Guide Questions

Vasa vasorum serve a function analogous to that of which of the following?

What tissue is directly associated with and extends into the heart valves?

Which of the following is true for ventricles?

Individuals with Marfan syndrome have mutations in the fibrillin gene and commonly experience aortic aneurisms. What portion of the arterial wall is most likely to be affected by the malformed fibrillin?

Which description is true of continuous capillaries?

Which of the following is true of pericytes?

During light microscopic examination of a tissue, you note a vessel that has no smooth muscle but a large amount of connective tissue at its periphery. Which of the following vessels are you examining?

A 43-year-old woman notices a lump in her left breast which upon pathological examination of a needle biopsy is diagnosed as stage 3 adenocarcinoma of the mammary gland. She elects to have a single mastectomy and the surgeon also removes several axillary lymph nodes to be examined to determine the tumor’s state of metastasis. The patient recovers well from the surgery, but at a 6-month follow-up visit at the clinic her upper left arm is seen to be swollen and the surgeon prescribes a bandage wrap for “lymph edema.” This condition likely resulted from which of the following?

A 66-year-old man diagnosed with type II diabetes 10 years earlier presents with an aching pain in the muscles of his lower extremities. He says the pain is relieved by rest and worsened by physical activity. His lower limbs appear cold, pale, discolored, and he has a sore on the skin of his left heel. He has a weak tibial pulse on both sides and poor skin filling from dermal capillaries. The problems with blood distribution in this patient’s leg are most likely associated with what vascular structures?

A 62-year-old man of African descent presents with exercise-induced angina. His serum cholesterol is 277 mg/dL (normal <200), LDL is 157 (normal <100), HDL is 43 (normal >35), and triglycerides 170 (normal <150). His body mass index (BMI) is 34 and his coronary risk ratio is 6.84 (normal <5). Cardiac catheterization reveals an occlusion of the left anterior descending and the origin of the right coronary artery. This disease process initially involved which one of the following?

. Which of the following components increase(s) as a proportion of the respiratory tract wall from trachea to alveoli?

. Air moving rapidly across the vocal cords and causing them to vibrate and produce sound is contacting what type of epithelium?

Which structural feature distinguishes between terminal and respiratory bronchioles?

Which of the following features distinguishes a bronchus within a lung from the primary bronchi?

Which feature involved in protection of the respiratory tract is absent from the digestive tract

Which of the following is true of pulmonary surfactant?

The pulmonary (functional) and bronchial (nutritive) arterial systems enter the lungs separately at the hilus but anastomose into a single system at which level?

After 35 weeks of gestation, a 5-lb 5-oz girl is born to a 30-year-old gravid 2, para 2 (G2P2) woman. The infant has rapid and labored breathing, which is viewed as transient tachypnea of the newborn. The infant’s 1- and 5-min APGAR scores are 8 and 9, respectively. She has respiratory distress, with a normal pulse and no heart mur¬murs. She is transported to the neonatal intensive care unit with worsening tachypnea. In this infant which of the following is likely to be involved?

A teenage girl presents at the ER with paroxysms of dyspnea, cough, and wheezing. Her parents indicate that she had these “attacks” dur¬ing the past winter and that they have worsened and become more frequent during the spring. Which of the following cell types and their location is correctly matched to a function it may perform in this patient’s disorder?

A 28-year-old man is diagnosed with a testicular germ cell tumor. The tumor is surgically removed and he begins chemotherapy with cisplatin, etoposide, and bleomycin. Bleomycin chemotherapy is known to affect the lung blood-air barrier. Which of the following best describes the structural site of those effects?

In which of the following structures of the oral cavity would taste buds be localized in the highest concentration?

Certain antibiotic therapies slow the replacement of the cells lining the small intestine. This may cause the loss of what tissue type?

The teniae coli of the large intestine represent an organ-specific specialization of which layer of the intestinal tract wall?

Which of the following would most likely result from a reduction in the number of Paneth cells?

A medical student on a rotation in the pathology laboratory is given an unlabeled microscope slide with tissue provided by a gas¬troenterologist from a cancer patient she is attending. The mucosa and submucosa are poorly preserved, with only the thick muscu¬laris well-stained, showing striated fibers. The slide most likely shows a biopsy of which region of the GI tract?

Diarrhea may result if which of the following organs fails to carry out its role in absorbing water from the feces?

Which of the following is true of the absorptive cells of the small intestine?

A 52-year-old man is diagnosed with a carcinoid after an appen¬dectomy. The enteroendocrine cells producing this disorder differ from goblet cells in which of the following?

A 14-month-old girl is brought to the pediatric dentistry clinic because her erupted deciduous teeth are opalescent with fractured and chipped surfaces. X-rays reveal bulb-shaped crowns, thin roots, and enlarged central cavities. Tissue immediately surrounding one tooth’s central cavity is biopsied and prepared for histology, which reveals irregular, widely spaced tubules. Which of the following applies to this irregular tissue layer?

A 39-year-old woman presents with dyspnea, fatigue, pallor, tachy¬cardia, anosmia, and diarrhea. Laboratory results are: hematocrit 32% (normal 36.1%-44.3%), MCV 102 fL (normal 78-98 fL), 0.3% reticulocytes (normal 0.5%-2.0%), 95 pg/mL vitamin B12 (normal 200-900 pg/mL), and an abnormal stage I of the Schilling test. Auto¬antibodies are detected against a cell type located in one region of the GI tract. In which regions would those cells be found?

In a liver biopsy from a long-time drug user which of the following hepatocyte organelles would be expected to be more extensive than normal?

Which description is true of pancreatic zymogens?

Which process increases in response to parasympathetic stimulation of the salivary glands?

Which feature is unique to the exocrine pancreas?

Which description is true of the bile canaliculi?

Which description is true of the gallbladder?

Which description is true for the hepatic space of Disse?

A 50-year-old woman presents to the family medicine clinic. She admits to drinking a six-pack of beer each day with a little more intake on weekends. Laboratory tests show elevated alanine amino¬transferase/serum glutamic oxaloacetic transaminase (AST/SGOT). Her sclerae appear jaundiced and her serum bilirubin is 2.5 mg/dL (normal 0.3-1.9 mg/dL). A biopsy shows hepatic fibrosis with sig¬nificant loss of normal lobular structure. Jaundice is most likely to result when the proper location or orientation of what hepatic structures is disrupted?

A 48-year-old woman is referred to an allergy and rheumatology specialist with itching eyes, dryness of the mouth, difficulty swallow¬ing, loss of the sense of taste, hoarseness, fatigue, and swollen parotid glands. She reports increasing joint pain over the past 2 years. She complains of frequent mouth sores. Laboratory tests show a positive antinuclear antibody (ANA) and rheumatoid factor (RF) levels of 70 U/mL (normal <60 U/mL) by the nephelometric method. A parotid gland biopsy shows inflammatory infiltrates in the interlobular con¬nective tissue with damage to the acinar cells and striated ducts. In this case, resorption of which of the following will be most altered by destruction of those ducts?

A young child presents with hepatomegaly and renomegaly, failure to thrive, stunted growth, and hypoglycemia. A deficiency in glucose-6-phosphatase is identified and the diagnosis of von Gierke disease is made. What cellular structures would be expected to accumulate in hepatocytes during progression of this disorder?

Blood in the renal arcuate arteries flows next into which vessels?

Which cell type comprises the visceral layer of Bowman capsule?

Which type of epithelium lines the thick ascending limb of the loop of Henle?

Which cell is a modified smooth muscle cell that secretes renin?

Epithelial cell membrane domains containing many stiffened plaques of protein are an important feature in which part of the urinary system?

An immunohistochemical technique using antibodies against aquaporins to stain a section of kidney would be expected to stain cells in which structures most intensely?

What type of epithelium lines the prostatic urethra?

A 14-year-old patient presents in the nephrology clinic with fatigue, malaise, anorexia, abdominal pain, and fever. She reports a loss of 6 lb in the past 2 months. Serum gamma globulin and the immu¬noglobulins IgG, IgA, and IgM are all elevated. Her serum creatine is 1.4 mg/dL (normal 0.6-1.2 mg/dL) and urinalysis of glucose and protein are 2+ on a dipstick test, confirmed by laboratory at 8.0 g/dL and 0.95 g/dL, respectively. A renal biopsy is prepared for light microscopy, and an infiltrate containing lymphocytes, plasma cells, and eosinophils is found among tubules having cells with prominent brush borders. Which one of the following statements correctly pertains to these epithelial cells?

A 45-year-old man presents with nephrolithiasis or kidney stones. The process of calcium oxalate stone formation as seen in this patient begins with Randall plaques found in the basement membranes of which one of the following structures found only in the renal medulla?

A 15-year-old boy presents with hematuria, hearing loss, lens dislocation, and the onset of cataracts. Genetic analysis reveals a muta¬tion in the COL4A5 gene. Transmission EM examination of a renal biopsy confirms that the disorder has affected a component of the renal corpuscles in which damage disrupts normal glomerular fil¬tration. Which one of the following structures would most likely be abnormal in the TEM of this patient’s biopsy?