COGNITIVE QUESTIONS
Cell Injury
1. 50-year-old male patient with history of hypertension for past 20 years on irregular treatment
a. Mention the common type of adaptation seen in above condition
b. Mention the organ involved
c. Mention the other cause of above condition
d. Mention the mechanism involved in above condition
2. 50-year-old female presented with menorrhagia. USG examination revealed endometrial
thickness of 20 mm
a. Mention the common type of adaptation seen in above condition
b. Mention the organ involved
c. Mention the other example for above adaptation
d. Mention the mechanism involved in above condition
3. 30-year-old female presented with recurrent retrosternal discomfort for the past 5 years. UGI
scopy confirmed GERD.
a. Mention the common type of adaptation seen in above condition
b. Mention the organ involved
c. Mention the clinical importance of above condition
d. Mention the mechanism involved in above condition
4. 20-year-old boy presented with right cervical lymphadenopathy, loss of weight, loss of appetite
and evening rise of temperature
a. Mention the type of necrosis seen in microscopic section of cervical node
b. Mention the microscopic appearance of above type of necrosis
c. Mention the macroscopic appearance of above type of necrosis
d. Mention the type of immunity involved in above condition
5. 60 years old chronic alcoholic for the past 10 years. USG abdomen shows liver enlargement with
smooth surface
a. Mention the cause for liver enlargement
b. Mention the other causes of above condition
c. Mention the other organ involved by above condition
d. mention the special stain and procedure needed to confirm the diagnosis
6. 70 years old male, known case of Rheumatic heart disease. Echocardiogram shows severely
narrowed mitral valve with multiple white specks
a. Mention the reason for white specks
b. Define the above condition
c. Mention the type of above condition
d. Mention the causes for other type of above condition
,7. 80 years old male died of hypovolemic shock after a road traffic accident. On autopsy, microscopic
section of cardiac muscle shows yellow brown material seen in cytoplasm
a. State the reason for yellow brown material
b. State the mechanism of formation of above colored material
c. State the other name of colored material
d. Mention the other causes for accumulation of above mentioned colored material
8. 80 years old lady sustained a fracture neck of femur. She is immobilized with plaster of Paris for past
2 month
a. Mention the common type of adaptation seen in above condition
b. Mention the organ involved
c. Mention the one other cause of above condition
d. Mention the mechanism involved in above condition
9. 25 years old, known case of systemic lupus erythematosus, developed palpable purpura in skin
a. Mention the type of necrosis seen in microscopic section of blood vessels
b.Mention the microscopic appearance of above type of necrosis
c.Mention the reason for above type of necrosis
d.Mention the other example for above mentioned type of necrosis
10. 50 years old lady presented with breast lump after blunt trauma
a. Mention the type of necrosis seen in microscopic section of breast lump
b. Mention the microscopic appearance of above type of necrosis
c. Mention the reason for above type of necrosis
d. Mention the other example for above mentioned type of necrosis
answer key
1. a. hypertrophy
b. left ventricle of heart
c. Aortic stenosis
d. Increased production of cellular protein
2. a. Hyperplasia
b. Endometrium of uterus
c. Benign prostatic hyperplasia
d. Growth factor driven proliferation of mature cells or increased production of new cells from
stem cells
3. a. Metaplasia
b. Lower end of esophagus
c. Development of esophageal adenocarcinoma
, d. Reprogramming of stem cells
4. a. Caseous necrosis
b. Eosinophilic amorphous and granular
c. Cheese like appearance
d. cell mediated immunity
5. a. Fatty change
b. Diabetes , Protein malnutrition, obesity, toxins and anoxia
c. Heart, muscle and kidney
d. Oil red O stain or sudan black and frozen section
6. a. Pathologic calcification
b. Abnormal tissue deposition of calcium salts, together with small amount of iron, magnesium
and other mineral salts
c. Dystrophic and metastatic calcification
d. hyperparathyroidism, resorption of bones ,renal failure and vitamin D related disorders
7. a. Hemosiderin
b. lipid peroxidation due to free radical injury
c. Wear and tear pigment, aging pigment
d. cancer cachexia, aging and severe malnutrition
8. a. Atrophy
b. skeletal muscles
c. Denervation, reduced blood supply, loss of endocrine stimulation, pressure, inadequate
nutrition
d. Degradation of proteins by ubiquitin proteasome pathway
9. a. Fibrinoid necrosis
b. Bright pink and amorphous
c. Deposition of immune complexes in the vessel wall
d. Malignant hypertension
10. a. Fat necrosis
b. shadowy outline of necrotic fat cells with basophilic calcium deposits, surrounded by
inflammatory reaction
c. necrosis of fat cells by enzymes
d. peritoneal fat necrosis followed by acute pancreatitis
Inflammation and repair
1.
a. A 25yrs female ate ice cream and after 24- 48 hrs complaints of throat infection
a. Mention type of inflammation- Acute inflammation
b. Mention 4 cardinal signs of inflammation-rubor (redness), tumor (swelling),
calor (heat), and dolor (pain).loss of function (functio laesa),
c. Mention two main vascular events of acute inflammation-Changes in Vascular Flow and
Caliber,Increased Vascular Permeability (Vascular Leakage)
d. Mention 4 cellular events of inflammation
, Leukocyte Adhesion to Endothelium
Leukocyte Migration Through Endothelium
Chemotaxis of Leukocytes
Phagocytosis
2. A 35yrs male complaints of evening raise of temperature, cough with expectoration, loss of
weight. ESR elevated. On examination matted cervical nodes present and Biopsy sent for HPE
a. State the probable diagnosis- tuberculosis or tuberculous lymphadenitis
b. Mention gross and microscopic features
Grossly, the cut section of lymphnode is granular, cheesy appearance , called
caseous necrosis.
Micro-area of central necrosis(necrotic material appears as amorphous,
structureless, eosinophilic, granular debris, with complete loss of cellular details)
surrounded by multiple Langhans-type giant cells, epithelioid cells,
and lymphocytes.
c. List 4 examples related to microscopic features
Tuberculosis , Leprosy, Crohn disease, sarcoidosis, syphillis etc
d. Mention the type of immunity
CD4+ T Cell–Mediated Inflammatory Reaction(delayed-type hypersensitivity
reaction )
3. A 25 yrs female underwent caeseration section. After one week oozing from the site of surgery
a. Mention type of wound healing- primary wound healing
b. Mention gross and microscopic features of granulation tissue
Gross -pink, soft, granular appearance
Micro- proliferation of fibroblasts and new thin-walled, delicate capillaries
(angiogenesis) in a loose ECM, often with admixed inflammatory cells,
mainly macrophages
c. Mention 4 factors involves in delaying wound healing
Infection, Diabetes, steroids, vitamin c deficiency, the type and extent of
tissue injury, foreign bodies, location of injury ,Venous leg ulcers
d. Mention 4 complication
Hypertrophic scars ,keloids, Exuberant granulation, desmoids, or
aggressive fibromatoses, and contracture
4. A 48yrs male got severe lacerations with ragged edges of skin and deep wide injury to legs after
road traffic accident.
a. State the probable diagnosis- Secondary intention or secondary wound healing
b. Mention gross and microscopic features of granulation tissue
Gross -pink, soft, granular appearance
Micro- proliferation of fibroblasts and new thin-walled, delicate capillaries
(angiogenesis) in a loose ECM, often with admixed inflammatory cells, mainly
macrophages
c. Mention 4 factors involves in delaying wound
Cell Injury
1. 50-year-old male patient with history of hypertension for past 20 years on irregular treatment
a. Mention the common type of adaptation seen in above condition
b. Mention the organ involved
c. Mention the other cause of above condition
d. Mention the mechanism involved in above condition
2. 50-year-old female presented with menorrhagia. USG examination revealed endometrial
thickness of 20 mm
a. Mention the common type of adaptation seen in above condition
b. Mention the organ involved
c. Mention the other example for above adaptation
d. Mention the mechanism involved in above condition
3. 30-year-old female presented with recurrent retrosternal discomfort for the past 5 years. UGI
scopy confirmed GERD.
a. Mention the common type of adaptation seen in above condition
b. Mention the organ involved
c. Mention the clinical importance of above condition
d. Mention the mechanism involved in above condition
4. 20-year-old boy presented with right cervical lymphadenopathy, loss of weight, loss of appetite
and evening rise of temperature
a. Mention the type of necrosis seen in microscopic section of cervical node
b. Mention the microscopic appearance of above type of necrosis
c. Mention the macroscopic appearance of above type of necrosis
d. Mention the type of immunity involved in above condition
5. 60 years old chronic alcoholic for the past 10 years. USG abdomen shows liver enlargement with
smooth surface
a. Mention the cause for liver enlargement
b. Mention the other causes of above condition
c. Mention the other organ involved by above condition
d. mention the special stain and procedure needed to confirm the diagnosis
6. 70 years old male, known case of Rheumatic heart disease. Echocardiogram shows severely
narrowed mitral valve with multiple white specks
a. Mention the reason for white specks
b. Define the above condition
c. Mention the type of above condition
d. Mention the causes for other type of above condition
,7. 80 years old male died of hypovolemic shock after a road traffic accident. On autopsy, microscopic
section of cardiac muscle shows yellow brown material seen in cytoplasm
a. State the reason for yellow brown material
b. State the mechanism of formation of above colored material
c. State the other name of colored material
d. Mention the other causes for accumulation of above mentioned colored material
8. 80 years old lady sustained a fracture neck of femur. She is immobilized with plaster of Paris for past
2 month
a. Mention the common type of adaptation seen in above condition
b. Mention the organ involved
c. Mention the one other cause of above condition
d. Mention the mechanism involved in above condition
9. 25 years old, known case of systemic lupus erythematosus, developed palpable purpura in skin
a. Mention the type of necrosis seen in microscopic section of blood vessels
b.Mention the microscopic appearance of above type of necrosis
c.Mention the reason for above type of necrosis
d.Mention the other example for above mentioned type of necrosis
10. 50 years old lady presented with breast lump after blunt trauma
a. Mention the type of necrosis seen in microscopic section of breast lump
b. Mention the microscopic appearance of above type of necrosis
c. Mention the reason for above type of necrosis
d. Mention the other example for above mentioned type of necrosis
answer key
1. a. hypertrophy
b. left ventricle of heart
c. Aortic stenosis
d. Increased production of cellular protein
2. a. Hyperplasia
b. Endometrium of uterus
c. Benign prostatic hyperplasia
d. Growth factor driven proliferation of mature cells or increased production of new cells from
stem cells
3. a. Metaplasia
b. Lower end of esophagus
c. Development of esophageal adenocarcinoma
, d. Reprogramming of stem cells
4. a. Caseous necrosis
b. Eosinophilic amorphous and granular
c. Cheese like appearance
d. cell mediated immunity
5. a. Fatty change
b. Diabetes , Protein malnutrition, obesity, toxins and anoxia
c. Heart, muscle and kidney
d. Oil red O stain or sudan black and frozen section
6. a. Pathologic calcification
b. Abnormal tissue deposition of calcium salts, together with small amount of iron, magnesium
and other mineral salts
c. Dystrophic and metastatic calcification
d. hyperparathyroidism, resorption of bones ,renal failure and vitamin D related disorders
7. a. Hemosiderin
b. lipid peroxidation due to free radical injury
c. Wear and tear pigment, aging pigment
d. cancer cachexia, aging and severe malnutrition
8. a. Atrophy
b. skeletal muscles
c. Denervation, reduced blood supply, loss of endocrine stimulation, pressure, inadequate
nutrition
d. Degradation of proteins by ubiquitin proteasome pathway
9. a. Fibrinoid necrosis
b. Bright pink and amorphous
c. Deposition of immune complexes in the vessel wall
d. Malignant hypertension
10. a. Fat necrosis
b. shadowy outline of necrotic fat cells with basophilic calcium deposits, surrounded by
inflammatory reaction
c. necrosis of fat cells by enzymes
d. peritoneal fat necrosis followed by acute pancreatitis
Inflammation and repair
1.
a. A 25yrs female ate ice cream and after 24- 48 hrs complaints of throat infection
a. Mention type of inflammation- Acute inflammation
b. Mention 4 cardinal signs of inflammation-rubor (redness), tumor (swelling),
calor (heat), and dolor (pain).loss of function (functio laesa),
c. Mention two main vascular events of acute inflammation-Changes in Vascular Flow and
Caliber,Increased Vascular Permeability (Vascular Leakage)
d. Mention 4 cellular events of inflammation
, Leukocyte Adhesion to Endothelium
Leukocyte Migration Through Endothelium
Chemotaxis of Leukocytes
Phagocytosis
2. A 35yrs male complaints of evening raise of temperature, cough with expectoration, loss of
weight. ESR elevated. On examination matted cervical nodes present and Biopsy sent for HPE
a. State the probable diagnosis- tuberculosis or tuberculous lymphadenitis
b. Mention gross and microscopic features
Grossly, the cut section of lymphnode is granular, cheesy appearance , called
caseous necrosis.
Micro-area of central necrosis(necrotic material appears as amorphous,
structureless, eosinophilic, granular debris, with complete loss of cellular details)
surrounded by multiple Langhans-type giant cells, epithelioid cells,
and lymphocytes.
c. List 4 examples related to microscopic features
Tuberculosis , Leprosy, Crohn disease, sarcoidosis, syphillis etc
d. Mention the type of immunity
CD4+ T Cell–Mediated Inflammatory Reaction(delayed-type hypersensitivity
reaction )
3. A 25 yrs female underwent caeseration section. After one week oozing from the site of surgery
a. Mention type of wound healing- primary wound healing
b. Mention gross and microscopic features of granulation tissue
Gross -pink, soft, granular appearance
Micro- proliferation of fibroblasts and new thin-walled, delicate capillaries
(angiogenesis) in a loose ECM, often with admixed inflammatory cells,
mainly macrophages
c. Mention 4 factors involves in delaying wound healing
Infection, Diabetes, steroids, vitamin c deficiency, the type and extent of
tissue injury, foreign bodies, location of injury ,Venous leg ulcers
d. Mention 4 complication
Hypertrophic scars ,keloids, Exuberant granulation, desmoids, or
aggressive fibromatoses, and contracture
4. A 48yrs male got severe lacerations with ragged edges of skin and deep wide injury to legs after
road traffic accident.
a. State the probable diagnosis- Secondary intention or secondary wound healing
b. Mention gross and microscopic features of granulation tissue
Gross -pink, soft, granular appearance
Micro- proliferation of fibroblasts and new thin-walled, delicate capillaries
(angiogenesis) in a loose ECM, often with admixed inflammatory cells, mainly
macrophages
c. Mention 4 factors involves in delaying wound
