1 ) saponification could be seen in?

a- caseous necrosis.
b- fat necrosis.
c- Coagulative necrosis.
d- liquefactive necrosis.

2 ) the cell response for cell injury that u can see in light microscope swelling or fat change :
a- blebs in plasma membrane
b- detachments of ribosome
c- Vacuolation in Mitochondria
d- Myelin figures
e- Swell or fatty change

3) steatosis is accumulation of :
a- triglycerides
b- cholesterol
c - proteins
d- collagen

4 ) A mechanism of cell injury :

a - loss of permeability
b - loss of membrane potential
c - oxidative stress
d - ATP depletion
e - all of them

5)Glycogen accumulation is associated with:

a- diabetes
b- liver failure
c- renal disease
d- pancreatitis

6) The type of necrosis associated with tuberculosis is:

a- coagulative necrosis
b- liquefactive necrosis
c- fibrinoid
d- caseous necrosis

7) Which of the following is an anti-apoptic factor:

a- Bak
b- Bax
c- Bcl-2
8)the degradation of cytoskeleton elements in the cell is done by which enzyme?
a- DNase
b-ATPase
c- protease

9)which of the necrosis patterns represent complexes of antigens and antibodies ?

a- coagulative necrosis
b- fibrinoid
c- caseous
d- liquefactive

10)autophagy is accompanied with :

a- metaplasia
b- hyperplasia
c- abundance of nutrients
d- atrophy

11)which of the following is a central factor in necrosis :

a- chromatin clumping
b- extensive membrane damage
c- appearance of densities
d- ribosomes detachment

12) tissue border is visible in which type of necrosis :

a- coagulative
b-fibrinoid
c- liquidative
d- gangrenous
e- fatty

13) all the following remove free radicals except:

a-SOD
b-catalase
c-vit.E
d-nitric oxide

14)clumping of chromatin is secondary to:

a- influx of Ca
b- influx of Na
c- low pH
d- efflux of K
15)The shrinkage of muscle cells due to loss of enervation is described as :
a- physiological atrophy
b- pathological atrophy
c- physiological hypertrophy
d- pathological hypertrophy
e- irreversible injury

16)A bone was fractured then fixed and immobilized this will lead to :
a- atrophy
b- gangrenous
c- hyperplasia
d- metaplasia

17)Regarding metaplasia , one of the following is false:

a- it's a reversible change
b- could happen to epithelium and
mesenchymal cells
c- squamous metaplasia occurs in
respiratory tract
d- reprogramming of stem cells is
thought to be the mechanism
d- it's totally safe and doesn't has
negative implication

18)One of the following is not related to membrane damaged :

a- ribosomes dissolution
b- free radicals injury
c- cytoskeleton deficiency
d- lipid breakdown products
e- decreased phospholipids synthesis

19)one of the pairs are mismatched:

a-coagulative------kidney
b-liquefactive------spleen
c-gangrenous-----foot

20)The degradation of cytoskeleton elements intermediate filaments is due to activation of ca+2

dependent :
a- proteases
b- phospholipases
c- endonucleases
d- ATPases
21)All of the following regarding pathologic calcification is true EXCEPT :
a- a person with hypercalcemia can
develop a dystrophic calcification
b- the extensive metastatic
calcification in the renal tubules is
always harmless

22) which is true of squamous metaplasia in the respiratory epithelium:

a- indicates an irreversible tissue damage
b- it may be due to the continuous inhalation of an irritant
c- it may be complicated by dystrophic calcification
d- it may be a part of an aging process

23) each type of necrosis is correctly paired with its likely involvement except:
a- coagulative necrosis – heart
b- liquefactive necrosis- brain
c- coagulative necrosis – kidney
d- caseous necrosis- pancreas

24) one of the following about apoptosis is false:

a- an inactive process
b- associated with heavy inflammatory cell infiltrate
c- could be physiologic
d- occur in single cells
e- may occur in viral infections

25)under certain conditions, which of the following show increase in number and the size of
component cells with increase in their cytoplasm and size of organelles:
a- female breast at menopause
b- the ovary at menopause
c- the myometrium during pregnancy
d- skeletal muscle fibers after exercise

26) apoptic bodies are most likely due to:

a- activation of lipases
b- activation of caspases
c- activation of catalases
d- lipid peroxidation
27)Which of the following is anti-apoptotic?
a-BAX
b-BAK
c-BCL2
d-ROS
e-Cytochrome C

28)All of these are consequences of hypoxia to the mitochondria except:

a-Fatty change
b-Increase in the acidity
c-Decrease lactic acid
d-Potassium ions efflux
e-Swelling of the cell

29)All of these are pathological conditions of apoptosis except:

a) Chronic duct obstruction
b) The host immune response after hepatitis
c) Hormone deprivation
d) Accumulation of misfolded proteins

30)Which of the following is a characteristic of REVERSIBLE cell injury?

a) Pyknosis
b) shrinkage of the cell
c) Karyolysis
d) Increase eosinophilia
e) Rupture of cell membrane

31)Apoptosis differ from necrosis in all of these except:

a) Apoptosis and apoptosis can be both either physiological or pathological
b) Necrosis elicits inflammatory response, but apoptosis does not
c) Apoptosis is suicide of the cell, but necrosis is homicide
d) Necrosis causes rupture of the lysosome while apoptosis does not

32)The intrinsic pathway of apoptosis occurs in which organelle?

a) Smooth Cytoplasmic reticulum
b) Rough endoplasmic reticulum
c) Mitochondria
d) Lysosomes
e) Cytoplasm
33)A patient came to emergency room with chest pain for 3 hours. Lab tests show increased
levels of creatine kinase in plasma, what is the cause of that elevation?
a) Mitochondrial swelling
b) Lysosomes rupture
c) Inflammation
d) Rupture of plasma membrane
e) Loss of function of the cell
34)If you take an electron micrograph biopsy and study it for an irreversible injured liver cell,
which of these changes are most likely to find specific for this irreversible injury?
a) Plasma membrane clumping
b) Loss of plasma membrane microvilli
c) Rupture of lysosomes
d) Mitochondrial swelling
e) Chromatin clumping

35)all of these are mechanisms of adaptation except:

a) hypermetaplasia
b) metaplasia
c) atrophy
d) hypertrophy
e) hyperplasia

36)Barret esophagus is mostly seen in patients with:

a) Smoking
b) GERD (gastroesophageal reflux disease)
c) Duodenal ulcers
d) Stomach ulcers
e) Alcohol abuse

37)Which of the following events of necrosis could be seen under the light microscope:
a) Increase in eosinophilia
b) Formation of myelin figures
c) Clumping of the plasma membrane
d) Fatty change
e) Karyorrhexis
38)Steatosis is accumulation of --------------------- inside the cells.
a) Cholesterol
b) Cholesterol esters
c) Fatty acids
d) Triglycerides
e) All are true

39)Glycogen can be specifically stained by which of these stains:

a) H&E
b) PAS
c) Metal stain
d) Crystal violet

40)A person with myocardial infarction came to emergency room. He developed a stroke before
a weak and the take a brain biopsy, which of the following you suspect to find in this biopsy?
a) The biopsy of necrotic area will be hard
b) The necrosis will form mostly granuloma
c) Pus filling an abscess
d) Tumor filled with yellowish material
e) Increase in eosinophilia under the microscope

41)The programmed cell death of cells is called:

a) Coagulative necrosis
b) Fibrinoid necrosis
c) Apoptosis
d) Atrophy
e) Cell injury

42)Which of the following makes more chance to the conversion to MALIGNANT?

a) Hyperplasia
b) Hypertrophy
c) Metaplasia
d) Atrophy
43)A 40 year-old patient complaining of upper left quadrant abdominal pain, a biopsy was taken
from his spleen and shown under the microscope to reveal………. :
a) Caseous necrosis
b) Coagulative necrosis
c) Apoptosis
d) Liquefactive necrosis
e) Fat necrosis

44)A pathologist notes cloudy swelling, hydropic change and fatty change in the liver of a patient
with a history of alcohol abuse. These morphological changes are all examples of:
a) Early neoplastic change
b) Hyaline change
c) Reversible cell injury
d) Irreversible cell injury
e) Necrosis
f) Apoptosis

45)Mallory bodies are the accumulation of:

a) Proteins
b) Cholesterol
c) Cholesterol ester
d) Triglycerides
e) None of the above

46) what is the first point of attack of hypoxia in the cell?

a- accumulation of lactic acid
b- alteration on cellular energy metabolism
c- detachment of ribosomes from the granular ER
d- oxidative phosphorylation by mitochondria

47) CELL INJURY refers to any irreversible biochemical or structural alteration that impairs the
normal functional ability of the cell
a- true
b- false

48) What is the main factor in determining the pathogenesis of irreversible cell injury
a- cell membrane damage
b- severe vacoulizattion of the mitochondria
c- swelling of lysosome
49) Hyperplasia is primarily operative in which of the following growth alterations?
a- Appearance of affected kidney in renovascular hypertension
b- Thickned bladder wall in a pt with urethral obstruction
c- Barrett's esophagus in a pt with gastroesophageal reflux
d- Enlarged left atrium in a pt with severe mitral stenosis
e- Galactorrhea in a woman with a prolactinoma

50) All of these are consequences of hypoxia to the mitochondria except:

a-Fatty change
b-Increase in the acidity
c-Decrease lactic acid
d-Potassium ions efflux
e-Swelling of the cell

Answer key:
1-B 26-B
2-E 27-C
3-A 28-C
4-E 29-C
5-A 30-D
6-D 31-A
7-C 32-C
8-C 33-D
9-B 34-C
10-D 35-A
11-B 36-B
12-A 37-D
13-D 38-D
14-C 39-B
15-B 40-C
16-A 41-C
17-D 42-C
18-A 43-B
19-B 44-C
20-A 45-A
21-B 46-D
22-B 47-B
23-B 48-A
24-B 49-E
25-D 50-C