Casos clinicos patologia

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Cellular Pathology
PBD7 Chapter 1: Cellular Adaptations, Cell Injury, and Cell Death
PBD8 Chapter 1: Cellular Responses to Stress and Toxic Insults:
Adaptation, Injury, and Death
BP7 Chapter 1: Cell Injury, Adaptation, and Death
BP8 Chapter 1: Cell Injury, Death, and Adaptation

1 A 17-year-old boy infected with hepatitis A experiences
mild nausea for about 1 week and develops verymild scleral
icterus. On physical examination, he has minimal right upper
quadrant tenderness. Laboratory findings include a serum
AST of 68 U/L, ALT of 75 U/L, and total bilirubin of 5.1 mg/
dL. The increase in this patient’s serum enzyme levels most
likely results from which of the following changes in the
hepatocytes?
 (A) Autophagy by lysosomes
 (B) Clumping of nuclear chromatin
 (C)Defects in the cell membrane
 (D) Dispersion of ribosomes
 (E) Swelling of the mitochondria
2 A 16-year-old boy sustained blunt trauma to the
abdomen when the vehicle he was driving struck a bridge
abutment at high speed. Peritoneal lavage shows a hemoperitoneum, and at laparotomy, a small portion of the left lobe of
the liver is removed because of the injury. Several weeks later,
a CTscan of the abdomen shows that the liver has nearly

regained its size before the injury. Which of the following
processes best explains this CT scan finding?
 (A) Apoptosis
 (B) Dysplasia
 (C) Fatty change
 (D) Hydropic change
 (E) Hyperplasia
 (F) Hypertrophy
 (G) Metaplasia
3 On a routine visit to the physician, an otherwise healthy
51-year-old man has a blood pressure of150/95 mm Hg. If
his hypertension remains untreated for years, which of the
following cellular alterations would most likely be seen in his
myocardium?
 (A) Atrophy
 (B) Hyperplasia
 (C) Metaplasia
 (D) Hemosiderosis
 (E) Hypertrophy
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UNIT I

General Pathology

6 A 38-year-old woman experienced severe abdominal
pain with hypotension and shock that led to her death within36 hours after the onset of the pain. From the gross appearance of the mesentery, seen in the figure at the bottom of the
previous column, which of the following events has most
likely occurred?
 (A) Hepatitis B virus infection
 (B) Small intestinal infarction
 (C) Tuberculous lymphadenitis
 (D) Gangrenous cholecystitis
 (E) Acute pancreatitis

4 A 72-year-old man died suddenly fromcongestive heart
failure. At autopsy, the heart weighed 580 g and showed
marked left ventricular hypertrophy and minimal coronary
arterial atherosclerosis. A serum chemistry panel ordered
before death showed no abnormalities. Which of the following
pathologic processes best accounts for the appearance of the
aortic valve seen in the figure?
 (A) Amyloidosis
 (B) Dystrophic calcification (C) Lipofuscin deposition
 (D) Hemosiderosis
 (E) Fatty change
5 A 69-year-old woman has had transient ischemic attacks
for the past 3 months. On physical examination, she has
an audible bruit on auscultation of the neck. A right carotid
endarterectomy is performed. The curetted atheromatous
plaque has a grossly yellow-tan, firm appearance. Microscopically, which of the followingmaterials can be found in abundance in the form of crystals that produce long, cleft-like
spaces?
 (A) Glycogen
 (B) Lipofuscin
 (C) Hemosiderin
 (D) Immunoglobulin
 (E) Cholesterol

7 In an experiment, cells are subjected to radiant energy
in the form of x-rays. This results in cell injury caused by
hydrolysis of water. Which of the following cellular enzymes
protects the cells from thistype of injury?
 (A) Phospholipase
 (B) Glutathione peroxidase
 (C) Endonuclease
 (D) Lactate dehydrogenase
 (E) Protease
8 A 47-year-old woman has had worsening dyspnea for
the past 5 years. A chest CT scan shows panlobular emphysema. Laboratory studies show the PiZZ genotype of α1antitrypsin (AAT) deficiency. A liver biopsy specimen
examined microscopically shows abundant...