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General Pathology - Final Exam In the remodeling phase what type of collagen is replaced? ✔✔Type 3 Which phase of wound healing is associated with the intermolecular cross-linking of collagen? ✔✔Remodeling phase Vascular maturation is associated with? ✔✔Increased levels of angiopoietins All are acute phase proteins except ✔✔Plasminogen Angiogenesis is a process that involves several signaling pathways. They include the following except: ✔✔Kinin signaling The remodeling phase of wound healing by primary intention includes all of the following except: ✔✔Complete by 3 months in healthy individuals When macrophages enter particular organs they acquire new names: ✔✔TRUE Most inflammatory activity takes places at the post capillary venule because of the following characteristics except: ✔✔No surrounding basal lamina pericytes All are major components of acute inflammation except ✔✔Fibroblast migration and deposition of collagen tumor A critical function of inflammation is the delivery of WBC to the injury site. This process is called transmigration. ✔✔FALSE A 17 year old male suffers from acute viral hepatitis. Blood tests reveal elevated liver enzymes (AST and ALT). The most likely cause of these elevated enzyme levels is related to which of the following changes in his hepatocytes? ✔✔Cell lysis Reversible cell injury feature includes the following except? ✔✔Myelin figures A 68 year old woman suffers the rapid onset of right hemiparesis (weakness on one side of the body) and severe aphasia (inability to speak). Two months later a CT scan of her head reveals a large cystic area in the left parietal lobe of her brain. Which of the following pathologic processes accounts for this CT finding? ✔✔Liquifactive necrosis Metabolic changes in aging include all of the following except ✔✔Decreased nutrient uptake A 45 year old male suffers from acute myocardial ischemia. A biopsy of the ischemic tissue would likely show? ✔✔Some condensation of nuclear contents
Which type of necrosis is associated with a predominance of heterolysis? ✔✔Coagulative A process of apoptosis executioner caspases do all of the following except ✔✔Cleave DNA into random fragments In an experiment, a tissue preparation is subjected to oxidant stress. There are increased numbers of free radicals generated within the cells. Generation of which of the following enzymes within these cells would most likely be protective? ✔✔Glutathione peroxidase A 53 year old man suffers a cardiac arrest and his wife calls emergency services. The paramedics arrive a few minutes later and begin life support measures. A regular heart rate is established after 40 minutes of resuscitative efforts as he is being transported to the hospital. A thrombolytic agent (tPA) is administered. Which of the following cellular processes is most likely to occur in his myocardium immediately following administration of the tPA? ✔✔Free radical injury All are nuclear changes in irreversible cell injury except? ✔✔Autolysis Hyperplasia is an increase in the size of the cells and eventually an increase in the size of the organ. ✔✔False Identify the cytoskeletal structure composed of actin ✔✔Microfilaments The difference between wet and dry gangrene. ✔✔Presence of infection The cellular response to injury depends on the following except ✔✔Cellular adaptability A 30 year old man goes skiing, sustains a left femoral fracture. His leg is placed in a plaster cast. After the leg has been immobilized for several weeks the diameter of the left calf has decreased. This would be? ✔✔Atrophy Pathology studies all of the following except? ✔✔Clinical management Caseous necrosis has what kind of appearance? ✔✔Gross cheesy appearance ATP depletion results in the decline in mitochondrial permeability which ✔✔Associated with leakage of cytochrome c from the inner membrane Which of the following processes is most likely occurring in the endometrium just before the onset of bleeding? ✔✔Apoptosis Which of the following processes that occurred in the breast during pregnancy allowed her to breastfeed the infant? ✔✔Lobular hypoplasia
A consequence of mitochondrial damage is? ✔✔Leakage of cytochrome c Generation of free radicals occur due to these processes except? ✔✔During apoptosis Karyorrhexis is condensation of the nucleus ✔✔False The picture of the aortic valve is? ✔✔Dystrophic calcification The picture of the 2 uteruses shows? ✔✔Hypertrophy and hyperplasia Integrins located on WBC bind to endothelial surface immunoglobulins ✔✔True PMN chemotactic agents include all of the following except ✔✔Cytosolic calcium Most chemical mediators of inflammation act by ✔✔Direct gene activation There are 3 interrelated plans in derived protein mediator groups that are activated by activated factor X. ✔✔None (complement, kinin, clotting) Plasma kininogens are cleaved by specific proteases to produce bradykinin which causes? ✔✔Pain Angiogenesis is most associated with which phase of wound healing? ✔✔Proliferative The key step in the activation of the complement system is the activation of? ✔✔C3 convertase In the successful response to simple acute viral induced inflammation macrophages function in all of the following roles except ✔✔They don't remove the virus Wound continued for a worker but over ensuing 45 days the wound became disfigured by a prominent raised modular scar which interfered with his ability to perform his job efficiently. Which of the following terms best describes the process? ✔✔Keloid formation This process most likely involves (question about wound healing) ✔✔Increased collagen production An 18 year old male lacerated his hand by punching a window requiring primary closure with sutures which were removed 7 days following his injury. The most accurate statement regarding his wound would be: ✔✔The tensile strength of the wound is ~10% of a completely healed wound The most important factor in successful wound healing is: ✔✔Nutrition The function of stem cells in tissue repair is most likely: ✔✔A source of growth factors that allows adult tissue cells to proliferate
The C5-9 Mac complex induces: ✔✔Cell lysis Endothelial nitric oxide does all of the following except: ✔✔Activates platelet aggregation and adhesion A routine complete blood count performed on a 26 year old student reveals an abnormal differential WBC count. She has been complaining of frequent sneezing and watery eyes during the past several weeks. She reports frequent similar episodes during spring and summer. Which of the following cell types is most likely to be increased? ✔✔Eosinophils Characteristics of granulation tissue include all of the following except ✔✔A predominance of irregularly arranged type I collagen fibers Cytokines release the initial inflammatory response after an injury and they: ✔✔Serve to start the cell cycle A 36 year old man with a history of recurrent epigastric pain undergoes an upper GI endoscopy which reveals a well demarcated shallow ulcer of the gastric antrum. The most appropriate term to describe this pathologic process is: ✔✔Chronic inflammation A 20 year old male complains of "tumor-like" growth on his left ear lobe. One-month prior during a frat party he had been "convinced" to have his ear pierced (alcohol was involved). ✔✔An increased number of fibroblasts The proliferative phase of wound healing is associated with all of the following except: ✔✔Decreased vascularity Oxygen derived from free radicals can combine with NO to form reactive nitrogen intermediates. These can cause: ✔✔All of the above (endothelial cell damage, activation of anti- proteases, injury of multiple cell types) Neuropeptides play a role in imitating and propagating inflammatory responses. Substance P medicated all of the following except: ✔✔Fever regulation Increased capillary endothelial permeability during inflammation is due to all of the following except: ✔✔Increase in intravascular plasma colloid pressure A 30 year old female with sudden onset of dry cough, fatigue and shortness of breath was admitted to the hospital for pulmonary sarcoidosis. An ultra-structural examination you would expect to see: ✔✔All of the above (non-caseating tissue necrosis, giant cell formation, focal lymphocytic infiltration in the adjacent lung)
You suspect (the 19 year old) may have an abnormality of: ✔✔Fibrillin- 1 Infectious processes may be associated with the onset of autoimmune disorder because ✔✔All of the above (the infectious agent has an antigen that mimics a normal self-antigen, the infectious process may alter self-antigens to resemble foreign antigens, the injury associated with the infection may expose new antigens that are normally hidden from the immune system) Which of the following types of emboli will result in widespread mental changes due to CNS deterioration, thrombocytopenia, petechiae, and acute respiratory distress. ✔✔Fat embolism Hyperemia is indicative of ✔✔All of the above (arteriolar dilation, working muscle, inflammation) Petechia are indicative of ✔✔All of the above (increased intravascular pressure, thrombocytopenia, clotting factor defect) A 17 year old Canadian is involved in a snow-mobile wreck in which she drove her machine through the drive-through window of the local Tim Horton's. She suffered an isolated high thoracic spine injury with a complete spinal cord injury; she is paralyzed and insensate from C8 and below. She is hypotensive, tachycardic, and has a low urine output. The most appropriate description of her type of shock would be? ✔✔Distributive A mother has been bringing her child to the clinic on a regular basis for follow up. The child has failed to thrive and shows signs of mental retardation, an eye examination shows cataracts in both eyes. This child is most likely to have? ✔✔Galactosemia A 25 year old woman with amenorrhea has never had menarche. On physical examination, she is 145 cm (4ft, 9in.) tall. She has a webbed neck, a broad chest, and widely spaced nipples. Strong impulses are palpable in the upper extremities, but there are only weak pulses in the lower extremities. On an abdominal MRI, the ovaries are small, elongated, and tubular. Which of the following karyotypes is most likely to be present in this patient. ✔✔45,X The irreversible stage of shock is associated with: ✔✔Failure of compensatory mechanisms to such an extent that irreversible cellular and tissue injury occurs in vital organs The innate immunity involves the following except: ✔✔Antibody formation A 50 year old fire fighter emerges from a burning house with third-degree burns over 70% of his body. The patient expires 24 hours later. Which of the following was the most likely cause of death? ✔✔Hypovolemic shock The initial (primary) hemostatic plug formed in hemostasis: ✔✔consists of activated platelets
Which type of mutation almost guarantees an abnormal gene product? ✔✔Non-sense mutation Hypersensitivity to poison ivy is: ✔✔Initiated by T-helper cells With respect to disorders due to mitochondrial gene defects: ✔✔Only the children of affected females will be effected The formation of the final hemostatic plug requires all of the following except: ✔✔Activation of the intrinsic coagulation cascade The most important factor in Virchow's triad of thrombosis is: ✔✔Endothelial injury / activation Immune complex mediated hypersensitivity reaction (Type III) ✔✔Produce symptoms related to the location of immune complex depositions A 24 year old woman with a past medical history of a severe motorcycle crash in which she suffered an open proximal femur fracture requiring emergent fixation, after her surgery she received a transfusion of 4 units of blood. 2 years after that she underwent an emergent C-section for placental abruption at 34 weeks, this necessitated a transfusion again however this time shortly after beginning the transfusion she developed generalized urticarial, laryngeal edema, dyspnea and wheezing. Her transfusion reaction involves: ✔✔Type I hypersensitivity You suspect a lab evaluation will most likely reveal antibodies of what class (in relation to the hypersensitivity question)? ✔✔IgE The pathogenesis of systemic sclerosis (scleroderma) involves: ✔✔Vascular injury An individual with sickle cell disease may: ✔✔Have siblings who are resistant to malaria Anaphylaxis can be triggered by cross-linking IgE antibodies to: ✔✔Mast cells A 50 year old female for the past year has noted that it is more difficult to use the keyboard of her computer because she finds it hard to move her fingers, though the joints are not painful. She has lost the facial wrinkles that she began to develop in middle age. A skin biopsy is performed and shows extensive dermal fibrosis. These findings are most typical for which of the following? ✔✔Systemic sclerosis The major role of activated factor XIII in the coagulation cascade is: ✔✔Stabilize fibrin networks Betty White, a 93 year old female with a history of at least three pervious MI's and subsequent congestive heart failure is found slumped in your waiting room. On X-ray the heart shadow is enlarged suggestive of cardiac tamponade. Which type of shock would be least likely? ✔✔Distributive Warm feet would indicate the likely type of shock to be: ✔✔Distributive
The process by which the ciliated columnar epithelium of the bronchi is transformed into squamous epithelium following prolonged smoking is known as: ✔✔Metaplasia Changes following acute hemorrhage will include the following except: ✔✔Increase in the hematocrit All are cold antibody disease characteristics except: ✔✔IgG mediated Paroxysmal nocturnal hemoglobinuria will be associated with the following except: ✔✔Leukocytosis Heinz bodies are oxidized Hgb molecules which precipitate and caused by the following except: ✔✔Tumors Hemolytic anemia shar the following features except: ✔✔Decreased erythropoietin levels
