CMI CMI Pathology & Disease Processes 2 — Questions and Answers
Question 1: Which morphological pattern best represents caseous necrosis as seen in tuberculosis?
- Firm coagulated tissue
- Cheesy, amorphous eosinophilic material (Correct answer)
- Liquefied pus-filled cavity
- Chalky white saponified fat
Correct answer: Cheesy, amorphous eosinophilic material
Caseous necrosis in tuberculosis appears as soft, cheese-like amorphous eosinophilic debris lacking recognizable cell structure.
Question 2: When illustrating metastatic spread, which route do carcinomas most commonly use?
- Perineural spread
- Hematogenous spread
- Direct extension
- Lymphatic spread (Correct answer)
Correct answer: Lymphatic spread
Carcinomas (epithelial malignancies) most commonly spread via lymphatic channels, whereas sarcomas favor hematogenous routes.
Question 3: Which cell type forms the granuloma core in chronic granulomatous inflammation?
- Neutrophils
- Mast cells
- Epithelioid macrophages (Correct answer)
- Plasma cells
Correct answer: Epithelioid macrophages
Granulomas are characterized by a central aggregate of epithelioid macrophages, often surrounded by lymphocytes and multinucleated giant cells.
Question 4: In illustrating cirrhosis, which fibrous change replaces normal hepatic architecture?
- Periportal fibrosis only
- Bridging fibrosis forming regenerative nodules (Correct answer)
- Central vein hyalinosis
- Centrilobular fatty change
Correct answer: Bridging fibrosis forming regenerative nodules
Cirrhosis is defined by diffuse bridging fibrosis that subdivides the liver into regenerative parenchymal nodules, disrupting normal architecture.
Question 5: Which vascular change is illustrated in hypertensive end-organ damage to small arteries?
- Fibrinoid necrosis and hyaline arteriolosclerosis (Correct answer)
- Mönckeberg medial calcification
- Cystic medial necrosis
- Nodular polyarteritis
Correct answer: Fibrinoid necrosis and hyaline arteriolosclerosis
Chronic hypertension causes hyaline arteriolosclerosis (protein deposition) and in malignant hypertension, fibrinoid necrosis of arteriolar walls.
Question 6: In a pathology illustration of myocardial infarction at 24 hours, what histological finding is most prominent?
- Granulation tissue ingrowth
- Contraction band necrosis and neutrophil infiltration (Correct answer)
- Fibrous scar replacement
- Ghost cell outlines with preserved architecture
Correct answer: Contraction band necrosis and neutrophil infiltration
At 24 hours post-infarction, coagulative necrosis with early neutrophil infiltration and contraction bands from reperfusion become visible.
CMI CMI Pathology & Disease Processes 2
Which morphological pattern best represents caseous necrosis as seen in tuberculosis?