A 22-year-old patient

presents for a colonoscopy to confirm a diagnosis of Crohn's disease or

ulcerative colitis. He has been suffering from crampy abdominal pain with

watery diarrhea with admixture of blood and mucus for several weeks. During the

endoscopy, a typical picture of mucosal damage by these autoimmune

inflammations is described and a biopsy is taken for histological examination,

which finally establishes the diagnosis of ulcerative colitis. Ulcerative

colitis is a rare autoimmune type of

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?

A 64-year-old man

with diverticular disease comes to the emergency department because of painless

rectal bleeding, dizziness, and lightheadedness for 2 hours. His

temperature is 37.8°C, his pulse is 120/min, his respirations are 23/min, and his blood pressure is 83/61 mmHg. His skin and mucous membranes are

pale. Physical examination shows bright red rectal bleeding. Endoscopic

hemostasis is performed. On the base of liver enzymes elevation together with

hemoglobin decrease in plasma, we assume that hypoxic damage of hepatocytes has

occurred, especially in zone III (near the central vein). Which unit of the

liver parenchyma consists of 3 zones, one of which is the zone around the

central vein?

An investigator

studying new drug delivery systems administers an aerosol containing 10 μm sized particles to a healthy subject via

a special mask. These particles are found to deposit

on the surface of the respiratory tract with a pseudostratified epithelium.

Which of the following mechanism is the most likely way of clearance of the

particulate matter in this subject?

A younger colleague

asks you for advice. He received an insufficiently labeled sample from an

intestinal biopsy. The presence of which cells will best tell him whether it is

a small or large intestine?

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 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

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 12-year-old female patient presents for an

orthodontic check-up after braces placement. In one spot, part of her braces

are slightly pushing and interfering. There is a white spot that cannot be

wiped off. As a result of mechanical irritation, the mucous membrane of the

vestibular surface of the lip has become irritated and keratinised. Such spots

are known as leukoplakia and, in addition to mechanical irritation, a number of

other factors may be involved in their formation. However, the exact cause has

not yet been described. The transformation of which epithelium is involved

here, which normally forms the oral mucosa?

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?