliferation of abnormal cells, leading to abnormal formation of an organ

Answer 28

Dysplasia

Question 29

How do live attenuated vaccinations work?

Answer 29

Introduce a disabled virus that replicates but causes minimal illness. The virus infects host cells and creates a long lasting humoral and cell mediated immune response that mirrors a normal infection

Question 30

How do inactivated vaccinations work?

Answer 30

Viral fragments are introduced and taken up by the APCs and displayed by the B and T lymphocytes. The virus doesnt replicate with the host cells so it is more of a humoral immunity response: multiple boosters are needed

Question 31

How do mRNA vaccinations work?

Answer 31

Can be rapidly produced and can target any known protein

They can then be translated to the encoded viral protein and translate to the cell surface. This triggers a B and T cell mediated response which leads to long lasting immunity

Question 32

How do alcohol based disinfectants work? What do they target?

Answer 32

The disinfectant ills vegetative bacteria, fungus, and enveloped viruses.

It dissolves the lipid bilayer membrane and denatures their proteins