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65 Cards in this Set

  • Front
  • Back
Which of the following electrolytes has the greatest influence on body fluid distribution?
a. Bicarbonate
b. Calcium
c. Chloride
d. Potassium
e. Sodium
e. sodium
In a patient with hypovolemic shock, which of the following tissues is most vulnerable to effects of poor perfusion?
a. myocardium
b. pulmonary parenchyma
c. Renal tubular epithelium
d. smooth muscle of bowel wall
c. renal tubular epithelium
Cyanide exerts its toxic effect on cells by interference with mitochondria oxidative phosphorylation. Therefore, of the following, the earliest light microscope morphology manifestation of accidental cyanide ingestion would be
a. Cellular swelling
b. Dispersion of ribosomes
c. Membrane “blebs”
d. Mitochondrial calcification
e. Nuclear pyknosis
a. Cellular swelling
Which of the following statements best defines the term “labile cells”?
a. Cells in a continuous cycle of cell division
b. Cells incapable of mitotic division
c. Cells which have a constant but irregular mitotic rate
d. Cells which rarely divide but proliferate in response to injury
e. Cells that require the presence of growth factors for mitotic division
a. cells in a continuous cycle of cell division
Which of the following is most likely to have grossly identifiable lines of Zahn?
a. Arterial Thrombus
b. Capillary Thrombus
c. Extravascular hematoma
d. Postmortem Clot
e. Venous Thrombus
a. Arterial Thrombus
Of the following cell types, the first to aggregate at the site of acute tissue injury usually is:
a. B-lymphocytes
b. Macrophages
c. Neutrophils
d. Plasma cells
e. T-lymphocytes
c. Neutrophils
A 75-year-old man, who carries a diagnosis of severe atherosclerotic peripheral vascular disease has had impaired arterial blood supple to the lower extremities for several years. One would expect to find which of the following as an associated condition?
a. Atrophic skin
b. Fatty hypoplasia
c. Muscular hypertrophy
d. Osseous metaplasia
e. Subcutaneous pitting edema
a. Atrophic skin
Following a myocardial infarction, the increased level of the serum enzyme creatine kinase is due to:
a. Mitochondrial swelling
b. Nuclear lysis
c. Increased permeability of plasma membrane
d. Increased endoplasmic reticulum
e. Increased golgi activity
C.Increased permeability of plasma membrane
A 55-year-old woman is diagnosed with infiltrating ductal carcinoma of the left breast for which she chooses to undergo a modified radical mastectomy. On a routine follow up visit six months later, she complains of being unable to wear her wedding ring because of swelling in her hand and arm. The swelling is most likely due to
a. Increased intravascular hydrostatic pressure
b. Decreased intravascular osmotic pressure
c. Increased interstitial osmotic pressure
d. Decreased interstitial hydrostatic pressure
e. Decreased lymphatic drainage
e. Decreased lymphatic drainage
A 48 year old chronic alcohol abuser presents with complications of abdominal pain. Laboratory data reveals abnormal liver function and a liver biopsy shows lipid accumulation within the hepatocytes. The lipids are most likely located in which of the following locations?
a. Cytoplastmic vacuoles (liposomes)
b. Lysosomes
c. Mitochondria
d. Nucleus
e. Rough ER
a. Cytoplastmic vacuoles (liposomes)
Over the course of 18 hours, a 16 month old girl develops a fever (102 F), becomes irritable, and begins pulling at her left ear. A diagnosis of acute otitis media is established. In this instance, fever is a result of inflammatory mediators (endogenous pyrogens) released primarily from which cell type?
a. eosinophils
b. fibroblasts
c. macrophages
d. mast cells
e. plasma cells
c. macrophages
Of the following, the earliest step in the formation of a thrombus is usually
a. Activation of thrombus
b. Development of fibrin plugs
c. Endothelial injury
d. Margination of leukocytes
e. Trapping of red cells
c. Endothelial injury
Most infarcts of the kidney are ultimately replaced by
a. Cystic cavities
b. Calcium deposits
c. Granulomatous inflammation
d. Regenerated parenchyma
e. Scar tissue
e. scar tissue
During a routine physical exam for a new insurance policy, a 52 yo male is noted to have an enlarged heart shadow on chest x-ray. EKG suggests left ventricular hypertrophy which is confirmed by cardiac ultrasound. The muscle hypertrophy is due to
a. Chronic inflammation
b. Decreased nutrient supply
c. Increased hormonal stimulation
d. Increased resistance to blood flow
e. Increased peripheral sensitivity to growth factors
d. Increased resistance to blood flow
Of the conditions listed below, the most common cause of delayed wound healing is
a. foreign body reaction to sutures
b. infection
c. malnutrition
d. vit c deficiency
e. zinc deviciency
b. infection
of the following, caseous necrosis would most likely be associated with
a. pulmonary tuberculosis
b. soft tissue abcesses
c. strep throat
d. thrombophlebitis
e. viral bronchitis
a. pulmonary tuberculosis
A 56 yo diabetic man, who has had atrial fibrillation since a myocardial infarc seven years ago, developed acute appendicitis. On the fourth post op day, he experienced left flank pain, paralysis of the right side of the body and sharply demarcated ischemic changes in the left foot. These signs and symptons are most likely due to
a. Arterial thromboemboli
b. Diabetic vascular dz
c. Fat embolism syndrome
d. Septicemia
e. Venous thrombosis
a. Arterial thromboemboli
Which of the following is a feature of healing by second intention that is not present in healing by first intention?
a. Collagen synthesis
b. Epithelialization
c. Inflammatory cells
d. Neovascularization
e. Wound contraction
e. Wound contraction
A 17 yo woman presents to the emergency room with a 12 hr hx of nausea, vomiting, and right lower quadrant abdominal pain. A CBC reveals an elevted white blood cell count. She was taken to surgery and the appendix removed. Histological examination of the appendix revealed each of the following features listed below. Which is the most indicative of acute appendicitis?
a. Dilation of blood vessels
b. Interstitial edema
c. Neutrophilic infiltrate
d. Pyknotic nuclei
e. Swelling of cell cytoplasm
c. Neutrophilic infiltrate
An 8 yo boy develops a sore throat, fever, and a clear nasal discharge indicative of the common cold. In the inflammatory infiltrate within the submucosal tissue, of the nasopharynx, you would expect to find predominance of
a. Neutrophils
b. Lymphocytes
c. Mast cells
d. Eosinophils
e. Plasma cells
b. Lymphocytes
A 23 yo woman presented to her physician with a history of abrupt onset of fever and left flank pain. Her physician suspects that has an acute infection of the left kidney. Which of the following findings on routine CBC would support the suspected dx?
a. eosinophilia
b. granulocytosis
c. leucopenia
d. lymphocytosis
e. thrombocytopenia
b. granulocytosis
The most common underlying cause of fat emboli syndrome is
a. Diabetes mellitus
b. Enzymatic fat necrosis
c. Fractures of long bones
d. Trauma to subcutaneous soft tissue
e. Steatosis
c. Fractures of long bones
A 55 yo female develops left ventricular heart failure and pulmonary congestion. If the congestion becomes chronic, it may eventually lead to which of the following pulmonary complications?
a. Alveolar pneumocyte hyperplasia
b. Gangrenous necrosis
c. Granulomatous inflammation
d. Interstitial fibrosis
e. Malignant neoplasms
d. Interstitial fibrosis
The erythema associated with acute inflammation is the result of
a. Dilation of blood vessels
b. Edema of interstitial tissue
c. Margination of leukocytes
d. Precipitation of fibrin
e. Thrombosis of blood vessels
a. Dilation of blood vessels
The underlying tissue damage in most cases of hemorrhagic infaction of the lung is
a. Caseous necrosis
b. Coagulation necrosis
c. Fibrinoid necrosis
d. Gangrenous necrosis
e. Liquefaction necrosis
b. Coagulation necrosis
The principal types of proliferating cells in granulation tissue are
a. Fibroblasts and macrophages
b. Fibroblasts and endothelial cells
c. Leukocytes and endothelial cells
d. Lymphocytes and fibroblasts
e. Make it rain on them hoes
b. Fibroblasts and endothelial cells
The fibrin thrombi seen in associate with disseminated intravascular disease are typically found in the
a. aorta
b. capillaries
c. coronary arteries
d. leg veins
e. lymphatic channels
b. capillaries
Which of the following types of exudate would have the lowest protein count
a. Catarrhal
b. Fibrinous
c. Hemorrhagic
d. Purulent
e. Serous
e. Serous
. A 77 yo man dies after two years of progressive congestive heart failure that was refractory to treatment. On microscopic examination of the lungs, which of the following might you expect to see in the alveolar macrophages?
a. Apoptotic bodies
b. Autophagic vacuoles
c. Hemosiderin pigment
d. Karyorrhexis
e. Mitochondrial calcification
c. Hemosiderin pigment
Chronic free radical damage to cells is reflected morphologically by
a. Accumulation of lipofuscin pigment
b. Calcification of mitochondria
c. Cytoplasmic eosinophilia
d. Ridin’ dirty
e. Nuclear chromatin clumping
a. Accumulation of lipofuscin pigment
Non union of a bone fracture us usually due to
a. Inadequate immobilization
b. Malnutrition
c. Osteoclastic bone resorption
d. Secondary infection
e. Soft tissue hemorrhage
a. Inadequate immobilization
During the third trimester of pregnancy, prolactin secretion from the pituitary gland stimulates glandular epithelial cells of the breasticles to produce milk. The glandular epithelial cells typically respond by undergoing
a. Atrophy
b. Dysplasia
c. Hyperplasia
d. Hypertrophy
e. Metaplasia
c. Hyperplasia
A characteristic feature of apoptotic cell death is the
a. Activation of fibroblasts
b. Energy dependent mechanism of destruction
c. Extensive tissue damage
d. Granulomatous inflammatory rx
e. Hemorrhage into surrounding tissue
b. Energy dependent mechanism of destruction
Prostacyclin and thromboxane are products of which pathway
a. Complement cascade
b. Cyclooxygenase
c. Lipoxygenase
d. Coagulation cascade
b. Cyclooxygenase
Which of the following is the principal factor underlying localized edema in inflammation
a. Lymphatic obstruction
b. Increased capillary permeability
c. Reduced extravascular osmotic pressure
d. Obstruction of arterial outflow
b. Increased capillary permeability
The enzymes responsible for the liquefaction of tissue in an abscess are mainly
a. Lymphocytes
b. Macrophages
c. Mast cells
d. Necrotic cells
e. Neutrophils
e. Neutrophils
Which of these terms best describes a pin-point hemorrhage?
a. Ecchymoses
b. Hematoma
c. Petechia
d. Hemothorax
c. Petechia
Cervical tissue from a 24 yo woman shows squamous epithelium of the endocervical canal which is normally lined by mucous secreting columnar epithelium. This is felt to be caused by
a. Bacterial infection
b. Chronic irritation
c. Congenital defect
d. Genetic mutation
e. Immunologic rxn
b. Chronic irritation
Most pulmonary thromboemboli originate
a. Deep leg veins
b. Inferior vena cava
c. Pelvic venous plexus
d. Portain vein
e. Perkinje fibers
a. Deep leg veins
All of these are related to right sided hear failure except
a. hepatic congestion
b. pulmonary congestion
c. portal hypertension
d. engorgement of the neck veins
b. pulmonary congestion
In the process of necrosis, a reduction in the size of the nucleus and a condensation of nuclear material is known as
a. Pyknosis
b. Karyolysis
c. Karyorrhexis
d. Metachromasia
a. Pyknosis
Interleukin-1 and tumor necrosis factor of inflammation are produced by what bad ass mother of a cell?
a. Platelets
b. Mast cells
c. lymphocytes
d. activated macrophages
d. activated macrophages
This represents deposition of calcium salts within normal tissues
a. dystrophic calcification
b. hyperplastic calcification
c. metastatic calcification
d. neoplastic calcification
c. metastatic calcification
Which of the organisms would be least likely to produce chronic granulomatous inflammation?
a. Strep pneumoniae
b. Mycobacterium tuberculosis
c. Histoplasma something something something
d. Pneumocystis carinii
a. Strep pneumoniae
Chronic granulomatous inflammation is characterized by all these except:
a. macrophages
b. neutrophils
c. epitheliod cells
d. giant cells
b. neutrophils
. The intrinsic coagulation pathway involves all of these factors except
a. VII
b. XI
c. IX
d. XII
a. VII
Coagulation necrosis is best described
a. Eosinophilic cytoplasm with cell outline preserved
b. Granular, friable mass of material with no cell outline
c. Localized, solid, basophilic lesion with decalcification
d. Necrosis in which tissue is converted to a fluid
a. Eosinophilic cytoplasm with cell outline preserved
All of the following are possible mechanisms by which cells are induced to grow except
a. Decrease in cell density
b. Loss of contact inhibition
c. Low oxygen tension
d. Stimulation by growth factors
c. Low oxygen tension
A 16 yo female was bit by an unknown insect on the inner thigh. Within an hour, the surrounding skin had developed a distinct redness. This is most likely due to
a. Edema
b. Hyperemia
c. Injected pigment
d. Lymphatic obstruction
e. Venous thrombosis
b. Hyperemia
At autopsy, a 69 yo female was found to have hemosiderin laden alveolar macrophages, “nutmeg” liver, hydrothorax and dependent edema. Most likely explanation is:
a. Congestive heart failure
b. Deep leg vein thrombosis
c. Disseminated intravascular coagulation
d. Hemophilia A
e. Pulmonary infarct.
a. Congestive heart failure
. A 76 yo male with a documented coronary artery dz develops signs and symptoms suggestive of a MI. Microscopic examination of the heart is most likely to reveal:
a. Caseous necrosis
b. Coagulation necrosis
c. Enzymatic fat necrosis
d. Gangrenous necrosis
e. Liquefactive necrosis
b. Coagulation necrosis
Inflammatory vasodilation can be evoked by each of the following except:
a. Angiotension
b. Histamine
c. C3 and C5
d. Bradykinin
a. Angiotension
In viral and rickettsial infections, this cell type usually predominates
a. Neutrophil
b. Macrophage
c. Eosinophil
d. Lymphocyte
d. Lymphocyte
54. Fungal infections usually produce which type of inflammatory response
a. Acute fibrinopurulent
b. Acute hemorrhagic
c. Chronic granulomatous
d. A and B
c. Chronic granulomatous
Monocytes give rise to
a. Macrophages
b. Epithelioid cells
c. Giant cells
d. All the above
d. All the above
This cell is usually associated with allergic rxns and parasitic infestations
a. Neutrophil
b. Eosinophil
c. Macrophage
d. Basophil
b. Eosinophil
Tissue damage at the site of acute inflmmation is often the result of release of enzymes from which neutrophil organelle:
a. Liposome
b. Golgi apparatus
c. Rough Er
d. Lysosome
d. Lysosome
Which componenet of complement is the most powerful chemoattractant
a. C3a
b. C3b
c. C5a
d. C6-8
c. C5a
Which tissue is the most susceptible to liquefactive necrosis following ischemic injury
a. Brain
b. Intestine
c. Liver
d. Pancreas
a. Brain
An abscess in the oral cavity with central necrosis extruding pus with sulfur granules would be caused by which of the following
a. Furuncle
b. Tuberculosis
c. Actinomycosis
d. Vincents infection
c. Actinomycosis
Which of the following do striated muscle, smooth muscle, and cardiac muscle have in common?
a. Hyperplasia of these elements is common
b. They have a limited capacity to regenerate
c. Hypertrophy is a common response to injury
d. They need a constant high o2 concentration
e. This is a really shitty question
f. B and E
b. They have a limited capacity to regenerate
. In the process of cell death, lysosomal enzymes function mainly to
a. Autolyze necrotic cells
b. Mediate cell degeneration
c. Act as a major target for cell injury
d. Activate the complement sequence
a. Autolyze necrotic cells
Which of the following pathologic changes is irreversible?
a. Fatty change in liver cells
b. Karyolysis in myocardial cells
c. Glycogen deposition in hepatocyte nuclei
d. Hydropic vacuolization of renal tubules
b. Karyolysis in myocardial cells
Which of the following inflammatory response is associated with an infection cause by pyrogenic pathogens?
a. Catarrhal
b. Granulomatous
c. Pseudomembranous
d. Acute suppurative
d. Acute suppurative
During repair, which of the following substances is essential for procollagen fibers to transform into collagen fibers?
a. Cortisone
b. Carotene
c. Ascorbic acid
d. Prothrombin
e. Thromboplastin
c. Ascorbic acid