review cell adaptation, injury and death
TRANSCRIPT
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8/17/2019 REVIEW Cell Adaptation, Injury and Death
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ReviewAdaptasi, Jejas dan
Kematian sel
Penimbunan patologis
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A 48-year-old male with a history of
hroni al oholism who is ontinuingto perform ade!uately on the job willmost often have whi h of thefollowing "ndings in liver#
$A% &holestasis$'% (atty hange$&% )emo hromatosis
$*% )ypertrophy of smooth endoplasmireti ulum$+% &oagulative ne rosis
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A 48-year-old male with a history of
hroni al oholism who is ontinuingto perform ade!uately on the job willmost often have whi h of thefollowing "ndings in liver#
$A% &holestasis$'% (atty hange$&% )emo hromatosis
$*% )ypertrophy of smooth endoplasmireti ulum$+% &oagulative ne rosis
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&ellular injury through generation of
free radi als is +A . typi al for#A/ Pulmonary di0use alveolar damagefrom o1ygen to1i ity'/ A ute purulent in2ammation&/ A umulation of lipo hrome pigmentin myo ardium with aging*/ Radiation therapy for breast
ar inoma+/ A ute myo ardial infar tion
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&ellular injury through generation of
free radi als is +A . typi al for#A/ Pulmonary di0use alveolar damagefrom o1ygen to1i ity'/ A ute purulent in2ammation&/ A umulation of lipo hrome pigmentin myo ardium with aging*/ Radiation therapy for breast
ar inoma+/ A ute myo ardial infar tion/
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3n whi h of the following situations is
epithelial metaplasia most li ely tohave o urred#A/ .anning of the s in following sunlighte1posure'/ a tation following pregnan y&/ 5itamin A de" ien y*/ A ute myo ardial infar tion
+/ 6rinary obstru tion from an enlargedprostate
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3n whi h of the following situations is
epithelial metaplasia most li ely tohave o urred#A/ .anning of the s in following sunlighte1posure'/ a tation following pregnan y&/ 5itamin A de" ien y/*/ A ute myo ardial infar tion
+/ 6rinary obstru tion from an enlargedprostate
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)ypertrophy is best illustrated by#
A/ .he uterine myometrium inpregnan y'/ .he female breast at puberty&/ .he liver following partial rese tion*/ .he ovary following menopause+/ .he ervi1 with hroni in2ammation
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)ypertrophy is best illustrated by#
A/ .he uterine myometrium inpregnan y/'/ .he female breast at puberty&/ .he liver following partial rese tion*/ .he ovary following menopause+/ .he ervi1 with hroni in2ammation
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Karyorrhe1is refers to#
A/ *isintegration of the ell ytoplasm'/ &ell membrane lysis&/ *isintegration of the ell nu leus*/ 7ito hondrial swelling and lysis+/ 1ygen to1i ity
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Karyorrhe1is refers to#
A/ *isintegration of the ell ytoplasm'/ &ell membrane lysis&/ *isintegration of the ell nu leus/*/ 7ito hondrial swelling and lysis+/ 1ygen to1i ity
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A 49-year-old s hi:ophreni male
dran a pint of ;eritol $ ontainingvitamins with iron% ea h day for
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A 49-year-old s hi:ophreni male
dran a pint of ;eritol $ ontainingvitamins with iron% ea h day for
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=hi h of the following tissues is
most li ely to withstand hypo1ia withthe least damage in a patient withloss of blood pressure and resultantsho #
A/ eletal mus le'/ mall intestinal epithelium&/ Retina
*/ 7yo ardium+/ )ippo ampus
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=hi h of the following tissues is
most li ely to withstand hypo1ia withthe least damage in a patient withloss of blood pressure and resultantsho #
A/ eletal mus le/'/ mall intestinal epithelium&/ Retina
*/ 7yo ardium+/ )ippo ampus
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(o al fat ne rosis is most often
asso iated with whi h of thefollowing lini al onditions#A/ (ibrinous peri arditis'/ &hroni salpingitis&/ A ute pan reatitis*/ )epatitis+/ A ute gastritis
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(o al fat ne rosis is most often
asso iated with whi h of thefollowing lini al onditions#A/ (ibrinous peri arditis'/ &hroni salpingitis&/ A ute pan reatitis/*/ )epatitis+/ A ute gastritis
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.he spleen at autopsy on se tioning
shows a tan to white, wedge-shapedlesion with base on the apsule/ .hismost li ely represents the result of#
A/ &oagulative ne rosis'/ Abs ess formation&/ 7etaplasia*/ &aseous ne rosis
+/ i!uefa tive ne rosis
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.he spleen at autopsy on se tioning
shows a tan to white, wedge-shapedlesion with base on the apsule/ .hismost li ely represents the result of#
A/ &oagulative ne rosis/'/ Abs ess formation&/ 7etaplasia*/ &aseous ne rosis
+/ i!uefa tive ne rosis
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A >?99 gm liver from a >?-year-old
female has a yellow, greasy utsurfa e/ .his appearan e most li elyresulted from#
A/ ;ala tosemia'/ 3ron a umulation&/ 7y oba terium tuber ulosis infe tion*/ Al oholism
+/ )ypo1ia
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A >?99 gm liver from a >?-year-old
female has a yellow, greasy utsurfa e/ .his appearan e most li elyresulted from#
A/ ;ala tosemia'/ 3ron a umulation&/ 7y oba terium tuber ulosis infe tion*/ Al oholism/
+/ )ypo1ia
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3n whi h of the following ases will thegreatest degree of permanent damageresult#
A/ .uber ulosis infe tion with solitaryaseating granuloma of lung
'/ A ?9-year-old male surviving a myo ardialinfar tion&/ )uman papillomavirus infe tion with
ervi al dysplasia*/ Adult revived after being at the bottom ofa swimming pool for @9 minutes+/ 7ultiple transfusions of red blood ells for
hroni anemia
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3n whi h of the following ases will thegreatest degree of permanent damageresult#
A/ .uber ulosis infe tion with solitaryaseating granuloma of lung
'/ A ?9-year-old male surviving a myo ardialinfar tion&/ )uman papillomavirus infe tion with
ervi al dysplasia*/ Adult revived after being at the bottom ofa swimming pool for @9 minutes/+/ 7ultiple transfusions of red blood ells for
hroni anemia
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A ?>-year-old male who isdeveloping an a ute myo ardialinfar tion from oronary o lusionhas an irreversible injury to themyo ardium when#
$A% ;ly ogen is depleted$'% &ytoplasmi sodium in reases$&% u lei undergo aryorrhe1is
$*% 3ntra ellular p) diminishes$+% 'lebs form on ell membrane
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A ?>-year-old male who isdeveloping an a ute myo ardialinfar tion from oronary o lusionhas an irreversible injury to themyo ardium when#
$A% ;ly ogen is depleted$'% &ytoplasmi sodium in reases$&% u lei undergo aryorrhe1is/
$*% 3ntra ellular p) diminishes$+% 'lebs form on ell membrane
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=hile in a home improvement enterwarehouse buying paint, a >?-year-oldmale hears B oo out belowCB and isthen stru on the leg by a falling palletra / .he yellow-brown olor of the
bruise to his thigh a ouple of wee safter injury is due to a umulation of#A/ ipofus in'/ 'ilirubin&/ 7elanin*/ )emosiderin+/ ;ly ogen
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=hile in a home improvement enterwarehouse buying paint, a >?-year-oldmale hears B oo out belowCB and isthen stru on the leg by a falling palletra / .he yellow-brown olor of the
bruise to his thigh a ouple of wee safter injury is due to a umulation of#A/ ipofus in'/ 'ilirubin&/ 7elanin*/ )emosiderin/+/ ;ly ogen
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After years of breathing dirty ity air,your lungs have a umulated#
A/ Anthra oti pigment'/ ipofus in&/ 7elanin*/ )emosiderin+/ 'iliverdin
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After years of breathing dirty ity air,your lungs have a umulated#
A/ Anthra oti pigment/'/ ipofus in&/ 7elanin*/ )emosiderin+/ 'iliverdin
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+ven after thrombolyti therapy torestore oronary blood 2ow early inthe ourse of a myo ardial infar tion,a reperfusion injury o urs be ause of#
A/ &ytos eletal intermediate "lament loss
'/ A de reased intra ellular p) fromanaerobi gly olysis&/ An in rease in to1i o1ygen radi als
*/ 7ito hondrial swelling+/ u lear hromatin lumping andde reased protein synthesis
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+ven after thrombolyti therapy torestore oronary blood 2ow early inthe ourse of a myo ardial infar tion,a reperfusion injury o urs be ause of#
A/ &ytos eletal intermediate "lament loss
'/ A de reased intra ellular p) fromanaerobi gly olysis&/ An in rease in to1i o1ygen radi als/
*/ 7ito hondrial swelling+/ u lear hromatin lumping andde reased protein synthesis
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.he presen e of s!uamousepithelium in the lower tra hea of a4
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.he presen e of s!uamousepithelium in the lower tra hea of a4
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A ?D-year-old female had a erebralinfar tion/ 7onths later, a omputedtomographi $&.% s an shows a
ysti area in her erebral orte1/ .he &. "nding is a lesion that is the
onse!uen e of resolution from#A/ i!uefa tive ne rosis'/ Atrophy
&/ &oagulative ne rosis*/ &aseous ne rosis+/ Apoptosis
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A ?D-year-old female had a erebralinfar tion/ 7onths later, a omputedtomographi $&.% s an shows a
ysti area in her erebral orte1/ .he &. "nding is a lesion that is the
onse!uen e of resolution from#A/ i!uefa tive ne rosis/'/ Atrophy
&/ &oagulative ne rosis*/ &aseous ne rosis+/ Apoptosis
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(eatures of hypo1i ell injuryin lude all of the following +E&+P.#
A/ &ell swelling'/ a of A.P generation&/ 7ito hondrial al ium deposition*/ a ti a idosis+/ Apoptosis
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(eatures of hypo1i ell injuryin lude all of the following +E&+P.#
A/ &ell swelling'/ a of A.P generation&/ 7ito hondrial al ium deposition*/ a ti a idosis+/ Apoptosis/
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.he light brown perinu lear pigmentseen on )F+ staining of the ardiamus le "bers in the heart of an 89year old male is#
A/ )emosiderin resulting from ironoverload'/ ipo hrome from Bwear and tearG&/ ;ly ogen resulting from a storage
disease*/ &holesterol as a onse!uen e ofatheros lerosis+/ &al ium deposition following ne rosis
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.he light brown perinu lear pigmentseen on )F+ staining of the ardiamus le "bers in the heart of an 89year old male is#
A/ )emosiderin resulting from ironoverload'/ ipo hrome from Bwear and tearG/&/ ;ly ogen resulting from a storage
disease*/ &holesterol as a onse!uen e ofatheros lerosis+/ &al ium deposition following ne rosis
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.he best mi ros opi eviden e forremote hemorrhage in the jointspa e of a hemophilia would be thepresen e of#
A/ ipofus in'/ Russell bodies&/ eutrophils*/ &holesterol rystals
+/ Anthra oti pigment
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.he best mi ros opi eviden e forremote hemorrhage in the jointspa e of a hemophilia would be thepresen e of#
A/ ipofus in'/ Russell bodies&/ eutrophils*/ &holesterol rystals/
+/ Anthra oti pigment
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A
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A
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'one marrow ells from an organ donor areultured in vitro at > & in the presen e of
re ombinant erythropoietin forming olony,ommitted to the erythro yte pathway of
di0erentiation/ .his event represents ane1ample of whi h of the followingphysiologi adaptations to transmembranesignalingL
$A% Atrophy$'% *ysplasia$&% )yperplasia$*% )ypertrophy$+% 7etaplasia
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'one marrow ells from an organ donor areultured in vitro at > & in the presen e of
re ombinant erythropoietin forming olony,ommitted to the erythro yte pathway of
di0erentiation/ .his event represents ane1ample of whi h of the followingphysiologi adaptations to transmembranesignalingL
$A% Atrophy$'% *ysplasia$&% )yperplasia/$*% )ypertrophy$+% 7etaplasia
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A ?9-year-old hroni al oholi presents to theemergen y room with @< hours of severe
abdominal pain/ .he pain radiates to the baand is asso iated with an urge to vomit/Physi al e1amination dis loses e1!uisiteabdominal tenderness/ aboratory studies
show elevated serum amylase/ =hi h of thefollowing morphologi hanges would bee1pe ted in this patientL
$A% &oagulative ne rosis$'% &aseous ne rosis$&% (at ne rosis$*% (ibrinoid ne rosis$+% i!uefa tive ne rosis
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A H8-year-old man with a history ofgastroesophageal re2u1 disease su0ers a massive
stro e and e1pires/ )istologi e1amination of theabnormal tissue shows intestine-li e epitheliumomposed of goblet ells and surfa e ells similar
to those of in ompletely intestinali:ed gastrimu osa/ =hi h of the following terms bestdes ribes this morphologi response to persistentinjury in the esophagus of this patientL
$A% Atypi al hyperplasia$'% &omple1 hyperplasia
$&% ;landular metaplasia$*% imple hyperplasia$+% !uamous metaplasia
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A H8-year-old man with a history ofgastroesophageal re2u1 disease su0ers a massive
stro e and e1pires/ )istologi e1amination of theabnormal tissue shows intestine-li e epitheliumomposed of goblet ells and surfa e ells similar
to those of in ompletely intestinali:ed gastrimu osa/ =hi h of the following terms bestdes ribes this morphologi response to persistentinjury in the esophagus of this patientL
$A% Atypi al hyperplasia$'% &omple1 hyperplasia
$&% ;landular metaplasia/$*% imple hyperplasia$+% !uamous metaplasia
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A &. s an of a 4>-year-old woman witha parathyroid adenoma andhyperparathyroidism reveals e1tensive
al ium deposits in the lungs and idneyparen hyma/ .hese radiologi "ndings
are best e1plained by whi h of thefollowing me hanisms of diseaseL$A% Arterios lerosis$'% *ystrophi al i" ation
$&% ;ranulomatous in2ammation$*% 7etastati al i" ation$+% .umor embolism
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A &. s an of a 4>-year-old woman witha parathyroid adenoma andhyperparathyroidism reveals e1tensive
al ium deposits in the lungs and idneyparen hyma/ .hese radiologi "ndings
are best e1plained by whi h of thefollowing me hanisms of diseaseL$A% Arterios lerosis$'% *ystrophi al i" ation
$&% ;ranulomatous in2ammation$*% 7etastati al i" ation/$+% .umor embolism
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A ?-year-old woman with Al:heimerdisease dies of ongestive heartfailure/ .he brain at autopsy issmaller/ .his patientMs braine1empli"es whi h of the followingresponses to hroni injuryL
$A% Anaplasia$'% Atrophy
$&% *ysplasia$*% )yperplasia$+% )ypertrophy
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A ?-year-old woman with Al:heimerdisease dies of ongestive heartfailure/ .he brain at autopsy issmaller/ .his patientMs braine1empli"es whi h of the followingresponses to hroni injuryL
$A% Anaplasia$'% Atrophy/
$&% *ysplasia$*% )yperplasia$+% )ypertrophy
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A H4-year-old man with long-standing anginape toris and arterial hypertension dies of
spontaneous intra erebral hemorrhage/ Atautopsy, the heart appears globoid/ .he leftventri le measures
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A H4-year-old man with long-standing anginape toris and arterial hypertension dies of
spontaneous intra erebral hemorrhage/ Atautopsy, the heart appears globoid/ .he leftventri le measures
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A wee s of gestation with a severemalformation of the entral nervous system/7R3 studies of the neonate reveal poren ephalyand hydro ephalus/ An E-ray "lm of the headshows irregular densities in the basal ganglia/
.hese E-ray "ndings are best e1plained bywhi h of the following me hanisms of diseaseL
$A% Amnioti 2uid embolism$'% *ystrophi al i" ation$&% ;ranulomatous in2ammation$*% 7etastati al i" ation$+% rgan immaturity
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A wee s of gestation with a severemalformation of the entral nervous system/7R3 studies of the neonate reveal poren ephalyand hydro ephalus/ An E-ray "lm of the headshows irregular densities in the basal ganglia/
.hese E-ray "ndings are best e1plained bywhi h of the following me hanisms of diseaseL
$A% Amnioti 2uid embolism$'% *ystrophi al i" ation/$&% ;ranulomatous in2ammation$*% 7etastati al i" ation$+% rgan immaturity
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A H?-year-old man su0ers a heartatta and e1pires/ +1amination of thelungs at autopsy reveals numerousdar pigmented nodules s atteredthroughout the paren hyma/ =hat is
the appropriate diagnosisL$A% Anthra osis$'% Asbestosis$&% )emosiderosis$*% ar oidosis$+% ili osis
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A H?-year-old man su0ers a heartatta and e1pires/ +1amination of thelungs at autopsy reveals numerousdar pigmented nodules s atteredthroughout the paren hyma/ =hat is
the appropriate diagnosisL$A% Anthra osis/$'% Asbestosis$&% )emosiderosis$*% ar oidosis$+% ili osis
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A >8 wee s of gestation/ As a result ofmaternal hypergly emia during pregnan y,pan reati islets in the neonate would bee1pe ted to show whi h of the followingmorphologi responses to injuryL
$A% Atrophy$'% *ysplasia$&% )yperplasia$*% 7etaplasia$+% e rosis
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A >8 wee s of gestation/ As a result ofmaternal hypergly emia during pregnan y,pan reati islets in the neonate would bee1pe ted to show whi h of the followingmorphologi responses to injuryL
$A% Atrophy$'% *ysplasia$&% )yperplasia/$*% 7etaplasia$+% e rosis
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A ?D-year-old female al oholi is brought to theemergen y room with a fever $>8/ &N@9> (%
and foul-smelling breath/ .he patientsubse!uently develops a utebron hopneumonia and dies of respiratoryinsuO ien y/ A pulmonary abs ess is identi"edat autopsy/ )istologi e1amination of the wall ofthis lesion would most li ely demonstrate whi hof the following pathologi hangesL
$A% &aseous ne rosis$'% &oagulative ne rosis$&% (at ne rosis$*% (ibrinoid ne rosis$+% i!uefa tive ne rosis
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A ?D-year-old female al oholi is brought to theemergen y room with a fever $>8/ &N@9> (%
and foul-smelling breath/ .he patientsubse!uently develops a utebron hopneumonia and dies of respiratoryinsuO ien y/ A pulmonary abs ess is identi"edat autopsy/ )istologi e1amination of the wall ofthis lesion would most li ely demonstrate whi hof the following pathologi hangesL
$A% &aseous ne rosis$'% &oagulative ne rosis$&% (at ne rosis$*% (ibrinoid ne rosis$+% i!uefa tive ne rosis/
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A
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A
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A >@-year-old woman omplains ofin reased vaginal dis harge of @-month
duration/ A ervi al Pap smear/ uper" ialepithelial ells are identi"ed with arrows/=hen ompared to ells from the deeperintermediate layer $top%, the nu lei of thesesuper" ial ells e1hibit whi h of thefollowing ytologi featuresL
$A% Karyolysis$'% Karyorrhe1is$&% Py nosis$*% egmentation$+% 5iral in lusion bodies
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A >@-year-old woman omplains of in reasedvaginal dis- harge of @-month duration/ A
ervi al Pap smear is shown in the image/uper" ial epithelial ells are identi"ed with
arrows/ =hen ompared to ells from thedeeper intermediate layer $top%, the nu lei of
these super" ial ells e1hibit whi h of thefollowing ytologi featuresL
$A% Karyolysis$'% Karyorrhe1is
$&% Py nosis/$*% egmentation$+% 5iral in lusion bodies
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A ?
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An 8
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An 8
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A
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A
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A 9-year-old man is hospitali:ed after su0eringa mild stro e/ =hile in the hospital, he suddenly
develops rushing substernal hest pain/Analysis of serum proteins and +&; on"rm adiagnosis of a ute myo ardial infar tion/ .hepatient subse!uently develops an arrhythmiaand e1pires/ )istologi e1amination of thea0e ted heart mus le would demonstrate whi hof the following morphologi hangesL
$A% &aseous ne rosis$'% &oagulative ne rosis$&% (at ne rosis$*% (ibrinoid ne rosis$+% i!uefa tive ne rosis
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A 9-year-old man is hospitali:ed after su0eringa mild stro e/ =hile in the hospital, he suddenly
develops rushing substernal hest pain/Analysis of serum proteins and +&; on"rm adiagnosis of a ute myo ardial infar tion/ .hepatient subse!uently develops an arrhythmiaand e1pires/ )istologi e1amination of thea0e ted heart mus le would demonstrate whi hof the following morphologi hangesL
$A% &aseous ne rosis$'% &oagulative ne rosis/$&% (at ne rosis$*% (ibrinoid ne rosis$+% i!uefa tive ne rosis
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=hi h of the following histologifeatures would provide de"nitiveeviden e of ne rosis in themyo ardium of myo ardial infar tpatientL
$A% *isaggregation of polyribosomes$'% 3n reased intra ellular volume$&% 3n2u1 of lympho ytes
$*% 7ito hondrial swelling andal i" ation
$+% u lear fragmentation
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=hi h of the following histologifeatures would provide de"nitiveeviden e of ne rosis in themyo ardium of myo ardial infar tpatientL
$A% *isaggregation of polyribosomes$'% 3n reased intra ellular volume$&% 3n2u1 of lympho ytes
$*% 7ito hondrial swelling andal i" ation
$+% u lear fragmentation/
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78/101
A 4?-year-old man presents with in reasingabdominal dis omfort and yellow
dis oloration of his s in and s lera/ Physi ale1amination reveals hepatomegaly and jaundi e/ A Prussian blue stain of a liverbiopsy is shown in the image/ =hat is the
major intra ellular iron storage protein inthis patientMs hepato ytesL
$A% 'ilirubin$'% )aptoglobin
$&% )emoglobin$*% )emosiderin$+% .ransferrin
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79/101
A 4?-year-old man presents with in reasingabdominal dis omfort and yellow
dis oloration of his s in and s lera/ Physi ale1amination reveals hepatomegaly and jaundi e/ A Prussian blue stain of a liverbiopsy is shown in the image/ =hat is the
major intra ellular iron storage protein inthis patientMs hepato ytesL
$A% 'ilirubin$'% )aptoglobin
$&% )emoglobin$*% )emosiderin/$+% .ransferrin
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8/17/2019 REVIEW Cell Adaptation, Injury and Death
80/101
A H9-year-old man with hroni ystitisomplains of urinary fre!uen y and pelvi
dis omfort/ *igital re tal e1amination isunremar able/ 'iopsy of the bladder mu osareveals fo i of glandular epithelium and hroniin2ammatory ells/ o ytologi signs of atypiaor malignan y are observed/ =hi h of thefollowing terms best des ribes the morphologiresponse to hroni injury in this patientL
$A% Atrophy$'% *ysplasia$&% )yperplasia$*% )ypertrophy$+% 7etaplasia
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81/101
A H9-year-old man with hroni ystitisomplains of urinary fre!uen y and pelvi
dis omfort/ *igital re tal e1amination isunremar able/ 'iopsy of the bladder mu osareveals fo i of glandular epithelium and hroniin2ammatory ells/ o ytologi signs of atypiaor malignan y are observed/ =hi h of thefollowing terms best des ribes the morphologiresponse to hroni injury in this patientL
$A% Atrophy$'% *ysplasia$&% )yperplasia$*% )ypertrophy$+% 7etaplasia/
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82/101
A H8-year-old woman with a history ofhyperlipidemia dies of ardia arrhythmia
following a massive heart atta /Pero1idation of whi h of the followingmole ules was primarily responsible for
ausing the loss of membrane integrity inardia myo ytes in this patientL$A% &holesterol$'% ;lu ose transport proteins
$&% ;ly osphingolipids$*% Phospholipids$+% odium-potassium A.Pase
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83/101
A H8-year-old woman with a history ofhyperlipidemia dies of ardia arrhythmia
following a massive heart atta /Pero1idation of whi h of the followingmole ules was primarily responsible for
ausing the loss of membrane integrity inardia myo ytes in this patientL$A% &holesterol$'% ;lu ose transport proteins
$&% ;ly osphingolipids$*% Phospholipids/$+% odium-potassium A.Pase
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84/101
A
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85/101
A
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86/101
A ?H-year-old woman with a history ofhyperlipidemia and hypertension develops
progressive, right renal artery stenosis/ver time, this patientMs right idney gets
smaller following morphologi adaptationsto partial is hemia/ =hat do you all this
idney hangeL$A% Atrophy$'% *ysplasia$&% )yperplasia$*% )ypertrophy$+% eoplasia
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8/17/2019 REVIEW Cell Adaptation, Injury and Death
87/101
A ?H-year-old woman with a history ofhyperlipidemia and hypertension develops
progressive, right renal artery stenosis/ver time, this patientMs right idney gets
smaller following morphologi adaptationsto partial is hemia/ =hat do you all this
idney hangeL$A% Atrophy/$'% *ysplasia$&% )yperplasia$*% )ypertrophy$+% eoplasia
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8/17/2019 REVIEW Cell Adaptation, Injury and Death
88/101
A ?-year-old boy su0ers blunt trauma tothe leg in an ar a ident/ i1 months
later, bone trabe ulae have formed withinthe striated s eletal mus le at the site oftissue injury/ .his pathologi ondition isan e1ample of whi h of the followingmorphologi adaptations to injuryL
$A% Atrophy$'% *ysplasia
$&% 7etaplasia$*% 7etastati al i" ation$+% *ystrophi al i" ation
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8/17/2019 REVIEW Cell Adaptation, Injury and Death
89/101
A ?-year-old boy su0ers blunt trauma tothe leg in an ar a ident/ i1 months
later, bone trabe ulae have formed withinthe striated s eletal mus le at the site oftissue injury/ .his pathologi ondition isan e1ample of whi h of the followingmorphologi adaptations to injuryL
$A% Atrophy$'% *ysplasia
$&% 7etaplasia/$*% 7etastati al i" ation$+% *ystrophi al i" ation
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8/17/2019 REVIEW Cell Adaptation, Injury and Death
90/101
A @H-year-old girl with a history of sui idaldepression swallows a ommer ial solvent/ Aliver biopsy is performed to assess the degree ofdamage to the hepati paren hyma/ )istologie1amination demonstrates severe swelling of the
entrilobular hepato ytes/ =hi h of the followingme hanisms of disease best a ounts for thereversible hanges noted in this liver biopsyL
$A% *e reased stores of intra ellular A.P$'% 3n reased storage of trigly erides and free fattya ids
$&% 3ntra ytoplasmi rupture of lysosomes$*% 7ito hondrial membrane permeability transition$+% Protein aggregation due to in reased ytosoli p)
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92/101
A 49-year-old man is pulled from the o eanafter a boating a ident and resus itated/
i1 hours later, the patient develops a uterenal failure/ Kidney biopsy revealseviden e of aryorrhe1is and aryolysis inrenal tubular epithelial ells/ =hi h of the
following bio hemi al events pre ededthese pathologi hangesL$A% A tivation of a NK A.Pase$'% *e rease in intra ellular al ium
$&% *e rease in intra ellular p)$*% 3n rease in A.P produ tion$+% 3n rease in intra ellular p)
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8/17/2019 REVIEW Cell Adaptation, Injury and Death
93/101
A 49-year-old man is pulled from the o eanafter a boating a ident and resus itated/
i1 hours later, the patient develops a uterenal failure/ Kidney biopsy revealseviden e of aryorrhe1is and aryolysis inrenal tubular epithelial ells/ =hi h of the
following bio hemi al events pre ededthese pathologi hangesL$A% A tivation of a NK A.Pase$'% *e rease in intra ellular al ium
$&% *e rease in intra ellular p)/$*% 3n rease in A.P produ tion$+% 3n rease in intra ellular p)
ld h f
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94/101
A ?8-year-old man presents with symptoms ofa ute renal failure/ )is blood pressure is
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95/101
A 4 ld i h hi f h
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96/101
A 4 -year-old man with a history of heavysmo ing omplains of hroni ough/ A oin
lesionG is dis overed in his right upper lobeon hest E-ray/ 'ron hos opy and biopsy failto identify a mass, but the bron hial mu osadisplays s!uamous metaplasia/ =hat is the
most li ely out ome of this morphologiadaptation if the patient stops smo ingL$A% Atrophy$'% 7alignant transformation
$&% e rosis and s arring$*% Persisten e throughout life$+% Reversion to normal
A 4 ld i h hi f h
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8/17/2019 REVIEW Cell Adaptation, Injury and Death
97/101
A 4 -year-old man with a history of heavysmo ing omplains of hroni ough/ A oin
lesionG is dis overed in his right upper lobeon hest E-ray/ 'ron hos opy and biopsy failto identify a mass, but the bron hial mu osadisplays s!uamous metaplasia/ =hat is the
most li ely out ome of this morphologiadaptation if the patient stops smo ingL$A% Atrophy$'% 7alignant transformation
$&% e rosis and s arring$*% Persisten e throughout life$+% Reversion to normal/
A H9 ld f i h
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98/101
A H9-year-old farmer presents withmultiple pat hes of dis oloration on hisfa e/ 'iopsy of lesional s in revealsa tini eratosis/ =hi h of the followingterms best des ribes this response ofthe s in to hroni sunlight e1posureL
$A% Atrophy$'% *ysplasia$&% )yperplasia
$*% )ypertrophy$+% 7etaplasia
A H9 ld f i h
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8/17/2019 REVIEW Cell Adaptation, Injury and Death
99/101
A H9-year-old farmer presents withmultiple pat hes of dis oloration on hisfa e/ 'iopsy of lesional s in revealsa tini eratosis/ =hi h of the followingterms best des ribes this response ofthe s in to hroni sunlight e1posureL
$A% Atrophy$'% *ysplasia/ $&% )yperplasia
$*% )ypertrophy$+% 7etaplasia
A >> ld h b l i l
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100/101
A >>-year-old woman has an abnormal ervi alPap smear/ A ervi al biopsy reveals that theepithelium la s normal polarity $shown in theimage%/ 3ndividual ells display hyper hromatinu lei, a larger nu leus-to- ytoplasm ratio, anddisorderly tissue arrangement/ =hi h of thefollowing adaptations to hroni injury bestdes ribes these hanges in the patientMs
ervi al epitheliumL$A% Atrophy$'% *ysplasia
$&% )yperplasia$*% )ypertrophy$+% 7etaplasia
A >> ld h b l i l
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101/101
A >>-year-old woman has an abnormal ervi alPap smear/ A ervi al biopsy reveals that theepithelium la s normal polarity $shown in theimage%/ 3ndividual ells display hyper hromatinu lei, a larger nu leus-to- ytoplasm ratio, anddisorderly tissue arrangement/ =hi h of thefollowing adaptations to hroni injury bestdes ribes these hanges in the patientMs
ervi al epitheliumL$A% Atrophy$'% *ysplasia/
$&% )yperplasia$*% )ypertrophy$+% 7etaplasia