Altered Cellular Biology

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 (normal tissue is stratified squamous epithelium). Which of the following mucosal alterations is most likely represented by these findings?

~Hyperplasia
~Carcinoma
~Metaplasia
~Dysplasia
~Ischemia
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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 (normal tissue is stratified squamous epithelium). Which of the following mucosal alterations is most likely represented by these findings?

~Hyperplasia
~Carcinoma
~Metaplasia
~Dysplasia
~Ischemia
Metaplasia
A 59 year old woman has the loss of consciousness that persisted for over an hour. When she became arousable, she could not speak or move her right arm or leg, and symptoms were consistent for a cerebral vascular accident (stroke). A cerebral angiogram revealed an occlusion to her left middle cerebral artery. Months later, a computed tomographic (CT) scan shows a large 5 cm cystic area in her left parietal lobe cortex. This CT finding is most likely the consequence of resolution from which of the following cellular events?

~Coagulative necrosis
~Caseous necrosis
~Apoptosis
~Atrophy
~Liquefactive necrosis
Liquefactive necrosis
A 19 year old woman gives birth to her first child. She begins breastfeeding the infant. She continues breastfeeding for almost a year with no difficulties and no complications. Which of the following cellular processes that. began in the breast during pregnancy allowed her to nurse the infant for this period of time?

~Dysplasia
~Atrophy
~Anaplasia
~Metaplasia
~Hyperplasia
Hyperplasia
A 20 year old woman had Goodpasture syndrome which progressed to chronic renal failure. She was 165 cm tall and weighed 55kg. She is hypertensive and had blood pressure measurements in the range of 150/90 to 180/110 mm Hg, but she did not regularly take medications. Laboratory studies showed her blood urea nitrogen was over 100 mg/dL. She required chronic dialysis. She died from heart failure. At autopsy, her heart weighed 540 gm (normal 250-350 gm). The size of her heart is most likely to be the result of which of the following processes involving the myocardial fibers?

~Fatty degeneration
~Fatty infiltration
~Fat necrosis
~Edema
~Hypertrophy
Hypertrophy
A 40 year old woman has the sudden onset of severe abdominal pain. On physical examination she has diffuse tenderness in all abdominal quadrants, with marked guarding and muscular rigidity. She has laboratory findings that include serum AST of 43 U/L, ALT of 30 U/L, LDH 630 U/L, and lipase 415 U/L. An abdominal CT scan reveals peritoneal fluid collections and decreased attenuation along with enlargement of the pancreas consistent for pancreatitis. Which of the following cellular changes is most likely to accompany these findings?

~Fat necrosis
~Apoptosis
~Hyperplasia
~Liquefactive necrosis
~Gangrenous necrosis
Fat necrosis
A 26 year old man died from complications of destruction of the aortic valve by large, irregular vegetation from which Staphylococcus aureus was cultured. At autopsy, the spleen on sectioning grossly reveals the presence of a tan to white, wedge-shaped 1.5 x 3 cm lesion with base on the capsule. The splenic findings are most likely to result from which of the following cellular abnormalities?

~Metaplasia
~Coagulative necrosis
~Abscess formation
~Liquefactive necrosis
~Caseous necrosis
Coagulative necrosis
A 73 year old man suffers a "stroke." On physical examination he cannot move his right arm. A cerebral angiogram demonstrates occlusion of the left middle cerebral artery. An echocardiogram reveals a thrombus within a dilated left atrium. Which of the following is the most likely pathologic alteration from this event that has occurred in his brain?

~Pale infarction with coagulative necrosis
~Cerebral softening from liquefactive necrosis
~Recovery of damaged neurons if the vascular supply is reestablished
~Fat necrosis from the release of digestive enzymes
~Wet gangrene with secondary bacterial infection
Cerebral softening from liquefactive necrosis
A 45 year old female presents to her dermatologist complaining of a non-healing infective lesion on her right leg. the lesion was biopsied and the pathology report reads: granulomatous lesion, with a rim of multinucleated giant cells. What type of necrosis would these findings be consistent with?

~Foam cell necrosis
~Pyogenic necrosis
~Eosinophilic necrosis
~Fibrinous necrosis
~Caseous necrosis
Caseous necrosis
A nurse in the emergency department admits a male patient who has experienced severe frostbite to his hands and toes after becoming lost on a ski hill. The nurse recognizes that which of the following phenomena has contributed to his tissue damage.

~Autonomic nervous stimulation has resulted in injury
~Decreased blood viscosity has resulted in interstitial bleeding
~Reactive vasodilation has compromised perfusion
~Decreased blood flow has induced hypoxia.
Decreased blood flow has induced hypoxia
All of the following are biochemical mechanisms of cellular injury EXCEPT

~Efflux of calcium
~Accumulation of reactive oxygen species
~Mitochondrial damage and dysfunction with resulting ATP depletion
~Defect in membrane permeability
~Damage to DNA and protein synthesis
Damage to DNA and protein synthesis
A 25 year old male sustained a deep laceration to his left hand while chopping meat for dinner. He was transported to the ER and appropriate management was initiated. He was discharged from the ER without incident. Five days later he noticed an increase in pain and a foul smell emanating from the wound site. He returned to the ER for further management. All the following are potentially reversible cellular responses EXCEPT ~Necrosis ~Metaplasia ~Atrophy ~Hyperplasia ~HypertrophyNecrosisMetaplasia is ~The replacement of one differentiated cell type with another ~The transformation of a cell type to malignancy ~An irreversible cellular adaptation ~The disorganization of cells into various sizes, shapes, and arrangementsThe replacement of one differentiated cell type with anotherApoptosis is a process that results in cellular ~Atrophy ~Death ~Proliferation ~Mutation ~GrowthDeathWasting of an organ or tissue from non-use is termed ~Hypertrophy ~Hematoma ~Crepitus ~Dysplasia ~AtrophyAtrophyA decrease in blood flow to a tissue or organ resulting in impairment of cellular function is known as ~Anemia ~Hypoxia ~Aneurysm ~Ischemia ~NecrosisIschemiaCoagulative necrosis ~Resembles crumbly cheese ~Can result from the interrupted blood supply ~Is reversible if promptly and aggressively managed ~Remains functional for 5-7 days ~Only seen in brain tissuesCan result from the interrupted blood supplyReperfusion injury to cells ~Results in very little cellular damage ~Results from calcium deficiency in cells ~Occurs following nutritional injury ~Involves formation of reactive oxygen species (free radicals) ~All of the aboveInvolves formation of reactive oxygen species (free radicals)Liquefactive necrosis occurs in the brain because ~Debris is not digested by hydrolases ~Of protein denaturation ~It is rich in hydrolytic enzymes and lipids ~Ischemia results in chemical injuryIt is rich in hydrolytic enzymes and lipidsA 2 year old swallowed a watch battery. Following ingestion, kidney function was impaired, and the heart began to fail. Which of the following is the most likely cause? ~Karyorrhexis ~Coagulative necrosis ~Ammonia accumulation ~Fat necrosis ~Caseous necrosisCoagulative necrosisA 50 year old diabetic presents to the ER with an infected wound from an above the knee amputation 7 days prior. the culture reveals that the wound was infected with Clostridium bacteria. The patient succumbs to the infection and dies a week later. Which of the following is the most likely cause of death? ~Gas gangrene ~Caseous necrosis ~Fat necrosis ~Apoptosis ~KaryolysisGas gangreneWhat organs are affected by the type of necrosis that results from hypoxia caused by severe ischemia or caused by chemical injury? ~Lungs and pulmonary vessels ~Brain and spinal cord ~Kidneys and heart ~Muscles and bones ~PancreasKidneys and heartWhen the heart's workload increases, what changes occurs to the myocardial cells? ~They divide and increase in size ~They increase in size ~They increase in number ~They undergo metaplasiaThey increase in sizeAfter ovulation, the uterine endometrial cells divide under the influence of estrogen. This is an example of hormonal ~Hyperplasia ~Dysplasia ~Hypertrophy ~Anaplasia ~MetaplasiaHyperplasiaA pathology report comes back indicating that muscular atrophy has occurred. Muscular atrophy involves the decrease in muscle cell ~Number ~Size ~Vacuoles ~Lipofuscin ~StrengthSizeIn response to an increase in workload, the myocardium will hypertrophy which is an ~Increase in size by increasing the total number of cells ~Increase in size by increasing the intracellular content ~Decrease in length ~Increase in excitability ~Increase in contractilityIncrease in size by increasing the intracellular contentA biopsy of the bronchial tissues was obtained. Pathology report reveals that stratified squamous epithelium have replaced columnar tissues. This form of adaptation is ~Anaplasia ~Hyperplasia ~Metaplasia ~Dysplasia ~CINMetaplasiaA 25 year old is pregnant. As a direct consequence of her pregnancy, her breasts have enlarged. This is a consequence of ~Hormonal anaplasia ~Compensatory anaplasia ~Compensatory hyperplasia ~Hormonal hyperplasia ~DysplasiaHormonal hyperplasiaA 35 year old female returns to her gynecologist for consultation on her most recent pap smear. The pap smear demonstrated abnormal changes in the shape and organization of the cervical cells. What term best describes this type of change? ~Metaplasia ~Atrophy ~Hyperplasia ~Hypertrophy ~DysplasiaDysplasiaA 55 year old obese male complains of chest pain on exertion. The chest pain, i.e. angina pectoris is most likely due to ~Ischemia ~Malnutrition ~Free radicals ~Chemical toxicity ~ApoptosisIschemiaA 52 year old male suffered a myocardial infarction secondary to atherosclerosis and ischemia. Once blood flow is returned to the damaged heart, reperfusion injury occurs because of ~Lipid accumulation in the hearts blood vessels ~Decrease in intracellular calcium concentration ~Vacuolation ~Oxidative stressDecrease in intracellular calcium concentrationIn irreversible cell injury, the accumulation of _____ in the intracellular space is a common finding. ~Sodium ~Potassium ~Calcium ~Magnesium ~ChlorideCalciumA 21 year old female donated blood at the local red cross. Shortly after leaving the blood bank, she noticed swelling at the site of needle insertion. Concerned, she called the red cross and was informed by the nurse that "it's just a hematoma and to apply pressure." Five days later, she noticed a change in the color of her skin, yellowish to purple, at the needle site. Concerned, she called the local health center. The best or most appropriate answer would be: Not to worry, the bruising is due to an accumulation of ~Transferrin ~Bilirubin ~Albumin ~Liposuction ~MelaninBilirubinIncarcerated individuals exposed to an infected tuberculosis patient is likely at risk for ~Coagulative necrosis ~Liquefactive necrosis ~Caseous necrosis ~Autonecrosis ~Fast necrosisCaseous necrosis