CELL INJURY

1 Cell injury
a. Is characterized by increased
oxidative phosphorylation decreased
-> anaerobic glycolysis
b. Results in efflux of calcium from the
cell influx and release of
mitochondrial
c. May result in free radical induced
damage may result from, or cause
it
d. May be increased by enzymes such
as catalase catalase is free radical
scavenger H2O2 -> H2O and O2
e. Results in increased membrane
phospholipid loss of
2. Tissue
a. Hypertrophy is characterized by
increased numbers of cells
b. Hyperplasia is characterized by
increased size of cells
c. Necrosis is always pathological - true
d. Response to injury may involve
apoptosis, which is never a normal
response
e. Reperfusion after ischaemia never
results in full cell recovery
3. Hypertrophy
a. occurs after partial hepatectomy hyperplasia
b. increases function of an organ
exponentially
c. is triggered by mechanical and trophic
chemicals - true
d. occurs after denervation - atrophy
e. is usually pathological
4. All of the following are features of
apoptosis EXCEPT:
a. Cell swelling - shrinkage
b. Chromatin condensation
c. Formation of cytoplasmic blebs
d. Lack of inflammation
e. Phagocytosis of apoptotic bodies

5. Dystrophic calcification
a. Is formed only in coagulative necrosis
occurs is atheroscleosis, damaged
heart valves and areas of necrosis
(coagulative, liquefactive and
caeseous)
b. Does not occur on heart valves
c. Rarely dauses dysfunction
d. Is rarely found on mitochondria
initiation of intracellular calcification
occurs in mitochondrial of dead or
dying cells
e. Is formed by crystalline calcium
phosphate mineral similar to bone
hydroxyapatite
6. Irreversible cell injury is characterized
by
a. Dispersion of ribosomes
b. Cell swelling
c. Nuclear chromatin clumping
d. Lysosomal rupture
e. Cell membrane defects
characterized by mitochondrial
dysfunction and profound
disturbances in membrane function
7. Metaplasia
a. Can be caused by vitamin B12
deficiency Vit A (retinoic acid)
b. Preserves mucus secretion in the
respiratory tract will affect b/c loss of
mucous production and ciliary action
c. Is typically an irreversible process
d. Is the process that occurs in Barretts
oesophagitis - sqaumous -> columnar
e. Is an increase in the number and size
of cells in a tissue
8. Which of the following is not
associated with atrophy
a. Decreased smooth endoplasmic
reticulum
b. Decreased rough endoplasmic
reticulum
c. ?
d. ?

e. decreased autophagic vacuoles

increased autophagocytosis
9. Metastatic calcification occurs in
a. Old lymph nodes
b. Gastric mucosa excretes acid,
therefore an internal alkaline
compartment, also kidneys, lungs,
systemic arteries, pulmonary veins
c. Atherosclerotic vessels
d. Damaged heart valves
e. ?
10. Metaplasia
a. Involves the formation of malignant
cells in a tissue - predisposes
b. Of the respiratory tract often involves
the replacement of squamous cells
with columnar cells columnar with
squamous
c. Is a reversible change in which one
mature cell type is replaced by
another mature cell type - correct
d. Of the oesophagus, is normally a
change from columnar to squamous
cell types squamous -> columnar in
Barretts, hence normally glandular
cancers
e. Is due to changed gene expression in
mature cell types to produce a
different mature cell type the mature
cells dont change, stem or
undifferential cells undergo
reprogramming
11. The most important factor in
irreversible cell injury is
a. ATP depletion
b. Decreased protein synthesis
c. Decreased pH
d. Membrane damage profound
membrane dysfunction is a hallmark
e. Loss of intracellular K+
12. Morphological and biochemical
changes of reversible cell injury
include
a. Decrease in anaerobic glycolysis -

increase
b. Shrinkage of the endoplasmic
reticulum in atrophy
c. Intracellular accumulation of sodium
true, partly why there is swelling of
cells
d. Decreased membrane permeability increased
e. Lysosomal membrane leakage
swelling and rupture occurs in
irreversible
13. Hyperplasia
a. Results in a reversible change to
another cell type - metaplasia
b. May be a precursor to malignancy
true, it is the fertile soil
c. Is defined as an increase in cell size hypertophy
d. May occur due to increased functional
demand in striated muscle vast
majority is hypertrophy
e. Persists when the stimulus is removed
14. In reversible cell injury, all are true
except
a. ATP depletion is responsible for acute
cellular swelling - correct, via failure of
NA+/K+ ATPase pump and metabolic
products of anaerobic gycloyisis
b. Can cause myocardial cells to cease
contraction within 60 seconds
c. ATP is generated anaerobically from
creatine phosphate
d. Mitochondrial swelling and
degranulation of ER are the hallmarks
of irreversible cellular damage these
occur as result of decreased ATP, but
are reversible
e. Is associated with myelin figures - true
15. Metaplasia
a. Is irreversible
b. Is commonly a change from
squamous to columnar epithelium
c. An example is the transformation of
epithelial cells into chrondroblasts to

produce cartilage
d. Retinoids may play a role
e. Even if the stimuli is persistent, it is a
benign lesion
16. In apoptosis
a. It involves physiologic and pathologic
stimuli
b. Histologically, it involves coagulative
necrosis
c. Its DNA breakdown is random and
diffuse
d. Its mechanism involves ATP depletion
e. It involves an inflammatory tissue
reaction
17. Hyperplasia
a. Occurs after partial hepatectomy
b. Refers to an increases in the size of
cells
c. Is always a pathological process
d. Often occurs in cardiac and skeletal
muscle
e. Usually progresses to cancerous
proliferation
18. Metastatic calcification
a. causes widespread tissue damage usually
b. occurs with normal calcium levels elevated
c. can be caused by systemic
sarcoidosis true, Vit D related
d. occurs in hypothyroidism hyperparathyroidism
e. is caused by drinking large quantities
of milk
19. With regard to apoptosis, which of the
following is INCORRECT
a. It may be regarded as a normal
physiological process
b. It is characterized by chromatin
condensation
c. It often elicits a strong inflammatory
response usually does not
d. It is the process by which ovaries
atrophy in post menopausal women

e. It is characterized by cell shrinkage

20. With regard to cellular injury, all of the
following are reversible EXCEPT
a. Decreased ATP
b. Intracellular release of lysosomal
enzymes - irreversible
c. Decreased Na pump activity
d. Detachment of ribosomes
e. ER swelling
21. Metaplasia is seen in all of the
following except
a. Respiratory epithelium of cigarette
smokers
b. Vitamin A excess it occurs from
deficiency, excess -> cell swelling and
rupture
c. Barretts oesophagitis
d. Epithelium of a pancreatic duct
containing stones
e. Foci of cell injury connective tissue
metaplasia?
22. Regarding atrophy, all are correct
EXCEPT
a. Persistance of residual bodies
b. Decreased myofilaments
c. Decreased rough endoplasmic
reticulum
d. Decreased autophagic vacuoles
increased because cell autophages
for survival
e. Deceased smooth endoplasmic
reticulum
23. Which of the following is an example of
hypertrophy
a. Increase in liver size after partial
hepatectomy
b. Increase in size of female breast
c. Increased respiratory epithelium in
response to vitamin A deficiency
d. Increase in size of female uterus in
pregnancy
e. Endometrial proliferation
24. Regarding fatty change which is
INCORRECT?

a. May result from protein malnutrition

b. Fatty acids are oxidized in the
mitochondria
c. May result from diabetes mellitus
d. May represent unmasking of normal
cell fat content
e. In heart is caused by severe anaemia
25. Dystrophic calcification
a. Occurs in normal cells and tissues
b. Occurs in sarcoidosis vit D increase
-> metastatic calcification
c. Occurs in multiple myeloma
d. Often causes organ dysfunction can
be a source of significant pathology
e. ?
26. An example of hypertrophy is
a. The pubertal breast
b. The pregnant uterus
c. Post partial hepatectomy
d. ?
e. ?
27. Fatty change occurs in all of the
following EXCEPT:
a. Heart
b. Liver
c. Skeletal muscle
d. Spleen
e. Kidney
28. In the heart fatty change occurs in
response to
a. Alcohol consumption
b. Profound anaemia
c. Atherosclerosis
d. Carbon tetrachloride
e. Protein malnutrition
29. Cytosolic calcium in cell injury
a. Only enters by active transport
b. Partially derives from mitochondria
c. Increases ATP
d. Inactivates phospholipase
e. Inactivate protease
30. Metaplasia
a. is an irreversible change in cell type

b. is most commonly a change from

squamous to columnar
c. does not occur in mesenchymal cells
d. may progress to cancer transformation
e. is usually accompanies by
hypertrophy
31. Irreversible cell injury is characterized
by
a. loss of functional polarity in polarized
epithelium
b. detachment of ribosomes from
endoplasmic reticulum
c. acute cellular swelling
d. severe mitochondrial vacuolization
e. formation of membrane blebs
32. Metaplasia is
f. irreversible
g. commonly squamous changing to
columnar epithelium
h. always malignant
i. stimulated by chemicals and growth
factors
j. not related to genetic reprogramming
of stem cells
2 33. Apoptosis
a. involves transfer of cytochrome C from
the cytosol to the mitochondria out
from mitochondria
b. involves DNA fragmentation cleaves
into 180 200 base pair fragments
(ladder pattern on EP)
c. is mediated by caspase inactivation activation
d. is suppressed by Fas-Fas ligand
interaction is activated by
e. is activated by Bcl-2 Bcl-2 and BCLx are to main anti-apoptotic proteins
3 34. Coagulative necrosis:
a. Results from necrosis in which cellular
enzymatic digestion predominates
over protein denaturation
b. Is characterized by a marked
leukocytic infiltrate
c. Is uncommon after myocardial

infarction
d. Usually occurs after irreversible
ischaemic cellular damage
e. Is not usually seen in association with
caseous necrosis
4 35. Which is incorrect regarding
necrosis?
a. Autolysis may follow owing to
denaturation of protein - ?
b. Heterolysis is digestion by lysosomal
enzymes of immigrant leukocytes
c. Dystrophic calcification is seen
particularly in necrotic fat cells ->
calcium soaps
d. Coagulation necrosis is the most
common pattern of necrosis
e. Liquefaction necrosis occurs when
autolysis and heterolysis prevail over
protein denaturation

5 36. Coagulative necrosis:

a. Is the least common manifestation of
necrosis
b. Completely obliterates tissue
architecture
c. Leads to formation of a liquid viscous
mass
d. Is characteristic of hypoxic death of
cells in all tissue except the brain
e. Is characteristic of focal bacterial
infection
6 37. Hypoxia results in:
a. Influx of K+ into the cell
b. Decreased intracellular Ca2+
c. Increased intracellular pH
d. Influx of Na+ into the cell
e. Efflux of H20 into the interstitium