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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?

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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?

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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?

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A 63-year-old man comes to the physician for

a follow-up evaluation of chronic, retrosternal chest pain. The pain

is worse at night and after heavy meals. He has taken medicines to reduce the

production of stomach acids for several months without any relief from his symptoms.

An upper endoscopy shows changes in the

distal

esophagus

and in the area above the gastro-oesophageal junction. A biopsy

of the distal esophagus shows simple columnar epithelium with goblet

cells, which does not occur normally here. Which type of epithelium should

normally occur here?

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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?

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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?

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A 15-year-old girl had her tongue pierced unprofessionally by her

friend. Unfortunately, this unprofessional execution led to an infection of the

tongue, as well as the sublingual salivary gland located nearby. Which of the

following describes the histological description of this gland?

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The researcher was

very interested in an atypical symptom of the disease of COVID-19, namely the

loss of taste. He would like to investigate in more detail the mechanism by

which the taste buds are affected. He obtained tongue samples from patients who

had died of the disease. What kind of papillae of the tongue should he focus on

to most easily find places with an accumulation of taste buds?

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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?

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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?

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