robbins Flashcards
1
Q
A 50-year old man has blood pressure of 150/90 mm Hg. If this person remains untreated for years, which of the following cellular alterations will be seen in the myocardium? A. atrophy B. metaplasia C. hypertrophy D. dysplasia
A
C
2
Q
On day 28 of her menstrual cycle, a 26-year old woman experiences menstrual bleeding which lasts for 5 days. She has had regular cycles for many years. Which of the following processes is most likely occurring in the endometrium just before onset of bleeding?
A. apoptosis
B. heterophagocytosis
C. liquefactive necrosis
D. hyperplasia
A
A
3
Q
A 70-year old woman suddenly lost consciousness and on awakening one hour later, she could not speak nor move her right arm and leg. Two months later, a head MRI showed a large cystic area in the left parietal lobe. Which of the following pathologic processes has most likely occurred in the brain?
A. coagulative necrosis
B. fat necrosis
C. apoptosis
D. liquefactive necrosis
A
D
4
Q
A 3-year old child touches a lit candle. Within several hours, there is marked erythema of the skin of the fingers on the child’s left hand, and small blisters appear on the finger pads. Which of the following terms best describe the process?
A. fibrinous inflammation
B. ulceration
C. abscess formation
D. serous inflammation
A
D
5
Q
A woman who is allergic to cats visits a friend who keeps several pet cats. During the visit, she inhales cat dander and within minutes, she develops nasal congestion and abundant nasal secretions. Which of the following substances is most likely to produce these findings?
A. tumor necrosis factor
B. bradykinin
C. histamine
D. complement C5a
A
C
6
Q
Which of the following changes best describes the pathophysiology involved in the production of pulmonary edema in patients with congestive heart failure?
A. widespread endothelial damage
B. decreased plasma oncotic pressure
C. acute lymphatic obstruction
D. increased hydrostatic pressure
A
D
Regional Inc hydrostatic pressure can result fr focal impairment in venous return (DVT)
Systemic Inc hydrostatic pressure w/ systemic edema occurs MC in CHF
Reduced plasma osmotic pressure occurs w/ dec albumin
7
Q
While preparing her lunch, a housewife nicks her finger with a knife. Seconds after the injury, the bleeding stops. Which of the following mechanisms is most likely to reduce blood loss from a small dermal arteriole?
A. protein C activation
B. vasoconstriction
C. neutrophil chemotaxis
D. platelet aggregation
A
B
8
Q
A 23 –year old who had a myocardial infarction 1 year a year ago now has chest pain when exercising. His underlying disease is due to an absence of LDL receptors on liver cells, inherited as an autosomal dominant condition. Which of the following laboratory findings is most likely to be present in this patient?
A. ketonuria
B. hypercholesterolemia
C. hypoglycemia
D. abetalipoprotenemia
A
B
9
Q
Which of the following is a feature of necrosis?
A. reduced cell size B. intact cellular contents
intact plasma membrane D. karyolysis
A
D
10
Q
Which of the following is characteristic of apoptosis?
A. absence of inflammation B. affects numerous cells at a time
C. cell swelling D. leaking of enzymes
A
A
11
Q
Which is characteristic of irreversible injury?
A. cell swelling B. fatty change
C. surface blebs
D. cell membrane defects
A
D
12
Q
Which of the following substances may cause edema during inflammation?
A. histamine B. C5a
C. interleukine-1 D. TNF
A
A
13
Q
Type of inflammation induced by indigestible foreign bodies.
A. serous B. granulomatous
C. suppurative D. fibrinous
A
B
14
Q
The hallmark of acute inflammation is:
A. vasoconstriction B. vasodilation
C. increased vascular permeability
D. slowing of circulation
A
C
15
Q
Which of the following is an example of wound healing by primary intention?
A. compound fracture fixation B. fistula repair
C. endoscopic surgery D. abscess drainage
A
C
16
Q
A wound will attain maximum strength at what time?
A. 2 weeks B. 1 month
C. 3 months D. 6 months
A
C
17
Q
This is the most abundant glycoprotein in basement membrane.
A. elastin B. laminin
C. proteoglycan D. fibronectin
A
B
18
Q
This is a potent angiogenic growth factor.
A. Epidermal growth factor B. platelet derived growth factor
C. fibroblast growth factor D. transforming growth factor
A
C
19
Q
The serum AST & ALT are observed to be increasing in a 61 y/o man over the past wk. He also has increasing lower leg swelling w/ grade 2+ pitting edema to the knees. He has prominent jugular venous distention in neck veins to the level of the mandible. W/c of the ff., underlying conditions is he most likely to have, if the gross appearance of the liver shows “nutmeg” pattern?
A. portal vein thrombosis B. chronic hepatitis
C. congestive heart failure D. bile duct obstruction
A
C
20
Q
Systemic Lupus Erythematosus can be confirmed by testing for which antibodies? A. SS-A B. dsDNA C. centromere D. anti-GBM
A
B
21
Q
A patient with myasthenia gravis developed progressive muscle weakness. This is what type of hypersensitivity reaction? A. type I B. type II C. type III D. type IV
A
B
22
Q
The hallmark of granulomatous inflammation is the:
A. epithelioid cell B. fibroblast
C. neutrophil D. giant cell
A
A
23
Q
The main pathogenetic mechanism of edema in inflammatory diseases is:
A. increase osmotic pressure
B. decrease hydrostatic intravascular pressure
C. low serum albumin
D. increase vascular permeability
A
D
24
Q
Sudden death in pulmonary embolism is due to: A. acute right heart failure B. cardiac tamponade C. superior vena cava syndrome D. respiratory distress syndrome
A
A
25
Which of the following substances accumulates in atherosclerotic blood vessels?
A. Fatty acids B. Cholesterol esters
C. Tryglicerides
D. Phospholipids
B
26
The role of histamine in acute inflammatory response include:
A. Platelet release and aggregation
B. Increased vascular permeability of the venules
C. Increased vascular permeability of the arterioles
D. Membrane lysis
B
27
The central figure in chronic inflammation is the Macrophage because of its role in:
A. Breakdown of collagen and fibronectin
B. Production of 02 and Nitric oxide metabolites
C. Emigration from the blood stream to site of injury
D. Inhibition by cytokines and oxidized lipids
B
28
Which of the following statements in NOT true of red infarcts?
A. It occurs in organs with double blood supply
B. Commonly found in the heart and kidneys
C. Seen in venous occlusion with infarction
D. Seen in organs with well developed anastomosis
B
29
Which of the following is an irreversible form of cellular injury?
A. Nuclear pyknosis B. Dilatation of ER C. Mitochondrial swelling
D. Plasma membrane blebs
A
30
```
The main difference between healing by primary intention and secondary intention is
A. Leukocyte migration
B. Amount of Granulation tissue
C. Fibrosis
D. Contraction
```
D
31
This process is always seen in chronic inflammation:
A. Proliferation of blood vessels
B. Increase in edema fluid C. Emigration of neutrophils
D. Incerase premeability of blood vessels
A
32
Edema can result from any of the following mechanisms:
A. increased hydrostatic pressure of the blood
B. increased osmotic pressure of interstitial fluid (sodium retention)
C. decreased oncotic pressure of plasma protein
D. all of the above are correct
D
33
The most common cause of the occurrence of Klinefelter’s syndrome:
A. non-disjunction in meiotic division in oogenesis
B. non-disjunction in meiotic division in spermatogenesis
C. non-disjunction in meiotic division in embryogenesis
D. translocation
A
34
```
The number of Barr bodies in a patient with 48 XXXY karyotype:
A. none
B. one
C. two
D. three
```
C
35
```
The following are suppressor genes EXCEPT:
A. p53
B. bcl-2
C. APC
D. NF – I
```
B
36
```
In hypertrophy, at what point of the cell cycle is blocked?
A. S to G0
B. S
C. G0 to G1
D. M to G0
```
A
37
```
Which of the following substances disrupt the steady state and causes cell swelling?
A. Calcium
B. Chloride
C. Potassium
D. Sodium
```
D
38
```
Which facilitates the degradation of denatured protein that is beyond repair to prevent further injury to the cell?
A. Caspases
B. Chaperones
C. Laminin
D. Ubiquitin
```
D
39
The formation of giant cells in a granulomatous inflammation is for the purpose of:
A. Acquiring faster amoeboid movement to run after the offending agent
B. Acquiring greater capability for phagocytosis
C. Forming a barrier around the offending agent
D. Presenting more efficiently the antigen-MHC complex
C
40
Aging causes cell damage and death through which mechanism?
A. Accumulation of intracellular calcium
B. Increasing ligands for Fas or death receptor
C. Mutation of nuclear DNA
D. Production of oxygen-derived free radicals
D
41
The pathogenesis of coagulation necrosis is:
A. Action of powerful proteolytic enzymes from lysosomes and inflammatory cells
B. Activation of the Fas or death receptor
C. Inactivation of autolytic or intracellular enzymes and dehydration without cell decomposition
D. Rapid entry of water and calcium with saponification of cellular contents
C
42
The key mechanism of apoptosis is:
A. Cessation of mRNA synthesis
B. Coiling of DNA chromatin
C. DNA fragmentation by endonuclease activation
D. Non-specific degradation & random DNA cleavage
C
43
In the vascular phase of acute inflammation, the interstitial osmotic pressure progressively increases due to the increasing amount of:
A. Lymphatic flow resulting in reduced interstitial fluid
B. Neutrophils
C. Plasma proteins
D. Proteinaceous debris from dead bacteria
C
44
The formation of esophageal varices secondary to cirrhosis is primarily due to:
A. Active congestion B. Passive congestion
C. Thrombosis
D. Embolism
B
45
```
Chalky-white appearance of necrotic tissues is seen in which of the following:
A. caseation necrosis
B. coagulation necrosis
C. enzymatic fat necrosis
D. liquefaction necrosis
```
C
46
Which of the following are characteristics of antemortem clots:
A. lines of Zahn C. both
B. currant jelly clots D. neither
A
47
Which of the following is the most important factor in the development of thrombosis:
a. Stasis
b. turbulence
c. endothelial injury
d. hypercoagulability of blood
C
48
```
This involves the synthesis of relatively short DNA fragments from a DNA template:
A. PCR
B. FISH
C. SNP
D. MLPA
```
A
49
```
This method involves hybridization of radiolabeled sequence-specific probes to genomic DNA that has been first digested with a restriction enzyme and separated by gel electrophoresis:
A. Northern blot
B. Southern blot
C. Western blot
D. Eastern blot
```
B
50
This method blends DNA hybridization, DNA ligation, and PCR amplification to detect deletions and duplications of any size
A. Cytogenomic Array Technology
B. Fluorescence in Situ Hybridization
C. Multiplex Ligation-Dependent Probe Amplification
D. Array-Based Comparative Genomic Hybridization
C
51
```
There is deletion of band q12 on long arm of paternal chromosome 15 occurs in this disease. Patients have mental retardation, short stature, hypotonia, hyperphagia, small hands and feet, and hypogonadism.
A. Angelman syndrome
B. Prader-Willi syndrome
C. Fragile X syndrome
D. Turner syndrome
```
B
52
```
The second most common genetic cause of mental retardation and is caused by a trinucleotide mutation in the familial mental retardation-1 (FMR1) gene.
A. Huntington syndrome
B. Friedrich ataxia
C. Fragile X syndrome
D. Angelman syndrome
```
C
53
```
This is characterized by CAG trinucleotide repeats:
A. Kennedy disease
B. Huntington disease
C. Haw River syndrome
D. All of the above
```
D
54
Choose the correct answer:
A. True hermaphrodite implies the presence of both ovarian and testicular tissue.
B. Pseudo-hermaphrodite represents an agreement between the phenotypic and gonadal sex
C. Both statements are true
D. Both statements are false
A
55
Which of the following is false about the Lyon hypothesis:
A. All X chromosomes are genetically active
B. The other X of either maternal or paternal origin undergoes heteropyknosis and is rendered inactive
C. Inactivation of either the maternal or paternal X occurs at random among all the cells of the blasto- cyst on or about day 5.5 of embryonic life
D. Inactivation of the same X chromosome persists in all the cells derived from each precursor cell.
A
56
```
This syndrome has this karyotype: 47,XX, +18
A. Down syndrome
B. Edward syndrome
C. Patau syndrome
D. Angelman syndrome
```
B
57
```
This results when one arm of a chro- mosome is lost and the remaining arm is duplicated, resulting in a chromosome consisting of two short arms only or of two long arms:
A. translocation
B. inversion
C. ring chromosome
D. isochromosome
```
D
58
```
Glycogen storage disease with lack of lysosomal acid maltase, and all organs are affected, but heart involvement is predominant:
A. von Gierke disease
B. McArdle disease
C. Pompe disease
D. Hurler disease
```
C
59
```
This lysosomal storage disease results in accumulation of glucocerebroside in mononuclear phagocytic cells:
A. Tay-Sachs disease
B. Niemann-Pick disease type B
C. Niemann-Pick disease type C
D. Gaucher disease
```
D
60
```
This lysosomal storage disease is caused by a defect in cholesterol transport and resultant accumulation of cholesterol and gangliosides in the nervous system. Affected children most commonly exhibit ataxia, dysarthria, and psychomotor regression.
A. Tay-Sachs disease
B. Niemann-Pick disease type B
C. Niemann-Pick disease type C
D. Gaucher disease
```
C
61
```
This syndrome is caused by a mutation in the FBN1 gene encoding fibrillin, which is required for structural integrity of connective tissues and regulation of TGF-β signaling:
A. Marfan syndrome
B. Ehlers-Danlos syndrome
C. Fragile X syndrome
D. Angelman syndrome
```
A
62
```
Which of the following is not an X-linked recessive disorder:
A. Duchenne muscular dystrophy
B. Osteogenesis imperfecta
C. Diabetes insipidus
D. Agammaglobulinemia
```
B
63
```
Which of the following is an autosomal recessive disorder:
A. Achondroplasia
B. Osteogenesis imperfect
C. Congenital adrenal hyperplasia
D. Tuberous sclerosis
```
C
64
```
Ascites from liver cirrhosis is due to:
A. increased hydrostatic pressure
B. reduced plasma oncotic pressure
C. impaired venous return
D. Sodium retention
```
B
65
Which statement is false:
A. Hyperemia is a passive process.
B. Hyperemia is due to increased delivery of oxygenated blood.
C. Congestion can be systemic, as in cardiac failure, or localized.
D. None of the above
A
66
```
Secondary hemostasis is:
A. clot stabilization
B. formation of platelet plug
C. clot resorption
D. deposition of fibrin
```
D
67
```
Which of the following factors cannot be evaluated by prothrombin time:
A. V
B. VII
C. X
D. XII
```
D
68
```
Genetic deficiency of platelet surface receptor GpIb:
A. Bernard-Soulier syndrome
B. Glanzmann thrombasthenia
C. vWF disease
D. ITP
```
A
69
```
platelet dense granules contain:
A. fibrinogen
B. serotonin
C. platelet factor 4
D. PDGF
```
B
70
```
Bleeding disorder with defect in platelet aggregation:
A. Bernard-Soulier syndrome
B. Glanzmann thrombasthenia
C. vWF disease
D. ITP
```
B
71
Which of the following statements is incorrect:
A. factor VIIa/tissue factor complex is the most important activator of factor IX
B. factor IXa/factor VIIIa complex is the most impor tant activator of factor X
C. factor XII deficiency is associated with severe bleeding
D. factor XI deficiency is only associated with mild bleeding
C
72
```
D-dimers is/are:
A. fibrin split products
B. produced by the platelet
C. the most important plasminogen activator
D. all of the above
```
A
73
Which of the following inhibit platelet activation and aggregation:
A. prostacyclin B. adenosine diphosphatase
C. nitric oxide
D. all of the above
D
74
```
This syndrome has protean clinical manifestations, including recurrent thromboses, repeated miscarriages, cardiac valve vegetations, and thrombocytopenia.
A. Lupus anticoagulant syndrome
B. Antiphospholipid Antibody Syndrome
C. Factor V Leiden
D. both A and B
```
D
75
```
Most common site of arterial thrombi in decreasing order:
A. cerebral>coronary>femoral
B. coronary>cerebral>femoral
C. coronary>femoral>cerebral
D. cerebral>femoral>coronary
```
B
76
```
Libman-Sacks endocarditis is associated with:
A. infective endocarditis
B. ASD
C. SLE
D. venous thrombosis
```
C
77
```
Volume of air embolism necessary to produce clinical effect in the pulmonary circulation:
A. 10cc
B. 20cc
C. 50cc
D. >100cc
```
D
78
```
Chronic form of gas embolism that occurs when individuals experience sudden decreases in atmospheric pressure:
A. caisson disease
B. Grecian disease
C. decompression sickness
D. all of the above
```
C
79
True of amniotic fluid embolism:
A. second most common cause of maternal morbidity worldwide
B. underlying cause is infusion of meconium into the maternal circulation
C. results in permanent neurologic deficit in 85% of survivors
D. does not result in disseminated intravascular coagulation
C
80
```
Leukocyte adhesion molecule found in neutrophils:
A. E-selectin
B. L-selectin
C. P-selectin
D. S-selectin
```
B
81
```
Which of the following does not cause vasoconstriction:
A. prostacyclin
B. thromboxane
C. leukotriene
D. none of the above
```
A
82
```
Which of the following is/are anaphylatoxins:
A. C3a, C4a
B. C3a, C5a
C. C3a, C4a, C5a
D. C3a only
```
C
83
```
Which of the following is/are opsonins:
A. C3b
B. C3b, C5b
C. C3b, C4b, C5b
D. C5a, C5b
```
A
84
```
Deficiency of CD55 and CD59 result to:
A. paroxysmal cold hemoglobinuria
B. paroxysmal nocturnal hemoglobinuria
C. Alkaptonuria
D. all of the above
```
B
85
```
Functions of bradykinin except:
A. increases vascular permeability
B. causes relaxation of smooth muscle
C. dilation of blood vessels
D. pain when injected into the skin
```
B
86
Which pair is incorrect:
A. TNF – fever
B. bradykinin – pain C. C3a - chemotaxis
D. leukotriene - vasodilation
D
87
Principal cells in chronic inflammation:
A. neutrophil
B. macrophage C. lymphocyte
D. plasma cell
B
88
The granules of these cells contain major basic protein
A. neutrophil
B. eosinophil C. basophil
D. plasma cell
B
89
Which is not an acute-phase protein:
A. CRP
B. fibrinogen C. serum amyloid A
D. TNF
D
90
```
Which of the following is true of miRNA:
A. they are long RNAs
B. they encode proteins
C. they are involved in posttranscriptional silencing of gene expression
D. all are correct
```
C
91
```
This is found in the inner face of the plasma membrane and provide a negative charge for protein interactions. When exposed to the extracellular surface, they serve as “eat me” signals for phagocytes
A. phosphatidylinositol
B. phosphatidylserine
C. phospholipase C
D. sphingomyelin
```
B
92
```
This is the movement of endocytosed vesicles between the apical and basolateral compartments of cells:
A. Endocytosis
B. Potocytosis
C. Pinocytosis
D. Transcytosis
```
D
93
```
The most abundant cytosolic protein:
A. F-actin
B. G-actin
C. Lamin A
D. Lamin B
```
B
94
```
Microtubule motor proteins for anterograde transport:
A. kinesin
B. dyneins
C. actin
D. myosin
```
A
95
```
Site for ATP synthesis in the mitochondria:
A. core matrix
B. inner membrane
C. outer membrane
D. intermembrane space
```
D
96
```
Phenomenon wherein rapidly growing cells (both benign and malignant) increase glucose and glutamine uptake and decrease their production of ATP per glucose molecule:
A. Hasselbach phenomenon
B. Warburg effect
C. Goissburg effect
D. Waldrenstrom effect
```
B
97
```
Which of the following are proapoptotic proteins:
A. Bcl-2
B. Bcl-x
C. Bax
D. both A & B
```
C
98
```
Pigment associated with brown atrophy
A. melanin
B. lipofuscin
C. carbon
D. homogentisic acid
```
B
99
```
Which ensures correct folding of proteins
A. Caspases
B. Chaperones
C. Sirtuins
D. Ubiquitin
```
B
100
```
Which induces the expression of a variety of genes that cumulatively promote longevity
A. Caspases
B. Chaperones
C. Sirtuins
D. Ubiquitin
```
C
