Histology Certification Pathological Changes 2 — Questions and Answers
Question 1: Which term describes irreversible cell injury characterized by cell swelling, membrane rupture, and inflammation?
- Apoptosis
- Necrosis (Correct answer)
- Autophagy
- Senescence
Correct answer: Necrosis
Necrosis is an uncontrolled, irreversible form of cell death associated with membrane disruption and inflammatory response.
Question 2: In coagulative necrosis, the tissue architecture is preserved because of which of the following?
- Enzymatic digestion predominates
- Protein denaturation prevents autolysis (Correct answer)
- Lipid peroxidation is blocked
- Inflammatory cells are absent
Correct answer: Protein denaturation prevents autolysis
In coagulative necrosis, heat or ischemia denatures structural proteins, including enzymes, preventing autolytic digestion and preserving tissue architecture.
Question 3: Liquefactive necrosis is characteristically seen in infarcts of which organ?
- Heart
- Kidney
- Brain (Correct answer)
- Liver
Correct answer: Brain
The brain undergoes liquefactive necrosis because its high lipid content and abundance of hydrolytic enzymes lead to rapid digestion of necrotic tissue.
Question 4: Caseous necrosis, which appears as soft, cheese-like material on gross examination, is most associated with infection by which organism?
- Staphylococcus aureus
- Mycobacterium tuberculosis (Correct answer)
- Candida albicans
- Clostridium perfringens
Correct answer: Mycobacterium tuberculosis
Caseous necrosis is a hallmark of granulomatous inflammation caused by Mycobacterium tuberculosis.
Question 5: Fat necrosis secondary to acute pancreatitis results from the action of which enzymes released by damaged pancreatic cells?
- Proteases and nucleases
- Lipases and phospholipases (Correct answer)
- Amylases and glucosidases
- Collagenases and elastases
Correct answer: Lipases and phospholipases
Pancreatic lipases and phospholipases digest adipose tissue triglycerides, releasing fatty acids that combine with calcium to form saponification (chalky deposits).
Question 6: Which of the following is a histological hallmark of gangrenous necrosis in an extremity?
- Preserved cell outlines with ghost nuclei
- Complete liquefaction of tissue
- Mixed coagulative necrosis with superimposed bacterial infection (Correct answer)
- Granuloma formation with Langhans giant cells
Correct answer: Mixed coagulative necrosis with superimposed bacterial infection
Gangrenous necrosis (wet gangrene) combines ischemic coagulative necrosis with superimposed bacterial infection and liquefaction.
Question 7: Fibrinoid necrosis is most characteristically seen in which pathological condition?
- Tuberculosis
- Malignant hypertension and immune vasculitis (Correct answer)
- Myocardial infarction
- Pulmonary embolism
Correct answer: Malignant hypertension and immune vasculitis
Fibrinoid necrosis occurs in vessel walls in malignant hypertension and autoimmune vasculitides, where plasma proteins including fibrin deposit in the necrotic wall.
Histology Certification Pathological Changes 2
Which term describes irreversible cell injury characterized by cell swelling, membrane rupture, and inflammation?