Dukes PATHOMA Deck Questions and Answers 100%
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What is metaplasia? Correct Ans-A change in cell type , most commonly involving surface
epithelium (changing to a type more suitable to handle the change in stress)
Describe the metaplastic process observed in Barrett esophagus:; Correct Ans-Change
from non-keratinizing stratified squamous (handles friction of food bolus) to non-ciliated
columnar with goblet cells (better for handling acid). <img src="paste-33870112096259.jpg"
/>
How does metaplasia occur? Correct Ans-Reprogramming of stem cells
Is metaplasia reversible? Correct Ans-Yes, in theory, with the removal of the stressor.
How do you treat Barrett esophagus? Correct Ans-Remove the stressor, i.e. treat the acid
reflux
Are we concerned about metaplastic processes? Correct Ans-Yes - metaplasia can progress
to dysplasia and eventually cancer
, Dukes PATHOMA Deck Questions and Answers 100%
Pass
Does all metaplasia lead to cancer? Can you name a metaplastic process that has 0% chance
of causing cancer? Correct Ans-Though most types of metaplasias can theoretically
progress to cancer (e.g. Barrett esophagus->adenocarcinoma), many do not. ; Apocrine
metaplasia of breast ;has no propensity for malignant transformation
What processes is vitamin A essential for? Correct Ans-It's necessary for differentiation of
specialized epithelial surfaces (e.g. conjunctiva), and essential for the maturation of certain
immune cells (such as neutrophils).; *Note: also helps reduce mortality in measles
Describe the pathological effects of vitamin A deficiency:; Correct Ans-Deficiency of
vitamin A results in metaplastic ; specialized epithelium . For example, the squamous
epithelium of the conjunctiva undergoes metaplasia into stratified keratinizing squamous
epithelium . This is keratomalacia . Vitamin A is also important for maturation of immune
cells. Remember that retinoic acid (vitmain A derivative) is important for neutrophil
maturation (remember, ATRA is used to treat APL).; <img src="paste-35815732281347.jpg" />
What is myositis ossificans? Correct Ans-Inflammation of the skeletal muscle induces
metaplastic change in the connective tissue of the muscle to produce bone.; *Note: it's
, Dukes PATHOMA Deck Questions and Answers 100%
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clinically important to differentiate this process from osteosarcoma. myositis ossificans is
clearly detached from bone on imaging. osteosarcoma would not be.; <img src="paste-
36790689857539.jpg" />
An increase in stress on an organ leads to? Correct Ans-An increase in organ size by
hypertrophy or hyperplasia .
By what three general processes does cellular hypertrophy occur? Correct Ans-Gene
activation; Increased Protein synthesis Increased production of organelles.
By what general mechanism does hyperplasia occur? Correct Ans-Production of new cells
from stem cells.
Is the pregnant uterus an example of hypertrophy or hyperplasia? Correct Ans-Both
What is a permanent tissue? Can a permanent tissue grow? What are the (3) permanent
tissues? Correct Ans-A permanent tissue is one that cannot make new cells (no lingering
, Dukes PATHOMA Deck Questions and Answers 100%
Pass
stem cells/progenitors).; Permanent tissues can only grow by hypertrophy. Skeletal muscle,
cardiac muscle, and nerve.
How does the heart respond to persistent hypertension? What are the two basic types of
cardiac hypertrophy and what causes them?; Correct Ans-Being a permanent tissue, it
grows via hypertrophy . Pressure overload ' concentric hypertrophy (sarcomeres added in
parallel. HCM) Volume overload ' eccentric hypertrophy (sarcomeres added in sequence.
DCM)
What concern exists with endometrial hyperplasia? What hyperplastic process doesn't carry
this same concern? Correct Ans-As a general rule: pathologic hyperplasias increase risk for
cancer.; Endometrial hyperplasia is a pathologic hyperplasia (caused by excess estrogen
secretion) that carries a risk for progression to dysplasia and eventually cancer. BPH is a type
of pathologic hyperplasia does not increase the risk for cancer ;(is an exception to the rule);
What are three examples of "decreases in stress" that lead to atrophy? Correct Ans-
Decreased hormonal stimulation (breast atrophy); Disuse (muscle atrophy); Decreased
nutrient/blood supply (kidney atrophy)
Pass
What is metaplasia? Correct Ans-A change in cell type , most commonly involving surface
epithelium (changing to a type more suitable to handle the change in stress)
Describe the metaplastic process observed in Barrett esophagus:; Correct Ans-Change
from non-keratinizing stratified squamous (handles friction of food bolus) to non-ciliated
columnar with goblet cells (better for handling acid). <img src="paste-33870112096259.jpg"
/>
How does metaplasia occur? Correct Ans-Reprogramming of stem cells
Is metaplasia reversible? Correct Ans-Yes, in theory, with the removal of the stressor.
How do you treat Barrett esophagus? Correct Ans-Remove the stressor, i.e. treat the acid
reflux
Are we concerned about metaplastic processes? Correct Ans-Yes - metaplasia can progress
to dysplasia and eventually cancer
, Dukes PATHOMA Deck Questions and Answers 100%
Pass
Does all metaplasia lead to cancer? Can you name a metaplastic process that has 0% chance
of causing cancer? Correct Ans-Though most types of metaplasias can theoretically
progress to cancer (e.g. Barrett esophagus->adenocarcinoma), many do not. ; Apocrine
metaplasia of breast ;has no propensity for malignant transformation
What processes is vitamin A essential for? Correct Ans-It's necessary for differentiation of
specialized epithelial surfaces (e.g. conjunctiva), and essential for the maturation of certain
immune cells (such as neutrophils).; *Note: also helps reduce mortality in measles
Describe the pathological effects of vitamin A deficiency:; Correct Ans-Deficiency of
vitamin A results in metaplastic ; specialized epithelium . For example, the squamous
epithelium of the conjunctiva undergoes metaplasia into stratified keratinizing squamous
epithelium . This is keratomalacia . Vitamin A is also important for maturation of immune
cells. Remember that retinoic acid (vitmain A derivative) is important for neutrophil
maturation (remember, ATRA is used to treat APL).; <img src="paste-35815732281347.jpg" />
What is myositis ossificans? Correct Ans-Inflammation of the skeletal muscle induces
metaplastic change in the connective tissue of the muscle to produce bone.; *Note: it's
, Dukes PATHOMA Deck Questions and Answers 100%
Pass
clinically important to differentiate this process from osteosarcoma. myositis ossificans is
clearly detached from bone on imaging. osteosarcoma would not be.; <img src="paste-
36790689857539.jpg" />
An increase in stress on an organ leads to? Correct Ans-An increase in organ size by
hypertrophy or hyperplasia .
By what three general processes does cellular hypertrophy occur? Correct Ans-Gene
activation; Increased Protein synthesis Increased production of organelles.
By what general mechanism does hyperplasia occur? Correct Ans-Production of new cells
from stem cells.
Is the pregnant uterus an example of hypertrophy or hyperplasia? Correct Ans-Both
What is a permanent tissue? Can a permanent tissue grow? What are the (3) permanent
tissues? Correct Ans-A permanent tissue is one that cannot make new cells (no lingering
, Dukes PATHOMA Deck Questions and Answers 100%
Pass
stem cells/progenitors).; Permanent tissues can only grow by hypertrophy. Skeletal muscle,
cardiac muscle, and nerve.
How does the heart respond to persistent hypertension? What are the two basic types of
cardiac hypertrophy and what causes them?; Correct Ans-Being a permanent tissue, it
grows via hypertrophy . Pressure overload ' concentric hypertrophy (sarcomeres added in
parallel. HCM) Volume overload ' eccentric hypertrophy (sarcomeres added in sequence.
DCM)
What concern exists with endometrial hyperplasia? What hyperplastic process doesn't carry
this same concern? Correct Ans-As a general rule: pathologic hyperplasias increase risk for
cancer.; Endometrial hyperplasia is a pathologic hyperplasia (caused by excess estrogen
secretion) that carries a risk for progression to dysplasia and eventually cancer. BPH is a type
of pathologic hyperplasia does not increase the risk for cancer ;(is an exception to the rule);
What are three examples of "decreases in stress" that lead to atrophy? Correct Ans-
Decreased hormonal stimulation (breast atrophy); Disuse (muscle atrophy); Decreased
nutrient/blood supply (kidney atrophy)
