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  • Question 1 - The passage of leukocytes through the wall of the blood vessels is best...

    Correct

    • The passage of leukocytes through the wall of the blood vessels is best described by which of the following terms?

      Your Answer: Diapedesis

      Explanation:

      The steps involved in leukocyte arrival and function are:

      1. margination: cells migrate from the centre to the periphery of the vessel

      2. rolling: selectins are upregulated on the vessel walls

      3. adhesion: upregulation of the adhesion molecules ICAM and VCAM on the endothelium interact with integrins on the leukocytes, interaction of these results in adhesion

      4. diapedesis and chemotaxis: diapedesis is the transmigration of the leukocyte across the endothelium of the capillary and towards a chemotactic product

      5. phagocytosis: engulfing the offending substance/cell.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      5.6
      Seconds
  • Question 2 - Which of the following morphological features is most characteristic of hyaline degeneration? ...

    Correct

    • Which of the following morphological features is most characteristic of hyaline degeneration?

      Your Answer: Homogeneous, ground-glass, pink-staining appearance of cells

      Explanation:

      The characteristic morphological features of hyaline degeneration is ground-glass, pinking staining cytoplasm with an intact cell membrane. The accumulation of lipids, calcium salts, lipofuscin and an amorphous cytoplasm with an intact cell membrane are all characteristically found in different situations.

      Pyknotic nucleus and orphan Annie eye nucleus are not seen in hyaline degeneration.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      14.2
      Seconds
  • Question 3 - A histopathological analysis of a specimen showed loss of individual cell structure with...

    Correct

    • A histopathological analysis of a specimen showed loss of individual cell structure with karyorrhexis and fragmentation. The overall integrity of the tissue structure is preserved. This is typical of which of the following pathologies?

      Your Answer: Viral hepatitis

      Explanation:

      Viral infections will cause necrosis of the hepatocytes with characteristic changes of karyorrhexis and cell fragmentation.

      Brown atrophy of the heart is due to accumulation of lipofuscin in the myocardium.

      Tissue destruction associated with transplant rejection leads to widespread loss of structural integrity.

      Single cell necrosis is not characteristically seen in chronic alcoholic liver.

      Barbiturate overdose will result in hypertrophy of the smooth endoplasmic reticulum.

      Carcinoma insitu will cause dysplastic cells without the overall structural integrity being disrupted.

      Atrophy is due to apoptosis with ordered cellular fragmentation and phagocytosis and will not induce an inflammatory process unlike necrosis.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      64.9
      Seconds
  • Question 4 - A butcher accidentally cut himself on his right index finger. Which of the...

    Correct

    • A butcher accidentally cut himself on his right index finger. Which of the following substances when in contact with the basement membrane of the injured vasculature will activate the coagulation cascade as well as the kinin system in a first response to this injury?

      Your Answer: Hageman factor

      Explanation:

      Hageman factor/factor XII in the intrinsic pathway activates prekallikrein and factor XI. Deficiency will not cause excessive bleeding as other coagulation factors will be utilized but the PTT will be greater than 200 seconds.

      Thromboxane promotes platelet aggregation and causes vasoconstriction.

      Plasmin, which is cleaved from plasminogen acts as an anticoagulant which breaks down thrombi.

      Platelet activating factor promotes platelet aggregation and is also chemotactic to neutrophils.

      Histamine acts as a vasodilator.

      Platelet inhibiting factor acts an anticoagulant.

      Renin is a hormone released from the kidney that causes vasoconstriction and water retention.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      12.3
      Seconds
  • Question 5 - A 27 year old women works in a dry-cleaning shop. She was exposed...

    Correct

    • A 27 year old women works in a dry-cleaning shop. She was exposed to massive amounts of carbon tetrachloride on her skin as well as inhaled. Which of the following organs is most susceptible to damage?

      Your Answer: Liver

      Explanation:

      Carbon tetrachloride (CCl4) is a common agent used in the dry cleaning industry and is thought to cause the formation of free radicals. It causes rapid breakdown of the endoplasmic reticulum due to decomposition of lipids and severe liver cell injury. Within less than 30 mins, hepatic protein synthesis declines, lipid export is reduced due to lack of apoprotein and there is an influx of calcium and cell death.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      7.7
      Seconds
  • Question 6 - Which of the following factors will not affect the wound healing process in...

    Correct

    • Which of the following factors will not affect the wound healing process in a young women who suffered serious burns to her chest and hands?

      Your Answer: Vitamin A deficiency

      Explanation:

      Healing can be sped-up or slowed down due to various reasons: 1. blood supply, 2. infection, 3. denervation, 4. collection of blood/hematoma, 5. mechanical stress, 6. foreign body, 7. techniques used during surgery and 8. dressing of the wound. Other systemic factors include 1. nutrition e.g. deficiency of zinc, vitamin C, protein deficiency, 2. metabolic status, 3. circulatory status and 4. hormonal influence

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      10.4
      Seconds
  • Question 7 - Which of the following key features will be seen in an organ undergoing...

    Correct

    • Which of the following key features will be seen in an organ undergoing atrophy?

      Your Answer: A greater number of autophagic vacuoles

      Explanation:

      Atrophy is characterised by the breakdown of intracellular components along with organelles and packing them into vacuoles known as autophagic vacuoles. This is an adaptive response that separates the damaged cellular structures from the rest of the cells.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      11.1
      Seconds
  • Question 8 - In which of the following situations will fat necrosis occur? ...

    Correct

    • In which of the following situations will fat necrosis occur?

      Your Answer: Trauma to the breast

      Explanation:

      Fat necrosis is necrosis of adipose tissue with subsequent deposition of calcium, giving it a white chalky appearance. It is seen characteristically in trauma to the breast and the pancreas with subsequent involvement of the peripancreatic fat. In the breast it may present as a palpable mass with is usually painless or as an incidental finding on mammogram. Fatty acids are released from the traumatic tissue which combine with calcium in a process known as saponification, this is an example of dystrophic calcification in which calcium binds to dead tissue. The central focus is surrounded by macrophages and neutrophils initially, followed by proliferation of fibroblasts, neovascularization and lymphocytic migration to the site of the insult.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      5.7
      Seconds
  • Question 9 - Which of the given options best describes the metabolic changes which occur following...

    Correct

    • Which of the given options best describes the metabolic changes which occur following a severe soft tissue injury sustained after a PVA?

      Your Answer: Mobilisation of fat stores

      Explanation:

      The following metabolic responses occur following trauma as part of a coping mechanism for the additional stress. These include acid base changes (metabolic acidosis or alkalosis), decrease urine output and osmolality, reduced basal metabolic rate (BMR), gluconeogenesis with amino acid breakdown and shunting, hyponatraemia as a result of impaired functioning of sodium pumps, hypoxic injury, coagulopathies, decreased immunity, increase extracellular fluid and hypovolemic shock, increase permeability leading to oedema, break down and mobilization of fat reserves, pyrexia and reduced circulating levels of albumin.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      14
      Seconds
  • Question 10 - A histological examination of a lump showed an abnormal amount and arrangement of...

    Correct

    • A histological examination of a lump showed an abnormal amount and arrangement of normal tissue in an otherwise normal area. This condition is known as?

      Your Answer: Hamartoma

      Explanation:

      A hamartoma is a condition best described as tissue normally present in an area arranged haphazardly in an disorganized, abnormal fashion. They are never malignant and do not metastasis.

      All the neoplastic, cancerous lesions comprise of a mixture of different cells that are not normal to that area.

      Metaplasia is a change in the type of the epithelium.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      71.2
      Seconds
  • Question 11 - A histology report of a cervical biopsy taken from a patient with tuberculosis...

    Correct

    • A histology report of a cervical biopsy taken from a patient with tuberculosis revealed the presence of epithelioid cells. What are these cells formed from?

      Your Answer: Macrophages

      Explanation:

      Granulomas formed in tuberculosis are called tubercles and are made up polynuclear phagocytes, Langhans cells and epithelioid cells. Macrophages when enlarged, consist of abundant cytoplasm and have a tendency of arranging themselves very closely to each other representing epithelial cells. These enlarged macrophages are therefore termed as epithelioid cells.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      11.7
      Seconds
  • Question 12 - A cyclist fell and sustained a laceration to his elbow which was shortly...

    Correct

    • A cyclist fell and sustained a laceration to his elbow which was shortly sutured in the emergency department. Which of the following factors will aid in the wound healing process?

      Your Answer: Presence of sutures

      Explanation:

      Foreign bodies including sutures will delay wound healing, however due to the net affect being helpful they are used. Secondary wound infection will delay healing and is a potential post op complication. Corticosteroids depresses the wound healing ability of the body. Poor nutrition will also delay healing leading to decreased albumin, vit D and vit C. Diabetic patients with atherosclerosis with poor perfusion of tissues have notoriously delayed/poor healing.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      6.8
      Seconds
  • Question 13 - A 27 year old women had developed a darker complexion following a vacation...

    Correct

    • A 27 year old women had developed a darker complexion following a vacation to India. She had no erythema or tenderness. Her skin colour returned to normal over a period of 1 month. Which of the these substances is related to the biochemical change mentioned above?

      Your Answer: Tyrosine

      Explanation:

      The tanning process can occur due to UV light exposure as a result of oxidation of tyrosine to dihydrophenylalanine with the help of the tyrosinase enzyme within the melanocytes. Hemosiderin can impart a brown colour due to breakdown of RBC but its usually due to a trauma and is known as haemochromatosis.

      Lipofuscin gives a golden brown colour to the cell granules not the skin.

      Homogentisic acid is part of a rare disease alkaptonuria, with characteristic black pigment deposition within the connective tissue.

      Copper can impart a brown golden colour, but is not related to UV light exposure.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      14.8
      Seconds
  • Question 14 - The wound healing process is documented in patients undergoing laparoscopic procedures. The port...

    Correct

    • The wound healing process is documented in patients undergoing laparoscopic procedures. The port incisions are sutured closed and the wounds observed every few weeks for re-epithelialisation and tensile strength. Which substance is mostly likely to be found at a cellular level involved in wound healing?

      Your Answer: Tyrosine kinase

      Explanation:

      Cell surface growth factor receptors require intercellular proteins such as tyrosine kinase which are necessary to initiate a series of events that eventually lead to cell division and growth. Tyrosine kinase is an enzyme that transfers a phosphate group to the tyrosine residue in a protein. This phosphorylation will lead to an up regulation of the enzyme activity.

      Fibronectin acts in the extracellular matrix to bind macromolecules (such as proteoglycans) via integrin receptors to aid attachment and migration of cells.

      Laminin is an extracellular matrix component that is abundant in basement membranes.

      Hyaluronic acid is one of the proteoglycans in the extracellular matrix.

      Collagen fibres are part of the extracellular matrix that gives strength and stability to connective tissues.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      31.8
      Seconds
  • Question 15 - Which of the following is not seen as a complication of wound healing?...

    Correct

    • Which of the following is not seen as a complication of wound healing?

      Your Answer: Malignancy

      Explanation:

      Complications in wound healing can originate due to abnormalities in the repair process. These abnormalities are :

      1) Deficient scar formation: insufficient granulation tissue can lead to wound dehiscence and ulceration. Dehiscence or wound rupture is seen most commonly in abdominal surgery due to increased intraabdominal pressure. Ulcerations are common in extremity wounds due to inadequate vascularization.

      2) Excessive formation of repair components: collagen being laid down may begin normally however later lead to a raised scar also called a hypertrophic scar, which can extend beyond its boundaries to form a keloid and

      3) Formation of contractures.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      5.8
      Seconds
  • Question 16 - A cell is classified on the basis of its regenerative ability. Which of...

    Correct

    • A cell is classified on the basis of its regenerative ability. Which of the following cells represent a permanent cell?

      Your Answer: Erythrocyte

      Explanation:

      An erythrocyte is the last cell in the progeny of RBC cell division and is not capable of further division and regeneration. Hepatocytes, osteocytes and epithelium of kidney tubules are all stable cells. Colonic mucosa and pluripotent hematopoietic stem cells are all labile cells.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      8.4
      Seconds
  • Question 17 - Which of the following morphological characteristic is a salient feature of a pure...

    Correct

    • Which of the following morphological characteristic is a salient feature of a pure apoptotic cell?

      Your Answer: Chromatin condensation

      Explanation:

      Apoptosis is the programmed death of cells which occurs as a normal and controlled part of an organism’s growth or development. The changes which occur in this process include blebbing, cell shrinkage, nuclear fragmentation, chromatin condensation, chromosomal DNA fragmentation, and global mRNA decay. The cell membrane however remains intact and the dead cells are phagocytosed prior to any content leakage and thus inflammatory response.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      18.8
      Seconds
  • Question 18 - The periphery of a haematoma is infiltrated by fibroblasts, collagen and new vasculature....

    Correct

    • The periphery of a haematoma is infiltrated by fibroblasts, collagen and new vasculature. This process is best described as?

      Your Answer: Organisation of the haematoma

      Explanation:

      Formation of granulation tissue at the periphery of the hematoma is a normal process leading to resolution. This granulation tissue is composed of new capillaries, fibroblasts and collagen. Lysis of a blood clot can occur, but the actual process of this response is known as organization, wherein the scar tissue will become part of the vessels. This is followed by recanalization and embolization which can lead to eventual complications. Proliferation of a clot will occur due to an imbalance in the clotting and lysing systems. Thrombosis has nothing to do with the process described above.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      14.6
      Seconds
  • Question 19 - Which of the following changes in the histology of the cell is most...

    Incorrect

    • Which of the following changes in the histology of the cell is most likely to be accompanied by disruption of the cell membrane following an injury?

      Your Answer: Pyknosis

      Correct Answer: Coagulative necrosis

      Explanation:

      The process of necrosis ends with the rupture of the cell membrane and the consequent release of the cellular components into the surrounding tissue. Apoptosis, pyknosis and karyorrhexis are not reversible events but the cell membrane remains intact. Cloudy swelling and hydropic changes are also reversible but again the cell membrane remains intact and they are therefore different and distinct from necrosis.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Pathology
      38.2
      Seconds
  • Question 20 - Which of the following is NOT a nutritional factor involved in wound healing:...

    Correct

    • Which of the following is NOT a nutritional factor involved in wound healing:

      Your Answer: Vitamin B3

      Explanation:

      Vitamin B6 is required for collagen cross-links.

      Vitamin A is required for epithelial cell proliferation.

      Zinc is required for RNA and DNA synthesis.

      Copper is required for cross-linking of collagen.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Physiology
      7.1
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cell Injury & Wound Healing (19/20) 95%
Pathology (18/19) 95%
Physiology (1/1) 100%
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