Histology Midterm

1. In the adult, neurons are an example of which of the following?

Continuously dividing cells

Labile cells

Permanent cells

Quiescent cells

Stable cells

2. Histologic examination of normal skin demonstrates small numbers of perivascular cells, with darkly stained ovoid nuclei and granular cytoplasm on hematoxylin and eosin staining. The cells demonstrate metachromasia of the cytoplasm when stained with Giemsa stain. Which of the following products would these cells be most likely to secrete?

Bradykinin

Complement factor 3a

Histamine

Interleukin 2

Nitric oxide

3. A 27-year-old, 5-ft-10 in. a tall woman presents in the emergency room with a pneumothorax but is afebrile. On physical examination, it is noted that she has scoliosis, pectus excavatum, ectopia lentis, and myopia. Her musculoskeletal exam reveals long upper and lower extremities, including the fingers and toes, and an overall gangly, lanky appearance. Her arm-span (6 ft 3 in.) noticeably exceeds her height. She has very flexible fingers and a narrow face as well as a narrow mouth with overcrowded teeth. There are stretch marks across her buttocks. Which part of the cardiovascular system would often be adversely affected in this syndrome?

Middle cerebral artery

Basilar artery

Aorta

Lymphatic vessels

Superior vena cava

4. Most fascia of the body that attach to bones attach by which of the following mechanisms?

Blending with the covering periosteum

Inserting deeply into the cancellous bone

Inserting deeply into the cartilage

Inserting deeply into the diaphysis

Inserting deeply into the marrow

5. In the synthesis of collagen, the hydroxylation of proline and lysine occurs in which of the following?

Golgi apparatus

Secretory vesicles

Rough endoplasmic reticulum

Smooth endoplasmic reticulum

Lysosomes

6. A pregnant 29-year-old woman diagnosed with type I diabetes 2 decades ago, taking Humulin three times per day, is referred to the ophthalmology clinic. She is complaining of "floaters" and difficulty with night-time driving. Dilated indirect ophthalmoscopy coupled with biomicroscopy and fundus photography detect the presence of proliferative diabetic retinopathy with leaky retinal vessels indicative of increased vascular permeability, growth of new, fragile vessels on the retina and posterior surface of the vitreous and macular edema. Overexpression of fibronectin is a histological marker of diabetic microangiopathy. Which of the following is the primary function of fibronectin in the basement membrane?

Elasticity

Cell attachment and adhesion

Binding to selectins

Binding to cadherins

Binding to actin filaments

7. Infections in hyaline cartilage typically destroy the cartilage because:

Cartilage contains chondroitin sulfate

Cartilage contains collagen

Cartilage is not innervated

Cartilage is relatively avascular

Cartilage tends to become calcified

8. The extracellular matrix and the cytoskeleton communicate across the cell membrane through which of the following?

Proteoglycans

Integrins

Cadherins

Intermediate filaments

Microtubules

9. A 40-year-old woman is referred to a dermatologist with more than 100 oval or round red-brown macules on her back. There is a positive Darier's sign. The dermatologist takes a skin biopsy, which is stained with toluidine blue. There is an excessive number of the metachromatically stained cells labeled with the arrows and shown in the inset to the lower left in the photomicrograph below. Which of the following would be the most likely expected symptom in the patient?

Inhibition of HCl production by parietal cells

Darkening of the skin

Osteoporosis

Anemia

Edema

10. A premature infant develops progressive difficulty breathing over the first few days of life. Deficient surfactant synthesis by which of the following cell types may have contributed to the baby's respiratory problems?

Alveolar capillary endothelial cells

Bronchial mucous cells

Bronchial respiratory epithelium

Type I pneumocytes

Type II pneumocytes

11. A 33-year-old homeless woman has been living in an abandoned building eating dried meat, bread from the trash cans outside a bakery. She smokes cigarettes she "bums" from others. She presents at the free clinic with bleeding under the skin particularly around hair follicles with bruises on her arms and legs. She is irritable, clinically depressed, and fatigued with general muscle weakness. Her gums are bleeding, swollen, purple, and spongy. Her incisors and second molars are loose. She has an infected toe, which may be broken. She is afebrile and a glucose finger stick is normal and urine dipstick shows no sugar, protein or ketones. You suspect a vitamin deficiency. What might be the underlying mechanism for the symptoms in this patient?

Decreased degradation of collagen

Stimulation of prolyl hydroxylase

Formation of unstable collagen helices

Excessive callus formation in healing fractures

Organ fibrosis

12. A 40-year-old woman presents with a several-year history of progressive abdominal colic and constipation. Colonic biopsy stained with hematoxylin and eosin demonstrates deposition of a pink acellular material in the submucosa and around blood vessels. When sections from this biopsy are stained with Congo red, the acellular material exhibits green birefringence. The birefringence is thought to be most closely related to which of the following protein properties?

Ability to bind to oxygen

Beta-pleated sheet tertiary structure

Electrophoretic mobility

Hydroxyproline content

Molecular weight

13. A 24-year-old delivery driver is involved in an accident and sustains a wide abrasion over his left elbow. The abrasion results in the total loss of epidermis over a large area of his left arm, but one month later, the abrasion has healed, with regrowth of the epidermis. Which of the following mechanisms accounts for the restoration of the epidermis over the abraded area?

Growth of epidermis from hair follicles and sweat glands in the dermis

Migration of endothelial cells from newly grown capillaries

Transformation of dermal fibroblasts into epidermal cells

Transformation of macrophages into epidermal cells

Transformation of melanocytes into epidermal cells

14. A surgical pathology specimen from a 24-year-old woman seen at a reproductive medicine clinic demonstrates a ciliated columnar epithelium. From which of the following locations in the female genital tract was the biopsy obtained?

Cervix

Endometrium

Fallopian tube

Ovary

Vagina

15.
5. A 29-year-old man with reactive airway disease undergoes endobronchial biopsy. The biopsy material is prepared for light microscopy as well as electron microscopy. The cell pictured above in an electron micrograph stains reddish purple with toluidine blue. The cell depicted is most likely a(n):

Alveolar macrophage

Histiocyte

Mast cell

Type II pneumocyte

16. A 65-year-old African-American man who has a history of both urinary tract infections and urinary stones presents at the urology clinic with hematuria. He has a dietary history high in saturated fats and has been exposed to second-hand smoke both at home (his wife smokes) and at work where many of his coworkers smoke. His work as a machinist exposed him to metal parts. Before working as a machinist he worked as a commercial painter. Cystoscopy identified several bladder tumors and was followed by transurethral resection and biopsy (TURB). The biopsy shows a transitional cell carcinoma 4.5 cm. in diameter staged as "T3aN1M2." Which of the following would facilitate the processes involved in the "M2" classification?

Lysyl oxidase

Metalloproteinases

Plasminogen

Serpins

TIMPs

17. Which of the following sites contains striated muscle that is not under voluntary control?

Bladder

Colon

Esophagus

Gallbladder

Stomach

18.
14. Which of the following occurs at the darkly stained band indicated by the arrow?

Acrosome reaction

Aromatase acts on testosterone

Capacitation

Implantation receptors are exhibited

Meiosis is resumed

19. In which of the following organs are fenestrated endothelial cells common?

Heart

Liver

Lungs

Pancreas

Stomach

20.
10. Axons found around the area indicated by the arrow in the figure above are myelinated by:

Astrocytes

Dorsal root ganglion cells

Microglia

Oligodendrocytes

Schwann cells

21.
13. The modified structures at the border of the epithelium shown above are immotile in a 23-year-old patient. Which of the following would be a consequence of this lack of motility?

Implantation failure

Kartagener's syndrome

Malabsorption syndrome

Reduction in number of disaccharidases

Uptake and digestion of spermatid residual bodies

22. Routine chest x-ray of a worker in a tuberculosis sanitorium reveals a focal calcification initially thought to be a lung lesion. However, x-rays taken in different views establish that the abnormal calcification involves a structure other than the lung. Physiologic calcification of which of the following structures would most likely cause the radiologic shadow?

Aorta

Costal cartilage

Intercostal arteries

Intercostal veins

Vena cava

23. 1. A 27-year-old male presents to the doctor with complaints of "heartburn" and painful, sour-tasting acid reflux that has not been alleviated by over-the-counter medications. An endoscopic exam is performed and a biopsy of the distal esophagus is taken. Microscopic examination of the tissue shows normal tissue without pathologic changes. What type of mucosa is normal for the distal esophagus?

Ciliated, columnar epithelium

Keratinized, stratified, squamous epithelium

Non-ciliated, columnar epithelium

Non-keratinized, simple, squamous epithelium

Non-keratinized, stratified, squamous epithelium

Pseudostratified, columnar epithelium

24. 1. A 35-year-old male presents to the urologist for an infertility evaluation. A biopsy of his testis is performed to check sperm production and maturation. A microscopic section reveals only a few germ cells near the basal lamina in the seminiferous tubule. Which of the following cells is the germ cell closest to the basal lamina in the seminiferous tubule?

Primary spermatocyte

Secondary spermatocyte

Spermatid

Spermatogonia

Spermatozoa

25. Brunner's glands secrete an alkaline product that helps achieve optimal pH for the activity of pancreatic enzymes. Where are these glands located?

At the base of villi throughout the small intestine

In the epithelium of the ampulla of Vater

In the mucosa and submucosa of the jejunum

In the submucosa of the duodenum

In the submucosa of the ileum

26. Microscopic examination of a PAS-stained histological section through a Graafian follicle demonstrates a bright reddish-pink, acellular ring around the ovum. Which of the following terms most accurately describes this ring?

Corona radiata

Cumulus oophorus

Theca externa

Theca interna

Zona pellucida

27. A researcher is examining the distribution of an ion channel protein in the kidney. She incubates slices of kidney tissue in a dilute solution of a specific antibody directed against the protein, then uses the immunoperoxidase method to localize the ion channel proteins. She notes the presence of brown pigment in a population of epithelial cells, which on closer examination, have a brush border. The researcher concludes that the protein is probably present in cells of the:

Collecting duct

Deep portion of loop of Henle

Distal convoluted tubule

Glomerulus

Proximal convoluted tubule

28. The primary function of entactin (also known as nidogen) is to crosslink which of the following?

Laminin to collagen

Cells to the basal lamina

Cells to the extracellular matrix

Collagen

Actin

29. A 14-year-old boy presents with thin, translucent skin, and a history of easy bruising. Biochemical studies of the patient's dermal fibroblasts cultured from a skin biopsy show abnormal electrophoretic mobility and abnormal secretion of type III procollagen. A mutation in the COL3A1 gene is identified by molecular testing. Which of the following symptoms would be most expected in this patient?

Rupture of the intestinal or aortic walls

Hyperextensibility of the integument

Hypermobility of synovial joints

Increased degradation of proteoglycans in articular cartilages

Imperfections in dentin formation (dentinogenesis imperfecta)

30. Nissl bodies correspond to which of the following cytoplasmic organelles?

Golgi apparatus

Mitochondria

Nucleoli

Rough endoplasmic reticulum

Smooth endoplasmic reticulum

31. A 36-year-old man is referred by his family medicine physician to the pulmonary clinic. He complains of shortness of breath following physical activity and a decreased capacity for exercise. He says that strenuous exercise including yard work is impossible without sitting down and resting every few minutes. After he takes several deep breaths during the physical exam he begins to wheeze. He is not a smoker and as an office worker, he is not exposed to dust, fumes or other irritants at work. He appears slightly jaundiced. Serum alpha-1 antitrypsin (AAT) concentration is below normal and is followed up with alpha-1 antitrypsin phenotype and DNA testing indicating one copy of S and one of Z (SZ) mutations and 40% abnormal AAT protein production. Desmosine and isodesmosine are elevated in the urine. Desmosine and isodesmosine contribute to the elasticity of the lung by:

Cross-linking fibrillin

Cross-linking tropoelastin

Activating elastase

Inactivating AAT

Binding type IV collagen to elastin

32. A 55-year-old Caucasian man presented with generalized back pain. His physical examination reveals slight right-sided muscular weakness and a pulse of 78/min, regular; blood pressure 140/82 mm Hg. X-ray examination of the spine showed two wedged thoracic vertebrae, T7 and T8; no osteolytic lesions are observed. Peripheral blood: Hb 11 g/dL, WBC 6.0 m 109/l (polymorphs 81%, lymphocytes 16%, monocytes 2%, eosinophils 1%), platelets 300 m 109/1 (300 000/mm3). The blood film was normal. The bone marrow shows an increase in the cells shown in the accompanying light micrograph. Other tests were all normal. The cells in the light micrograph synthesize which of the following?

Collagen

Heparin and histamine

Histaminase

IgA

Myeloperoxidase

33.
12. The cell in the center of the electron micrograph above is important in wound healing and plays a role in the pathological process underlying Dupuytren's contracture. Which of the following cell types is depicted?

Endothelial cell

Myoepithelial cell

Myofibroblast

Pericyte

Smooth muscle cell

34. A male child is born with an absence of the normal structure labelled between the arrows; inclusions of that structure are found within the cells in the photomicrograph. He presents with refractory diarrhea and is chronically dependent on parenteral nutrition. What is the primary function of the structure labeled between the arrows in the photomicrograph below?

Extensive movement of substances over cell surfaces

Increase in surface area for absorption

Cell motility

Transport of intracellular organelles through the cytoplasm

Stretch

35. A 5-year-old boy falls off his bike and fractures his humerus. He is taken to the emergency room, and the bone is set by one of the emergency room physicians. Which of the following is responsible for producing the majority of the new bone that will reunite the two fragments?

Cancellous bone

Cartilage

Compact bone

Marrow

Periosteum

36. Microscopic examination of a section of a normal young adult ovary reveals large numbers of unusually large cells surrounded by a single layer of flat epithelial cells. In which phase of the cell cycle are these cells arrested?

Diplotene stage of the 1st meiotic division

Diplotene stage of the 2nd meiotic division

Metaphase stage of mitosis

Prophase stage of mitosis

Prophase stage of the 2nd meiotic division

37. Damage to which of the following structures might produce hair cell loss?

Basilar membrane

Organ of Corti

Reissner's membrane

Scala tympani

Scala vestibuli

38. Observation of a hematoxylin and eosin-stained microscope slide reveals that the nuclei are blue. What is the basis for this observation?

Eosin binds to carbohydrates

Eosin binds to lipids

Eosin binds to nucleic acids

Hematoxylin binds to lipids

Hematoxylin binds to nucleic acids

39. The tissue shown in the photomicrograph differs from white adipose tissue in which of the following ways?

Export of fatty acids

Role as a thermal insulator

Use of fatty acids to produce heat

Activation of the adenylate cyclase system

Initiation of shivering

40. Which of the following is a major contributor to the tensile strength of collagen?

Interactions with the FACIT collagens

The double helical arrangement of collagen

Electrostatic interactions

Intramolecular and intermolecular cross-links

Low concentrations of lysine

41. A 46-year-old woman who has been a type I diabetic for 35 years visits your family medicine office. She has foot ulcers on both her right and her left feet. You prescribe Beclaperin gel, a prescription drug for the treatment of diabetic foot ulcers. It contains a platelet-derived growth factor (PDGF). Which of the following is the most likely mechanism for the action of PDGF in the improvement of wound healing?

Acceleration of chemotaxis of monocytes-macrophages

Inhibition of vascular smooth-muscle cell proliferation

Inhibition of fibroblast proliferation

Inhibition of granulation tissue formation

Secretion of type II collagen from fibroblasts

42.
8. The photomicrograph shows a section of synovium from the knee joint of a patient with rheumatoid arthritis (RA). Which of the following are the most abundant cells in the inflammatory infiltrate?

Eosinophils

Langhans type giant cells

Lymphocytes and plasma cells

Neutrophils

Type A and B synovial cells

43. A 36-year-old Asian male complains of difficulty swallowing. Esophagoscopy reveals a polypoid mass that is subsequently biopsied. In addition to tumor cells, the esophageal biopsy show normal smooth muscle and striated muscle in the same section. Which portion of the esophagus was the source of this biopsy?

Lower esophageal sphincter

Lower third of the esophagus

Middle third of the esophagus

Upper esophageal sphincter

Upper third of the esophagus

44. Which of the following hormones is secreted by anterior pituitary cells that stain with acidic dyes?

ACTH

FSH

LH

Prolactin

TSH

45. Tropocollagen is not assembled in the cell because of which of the following?

Action of lysyl oxidase in the Golgi apparatus

Acidity of clathrin-coated vesicles

Presence of nonhelical registration peptides at the ends of the triple helix

Presence of specific collagenases in the RER and Golgi apparatus

Presence of specific inhibitors of peptidase activity in the Golgi apparatus

46. An AIDS patient develops symptoms of pneumonia, and Pneumocystis carinii is suspected as the causative organism. Bronchial lavage is performed. Which of the following stains would be most helpful in demonstrating the organism's cysts on slides made from the lavage fluid?

Alcian blue

Hematoxylin and eosin

Methenamine silver

Prussian blue

Trichrome stain

47. Which of the following tissues normally has the highest percentage of mucus-secreting cells?

Esophageal mucosa

Oral mucosa

Parotid gland

Sublingual gland

Submandibular gland

48. 1.

In this section of a healing bone fracture, which of the following best describes the cell at the arrow?

Apoptotic cell

Bone-lining macrophage

Dividing osteoblast

Necrotic cell

Typical osteoblast

49. Diseases in which there is a loss of function mutation in integrin expression on lymphocytes would most likely result in:

Leukopenia

Leukocytosis

Lymphadenopathy

Lymphocyte apoptosis

Increased numbers of plasma cells in the blood

50.
9. The leukocyte pictured above stains intensely with acidic dyes such as eosin. Which of the following substances is contained in the crystalline core of the granule at the arrow?

Lactoferrin

Major basic protein

Myeloperoxidase

Histamine

Tartrate-resistant acid phosphatase

51. A gastric biopsy is taken from a 42-year-old man. As the pathologist inspects the specimen, he observes numerous, normal cuboidal-to-columnar cells with apical membrane-bound secretion granules in the gastric glands. From which area of the stomach was the biopsy most likely taken?

Cardiac region

Columns of Morgagni

Fundic region

Greater omentum

Pyloric region

52.
6. Which of the labeled structures is responsible for the secretion of renin?

A

B

C

D

E

53. Laminin functions in which of following ways?

As an integrin

In cell-cell adhesion

As the insoluble scaffolding of the basal lamina

As the filtration molecule in the basement membrane

In adherence of epithelia to the basement membrane

54. Following a fracture of the humerus, an adult patient has a biopsy of the healing area. Which of the following types of bone will the biopsy most likely show?

Cancellous

Compact

Spongy

Trabecular

Woven

55. Which of the following is found in the respiratory zone of the lung?

Goblet cells

Main bronchi

Mucous cells

Terminal bronchioles

Type I epithelial cells

56.
4. What is the primary function of the cell pointed to in the figure above?

It produces low-molecular weight polypeptides

It secretes bactericidal enzymes

It secretes lipases

It secretes mucins

It secretes pepsinogen

57.
7. A 25-year-old man presents with a 4-cm mass above the clavicle. Chest X-ray demonstrates marked mediastinal widening. Excisional biopsy of the supraclavicular mass demonstrates areas with the appearance shown in the photomicrograph above. The large cell (indicated with the arrow) is most likely which of the following?

Langhans cell

LE cell

Mott cell

Reed-Sternberg cell

Touton cell

58. 1.
Which of the following products do the cells indicated above produce?

Alkaline phosphatase

Hydrochloric acid

Immunoglobulin

Major basic protein

Mucus

Surfactant

Von Willebrand's factor

Zymogen

59. A 32-year-old renal transplant patient who had been doing well on azathioprine and prednisone abruptly develops fever, chills, and cough productive of rust-colored sputum. A fiberoptic biopsy is performed that shows tissue destruction and areas suspicious for fungus. Which of the following special stains would best demonstrate fungal forms?

Gram's stain

Hematoxylin and eosin

Masson's trichrome

Methenamine silver

Ziehl-Neelsen stain

60.
11. The black line drawn across this photomicrograph of a seminiferous tubule represents the line of demarcation between which of the following ? Immediately above Immediately below

61. A pathologist is looking at a histological section of aorta stained to demonstrate the many wavy fibers that provide the aorta with the flexibility to stretch and then return to its original shape. These fibers are also found in substantial numbers in the

Biceps muscle