A 9-year-old girl comes to the dentist with her

mother. A large swelling, even a cyst, is forming under her tongue. It is a

so-called ranula, which is a retention cyst of the sublingual gland, formed by

obliteration (closure) of the duct, probably as a result of a previous

infection. The outflow of the saliva produced is impossible. The stagnant

saliva dilates the ducts, forming a secretion-filled cyst. The treatment here

is extirpation (surgical removal). Which characteristic describes the closed

main duct of the salivary gland here?

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 67-year-old pensioner presents to his doctor

with a respiratory infection. The man has worked as a coal miner all his life,

and this lifelong exposure to coal dust has led to the development of a disease

called coal worker pneumoconiosis, which results in a chronic cough and

significant shortness of breath. Coal dust is normally phagocytosed by alveolar

macrophages, but the inorganic components are not degraded by the lysosomal apparatus

of macrophages. However, if their phagocytic capacity is exceeded and

pro-inflammatory factors and aggressive enzymes are released from macrophages,

inflammation develops. This can lead to fibrotic changes in the lungs. This

disease makes even mild respiratory infections in this patient more severe.

What is another name for alveolar macrophages?

A 38-year-old patient

presents with a painful swelling of the submandibular gland on the left side.

Especially during meals, the gland is painful and produces a large amount of

saliva. During this, small stones are released from the duct. The cause of his

difficulties is the so-called sialolithiasis, i. e. the formation of salivary

stones. The most common cause is a change in the composition of saliva. The

viscosity of saliva increases, and a mucoprotein matrix is ​​formed, into which

inorganic material (calcium, magnesium, phosphorus salts) is subsequently

deposited and a stone is formed. Which parts of the submandibular gland are

involved in the production and composition of saliva?

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?

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 36-year-old man

presents with abdominal pain and gastroesophageal reflux (connected with

heartburn). An endoscopic exam reveals gastric ulcers. A serum analysis reveals

increased levels of gastrin, a hormone that stimulates the release of gastric

acid from the parietal cells of gastric glands. Which of the following cell

types is the source of the hormone?

A 46-year-old female patient

is found to be anemic during a preventive taking of blood. Despite a healthy

and varied diet, which the patient claims to follow, other findings in her

blood count, such as the presence of large erythrocytes (megalocytes) and low

levels of vitamin B12, make it look like anemia based on a deficiency of this

very important vitamin. Therefore, if the patient is taking enough of it in her

diet, the problem is likely to be in its absorption in the digestive system. In

order for this vitamin to be absorbed from the digestive tract into the blood,

it must be bound to an intrinsic factor in the stomach. Indeed, antibodies to

intrinsic factor have been demonstrated in this patient. Which cells of the

gastric glands produce this factor?

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

A 3-year-old girl is brought

to the emergency at night. It all started just a few hours ago when she

complained about a beginning sore throat. Unfortunately, the pain has increased

significantly to the point that the girl is unable to speak or swallow due to

the pain. She sits in a forward position, is very pale, finds it difficult to

breathe and has a high fever. Already according to the clinical picture, the

cause is clear to the doctor. High inflammatory parameters and gentle physical

examination confirm the diagnosis of acute epiglottitis, a life-threatening

swelling and inflammation of the epiglottis caused by