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A 17-year-old male infected with hepatitis A experiences some mild nausea for about a week and has very mild scleral icterus. Laboratory findings include elevations in the levels of the hepatic enzymes aspartate transaminase (AST) and alanine transaminase (ALT). The increase in the enzyme levels in the serum results from which of the following changes in the hepatocytes? (A) Dispersion of ribosomes (B) Autophagy by lysosomes (C) Swelling of the mitochondria (D) Clumping of nuclear chromatin (E) Defects in the cell membrane
(E) Defects in the cell membrane
A 54-year-old male experienced the onset of severe chest pain. An electrocardiogram demonstrated changes consistent with an acute myocardial infarction. He was given thrombolytic therapy with tissue plasminogen activator (tPA). However, his serum creatine kinase increased after this therapy. Which of the following events most likely occurred? (A) Reperfusion injury (B) Cellular regeneration (C) Chemical injury (D) Increased synthesis of creatine kinase (E) Myofiber atrophy
(A) Reperfusion injury
A 51-year-old male has a blood pressure of 150/95 mm Hg. If this condition remains untreated for years, which of the following cellular alterations will be seen in the heart? (A) Atrophy (B) Hyperplasia (C) Metaplasia (D) Hemosiderosis (E) Hypertrophy
(E) Hypertrophy
The aortic valve seen in the figure was discovered at the autopsy of a 72-year-old male. The heart weighed 580 g, with marked left ventricular hypertrophy and minimal coronary arterial atherosclerosis. A serum chemistry panel revealed no abnormalities prior to death from congestive heart failure. Which of the following pathologic processes accounts for the appearance of the valve? (A) Amyloidosis (B) Dystrophic calcification (C) Lipofuscin deposition (D) Hemosiderosis (E) Fatty change
(B) Dystrophic calcification
A right carotid endarterectomy is performed on a 69-year-old female who had an audible bruit on auscultation of the neck. Examination of the curetted atheromatous plaque reveals a grossly yellow-tan, firm appearance. Microscopically, which of the following materials can be found in abundance in the form of crystals producing long, cleftlike spaces? (A) Glycogen (B) Lipofuscin (C) Hemosiderin (D) Immunoglobulin (E) Cholesterol
(E) Cholesterol
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Change results from which of the following alterations in the calf muscles? Options: (A) Aplasia (B) Hypoplasia (C) Atrophy (D) Dystrophy (E) Hyalin change
Answer: (C) Atrophy
Which of the following cells have the highest telomerase activity? Options: (A) Endothelial cells (B) Germ cells (C) Neurons (D) Neutrophils (E) Erythrocytes
Answer: (B) Germ cells
A 38-year-old woman experienced severe abdominal pain with hypotension and shock that led to her death within 36 hours. From the gross appearance of the mesentery, which of the following events has most likely occurred? Options: (A) Hepatitis B virus infection (B) Small intestinal infarction (C) Tuberculous lymphadenitis (D) Gangrenous cholecystitis (E) Acute pancreatitis
Answer: (E) Acute pancreatitis
Absorption of radiant energy, such as x-rays, can result in cell injury by causing hydrolysis of water. Which of the following cellular enzymes protects cells from this type of injury? Options: (A) Phospholipase (B) Glutathione peroxidase (C) Endonuclease (D) Lactate dehydrogenase (E) Proteases
Answer: (B) Glutathione peroxidase
In patients with emphysema due to α1-antitrypsin deficiency, the molecular mechanism responsible for the accumulation of α1-antitrypsin in hepatocytes is? Options: (A) Excessive hepatic synthesis of α1-antitrypsin (B) Retention in the endoplasmic reticulum because of poorly folded α1-antitrypsin (C) Decreased catabolism of α1-antitrypsin in lysosomes (D) Inability to metabolize α1-antitrypsin (E) Impaired dissociation from chaperones
Answer: (B) Retention in the endoplasmic reticulum because of poorly folded α1-antitrypsin
A 63-year-old man experienced diaphoresis and substernal chest pain after thrombosis of the left anterior descending artery. His serum creatine kinase level was elevated. Which of the following patterns of tissue injury was most likely? Options: (A) Liquefactive necrosis (B) Caseous necrosis (C) Coagulative necrosis (D) Fat necrosis (E) Gangrenous necrosis
Answer: (C) Coagulative necrosis
After several weeks of immobilization of the leg in a plaster cast, the diameter of the calf often decreases. This change results from which of the following alterations? Options: (A) Aplasia (B) Hypoplasia (C) Atrophy (D) Dystrophy (E) Hyalin change
Answer: (C) Atrophy
A 32-year-old male experiences ‘heartburn’ with substernal pain from reflux of gastric contents into the lower esophagus. After many months, the esophageal epithelium exhibits pathologic changes. Which of the following pathologic alterations has occurred? Options: (A) Squamous metaplasia (B) Mucosal hypertrophy (C) Columnar epithelial metaplasia (D) Atrophy of lamina propria (E) Goblet cell hyperplasia
Answer: (C) Columnar epithelial metaplasia
On day 28 of the menstrual cycle in a 23-year-old female, there is menstrual bleeding that lasts for a few days. She has had these regular cycles for many years. Which of the following processes is most likely happening in the endometrium just before the onset of bleeding? Options: (A) Liquefactive necrosis (B) Caseous necrosis (C) Coagulative necrosis (D) Fat necrosis (E) Gangrenous necrosis
Answer: (c) coagulative
Many drugs that are used to treat cancer cause death of tumor cells by apoptosis. Mutational inactivation of which of the following genes can render tumor cells resistant to the effects of such chemotherapeutic drugs? Options: (A) BCL-2 (B) BAX (C) p53 (D) RAS (E) MYC
Answer: (C) p53
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A key protein involved in the initiation of apoptosis, released from mitochondria into the cytosol, is: Options: (A) bcl-2 (B) p53 (C) NF-κB (D) P450 (E) Granzyme B
Answer: (B) p53
Which process in the breast during pregnancy enables lactation? Options: (A) Stromal hypertrophy (B) Lobular hyperplasia (C) Epithelial dysplasia (D) Intracellular accumulation of fat (E) Ductal epithelial metaplasia
Answer: (B) Lobular hyperplasia
A patient with congenital anemia requiring multiple transfusions shows abnormal liver function. What is most likely found in liver biopsy? Options: (A) Steatosis in hepatocytes (B) Bilirubin in canaliculi (C) Glycogen in hepatocytes (D) Amyloid in portal triads (E) Hemosiderin in hepatocytes
Answer: (E) Hemosiderin in hepatocytes
A 3-cm lung nodule with soft, white center that grew Mycobacterium tuberculosis represents which pathology? Options: (A) Apoptosis to (O) Metastatic calcification
Answer: (C) Caseous necrosis
Enlarged prostate gland with nodular glands and stroma on microscopy indicates: Options: (A) Apoptosis to (O) Metastatic calcification
Answer: (K) Hyperplasia
Liver regeneration after partial resection following trauma demonstrates: Options: (A) Apoptosis to (O) Metastatic calcification
Answer: (K) Hyperplasia
