NBME PATHOLOGY FINAL TEST BANK EXAM NEWEST ACTUAL EXAM COMPLETE 200+ QUESTIONS AND CORRECT DETAILED ANSWERS
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NBME PATHOLOGY FINAL TEST BANK EXAM NEWEST ACTUAL EXAM COMPLETE 200+ QUESTIONS AND CORRECT DETAILED ANSWERS/NBME PATHOLOGY FINAL TEST BANK EXAM NEWEST ACTUAL EXAM COMPLETE 200+ QUESTIONS AND CORRECT DETAILED ANSWERS
NBME PATHOLOGY FINAL TEST BANK EXAM NEWEST 2024-2025 ACTUAL EXAM COMPLETE 200+
QUESTIONS AND CORRECT DETAILED ANSWERS
Apoptosis: - correct answer Programmed cell death. REQUIRES ATP. Can occur via the intrinsic
or extrinsic pathways, both of which involve activation of cytosolic caspases which mediate
cellular breakdown. ***Unlike necrosis, apoptosis does not involve significant inflammation.
Involves eosinophilic cytoplasm, cell shrinkage, pyknosis and basophilia, membrane blebbing
and karyorrhexis, and formation of apoptotic bodies which are phagocytosed. **DNA laddering
is a sensitive indicator of apoptosis** Occurs because during karyorrhexis endonucleases yield
180bp fragments.
Radiation therapy does what? - correct answer Causes apoptosis of cancer cells because it
causes formation of free radicals which lead to dsDNA breakage. rapidly dividing cells like skin
and GI mucosa are highly susceptible to radiation-induced apoptosis.
Intrinsic pathway of apoptosis: what is its general purpose / when does it occur? - correct
answer It's involved in tissue remodeling in embryogenesis. Often occurs when a regulating
factor is withdrawn from a proliferating cell population. For example, low IL-2 after completion
of an immunological reaction causes apoptosis of proliferating effector cells. Also occurs in
response to injury from radiation, toxins, hypoxia,etc. Changes in proportions of pro- and anti-
apoptotic factors leads to an increase in mitochondrial permeability and cyt c release.
BAK, BAX, Bcl-2: Which of these are pro- and which are anti-apoptotic? - correct answer BAX
and BAK are pro. Bcl-2 is anti-apoptotic.
How does Bcl-2 function? - correct answer It prevents cyt c release by binding to an inhibiting
Apaf-1, which normally INDUCES caspases.
What happens if Bcl-2 is overexpressed? - correct answer This occurs in follicular lymphoma.
Apaf-1 is over-inhibited which leads to tumorigenesis because of lowered caspase activation.
Extrinsic pathway of apoptosis: 2 basic pathways? - correct answer 1. Ligand receptor
interactions. FasL binding to Fas (CD95). 2. Immune cell-->cytotoxic T-cell release of perforin
and granzyme B.
Where is Fas-FasL interaction required? - correct answer In thymic medullary negative
selection. Mutations in Fas increases the numbers of circulating self-reactive lymphocytes due
to failure of clonal deletion. **Defective fas-fasL interactions is the basis of autoimmune
disorders**
How does Fas initiate cell death? - correct answer After it crosslinks with FasL, multiple Fas
molecules coalesce. This makes a binding site for a death domain.
Necrosis: - correct answer Exogenous injury causes enzymatic degradation and protein
denaturation of a cell. IC components extravasate. **There's an inflammatory process unlike
apoptosis**
, NBME PATHOLOGY FINAL TEST BANK EXAM NEWEST 2024-2025 ACTUAL EXAM COMPLETE 200+
QUESTIONS AND CORRECT DETAILED ANSWERS
Coagulative necrosis occurs in the: - correct answer Caused by ischemia or infarction typically.
heart, liver, kidney. Occurs in tissues supplied by end arteries. High cytoplasmic binding of
acidophilic dye. Proteins denature first followed by enzymatic degradation.
Liquefactive necrosis occurs in the: - correct answer brain, bacterial abscess and pleural
effusion. Occurs in CNS because of high fat content there. Unlike coag necrosis, enzymatic
degradation due to release of lysosomal enzymes occurs first.
Caseous necrosis: - correct answer TB, systemic fungi, Nocardia. Tissue maintains a cheese-like
appearance. Tissue is a proteinaceous dead cell mass.
Fatty necrosis: - correct answer Enzymatic--Pancreas. Saponification. Released fatty acids
interact with calcium to form soaps. Calc deposits appear dark on staining. Nonenzymatic--
breast trauma.
Fibroid necrosis: - correct answer Occurs in blood vessels. Henoch-Schonlein purpura, Churg-
Strauss syndrome. Malignant hypertension. Accumulation of amorphous, basic proteinaceous
substances resembling fibrin.
Gangrenous necrosis: - correct answer Dry (ischemic coagulative) and wet (infection). Common
in limbs and GI tract.
Reversible cell injury with O2: - correct answer low ATP synthesis, cellular swelling because
with no ATP there's impaired Na/K pump. Nuclear chromatin clumping. Low glycogen. Fatty
change. Ribosomal detachment (low protein synthesis).
Irreversible cell injury: - correct answer nuclear pyknosis, karyolysis and karyorrhexis. Ca2+
influx--> caspase activation. PM damage. lysosomal rupture. mitochondrial permeability.
Areas of the brain susceptible to ischemia: - correct answer ACA / MCA / PCA boundary areas.
The watershed areas, or border zones, receive dual blood supply from most distal branches of
two arteries. However, systemic hypoperfusion may cause ischemia in these areas. **Hypoxic
ischemic encephalopathy affects pyramidal cells of the hippocampus and Purkinjie cells of the
cerebellum.
Areas of heart: - correct answer Subendocardium (LV)
Areas of kidney: - correct answer Straight segment of the proximal tubule (medulla) and thick
ascending loop (medulla).
Areas of liver: - correct answer Area around central vein (zone III)
Areas of colon: - correct answer splenish flexure, colon
Red infarct: - correct answer Occur in loose tissues with multiple blood supplies such as liver,
lung, intestines.
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