Communication: Discussion Board: Mid-Term Study Questions Cell Injury Plasma cells (differentiated B lymphocytes) were found to contain increased amounts of rough endoplasmic reticulum. What is the explanation for this finding? At autopsy, a small heart in a 90-year old woman was found full of lipofuscin. What is a reasonable explanation for this finding? The left ventricle of the heart was 2.5 cm thick (normal = 1.5 cm). What is the name for this morphological adaptation to chronic stress? Large amounts of brown pigment were noted in a liver biopsy specimen obtained from a man who had hemolytic anemia. What is the name for this brown pigment? What is the name for this intracellular storage disorder? A 60-year old man died due to myocardial infarction. At autopsy, the heart tissue histologically demonstrated loss of nuclei, loss of cell outlines, deeply eosinophilic staining of the cytoplasm, and loss of cross striation of cardiac myocytes. This heart shows signs of: A chronic smoker presented to the hospital with relentless coughing and a bronchial biopsy was performed. The biopsy contained fragments of mature squamous epithelium with no evidence of nuclear atypia. This pathologic change is called: Actinic keratosis is a pre-neoplastic condition marked by variation in size and shape of epithelial cells, irregular nuclei, and disorderly maturation. This condition is an example of an adaptation to persistent stress termed: At the autopsy of an 80-year old man, the brain was found to have thinned gyri and widened sulci. What is the name for this morphological adaptation to chronic persistent injury? Renal cell carcinoma may secrete erythropoietin which results in erythrocytosis. The bone marrow of such patients contains an increased number of red blood cell precursors. This condition is called erythroid: Inflammation A slap on the face produced an area of redness on the check. Why did the face become red? What is the name for this phenomenon? White blood cells (WBCs) were attached to the endothelial cells of small blood vessels in the area of inflammation. What is the reason for this "pavementing"? What is this process called? The WBC's recovered from the urethral discharge of a man with gonorrhea were found to contain bacteria. How did the bacteria enter the WBCs? What is this process called? A kidney was affected by inflammation for 2 months. What types of cells would one expect to find in this tissue? The pericardium was covered with a shaggy, soft, red material that could be removed easily. What is this surface material largely composed of? Immunopathology An eye infection was diagnosed in a person who cannot produce tears. Such infections are likely to be recurrent. Name this syndrome. A man experienced attacks of sneezing every spring. This is most likely an example of which hypersensitivity reaction? Group A blood given to a group B person caused severe hemolysis. Why did hemolysis occur? Three days after a purified protein derivative (PPD) isolated from Mycobacterium tuberculosis was injected into the skin of a patient, an area of hardening (induration) 1 cm in diameter was produced. This area of induration is due to which type of hypersensitivity reaction taking place in the skin? An Rh-positive baby, the second child of an Rh-negative mother, was jaundiced. Why was the child yellow? Neoplasia A small nodule measuring 2 cm in diameter was removed form the breast of a 25-year old woman. If this nodule is a benign neoplasm if ductal epithelial origin it would be called: An islet cell tumor measuring 3 cm in diameter was found in the pancreas. There were also metastases in the lymph nodes. On histologic examination, it could not be determined whether the primary tumor was benign or malignant. Is this tumor benign or malignant? A 14-year old boy died of osteosarcoma that had metastasized in the lungs. Where did this tumor most likely arise? A former shipyard worker who was a smoker developed cancer and received compensation for a workplace-related injury. What cancer is this? What is the histological diagnosis? A woman who was diagnosed as having hepatitis B virus (HBV) in her youth developed a carcinoma at the age of 60 years. This carcinoma was found in which organ? Developmental and Genetic Diseases A mentally retarded child with slanted eyes, epicanthus, and simian crease of the palm was born to a 35-year old woman. What marker protein is the basis for prenatal diagnosis? An infertile 21-year old woman was found to have a 45,X karyotype. What is the most likely explanation of this finding? What is the diagnosis? What is the name for the chromosomal error which most likely occurred during meiosis? A man with familial hypercholesterolemia has two sons and two daughters. What percentage of his children may also have the disease? A neonate developed meconium ileus shortly after birth and subsequently developed pancreatitis and recurrent pulmonary infections. The child's skin tasted salty. What is the likely diagnosis? Do the infant's parents have any signs of the disease? Hemodynamic Disorders A 68-year old man with known heart disease developed pain under the right costal margin. What is the likely cause of this pain? A patient with pulmonary tuberculosis expectorates blood. What is this called? A 45-year old woman with a massive traumatic hematoma became jaundiced. What is the cause of this jaundice? A pregnant woman had swollen painful legs. What is a likely cause of swelling in her legs? A woman with varicose veins developed chest pain and expectorated blood the next day. What could have caused these symptoms? A 56-year with a prior history of myocardial infarction developed gangrene of the toe. What is the cause of the gangrene? A 23-year old woman with burn injuries developed Diffuse Alveolar Damage (DAD) and became short of breath. Auscultation revealed pulmonary rales (rattling sounds). What is the most likely cause of rales and shortness of breath in this woman? Heart A 30-year old man was told that he had a heart murmur. What produces heart murmurs? A 50-year old man complained of chest pain. What is the most likely cause of precordial pain? A 55-year old woman was diagnosed as having angina pectoris. What causes angina pectoris? A 50-year old man complained of shortness of breath. Why do patients with heart disease often have shortness of breath? A 60-year old man complained of leg cramps, which were so severe that he had to stop walking. What is the pathologic basis for "intermittent claudication" in this patient? Lung A young man sneezed each time he was close to cats. What is the principal cause of his sneezing? A 50-year old chronic alcoholic was brought to the hospital with fever and shortness of breath. He was coughing and expectorating yellow sputum. What is the most likely cause of his distress? A chronic smoker who was admitted to the hospital had shortness of breath and was expectorating large amounts of yellowish sputum. There was no fever or leg edema. What is the diagnosis? A 5-year old girl had a sudden attack of suffocating cough accompanied by wheezing respiration. There was no fever, but the child appeared anxious and in distress. What is the most likely diagnosis? A 60-year old coal miner developed progressive shortness of breath. X-ray studies showed numerous nodular masses in both lungs. What diagnosis should be considered? A 35-year old man was salvaged from a burning house. Because of marked shortness of breath, he was placed on a ventilator. What is the cause of shortness of breath? A chronic smoker became hoarse and, after a few days, could not speak at all. What pathologic finding would account for these symptoms? A chronic smoker, with a long-standing chronic bronchitis, expectorated blood during a paroxysm of coughing. What is a possible cause of hemoptysis in this patient? During a routine chest X-ray examination in a 60-year old woman, three round nodules were found in the left lung and two in the right lung. What is the most likely diagnosis?