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Cellular Adaptation and Cellular Damage

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Question 1
Mature neurons are said to be ...
A
Labile
B
Formed
C
Stable
D
Permanent
Question 1 Explanation: 
Adult neurons are permanently fixed. There are, of course, exceptions, but the bulk - and certainly the preponderance of clinically relevant neurons - are considered non-convertible.
Question 2
Which cell type cannot undergo hyperplasia?
A
Lactotrophic cells
B
Hepatocytes
C
Endometrial
D
Pseudounipolar neuron
Question 2 Explanation: 
Neurons cannot undergo hyperplasia.
Question 3
Which are true of hypertrophic cells?
A
Increase in cell size
B
Occurs in permanent cells only
C
No new structural synthesis
D
No increase in cytosolic volume
Question 4
Increased cell size to compensate for a left ventricular outflow stenosis is an example of ...
A
Physiological hyperplasia
B
Pathological hyperplasia
C
Physiological hypertrophy
D
Pathological hypertrophy
Question 4 Explanation: 
In patients with aortic stenosis, the left ventricle must work harder to force the blood out. The cells will increase in size and therefore we get hypertrophy. As this is a result of a pathology (stenosis) it is pathological. Hypertension can also cause pathological hypertrophy. Physiological hypertrophy is sometimes seen in athletes.
Question 5
Which of the following may cause a sarcopenic vastus medialis?
A
Increased workload
B
Denervation
C
Increased perfusion
D
Endocrine hyperstimulation response
Question 5 Explanation: 
Denervation is the loss of nerve supply. The vastus medialis is a muscle found in the quadraceps. Loss of innervation to a muscle a commonly recognised cause of muscular atrophy.
Question 6

STEM 1 - Question 1

A patient with a history of GORD undergoes an endoscopy. On biopsy, the cells of the distal oesophagus are found to have undergone a cellular transition.
What kind of change are they likely to have undergone?
A
Metaplastic
B
Dysplastic
C
Neoplastic
D
Hyperplastic
Question 6 Explanation: 
This patient has Barrett's oesophagus. In a response to the inflammation from the continued exposure to stomach acid, the cells of the distal oesophagus undergo transformation from squamous cells to gastric columnar epithelium. This is a reversible change from one adult cell type to another. Therefore this a metaplastic change.
Question 7

STEM 1 - Question 3

Which is a more likely symptom?
A
Pain worse with cold drinks
B
Pain worse on standing
C
Pain between inferior angle of scapulae
D
Pain localised, sharp
Question 8

STEM 1 - Question 3

The cells continue to change, become undifferentiated and enter a premalignant phase, but are still bound to neuroendocrine regulation.
What state is this cell population best described as entering?
A
Metaplasia
B
Dysplasia
C
Neoplasia
D
Hyperplasia
Question 8 Explanation: 
This is a dysplastic change - the cells are beginning to lose their function and develop an atypical appearance but their growth is still under neuroendocrine control.
Question 9
A cell is proliferating even as pro-growth neuroendocrine signals are fully removed.
Which state best describes the above?
A
Metaplasia
B
Dysplasia
C
Neoplasia
D
Hyperplasia
Question 9 Explanation: 
Remember that neoplasia is an abnormal growth of cells that persists after the stimulus has been removed.
Question 10
A patient is in short term respiratory alkalosis due to a mountain climb.  Which best explains his state?
A
Oxygen-tension related hypoxia
B
Haemoglobin related anaemia
C
Ischaemic embolus
D
Ischaemic cardiac failure
Question 11
Which of the following is not a major method of cell injury?
A
Osmotic environmental damage
B
Enzymatic disruption
C
Biochemical reactions
D
Integrity of the cellular membrane
Question 12
Which cell type below would be most at risk first from a local infarct?
A
Skeletal muscle
B
Pancreatic beta cell
C
Enterocytes
D
Myocardial cell
Question 12 Explanation: 
Myocardial cells (cells of the heart) would be most at risk from ischaemia as they have a higher rate of glycolytic activity.
Question 13
Loss of cellular calcium homeostasis can cause...
A
DNA synthesis
B
Formation of cellular membranes
C
Decrease of ATPase activity
D
Increase of respiration rate
Question 14
Antioxidants such as ascorbic acid prevent damage from reactive oxygen species (ROS) via which best fitting mechanism?
A
Remove an electron from ROS
B
Generation of further free radicals
C
Reaction of inorganic with organic compounds
D
Donation of electron to ROS
Question 14 Explanation: 
ROS: reactive oxygen species are profoundly damaging to cells.
Question 15
A patient has sufficient UVB exposure to trigger generation of ROS.  Which of the following is increased in the epidermis as a response?
A
Deiodination of the membrane lipid
B
Autocatalytic chain reactions
C
Protein tertiary structure proliferation
D
DNA synthesis of mitochondria in the short term
Question 15 Explanation: 
Ultraviolet type B exposure is commonly seen from sunlight.
Question 16
Coagulative necrosis is:
A
Pathological
B
Physiological
C
Internally controlled
D
Nuclear dissolution
Question 17
Apoptosis is defined as
A
Enzymatical cell digestion
B
Cellular extravasation
C
Only physiologic
D
Nuclear dissolution
Question 18
T/F - coagulative necrosis utilises apoptotic enzymatic digestion
A
True
B
False
Question 19
A cerebrovascular accident (i.e. stroke) causes necrosis to the cortical grey matter. What is this type of necrosis classically defined as?
A
Coagulative
B
Caseous
C
Liquefaction
D
Gangrenous
Question 20
A patient has insidious fever onset, haemoptysis and is administered rifampicin and isoniazid for a number of months. Were a biopsy of her diseased lung to be taken, what necrotising pattern would be realised by the pathologist?
A
Coagulative
B
Caseous
C
Liquefactive
D
Gangrenous
Question 20 Explanation: 
The stem suggests the patient has tuberculosis. There is a common treatment algorithm and classically a caseous presentation of necrosis found in lung parenchyma.
Question 21
A 34YOF, currently breastfeeding her twins, presents with localised tenderness, redness and swelling of the periareolar region of the left breast.  A necrosis has occurred. Which type of necrosis is more likely?
A
Caseous
B
Fibrinous
C
Gangrenous
D
Lipid
Question 22
A patient presents with nonreducible mass of the scrotum revealed to be a varicocele.  What form of infarct is the ipsilateral testicle at risk of?
A
Red
B
White
C
Ischaemic
D
Proliferative
Question 23
In which of the following instances would pathological apoptosis be prudent?
A
ER stress
B
Embryogenesis
C
Proliferative potential loss of stem cell population
D
Potentially harmful lymphocytic elimination
Question 23 Explanation: 
In states of DNA, organelle damage, intracellular invasion (Eg viral) or pathological atrophy second to infarct/duct occlusion, pathological apoptosis is initiated.
Question 24
Which of the following are best matched to the process of apoptosis?
A
Enlarged cell size
B
Frequent adjacent cellular inflammation
C
Intact cellular contents
D
Disrupted cellular membrane
Question 25
Which of the following are best matched to the process of necrosis?
A
Cell shrinkage
B
Nuclear condensation (pyknosis)
C
Altered structure of lipid membrane, but integrity persists
D
No adjacent inflammation
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