USMLE Step 1 Question 353

Question:

A pathology resident discovers that the cheap labels on a box of pathology slides have peeled off. He looks at one slide under the microscope and compares it to the one-line patient summaries he has been given. The slide shows fat necrosis. To whom does this slide most likely belong?

Correct Answer: D.  55-year-old alcoholic man with acute pancreatitis

When pancreatic cells are injured during acute inflammation (pancreatitis), they release lipases that digest surrounding fat into soaps, a process called fat necrosis (Answer D). Tuberculosis is characterized by caseous necrosis; granulomas that look like cheese.

Abscesses are collections of liquefied dead tissue and neutrophils, which is known as liquefactive necrosis. Cell death due to hypoperfusion, as in MI, is called coagulative necrosis. The exception is when brain tissue dies, because it is the only tissue that undergoes liquefactive necrosis.