Mod Review By: Kmsa-med

Pap smears are cytological smears that detect early pre-cancerous changes of the cervix. This means that the test is specifically designed to identify abnormal cells in the cervix that could potentially develop into cervical cancer. It is not intended to detect pre-cancerous changes in the large intestine or small intestine. Therefore, the correct answer is cervix.

Atherosclerosis is the most likely pathologic process that could occur in this patient. Atherosclerosis is a condition where plaque builds up inside the arteries, leading to their narrowing and hardening. This can result in reduced blood flow and oxygen supply to various organs and tissues, increasing the risk of complications such as heart attack, stroke, and peripheral artery disease. Given the patient's age, smoking history, and medical conditions like diabetes and high blood pressure, all of which are risk factors for atherosclerosis, it is the most plausible answer.

Coagulation necrosis is characterized by protein denaturation, which leads to the loss of cell structure and function. This type of necrosis occurs when there is a lack of blood supply to the affected area, causing the cells to undergo irreversible damage. Enzymatic degradation is minimal in coagulation necrosis compared to other types, such as liquefactive necrosis where enzymes play a significant role in tissue breakdown. Therefore, the correct answer is coagulation necrosis.

The correct answer is Adenoma. An adenoma is a benign tumor that arises from glandular tissue, in this case, the anterior pituitary gland. Enlargement of the anterior pituitary due to a tumor is a common condition known as pituitary adenoma. It is the most likely histologic diagnosis because adenomas are the most common type of tumor found in the anterior pituitary. Adenomas can cause hormonal imbalances and symptoms related to the excess production of specific hormones.

Hepatocytes are stable cells because they have the ability to divide and replicate, but at a much slower rate compared to labile cells (such as skin cells) and permanent cells (such as neurons). Stable cells are able to enter the cell cycle and undergo mitosis when needed, but they typically remain in a quiescent state until stimulated by injury or tissue regeneration. This ability allows hepatocytes to maintain the liver's function and regenerate damaged tissue when necessary.

Thrombin is not an antiplatelet, but rather a procoagulant enzyme that plays a key role in the clotting cascade. It converts fibrinogen into fibrin, which forms a mesh that helps in clot formation. Antiplatelets, on the other hand, work by inhibiting platelet aggregation and preventing the formation of blood clots. Adenosine triphosphatase and Prostacyclin are examples of antiplatelets, as they inhibit platelet activation and aggregation, reducing the risk of clot formation.

BRCA1 is a tumor suppressor gene that plays a crucial role in repairing damaged DNA. Mutations in BRCA1 can lead to impaired DNA repair mechanisms, which increases the risk of developing breast and ovarian cancer. Therefore, the correct answer is DNA repair.

After a partial hepatectomy, the liver cells undergo regeneration to compensate for the lost tissue. This process involves an increase in the number of liver cells through cell division, resulting in the restoration of the liver's size and function. This increase in cell number is known as hyperplasia. Hypertrophy refers to an increase in cell size, which is not the case in liver regeneration. Metaplasia refers to the transformation of one type of tissue into another, which is also not applicable here. Atrophy refers to a decrease in cell size or number, which is the opposite of what happens during liver regeneration.

Mesangial cells are specialized cells found in the kidney. They are responsible for providing structural support to the glomerulus, which is the filtering unit of the kidney. Additionally, mesangial cells are involved in regulating blood flow and the filtration process in the kidney. They also have immune functions, such as phagocytosis and production of inflammatory mediators. Therefore, mesangial cells can be considered as the macrophages of the kidney, contributing to its immune defense and maintenance of proper kidney function.

Lines of Zahn are characteristics of thrombi. Thrombi are blood clots that form within blood vessels and can obstruct blood flow. The lines of Zahn are alternating layers of platelets, fibrin, and red blood cells that are seen in the formation of thrombi. This characteristic appearance helps distinguish thrombi from postmortem clots, which do not show these layers. Therefore, the correct answer is trombi.

The stage of breast cancer according to the TNM system will be T1N1M1. This is because the patient has a 1.8cm breast lump (T1), presence of two axillary lymph nodes (N1), and one lung mass (M1). The TNM system is used to classify the size and extent of the primary tumor (T), the involvement of lymph nodes (N), and the presence of distant metastasis (M). Based on the information given, the patient's cancer has spread to the lymph nodes and distant sites, indicating stage IV disease.

c-erbB2, also known as HER2, is a gene that is strongly linked to breast and ovarian cancer. This gene plays a crucial role in regulating cell growth and division. Mutations or amplification of the c-erbB2 gene can lead to overexpression of the HER2 protein, which in turn can promote uncontrolled cell growth and the development of cancer. Targeted therapies, such as HER2 inhibitors, have been developed to specifically target and block the activity of the HER2 protein, providing effective treatment options for patients with HER2-positive breast and ovarian cancers.

The correct answer is hypertrophy. In ischemic heart disease (IHD), the blood supply to the heart is reduced, leading to decreased oxygen and nutrient delivery. The heart responds to this stress by increasing in size, specifically the size of individual cardiac muscle cells. This adaptive mechanism, known as hypertrophy, allows the heart to pump more forcefully and compensate for the reduced blood supply. However, prolonged hypertrophy can lead to further heart damage and eventually heart failure.

Myleoperoxidase enzyme produces HOCl (hypochlorous acid), which is a potent antimicrobial agent. It is produced by neutrophils and plays a crucial role in killing bacteria and other pathogens. Therefore, it is an O2 independent antimicrobial, as it does not require oxygen to exert its antimicrobial activity. On the other hand, defensins, bacterial permeability increasing protein, and major basic protein are also antimicrobial agents, but they are O2 dependent, meaning that their activity is enhanced in the presence of oxygen.

Tumours of the testes are associated with Alpha fetoprotein. Alpha fetoprotein is a protein that is normally produced by the liver of a developing fetus. However, certain types of tumors, particularly those arising from the testes, can also produce this protein. Therefore, elevated levels of alpha fetoprotein in the blood can be indicative of testicular tumors. This marker is often used in the diagnosis and monitoring of testicular cancer.

Keloid is most commonly seen in the ear. Keloids are raised scars that occur due to an overgrowth of collagen in the skin during the healing process. They can develop after any type of injury to the skin, including ear piercings. The ear is a common site for keloid formation because it has a high concentration of cartilage, which is more prone to developing keloids. Keloids can be itchy, painful, and cosmetically undesirable, and may require medical intervention for treatment.

HNPCC is an autosomal dominant syndrome caused by defective mismatch repair proteins. Autosomal dominant means that a person only needs to inherit one copy of the defective gene from one parent to develop the syndrome. The location of the defective gene responsible for HNPCC is found on chromosome 2, as indicated in the answer.

Neutrophils are not cells of atherosclerotic plaque. Atherosclerotic plaque is primarily composed of foam cells, which are macrophages that have engulfed oxidized low-density lipoprotein (LDL) particles. T lymphocytes are also commonly found in atherosclerotic plaques and play a role in inflammation and immune response. Endothelial cells line the inner surface of blood vessels and are involved in the development and progression of atherosclerosis. However, neutrophils are not typically present in atherosclerotic plaques, as their role is more prominent in acute inflammation rather than chronic inflammatory conditions like atherosclerosis.

Phospholipid complexes help to restrict coagulation to the site of injury. This is because phospholipids are essential components of platelet membranes and are released at the site of injury. These phospholipid complexes provide a surface for the coagulation factors to bind and initiate the clotting cascade. By localizing the coagulation process to the site of injury, phospholipid complexes help prevent the formation of unwanted clots in the bloodstream, ensuring that clotting occurs only where it is needed to stop bleeding.

Streptokinase is the correct answer because it is a thrombolytic agent that helps dissolve blood clots, but it does not induce angiogenesis. Angiogenesis is the formation of new blood vessels, and growth factors typically stimulate this process. Aspirin, leg compression during surgery, and heparin sub-cutaneously can all induce angiogenesis by promoting blood vessel growth and development.

Immunohistochemical refers to a technique used to detect specific proteins or antigens in tissues using antibodies. In the context of the question, substances produced by the body in response to the presence of cancer growth or cancer tissue can be detected using immunohistochemical methods. This technique helps in identifying and characterizing cancer cells or tumors based on the presence or absence of specific markers. It is commonly used in cancer diagnosis and research to understand the molecular characteristics of tumors and guide treatment decisions.

The main serious complication of ruptured atherosclerosis is hypovolemic shock. When atherosclerosis ruptures, it can cause severe bleeding, leading to a rapid loss of blood volume. This sudden decrease in blood volume can result in hypovolemic shock, a life-threatening condition characterized by inadequate blood flow to the body's organs and tissues. Hypovolemic shock can cause organ failure and even death if not promptly treated. Aneurysm, thrombosis, and clotting are also potential complications of ruptured atherosclerosis, but hypovolemic shock is the most immediate and severe consequence.

The local factors that influence wound healing include TB (tuberculosis), anatomical location of the wound, and mechanical factors. TB can delay wound healing due to its impact on the immune system. The anatomical location of the wound plays a role in the healing process as different areas of the body have varying blood supply and tissue quality. Mechanical factors such as tension, pressure, and shear can affect wound healing by disrupting the formation of new tissue.