Question 1

Which of the following describes metaplasia?
A) Increase in the number of cells (mitosis) in an organ or tissue
B) Decrease in the number of cells (mitosis) in an organ or tissue
C) Increase in individual cell size in an organ or tissue
D) Decrease in individual cell size in an organ or tissue
E) Reversible change in which one adult cell is replaced by another adult cell type

Accepted Answer

Metaplasia is a reversible process where one differentiated cell type is replaced by another, often as an adaptive response to chronic irritation or inflammation.

Question 2

Which of the following is the most common stem cell reprogramming change involved in respiratory tract cancer?
A) Squamous to columnar
B) Squamous to cuboidal
C) Columnar to squamous
D) Columnar to cuboidal
E) Cuboidal to squamous

Accepted Answer

In respiratory tract cancers, particularly in the context of smoking-related lung cancer, the most common reprogramming change is from columnar to squamous cells, known as squamous metaplasia.

Question 3

In Barrett esophagus, metaplasia occurs as a result of refluxed gastric acid. Which of the following changes occurs?
A) Squamous to columnar
B) Squamous to cuboidal
C) Columnar to squamous
D) Columnar to cuboidal
E) Cuboidal to squamous

Accepted Answer

In Barrett's esophagus, the normal squamous epithelium of the esophagus is replaced by columnar epithelium due to chronic acid exposure from gastroesophageal reflux disease (GERD).

Question 4

Which of the following is associated with cell death and NOT specifically with reversible cell injury?
A) Membrane blebs
B) Clumping of chromatin
C) Swelling of ER
D) Swelling of mitochondria
E) Myelin ﬁgures

Accepted Answer

Myelin figures are associated with irreversible cell injury and cell death, as they are indicative of the breakdown of cellular membranes.

Question 5

Which of the following is NOT associated with cell death?
A) Nuclear condensation (pyknosis)
B) Nuclear fragmentation (karyorrhexis)
C) Dissolution of the nucleus (karyolysis)
D) Decrease in intracellular Ca++
E) Amorphous mitochondrial densities

Accepted Answer

A decrease in intracellular Ca++ is not typically associated with cell death; rather, an increase in intracellular Ca++ is often observed during cell death processes.

Question 6

Which of the following causes of cell injury involves a single amino acid substitution in hemoglobin S in sickle cell anemia?
A) Oxygen deprivation
B) Physical agents
C) Chemical agents and drugs
D) Infectious agents
E) Immunologic reactions
F) Genetic derangements
G) Nutritional imbalances

Accepted Answer

Sickle cell anemia is caused by a genetic mutation leading to a single amino acid substitution in the hemoglobin molecule, which is a genetic derangement.

Question 7

Which of the following is NOT a principle relevant to most forms of cell injury?
A) The cellular response to injurious stimuli depends on the type of injury, its duration, and its severity
B) The result of cell injury involves an increase in ATP production and decrease in intracellular Ca++
C) Cell injury results from functional and biochemical abnormalities in one or more of several essential cellular components
D) The consequences of cell injury depend on the type, state, and adaptability of the injured cell

Accepted Answer

Cell injury typically involves a decrease in ATP production and an increase in intracellular Ca++, not the opposite.

Question 8

Depletion of ATP to <5% to 10% of normal levels has widespread effects on many critical cellular systems. Which of the following is NOT a condition which may lead to
Depletion of ATP?
A) Activity of the plasma membrane energy-dependent sodium pump is reduced
B) Failure of the Ca++ pump
C) Cellular energy metabolism is altered
D) Increase in protein synthesis followed by necrosis
E) Unfolding or misfolding of existing proteins

Accepted Answer

An increase in protein synthesis followed by necrosis is not a condition that leads to ATP depletion; rather, ATP depletion can lead to decreased protein synthesis.

Question 9

Ischemia reduces oxidative phosphorylation in mitochondria, resulting in a decrease in ATP production. Which of the following would NOT follow as a morphologic
Consequence?
A) Increased anaerobic glycolysis
B) Increase in pH and glycogen
C) Decrease in protein synthesis
D) Inﬂux of Ca++, H2O, and Na++
E) Eﬄux of K+

Accepted Answer

Ischemia leads to decreased ATP production, causing increased anaerobic glycolysis, decreased protein synthesis, and ionic imbalances. However, it results in a decrease in pH and glycogen, not an increase.

Question 10

Which of the following would NOT cause mitochondrial damage?
A) Increase in cytosolic Ca++
B) Oxidative stress
C) Retention of cytochrome c
D) Breakdown of phospholipids through the phospholipase A2 and sphingomyelin pathways
E) Lipid breakdown products (e.g. free fatty acids and ceramide)

Accepted Answer

Retention of cytochrome c does not cause mitochondrial damage; rather, its release from mitochondria is a consequence of damage and can lead to apoptosis.

Question 11

Which of the following most likely occurs if cytochrome c is released into the cytosol
A) Apoptosis
B) Hypertonicity
C) Hypotonicity
D) Increased extracellular Ca++
E) Decreased intracellular K+

Accepted Answer

Cytochrome c release into the cytosol is a key step in the intrinsic pathway of apoptosis, leading to the activation of caspases that execute cell death.

Question 12

Cell injury often results in increased intracellular calcium and this in turn mediates a variety of deleterious eﬀects. Which of the following is NOT activated by calcium?
A) ATPases
B) Phospholipases
C) Proteases
D) Endonucleases
E) ATP synthase

Accepted Answer

ATP synthase is not activated by calcium; it is an enzyme that synthesizes ATP from ADP and inorganic phosphate, primarily driven by a proton gradient across the mitochondrial membrane.

Question 13

Some energy producing processes produce reactive oxygen species (free radicals) that can cause damage to cells. Which of the following is NOT a mechanism of free
Radical generation?
A) Absorption of radiant energy
B) Enzymatic metabolism of exogenous chemicals or drugs
C) During creation of ATP via glycolysis
D) Free electron donation from transition metals (e.g. copper, iron)
E) Reduction-oxidation reactions during normal metabolic processes

Accepted Answer

Glycolysis is a process that generates ATP without involving free radical generation, unlike the other processes listed.

Question 14

Which of the following is NOT a mechanism by which free radicals cause cell injury?
A) Lipid peroxidation of membranes
B) Oxidative modiﬁcation of proteins
C) Lesions in DNA
D) Reactions with!-carotene
E) Reactions with thymine

Accepted Answer

Free radicals typically cause cell injury through lipid peroxidation, oxidative modification of proteins, and DNA damage. Reactions with β-carotene are not a recognized mechanism of free radical-induced cell injury.

Question 15

Which of the following is NOT involved in free radical neutralization?
A) Superoxide dismutase (SOD)
B) Nitric oxide (NO)
C) Vitamins A, C, and E
D) Glutathione peroxidase and reductase
E) Fenton (ferritin)

Accepted Answer

The answer of Which of the following is NOT involved...

Question 16

The two patterns of reversible cell injury are cellular swelling and fatty change. Which of the following would NOT be an ultrastructural change seen in such a cell?
A) Decreased lysosomal activity
B) Plasma membrane alterations
C) Mitochondrial changes
D) Dilation of the ER Nuclear alteration

Accepted Answer

Decreased lysosomal activity is not typically associated with reversible cell injury. The other options are common ultrastructural changes seen in reversible cell injury.

Question 17

Which of the following would NOT be an ultrastructural change seen in a reversibly injured cell?
A) Blebbing
B) Microvillli distortion
C) Myelin ﬁgured
D) Amorphous densities
E) Cell shrinking
F) Loosening of intracellular attachments

Accepted Answer

Cell shrinking is typically associated with irreversible injury or apoptosis, not reversible injury.

Question 18

In the image to the right, A is normal myocardium and B is myocardium with coagulation necrosis. Which of the following can be discerned in B, suggesting necrosis?
A) Eosinophilia
B) Myeline ﬁgures
C) Blebbing
D) Cell swelling
E) Apoptosis

Accepted Answer

The answer of In the image to the right, A...

Question 19

Match the following description with the term:
-Nuclear shrinkage and increased basophilia
A) Karyolysis
B) Pyknosis
C) Karyorrhexis

Accepted Answer

Pyknosis refers to the condensation of chromatin in the nucleus of a cell, leading to nuclear shrinkage and increased basophilia.

Question 20

Match the following description with the term:
-Nucleus undergoes fragmentation
A) Karyolysis
B) Pyknosis
C) Karyorrhexis

Accepted Answer

Karyorrhexis is the process where the nucleus undergoes fragmentation.

Quiz 1: Pathology

Which of the following describes metaplasia?

Which of the following is the most common stem cell reprogramming change involved in respiratory tract cancer?

In Barrett esophagus, metaplasia occurs as a result of refluxed gastric acid. Which of the following changes occurs?

Which of the following is associated with cell death and NOT specifically with reversible cell injury?

Which of the following is NOT associated with cell death?

Which of the following causes of cell injury involves a single amino acid substitution in hemoglobin S in sickle cell anemia?

Which of the following is NOT a principle relevant to most forms of cell injury?

Depletion of ATP to <5% to 10% of normal levels has widespread effects on many critical cellular systems. Which of the following is NOT a condition which may lead to Depletion of ATP?

Ischemia reduces oxidative phosphorylation in mitochondria, resulting in a decrease in ATP production. Which of the following would NOT follow as a morphologic Consequence?

Which of the following would NOT cause mitochondrial damage?

Which of the following most likely occurs if cytochrome c is released into the cytosol

Cell injury often results in increased intracellular calcium and this in turn mediates a variety of deleterious eﬀects. Which of the following is NOT activated by calcium?

Some energy producing processes produce reactive oxygen species (free radicals) that can cause damage to cells. Which of the following is NOT a mechanism of free Radical generation?

Which of the following is NOT a mechanism by which free radicals cause cell injury?

Which of the following is NOT involved in free radical neutralization?

The two patterns of reversible cell injury are cellular swelling and fatty change. Which of the following would NOT be an ultrastructural change seen in such a cell?

Which of the following would NOT be an ultrastructural change seen in a reversibly injured cell?

In the image to the right, A is normal myocardium and B is myocardium with coagulation necrosis. Which of the following can be discerned in B, suggesting necrosis?

Match the following description with the term: -Nuclear shrinkage and increased basophilia

Match the following description with the term: -Nucleus undergoes fragmentation