MIDTERMS Flashcards by Shiela Micah Gascon

Patient presents with mental retardation, long face with large mandible, large everted ears and large testicles. The most likely diagnosis is:

Hunter syndrome
Hurler syndrome
Patau syndrome
Fragile X syndrome
all of the above

Fragile X syndrome

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Reprogramming of stem cell pathway is the underlying mechanism of which cellular adaptation?
atrophy
Metaplasia
Hyperplasia
Hypertrophy
all of the above

Metaplasia

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Itai-itai disease is a disease seen in ____________ toxicity.
Cadmium
Mercury
Lead
Arsenic

Cadmium

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What receptor is expressed on the plasma membrane of dendritic cells that detect fungal glycans and elicit inflammatory reaction against fungi.
Toll like receptor
C-type Lectin Receptors (CLRs)
Rig-Like Receptors (RLR)
G-Protein Coupled Receptors

C-type Lectin Receptors (CLRs)
FUNGI

rig like - virus
g protein - bacterial
tlr - transcription factors

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Overdose with acetaminophen can be treated by:
N-acetylcysteine
Thiamine
Naloxone
Activated charcoal

N-acetylcysteine

Activated charcoal - also correct but universal antidote

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The following causes vascular permeability except:
Prostaglandin D2
Prostaglandin E2
Leukotriene D4
None of the above

None of the above

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DNA structural variations in the genome that involve the deletion, duplication, or rearrangement of large DNA segments.
Single nucleotide polymorphisms
Copy number variation
Tandem repeats
Chromosal aberrations
None of the above

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The most potent hallucinogen.

MDMA
LSD
PCP
Cocaine

LSD

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Which of the following T cell subset is involved in immediate hypersensitivity reaction?

T-helper 1
T-helper 2
T-helper 3
T-helper 4

T-helper 2

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Phenomenon of unresponsiveness to an antigen as a result of lymphocytes to that antigen, describes

Anergy
self tolerance
Autoimmunity
immunologic tolerance

immunologic tolerance

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Aflatoxin has been associated with the development of this malignancy.
Lung cancer
Acute Myeloid Leukemia
Angiosarcoma
Liver cancer

Liver cancer

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Phenomenon of unresponsiveness to an antigen as a result of lymphocytes to that antigen, describes

Anerygy
Autoimmunity
self tolerance
immunologic tolerance

Anerygy

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Tay-Sachs disease is caused by?

Glycogen accumulation within the cells.
Glucocerebrosidase deficiency causing accumulation of glucocerebroside.
Point mutations or deletions in LDL receptors causing abnormal transport.
Deficiency in hexosaminidase A.

Deficiency in hexosaminidase A.

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37 years old patient came to you with imaging findings stating that the liver has central vein and sinusoidal distension as well as centrilobular necrosis. You remember during discussion of the acinar model of blood flow that the centrilobular hepatocytes is at what zone?
Zone 1
Zone 2
Zone 3
Zone 4

ZONE 3

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Which of the following is an example of intracellular hyaline?
Pink deposits in walls of arterioles in patients with chronic hypertension
Deposition in the basement membrane of the kidney of a patient with CKD
Presence of Russell bodies
All of the above

Presence of Russell bodies

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64 years old male was celebrating his birthday with his family when he suddenly clutched his left chest. He was suddenly rushed to the emergency room within minutes. Laboratory shows an elevated Troponin I, and ECG changes were also noted. As he is still within the time of the golden period what is the best emergent therapy than can be administered?

Aspirin
Vitamin K
Tissue plasminogen activator
Heparin

Tissue plasminogen activator

clutched his left chest levine sign(MI)

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Which of these cytokine has a role in allergies?

Th1
Th2
Th4
Th17
None of the above

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In which of the following organs is the pathologic finding of a focal, hemorrhagic lesion most likely to be seen?

Lung with pulmonary thromboembolism
Kidney with renal artery thrombus
Heart with complete coronary artery occlusion
Brain with middle cerebral artery thrombus

Lung with pulmonary thromboembolism

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Which of the following changes best describes the pathophysiology of pulmonary edema in patients with congestive heart failure?

Widespread endothelial damage
Acute lymphatic obstruction
Decreased plasma oncotic pressure
Increased hydrostatic pressure

Increased hydrostatic pressure

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B cells develop in the bone marrow, now as a step in their maturation, B cells that recognize self antigen will undergo what process after?

Apoptosis
MHC restriction
Receptor Editing
Somatic recombination

Receptor Editing

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Pathology of myasthenia gravis is due to:

Phagocytosis
Vasoactive release of amines
antibody mediated cellular dysfuction
immune complex deposition

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Features of acute inflammation except
Mild local and systemic signs
Fast: minutes to hours
Mild tissue injury
Cellular infiltrates are mainly neutrophil

Mild local and systemic signs

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A part of histone organization which leads to transcriptional silencing
Histone methylation
Histone phosphorylation
Histone Acetylation
DNA methylation

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A lysosomal storage disease with a mutation in the gene that encodes glucosylceraminidase presents with an accumulation of glucosylceramide in mononuclear phagocytic cells in the liver, spleen and marrow. The pathognomonic cells shows:
zebra bodies
wrinkled tissue paper celled cytoplasm
8 to 20 multinucleated cells
hydrophic cells with peri-nuclear halo
all of the above

wrinkled tissue paper celled cytoplasm
GAUCHERS DISEASE

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Minamata disease is a disease seen in ____________ toxicity. Cadmium Mercury Lead Arsenic

Mercury

Deposition of immune complex is seen in which hypersensitivity reaction TYPE I TYPE II TYPE III TYPE IV

TYPE III

In tuberculosis, naive T-cells are differentiated into Th1 through: Granuloma formation PD-1 blockade IL-12 stimulation Caseous necrosis and formation of epithelioid cells.

IL-12 stimulation

What is the most common etiologic factor in acute myeloid leukemia? Benzene Radiation Exposure Mercury Lead None of the above

Benzene

Perforins and granzymes are used by what cell types? CD8+ T cells, NK cells NK cells, Macrophages CD8+ T cells, CD4+ T cells CD4+ T cells, NK cells

CD8+ T cells, NK cells NK CELLS - PRODUC GRANZYME

A 6 y/o child has a legs appearing “bowed” and a chest xray is notable for excess cartilage at the costochondral junction of the ribs. She is most likely suffering from Ricketts Achondroplasia - lack cartilage formation, dwarfs Osteoid osteoma Osteoporosis

Ricketts

Which cellular change may be reversed when injurious stimuli is removed? Pyknosis swelling of endoplasmic reticulum BOTH NEITHER

swelling of endoplasmic reticulum

65-year-old patient came for consult and presented with fever, weight loss, and cough. Due to gross negligence, the patient expired and autopsy was done revealing, neutrophilic infiltrates with central liquefaction and surrounding granulation and fibrosis in the absence of granuloma. Microorganism was revealed to have distinctive branched chains and thin aerial filaments resembling hyphae. Which microorganism should be considered? Aspergillus fumigatus - acute branches, thin filaments Nocardia spp. Mycobacterium tuberculosis Rhizopus spp.

Nocardia spp.

All of the following are true regarding ethanol consumption, except Acetaldehyde is the major metabolite of alcohol and is responsible for many of the toxic effects Acute alcohol intoxication results in primarily CNS depressant effects aldehyde dehydrogenase is the major enzyme responsible for metabolizing alcohol all of the choices are true. none of the choices are false

aldehyde dehydrogenase is the major enzyme responsible for metabolizing alcohol

Abundant in liver and gonads where it is used for steroid hormone and lipoprotein synthesis, and modification of hydrophobic compounds into water-soluble molecules smooth endoplasmic reticulum rough endoplasmic reticulum Lysosomes proteasome

smooth endoplasmic reticulum

Ubiquitous mold that microscopically have septate filaments branching at acute angles Aspergillus Mucor spp Blastomyces dermatitidis Coccidiodes immitis

Aspergillus

A nematode that causes patchy interstitial myocarditis characterized by many eosinophil and scattered giant cells. Tricnella spiralis T. cruzi - american treponemiasis (bed bug,painless) S. mansoni - trematode (hematodium x cause scc (urinary bladder), japonicum) N. gonorrhea

Tricnella spiralis - only nematode - can only cause myocarditis

The following agents may cause lung cancer except Berrylium Asbestos Radon Chromium Cadmium all can cause lung cancer

Chromium

The following are primary granules except: Elastase Collagenase Acid hydrolase Myeloperoxidase

Collagenase

Rocker bottom feet is frequently observed in patients with TRISOMY 13 TROSOMY 21 TRISOMY 18 NONE OF THE ABOVE

TRISOMY 13 - FREQUENTLY TRISOMY 18 - NOT FREQUENT

Which of the following viruses can enter latency? HSV HPV CMV JC virus

HSV HSV 1 AND 2 VARICELLA ZOSTER

FLIP is a protein produced by poxvirus and herpes virus which inhibits apoptotic process by blocking what specific molecule? BCL-XL Fas Ligand FADD TNF-1

FADD

Type of mutation occur when the insertion or deletion of one or two base pairs alters the reading frame of the DNA strand silent mutation frame shift mutation missense mutation non-sense mutation all of the above

frame shift mutation

Release of this molecule happens as a protective response to deal with hypoxic stress; this molecule promotes new blood vessel formation, stimulates cell survival pathways, and enhances glycolysis. VEGF-A Angiostatin VEGF-D HIF-1

A clinicopathologic entity with a triad of dry eyes, dry mouth and arthritis. Scleroderma sjogren syndrome SLE dermatomyositis

sjogren syndrome

An alteration within cells or in extracellular space which gives a homogenous glassy pink appearance in routine H&E histologic sections is called: coagulation necrosis Steatosis hyaline change fibrinoid necrosis

Receptor protein responsible for the binding of platelets to vwf on ECM? gpIa gpIb GpIIb GpIIb/IIIa

gpIb

Good pasture syndrome is what type of hypersensitivity reaction? TYPE I TYPE II TYPE III TYPE IV

TYPE II

It is the basic subunit of chromatin which consists of 147 base pairs of DNA wrapped in approximately two turns around an octameric protein core containing two copies each of histones Histone Nucleosome Chromatin Centromere

Nucleosome

This vitamin A derivative is used in the treatment of Acute Promyelocytic Leukemia. 13-cis-retinoic acid Beta-carotene Isotretinoin all-trans-retinoic acid

all-trans-retinoic acid

This complement protein acts as an opsonin when fixed to the microbial cell wall. C1q C5a C3b C3a

C3b

An alteration within cells or in extracellular space which gives a homogenous glassy pink appearance in routine H&E histologic sections is called _____. coagulation necrosis Steatosis hyaline change fibrinoid necrosis liquefaction necrosis

hyaline change

Glycogen storage diseases arises with lack of the following enzyme, except Acid maltase Muscle phosphorylase glucose 6 phospatase ALL OF THE ABOVE NONE OF THE ABOVE

NONE OF THE ABOVE

A 68 year old female with multiple myeloma dies of acute renal failure. At autopsy, her kidneys and liver were pale gray, with waxy cut sections, while her spleen showed tapioca-like granules. On histology, these organs show deposits that have empty vacuoles that uptake Sudan black -AML are infiltrated by neutrophils and histiocytes will fluoresce an apple green color when stained with Congo red are bluish, with concentric laminations -SCWANOMA BODIES

will fluoresce an apple green color when stained with Congo red TAPIOCA LIKE -amyloid

The following categories of pathophysiology of edema and the clinical condition are correct, except: Nephrotic syndrome- decreased oncotic pressure Sodium retention- increased hydrostatic pressure Kwashoirkor- decreased oncotic pressure Filariasis- lymphatic obstruction None of the above All are correct

Abnormal fusion of primary granules which results in a malfunctioning WBC with a diminished phagocytic capability Chediak-Higashi syndrome Leukocyte adhesion defect Chronic granulomatous disease Myeloperoxidase deficiency

Chediak-Higashi syndrome -neutropenia -defectuve granulation -delayed microbial killing CGD-OXIDATIVE BURST MPO-PEROCYTE SYSTEM

An example of point mutation wherein a purine base is replaced by another purine base or a pyrimidine base is replaced by another pyrimidine base. genomic imprinting Transition silent mutation gonadal mosaicism all of the above

Transition

Formed by homotypic extracellular interactions between transmembrane glycoproteins that mechanically attach cells and their cytoskeletons to other cells. Occluding junctions Anchoring junctions Gap junctions Communicating junctions

Member of the immunoglobulin superfamily, is an adhesion molecule present in the intercellular junction CD34 CD31 ICAM VCAM

CD31 -PECAM ENDOTHELIUM TO VASCULAR

True about EXUDATE low protein and little to no cellular debris it is essentially an ultrafiltrate of the blood this is an implication that there is increased permeability triggered by some sort of tissue injury. this is an implication of osmotic or hydrostatic imbalances in the vessels, without an increase in the permeability of the vascular walls.

this is an implication that there is increased permeability triggered by some sort of tissue injury.

The most common sexually transmitted bacterial disease is N. gonrrhea C. trachomatis Both none of the above

Which of the following is NOT TRUE of the effects of alcoholism on cellular processes? Depletion of NAD impairs fatty acid oxidation leading to steatosis. Depletion of NAD impairs conversion of lactate to pyruvate leading to acidosis. Reactive oxygen species derived from alcohol metabolism causes lipid peroxidation of hepatocyte membranes. Acetaldehyde triggers enterotoxin release from gram-positive bacteria.

Acetaldehyde triggers enterotoxin release from gram-positive bacteria. should be gram negative

This is produced by COX-1 which is expressed constitutively by “healthy” endothelium under normal flow conditions. PGE2 PGF2 PGI2 PGD2

PGI2 PROSTACYCLIN

Increased number of hemosiderin-laden macrophages is a tell-tale sign of _____. old hemorrhage Melanoma sunburn or radiation injury formation of myelin figures all of the above

What is the second most common cause of mental retardation after trisomy 21? TURNER'S SYNDROME FRAGILE X SYDROME MARFAN SYNDROME KLIENFELTER'S SYDNROME

Which of the following does not belong to Adaptive immunity? Antibodies Dendritic cell Epithelial barriers T-Lymphocyte

Epithelial barriers innate - skin and leukocytes and complement activation adaptive - acquired (humoral extra, intra-cell med)

Alcohol metabolism by the enzyme catalase is seen in which part of the hepatocyte? Peroxisome Mitochondria Microsomes Cytosol

Peroxisome

A patient takes aspirin for arthritis. Although her joint pain is reduced with this therapy, the inflammatory process continues. Aspirin therapy alleviates pain via reduction in the synthesis of Complement C1q Histamine Leukotriene E4 Prostaglandins

Prostaglandins

What do both the skin and gut epithelial cells produce to protect against infectious disease? IgA antibodies - mucous IgG antibodies - cross placenta IgM antibodies - only pentamer, 1st IgE antibodies - hypersensitivity and parasitis

IgA antibodies

Which of the following are not involved in the measurement of extrinsic pathway of coagulation cascade? Factor XII Factor X Factor VII Factor V

Factor XII

These are selectins found in lymphocytes and monocytes. L-selectin P-selectin E-selectin CD-31

L-selectin

These are intracellular proteins expressed from the bile duct epithelia. Uric acid Troponin Alkaline phosphatase Transaminase

Which among the following is a feature of irreversible cell injury? Presence of small clear vacuoles within cytoplasm Dilation of endoplastic reticulum Changes in cellular membrane, specifically blebbing None of the above

Leukocytes inability to migrate to the site of infection and inflammation due to a mutation in fucosyl transferase Leukocyte adhesion defect 1 Leukocyte adhesion defect 2 Myeloperoxidase deficiency Chronic granulomatous disease

Plasma membrane transport proteins where transport is relatively slow, solute binds and undergo a series of conformational changes to transport the ligand across the membrane Carrier protein Channel protein Facilitated Diffusion proteins None of the above

Carrier protein

The increase in heart size in chronic hemodynamic overload due to hypertension is largely due to fatty change myocyte intracellular accumulation muscle hyperplasia myocyte hypertrophy

HIV viral surface proteins essential for viral entry into cells. Gp41 P17 Gp120 p24

Gp120 receptor - CXCR

Autoimmune haemolytic anemia is an example of this hypersensitivity TYPE I TYPE II TYPE III TYPE IV

A patient with prolonged PTT and normal PT likely has a deficiency in which of the following coagulation factors? Factor VIII Factor VII Factor V Thrombin

Factor VIII

Along with SLE, Antiphospholipid antibody syndrome (APAS) has this target antibody which is present in endothelial cell walls, platelets, macrophages, and the mitochondria. Lipooligosaccharide Lipopolysaccharide Cardiolipin M protein

Cardiolipin and betaglycoprotein 1

Initial receptor for viral infection of measles virus expressed on activated lymphocytes, dendritic cells and monocytes. CD46 Nectin 4 SLAMF-1 CD155

SLAMF-1 CD155 - POLIO

Numerous factors are considered in platelet adhesion defects including loss of factors and glycoprotein deficiencies. One such deficiency is Glanzmann thrombasthenia which primarily involves which of the following complexes? gpIIb-IIa complex gpIIa-IIb complex gpIIb-IIIa complex gpIIa-IIIb complex

gpIIb-IIIa complex

This is a basic form of nuclear chromatin which is cytochemically dense and transcriptionally inactive Telomere Centromere Heterochromatin Euchromatin

Heterochromatin

Which of the following is responsible for Neutralization of microbe, phagocytosis and complement activation? Regulatory T-Lymphocyte Cytotoxic T-Lymphocyte Helper T-lymphocyte B-lymphocyte

B-lymphocyte -HELPER ONLY, SUPPORT

Which of the following is a stable cell Epidermis Cardiac Myocytes Neuron Hepatocyte

Hepatocyte

Indicate type of hypersensitivity reaction: Poststreptococcal glomerulonephritis TYPE I TYPE II TYPE III TYPE IV

TYPE III 1-IgE,th1 2-antibodies 3-antigen and antibody plus depositions 4-chronic clinical features

This occurs when a venous embolus passes through an interatrial or intraventricular defect and gains access to the systemic arterial circulation. air embolism Caisson’s disease paradoxical embolism fat embolism

paradoxical embolism caissons - air emboli

Cell death by necrosis due to mitochondrial dysfunction will be preceded by which event? increased sirtuins release of cytochrome C formation of mitochondrial permeability transition pores imbalance of BCL2 proteins causing outer membrane leakiness

formation of mitochondrial permeability transition pores

A 14 year-old female suddenly notices enlargement of her breast followed by cramping in the hypogastric area and episodic fatigue. What could be the cause of the changes in her breast? Physiologic hypertrophy Pathologic hypertrophy Physiologic hyperplasia Metaplasia

Physiologic hyperplasia

A 26-year- old man has a sudden loss of vision in the right eye. On physical examination, there is a subluxation of the right crystalline lens. On auscultation of the chest, a mid-systolic click is audible. Echocardiogram was requested showing a floppy mitral valve and dilated aortic arch. On interview, patient says his brothers also have similar symptoms. This is caused by a defect in? Collagen NF-2 NF-1 Fibrillin-1

Fibrillin-1 MARFAN SYNDROME NF - NEUROFIBROMATOSIS COLLAGEN - EHLER DANLOS

coagulation factors are inhibited by Protein C and S? Factors VIII and VWF Va and VIIIa II and IX IX and XIII

What is it called when viral agents have a predilection for certain types of cell to infect? Tropism Antigenic variation Transmission Virulence

Tropism

Cell change characterized by fading basophilia, presumably due to enzymatic degradation by endonucleases. Karyorrhexis Karyolysis Karyoptosis Pyknosis

Karyolysis

The following are autosomal dominant disorders except: Huntington disease Myotonic dystrophy Duchenne muscular dystrophy Hereditary spherocytosis

Duchenne muscular dystrophy

There is progressive fibrosis interstitial and perivascular fibrosis in the skin and multiple organs Mixed connective tissue disease SLE Sjogren scleroderma

scleroderma - CHRONIC INFLAMMATION *SJOGREN - DRY EYES, DRY MOUTH, DESTRUCTION LACRIMAL AND SALIVARY GLANDS *SLE -MULTIPLE ORGANS *MIXED CT -

A 24-year-old male student came for consult due to occasional dysuria. Further PE revealed a red swollen, tender "mass" in the left inguinal area and scanty, clear-to-white penile discharge. He admits to being sexually active with multiple partners. As a medical practitioner, your initial suspect would be infection caused by? Neisseria gonorrheae Treponema pallidum Chlamydia trachomatis Haemophilus ducreyi

Chlamydia trachomatis DYSURIA - STI-PENILE DISCHARGE YELLOWISH - GONORRHEA TREPONEMA - CHUNKER NOT PAINFUL HAEMOPHLUS - CHUNKROID PAINFUL

A 1-year-old child with failure to thrive now exhibits frequent episodes of seizure. Physical examination shows hepatomegaly and ecchymoses of the skin. His blood glucose is abnormally low. Biopsy of his liver was done revealing vacuolated cells positively staining for glycogen. The disease most likely to cause this is? Tay-Sachs disease McArdle Disease von Gierke Disease Pompe Disease

von Gierke Disease *G6 PHOSPHATASE SEVERE HYPOGLYCEMIA

Surface protein is S. pyogenes responsible for antibodies and T cells cross-reacting with cardiac proteins. LPS m protein c protein s protein none of the above

m protein

A Trinucleotide repeat Mutations are amplifications of a sequence of three nucleotides, they also are associated with an Anticipation-type of inheritance, An example is the second most common cause of Mental retardation with a prominent PE finding of Macro-orchidism. What Nucleotide repeat will be seen in this patient? CAG GAA CGA GCA NONE OF THE ABOVE ALL ARE CORECT

NONE OF THE ABOVE FRAGILE X SYNDROME (FMR-1) 200 OR MORE REPEATS

A 19 y/o female develops a sore throat and fever during the past day. Physical Exam shows pharyngeal erythema and congestion. She is given naproxen. Which of the following features of the acute inflammatory response is most affected by the drug Vasodilation Emigration Leukocytosis Phagocytosis

Vasodilation NSAIDS- NAPROXEN-PROSTAGLANDINS

Opportunistic pathogen that causes progressive multifocal leukoencephalopathy B. burgdorferi - lyme disease JC Virus C. difficile -psedomembranous colitis M. furfur - fungi

JC Virus