Pathology 14Mar2009
1 – Cellular Adaptations, Cell Injury, and Cell Death
1.1) Which of the following is NOT characteristic of reversible cell injury?
a) Reduced oxidative phosphorylation
b) ATP depletion
c) Cellular shrinking
d) Changes in ion concentrations
e) Water influx
1.2) Which of the following is NOT a characteristic of irreversible cell injury?
a) Necrosis, which is always pathologic or apoptosis
b) Intracellular accumulations (e.g. lipids) or calcification
c) Structural changes (e.g. mitochondrial densities)
d) Profound disturbances in membrane function
e) Adaptable mitochondrial dysfunction
Match the cellular response normally seen in cells with the stimuli (description):
2.1) Chronic irritation (chemical or physical) a) Hyperplasia/Hypertrophy
2.2) Increased demand, increased trophic stimulation b) Atrophy
2.3) Reduced oxygen supply, chemical injury, infection c) Metaplasia
2.4) Metabolic alterations, genetic or acquired d) Injury/Necrosis/Apoptosis
2.5) Decreased nutrients, stimulation e) Calcifications/Intracellular accumulations
3) Which of the following describes hyperplasia?
a) Increase in the number of cells (mitosis) in an organ or tissue
b) Decrease in the number of cells (mitosis) in an organ or tissue
c) Increase in individual cell size in an organ or tissue
d) Decrease in individual cell size in an organ or tissue
e) Reversible change in which one adult cell is replaced by another adult cell type
4.1) Most forms of pathologic hyperplasia are caused by excessive hormonal stimulation
or growth factors acting on target cells. If a patient had hyperplasia of the endometrium,
which of the following is the most likely?
a) Increased risk of miscarriage
b) Decreased risk of miscarriage
c) Increased risk of endometrial cancer
d) Decreased risk of endometrial cancer
e) Increased risk of neurologic disease
4.2) Infection from which of the following is associated with hyperplasia?
a) Papillomavirus
b) Enterobacteria
c) Staphylococci
d) Streptococci
e) Hook worms
5.1) Which of the following describes hypertrophy?
a) Increase in the number of cells (mitosis) in an organ or tissue
b) Decrease in the number of cells (mitosis) in an organ or tissue
c) Increase in individual cell size in an organ or tissue
d) Decrease in individual cell size in an organ or tissue
e) Reversible change in which one adult cell is replaced by another adult cell type
DO NOT DISTRIBUTE -1-
,Pathology 14Mar2009
5.2) In the heart, the stimulus for hypertrophy is usually chronic hemodynamic overload,
resulting from either hypertension or faulty valves. During cardiac muscle hypertrophy,
____ myosin heavy chains are replaced by ____ myosin heavy chains, which leads to
____ ATPase activity and a slower, more efficient contraction.
a) !; "; Increased
b) !; "; Decreased
c) "; !; Increased
d) "; !; Decreased
5.3) Atrial natriuretic factor (ANF) serves to reduce hemodynamic load. In the embryonic
heart, the gene for ANF is expressed in both the atrium and the ventricle. After birth,
____ expression of the gene is down regulated. Cardiac hypertrophy is associated with
a(n) ____ of ANF gene expression.
a) Atrial; Decrease
b) Atrial; Increase
c) Ventricular; Decrease
d) Ventricular; Increase
6.1) Which of the following types of atrophy is involved in marasmus?
a) Decreased workload
b) Loss of innervation
c) Diminished blood supply
d) Inadequate nutrition (protein-calorie)
e) Loss of endrocrine stimulation
f) Aging (senile atrophy)
g) Pressure
6.2) Which of the following types of atrophy is involved in ischemia?
a) Decreased workload
b) Loss of innervation
c) Diminished blood supply
d) Inadequate nutrition (protein-calorie)
e) Loss of endrocrine stimulation
f) Aging (senile atrophy)
g) Pressure
6.3) Which of the following is associated with cachexia, seen in patients with chronic
inflammatory diseases and cancer?
a) Decreased workload
b) Loss of innervation
c) Diminished blood supply
d) Inadequate nutrition (protein-calorie)
e) Loss of endrocrine stimulation
f) Aging (senile atrophy)
g) Pressure
6.4) Which cellular organelle contains acid hydrolases (e.g. cathepsins) and other
enzymes to degrade endocytosed proteins from the extracellular environment and the cell
surface as well as some cellular components during atrophy?
a) Smooth ER
b) Rough ER
DO NOT DISTRIBUTE -2-
, Pathology 14Mar2009
c) Golgi
d) Mitochondria
e) Lysosomes
6.5) The ____-proteasome pathway is responsible for the degradation of many cytosolic
and nuclear proteins.
a) Ubiquitin
b) Ouabain
c) Angiotensin
d) Methionine
e) Decarboxylase
6.6) Which of the following opposes proteasome-mediated protein degradation?
a) Thyroid hormone
b) Cytokines
c) Glucocorticoids
d) Dexamethasone
e) Insulin
6.7) Atrophy may be accompanied by residual bodies, such as lipofuscin granules, which
can turn tissue what color?
a) Yellow
b) Blue
c) Brown
d) White
e) Red
7.1) Which of the following describes metaplasia?
a) Increase in the number of cells (mitosis) in an organ or tissue
b) Decrease in the number of cells (mitosis) in an organ or tissue
c) Increase in individual cell size in an organ or tissue
d) Decrease in individual cell size in an organ or tissue
e) Reversible change in which one adult cell is replaced by another adult cell type
7.2) Which of the following is the most common stem cell reprogramming change
involved in respiratory tract cancer?
a) Squamous to columnar
b) Squamous to cuboidal
c) Columnar to squamous
d) Columnar to cuboidal
e) Cuboidal to squamous
7.3) In Barrett esophagus, metaplasia occurs as a result of refluxed gastric acid. Which of
the following changes occurs?
a) Squamous to columnar
b) Squamous to cuboidal
c) Columnar to squamous
d) Columnar to cuboidal
e) Cuboidal to squamous
8.1) Which of the following is associated with cell death and NOT specifically with
reversible cell injury?
a) Membrane blebs
DO NOT DISTRIBUTE -3-
1 – Cellular Adaptations, Cell Injury, and Cell Death
1.1) Which of the following is NOT characteristic of reversible cell injury?
a) Reduced oxidative phosphorylation
b) ATP depletion
c) Cellular shrinking
d) Changes in ion concentrations
e) Water influx
1.2) Which of the following is NOT a characteristic of irreversible cell injury?
a) Necrosis, which is always pathologic or apoptosis
b) Intracellular accumulations (e.g. lipids) or calcification
c) Structural changes (e.g. mitochondrial densities)
d) Profound disturbances in membrane function
e) Adaptable mitochondrial dysfunction
Match the cellular response normally seen in cells with the stimuli (description):
2.1) Chronic irritation (chemical or physical) a) Hyperplasia/Hypertrophy
2.2) Increased demand, increased trophic stimulation b) Atrophy
2.3) Reduced oxygen supply, chemical injury, infection c) Metaplasia
2.4) Metabolic alterations, genetic or acquired d) Injury/Necrosis/Apoptosis
2.5) Decreased nutrients, stimulation e) Calcifications/Intracellular accumulations
3) Which of the following describes hyperplasia?
a) Increase in the number of cells (mitosis) in an organ or tissue
b) Decrease in the number of cells (mitosis) in an organ or tissue
c) Increase in individual cell size in an organ or tissue
d) Decrease in individual cell size in an organ or tissue
e) Reversible change in which one adult cell is replaced by another adult cell type
4.1) Most forms of pathologic hyperplasia are caused by excessive hormonal stimulation
or growth factors acting on target cells. If a patient had hyperplasia of the endometrium,
which of the following is the most likely?
a) Increased risk of miscarriage
b) Decreased risk of miscarriage
c) Increased risk of endometrial cancer
d) Decreased risk of endometrial cancer
e) Increased risk of neurologic disease
4.2) Infection from which of the following is associated with hyperplasia?
a) Papillomavirus
b) Enterobacteria
c) Staphylococci
d) Streptococci
e) Hook worms
5.1) Which of the following describes hypertrophy?
a) Increase in the number of cells (mitosis) in an organ or tissue
b) Decrease in the number of cells (mitosis) in an organ or tissue
c) Increase in individual cell size in an organ or tissue
d) Decrease in individual cell size in an organ or tissue
e) Reversible change in which one adult cell is replaced by another adult cell type
DO NOT DISTRIBUTE -1-
,Pathology 14Mar2009
5.2) In the heart, the stimulus for hypertrophy is usually chronic hemodynamic overload,
resulting from either hypertension or faulty valves. During cardiac muscle hypertrophy,
____ myosin heavy chains are replaced by ____ myosin heavy chains, which leads to
____ ATPase activity and a slower, more efficient contraction.
a) !; "; Increased
b) !; "; Decreased
c) "; !; Increased
d) "; !; Decreased
5.3) Atrial natriuretic factor (ANF) serves to reduce hemodynamic load. In the embryonic
heart, the gene for ANF is expressed in both the atrium and the ventricle. After birth,
____ expression of the gene is down regulated. Cardiac hypertrophy is associated with
a(n) ____ of ANF gene expression.
a) Atrial; Decrease
b) Atrial; Increase
c) Ventricular; Decrease
d) Ventricular; Increase
6.1) Which of the following types of atrophy is involved in marasmus?
a) Decreased workload
b) Loss of innervation
c) Diminished blood supply
d) Inadequate nutrition (protein-calorie)
e) Loss of endrocrine stimulation
f) Aging (senile atrophy)
g) Pressure
6.2) Which of the following types of atrophy is involved in ischemia?
a) Decreased workload
b) Loss of innervation
c) Diminished blood supply
d) Inadequate nutrition (protein-calorie)
e) Loss of endrocrine stimulation
f) Aging (senile atrophy)
g) Pressure
6.3) Which of the following is associated with cachexia, seen in patients with chronic
inflammatory diseases and cancer?
a) Decreased workload
b) Loss of innervation
c) Diminished blood supply
d) Inadequate nutrition (protein-calorie)
e) Loss of endrocrine stimulation
f) Aging (senile atrophy)
g) Pressure
6.4) Which cellular organelle contains acid hydrolases (e.g. cathepsins) and other
enzymes to degrade endocytosed proteins from the extracellular environment and the cell
surface as well as some cellular components during atrophy?
a) Smooth ER
b) Rough ER
DO NOT DISTRIBUTE -2-
, Pathology 14Mar2009
c) Golgi
d) Mitochondria
e) Lysosomes
6.5) The ____-proteasome pathway is responsible for the degradation of many cytosolic
and nuclear proteins.
a) Ubiquitin
b) Ouabain
c) Angiotensin
d) Methionine
e) Decarboxylase
6.6) Which of the following opposes proteasome-mediated protein degradation?
a) Thyroid hormone
b) Cytokines
c) Glucocorticoids
d) Dexamethasone
e) Insulin
6.7) Atrophy may be accompanied by residual bodies, such as lipofuscin granules, which
can turn tissue what color?
a) Yellow
b) Blue
c) Brown
d) White
e) Red
7.1) Which of the following describes metaplasia?
a) Increase in the number of cells (mitosis) in an organ or tissue
b) Decrease in the number of cells (mitosis) in an organ or tissue
c) Increase in individual cell size in an organ or tissue
d) Decrease in individual cell size in an organ or tissue
e) Reversible change in which one adult cell is replaced by another adult cell type
7.2) Which of the following is the most common stem cell reprogramming change
involved in respiratory tract cancer?
a) Squamous to columnar
b) Squamous to cuboidal
c) Columnar to squamous
d) Columnar to cuboidal
e) Cuboidal to squamous
7.3) In Barrett esophagus, metaplasia occurs as a result of refluxed gastric acid. Which of
the following changes occurs?
a) Squamous to columnar
b) Squamous to cuboidal
c) Columnar to squamous
d) Columnar to cuboidal
e) Cuboidal to squamous
8.1) Which of the following is associated with cell death and NOT specifically with
reversible cell injury?
a) Membrane blebs
DO NOT DISTRIBUTE -3-
