Fill-In-The-Blank: these statements are conceptual; as such there may be other correct answers in addition to the ones provided.
Cell damage due to oxidation results from the production of
Longstanding inflammation due to or can lead to excess ROS production and tissue damage
Solar (ultraviolet) radiation damages DNA by producing
Ionizing radiation has the greatest effects on the bone marrow and GI system where cells are
A hyperplastic thyroid is enlarged because of an increase in
A hypertrophic heart is enlarged because of an increase in
The transformation of mucosa from one tissue type to another is called
Two examples of reversible injury are and
The accumulation of fatty acids in cells is called
Insufficient supply of oxygen to a tissue is called
Inadequate blood supply is called
Tissue death due to ischemia is called
The dead tissue resulting from irreversible cell injury is called
Gangrene is the combination of dead tissue and
Cheese-like necrosis often found in the center of T.B. granulomas is called
Programmed cell death is called
In contrast to necrosis, apoptosis typically does not cause
Multiple Choice Questions:
1) You see a 12 y.o. patient with a longstanding history of severe sunburns who also appears to have developed multiple skin cancers. You suspect this patient might suffer from a genetic abnormality that prevents them from repairing: Chromosome Breaks Thymine Dimers Frameshift Mutations DNA Strand Breaks
Explanation: UV radiation causes the formation of thymine dimers. The disease, called Xeroderma pigmentosum, occurs in patients that cannot excise these dimers.
2) You see a patient with longstanding rheumatoid arthritis, a chronic autoimmune disease. You know that this patient is at significantly increased risk of cardiovascular disease (atherosclerosis) because they have systemically elevated levels of: Catalase Superoxide Dismutase Reactive Oxygen Species (ROS) Glutathione
Explanation: Autoimmune diseases and chronic infections are sometimes associated with elevated ROS due to uncontrolled inflammation (including oxidative bursts). The other choices are antioxidants.
3) You receive a pathology report on a stomach biopsy of a patient with chronic gastritis due to infection with helicobacter pylori. The biopsy shows chronic inflammation and intestinal-type (not gastric) epithelium. This finding is most likely: Due to the biopsy mistakenly being taken from the intestine, not the stomach Gastric atrophy due to the ongoing infection Intestinal metaplasia due to the ongoing inflammation Pre-cancerous dysplasia because of excess ROS production
Explanation: Metaplasia is a benign cellular adaptation where one cell type is replaced with another. It typically occurs in epithelia that is damaged due to inflammation. It is NOT pre-cancerous; although ROS damage can also result in the development of dysplasia and ultimately cancer.
4) You see a patient with jaundice, due to liver dysfunction. A biopsy of the patient's liver shows numerous, scattered acidophil bodies (apoptotic liver cells). You suspect the patient's liver dysfunction may be due to: viral hepatitis an infarct of the liver fatty liver disease (steatosis) ischemic damage to the liver
Explanation: Apoptosis is programmed cell death and is typically caused by things like viral infection, hormone withdrawal, or irreparable DNA damage. Steatosis is reversible injury, and ischemia and infarction lead to necrosis not apoptosis.
5) Which of the following would be an example of hyperplasia? Enlargement of the rectus abdominis muscle after fitness training Increase in the number of milk-producing lobular cells in the breast prior to lactation Decreased mass of the kidney due to ischemia
Explanation: Hyperplasia refers to an increase in cell number. Enlargement of muscle involves an increase in cell size (hypertrophy).
6) Which of the following leads to cell death via necrosis (rather than apoptosis)? Withdrawal of growth factors / hormones Ischemia leading to infarction Cytotoxic T lymphocyte killing of a virally infected cells
Explanation: Necrosis is cell death due to an external injury such as hypoxia. Apoptosis is programmed cell death brought on by decreases in growth signals or by cytotoxic killing
7) Which of the following are examples of reversible cell injury? Steatosis Necrosis Apoptosis Hydropic Change (Cell Swelling) Both A and D
Explanation: Steatosis and hydropic change are reversible. Necrosis and apoptosis are, by definition, forms of irreversible cell death.
8) The replacement of respiratory mucosa with squamous mucosa due to the toxic effects of cigarette smoke is called... Dysplasia Metaplasia Atrophy Necrosis Apoptosis
Explanation: Metaplasia is the replacement of one cell type with another (more resistant) cell type.
9) What might you see in a histologic section of gangrene? Bacteria Necrotic Tissue Apoptotic Cells Caseous Debris Both A and B
Explanation: Gangrene is necrosis + bacteria
10) What type of necrosis would you see in a tuberculosis granuloma? Coagulative Liquefactive Gangrenous Caseous Both A and B
Explanation: Caseous or "cheese-like" necrosis is associated with granulomas due to T.B.
11) The presence of thymine (pyrimidine) dimers in DNA suggest exposure to? Reactive Oxygen Species Antioxidants Ionizing Radiation Ultraviolet Radiation
Explanation: U.V. radiation cause the crosslinking of adjacent thymine nucleotides in DNA.
12) What cell types are most affect by ionizing radiation? Bone Marrow Myocardium Skeletal Muscle Gastrointestinal Tract Both A and D
Explanation: Ionizing radiation affects rapidly dividing cells including the bone marrow and GI system
13) Steatosis of the liver is most associated with what these injuries? Excess ethanol use Excess tobacco use Inflammation (hepatitis) Acute bacterial infection Hepatic necrosis
Explanation: Alcohol use and obesity are the most common causes of steatosis.