Histology & Pathology - Block E Final Exam Review

1.

1 point

Lecture: Dr. St-Cyr – Pathology of diabetes (Feb 5)
Author: Doulia Hamad

Which of the following statements is TRUE of type II diabetes mellitus (T2DM)?

Subcutaneous and visceral fat put patients at the same risk for T2DM.

T2DM is the result of an autoimmune disease.

T2DM patients are not at increased risk of retinopathy and end-stage renal disease compared to the general population.

β-cell dysfunction contributes to the pathogenesis of T2DM.

End-stage renal failure is the most common cause of death in this patient population.

2.

1 point

Lecture: Dr. St-Cyr – Pathology of diabetes (Feb 5)
Author: Doulia Hamad

Regarding the pathogenesis of diabetes, which of the following is FALSE?

Hyperglycemia is the main cause of complications in diabetes.

Hypertension in diabetes increases the prevalence of hyaline arteriolosclerosis.

Kimmelstiel-Wilson lesions are a typical finding of diabetes.

Accelerated atherosclerosis in diabetes contributes to early onset of gangrene.

Diabetes does not affect protein kinase activation and basement membrane thickness.

3.

1 point

Lecture: Dr. St-Cyr – Pathology of diabetes (Feb 5)
Author: Doulia Hamad

A 38 year-old man with type I diabetes presents to your office. Since he was first diagnosed at the age of 10 and to this day, his disease has been poorly controlled.

Which of these statements is FALSE?

The patient is likely to have a fasting plasma glucose above 7 mmol/L.

Patients like this almost always present with excessive visceral obesity.

Lab tests are likely to show evidence of autoimmune disease.

This patient has a reduced number of functional pancreatic β cells.

This patient is at high risk of peripheral neuropathy.

4.

1 point

Lecture: Dr. Morales – Histology of Liver and Pancreas (Feb 9)
Author: Russell Frank

Which of the following about the pancreas is FALSE?

The pancreas develops from an evagination of the endodermal lining of the primitive intestine.

During development of the pancreas, cells from the islets of Langerhans differentiate and detach to form the mucous acini of the exocrine pancreas.

The pancreas produces active enzymes, hormones, and other substances.

Delta cells produce somatostatin, which can inhibit release of insulin.

The pancreas produces proenzymes, such as trypsinogen, which gets converted to trypsin by enterokinase.

5.

1 point

Lecture: Dr. Morales – Histology of Liver and Pancreas (Feb 9)
Author: Russell Frank

Which of the following correctly describes the flow of blood in the liver towards the inferior vena cava (IVC)?

Hepatic venule and hepatic arteriole → sinusoid → central vein → sublobular vein → portal vein → IVC

Portal venule and hepatic arteriole → sinusoid → sublobular vein → central vein → hepatic vein → IVC

Hepatic venule and hepatic arteriole → sinusoid → central vein → portal vein → sublobular vein → IVC

Portal venule and hepatic arteriole → central vein → sinusoid → hepatic vein → sublobular vein → IVC

Portal venule and hepatic arteriole → sinusoid → central vein → sublobular vein → hepatic vein → IVC

6.

1 point

Lecture: Dr. Marcus – Pancreas pathology – Feb 12
Author: Doulia Hamad

Which of the following statements is FALSE about pancreatitis? (Choose the INCORRECT statement).

Alcohol is a major etiology of acute and chronic pancreatitis.

Pancreas divisum is a possible cause of chronic pancreatitis,

The pathogenesis of acute pancreatitis does not always involve acinar cell injury.

Both mild and severe acute pancreatitis will have some degree of fat necrosis but only severe pancreatitis has parenchymal necrosis.

Autoimmune pancreatitis can mimic pancreatic cancer on radiological exam but does not necessarily need resection.

7.

1 point

Lecture: Dr. Marcus – Pancreas pathology – Feb 12
Author: Doulia Hamad

Which of the following is FALSE about cystic lesions of the pancreas? (Choose the INCORRECT statement).

Mucinous cystic neoplasms do not affect the main ductal system and have a high risk for malignancy.

Pancreatic neuroendocrine tumors are often biologically active and most commonly secrete insulin.

Ductal adenocarcinomas make up 90% of pancreatic cancers and are highly lethal.

Pancreas cancer most commonly presents in the head of the pancreas.

Pseudopapillary neoplasms are the most common and malignant type of neoplasms; resection is rarely curative.

8.

1 point

Lecture: Dr. Marcus – Pancreas pathology – Feb 12
Author: Doulia Hamad

Find the INCORRECT association:

von Hippel-Lindau disease – serous cystadenoma and neuroendocrine tumors.

Courvoisier’s sign – adenocarcinoma of the pancreas.

Risk factors for acute pancreatitis – hypercalcemia, pancreas divisum, shock, EtOH and gallstones.

Common complications of acute pancreatitis – adenocarcinoma of pancreas, pseudocysts and osteomalacia.

Mucin extruding from the ampulla – Intraductal Papillary Mucinous Neoplasm (IPMN)

9.

1 point

Lecture: Dr. Morales - Histology
Author: Lee Sterling

Auerbach's plexus can be found between which of the following layers of the GI tract?

Lamina Propria and Muscularis Mucosa

Submucosa and internal layer of the tunica muscularis

Internal and External Layer of the tunica muscularis

Tunica Muscularis and Serosa

10.

1 point

Lecture: Dr. Morales - Histology
Author: Lee Sterling

The following secretory cells can all be found in the gastric portion of the stomach. Which cell would require endogenous supplementation if its secretions were halted?

Mucous Cell

Zymogenic cell

Parietal cell

Argentaffin cell

11.

1 point

Lecture: Dr. Morales - Histology
Author: Lee Sterling

Which of the following cells is part of the body’s immune system and can be found in the small intestine crypts?

Enterocyte

M Cell

Paneth Cell

Goblet Cell

12.

1 point

Lecture: Dr. Morales - Histology
Author: Lee Sterling

The Valves of Kerckring are related to what histological feature?

Brunner’s glands

Intestinal Villi

Gatric folds

Plicae Circularis

13.

1 point

Lecture: Dr. Afif- Mucosal Immunity
Author: Saba Balvardi

Choose the Correct Statement.

Typical Celiac disease is characterized by villous atrophy AND systemic complications such as osteoporosis

Silent Celiac disease is characterized by positive serological markers but absence of GI tract changes

Latent Celiac disease is characterized by positive GI tract changes but no symptomes

the prevalence of asymptomatic Celiac disease is higher than symptomatic Celiac disease

14.

1 point

Lecture: Dr. Afif- Mucosal Immunity
Author: Saba Balvardi

Which of the following is a complication of Crohn's disease but not of Ulcerative colitis ?

Thromboembolism

Arthritis

Primary sclerosing cholangitis

Dermatitis herpetiformis

Fistulas

15.

1 point

Lecture: Dr. Afif- Mucosal Immunity
Author: Saba Balvardi

Which form/agent of therapy is the first line therapy used for treatment of mild to moderate ulcerative colitis?

Anti TNF treatment

5-ASA treatment

Gluten dietary restriction

Steroids treatment

Surgery

16.

1 point

Lecture: Dr Gologan - Upper GI pathology
Author: Ivan Serwadda

Your name is Google and you’re a first year resident on a GI rotation. Your staff physician gives you an endoscope to examine the esophagi of 17 random med students. Keen to impress them all, you try to remember what different upper GI pathologies look like. Which of these endoscopic findings are associated with the correct condition?

A. Strictures in eosinophilic esophagitis

B. Erythema in GERD

C. Salmon pink and velvety mucosa in Barrett’s esophagus

D. Vesicles in herpes esophagitis

E. All of the above

17.

1 point

Lecture: Dr. Gologan - Diseases of the Upper GI tract – Tuesday February 17th, 2015
Author: Isabella Albanese

Which of the following is NOT associated to GERD?

Intraepithelial eosinophils

Elongated lamina propria papillae

Thinning of basal cell layer

Greater involvement of the distal esophagus

Response to proton pump inhibitors

18.

1 point

Lecture: Dr. Gologan - Diseases of the Upper GI tract – Tuesday February 17th, 2015
Author: Isabella Albanese

Which of the following is FALSE about eosinophilic esophagitis?

Unlikely to be seen in patients with allergic rhinitis and dermatitis

Clinically indicated as a failure to respond to proton pump inhibitors

Presents with dysphagia and GERD-like symptoms

Tends to involve the entire esophagus

Numerous intraepithelial eosinophils seen histologically

19.

1 point

Lecture: Dr. Gologan - Diseases of the Upper GI tract – Tuesday February 17th, 2015
Author: Isabella Albanese

Which of the following is FALSE about Barrett esophagus (BE)?

The majority of patients with BE develop esophageal adenocarcinoma

Occurs in patients with prolonged GERD

Stratified squamous epithelium is transitioning to simple columnar epithelium with goblet cells

In low-grade dysplasia of Barrett esophagus, glandular epithelium appears darker

The mucosa of BE patients appears pink and velvety

20.

1 point

Lecture: Dr. Gologan - Diseases of the Upper GI tract – Tuesday February 17th, 2015
Author: Isabella Albanese

Which of the following is true about the difference between H. Pylori gastritis and autoimmune gastritis?

Both would be associated with an increase in gastrin production

Autoimmune gastritis is predominantly associated with neutrophil accumulation while H. Pylori is predominantly associated with lymphocytes and macrophages

Autoimmune gastritis is associated with diabetes mellitus and Graves disease

H. Pylori gastritis is always associated with achlorhydria and pernicious anemia

Autoimmune gastritis is more common in the antrum while H. Pylori gastritis is more common in the fundus and body of the stomach

21.

1 point

Lecture: Dr. Gologan - Neoplasia of the GI tract – Tuesday, February 24th, 2015
Author: Isabella Albanese

Which of the following correctly matches the cancer type with its associated histological change (Type B)?
a) Squamous cell carcinoma – irregular, complex glands
b) Squamous cell carcinoma – intercellular bridges
c) Adenocarcinoma – intercellular bridges
d) Adenocarcinoma – irregular, complex glands
e) Adenocarcinoma – keratinization

A, B and C are correct

A and C are correct

B and D are correct

Only D is correct

All or none of the above are correct

22.

1 point

Lecture: Dr. Gologan - Neoplasia of the GI tract – Tuesday, February 24th, 2015
Author: Isabella Albanese

Which of the following is FALSE about esophageal adenocarcinoma?

A mass with stricture formation in the vicinity of the gastro-esophageal junction is characteristic of esophageal adenocarcinoma

Esophageal tumor may lead to obstruction causing dysphagia

Associated cytological changes include high N/C ratio, irregular nuclei, prominent nucleoli and glandular atypia

Esophageal adenocarcinoma tends to occur in the proximal esophagus

Associated clinical symptoms include GERD-like symptoms, pain, weight loss and anemia

23.

1 point

Lecture: Dr. Gologan - Neoplasia of the GI tract – Tuesday, February 24th, 2015
Author: Isabella Albanese

Which of the following is true about gastric adenocarcinoma?

Intestinal adenocarcinoma has gastric folds that undergo thickening and effacement

Signet rings are round cells associated with cytoplasmic mucus accumulation and are associated with good prognosis

Gastric adenocarcinoma is associated with desmoplastic stroma

The diffuse type grossly forms a mass, sometimes ulcerated and on microscopy, consists of glands infiltrating the stroma

The intestinal type grossly infiltrates the stomach without obvious mass formation

24.

1 point

Lecture: Dr. Gologan - Neoplasia of the GI tract – Tuesday, February 24th, 2015
Author: Isabella Albanese

Which of the following are FALSE about the causes of colorectal adenocarcinoma (CRC)?

Polyps in FAP patients are mainly in proximal colon and HNPCC polyps are more frequent in distal colon

FAP patients present early in life and often undergo prophylactic colectomies

HNPCC (hereditary nonpolyposis colorectal cancer) is associated with rare polpyps and frequent CRCs

Familial adenomatous polyposis (FAP) is associated with hundreds of polyps

Defects in mismatch repair genes such as MSH2 are associated with microsatellite instability, which make up 15% of all CRCs