Kumar: Robbins and Cotran Pathologic Basis of Disease, 8

th
Edition
Chapter 01: Cellular Responses to tress and !o"ic #nsults: $daptation, #n%ur&, and
Death
!est Ban'
()*!#P*E C+,#CE
1. A 60-year-old man who had generalized atherosclerosis died 24 hours after having a
stroke. A cerebral infarct was found at autosy. !ecrosis of the brain is classified as
a. coagulative necrosis
b. li"uefactive necrosis
c. fat necrosis
d. fibrinoid necrosis
e. caseous necrosis
A!#$ %& %rain infarcts are characterized by li"uefactive necrosis.
2. A '0-year-old woman who had leukemia was treated with bone marrow translantation.
#he develoed a skin rash that was interreted as a sign of a graft-versus- host reaction.
A skin biosy was erformed. (n the eidermis& there were scattered dead eidermal cells
that had rounded contours and yknotic nuclei. )his form of cell death is caused by
a. activation of casases through recetor transmitted signals on the cell surface
b. inhibition of A)*ase
c. inhibition of o+idative hoshorylation
d. activation of lysosomal enzymes
e. deletion of glycogen
A!#$ A& ,raft-versus-host-induced cell death in the eidermis is a form of aotosis. (t is
mediated by casases and other enzymes of the suicide athway of .rogrammed cell death..
'. /take of bacteria into the cytolasm of neutrohilic leukocytes is called
a. autohagocytosis
b. heterohagocytosis
c. e+ocytosis
d. inocytosis
e. involution
A!#$ %& /take of bacteria and other e+ogenous articulate material into the hagosomes is
called hagocytosis.
4. A 00-year-old man died in a nursing home. 1uring the ast 10 years& he was unable to
care for himself and was mentally incoherent. 2e had no memory and could not hold a
conversation. 2e was unaware of his surroundings. At autosy& the brain showed signs of
)est %ank
Alzheimer disease& and there were neurons containing numerous neurofibrillary tangles.
)hese cytolasmic structures are formed from which comonent of the neurons3
a. !ucleus
b. 4ough endolasmic reticulum
c. #mooth endolasmic reticulum
d. 5itochondria
e. 6ytoskeleton
A!#$ 7& !eurofibrillary tangles are comosed of microtubule-associated roteins and
neurofilaments& which form the cytoskeleton of nerve cells.
8. 6ontinuous e+ression of the gene for atrial natriuretic factor in the myocardial cells of
the left ventricle is tyically a conse"uence of
a. myocardial infarction
b. angina ectoris
c. hyertension
d. hyotension
e. ventricular fibrillation
A!#$ 6& Atrial natriuretic factor 9A!:; is roduced during fetal life in both the atrial and
ventricular cells of the heart. After birth& the A!: gene remains active only in the atrium& but
can be activated in ventricular cells undergoing hyertrohy. Arterial hyertension is the
most common cause of ventricular hyertrohy.
6. /bi"uitin-roteasome degradation of lasma roteins is oosed by
a. insulin
b. interleukin-1
c. tumor necrosis factor
d. glucocorticoids
e. thyroid hormones
A!#$ A& (nsulin can oose ubi"uitin-roteasome degradation of lasma roteins& whereas
all other hormones and mediators of inflammation listed here accelerate it.
<. A 2=-year-old man was found to have cirrhosis of the liver and ulmonary emhysema.
)he liver cells contained globular inclusions in their cytolasm& which by electron
microscoy are shown to be located inside the
a. ,olgi aaratus
b. smooth endolasmic reticulum
c. rough endolasmic reticulum
d. mitochondria
e. ero+isomes
A!#$ 6& )he clinical history 9i.e.& the concurrence of cirrhosis and ulmonary emhysema;
suggests that this young man has
1
-antitrysin 9AA); deficiency. )he cytolasmic globules
in the liver cells reresent misfolded AA)& which cannot be e+creted from the liver cells and
1-2
)est %ank
remains inside the liver cells in the dilated cisterns of the rough endolasmic reticulum.
=. A 60-year-old obese man was admitted to the hosital for treatment of alcoholism. 2e
has diabetes mellitus. A liver biosy was erformed& and the secimen showed that the
liver cells contain increased amounts of
a. hemosiderin
b. bile
c. triglycerides
d. bilirubin
e. insulin
A!#$ 6& )he three most common causes of fatty liver are obesity& alcoholism& and diabetes
mellitus. :at is stored in the liver cells redominantly in the form of triglycerides.
0. A 88-year-old man who was on renal dialysis was admitted to the hosital for evaluation
of nausea and vomiting. A gastric biosy was erformed. )he gastric mucosa contained
foci of amorhous& bluish 9basohilic; material forming aggregates 10-20 m in
diameter. )hese aggregates were seen mostly in the stroma between the foveolar cells.
!o other abnormalities were seen& and the athologist concluded that these changes
reresent evidence of
a. Helicobacter pylori infection
b. etic ulcer formation
c. dystrohic calcification
d. metastatic calcification
e. aotosis
A!#$ 1& %luish material in the stroma of the stomach reresents foci of calcification. (n
atients who have chronic renal disease& such calcifications occur in the stomach& the lungs&
or the kidneys& and are classified as metastatic. 5etastatic calcifications occur in atients
who have hyercalcemia& which in this atient was most likely caused by secondary
hyerarathyroidism.
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