During a preventive dental check-up, 35-year-old

man is found to have tooth decay between his first and second molars. As the

decay has already penetrated the enamel and reached the dentin, new dentin

begins to form in response to this local irritation. What type of dentin is

produced?

A 45-year-old patient

comes to the dental emergency at night for an acute toothache. Previously, the

given tooth was more sensitive to cold or warm stimuli. Now the pain is

throbbing and constant, and cold stimuli tend to relieve it. Common analgesics

are ineffective. The patient is diagnosed with acute pulpitis, inflammation of

the dental pulp. The dental pulp is mainly made up of loose connective tissue,

which is also the reason why inflammation spreads easily here. What important

type of cell is also part of the pulp chamber?

A 69-year-old alcoholic

presents to a GP for a range of complaints including dyspepsia (feeling full

after eating, poor digestion), fatigue, weakness, exhaustion, lack of appetite,

weight loss, abdominal distension, swelling, arthralgia, and spinal pain. Even

a physical examination revealing hepatomegaly (enlarged liver), spider angioma,

and ascites (presence of fluid in the abdominal cavity) suggests that the

patient is suffering from cirrhosis. This is confirmed by laboratory, sonography,

and biopsy. Liver cirrhosis is the remodelling of the lobular structure of the

liver into a nodular structure due to the disappearance of hepatocytes,

replacement by connective tissue and nodule formation as a result of chronic

liver disease. Ito cells play an important role in this remodelling process.

Where would we find most of these cells?

A 42-year-old patient

comes to his dentist for a regular check-up. The patient suffers from

periodontitis for a long time, which is an inflammatory disease of the

supporting apparatus of the teeth, which consists of the gums, periodontal

ligaments, cementum, and the alveolar process of the bone. The cause is the activity

of microorganisms, their multiplication promotes dental plaque and tartar.

Periodontal ligaments made of dense connective tissue fix the tooth to the gum

or alveolus. Their quality can be significantly impaired even by the lack of

one vitamin. Which one?

During the stay in the maternity hospital, the

newborn has a problem. The meconium does not pass (meconium is the first

content of the intestine to be passed during the first 1-2 days). After

examination, the so-called Hirschsprung disease

An investigator is studying the clearance of respiratory particles in

healthy non-smokers. An aerosol

containing radio-labeled particles that are small enough to reach the

alveoli is administered to the subjects via a special mask. A

gamma scanner is then used to evaluate the rate of particle clearance from the

lungs. The primary mechanism of particle clearance most likely involves which

of the following cell types?

A 33-year-old woman is 32 weeks pregnant and

experiences premature amniotic fluid leakage and preterm labour. The woman is

given tocolytics (medication that inhibit uterine muscle activity). Their

administration stops or relieves the contractions of the uterus, thereby

delaying premature labour. The main benefit of tocolytic treatment is mainly

short-term, i.e. delaying preterm birth by two to seven days. The reason for

tocolytic treatment is to buy time for transport of the woman and baby to a

specialized centre and for time for administration of corticosteroids to induce

lung maturity of the fetus. One important factor in lung maturity is sufficient

surfactant production. Which lung cells produce it?

A 27-year-old female patient presents to her GP

for the second part of a preventive check-up. The patient's blood tests show a

fairly significant anemia. It soon becomes apparent that this is probably due

to a vitamin B12 deficiency, as the patient is a strict vegan and has not

supplemented her diet with this vitamin. During the physical examination, the

doctor notices one more symptom that would confirm this cause. The patient's

tongue has a distinct red colour and is completely smooth. In healthy

individuals, papillae can be observed macroscopically on the surface of the

tongue, which disappear in this condition, known as Hunter's glossitis. The

most common cause is vitamin B12 deficiency. Several types of papillae are

generally found on the tongue. But which of them has keratinized epithelium?

An investigator is conducting a study to document the histological

changes in the respiratory passages of a chronic smoker. He obtains multiple

biopsy samples from the respiratory system of a previously

healthy 25-year-old man. Histological examination of one sample

shows simple cuboidal cells with club cells and with a surrounding layer of smooth muscle. 

The 63-year-old patient came

to the doctor due to a dry cough lasting for many months, accompanied by

shortness of breath on exertion and fatigue. In addition, he had recently lost

a lot of weight. On physical examination, crepitus (a specific listening

phenomenon - like unzipping a Velcro strap) is present in the lungs. Decreased

oxygen saturation is also measured. In addition, the patient has typical mallet-shaped

fingers with clubbing nails in the shape of an hour glass. To confirm the

diagnosis suspected by his physician, a HRCT of the lungs (high-resolution CT

scan) is required, followed by a lung biopsy and histological examination of

the sample taken. The examination confirm the diagnosis of idiopathic pulmonary

fibrosis. It is probably a uniform pathological response of lung tissue to

infectious and non-infectious agents, but the cause of this disease is unknown.

In this disease, fibrosis and thickening of the blood-air barrier occurs. What

physiologically forms the blood-air barrier?