Home/Quiz/Pathology MCQs : Cell Injury, Inflammation & Repair Pathology MCQs : Cell Injury, Inflammation & Repair Welcome to your Pathology MCQs : Cell Injury, Inflammation & Repair 1. A 58-year-old man develops acute myocardial ischemia. Within minutes, cardiomyocytes become swollen because ATP depletion impairs which membrane mechanism? Na+/K+-ATPase Ca2+-ATPase of SR Na+/Ca2+ exchanger Voltage-gated Na+ channel Cl− channel None Hint 2. A hepatocyte exposed to a mild hypoxic insult shows fatty change and cellular swelling but recovers after oxygen is restored. Which finding indicates reversible injury? Severe membrane rupture Nuclear fragmentation Mitochondrial swelling with preserved function Lysosomal rupture with enzyme leakage Complete loss of ATP production None Hint 3. A patient has prolonged ischemia causing irreversible myocardial injury. Which finding is most characteristic of irreversible cell injury? Mild fatty change Transient ATP reduction Severe membrane damage with inability to reverse mitochondrial dysfunction Cellular swelling alone Ribosomal detachment only None Hint 4. A renal cortical infarct is examined 24 hours after arterial occlusion. The tissue architecture remains recognizable despite cell death. Which pattern is expected? Liquefactive necrosis Coagulative necrosis Caseous necrosis Fat necrosis Fibrinoid necrosis None Hint 5. A patient develops a cerebral infarction followed by softening of the affected area. Which type of necrosis occurs? Coagulative Caseous Liquefactive Fibrinoid Fat None Hint 6. A lung biopsy from a patient with tuberculosis shows a granular, cheese-like central area within a granuloma. Which pattern of necrosis is present? Coagulative Liquefactive Caseous Fat Fibrinoid None Hint 7. A cell undergoing programmed death becomes smaller, develops condensed chromatin, and fragments into membrane-bound bodies. Which process is occurring? Necrosis Apoptosis Autolysis Gangrene Metaplasia None Hint 8. A cell exposed to severe DNA damage activates the mitochondrial apoptotic pathway. Which protein family directly promotes mitochondrial outer membrane permeabilization? BCL-2 family pro-apoptotic proteins Selectins Integrins Cyclooxygenases Complement proteins None Hint 9. A damaged cell activates initiator caspases followed by activation of executioner caspases. Which executioner caspase is classically involved? Caspase-1 Caspase-3 Caspase-8 Caspase-9 Caspase-12 None Hint 10. A patient experiences reperfusion after prolonged limb ischemia. Which reactive oxygen species is particularly capable of initiating lipid peroxidation? Superoxide and its derivatives Nitric oxide only Carbon dioxide Urea Bilirubin None Hint 11. A patient with oxidative cellular injury relies on endogenous antioxidant defenses. Which enzyme converts hydrogen peroxide into water and oxygen? Catalase Elastase Trypsin Phospholipase A2 Myeloperoxidase None Hint 12. A patient with chronic alcohol use has hepatomegaly and increased hepatic triglyceride accumulation. What is the cellular change called? Hydropic change Fatty change Amyloidosis Dysplasia Metaplasia None Hint 13. A patient with long-standing hypertension develops an enlarged left ventricle without an increase in the number of cardiac myocytes. Which adaptation is present? Hyperplasia Hypertrophy Atrophy Metaplasia Dysplasia None Hint 14. A woman has increased endometrial glandular proliferation due to prolonged estrogen stimulation. Which adaptation is occurring? Hypertrophy Hyperplasia Atrophy Necrosis Dysplasia None Hint 15. A chronic smoker develops replacement of normal bronchial ciliated columnar epithelium by stratified squamous epithelium. Which adaptation is present? Hypertrophy Hyperplasia Metaplasia Anaplasia Necrosis None Hint 16. A patient presents with an acutely infected skin wound. Which leukocyte is usually predominant during the first 24 hours? Lymphocyte Plasma cell Neutrophil Eosinophil Macrophage None Hint 17. A neutrophil moves along the endothelial surface before firm attachment. Which adhesion molecules mediate rolling? Integrins Selectins Cadherins MHC molecules Fc receptors None Hint 18. A neutrophil becomes firmly attached to activated endothelium before transmigration. Which molecules are most important? Integrins Selectins alone Histamine receptors Complement C1 Immunoglobulin E None Hint 19. A neutrophil migrates toward a bacterial focus. Which complement fragment is a potent chemotactic factor? C1q C3b C5a C9 Factor H None Hint 20. A patient develops rapid erythema and edema after an insect bite. Which mediator is primarily responsible for the early increase in vascular permeability? Histamine TGF-beta IFN-gamma IL-10 Thromboxane A2 None Hint 21. A patient with acute inflammation develops fever and pain. Which mediator is strongly associated with fever and pain sensitization? PGE2 C3b TGF-beta IL-4 Bradykinin only None Hint 22. A patient with acute inflammation develops pain and increased vascular permeability. Which plasma-derived mediator contributes to both effects? Bradykinin C3b C1 inhibitor IL-2 Erythropoietin None Hint 23. A bacterium is coated with complement fragments that enhance its uptake by neutrophils. Which complement component is an important opsonin? C3b C5a C9 C1q only Factor XII None Hint 24. A neutrophil has recognized an opsonized bacterium. Which event occurs immediately before engulfment? Recognition and attachment DNA replication Fibroblast proliferation Collagen cross-linking Angiogenesis None Hint 25. A neutrophil kills bacteria by generating reactive oxygen species. Which enzyme initiates the respiratory burst? NADPH oxidase Catalase Collagenase Cyclooxygenase Lipoxygenase None Hint 26. A neutrophil converts hydrogen peroxide and chloride into a potent antimicrobial oxidant. Which enzyme catalyzes this reaction? Myeloperoxidase Catalase Superoxide dismutase Elastase Cyclooxygenase None Hint 27. A biopsy shows lymphocytes, macrophages, tissue destruction, and fibrosis persisting for months. Which type of inflammation is present? Acute inflammation Chronic inflammation Serous inflammation Fibrinous inflammation Suppurative inflammation None Hint 28. A patient with a Th1-dominant response develops macrophage activation. Which cytokine is the key macrophage-activating signal? IFN-gamma IL-5 IL-4 IL-10 Erythropoietin None Hint 29. A lung biopsy contains epithelioid macrophages, multinucleated giant cells, and surrounding lymphocytes. What structure is present? Abscess Granuloma Seroma Hematoma Keloid None Hint 30. A healing wound contains numerous newly formed capillaries, fibroblasts, and loose extracellular matrix. What is this tissue called? Granulation tissue Caseous tissue Fibrinoid tissue Necrotic tissue Hyaline tissue None Hint 31. A chronic inflammatory lesion develops excessive collagen deposition. Which cytokine is a major driver of fibrosis? TGF-beta IL-8 IL-2 IFN-alpha GM-CSF None Hint 32. A healing wound develops new capillaries under the influence of a potent endothelial growth factor. Which mediator is most important? VEGF TNF only IL-10 C5a Histamine only None Hint 33. A patient with vitamin C deficiency develops poor wound healing. Which collagen-related process is impaired? Hydroxylation of proline and lysine Translation of elastin Synthesis of keratin Degradation of fibrin Production of histamine None Hint 34. A scar extends well beyond the original wound margins and continues to enlarge. What is the diagnosis? Hypertrophic scar Keloid Contracture Ulcer Granulation tissue None Hint 35. A patient with congestive heart failure develops bilateral ankle swelling due to increased hydrostatic pressure. What mechanism is responsible? Increased hydrostatic pressure Decreased sodium retention Reduced venous pressure Increased plasma oncotic pressure Lymphatic obstruction only None Hint 36. A patient with heart failure has a low-protein fluid accumulation in the pleural cavity. Which term best describes the fluid? Exudate Transudate Pus Chyle Hematoma None Hint 37. A patient with bacterial pneumonia develops a pleural effusion rich in protein and leukocytes. What type of fluid is this? Transudate Exudate Serous transudate Pure lymph Chyle None Hint 38. During exercise, skeletal muscle arterioles dilate and blood flow increases. Which process is this? Hyperemia Congestion Thrombosis Embolism Infarction None Hint 39. A patient with chronic right-sided heart failure develops a bluish-red congested liver. Which process contributes to this appearance? Passive venous congestion Arterial hyperemia Arterial thrombosis Lymphatic hyperplasia Vasculitis None Hint 40. A postoperative patient develops a deep venous thrombosis. Which of the following is one component of Virchow triad? Endothelial injury Hypercalcemia Hypoglycemia Neutropenia Low body temperature None Hint 41. A hospitalized immobilized patient develops unilateral calf swelling. A thrombus is suspected in a deep leg vein. Which type of thrombus is most likely? Arterial platelet-rich thrombus Venous thrombus rich in red cells Fat embolus Air embolus Atheromatous embolus None Hint 42. A patient with a proximal deep venous thrombosis suddenly develops pleuritic chest pain and dyspnea. What is the most likely complication? Pulmonary embolism Stroke from atherosclerosis Renal infarction Splenic rupture Pericarditis None Hint 43. A renal artery branch is occluded by a thromboembolus, producing a wedge-shaped pale lesion. What is this lesion? Infarct Abscess Granuloma Hematoma Aneurysm None Hint 44. A patient develops severe hypotension and tissue hypoperfusion after massive blood loss. Which type of shock is most likely? Hypovolemic shock Cardiogenic shock Septic shock Neurogenic shock Anaphylactic shock None Hint 45. A slowly growing, well-circumscribed mass remains localized and resembles its tissue of origin. Which feature most strongly supports a benign neoplasm? Infiltrative growth Distant metastasis Well-circumscribed growth Marked anaplasia Vascular invasion None Hint 46. A tumor invades surrounding tissues and establishes deposits in distant organs. Which property defines it as malignant? Encapsulation Metastatic potential Slow growth only Normal differentiation Lack of invasion None Hint 47. A carcinoma shows marked pleomorphism, hyperchromatic nuclei, abnormal mitoses, and loss of differentiation. What term describes this appearance? Metaplasia Anaplasia Hyperplasia Hypertrophy Dysplasia only None Hint 48. A malignant tumor arises from glandular epithelial cells in the colon. What is the correct classification? Sarcoma Carcinoma Lymphoma Leukemia Melanoma None Hint 49. A malignant tumor arises from mesenchymal tissue and produces malignant osteoid. Which category does it belong to? Carcinoma Sarcoma Lymphoma Leukemia Papilloma None Hint 50. A chemical carcinogen causes permanent DNA damage in a cell. Which stage of carcinogenesis is represented by the initial irreversible genetic alteration? Promotion Initiation Progression Metastasis Invasion None Hint 51. A tumor loses functional RB protein, allowing inappropriate progression through the cell cycle. RB is best classified as which type of gene? Tumor suppressor gene Oncogenic virus only DNA repair enzyme only Growth factor receptor Housekeeping gene None Hint 52. A cancer cell develops constitutive signaling from an activated RAS protein. RAS is an example of what type of cancer-related gene? Tumor suppressor Proto-oncogene/oncogene DNA mismatch repair gene Apoptotic inhibitor only Structural collagen gene None Hint 53. A patient with a carcinoma develops tumor deposits in regional lymph nodes. Which route of spread is particularly characteristic of carcinomas? Lymphatic spread Direct spread through nerves only CSF spread only Transcoelomic spread only Hematogenous spread only None Hint 54. A patient develops urticaria, wheezing, and hypotension within minutes of exposure to an allergen. Which immunoglobulin mediates the reaction? IgA IgG IgM IgE IgD None Hint 55. A patient develops autoimmune hemolytic anemia due to antibodies directed against red-cell surface antigens. Which hypersensitivity mechanism is involved? Type I Type II Type III Type IV Type V only None Hint 56. A patient develops tissue injury due to deposition of circulating antigen-antibody complexes in vessel walls. Which mechanism is responsible? Type I Type II Type III Type IV Delayed-type only None Hint 57. A patient develops an indurated skin reaction 48 hours after exposure to a previously encountered antigen. Which hypersensitivity type is this? Type I Type II Type III Type IV Complement deficiency None Hint 58. A woman with chronic menstrual blood loss has microcytic, hypochromic anemia and low serum ferritin. What is the most likely diagnosis? Iron deficiency anemia Aplastic anemia Sickle cell anemia Hereditary spherocytosis Megaloblastic anemia None Hint 59. A patient has macrocytosis, glossitis, and hypersegmented neutrophils. Which type of anemia is most likely? Iron deficiency anemia Megaloblastic anemia Sideroblastic anemia Thalassemia Anemia of acute blood loss None Hint 60. A patient has macrocytic anemia, paresthesias, and impaired vibration sense. Which deficiency is most likely? Iron Vitamin B12 Vitamin K Vitamin C Folate only None Hint 61. A young adult has recurrent painful vaso-occlusive crises and chronic hemolytic anemia. Which hemoglobin is responsible? HbA HbA2 HbF HbS HbH None Hint 62. A child has severe microcytic anemia with target cells and increased hemolysis. Which disorder is caused by reduced globin-chain synthesis? Thalassemia Hereditary spherocytosis G6PD deficiency Autoimmune hemolysis Aplastic anemia None Hint 1 out of 31 Time's up
