Question 1

Normal myocardium is shown in the left hand panel of the accompanying photomicrograph,whereas the right hand panel shows abnormal myocardium.Which one of the following is the most likely pathophysiologic explanation for the changes seen in the myocardium on the right?

A)Acute inflammation,due to myocardial infarction
B)Ageing
C)Cancer of the myocardium
D)Increased number of cells
E)Increased synthesis of proteins and intermediate filaments

Accepted Answer

The photomicrograph demonstrates hypertrophy,which is due to an increased synthesis of proteins and intermediate filaments,when compared to normal.In muscle,it is usually due to increased workload,often systemic hypertension or aortic stenosis,in the case of the heart (the left ventricle is forced to pump against a greater systemic arterial pressure or load).

Question 2

Normal testis tissue is shown in the left hand panel of the accompanying photomicrograph,whereas the right hand panel shows abnormal testis.Which one of the following is the most likely pathophysiologic explanation for the changes seen in the testis on the right?

A)Acute inflammation
B)Ageing
C)Cancer of the testis (seminoma)
D)Increased number of cells
E)Increased synthesis of proteins and intermediate filaments

Ageing

Accepted Answer

The photomicrograph shows atrophy of the testis on the right,due,in this case,to old age (94 years).The seminiferous tubules show almost no spermatogenic activity,are filled mainly with Sertoli cells (labelled "Se").In between seminiferous tubules,one sees pink collagen or fibrosis (labelled "F").

Question 3

A 54 year old man had been experiencing heartburn for a number of years.His physician eventually decided to recommend upper GI endoscopy.A mid-oesophagus biopsy sample is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis?

A)Acute inflammation
B)Barrett's oesophagus
C)Colonic hyperplasia
D)Gastric hypertrophy
E)Giardia lamblia infection

Barrett's oesophagus

Accepted Answer

The photomicrograph shows an example of gastric metaplasia or Barrett's oesophagus.The fact the biopsy is mid-oesophagus should give you a hint that gastric mucosa is abnormal in this location.Another hint is the presence of squamous mucosa (S)on both sides of the gastric glands.

Deck 6: Disorders of Growth