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 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 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 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

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 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

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 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 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 59-year-old

lifelong alcoholic man presents with fever and abdominal pain that radiates to

his back. A physical exam reveals that his abdomen is tender in the midline

between the bottom of his ribs and his umbilicus. Blood tests reveal elevated

levels of pancreatic enzymes, and ultrasound suggests inflammation of the

pancreas or pancreatitis. The elevated pancreatic enzymes are from which of the

following cell types?