Histology NBME Practice Quiz
A 42-year-old man comes to the physician because of multiple lesions over his body.
Physical examination shows flaccid bullous erosions involving the upper and lower
extremities. A biopsy specimen of one of the lesions shows extensive epidermal
acantholysis resulting in the formation of an intraepidermal blister. An intact basal
layer of keratinocytes adherent to the basement membrane is identified. Which of the
following is most likely related to the pathogenesis of this disorder?
Select one:
a. Immediate (type I) hypersensitivity reaction to a topically applied agent
b. Infection with a herpesvirus
c. Development of autoantibodies against desmosomal proteins
d. Deposition of lgA-containing immune complexes within dermal papilla
e. Mutation of an anchoring filament protein
c. Development of autoantibodies against desmosomal proteins
A 75 year old man presents to the orthopedic clinic with the complaint of bone pain.
His laboratory report shows elevated level of serum alkaline phosphatase. A
histologic examination shows haphazardly oriented, prominent cement lines, that
create a mosaic pattern of lamellar bone. Which of the following cell types is most
likely involved in the initial lesion of his condition?
Select one:
a. Osteoclasts
b. Osteoblasts
c. Fibroblast
d. Endothelial cells
e. Chondrocytes
a. Osteoclasts
A 50-year-old woman is brought to the emergency department because of a 2-hour
history of shortness of breath and chest pain that radiates to her back between the
shoulder blades. Her respirations are 28/min. Physical examination shows
diaphoresis. An ECG shows no abnormalities. Coronary angiography shows
occlusion of the marginal branch of the left anterior descending coronary artery. A
percutaneous coronary revascularization is done. Due to revascularization free
radicals mediate cardiac muscles injury expected because her serum concentrations
of myocardial creatine kinase (CK-MB) and troponin I are increased. Which of the
following mechanisms best explains these laboratory findings?
Select one:
a. Membrane lipid peroxidation
b. Liquefactive necrosis of the myocardium
c. Cell shrinkage
,d. Protease inactivation by cytoplasmic free calcium ions
e. Formation of apoptotic bodies
a. Membrane lipid peroxidation
Which of the following cells in the inner ear are involved in detecting movements of
the head?
Select one:
a. Outer pillar cells
b. Cells of Hensen
c. Inner pillar cells
d. Hair cells in the organ of Corti
e. Hair cells in the maculae
e. Hair cells in the maculae
An 11-year-old boy has repeated episodes of staphylococcal pneumonia. When
incubated in vitro with Staphylococcus aureus, his peripheral blood neutrophils fail to
demonstrate a respiratory burst and do not kill the microorganisms, even though
electron microscopy of the neutrophils shows bacterial cells within phagosomes. This
failure to kill phagocytosed organisms is due to a deficiency of which of the
following?
Select one:
a. Lactoferrin
b. NADPH oxidase
c. Superoxide dismutase
d. Lysozyme
e. Lysosomal proteases
b. NADPH oxidase
A 76-year-old man with congestive heart failure comes to the physician because of a
1-month history of shortness of breath after walking up a flight of stairs. He has had
frequent nausea, and he has had to use two pillows to sleep during this period.
Diffuse, moist crackles are heard over both lungs. There is pitting edema above the
ankles. Which of the following best describes the function of the product secreted by
the atrial myocytes in this patient?
Select one:
a. Decreased glomerular filtration rate
b. Increased sodium reabsorption
c. Induction of vasoconstriction
d. Inhibition of renin release
e. Stimulation of aldosterone release
d. Inhibition of renin release
, Various regions of the respiratory system are reviewed at autopsy for evidence of
histopathology. Which of the following features is first to disappear as the epithelium
changes along the respiratory tube?
Select one:
a. Elastic fibers
b. Smooth muscle
c. Epithelium
d. Cartilage
e. Cilia
d. Cartilage
During a study of pulmonary artery pressure, subjects with hypertension experience a
decrease in this pressure after receiving a phosphodiesterase inhibitor. This
improvement in pulmonary artery pressure is most likely mediated by an increase in
the intracellular concentration of which of the following?
Select one:
a. Endothelin
b. Nitric oxide
c. Calcium
d. Adenosine
e. cGMP
e. cGMP
A 48-year-old woman comes to the physician because of a 3-month history of fatigue,
weakness, loss of appetite, and weight loss. Her serum parathyroid hormone
concentrations are increased. X-rays of the skeletal system show generalized
osteopenia, with subperiosteal resorption of bone within the phalanges. Which of the
following mechanisms is the most likely cause of the skeletal changes observed in
this patient?
Select one:
a. Parathyroid hormone-mediated induction of interleukin-1 (IL-1)
b. Parathyroid hormone-mediated induction of calcitonin
c. Paracrine stimulation of osteoclasts by osteoblasts
d. Parathyroid hormone-mediated production of transforming growth factor-B
e. Impaired calcification of preformed osteoid
c. Paracrine stimulation of osteoclasts by osteoblasts
A researcher exposes lung alveoli to NO, in an animal experiment study. He observed
massive necrosis of the epithelial lining of alveoli. One month later partial recovery of
the alveolar epithelium noted. This regenerated tissue is most likely derived from?
Select one:
a. Clara cells
b. Alveolar macrophage
c. Type II pneumocytes
A 42-year-old man comes to the physician because of multiple lesions over his body.
Physical examination shows flaccid bullous erosions involving the upper and lower
extremities. A biopsy specimen of one of the lesions shows extensive epidermal
acantholysis resulting in the formation of an intraepidermal blister. An intact basal
layer of keratinocytes adherent to the basement membrane is identified. Which of the
following is most likely related to the pathogenesis of this disorder?
Select one:
a. Immediate (type I) hypersensitivity reaction to a topically applied agent
b. Infection with a herpesvirus
c. Development of autoantibodies against desmosomal proteins
d. Deposition of lgA-containing immune complexes within dermal papilla
e. Mutation of an anchoring filament protein
c. Development of autoantibodies against desmosomal proteins
A 75 year old man presents to the orthopedic clinic with the complaint of bone pain.
His laboratory report shows elevated level of serum alkaline phosphatase. A
histologic examination shows haphazardly oriented, prominent cement lines, that
create a mosaic pattern of lamellar bone. Which of the following cell types is most
likely involved in the initial lesion of his condition?
Select one:
a. Osteoclasts
b. Osteoblasts
c. Fibroblast
d. Endothelial cells
e. Chondrocytes
a. Osteoclasts
A 50-year-old woman is brought to the emergency department because of a 2-hour
history of shortness of breath and chest pain that radiates to her back between the
shoulder blades. Her respirations are 28/min. Physical examination shows
diaphoresis. An ECG shows no abnormalities. Coronary angiography shows
occlusion of the marginal branch of the left anterior descending coronary artery. A
percutaneous coronary revascularization is done. Due to revascularization free
radicals mediate cardiac muscles injury expected because her serum concentrations
of myocardial creatine kinase (CK-MB) and troponin I are increased. Which of the
following mechanisms best explains these laboratory findings?
Select one:
a. Membrane lipid peroxidation
b. Liquefactive necrosis of the myocardium
c. Cell shrinkage
,d. Protease inactivation by cytoplasmic free calcium ions
e. Formation of apoptotic bodies
a. Membrane lipid peroxidation
Which of the following cells in the inner ear are involved in detecting movements of
the head?
Select one:
a. Outer pillar cells
b. Cells of Hensen
c. Inner pillar cells
d. Hair cells in the organ of Corti
e. Hair cells in the maculae
e. Hair cells in the maculae
An 11-year-old boy has repeated episodes of staphylococcal pneumonia. When
incubated in vitro with Staphylococcus aureus, his peripheral blood neutrophils fail to
demonstrate a respiratory burst and do not kill the microorganisms, even though
electron microscopy of the neutrophils shows bacterial cells within phagosomes. This
failure to kill phagocytosed organisms is due to a deficiency of which of the
following?
Select one:
a. Lactoferrin
b. NADPH oxidase
c. Superoxide dismutase
d. Lysozyme
e. Lysosomal proteases
b. NADPH oxidase
A 76-year-old man with congestive heart failure comes to the physician because of a
1-month history of shortness of breath after walking up a flight of stairs. He has had
frequent nausea, and he has had to use two pillows to sleep during this period.
Diffuse, moist crackles are heard over both lungs. There is pitting edema above the
ankles. Which of the following best describes the function of the product secreted by
the atrial myocytes in this patient?
Select one:
a. Decreased glomerular filtration rate
b. Increased sodium reabsorption
c. Induction of vasoconstriction
d. Inhibition of renin release
e. Stimulation of aldosterone release
d. Inhibition of renin release
, Various regions of the respiratory system are reviewed at autopsy for evidence of
histopathology. Which of the following features is first to disappear as the epithelium
changes along the respiratory tube?
Select one:
a. Elastic fibers
b. Smooth muscle
c. Epithelium
d. Cartilage
e. Cilia
d. Cartilage
During a study of pulmonary artery pressure, subjects with hypertension experience a
decrease in this pressure after receiving a phosphodiesterase inhibitor. This
improvement in pulmonary artery pressure is most likely mediated by an increase in
the intracellular concentration of which of the following?
Select one:
a. Endothelin
b. Nitric oxide
c. Calcium
d. Adenosine
e. cGMP
e. cGMP
A 48-year-old woman comes to the physician because of a 3-month history of fatigue,
weakness, loss of appetite, and weight loss. Her serum parathyroid hormone
concentrations are increased. X-rays of the skeletal system show generalized
osteopenia, with subperiosteal resorption of bone within the phalanges. Which of the
following mechanisms is the most likely cause of the skeletal changes observed in
this patient?
Select one:
a. Parathyroid hormone-mediated induction of interleukin-1 (IL-1)
b. Parathyroid hormone-mediated induction of calcitonin
c. Paracrine stimulation of osteoclasts by osteoblasts
d. Parathyroid hormone-mediated production of transforming growth factor-B
e. Impaired calcification of preformed osteoid
c. Paracrine stimulation of osteoclasts by osteoblasts
A researcher exposes lung alveoli to NO, in an animal experiment study. He observed
massive necrosis of the epithelial lining of alveoli. One month later partial recovery of
the alveolar epithelium noted. This regenerated tissue is most likely derived from?
Select one:
a. Clara cells
b. Alveolar macrophage
c. Type II pneumocytes
