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[HS 202] E2 (Pathology) > Samplex 2014 Set A > Flashcards

Samplex 2014 Set A Flashcards

1
Q

An adaptive mechanism which involves increase in the number of cells:

a. hyperplasia
b. induction
c. hypertrophy
d. metaplasia

A

A

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2
Q

An adaptive mechanism that results in a decrease of cytoplasmic volume and no. of organelles:

a. dysplasia
b. neoplasia
c. atrophy
d. agenesis

A

C

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3
Q

An adaptive mechanism which involves an increase in cell size and girth:

a. hyperplasia
b. hypertrophy
c. increase n/c ratio
d. none of the above

A

B

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4
Q

An adaptive mechanism which involves transformation of multipotential stem cells into cells not native to the injured cell:

a. dysplasia
b. anaplasia
c. metaplasia
d. hyperplasia

A

C

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5
Q

Clinical example of metaplastic phenomenon:

a. cardiomegaly
b. endometrial involution
c. liver regeneration
d. reflux in esophagus

A

D

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6
Q

Clinical example of a hyperplastic phenomenon:

a. Barret’s esophagus
b. prolapsed ectocervix
c. gastric adenocarcinoma
d. hypertension

A

D

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7
Q

Clinical example of hypertrophic phenomenon:

a. Barret’s esophagus
b. myocardial infarct
c. tuberculoma
d. hypertensive cardiomegaly

A

D

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8
Q

Clinical example of an atrophic phenomenon:

a. Alzheimer’s disease
b. endometrial hyperesteremia
c. tuberculoma
d. splenic infarct

A

A

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9
Q

Common sequelae of metaplastic phenomenon:

a. pulmonary failure
b. adrenocortical carcinoma
c. endometrial carcinoma
d. gastric carcinoma

A

D

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10
Q

Common sequelae of hypertrophy:

a. pulmonary failure
b. cardiac failure
c. hematopoietic failure
d. esophageal adenocarcinoma

A

B

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11
Q

Fibrinoid necrosis can be expected in:

A. Diabetes
B. Plasmacytoma
C. SLE
D. Fibrinous peritonitis

A

C

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12
Q

Liquefactive necrosis is expected in:

A. Cerebral infarct
B. Splenic infarction
C. Myocardial infarction
D. Hydrocephalous vacuole

A

A

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13
Q

Gangrenous necrosis can be expected in:

A. diabetic foot
B. diabetic granuloma
C. diabetic neuropathy
D. mucocele of appendix

A

A

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14
Q

Caseation necrosis can be expected in:

A. filariasis
B. sarcoidosis
C. histoplasma
D. scrofula

A

C

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15
Q

Coagulation necrosis can be expected in:

A. pulmonary infarct
B. intestinal infarct
C. cerebral infarct
D. splenic infarct

A

D

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16
Q

Which of the following is true:

A. gangrene refers to tissue necrosis with or without infection
B. acute inflammation does not occur around necrotic tissues
C. apoptosis usually does not cause inflammation
D. The blood vessels surrounding acutely inflamed tissues usually show progressive dilation from the time of injury

A

C

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17
Q

Necrosis is a characteristic of chronic inflammation:

A. leptospirosis
B. gummatous inflammation
C. plasmacytosis
D. tuberculosis

A

D

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18
Q

A 40y.o. patient having a lymphoma involving the lymph nodes in the paraaortic areas. Treated with chemotherapy results to loss of individual neoplastic cells through fragmentation of individual nucleus and cytoplasm. Over the weeks, lymphoma decreased in size as documented by abdominal CT scan.

By which of the following mechanisms did the neoplasm primarily respond to the therapy?

A. coagulative necrosis
B. phagocytosis
C. autolysis
D. apoptosis

A

D

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19
Q

A 43y.o. man has complained of mild burning substernal or epigastric pain following meals for the past 3 years. Upper GI endoscopy was performed and biopsies were taken of an erythematous area of the lower esophageal mucosa 3cm above the gastroesophageal junction. There is no mass lesion, no ulceration, and no hemorrhage noted. The biopsies demonstrated the presence of columnar epithelium with goblet cells.

Which of the ff. mucosal alteration is most likely represented by these findings?

A. agenesis
B. hypertrophy
C. adenocarcinoma
D. metaplasia

A

D

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20
Q

A 59y.o. woman lost consciousness for an hour. Upon arousal she was unable to speak or move her right arm and leg. Angiography showed an occlusion in her left cerebral artery. Months later, a CT scan revealed a 5cm cystic mass on her left parietal lobe. This is a result of the resolution of a previous:

A. liquefactive necrosis
B. Coagulation necrosis
C. Fat necrosis
D. Cystic Degeneration

A

A

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21
Q

A 19-year old recently gave birth to her first child. She started breastfeeding and continued for 2 years.

Which of the following cellular processes that occurred during pregnancy which allowed her to do this?

A. Stromal hypertrophy
B. Epithelial dysplasia
C. Ductal epithelial metaplasia
D. Lobular hyperplasia

A

D

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22
Q

A 80 y/o man dies from complications of Alzheimer’s disease. At autopsy his heart is small (250g) and dark brown on sectioning. Microscopically there is a light brown perinuclear pigment with H&E staining of the cardiac muscle fibers.

Which of the following substances is most likely increased in the myocardial fibers to produce this appearance in the heart?

a. hemosiderin from reabsorbed hemorrhages
b. lipochrome from “wear and tear”
c. dystrophic calcifications
d. carbon pigments from anthracosis

A

B

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23
Q

A 20- year old woman had Goodpasture syndrome which progressed to chronic renal failure. She was 165 cm tall, weighed 55kg and had a blood pressure of 150/90 – 180/110 but she did not take regular medications. Lab studies showed her BUN over 100 mg /dl. She required chronic dialysis. She died from heart failure. At autopsy her height weighed 540g.

The size of the heart is the result of:

a. hypertrophy
b. amyloid infiltration
c. post-infarct myocyte hyperplasia
d. fatty change

A

A

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24
Q

A 43-year-old man has complained of mild burning substernal pain following meals for the past 3 years. Upper GI endoscopy is performed and biopsies are taken of an erythematous area of the lower esophageal mucosa 3 cm above the gastroesophageal junction. There is no mass lesion, no ulceration, and no hemorrhage noted. The biopsies show the presence of columnar epithelium with goblet cells.

Which of the following mucosal alterations is most likely represented by these findings?

a. dysplasia
b. hyperplasia
c. metaplasia
d. carcinoma

A

C

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25
Q

A 26- year old man had destruction of the aortic valve by Staphylococcus aureus. Autopsy of the spleen reveals presence of tan to white wedge-shaped 1.5 x 3 cm lesion with base on capsule.

What is the possible pathogenesis?

a. coagulation necrosis
b. gangrenous necrosis
c. lymphoreticular hyperplasia
d. sinusoidal hypertrophy

A

A

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26
Q

A 20-year old man is involved in a motor vehicle accident, which resulted in multiple blunt trauma with laceration to his lower extremities. The left femoral artery is lacerated and he incurs extensive blood loss and remains hypotensive for hours during transport to the emergency department. On admission hematocrit is 12%.

Which of the following tissue is most likely to withstand impact of the events with least damage?

a. Skeletal muscle
b. Small intestine epithelium
c. Retina
d. Myocardium

A

A

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27
Q

A 35- year old woman developed icterus over the last week of her life. Lab studies show her to be hyperammonemia. She is found at autopsy to have 3500g liver with uniform, yellow, greasy cut surface. No necrosis of hepatocytes.

Which of the following would cause the see condition in the patient?

a. galactosemia
b. hemochromatosis
c. TB
d. malnutrition

A

D

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28
Q

A 55- year old man has a 30 year history of poorly managed DM. His right foot had black discoloration and softness, with areas of yellow exudates.

Upon amputation, what pathological process is expected?

a. enzymatic necrosis
b. gangrenous necrosis
c. coagulative necrosis
d. abscess formation

A

B

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29
Q

A 45- year old man has traumatic injury to his forearms and incurs extensive blood loss. BP is 70/30.

Which represents irreversible cell injury as a result of this injury?

a. cytoplasmic membrane blebbing
b. mitochondrial swelling
c. karyolysis
d. induction of ER

A

C

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30
Q

A 21-year old woman has a routine pap smear perform for a health screening exam. The pathology report indicates that some cells are found to cytologically have larger, more irregular nuclei. A follow- up cervical biopsy microscopically demonstrates disordered maturation of the squamous epithelium with hyper chromatic and peiomorphic nuclei extending nearly the full thickness of the epithelial surface. No inflammatory cells are present.

Which of the following descriptive terms is best applied in these pap smear and biopsy findings?

a. dysplasia
b. metaplasia
c. anaplasia
d. hyperplasia

A

A

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31
Q

Case: A 19 year old boy was rushed to the ER due to multiple stab wounds. He had a hypotensive BP and a respiratory rate of

The patient dies on the operating table due to blood loss despite massive blood transfusions. What caused this?

A. Cardiogenic shock
B. Septic shock
C. Anaphylactic shock
D. Hypovolemic shock
E. Neurogenic shock
A

E

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32
Q

Case: A 19 year old boy was rushed to the ER due to multiple stab wounds. He had a hypotensive BP and a respiratory rate of 32

The patient survived the operation but they next day experienced severe infection and peripheral vasodilation. Within hours the patient was dead. What caused this?

A. Cardiogenic shock
B. Septic shock
C. Anaphylactic shock
D. Hypovolemic shock
E. Neurogenic shock
A

B

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33
Q

Case: A 19 year old boy was rushed to the ER due to multiple stab wounds. He had a hypotensive BP and a respiratory rate of 32

During the operation, the patient’s heart stopped beating, the surgeon opened the pericardial sac and noticed large amounts of blood compressing the heart. He drained the blood and started massaging the patient’s heart. The patient survived. What could have been the cause of death if the patient died?

A. Cardiogenic shock
B. Septic shock
C. Anaphylactic shock
D. Hypovolemic shock
E. Neurogenic shock
A

A

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34
Q

What is the mechanism of death of a patient who had diarrhea and vomiting due to food poisoning?

A. Cardiogenic shock
B. Septic shock
C. Anaphylactic shock
D. Hypovolemic shock
E. Neurogenic shock
A

D

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35
Q

What cells produce the clinical symptoms of anaphylactic shock?

A. Neutrophils
B. Mast Cells
C. Macrophages
D. Lymphocytes

A

B

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36
Q

What is the most common clinical manifestation of shock?

A. Fever
B. Difficulty of breathing
C. Tachycardia
D. Hypotension

A

D

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37
Q

Respiratory Distress Syndrome is a common complication of shock, presenting clinically as dyspnea, and radiologically as white-out lungs. Which is a characteristic of it?

A. Neutrophils within alveolar cells
B. Proteinaceuos fluid in alveolar spaces
C. Hyaline membrane lining alveolar walls
D. AOTA

A

C

38
Q

Acute Renal Failure is a common complication of shock. Characteristic of increased blood levels of BU and creatinine with red cell cast in urine. Which microscopic finding is most specific to this condition?

A. Mononuclear cells in interstitium
B. Red cells in tubular lumen
C. Mononuclear cells in glomeruli
D. Focal necrosis of tubular epithelial cells

A

D

39
Q

The most common origin of pulmonary embolism is:

A. Deep leg vein
B. Femoral Vein
C. Aorta
D. Right ventricle

A

A

40
Q

Which of the ff. statements is true for paradoxical embolus?

A. The embolus originates in the arterial system and obstructs the venous flow
B. The embolus originates in the heart and obstructs the arterial flow
C. The embolus originates in the venous system and obstructs the arterial flow
D. The embolus originates in the heart and obstructs the venous flow

A

C

41
Q

What must exist for paradoxical embolism to occur?

A. left-sided valvular defect
B. ventricular septal defect
C. foramen ovale
D. all of the above

A

D

42
Q

A 32 y/o woman gave birth after prolonged labor. After which, she experienced difficulty in breathing. After 10 minutes, she died. What embolic material could have caused this?

A. amniotic fluid
B. thrombolytic material
C. air
D. fat

A

A

43
Q

Bends is caused by what embolic material?

A. thrombus
B. amniotic fluid
C. air
D. fat

A

C

44
Q

Elderly people with hip fracture are predisposed to ______ embolism.

A. fat
B. air
C. amniotic fluid
D. tumor

A

A

45
Q

Pale infarcts are usually seen in

A. spleen
B. small intestine
C. lungs
D. brain

A

A

46
Q

Necrosis in myocardial infarction is due to:

A. coagulation necrosis
B. caseation necrosis
C. liquefactive necrosis
D. fat necrosis

A

A

47
Q

Myocardial infarcts may either be pale or red depending on whether this condition occurred or not

A. repair by fibrosis
B. healing
C. reperfusion
D. infiltration by hemosiderin-laden macrophages

A

C

48
Q

Mechanism behind edema formation in filariasis

A. inflammation
B. lymphatic obstruction
C. electrolyte imbalance from worm load
D. decreased protein due to worm load

A

B

49
Q

The mechanism behind bipedal edema due to congestive heart failure is

A. increased oncotic pressure
B. decreased oncotic pressure
C. increased hydrostatic pressure
D. decreased hydrostatic pressure

A

C

50
Q

Fluid in the peritoneal space is termed

A. anasarca
B. hemoperitoneum
C. ascites
D. hydrothorax

A

C

51
Q

Which is a symptom that is more of LHF than RHF:

a. pulmonary edema congestion
b. bipedal edema
c. CPC of liver
d. CPC of spleen

A

A

52
Q

Which is a symptom that is more of LHF than RHF:

a. ascites
b. nutmeg liver
c. orthopnea
d. splenomegaly

A

C

53
Q

What is the mechanism of edema in neoplastic syndrome?

a. increase oncotic pressure
b. decrease oncotic pressure
c. increase hydrostatic pressure
d. decrease hydrostatic pressure

A

B

54
Q

The histological finding on CPC of lungs:

a. fluid in the alveoli
b. microhemorrhages
c. hemosiderin-laden macrophages
d. proteinaceous exudate

A

C

55
Q

The characteristic gross finding of chronic passive congestion in liver is

a. hepatomegaly
b. nutmeg liver
c. hemorrhagic necrosis
d. cirrhosis

A

B

56
Q

Iron- and calcium-containing fibrotic areas in CPC of the spleen:

a. Rokitansky Aschoff nodules
b. Rohr bodies
c. Gamna-Gandy bodies
d. granulomata

A

C

57
Q

The mechanism in formation of a thrombus in an aortic aneurysm:

a. endothelial cell injury
b. turbulent blood flow
c. slow blood flow
d. hypercoagulability of the blood

A

B

58
Q

The primary mechanism in formation of a thrombus in disseminated cancer:

a. endothelial cell injury
b. turbulent blood flow
c. slow blood flow
d. hypercoagulability of the blood

A

D

59
Q

The mechanism in formation of thrombus in coronary artery disease:

a. endothelial cell injury
b. turbulent blood flow
c. slow blood flow
d. hypercoagulability of the blood

A

A

60
Q

What is the characteristic of a thrombus that is not found in a post-mortem clot?

a. currant jelly and chicken fat combination
b. lines of Zahn
c. both
d. neither

A

B

61
Q

Best describe inflammatory process:

a. tissue injury eliminated. Inflammation response resolves but normal tissue and physical function not restored
b. affected area walled off by collection of inflammatory cells. Destruction of tissue by products of monocyte and forms abscess
c. Failure to eliminate insult results in persistence of inflammatory response
d. Chronic Inflammation seldom lead to scar formation

A

C

62
Q

Which is not true of inflammation?

a. it involves multiple participants
b. it occurs in both living and non-living tissues
c. it involves multiple processes overlapping in a continuum
d. it may become harmful

A

B

63
Q

The chronic inflammatory response is not characterized by:

a. inflammation and prolonged during due to persistent of injurious agent
b. May develop as an insidious, low-grade subclinical process without history of a prior acute episode.
c. replacement of damaged tissues similar to that originally present
d. characterized by tissue infiltration with macrophages, lymphocytes and plasma cells or eosinophils.

A

C

64
Q

Repair by fibrosis as opposed to healing by regeneration, is mainly characterized by:

a. replacement of injured tissue by parenchymal cells of the same type
b. replacement by connective tissue
c. starts as early as 24 hours
d. granulation tissue at 3-5 days.

A

B

65
Q

In the process of Leukocyte Migration, TRANSMIGRATION is mainly characterized:

a. initial rapid and loose adhesion
b. activation of leukocytes resulting in increased avidity
c. stable binding of integrins on activated leukocytes
d. directed migration of leukocytes

A

B

66
Q

Which of the following processes involves selectins?

a. Rolling
b. Adhesions
c. Transmigration
d. Chemotaxis

A

A

67
Q

Two processes in inflammation and repair: one requires the presence of neutrophils and edema while the other refers to fibrous tissue formation.

a. Acute Inflammation and Granulomatous Inflammation
b. Chronic Inflammation and Granulomatous Inflammation
c. Acute Inflammation and Granulation Tissue
d. Acute Inflammation and Fibrosis

A

D

68
Q

In a wound with pus, the presence of neutrophils:

a. Is an indication of healing
b. Suggests that there is bacterial infection
c. Indicates that healing will progress more quickly

A

C

69
Q

Presence of fluid indicates:

a. suppurative inflammation
b. serous inflammation
c. granulomatous inflammation
d. chronic inflammation

A

B

70
Q

In order for an ulcer to progress:

a. Squamous cell metaplasia
b. Necrosis and acute inflammation must not stop
c. Fibrotic tissue must be removed
d. Formation of granulomatous tissue

A

B

71
Q

Gross examination of a heart showed pericarditis. The irregular masses of deeply eosinophilic acellular material at the surface of the pericardium on microscopic examination is:

A. fibrinous exudate
B. necrotic debris
C. thrombogenic material
D. granulomatous inflammation

A

A

72
Q

Examination of the pericardial tissue adjacent to this material are varying substances of granulation tissue and young fibrous tissue, which will eventually:

A. differentiate into pericardial adipose tissue
B. differentiate into fibrinous material and be cleared
C. undergo necrosis and removal
D. modified into dense fibrous tissue

A

D

73
Q

Examination of inflamed tissue shows loose connective tissue with numerous small blood vessels and plump endothelial cells. This pathologic process is:

A. Granulomatous inflammation
B. Granulation tissue
C. Granulomatous fibrosis
D. Granulation inflammation

A

B

74
Q

Based on the varied nature of inflammatory processes to different organisms, which etiology in addition should be considered when suppurative inflammation is characterized?

A. bacterial infection
B. viral infection
C.fungal infection
D. rickettsial infection

A

A

75
Q

A liver showed multinodular aggregation of macrophages with numerous cytoplasm. What do these nodules represent?

A. foci of granulomatous inflammation
B. fibrosis (i.e. scarring)
C. regenerating or healing hepatocytes
D. masses of chronic inflammation

A

A

76
Q

The repair of necrosis in the kidney is very different than that in the skin because of

A. different growth factors at the two sites
B. different proliferative capacity of cells
C. different nutritional status of the organs
D. different cell-to-cell communication

A

B

77
Q

Histologic abnormality of a hypertophic scar in a skin specimen presents as:

A. chronic inflammation
B. granulation tissue
C.excess normal looking dermis
D. dermal collagen thick bands

A

D

78
Q

26 year old male with a long history of drug abuse died after developing progressive pulmonary failure with unproductive cough. The drug market is known to have drugs that were cut (diluted) with contaminants (i.e. Talc & White powder). Upon histological examination, granulomatous inflammation was found. The etiologic agent caused this pattern of injury because it was:

A. Infectious
B. Immunogenic
C. Toxic
D. Nondegradable

A

D

79
Q

In a case of viral myocarditis, the myocardium showed small clusters of lymphocytes on infected myocytes. The major pathologic process in the heart is:

A. acute inflammation
B. chronic inflammation
C. granulation tissue
D. granulomatous inflammation

A

B

80
Q

Myocardial infiltrates of mononuclear leukocytes are characteristic of:

A. acute viral myocarditis but not chronic viral myocarditis
B. chronic viral myocarditis but not acute viral myocarditis
C. neither chronic viral myocarditis or acute viral myocarditis
D. both chronic viral myocarditis or acute viral myocarditis

A

B

81
Q

In bacterial killing/degradation, what is the main process?

a. Reactive oxygen species in lysosomes
b. Bactericidal permeability activity
c. Lysozymes
d. Lactoferrin

A

A

82
Q

The cytokines most important in directly producing the systemic inflammation in disease

a. IL-1 and IL-2
b. IL-1 and TNF
c. IL-1 and PDGF
d. TNF and PDGF

A

B

83
Q

Which of the ff. is a “cell-derived inflammatory mediator”?

a. coagulation cascade: fibrin framework
b. bradykinin: pain
c. histamine: vasodilation
d. C3b: phagocytosis

A

C

84
Q

Which of the ff. events is mediated by histamine?

a. endothelial cell contraction
b. endothelial cell detachment
c. leukocytes adhere to endothelium and increase ROS leakage into endothelium
d. increased transcytosis

A

A

85
Q

This factor induces angiogenesis and increases vascular permeability

a. FGF
b. VEGF
c. PDGF
d. TGF-b

A

B

86
Q

This factor induces chemotaxis and endothelial proliferation

a. FGF
b. VEGF
c. PDGF
d. TGF-b

A

A

87
Q

TGF-b is not involved in:

a. neutrophil migration
b. monocyte chemotaxis
c. fibroblast migration
d. fibroblast proliferation

A

A

88
Q

Type of collagen predominant in late, healing wounds

a. I
b. II
c. III
d. IV

A

C

89
Q

Complete regeneration will most likely happen in which of the ff:

a. chronic inflammation w/ high proliferative capacity
b. chronic inflammation w/ low proliferative capacity
c. acute inflammation w/ ECM destruction
d. acute inflammation w/o ECM destruction

A

D

90
Q

Which of the ff is a characteristic of secondary intention?

a. less intense inflammatory reaction
b. wound with extensive tissue loss
c. larger area of wound defect
d. smaller cells of granulation tissue

A

C

[HS 202] E2 (Pathology) (5 decks)

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