Pathoma (Complete) Exam with Complete Solutions
What kind of growth adaptation does cervical intraepithelial neoplasia (CIN) represent? What
is it a precursor for? Is it reversible? Correct Ans-dysplasia
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.
Correct Ans-aplasia (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. Correct Ans-atrophy (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. Correct Ans-hypoxia
oxygen
oxidative phosphorylation
ATP
What are the 3 main causes of hypoxia? Correct Ans-1. ischemia
, Pathoma (Complete) Exam with Complete Solutions
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. Correct
Ans-atherosclerosis
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
<______) Correct Ans-60 mmHg
90%
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? Correct Ans-
carbon monoxide poisoning
What is the difference between anemia and carbon monoxide poisoning in terms of arterial
blood gases? Correct Ans-PaO2 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? Correct Ans-Methemoglobinemia 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.
, Pathoma (Complete) Exam with Complete Solutions
-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 ___________ Correct Ans-Oxidative Phosphorylation
ATP -- necessary for Na/K Pump
What is the hallmark of REVERSIBLE cellular injury? Correct Ans-Cellular 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? Correct Ans-Membrane 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?
Correct Ans-LOSS OF NUCLEUS (pyknosis - nucleus shrinks down, karyorrhexis - nucleus
fragmentation, karyolysis - dissolution, nuclear fragments further breakdown)
, Pathoma (Complete) Exam with Complete Solutions
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 ______. Correct
Ans-Acute inflammation
Pathologic
___________ necrosis is seen with ischemic infarction of any organ except for _______.
Correct Ans-coagulative
brain
In coagulative necrosis, the area of infarcted/occluded tissue is often __________ and
_______. Correct Ans-wedge-shaped (pointing to vascular occlusion)
pale
Study the image: Correct Ans-
What is the difference between the picture on the L and R? What kind of necrosis is seen
here? Correct Ans-The 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
What kind of growth adaptation does cervical intraepithelial neoplasia (CIN) represent? What
is it a precursor for? Is it reversible? Correct Ans-dysplasia
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.
Correct Ans-aplasia (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. Correct Ans-atrophy (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. Correct Ans-hypoxia
oxygen
oxidative phosphorylation
ATP
What are the 3 main causes of hypoxia? Correct Ans-1. ischemia
, Pathoma (Complete) Exam with Complete Solutions
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. Correct
Ans-atherosclerosis
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
<______) Correct Ans-60 mmHg
90%
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? Correct Ans-
carbon monoxide poisoning
What is the difference between anemia and carbon monoxide poisoning in terms of arterial
blood gases? Correct Ans-PaO2 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? Correct Ans-Methemoglobinemia 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.
, Pathoma (Complete) Exam with Complete Solutions
-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 ___________ Correct Ans-Oxidative Phosphorylation
ATP -- necessary for Na/K Pump
What is the hallmark of REVERSIBLE cellular injury? Correct Ans-Cellular 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? Correct Ans-Membrane 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?
Correct Ans-LOSS OF NUCLEUS (pyknosis - nucleus shrinks down, karyorrhexis - nucleus
fragmentation, karyolysis - dissolution, nuclear fragments further breakdown)
, Pathoma (Complete) Exam with Complete Solutions
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 ______. Correct
Ans-Acute inflammation
Pathologic
___________ necrosis is seen with ischemic infarction of any organ except for _______.
Correct Ans-coagulative
brain
In coagulative necrosis, the area of infarcted/occluded tissue is often __________ and
_______. Correct Ans-wedge-shaped (pointing to vascular occlusion)
pale
Study the image: Correct Ans-
What is the difference between the picture on the L and R? What kind of necrosis is seen
here? Correct Ans-The 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
