Complete Pathoma Exam Study Guide
Comprehensive 100% Verified Study
Guide
Latest Updated 2024/2025
________ involves gene activation, protein synthesis, and production of organelles while
_________ involves the production of new cells from stem cells. - ansHypertrophy
Hyperplasia
*these two usually occur together (e.g. uterus during pregnancy)
Permanent tissues (such as cardiac m., nerve, and skeletal m.) cannot undergo _________ so it's
only option is to undergo _________. - anshyperplasia
hypertrophy
Study the image: - ans
What kind of growth adaptation is occurring here and in what type of tissue? - ansHypertrophy
of cardiac myocytes in left ventricle (cardiac myocytes undergo hypertrophy not hyperplasia in
response to systemic hypertension)
Pathologic __________ can progress to dysplasia and eventually cancer. What is a notable
exception to this? - anshyperplasia
*exception: benign prostatic hyperplasia (BPH) which does not increase the risk for prostate
cancer
Atrophy is a response to a decrease in stress which leads to a decrease in organ size by a
decrease in ____ and____ of cells. - anssize and number
Decrease in cell size occurs how? - ansupiquitin-proteosome degradation of the cytoskeleton and
autophagy of cellular components.
Decrease in cell number occurs by __________. - ansapoptosis
A change in stress on an organ leads to _________. - ansmetaplasia (a change in cell type)
-the metaplastic cells are better able to handle the new stress
Study the image: - ans
What kind of growth adaptation do you see here? What is this called? - ansThis is an example of
metaplasia in Barrett's Esophagus. Note the squamous epithelium on the left and how it changes
to columnar epithelium as you progress to the right. Note the goblet cells in the columnar
epithelium portion.
Describe how Barrett's esophagus is a classic example of metaplasia - ansEsophagus is normally
lined by nonkeratinizing squamous epithelium, but with acid reflux from the stomach metaplasia
occurs to non ciliated, mucin-producing columnar cells.
T/F: Metaplasia is reversible with removal of the driving stressor - ansTRUE
Study the image: - ans
What is this condition called and what is it caused by? - ansKeratomalacia caused by vitamin A
deficiency
In vitamin A deficiency, the thin _________ lining of the conjunctiva undergoes metaplasia into
___________ ___________ __________ epithelium. What is this change called? - anssquamous
,Complete Pathoma Exam Study Guide
Comprehensive 100% Verified Study
Guide
Latest Updated 2024/2025
stratified keratinizing squamous
Keratomalacia
Study the image: - ans
What is the pathology? What other condition could this be confused with and what are the
distinguishing features that rule it out? - ansMyositis ossificans which is a type of metaplasia in
which muscle tissue changes to bone during healing after trauma.
-this could be confused with an osteosarcoma but note that the bone adjacent to the mass is
normal and there is a distinct separation between the mass and the bone, implying it is not
growing off the bone (in osteosarcoma, the mass will be growing from the bone)
What kind of growth adaptation does cervical intraepithelial neoplasia (CIN) represent? What is
it a precursor for? Is it reversible? - ansdysplasia
precursor to cervical cancer
*dysplasia is reversible with alleviation of inciting stress
_____ is failure of cell production during embryogenesis and _______ is a decrease in cell
production during embryogenesis, resulting in a small organ. Give an example of both. -
ansaplasia (e.g. unilateral renal agenesis)
hypoplasia (e.g. streak ovary in Turner's syndrome)
Slow developing ischemia results in _________ while acute ischemia results in _______. give an
example of each. - ansatrophy (renal artery atherosclerosis)
injury (renal artery embolus)
Low oxygen delivery to tissues (______) is an important cause of cell injury because ______ is
the final electron acceptor in the electron transport chain, so a decrease in this would impair
_____________, resulting in decreased _____ production. - anshypoxia
oxygen
oxidative phosphorylation
ATP
What are the 3 main causes of hypoxia? - ans1. ischemia
2. hypoxemia
3. decreased O2 carrying capacity of blood
Ischemia is decreased blood flow through an organ and arises with decreased arterial perfusion
(e.g. _________), decreased venous drainage (e.g. ________), or shock. - ansatherosclerosis
Budd-Chiari syndrome (thrombosis of hepatic vein causing infarction of the liver)
Hypoxemia is defined as low partial pressure of O2 in the blood (PaO2 < ______, SaO2
<______) - ans60 mmHg
90%
,Complete Pathoma Exam Study Guide
Comprehensive 100% Verified Study
Guide
Latest Updated 2024/2025
If a patient came in after being exposed to excessive smoke from fires, having a cherry-red
appearance of skin and complaining of a headache, what should you suspect? - anscarbon
monoxide poisoning
What is the difference between anemia and carbon monoxide poisoning in terms of arterial blood
gases? - ansPaO2 is normal in both anemia and carbon monoxide poisoning.
SaO2 is decreased in CO poisoning and normal in anemia.
Which decreased O2-carrying capacity condition is characterized by chocolate colored blood?
What is the treatment? - ansMethemoglobinemia where iron in heme is oxidized to Fe3+
(normally Fe2+ binds O2), so it can no longer bind O2. PaO2 is normal while SaO2 is decreased.
Seen with oxidative stress (e.g. sulfa or nitrate drugs) or in newborns.
-treatment with methylene blue, which helps to reduce Fe3+ back to Fe2+ state.
Hypoxia impairs_________, which results in decreased production of _________; this is
necessary for function of ___________ - ansOxidative Phosphorylation
ATP -- necessary for Na/K Pump
What is the hallmark of REVERSIBLE cellular injury? - ansCellular swelling
-cytosol swelling results in the loss of microvilli and membrane blebbing
-swelling of the RER results in dissociation of ribosomes and decreased protein synthesis.
What is the hallmark of IRREVERSIBLE cellular injury? - ansMembrane damage
-cytosolic enzymes leak into serum (e.g. cardiac troponin)
-additional Ca2+ enters the cell
-loss of electron transport chain in inner mitochondrial membrane
-cytochrome C leaks into cytosol, activating apoptosis pathway
-lysosomes leak into cytosol
end result of irreversible injury = CELL DEATH
What is the morphologic feature of cell death? What are the two mechanisms of cell death? -
ansLOSS OF NUCLEUS (pyknosis - nucleus shrinks down, karyorrhexis - nucleus
fragmentation, karyolysis - dissolution, nuclear fragments further breakdown)
two mechanisms of cell death are necrosis and apoptosis
Necrosis = murder
Apoptosis = cellular suicide
Necrosis is follow by _____. It is never a physiologic process, it is always ______. - ansAcute
inflammation
Pathologic
, Complete Pathoma Exam Study Guide
Comprehensive 100% Verified Study
Guide
Latest Updated 2024/2025
___________ necrosis is seen with ischemic infarction of any organ except for _______. -
anscoagulative
brain
In coagulative necrosis, the area of infarcted/occluded tissue is often __________ and _______. -
answedge-shaped (pointing to vascular occlusion)
pale
Study the image: - ans
What is the difference between the picture on the L and R? What kind of necrosis is seen here? -
ansThe picture on the right is of normal renal histology. All the nuclei are within the cells and
the structure is maintained. On the left, there is no nuclei seen but all the membranes are still
intact so that you can still tell this is a kidney histology slide. This is an example of
COAGULATIVE necrosis.
Study the image: - ans
What is shown here? - ansThis is an image of a testicle that has undergone hemorrhagic/Red
infarction. This occurs if blood re-enters loosely organized tissue.
Liquefactive necrosis is characteristic of _____, ____, and ______. - ans1. brain infarction
(proteolytic enzymes from MICROGLIAL cells liquefy the brain)
2. abscess (proteolytic enzymes from NEUTROPHILS liquefy tissue)
3. pancreatitis (proteolytic enzymes form pancreas liquefy parenchyma)
Study the image: - ans
What kind of necrosis is seen here? - ansGangrenous necrosis (dry gangrene) which is a type of
coagulative necrosis that resembles mummified tissue, characteristic of ischemia in the lower
limb and GI tract.
-if superimposed infection of dead tissue occurs, then liquefactive necrosis ensues (wet
gangrene). You can see some wet gangrene in this image by the toes.
Study the image: - ans
What kind of necrosis is seen here? What type of conditions is this type characteristic of? -
ansCaseous necrosis, which is a combination of coagulative and liquefactive. It is soft and friable
tissue with "cottage-cheese" like appearance. This type of necrosis is characteristic of
granulomatous inflammation due to TB or fungal infection.
Study the image: - ans
What kind of necrosis is shown here? - ansFat necrosis of peri-pancreatic adipose tissue
(remember, liquefactive necrosis is what occurs in the actual pancreas)
-necrotic adipose tissue with chalky-white appearance due to calcification
-fat necrosis occurs when there is trauma to fat or with pancreatitis-mediated damage of
peripancreatic fat (as shown in the last image)
Comprehensive 100% Verified Study
Guide
Latest Updated 2024/2025
________ involves gene activation, protein synthesis, and production of organelles while
_________ involves the production of new cells from stem cells. - ansHypertrophy
Hyperplasia
*these two usually occur together (e.g. uterus during pregnancy)
Permanent tissues (such as cardiac m., nerve, and skeletal m.) cannot undergo _________ so it's
only option is to undergo _________. - anshyperplasia
hypertrophy
Study the image: - ans
What kind of growth adaptation is occurring here and in what type of tissue? - ansHypertrophy
of cardiac myocytes in left ventricle (cardiac myocytes undergo hypertrophy not hyperplasia in
response to systemic hypertension)
Pathologic __________ can progress to dysplasia and eventually cancer. What is a notable
exception to this? - anshyperplasia
*exception: benign prostatic hyperplasia (BPH) which does not increase the risk for prostate
cancer
Atrophy is a response to a decrease in stress which leads to a decrease in organ size by a
decrease in ____ and____ of cells. - anssize and number
Decrease in cell size occurs how? - ansupiquitin-proteosome degradation of the cytoskeleton and
autophagy of cellular components.
Decrease in cell number occurs by __________. - ansapoptosis
A change in stress on an organ leads to _________. - ansmetaplasia (a change in cell type)
-the metaplastic cells are better able to handle the new stress
Study the image: - ans
What kind of growth adaptation do you see here? What is this called? - ansThis is an example of
metaplasia in Barrett's Esophagus. Note the squamous epithelium on the left and how it changes
to columnar epithelium as you progress to the right. Note the goblet cells in the columnar
epithelium portion.
Describe how Barrett's esophagus is a classic example of metaplasia - ansEsophagus is normally
lined by nonkeratinizing squamous epithelium, but with acid reflux from the stomach metaplasia
occurs to non ciliated, mucin-producing columnar cells.
T/F: Metaplasia is reversible with removal of the driving stressor - ansTRUE
Study the image: - ans
What is this condition called and what is it caused by? - ansKeratomalacia caused by vitamin A
deficiency
In vitamin A deficiency, the thin _________ lining of the conjunctiva undergoes metaplasia into
___________ ___________ __________ epithelium. What is this change called? - anssquamous
,Complete Pathoma Exam Study Guide
Comprehensive 100% Verified Study
Guide
Latest Updated 2024/2025
stratified keratinizing squamous
Keratomalacia
Study the image: - ans
What is the pathology? What other condition could this be confused with and what are the
distinguishing features that rule it out? - ansMyositis ossificans which is a type of metaplasia in
which muscle tissue changes to bone during healing after trauma.
-this could be confused with an osteosarcoma but note that the bone adjacent to the mass is
normal and there is a distinct separation between the mass and the bone, implying it is not
growing off the bone (in osteosarcoma, the mass will be growing from the bone)
What kind of growth adaptation does cervical intraepithelial neoplasia (CIN) represent? What is
it a precursor for? Is it reversible? - ansdysplasia
precursor to cervical cancer
*dysplasia is reversible with alleviation of inciting stress
_____ is failure of cell production during embryogenesis and _______ is a decrease in cell
production during embryogenesis, resulting in a small organ. Give an example of both. -
ansaplasia (e.g. unilateral renal agenesis)
hypoplasia (e.g. streak ovary in Turner's syndrome)
Slow developing ischemia results in _________ while acute ischemia results in _______. give an
example of each. - ansatrophy (renal artery atherosclerosis)
injury (renal artery embolus)
Low oxygen delivery to tissues (______) is an important cause of cell injury because ______ is
the final electron acceptor in the electron transport chain, so a decrease in this would impair
_____________, resulting in decreased _____ production. - anshypoxia
oxygen
oxidative phosphorylation
ATP
What are the 3 main causes of hypoxia? - ans1. ischemia
2. hypoxemia
3. decreased O2 carrying capacity of blood
Ischemia is decreased blood flow through an organ and arises with decreased arterial perfusion
(e.g. _________), decreased venous drainage (e.g. ________), or shock. - ansatherosclerosis
Budd-Chiari syndrome (thrombosis of hepatic vein causing infarction of the liver)
Hypoxemia is defined as low partial pressure of O2 in the blood (PaO2 < ______, SaO2
<______) - ans60 mmHg
90%
,Complete Pathoma Exam Study Guide
Comprehensive 100% Verified Study
Guide
Latest Updated 2024/2025
If a patient came in after being exposed to excessive smoke from fires, having a cherry-red
appearance of skin and complaining of a headache, what should you suspect? - anscarbon
monoxide poisoning
What is the difference between anemia and carbon monoxide poisoning in terms of arterial blood
gases? - ansPaO2 is normal in both anemia and carbon monoxide poisoning.
SaO2 is decreased in CO poisoning and normal in anemia.
Which decreased O2-carrying capacity condition is characterized by chocolate colored blood?
What is the treatment? - ansMethemoglobinemia where iron in heme is oxidized to Fe3+
(normally Fe2+ binds O2), so it can no longer bind O2. PaO2 is normal while SaO2 is decreased.
Seen with oxidative stress (e.g. sulfa or nitrate drugs) or in newborns.
-treatment with methylene blue, which helps to reduce Fe3+ back to Fe2+ state.
Hypoxia impairs_________, which results in decreased production of _________; this is
necessary for function of ___________ - ansOxidative Phosphorylation
ATP -- necessary for Na/K Pump
What is the hallmark of REVERSIBLE cellular injury? - ansCellular swelling
-cytosol swelling results in the loss of microvilli and membrane blebbing
-swelling of the RER results in dissociation of ribosomes and decreased protein synthesis.
What is the hallmark of IRREVERSIBLE cellular injury? - ansMembrane damage
-cytosolic enzymes leak into serum (e.g. cardiac troponin)
-additional Ca2+ enters the cell
-loss of electron transport chain in inner mitochondrial membrane
-cytochrome C leaks into cytosol, activating apoptosis pathway
-lysosomes leak into cytosol
end result of irreversible injury = CELL DEATH
What is the morphologic feature of cell death? What are the two mechanisms of cell death? -
ansLOSS OF NUCLEUS (pyknosis - nucleus shrinks down, karyorrhexis - nucleus
fragmentation, karyolysis - dissolution, nuclear fragments further breakdown)
two mechanisms of cell death are necrosis and apoptosis
Necrosis = murder
Apoptosis = cellular suicide
Necrosis is follow by _____. It is never a physiologic process, it is always ______. - ansAcute
inflammation
Pathologic
, Complete Pathoma Exam Study Guide
Comprehensive 100% Verified Study
Guide
Latest Updated 2024/2025
___________ necrosis is seen with ischemic infarction of any organ except for _______. -
anscoagulative
brain
In coagulative necrosis, the area of infarcted/occluded tissue is often __________ and _______. -
answedge-shaped (pointing to vascular occlusion)
pale
Study the image: - ans
What is the difference between the picture on the L and R? What kind of necrosis is seen here? -
ansThe picture on the right is of normal renal histology. All the nuclei are within the cells and
the structure is maintained. On the left, there is no nuclei seen but all the membranes are still
intact so that you can still tell this is a kidney histology slide. This is an example of
COAGULATIVE necrosis.
Study the image: - ans
What is shown here? - ansThis is an image of a testicle that has undergone hemorrhagic/Red
infarction. This occurs if blood re-enters loosely organized tissue.
Liquefactive necrosis is characteristic of _____, ____, and ______. - ans1. brain infarction
(proteolytic enzymes from MICROGLIAL cells liquefy the brain)
2. abscess (proteolytic enzymes from NEUTROPHILS liquefy tissue)
3. pancreatitis (proteolytic enzymes form pancreas liquefy parenchyma)
Study the image: - ans
What kind of necrosis is seen here? - ansGangrenous necrosis (dry gangrene) which is a type of
coagulative necrosis that resembles mummified tissue, characteristic of ischemia in the lower
limb and GI tract.
-if superimposed infection of dead tissue occurs, then liquefactive necrosis ensues (wet
gangrene). You can see some wet gangrene in this image by the toes.
Study the image: - ans
What kind of necrosis is seen here? What type of conditions is this type characteristic of? -
ansCaseous necrosis, which is a combination of coagulative and liquefactive. It is soft and friable
tissue with "cottage-cheese" like appearance. This type of necrosis is characteristic of
granulomatous inflammation due to TB or fungal infection.
Study the image: - ans
What kind of necrosis is shown here? - ansFat necrosis of peri-pancreatic adipose tissue
(remember, liquefactive necrosis is what occurs in the actual pancreas)
-necrotic adipose tissue with chalky-white appearance due to calcification
-fat necrosis occurs when there is trauma to fat or with pancreatitis-mediated damage of
peripancreatic fat (as shown in the last image)
