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A 40-year-old man had undifferentiated carcinoma of the lung. Despite chemotherapy, the man died of widespread metastases. At autopsy, tumors were found in many organs. Histologic examination showed many foci in which individual tumor cells appeared shrunken and deeply eosinophilic. Their nuclei exhibited condensed aggregates of chromatin under the nuclear membrane. The process affecting these shrunken tumor cells was most likely triggered by the release of which of the following substances into the cytosol. _ _

A. Lipofuscin
B. Cytochrome c
Catalase
D. Phospholipase
E. BCL-2

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A 70-year-old man died suddenly and unexpectedly. At autopsy, multiple tissue sites were sampled for microscopic analysis. Examination of the tissues showed noncrystalline amorphous deposits of calcium salts in gastric mucosa, renal interstitium, and alveolar walls of lungs. Which of the following conditions is most likely to explain these findings. _ _

A. Chronic hepatitis
B. Chronic glomerulonephritis
C. Disseminated tuberculosis
D. Generalized atherosclerosis
E. Normal aging process

A 63-year-old man has a 2-year history of worsening congestive heart failure. An echocardiogram shows mitral stenosis with left atrial dilation. A thrombus is present in the left atrium. One month later, he experiences left flank pain and notes hematuria. Laboratory testing shows elevated serum AST. Which of the following patterns of tissue injury is most likely to be present. _ _

A. Liquefactive necrosis
B. Caseous necrosis
Coagulative necrosis
D. Fat necrosis
E. Gangrenous necrosis

At autopsy, a 40-year-old man has an enlarged (2200 g) liver with a yellow cut surface. The microscopic appearance of this liver is shown in the preceding figure. Before death, the man's total serum cholesterol and triglyceride levels were normal, but he had a decreased serum albumin concentration and increased prothrombin time. Which of the following activities most likely led to these findings. _ _

A. Injecting heroin
B. Playing basketball
C. Drinking beer
D. Smoking cigarettes
E. Ingesting aspirin Courtesy of Dr. James Crawford, Department of Pathology, Brigham and Women's Hospital, Boston, MA.

A 22-year-old woman with leukemia undergoes bone marrow transplantation and receives partially mismatched donor marrow. One month later, she has a scaling skin rash. Examination of a skin biopsy specimen reveals the cellular change shown in the figure. This change most likely results from which of the following biochemical reactions. _ _

Activation of caspases
B. Reduction of ATP synthesis
C. Increase in glycolysis
D. Activation of lipases
E. Lipid peroxidation

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