What type of metaplasia is seen in Barrett esophagus?
B) Squamous to columnar
Which of the following mechanisms is most likely responsible for the initial cellular swelling seen in reversible injury?
C) Loss of ATP-dependent sodium-potassium pump function
Reversible cell injury often begins with cellular swelling due to the failure of ATP-dependent sodium-potassium pumps, leading to an influx of sodium and water.
This protein is thought to promote the expression of several genes whose products increase longevity. Its function includes: inhibiting metabolic activity, reducing apoptosis, stimulating protein folding, increasing insulin sensitivity and counteracting the harmful effects of oxygen free radicals.
D) Sirtuin
A 25-year-old man presents with a stab wound to the abdomen. Exploratory surgery reveals pancreatic tissue with areas of chalky white deposits. This type of necrosis is indicative of:
A) Fat necrosis
Fat necrosis, seen in acute pancreatitis, involves the release of lipases that digest fat cells, leading to chalky white deposits due to saponification.
A biopsy of liver tissue from a patient with chronic alcohol abuse shows hepatocyte necrosis with inflammatory cell infiltration and areas of fibrosis. This pattern of cell death is most consistent with:
C) Coagulative necrosis
Chronic alcohol abuse can lead to hepatocyte necrosis characterized by coagulative patterns with inflammatory infiltration and fibrosis.
Histologic sections of a scar tissue from the upper chest of a 7-year-old boy showed extensive granulation tissue, neovascularization, and prominent fibrocollagenous tissue formation.
Which of the following growth factors is responsible for angiogenesis?
C) VEGF-1
Which of the following scenarios is an example of healing by SECOND INTENTION?
D) Hacking wound on the leg from a machete.
During leukocyte recruitment to site of injury, the weak rolling interactions slow down the leukocytes and give them the opportunity to bind more firmly to the endothelium. Firm adhesion is mediated by a family of heterodimeric leukocyte surface proteins called ________________
C) Integrin
Which of the following factors DOES NOT contribute to poor healing?
C) Vitamin C supplementation
This type of leucocyte (see photo below) are activated cells capable of secreting immunoglobulin or antibodies.
C) Plasma cells
A 35-year-old woman comes to the clinic for chief complaint of “hard skin.” Physical exam reveals patches of skin that appears tight and shiny, with hair loss. Thes skin patches feel hard on palpation. The woman also tells you that she notices her fingers “changing color” when exposed to cold temperatures.
What is the diagnosis of this patient?
B) Scleroderma
A 45-year-old man is brought to the Emergency Department due to a vehicular accident with severe trauma. Blood transfusion is ordered. However, a clerical error resulted in the wrong type of blood transfused.
Immediately after transfusion, the patient becomes faint and hypotensive. Work up reveals free hemoglobin in the plasma and urine.
Which of the following mechanisms of actions is responsible for the events described?
B) Complement-mediated lysis of red cells
This disease is associated with failure of the mechanisms that maintain self-tolerance. A hallmark is the production of autoantibodies, such as antibodies to double-stranded DNA and Smith [Sm] antigen. These autoantibodies are virtually diagnostic.
Identify this condition.
C) Systemic lupus erythematosus
This is a pattern recognition receptor that generates a signal via a cytosolic multiprotein complex called an inflammasome.
A) NOD like receptor
A 55 year old female patient is seen at your clinic for chief complaint of “nervousness.” Physical exam shows a thin woman with exophthalmos, and a diffusely enlarged, non-tender thyroid. She is also tachycardic and hypertensive. Labs show increased T3 and T4 and low TSH.
Which of the following is the most likely mechanism of disease?
C) Type 2 Hypersensitivity
This is now the most common cause of death worldwide
C) Cardiovascular diseases
A 28-year-old male scuba diver trip descends to a depth of 50 meters. After 30 minutes, he has a malfunction in his equipment and quickly returns to the boat on the surface.
He develops difficulty breathing within 5 minutes, with dyspnea and substernal chest pain, followed by a severe headache and vertigo.
An hour later, he develops severe muscle and joint aches. These symptoms disappeared within 24 hours.
Which of the following occluding his arterioles is the most likely cause of his findings?
A) Nitrogen gas bubbles
This happens when an artery wall thickens as a result of invasion and accumulation of white blood cells (macrophages and foam cells) and proliferation of intimal-smooth-muscle cell creating a plaque.
B) Atherosclerosis
A 56-year-old female with a one-week history of dysuria and flank pain develops chills, high fever, and confusion. Her blood pressure is 80/40 mm Hg and her heart rate is 120/min. Her extremities are warm and her breath is rapid and shallow.
This marker of acute inflammation is expected to be elevated in this condition:
D) Procalcitonin
Markers of acute inflammation such as C-reactive protein and procalcitonin are expected to be elevated in septic shock.
A 58-year-old woman with hypercholesterolemia died after a severe, crushing, substernal chest pain. The left coronary artery at autopsy is shown below.
The material that has totally occluded the lumen of this blood vessel is largely composed of which of the following cellular components?
C) Platelets and red blood cells
Which of the following statements is TRUE?
B) All hereditary diseases are genetic disorders.
Marfan syndrome is an autosomal genetic disorder caused by mutations affecting the structure and/or function of the protein fibrillin-1. Which of the following is the primary cause of death associated with this disease?
B) Aortic dissection
Rellana and Renalla are two sisters born one year apart. Both of them, along with their father, are diagnosed with neurofibromatosis type I, a single-gene, autosomal disorder that resulted in multiple masses (neurofibromas) seen in their trunk and limbs.
However, despite inheriting the same mutation the sisters have different clinical presentations – Renalla, the older sister, also exhibits pigmented nodules in her irises, hyperpigmented skin macules and occasional seizures. Rellana does not suffer from these, and has a much lower count of mass lesions.
What concept in genetic disorders is illustrated by this case?
D) Variable expressivity
This myopathic type of a glycogen storage disease results from an inherited deficiency of the enzyme muscle phosphorylase. Signs and symptoms include cramping during strenuous exercise, elevated creatine kinase blood levels, and myoglobin in the urine in half of cases.
What disease is this?
C) McArdle disease
The following shows a pedigree of a family affected with Leber hereditary optic neuropathy:
Affected mothers can transmit the disease to her offspring, while affected fathers do not. The mode of inheritance this disease exemplifies is:
A) Mitochondrial (maternal) inheritance
This is carcinogenic because of its ability to cause pyrimidine dimers to form in DNA which is responsible for the induction of cutaneous cancers.
E) UVB
Which of the following is a ubiquitous herpesvirus implicated in the pathogenesis of Burkitt lymphomas, B-cell lymphomas, and nasopharyngeal cancer?
C) Epstein-Barr virus
A 60-year-old male has experienced vague abdominal discomfort accompanied by weakness and generalized malaise for the past 6 months. On physical examination, there is a midabdominal firm mass. The stool is positive for occult blood. An abdominal CT scan shows an 14 × 7 cm mass involving the wall of the distal ileum and adjacent mesentery. A laparotomy is performed and the mass is removed.
Microscopically, the mass is composed of sheets of poorly differentiated malignant cells with large nuclei, prominent nucleoli, and frequent mitotic figures.
Which of the following laboratory tests will help determine the tissue of origin of poorly differentiated or undifferentiated malignant tumors as noted in this patient's condition?
A) Immunohistochemistry
A 66-year-old man with chronic cough has an episode of hemoptysis. A chest radiograph shows a 6-cm mass in the right lung. A sputum cytologic analysis shows malignant squamous cells.
Metastases from his lung lesion are most likely to be found at which of the following sites?
B) Hilar lymph nodes
This denotes a malignant tumor in which the neoplastic epithelial cells grow in a glandular pattern.
adenocarcinoma
A 55-year-old man presents with hematuria and weight loss. Imaging reveals a renal mass. Biopsy shows clear cell renal carcinoma.
Which gene is most likely mutated in this patient, contributing to the pathogenesis of his renal carcinoma?
B) VHL
A 45-year-old woman is diagnosed with breast cancer. Genetic testing shows a mutation in a tumor suppressor gene, predisposing her to the disease.
Which tumor suppressor gene is most commonly associated with familial breast cancer?
D) BRCA1
A 30-year-old male with a history of familial adenomatous polyposis (FAP) develops colon cancer. Genetic analysis reveals a mutation in a gene responsible for cell cycle regulation.
Which gene mutation is most likely responsible for this patient’s condition?
D) APC
A 60-year-old smoker develops squamous cell carcinoma of the lung. Biopsy reveals overexpression of an oncogene associated with cell growth.
Which oncogene is most likely overexpressed in this case?
B) EGFR
A 65-year-old man is diagnosed with chronic myelogenous leukemia (CML). Cytogenetic analysis reveals the presence of the Philadelphia chromosome.
The Philadelphia chromosome results from a translocation between which chromosomes, leading to the formation of an oncogene?
