TOB Flashcards
1
Q
Match the description to the disorder.
An obstetric complication arising from implantation in the lower uterine segment. →
Incomplete differentiation of cytotrophoblast cells to endothelium results in poor blood supply to the embryo, one consequence of which is maternal hypertension. →
Poor growth of foetus due to, for example, poor supply of oxygen and nutrients. →
A potentially life-threatening disorder resulting from implantation outside the womb. →
A
An obstetric complication arising from implantation in the lower uterine segment. → Placenta praevia,
Incomplete differentiation of cytotrophoblast cells to endothelium results in poor blood supply to the embryo, one consequence of which is maternal hypertension. → Pre-eclampsia,
Poor growth of foetus due to, for example, poor supply of oxygen and nutrients. → Intra-uterine growth restriction (IUGR),
A potentially life-threatening disorder resulting from implantation outside the womb. → Ectopic pregnancy
2
Q
Identify the two main specialisation of stratified squamous epithelia.
A
Prevention of water loss, Protection from abrasion
3
Q
Identify the features in a section of ground bone
A
A lamella → E,
Canaliculi → A,
Osteocyte in a lacuna → D,
Volkmann’s (Perforating) canal → B,
Haversian (central) canal → C
4
Q
Identify the features in this photomicrograph of foetal tongue.
A
Ground substance → B,
Myoblasts fusing to form a myotube → A,
Nucleus of a mesenchymal cell → C
5
Q
Koch’s postulates
A
- *1)** Same pathogen present in every case of the disease
- *2)** Pathogen must be grown in pure culture
- *3)** Pathogen isolated from pure culture must cause the disease when inoculated into a healthy, susceptible laboratory animal
- *4)** The pathogen must be re-isolatedfrom inoculated lab animal and shown to be the same as the originally inoculated pathogen
Exceptions to Koch’s Postulates
•Some bacteria and viruses can’t be grown on artificial media
•Some diseases caused by several microbes
•Some pathogens cause many different diseases
•Some pathogens only cause disease in humans
6
Q
Match the type of neuron to its function
Relay information from sensory to motor neurons →
Conduct signals from the periphery to the CNS →
Conduct signals from the CNS to the periphery →
A
Relay information from sensory to motor neurons → Interneurons,
Conduct signals from the periphery to the CNS → Afferent neurons,
Conduct signals from the CNS to the periphery → Efferent neurons
7
Q
What type of epithelium lines apocrine glands?
A
Simple columnar epithelium lines the secretory portion of the glands. In this slide, the ductal epithelium appears to be simple cuboidal.
8
Q
Match the glial cell to the description.
Myelinate axons in the PNS →
Myelinate axons in the CNS →
Maintain the blood:brain barrier →
Provides support to ganglionic neurons →
Lines the ventricles and central canal. →
Produces and moves CSF →
Macrophages →
A
Myelinate axons in the PNS → Schwann cells,
Myelinate axons in the CNS → Oligodendrocytes,
Maintain the blood:brain barrier → Astrocytes,
Provides support to ganglionic neurons → Satellite cells,
Lines the ventricles and central canal. → Ependymal
Produces and moves CSF → Ependyma,
Macrophages → Microglia
9
Q
Identify the structures in the following diagram showing an embryo ay day 13 following fertilisation.
A
Primary chorionic villi → A
Amniotic cavity → B
Remnant of primary yolk sac → F
Secondary yolk sac → E
Cytotrophoblast → D
Epiblast → C
10
Q
A
The correct answer is: Synaptic vesicles → E,
Schwann cell (myelinates axons) → D,
Sarcolemma → G,
Sarcolemma with nicotinic ACh receptors → H,
Active zone (site of neurotransmitter release) → F,
Motor nerve fibre → A,
Synaptic cleft → I,
Axon terminal → C,
Myelin sheath of axon → B,
Junctional folds → J
11
Q
Which T-cell population is depleted following HIV infection?
A
Helper T-cells (CD4+)
12
Q
A
Collagen → A,
A skeletal muscle fibre → D,
Skeletal muscle nucleus → E,
Interdigitating myotendinous junction → C,
A fibroblast nucleus → B
13
Q
How long is the pre-embryonic period?
A
Two weeks
14
Q
Match the histiocyte (tissue macrophage) to the organ
Langerhans cells →
Kupffer cells →
Microglia →
Dust cells →
A
Langerhans cells → Epidermis
Kupffer cells → Liver
Microglia → CNS
Dust cells → Lung
15
Q
Which cell type of the oral mucosa releases IgA (immunoglobulin A) to protect against oral pathogens?
A
Plasma cells (mature B-lymphocytes).
16
Q
What is the cellular basis of amylotropic lateral sclerosis (ALS)?
A
Degeneration of somatic motor neurons from unknown causes.
17
Q
Secretion of hormones
Absorption
Clearance of particles
Distension and protection from toxins
Protection against abrasion and water loss, keeping surface moist
Secretion, gas exchange
Protection against abrasion and water loss, keeping surface dry
Sodium resorption
A
Secretion of hormones → Cuboidal epithelium of thyroid follicles,
Absorption → Simple columnar,
Clearance of particles → Pseudostratified ciliated columnar,
Distension and protection from toxins → Transitional,
Protection against abrasion and water loss, keeping surface moist → Stratified squamous non-keratinised,
Secretion, gas exchange → Simple squamous,
Protection against abrasion and water loss, keeping surface dry → Stratified squamous keratinised,
Sodium resorption → Striated columnar
18
Q
A
Which region(s) acts as an energy store? → D,
Which label identifies an exocrine duct? → B,
Which region produces pancreatic enzymes? → A,
Which region(s) is damaged in type I diabetes. → C
19
Q
A
Stratum granulosum → C
Stratum corneum → A
Papillary dermis → F
Stratum spinosum → D
Stratum lucidum → B
Stratum basale → E
20
Q
Why are lymph nodes a common site of metastatic tumour spread, for example in breast cancer?
A
Metastatic cells can travel via the lymph to the nearest draining lymph node and seed there.
21
Q
A
Mucosa → F,
Serosa → E,
Circular muscle → C,
Submucosa → B,
MALT → A
Longitudinal muscle → D
22
Q
Neoplasia is the uncontrolled growth of cells. What name is given to a neoplasm (cancer) of epithelial origin?
A
Carcinoma
23
Q
What type of stem cell divides to form myoblasts that can effect skeletal muscle repair, or induce hypertrophy?
A
Satellite cells
24
Q
What are the functions of mast cells?
A
Local inflammation, innate immunity, tissue repair
25
**Match the description to the cytoskeletal component.**
Dynamic elements associated with movement of organelles and cilia.
Tough, derformable and stable filaments that provide integrity to epithelia. Provide continuity to desmosomes.
Highly-dynamic filaments associated with microvilli and cortical regions of the cell
Dynamic elements associated with movement of organelles and cilia. → **Microtubules**
Tough, derformable and stable filaments that provide integrity to epithelia. Provide continuity to desmosomes. → **Intermediate filaments**
Highly-dynamic filaments associated with microvilli and cortical regions of the cell → **Microfilaments**
26
Feature A is: → Stratified squamous keratinised epithelium,
Feature B is: → A region of dense irregular connective tissue,
Feature C is: → An arrector pili muscle,
Feature D is: → A sebaceous gland,
The features labelled E are: → Eccrine sweat glands,
Feature F is: → Adipose,
Feature G is: → A blood vessel,
Feature H is: → The germinal region of a hair follicle
27
Explain why neurons in the ventral horn are larger than those in the dorsal horn?
Motor neuron cell bodies are located in the ventral horn. These cells are highly biosynthetic and support very long axons.
28
What is the name of the disorder resulting from a swelling of the parotid gland due to a viral infection?
Mumps
29
Of which embryological structure is the central canal a remnant?
The central cavity of the neural tube
30
What structure results from compaction?
The blastocyst
31
Generally, fibrosis will stiffen the chambers of the heart and reduce their capacity to fill effectively. Fibrosis of which specific cardiac feature will lead to arrhythmias?
Sinoatrial node
32
Macrophage
A lysosome → D,
A nucleolus → A,
A cytoplasmic extension (a pseudopod) → C,
A pinocytotic vesicle → E,
A Golgi body → B
33
What is the normal range for white blood cells?
4-11x109/L
34
Which structures are derived from the outer cell mass (trophoblast)?
The outer layers of the placenta
The umbilicus
The amnion
Chorionic villi
35
From which immune cell type do macrophages develop?
Monocytes
36
Match the plane of folding with the underlying process driving it.
Longitudinal folding →
Transverse folding →
Longitudinal folding → Enlargement of cerebral vesicles and somites,
Transverse folding → Enlargement of amniotic cavity
37
Simple cuboidal epithelium → E
Pseudostratified ciliated columnar epithelium → C
Simple columnar epithelium → G
Simple squamous epithelium → B
Stratified squamous non-keratinised epithelium → F
Stratified cuboidal epithelium → H
Transitional epithelium (urothelium) → A
Striated simple columnar epithelium → I
Stratified squamous keratinised epithelium → D
38
What blood test should be done on any patient presenting with a headache, and why?
ESR, to exclude temporal arteritis
39
Each cell is totipotent at the 16 cell stage. What does this mean?
Cells have the potential to become any cell type
40
What name is given to squamous epithelium lining the chambers of the heart and blood vessels?
Endothelium
41
Anatomically, where are most parasympathetic ganglia located? Give the most appropriate answer.
Close to end organs
42
Oesophageal lumen → A,
Stratified squamous non-keratinised epithelium → B,
Lamina propria → H,
Circular muscle layer → E,
Adventitia → G,
Londitudinal muscle layer → F,
Submucosa → D,
Muscularis mucosae → C
43
Match the teratogen with the major developmental outcomes.
Maternal cytomegalovirus infection → **Multiple defects including microcephaly, visual impairment, cognitive impairment, foetal death**
Thalidomide → Shortened limbs,
Toxoplasmosis from poorly cooked meat →
Alcohol →
Maternal cytomegalovirus infection → **Multiple defects including microcephaly, visual impairment, cognitive impairment, foetal death**
Thalidomide → **Shortened limbs**
Toxoplasmosis from poorly cooked meat → **Hydrocephalus**
Alcohol → **Cognitive impairment**
44
What is stored in the colloid?
Thyroglobulin
45
Why are the ependyma not considered to form an epithelium?
They are not associated with a basement membrane, which may explain why the structure is so easily disturbed with histological preparation
46
What disorder results from genetic abnormalities in type I collagen synthesis?
Osteogenesis imperfecta
47
Cranial nerves III, VII, IX and X → A,
Brain → D,
Spinal cord → E,
Sympathetic nervous system → F,
Filum terminale → G,
Parasympathetic nervous system → B,
Sacral parasympathetic outflow → C
48
What is the major fuel used by cardiac myocytes?
Triglyceride
49
What type of cell will effect the repair of a tendon?
Fibroblast
50
Leiomyomas are benign tumours of smooth muscle, most commonly found in the myometrium. What is the common name for leiomyomas of the uterus, and what problems are associated with this phenomenon?
Fibroids. They can cause heavy and/ or painful periods.
51
What is the name of the family of intermediate filaments that supports the nuclear membrane?
Lamins
52
What are malignant tumours of cartilage called?
Chondrosarcomas. Sarcomas are tumours of mesenchymal origin.
53
If a patient has raised intracranial pressure, what is the typical sign seen when their retina is examined?
Papilloedema
54
What is the function of Paneth cells?
These are exocrine cells that release various bactericidal compounds, such as lysozyme and defensins.
55
There is decreased resistance in elastic fibre-rich tissues In Marfan’s syndrome. Which gene is mutated in this disorder?
Fibrillin
56
Why does mucus stain weakly in H&E preparations?
It is removed during fixation
57
Match the disorder affecting skin to the description
Salty sweat arising from an inability to reabsorb extracellular sodium as a consequence of the CFTR mutation →
Blistering resulting from collagen VII mutations →
Autoimmune destruction of melanocytes →
A pre-malignant thickening of the epidermis. →
Excessive scarring resulting from overactive collagen deposition by fibroblasts →
Deep tissue swelling arising from a hypersensitivity reaction mediated by mast cells →
Salty sweat arising from an inability to reabsorb extracellular sodium as a consequence of the CFTR mutation → **Cystic fibrosis**,
Blistering resulting from collagen VII mutations → **Epidermolysis bullosa**,
Autoimmune destruction of melanocytes → **Vitiligo**,
A pre-malignant thickening of the epidermis. → **Actinic keratosis**,
Excessive scarring resulting from overactive collagen deposition by fibroblasts → **Keloids**,
Deep tissue swelling arising from a hypersensitivity reaction mediated by mast cells → **Angio-oedema**
58
Name three common fixatives
Alcohol, Formaldehyde, Glutaraldehyde
59
Where do macrophages mature?
In tissues
60
Activation of which receptors on the surface of basophils (and mast cells) leads to degranulation, and is important in hypersensitivity reactions?
IgE
61
Yolk sac → D
Heart tube → E
Cloacal membrane → C
Oropharyngeal membrane → A
Hind gut → B
62
CML is associated with a reciprocal translocation involving exchange of genetic material between chromosomes 9 and 22.
No genetic information is lost. What type of reciprocal translocation is this?
balanced
63
With continued exposure to smoke, epithelial cells can begin to loose function or form. What is this process called?
Dysplasia
64
From which germ layers are the following structures derived?
Parenchyma of glands →
Respiratory tract →
Muscle →
Vascular system →
Bone →
Nervous tissue →
Lining of GI tract →
Epidermis →
Parenchyma of glands → **Endoderm**,
Respiratory tract → **Endoderm**,
Muscle → **Mesoderm**,
Vascular system → **Mesoderm**,
Bone → **Mesoderm**,
Nervous tissue → **Ectoderm**,
Lining of GI tract → **Endoderm**,
Epidermis → **Ectoderm**
65
Outer longitudinal smooth muscle → B,
A mucous membrane comprised of simple columnar epithelium an lamina propria → F,
A region of loose or dense irregular connective tissue containing glands, adipose, nerve, immune cells and blood vessels → D, the submucosa,
Inner circular smooth muscle → C,
A region of lymphoid tissue → G,
A region containing connective tissue and simple squamous epithelium (mesothelium) → A, the serosa,
A structure that allows local movement of the mucosa → E, muscularis mucosae
66
How does CSF return to the circulatory system?
Via the arachnoid villi (shown in the cartoon of the meninges above) that project into the dural sinuses.
67
The most common type of collagen in the body. Forms fibrils, fibres and bundles.
Forms fibrils and fibres but not bundles to form a meshwork.
Sheet forming collagen found in basement membranes.
Anchor forming collagen that attaches basal lamina to underlying reticular lamina.
Forms fibrils but not fibres to give cartilage a glassy appearance.
The most common type of collagen in the body. Forms fibrils, fibres and bundles. → **Type I**,
Forms fibrils and fibres but not bundles to form a meshwork. → **Type III**,
Sheet forming collagen found in basement membranes. → **Type IV**,
Anchor forming collagen that attaches basal lamina to underlying reticular lamina. → **Type VII**,
Forms fibrils but not fibres to give cartilage a glassy appearance. → **Type II**
68
From which cell type do osteoclasts develop? Monocytes.
These are giant cells that arise from the fusion of macrophages.
69
Epithelium A is: → **Simple squamous**
Epithelium B is: → **Simple cuboidal**
70
Cartilage is maintained by both appositional and interstitial growth. Define these terms.
**Interstitial**: division of chondrocytes within cartilage
**Appositional**: differentiation of chondroblasts of the perichondrium
71
What cell surface specialisation discriminates proximal from distal collecting ducts of the kidney?
Microvili
Brush border
72
What is the name of the structure separating all epithelia from underlying lamina propria?
Basement membrane
73
What disorder results from the autoimmune destruction of post - synaptic acetyl choline receptors at neuromuscular junctions?
Myasthenia gravis
74
What is the term used to describe breathlessness in a patient when lying flat?
Why does this happen?
What does a patient usually do to reduce the symptoms?
**Orthopnoea**.
On lying flat, blood in the legs moves to the torso, leading to increase in central and lung blood volume.
This in turn increases pulmonary capillary pressure. Patient usually uses an increasing number of pillows to sleep
75
What is the term used to describe fluid accumulating in the lungs?
Pulmonary oedema
76
Which RBC cell surface molecules bear the antigenic determinants of the ABO blood group?
Glycophorin A
77
From what site would a bone marrow sample most likely be collected?
From the superior iliac crest
78
Parotid gland → C,
Pancreas → B,
Sublingual gland → D,
Submandibular glands → A
79
Of which type of connective tissue are tendons composed?
Dense regular
80
What is the most common method of isolating a biopsy of breast tissue?
Needle
81
What is the major product of the uterine gland, and what is its purpose?
Glycogen to nourish an implanted embryo
82
Which of the following is a feature of **compact bone**, which is a feature of **spongy bone**, and which is a feature of **both**?
Contains osteons →
Lamellar organisation →
Contains osteocytes trapped in lacunae →
Covered in endosteum →
Covered in an outer layer of periosteum →
Contains osteons → **Compact**,
Lamellar organisation → **Both**,
Contains osteocytes trapped in lacunae → **Both**,
Covered in endosteum → **Spongy**,
Covered in an outer layer of periosteum → **Compact**
83
What is the biological significance of the bulge of the follicle?
The bulge region of the follicular epithelium contains epidermal stem cells.
84
Name the sesamoid and irregular bones
Vertebrae, bones of the pelvis (ileum, sacrum, coccyx)
patella
85
Which layer of connective tissue provides a channel for the re-growth of damaged axons?
Endoneurium
86
The intracellular location of lysosomes is regulated by the cytoskeleton, specifically microtubules. Of which protein sub-unit are microtubules primarily comprised?
Tubulin ( specifically heterodimers of α and β tubulin)
87
Name the principle component of osteoid.
Type I collagen
88
What are the potential complications of long-term steroid use?
Skin atrophy
Increased risk of infection
Hypertension
Loss of bone density
Weight gain
Hyperglycaemia
89
From which tissue do osteoblasts derive?
Mesenchymal connective tissue
90
What smooth muscle connects the ends of the C-shaped cartilage?
The trachealis muscle
91
From which collection of cells does the primary yolk sac form?
Extraembryonic mesoderm
92
What name is given to the fibrous outer connective tissue layer of bone?
Periosteum
93
In which of thebones of adults does haematopoiesis take place?
Vertebrae
Scapula
Skull
Ribs
Pelvis
94
Sacral parasympathetic outflow → 2,
Cranial parasympathetic outflow → 1,
Thoracolumbar sympathetic outflow → 3
95
What are the health implications of an accumulation excess of visceral fat (i.e. fat around organs)?
Cytokines produced by fat cells (adipokines) result in chronic inflammation, with metabolic consequences including insulin resistance. Subcuticular fat is much more stable metabolically.
96
Modulators of immune cell activity →
Recruits immune cells, particularly eosinophils and neutrophils →
Increases vascular permeability →
Anti-coagulant →
Modulators of immune cell activity → **Cytokines**,
Recruits immune cells, particularly eosinophils and neutrophils → **Chemotactic factors**,
Increases vascular permeability → **Histamine**,
Anti-coagulant → **Heparin**
97
What are the contents of neutrophil granules?
Chemokines
Myeloperoxidase
Defensins
Lysozyme
98
A → Eosinophil
B → Basophil
C → Neutrophil
D → Monocyte
E → Platelet
F → Lymphocyte
99
Of what is Nissl substance comprised?
Rough endoplasmic reticulum
100
Which organ has sympathetic but not parasympathetic innervation?
Adrenal glands
101
In a patient with long standing rheumatoid disease, give two signs that you would you expect to see in her hands?
Small joint swelling (MCP), ulnar deviation, rheumatoid nodules
102
Scleroderma is a thickening of the dermis, particularly affecting joints. What could a major consequence of this be? Reduced joint mobility
Reduced joint mobility
103
What is the embryonal origin of melanocytes?
Neural crest
104
Myotubes form what?
Skeletal muscle fibres
105
Match the epithelium to the location
Sweat ducts
Skin
Lining of blood vessels, mesothelium, lining of Bowman's capsule
Renal calyces, ureters, bladder, urethra
Salivary gland ducts
Oral cavity, oesophagus, vagina, cornea
Lower GI tract.
Upper respiratory tract
Thyroid follicles, renal collecting tubules
Sweat ducts → **Stratified cuboidal**,
Skin → **Stratified squamous** **keratinised**,
Lining of blood vessels, mesothelium, lining of Bowman's capsule → **Simple squamous**,
Renal calyces, ureters, bladder, urethra → Transitional, Salivary gland ducts → **Striated columnar**,
Oral cavity, oesophagus, vagina, cornea → **Stratified squamous non-keratinised**,
Lower GI tract. → **Simple columnar**,
Upper respiratory tract → **Pseudostratified ciliated columnar**,
Thyroid follicles, renal collecting tubules → **Cuboidal**
106
Why does the papillary dermis have finer fibres and more ground substance than the reticular dermis?
The fine fibres of the papillary dermis allow passage of microvasculature and migratory cells such as lymphocytes. The thick fibres of the reticular dermis provide mechanical strength.
107
What are the two major structural components of elastic fibres?
Elastin and fibrillin.
108
What is the function of the muscularis mucosae?
Local movement of the epithelial surface
109
Hypertension can lead to left ventricular hypertrophy.
By what mechanism do cardiac myocytes enlarge?
By increasing the number of thick and thin filaments
110
Striations are related to the Na + reabsorption function of ductal epithelium. Why is [Na +] high in secretions produced by salivary gland cells?
To draw water out of cells
111
Other than promoting the reduction of sebum secretion by sebocytes, a reduction in proliferation of which cell type might lead to dry/ brittle skin in hypothryroidism?
Keratinocytes
112
Name the components of basophil granules
Chemokines
Histamines
Heparin
113
Which type of bone is disproportionately impacted in osteoporosis?
Cancellous (spongy) bone
114
What name is given to the simple squamous epithelium of serous membranes?
Mesothelium
115
Simple squamous epithelium of capillary → A,
Myoepithelial cells → D,
Stratified cuboidal epithelium of duct → B,
Secretory portion of sweat gland → C
116
What is the most appropriate definition of a nosocomial infection?
An infection contracted while under medical care
117
Match the image with the tissue.
Parotid gland → C,
Pancreas → B,
Submandibular glands → A,
Sublingual gland → D
118
Vein → G,
Skeletal muscle → D,
Muscle fibre → K,
Artery → F,
Fascicle → I,
Myofibril → M,
Endomysium → J,
Tendon → A,
Perimysium → E,
Deep fascia → B,
Epimysium → C,
Nerve → H,
Satellite cell → N,
Muscle fibre nucleus → L
119
By what method would a bone marrow sample most likely be collected?
Trephine biopsy
120
Give two causes of chronic obstructive pulmonary disease.
Smoking, biomass fuel pollution, air pollution, dust inhalation
121
Identify the features of a sectioned long bone.
Section C is: → **Medullary cavity**,
Section B is: → **Cortical bone**,
Feature A is: → **Spongy bone**
122
Pseudopodia extended by macrophages are important in the sensing and capture of prey. The dynamic assembly of which cytoskeletal component allows the movement of pseudopodia?
Microfilaments
123
What disorder results from the autoimmune destruction of myelin in the peripheral nervous system?
Guillain–Barré syndrome
124
Different histological stains identify discrete cellular features. Identify the stain that would most effectively identify the following:
General tissue organisation
Glycoproteins, for example in the basement membrane or in mucus
Connective tissue and muscle
Reticular fibres
Elastic fibres
Different types of immune cells
General tissue organisation → H&E,
Glycoproteins, for example in the basement membrane or in mucus → Periodic acid Schiff (PAS),
Connective tissue and muscle → Masson's trichrome,
Reticular fibres → Silver stain,
Elastic fibres → van Gieson or orcein,
Different types of immune cells → Giemsa (or Wright's)
125
Match the virus to the disease it causes.
Coronaviruses →
Rotavirus →
Papillomaviruses →
Picornaviruses →
Myxoviruses →
Coronaviruses → **Colds, severe acute respiratory syndrome (SARS),**
Rotavirus → **Diarrhoea and vomiting,**
Papillomaviruses → **Warts and cervical cancer,**
Picornaviruses → **Polio, hepatitis A, colds,**
Myxoviruses → **Influenza, measles, mumps**
126
Chronic reflux of stomach acid can lead to Barrett’s oesophagus. What is the cellular basis of this disorder?
A metaplastic change of stratified to columnar epithelium to protect the epithelium from stomach acid.
127
Match the organism to the classification
## Footnote
Gram negative cocci →
Gram negative bacilli →
Gram positive cocci →
Gram positive bacilli →
Gram negative cocci → **Neisseria**
Gram negative bacilli → **Escherichia Salmonella, Helicobacter, Pseudomonas, Legionella, Bacteriodes**
Gram positive cocci → **Staphylococcus, streptococcus**
Gram positive bacilli → **Clostridium**
128
What makes up the extracellular matrix
**ground substance**
HA forms an axis for the attachment of proteoglycan monomers(core proteins bound to shorter GAGs) to form a **hyaluronate-proteoglycan-aggregate**
129
What are the dark pink rings surrounding the collecting tubules?
These indicate the highly-glycated basement membrane
130
In obesity, or in alcoholic liver disease, hepatocytes can fill with lipid. What is the name of this process?
Steatosis
131
Case study: abnormality of embryological development or foetal growth. A pregnant 22 year old woman in her first trimester is worried about her alcohol consumption and poor diet, and so seeks advice from her GP. The GP weighs her and finds her to have a BMI of 31.
Based on the woman’s diet, the GP suggest folic acid supplementation. Why is this beneficial?
It promotes neural tube closure, It promotes limb development
132
What disorder results from damage or compression of the sciatic nerve?
Sciatica, characterised by a stabbing pain radiating throughout the course of the sciatic nerve.
133
Describe the zona pellucida
The translucent glycoprotein shell surrounding the oocyte that dissolves prior to implantation
134
Sagittal → Plane 3,
Coronal → Plane 1,
Transverse → Plane 2
135
Connective tissue A is: → Dense irregular,
Connective tissue B is: → Adipose,
Connective tissue C is: → Loose irregular,
Connective tissue D is: → Dense regular
136
Which type of stem cell will repair damaged neonatal cardiac myocytes?
mesenchymal stem cells
137
Name two types of aura, and two symptoms for each
Sensory: numbness/tingling.
Visual: bright zigzag lines
138
Why is it difficult to cut thin sections of fresh tissue?
139
A blood vessel in the submucosa → F
Smooth muscle fibres → D
Goblet cell → A
Enterocytes (simple columnar epithelium) → B
Lamina propria → C
Muscularis mucosa → E
140
Of which type of collagen are reticular fibres comprised?
Type III
141
Match the type of hypersensitivity to the description.
T-cell mediated delayed hypersensitivity → **Type IV**
Circulating complexes form as secreted IgG binds soluble antigens → **Type III**
Recognition of host cells as foreign by IgA or IgM → **Type II**
Immediate hypersensitivity (allergy) mediated via IgE → **Type I**
142
In lipodystrophy, there is a deficiency in the capacity to store fat in relatively inert depots (such as the subcutis). What is the pathological consequence of this?
Fat will accumulate in organs instead, with chronic inflammation resulting from adipokine release leading to organ failure (such as in epicardial deposition).
143
What is the principal function of myelin?
It is an electrical conductor that speeds the propagation of nerve impulses.
144
Where would you insert a needle to withdraw CSF in a lumbar puncture, and why?
The subarachnoid space inferior to L2 is used for extracting CSF as the spinal cord ends at that level, with only the cauda equina projecting further inferiorly. Thus the chance of damage to the spinal cord is reduced.
145
What clue does the histology of tendon give you with regard to its healing ability?
It is poorly vascularised.
146
What clinical signs would you expect to find in a patient with a tension headache?
none
147
Schwann cells myelinate axons in the PNS, while oligodendrocytes perform this function in the CNS.
Endoneurium → C,
Myelin sheath → B,
Axon → A,
Blood vessels → G,
Fascicle → D,
Epineurium → H, F,
Perineurium → E
148
You consider whether he may have long standing bleeding in his stomach.
What type of anaemia is he likely to get with a bleed?
Iron deficiency, microcytic anaemia
149
What disease results from an impairment in myelination in the CNS, and what cells are targeted?
Multiple sclerosis; oligodendrocytes
150
Mucus is a glycoprotein. Which of the following stains would identify this substance more effectively than H&E?
Periodic acid Schiff
151
Sun exposure can lead to disorganised deposition of excess elastic fibres in the dermis. What is this phenomenon called?
Solar or actinic elastosis
152
Match the antibiotic (or class of antibiotic) with the most appropriate mechanism of action. Target organisms are shown in brackets.
Trimethoprim (protozoa and Pneumocystis jiroveci [a common opportunistic infection of the immunocompromised]) →
Gentamycin (Gram negative organisms) →
Ciprofloxacin (Pseudomonas) →
Erythromycin (Gram positive cocci) →
Metronidazole (anaerobes) →
Betalactams (broad spectrum antibiotics) →
Tetracycline (many Gram positive and some Gram negative organisms) →
Rifampicin (broad spectrum) →
Vancomycin (MRSA) →
Trimethoprim (protozoa and Pneumocystis jiroveci [a common opportunistic infection of the immunocompromised]) → **Folate metabolism**
Gentamycin (Gram negative organisms) → **Protein synthesis**
Ciprofloxacin (Pseudomonas) → **DNA synthesis**
Erythromycin (Gram positive cocci) → **Protein synthesis**
Metronidazole (anaerobes) → **DNA synthesis**
Betalactams (broad spectrum antibiotics) → **Cell wall**
Tetracycline (many Gram positive and some Gram negative organisms) → **Protein synthesis**
Rifampicin (broad spectrum) → **RNA polymerase**
Vancomycin (MRSA) → **Cell wall**
153
Identify the two main functions of transitional epithelia.
Distensibility, Protection of underlying tissues from toxic substances
154
Which interleukin is primarily involved in the development of myeloid lineages?
IL-3
155
What is the anatomical significance of the conus medullaris?
This is where the spinal cord terminates. Distal to this the spinal cord is a collection of nerve roots forming the cauda equina.
156
Z disc → C,
Titin → B,
A band → D,
Relaxed sarcomere → A,
I band → E
157
A Golgi body’s cis face → A,
A mitochondrion → D,
A vesicle budding from the trans face of a Golgi body → C,
A Golgi body’s trans face → B
158
How are circulating levels of RBCs maintained?
[Reduced p02] is detected by [peritubular cells of kidney], whose cells release [EPO] to promote maturation of erythrocyte precursors in the [Bone marrow].
159
What is the outcome of the first cleavage of the zygote
Two blastomeres of equal size
160
sensory neuron from the dorsal horn of the spinal cord
Myelin → A,
Glial cell nuclei → F,
Axon → E,
Blood vessel → G,
Axon hillock → D,
Nucleolus → C,
Nissl substance → B,
Neuropil → H
161
Tunica intima → B,
Tunica adventitia → D,
Lumen → A,
Tunica media → C
162
Match the organism to a disease(s) with which it is commonly associated.
## Footnote
Chlamydia species →
Bacteriodes fragilis →
Shigella species →
Escherichia coli →
Streptococcus pyogenes →
Neisseria meningitides →
Staphylococcus aureus →
Salmonella typhi →
Mycobacterium leprae →
Helicobacter pylori →
Group B streptococci →
Clostridium difficile →
Pseudomonas aeruginosa →
Neisseria gonorrhoroeae →
Legionella pneumophila →
Streptococcus pneumoniae →
lostridium perfringens →
Mycobacterium tuberculosis →
Chlamydia species → STIs,
Bacteriodes fragilis → GI tract infections,
Shigella species → Diarrhoea,
Escherichia coli → Food poisoning,
Streptococcus pyogenes → Throat infections,
Neisseria meningitides → Meningitis,
Staphylococcus aureus → Skin infections, bloodstream infections,
Salmonella typhi → Typhoid,
Mycobacterium leprae → Leprosy,
Helicobacter pylori → Stomach ulcers,
Group B streptococci → Usually asymptomatic, but can cause neonatal infections,
Clostridium difficile → Diarrhoea,
Pseudomonas aeruginosa → Pneumonia, sepsis, UTI and GI infections,
Neisseria gonorrhoroeae → Gonorrhoeae,
Legionella pneumophila → Legionnaires’ disease,
Streptococcus pneumoniae → Pneumonia, C
lostridium perfringens → Food poisoning,
Mycobacterium tuberculosis → Tuberculosis
163
Trophoblast lacunae → A,
Hypoblast → H,
Enlarged blood vessel → B and C,
Exocoelomic membrane → I,
Cytotrophoblast → E,
Epiblast → G,
Syncitiotrophoblast → D,
Amniotic cavity → F,
Fibrin plug → J,
Primitive yolk sac → K
164
Endometrium → B,
Uterine epithelium → D
Uterine gland → C
Myometrium → A
165
Staphylococci → A
Streptococci → C
Diplicocci → D
Bacilli/ rods → B
166
Basement membrane → E
Brush border → A
Bowman's capsule → D
Lumen of a distal convoluted tubule → F
Glomerulus → C
Lumen of a proximal convoluted tubule → B
167
Where are melanocytes located?
In the basal layer of the epidermis
168
Describe the intermediate filament desmin
It is found throughout the cytoplasm and gives stability to muscle cells
169
epiphyseal growth plate
Resting or reserved cartilage → Zone 1,
Proliferating cartilage → Zone 2,
Hypertrophying cartilage → Zone 3,
Ossification → Zone 5,
Calcifying cartilage → Zone 4
170
What structures allow transport of chemicals such as newly synthesised neurotransmitters transferred from the cell body to the synapse, and what is their major component?
Microtubules, composed primarily of tubulin
171
The upper panel: myelinated nerve fibre; lower panel: unmyelinated fibres. Inset in the upper panel is the myelin sheath at higher magnification.
Collagen fibril of endoneurium → A,
Golgi body of Schwann cell → E,
Axon of myelinated fibre with neurofilaments, microtubules and mitochondria → B,
Unmyelinated fibres surrounded by Schwann cell cytoplasm → G,
Schwann cell cytoplasm → C,
Schwann cell nucleus → F,
Layers of Schwann cell membrane and myelin → D
172
Match the layer of the epidermis to its function.
Comprised of squames (dead cells) embedded in ceramide (lipid). Forms an impermeable barrier →
Layer containing keratinocyte stem cells and melanocytes →
The last living layer of the epidermis. Cells contain keratohyalin that is comprised of cornifed envelope proteins. →
A layer comprised of loose irregular connective tissue that supplied nutrients to the epidermis →
A distinct histological layer between the stratum granulosum and stratum corneum. May be an artefact of preparation. →
Layer containing transit amplifying cells attached by desmosomes. Critical in regulating the thickness of the epidermis →
Comprised of squames (dead cells) embedded in ceramide (lipid). Forms an impermeable barrier → **Stratum corneum**
Layer containing keratinocyte stem cells and melanocytes → **Stratum basale**
The last living layer of the epidermis. Cells contain keratohyalin that is comprised of cornifed envelope proteins. → **Stratum granulosum**
A layer comprised of loose irregular connective tissue that supplied nutrients to the epidermis → **Papillary dermis**
A distinct histological layer between the stratum granulosum and stratum corneum. May be an artefact of preparation. → **Stratum lucidum**
Layer containing transit amplifying cells attached by desmosomes. Critical in regulating the thickness of the epidermis → **Stratum spinosum**
173
Match the blood cell or derivative to its function. Give the most appropriate answer.
Clotting →
Phagocytosis, particularly of bacteria →
Oxygen transport →
Adaptive immunity →
Allergic reactions →
Mildly phagocytic APCs that differentiate into macrophages in tissues →
Defence against helminth infestation →
Clotting → **Platelets**
Phagocytosis, particularly of bacteria → **Neutrophils**
Oxygen transport → **Red blood cells**
Adaptive immunity → **Lymphocytes**
Allergic reactions → **Basophils**
Mildly phagocytic APCs that differentiate into macrophages in tissues → **Monocytes**
Defence against helminth infestation → **Eosinophils**
174
Arachnoid mater → B
Dura mater → A
Pia mater → C
175
What type of tissue will replace damaged cardiac muscle?
Dense connective tissue
176
Match the embryonic structure with its fate.
The cephalic end of the neural tube →
The notochord →
The lumen of the neural tube →
**The cephalic end of the neural tube** → Primary cerebral vesicles, and ultimately the brain,
**The notochord** → The nucleus pulposus of the spinal cord,
**The lumen of the neural tube** → The central canal of the spinal cord and ventricular system of the brain
177
Order the stages of neutrophil maturation
Myeloblast → 1
Promyelocyte → 2
Myelocyte → 3
Metamyelocyte → 4
Band cell → 5
Neutrophil → 6
178
Describe the function of dystrophin
It links the cytoskeleton with the ECM
179
Of what is the nucleus pulposus comprised, and what is its function?
It is primarily a gel matrix (mainly water and hyaluronic acid), which acts as a shock absorber.
180
What type of cell most commonly secretes and assembles collagen?
Fibroblast
181
What name is given to the nerve terminals that supply voluntary muscle?
motor end plate
182
Match the event to the outcome.
A split occurs at the early blastocyst stage →
Two separate eggs are fertilised →
A single zygote splits prior to the formation of the blastocyst →
A split occurs at the early blastocyst stage → **Monozygotic twins sharing a placenta**
Two separate eggs are fertilised → **Dizygotic twins**,
A single zygote splits prior to the formation of the blastocyst → **Monozygotic twins with separate placentas**
183
What structures provide electrical continuity between cardiac muscle fibres?
Gap junctions
184
From which cell layer is the notochord derived?
Epiblast
185
What is the term for a cancer of epidermal keratinocytes?
What is the term for cancer arising from glandular epithelium, such as that of the colon?
What is the term for a malignant tumour of connective or other non-epithelial tissue.
Squamous cell carcinoma
Adencarcinoma
Sarcoma
186
gastrulation
Epiblast → A,
Primitive node → B,
Hypoblast → E,
Primitive streak → C,
Invaginating mesodermal cells → D
187
Scattered light from samples illuminated from the side reveals structure in unstained specimens →
Detects light emitted by UV-illuminated specimens, allowing identification of specific proteins immunolabelled with dyes such as fluorescein →
Exploits interference patterns of refracted light to create an impression of depth in unstained and unfixed specimens →
Uses laser illumination and a pinhole to allow capture of optical sections →
Routine study of stained sections →
Reveals structure in unfixed and unstained (often live) sample by exploiting retardation of light as it passes through specimens →
A technique used to reveal collagen organisation in picrosirius stained specimens →
Provides high resolution images of surfaces by passing an electron beam across a sample prepared with heavy metals →
Provides high resolution imaging by passing a high-energy beam of electrons through a very thin section. →
Scattered light from samples illuminated from the side reveals structure in unstained specimens → **Dark field,**
Detects light emitted by UV-illuminated specimens, allowing identification of specific proteins immunolabelled with dyes such as fluorescein → **Fluorescence microscopy**,
Exploits interference patterns of refracted light to create an impression of depth in unstained and unfixed specimens → **Differential (or Nomarski) interference microscopy**,
Uses laser illumination and a pinhole to allow capture of optical sections → **Confocal microscopy**,
Routine study of stained sections → **Bright-field microscopy**,
Reveals structure in unfixed and unstained (often live) sample by exploiting retardation of light as it passes through specimens → **Phase contrast** **micropscopy**,
A technique used to reveal collagen organisation in picrosirius stained specimens → **Cross-polar microscopy**,
Provides high resolution images of surfaces by passing an electron beam across a sample prepared with heavy metals → **Scanning electron microscopy**,
Provides high resolution imaging by passing a high-energy beam of electrons through a very thin section. → **Transmission electron microscopy**
188
What is a “slipped” or herniated disc?
Displacement of the nucleus pulposus due to weakness in the annulus fibrosus, which cracks particularly with age and when under excess forces. The displaced disc can put pressure on adjacent nerves.
189
Match the description with the classification of osteoporosis
## Footnote
Affects post menopausal women, and results from an increase in osteoclast activity. →
Affects both men and women, and results from an age-related decrease in osteoblast activity. →
Loss of bone density resulting form disease (e.g. multiple myeloma) or long-term steroid usage →
Affects post menopausal women, and results from an increase in osteoclast activity. → **Primary osteoporosis, type 1**,
Affects both men and women, and results from an age-related decrease in osteoblast activity. → **Primary osteoporosis, type 2**,
Loss of bone density resulting form disease (e.g. multiple myeloma) or long-term steroid usage → **Secondary osteoporosis**
190
What is the thick layer seen immediately below the respiratory epithelium?
Basement membrane, which is unusually thick in respiratory epithelium and not normally visible with H&E staining in other areas.
191
What is the function of the synovial cells that surround some tendons?
Production of lubricating fluid
192
On which layer of the epidermis do inflammatory cytokines act to promote hyperproliferation?
Stratum basale
193
What is the embryo called at the 16 cell stage?
A morula
194
Connective tissue → C,
Smooth muscle → B,
An elastic lamina → A
195
Match the disorder of bone to the description
The correct answer is: Loss of bone density due to diminished osteoblast function with age → **Type II osteoporosis**,
Bone softening in childhood as a consequence of a vitamin D deficiency → **Rickets**,
Short-limbed dwarfism resulting from a point mutation in the FGF-3 gene leading to reduced chondrocyte activity at the epiphyseal growth plate, and early closure. → **Achondroplasia**,
Reduced mineralisation of osteoid leading to bone pain and muscle weakness in adults with a vitamin D deficiency → **Osteomalacia**,
Brittle bones form due to defects in type I collagen production → **Osteogenesis imperfecta type I-IV**,
Increase in appositional growth in adults resulting from an over-active pituitary gland → **Acromegaly**,
Loss of bone density due to overactive osteoclasts following menopause → **Type I osteoporosis**,
Diminished stature as a consequence of reduced activity at epiphyseal growth plates resulting from an under-active pituitary gland before puberty → **Pituitary dwarfism**,
Increased stature as a consequence of enhanced activity at epiphyseal growth plates stimulated by an over-active pituitary gland before puberty → **Giganitism**
196
What name is given to flattened tendons?
Aponeuroses attach sheet-like muscles to bone, cartilage or the connective tissue of other muscles.
197
Match the muscle disorder to the description.
The correct answer is: A rare life-threatening genetic disease in which exposure to certain anaesthetics causes severe muscle contractions and a rapid rise in body temperature. An early sign is increased CO2 production. →
An X-linked recessive disease causing progressive muscle weakness due to an absence of the protein dystrophin →
A chronic disease caused by autoantibody destruction of end plate ACh receptors →
A serious form of paralytic illness resulting from Clostridium infection →
Irreversible inhibition of acetylcholinesterase resulting from exposure to pesticides leading to heart and respiratory problems →
The correct answer is: A rare life-threatening genetic disease in which exposure to certain anaesthetics causes severe muscle contractions and a rapid rise in body temperature. An early sign is increased CO2 production. → **Malignant hypothermia**,
An X-linked recessive disease causing progressive muscle weakness due to an absence of the protein dystrophin → **Duchenne muscular dystrophy**,
A chronic disease caused by autoantibody destruction of end plate ACh receptors → **Myasthenia gravis**,
A serious form of paralytic illness resulting from Clostridium infection → **Botulism**,
Irreversible inhibition of acetylcholinesterase resulting from exposure to pesticides leading to heart and respiratory problems → **Organophosphate poisoning**
198
What is the function of epidermal Langerhans cells?
They are antigen presenting cells
199
Why are mucous glands pale-staining?
Their contents are lost during tissue processing.
200
Described the cellular basis of Tay-Sachs disease
A failure to breakdown glycolipids leads to the accumulation of gangliosides in nerve cells, interfering with normal function.
201
Identify the cells of the reticuloendothelial system responsible for destroying damaged RBCs.
Macrophages
202
Match the lymphocyte to the function
Kill infected cells in an MHC-dependent fashion → **CD8+ (cytotoxic) T-cells**
Regulate immune functions, e.g. in activating B cells → **CD4+ (helper) T-cells**
Kills "stressed cells" in an MHC-independent fashion → **Natural killer (NK) cells**
Produce immunoglobulins → **Plasma cells**
Lymphoid progenitor cells → **Lymphoblasts**
Suppress immune functions → **CD4+ CD25+ (regulatory) T-cells**
203
Describe the effect that smoking has on the morphology of respiratory epithelium.
Metaplasia: epithelium changes from pseudostratified columnar to stratified squamous
204
What name is given to inflammation of a peripheral nerve?
Neuritis
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