Chapter·PathologyCell injury

Irreversible cell injury (necrosis)Downloads

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1

A 78-year-old man dies suddenly from complications of acute kidney failure. An autopsy is performed and microscopic evaluation of the kidneys shows pale, swollen cells in the proximal convoluted tubules. Microscopic evaluation of the liver shows similar findings. Which of the following is the most likely underlying mechanism of these findings?

ADouble-stranded DNA breakage

BImpaired Na+/K+-ATPase pump activity

CFree radical formation

DCytochrome C release

ECytoplasmic triglyceride accumulation

2

A 72-year-old female is brought to the emergency department by ambulance because she was unable to walk. She says that she cut her leg while falling about a week ago. Since then, the wound has started draining fluid and become progressively more painful. She is found to have necrotizing fasciitis and is taken emergently to the operating room. Histological examination of cells along the fascial planes reveal cells undergoing necrosis. Which of the following represents the earliest sign that a cell has progressed to irreversible damage in this patient?

AFragmentation of the nucleus

BMembrane blebbing from organelles

CChromatin dissolution and disappearance

DRibosomal detachment from the endoplasmic reticulum

ECondensation of DNA into a basophilic mass

3

A 59-year-old woman with a history of chronic kidney disease comes to the physician for a 3-month history of easy fatiguability. Physical examination shows subconjunctival pallor. Her hemoglobin concentration is 8.9 g/dL, mean corpuscular volume is 86 μm3, and serum ferritin is 225 ng/mL. Treatment with erythropoietin is begun. A peripheral blood smear is obtained one week after treatment. A photomicrograph of the smear after specialized staining is shown. The prominent color of the intracellular structure in some of the cells is most likely the result of staining which of the following?

AGolgi apparatus

BRibosomal RNA

CRemnants of the nucleus

DDenatured globin chains

EMitochondria

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