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1

Which of the following is not a characteristic of a malignant tumor?
a. Lack of differentiation and morphology is often atypical
b. Rate of growth may be erratic and vary from slow to rapid
c. Cells are usually, well differentiated, cohesive and well demarcated
d. Are locally invasive

C

2

Prussian blue is often used to stain _____ in cells.
a. Iron
b. Mitochondria
c. Calcium
d. Ribosomes

A

3

___________ means one mature cell type which should be present in the specific site is reversibly replaced by another mature differentiated cell type.
a. Atrophy
b. Hypertrophy
c. Metaplasia
d. Hyperplasia

C

4

Which of the following descriptions related to necrosis and apoptosis are incorrect?
a. Both of necrosis and apoptosis are irreversible injuries.
b. The hallmark of apoptosis is chromatin condensation and cell fragments.
c. Inflammation presents in both of necrosis and apoptosis.
d. BothrequireATP.

C

5

Which of the following is a characteristic of fibrosis?
a. Consequence of previous damage, such as necrosis, to an organ
b. Replacement of normal cells in a tissue by collagen-producing cells, or
fibroplasia
c. Excess extra-cellular collagen decreases the original function of the organ
d. A and C
e. A, B and C

E

6

Match the below terms to the below definitions
Hyperplasia Hypertrophy Atrophy Metaplasia
1. a reversible change in which one adult cell type is replaced by another adult cell type
2. the number of cells in an organ or tissue is increased, resulting in the increase of organ volume
3. cell is enlarged without division, most commonly caused by more work load
4. reduced cell size resulted from cell substance lost

1. metaplasia
2. hyperplasia
3. hypertrophy
4. atrophy

7

The accumulation of protein fluid in between cells or within a cavity is called:
a. Infarction
b. Edema
c. Fibrosis

B

8

Which of the following effects is NOT typically compatible with an apoptosis pathway activated during embryogenesis?
a. Phagocytosis of apoptotic bodies and cells
b. DNAcleavageinto50-300kilobasefragments
c. Immediate breakdown of the plasma membrane
d. Chromatin condensation and formation of apoptotic bodies

C

9

A mass of neoplastic liver tissue is observed. Which of the following statements would have favorable prognostic value?
a. A tremendous number of mitotic events (mitotic figures) are observed.
b. A collagen capsule is observed surrounding the tissue mass.
c. Interdigitation of abnormal cells and anatomically normal hepatocytes is
observed.
d. Cells of the neoplastic mass share little resemblance to hepatocytes.

B

10

Which of the following is not a characteristic of apoptosis?
a. Cell shrinkage
b. Releasedcytoplasmiccontents
c. Absence of inflammation
d. Chromatin condensation

B

11

True or False: Dysplasia are disturbances in the size, shape, and organization of epithelial cells in response to injurious agents. While dysplasias normally regress, they also share cytologic features of cancer cells and are considered preneoplastic lesions.

TRUE

12

What of the following nuclear changes are not observable by basic H&E histology?
a. Pyknosis
b. Karyolysis
c. Karyomegaly
d. Aneuploidy

D

13

In regards to fibrosis, the collagen excess directly results from:
a. Release of collagen from necrotic cells
b. Secretionofcollagenfrominfiltratingmacrophages
c. Extracellular deposition of collagen from fibroblasts
d. Retentionofcellmembranesfromnecroticcells

C

14

Increased amounts of dark blue deposits in macrophages found in the lung when stained using Prussian Blue most likely suggests:
a. Emphysema
b. Tuberculosis
c. Lung collapse
d. Left heart failure

D

15

Intracellular depositions can include all of the following, EXCEPT:
a. Lipid droplets in the liver in fatty liver diseases
b. Mallory bodies found in people with alcoholism
c. Iron stored in hemosiderin
d. Collagen due to fibrosis

D

16

True or False: Within a tumor, all of the cells have the exact same mutations, such as there is absolutely no heterogeneity.

FALSE

17

What is the correct sequence of events in wound healing?
a. Granulation tissue, Wound contraction, Inflammation
b. Inflammation, Granulation tissue, Wound contraction
c. Wound contraction, Inflammation, Granulation tissue

B

18

Necrosis...
a. is found in the center of granulomas from patients with tuberculosis.
b. is characterized by a lack of an inflammatory response.
c. shows characteristic laddering of isolated DNA run on agarose gels.
d. can be seen in the heart under the light microscope with an H&E stained
section within 30 MINUTES after a myocardial infarct.

A

19

The prefix adeno- implies cancer from what type of cell
a. Glandular or ductal- epithelial
b. Neural
c. Adrenal gland
d. Mesenchymal lineage

A

20

20. Loss of innervation to a particular area of the body can cause that area to become:
a. Metaplastic
b. Atrophic
c. Hypertrophic
d. Hyperplastic

B

21

21. An increased thickness of the heart wall in response to resistance to blood flow
such as (high blood pressure) results from which of the following cellular processes?
a. Metaplasia
b. Hypertrophy
c. Hyperplasia
d. Inflammation

B

22

22. Why have programmed necrosis? Could be related to infections of certain pathogens. Which ones were implicated in Dr. Demarzo lecture notes?
a. prions
b. viruses
c. extra-cellular bacteria
d. cestodes

B

23

23. Autocrine, paracrine, and endocrine signaling can be summarized as follows: a. Autocrine factors signal the originating cell. Paracrine factors signal
immediately adjacent cells. Endocrine factors enter the circulatory system to signal distant cells.
b. Autocrine factors signal the originating cell. Paracrine factors enter the circulatory system to signal distant cells. Endocrine factors diffuse a short distance to signal nearby cells.
c. Autocrine factors signal the originating cell. Paracrine factors diffuse a short distance to signal nearby cells. Endocrine factors signal immediately adjacent cells.
d. Autocrine factors signal the originating cell. Paracrine factors diffuse a short distance to signal nearby cells. Endocrine factors enter the circulatory system to signal distant cells.

A

24

24. Tingible bodied macrophages are clues that which pathological process is occurring?
a. Metaplasia
b. Hypertrophy
c. Apoptosis
d. Hyperplasia

C

25

25. An increase in cell number due to physiological need within a tissue is called which of the following?
a. Metaplasia b. Hypertrophy c. Hyperplasia d. Hypoplasia

C

26

26. What is context dependent signaling?
a. The physiological response which creates stress granules in the nucleus
under different types of stress
b. The phenomenon where the same signaling factor can create different
responses in different cell types
c. When endocrine cells release factors in response to a specific stimuli d. Signaling which can occur even in the absence of upstream effectors

B

27

27. Which of the following characteristics is not found in in situ carcinoma? a. Invasion through basement membrane
b. Large, irregular nuclei
c. High mitotic rate
d. Clonal somatic mutations of cells

A

28

28. Select the words that complete the following sentence: ________ refers to growth of neoplastic cells into adjacent tissue, while ________ involves spreading to the body from primary site through lymphatic channels or blood vessels.
a. Metastasis; invasion
b. Invasion; metastasis
c. Invasion; transformation
d. Metastasis; immortalization

B

29

29. Which of the following blood proteins is important for maintaining osmotic pressure? a. Globulin
b. Fibrinogen
c. Albumin
d. C-reactive protein (CRP)

C

30

30. Lecture Question: The cortex of this brain shows a pathologic change called?
a. Infarction
b. Atrophy
c. Sclerosis
d. Astrocytoma

B

31

31. What is the most likely diagnosis?
a. Encephalitis
b. Brain abscess
c. Stroke- hemorrhage and necrosis d. Brain atrophy

C

32

32. Which is not an example of metaplasia:
a. columnar epithelium in the airways becoming squamous epithelium after
chronic exposure to cigarette smoke
b. neuron in the brain becoming a glial cell when exposed to glial transcription
factors
c. squamous epithelium in the esophagus becoming columnar epithelium after
chronic exposure to stomach acid
d. glandular epithelium of the cervix becoming squamous epithelium after
chronically low vaginal pH

B

33

33. Which of the following activities results in substantial hyperplasia of the specified tissue?
a. Exercising muscle cells
b. Regeneration of liver after hepatectomy- removing a liver lobe
c. De-innervating leg muscle

B

34

34. During tissue healing, the wound contraction phase coincides with the start of which process?
a. Leukocyte migration
b. Inflammation
c. Collagen accumulation and remodeling
d. Pus formation

C

35

35. After 24 hours following a myocardial infarct, damaged tissue can be identified by using H&E stain by observing which of the following.
a. An extensive network of fibrous scar-tissue. b. Cardiomyocyte hyperplasia.
c. Metaplasia
d. Absence of nuclei in cardiomyocytes.

D

36

36. Which of the following is not a type of cell adhesion molecule?
a. VCAM
b. Prostaglandins
c. Integrins
d. Cadherins

B

37

37. Corticosteroids cause ____________ in thymocytes of the thymus.
a. Hyperplasia
b. Hypertrophy
c. Metaplasia
d. Apoptosis

D

38

38. Which is the role of macrophage in wound healing?
a. Stimulate chemotaxis and the activation of inflammatory cells and fibroblasts.
b. Promote angiogenesis
c. Stimulate matrix remodeling and synthesis.
d. All of the above.

D

39

39. Fibrinoid necrosis occurs in which tissue?
a. Fibroids of the uterus
b. Fibrous connective tissue
c. Blood vessels

C

40

40. Which of the following is NOT a function of the extracellular matrix (ECM)?
a. sequester water to provide turgid support for cells
b. mechanical support for cell anchorage/migrating
c. helps control the growth of the cell
d. helps maintain cell differentiation via the type of ECM proteins expressed
e. allows space for foreign pathogens to navigate between cells more easily so
as not to disrupt the function of the cells
f. establishes tissue microenvironments, such as the boundary formed by the
basement membrane between the epithelium and the connective tissue below

E

41

blood cell type histology

A

42

42. Melanoma is highly associated with DNA damage due to UV radiation from sun exposures. 2 most frequently affected pathways are PI-3K (Phospholipid kinase) and BRAF (Serine/threonine kinase) pathways. In both pathways, there are 2 major tumor suppressers genes that are frequently mutated, giving rise to on-going activation of PI-3K and BRAF pathways which in turn, lead to melanocytic cell survival and proliferation. Name these two tumor suppressors.
a. P53, APC
b. P14, P15
c. PTEN, P16
d. PTEN, P14
e. P16, P53

C

43

43. Which of the following is not associated with increased signaling through a tyrosine kinase receptor?
a. Melanoma
b. Mastocytosis
c. Xeroderma pigmentosum
d. Seborrheic keratoses
e. Acanthosis nigricans

C

44

44. Which type of epithelium provides physical barrier function to the epidermis?
b. Langerhans cells
c. Stratified squamous epithelium
d. Melanocytes
e. Merkel cells

C

45

45. Antibodies to desmoglein-3 are found in which category of diseases?
a. Infectious
b. Neoplastic
c. Autoimmune
d. Toxic
e. Traumatic

C

46

46. Antibodies targeting IL-17 are effective treatment in which skin disease?
a. Melanoma
b. Mastocytosis
c. Psoriasis
d. Seborrheic keratoses
e. Acanthosis nigricans

C

47

47. Above is a schematic of a myocyte and key proteins mutated in dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM).
Which of the following is FALSE?
a. HCM is a 100% genetic disease but DCM is familial in 30-50% of cases
b. DCM arises from mutations in a group of genes encoding proteins in cytoskeleton and sarcolemma.
c. A mutation in a gene encoding nuclear envelop can also give rise to DCM.
d. In familial DCM, X-linked inheritance is the most predominant inheritance pattern.
e. Myosin binding protein C and myosin light chains are mutated in both DCM and HCM.

D

48

48. Above schematic describes the sequence of atherosclerotic plaque formation. Which of the following description is INCORRECT?
a. Endothelial injury can be caused by hypercholesterolemia, hemodynamic disturbances and even infectious agents.
b. The injury increases the vascular permeability and recruit platelets and circulating monocytes to the site of injury.
c. The inflammatory cytokines and growth factors released from macrophages cause smooth muscle cells to migrate and form plaques in intima.
d. Migrated smooth muscle cells proliferate and create extracellular matrix including collagen, proteoglycan and elastic fibers.
e. The cholesterol content in the plaque is due to imbalance of influx and efflux of Low density cholesterol (LDL) and High density cholesterol (HDL). LDL helps to clear lipid accumulated in the plaque.

E

49

49. Order of blood flow in the heart
a. RA > RV > LUNG > LA > LV
b. LUNG > LA > LV > RA > RV
c. RV > LV > LUNG > RA > RV
d. LA > LV > RA > RV > LUNG

A

50

50. A Carotid artery with atherosclerosis has all characteristics EXCEPT:
a. Has a markedly expanded intima
b. Has cholesterol clefts where the lipid was removed with processing the tissues
c. Many have eccentrically placement of the plaque in the vessel
d. Has numerous eosinophils within the plaque

D

51

51. Which is True about the heart after myocardial infarctions
a. The heart wall is most vulnerable to rupture at 4 days due to fibroblast infiltrate
b. The heart wall is most vulnerable to rupture at 10 days due to neutrophil infiltrate
c. The heart wall is most vulnerable to rupture at 4 days due to neutrophil infiltrate
d. The heart wall is most vulnerable to rupture at 4 days due to lymphocyte infiltrate

C

52

52. Cystic fibrosis is an ion transport disorder in the plasma membrane of ductal epithelia that leads to accumulation of thick mucus in the airways. Which of the following is FALSE?
a. The ion channel defect is due to mutations on cystic fibrosis transmembrane conductance regulator (CFTR) gene on chromosome 7q31.2 which encode protein components of the ion channel.
b. The mutation results in loss of Potassium secretion to the lumen.
c. The mutation results in loss of Chloride secretion to the lumen.
d. Increased resorption of Sodium and water dehydrates the mucus.
e. Thick mucus can block the airway and interrupt the muco-cilliary actions of the
airway.

B

53

53. When Tuberculosis is found in the lung, one way to distinguish it from Sarcoidosis in the lung would be:
a. Caseation of granulomas is seen only with sarcoidosis
b. Caseation (necrosis) of granulomas is seen only with in TB
c. Acid Fast positive bacteria in sarcoidosis
d. PCR positive Mycobacteria in sarcoidosis

B

54

54. What is a function of type II epithelial cells in the alveoli?
a. Transmit oxygen to the blood
b. Secrete mucous
c. Absorb water
d. Secrete surfactant

D

55

55. All is TRUE about a Lung with “heart failure cells” EXCEPT:
a. These cells would stain blue with Prussian blue
b. Heart failure cells are macrophages that ingested red blood cells
c. Most commonly seen with right heart failure versus left heart failure d. Prussian blue stains heart failure cells blue due to iron within cells

C

56

56. The alveolar pathology (pink fluid in airspaces) in the photo below is a photomicrograph of?
a. Emphysema
b. Pulmonary edema
c. Pulmonary fibrosis
d. Pulmonary granuloma

B

57

57. If you were to look into the bronchus from a person with asthma, one will see an increase amount of
a. plasma cells and mucous
b. Eosinophils and mucous
c. Monocytes and mucous
d. Neutrophils and mucous

B

58

58. Which of the following microorganisms is typically associated with epithelioid cells and giant cells?
a. Staphylococcus aureus
b. Streptococcus pyogenes
c. Pseudomonas aeruginosa
d. Mycobacterium tuberculosis

D

59

59. What substance secreted by cells in the alveolar wall helps to prevent collapse?
a. Mucin
b. Surfactant
c. Cytokines
d. Collagen

B

60

60. Prostate cancer has multiple risk factors including age, race, hormone levels and environmental influences. Which of the following information regarding pathogenesis of prostate cancer is INCORRECT?
a. Androgen can promote prostate cancer progression by binding to Androgen receptor (AR) and inducing cell growth and survival.
b. Polymorphic variation of CAG repeats on AR gene correlates to incidence of prostate cancer.
c. Many prostate cancers can escape androgen dependency and bypass Androgen-AR binding and activate alternate signaling pathways such as PI3K/AKT pathway.
d. Chromosomal rearrangement of ETS family transcription factor gene (ETV or ERG) next to TERT promoter is commonly found in prostate cancer.
e. In prostate cancer, genomic deletions or amplifications are more commonly found than point mutations.

D

61

61. What is the name for inflammation in the oviduct?
a. Salpingitis
b. Phlebitis
c. Orchiditis
d. Glossitis

A

62

62. Which of the following is NOT true of prostate cancer?
a. Typically occurs in the peripheral zone of the prostate
b. Is the late form of benign prostate hyperplasia (BPH)
c. There is no good imaging method to detect prostate cancer (compared to other tumors like breast cancer)
d. Has a heritable component

B

63

63. A sixty year old man comes into the doctor’s office and he tells the doctor that he wakes up a couple of times each night to urinate. His symptoms are likely due to:
a. Prostate cancer
b. Glandular hyperplasia in central zone of the prostate
c. Glandular Hyperplasia in the peripheral zone of the prostate

B

64

64. More than 70 different types of Human papillomavirus (HPV) have been identified to be able to cause warts (benign papilloma) in humans. High risk group HPV 16 AND 18 are associated with pathogenesis of cervical cancer and head and neck cancer. Immortalization of infected cells is due to oncogenic properties of 2 viral proteins. Which of the following has the CORRECT combination of 2 viral proteins? See above figure
a. E1, E5
b. L1, L2
c. E6, E7
d. L2, L1

C

65

65. In general, Endometriosis is a:
a. Vascular disease
b. Peritoneal disease
c. Thoracic disease
d. Ventricular disease

B

66

66. Both genetic and environmental factors can influence the development of testicular germ cell tumors. Certain alleles at KIT and BAK loci are linked to increased risk of familial germ cell tumor development, such that sons of affected fathers have 4X increased risk, and brothers have 8-10X increased risk of tumor development. Environmental factors may include in utero exposures to pesticides and nonsteroidal estrogens. However, regardless of an individual’s genetic or environmental predisposing factors, the pathogenesis of testicular germ cell tumors can vary depending on tumor type. Which of the following regarding testicular germ cell tumor pathogenesis is CORRECT?
a. Only spermatocytic seminomas originate from an intratubular germ cell neoplasia (ITGCN), which arise in utero but may remain dormant for many years.
b. 25% of yolk sac tumors, the most common type of germ cell tumor in adults, have activating mutations in the gene encoding KIT, a receptor tyrosine kinase.
c. Both seminomas and embryonal carcinomas express OCT3/4, a transcription factor involved in pluripotent stem cell maintenance.
d. Choriocarcinomas are highly malignant tumors typically associated with high levels of hemorrhage and necrosis as well as negative staining for human chorionic gonadotropin (HGC).

C

67

67. Type I Endometrial Carcinoma accounts for ~80% of endometrial malignancies. It is characterized by well differentiated glandular formations and endometrial hyperplasia. The development of endometrial carcinoma from normal tissue is also very well characterized and follows a stereotyped progression of mutations in tumor suppressors and oncogenes. Which of the following statements regarding mutations involved in the development of endometrial carcinoma is INCORRECT?
a. PTEN tumor suppressor mutations are found in 30-80% of endometrioid carcinomas.
b. The PI3K/AKT signaling pathway is stimulated by activating mutations in KRAS, which occur in ~25% of cases.
c. PIK3CA is a tumor suppressor gene that can contain activating mutations associated with invasion.
d. Loss-of-function mutations in ARID1A enhance PI3K/AKT signaling and occur in ~1/3 of tumors.

C

68

68.Occurring in all pregnancies, this photo shows an example of:
a. Metaplasia
b. Fibrosis
c. Hypertrophy d. Dysplasia

C

69

69. Which genes are NOT methylated or mutated in the understood progression to colorectal cancer?
a. p53
b. BRCA1
c. APC
d. KRAS

B

70

70. In cholera, what pathology in the mucosa would you see if you looked at intestines microscopically?
e. Necrotizing inflammation
f. Granulomatous inflammation
g. Neutrophilic inflammation
h. Normal mucosa

H

71

71. Which is FALSE related to Ulcerative colitis or Crohn’s disease
a. Crohn’s disease is transmural
b. Crohn’s disease has deep knife like ulcers
c. Ulcerative colitis has granulomas
d. Both have pseudopolyps

C

72

72. Where do colon cancers usually metastasize to?
a. Small intestines
b. Liver
c. Stomach
d. Salivary glands

B

73

73. Which is generally FALSE about a liver from a long term alcoholic
a. Fattydegenerationcanbeseeninhepatocytes
b. Fibrosis is rare
c. Inflammation is common
d. Hepatocyte regeneration occurs

B

74

74. Among colorectal neoplasias, which one of these four cancers has gene hypermethylation of the target genes listed here?
a. MYH-associated polyposis (MYH)
b. Sporadic colon cancer (MSH2, MLH1)
c. Hereditary nonpolyposis colorectal cancer (MSH2, MLH1)
d. Sporadic colon cancer (MLH1, BRAF)

D

75

75. The two most commonly found pathology in Alzheimer’s disease (AD) are accumulation of plaques and tangles in brains. The plaque is made of aggregates of Aβ peptides while the tangle is made of aggregates of Tau, a microtubule binding protein. Together, plaques and tangles contribute to neuronal damage through various means. Which of the following information regarding pathogenesis of AD is INCORRECT?
a. Mutations and copy number increase in Amyloid precursor protein (APP) gene can contribute to familial AD.
b. The Aβ portion of the APP is completely intracellular in location. c. Aβ oligomers aggregates can interrupt synaptic functions.
d. Aβ oligomer aggregates cause neuronal cell death.
e. Phosphorylated Tau protein cause microtubule disassembly and tangle
formation.

B

76

76. What type of cells are found in the meninges and are characteristic of viral meningitis?
a. Neutrophils
b. Lymphocytes
c. Basophils
d. Platelets

B

77

77. Which of the following is not caused by trinucleotide repeat in DNA?
a. Fragile X syndrome
b. Huntington disease
c. Friedreich ataxia
d. Alzheimer’s disease
e. Spinocerebellar ataxia

D

78

78. The cells in the CNS which myelinate axons are:
a. Neurons
b. Astrocytes
c. Oligodendroglia
d. Microglia

C

79

79. Which of the following disorders is not associated with cellular inclusions?
a. Multiple sclerosis
b. Huntington’s Disease
c. Alzheimer’s Disease
d. Parkinson’s Disease

A

80

80. Which of the following is not a feature of astrocytes?
a. major cell in CNS repair
b. act as physical barriers
c. branched cells found in both white and grey matter
d. wrap around and insulate axons

D

81

81. The “Lewy Body” observed in the image here is found in neurons from patients with which disorder.
a. Alzheimer’s disease
b. Huntington’s Disease
c. Pick’s Disease
d. Parkinson’s Disease

D

82

82. (see above figure) The tumor suppressor RB was first identified by studying retinoblastoma. Above schematic describes the pathogenesis of retinoblastoma and Knudson’s Two hit hypothesis for cancer development. Which of the following information is INCORRECT?
a. About 60% of retinoblastoma is familial form.
b. Two mutations hitting both alleles of RB is required for development of
retinoblastoma.
c. In familial cases, patients inherit 1 normal and 1 defective copy of RB gene, and
are at higher risk of losing the remaining normal RB due to spontaneous somatic
mutation.
d. In sporadic cases, retinoblastoma often develops in one eye only.
e. Familial retinoblastoma patients are at more risk of developing osteosarcoma,
breast and colon cancer.

A

83

83. An eye melanoma that invades and connect the iris to the cornea is growing in the:
a. Posterior chamber
b. Anterior chamber
c. Vitreous chamber
d. Retinal chamber

B

84

84. See above-Glaucoma is a collection of diseases characterized by distinct changes in the visual field and the cup of the optic nerve. It is associated with an impediment of aqueous humor egress from the eye (C, D) leading to elevated intraocular pressure. Which of the following statement about glaucoma is false?
a. Although the pathogenesis of glaucoma is still unknown, mutations in myocilin (MYOC) and optineurin (OPTN) are thought to be responsible of different
subsets of glaucoma
b. Presence of VEGF in the aqueous humor is thought to induce the
development of fibrovascular membrane over the surface of the iris. c. Retinoblastoma could be a cause of glaucoma.
d. Continued production of the aqueous humor by the trabecular network could
lead to intraocular pressure.
e. A single nucleotide polymorphism in the LOX1 gene is associated with
pseudoexfoliatin glaucoma.

D

85

85. Which of the following is NOT a characteristic of neutrophils?
a. Phagocytic
b. Have long life span and provides memory in immune response
c. Have multi-lobed nucleus and is incapable of cell replication
d. Respond to acute bacterial infection

B

86

86. The earliest stage of myeloid differentiation in the bone marrow is:
a. band.
b. promyelocyte.
c. myeloblast.
d. erythoblast.

C

87

87. For a 40 year old male, what proportion of the bone marrow is composed of hematopoietic cells?
a. 30%
b. 40%
c. 60%
d. 80%

C

88

88. Which of the following events is the earliest cellular event in inflammation?
a. Influx of monocytes
b. Influx of lymphocytes
c. Influx of neutrophils
d. Influx of fibroblasts

C

89

89. Autoimmune diseases develop due to a combination of inheritance of susceptible genes, defective self-tolerance and environmental triggers. Which of the following is NOT one of the susceptible genes associated with autoimmunity?
a. PTPN22
b. NOD2
c. IL-2 receptor
d. CTLA4
e. SOD2

E

90

90. Although we typically think of bone as a hard mineral structure, living bone is made up of proteins re critical to bone's structure and function. Osteogenesis imperfecta is an inherited disease, typically due to autosomal dominant mutations, that leads to too little bone formation and extremely fragile bones and can be fatal in severe cases. The DNA that encodes for which protein is mutated in this disease?
a. Hemoglobin
b. Collagen
c. Ras
d. Myosin

B

91

91. The cause of Paget’s disease is unknown. Recent evidence suggest genetic and environmental factors contributes to pathogenesis. Which of the following is TRUE?
a. The disease onset usually starts in young adults (15-20 years old).
b. 40-50% of familial cases and 5-10% of sporadic cases carry mutations on
SQSTM1 gene.
c. SQSTM1 mutation activates the NK-KB pathway which in turn decreases the
osteoclast activity.
d. Paget’s disease can be broken down into 3 sequential stages. First a quiescent osteosclerotic stage followed by osteoclastic-osteoblastic stage and osteolytic stage.
e. It is most common in native populations of Scandinavia, China, Japan, and Africa.

B

92

92. What cells are shown in the images?
a. upper image: osteocytes, lower image: osteoclasts
b. upper image: osteoclasts, lower image: osteoblasts
c. upper image: osteoblasts, lower image: osteocytes
d. upper image: osteoblasts, lower image: osteoclasts

D

93

93. Spinal Muscular Atrophy is an autosomal recessive disorder that is caused by loss of function mutations in the SMN1 gene. Loss of SMN1 function can lead to loss/death of many motor neurons in utero. Some survive to innervate the muscle. The image below shows skeletal muscle taken from someone with SMA. Many of the de- innervated fibers are rounded and atrophic, which is denoted by the name of the disorder. What process is happening in the innervated myofibers indicated by the green arrows- see below photo?
a. Satellite cell metaplasia
b. Compensatory hypertrophy
c. Apoptosis
d. Myocyte hyperplasia

B

94

94. Above schematic describes the relationship of sarcolemma and its associated proteins. Which protein is an intracellular protein which bridges cytoskeletal proteins and transmembrane proteins and loss of function of this protein is due to a mutation of this gene on X chromosome causing X-linked muscular dystrophy or Duchenne muscular dystrophy. What is this protein?
a. Dystrobrevin
b. Dystrophin
c. Dysbindin
d. Syntrophins
e. Dystroglycans

B

95

95. This diagram illustrates possible mechanisms of development of polycystic kidney disease (PKD). The current hypothesis describes mutations on genes that encode cilium of the tubular epithelium of the kidney initiate the disease. Which of the following genes is not associated with PKD?
a. Nephrocystin
b. Fibrocystin
c. Polycystin 1
d. Polycystin2
e. Polycystin3

E

96

96. Which is NOT a normal function of the kidney?
a. Filtration and waste excretion
b. Homeostasis of water-soluble molecules
c. Electrolyte homeostasis/acid-base balance
d. Excretion of large molecular weight proteins
e. Hormone production such as renin

D

97

97. The key cell implicated in the pathogenesis of proteinuric states is the:
a. Neutrophil
b. Tubular epithelial cell
c. Podocyte
d. Eosinophil

C

98

98. Of the following measures of renal function, which is best to estimate glomerular filtration rate?
a. urine volume
b. creatinine clearance
c. urinary protein excretion
d. urinary sodium excretion

B

99

99. Alcohol will cause which of the following: a. Inhibition of ADH, urine dilute
b. Increase in ADH, urine concentrated
c. Increase in ADH, urine dilute
d. Inhibition of ADH, urine concentrated

D

100

100. What is this structure name?
a. glomerulus
b. ascending tube
c. descending tube
d. loop of henle

A

101

101. A patient in renal failure who is anemic would likely have inadequate levels of which of the following proteins (since it is made by the kidney)?
a. Erythropoietin
b. Colony-Stimulating Factor
c. Thrombopoietin
d. Prothrombin

A

102

102. Panel A of the above figure shows formation of immune complexes in membranous nephropathy, which occurs when antibodies react to antigens present in the glomerulus. Complement activation and shedding of immune complexes in membranous nephropathy most often occurs due to antibodies binding to which of the following proteins present on the glomerular epithelial cell membrane?
a. Epidermal growth factor receptor (EGFR)
b. Ezrin (EZR)
c. M-type phospholipase A2 receptor (PLA2R) d. Radixin (RDX)

C