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LEVEL II > PATHO BMEX > Flashcards

PATHO BMEX Flashcards

1
Q

Cyanide poisoning

A. forms free radicals
B. acts on the Krebs cycle
C. inhibits oxidation-reduction
D. inhibits cell mitosis

A

C. inhibits oxidation-reduction

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2
Q

Features of Warburg effect, which is an adaptation mechanism, include the following, EXCEPT

A. Anaerobic glycolysis
B. Production of lactate
C. Metabolites produced are precursor for synthesis of cellular components
D. Increase rate of glucose uptake

A

A. Anaerobic glycolysis

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3
Q

Hyaline change is usually associated with chronic

A. Alzheimer’s disease
B. Gaucher’s disease
C. hypertension
D. nephrotic syndrome

A

C. hypertension

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4
Q

In apoptosis, activation of plasma membrane receptor ___ by its ligand by-passes BCL2 to activate other caspases

A. CD94
B. CD94
C. CD93
D. CD95

A

D. CD95

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5
Q

Most important in the pathogenesis of ischemic cell injury is

A. ribosomal detachment → ↓ protein synthesis →
cytoskeletal abnormality
B. reduced ATP → ↑ cytosolic calcium → membrane injury
C. free radical formation → DNA damage → cell injury
D. lipid peroxidation → lipid deposition → fatty change

A

B. reduced ATP → ↑ cytosolic calcium → membrane injury

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6
Q

Starvation can cause fatty change in the liver by

A. decreased apoprotein synthesis
B. excessive entry of free fatty acid
C. decreased fatty acid oxidation
D. increased fatty acid synthesis

A

B. excessive entry of free fatty acid

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7
Q

This is an UNLIKELY effect of hypoxia on the cell

A. Increased cytosolic calcium
B. Impaired protein synthesis
C. Metabolic acidosis
D. Mutation of DNA

A

D. Mutation of DNA

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8
Q

What form of hyperplasia dose endometrial hyperplasia convey?

A. Pathologic
B. Hormonal
C. Compensatory
D. Cancerous

A

A. Pathologic

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9
Q

What medical ailment may allow the creeping spread of gangrenous necrosis if it is poorly managed?

A. Hypertension
B. Stroke
C. Diabetes
D. Trauma

A

C. Diabetes

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10
Q

A 30-year-old carpenter hit his thumb while hammering a nail. The skin is not broken. Within 2 days there is a purple color to the site of injury. Which of the following substances has most likely accumulated at the site of injury to produce a yellow-brown color 14 days later?

A. Bilirubin
B. Bilirubin
C. Lipofuscin
D. Hemosiderin

A

D. Hemosiderin

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11
Q

Biopsy of an inflamed skin lesion shows vasodilation and leukocyte margination. What glycoprotein mediates initial anchorage of segmented neutrophils to endothelial cells in this skin lesion?

A. Selectin
B. Integrin
C. Laminin
D. Cadherin

A

A. Selectin

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12
Q

Granulomatous inflammation

A. may sometimes be a component of the acute inflammatory response
B. consists in part of microscopic aggregates of transported lymphocytes
C. may result from non-immune mechanisms
D. indicates the presence of tuberculosis

A

B. consists in part of microscopic aggregates of transported lymphocytes

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13
Q

In acute inflammation, this hemodynamic event is the last to occur

A. Margination
B. Phagocytosis
C. Stasis
D. Emigration

A

C. Stasis

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14
Q

One of the most efficient mechanisms of clearing pathogenic bacteria

A. Natural killer cell
B. Antibody-dependent cell cytotoxicity
C. Complement-mediated opsonization
D. Cytotoxic T cell lymphocyte

A

C. Complement-mediated opsonization

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15
Q

Which of the following is responsible for fever in acute inflammation?

A. Leukotriene E4
B. Pathogen associated molecular patterns
C. Prostaglandin E2
D. C3a

A

C. Prostaglandin E2

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16
Q

Which of the following is true of granulation tissue?

A. It is primarily a collection of fibrin/platelet clot
B. Most collagen in normal skin is type III
C. Fibroblasts involved in wound repair migrate into the wound from the systemic circulation
D. Most collagen in healed wounds is type I

A

D. Most collagen in healed wounds is type I

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17
Q

Which of the following sequence is NOT appropriate if you’re asked to detail the sequence of events in the healing of a gaping skin wound?

A. One week – surface debris is shed
B. Few days – full thickness epithelium restored
C. Many months – remodeling of collagen
D. Early – blood clot fills the wound

A

B. Few days – full thickness epithelium restored

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18
Q

A 50-year-old man was brought to the ER for chest pain. An elevated serum creatinine kinase and an angiogram reveals he had a heart attack. Which of the following substances would you most expect to be elaborated around the region of tissue damage in the next 3 days as an initial response to increase myocardial function and promote healing?

A. EGF
B. Leukotriene B4
C. VEGF
D. PDGF

A

C. VEGF

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19
Q

A 10-year-old boy trips at school and scrapes the palms of his hands. The wounds are cleaned and covered with sterile gauze. Which of the following cellular processes helps restore normal epithelium structure and function?

A. Collagen and fibronectin-rich extracellular matrix deposition
B. Myofibroblast differentiation and syncytia formation
C. Contact inhibition of epithelial cell growth and motility
D. Proliferation of capillary endothelial cells (angiogenesis)

A

C. Contact inhibition of epithelial cell growth and
motility

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20
Q

A 34-year-old woman has a benign mole removed from her back under local anesthesia. Which of the following families of cell adhesion molecules is the principal component of the “provisional matrix” that forms during early wound healing?

A. Laminins
B. Integrins
C. Cadherins
D. Fibronectins

A

D. Fibronectins

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21
Q

A medical student develops a “red face” after being asked a question during a lecture. Which of the following statements best describes the vascular reaction?

A. Passive hyperemia
B. Minute hemorrhage
C. Allergic reaction
D. Active hyperemia

A

D. Active hyperemia

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22
Q

A patient suffers a massive heart attack and dies. Microscopic examination of the liver at autopsy would most likely reveal which of the following histopathologic changes?

A. Sinusoids dilated with blood
B. Massive hepatic necrosis
C. Large iron deposits with hepatocytes
D. Diffuse hydropic degeneration

A

A. Sinusoids dilated with blood

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23
Q

Deep vein thrombosis may lead to

A. cerebral infarction
B. pulmonary hemorrhage
C. myocardial infarction
D. None of these

A

B. pulmonary hemorrhage

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24
Q

Infarcts typical of arterial occlusion in solid organs are

A. red
B. black
C. caseous
D. white

A

D. white

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25
Q

How does a physician prove or confirm the diagnosis of Cooley’s anemia?

A. Flow cytometry
B. Hemoglobin electrophoresis
C. Coomb’s test
D. Sodium metabisulfite test

A

B. Hemoglobin electrophoresis

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26
Q

The development of aplastic anemia most often stems from which of the following?

A. Acquired clonal stem cell disorder
B. Bone marrow stem cell injury
C. Autoantibodies directed against the red cell surface
D. Impaired DNA synthesis

A

A. Acquired clonal stem cell disorder

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27
Q

Well-made blood smears offer insights as to the underlying cause of anemia and, as for microangiopathic hemolytic anemia, what blood cell is most readily found?

A. Target cell
B. Schistocyte
C. Bite cell
D. Stomatocyte

A

B. Schistocyte

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28
Q

Which laboratory blood parameter is not depressed in cases of severe beta-thalassemia major?

A. MCV
B. MCHC
C. Haptoglobin
D. Serum iron

A

D. Serum iron

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29
Q

Which of the following pairs is correct demonstrating an observable tissue change in organs impaired by severe anemia?

A. Liver: fatty change
B. Myocardium: hypertrophy
C. Kidney: hydropic degeneration
D. Eye: retinopathy

A

A. Liver: fatty change

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30
Q

A 40-year-old man experienced near-drowning while snorkeling. Six hours later, the patient develops acute renal failure. Kidney biopsy reveals evidence of karyorrhexis and karyolysis in renal tubular epithelial cells. Which of the following biochemical events preceded these pathologic changes?

A. Decrease in intracellular calcium
B. Activation of Na+/K+ ATPase
C. Increase in ATP production
D. Decrease in intracellular pH

A

D. Decrease in intracellular pH

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31
Q

A middle-aged man presents with increasing abdominal girth and yellow discoloration of his skin and sclera. PE reveals hepatomegaly and jaundice. A Prussian blue stain of a liver biopsy is positive. What is the major intracellular accumulation in this patient’s hepatocytes?

A. Hemosiderin
B. Bilirubin
C. Transferrin
D. Hemoglobin

A

A. Hemosiderin

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32
Q

An elderly woman suffers an acute myocardial infarction. Thrombolytic therapy is administered to restore coronary blood flow. In spite of this therapy, the degree of myocardial fiber injury may increase because of which of the following cellular abnormalities?

A. Increased free radical formation
B. Loss of cytoskeletal proteins
C. Decreased intracellular pH from anaerobic glycolysis
D. Clumping of nuclear chromatin

A

A. Increased free radical formation

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33
Q

Excision and microscopic exam of a lung nodule from a TB patient shows caseous necrosis and calcification. Which of the following processes explains the appearance of calcium deposition?

A. Dystrophic calcification
B. Excessive ingestion of Ca++
C. Hypercalcemia
D. Metastatic calcification

A

A. Dystrophic calcification

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34
Q

A medical student with asthma presents with respiratory distress. Which of the following mediators of inflammation is the most powerful stimulator of bronchoconstriction and vasoconstriction in this patient?

A. Interleukin-1
B. Bradykinin
C. Leukotrienes
D. TNF-α

A

C. Leukotrienes

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35
Q

A young woman developed a growth on her earlobe after getting her ears pierced. The swelling is not painful but is unsightly to look at and is growing. Which of the following factors is responsible for this patient’s condition?

A. Interleukin-6
B. Interleukin-10
C. TGF-β
D. ADP

A

C. TGF-β

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36
Q

Formylated peptides derived from bacteria, leukotrienes derived from plasma membranes and complement fragments have in common in that they all mediate a process important for formation of pus. This process is called

A. margination
B. chemotaxis
C. phagocytosis
D. extravasation

A

B. chemotaxis

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37
Q

Group of plasma proteins that upon activation form intermediate complexes and fragments which act as vasoactive mediators of inflammation, prime phagocytic cells for a more active response to bacteria, and act as chemotactic factors

A. Kallikreins
B. Hageman factor
C. Complement
D. Kinins

A

C. Complement

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38
Q

A 65-year-old man was admitted to the hospital with complaints of squeezing chest pain radiating to the left arm and excessive sweating three days ago. He was given emergency interventions followed by medical management. This morning, the patient is complaining again of mild chest discomfort increasing consistently. Which of the following biomarkers is most likely to help reach a diagnosis in this patient?

A. Aspartate aminotransferase
B. Troponin
C. Creatinine kinase
D. Alkaline phosphatase

A

C. Creatinine kinase

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39
Q

A 72-year-old female presents to the hospital with shortness of breath and lethargy. She complains of dull aching pain in both lower extremities. On examination, bilateral pitting edema is noted on both ankles. Which of the following is the likely cause of this edema?

A. Chronic venous insufficiency
B. Cardiac or systemic origin
C. Hyperlipidemia
D. Primary varicose veins

A

B. Cardiac or systemic origin

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40
Q

An elderly woman has sudden onset of severe dyspnea and goes into cardiac arrest, from which she cannot be resuscitated. At autopsy, she has the gross finding of a saddle pulmonary embolus. This event is most likely to present as a consequence of which of the following?

A. Marked thrombocytopenia
B. Congestive heart failure
C. Cerebrovascular accident
D. Placement of a hip prosthesis

A

D. Placement of a hip prosthesis

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41
Q

Fill in the blanks: “The osmotic fragility test uses RBCs suspended in buffered solutions of varying concentration to validate the presence of an erythrocyte membrane defect. RBC lyses when incubated in a ______ NaCl solution in a patient with _______.”

A. hypertonic; sickle cell anemia
B. hypotonic; hereditary stomatocytosis
C. hypotonic; hereditary spherocytosis
D. hypertonic; hereditary spherocytosis

A

C. hypotonic; hereditary spherocytosis

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42
Q

Before surgical removal of the uterus of a patient with leiomyosarcoma, it is desirable to look for metastasis in the

A. brain
B. lung
C. liver
D. bone

A

B. lung

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43
Q

Cellular proteins that are important to a carcinoma’s ability to invade surrounding matrix include all of the following, EXCEPT

A. fibronectin receptor
B. type IV collagenase
C. laminin receptor
D. CD44 adhesion molecule

A

D. CD44 adhesion molecule

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44
Q

P53 gene mutation results in loss of its tumor suppressor activity. Cellular neoplastic transformation arising from the mutation is due to

A. activation of GF receptor
B. inability to hydrolyze GTP
C. loss of cell cycle arrest
D. transcriptional activation

A

C. loss of cell cycle arrest

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45
Q

This is a mismatch

A. MYC mutation – angiogenesis
B. β-catenin gene activation – invasion
C. PD-L1 – immunoediting
D. β2-microglobulin – metastasis

A

D. β2-microglobulin – metastasis

46
Q

This is a mismatch: Tumor marker – Tumor type

A. APC mutants in serum – Colon cancer
B. Carcinoembryonic antigen – Pancreatic cancer
C. Immunoglobulins – Multiple myeloma
D. CA-125 – Breast cancer

A

D. CA-125 – Breast cancer

47
Q

Which of the following genes is most likely translocated and leads to formation of hybrid gene that greatly increases tyrosine kinase activity?

A. P53
B. RAS
C. RB
D. ABL

A

D. ABL

48
Q

Which of the following phases of the cell growth cycle is most likely to be affected in a patient with ovarian cancer from mutation of P53 gene?

A. Prophase
B. G2
C. G1
D. S phase

A

C. G1

49
Q

A 68-year-old man complains of recent changes in bowel habits and blood-tinged stools.
Colonoscopy reveals a mass in the sigmoid colon. Biopsy of the mass shows infiltrating malignant glands. These neoplastic cells have most likely acquired a set of mutations that cause which of the following changes in cell behavior?

A. Loss of cell cycle restriction point control
B. Decreased cellular motility
C. Increased cell-cell adhesion
D. Enhanced stem cell differentiation

A

A. Loss of cell cycle restriction point control

50
Q

A child is born with a single functional allele of a tumor suppressor gene. At the age of five the remaining normal allele is lost through a point mutation. As a result, the ability to inhibit cell cycle progression until the cell is ready to divide is lost. Which of the following neoplasms is most likely to arise via this mechanism?

A. Retinoblastoma of eye
B. Chronic myeloid leukemia
C. Infiltrating ductal carcinoma of breast
D. Small cell carcinoma of the lung

A

A. Retinoblastoma of eye

51
Q

A healthy 40 y.o. male has a skin nodule on his right arm that has become larger and darker with more irregular outlines over the past 3 months. On PE, this lesion is darkly pigmented, and slightly raised nodule. No other skin lesions are noted. Three non-tender enlarged lymph nodes are palpable in the right axilla. The lesion is excised and microscopic examination shows a neoplasm composed of darkly pigmented, atypical, polygonal, spindle cells. Which of the following risk factors is most important for development of this neoplasm?

A. Allergy to insect bite
B. Inheritance of a faulty mutant gene
C. Chronic exposure to ultraviolet radiation
D. Cigarette smoking

A

C. Chronic exposure to ultraviolet radiation

52
Q

A 50-year-old woman present with a 2-year history of upper truncal obesity and depression. Serum levels of glucose and cortisol are elevated. A CT scan of the abdomen reveals a 2-cm suprarenal mass. If this neoplasm is benign, which of the following is the most appropriate diagnosis?

A. Adenoma
B. Chondroma
C. Teratoma
D. Lipoma

A

A. Adenoma

53
Q

During hospitalization, an elderly woman develops thrombophlebitis. She recovers and is discharged. Months later, which of the following terms would best describe the process seen in a femoral vein after recovery from her thrombophlebitis?

A. Organization
B. Embolization
C. Propagation
D. Chronic inflammation

A

A. Organization

54
Q

A 50-year-old firefighter emerges from a burning house with third-degree burns over 70% of his body. The patient dies 24 hours later. Which of the following is most likely cause of death?

A. Hypovolemic shock
B. Asphyxia
C. Pulmonary saddle embolism
D. Congestive heart failure

A

A. Hypovolemic shock

55
Q

A depressed teenage girl swallows a commercial solvent. A liver biopsy demonstrates severe swelling of the centrilobular hepatocytes. Which of the following mechanisms of disease best accounts for the reversible changes noted in this liver biopsy?

A. Decreased stores of intracellular ATP
B. Protein aggregation due to increased cytosolic pH
C. Intracytoplasmic rupture if lysosomes
D. Mitochondrial membrane permeability

A

A. Decreased stores of intracellular ATP

56
Q

The Armani-Ebstein cells are glycogen deposits found in which organ of diabetic patients?

A. Liver
B. Pancreas
C. Heart
D. Kidney

A

D. Kidney

57
Q

The tumor-suppressor gene often implicated in a classic two-hit mechanism for loss of tumor
suppression is

A. BCL2
B. K-RAS
C. Rb
D. p53

A

C. Rb

58
Q

Siderosis is a lung disease caused by inhalation of particles of

A. Coal dust
B. Iron
C. Mercury
D. Carbon

A

B. Iron

59
Q

A young woman in excellent health has a 2 cm firm, rounded mass palpable beneath the skin of the left forearm. She has no difficulty using the arm and there is no associating pain with the mass, either in movement or on palpation. The overlying skin appears normal. The mass does not change in size over the next year. Which of the following neoplasms is she most likely to have?

A. Melanoma
B. Metastatic carcinoma
C. Leiomyoma
D. Lipoma

A
60
Q

A young woman in excellent health has a 2 cm firm, rounded mass palpable beneath the skin of the left forearm. She has no difficulty using the arm and there is no associating pain with the mass, either in movement or on palpation. The overlying skin appears normal. The mass does not change in size over the next year. Which of the following neoplasms is she most likely to have?

A. Melanoma
B. Metastatic carcinoma
C. Leiomyoma
D. Lipoma

A

D. Lipoma

61
Q

Which is considered as the most reactive oxygen-derived free radical?

A. Peroxynitrite
B. Hypochlorite
C. Hydroxyl radical
D. Superoxide anion

A

C. Hydroxyl radical

62
Q

Identify the chemical mediator described.

Principal cyclooxygenase product in platelets which causes platelet aggregation

A. Prostacyclin
B. Serotonin
C. Thromboxane A2
D. Prostaglandin D2
E. Prostaglandin E2

A

C. Thromboxane A2

63
Q

Identify the chemical mediator described.

Principal cyclooxygenase product of endothelial cells which causes vasodilation

A. Prostacyclin
B. Serotonin
C. Thromboxane A2
D. Prostaglandin D2
E. Prostaglandin E2

A

A. Prostacyclin

64
Q

Identify the chemical mediator described.

Major product of mast cells which causes bronchoconstriction and vasodilation

A. Prostacyclin
B. Serotonin
C. Thromboxane A2
D. Prostaglandin D2
E. Prostaglandin E2

A

D. Prostaglandin D2

65
Q

Which of the following factors causes chemical cellular injury by being converted to toxic metabolites forming free radicals?

A. Mercuric chloride
B. Carbon tetrachloride
C. Ultraviolet rays
D. Cyanide

A

B. Carbon tetrachloride

66
Q

Lung metastasis from breast carcinoma is most likely related to

A. Lymphatic connections
B. Proximity of breast to the lungs
C. A matching ligand-receptor binding
D. Internal mammary artery spread

A

C. A matching ligand-receptor binding

67
Q

The most common oncogene involved in the development of human cancer is

A. p53
B. RAS
C. myc
D. APC

A

B. RAS

68
Q

What is the immediate effect of reduction in oxidative phosphorylation and mitochondrial activity?

A. Clumping of chromatin
B. Vacuolar degeneration
C. Fatty change
D. Necrosis

A

B. Vacuolar degeneration

69
Q

Emigration during acute inflammation is best morphologically manifested as

A. Attachment of PMN on endothelial lining
B. Concentration of WBC at peripheral part of the blood stream
C. Presence of PMN in muscular wall of blood vessel
D. Aggregation of WBC in particular area of interstitial tissue

A

C. Presence of PMN in muscular wall of blood vessel

70
Q

In adult patient showing manifestations of acute inflammation, the giving of NSAIDs is most likely to
minimize this feature of the acute inflammatory response

A. Vasodilation
B. Emigration
C. Phagocytosis
D. Chemotaxis

A

A. Vasodilation

71
Q

The hallmark of acute inflammation is

A. Tissue damage
B. Angiogenesis
C. Active hyperemia
D. Vascular leakage

A

D. Vascular leakage

72
Q

Sectioning of an organ from a 60-year-old man during autopsy shows focal, wedge-shaped area that is firm and is accompanied by extensive hemorrhage, giving it a red appearance. The lesion has a base on the surface of the organ. In which of the following situations will the lesion most likely occur?

A. Heart with coronary thrombosis
B. Kidney with septic embolus
C. Brain with cerebral arterial aneurysm
D. Lung with pulmonary thromboembolism

A

D. Lung with pulmonary thromboembolism

73
Q

Microscopic exam of a biopsy from a gastric ulcer base showed fibrosis, mononuclear cell infiltrates, angiogenesis. The pathologic process is a

A. Granulomatous inflammation
B. Healed abscess
C. Granulation tissue
D. Chronic inflammation

A

D. Chronic inflammation

74
Q

A hysterectomy was done in a 70-year-old woman with a fleshy, tan mass replacing the uterus. Microscopy showed a pleomorphic spindle cell tumor with mitotic figure >20/hpf, and extensive necrosis. The most likely diagnosis is

A. Leiomyosarcoma
B. Choriocarcinoma
C. Leiomyoma
D. Hydatidiform mole

A

A. Leiomyosarcoma

75
Q

Atherosclerosis is the accumulation of foam cells and smooth muscle cells in which layer of the aorta or artery?

A. Intima
B. Serosa
C. Adventitia
D. Media

A

A. Intima

76
Q

An alcoholic is brought to the ER 4 hours after vomiting blood and experiencing bloody stools. The patient was diagnosed with alcoholic cirrhosis 2 years ago. Endoscopy reveals large esophageal varices, one of which is actively bleeding. Which of the following best explains the pathogenesis of dilated esophageal veins in this patient?

A. Increased capillary permeability
B. Increased intravascular hydrostatic pressure
C. Decreased intravascular oncotic pressure
D. Vasodilation of capillaries

A

B. Increased intravascular hydrostatic pressure

77
Q

Adaptation has happened if the cell

A. Undergoes dystrophic calcification
B. Undergoes necrosis
C. Loses its genetic apparatus
D. Is replaced by another cell type

A

D. Is replaced by another cell type

78
Q

What is the tumor marker for germ cell tumors?

A. A carcinoembryonic antigen
B. Human chorionic gonadotrophin
C. Acid phosphatase
D. Alpha fetoprotein

A

D. Alpha fetoprotein

79
Q

Psoriasis is a form of hyperplasia due to chronic injury. It is characterized by the presence of nucleated keratinocytes in the stratum corneum which is called

A. Hypokeratosis
B. Parakeratosis
C. Hyperkaratosis
D. Prekeratosis

A

B. Parakeratosis

80
Q

A young girl had a swollen tonsil with an overlying yellow exudate. Which of these substances is most likely to increase in response to pyrogens released by the activated macrophage

A. Interleukin
B. Prostaglandin
C. TNF
D. NO

A

B. Prostaglandin

81
Q

A 25-year-old laborer is injured by a piece of metal in his left hand. The patient goes to the ER to have the metal removed. Which of the following mediators of inflammation plays the most important role in stimulating platelet aggregation at the site of injury following this minor surgical procedure?

A. Prostaglandin E2
B. Leukotriene C4
C. Leukotriene D4
D. Thromboxane A2

A

D. Thromboxane A2

82
Q

Histologic examination of the esophagus in a 60-year-old man with a history of gastroesophageal reflux disease would likely show

A. Atypical hyperplasia
B. Glandular metaplasia
C. Simple hyperplasia
D. Squamous metaplasia

A

B. Glandular metaplasia

83
Q

A college student who is a book nerd frequently has his meal as at a fast food store. Which tissue change is most likely to occur in his body

A. Hypertrophy of adipocytes
B. Fatty degeneration of myocardium
C. Atherosclerosis
D. Metaplasia of muscle cells to fat cells

A

A. Hypertrophy of adipocytes

84
Q

A karate instructor incurs traumatic blow on his left upper arm. He continues to have pain and tenderness even after 3 months have passed plain film x-ray showed 4 cm circumscribed mass of soft tissue adjacent to the humerus. The mass showed peripheral brightness in xray. Over the next year the mass gradually resolved. Which of the following is the mechanism regarding the mass

A. Hypertrophy
B. Dysplasia
C. Metaplasia
D. Tumor mass

A

C. Metaplasia

85
Q

You are part of the research project on stroke of guinea pig. Which of the following happens in ischemic tissue

A. Influx Na and Ca
B. Influx of K & Ca
C. Efflux of Na and Ca
D. Efflux of K & Ca

A

A. Influx Na and Ca

86
Q

During cellular hypoxia, shift to anaerobic glycolysis will lead to

A. Inhibit phosphofructokinase
B. Unmasking of phosphatide groups
C. Increased cellular pH
D. All of the above

A

B. Unmasking of phosphatide groups

87
Q

An elderly woman complains of SOB and chest pain that radiates to her left shoulder. Despite thromboembolic treatment, she still died. What will you see under the light microscope when you view her heart

A. Swelling of myocardial cells
B. Rupture of myocardial cell
C. Calcification of myocardial cell
D. Preservation of anucleated myocardial cellsmembrane

A

B. Rupture of myocardial cell

88
Q

An elderly woman has breast cancer. She is treated with a chemotherapeutic agent which results in the loss of individual neoplastic cells through fragmentation of nuclei and cytoplasm. Over the following months, the tumor decreases in size, as seen on abdominal CT scans. By which of the following mechanisms has the neoplasm responded to therapy

A. Phagocytosis
B. Acute inflammation
C. Apoptosis
D. Granulomatous necrosis

A

C. Apoptosis

89
Q

A young adult went on a vacation and later spends time on the beach. The next day, he has a darker complexion. His skin showed no warmth, erythema, and tenderness. His complexion returned to its original color within a month. Which of the following substances explains the biochemical process of the skin changes

A. Lipofuscin
B. Iron oxide
C. Tyrosine
D. Glycogen

A

C. Tyrosine

90
Q

Microscopic exam of a lung nodule from a TB patient shows caseous necrosis & calcification. Which of the following is responsible for the accumulation of calcium

A. Metastatic calcification
B. Dystrophic calcification
C. Hypercalcemia
D. Ingestion of calcium

A

B. Dystrophic calcification

91
Q

Boy falls on rusty nail and punctures his skin. Wound is cleaned and covered with sterile gauze. Which of the following is the initial event of healing process?

A. Formation of Fibrin Clot
B. Accumulation of acute inflammatory cells
C. Differentiation and migration of myofibroblasts
D. Macrophage-mediated phagocytosis of cellular debris

A

A. Formation of Fibrin Clot

92
Q

A diagnosis of staphylococcus aureus pneumonia is made on an elderly female. She receives a course of antibiotic therapy 2 weeks later. She has no productive cough but she still has fever. Chest X-ray reveals 3cm rounded density in Right Lower Lobe whose liquified contents form a central-air fluid level. There are no surrounding infiltrates. What is the best description for this outcome of her pneumonia.

A. Regeneration
B. Hypertrophic scar
C. Abscess formation
D. Progressive Chronic Inflammation

A

C. Abscess formation

93
Q

Which of the following proteins activate the complement, coagulation, and fibrinolytic pathways?

A. Bradykinin
B. Hageman factor
C. Kallikrein
D. Plasmin

A

B. Hageman factor

94
Q

A 40 year old man complained of 2 weeks increasing abdominal pain. PE shows Right Upper Quadrant pain. Elevated Alkaline Phosphatase and Bilirubin. Portal fibrosis and accumulation of Schistosome eggs. Which of the following inflammatory cells would dominate?

A. Basophil
B. Eosinophil
C. Macrophage
D. Plasma cell

A

B. Eosinophil

95
Q

A 50 yr old woman with long standing diabetes and hypertension develops end-stage renal disease and dies. A shaggy fibrin rich exudate is noted on the visceral pericardium at autopsy. Which of the following best explains pathogenesis of this fibrinous exudates?

A. chronic passive congestion
B. marginalization of segmented neutrophils
C. injury and increase neutrophils
D. antibody binding and complement activation

A

C. injury and increase neutrophils

96
Q

A 40 y.o female presents with cough and fever.
Chest Xray - (+) of granuloma
Sputum Sample - (+) Tb bacteria
What type of cells causes the formation of epithelioid in this case?

A. Macrophage
B. Lymphocyte
C. B cell
D. T cell

A

A. Macrophage

97
Q

Which of the ff proteins helps stimulate healing and angiogenesis in a patient with diabetes and who develops an ulcer in her right leg?

A. a1-antitrypsin
B. Desmin
C. a2-macroglobulin
D. Metalloproteinases

A

D. Metalloproteinases

98
Q

Chronic Granulomatous disease is characterized by impaired microbicidal ability due to

A. NADH oxidase deficiency
B. T cell deficiency
C. Lack of adhesion molecules
D. Complement deficiency

A

A. NADH oxidase deficiency

99
Q

Collagen deposition that accompanies tissue reaction with inhalation of silica dust in a senior citizen, with increasing dyspnea, no cough, no fever with multiple pulmonary nodules is primarily a function of

A. Histamine release of mast cells
B. Foreign body giant cell formation
C. Plasma B cell production of Immunoglobulin
D. Release of Growth factors by macrophages

A

D. Release of Growth factors by macrophages

100
Q

Presence of hemosiderin-laden macrophages in alveolar spaces and seprae indicate:

A. Right heart failure
B. Patient is receiving blood transfusion
C. Occurence of previous hemorrhage
D. All of these

A

C. Occurence of previous hemorrhage

101
Q

An elderly women with heart failure complain of swelling in her legs. The following can help aleviate the edema except:

A. reduce blood volume through the use of diuretic drugs
B. elevate the legs whenever possible to lower the venous pressure
C. use of vasodilatory drugs to reduce the precapillary resistance
D. increase tissue interstitial pressure by wearing compression stockings

A

C. use of vasodilatory drugs to reduce the precapillary
resistance

102
Q

A 60 year old male with ischemic heart disease and has a history of smoking complains of increasing shortness of breath. PE revealed that the patient has swollen legs, enlarged liver, and fluid located at the pleural spaces ( rales can be heard upon auscultation). The patient suffered massive heart attack and dies. Microscopic examination of the liver at autopsy showed which of the following histopathologic changes?

A. Massive hepatic necrosis
B. Diffused hydropic degeneration
C. Large iron deposits within hepatocytes
D. Sinusoids dilated with blood

A

D. Sinusoids dilated with blood

103
Q

Which of the following types of capillaries permits plasma and interstitial proteins exerts the strongest oncotic effect

A. Continuous
B. Fenestrated
C. Discontinous
D. None of these

A

C. Discontinous

104
Q

On sectioning of an organ of a 60-year-old man during autopsy, a focal, wedge-shape that is firm shows extensive hemorrage, giving it a red appearance. The base of the organ is the surface of the lesion. Which of these correctly describes the lesion?

A. Kidney with septic embolus
B. Heart with cardiac thrombus
C. Brain with cerebral artery aneurysm
D. Lung with pulmonary thromboembolus

A

D. Lung with pulmonary thromboembolus

105
Q

A 65 yo woman with a history of heavy smoking and repetitive bouts of pneumonia with a 2-week fever history and productive cough. A transbroncial biopsy confirmed pneumonia and showed preneoplastic changes of bronchial mucosa. Which of the following describes the bronchial mucosal lesion?

A. Abnormal pattern of cellular maturation
B. Ulceration and necrosis of epithelial cells
C. Increase in otherwise normal cells
D. Transformation of differentiated cells to another cell type

A

A. Abnormal pattern of cellular maturation

106
Q

A senior citizen came in for a 6mo history of increasing weight loss and fatigue. PE reveals hepatomegaly. Biopsy reveals mucus secreting adenocarcinoma. The patient’s liver cancer is mostly originated in which of the ff. organ?

A. Adrenal medulla
B. Bone marrow
C. Pancreas

A

C. Pancreas

107
Q

Compared to normal somatic cells, germ cell neoplasms can cause the increase in the synthesis of these proteins?

A. Desmin
B. Cytochrome
C. P selectin
D. Telomerase

A

D. Telomerase

108
Q

Cervical biopsy in a 25 year old female reveals invasive squamous cell carcinoma. Molecular tests for HPV in the tumor cells are positive. Which of the following mechanisms of disease best explain the role of HPV in the pathogenesis of neoplasia in this patient?

A. Invasive mutagenesis
B. Activation of cellular oncogenes
C. Enhanced telomerase gene
D. Inactivation of tumor suppressor proteins

A

D. Inactivation of tumor suppressor proteins

109
Q

A Septuagenarian was diagnosed with invasive prostatic adenocarcinoma. Histologic grading of this patient’s carcinoma is based primarily on?

A.Capsular involvement
B. Volume of prostate involved by tumor
C. Resemblance to normal tissue of origin
D. Extent of regional lymph node involvement

A

C. Resemblance to normal tissue of origin

110
Q

30 year old woman discovers lump in left breast upon self examination. mother and sister had breast cancer. mammography: ill defined density in outer quadrant of left breast with microcalcification
needle aspiration: malignant ductal epithelial cells genetic screening: BRCA1 mutation aside from cell cycle control, BRCA1 controls which of the following?

A. apoptosis
B. cell adhesion
C. DNA repair
D. gene transcription

A

C. DNA repair

111
Q

A 60 year old male who worked for 30 years at a chemical factory complains of blood in his urine. Urine cytology disclosed dysplastic cells. Biopsy Demonstrated transition cell carcinoma. Which carcinogen.. His bladder cancer?

A. Aniline dye
B. Arsenic
C. Benzene
D. Vinyl chloride

A

A. Aniline dye

LEVEL II (16 decks)

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