Test Bank for Robbins & Kumar Basic
Pathology|11thedition|2026 updates |All
Chapters covered
Editors: Vinay Kumar, Abul K. Abbas, Jon C. Aster, Andrea T Deyrup
,Table of Contents
Chapter 1: Cell Injury, Cell Death, and Adaptations .......................................................................... 3
Chapter 2: Inflammation and Repair .............................................................................................. 20
Chapter 3: Hemodynamic Disorders, Thromboembolism, and Shock.............................................. 36
Chapter 4: Genetic and Pediatric Diseases ..................................................................................... 53
Chapter 5: Diseases of the Immune System.................................................................................... 71
Chapter 6: Neoplasia...................................................................................................................... 89
Chapter 7: Environmental and Nutritional Diseases ..................................................................... 107
Chapter 8: Blood Vessels.............................................................................................................. 125
Chapter 9: Heart .......................................................................................................................... 143
Chapter 10: Hematopoietic and Lymphoid Systems ..................................................................... 161
Chapter 11: Lung.......................................................................................................................... 179
Chapter 12: Kidney and Its Collecting System ............................................................................... 197
Chapter 13: Oral Cavities and Gastrointestinal Tract .................................................................... 215
Chapter 14: Liver and Gallbladder ................................................................................................ 233
Chapter 15: Pancreas and Biliary System...................................................................................... 251
Chapter 16: Male Genital System and Lower Urinary Tract........................................................... 269
Chapter 17: Female Genital System and Breast ............................................................................ 287
Chapter 18: Endocrine System ..................................................................................................... 304
Chapter 19: Bones, Joints, and Soft Tissue Tumors ....................................................................... 322
Chapter 20: Peripheral Nerves and Muscles ................................................................................. 339
Chapter 21: Central Nervous System ............................................................................................ 356
Chapter 22: Skin........................................................................................................................... 374
,Chapter 1: Cell Injury, Cell Death, and Adaptations
1.
A 56-year-old man presents with severe substernal chest pain lasting 45 minutes. ECG shows ST-
segment elevation in leads V1–V4. Despite reperfusion therapy, myocardial tissue undergoes irreversible
injury. Which cellular event most directly signifies irreversible cell injury?
A. Decreased oxidative phosphorylation
B. ATP depletion
C. Loss of mitochondrial membrane integrity
D. Intracellular sodium accumulation
ANS: C
Rationale:
Irreversible cell injury is defined by catastrophic mitochondrial damage, particularly loss of membrane
integrity, which prevents ATP generation and triggers necrosis or apoptosis. ATP depletion and ionic
imbalance are early and potentially reversible events.
2.
During a prolonged surgical procedure, a patient experiences transient hypotension but recovers
without organ damage. Which intracellular alteration best reflects reversible cell injury?
A. Nuclear fragmentation
B. Plasma membrane rupture
C. Cellular swelling
D. Cytochrome c release
ANS: C
Rationale:
Cellular swelling results from failure of ATP-dependent ion pumps and is a classic manifestation of
reversible injury. Nuclear fragmentation and cytochrome c release indicate irreversible damage.
3.
Renal tubular epithelial cells subjected to ischemia demonstrate cytoplasmic vacuolization and swelling.
The primary mechanism responsible for this change is:
A. Lipid peroxidation
B. Failure of Na⁺/K⁺-ATPase
C. Caspase activation
D. DNA strand breaks
ANS: B
, Rationale:
ATP depletion leads to Na⁺/K⁺-ATPase failure, causing sodium and water influx and cellular swelling.
Other mechanisms are associated with irreversible injury.
4.
A patient with septic shock develops widespread cellular injury due to oxidative stress. Reactive oxygen
species cause cellular damage primarily by:
A. Suppressing protein synthesis
B. Lipid peroxidation of cell membranes
C. Stabilizing mitochondrial membranes
D. Preventing calcium influx
ANS: B
Rationale:
ROS cause injury through lipid peroxidation, protein oxidation, and DNA damage. Lipid peroxidation
disrupts membrane integrity and cellular homeostasis.
5.
A 48-year-old man with chronic alcohol use is found to have fatty liver on imaging. Which mechanism
best explains this intracellular lipid accumulation?
A. Increased fatty acid oxidation
B. Decreased apoprotein synthesis
C. Increased lipoprotein secretion
D. Enhanced ATP production
ANS: B
Rationale:
Alcohol impairs apoprotein synthesis, reducing triglyceride export and leading to hepatic steatosis, a
reversible form of cell injury.
6.
A hypoxic tissue sample shows cells with disrupted membranes and surrounding inflammation. Which
form of cell death is most consistent with these findings?
A. Apoptosis
B. Autophagy
C. Necrosis
D. Senescence
ANS: C
Pathology|11thedition|2026 updates |All
Chapters covered
Editors: Vinay Kumar, Abul K. Abbas, Jon C. Aster, Andrea T Deyrup
,Table of Contents
Chapter 1: Cell Injury, Cell Death, and Adaptations .......................................................................... 3
Chapter 2: Inflammation and Repair .............................................................................................. 20
Chapter 3: Hemodynamic Disorders, Thromboembolism, and Shock.............................................. 36
Chapter 4: Genetic and Pediatric Diseases ..................................................................................... 53
Chapter 5: Diseases of the Immune System.................................................................................... 71
Chapter 6: Neoplasia...................................................................................................................... 89
Chapter 7: Environmental and Nutritional Diseases ..................................................................... 107
Chapter 8: Blood Vessels.............................................................................................................. 125
Chapter 9: Heart .......................................................................................................................... 143
Chapter 10: Hematopoietic and Lymphoid Systems ..................................................................... 161
Chapter 11: Lung.......................................................................................................................... 179
Chapter 12: Kidney and Its Collecting System ............................................................................... 197
Chapter 13: Oral Cavities and Gastrointestinal Tract .................................................................... 215
Chapter 14: Liver and Gallbladder ................................................................................................ 233
Chapter 15: Pancreas and Biliary System...................................................................................... 251
Chapter 16: Male Genital System and Lower Urinary Tract........................................................... 269
Chapter 17: Female Genital System and Breast ............................................................................ 287
Chapter 18: Endocrine System ..................................................................................................... 304
Chapter 19: Bones, Joints, and Soft Tissue Tumors ....................................................................... 322
Chapter 20: Peripheral Nerves and Muscles ................................................................................. 339
Chapter 21: Central Nervous System ............................................................................................ 356
Chapter 22: Skin........................................................................................................................... 374
,Chapter 1: Cell Injury, Cell Death, and Adaptations
1.
A 56-year-old man presents with severe substernal chest pain lasting 45 minutes. ECG shows ST-
segment elevation in leads V1–V4. Despite reperfusion therapy, myocardial tissue undergoes irreversible
injury. Which cellular event most directly signifies irreversible cell injury?
A. Decreased oxidative phosphorylation
B. ATP depletion
C. Loss of mitochondrial membrane integrity
D. Intracellular sodium accumulation
ANS: C
Rationale:
Irreversible cell injury is defined by catastrophic mitochondrial damage, particularly loss of membrane
integrity, which prevents ATP generation and triggers necrosis or apoptosis. ATP depletion and ionic
imbalance are early and potentially reversible events.
2.
During a prolonged surgical procedure, a patient experiences transient hypotension but recovers
without organ damage. Which intracellular alteration best reflects reversible cell injury?
A. Nuclear fragmentation
B. Plasma membrane rupture
C. Cellular swelling
D. Cytochrome c release
ANS: C
Rationale:
Cellular swelling results from failure of ATP-dependent ion pumps and is a classic manifestation of
reversible injury. Nuclear fragmentation and cytochrome c release indicate irreversible damage.
3.
Renal tubular epithelial cells subjected to ischemia demonstrate cytoplasmic vacuolization and swelling.
The primary mechanism responsible for this change is:
A. Lipid peroxidation
B. Failure of Na⁺/K⁺-ATPase
C. Caspase activation
D. DNA strand breaks
ANS: B
, Rationale:
ATP depletion leads to Na⁺/K⁺-ATPase failure, causing sodium and water influx and cellular swelling.
Other mechanisms are associated with irreversible injury.
4.
A patient with septic shock develops widespread cellular injury due to oxidative stress. Reactive oxygen
species cause cellular damage primarily by:
A. Suppressing protein synthesis
B. Lipid peroxidation of cell membranes
C. Stabilizing mitochondrial membranes
D. Preventing calcium influx
ANS: B
Rationale:
ROS cause injury through lipid peroxidation, protein oxidation, and DNA damage. Lipid peroxidation
disrupts membrane integrity and cellular homeostasis.
5.
A 48-year-old man with chronic alcohol use is found to have fatty liver on imaging. Which mechanism
best explains this intracellular lipid accumulation?
A. Increased fatty acid oxidation
B. Decreased apoprotein synthesis
C. Increased lipoprotein secretion
D. Enhanced ATP production
ANS: B
Rationale:
Alcohol impairs apoprotein synthesis, reducing triglyceride export and leading to hepatic steatosis, a
reversible form of cell injury.
6.
A hypoxic tissue sample shows cells with disrupted membranes and surrounding inflammation. Which
form of cell death is most consistent with these findings?
A. Apoptosis
B. Autophagy
C. Necrosis
D. Senescence
ANS: C
