MLT GlobeBasic Pathology: Cell injury, adaptation & death
93 Basic Pathology MCQs on Cell injury, adaptation & death with answers and explanations.
In long-standing hypertension, the heart enlarges because individual cardiac muscle cells become bigger without dividing. This is:
Hypertrophy is an increase in cell size. Adult cardiomyocytes have almost no capacity to divide, so the heart enlarges through hypertrophy rather than hyperplasia (more cells).
If apoptosis in a tissue outpaces cell renewal for a long time, what is the expected result?
More programmed cell death than replacement shrinks the tissue. Too little apoptosis instead favours tumours and autoimmunity.
In a dying cell, a small, shrunken, uniformly dark nucleus is described as:
Pyknosis is nuclear condensation and shrinkage. Karyorrhexis is fragmentation, karyolysis is fading of the nucleus, and a vesicular nucleus is pale with open chromatin.
A myocardial infarct shows preserved cell outlines with no nuclei. Which necrosis typically follows ischaemia in solid organs?
Ischaemia in solid organs except the brain produces coagulative necrosis, where tissue architecture persists for days. Brain infarcts liquefy.
The heart of a weightlifter enlarges because its muscle fibres get bigger, not more numerous. This is:
Hypertrophy is increased cell size; hyperplasia is increased cell number. Cardiac myocytes cannot divide, so they adapt by hypertrophy.
If injury persists beyond the cell's ability to adapt, irreversible injury ends in:
Hypertrophy, atrophy and metaplasia are adaptations to stress. Irreversible injury ends in cell death, a key event in disease evolution.
A cardiac myocyte enlarges in response to long-standing hypertension. What mainly accounts for the larger cell size?
Hypertrophy results from more structural proteins and organelles. Increased DNA synthesis with mitosis describes hyperplasia, and water accumulation is cell swelling, a form of injury.
The thyroid gland of a patient with Graves disease enlarges because the number of follicular cells rises. This adaptation is called:
An increase in cell number that enlarges an organ is hyperplasia. Hypertrophy increases cell size, not number.
A woman with an estrogen-secreting ovarian tumor develops abnormal uterine bleeding and a thickened endometrium. The endometrial change is best classed as:
Excess hormonal stimulation causing endometrial proliferation is pathological hyperplasia, which increases the risk of endometrial carcinoma.
Long-standing acid reflux converts the squamous lining of the lower esophagus into intestinal-type columnar epithelium with goblet cells. This is an example of:
Replacement of one differentiated epithelium by another (squamous to columnar) is metaplasia. Barrett esophagus is the classic example and may later progress to dysplasia.
Which microscopic finding helps distinguish necrosis from apoptosis?
Necrosis releases cell contents through a ruptured membrane, provoking inflammation. Apoptosis shows shrinkage, apoptotic bodies and an intact membrane without inflammation.
A brain abscess and an old cerebral infarct both show tissue converted into a soft, fluid mass. Which type of necrosis is this?
Enzymatic digestion by neutrophils (bacterial infection) or the lipid-rich brain itself after hypoxia produces liquefactive necrosis.
A lymph node from a patient with tuberculosis shows cheesy, white-yellow material at its center. The necrosis is:
Caseous ('cheese-like') necrosis is typical of tuberculous granulomas, showing amorphous granular debris without preserved architecture.
Hypoxic death of cells in which setting characteristically produces liquefactive rather than coagulative necrosis?
Most solid organs show coagulative necrosis after ischemia, but brain infarcts liquefy because of the tissue's high lipid and enzyme content.
The left ventricle thickens in a patient with long-standing aortic stenosis. This change is classified as:
Cardiac myocytes cannot divide effectively, so pressure overload from hypertension or valve disease causes pathological hypertrophy.
Which of the following pigments is exogenous rather than produced within the body?
Carbon is inhaled from polluted air and stored in lung macrophages and lymph nodes. Lipofuscin, hemosiderin and bilirubin are endogenous pigments.
Which adaptation to increased demand is available only to tissues whose cells can still divide?
Hyperplasia requires cells able to proliferate. Non-dividing cells such as cardiac and skeletal muscle can only respond by hypertrophy.
After menopause, falling estrogen causes the endometrium and breast tissue to shrink. This change is best termed:
Loss of hormonal stimulation at menopause is a normal event, causing physiological atrophy. Aplasia means failure of an organ to develop.
Cellular adaptations such as hypertrophy and atrophy are considered:
Adaptations are reversible changes in cell size, number, phenotype or activity; cells return to baseline when the stimulus is withdrawn.
The heart of an elderly patient is small and dark brown owing to abundant wear-and-tear pigment. This appearance is called:
Lipofuscin accumulates in aging or atrophic cells; large amounts give organs a brown color, known as brown atrophy.