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A. TNF-α
B. Endothelin-1
C. Angiotensin II
D. replacement of α myosin with β myosin
E. Increased expression of atrial natriuretic factor
A. TNF
B. Insulin
C. Lysosomes
D. Glucocorticoids
E. Thyroid hormone
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
A. 1, 2, 5
B. 1, 3, 5
General pathology 2008-2009
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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. Atrophy
B. Hypertrophy
C. Hyperplasia
D. a&b
E. b&c
A. Chronic irritation
B. Loss of innervation
C. Decreased workload
D. Dimished blood supply
E. Loss of endocrine stimulation
A. 1, 2, 3
B. 1, 2, 3, 4
C. 2, 3, 4, 5
D. 2, 3, 5
E. 3, 4, 5
A. Increased workload
B. Loss of innervation
C. Inadequate nutrition
D. Diminished blood supply
E. Increased endocrine stimulation
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
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
17. RER (rough endoplasmic reticulum) is high in cells that produce large amounts of
extracellular proteins such as
20. The increase in tissue mass via the process of hyperplasia is always achieved by
23. All the following are true about increased intracellular free calcium ions except:
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
a. Heart
b. Liver
c. Brain
d. Muscle
e. Kideny
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
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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
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
A. Coagulative necrosis
B. Caseation necrosis
C. Liquefactive necrosis
D. Gangrene
E. Fat necrosis
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
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
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C. Activation of complement pathway
D. Promotion of mitochondrial permeability transition
E. Compromised cellular antioxidant defense mechanisms
42. What are the two main anti-apoptotic in the Bcl-2 family are
43. What are the two caspases that serves as initiators in the initiation phase of apoptosis?
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
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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
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
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
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51. Which of the following is not likely to cause apoptosis of the normal cell:
A. Cell shrinkage
B. Condensed chromatin
C. Nuclear fragmentation
D. Formation of apoptotic bodies
E. High amplitude mitochondrial swelling
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
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
A. BAK
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B. IAP
C. AIF
D. APAF-1
E. Cytochrome –c
58.. CCL4 and protein malnutrition can lead to fatty liver due to?
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?
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
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E. Cholesterols
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
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
A. 1, 2, 3, 4, 5
B. 1, 3, 5
C. 2, 3, 4, 5
D. 2, 4, 5
E. 3, 5
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
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
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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
75. Which DNA virus produces large distinct eosinophilic intracytoplasmic inclusion bodies
A. Herpesviruses
B. Adenoviruses
C. Parvoviruses
D. Pox viruses
E. All the above
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
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
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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
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
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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
Answer: B p14
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
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6. True or False- Lipid peroxidation can lead to lipidosis?
A. 1
B. 1,2
C. 2,3,4
D. 3,4
E. None of the above
Answer: A p20
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
Answer A p6
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
A. 1,2,3
B. 1,2,4
C. 2,3
D. 2,3,4,5
E. 3,4
Answer: D p 10
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
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
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
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
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
A. 1,2
B. 2,3
C. 3,4
D. 4,5
E. All of the above
Answer: E p14
A. 1,2,3,4,5
B. 1,2,3
C. 1,3
D. 3,4,5
E. 4,5
Answer: A p 15
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
Answer: E p15-16
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.
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
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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
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
A) BAX
B) BCL-2
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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
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
A. 1,2
B. 2,3,4
C. 2,4,5
D. 3,4,5
E. All of the above
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
Answer E p19-20
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
Answer: A p21
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
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
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
Answer: A p27
Answer; B p29
Answer D. p29
45. When BCL-2 and BCL-x are replaced by BAK BAX and BIM which of the
following occurs:
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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
Answer: D p30
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
Answer: D p31
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
Answer: D p 32
Answer: A p33
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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
Answer: E p36
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
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
Answer: B p43
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
Answer. B Robbins, pg 27
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
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
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
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
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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:
A) 1, 3, 4, 5
B) 1, 2, 4, 5
C) 1, 2, 3, 5
D) 1, 2, 3, 4, 5
Answer: C
Answer: D
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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
Answer: B
1) Hemosiderin
2) Bilirubin
3) Hemoglobin
4) Biliverdin Robbins p 40
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A) 1, 2, 3, 4
B) 3, 2, 4, 1
C) 3, 4, 2, 1
D) 3, 1, 2, 4
Answer: C
Answer: E
A. 1,2,3
B. 2
C. 1,2
D. 1,4
E. None
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Answer: B
Q1. All of the following is true about autophagic cell death EXCEPT ?
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
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)
A. 1,2,3
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B. 1,3,4,5
C. 1,3,4
D. 3,4,5
E. 2,5
Answer: C
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)
Answer: B
Q. During acute inflammation vascular leakage at arterioles takes place due to? (Robbins
pp 51-52)
A. 1,2,3,4
B. 2,3,4
C. 2,3
D. 1,4
E. 2
Answer: E
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 ?
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)
Answer: E
1. DAF
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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
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
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
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E) Increased mitochondrial permeability
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
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
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A) Apaf-1
B) Fas protein
C) Cytochrome C
D) Withdrawal of growth factors
E) Mitochondrial permeability transition
Answer: B, Page34-35
A. Stretch
B. Angiotensin II
C. α-adrenergic agonists
D. Atrial natriuretic factor
E. Insulin-like growth factor 1
Which base does react with oxygen free radicals to produce single-stranded breaks in
DNA?
a. Adenine
b. Cytosine
c. Guanine
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d. Thymine
e. Uracil
a. 1,2,4
b. 1,3,5
c. 2,3,5
d. 2,4,5
e. 3,4,5
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
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
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
Page 14-23
Which among the following are NOT features of reversible cell injury?
1- Nuclear pyknosis
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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
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
A) Bak
B) Bax
C) Bcl-2
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D) Apaf-1
E) Cytochrome C
Robbins Ch1
(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
(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
(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
(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
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
Which of the following may result from ATP depletion in the case of ischemia?
A. 1,3,4
B. 1,3,5
C. 2,3,5
D. 2,4,5
E. 3,4,5
Answer: C pg. 16
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
a. Caspase 6
b. Caspase 8
c. Caspase 9
d. Caspase 10
e. Caspase 12
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a. Caspase 3
b. Caspase 6
c. Caspase 7
d. Caspase 9
e. Caspase 12
a. Bax
b. Bak
c. Bid
d. Bim
e. Bcl-X
a. 1, 2
b. 1, 5
c. 2, 3
d. 3, 4
e. 4, 5
Which of the following brown pigment granules represent undigested material derived
from intracellular lipid peroxidation?
a. Hemosiderin
b. Lipofuscin
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c. Melanin
d. Copper
e. Bile
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
a. Fatty liver
b. Xanthomas
c. Cholesterolosis
d. Atherosclerosis
e. Niemann-Pick disease, type C
Which of the following is the unfolded protein response that reduces the levels of
misfolded proteins in the cell?
Answer: B page 5
A) 1,2
B) 1,3
C) 2,3
D) 2,4
E) 3,5
Answer: C page 10
Answer: B pg 41
Answer: E pg 39-41
Answer: E pg 50-52
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
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
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
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D. Factor XII
E. Bradykinin
Answer: B pg 65
Robbins Ch 1
Answer: B page 5
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
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
A. Efflux of K+
B. Influx of Na+
C. Influx of Ca2+
D. Decreased pH
E. Leakage of H+ by mitochondria
A. 2H2O2 O2 + 2H2O
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B. 2O2- + 2H H2O2 + O2
C. 2OH + 2GSH GSSG + 2H2O
D. H2O2 + 2GSH GSSG + 2H2O
E. H2O2 + Fe2+ Fe3+ + OH + OH-
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
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
A. pathologic
B. cell swelling
C. fragmented nucleus
D. disrupted plasma membrane
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E. frequent adjacent inflammation
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
A. Bak
B. Bax
C. Bim
D. AIF
E. Bcl-2
Answer: E pg 28-30
A. IL-1
B. TNF
C. Insulin
D. Glucocorticoids
E. Thyroid hormone
Answer: C
A. Ca
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B. Fe
C. Cu
D. Glutathione
E. Ascorbic acid
Answer: A
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)
Answer: D
Metastatic calcification may occur in all of the following pathologic states EXCEPT: (p.
41-42)
A. Multiple myeloma
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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
Ubiquitin is a: (p 38)
A. Proteasome
B. Phospholipase
C. Intracellular lipid
D. Heat-shock protein
E. Accumulated glycogen
Answer: D
Answer: A pg 41
Answer: A
Answer: A
Answer: C
Answer: A