Histo Ch 18 Endocrine lip, Histo lip Ch 13 GIT, Histo Lip ch 14 Liver multi not finished, Histo lip ch 15 urinary multi, Lip Circulation ch10 multi, Histo chapter 11 Circulation, Histo Chapter urinary, Histo chapter 15 digestion tract, Histo ch 17

38 A 24 - year - old skydiver asks you about the physiology of the " adrenaline rush " that she experiences when jumping from airplanes . Which of the following neurotransmit ters stimulates the release of adrenalins from chromaffin cells in the adrenal medulla ?

Acetylcholine

35 You are asked to discuss your research on parathyroid gland pathophysiology at a national conference on " aging and the endocrine system . " Which of the follow ing cells is expected to be relatively more abundant in the parathyroid glands of an elderly patient , compared to a younger patient ?

Adipocytes

42 A 53 - year - old man complains of muscle weakness and dizziness of 3 months ' duration . His blood pressure is elevated ( 185/100 mm Hg ) . Endocrine studies reveal ele vated serum levels of aldosterone . Cells in which of the fol lowing anatomic locations secrete this mineralocorticoid ?

Adrenal cortex , zona glomerulosa

3. Which structural feature distinguishes between terminal and respiratory bronchioles ?

Alveoli

41 A 40 - year - old woman complains of recent changes in her bodily appearance , including upper truncal weight gain and moon facies . Endocrine studies reveal elevated . serum levels of cortisol and corticotropin ( ACTH ) . The patient is subsequently diagnosed with Cushing disease . ACTH is synthesized primarily by endocrine cells in which of the following anatomic locations ?

Anterior pituitary

21 Concentration of bile salts and pigments within the lumen of the gallbladder depends on active transport of Nat and HCO ,, as well as passive transport of H₂O . Which of the following proteins facilitates the passive transport of water across the plasma membrane of epi thelial cells lining the gallbladder ?

Aquaporin

6. Which of the following is true of pericytes ?

Are associated with the basal lamina of capillary endothelial cells

2. Which description is true of pancreatic zymogens ?

Are inactive until they reach the duodenal lumen

9 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 ?

Arterioles

12 You are asked to lead a problem - based learning session on valvular heart disease . Which of the following tissues forms the central core of heart valves ?

Avascular dense connective tissue

30 As part of your research on mechanisms of thyroid hor mone secretion , you develop a monoclonal antibody directed against the sodium / iodide cotransporter ( sym porter ) . Using indirect immunofluorescence assays , you demonstrate that this antibody specifically binds ( labels ) which of the following cells and membranes within the thyroid gland ?

Basolateral membranes of follicular epithelial cells

3 The parents of an 8 - year - old boy are concerned about his weight loss following a flu - like illness . Urinalysis reveals glucosuria ( glucose in the urine ) . His fasting blood glu cose is 220 mg / dl ( normal = 50 to 100 mg / dL ) . The child is diagnosed with diabetes mellitus type 1. Which of the following cells in the endocrine pancreas produces insulin ?

Beta cells

28 Which of the following is an essential secretory product of the submucosal glands: brunner glands

Bicarbonate ions

29 A 69 - year - old man is brought to the emergency room in a disoriented state . Physical examination reveals an odor of alcohol , as well as jaundice and ascites . Serum levels of aspartate aminotransferase ( AST ) , alanine aminotransferase ( ALT ) , alkaline phosphatase , and bilirubin are all elevated . Increased serum levels of alkaline phosphatase are an indi cator of injury to which of the following tissues / structures ?

Bile ducts

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

Bladder mucosa

10. 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 ?

Body of the stomach

18 Binding of FSH to the plasma membranes of follicu lar epithelial cells in the ovary is known to activate G protein - coupled receptors that regulate the maturation of ovarian follicles . FSH receptor binding stimulates the production of which of the following second messenger molecules in ovarian follicular cells ?

CAMP

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

Cardiac skeleton

1 You are asked to discuss the gross and microscopic anatomy of the liver during a pathology conference . Classic liver lobules are described as hexagonal prisms that sur round which of the following anatomic structures ?

Central vein

5 A 75 - year - old man with congestive heart failure com plains of increasing shortness of breath . On physical examination , the patient has an enlarged and tender liver and swollen legs . Increased venous pressure due to right - sided heart failure primarily affects which of the following regions of this patient's liver ?

Centrilobular hepatocytes

4. Which feature is unique to the exocrine pancreas ?

Centroacinar cells

14 You are analyzing patterns of stem cell renewal and terminal differentiation in the GI tract . As part of your research you generate monoclonal antibodies that iden tify specific populations of gastric epithelial cells . One of your antibodies recognizes a protease found in zymogen granules . Which of the following cells is characterized by the presence of zymogen secretory granules ?

Chief cells

33 A 72 - year - old man complains of abdominal discomfort . Physical examination reveals neuromuscular weakness . Laboratory studies show markedly elevated levels of serum calcium and parathyroid hormone ( PTH ) . This polypeptide hormone is synthesized and secreted by which of the following endocrine cells ?

Chief cells

12 A 40 - year - old woman presents with an 8 - month history of generalized itching , weight loss , fatigue , and yellow sclerae . Physical examination reveals mild jaundice . A liver biopsy discloses bile duct injury and inflammation Which of the following cells forms the lining epithelium of the biliary tree ?

Cholangiocytes

35 After your lecture , a colleague asks you to comment on recent drug discovery efforts to regulate nutrient uptake in the small intestine . What hormone stimu lates gallbladder contraction and pancreatic enzyme secretion ?

Cholecystokinin

18 A 40 - year - old woman with a history of indigestion inquires about the location of her gallbladder . She also asks for information regarding risk factors for gallstones . What normal component of bile is associated with the pathogenesis of gallstones ?

Cholesterol

16 One of your classmates casually mentions that the liver produces about 1 L of bile per day . As you attempt to confirm this surprising information through indepen dent study , you learn that cholangiocytes continuously monitor the flow of bile . What subcellular organelle is sensitive to the directional flow of bile in the biliary tree

Cilia

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

Cilia

25 Laboratory analysis of serum collected from the patient described in Question 24 will reveal autoantibodies directed against which of the following basement mem brane proteins ?

Collagen type IV

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

Collecting ducts

9. 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 ?

Collecting ducts

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

Colon

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

Coronary arteries

44 Which of the following best describes the physiologic mechanism responsible for the formation and excretion of hyperosmotic urine ?

Countercurrent multiplier system

3 A 68 - year - old diabetic man with chronic kidney disease complains of weakness and fatigue . Physical examina tion reveals marked pallor . The CBC reveals a normo cytic anemia . Which of the following best describes the pathogenesis of anemia in this patient ?

Decreased serum levels of erythropoietin

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

Elastic fibers

45 During the seminar , you are asked to discuss the cellular mechanisms that mediate antibody transport across the epithelial barrier of the GI tract . Which of the following cells transports IgA from the lamina propria of the mucosa to the lumen of the gut ?

Enterocytes

6 Autopsy of the patient described in Question 5 reveals 400 mL of blood in the pericardial cavity . This blood is in direct contact with which of the following anatomic structures ?

Epicardium

1 The gastrointestinal ( GI ) tract is compartmentalized into organs that are specialized for digestion of food and absorption of nutrients . Most variation and specializa tion along the length of the GI tract occur in which of the following tissue layers ?

Epithelium of mucosa

5. 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 ?

Esophagus

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 ?

Failure of type II pneumocytes to complete differentiation and become fully functional

21 A 52 - year - old woman complains of swelling in the ante rior portion of her neck that she first noticed 6 months ago . Except for some discomfort during swallowing . the patient does not report any significant symptoms . Laboratory studies show elevated serum levels of thyroid hormones ( T , and T ) . These tyrosine - based polypeptide hormones are synthesized and secreted by which of the following endocrine cells ?

Follicular cells

20 Which of the following cells helps to organize clusters of glandular epithelial cells in the pars distalis of the ante rior pituitary ?

Folliculostellate cells

6. Which of the following is true of pulmonary surfactant ?

Forms layer rich in phospholipid overlying a thin aqueous phase

10. 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 ?

Fused basal laminae of epithelial and endothelial cells

10. A 15 - year - old male presents with hematuria , hearing loss , lens dislocation , and the onset of cataracts . Genetic analysis reveals a mutation 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 filtration . Which one of the following structures would most likely be abnormal in the TEM of this patient's biopsy ?

Glomerular basement membranes

10. A young child presents with hepatomegaly and renomegaly , fail ure 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 accu mulate in hepatocytes during progression of this disorder

Glycogen granules

13 A 50 - year - old malnourished man presents with a 6 - month history of night blindness . Physical examination reveals corneal ulceration . The patient is subsequently diagnosed with vitamin A deficiency . Which of the following cells in the liver stores vitamin A as retinyl esters ?

Hepatic stellate cells

8. 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 signifi cant loss of normal lobular structure . Jaundice is most likely to result when the proper location or orientation of what hepatic structures is disrupted ?

Hepatocytes

11 A 16 - year - old boy presents with lethargy and head aches . His parents note that he drinks water exces sively . A 24 - hour urine collection shows polyuria . His fasting blood sugar is normal . Laboratory studies reveal decreased serum levels of antidiuretic hormone ( ADH ) . This polypeptide hormone is synthesized in which of the following organs / glands ?

Hypothalamus

44 During a small group seminar , you are asked to discuss humeral immunity in the GI tract . Plasma cells in the lamina propria secrete primarily which of the following classes of immunoglobulin

IgA

2 A 56 - year - old woman with a history of chronic renal disease complains of bone and joint pain . Laboratory studies reveal hypocalcemia and vitamin D , deficiency Which of the following describes the most likely reason for vitamin D , deficiency in this patient ?

Inadequate hydroxylation of calcidiol ( vitamin D₂ )

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

Increased number of intestinal bacteria

23 A 44 - year - old woman presents with burning epigas tric pain that usually occurs between meals . The pain can be relieved with antacids . The patient also reports a recent history of tarry stools . Gastroscopy reveals a bleeding mucosal defect in the antrum measuring 1.5 cm in diameter . Which of the following is the most likely underlying cause of peptic ulcer disease in this patient ?

Infection

10. 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 triglyc erides 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 ?

Injury to endothelial cells

30 A 44 - year - old woman comes to the physician with a 6 - week history of episodic hunger and fainting spells . She is currently seeing a psychiatrist because she is irri table and quarreling with her family . Laboratory studies show a serum glucose concentration of 35 mg / dL ( nor mal = 90 mg / dL ) . A CT scan of the abdomen demon strates a 1.5 - cm mass in the pancreas . An EM study of the tumor reveals membrane - bound , dense - core gran ules . These secretory vesicles most likely contain which of the following pancreatic hormones ?

Insulin

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

Interlobular arteries

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

Irregular plates of cartilage

7. Which description is true for the hepatic space of Disse ?

Is directly contacted by hepatocytes

9. 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 ?

It is the site of inflammation in diabetic patients and is sensitive to vitamin C deficiency .

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

Juxtaglomerular cells

48 What is the major source of cholesterol present in the foamy cytoplasm of spongiocytes in the zona fasciculata of the adrenal cortex ?

Low - density lipoproteins

24 You are asked to present a seminar on the pharmacoge netics of thyroid hormone secretion . Which of the fol lowing types of enzymes is required for the conversion of iodinated thyroglobulin to active thyroid hormones ( T , and T ) in the cytoplasm of follicular epithelial cells ?

Lysosomal protease

9. 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 ?

Mast cells in BALT bronchoconstriction , and edema

43 You are asked to present a lecture on the pathophysiol ogy of urine formation . Interstitial connective tissue is most hyperosmotic in which region of the kidney ?

Medulla at apex of the pyramid

22 You are investigating the activation of smooth muscle in the muscularis mucosae of the stomach and its role in assisting outflow from gastric glands . The cell bodies for visceral motor fibers that innervate the muscularis mucosae are present in which of the following anatomic locations ?

Meissner plexus

46 You are asked to discuss the neuropharmacology of the pineal gland at a conference on " advances in psychobiol ogy . " What is the principal hormone produced by the pineal gland located in the posterior wall of the third ventricle of the brain ?

Melatonin

51 Which portion of the male urethra is surrounded by the external urethral sphincter ?

Membranous urethra

31 Which of the following biological processes describes the critical function of the structure described in Question 30

Monitoring Na in primary urine

5. Which description is true of continuous capillaries ?

Most common in both brain and muscle

3. The teniae coli of the large intestine represent an organ - specific spe cialization of which layer of the intestinal tract wall ?

Muscularis externa

9. 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 posi tive 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 interlob ular connective 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 ?

Na

4 Which of the following terms best describes the basic structural and functional unit of the kidney that filters the blood and produces urine ?

Nephron

28 A 62 - year - old alcoholic presents to the emergency room with 8 hours of severe abdominal pain and vomiting . Physical examination discloses exquisite abdominal ten derness . Serum levels of amylase and lipase are elevated These laboratory data indicate that this patient has suf fered injury to which of the following internal organs

Pancreas

45 A 44 - year - old woman suffers from long - standing peptic ulcer disease that is largely unresponsive to pharmaco logic therapy . Laboratory studies reveal high serum levelsof gastrin . If this patient has a gastrin - secreting tumor , then imaging studies would most likely reveal a mass in which of the following organs / glands ?

Pancreas

25 A 48 - year - old woman presents with flank pain . Laboratory studies show elevated serum levels of para thyroid hormone ( PTH ) and calcium . Imaging studies . reveal stones in the patient's right renal pelvis and ureter . Which of the following endocrine cells secretes a poly peptide hormone that opposes the action of PTH and decreases serum calcium levels in this patient ?

Parafollicular cells

5 You are asked to give a lecture on the cellular and molec ular mechanisms of hormone secretion . The cytoplasm of which of the following endocrine cells is expected to show an abundance of dense core , membrane bound secretory granules when examined by electron microscopy ?

Parafollicular cells of the thyroid

12 A 58 - year - old woman with a history of indigestion after meals and " heartburn " presents with upper abdominal pain . She is currently being treated with proton pump inhibitors for gas troesophageal reflux disease ( GERD ) . Which of the follow ing types of epithelial cells has proton pumps and generates hydrochloric acid ( HCl ) within the lumen of the stomach ?

Parietal cells

19 A 34 - year - old man presents with a 5 - month history of weakness and fatigue . A peripheral blood smear shows megaloblastic anemia . Further laboratory studies dem onstrate vitamin B12 deficiency . This patient's anemia is most likely caused by autoantibodies directed against which of the following GI cells ?

Parietal cells

15 The hypothalamo - hypophyseal portal system conveys releasing hormones ( neuropeptides ) from the median eminence of the hypothalamus directly to which of the following anatomic locations ?

Pars distalis of the anterior pituitary

11 A 16 - year - old boy presents with lethargy and head aches . His parents note that he drinks water exces sively . A 24 - hour urine collection shows polyuria . His fasting blood sugar is normal . Laboratory studies reveal decreased serum levels of antidiuretic hormone ( ADH ) . This polypeptide hormone is synthesized in which of the following organs / glands ? 12 For the patient described in Question 11 , ADH ( argi nine vasopressin ) enters the systemic circulation through fenestrated capillaries that are present in which of the following anatomic locations ?

Pars nervosa of the posterior pituitary

35 A 59 - year - old diabetic woman complains of declining visual acuity . Funduscopic examination of the patient's retina reveals capillary microaneurysms and small hemorrhage . Loss of which of the following components from the capillary wall is the most likely cause of early stage diabetic retinopathy in this patient ?

Pericytes

28 Which of the following biological processes describes the primary function of the mesangial cells described in Question 27 ?

Phagocytosis and endocytosis

4 A 24 - year - old woman experiences severe bleeding dur ing delivery of a preterm infant due to abnormal sepa ration of the placenta . Five months later , she presents with profound lethargy , pallor , muscle weakness , failure of lactation , and amenorrhea . You suspect that the mul tiple hormone deficiencies in this patient were caused by postpartum injury to which of the following endocrine organs ?

Pituitary gland

46 A 16 - year - old boy presents with headaches and muscle weakness His parents note that he drinks water excessively . A 24 - hour urine collection shows polyuria . The fasting blood sugar is normal . This patient may have an injury affecting which of the following endocrine organs

Pituitary gland

2. Which cell type comprises the visceral layer of Bowman capsule ?

Podocytes

26 Which of the following cells collaborates with capillary endothelial cells to synthesize the glomerular basement membrane described in Questions 24 and 25 ?

Podocytes

36 Which of the following structures serves as the primary site for reabsorption of water , electrolytes , amino acids , sugars , and polypeptides from the glomerular ultrafiltrate ?

Proximal convoluted tubule

14 You are asked to provide a brief overview of the anatomy and physiology of the kidney . Which of the following anatomic terms best describes the initial portion of a nephron ?

Renal corpuscle

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

Respiratory bronchioles

6. Which description is true of the gallbladder ?

Secretes mucus .

32 During a clinical conference , you are asked to summa rize the role of juxtaglomerular cells in maintaining a constant rate of glomerular filtration . Which of the fol lowing biological processes describes the function of JG cells in the kidney ?

Secretion of renin

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

Simple columnar epithelium

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

Simple cuboidal

29 Which of the following best describes the average epi thelial morphology of a hypoactive thyroid gland ?

Simple squamous

9 A 56 - year - old man complains of recurring heart palpi tations and is subsequently diagnosed with a cardiac arrhythmia . Which of the following cardiac structures functions as the " pacemaker " of the heart ?

Sinoatrial node

34 You are invited to give a lecture on the pathobiology of enteroendocrine cells at a national conference on " child hood obesity " organized by First Lady Michelle Obama . During your lecture , you mention that enteroendocrine cells secrete a wide variety of polypeptide hormones . Which hormone produced in the stomach stimulates the perception of hunger ?

Skip

1. 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 ?

Smooth endoplasmic reticulum

13 Immunohistochemical methods are used to identify a subset of axons in the posterior pituitary that contain oxytocin and its intracellular - binding protein ( neurophysin ) . Following release from these terminal axons , oxytocin travels through the circulation and binds to G protein - coupled receptors on the surface of which of the following types of cells ?

Smooth muscle cells

8 Your laboratory instructor asks you to discuss endocrine exocrine , absorptive , and secretory functions of the liver Secreted proteins such as albumin , clotting factors , and nonimmune globulins enter what microscopic cavity before entering the liver sinusoid ?

Space of Disse

2 During a small group discussion , you are asked to explain structural and functional differences between rugae , villi , microvilli , plicae circulares , teniae coli , and haustra . Rugae are found in which of the following seg ments of the GI tract ?

Stomach

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

Stratified squamous nonkeratinized

41 Further examination of the specimen provided for Question 40 reveals arterioles and venules ( arrows shown in the image ) . These blood vessels are located within which of the following layers of the GI tract ?

Submucosa

8 . 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 fol low - 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 ?

Surgical disruption of the left arm's lymphatic drainage by removal of lymph nodes

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

Synthesize triglycerides from absorbed lipids

8. 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 ?

The direction of release of secretion

8. 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 per tains to these epithelial cells ?

The primary site for the reduction of the tubular fluid volume

6 The parents of an 8 - week - old girl complain that their child is apathetic and sluggish . Further testing reveals mental and physical retardation . The child is diagnosed with cretinism . Hormone replacement therapy is initi ated . Agenesis during development of which of the following organs would explain the pathogenesis of physical and mental retardation in this infant ?

Thyroid gland

7. What type of epithelium lines the prostatic urethra ?

Transitional ( urothelium )

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

Tunica media

1 A 46 - year - old man presents with excruciating episodic colicky ) pain on the right side , radiating from the flank to his inguinal region . The episodes of pain last about 30 minutes . Imaging studies reveal a urinary stone . Based on the patient's symptoms , the stone most likely lodged in which of the following components of the urinary system ?

Ureter

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

Vallate papillae

45 The concentration of urine in the collecting ducts is dependent on which of the following hormones ?

Vasopressin

7. 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

Venule

3. Which of the following is true for ventricles ?

Walls contain purkinje fibers of the right and left branches from the atrioventricular

3. Which process increases in response to parasympathetic stimula tion of the salivary glands ?

a . Volume of secretion

5. Which description is true of the bile canaliculi ?

d . Lumens are entirely sealed by junctional complexes