Compiled General Pathology Questions (2009-2010) Chapter 1
1. Which of the following f ollowing is not a characteristic of reversible cell injury (Robbins 12) A. Cell Cell swel swelli ling ng B. Blebbing of plasma membrane C. Clumpi Clumping ng of nuclea nuclearr chroma chromatin tin D. Detachment of ribosomes from ER E. Fragme Fragmenta ntatio tion n of nucle nuclear ar membr membrane ane 2. Which of the following f ollowing is not a reversible tissue change (Robbins 6) A. B. C. D. E.
Atrophy Necros rosis Meta Metap plas lasia Hype Hyperp rpla lasi siaa Hyper yperttrop rophy
3. The order of acute cell swelling due to hypoxia is (PBVD 14) 1. Depl Deplet etio ion n of ATP ATP 2. Defi Defici cien ency cy of of oxyg oxygen en + + 3. Failure of Na -K pump + ++ 4. Influx of Na , CA , and H2O 5. Decrease in oxidative phosphorylation A. B. C. D. E.
1,2 1,2,3,4 ,3,4,5 ,5 2,1,3,4 ,3,4,,5 2,5,1,3 ,1,3,,4 2,5 2,5,1,4 ,1,4,3 ,3 5,4,3,2 ,3,2,,1
4. The most likely cellular response to an acute and transient reduction in oxygen supply to tissues is:
a. Atrophy b. Necrosis c. Apoptosis d. Hyperplasia e. Cellular swelling
5. Which of the following f ollowing is not expected with cellular necrosis?
a. Karyolysis b. Cell swelling c. Adjacent inflammation d. Nucleosome-size fragments e. Amorphous mitochondrial densities
6. Place in order the sequence of events leading to cellular hydropic degeneration:
1. Hypoxia 2. Cisternae of ER distend 3. Osmotic water shifts occur 4. Decreased ATP production 5. Sodium enters the cell and Potassium exits
a. 1, 2, 3, 4, 5 b. 1, 3, 2, 4, 5 c. 1, 4, 3, 5, 2 d. 1, 4, 5, 3, 2 e. 5, 4, 3, 2, 1
7. Cardiac glycosides cause myocardial degeneration and necrosis by? A Inh Inhibition of Na Na+-K+ pump B Activation of Na+-K+ pump C Activation of Ca pump D Inhibition of Ca pump E Both A and D
8. Prolonged progesterone induced cystic endometrial hyperplasia is an example of?
A. B. C. D. E.
Meta Metap plas lasia Patho Patholog logic ic hyperp hyperplas lasia ia Patho Patholog logic ic hypert hypertrop rophy hy Compen Compensat satory ory hyperp hyperplas lasia ia Compen Compensat satory ory hypert hypertrop rophy hy
9. Which of the following f ollowing mechanism can lead to cardiac hypertrophy? 1. Stimul Stimulati ation on by growth growth factor factorss 2. Acti Action on of of mech mechan anic ical al sen senso sor r 3. Stimulation by vasoactive agents 4. Switching from adult to neonatal isoforms of proteins 5. Re-exp Re-expres ressio sion n of embry embryoni onicc gene gene like like ANF ANF
A. B. C. D. E.
1,2,3 1,4,5 1,2,4,5 2,3,4,5 1,2,3,4 ,3,4,,5
10. Which type of of cellular adaptive response is induced induced by Vitamin Vitamin A deficiency? (Robbins p. 10) a. Atrophy b. Metaplasia c. Hyperplasia d. Hypertrophy e. Both c and d
11. Which cellular adaptations adaptations will most likely lead to malignant transformation? transformation? (Robbins pgs. pgs. 8 & 10) a. Hypertrophy and Atrophy b. Hyperplasia and Metaplasia c. Hypertrophy and Metaplasia d. Hypertrophy and Hyperplasia e. All of the above
12. What are two features of reversible reversible cell injury that can be recognized recognized under the light microscope? microscope? (Robbbins p. 12)
a. Cellular swelling and fatty change b. Myelin figures and nuclear pyknosis c. Karyolysis and ribosomal detachment d. Plasma membrane blebbing and chromatin clumping e. Adjacent inflammation and amorphous mitochondrial densities
13. On a routine H&E stain, stain, which organelle is responsible responsible for cytoplasmic basophilia? basophilia? (PBVD p. 8) a. Rough ER b. Smooth ER c. Lysosomes d. Golgi complex e. Microtubules
14. Autophagocytosis, Autophagocytosis, lysosomes, and the ubiquitin proteasome pathway pathway likely play a role in which cellular adaptation? adaptation? (PBVD p. 38) a. Atrophy b. Metaplasia c. Hyperplasia d. Hypertrophy e. Both c and d
15.
All of the following cellular components are frequently damaged by injurious stimuli except:
a. mitochondria, b. cell membranes c. DNA in nucleus nucleus d. nuclear membrane e. the machinery of protein protein synthesis synthesis and packaging
16.
All of the following are major causes of ATP depletion except:
a. reduced supply of oxygen and nutrients b. mitochondrial damage c. actions of some some toxins d. protein synthesis e. ischemi
17.
Depletion of ATP results in:
a. Cell swelling, dilation of endoplasmic endoplasmic reticulum reticulum b. Decreased rate of anaerobic glycolysis c. Increased protein protein synthesis synthesis d. none of the above e. all of the above above
18.
Which of the following statements is true regarding mechanisms for increased intracellular Ca2+
causing cell injury: a. The accumulation of Ca2+ in mitochondria results in opening of the mitochondrial permeability transition pore and failure of ATP generation. b. Increased cytosolic Ca2+ activates a number of enzymes (phospholipases, endonucleases, proteases), with potentially deleterious cellular effects. c. Increased intracellular Ca2+ levels levels also result in the induction induction of apoptosis, apoptosis, by direct activation of caspases and by increasing mitochondrial permeability. d. A,B, and C e. none of the above
19.
Following biochemical mechanisms may contribute to membrane damage except:
a.
Reactive oxygen species
b.
Decreased phospholipid synthesis.
c.
Increased phospholipid phospholipid breakdown.
d.
Cytoskeletal abnormalities.
e.
Dissemination of lipid breakdown products
20. Irreversible cell injury includes ? a. Nuclear condensation b. Loss of ribosomes c. Lysosome rupture d. Myelin figures e. All of the above
21. All of the following are involved in cellular hypertrophy except? a. IGF-1 b. TGF-β c. Endothelin-1 d. Angiotensin-II e. Papillomavirus
22. Which of the following is the earliest manifestation in almost all forms of cellular injury (Robbins: p13)
A. B. C. D. E.
Cell Cell swel swelli ling ng Cell Cell shri shrink nkag agee Cell Cell frag fragme ment ntat atio ion n Mitoch Mitochond ondria riall swelli swelling ng Conden Condensat sation ion of chroma chromatin tin
23. The following changes differentiates necrosis from apoptosis (Robbins: p13)
1. Cell Cell swelli elling ng 2. Cell Cell shrin hrink kage age 3. Nuclear pyknosis
4. Nucl Nuclea earr frag fragmen menta tati tion on 5. Disr Disrup upte ted d cel celll mem membr bran anee
A. B. C. D. E.
1,2,4 1,2,5 1,3,5 2,3,5 2,4,5
24. Which of the following following will will not result in in the generation of free radicals? (Robbins p.21 ) a. Inflammation b. Redox reactions c. Fenton reactions d. Catalase activation e. Absorption of radiant energy
25. Which type of necrosis may lead lead to the accumulation of gitter gitter cells? (PBVD p.23) a. Fat b. Gangrene c. Caseation d. Coagulative e. Liquefactive
26. Which of the following microscopic features differentiates differentiates necrosis from post-mortem autolysis? (PBVD p.20) a. Cellular swelling b. Nuclear pyknosis c. Cytoplasmic eosinophilia d. Associated inflammation e. Loss of cell to cell adhesion
27. Administration of which pharmaceutical pharmaceutical agent(s) would contribute to ischemia/reperfusion ischemia/reperfusion injury? (Review article) a. Superoxide dismutase b. NO synthase inhibitor c. Xanthine oxidase inhibitor d. Monoclonal antibody to ICAM-1 e. All of the above
28. Consequences of ischemia include all of the following except? a. Increased cellular pH b. Failure of the Ca 2+ pump c. Failure of the Na +/K + pump d. Depletion of glycogen stores e. Detachment of ribosomes from the RE
29. Cyclosporine may reduce cell injury during ischaemia by? a. Decreased production of cytochrome C b. Stabilizing membrane-bound Na +/K + pump c. Stabilizing membrane-bound Ca 2+ channels d. Reduces production of reactive oxygen species e. Prevents opening of the mitochondrial permeability transition transition pore
30. Which of the following is an example of a Fenton reaction? a. O2- → H2O2 b. H2O2 → H2O + O2 c. OH- → H2O2 → H2O +O2 d. H2O2 + Fe2+ → Fe3+ + OH + OHe. H2O2 + Cu3+ → Cu2+ + OH + OH-
31. Ischemia causes all of the following cellular effects except? a. Increased cytoplasmic calcium b. Increased anaerobic glycolysis c. Increased cellular glycogen
d. Detachment of ribosomes e. Chromatin clumping
32. Increased intracellular calcium activates which of the f ollowing? a. ATPase b. Proteases c. Phospholipase d. Endonucleases e. All of the above
33. Reactive oxygen species can cause all of the following except? a. Enhances degradation by the multicatalytic proteasome complex. b. Generation of CCl3 from CCl4 c. Protein-protein cross linkages d. DNA strand breaks e. Lipid peroxidation
34. Intracellular calcium is mostly found in which of the following compartments? a. ER b. Cytosol c. Mitochondria d. Lysosomes e. A and C
35. Increase cytosolic calcium levels affect mitochondria in which of the following ways? a. opening of the mitochondrial transition pore b. Detachment of ribosomes from RER
c. Misfolding of proteins d. clumping of chromatin e. production of ROS
36. Reperfusion of ischemic tissue causes cell damage by which of the following mechanisms? a. Massive influx of intracellular calcium b. Generation of reactive oxygen species c. Direct damage from neutrophils d. Activation of complement e. all of the above
37. Which of the following following are effects of hypoxia inducible inducible factor-1? 1. Suppresses the formation of free radicals 2. Stimulation of cell survival pathways 3. Enhancement of anaerobic glycolysis 4. Inhibits oxidative phosphorylation 5. New blood vessel formation
a. 1,2,3 b. 1,4,5 c. 2,3,4 d. 2,3,5 e. 3,4,5
38. Rigor mortis may not occur in which of the ffollowing ollowing cases (PBVD 26) A. High temperatures B. ATP depleted animals C. Within 10 minutes of death D. A & B
E. All of the above 39. Which of the following is not a major cause of ATP depletion (Robbin 18) A. Reduced oxygen supply B. Reduced nutrient supply C. Mitochondrial damage D. Some toxic action E. None of the above 40. The suggested hypothesis of ischemia/reprofusion injury is an imbalance of which of the following (J Pathol 2000;190:255-266) 2000;190:255-266) 1. ICAM-1 2. Endothelin 3. Superoxide 4. Nitric oxide 5. Prostacyclin A. 1,2 B. 2,3 C. 2,4 D. 3,4 E. 3,5
41. Direct consequences of increased intracellular calcium include (Robbins P. 19) 1. Activation of cellular phospholipases, phospholipases, proteases and endonucleases 2. Depletion of ATP production due to mitochondrial damage 3. Activates caspases and induces apoptosis 4. Increases free radical production 5. Increases anaerobic glycolysis A. B. C. D. E.
1,2,3 1,2,3,4 1,3,4,5 4,5 1,2,3,4 ,3,4,,5
42. Which if the following is true regards ischemic reperfusion injury to the endothelium of the blood vessels (Review article) A. Impaired nitric oxide function in the a rterioles B. Increased inflammatory response in the venules C. Increased filtration into interstitium and reduced capillary reperfusion D. Decreased nitric oxide production production leads to increased superoxide production production
E. All the above
43. Which of the following is the most reactive O2 derived free r adical? A. B. C. D. E.
Hydroxyl ion Superoxide an anion Hydrogen peroxide Peroxynitrate anion Hydrogen free radicle
44. Formation of superoxide anion by oxidative enzymes can take place in all of the following cellular organelles except? A. B. C. D. E.
ER Nucleus Pero Perox xisom isomee Mito Mitoch chon ondr dria ia Plas Plasma ma memb membra rane ne
45. Inactivation of free radical H2O2 to H2O and O2 can be done by which of the following enzyme system? A. Glutathione peroxidase
B. C. D. E.
Supe Supero roxi xide de dism dismut utas asee Catalase All All of of the the abov abovee A and C only
46. Hypothermia can reduce the deleterious effect of ischemia by all of the following mechanism except? A. Reducing Reducing metabo metabolic lic demand demandss of stressed stressed cells cells B. Decreas Decreasing ing free free radic radical al forma formatio tion n C. Enhancing anaerobic glycolysis D. Decreas Decreasing ing cell cell swell swelling ing E. Redu Reduci cing ng infl inflam ammat matio ion n
