NBME PATHOLOGY EXAM 1 2025/2026 SPRING-
SUMMER QUESTIONS AND ANSWERS GRADED
A+
This type of necrosis features cell shape and organ structure preservation
due to coagulation of proteins
Coagulative necrosis
Where is coagulative necrosis seen?
Wedge shaped infarcts of solid organs
NOT the Brain or Pancreas
This type of necrosis features enzymatic lysis of cells and proteins due
to release of neutrophil enzymes
Liquefactive
When is liquefactive necrosis seen?
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Brain infarcts
Abscesses
Pancreatitis
This type of necrosis is characterized by a coagulative necrosis that
resembles tissue mummification (dry form), commonly involving the
lower extremities and GI tract.
Superimposed Liquefactive necrosis leads to the "wet" form.
Gangrenous
This type of necrosis is a combination of coagulative and liquefactive
necrosis that results in a "cottage cheese" like appearance of the affected
tissue.
Caseous Necrosis
When is Caseous Necrosis seen?
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Most characteristic of granulomatous inflammation in the lungs due to
TB or fungal infection
This form of necrosis leads to the chalky white appearance of adipose
tissue due to the deposition of calcium in saponified fat.
Fat necrosis
When is fat necrosis seen?
Trauma to the breast and Acute Pancreatitis
This form of necrosis is characterized by leakage of protein into blood
vessel walls.
Fibrinoid
When is fibrinoid necrosis seen?
1. Malignant HTN
2. Vasculitis
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What type of hypersensitivity reaction is Fibrinoid necrosis?
Type III
What is Apoptosis?
Energy (ATP) dependent cell death. The dying cell shrinks and nucleus
condenses / fragments in an organized manner.
(eosinophilic cytoplasm and basophilic nucleus)
Describe the intrinsic pathway of activation (Caspase-Apoptosis)
Occurs in response to cellular injury that inactivates BCL2.
This allows Cytochrome C to leak out of the mitochondria and activate
caspases to chop up the cell
Describe the extrinsic pathway of activation (Caspase-Apoptosis)