FOM - ACTUAL Exam 2 QEUSTIONS AND CORRECT
ANSWERS LATEST UPDATE 2024-2025 |PREMIUM
GRADING A++
A 45-year-old with a long history of alcoholism presents with severe epigastric pain, nausea,
vomiting, fever, and an increase in serum amylase. During a previous hospitalization for a similar
episode, computed tomography (CT) scanning demonstrated calcifications in the pancreas. A
diagnosis of acute pancreatitis superimposed on chronic pancreatitis was made. In this condition,
which of the following types of necrosis is most characteristic?
A. Caseous
B. Coagulative
C. Enzymatic (fat)
D. Fibrinoid
E. Liquefactive - Correct Answer- C
Why are there calcifications in the injured pancreas?
A. Acute pancreatitis is associated with generalized (metastatic) hypercalcemia.
B. Fatty acids released by fat necrosis (causing lipolysis of triglycerides) bind calcium (to form
calcium soaps)
C. Osseous metaplasia of the pancreas is seen in chronic pancreatitis. - Correct Answer- B
A 53-year-old is investigated for hypertension and is found to have a left kidney that is smaller than
normal. Contrast studies reveal stenosis (narrowing) of the left renal artery. The size change in the
right kidney is an example of which of the following adaptive changes?
A. Atrophy
B. Hyperplasia
C. Hypertrophy
D. Metaplasia - Correct Answer- A
A 56-year-old experiences chest pain/angina following a workout in the gym. When evaluated in the
Emergency Department of a nearby hospital, a myocardial infarct is ruled out, and he is referred to a
cardiologist for management of angina that is reversed after medication. Had microscopic
,examination of the affected area of his heart been possible at the time of the event, which of the
following would be the most likely cellular change to be found?
A. Karyolysis
B. Karyorrhexis
C. Pyknosis
D. Swelling of the endoplasmic reticulum - Correct Answer- D
A 64-year-old presents with fever, chills, headache, neck stiffness, vomiting, and confusion.
Examination of the cerebrospinal fluid reveals changes consistent with bacterial meningitis, and
brain imaging demonstrates a localized abscess. Which of the following types of necrosis is most
characteristic of abscess formation?
A. Caseous
B. Coagulative
C. Enzymatic
D. Fibrinoid
E. Liquefactive - Correct Answer- E
A 54-year-old is referred because of skin hyperpigmentation, hepatic dysfunction, and diabetes
mellitus. A diagnosis of hereditary hemochromatosis is made. Accumulation of which of the
following substances causes damage to organs in this disorder?
A. Bilirubin
B. Iron
C. Lead
D. Lipofuscin
E. Melanin - Correct Answer- B
A 62-year-old dies 24 hours after the onset of substernal chest pain radiating down their left arm.
EKG and lab tests are consistent with myocardial infarct. Which of the following morphological
myocardial findings is an indicator of irreversible cellular injury?
A. Plasma membrane blebs
,B. Mitochondrial swelling
C. Nuclear fragmentation
D. Ribosomal disaggregation - Correct Answer- C
A 70-year-old presents with sudden onset of left-sided weakness, spasticity, and hyperactive
pathologic reflexes. A clinical diagnosis of stroke is made. The most serious consequences of this
disorder are the result of damage to which of the following cell types?
A. Labile cells
B. Multipotent adult progenitor cells
C. Permanent cells
D. Stable cells - Correct Answer- C
A 16-year-old sustained blunt trauma to the abdomen when the vehicle they were driving struck a
bridge abutment at high speed. Peritoneal lavage shows a hemoperitoneum, and at laparotomy, a
small portion of the left lobe of the liver is removed because of the injury. Several weeks later, a CT
scan of the abdomen shows that the liver has nearly regained its size before the injury. Which of the
following processes best explains this CT scan finding?
A. Apoptosis
B. Fatty change
C. Hydropic change
D. Hyperplasia
E. Hypertrophy
F. Metaplasia - Correct Answer- D
On a routine visit to the physician, an otherwise healthy 51-year-old has a blood pressure of 150/95
mm Hg (N120/80mm hg). If their hypertension remains untreated for years, which of the following
cellular alterations would most likely be seen in their myocardium?
A. Atrophy
B. Hyperplasia
C. Metaplasia
D. Hemosiderosis
, E. Hypertrophy - Correct Answer- E
A 72-year-old died suddenly from congestive heart failure. At autopsy, the heart weighed 580 g
(N=236-412 g) and showed marked left ventricular hypertrophy and minimal coronary arterial
atherosclerosis. A serum chemistry panel ordered before death showed no abnormalities. Which of
the following pathologic processes best accounts for the appearance of the aortic valve seen in the
figure below?
A. Dystrophic calcification
B. Lipofuscin deposition
C. Hemosiderosis
D. Fatty change - Correct Answer- A
In an experiment, cells are subjected to radiant energy in the form of x-rays. This results in cell
injury caused by hydrolysis of water. Which of the following cellular enzymes protects the cells from
this type of injury?
A. Phospholipase
B. Glutathione peroxidase
C. Endonuclease
D. Lactate dehydrogenase
E. Protease - Correct Answer- B
A 47-year-old has had worsening dyspnea for the past 5 years. A chest CT scan shows panlobular
emphysema. Laboratory studies show the PiZZ genotype of α1-antitrypsin (AAT) deficiency. A liver
biopsy specimen examined microscopically shows abundant PAS-positive globules within periportal
hepatocytes. Which of the following molecular mechanisms is most likely responsible for this finding
in the hepatocytes?
A. Excessive hepatic synthesis of AAT
B. Retention of poorly folded AAT in the endoplasmic reticulum
C. Decreased catabolism of AAT in lysosomes
D. Inability to metabolize AAT
E. Impaired dissociation of AAT from chaperones - Correct Answer- B
ANSWERS LATEST UPDATE 2024-2025 |PREMIUM
GRADING A++
A 45-year-old with a long history of alcoholism presents with severe epigastric pain, nausea,
vomiting, fever, and an increase in serum amylase. During a previous hospitalization for a similar
episode, computed tomography (CT) scanning demonstrated calcifications in the pancreas. A
diagnosis of acute pancreatitis superimposed on chronic pancreatitis was made. In this condition,
which of the following types of necrosis is most characteristic?
A. Caseous
B. Coagulative
C. Enzymatic (fat)
D. Fibrinoid
E. Liquefactive - Correct Answer- C
Why are there calcifications in the injured pancreas?
A. Acute pancreatitis is associated with generalized (metastatic) hypercalcemia.
B. Fatty acids released by fat necrosis (causing lipolysis of triglycerides) bind calcium (to form
calcium soaps)
C. Osseous metaplasia of the pancreas is seen in chronic pancreatitis. - Correct Answer- B
A 53-year-old is investigated for hypertension and is found to have a left kidney that is smaller than
normal. Contrast studies reveal stenosis (narrowing) of the left renal artery. The size change in the
right kidney is an example of which of the following adaptive changes?
A. Atrophy
B. Hyperplasia
C. Hypertrophy
D. Metaplasia - Correct Answer- A
A 56-year-old experiences chest pain/angina following a workout in the gym. When evaluated in the
Emergency Department of a nearby hospital, a myocardial infarct is ruled out, and he is referred to a
cardiologist for management of angina that is reversed after medication. Had microscopic
,examination of the affected area of his heart been possible at the time of the event, which of the
following would be the most likely cellular change to be found?
A. Karyolysis
B. Karyorrhexis
C. Pyknosis
D. Swelling of the endoplasmic reticulum - Correct Answer- D
A 64-year-old presents with fever, chills, headache, neck stiffness, vomiting, and confusion.
Examination of the cerebrospinal fluid reveals changes consistent with bacterial meningitis, and
brain imaging demonstrates a localized abscess. Which of the following types of necrosis is most
characteristic of abscess formation?
A. Caseous
B. Coagulative
C. Enzymatic
D. Fibrinoid
E. Liquefactive - Correct Answer- E
A 54-year-old is referred because of skin hyperpigmentation, hepatic dysfunction, and diabetes
mellitus. A diagnosis of hereditary hemochromatosis is made. Accumulation of which of the
following substances causes damage to organs in this disorder?
A. Bilirubin
B. Iron
C. Lead
D. Lipofuscin
E. Melanin - Correct Answer- B
A 62-year-old dies 24 hours after the onset of substernal chest pain radiating down their left arm.
EKG and lab tests are consistent with myocardial infarct. Which of the following morphological
myocardial findings is an indicator of irreversible cellular injury?
A. Plasma membrane blebs
,B. Mitochondrial swelling
C. Nuclear fragmentation
D. Ribosomal disaggregation - Correct Answer- C
A 70-year-old presents with sudden onset of left-sided weakness, spasticity, and hyperactive
pathologic reflexes. A clinical diagnosis of stroke is made. The most serious consequences of this
disorder are the result of damage to which of the following cell types?
A. Labile cells
B. Multipotent adult progenitor cells
C. Permanent cells
D. Stable cells - Correct Answer- C
A 16-year-old sustained blunt trauma to the abdomen when the vehicle they were driving struck a
bridge abutment at high speed. Peritoneal lavage shows a hemoperitoneum, and at laparotomy, a
small portion of the left lobe of the liver is removed because of the injury. Several weeks later, a CT
scan of the abdomen shows that the liver has nearly regained its size before the injury. Which of the
following processes best explains this CT scan finding?
A. Apoptosis
B. Fatty change
C. Hydropic change
D. Hyperplasia
E. Hypertrophy
F. Metaplasia - Correct Answer- D
On a routine visit to the physician, an otherwise healthy 51-year-old has a blood pressure of 150/95
mm Hg (N120/80mm hg). If their hypertension remains untreated for years, which of the following
cellular alterations would most likely be seen in their myocardium?
A. Atrophy
B. Hyperplasia
C. Metaplasia
D. Hemosiderosis
, E. Hypertrophy - Correct Answer- E
A 72-year-old died suddenly from congestive heart failure. At autopsy, the heart weighed 580 g
(N=236-412 g) and showed marked left ventricular hypertrophy and minimal coronary arterial
atherosclerosis. A serum chemistry panel ordered before death showed no abnormalities. Which of
the following pathologic processes best accounts for the appearance of the aortic valve seen in the
figure below?
A. Dystrophic calcification
B. Lipofuscin deposition
C. Hemosiderosis
D. Fatty change - Correct Answer- A
In an experiment, cells are subjected to radiant energy in the form of x-rays. This results in cell
injury caused by hydrolysis of water. Which of the following cellular enzymes protects the cells from
this type of injury?
A. Phospholipase
B. Glutathione peroxidase
C. Endonuclease
D. Lactate dehydrogenase
E. Protease - Correct Answer- B
A 47-year-old has had worsening dyspnea for the past 5 years. A chest CT scan shows panlobular
emphysema. Laboratory studies show the PiZZ genotype of α1-antitrypsin (AAT) deficiency. A liver
biopsy specimen examined microscopically shows abundant PAS-positive globules within periportal
hepatocytes. Which of the following molecular mechanisms is most likely responsible for this finding
in the hepatocytes?
A. Excessive hepatic synthesis of AAT
B. Retention of poorly folded AAT in the endoplasmic reticulum
C. Decreased catabolism of AAT in lysosomes
D. Inability to metabolize AAT
E. Impaired dissociation of AAT from chaperones - Correct Answer- B
