A 5-year-old boy underwent tonsila pharyngea

(pharyngeal tonsil) surgery. Unfortunately, as a

result of frequent respiratory infections, this tonsil became enlarged, which

led to nasal obstruction, where the boy breathed only through his mouth and

snored heavily at night. The prolonged mouth breathing increased his susceptibility

to respiratory infections and also led to the remodelling of the palate and

upper dental arch. In addition, the enlarged tonsil covered the opening of the

Eustachian tube, leading to recurrent otitis media and hearing loss. The

surgery went perfectly fine, however, the removed tonsil was sent to pathology

for histological examination due to its size. What epithelium is normally found

on the surface of this tonsil?

A

38-year-old man presents with persistent bad breath. A physical exam reveals

white, round spots on his palatine tonsils. Close examination reveals that

these are hard structures embedded into the tonsil, so-called tonsil stones.

They are calcified structures that develop through the accumulation of

material, bacteria, and fungi. In which part of the tonsil does this material

accumulate and can form stones?

A 32-year-old female patient

is pregnant for the third time. She presented today for a prenatal check-up at

28 weeks gestation. In her previous pregnancies, she has had problems with

Rh-incompatibility because she is Rh-negative and her husband is Rh-positive.

Therefore, in the past she has received anti-D (Rh) immunoglobulins after

deliveries to neutralize any Rh antigens to prevent immunization and the

production of antibodies against the Rh factor. During this pregnancy, however,

the patient was found to have elevated levels of anti-D (Rh) antibodies,

suggesting that sensitization must have already occurred at some point. The

doctors performed further tests and found that the anti-D (Rh) antibodies,

because of their type, could have crossed the placental barrier to the fetus.

This is a huge risk to the fetus because anti-D antibodies can attack the Rh-positive

blood cells of the fetus, which in extreme cases can lead to hemolytic disease.

Which class of antibodies can cross the placental barrier?

A

26-year-old man is brought to the hospital in a very serious condition after a

motorcycle accident. The cause is massive bleeding into the abdominal cavity.

During surgery, a splenectomy (removal of the spleen) is performed due to a

rupture. The patient is subsequently instructed that life without a spleen does

not bring significant limitations. However, the immune system weakens and the

body´s defense against encapsulated bacteria deteriorates, so vaccination

against them is recommended. In which part of the spleen are the B-lymphocytes

and plasma cells that produce antibodies against these bacteria?

A 19-year-old female patient

suffers from a variety of non-specific problems such as fatigue, weakness,

malaise, abdominal pain, occasional diarrhoea and vomiting. In addition, she is

very pale and has lost weight since her last check-up with the doctor. A bland

non-specific rash is present on her skin. In the blood count that is done, only

mild anemia is present. As these symptoms have been present in the patient for

a longer period of time, further investigations are made to find possible

causes. One possibility that is eventually confirmed both laboratory and

histologically is celiac disease. The disease is a genetic disorder of mucosal

immunity. It reacts abnormally to gluten and prolamins found in wheat and other

cereals. The damage of the intestinal mucosa that occurs in patients when

gluten is present in the intestine is caused by T-lymphocytes. The result is

mucosal atrophy with impaired absorption of nutrients. Antigen presenting cells

play an important role in the activation of T-lymphocytes and transmit these

antigens to T-lymphocytes. These cells receive the antigen (here gluten) from the

lumen of the intestine by transcytosis via a special type of intestinal

epithelial cells located above the lymphoid tissue clusters in the intestinal

mucosa (typically Peyer's patches). How do we call these cells?

A 43-year-old man comes to the physician because of shortness

of breath, double vision, and fatigue for the past 6 weeks. He

has no history of serious medical illness and takes no medications. A CT scan

of the chest shows an anterior mediastinal mass. A sample from the

histological examination of this mass shows that it is thymic tissue. Which of

the following immunologic processes normally occurs in this organ?

During an experiment, the immunophenotypes of different cells in a

sample are determined. The cells are labeled with fluorescent antibodies

specific to surface proteins, and a laser is then focused on the samples. The

result shows most of the cells in the sample to be positive

for CD8 surface protein. Which of the following cell types is most

likely represented in this sample?

A 63-year-old female patient comes to the doctor

because of worsening fatigue, and she has recently lost a lot of weight unintentionally.

She has occasional pain in her left lower back and often feels full after

eating. During physical examination, the woman is subfebrile and relatively large

splenomegaly (enlarged spleen) is present. The blood count shows marked

leukocytosis with a left shift in neutrophils, eosinophilia, basophilia as

well as thrombocytopenia and anemia. Cytogenetic examination of the bone marrow

aspirate demonstrates the presence of the Philadelphia chromosome and further

examination confirms the diagnosis of chronic myeloid leukemia, which in this

patient is associated with hypersplenism, i.e., excessive function of the

spleen, which increasingly destroys red blood cells. In which part of the

spleen does this red blood cell destruction take place?

A

26-year-old woman come to the doctor because of enlarged lymph nodes in the

neck and axilla area, in addition, she suffers from fatigue, night sweats, and

fever. The doctor will perform blood tests that prove acute toxoplasmosis

infection. If an enlarged lymph node were examined histologically, what would

we find?

While creating new

slides for students, the histology laboratory technician mixed up the slides

with the placenta. However, half of the placenta samples are from the first

trimester of pregnancy, and the other part is from the third trimester. Which

characteristics will help the laboratory technician to distinguish the given

samples from each other?