Block 9 Cell Injury Response Cause Necrosis MCQ's
.JPG "Block 9 Cell Injury Response Cause Necrosis MCQ")
Cellular injury -response, adaptation, causes, morphology, mechanisms, necrosis
- 1.
A 65 year old chronic alcoholic woman presents with angina and dyspnea. Her family history is significant for 3 siblings who died of myocardial infarction in their 40's and 50's. Physical examination reveals a diaphoretic woman in acute distress with an elevated blood pressure, pulse and respiratory rate. On general survey, you notice the skin lesions seen below. Biopsies from these skin lesions show foam cells or macrophages with an intracellular accumulation of:- A.
Protein
- B.
Lipid
- C.
Cholesterol
- D.
Pigment
- 2.A 45 year old man comes to the emergency room with slurred speech and right sided weakness. His family history is significant for familial hypercholesterolemia. Physical examination reveals an obese man with difficulty speaking, carotid bruits, and significant weakness in his right upper and lower extremities. Laboratory data reveals elevated serum cholesterol and triglycerides. An MRI of the brain reveaIs an abnormal area in the left temporal lobe. A biopsy of this area would most likely show:
- A.
Coagulative necrosis.
- B.
Liquefactive necrosis
- C.
Liquefactive necrosis and gangrenous necrosis
- D.
Coagulative necrosis and liquefactive necrosis.
- 3.
During your surgery rotation your are part of a medical team performing an exploratory emergency laproscopic surgery of the abdomen. A look through the laprascope reveals the image seen below. What is the most likely diagnosis.
- A.
Traumatic fat necrosis
- B.
Enzymatic fat necrosis
- C.
Caseous necrosis
- D.
Coagulative necrosis and calcifications
- 4.
During your pediatric rotation you are asked to examine a newborn. His physical examination was with normal limits with the exception of his right hand which is shown below. What is the underlying defect that has caused this deformity?
- A.
A defect in physiologic apoptosis and developmental involution
- B.
A defect in pathologic apoptosis and developmental involution
- C.
A defect in physiologic apoptosis and organogenesis
- D.
A defect in pathologic apoptosis and cell death induced by cytotoxic T cells
- 5.75-year-old woman complains of shortness of breath and chest pain that radiates to the left shoulder. Serum levels of CK-MB (myocardial creatinine kinase) and cardiac muscle troponin I (cTnI) are elevated. Despite thrombolytic therapy the patient dies. What would you most likely see on light microscopic examination of the heart?
- A.
Preservation of cardiac tissue structure without nuclei
- B.
Rupture of cardiac cell membranes
- C.
Cardiomyocyte swelling
- D.
Amorphous appearance of cardiac tissue
- 6.A patient is admitted with severe substernal chest pain of 4 hours duration. Lab tests reveal increased levels of serum troponin. This is most likely due to :
- A.
Mitochondrial swelling associated with reversible injury.
- B.
Nuclear lysis associated with irreversible injury.
- C.
Increase in intracellular calcium associated with irreversible injury.
- D.
Damage of cell membranes associated with irreversible injury.
- 7.You are asked to review a liver biopsy from a patient with a history of alcohol abuse. Which of the following pathologic changes will most likely lead to death of hepatocytes and liver cirrhosis?
- A.
Fatty change
- B.
Hydropic change
- C.
Glycogen deposition
- D.
Karyolysis
- 8.A 1O-year-old African boy with a known history of sickle cell disease presents to the emergency department complaining of left upper quadrant pain suggestive of a splenic infarct. Microscopic examination of the spleen would most likely reveal:
- A.
Caseous necrosis
- B.
Coagulative necrosis
- C.
Fibrinoid necrosis
- D.
Gangrenous necrosis
- 9.During your obstetrics and gynecology rotation, you are asked to examine a woman with ambiguous genitalia, A biopsy reveals the presence of both ovarian and testicular tissue. This is most likely a result of a defect in:
- A.
Physiologic apoptosis and developmental involution.
- B.
Pathologic apoptosis and developmental involution
- C.
Physiologic apoptosis and hormonal dependent involution
- D.
Pathologic apoptosis and hormonal dependent involution
- 10.You are asked to participate in a research project on stroke in a rat model. Which of the following occurs in ischemic cell injury?
- A.
Influx of Na+ and Ca++ resulting in liquefactive necrosis
- B.
Influx of K+ and Ca++ resulting in coagulative necrosis
- C.
Efflux of K+ and Ca++ resulting in liquefactive necrosis
- D.
Efflux of Na+ and Ca++ resulting in coagulative necrosis
- 11.69 year old African American man complains of chest pain which radiates to the left arm. He is rushed to the emergency room (ER) for evaluation. His past medical history is significant for poorly controlled hypertension. Physical exam reveals an obese diaphoretic man in acute distress. His vital signs reveal an increase in the respiratory and pulse rate as well as an elevated blood pressure. A complete blood count with differential and chemistry panel was done upon arrival to the ER and was within normal limits. His EKG was abnormal with S-T segment elevations. Despite thrombolytic therapy the patient dies two hours later. A consent for autopsy was obtained from his wife. What would you expect to find upon gross examination of the heart?
- A.
Coagulative necrosis of myocardium
- B.
Increased serum creatinine kinase myocardiaI band (CK-MB) fraction
- C.
Left ventricle hypertrophy
- D.
Neutrophils infiltrating the myocardium
- 12.A 60 year old Mexican woman has been complaining of retrosternal burning and discomfort shortly after meals far the last 15 year. She reports taking antacids for relief. An extensive work-u p is done to rule out myocardial infarction. A biopsy of her esophagus reveals mucus secreting columnar epitheIium. What are the most likely diagnosis and explanation?
- A.
Barrett's esophagitis, which is an irreversible metaplastic adaptive response
- B.
Barrett's esophagitis which is an irreversible dysplastic adaptive response
- C.
Barrett's esophagitis which is a reversi ble hyperplastic adaptive response
- D.
Barrett's esophagitis which is a reversible metaplastic adaptive response
- 13.A 62-year-old medical missionary has recently returned to the US from a tour in an emerging nation. She presents to her family physician with a complaint of a productive cough and some dyspnea. She says that this has been going on for some time, but she wanted to wait for medical care in the states. She has no history of smoking and rarely drinks alcohol. Physical exam reveals some lung consolidation on auscultation and a low grade fever. A chest x-ray reveals multifocal 1-3 cm nodules, a few being cavitated. Acid fast stains of the sputum reveal acid-fast organisms; however the results of cultures are yet to be determined. Which of the following is the Most Likely cause of the lung lesions?
- A.
Acute purulent pneumonitis
- B.
Bronchogenic carcinoma
- C.
Granulomatous pneumonitis
- D.
Parasitic migration tracts
- E.
Pulmonary abscesses
- 14.A pathologist receives a surgical specimen taken from a 12-year-old boy. The submitted history is not helpful. The specimen is processed for histopathology and the pathologist submits the following report. The specimen was one cm in diameter and nodular. The cut surface revealed a central region of white creamy material surrounded by a rim of firm tissue. Microscopically, the central region consisted of neutrophils, some of which were apoptotic. The neutrophils were surrounded by a capsule of proliferating granulation tissue. What is your diagnosis?
- A.
Abscess
- B.
Benign neoplasm
- C.
Cellulitis
- D.
Granuloma
- E.
Infarct
- 15.A 50 y/o white man complains of sudden onset of chest pain. His laboratory test show elevated cardiac enzymes and troponin in his serum. This increase in enzyme levels is most likely a resuIt of which of the following changes in myocardiocytes?
- A.
Swelling of the mitochondria
- B.
Disruption of protein synthesis
- C.
Heterophagy by Iysosomes
- D.
Damage to the cell membrane
- E.
Karryorhexis of the nucleus
.JPG "During your surgery rotation your are part of a medical team performing an exploratory emergency laproscopic surgery of the abdomen. A look through the laprascope reveals the image seen below. What is the most likely diagnosis.")
.JPG "During your pediatric rotation you are asked to examine a newborn. His physical examination was with normal limits with the exception of his right hand which is shown below. What is the underlying defect that has caused this deformity?")
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