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Robbins pathology endocrine pancreas gland

by Ezatullah · 20 questions · 3 saves · 0 likes
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#1
1) In Robbins & Cotran's description of pancreatic islet cell architecture, which cell type predominates in the periphery of islets and primarily secretes glucagon?
  1. Delta cells
  2. PP (F) cells
  3. Beta cells
  4. Alpha cells
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Alpha cells
#2
2) Which histopathologic feature is most characteristic of longstanding type 2 diabetes mellitus in the endocrine pancreas as noted in Robbins?
  1. Lymphocytic infiltration of islets
  2. Extensive beta cell hyperplasia
  3. Islet amyloid deposition
  4. Pancreatic acinar atrophy
Show answer
Islet amyloid deposition
#3
3) According to Robbins, which autoimmune marker is most specifically associated with type 1A (immune-mediated) diabetes mellitus?
  1. Anti-insulin receptor antibodies
  2. Anti-TSH receptor antibodies
  3. Islet cell autoantibodies (ICA) and anti-GAD antibodies
  4. Antibodies to pancreatic acinar enzymes
Show answer
Islet cell autoantibodies (ICA) and anti-GAD antibodies
#4
4) In the pathogenesis of diabetic microangiopathy described in Robbins, which molecular mechanism contributes to basement membrane thickening in islet capillaries?
  1. Enhanced nonenzymatic glycosylation of proteins
  2. Activation of complement classical pathway
  3. Decreased advanced glycation end product (AGE) formation
  4. Reduced polyol pathway flux
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Enhanced nonenzymatic glycosylation of proteins
#5
5) Which morphological change in pancreatic beta cells is associated with acute hyperglycemia according to Robbins?
  1. Prominent lipofuscin accumulation
  2. Neoplastic transformation to insulinoma
  3. Increased insulin granule exocytosis and degranulation
  4. Nuclear pyknosis and cell loss
Show answer
Increased insulin granule exocytosis and degranulation
#6
6) Robbins describes genetic syndromes affecting pancreatic endocrine function. Which syndrome is classically associated with multiple endocrine neoplasia type 1 (MEN1) including pancreatic neuroendocrine tumors?
  1. Tuberous sclerosis
  2. Multiple endocrine neoplasia type 1 (MEN1) due to MENIN mutation
  3. Neurofibromatosis type 1
  4. Von Hippel-Lindau disease
Show answer
Multiple endocrine neoplasia type 1 (MEN1) due to MENIN mutation
#7
7) Robbins highlights islet cell hyperplasia seen in certain states. Which condition is most commonly associated with diffuse islet cell hyperplasia leading to persistent hypoglycemia in neonates?
  1. Congenital hyperinsulinism (beta-cell dysregulation)
  2. Neonatal autoimmune diabetes
  3. Maternal preeclampsia
  4. Inherited glucagon deficiency
Show answer
Congenital hyperinsulinism (beta-cell dysregulation)
#8
8) In Robbins' account of pancreatitis effects on the endocrine pancreas, which finding is most likely after severe chronic pancreatitis?
  1. Destruction of islets leading to secondary diabetes (type 3c)
  2. Marked increase in islet mass
  3. Selective beta-cell hyperfunction
  4. Autoimmune transformation of exocrine tissue
Show answer
Destruction of islets leading to secondary diabetes (type 3c)
#9
9) Which molecule, discussed in Robbins, is co-secreted with insulin and plays a role as a marker of endogenous insulin production?
  1. Somatostatin
  2. Glucagon-like peptide-1 (GLP-1)
  3. Amylin (IAPP)
  4. Insulin-like growth factor 1 (IGF-1)
Show answer
Amylin (IAPP)
#10
10) Robbins describes oxidative stress in diabetic islets. Which intracellular pathway is emphasized as contributing to beta-cell dysfunction under chronic hyperglycemia?
  1. Suppression of protein kinase C isoforms
  2. Enhanced mitochondrial biogenesis protecting beta cells
  3. Increased polyol (sorbitol) pathway flux
  4. Downregulation of hexosamine pathway
Show answer
Increased polyol (sorbitol) pathway flux
#11
11) Which histologic pattern is characteristic of an insulinoma as described in Robbins pathology of the endocrine pancreas?
  1. Diffuse amyloid replacement of islets
  2. Dense lymphocytic infiltration destroying islets
  3. Well-differentiated neuroendocrine tumor with uniform cells and abundant cytoplasmic secretory granules
  4. Squamous metaplasia of islet cells
Show answer
Well-differentiated neuroendocrine tumor with uniform cells and abundant cytoplasmic secretory granules
#12
12) According to Robbins, which islet hormone is primarily responsible for inhibiting insulin and glucagon secretion and is secreted by delta cells?
  1. Ghrelin
  2. Somatostatin
  3. Amylin
  4. Pancreatic polypeptide
Show answer
Somatostatin
#13
13) Robbins discusses glucotoxicity mechanisms. Which effect best describes glucotoxicity on beta cells?
  1. Improved insulin gene expression and secretion
  2. Impaired insulin gene transcription and increased apoptosis
  3. Conversion of beta cells to alpha cells
  4. Induction of net beta-cell proliferation
Show answer
Impaired insulin gene transcription and increased apoptosis
#14
14) In Robbins, which imaging or pathologic feature helps distinguish a gastrinoma within the pancreas from other pancreatic neuroendocrine tumors?
  1. Presence of abundant mucin production
  2. Marked peptic ulcer disease and multiple tumors in the 'gastrinoma triangle'
  3. Frequent association with MEN2A
  4. Extensive islet amyloid deposition within the tumor
Show answer
Marked peptic ulcer disease and multiple tumors in the 'gastrinoma triangle'
#15
15) Robbins emphasizes developmental origins of islets. From which embryonic tissue do pancreatic endocrine cells arise?
  1. Ectodermal placodes
  2. Endoderm of the foregut
  3. Lateral plate mesoderm
  4. Neural crest
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Endoderm of the foregut
#16
16) Which transcription factor, highlighted in Robbins, is critical for pancreatic beta-cell differentiation and maintenance of insulin expression?
  1. PAX6
  2. PDX1 (IPF1)
  3. HNF1-alpha
  4. NKX2-5
Show answer
PDX1 (IPF1)
#17
17) Robbins describes pancreatic polypeptide (PP) cells. Which physiologic effect is primarily attributed to PP secretion?
  1. Directly stimulates glucagon release
  2. Increases gastric acid secretion
  3. Inhibits pancreatic exocrine secretion and gallbladder contraction
  4. Stimulates insulin release and lipogenesis
Show answer
Inhibits pancreatic exocrine secretion and gallbladder contraction
#18
18) Which molecular deposit is characteristic of islet pathology in type 2 diabetes and can be identified by Congo red staining as described in Robbins?
  1. Fibrin thrombi
  2. Glycogen accumulations
  3. Islet amyloid polypeptide (IAPP) amyloid
  4. Insulin crystals
Show answer
Islet amyloid polypeptide (IAPP) amyloid
#19
19) Robbins notes that beta-cell mass in type 2 diabetes is influenced by both replication and apoptosis. Which circulating factor is discussed as promoting beta-cell proliferation?
  1. Leptin
  2. Tumor necrosis factor-alpha (TNF-α)
  3. Interleukin-1 beta
  4. Glucagon-like peptide-1 (GLP-1)
Show answer
Glucagon-like peptide-1 (GLP-1)
#20
20) In Robbins' pathology, endocrine pancreatic tumors are graded/assessed by mitotic activity and Ki-67 index. Which statement best reflects the prognostic significance of Ki-67 in pancreatic neuroendocrine tumors?
  1. Higher Ki-67 index correlates with lower tumor aggressiveness
  2. Ki-67 index has no prognostic value in neuroendocrine tumors
  3. Higher Ki-67 index correlates with higher grade and worse prognosis
  4. Ki-67 is used only to identify hormone production
Show answer
Higher Ki-67 index correlates with higher grade and worse prognosis
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