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General pathology 2008-2009

Compiled by Bhupinder Bawa


1. Which of the following has not been associated with hypertrophy?

A. TNF-α
B. Endothelin-1
C. Angiotensin II
D. replacement of α myosin with β myosin
E. Increased expression of atrial natriuretic factor

2. Which of the following does not stimulate proteolysis?

A. TNF
B. Insulin
C. Lysosomes
D. Glucocorticoids
E. Thyroid hormone

3. Morphologic manifestations of reversible cell injury include which of the following?

A. Cell swelling
B. Nuclear pyknosis
C. Chromatin clumping
D. Nuclear fragmentation
E. Cell membrane fragmentation

4. An imbalance between the protein production and degradation will most probably lead to the
following cellular response

A. Atrophy
B. Metaplasia
C. Hyperplasia
D. Hypertrophy
E. All the above

5. The following cellular responses are controlled by several growth factors except

A. Atrophy
B. Metaplasia
C. Hyperplasia
D. Hypertrophy
E. None of the above

6. Which of the following are features of apoptosis?

1. Increased cell size


2. Fragmentation of nucleus
3. Intact plasma membrane
4. Enzymatic digestion of cellular content
5. Often a physiologic process

A. 1, 2, 5
B. 1, 3, 5
General pathology 2008-2009
Compiled by Bhupinder Bawa
C. 2, 3, 4
D. 2, 3, 5
E. 3, 4, 5

7. The cytomorphologic changes characteristic of irreversible cell injury include all except

A. plasma cell damage


B. lysosomal swelling
C. loss of mitochondria
D. calcium entry into cell
E. amorphous densities in mitochondria

8. Hormone-induced growth in the uterus is usually a result of which process/es?

A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. a&b
E. b&c

9. Increased size of cells due to hypertrophy is due to which of the following?

A. The increased synthesis of DNA


B. Accumulation of excess phospholipid
C. Cell swelling due to water accumulation
D. Cell swelling due to glycogen accumulation
E. The synthesis of more structural components

10. Which of the following is NOT a cause of atrophy?

A. Chronic irritation
B. Loss of innervation
C. Decreased workload
D. Dimished blood supply
E. Loss of endocrine stimulation

11. The hallmarks of reversible cell injury are:

1) Loss of membrane permeability


2) Adenosine triphosphate depletion
3) Reduced oxidative phosphorylation
4) Condensation of the nuclear chromatin
5) Cellular swelling due to changes in ion concentrations and water influx

A. 1, 2, 3
B. 1, 2, 3, 4
C. 2, 3, 4, 5
D. 2, 3, 5
E. 3, 4, 5

12. All of the following can lead to atrophy except?


General pathology 2008-2009
Compiled by Bhupinder Bawa

A. Increased workload
B. Loss of innervation
C. Inadequate nutrition
D. Diminished blood supply
E. Increased endocrine stimulation

13. Which of the following structural change is a indicator of irreversible injury?

A. Cell swelling
B. Mitochondrial swelling
C. Blebbing of plasma membrane
D. Clumping of nuclear chromatin
E. Amorphous densities in swollen mitochondria

14. Chronic exposure to phenobarbital can lead to enlargement of which of the following
organelle in hepatocytes?

A. SER
B. Ribosomes
C. Mitochondria
D. Golgi complex
E. All of the above

15. Glycogen in the hepatocytes can be identified using

A. PAS
B. H & E stain
C. Giemsa stain
D. Toluidine blue
E. Any of the above

16. The metachromatic granules of mast cell tumors can be demonstrated by using

A. H & E stain or Periodic acid-Schiff (PAS)


B. Periodic acid-Schiff (PAS) only
C. Giemsa stain or Toluidine blue
D. Giemsa stain and PAS
E. Any of the above

17. RER (rough endoplasmic reticulum) is high in cells that produce large amounts of
extracellular proteins such as

A. Pancreatic acinar cells


B. Reactive fibroblasts
C. Hepatocytes
D. Plasma cells
E. All the above

18. Hypertrophy is the process that


General pathology 2008-2009
Compiled by Bhupinder Bawa
A. Occurs with cell division/mitosis
B. Involves cell enlargement
C. Frequently occurs with hyperplasia
D. b&c
E. a&c

19. The mechanism of hyperplasia involves

A. Production of transcription factors that turn on many cellular genes


B. Activation of intracellular signal pathway
C. levels of growth factor receptors
D. Production of growth factors
E. All of the above

20. The increase in tissue mass via the process of hyperplasia is always achieved by

A. Proliferation of the remaining cells


B. Development of new cells from stem cells
C. cell enlargement
D. None of above
E. both a & b

21. What are the triggers for hypertrophy

A. Trophic triggers such as IGF-1, α-adrenergic agonists, angiotensin II


B. Mechanical triggers e.g. stretch
C. Cell death
D. a&b
E. b&c

22. Barrett metaplasia (Barrett esophagus)

A. Is metaplasia from squamous to columnar type


B. Is metaplasia from columnar to squamous type
C. May lead to glandular adeno(carcinoma)
D. a & c only
E. a & b only

23. All the following are true about increased intracellular free calcium ions except:

A. Increased intracellular catalytic enzyme activity


B. Increased mitochondrial permeability
C. A primary event in cellular injury
D. Cause irreversible cellular injury
E. Induce apoptosis

24. Which of the following is true regards ischemic reperfusion injury?

A. Activation of complement pathway


B. Necrosis and apoptosis occurs
C. Free radical formation
General pathology 2008-2009
Compiled by Bhupinder Bawa
D. Leukocyte infiltration
E. All the above
25. The following are considered reversible cellular changes:

1. Cell swelling
2. Vacoular degeneration
3. Severe mitochondrial swelling
4. Blebbing of plasma membrane
5. Increased intracellular calcium ions

A. 1,2,3
B. 1,2,4
C. 1,2,5
D. 1,3,4
E. 1,3,5

26. The following tissue primarily undergo liquefactive necrosis

a. Heart
b. Liver
c. Brain
d. Muscle
e. Kideny

27. The following are the features of coagulative necrosis

1. Cellular acidosis
2. Loss of cellular architecture
3. Basic cellular architecture is retained
4. Cytoplasm is homogenous and eosinophilic
5. Converts dead cells into granular friable mass

A. 1, 2, 4
B. 1, 2, 5
C. 1, 3, 4
D. 1, 4, 5
E. 2, 4, 5

28. Enzymatic fat necrosis occurs typically as a result which of the following enzymatic action:

A. Lipases
B. Amylases
C. Chymotrypsin
D. Trypsin
E. Steapsin

29. Cellular injury as a consequence of increased cytosolic calcium levels is due to:

1. Decreased ATP
2. Decreased phospholipids
3. Nucleus chromatin damage
General pathology 2008-2009
Compiled by Bhupinder Bawa
4. Inactivation of superoxide dismutase
5. Disruption of membrane and cytoskeletal proteins

A. 1, 2, 3, 4, 5
B. 1, 2, 3, 4
C. 1, 2, 3, 5
D. 1, 3, 4
E. 1, 3, 5

30. The enzyme that is present in peroxisomes and catalyses the reaction that leads to the
decomposition of hydrogen peroxide is:

A. Catalase
B. Ceruloplasmin
C. Hydrogen peroxidase
D. Superoxide dismutase
E. Glutathione peroxidase

31. Coagulation necrosis is not usually considered in which organ:

A. Liver
B. Brain
C. Kidney
D. Lymph Node
E. Skeletal muscle

32. The depletion of ATP within the cell does not lead to:

A. Increased pH
B. Misfolded proteins
C. Ribosomal detachment
D. Failure of the calcium pump
E. Failure of the sodium/potassium pump

33. The usual type of necrosis occurring in the CNS is:

A. Coagulative necrosis
B. Caseation necrosis
C. Liquefactive necrosis
D. Gangrene
E. Fat necrosis

34. Post-mortem clotting is characterized by all of the following except:

A. Unattached to vessel wall


B. Contain two distinct portions
C. Appear dull and dry in color
D. Conforms to the shape of the vessel
E. Form in the heart and vessels within several hours of death

35. Wet gangrene is a combination of which two types of necrosis?


General pathology 2008-2009
Compiled by Bhupinder Bawa

A. Coagulative and liquefactive


B. Coagulative and fat
C. Caseous and liquefactive
D. Dry gangrene and caseous
E. Gas gangrene and fat

36. Depletion of ATP can lead to all of the following except?

A. Increased influx of Na+


B. Increased influx of K+
C. Increased influx of Ca2+
D. Reduced protein synthesis
E. Increased anaerobic glycolysis

37. Mitochondrial damage can be caused by the following?

1. Increased cytosolic calcium


2. Increased generation of ROS
3. Increased anaerobic glycolysis
4. Breakdown of phospholipids by phospholipases
5. Reduced activity of plasma membrane Na pumps

A. 1,2,3
B. 2,4,5
C. 1,2,4
D. 1,2,4,5
E. 1,2,3,4,5

38. Sustained increased intracellular calcium can directly activate all of the following enzymes
except?

A. ATPases
B. Proteases
C. Glucosidases
D. Endonucleases
E. Phospholipases

39. All of the following can act as cellular antioxidant except?

A. Catalase
B. Vitamin E
C. NADP oxidases
D. Superoxide dismutase
E. Glutathione peroxidases

40. The following mechanisms cause post-ischemia reperfusion injury leading to cell death,
except?
A. Deposit of IgG in ischemic tissues
B. Increased generation of free radicals
General pathology 2008-2009
Compiled by Bhupinder Bawa
C. Activation of complement pathway
D. Promotion of mitochondrial permeability transition
E. Compromised cellular antioxidant defense mechanisms

41. What is the most characteristic morphological feature of apoptosis?

A. Inflammation in the adjacent tissue


B. Chromatin condensation
C. Cell shrinkage
D. Cytoplasmic blebs
E. All of the above

42. What are the two main anti-apoptotic in the Bcl-2 family are

A. Bak and Bax


B. Bim and Bak
C. Ced-9 and Ced-3
D. Bcl-2 and Bcl-x
E. Bcl-2 and Bim

43. What are the two caspases that serves as initiators in the initiation phase of apoptosis?

A. Caspase-3 and Caspase-4


B. Caspase-3 and Caspase-6
C. Caspase-8 and caspase-9
D. Caspase-3 and Caspase-9
E. Caspase-4 and caspase-9

44. What is the classical example of apoptosis

A. Program cell death during embryogenesis


B. Growth factor deprivation apoptosis
C. Cytotoxic T cell mediated apoptosis
D. DNA damage mediated apoptosis
E. Nutrition deprivation apoptosis

45. Apoptosis by extrinsic pathway is characterized by

1. Caspase 8 is activation
2. Caspase 9 is activation
3. Receptor ligand interactions
4. Decreased mitochondrial permeability
5. FLIP protein inhibits the pathway

A. 1,3,4
B. 1,3,5
C. 2,3,4
D. 1,4,5
E. 2,4,5
General pathology 2008-2009
Compiled by Bhupinder Bawa

46. Apoptosis by intrinsic pathway is characterized by

1. Caspase 9 activation
2. Caspase 8 activation
3. Increased Bcl-2 protein
4. Receptor ligand interaction
5. Decreased mitochondrial permeability

A. 1
B. 1, 5
C. 1, 3, 5
D. 2, 3, 4, 5
E. 1, 2, 3, 4, 5

47. The lipofuscin pigment accumulation inside the cell is as a result of

A. Accumulation of lysosomal undigested lipids


B. Accumulation of lysosomal undigested proteins
C. Excess free fatty acid deposition
D. Compromised fat metabolism
E. All the above

48. Which of the following mechanisms contributes to recognition and phagocytosis of apoptotic
cells by phagocytes?
A. Recognition of bcl-2 on the cell surface
B. Upregulation of CD4 molecules on the cell surface
C. Loss of expression of FAS ligand on the cell surface
D. Loss of expression of thrombospondin on the surface of cells
E. Expression of phosphatidylserine on the outer plasma membrane

49. Which of the following proteins can inhibit apoptosis?


A. FLIP
B. FLOP
C. CD95
D. TNFR1
E. Caspase 10

50. Which of the following proteins do NOT play a role in the INTRINSIC apoptosis pathway?

1. TNFR1
2. Bcl-2
3. Apaf-1
4. Caspase-9
5. Caspase-8

A. 1, 2, 4
B. 1, 3, 5
C. 1, 5
D. 2, 4
E. 2, 5
General pathology 2008-2009
Compiled by Bhupinder Bawa

51. Which of the following is not likely to cause apoptosis of the normal cell:

A. Intracellular lysosomal rupture


B. Failure to repair damaged DNA
C. Binding of TNF to TNF type 1 receptor
D. Deprivation of relevant growth factors
E. Antigen recognition by cytotoxic T-lymphocytes

52. Apoptotic cells are not characterized by:

A. Cell shrinkage
B. Condensed chromatin
C. Nuclear fragmentation
D. Formation of apoptotic bodies
E. High amplitude mitochondrial swelling

53. Characteristics of the extrinsic apoptotic pathway include all except?

A. Binding of a ligand to a death receptor


B. Activation of caspase zymogens
C. Increased mitochondrial permeability
D. Activation of execution caspases
E. Both b and c

54. Tolerance to a drug is due to which cellular adaptation in hepatocytes?

A. hyperplasia of mitochondria
B. atrophy of intermediate filaments
C. hypertrophy of the Golgi apparatus
D. hypertrophy of the smooth endoplasmic reticulum
E. hyperplasia of the rough endoplasmic reticulum

55. The sequence of events during intrinsic pathway of apoptosis is?

1. Activation of executioner caspases


2. cytochrome c binds caspase 9 and APAF
3. withdrawal of growth factors and/or hormones
4. Increased permeability of mitochondrial membrane
5. Loss of anti-apoptotic molecules from mitochondria

A. 3,4,5,2,1
B. 5,4,2,1,3
C. 4,5,2,1,3
D. 3,5,4,2,1
E. 1,2,3,4,5

56. All of the following are pro-apoptotic proteins except?

A. BAK
General pathology 2008-2009
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B. IAP
C. AIF
D. APAF-1
E. Cytochrome –c

57. All of the following are mechanism of intracellular accumulation except?

A. Deficiency of critical enzymes


B. Inability to degrade phagocytosed particles
C. Abnormal metabolism of normal substances
D. Inability to phagocytose exogenous substances
E. Mutation causing protein misfolding or transport

58.. CCL4 and protein malnutrition can lead to fatty liver due to?

A. Alteration of mitochondrial and microsomal function


B. Increase in fatty acid mobilization
C. Decreased synthesis of apoprotein
D. Inhibiting fatty acid oxidation
E. All of the above

59. All of the following are structural changes that can accompany cellular aging except?

A. lipid accumulation
B. lipofuscin accumulation
C. abnormally lobed nuclei
D. decreased endoplasmic reticulum
E. accumulation of abnormally folded proteins

60. All of the following conditions are manifested by cholesterol accumulation, except ?

A. Fatty liver
B. Xanthomas
C. Cholesterolosis
D. Atherosclerosis
E. Niemann-Pick disease, type C

61. All of the following are true regarding protein misfolding except?

A. Misfolded proteins accumulate in ER


B. Misfolded proteins trigger increased production of chaperons
C. Deprivation of glucose and oxygen can trigger protein misfolding
D. Misfolded proteins can trigger cell death by activation of caspase 8
E. Misfolded proteins can deposit and interfere with normal cell function

62. Which of the following is a main component of the myelin figures in necrotic cells?

A. Cholesterol esters
B. Lipid peroxides
C. Phospholipids
D. Triglycerides
General pathology 2008-2009
Compiled by Bhupinder Bawa
E. Cholesterols

63. The following statements are correct, EXCEPT

A. Internal RNA of telomerase serves as the template for synthesizing telomere DNA
B. RNA sequences in the telomerase are same across species
C. Telomeres protect chromosomal ends from degradation
D. There is no telomerase activity in normal somatic cells
E. Telomere shortening results in cell cycle arrests

64. Cholesterolosis is the term used to describe abnormal accumulation of

A. Cholestrol-laden macrophages in the lamina propria of the gall bladder


B. Cholesterol-laden macrophages in the liver
C. Cholestrol-laden macrophages in the skin
D. Hemosiderin in the macrophages
E. Glycogen in a cell

65. The following are true about Glycogenoses except

A. Also called glycogen storage disease


B. Enzymatic defects in synthesis or breakdown of glycogen
C. Grossly looks similar to fatty change
D. Greasy in consistency/texture
E. Stained using PAS

66. Sequence of events in Dystrophic calcification

1. Binding of calcium to phospholipids on vesicle membrane


2. Repeat cycle of accumulation of calcium and phosphorus
3. Formation of calcium-phosphorus microcrystals
4. Phosphatases generate phosphate groups
5. Binding of calcium to phosphate groups

A. 1, 4, 5, 2, 3
B. 1, 5, 4, 2, 3
C. 1, 3, 4, 5, 2
D. 1, 3, 5, 4, 2
E. 1, 2, 3, 4, 5

67. Which of the following mechanisms can result in hepatic lipidosis? PBVD p. 40

1) Impaired synthesis of apoproteins


2) Impaired release of lipoproteins from hepatocytes
3) Impaired combination of triglycerides and protein to form lipoprotein
4) Excessive delivery of free fatty acids either from the gut or from adipose tissue
5) Decreased β-oxidation of fatty acids to ketones and other substances because of mitochondrial
injury
General pathology 2008-2009
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A. 1, 2, 3, 4, 5
B. 1, 3, 5
C. 2, 3, 4, 5
D. 2, 4, 5
E. 3, 5

68. Which of the following is not a mechanism of intracellular accumulations?

A. Glucocorticoid deficiency leads to accumulation of glycogen


B. Cells lack the enzymes required to metabolize an exogenous substance
C. A genetic defect affects metabolism of a normal endogenous substance
D. Rate of production of a normal endogenous substance exceeds metabolism
E. α1-antitrypsin deficiency leads to accumulation of proteins products in a cell

69. Which of the following stains can be used to help identify lead inclusion bodies?

A. PAS
B. Giemsa
C. Congo Red
D. Prussian Blue
E. Ziehl Neelsen

70. Steatosis (fatty change) occurs in:


1. Brain
2. Liver
3. Muscle
4. Skin
5. Kidney

A. 2, 3, 5
B. 1, 2, 3
C. 2, 4, 5
D. 2, 3, 4
E. 2, 3, 4, 5

71. The protein chaperone often involved with degrading misfolded proteins that cannot be
repaired is:

A. hsp 60
B. hsp 70
C. hsp 90
D. ubiquitin
E. chaperonin

72. Vacuoles in hepatocytes that stain negative for Sudan III and positive for the PAS reaction
most likely contain:
A. Fat
B. Iron
C. Amyloid
D. Glycogen
General pathology 2008-2009
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E. Water (hydropic degeneration)

73. The endogenous aging pigment derived through lipid peroxidation is:

A. Ceroid
B. Lipochrome
C. Lipofuscin
D. Hemosiderin
E. Bilirubin

74. Lipofuscin or lipochrome can be seen on the histopathological section as

A. Yellow-brown, finely granular intracytoplasmic, often perinuclear


B. black -brown, coarsely granular intracytoplasmic, often in the centre
C. reddish purple, uniformly sized clear intracytoplasmic vacuoles
D. purple, finely granular intranuclear, often perinuclear
E. golden brown, intracytoplasmic crystalline pigment

75. Which DNA virus produces large distinct eosinophilic intracytoplasmic inclusion bodies

A. Herpesviruses
B. Adenoviruses
C. Parvoviruses
D. Pox viruses
E. All the above

76. Hereditary amyloidosis is found in which breeds of dogs and cats

A. Chow-chow dogs and bengal cats


B. Shar-pei dogs and Abyssinian cats
C. Akita dogs and DSH cats
D. Chines dogs and orange cats
E. Poodle dogs and burmese cats

77. Pseudogout is characterized by the deposition of what type of crystals

A. Urate crystals
B. Calcium crystals
C. Calcium pyrophosphate crystals
D. Calcium oxalate monohydrate crystals
E. Calcium oxalate monohydrate and dihydrate crystals

78. Congenital porphyria of calves, cats and pigs is an inherited metabolic defect in heme
synthesis caused by

A. Deficiency of porphyrinogen III cosynthetase


B. Deficiency of porphyrinogen II cosynthetase
C. Deficiency of porphyrinogen I cosynthetase
D. Deficiency of uroporphyrinogen III cosynthetase
E. Deficiency of uroporphyrinogen II cosynthetase
General pathology 2008-2009
Compiled by Bhupinder Bawa

Answers:
1. A (Robbins p 9) TNF-α is associated with atrophy.
2. B Glucocorticoids, thyroid hormone and lysosomes are all involved in the ubiquitin-proteosome
pathway for degrading cytosolic and nuclear proteins. Insulin opposes this pathway.
3. A
4. A
5. A
6. D (Robbins pg. 13)
7. B (PBVD pg. 10)
8. E
9. E (Robbins p. 7)
10. A (Robbins p. 9)
11. D (Robbins p. 11)
12. A (Robbins pp 9)
13. E (Robbins pp 12)
14. A
15. A
16. C
17. E
18. D
19. E
20. E
21. D
22. D
23. C
24. E
25. B
26. C
27. C
28. A
29. C (Robbins p. 16) Increased intracellular calcium leads to activation of ATPases,
phospholipases, proteases, and endonucleases
30. A (Robbins p. 16)
31. B
32. A
33. C (PBVD p. 23)
34. C (PBVD p. 26)
35. A (Robbins p. 22)
36. B (Robbins pp 14)
37. D (Robbins pp 15)
38. C (Robbins pp 16)
39. C (Robbins pp 17)
40. A (Robbins pp 24)
41. B
42. D
43. C
44. A
45. B
46. A
General pathology 2008-2009
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47. A
48. E (Robbins p. 27) Phosphatidyleserine ‘flips’ from the inner membrane to the outer during
apoptosis and is a marker for phagocytosis. Thrombospondin IS expressed on the surface during
apoptosis.
49. A (Robbins p. 29) FLIP binds to but does not cleave pro-caspase-8. CD95 synonymous with Fas.
TNFR1 is a death receptor similar to Fas. Caspase 10 is a pro-apoptotic protein in humans.
50. C (Robbins p. 29-30)
51. A
52. E
53. C (Robbins p. 29)
54. D (Robbins p. 33)
55. D (Robbins pp 29)
56. B (Robbins pp 30)
57. D (Robbins pp 35)
58. C (Robbins pp 36)
59. A (Robbins pp 42)
60. A (Robbins pp 37)
61. D (Robbins pp 37-39)
62. C (Robbins pp 35)
63. B (Robbins pp 43-44)
64. A (Robbins pp. 37)
65. D (Robbins pp. 39)
66. A (Robbins pp. 41)
67. A (PBVD p. 40)
68. A (PBVD pp. 38-39)
69. E (PBVD p. 44)
70. A (PBVD p.39, Robbins p.35)
71. D (Robbins p.38)
72. D (Robbins p.36)
73. C (PBVD p.52)
74. A
75. D
76. B
77. C
78. D

PBVD
Chapter 1

1. Brain cells differ in glucose metabolism in which of the following ways?


A. Brain cells do not contain α-keto-glutarase
B. Brain cells cannot generate ATP anaerobically
C. Anoxia leads to failure of the sodium potassium pump
D. Anerobic glycolysis in the brain is preferred over aerobic glycolysis
E. Brain cells do not differ from other cells regarding glucose metabolism

Answer: B. pp12-13- prolonged anoxia and use of glucose via anaerobic means will
cause failure of the sodium potassium pump eventually in all other cells
General pathology 2008-2009
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2. Cardiac glycosides act in which of the following ways?
A. They cause DNA damage
B. They disrupt the mitotic spindle
C. They are sodium channel blockers
D. They inhibit the Na/K pump directly
E. All of the above

Answer: D p13

3. Certain hemolytic Streptococci cause cell membrane damage by which of the


following mechanisms?
A. They cause the membrane attack complex of serum complement to form on
cells.
B. Exotoxin Streptolysin-O penetrates cell membranes forming channels
C. Exotoxins cause disruption of the Na/K ATP pump.
D. Exotoxins cause inlflux of Ca+² ions
E. None of the above

Answer: B p14

4. Hydropic degeneration can be differentiated from lipid or glycogen vacuoles by:


A. color
B. Texture
C. Failure to stain with oil-red-O or PAS
D. Failure of nuclear membranes to become indented by vacuoles
E. There is no way to differentiate these types of degeneration

Answer: C p15 The point of the question is to differentiate between hydropic deg vs fat
and/or lipid. Lipid will stain with Oil red O and glycogen with PAS but water will not
stain with either.

5. Deleterious effects of high intracellular Ca++ levels include which of the following?
1. Membrane bound PLA2 is activated
2. Proteases are activated causing cytoskeletal damage
3. ATPases are activated accelerating depletion of ATP
4. Activated PLA2 leads to destruction of cellular organelles
5. Endonucleases are activated causing destruction of chromatin

A. 1,2,3,4,5
B. 1,3,4
C. 2,3,4,5
D. 3,4,5
E. 4,5

Answer: A p18
General pathology 2008-2009
Compiled by Bhupinder Bawa
6. True or False- Lipid peroxidation can lead to lipidosis?

Answer: T p19-20. damage of RER leads to decreased lipoprotein synthesis


leading to decreased lipid exportation and increased intracellular lipid accumulation.

7. The superoxide radical is involved in which of the following reactions?

1. Superoxide catalyzes the reduction of Fe3+  Fe2+


2, Superoxide is converted to H2O2 by SOD
3. Superoxide is converted to OH by catalase
4. Superoxide is converted to OH- by Fe2+

A. 1
B. 1,2
C. 2,3,4
D. 3,4
E. None of the above

Answer: B p19 and Peroxide is converted to OH and O2 by catalase

8. Coagulaton necrosis is called so because of…

A. Coagulation of proteins in the cell by increasing acidity of the cell


B. The slow inflammatory response
C. The retention of cellular detail
D. Karyolysis
E. None of the above

Answer: A p20

9. Atrophy of organs will show which histological changes?


A. Increase of autophagous vacuoles and lipofuscin
B. Decrease in mitochondrial number
C. Decrease in myofilament number
D. Fibrosis
E. All of the above

Answer: E p32-33, 37-38

10. Which of the following is true regarding reactive systemic amyloidosis?

1. It is the most common form of amyloidosis in domestic animals


2. Amyloid forms in the mesangium and BM of glomeruli
3. Space of Disse is the most common site in birds
4. Spleen is the most frequent site in mammals
5. Amyloid forms in the pancreatic islets of cats
General pathology 2008-2009
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A. 1,2,3,4,5
B. 1,2,3,4
C, 1,2,3
D. 1,5
E. 2,4

Answer: B p46

Robbins
General Pathology

Chapter 1

1. Which of the following statements about adaptation and cell injury are true?
1. Adaptations result in new steady states
2. Cell injury always results in a morphologic alteration
3. Both adaptation and to a certain extent cell injury are reversible
4. Cell injury can result from direct insults or progress from an adaptive state.
5. Adaptation and cell injury along with cell death are a progression of cellular
responses

A. 1,2,3
B. 1,3,4,5
C. 2,3,5
D. 2,4,5
E. All of the above

Answer B p 4-5

2. The difference between hormonal and compensatory hyperplasia can best be


summarized as:
A. Hormonal hyperplasia increases the functional capacity of a tissue when needed,
and compensatory hyperplasia is in response to an altered metabolic need or
injury to tissue
B. Hormonal hyperplasia results from abnormal hormone concentrations but
compensatory hyperplasia is the result of normal healing of tissues
C. Compensatory hyperplasia is abnormal proliferation of tissues, but hormonal
hyperplasia is normal proliferation of tissue
D. Compensatory hyperplasia is hyperplasia from organ damage, and hormonal
hyperplasia results from abberent hormones.
E. None of the above

Answer A p6

3. Cardiac muscle hypertrophy involves induction of which of the following genes?


General pathology 2008-2009
Compiled by Bhupinder Bawa
1. c-fos and c-jun transcription factors
2. TGF-β, insulin like GF-1
3. alpha-adrenergic agonists
4. IFN-γ
5. endothelin-1
6. FGF

A. 1,2,3,4,5
B. 1,2,3,5,6
C. 1,2,4
D. 1,2,5
E. 2,3,5,6

Answer B p7

4. During cardiac hypertrophy β- myosin Heavy chains are replaced by α- myosin


heavy chains? True or False?

Answer: False Its alpha that’s replaced by beta p 7

5. One method of atrophy is the ubiquitin-proteastome pathway. Which of the


following can be involved in this pathway?
1. Insulin
2. TNF-α
3. Ubiquitin
4. Glucocorticoids
5. Thyroid hormone

A. 1,2,3
B. 1,2,4
C. 2,3
D. 2,3,4,5
E. 3,4

Answer: D p 10

6. Remnants of autophagic vacuoles may be described as:


1. calcareous corpuscles
2. Lipofuscin granules
3. Residual bodies
4. Brown atrophy
5. Proteostomes

A. 1,2
B. 2,3
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C. 2,3,4
D. 3,4,5
E. None of the above

Answer: C p10

7. Which of the following can cause squamous metaplasia of columnar epithelium:


1. gall stones
2. acid Reflux
3. Cigarrete smoke
4. Hypovitaminosis A
5. Salivary gland stones

A. 1,3,4,5
B. 1,2,4,5
C. 2,3,4
D. 3,4,5
E. All of the above

Answer: A p 10

8. The hallmarks of reversible cellular injury are:

1.ATP depletion
2.Cellular swelling
3.Nuclear condensation
4.Chromatin aggregation
5. Reduced oxidative phosphorylation

A. 1,2,3
B. 1,3,5
C. 1,2,5
D. 2,4,5
E. 3,4,5

Answer: C p 11

9. Apoptosis differs from necrosis in that:


1. necrosis is always pathologic
2. Apoptosis is always secondary to cell injury
3. Necrosis is part of normal biochemical processes
4. Apoptosis is characterized by nuclear dissolution
5. Necrosis is characterized by loss of cell membrane integrity.

A. 1,3,5
B. 1,4,5
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C. 2,3,4
D. 2,4,5
E. All of the above

Answer: B p11-13

10. Morphologic features of necrosis include which of the following:


1. Pyknosiskaryorrhexis karyolysis
2. Cell membrane disruption
3. adjacent inflammation
4. cell swelling
5. Cell leakage

A. 1,2,3
B. 1,3,5
C. 2,3,4
D. 2,4,5
E. All of the above

Answer E p13

11. Morphologic features of Apoptosis that may look like necrosis include:
A. Shrinkage
B. Nuclear fragmentation
C. Intact cellular components
D. All of the above
E. None of the above

Answer: B p13

12. The most important targets for injurious cellular stimuli include:
1. the genetic apparatus of the cell
2. Mitochondrial respiration
3. Cell membrane integrity
4. protein synthesis
5. cytoskeleton

A. 1,2.3,4,5
B. 1,2,3,4
C. 2,3,4,5
D. 2,3,4
E. 3,4,5

Answer: A p14

13. ATP is required for which cellular functions:


General pathology 2008-2009
Compiled by Bhupinder Bawa
1. deacylation-reacylation reactions
2. membrane transport
3. Osmotic regulation
4. protein synthesis
5. lipogenesis

A. 1,2
B. 2,3
C. 3,4
D. 4,5
E. All of the above

Answer: E p14

14. The consequences of ATP depletion include which if the following:


1. Intracellular sodium accumulation
2. Influx of intracellular calcium
3. reduction in protein synthesis
4. Intracellular pH decreases
5. Protein misfolding

A. 1,2,3,4,5
B. 1,2,3
C. 1,3
D. 3,4,5
E. 4,5

Answer: A p 15

15. Mitochondrial damage can occur by which of the following:


1. oxidative stress
2. phospholipase A
3. Free fatty acids
4. induction of NFKB
5. increases of cytosolic calcium

A. 1,2,3,4
B. 1,2,3,5
C. 2,3,4,5
D. 2,4,5
E. 3,4,5

Answer: B p15

16. Calcium activated cellular enzymes include:


A. ATPases
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B. Proteases
C. Endonucleases
D. Phospholipases
E. All of the above

Answer: E p15-16

17. Free radicals produced in cellular metabolism include:


1. Fe2+
2. CCl4
3. Hydroxyl radical
4. Superoxide anion radical
5. Peroxynitrite anion (ONOO-)

A. 1,2,3
B. 1,3,5
C. 2,3,4
D. 3,4,5
E. None of the above

Answer D p16

18. True or False, the fenton reaction describes oxidized Ferric iron (Fe3+) reacting
with H2O2 to form Reduced ferrous iron (Fe²+).

Answer: False p16, Reduced ferrous iron reacts with hydrogen peroxide to form OH
and OH- radical.

19. True or False- Lipid peroxidation describes oxidative damage to the outer cell
membrane only.

Answer: False- p16 Lipid peroxidation can occur in all lipid membrane organelles as
well.

20. True or False- Lipid peroxidation requires unsaturated fatty acids:

Answer: True. P16 double bonds in unsaturated fatty acids are attacked by oxygen
derived free radicals particularly OH

21. Free radicals oxidize amino acids forming which of the following:
A. protein-protein cross links
B. protein fragmentation
C. Disulfide bonds
D. All of the above
E. None of the above
General pathology 2008-2009
Compiled by Bhupinder Bawa
Answer: D pp16-17

22. Oxidative damage to DNA can come in which of the following forms:

A. DNA alkylation
B. single stranded breaks
C. Base pair substitution
D. defects in RNA transcription
E. None of the above

Answer: B p17

23. From Robbins Online: Question: A 38-year-old man has had headaches and
nausea for the past 2 months. Laboratory findings show hypercalcemia and
hypophosphatemia and normal serum albumin. Urine microscopic analysis shows
deposition of calcium salts in the renal tubular epithelium. Which of the following
processes has most likely produced this change in the kidney?
A) Dystrophic calcification

B) Renal tubular atrophy

C) Autophagocytosis

D) Metastatic calcification

E) Cellular aging

Answer: D
Explanation: Deposition of calcium in normal healthy tissues as a result of prolonged
hypercalcemia is called metastatic calcification. This process may occur in
hyperparathyroidism. Dystrophic calcification refers to calcium deposition in injured
tissues, with normal serum calcium levels. Atrophy decreases cell size but is not
accompanied by calcium deposition. Autophagocytosis yields more golden-brown
lipofuscin pigment in the cytoplasm, particularly in hepatocytes and myocardial
fibers, a process that becomes more apparent with aging. See pages 41-42

24. From Robbins Online: Question: An experiment introduces a "knockout" gene


mutation into a cell line. The frequency of cell karyorrhexis and cytoplasmic
fragmentation is increased, compared with a cell line without the mutation. Overall
survival of the mutant cell line is reduced. Which of the following genes is most
likely to be affected by this mutation?

A) BAX

B) BCL-2
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Compiled by Bhupinder Bawa
C) C-MYC

D) FAS

E) TP53

Answer: B
Explanation: The BCL-2 gene product inhibits cellular apoptosis by binding to Apaf-1.
The BAX gene product promotes apoptosis. The C-MYC gene is involved with
oncogenesis. The FAS gene encodes for a cellular receptor for FAS ligand, which signals
apoptosis. TP53 gene activity normally stimulates apoptosis, but mutation favors cell
survival. See pages 29-30

24. Choose the correct pair(s) of anti-oxidant enzymes and cellular locations:

1. mitochondria/glutathione peroxidase
2. Mitochondria/ copper-zinc-SOD
3. cytosol/ceruloplasmin
4. Peroxisome/catalase
5. cytosol/ Vitamin E

A. 1,2,3
B. 1,3,4
C. 2,3,4
D. 3,4,5
E. All of the above

Answer: B p17

25. True or false: Oxidized Glutathione is abbreviated “GSSG”?

Answer: True p18

26. Mitochondrial dysfunction and increasing intracellular calcium levels can both
lead to membrane damage by which of the following method(s).
A. Decreased availability of phospholipids
B. Decreasing phospholipid synthesis
C. Lipid breakdown products
D. Protease activation
E. None of the above

Answer: A p18 Mitochondial dysfunction leads to decreasing phospholipid


synthesis, and calcium leads to increased phospholipid degradation, both contribute to
phospholipid loss. Calcium increase alone leads to lipid breakdown products and
protease activation. Calcium increases do not lead to decreased phospholipid synthesis.
General pathology 2008-2009
Compiled by Bhupinder Bawa
27. The progression from reversible cell injury to irreversible cell injury is associated
with which of the following:

1. some damage to the plasma membrane


2. Small influx of calcium into the cell
3. Vacuolization of mitochondria
4. Persistent or excessive injury
5. Lysosomal swelling

A. 1,2
B. 2,3,4
C. 2,4,5
D. 3,4,5
E. All of the above

Answer: D p19. Reversible injury progresses to irreversible injury with extensive


damage of cell membranes, influx of calcium, and lysosomal leakeage and extensive loss
of ATP.

28. Under light microscopy reversible cell injury is recognized as which two
morphologic patterns:
A. Nuclear fragmentation and cell swelling
B. Chromatin clumping and cell swelling
C. Fatty change and nuclear swelling
D. Fatty change and cell swelling
E. None of the above

Answer: D P19

29. The ultrastructural changes of reversible cell injury include:


A. plasma membrane blebbing, blunting and distortion of microvilli
B. mitochondrial swelling and amorphous densitites
C. dilation of ER and detachment of polysomes
D. nuclear disaggregation
E. All of the above

Answer E p19-20

30. Morphologic changes following cell death result largely from:


A. Degradative action of enzymes
B. Degradation of cytoskeletal components
C. Leakage of cellular organelles into extracellular space
D. Action of saprophytic organisms on dead tissue and organs
E. None of the above

Answer: A p21 ???bad q???


General pathology 2008-2009
Compiled by Bhupinder Bawa

31. The morphologic appearance of necrosis and autolysis takes hours to appear: True
or False?

Answer: True

32. Enzymatic digestion of dead cells that comes from the cells own lysosomes is
most properly called:
A. Necrosis
B. Apoptosis
C. Autolysis
D. Suicide
E. All of the above

Answer: C p21

33. Increased eosinophilia of necrotic cells is caused by:


A. Loss of RNA in cytoplasm
B. Loss of DNA from the nucleus
C. Increased protein in cytoplasm
D. Leakage of DNA from nucleus to cytoplasm
E. None of the above

I forgot To put the answer- off hand I would say A??

34. A glassy homogenous appearance of necrotic cells can be attributed to;


A. Loss of glycogen particles
B. Loss of cytoskeleton components
C. Loss of cell organelles
D. Cell swelling
E. All of the above

Answer: A p21

35. Cytoplasmic vaculation can be attributed to:


A. Enzymatic digestion of cellular organelles
B. Loss of glycogen stores
C. Nuclear dissolution
D. A and C
E. All of the above

Answer: A p21

36. Dead cells may ultimately be replaced by whorled phospholipid masses called:
A. Myelin figures
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B. Kaolin granules
C. Keratin pearls
D. Keratohyalin granules
E. None of the above

Answer: A p21

37. Match the flowing terms with their definitions:


A. Karyolysis 1. nucelear shrinkage and increased basophilia
B. Pyknosis 2. Fragmentation of the nucleus
C. Karyorrhexis 3. Fading of chromatin

Answers: A:3, B:1, C:2 p21

38. Proposed mechanisms of ischemia-reperfusion injury include:


1. cellular antioxidant defense mechanisms decreased by ischemia
2. reoxygenation causing free radical production
3. promotion of mitochondrial permeability
4. complement pathway
5. inflammation

A. 1,2,3,4,5
B. 1,2,3,4
C. 1,2,3
D. 2.3.4.5
E. None of the above

Answer: B p24

39. Fatty liver caused by CCl4 poisoning is through the failure of which of the
following:
A. Apoprotein synthesis
B. Albumin synthesis
C. Glycogen synthesis
D. Glycogen storage
E. All of the above

Answer A. p25

40. Morphologic features of apoptosis include:


A. Cell shrinkage
B. Chromatin condensation
C. Phagocytosis by macrophages
D. Cytoplasmic blebs with or without nuclear fragments
E. All of the above
General pathology 2008-2009
Compiled by Bhupinder Bawa
Answer: E p27

41. Activation of caspases causes which of the following:


1. Cleave lamins
2. Activating DNAses
3. Cleaving cytoskeleton
4. Condensation of chromatin
5. Breaking down nuclear scaffold

A. 1,2,3,4,5
B. 1,2,3,5
C. 1,2,3
D. 2,3,5
E. 4,5

Answer: B p27

42. Phagocytic recognition is mediated by:


A. Phosphatidylserine expression on cell membranes
B. Phosphatidylserine removal from cell membranes
C. Annexin V expression
D. Thrombospondin degradation
E. None of the above

Answer: A p27

43. Which of the following statements in untrue?


A. FAS must be cross linked by its ligand
B. Pro-caspase 8 molecules are cleaved by FADD
C. The extrinsic pathway can be inhibited by FLIP
D. Some TNF receptor family members do not contain cytoplasmic death domains
E. None of the above statements are untrue

Answer; B p29

44. Anti-apoptotic proteins BCL-2 and BCL-x normally reside where?


A. The cytoplasm
B. The nucleus
C. The mitochondrial membranes
D. A and C
E. None of the above

Answer D. p29

45. When BCL-2 and BCL-x are replaced by BAK BAX and BIM which of the
following occurs:
General pathology 2008-2009
Compiled by Bhupinder Bawa
A. The mitochondrial membrane becomes more permeable
B. The cytoskeleton breaks down
C. The nucleus shrinks
D. None of the above
E. All of the above

Answer: A. p30

46. Functions of cytochrome c in the cytoplasm of a cell include:


A. binding to and activating AIF
B. Binding to Apaf-1
C. Activation of Pro-caspase 9
D. All of the above
E. None of the above

Answer: D p30

47. The term “caspase” refers to what functionality of the enzyme?


A. Cysteine protease
B. Cleaving after aspartic acid residues
C. Breaking up of the CASP molecule complex
D. A and B
E. B and C

Answer: D p30

48. Which of the following statements explain why there is little to no inflammatory
response to apoptotic cells.
1. dying cells secrete soluble factors that recruit phagocytes.
2. Macrophages can secrete substances that bind specifically to apoptotic cells.
3. Numerous macrophage receptors have been shown to be involved in binding
apoptotic cells.
4. Apoptotic cells have marker molecules on their surfaces which facilitate early
recognition by phagocytes.
5. viable cells appear to prevent their own engulfment by macrophages through
expression of certain surface molecules.

A. 1,2,3,4,5
B. 1,2,3,4
C. 1,2,3
D. 2,3,4,5
E. 2,3,4

Answer: B p31

49. What is the function of P53 in apoptosis?


General pathology 2008-2009
Compiled by Bhupinder Bawa
A. p53 triggers apoptosis if DNA repair fails by stimulating transcription of Bak and
Bax.
B. P53 stimulates transcription of Apaf-1 which activates caspases
C. P53 causes cell cycle arrest
D. A and B
E. All of the above

Answer: D p31

50. TNF causes apoptosis by…?


A. Inhibiting NF-kB
B. Activating FADD
C. Activating NF-kB
D. A and B
E. None of the above

Answer: D p31

51. Cytolytic T cells can activate apoptosis by which of the following mechanisms.
A. Secrete perforin
B. Secretion of Granzyme B
C. Secreting aspartate-residue-cleaving enzymes
D. All of the above
E. None of the above

Answer: D p31

52. Common endpoints of heterophagy and autophagy are:


A. Residual bodies
B. Lipofuscin pigment
C. Exocytosis
D. A and B
E. None of the above

Answer: D p 32

53. Barbiturate drug resistance can be attributed to which of the following:


A. Hypertrophy of Smooth ER
B. Hyperplasia of Smooth ER
C. Hypertrophy of Rough ER
D. Hyperlasia of Rough ER
E. None of the above

Answer: A p33
General pathology 2008-2009
Compiled by Bhupinder Bawa
54. Which of the following cytoskeletal components are involved in leukocyte
migration?
1. Thin filaments
2. Microtubules
3. Intermediate filaments
4. Desmin filaments
5. Vimentin filaments

A. 1,2,3,4,5
B. 1,2,3,4
C. 1,2,3
D. 1,2
E. 3,4,5

Answer: D p34

55. Fatty liver may be attributed to which of the following causes:


A. Protein malnutrition
B. CCl4 toxicity
C. Starvation
D. Anoxia
E. All of the above

Answer: E p36

56. Eosinophilic intracellular inclusions located in plasma cells may be called:


A. Russel bodies
B. Chaperones
C. Amyloid
D. A and C
E. None of the above

Answer: A p37

57. The unfolded protein response may cause apoptosis by activation of:
A. Caspase 12
B. Ubiquitin
C. Bax
D. A and B
E. None of the above

Answer: A p38

58. Examples of hyaline change include


1. Amyloidosis
2. Russel bodies
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Compiled by Bhupinder Bawa
3. Reabsorption droplets
4. Mallory alcoholic protein (humans)

A. 1,2,3
B. 2,3,4
C. 2
D. 3,4
E. 4

Answer: B p39

59. Glycogen is found in which of the following cells in Diabetes mellitus (humans)
A. Distal portion of the proximal convoluted tubules
B. Descending loop of Henle
C. Pancreatic beta cells
D. Heart muscle
E. All of the above

Answer: E p39

60. Genetic and environmental factors influence cellular aging. Which of the
following is NOT involved in the cellular aging process.
A. Accumulation of damaged cell proteins and organelles
B. Abnormal cellular signaling
C. Accumulation of mutations
D. Replicative senescence
E. None of the above

Answer: E p42

61. In immortal cells telomerase activity is characterized by;


A. Shortening telomeres by cleaving specific DNA base pairs from the chromosome
B. lengthening telomeres using its own RNA template
C. lengthening telomeres using the DNA as a template
D. shortening telomeres
E. None of the above

Answer: B p43

62. IGF-1 receptor pathway influences aging in which way?


A. activation of kinases may lead to silencing a number or genes and promote aging
B. activation of kinases lead to activation of pro-aging genes
C. Activation of kinases lead to activation of anti-aging genes
D. Downstream activation of pro-aging genes
E. None of the above
General pathology 2008-2009
Compiled by Bhupinder Bawa
Answer: A p43

All of the following are features of apoptosis except:

A. reduced cell size


B. enlarged cell size
C. intact cellular contents
D. intact plasma membrane
E. fragmentation of the nucleus

Answer: B Robbins pg 13, Table 1-2

Which of the following are causes of atrophy?

1. aging
2. disuse
3. pressure
4. inadequate nutrition
5. loss of endocrine stimulation

A. 1,2,3
B. 2,3,4
C. 3,4,5
D. 1,2,4,5
E. 1,2,3,4,5

Answer: E Robbins pg 9

Which of the following is the correct sequence of events involved in acute cell swelling?

1. hypoxia
2. Ca influx
3. increased glycolysis
4. ribosome detachment
5. failure of Na-K pump

A. 1,2,3,4,5
B. 1,3,5,4,2
C. 1,3,4,5,2
D. 1,3,4,2,5
E. 1,4,3,5,2

Answer: C PBVD pg 14

Which of the following is the most characteristic feature of apoptosis?


General pathology 2008-2009
Compiled by Bhupinder Bawa
A. cell shrinkage
B. chromatin condensation
C. formation of apoptotic bodies
D. formation of cytoplasmic blebs
E. phagocytosis of apoptotic bodies

Answer. B Robbins, pg 27

Which of the following are involved in the extrinsic apoptosis pathway?

1. Fas
2. Bax
3. FADD
4. Bcl-2
5. caspase-8

A. 1,2,3
B. 1,2,4
C. 1,3,4
D. 1,3,5
E. 1,4,5

Answer: D Robbins, pg 29

Which of the following favor apoptosis?

1. Bim
2. FLIP
3. Bcl-2
4. FADD
5. Apaf-1

A. 1,2,3
B. 1,3,5
C. 1,4,5
D. 2,3,5
E. 2,4,5

Answer: C Robbins, pg 29-30

Which of the following are true regarding amyloidosis?

1. the liver is primary site of RSA in birds


2. the spleen is the most common site of RSA in animals
3. pancreatic islet amyloidosis in cats is localized amyloidosis
4. reactive systemic amyloidosis is secondary to chronic inflammation
General pathology 2008-2009
Compiled by Bhupinder Bawa
5. immunocyte dyscrasia is the most common form of amyloidosis in animals

A. 1,2,3
B. 1,2,4
C. 1,2,3,5
D. 2,3,4,5
E. 1,2,3,4,5

Answer: C PBVD, pg 46

Which one of the following pathologic states is not an example of or a cause of


metaplasia? (p. 36 PBVD)
A) Estrogen toxicity
B) Vitamin A deficiency
C) Prolonged steroid therapy
D) Cholelithiasis of biliary ducts
E) Extramedullary hematopoiesis

Answer: C

Which one of the following is not involved in reversible cell injury? (p. 11-12 Robbins)
A) ATP depletion
B) cellular swelling
C) Chromatin clumping
D) Nuclear condensation
E) Reduced oxidative phosphorylation

Answer: D

Which of the following are features of irreversible cell injury? (PBVD p. 18)
1) chromatin clumping
2) cell membrane damage
3) lack of mitochondrial function
4) swelling of endoplasmic reticulum

A) 1, 2
B) 1, 4
C) 2, 3
D) 2, 4
E) 3, 4

Answer: C

Place the following steps of cell injury in the correct sequence. (Robbins p. 24)
1) ischemia
2) influx of Na, water
General pathology 2008-2009
Compiled by Bhupinder Bawa
3) decreased ATP production
4) loss of membrane phospholipids
5) decreased activity of Na K ATPase pump

A) 1, 2, 3, 4, 5
B) 1, 3, 5, 2, 4
C) 2, 4, 3, 1, 5
D) 3, 5, 4, 1, 2
E) 5, 4, 3, 2, 1

Answer: B

Which one of the following is not a structural change that can be associated with cellular
aging? (Robbins p. 42)
A) lipid accumulation
B) lipofuscin accumulation
C) abnormally lobed nuclei
D) decreased endoplasmic reticulum
E) accumulation of abnormally folded proteins

Answer: A

1) Increased cytosolic calcium in cellular injury may result in which of the following:

1) Nucleus chromatin damage


2) Decreased ATP
3) Disruption of membrane and cytoskeletal proteins
4) Breakdown of proteases
5) Phospholipase activation Robbins p15-16

A) 1, 3, 4, 5
B) 1, 2, 4, 5
C) 1, 2, 3, 5
D) 1, 2, 3, 4, 5

Answer: C

2) Which one of the following statements is INCORRECT?

A) Coagulation necrosis is usually a direct result of hypoxic cell injury.


B) Caseation necrosis is often associated with poorly degradable lipids of bacterial origin.
C) Liquefactive necrosis is the usual type of necrosis in the CNS.
D) Areas of coagulation necrosis undergo rapid proteolysis.
E) The initial lesion in gangrene is coagulation necrosis. PBVD p22-23

Answer: D
General pathology 2008-2009
Compiled by Bhupinder Bawa

1) Which of the following are NOT proapoptotic:

1) Caspase-8
2) Caspase-9
3) FLIP
4) Cytochrome c
5) Bcl-2 Robbins p29-30

A) 1, 2, 3
B) 3, 4, 5
C) 3, 5
D) 3, 4
E) 5

Answer: C

2) The role of the P-450 mixed function oxidase system is to:

A) detoxify a compound to render it less injurious


B) increase the solubility of a compound to facilitate its excretion
C) reduce the number of reactive oxygen species within the cell
D) induce apoptosis
E) inhibit apoptosis Robbins p33

Answer: B

1) Which of the following statements about chaperones is INCORRECT?

A) If protein folding is unsuccessful, chaperones facilitate degradation of the damaged


protein.
B) They can initiate cellular apoptosis via caspase-12.
C) Some are induced by stress.
D) Some are synthesized constitutively and affect normal intracellular protein trafficking.
E) Chaperones increase protein translation in response to increased levels of misfolded
proteins in the cell.
Robbins p 37-38
Answer: E

2) The order of pigment production in the common bruise is:

1) Hemosiderin
2) Bilirubin
3) Hemoglobin
4) Biliverdin Robbins p 40
General pathology 2008-2009
Compiled by Bhupinder Bawa
A) 1, 2, 3, 4
B) 3, 2, 4, 1
C) 3, 4, 2, 1
D) 3, 1, 2, 4

Answer: C

3) Which of the following statements about pathologic calcification are incorrect?

1) Metastatic calcification may occur in normal tissues when there is a hypercalcemia.


2) Dystrophic calcification is encountered in areas where there is a high rate of cellular
apoptosis.
3) Initiation of intracellular calcification occurs in the mitochondria of dead or dying
cells.
4) Metastatic calcification usually occurs in tissues that lose acid and therefore have an
internal alkaline compartment.
5) Metastatic calcification usually occurs in tissues that lose bases and therefore have an
internal acidic compartment.
Robbins p 41-42
A) 2
B) 5
C) 4
D) 2, 4
E) 2, 5

Answer: E

Q. Which of the following is NOT TRUE for telomers.

1. Each cell division cycle leads to deletion of 50-200 bp of telomeric DNA.


2. Function of telomer is dependent on the length of telomeric repeat sequence.
3. Telomerase is ribonucleoprotein complex constituting a RNA subunit and
catalytic protein part.
4. Telomers protect chromosome ends from recombinBation, fusion and being
recognized as damaged ends.

A. 1,2,3
B. 2
C. 1,2
D. 1,4
E. None
General pathology 2008-2009
Compiled by Bhupinder Bawa
Answer: B
Q1. All of the following is true about autophagic cell death EXCEPT ?

1. Autophagy is associated with cellular ATP depletion


2. Necrosis, apoptosis and autophagocytosis are mutually exclusive
3. Swelling of mitochondria along with decreased number of mitochondria.
4. Autphagic vacuoles are removed with phagocytosis with inflammation
5. Autophagy is upregulated in sublethaly injured and physiological regressed cells.

A. 1,2,4
B. 2,4
C. 2,3,4,5,
D. 3,4
E. 1,2,3

Answer: A

Q. Dysregulated apoptosis with excessive cell death is not seen in? (Robbins, pp 32).

A. Neurodegenerative disorders.
B. Myocardial infarction
C. Stroke
D. Autoimmune disorder
E. Viral infection.

Answer: D

Q. All of the following are intermediate filaments EXCEPT (Robbins, pp 34)

A. Keratin filaments
B. Neurofilaments
C. Myosin filaments
D. Vimentin filaments
E. Desmin filaments

Answer C

Q. Organs undergoing acute cell swelling show these characteristics. (PBVD, p 12)

1. Organs are pale in color.


2. Affected organs have increased specific gravity.
3. Affected organs are larger and heavier than normal.
4. Parenchyma of affected organs bulge on cut surfaces.
5. Cells of affected organ show an increase in normal organelles.

A. 1,2,3
General pathology 2008-2009
Compiled by Bhupinder Bawa
B. 1,3,4,5
C. 1,3,4
D. 3,4,5
E. 2,5

Answer: C

Q. All of these help in neutralization of free radicals EXCEPT (Robbins 16-17)

A. Superoxide dismutase
B. Glutathione peroxidase
C. Xanthine oxidase
D. Catalase
E. Vitamin E

Answer: C

Q. All of the following can result in hepatic lipidosis except ? (PBVD pp 40)

A. Decrease synthesis of apoprotien.


B. Increased β -oxidation of fatty acids to ketones
C. Impaired synthesis of α -glycerophosphate.
D. Increased delivery of free fatty acids to liver.
E. Impaired release of lipoproteins from heptocytes.

Answer: B

Q. During acute inflammation vascular leakage at arterioles takes place due to? (Robbins
pp 51-52)

1. Endothelial cell contraction


2. Direct injury to endothelial cells
3. Leukocyte induced endothelial injury
4. Increased transcytosis

A. 1,2,3,4
B. 2,3,4
C. 2,3
D. 1,4
E. 2

Answer: E

Q. The sequences of cellular events associated with leukocytes extravasation is?


(Robbins pp 53).
General pathology 2008-2009
Compiled by Bhupinder Bawa
1. Margination
2. Pavementing
3. Rolling
4. Diapedesis
5. Stasis

A. 5,4,3,2,1
B. 5,1,3,2,4
C. 5,3,1,2,4
D. 1,3,2,4,5
E. 5,1,2,3,4

Answer: C

Q. Which of the following are the sequence of events associated with chemotaxis ?

Activation of calcium dependent GTPases


Cross linkage and disassembly of actin filaments.
Activation of phospholipase C and phosphoinositol -3 kinase
Polymerization of actin filaments at the leading edge of leukocytes
Binding and activation of G-protein receptor by chemotactic agent.

A. 5,3,1,4,2
B. 5,1,3,4,2
C. 5,3,1,2,4
D. 5,1,3,2,4
E. 5,3,4,1,2

Answer: C

Q. All of the following can inhibit complement activation system EXCEPT ? (Robbins pp
66)

F. Decay accelerating factor


G. C1 inhibitor
H. CD59
I. Factor 1
J. Plasmin

Answer: E

Q. Paraoxysmal nocturnal hemoglobinuria can occur due to defective expression of ?


(Robbins pp 66-67)

1. DAF
General pathology 2008-2009
Compiled by Bhupinder Bawa
2. CD59
3. C1
4. C3

A. 1,2,3
B. 1,2
C. 3, 4
D. 1only
E. All of the above

Answer; B

Q. Which of the following facilitates activation of Hageman factor ? (Robbins pp 65-68)

1. Collegen and basement membrane


2. Activated platelets
3. HMWK
4. Kallikrein
5. Plasmin

A. 1,2
B. 1,2,3
C. 3,4,5
D. 1,2,3,4
E. 1,2,3,4,5

Answer: E

Robbins

All of the following are features of apoptosis except:


A) Cellular swelling
B) Intact plasma membrane
C) Fragmentation of nucleus
D) Minimal adjacent inflammation
E) Means of eliminating unwanted cells

Answer: A page 13

Increased intracellular calcium causes cell injury by all of the following mechanisms
except:
A) Activation of proteases
B) Activation of endonucleases
C) Activation of Phospholipases
D) Lipid peroxidation of membranes
General pathology 2008-2009
Compiled by Bhupinder Bawa
E) Increased mitochondrial permeability

Correct answer: D, Page 16

The following are features of reversible cell injury except:


A) Nuclear pyknosis
B) Mitochondrial swelling
C) Plasma membrane blebbing
D) Formation of cytoplasmic lipid vacuoles
E)) Increase in organ weight when many cells affected in organ

Correct answer: A, page 20-21

The following mechanisms cause post-ischemia reperfusion injury leading to cell death,
except?
A) Increased generation of free radicals
B) Increased expression of adhesion molecules
C) Deposit of IgG antibodies in ischemic tissues
D) Promotion of mitochondrial permeability transition
E) Compromised cellular antioxidant defense mechanisms

Answer: C Pages 24-25

The following are physiologic events in which apoptosis occurs:

1) Cell depletion in proliferating cell populations


2) Programmed cell death during embryogenesis
3) Elimination of self-reactive lymphocytes
4) Cell death induced by Cytotoxic T cells
5) TNF mediated cell death in tumors

A) 1,2,3
B) 1,2,4
C) 2,3,4
D) 1,2,3,4
E) 1,2,3,4,5

Answer: D pages 26
General pathology 2008-2009
Compiled by Bhupinder Bawa

The following are components of the intrinsic pathway of apoptosis except:

A) Apaf-1
B) Fas protein
C) Cytochrome C
D) Withdrawal of growth factors
E) Mitochondrial permeability transition

Answer: B, pages 29-30

The following mechanisms cause intracellular accumulations except.


A) Alterations in protein folding
B) Increased proteosome activity
C) Inability to degrade exogenous substance
D) Metabolism of endogenous substance is inadequate
E) Genetic defect in metabolism of endogenous substance

Answer: B, Page34-35

Followings are triggers for myocardial hypertrophy except

A. Stretch
B. Angiotensin II
C. α-adrenergic agonists
D. Atrial natriuretic factor
E. Insulin-like growth factor 1

(D, reference page 8, Figure 1-4)

Which base does react with oxygen free radicals to produce single-stranded breaks in
DNA?

a. Adenine
b. Cytosine
c. Guanine
General pathology 2008-2009
Compiled by Bhupinder Bawa
d. Thymine
e. Uracil

Answer d (reference page 17)

Which of the followings are not features of ischemic cell injury?

1. Cell death by ischemia-reperfusion is usually manifested as necrosis and


apoptosis
2. Cell death by ischemia is usually manifested as apoptosis
3. Ischemia tends to injure tissues faster than does hypoxia
4. Glycolytic energy production continues in prolonged ischemia
5. Ischemic injury is a non-inflammatory reaction

a. 1,2,4
b. 1,3,5
c. 2,3,5
d. 2,4,5
e. 3,4,5

Answer d (Reference Page 23,24)

The following statements are correct, EXCEPT

a. Internal RNA of telomerase serves as the template for synthesizing telomere DNA
b. RNA sequences in the telomerase are same across species
c. Telomeres protect chromosomal ends from degradation
d. There is no telomerase activity in normal somatic cells
e. Telomere shortening results in cell cycle arrests

(Answer b Reference Page 43-44)

Loss of hormonal stimulation to a tissue can result in which of the following?


a. Hyperplasia
b. Hypertrophy
General pathology 2008-2009
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c. Oncosis
d. Apoptosis
e. Metaplasia

Answer: d Reference: Page 10

Which of the following morphologic features is not associated with apoptosis.


a. Cell shrinkage
b. Nuclear fragmentation
c. Intact mitochondria
d. Plasma membrane fragmentation
e. Miminal pericellular inflammation

Answer: d Reference: Page 13

Cardiac hypertrophy results in:


a. Reinduction of developmental gene expression
b. More rapid myocyte contraction
c. Replacement of β -myosin by α -myosin
d. Decreased contraction efficiency
e. Increased myosin ATPase activity

Answer: a Reference: Page 7-8

Increased cytoplasmic calcium that occurs following cell injury is due to influx of
calcium across the:
a. Plasma membrane
b. Plasma and mitochondrial membranes
c. Plasma, mitochondrial and endoplasmic reticulum membranes
d. Mitochondrial and endoplasmic reticulum membranes
e. Mitochondrial, endoplasmic reticulum and peroxisome membranes

Answer: c Reference: Page 15-16

Inactivation of superoxide anion is predominately due to:


a. Superoxide dismutase
b. Spontaneous dismutation
c. Vitamin E scavenging
General pathology 2008-2009
Compiled by Bhupinder Bawa
d. Glutathione peroxidase
e. Catalase

Answer: b Reference: Page 17

Which of the following is most likely associated with irreversible cell injury:
a. Reduced ouabain-sensitive Na+,K+ -ATPase activity
b. Ribosomal detachment from endoplasmic reticulum
c. Increased cytosolic calcium
d. Reduced mitochondrial proton motive potential
e. Reduced Ca2+, Mg2+ -ATPase activity

Answer: d Reference: Page 15

The presence of Bcl-2 in the mitochondrial membrane is important for:


a. Activation of APAF-1
b. Release of cytochrome C
c. Stimulation of caspase 9
d. Maintenance of normal mitochondrial permeability
e. Activation of apoptosis inducing factor

Answer: d Reference: Page 30

Recognition of apoptotic cells by phagocytes is promoted by


a. FAS-L
b. Phosphatidylserine
c. Cytochrome C
d. TNF-R
e. FAS

Answer: b Reference: Page 27

Page 14-23

Which among the following are NOT features of reversible cell injury?

1- Nuclear pyknosis
General pathology 2008-2009
Compiled by Bhupinder Bawa
2- Plasma membrane blebbing
3- Marked mitochondrial swelling
4- Dilation of endoplasmic reticulum with ribosomal detachment
5- Karyolysis

a) 1,2,4
b) 1,3,5
c) 2,3,5
d) 2,4,5
e) 3,4,5

Answer- b

Reperfusion injury involves all of the following EXCEPT?

A) Complement cascade activation


B) Oxygen free radical formation
C) Granulomatous inflammation
D) Neutrophilic inflammation
E) Apoptosis

Answer: C Reference page #: 24-25

Increased mitochondrial permeability leading to cell death involves all of the following
EXCEPT?

A) Influx of calcium
B) Influx of hydrogen ions
C) Release of cytochrome C
D) Decreased ATP production
E) Severe mitochondrial swelling

Answer: B Reference page #: 15, 23, 30

Pro-apoptotic substances include all of the following EXCEPT?

A) Bak
B) Bax
C) Bcl-2
General pathology 2008-2009
Compiled by Bhupinder Bawa
D) Apaf-1
E) Cytochrome C

Answer: C Reference page #: 28-31

Robbins Ch1

August 16, 2005 page 1~13

(KK) All of the following conditions stimulate protein degradation by the ubiquitin-
proteasome pathway, EXCEPT:

a. Insulin
b. Glucocorticoids
c. Thyroid hormone
d. Muscle denervation
e. Tumor necrosis factor

(Answer a ref. page 10)

(KK) All of the followings are triggers for myocardial hypertrophy, EXCEPT:

a. Angiotensin II
b. Mechanical stretch
c. α-adrenergic hormones
d. Atrial natriuretic factor
e. Insulin-like growth factor 1

(Answer d ref. page 8, Figure 1-4)

August 23, 2005 page 14~22

(KK) Which of the following located in peroxisomes prevent cell injury by reactive
oxygen species?

a. Catalase
b. Vitamin E
c. Ascorbic acid
d. Superoxide dismutases
e. Glutathione peroxidase

(Answer a ref. page 17 fig. 1-14)


General pathology 2008-2009
Compiled by Bhupinder Bawa

(KK) Which of the following base reacts with oxygen free radicals to produce single-
stranded breaks in DNA?

a. Thymine
b. Cytosine
c. Adenine
d. Guanine
e. Uracil

(Answer a ref. page 17)

Which one of the following is not a characteristic of apoptosis?

A. Cell size is reduced.


B. Plasma membranes remain intact.
C. Adjacent inflammation is common.
D. Apoptosis can be a physiologic or pathologic process.
E. Nucleosome sized fragments are formed by the nucleus.

Answer: C pg. 13, Table 1-2

Which of the following are characteristics of cells that have undergone reversible cell
damage?

1. loss of ribosomes
2. lysosomal rupture
3. clumping of chromatin
4. presence of myelin figures
5. swelling of endoplasmic reticulum and mitochondria

A. 1, 2
B. 1, 3
C. 2, 5
D. 3, 5
E. 4, 5

Answer: D pg. 12, Figure 1-8

Which of the following may result from ATP depletion in the case of ischemia?

1. Increased efflux of K+.


2. Decreased influx of Na+.
General pathology 2008-2009
Compiled by Bhupinder Bawa
3. Detachment of ribosomes.
4. Increased protein synthesis.
5. Decrease in glycogen stores.

A. 1,3,4
B. 1,3,5
C. 2,3,5
D. 2,4,5
E. 3,4,5

Answer: B pg. 14-15, Figure 1-11

Which of the following is not an initiator of free radicals within cells?

A. Absorption of radiant energy such as x-rays.


B. Nitric oxide from endothelial cells or macrophages.
C. Enzymatic metabolism of endogenous chemicals or drugs.
D. Donation or acceptance of free electrons by transition metals.
E. Reduction-oxidation reactions that occur during normal metabolic processes.

Answer: C pg. 16

August 30, 2005


Robbins Ch.1 page 23~32

Which of the following is directly activated by the complex of apoptosis activating factor
1 and cytochrome c in apoptosis?

a. Bid
b. Bcl-2
c. Caspase 7
d. Pro-Caspase 9
e. Apoptosis inducing factor

(Answer d ref. page 30)

Which of the following is an executioner caspase in apoptosis?

a. Caspase 6
b. Caspase 8
c. Caspase 9
d. Caspase 10
e. Caspase 12
General pathology 2008-2009
Compiled by Bhupinder Bawa

(Answer a ref. page31)

Activation of which of the following caspase particularly converts cytoplasmic DNase


into an active form in apoptosis?

a. Caspase 3
b. Caspase 6
c. Caspase 7
d. Caspase 9
e. Caspase 12

(Answer a ref. page 31)

All of the following Bcl family members are pro-apoptotic, EXCEPT:

a. Bax
b. Bak
c. Bid
d. Bim
e. Bcl-X

(Answer e ref. page 29, 30)

Which of the following are examples of heterophagy?

1. removal of damaged organelles during cell injury


2. uptake and digestion of bacteria by neutrophils
3. removal of apoptotic cells by macrophages
4. cellular atrophy by nutrient deprivation
5. cellular remodeling of differentiation

a. 1, 2
b. 1, 5
c. 2, 3
d. 3, 4
e. 4, 5

(Answer c ref. page 32)

Which of the following brown pigment granules represent undigested material derived
from intracellular lipid peroxidation?

a. Hemosiderin
b. Lipofuscin
General pathology 2008-2009
Compiled by Bhupinder Bawa
c. Melanin
d. Copper
e. Bile

(Answer b ref. page 32)

Which of the following is a main component of the myelin figures in necrotic cells?

a. Cholesterol esters
b. Lipid peroxides
c. Phospholipids
d. Triglycerides
e. Cholesterols

(Answer c ref. page 35)

All of the following conditions are manifested by cholesterol accumulation, EXCEPT:

a. Fatty liver
b. Xanthomas
c. Cholesterolosis
d. Atherosclerosis
e. Niemann-Pick disease, type C

(Answer a ref. page37)

Which of the following is the unfolded protein response that reduces the levels of
misfolded proteins in the cell?

a. Decrease in the production of chaperones and slowing down protein translation


b. Increase in the production of chaperones and slowing down protein translation
c. Decrease in the production of chaperones and accelerate protein translation
d. Increase in the production of chaperones and accelerate protein translation
e. None of the above

(Answer b ref. page 38)

Which of the following is the chronological microscopic finding of localized


hemorrhage?

a. Hemoglobin > hemosiderin > biliverdin > bilirubin


b. Hemosiderin > bilirubin > biliverdin > hemoglobin
c. Bilirubin > biliverdin > hemoglobin > hemosiderin
General pathology 2008-2009
Compiled by Bhupinder Bawa
d. Biliverdin > hemoglobin > hemosiderin > bilirubin
e. Hemoglobin > biliverdin > bilirubin > hemosiderin

(Answer e ref. page 40)


The following are cellular adaptations to altered physiologic stimuli except:
A) Atrophy
B) Apoptosis
C) Metaplasia
D) Hyperplasia
E) Hypertrophy

Answer: B page 5

The following stimulate protein degradation by the ubiquitin-proteasome pathway except:


1) TNF-α
2) TGF-β
3) Insulin
4) Glucocorticoids
5) Thyroid hormone

A) 1,2
B) 1,3
C) 2,3
D) 2,4
E) 3,5

Answer: C page 10

Which of the following is not a characteristic of dystrophic calcification?

A. common in areas of necrosis


B. can be caused by increased PTH
C. similar to hydroxyapatite of bone
D. telltale sign of previous cell injury
E. has initiation and propagation phases

Answer: B pg 41

Which of the following statements in false concerning pigments?

A. Hemosiderin may be formed when there is an excess of local or systemic iron.


General pathology 2008-2009
Compiled by Bhupinder Bawa
B. Bilirubin is normal bile pigment derived from hemoglobin and does not
contain iron.
C. Exogenous pigments such as carbon may be seen in tracheobronchial lymph
nodes due to air pollution.
D. Lipofuscin is an insoluble pigment composed of polymers of lipids and
phospholipids complexed with protein.
E. Melanin is an endogenous, hemoglobin derived, brown-black pigment formed
from oxidation reactions within melanocytes.

Answer: E pg 39-41

Which of the following is false concerning increased vascular permeability?

A. TNF may cause reorganization of the cytoskeleton in an endothelial cell.


B. Endothelial cells may contract as a result histamine binding to its receptor.
C. New blood vessels remain leaky until their endothelial cells have matured.
D. In the immediate sustained response all levels of the vasculature are affected.
E. Proteolytic enzymes released from activated leukocytes may cause increased
transcytosis.

Answer: E pg 50-52

Which of the following endothelial molecules play a role in leukocyte adhesion?

1. ICAM-1
2. PECAM
3. VCAM-1
4. P-selectin
5. E-selectin

A. 1,2,3
B. 1,3,5
C. 2,3,4
D. 2,3,5
E. 3,4,5

Answer: B pg 54 Table 2-1

Which of the following is false concerning ischemia-reperfusion injury?

A. Affected tissues often have neutrophilic infiltrates.


General pathology 2008-2009
Compiled by Bhupinder Bawa
B. IgE deposits in ischemic tissues and activates the complement pathway.
C. Reactive oxygen species promote the mitochondrial permeability transition.
D. Inflammation occurs due to cytokines and adhesion molecules produced by
hypoxic tissues.
E. Increased generation of oxygen free radicals initiates new damage after the
ischemic insult is over.

Answer: B pg. 24-25

Which of the following are components of the Extrinsic (Death Receptor- Initiated)
Pathway?

1. FAS
2. Bcl-2
3. TNF receptor
4. cytochrome C
5. FADD

A. 1,2,4
B. 1,3,5
C. 2,3,4
D. 2,3,5
E. 3,4,5

Answer: B pg. 28-30

Activation of which of the complement proteins is the critical step in the elaboration of
the biological function of complement?

A. C1
B. C2
C. C3
D. C4
E. C5

Answer: C pg 64

Which substance provides the main link between the coagulation system and
inflammation?

A. plasmin
B. thrombin
C. kallikrein
General pathology 2008-2009
Compiled by Bhupinder Bawa
D. Factor XII
E. Bradykinin

Answer: B pg 65

Robbins Ch 1

The following are cellular adaptations to altered physiologic stimuli except:


A) Atrophy
B) Apoptosis
C) Metaplasia
D) Hyperplasia
E) Hypertrophy

Answer: B page 5

The following stimulate protein degradation by the ubiquitin-proteasome pathway except:


1) TNF-α
2) TGF-β
3) Insulin
4) Glucocorticoids
5) Thyroid hormone

A) 1,2
B) 1,3
C) 2,3
D) 2,4
E) 3,5

Answer: C page 10

All of the following are important elements of the extrinsic pathway of apoptosis except:
A) FLIP is inhibitor of pathway
B) Withdrawal of growth hormones
C) Binding of TNF to TNFR or FasL to Fas (CD95)
D) Activation of caspases 8 and 9 through FADD
E) Endonuclease activation and breakdown of cytoskeleton by executioner caspases

Answer: B page 29-30


General pathology 2008-2009
Compiled by Bhupinder Bawa
All of the following are components of heterophagy except:
A) Exocytosis
B) Pinocytosis
C) Phagocytosis
D) Phagolysosome formation
E) Autophagic vacuole formation

Answer: E autophagy page 32

All of the following stimulate protein degradation by the ubiquitin-proteasome pathway,


EXCEPT:

A. Fasting
B. Diabetes
C. Immobilization
D. Vitamin A deficiency
E. Hyperadrenocorticism

(Answer ref. page 10-11, Muscle protein breakdown and the critical role of
the ubiquitin-proteasome pathway in normal and disease states. J Nutr. 1999)

All of the following are possible sequela of ATP depletion associated with cell injury,
EXCEPT:

A. Influx of Na+
B. Influx of Ca2+
C. Decrease AMP
D. Protein misfolding
E. Accumulation of inorganic phosphates

(Answer C ref. page 14, fig 1-11)

Activation of ATPase, phospholipase, protease and endonuclease in cell injury are


triggered by:

A. Efflux of K+
B. Influx of Na+
C. Influx of Ca2+
D. Decreased pH
E. Leakage of H+ by mitochondria

(Answer C ref. page 16, fig 1-13)

Which of the following reaction is catalyzed by superoxide dismutases is:

A. 2H2O2  O2 + 2H2O
General pathology 2008-2009
Compiled by Bhupinder Bawa
B. 2O2- + 2H  H2O2 + O2
C. 2OH + 2GSH  GSSG + 2H2O
D. H2O2 + 2GSH  GSSG + 2H2O
E. H2O2 + Fe2+  Fe3+ + OH + OH-

(Answer B ref. page 17. A- catalase, C&D- glutathione peroxidase, E- fenton


reaction- not antioxidant reaction)

Which of the following caspases serve as executioners in apoptosis?

1. caspase 3
2. caspase 6
3. caspase 8
4. caspase 9

A. 1, 2
B. 1, 3
C. 2, 3
D. 2, 4
E. 3, 4

(Answer A ref. page 31)

Which of the following are hallmarks of reversible cell injury?

1. ATP depletion
2. cellular swelling
3. severe membrane damage
4. leaking of cellular contents
5. reduced oxidative phosphorylation

A. 1,2,3
B. 1,2,5
C. 1,3,5
D. 2,3,5
E. 3,4,5

Answer: B pg 11

All of the following are features of necrosis except:

A. pathologic
B. cell swelling
C. fragmented nucleus
D. disrupted plasma membrane
General pathology 2008-2009
Compiled by Bhupinder Bawa
E. frequent adjacent inflammation

Answer: C pg 13, Table 1-2

Which of the following are executioner caspases?

1. 2
2. 3
3. 6
4. 8
5. 9

A. 1,2
B. 2,3
C. 3,4
D. 3,5
E. 4,5

Answer: B pg 31

All of the following are pro-apoptotic except:

A. Bak
B. Bax
C. Bim
D. AIF
E. Bcl-2

Answer: E pg 28-30

Which of the following inhibits stimulation of proteasome-mediated


protein degradation? (p 10)

A. IL-1
B. TNF
C. Insulin
D. Glucocorticoids
E. Thyroid hormone

Answer: C

All of the following are involved in cell antioxidant activity EXCEPT: (p


17)

A. Ca
General pathology 2008-2009
Compiled by Bhupinder Bawa
B. Fe
C. Cu
D. Glutathione
E. Ascorbic acid

Answer: A

Which of the following statements regarding Apaf-1 is correct? (p 30)

A. It directly inhibits caspase-9.


B. It is an anti-apoptotic factor.
C. It may be directly inhibited by Bcl-2/Bcl-x.
D. It inhibits cytochrome c role in activating of caspase-9.
E. It is a mitochondrial protein that enters to the cytoplasm.

Answer: C

Regarding the role of calcium ion in cell injury, all of the following enzymes are
activated by Ca++ EXCEPT: (p 15-16)

A. ATPase
B. Phospholipase
C. Peroxidase
D. Protease
E. Endonuclease

Answer: C

Which of the following proteins can inhibit the extrinsic pathway of apoptosis and what
is the mechanism of inhibition? (p 28-29)

A. FADD, binds to caspase 8


B. FLIP, binds to pro-caspase 9
C. FasL, binds to caspase 8
D. FLIP, binds to pro-caspase 8
E. FADD, binds to pro-caspase 9

Answer: D

Metastatic calcification may occur in all of the following pathologic states EXCEPT: (p.
41-42)

A. Multiple myeloma
General pathology 2008-2009
Compiled by Bhupinder Bawa
B. Advanced atherosclerosis
C. Sarcoidosis
D. Vit.D toxicosis
E. Renal failure
Answer: B

Activation of which of the following chiefly leads to cell death in the unfolded protein
response:

A. Bax
B. Fas ligand
C. Caspase 10
D. Caspase 12
E. TNF receptor

(Answer D ref. page 38)

Ubiquitin is a: (p 38)

A. Proteasome
B. Phospholipase
C. Intracellular lipid
D. Heat-shock protein
E. Accumulated glycogen

Answer: D

Which of the following is not consistent with dystrophic calcification?

A. occurs in normal tissues


B. normal serum calcium levels
C. occurs locally in dying tissues
D. has initiation and propagation phases
E. no derangements in calcium metabolism

Answer: A pg 41

Increased cell activity leads to:


A) euplasia
B) proplasia
C) retroplasia
D) metaplasia
E) hyperplasia

Answer: B (euplasia is normal activity; retroplasia is decreased activity)


General pathology 2008-2009
Compiled by Bhupinder Bawa
Which vitamin deficiency can cause squamous metaplasia? (p. 10)
A) vitamin A
B) vitamin C
C) vitamin D
D) vitamin E
E) vitamin K

Answer: A

Robbins Chap. 1 p. 14-26


Mitochondrial injury leads to all of the following except: (p. 15-18)
A) protease activation
B) decreased ATP production
C) accumulation of free fatty acids
D) decreased phospholipid synthesis
E) increased cytosolic cytochrome c

Answer: A

Robbins Chap. 1 p. 26-34


Which one of the following is not a feature of physiologic apoptosis?
A) cell shrinkage
B) chromatin condensation
C) loss of cell membrane integrity
D) degradation of nuclear proteins
E) clearance of the cells by phagocytosis

Answer: C

Robbins Chap. 1 p. 34-44


All of the following are structural changes that can accompany cellular aging except: (p.
42)
F) lipid accumulation
G) lipofuscin accumulation
H) abnormally lobed nuclei
I) decreased endoplasmic reticulum
J) accumulation of abnormally folded proteins

Answer: A

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