review cell adaptation, injury and death

8/17/2019 REVIEW Cell Adaptation, Injury and Death

1/101

ReviewAdaptasi, Jejas dan

Kematian sel

Penimbunan patologis


2/101

A 48-year-old male with a history of

hroni al oholism who is ontinuingto perform ade!uately on the job willmost often have whi h of thefollowing "ndings in liver#

$A% &holestasis$'% (atty hange$&% )emo hromatosis

$*% )ypertrophy of smooth endoplasmireti ulum$+% &oagulative ne rosis


3/101

A 48-year-old male with a history of

hroni al oholism who is ontinuingto perform ade!uately on the job willmost often have whi h of thefollowing "ndings in liver#

$A% &holestasis$'% (atty hange$&% )emo hromatosis

$*% )ypertrophy of smooth endoplasmireti ulum$+% &oagulative ne rosis


4/101

&ellular injury through generation of

free radi als is +A . typi al for#A/ Pulmonary di0use alveolar damagefrom o1ygen to1i ity'/ A ute purulent in2ammation&/ A umulation of lipo hrome pigmentin myo ardium with aging*/ Radiation therapy for breast

ar inoma+/ A ute myo ardial infar tion


5/101

&ellular injury through generation of

free radi als is +A . typi al for#A/ Pulmonary di0use alveolar damagefrom o1ygen to1i ity'/ A ute purulent in2ammation&/ A umulation of lipo hrome pigmentin myo ardium with aging*/ Radiation therapy for breast

ar inoma+/ A ute myo ardial infar tion/


6/101

3n whi h of the following situations is

epithelial metaplasia most li ely tohave o urred#A/ .anning of the s in following sunlighte1posure'/ a tation following pregnan y&/ 5itamin A de" ien y*/ A ute myo ardial infar tion

+/ 6rinary obstru tion from an enlargedprostate


7/101

3n whi h of the following situations is

epithelial metaplasia most li ely tohave o urred#A/ .anning of the s in following sunlighte1posure'/ a tation following pregnan y&/ 5itamin A de" ien y/*/ A ute myo ardial infar tion

+/ 6rinary obstru tion from an enlargedprostate


8/101

)ypertrophy is best illustrated by#

A/ .he uterine myometrium inpregnan y'/ .he female breast at puberty&/ .he liver following partial rese tion*/ .he ovary following menopause+/ .he ervi1 with hroni in2ammation


9/101

)ypertrophy is best illustrated by#

A/ .he uterine myometrium inpregnan y/'/ .he female breast at puberty&/ .he liver following partial rese tion*/ .he ovary following menopause+/ .he ervi1 with hroni in2ammation


10/101

Karyorrhe1is refers to#

A/ *isintegration of the ell ytoplasm'/ &ell membrane lysis&/ *isintegration of the ell nu leus*/ 7ito hondrial swelling and lysis+/ 1ygen to1i ity


11/101

Karyorrhe1is refers to#

A/ *isintegration of the ell ytoplasm'/ &ell membrane lysis&/ *isintegration of the ell nu leus/*/ 7ito hondrial swelling and lysis+/ 1ygen to1i ity


12/101

A 49-year-old s hi:ophreni male

dran a pint of ;eritol $ ontainingvitamins with iron% ea h day for


13/101

A 49-year-old s hi:ophreni male

dran a pint of ;eritol $ ontainingvitamins with iron% ea h day for


14/101

=hi h of the following tissues is

most li ely to withstand hypo1ia withthe least damage in a patient withloss of blood pressure and resultantsho #

A/ eletal mus le'/ mall intestinal epithelium&/ Retina

*/ 7yo ardium+/ )ippo ampus


15/101

=hi h of the following tissues is

most li ely to withstand hypo1ia withthe least damage in a patient withloss of blood pressure and resultantsho #

A/ eletal mus le/'/ mall intestinal epithelium&/ Retina

*/ 7yo ardium+/ )ippo ampus


16/101

(o al fat ne rosis is most often

asso iated with whi h of thefollowing lini al onditions#A/ (ibrinous peri arditis'/ &hroni salpingitis&/ A ute pan reatitis*/ )epatitis+/ A ute gastritis


17/101

(o al fat ne rosis is most often

asso iated with whi h of thefollowing lini al onditions#A/ (ibrinous peri arditis'/ &hroni salpingitis&/ A ute pan reatitis/*/ )epatitis+/ A ute gastritis


18/101

.he spleen at autopsy on se tioning

shows a tan to white, wedge-shapedlesion with base on the apsule/ .hismost li ely represents the result of#

A/ &oagulative ne rosis'/ Abs ess formation&/ 7etaplasia*/ &aseous ne rosis

+/ i!uefa tive ne rosis


19/101

.he spleen at autopsy on se tioning

shows a tan to white, wedge-shapedlesion with base on the apsule/ .hismost li ely represents the result of#

A/ &oagulative ne rosis/'/ Abs ess formation&/ 7etaplasia*/ &aseous ne rosis

+/ i!uefa tive ne rosis


20/101

A >?99 gm liver from a >?-year-old

female has a yellow, greasy utsurfa e/ .his appearan e most li elyresulted from#

A/ ;ala tosemia'/ 3ron a umulation&/ 7y oba terium tuber ulosis infe tion*/ Al oholism

+/ )ypo1ia


21/101

A >?99 gm liver from a >?-year-old

female has a yellow, greasy utsurfa e/ .his appearan e most li elyresulted from#

A/ ;ala tosemia'/ 3ron a umulation&/ 7y oba terium tuber ulosis infe tion*/ Al oholism/

+/ )ypo1ia


22/101

3n whi h of the following ases will thegreatest degree of permanent damageresult#

A/ .uber ulosis infe tion with solitaryaseating granuloma of lung

'/ A ?9-year-old male surviving a myo ardialinfar tion&/ )uman papillomavirus infe tion with

ervi al dysplasia*/ Adult revived after being at the bottom ofa swimming pool for @9 minutes+/ 7ultiple transfusions of red blood ells for

hroni anemia


23/101

3n whi h of the following ases will thegreatest degree of permanent damageresult#

A/ .uber ulosis infe tion with solitaryaseating granuloma of lung

'/ A ?9-year-old male surviving a myo ardialinfar tion&/ )uman papillomavirus infe tion with

ervi al dysplasia*/ Adult revived after being at the bottom ofa swimming pool for @9 minutes/+/ 7ultiple transfusions of red blood ells for

hroni anemia


24/101

A ?>-year-old male who isdeveloping an a ute myo ardialinfar tion from oronary o lusionhas an irreversible injury to themyo ardium when#

$A% ;ly ogen is depleted$'% &ytoplasmi sodium in reases$&% u lei undergo aryorrhe1is

$*% 3ntra ellular p) diminishes$+% 'lebs form on ell membrane


25/101

A ?>-year-old male who isdeveloping an a ute myo ardialinfar tion from oronary o lusionhas an irreversible injury to themyo ardium when#

$A% ;ly ogen is depleted$'% &ytoplasmi sodium in reases$&% u lei undergo aryorrhe1is/

$*% 3ntra ellular p) diminishes$+% 'lebs form on ell membrane


26/101

=hile in a home improvement enterwarehouse buying paint, a >?-year-oldmale hears B oo out belowCB and isthen stru on the leg by a falling palletra / .he yellow-brown olor of the

bruise to his thigh a ouple of wee safter injury is due to a umulation of#A/ ipofus in'/ 'ilirubin&/ 7elanin*/ )emosiderin+/ ;ly ogen


27/101

=hile in a home improvement enterwarehouse buying paint, a >?-year-oldmale hears B oo out belowCB and isthen stru on the leg by a falling palletra / .he yellow-brown olor of the

bruise to his thigh a ouple of wee safter injury is due to a umulation of#A/ ipofus in'/ 'ilirubin&/ 7elanin*/ )emosiderin/+/ ;ly ogen


28/101

After years of breathing dirty ity air,your lungs have a umulated#

A/ Anthra oti pigment'/ ipofus in&/ 7elanin*/ )emosiderin+/ 'iliverdin


29/101

After years of breathing dirty ity air,your lungs have a umulated#

A/ Anthra oti pigment/'/ ipofus in&/ 7elanin*/ )emosiderin+/ 'iliverdin


30/101

+ven after thrombolyti therapy torestore oronary blood 2ow early inthe ourse of a myo ardial infar tion,a reperfusion injury o urs be ause of#

A/ &ytos eletal intermediate "lament loss

'/ A de reased intra ellular p) fromanaerobi gly olysis&/ An in rease in to1i o1ygen radi als

*/ 7ito hondrial swelling+/ u lear hromatin lumping andde reased protein synthesis


31/101

+ven after thrombolyti therapy torestore oronary blood 2ow early inthe ourse of a myo ardial infar tion,a reperfusion injury o urs be ause of#

A/ &ytos eletal intermediate "lament loss

'/ A de reased intra ellular p) fromanaerobi gly olysis&/ An in rease in to1i o1ygen radi als/

*/ 7ito hondrial swelling+/ u lear hromatin lumping andde reased protein synthesis


32/101

.he presen e of s!uamousepithelium in the lower tra hea of a4


33/101

.he presen e of s!uamousepithelium in the lower tra hea of a4


34/101

A ?D-year-old female had a erebralinfar tion/ 7onths later, a omputedtomographi $&.% s an shows a

ysti area in her erebral orte1/ .he &. "nding is a lesion that is the

onse!uen e of resolution from#A/ i!uefa tive ne rosis'/ Atrophy

&/ &oagulative ne rosis*/ &aseous ne rosis+/ Apoptosis


35/101

A ?D-year-old female had a erebralinfar tion/ 7onths later, a omputedtomographi $&.% s an shows a

ysti area in her erebral orte1/ .he &. "nding is a lesion that is the

onse!uen e of resolution from#A/ i!uefa tive ne rosis/'/ Atrophy

&/ &oagulative ne rosis*/ &aseous ne rosis+/ Apoptosis


36/101

(eatures of hypo1i ell injuryin lude all of the following +E&+P.#

A/ &ell swelling'/ a of A.P generation&/ 7ito hondrial al ium deposition*/ a ti a idosis+/ Apoptosis


37/101

(eatures of hypo1i ell injuryin lude all of the following +E&+P.#

A/ &ell swelling'/ a of A.P generation&/ 7ito hondrial al ium deposition*/ a ti a idosis+/ Apoptosis/


38/101

.he light brown perinu lear pigmentseen on )F+ staining of the ardiamus le "bers in the heart of an 89year old male is#

A/ )emosiderin resulting from ironoverload'/ ipo hrome from Bwear and tearG&/ ;ly ogen resulting from a storage

disease*/ &holesterol as a onse!uen e ofatheros lerosis+/ &al ium deposition following ne rosis


39/101

.he light brown perinu lear pigmentseen on )F+ staining of the ardiamus le "bers in the heart of an 89year old male is#

A/ )emosiderin resulting from ironoverload'/ ipo hrome from Bwear and tearG/&/ ;ly ogen resulting from a storage

disease*/ &holesterol as a onse!uen e ofatheros lerosis+/ &al ium deposition following ne rosis


40/101

.he best mi ros opi eviden e forremote hemorrhage in the jointspa e of a hemophilia would be thepresen e of#

A/ ipofus in'/ Russell bodies&/ eutrophils*/ &holesterol rystals

+/ Anthra oti pigment


41/101

.he best mi ros opi eviden e forremote hemorrhage in the jointspa e of a hemophilia would be thepresen e of#

A/ ipofus in'/ Russell bodies&/ eutrophils*/ &holesterol rystals/

+/ Anthra oti pigment


42/101

A


43/101

A


44/101

'one marrow ells from an organ donor areultured in vitro at > & in the presen e of

re ombinant erythropoietin forming olony,ommitted to the erythro yte pathway of

di0erentiation/ .his event represents ane1ample of whi h of the followingphysiologi adaptations to transmembranesignalingL

$A% Atrophy$'% *ysplasia$&% )yperplasia$*% )ypertrophy$+% 7etaplasia


45/101

'one marrow ells from an organ donor areultured in vitro at > & in the presen e of

re ombinant erythropoietin forming olony,ommitted to the erythro yte pathway of

di0erentiation/ .his event represents ane1ample of whi h of the followingphysiologi adaptations to transmembranesignalingL

$A% Atrophy$'% *ysplasia$&% )yperplasia/$*% )ypertrophy$+% 7etaplasia


46/101

A ?9-year-old hroni al oholi presents to theemergen y room with @< hours of severe

abdominal pain/ .he pain radiates to the baand is asso iated with an urge to vomit/Physi al e1amination dis loses e1!uisiteabdominal tenderness/ aboratory studies

show elevated serum amylase/ =hi h of thefollowing morphologi hanges would bee1pe ted in this patientL

$A% &oagulative ne rosis$'% &aseous ne rosis$&% (at ne rosis$*% (ibrinoid ne rosis$+% i!uefa tive ne rosis


47/101


48/101

A H8-year-old man with a history ofgastroesophageal re2u1 disease su0ers a massive

stro e and e1pires/ )istologi e1amination of theabnormal tissue shows intestine-li e epitheliumomposed of goblet ells and surfa e ells similar

to those of in ompletely intestinali:ed gastrimu osa/ =hi h of the following terms bestdes ribes this morphologi response to persistentinjury in the esophagus of this patientL

$A% Atypi al hyperplasia$'% &omple1 hyperplasia

$&% ;landular metaplasia$*% imple hyperplasia$+% !uamous metaplasia


49/101

A H8-year-old man with a history ofgastroesophageal re2u1 disease su0ers a massive

stro e and e1pires/ )istologi e1amination of theabnormal tissue shows intestine-li e epitheliumomposed of goblet ells and surfa e ells similar

to those of in ompletely intestinali:ed gastrimu osa/ =hi h of the following terms bestdes ribes this morphologi response to persistentinjury in the esophagus of this patientL

$A% Atypi al hyperplasia$'% &omple1 hyperplasia

$&% ;landular metaplasia/$*% imple hyperplasia$+% !uamous metaplasia


50/101

A &. s an of a 4>-year-old woman witha parathyroid adenoma andhyperparathyroidism reveals e1tensive

al ium deposits in the lungs and idneyparen hyma/ .hese radiologi "ndings

are best e1plained by whi h of thefollowing me hanisms of diseaseL$A% Arterios lerosis$'% *ystrophi al i" ation

$&% ;ranulomatous in2ammation$*% 7etastati al i" ation$+% .umor embolism


51/101

A &. s an of a 4>-year-old woman witha parathyroid adenoma andhyperparathyroidism reveals e1tensive

al ium deposits in the lungs and idneyparen hyma/ .hese radiologi "ndings

are best e1plained by whi h of thefollowing me hanisms of diseaseL$A% Arterios lerosis$'% *ystrophi al i" ation

$&% ;ranulomatous in2ammation$*% 7etastati al i" ation/$+% .umor embolism


52/101

A ?-year-old woman with Al:heimerdisease dies of ongestive heartfailure/ .he brain at autopsy issmaller/ .his patientMs braine1empli"es whi h of the followingresponses to hroni injuryL

$A% Anaplasia$'% Atrophy

$&% *ysplasia$*% )yperplasia$+% )ypertrophy


53/101

A ?-year-old woman with Al:heimerdisease dies of ongestive heartfailure/ .he brain at autopsy issmaller/ .his patientMs braine1empli"es whi h of the followingresponses to hroni injuryL

$A% Anaplasia$'% Atrophy/

$&% *ysplasia$*% )yperplasia$+% )ypertrophy


54/101

A H4-year-old man with long-standing anginape toris and arterial hypertension dies of

spontaneous intra erebral hemorrhage/ Atautopsy, the heart appears globoid/ .he leftventri le measures


55/101

A H4-year-old man with long-standing anginape toris and arterial hypertension dies of

spontaneous intra erebral hemorrhage/ Atautopsy, the heart appears globoid/ .he leftventri le measures


56/101

A wee s of gestation with a severemalformation of the entral nervous system/7R3 studies of the neonate reveal poren ephalyand hydro ephalus/ An E-ray "lm of the headshows irregular densities in the basal ganglia/

.hese E-ray "ndings are best e1plained bywhi h of the following me hanisms of diseaseL

$A% Amnioti 2uid embolism$'% *ystrophi al i" ation$&% ;ranulomatous in2ammation$*% 7etastati al i" ation$+% rgan immaturity


57/101

A wee s of gestation with a severemalformation of the entral nervous system/7R3 studies of the neonate reveal poren ephalyand hydro ephalus/ An E-ray "lm of the headshows irregular densities in the basal ganglia/

.hese E-ray "ndings are best e1plained bywhi h of the following me hanisms of diseaseL

$A% Amnioti 2uid embolism$'% *ystrophi al i" ation/$&% ;ranulomatous in2ammation$*% 7etastati al i" ation$+% rgan immaturity


58/101

A H?-year-old man su0ers a heartatta and e1pires/ +1amination of thelungs at autopsy reveals numerousdar pigmented nodules s atteredthroughout the paren hyma/ =hat is

the appropriate diagnosisL$A% Anthra osis$'% Asbestosis$&% )emosiderosis$*% ar oidosis$+% ili osis


59/101

A H?-year-old man su0ers a heartatta and e1pires/ +1amination of thelungs at autopsy reveals numerousdar pigmented nodules s atteredthroughout the paren hyma/ =hat is

the appropriate diagnosisL$A% Anthra osis/$'% Asbestosis$&% )emosiderosis$*% ar oidosis$+% ili osis


60/101

A >8 wee s of gestation/ As a result ofmaternal hypergly emia during pregnan y,pan reati islets in the neonate would bee1pe ted to show whi h of the followingmorphologi responses to injuryL

$A% Atrophy$'% *ysplasia$&% )yperplasia$*% 7etaplasia$+% e rosis


61/101

A >8 wee s of gestation/ As a result ofmaternal hypergly emia during pregnan y,pan reati islets in the neonate would bee1pe ted to show whi h of the followingmorphologi responses to injuryL

$A% Atrophy$'% *ysplasia$&% )yperplasia/$*% 7etaplasia$+% e rosis


62/101

A ?D-year-old female al oholi is brought to theemergen y room with a fever $>8/ &N@9> (%

and foul-smelling breath/ .he patientsubse!uently develops a utebron hopneumonia and dies of respiratoryinsuO ien y/ A pulmonary abs ess is identi"edat autopsy/ )istologi e1amination of the wall ofthis lesion would most li ely demonstrate whi hof the following pathologi hangesL

$A% &aseous ne rosis$'% &oagulative ne rosis$&% (at ne rosis$*% (ibrinoid ne rosis$+% i!uefa tive ne rosis


63/101

A ?D-year-old female al oholi is brought to theemergen y room with a fever $>8/ &N@9> (%

and foul-smelling breath/ .he patientsubse!uently develops a utebron hopneumonia and dies of respiratoryinsuO ien y/ A pulmonary abs ess is identi"edat autopsy/ )istologi e1amination of the wall ofthis lesion would most li ely demonstrate whi hof the following pathologi hangesL

$A% &aseous ne rosis$'% &oagulative ne rosis$&% (at ne rosis$*% (ibrinoid ne rosis$+% i!uefa tive ne rosis/


64/101

A


65/101

A


66/101

A >@-year-old woman omplains ofin reased vaginal dis harge of @-month

duration/ A ervi al Pap smear/ uper" ialepithelial ells are identi"ed with arrows/=hen ompared to ells from the deeperintermediate layer $top%, the nu lei of thesesuper" ial ells e1hibit whi h of thefollowing ytologi featuresL

$A% Karyolysis$'% Karyorrhe1is$&% Py nosis$*% egmentation$+% 5iral in lusion bodies


67/101

A >@-year-old woman omplains of in reasedvaginal dis- harge of @-month duration/ A

ervi al Pap smear is shown in the image/uper" ial epithelial ells are identi"ed with

arrows/ =hen ompared to ells from thedeeper intermediate layer $top%, the nu lei of

these super" ial ells e1hibit whi h of thefollowing ytologi featuresL

$A% Karyolysis$'% Karyorrhe1is

$&% Py nosis/$*% egmentation$+% 5iral in lusion bodies


68/101

A ?


69/101


70/101

An 8


71/101

An 8


72/101

A


73/101

A


74/101

A 9-year-old man is hospitali:ed after su0eringa mild stro e/ =hile in the hospital, he suddenly

develops rushing substernal hest pain/Analysis of serum proteins and +&; on"rm adiagnosis of a ute myo ardial infar tion/ .hepatient subse!uently develops an arrhythmiaand e1pires/ )istologi e1amination of thea0e ted heart mus le would demonstrate whi hof the following morphologi hangesL

$A% &aseous ne rosis$'% &oagulative ne rosis$&% (at ne rosis$*% (ibrinoid ne rosis$+% i!uefa tive ne rosis


75/101

A 9-year-old man is hospitali:ed after su0eringa mild stro e/ =hile in the hospital, he suddenly

develops rushing substernal hest pain/Analysis of serum proteins and +&; on"rm adiagnosis of a ute myo ardial infar tion/ .hepatient subse!uently develops an arrhythmiaand e1pires/ )istologi e1amination of thea0e ted heart mus le would demonstrate whi hof the following morphologi hangesL

$A% &aseous ne rosis$'% &oagulative ne rosis/$&% (at ne rosis$*% (ibrinoid ne rosis$+% i!uefa tive ne rosis


76/101

=hi h of the following histologifeatures would provide de"nitiveeviden e of ne rosis in themyo ardium of myo ardial infar tpatientL

$A% *isaggregation of polyribosomes$'% 3n reased intra ellular volume$&% 3n2u1 of lympho ytes

$*% 7ito hondrial swelling andal i" ation

$+% u lear fragmentation


77/101

=hi h of the following histologifeatures would provide de"nitiveeviden e of ne rosis in themyo ardium of myo ardial infar tpatientL

$A% *isaggregation of polyribosomes$'% 3n reased intra ellular volume$&% 3n2u1 of lympho ytes

$*% 7ito hondrial swelling andal i" ation

$+% u lear fragmentation/


78/101

A 4?-year-old man presents with in reasingabdominal dis omfort and yellow

dis oloration of his s in and s lera/ Physi ale1amination reveals hepatomegaly and jaundi e/ A Prussian blue stain of a liverbiopsy is shown in the image/ =hat is the

major intra ellular iron storage protein inthis patientMs hepato ytesL

$A% 'ilirubin$'% )aptoglobin

$&% )emoglobin$*% )emosiderin$+% .ransferrin


79/101

A 4?-year-old man presents with in reasingabdominal dis omfort and yellow

dis oloration of his s in and s lera/ Physi ale1amination reveals hepatomegaly and jaundi e/ A Prussian blue stain of a liverbiopsy is shown in the image/ =hat is the

major intra ellular iron storage protein inthis patientMs hepato ytesL

$A% 'ilirubin$'% )aptoglobin

$&% )emoglobin$*% )emosiderin/$+% .ransferrin


80/101

A H9-year-old man with hroni ystitisomplains of urinary fre!uen y and pelvi

dis omfort/ *igital re tal e1amination isunremar able/ 'iopsy of the bladder mu osareveals fo i of glandular epithelium and hroniin2ammatory ells/ o ytologi signs of atypiaor malignan y are observed/ =hi h of thefollowing terms best des ribes the morphologiresponse to hroni injury in this patientL

$A% Atrophy$'% *ysplasia$&% )yperplasia$*% )ypertrophy$+% 7etaplasia


81/101

A H9-year-old man with hroni ystitisomplains of urinary fre!uen y and pelvi

dis omfort/ *igital re tal e1amination isunremar able/ 'iopsy of the bladder mu osareveals fo i of glandular epithelium and hroniin2ammatory ells/ o ytologi signs of atypiaor malignan y are observed/ =hi h of thefollowing terms best des ribes the morphologiresponse to hroni injury in this patientL

$A% Atrophy$'% *ysplasia$&% )yperplasia$*% )ypertrophy$+% 7etaplasia/


82/101

A H8-year-old woman with a history ofhyperlipidemia dies of ardia arrhythmia

following a massive heart atta /Pero1idation of whi h of the followingmole ules was primarily responsible for

ausing the loss of membrane integrity inardia myo ytes in this patientL$A% &holesterol$'% ;lu ose transport proteins

$&% ;ly osphingolipids$*% Phospholipids$+% odium-potassium A.Pase


83/101

A H8-year-old woman with a history ofhyperlipidemia dies of ardia arrhythmia

following a massive heart atta /Pero1idation of whi h of the followingmole ules was primarily responsible for

ausing the loss of membrane integrity inardia myo ytes in this patientL$A% &holesterol$'% ;lu ose transport proteins

$&% ;ly osphingolipids$*% Phospholipids/$+% odium-potassium A.Pase


84/101

A


85/101

A


86/101

A ?H-year-old woman with a history ofhyperlipidemia and hypertension develops

progressive, right renal artery stenosis/ver time, this patientMs right idney gets

smaller following morphologi adaptationsto partial is hemia/ =hat do you all this

idney hangeL$A% Atrophy$'% *ysplasia$&% )yperplasia$*% )ypertrophy$+% eoplasia


87/101

A ?H-year-old woman with a history ofhyperlipidemia and hypertension develops

progressive, right renal artery stenosis/ver time, this patientMs right idney gets

smaller following morphologi adaptationsto partial is hemia/ =hat do you all this

idney hangeL$A% Atrophy/$'% *ysplasia$&% )yperplasia$*% )ypertrophy$+% eoplasia


88/101

A ?-year-old boy su0ers blunt trauma tothe leg in an ar a ident/ i1 months

later, bone trabe ulae have formed withinthe striated s eletal mus le at the site oftissue injury/ .his pathologi ondition isan e1ample of whi h of the followingmorphologi adaptations to injuryL

$A% Atrophy$'% *ysplasia

$&% 7etaplasia$*% 7etastati al i" ation$+% *ystrophi al i" ation


89/101

A ?-year-old boy su0ers blunt trauma tothe leg in an ar a ident/ i1 months

later, bone trabe ulae have formed withinthe striated s eletal mus le at the site oftissue injury/ .his pathologi ondition isan e1ample of whi h of the followingmorphologi adaptations to injuryL

$A% Atrophy$'% *ysplasia

$&% 7etaplasia/$*% 7etastati al i" ation$+% *ystrophi al i" ation


90/101

A @H-year-old girl with a history of sui idaldepression swallows a ommer ial solvent/ Aliver biopsy is performed to assess the degree ofdamage to the hepati paren hyma/ )istologie1amination demonstrates severe swelling of the

entrilobular hepato ytes/ =hi h of the followingme hanisms of disease best a ounts for thereversible hanges noted in this liver biopsyL

$A% *e reased stores of intra ellular A.P$'% 3n reased storage of trigly erides and free fattya ids

$&% 3ntra ytoplasmi rupture of lysosomes$*% 7ito hondrial membrane permeability transition$+% Protein aggregation due to in reased ytosoli p)


91/101


92/101

A 49-year-old man is pulled from the o eanafter a boating a ident and resus itated/

i1 hours later, the patient develops a uterenal failure/ Kidney biopsy revealseviden e of aryorrhe1is and aryolysis inrenal tubular epithelial ells/ =hi h of the

following bio hemi al events pre ededthese pathologi hangesL$A% A tivation of a NK A.Pase$'% *e rease in intra ellular al ium

$&% *e rease in intra ellular p)$*% 3n rease in A.P produ tion$+% 3n rease in intra ellular p)


93/101

A 49-year-old man is pulled from the o eanafter a boating a ident and resus itated/

i1 hours later, the patient develops a uterenal failure/ Kidney biopsy revealseviden e of aryorrhe1is and aryolysis inrenal tubular epithelial ells/ =hi h of the

following bio hemi al events pre ededthese pathologi hangesL$A% A tivation of a NK A.Pase$'% *e rease in intra ellular al ium

$&% *e rease in intra ellular p)/$*% 3n rease in A.P produ tion$+% 3n rease in intra ellular p)

ld h f


94/101

A ?8-year-old man presents with symptoms ofa ute renal failure/ )is blood pressure is


95/101

A 4 ld i h hi f h


96/101

A 4 -year-old man with a history of heavysmo ing omplains of hroni ough/ A oin

lesionG is dis overed in his right upper lobeon hest E-ray/ 'ron hos opy and biopsy failto identify a mass, but the bron hial mu osadisplays s!uamous metaplasia/ =hat is the

most li ely out ome of this morphologiadaptation if the patient stops smo ingL$A% Atrophy$'% 7alignant transformation

$&% e rosis and s arring$*% Persisten e throughout life$+% Reversion to normal

A 4 ld i h hi f h


97/101

A 4 -year-old man with a history of heavysmo ing omplains of hroni ough/ A oin

lesionG is dis overed in his right upper lobeon hest E-ray/ 'ron hos opy and biopsy failto identify a mass, but the bron hial mu osadisplays s!uamous metaplasia/ =hat is the

most li ely out ome of this morphologiadaptation if the patient stops smo ingL$A% Atrophy$'% 7alignant transformation

$&% e rosis and s arring$*% Persisten e throughout life$+% Reversion to normal/

A H9 ld f i h


98/101

A H9-year-old farmer presents withmultiple pat hes of dis oloration on hisfa e/ 'iopsy of lesional s in revealsa tini eratosis/ =hi h of the followingterms best des ribes this response ofthe s in to hroni sunlight e1posureL

$A% Atrophy$'% *ysplasia$&% )yperplasia

$*% )ypertrophy$+% 7etaplasia

A H9 ld f i h


99/101

A H9-year-old farmer presents withmultiple pat hes of dis oloration on hisfa e/ 'iopsy of lesional s in revealsa tini eratosis/ =hi h of the followingterms best des ribes this response ofthe s in to hroni sunlight e1posureL

$A% Atrophy$'% *ysplasia/ $&% )yperplasia

$*% )ypertrophy$+% 7etaplasia

A >> ld h b l i l


100/101

A >>-year-old woman has an abnormal ervi alPap smear/ A ervi al biopsy reveals that theepithelium la s normal polarity $shown in theimage%/ 3ndividual ells display hyper hromatinu lei, a larger nu leus-to- ytoplasm ratio, anddisorderly tissue arrangement/ =hi h of thefollowing adaptations to hroni injury bestdes ribes these hanges in the patientMs

ervi al epitheliumL$A% Atrophy$'% *ysplasia

$&% )yperplasia$*% )ypertrophy$+% 7etaplasia

A >> ld h b l i l


101/101

A >>-year-old woman has an abnormal ervi alPap smear/ A ervi al biopsy reveals that theepithelium la s normal polarity $shown in theimage%/ 3ndividual ells display hyper hromatinu lei, a larger nu leus-to- ytoplasm ratio, anddisorderly tissue arrangement/ =hi h of thefollowing adaptations to hroni injury bestdes ribes these hanges in the patientMs

ervi al epitheliumL$A% Atrophy$'% *ysplasia/

$&% )yperplasia$*% )ypertrophy$+% 7etaplasia

review cell adaptation, injury and death

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