Block 2

Secretin

(S cell) stimulates release of bicarbonate buffer from pancreas

Spleen

- Filter for the blood (similar to lymph nodes - filters for lymph) --- 'graveyard for old RBCs' - Humoral responses - production of antibodies against circulating antigens - Disposal of defective RBCs Hemoglobin broken down, iron recycled Bilirubin disposal - Storage of RBCs and platelets

Ileum

- Peyer's patches (lymphatic tissue) - M cells (nonabsorptive cells covering PPs - Bile acid resorption - Intrinsic factor/B12 absorption

Stratum Basalis

- renewal of the endometrium, remains relatively unchanged

Physiological effects of hormones on breast

1) Estrogen: • Growth of duct system • Deposition of adipose tissue 2) Progesterone: • Development of lobules (milk producing apparatus) 3) Prolactin: • Milk (production) secretion • And lobules (milk producing apparatus) 4) Oxytocin: • Milk ejection

The cells that require testosterone possess ______________, the enzyme that converts testosterone to its more active form, dihydrotestosterone.

5α-reductase

Hepatic acinus

Based on oxygen availability to hepatocytes • 3 zones according to proximity to hepatic arteries with central veins at the periphery • Useful in considering certain types of liver disease • Zone 1 (periportal) occurs in phosphorus poisoning or eclampsia. • Zone 2 (midzonal) - rare - is seen in yellow fever. • Zone 3 (centrilobular) occurs with ischemic injury, toxic effects, carbon tetrachloride exposure or chloroform ingestion. • Drugs such as acetaminophen (Tylenol) may be metabolized in zone 1 to toxic compounds that cause necrosis in zone 3.

Microfold cells (M cells)

Cells in the gastrointestinal tract that take up and transfer antigens to lymphocytes in Peyer's patches

Centrilobular Necrosis of the Liver

Congestive heart failure results in hypoperfusion and hypoxia in zone 3 • Sometimes referred to as "cardiac necrosis" • Nutmeg liver centrilobular necrosis

Pernicious (megaloblastic) anemia

Fatigue and weakness Reduced hemoglobin indicates anemia. Reddened, smooth tongue is seen in pernicious anemia. Autoimmune disease - antibodies to intrinsic factor, needed for absorption of Vit B12 (Cobalamin) RBCs are large in size WBCs show hypersegmented nucleus

Hyperaldosteronism (Conn's)

Hypersecretion of aldosterone • Often caused by a benign tumor • Most common between the ages of 30 and 50 • Symptoms: hypertension, headache, hypokalemia (low serum potassium), fatigue, intermittent paralysis, muscle weakness, and numbness.

Celiac disease

Immune response to gliadin- a gluten protein • Blunting of villi, crypt hyperplasia, lymphocyte infiltration • "Irritable bowel", malabsorption • Diet modification

Hepatitis

Inflammation of the liver • Infiltration with inflammatory cells---mostly lymphocytes if chronic • Can be self-limiting or can progress to fibrosis and cirrhosis • Symptoms include jaundice, anorexia, malaise • Caused by viruses, alcohol and other organic solvents, certain medications (e.g. acetominophen)

High prolactin levels inhibit ___, so no ovulation.

LH

Hepatocyte

Lateral domain (between hepatocytes) is where bile is secreted into canaliculi between cells. Sinusoidal domain has microvilli which extend into the space of Disse to facilitate nutrient uptake and secretion into the blood.

Ileum with Peyer's patches

Lymphoid nodules are proliferating masses of B lymphocytes • Cells will migrate into the lamina propria and take up locations just basal to the epithelium & M cells • Will mature into plasma cells and secrete IgA antibodies to protect against pathogens

Ileum with Peyer's patches

Lymphoid nodules are proliferating masses of B lymphocytes • Cells will migrate into the lamina propria and take up locations just basal to the epithelium & M cells • Will mature into plasma cells and secrete IgA antibodies to protect against pathogens

Blockage of the openings of the cervical mucosal glands frequently results in the accumulation of secretory products within the glands, leading to the formation of dilated ______________.

Nabothian cysts - benign cysts

__________ is basic function of Muscularis Externa.

Peristalsis Control is via MYENTERIC PLEXUS (ANS, Enteric) Cell bodies are parasympathetic Axons are parasympathetic & sympathetic

Ileum

Peyer's patches (lymphatic tissue) - M cells (nonabsorptive cells covering PPs - Bile acid resorption - Intrinsic factor/B12 absorption

Paneth cells

Present in intestinal crypts, secrete lysozyme; bacteriostatic, bacteriocidal effect GRANULES can be seen in apical part of cell

Aldosterone

Produced by the zona glomerulosa Released in response to angiotensin II Acts on the distal tubules and collecting ducts of the kidney to conserve Na+, secretion of K+, increasing water retention and increasing blood pressure

Fatty Liver Disease

Reversible condition where large vacuoles of triglyceride accumulate in liver cells via the process of steatosis (i.e. abnormal retention of lipids within a cell). • Causes include excessive alcohol intake, HFCS and obesity. • Accumulation of fat may also be accompanied by a progressive inflammation of the liver (hepatitis), called steatohepatitis.

Passage of sperm

Seminiferous tubules • Tubuli recti • Rete testis • Efferent ductules • Epididymis

M (Microfold) Cells

Specialized epithelial cells overlying Peyer's Patches • Basal lamina invaginations containing many lymphocytes & macrophages • Endocytose antigens & transport them to the lymphocytes and macrophages • Lymphocytes & macrophages then "disperse" information

Hepatitis A

Spread by contaminated food (especially raw shellfish), water or direct contact • 30 million cases a year • Incubation period is two to six weeks • HAV infection produces a self-limited disease that does not result in chronic infection or chronic liver disease. • 10-15% of patients experience a relapse of symptoms during the 6 months after acute illness

Sertoli cells

Support the developing spermatogenic cells • Establish the blood-testis barrier • Phagocytose the cytoplasm shed by developing spermatogenic cells • Produce: - Androgen-binding protein (ABP) - AntiMullerian hormone - Inhibin - Testicular transferrin - Fructose-rich medium

Pancreatitis

Symptoms: severe upper abdominal pain radiating to the back, nausea, and vomiting • Dx: greatly increased plasma lipase/amylase, visualization via ultrasound or CT • Tx: removal of stone, initially NPO- pancreatic enzymes • Chronic pancreatitis can lead to diabetes or pancreatic cancer.

Achalasia

T cell-mediated destruction or complete absence of myenteric ganglion cells in lower third of esophagus. Signs: Dysphagia is difficulty in swallowing. Odynophagia - pain produced by swallowing Dysphagia to liquids, in particular, is a characteristic of achalasia.

Crohn's disease

Transmural inflammation, • malabsorption, anemia, stenosis/blockage, Paneth cell metaplasia (to other regions)

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 surround which of the following anatomic structures? a. Central vein b. Bile duct c. Hepatic artery d. Portal vein e. Portal triad

a. Central vein

Which of the following cytologic features characterizes the epithelial cells that line the efferent ductules of the testes? a. Cilia b. Dense, membrane-bound secretory granules c. Lamellar bodies d. Glycogen-rich vacuoles e. Intracellular lipid droplets

a. Cilia

You are asked to give a lecture on the mechanisms of ovulation, fertilization, and early development. During oogenesis, which of the following biological events/ processes provides a signal for oocytes to complete the second meiotic division (meiosis II)? a. Fertilization b. Surge of FSH and LH c. Ovulation d. Second polar body formation e. First polar body formation

a. Fertilization

Which of the following terms best describes the basic structural and functional unit of the kidney that filters the blood and produces urine? a. Nephron b. Cortical labyrinth c. Renal lobule d. Renal pyramid e. Renal column

a. Nephron

You are conducting research on mechanisms on gonadal sex determination. What is the principal effect of testis-determining factor (TDF) on the development of the male reproductive system? a. Organization and differentiation of gonadal cords b. Development of male external genitalia c. Regression and loss of the uterus and uterine tubes d. Arrest of PGCs in prophase of meiosis I e. Differentiation of mesonephric tubules and ducts

a. Organization and differentiation of gonadal cords

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? a. Renal corpuscle b. Proximal convoluted tubule c. Distal convoluted tubule d. Collecting tubule glomerulus e. Loop of Henle

a. Renal corpuscle

Which of the following terms describes the female germ cell that is released into the uterine tube at the time of ovulation? a. Secondary oocyte b. Morula c. Zygote d. Oogonium e. Primary oocyte

a. Secondary oocyte

A 35-year-old pregnant woman asks for information regarding gender determination in her unborn child. You explain that the SRY gene on the Y chromosome encodes a protein that determines male gonadal sex and that female reproductive organ are inhibited from developing in male embryos by the müllerian-inhibiting factor (MIF). Which of the following cells in the embryo and fetus secrete this glycoprotein hormone? a. Sertoli cells b. Leydig cells c. Follicular cells d. Mesothelial cells e. Primordial germ cells

a. Sertoli cells

The secretory epithelium lining the endocervical canal in a woman of reproductive age would most likely exhibit which of the following patterns of differentiation? a. Simple columnar b. Stratified squamous c. Transitional d. Stratified columnar e. Simple squamous

a. Simple columnar

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 segments of the GI tract? a. Stomach b. Large intestine c. Rectum/anal canal d. Esophagus e. Small intestine

a. Stomach

The common laboratory test for pregnancy is based on the detection of a hormone that is synthesized and secreted by which of the following tissues/organs? a. Trophoblast of the conceptus b. Hypoblast of the developing embryo c. Epiblast of the developing embryo d. Corpus luteum of the maternal ovary e. Maternal pituitary (anterior lobe)

a. Trophoblast of the conceptus

Brunner's glands

alkaline secretion • Neutralizes pH of chyme entering from stomach; is protective in nature

A 27-year-old skydiver asks you about the physiology of the "adrenaline rush" that she experiences when jumping from airplanes. Which of the following neurotransmitters stimulates the release of adrenalins from chromaffin cells in the adrenal medulla? a. Serotonin b. Acetylcholine c. Glutamate d. Norepinephrine e. Dopamine

b. Acetylcholine

You are involved in a research project to investigate the mechanisms of fertilization. Hydrolytic enzymes that are necessary for sperm penetration of the zona pellucida are packaged in which of the following regions of the spermatozoan? a. Middle piece b. Acrosome c. Principal piece d. End piece e. Neck

b. Acrosome

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 identify 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? a. Plasma cells b. Chief cells c. Enteroendocrine cells d. Parietal cells e. Mucous cells

b. Chief cells

A 54-year-old woman presents with burning epigastric 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? a. Alcohol abuse b. Infection c. Tumor d. Emotional stress e. Aspirin use

b. Infection

What cell surface glycoprotein found on M cells suggests that these phagocytic cells present antigens to lymphocytes in the GI tract? a. CD4 b. MHC class II c. MHC class I d. IgM e. CD8

b. MHC class II

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? a. Nucleus ambiguous of the CNS b. Meissner plexus c. Sympathetic trunk d. Auerbach plexus e. Celiac ganglion

b. Meissner plexus

A 62-year-old man with a history of indigestion after meals and "heartburn" presents with upper abdominal pain. He is currently being treated with proton pump inhibitors for gastroesophageal 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? a. Goblet cells b. Parietal cells c. Paneth cells d. Enterocytes e. Chief cells

b. Parietal cells

Which of the following biological processes describes the primary function of the mesangial cells? a. Regulation of systemic blood pressure b. Phagocytosis and endocytosis c. Hormone synthesis and secretion d. Sodium/potassium homeostasis e. Maintenance of the glomerular filtration barrier

b. Phagocytosis and endocytosis

Androgen-binding protein (ABP) helps maintain a high concentration of testosterone within excurrent ducts and accessory glands of the male reproductive system. Which of the following cells in the adult testis secrete this important steroid-binding protein? a. Primary spermatocytes b. Sertoli cells c. Leydig cells d. Principal cells of the prostate e. Early and late spermatids

b. Sertoli cells

Clostridium perfringens

binds claudin; impairs junction, diarrhea due to loss of fluid

A 55-year-old man complains of muscle weakness and dizziness of 3 month's duration. His blood pressure is elevated (185/100 mm Hg). Endocrine studies reveal elevated serum levels of aldosterone. Cells in which of the following anatomic locations secrete this mineralocorticoid? a. Anterior pituitary b. Adrenal cortex, zona reticularis c. Adrenal cortex, zona glomerulosa d. Adrenal cortex, zona fasciculata e. Adrenal medulla

c. Adrenal cortex, zona glomerulosa

A 55-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? a. Adrenal cortex, zona fasciculata b. Adrenal cortex, zona glomerulosa c. Anterior pituitary d. Adrenal cortex, zona reticularis e. Neurohypophysis

c. Anterior pituitary

The parents of a 10-year-old boy are concerned about his weight loss following a flu-like illness. Urinalysis reveals glucosuria (glucose in the urine). His fasting blood glucose 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? a. Delta cells b. Alpha cells c. Beta cells d. PP cells e. F cells

c. Beta cells

A 75-year-old man with congestive heart failure complains 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? a. Extrahepatic bile ducts b. Intrahepatic bile ducts c. Centrilobular hepatocyte d. Portal vein e. Periportal hepatocytes

c. Centrilobular hepatocyte

A 41-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? a. Cholic acid b. Mucin c. Cholesterol d. Sodium chloride e. Bicarbonate

c. Cholesterol

Another of your monoclonal antibodies identifies proliferating stem cells in the gastric mucosa. You hope to use this antibody to isolate these progenitor cells using fluorescence-activated cell sorting (FACS). Which of the following locations in the mucosa provides a niche for multipotent gastric stem cells? a. Fundus of glandular epithelium b. Gastric pit c. Isthmus of glandular epithelium d. Neck of glandular epithelium e. Lamina propria

c. Isthmus of glandular epithelium

A 65-year-old alcoholic presents to the emergency room with 8 hours of severe abdominal pain and vomiting. Physical examination discloses exquisite abdominal tenderness. Serum levels of amylase and lipase are elevated. These laboratory data indicate that this patient has suffered injury to which of the following internal organs? a. Duodenum b. Stomach c. Pancreas d. Gallbladder e. Liver

c. Pancreas

During a small group seminar, you are asked to discuss pancreatic enzymes and their role in the digestion of food. Which of the following enzymes catalyzes the conversion of pancreatic proenzymes to active enzymes within the lumen of the duodenum? a. Phospholipase b. Alkaline phosphatase c. Trypsin d. Elastase e. Maltase

c. Trypsin

Examination of the fallopian tube reveals a mucosa lined by ciliated epithelial cells and nonciliated "peg" cells. Proteins secreted by the peg cells are believed to mediate which of the following biological functions related to fertilization? a. Lysis of the zona pellucida b. Block to polyspermy c. Formation of an endocervical plug d. Capacitation of sperm e. Sperm acrosome reaction

d. Capacitation of sperm

A 55-year-old woman complains of difficulty swallowing and a tendency to regurgitate his food. Further studies demonstrate a complete absence of peristalsis and failure of the lower esophageal sphincter to relax upon swallowing. These clinicopathologic findings are explained as a deficiency (or absence) of which of the following structures in the distal esophagus? a. Smooth muscle in the muscularis externa b. Presynaptic sympathetic nerves c. Presynaptic parasympathetic nerves d. Ganglion cells in the Auerbach plexus e. Ganglion cells in the Meissner plexus

d. Ganglion cells in the Auerbach plexus

Which of the following ovarian cells secretes a steroid hormone that stimulates the growth of uterine glands during the proliferative phase of the menstrual cycle? a. Granulosa lutein cells b. Theca externa cells c. Theca interna cells d. Granulosa cells e. Theca lutein cells

d. Granulosa cells

A 46-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 irritable 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 granules. These secretory vesicles most likely contain which of the following pancreatic hormones? a. Pancreatic polypeptide b. Glucagon c. Secretin d. Insulin e. Somatostatin

d. Insulin

The pancreas delivers an alkaline pH fluid to the duodenum that helps to neutralize the acidity of gastric juice, protect the small intestine, and provide an optimum pH for hydrolytic enzymes present in the lumen. What portion of the exocrine pancreas secretes most of this bicarbonate- and sodium-rich alkaline fluid? a. Pancreatic duct of Santorini b. Intralobular ducts c. Pancreatic duct of Wirsung d. Intercalated ducts e. Interlobular ducts

d. Intercalated ducts

When examined by electron microscopy, which of the following cytologic features best characterizes interstitial cells of Leydig? a. Apical membrane microvilli b. Segmented nuclei c. Glycogen vacuoles d. Intracellular lipid droplets e. Dense core secretory granules

d. Intracellular lipid droplets

Injury or inflammation affecting the canal of Herring in the liver lobule is associated with which of the following pathologic changes? a. Hypertrophy of smooth muscle in the ampulla of Vater b. Fibrosis of the common bile duct c. Gallstones (cholelithiasis) d. Intrahepatic bile lakes e. Fat droplets within hepatocytes

d. Intrahepatic bile lakes

During a hematopathology conference, you are asked to list and discuss the functions of the spleen. Which of the following cells removes senescent and defective RBCs from the circulation in the spleen? a. Endothelial cells b. Dendritic cells c. Kupffer cells d. Macrophages e. Reticular cells

d. Macrophages

A 32-year-old man presents with a 6-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? a. Chief cells b. Microfold cells c. Enteroendocrine cells d. Parietal cells e. Paneth cells

d. Parietal cells

On average, when examined by light microscopy, which of the following testicular cells is most abundantly represented in the seminiferous epithelium of an adult? a. Spermatogonia b. Secondary spermatocytes c. Sertoli cells d. Primary spermatocytes e. Leydig cells

d. Primary spermatocytes

During a clinical conference, you are asked to summarize the role of juxtaglomerular cells in maintaining a constant rate of glomerular filtration. Which of the following biological processes describes the function of JG cells in the kidney? a. Reabsorption of H2O from filtrate b. Monitoring Na+ in the filtrate c. Reabsorption of Na+ from the filtrate d. Secretion of renin e. Secretion of angiotensinogen

d. Secretion of renin

You are asked to discuss the hormonal regulation of testicular function during a clinical conference. Which of the following cells in the postpubertal testes have receptors for both FSH and testosterone and serve as the primary regulators of spermatogenesis? a. Leydig cells b. Spermatogonia c. Spermatocytes d. Sertoli cells e. Spermatids

d. Sertoli cells

Which of the following germ cells would be observed within the basal compartment of the seminiferous epithelium? a. Primary spermatocytes b. Spermatids c. Secondary spermatocytes d. Spermatogonia e. Spermatozoa

d. Spermatogonia

The concentration of urine in the collecting ducts is dependent on which of the following hormones? a. Angiotensin II b. Renin c. Angiotensin I d. Aldosterone e. ADH

e. ADH

A 52-year-old man presents with hematuria and bloody sputum. Over the next 3 days, he develops oliguria (decreased urine production) and renal failure. Laboratory analysis of serum collected from the patient will reveal autoantibodies directed against which of the following basement membrane proteins? a. Neph-2 b. Perlecan c. Laminin B d. α-Actinin-4 e. Collagen type IV

e. Collagen type IV

Which of the following maternal endocrine tissues/ organs secretes a hormone that controls the secretory phase of the uterine cycle and helps establishes a "window" for implantation of the blastocyst? a. Graafian follicle b. Posterior pituitary c. Anterior pituitary d. Adrenal cortex e. Corpus luteum

e. Corpus luteum

A 72-year-old diabetic man with chronic kidney disease complains of weakness and fatigue. Physical examination reveals marked pallor. The CBC reveals normocytic anemia. Which of the following best describes the pathogenesis of anemia in this patient? a. Chronic blood loss via the urine (hematuria) b. Increased destruction of circulating red blood cells c. Loss of erythrocyte progenitor cells from the bone marrow d. Inadequate supply of iron in the diet e. Decreased serum levels of erythropoietin

e. Decreased serum levels of erythropoietin

Which of the following biological processes accounts for the transformation of a primary to a secondary ovarian follicle? a. Proliferation of tissue macrophages b. Maturation of the zona pellucida c. Deposition of the extracellular matrix d. Formation of a second polar body e. Extracellular fluid accumulation

e. Extracellular fluid accumulation

You are invited to give a lecture on the pathology 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? a. Secretin b. Cholecystokinin c. Gastrin d. Leptin e. Ghrelin

e. Ghrelin

A vaginal smear is obtained from a 34-year-old woman who is undergoing in vitro fertilization. Which of the following cytologic features characterizes vaginal epithelial cells that are stimulated by estrogen during the menstrual cycle? a. Lamellar bodies b. Dense secretory granules c. Apical membrane microvilli d. Intracellular lipid droplets e. Glycogen-filled vacuoles

e. Glycogen-filled vacuoles

A 55-year-old malnourished man presents with a 5-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? a. Hepatocytes b. Cholangiocytes c. Endothelial cells d. Kupffer cells e. Hepatic stellate cells

e. Hepatic stellate cells

A 60-year-old woman with a history of chronic renal disease complains of bone and joint pain. Laboratory studies reveal hypocalcemia and vitamin D3 deficiency. Which of the following describes the most likely reason for vitamin D3 deficiency in this patient? a. Inability to excrete serum phosphate b. Insufficient supply of vitamin D in the diet c. Lack of adequate exposure to sunshine d. Excessive urinary loss of calcitriol (vitamin D3) e. Inadequate hydroxylation of calcidiol (vitamin D2)

e. Inadequate hydroxylation of calcidiol (vitamin D2)

An 8-year-old boy is brought to the physician by his parents who are concerned about the onset of puberty in their child. Physical examination reveals facial hair and enlargement of external male genitalia. Laboratory studies show elevated serum levels of testosterone. This patient may have a testosterone-producing tumor derived from which of the following endocrine cells? a. Follicular cells b. Sertoli cells c. Granulosa cells d. Chief cells e. Leydig cells

e. Leydig cells

During a research seminar, you are asked to discuss signaling molecules that control the development of the male reproductive system. Which of the following cells in the developing human embryo secrete a steroid hormone that stimulates the growth and differentiation of excurrent genital ducts, including the epididymis and vas deferens? a. Sertoli cells b. Primordial germ cells c. Follicular cells d. Spermatogonia e. Leydig cells

e. Leydig cells

A couple complains that they have been unable to conceive a child for the past 2 years. The man's sperm count is within the normal reference range. Electron microscopic examination of a sperm sample reveals a normal distribution of mitochondria. These intracellular organelles are located in which of the following regions of the spermatozoan? a. Neck b. Principal piece c. Acrosome d. End piece e. Middle piece

e. Middle piece

Which of the following structures serves as the primary site for reabsorption of water, electrolytes, amino acids, sugars, and polypeptides from the glomerular ultrafiltrate? a. Collecting duct b. Distal convoluted tubule c. Thin limbs of the long loop of Henle d. Thick descending limbs of the loop of Henle e. Proximal convoluted tubule

e. Proximal convoluted tubule

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? a. Duct of Wirsung b. Duct of Santorini c. Space of Mall d. Rokitansky-Aschoff sinus e. Space of Disse

e. Space of Disse

Proton pump inhibitors

e.g. Nexium: block acid production may cause dependency with long-term use

H2 receptor blockers

e.g. Tagamet: block histamine, decrease parietal cell activity including production of intrinsic factor

Carbonates

e.g. Tums, Rolaids: neutralize acid, long term and excessive use can can harm kidneys

blood-testis barrier

formed by tight junctions between Sertoli cells prevents immunological assault on sperm Basal versus Adluminal Compartments

Somatostatin

inhibits insulin and glucagon secretion

Somatostatin

inhibits insulin and glucagon secretion

Most lipids are absorbed through ________.

lacteals

Myenteric (Auerbach's) plexus

peristalsis

If flow in the DCT is low, macula densa cells stimulate the JG cells to secrete _______.

renin Renin acts via angiotensin II to increase blood pressure and increase filtration in the glomerulus • Angiotensin II also causes secretion of aldosterone whose action leads to increased blood volume

Stratum Functionalis

replaced every menstrual cycle

Hepatitis C

scarring of the liver and ultimately to cirrhosis • In some cases, those with cirrhosis will go on to develop liver failure, liver cancer or lifethreatening esophageal and gastric varices • HCV is spread primarily by blood-to-blood contact associated with intravenous drug use,

LH Surge leads to Ovulation and discharge of a ____________ with its Zona Pellucida & corona radiata cells attached.

secondary oocyte

Submucosal (Meissner's) plexus

sensory and control of submucosal glands

Ganglia and postsynaptic neurons of enteric system are located in the __________________ of GIT from esophagus to anus.

submucosa and muscularis externa

Helicobacter pylori

targets JAM and ZO-1, breaks epithelial barrier, stomach ulcers H Pylori releases urease. DX: stool sample, urease breath test

Most ____________ in the liver is found in the septa and portal tracts.

type I collagen

Prostatic cancer

• Affects primarily the peripheral zone • PSA (Prostate Specific Antigen) - No longer commonly used for routine screening - Single test at 60 yr & Annual rectal exam - Used to monitor treatment • Often metastasizes to vertebral column • Protective factors: - Sulphorane (broccoli) - Lycopene (tomatoes)

Space of Disse

• Between endothelial cells and hepatocytes (perisinusoidal space) • Contains microvilli of hepatocytes bathed in plasma • Provides access to nutrients from the blood • Porous endothelial walls allow passage of large proteins (albumin, fibrinogen) into the blood stream

Addison's disease

•Decreased cortisol production •AUTOIMMUNE •Symptoms: weight loss, sudden dizziness from having very low blood pressure, muscular pain •Increased pigmentation •May be fatal

Cushing's syndrome

•Excess of corticosteroids •Usually due to medications •Can (rarely) be due to overproduction of ACTH by a pituitary adenoma (Cushing disease) •Symptoms: weight gain in the face, above the collar bone and on the back of the neck (moon face, buffalo hump), thin limbs due to muscular atrophy, easy bruising, generalized weakness and fatigue, hypertension, andhyperglycemia.

Cortisol

•Produced by the zona fasciculata •Release triggered by ACTH in response to stress •Increases serum glucose, suppresses immune function, aids in protein and fat metabolism •Triggers surfactant production in the fetus

Dehydroepiandrosterone (DHEA)

•Produced by the zona reticularis •Released in response to ACTH •Androgen (only male hormone in women) •Production often decreases with age •Sometimes taken as a supplement

Pheochromocytoma

•Tumor of chromaffin cells •Excessive production of epinephrine •Symptoms: are EPISODIC: hypertension, headaches, hyperhidrosis, tachycardia, tachypnea, anxiety, nervousness, pain in the lower chest or upper abdomen, nausea, or heat intolerance •VMA urine test