PATHOLOGY CHAPTER 2 EXAM
REVIEW QUESTIONS WITH ANSWERS
On day 28 of her menstrual cycle, a 23-year-old woman experiences onset of menstrual
bleeding that lasts for 6 days. She has had regular cycles since menarche. Which of the
following processes most likely occurs in her endometrial cells to initiate the onset of
menstrual bleeding? - Answer-Apoptosis
An experiment introduces a knockout gene mutation into a cell line. The frequency of
shrunken cells with chromatin clumping, karyorrhexis, and cytoplasmic blebbing 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? - Answer-BCL2
A 47-year-old man has a lung carcinoma with metastases. He receives chemotherapy.
A month later, histologic examination of a metastatic lesion shows many foci in which
individual tumor cells appear shrunken and deeply eosinophilic. Their nuclei exhibit
condensed aggregates of chromatin under the nuclear membrane. The pathologic
process affecting these shrunken tumor cells is most likely triggered by release of which
of the following substances into the cytosol? - Answer-Cytochrome c
In a study of viral hepatitis infection, it is observed that cytotoxic T lymphocytes (CTLs)
induce death in virally infected hepatocytes. The CTLs release perforin to allow entry of
their granules. Which of the following substances is found in those granules that directly
activates programmed cell death? - Answer-Granzyme B
An experimental study of steatohepatitis in metabolic syndrome reveals that hepatocyte
cell membrane injury with necrosis occurs in response to increased amounts of tumor
necrosis factor (TNF). When a pharmacologic agent inhibiting caspases is administered,
cell necrosis still occurs. Which of the following substances forms a supramolecular
complex that increases the generation of reactive oxygen species? - Answer-Receptor-
interacting protein
A 71-year-old man diagnosed with pancreatic cancer is noted to have decreasing body
mass index. His normal connective tissues undergo atrophy by sequestering organelles
and cytosol in a vacuole, which then fuses with a lysosome. However, the cancer
continues to increase in size. Which of the following processes is most likely occurring
in the normal cells but is inhibited in the cancer cells of this man? - Answer-Autophagy
A new drug is developed that binds to cellular microtubules. The function of the
microtubules is diminished, so that mitotic spindle formation is inhibited. Which of the
following is the most likely use for this drug? - Answer-Chemotherapy
, A 69-year-old woman has had transient ischemic attacks for the past 3 months. On
physical examination, she has an audible bruit on auscultation of the neck. A right
carotid endarterectomy is performed. The curetted atheromatous plaque has a grossly
yellow-tan, firm appearance. Microscopically, which of the following materials can be
found in abundance in the form of crystals within cleftlike spaces? - Answer-Cholesterol
A 45-year-old woman has had worsening dyspnea for the past 5 years. A chest CT scan
shows panlobular emphysema. Laboratory studies show a deficiency of α1-antitrypsin
(AAT). Her AAT genotype is PiZZ. 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 her
hepatocytes? - Answer-Retained misfolded AAT in endoplasmic reticulum
A 69-year-old woman has had a chronic cough for the past year. A chest radiograph
shows a 6-cm mass in the left lung. A needle biopsy specimen of the mass shows
carcinoma. A pneumonectomy is performed, and examination of the hilar lymph nodes
reveals a uniform, dark black cut surface. Which of the following factors most likely
accounts for the appearance of these lymph nodes? - Answer-Cigarette smoking
A 22-year-old woman from Albania has a congenital anemia requiring multiple
transfusions of RBCs for many years. On physical examination, her skin has a bronze
color. Liver function tests show reduced serum albumin. Which of the following findings
would most likely appear in a liver biopsy specimen? - Answer-Hemosiderin in
hepatocytes
A 70-year-old man with hypercalcemia died suddenly. At autopsy, microscopic
examination showed noncrystalline amorphous deposits of calcium salts in gastric
mucosa, renal interstitium, and alveolar walls of lungs. Which of the following underlying
conditions would most likely explain these findings? - Answer-Diffuse parathyroid
hyperplasia
An experiment analyzes cells for enzyme activity associated with sustained cellular
proliferation. Which of the following cells is most likely to have the highest telomerase
activity? - Answer-Germ cells
A study of aging shows that senescent cells have accumulated damage from toxic
byproducts of metabolism. There is increased intracellular lipofuscin deposition.
Prolonged ingestion of which of the following substances is most likely to counteract this
aging mechanism? - Answer-Antioxidants
A 77-year-old woman has chronic renal failure. Her serum urea nitrogen is 40 mg/dL.
She is given a diuretic medication and loses 2 kg (4.4 lb). She reduces the protein in her
diet and her serum urea nitrogen decreases to 30 mg/dL. Which of the following terms
best describes cellular responses to disease and treatment in this woman? - Answer-
Adaptation
REVIEW QUESTIONS WITH ANSWERS
On day 28 of her menstrual cycle, a 23-year-old woman experiences onset of menstrual
bleeding that lasts for 6 days. She has had regular cycles since menarche. Which of the
following processes most likely occurs in her endometrial cells to initiate the onset of
menstrual bleeding? - Answer-Apoptosis
An experiment introduces a knockout gene mutation into a cell line. The frequency of
shrunken cells with chromatin clumping, karyorrhexis, and cytoplasmic blebbing 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? - Answer-BCL2
A 47-year-old man has a lung carcinoma with metastases. He receives chemotherapy.
A month later, histologic examination of a metastatic lesion shows many foci in which
individual tumor cells appear shrunken and deeply eosinophilic. Their nuclei exhibit
condensed aggregates of chromatin under the nuclear membrane. The pathologic
process affecting these shrunken tumor cells is most likely triggered by release of which
of the following substances into the cytosol? - Answer-Cytochrome c
In a study of viral hepatitis infection, it is observed that cytotoxic T lymphocytes (CTLs)
induce death in virally infected hepatocytes. The CTLs release perforin to allow entry of
their granules. Which of the following substances is found in those granules that directly
activates programmed cell death? - Answer-Granzyme B
An experimental study of steatohepatitis in metabolic syndrome reveals that hepatocyte
cell membrane injury with necrosis occurs in response to increased amounts of tumor
necrosis factor (TNF). When a pharmacologic agent inhibiting caspases is administered,
cell necrosis still occurs. Which of the following substances forms a supramolecular
complex that increases the generation of reactive oxygen species? - Answer-Receptor-
interacting protein
A 71-year-old man diagnosed with pancreatic cancer is noted to have decreasing body
mass index. His normal connective tissues undergo atrophy by sequestering organelles
and cytosol in a vacuole, which then fuses with a lysosome. However, the cancer
continues to increase in size. Which of the following processes is most likely occurring
in the normal cells but is inhibited in the cancer cells of this man? - Answer-Autophagy
A new drug is developed that binds to cellular microtubules. The function of the
microtubules is diminished, so that mitotic spindle formation is inhibited. Which of the
following is the most likely use for this drug? - Answer-Chemotherapy
, A 69-year-old woman has had transient ischemic attacks for the past 3 months. On
physical examination, she has an audible bruit on auscultation of the neck. A right
carotid endarterectomy is performed. The curetted atheromatous plaque has a grossly
yellow-tan, firm appearance. Microscopically, which of the following materials can be
found in abundance in the form of crystals within cleftlike spaces? - Answer-Cholesterol
A 45-year-old woman has had worsening dyspnea for the past 5 years. A chest CT scan
shows panlobular emphysema. Laboratory studies show a deficiency of α1-antitrypsin
(AAT). Her AAT genotype is PiZZ. 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 her
hepatocytes? - Answer-Retained misfolded AAT in endoplasmic reticulum
A 69-year-old woman has had a chronic cough for the past year. A chest radiograph
shows a 6-cm mass in the left lung. A needle biopsy specimen of the mass shows
carcinoma. A pneumonectomy is performed, and examination of the hilar lymph nodes
reveals a uniform, dark black cut surface. Which of the following factors most likely
accounts for the appearance of these lymph nodes? - Answer-Cigarette smoking
A 22-year-old woman from Albania has a congenital anemia requiring multiple
transfusions of RBCs for many years. On physical examination, her skin has a bronze
color. Liver function tests show reduced serum albumin. Which of the following findings
would most likely appear in a liver biopsy specimen? - Answer-Hemosiderin in
hepatocytes
A 70-year-old man with hypercalcemia died suddenly. At autopsy, microscopic
examination showed noncrystalline amorphous deposits of calcium salts in gastric
mucosa, renal interstitium, and alveolar walls of lungs. Which of the following underlying
conditions would most likely explain these findings? - Answer-Diffuse parathyroid
hyperplasia
An experiment analyzes cells for enzyme activity associated with sustained cellular
proliferation. Which of the following cells is most likely to have the highest telomerase
activity? - Answer-Germ cells
A study of aging shows that senescent cells have accumulated damage from toxic
byproducts of metabolism. There is increased intracellular lipofuscin deposition.
Prolonged ingestion of which of the following substances is most likely to counteract this
aging mechanism? - Answer-Antioxidants
A 77-year-old woman has chronic renal failure. Her serum urea nitrogen is 40 mg/dL.
She is given a diuretic medication and loses 2 kg (4.4 lb). She reduces the protein in her
diet and her serum urea nitrogen decreases to 30 mg/dL. Which of the following terms
best describes cellular responses to disease and treatment in this woman? - Answer-
Adaptation
