Histology Slides Covered Saturday, March 24, 2007 4:18 PM
• Pituitary ○ The pituitary consists of 2 distinct parts, neurohypophysis which develops as a downgrowth of the embryonic diencephalon (a part of the brain that will give rise to the hypothalamus). □ The hormones that are secreted from the neurohypophysis are synthesized by neurons
located in the supraoptic and paraventricular nuclei of the hypothalamus. The unmyelinated axons of these neurons pass through the median eminence and pituitary stem to end at axon terminals in the pars nervosa. The axon terminals lie in association with fenestrated capillaries in the pars nervosa and the vessels and axons are supported by pituicytes. Pituicytes are thought to be related to the glial cells of the CNS.
□
neurohypophysis
□
Unmyelinated axons
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□
pituicyte
□
Herring body
□
Blood vessel adenohypophysis which develops from the roof of the embryonic mouth (remember Rathke's pouch) □
The adenohypohysis contains blood vessels and cords of chromophobes and chromophils supported by a delicate connective tissue stroma.
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Connective tissue
□
Blood vessel
□
chromophobe □
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□
chromophils □
□
acidophil
□
basophils
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Thyroid Saturday, March 24, 2007 4:34 PM
• Thyroid ○ The thyroid gland consists of spherical units called the thyroid follicles which contain a homogeneous gel called colloid. Thyroglobulin is the principal constituent of colloid. Thyroxine and T3 are stored as iodinated tyrosine residues in the thyroglobulin molecule.
○ Follicles The follicles contain the colloid. A simple epithelium lines each of the follicles but the height of the epithelial cells and the size of the follicles can vary with the activity of the gland. The cells tend to be taller and the follicles smaller in diameter when the gland is most active. When the gland is more quiescent, the follicles tend to be larger and lined with shorter epithelial cells.
□
Follicular cells
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□
capillary
□
□
This is not a stratified e pithelium in the wa ll of a follicle. Instead, the sect ion has gone t angent ially t hrough t he simple epit helium in t he wall.
○ Parafollicular cells
The parafollicular cells are the pale staining, calcitonin secreting cells of the thyroid . They can be found within the follicle lining and sometimes in the connective tissue between the follicles.
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□
Parafollicular cell
Parafollicular cells
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□
Parafollicular cell
Parafollicular cell
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Adrenal Saturday, March 24, 2007 4:59 PM
• Adrenal ○ Cortex The adrenal cortex consists of 3 parts, the zona glomerulosa, the zona fasciculata and the zona reticularis. A ll 3 are involved in the production of steroid hormones. □
□
Zona glomerulosa
□
Zona fasciculata ◊
The zona fasciculata is the thickest part of the cortex, The ce lls are arranged radially in longitudinal rows (fasciculae). The cells are larger and lighter staining than the cells in
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longitudinal rows (fasciculae). The cells are larger and lighter staining than the cells in e ithe r the zona glomerulosa or the zona reticularis. This re gion of the cortex produces glucocorticoids and some androgen.
□
Zona fasciculata ◊
The cytoplasm in the ce lls of the zona fasciculata have a high content of small lipid droplets. The lipid is extracte d during tissue preparation giving the ce lls a frothy appearance and accounting for their lighter staining characte ristics.
□
Zona reticularis
In the zona re ticularis the ce lls a re a rranged in irregular cords that branch a nd merge with one a nother. The re gion produces androgens and glucocorticoids. The ce lls are smaller a nd more e osinophilic than the ce lls in the zona fasciculata. W hile they ca n re semble the ce lls in the zona glomerulosa they ca n be distinguished by their a rrangement into cords, whe re as the cells in the zona glomerulosa are a rra nged in circular a nd oval clusters. Use the higher m a gnification function to compare the appearance and orientation of the ce lls of the zona re ticula ris with tha t in the zona glomerulosa.
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□
Capillary
□
Capillary □
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□
capillary
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○ Medulla
The medulla consists of cells secreting epinephrine and norepinephrine in response to stimulation from preganglionic sympathetic fibres. □
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□
Medulla
□
Capillary
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□
Vein
□
Central vein □
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Urinary - Kidney Saturday, March 24, 2007 4:59 PM
• Urinary (Kidney, Ureter, Bladder) ○ Kidney The sample is a coronal section of a rodent kidney. This kidney has a single renal pyramid, in contrast to the human kidney with 15 of 20.
□ Renal corpuscle Regular: The renal corpuscle consists of a fenestrated capillary plexus known as a glomerulus, together with Bowmans capsule, the initial part of the urinary tubule.
◊
► Renal corpuscle
◊
► Parietal layer
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◊
► Urinary space
◊
► Podocyte
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◊
► Capillary
◊
► Mesangium
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â—Š
â–ş Mesangial cell
PAS staining: PA S stains basement membranes and can be useful for revealing some of MNU Page 20
PAS staining: PA S stains basement membranes and can be useful for revealing some of the relationships of structures in the renal corpuscle.
◊
► Urinary space
◊
► Parietal layer
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◊
► Podocyte
◊
► Mesangium
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◊
► Endothelium
◊
► Mesangial cell
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□ Convoluted tubules
The proximal and distal convoluted tubules make up the bulk of the cortex giving circular and oval profiles in sections. They are lined with a simple cuboidal epithelium. The proximal tubules are longer than the distal tubules and so more of their outlines are seen.
◊
► Proximal tubule
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◊
► Proximal tubule
◊
► Distal tubule
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◊
► Distal tubule
◊
► vessel
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◊
► Macula densa
◊
► Macula densa
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◊
► Macula densa
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PA S Staining
◊
► Proximal tubule
◊
► Apical border
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► Apical border
◊
► Distal tubule
◊
► Vessel
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◊
► Macula densa ◊
◊
► Macula densa
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□ Loop of henle
The loop of Henle consists of thick and thin segments and occupies the pyramids of the medulla and the medullary rays of the cortex. ◊
► Thick descending
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◊
► Thick ascending
◊
► Thin segment
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◊
► Thin segment
◊
► Capillary ◊
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◊
► Thin segment
PA S staining: The features of the loops of Henle can also be distinguished in the section stained with PA S.
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◊
► Thick descending
◊
► Thick ascending
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◊
► Thin segment
◊
► Capillary
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◊
► Thin segment
◊
► Capillary
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□ Collecting ducts and tubules
The collecting tubules are located in the medullary rays and in the medulla. They are lined with a simple cuboidal epithelium. There is a gradual transition to the collecting ducts which are mainly located in the medulla and lined with simple columnar epithelium. ◊
◊
► Collecting tubule
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◊
► Thick ascending
◊
► Thick ascending
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◊
► Collecting tubule
◊
► Thick ascending
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◊
► Collecting duct
◊
► Collecting tubule
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◊
► Collecting duct
◊
► Collecting duct
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PA S Staining: Collecting tubules and ducts in the medulla. ◊
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◊
► Collecting tubule
◊
► Collecting tubule
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◊
► Collecting duct
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Urinary - Ureter Saturday, March 24, 2007 5:53 PM
○ Ureter The calyces and the ureters share the same basic histological features in the wall
□ Muscosa □ The mucosa of the ureter consists of transitional epithelium resting on a lamina propria of
ordinary connective tissue. In the relaxed state the mucosa of the ureter is typically folded.
◊ Mucosa
◊ Transitional epithelium
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◊ Squamous cell
◊ Lamina propria
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□ Muscularis □
The muscularis of the ureter consists of an inner longitudinal layer and an outer circular layer. A s the ureter approaches the bladder, a third, outermost, longitudinal layer sometimes appears.
◊ Muscularis
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◊ Smooth muscle
◊ Smooth muscle
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◊ Smooth muscle
□ Adventitia □
The outermost layer to the ureter is an adventitia of ordinary connective tissue that connects the ureter to adjacent structures.
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ď‚Ž
â—Š adventitia
2006-02-01
A nnotation
Slide Text
Adve ntitia
Annotation De scription
The a dventitia is the outer connective tissue layer of the ureter. It ble nds imperceptibly into the loose connective tissue surrounding the orga n.
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Show
Urinary - bladder Saturday, March 24, 2007 5:53 PM
○ Bladder The wall of the bladder is very similar to that in the ureter, although the muscularis layer is not as well organized.
□ Mucosa □ A transitional epithelium supported on a lamina propria of ordinary connective tissue.
◊ Transitional epithelium
◊ Lamina propria
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◊ Squamous cell Mucosa
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A nnotation
Slide Text
Transitional Epithelium
Annotation De scription
As in the ureter the superficial cells of the transitional epithelium can appear squamous if the wall of the baldder is stretched.
2006-02-01
A nnotation
Slide Text
Lam ina Propria
Annotation De scription
The lamina propria is the connective tissue layer of the m ucosa that supports the e pithelium.
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A nnotation
Slide Text
Squamous Cell
Annotation De scription
An e x ample of squamous- shaped cells in the transitional epithelium of the bladder.
□ Muscularis □
The muscularis of the bladder consists of loosely arranged bundles of smooth muscle cells.
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Show
Show
Show
◊ Smooth muscle
◊ Smooth muscle
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◊ Smooth muscle
Muscularis
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A nnotation
Slide Text
Sm ooth Muscle
Annotation De scription
Tra nsverse section of smooth muscle bundle in the muscularis la ye r.
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A nnotation
Slide Text
Sm ooth muscle
Annotation De scription
La rge r bundles of smooth muscle in tra nsverse section in the m uscularis
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A nnotation
Slide Text
Sm ooth Muscle
Annotation De scription
O ute rmost layer of smooth muscle cut in transverse section.
□ Adventitia □
The outer connective tissue layer of the bladder wall.
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Show
Show
Show
ď‚Ž Adventitia
2006-02-01
A nnotation
Slide Text
Adve ntitia
Annotation Description The adventitia is an ordinary connective tissue.
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Pancreas Saturday, March 24, 2007 4:59 PM
• Pancreas ○ The pancreas is a mixed-function organ with both exocrine and endocrine components.
Exocrine Pancreas □ The exocrine pancreas consists of multiple spherical acini producing pancreatic digestive enzymes. The enzymes are release into a duct system which conveys them to the duodenum.
◊ Acinus
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◊ Pancreatic acinar cell
◊ Centroacinar cell
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◊ Small intralobular duct
◊ Large intralobular duct
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Endocrine Pancreas □ Regular staining: The endocrine pancreas consists of the spherical islets of Langerhans which synthesize pancreatic hormones and release them into the circulation.
◊ Islet of langerhans
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◊ Capillary
◊ Endocrine islet cell
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◊ Autonomic ganglion
□ Gormori Staining: The Gormori stain helps to differentiate the insulin-secreting beta cells (grey cytoplasm) from the glucagon-secreting alpha cells (pink cytoplasm).
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◊ Islet of langerhans
◊ Beta cells
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◊ Alpha cell
◊ Alpha cell
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◊ capillary
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Esophagus Saturday, March 24, 2007 4:59 PM
• Esophagus ○
The histological features of the e sophagus outlined in a transverse section.
○ Mucosa The mucosa consists of a stratified squamous non-keratinized epithelium, a lamina propria of
ordinary connective tissue and a muscularis mucosa that consists of only a single longitudinal layer of smooth muscle.
□
SSE (Stratified Squamous Epithelium)
□
Lamina propria MNU Page 67
Lamina propria
□
Papilla
□
Muscularis muscosa
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□
Lymphocytes
□
Papilla
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□
○ Submucosa
The submucosa of the esophagus contains submucosal glands. □
□
Submucosa
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□
Mucous gland
□
Duct
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□
○ Muscularis Externa
The muscularis externa consists of an inner circular layer and an outer longitudinal layer. Skeletal muscle fibres may be found in the muscularis in the upper part of the esophagus. □
□
Muscularis externa
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□
Myenteric plexus
□
Myenteric plexus
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□
Skeletal muscle
□
Striated muscle
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□
Smooth muscle
□
Muscle cells
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□
Skeletal muscle fibre
□
Smooth muscle cells
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□
Multipolar neuron
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○ Adenventitia
The adventitia of the esophagus is an ordinary connective tissue that anchors the organ to surrounding structures. □
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□
Adventitia
□
Unmyelinated nerve fibres
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□
Nerve fibres
□
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Stomach Saturday, March 24, 2007 4:59 PM
• Stomach ○ The outermost layer of the stomach is a serosa. The inner layer of the muscularis is thickened at the gastroduodenal junction to create the pyloric sphincter. The submucosa and mucosa are thrown into folds called rugae. The mucosa includes the gastric pits and the gastric glands.
Mucosa □ The mucosa of the stomach consists of a simple columnar epithelium resting on a lamina
propria of connective tissue. The muscularis mucosa is typical. The epithelium penetrates the lamina propria to form gastric pits and gastric glands.
◊ Gastric Pit
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◊ Smooth muscle
◊ Parietal cell
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◊ Chief cells
◊ Lumen
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◊ Parietal cell
◊ Chief cell
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◊ Lamina propria
◊ Gastric glands
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◊ Lamina propria
◊ Mucous neck cells
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◊ Mucous surface cells
◊ Smooth muscle
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Intestine Saturday, March 24, 2007 4:59 PM
• Intestine ○ Small Intestine The different regions of the small intestine share many common features in the layers that make up their wall. There are certain features however, that help to distinguish between the various regions.
□ Mucosa The mucosa of the intestine consists of a simple columnar epithelium containing a variety of
different cell types. The lamina propria is well vascularized and includes lymphatic capillaries called lacteals as well as blood vessels. The muscularis mucosa is typical. ◊
◊
► Enterocytes
◊
► Enteroendocrine cell
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◊
► Enteroendocrine cell
◊
► Paneth cell
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◊
► Enteroendocrine cell
◊
► Paneth cell
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◊
► Lymphocyte
◊
► Brush border
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◊
► Goblet cell
◊
► Lacteal
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◊
► Smooth muscle
◊
► Capillary
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◊
► Lacteal
◊
►
Paneth cells
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◊
► Muscularis mucosa ◊ Mucosa
2006-0208
A nnotation
Slide Text
Ente rocyte s
Show
Annotation The villi are covered and the crypts are lined with a simple columnar De scription e pithelium. Enterocytes and goblet cells are among the m ost common of the ce lls covering the villi. Enterocytes are also known as columnar absorptive cells. They contribute to the digestive process through digestive e nzymes bound to their apical cell membranes and they are also re sponsible for absorbing the products of digestion.
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A nnotation
Slide Text
Ente roe ndocrine Cell
Show
Annotation Basal eosinophilia and an apical nucleus and apical basophilic cytoplasm is De scription a k e y to re cognizing the e nteroendocrine ce ll. 2006-0208
A nnotation
Slide Text
Ente roe ndocrine Cell
Show
Annotation The re are a variety of hormone producing enteroendocrine ce lls. They De scription re le ase their secre tions into the adjacent lamina propria whe re they have paracrine affects on neighbouring ce lls or whe re they gain access to the circulatory system to have affects on more distant parts of the digestive syste m. 2006-0208
A nnotation
Slide Text
Paneth Cell
Show
Annotation Paneth cells are abundant in the crypt bases in the small intestine. De scription 2006-0208
A nnotation
Slide Text
Ente roe ndocrine Cell
Show
Annotation The enteroendocrine cells secrete hormones that play a role in co De scription ordinating the activities of other regions in the digestive system into the lam ina propria. Their secretory granules are also very eosinophilic. However, since they are secreted into the lamina propria they are stored on the basal side of the nucleus, adjacent to the basement m embrane. 2006-0208
A nnotation
Slide Text
Paneth Cell
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Show
Annotation Paneth cells are common deep in the crypts along with goblet cells, De scription ente roendocrine cells and crypt base columnar epithelial cells. Paneth cells secrete lysozyme and defensins into the crypts. The secretory granules are stored in the cell apex and are very eosinophilic. The apical secretory granules force the cell nucleus and rough ER into a basal position in the cell. These secretions help to lyse bacteria in the small intestine. 2006-0208
A nnotation
Slide Text
Lym phocyte
Show
Annotation The round dark nuclei that are a common finding in the epithelium of the De scription sm all intestine belong to intra-epithelial lymphocytes that have wandered into the epithelium. 2006-0208
A nnotation
Slide Text
Brush Border
Show
Annotation The apical band on the enterocytes is re ferred to as a brush border. It De scription indicates the presence of microvilli in the ce ll membranes. The m icrovilli incre ase the apical surface are a of cell membrane for absorption. 2006-0208
A nnotation
Slide Text
Goble t Cell
Show
Annotation Goble t cells synthesize m ucous, store it in their apice s and secrete it into De scription the lumen whe re it forms a protective sheet over the e pithelial ce lls. 2006-0209
A nnotation
Slide Text
Lacte al
Show
Annotation The smooth muscle bundles in the villi not only help m anipulate the villi to De scription incre ase the e fficiency of absorption (stirring the pot so to speak), they also help promote the circulation of chyle in the lymphatic capillaries.
2006-0209
A nnotation
Slide Text
Sm ooth Muscle
Show
Annotation The lamina propria of the small intestine is an ordinary connective tissue De scription rich in lym phocytes, plasma ce lls, and wandering granulocytes. Bundles of sm ooth m uscle ce lls are also common, extending from the muscularis m ucosa into the villi. 2006-0209
A nnotation
Slide Text
Capillary
Show
Annotation Blood and lymphatic vessels are abundant in the lamina propria, extending De scription into the cores of the vili. 2006-0209
A nnotation
Slide Text
Lacte al
Show
Annotation The lymphatic capillaries that extend into the villi are called lacteals. The De scription e osinophilic m aterial inside this particular example is due to coagulated lym ph - not re d blood cells. Lymphatics may contain lymphocytes, but not R BCs.
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A nnotation
Slide Text
Paneth cells
Show
Annotation The basal nucleus and basal basophilic cytoplasm with apical acidophilic De scription cytoplasm is a key to re cognizing the Paneth cells. 2006-0209
A nnotation
Slide Text
Muscularis Mucosa
Show
Annotation The m ucosa of the small intestine includes a typical muscularis m ucosa De scription with an inner circular layer (fibres cut in cross section toward the top of the box) and an outer longitudinal layer (cut in long section toward the bottom of the box).
ď‚Ž
Epithelial Renewal
Intestinal epithelial cells have a life span in the order of 4 to 6 days. The crypt base columnar cells are the stem cell population that works to renew the other cell types as they wear out.
â—Š
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◊
► Mitotic figure
◊
► Mitotic figure ◊
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◊
► Paneth cell
◊
► Paneth cells
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◊
□ Submucosa Submucosa ◊
The submucosa of the small intestine is a layer of connective tissue that supports the mucosa. The submucosa and the mucosa form multiple folds called the plicae circulares that partially encircle the lumen. These folds are most prominent in the jejunum and least obvious in the ileum. Mucous-secreting Brunners glands are a characteristic of the submucosa in the duodenum. Lymphoid follicles called Peyers patches are a characteristic of the mucosa in the ileum. ►
►
Submucosa
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►
Brunner's Gland
Peyer's Patches ◊
Lymphocytes are frequently found in the lamina propria of the GI tract. In the ileum, they typically occur in lymphoid follicles that become so large that they break out of the lamina propria and extend into the submucosa. These are Peyers patches and they are a characteristic feature of the ileum.
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►
Peyer's patch
►
Smooth muscle
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►
Muscularis mucosa
►
Smooth muscle
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►
○ Large Intestine The most obvious features in the large intestine are the lack of villi in the mucosa and the large number of goblet cells in the epithelium.
□ Mucosa
The mucosa of the large intestine lacks the villi that are a characteristic of the small intestine. Crypts of Lieberkuhn are present, but the predominating cell type is the goblet cell.
◊
► Crypt of Lierberkuhn
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► Epithelium ◊
► Brush border
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◊
►
Enteroendocrine cell
◊
► Paneth cell
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◊
►
Enteroendocrine cell
◊
► Lamina propria
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◊
► Muscularis mucosa
◊
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Male Reproductive System - Seminal Vesicle and Prostate Gland Saturday, March 24, 2007 4:59 PM
• Male Reproductive System - Seminal Vesicle and Prostate Gland ○ The 2 seminal vesicles and the prostate gland are the glands that produce the bulk of the seminal fluid.
Seminal Vesicle □ The two seminal vesicles are coiled glands that empty into the vasa deferentia. Between them they account for about 60% of the volume of the seminal fluid.
◊ Seminal Vesicle
◊ Mucosa
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◊ Epithelium
◊ Lamina Propria
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Prostate Gland □
The prostate gland surrounds the urethra and the ejaculatory ducts (an ejaculatory duct is the part of a vas deferens that penetrates the prostate to open into the prostatic part of the urethra).
◊ Prostate
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◊ Capsule
◊ Epithelium
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◊ Smooth muscle cell
◊ Prostatic Glands
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яВо
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Male Reproductive System - Testicle Saturday, March 24, 2007 8:56 PM
• Male Reproductive System - Testicle ○ The testicle is surrounded by a dense capsule of connective tissue, known as the tunica albuginea. Septae from the capsule divide the testicle into lobules which contain the seminiferous tubules, surrounded by interstitial connective tissue.
Seminiferous Tubule □ Each lobule of the testicle contains between 1 and 4 seminiferous tubules. These are made up of a modified, stratified epithelium consisting of spermatogenic cells and Sertoli cells. The spermatogenic cells include the spermatogonia and cells in various stages of spermatogenesis.
◊ Myoid Cell
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◊ Primary spermatocyte
◊ Sertoli cell
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◊ Sertoli Cell
◊ Residual Bodies
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◊ Spermatozoon
◊ Spermatid
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◊ Primary Spermatocyte
◊ Type B Spermatogonium
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◊ Pale Type A Spermatogonium
◊ Dark Type A Spermatogonium
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◊ Basement Membrane
◊ Myoid Cell
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◊ Myoid Cell
◊ Sertoli cell
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Interstitial Connective Tissue □
The interstitial connective tissue fills in the spaces between the seminiferous tubules in the lobuli of the testis. The steroid-secreting Leydig cells and a rich plexus of fenestrated capillaries lie within the interstitial connective tissue.
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◊ Leydig cell
◊ Leydig Cell
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◊ Venule
◊ Leydig Cell
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◊ Leydig cell
◊ Arteriole
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яВо
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Male Reproductive System - Epididymis and Vas Saturday, March 24, 2007 8:56 PM
Male Reproductive System - Epididymis and Vas ○ The histological features of the epididymis and the vas deferens.
Epididymis □ The epididymis receives and stores the spermatozoa from the testicle. While in the
epididymis, the spermatozoa undergo a functional maturation process, developing the ability to swim. A lthough the epididymis is only about 1 inch in length overall, inside is a coiled tube of approximately 20 feet in length.
◊ Capsule
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◊ Epidymal Tubule
◊ Epididymal Tubule
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◊ Interstitial Connective Tissue
◊ Smooth Muscle
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◊ Epithelium
◊ Principal Cells
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◊ Stereocilia
◊ Basal Cells
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Vas Deferens □
The vas deferens connects the epididymis with the urethra. It is one of the contents of the spermatic cord. The part of the vas deferens that passes through the prostate gland is referred to as the ejaculatory duct.
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◊ Vas Deferens
◊ Mucosa
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◊ Muscularis
◊ Inner Longitudinal Layer
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◊ Circular layer
◊ Outer Longitudinal Layer
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◊ Adventitia
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яВо
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Female Reproductive System - Uterus and Uterine Tube Saturday, March 24, 2007 7:40 PM
• Female Reproductive System ○ Uterus and uterine tube Both the uterus and the uterine tube consist of 3 basic layers, a mucosa, a muscularis, and a serosa. □
Uterus Uterus - Proliferative Phase ◊ The mucosal layer of the uterus is referred to as the endometrium. It is divided into the
stratum functionalis, which is sloughed during menstruation, and the stratum basalis which is the source of tissue for regeneration of the stratum functionalis. The muscularis of the uterus is referred to as the myometrium. A thin serosa covers the muscularis.
►
Serosa
►
Cervical crypt
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►
Cervical crypt
►
Uterine glands
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►
Simple Columnar Epithelium
►
Lamina propria
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►
Uterine gland
►
Endometrium
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►
Myometrium
►
Cervical wall
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ď‚Ž Cervix â—Š
This section of the cervix includes the inferior end that opens into the vagina. Note the abrupt transition from the simple columnar epithelial lining of the cervical canal and the stratified squamous non-keratinized epithelium that faces into the vagina. â–ş
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Cervical crypt
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Collagenous connective tissue
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Epithelial transition
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Uterus - Secretory Phase ◊
This is a section of the uterus in the secretory (luteal phase). The endometrium is swollen, the uterine glands are quite coiled, and the lining of the epithelial cells quite pale due to the accumulation of glycen depositis in the cytoplasm ►
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Endometrium
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Uterine glands
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Simple columnar epithelial cells
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Helicine artery
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Helicine artery
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Helicine artery
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Helicine artery
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Uterine Tube
The uterine tube consists of a highly folded mucosa, a muscularis including inner circular and outer longitudinal layers and a serosa. ◊
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► Mucosa
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► Mucosal folds
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► Ciliated cell
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► Muscularis
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► Smooth muscle fibers
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► Serosa
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Female Reproductive System - Ovary Saturday, March 24, 2007 8:15 PM
○ Ovary The ovary is surrounded by a covering of peritoneum, called the germinal epithelium. Beneath the germinal epithelium lies a dense connective tissue capsule called the tunica albuginea. The cortex makes up the outer part of the ovary and contains the follicles. The core or medulla of the organ consists mainly of a very vascular loose connective tissue.
□ Primordial Follicles
Primordial follicles are the least developed follicles in the ovary. They consist of a primary oocyte and a single layer of flattened follicular cells. ◊
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◊ Primordial Follicles
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◊ Follicluar Cell Nucleus ◊
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◊ Primary Oocyte
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□ Primary Follicles Primary Follicles ◊
When primordial follicles begin to advance in development, they convert first to primary follicles. Primary follicles consist of a primary oocyte surrounded by a cuboidal to columnar epithelium of follicular cells. A t first this is a single layer of cells, but with further development the follicular cells form a stratified epithelium. The follicular cells are also known as the granulosa cells. A n extracellular matrix called the zona pellucida develops between the primary oocyte and the innermost layer of follicular cells. Surrounding the layers of follicular cells is a condensation of the ovarian connective tissue called the theca. ◊
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► Primary Follicle
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► Theca
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► Zona pellucida
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► Primary Follicle
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► Primary Oocyte
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► Nucleus
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► Zona Pellucida
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Stratification of follicular (granulsosa) cells ◊
This example demonstrates the stratification of the follicular (granulosa) cells that is also a feature of the primary follicle. ◊
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► Primary Follicles
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► Zona Pellucida
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► Theca ◊
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► Primary Follicle
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► Primordial Follicle
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□ Secondary Follicles Secondary Follicle ◊
Secondary follicles are characterized by the appearance of fluid-filled spaces among the stratified follicular cells. These spaces will coalesce into a single chamber called the antrum in larger secondary follicles. ◊
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► Early Secondary Follicle
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► 7 - Theca Externa
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► 6 - Theca Interna
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► Theca
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► 2 - Follicular Fluid
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► 4 - Zona Pellucida
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► 3 - Primary Oocyte
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► 8 - Large Secondary Follicle
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► Antrum
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► Cumulus Oophorus
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► Mural Follicular Cell
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► 13 - Theca Externa
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► 12 - Theca Interna
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Additional Examples ◊
A dditional Examples of secondary follicles ◊
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► Secondary Follicle
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► Primary Oocyte
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► Zona Pellucida
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► Follicular Fluid
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► Theca Interna
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► Theca Externa
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□ Corpus Luteum Corpus Hemorrhagicum ◊
A t ovulation, the secondary oocyte and the first polar body are relased from the ovary surrounded by the zona pellucida and an enveloping layer of granulosa cells referred to as the corona radiata. The remains of the follicle, namely the theca and the mural follicular cells form the corpus luteum. ◊
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► Ruptured Follicle
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Corpus Luteum ◊
A s the blood clot in the antrum of the corpus hemorrhagicum is removed and replaced with fibrous tissue, the walls of the follicle collapse inward and become folded. The granulosa cells enlarge and secrete progesterone as well as estrogen. They are referred to as granulosa lutein cells. The cells of the theca interna begin secreting estrogens and progesterone as well as androgen. They are referred to as theca lutein cells. ◊
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► Residual Antrum
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► Granulosa Lutein Cell
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► Theca Lutein Cell
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Female Reproductive System - Breast Saturday, March 24, 2007 8:15 PM
○ Breast Non-Pregnant Breast □
The non-pregnant breast consists of the ducts of 15 to 20 breast lobes that open on the nipple. There is typically little development of the tubulo-alveolar glandular units that produce the breast secretion. The tissue between the ducts consists mainly of fibrous connective tissue and adipose tissue.
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Lactiferous Duct
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Duct Branches
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Adipose Tissue
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Skin
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Lactating Breast □
During pregnancy, the duct system elongates and branches extensively and secretory alveoli develop at the ends of the duct branches. A ll of this growth takes place at the expense of the connective tissue which becomes reduced to fibrous septae between the lobules of the breast lobes. □
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Breast Lobule
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Connective Tissue Septum
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Alveolus
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Plasma Cell
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Lymphocyte
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Lymphocyte
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Myoepithelial Cell
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Myoepithelial Cell
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Epithelial Cell
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Plasma Cell
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Liver Saturday, March 24, 2007 4:59 PM
• Liver ○ The liver is divided up into structural units called the liver lobules. The lobules are made up of hepatocytes and liver sinusoids. The sinusoids receive blood from the hepatic arterial system and the portal venous system. The arterial and venous blood mixes in the sinusoids of the lobule and drains into the central veins at the core of the lobule. The central veins in turn drain into the hepatic venous system.
Portal Areas □ The portal areas are found at the corners of the polygonal liver lobules. Each contains a hepatic arteriole, portal venule and a branch of the bile duct.
◊ Portal area
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◊ Hepatic arteriole
◊ Bile duct
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◊ Portal venule
◊ Bile duct
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◊ Bile duct
◊ Portal area
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◊ Hepatic arteriole
◊ Portal venule
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◊ Bile duct
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Hepatocytes and Sinusoids □
The hepatocytes and the sinusoids are found within the substance of the liver lobule.
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◊ Sinusoid
◊ Endothelial cell nucleus
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◊ Central vein
◊ Hepatocyte
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◊ Hepatocyte
◊ Polyploid nucleus
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яВо
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Gallbladder Saturday, March 24, 2007 4:59 PM
• Gallbladder ○ The gall bladder serves to store and concentrate bile. It also releases bile in response to cholecystokinin secreted by enteroendocrine cells of the duodenum. The cholecystokinin release is triggered by the presence of fat in the contents of the duodenum. Although it is an outgrowth of the digestive canal, there is no submucosa in the gall bladder, and there is no muscularis mucosa in the mucosa layer.
Muscosa □ The mucosa of the gall bladder is thrown into parallel folds when the organ is less full. The
folds spread out as it becomes more filled with bile. The mucosa consists of a simple columnar epithelium, supported on a well-vascularized lamina propria of connective tissue. A lthough it is an outgrowth of the digestive canal there is no muscularis mucosa in the mucosa of the gall bladder. Nor is there a submucosa to separate the mucosa from the muscularis externa.
◊ Mucosal folds
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◊ Epithelium
◊ Lamina propria
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Muscularis and Serosa □
The muscularis of the gall bladder consists of irregularly arranged bundles of smooth muscle fibres. The outermost layer is a serosa or adventitia, depending on the presence of a covering peritoneum
◊ Muscularis
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◊ Adventitia
◊ Liver
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◊ Serosa
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Parathyroid Saturday, March 24, 2007 4:59 PM
• Parathyroid ○ The parathyroid glands are typically found embedded within the capsule of the thyroid gland on its posterior surface, although occasionally they can be buried within the substance of the thyroid. The glands contain 2 main cell types, the chief cells and the oxyphils. These cells tend to cluster together into groups. The cells are supported by a delicate vascular connective tissue and the gland is surrounded by a thin connective tissue capsule which separates it from thyroid gland. Connective tissue septae penetrate the gland from the capsule dividing it into irregular lobules. With age, adipose tissue begins to infiltrate the interior of the gland.
□ Capsule
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□ Septum
□ Lobule
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□ Chief cell
□ Chief cell
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□ Oxyphil
□ Oxyphil
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□ Adipose
□ Fat cell First
A nnotation
Slide Text
C a psule
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Annotation De scription
The parathyroids have a thin delica te connective tissue capsule separating them from the thyroid gland.
Second
A nnotation
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Se ptum
Annotation De scription
Se pta e of connective tissue penetrate the parathyroid to separate the gland into irre gula r lobules.
Third
A nnotation
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Lobule
Annotation
Pa ra thyroid lobule
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show
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Annotation De scription
Pa ra thyroid lobule
Fourth
A nnotation
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C hie f Cell
Annotation De scription
The chief cells, also k nown a s principal ce lls are relatively small. They have e osinophilic cytoplasm and a round ce ntral nucleus.
Fifth
A nnotation
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C hie f Cell
Annotation De scription
The chief cells a lso contain lipid and glycogen droplets in their cytoplasm. These inclusions ca n extra ct during tissue prepara tion giving the cytoplasm of some chie f ce lls a vacuolated a ppeara nce.
Sixth
A nnotation
Slide Text
O x yphil
Annotation De scription
The oxyphil ce lls a re larger than the chief ce lls and have intensely eosinophilic cytopla sm. They usually occur in clusters among the chief ce lls.
Seventh
A nnotation
Slide Text
O x yphil
show
show
show
show
Annotation De scription
Eighth
A nnotation
Slide Text
Adipose
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Annotation De scription
Fa t ce lls a re a normal finding in the parathyroid glands. They normally incre ase with a ge , cre ating patches of a dipose in the glands.
Nineth
A nnotation
Slide Text
Fa t C e ll
Annotation De scription
Isolated fat ce ll.
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True-False-Answers-Past-Exams-MNU.docx Thursday, March 29, 2007 3:05 AM
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LDL particles are generated in plasma following catabolism of IDL particles a: True VLDL is metabolized in the circulation following hydrolysis of VLDL triglyceride, a step inhibited by ApoCIII a: True Mutations in the LDL receptor or the ApoB ligand can lead to hypercholesterolemia and are relatively common a: True Hepatic clearance of LDL particles in plasma only requires the interaction of LDL particles with LRP (LDL receptor related protein) a: FALSE LDL particles can not bind LRP due to the absence of ApoE a: True
Increased plasma ApoB is a hallmark of metabolic dyslipidemia a: True Hypercholesterolemia is a common feature of metabolic dyslipidemia a: FALSE! Metabolic dyslipidemia is an important component of the metabolic syndrome a: True Hypertriglyceridemia is a key feature of metabolic dyslipidemia a: True
LCAT mediates esterification of free cholesterol to form cholesterol ester in HDL a: True Cholesterol uptake by HDL from perihperal tissues is mediated by ABC-A1 transporter a: True Triglyceridemia enrichment of HDL3 particles is mediated by the action of CETP and results in the formation of larger HDL2 particles a: True Hepatic LCAT mediates selective cholesteryl ester uptake from HDL a: True Diabetes now regarded as CHD risk equivalent was a key feature of the ATP III guidelines a: True Higher triglyceride classification cut points were a key feature of the ATP III guidelines a: FALSE! Recommendations to use Framingham projections of 10-year CHD risk were a key feature of the ATP III guidelines a: True Higher cut-off point for HDL-cholesterol were a key feature of the ATP III guidelines a: True Identify patients with multiple risk factors for more intensified treatment were a key feature of the ATP III guidelines a: True
Increased plasma ApoB together with a small dense LDL particle profile are strong risk factors for development ischemic heart disease a: True An elevated ApoB/ApoAI ratio can be regarded as a positive cardiovascular risk factor a: True Presence of an ApoE4/E4 genotype is associated with hypertrilyceridemia due to development of dysbetalipoproteinemia (Type III hyperlipidemia) a: FALSE! q:
- TypeIII means both cholesterol and triglyceride are sig. increased in the blood due to increased presence of remnant VLDL particles (IDL)
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Homozygosity for apoE2 is associated with a recessive form of familial dysbetalipoproteinemia , although only a minority of apoE2/2 homozygotes actually develops hyperlipidemia
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Lipoprotein (a) has been shown to be a strong predictor of atherosclerotic disease in some epidemiological studies a: True q:
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High plasma homocysteine may be directly related to atherosclerosis development and appears to be linked to reduced folic acid, B12, and/or B6 vitamins a: True q:
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http://www.clevelandclinicmeded.com/ccjm/sept1999/ccjmoneminutesep99.htm - argues that Lp (a) screening shouldn't be done routinely
The connection between homocysteine and cardiovascular disease was suspected about 25 years ago when it was observed that people with a rare condition called homocystinuria are prone to develop severe cardiovascular disease in their teens and twenties. In this condition, an enzyme deficiency causes homocysteine to accumulate in the blood and to be excreted in the urine. Recent studies suggest that elevated blood homocysteine levels are as important as high blood cholesterol levels and c an operate independently. Some 10% to 20% of cases of coronary heart disease have been linked to elevated homocysteine levels. Both hereditary and dietary factors may be involved. - Pasted from <http://www.quackwatch.org/03HealthPromotion/homocysteine.html> Abnormal elevation also occurs among people whose diet contains inadequate amounts of folic acid, vitamin B6, or vitamin B12. Regardless of the cause of the elevation, supplementation with one or more of these vitamins can lower plasma levels of homocysteine.
Statin drugs work by lowering plasma cholesterol level by inhibiting low density lipoprotein receptor expression a: FALSE! Ezetimibe added to a statin drug is more likely to achieve the desired LDL cholesterol treatment target than doubling the dose of the same statin drug a: True Niacin is the more effective agent in raising HDL cholesterol levels but it paradoxically raises LDL cholesterol in a majority of the patients a: FALSE!
Thyroid hormones become more important in normal growth after 4 years of age a: FALSE! Deiodinase 1 is primarily involved in the local formation of T3 in tissues a: FALSE! Exposure of the newborn infant to cold leads to a rapid decrease in thyroid activity a: FALSE! Thyroid hormone is important for milk production in humans a: True Administration of a somatostatin agonist will increase pituitary TSH secretion a: FALSE!
Levels of testosterone are higher in the peripheral circulation than in the spermatic vein a: FALSE! Inhibin is produced by the sertoli cell and is primarily involved in inhibiting LH secretion a: FALSE! Testosterone bound to the androgen receptor is less stable than the dihydrotestosterone-androgen receptor complex a: True The Leydig cell produces androgen binding protein which helps maintain local levels of testosterone a: FALSE! 5Îą-reductase Type 1 is primarily found in reproductive tissues a: FALSE!
The testis do not produce large amounts of cortisol because it does not contain 17,20 lyase a: FALSE! The normal adrenal (zona fasciculata) does not produce large amounts of androgen due to the presence of high levels of 17,20 lyase a: FALSE! Pregnenolone is converted to progesterone in the endoplasmic reticulum by 3β-hydroxysteroid dehydrogenase a: True The ovarian thecal cell depends on the granulosa cell for the provision of androgen a: FALSE! In human pregnancy, the majority of estrogen produced by the placenta is estradiol FALSE!
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During implantation cytotrophoblasts actively invade into the decidua and can be found in the maternal lung a: FALSE! The umbilical vein carries deoxygenated blood and the umbilical artery carries oxygenated blood a: FALSE! Placental lactogen is low in the mother and high in the fetus and diverts glucose to the placenta a: FALSE! The placenta does not exhibit 17,20 lyase activity a: True Progesteron in the decidual tissue increases vascularization to facilitate implantation a: True
Regarding combination oral contraceptive a: True Regarding combination oral contraceptive a: True Regarding combination oral contraceptive a: True Regarding combination oral contraceptive a: True Regarding combination oral contraceptive a: FALSE!
pills, they prevent fertility with 100% effectiveness in most women pills, they offer some protection against endometrial cancer pills, they offer some protection against ovarian cancer
pills, they carry a significant risk for thromboembolic disease pills, they carry a significant risk for hypolycemia, especially in diabetics
A patient had to switch from combination oral contraceptive medication to triphasic formulation that provided higher estrogen and progestin doses at discrete intervals because a blood clot was found in her leg (does this make sense)? a: FALSE (doesn’t make sense) A patient had to switch from combination oral contraceptive medication to triphasic formulation that provided higher estrogen and progestin doses at discrete intervals because she experienced a great deal of mid-cycle vaginal bleeding? a: True, this a possible reason for switching A patient had to switch from combination oral contraceptive medication to triphasic formulation that provided higher estrogen and progestin doses at discrete intervals because she had persistent symptoms of nausea and migraine headache q: FALSE (doesn’t make sense) A patient had to switch from combination oral contraceptive medication to triphasic formulation that provided higher estrogen and progestin doses at discrete intervals because she had drug dependent acne? a: FALSE (doesn’t make sense) A patient had to switch from combination oral contraceptive medication to triphasic formulation that provided higher estrogen and progestin doses at discrete intervals because she developed severe hypertension? a: FALSE (doesn’t make sense)
Secretin stimulates pancreatic duct cells to release HCO3a: True Secretin is released from the S cells in the small intestine in response to acidification a: True Cholecystokinin CCK stimulates acinar cells directly to release pancreatic enzymes a: FALSE! Proteolytic enzymes are released from acinar cells in an inactive (zymogen) form a: True Lipase is released frot he pancreas in active form a: True
Albumin synthesis is a function of the liver True
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a: True Conjugation of bilirubin is a function of the liver a: True Synthesis of coagulation factors is a function of the liver a: True Synthesis of immunoglobulins is a function of the liver a: True Glycogen synthesis from glucose is a function of the liver a: True Encephalopathy secondary to accumulation of ammonia is a complication of liver disease a: True Cirrhosis (scarring of the liver) is a complication of liver disease a: True Portal hypertension with enlarged spleen is a complication of liver disease a: True Jaundice (yellowness) is a complication of liver disease a: True Decreased CCK release is a complication of liver disease a: FALSE!
In trying to find the root cause, if a patient was hospitalized and appeared to drift off to sleep frequently, you would likely check his feces for melena (upper GI blood loss with black tarry motions) a: True In trying to find the root cause, if a patient was hospitalized and appeared to drift off to sleep frequently, you would likely empty and sterilize his colon with lactulose and neomycin, both taken by mouth a: True In trying to find the root cause, if a patient was hospitalized and appeared to drift off to sleep frequently, you would likely double his dietary protein intake as red meat to make up for his increased requirements a: FALSE! In trying to find the root cause, if a patient was hospitalized and appeared to drift off to sleep frequently, you would likely give him frequent small meals of carbohydrate to minimize rises in blood glucose but reduce body protein breakdown a: True In trying to find the root cause, if a patient was hospitalized and appeared to drift off to sleep frequently, you would likely check for infected ascites (fluid in the abdomen) a: True
High incidence of lactase deficiency occurs among Asians, Africans and in Southern Mediterranean countries, but may also appear in previously lactose-tolerant Caucasians as they get older a: True Slowly increasing your intake of milk will improve your nutrition as lactase can be induced to increase in amount and activity a: FALSE! Symptoms of lactose intolerance are dependent on the size of lactose load entering the duodenum over time, which is regulated by the gastric emptying. Fat in enriched ice cream slwos down gastric emptying, which allows some individuals to tolerate the lactose load a: True Mild symptoms of lactose intolerance include flatus and abdominal distension, caused by colonic fermentation of unabsorbed lactose (H2 and CO2 production), while more severe symptoms of diarrhea and intestinal cramps are due to osmotic effects of excess lactose in the small bowel. a: True Other malabsorbed carbohydrates mimic lactose intolerance and these include chewing gums from artificial sweeteners, very large amounts of fructose, and non-digestible carbohydrates in legumes a: True
Chief cells secrete bicarbonate ions? FALSE!
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a: FALSE! Chief cells secrete Hydrochloric Acid (HCl) a: FALSE! Chief cells secrete trypsin a: FALSE! Chief cells secrete pepsinogen (inactive form) a: True Chief cells secrete amylase a: FALSE!
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Which one of the following drugs is most likely to have a clinically important adverse interaction with hepatic cytochrome P450: Cimetidine, Ranitidine, Famotidine, Pantoprazole, Domeperidone? a: Cimetidine
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Hyperglycemia can cause water to shift out of cells a: True Excretion of large amounts of ketoacid anions in urine contributes to increased urine sodium loss and reduction in extracellular fluid volume a: True
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On insulin administration, a: True On insulin administration, a: True On insulin administration, a: True On insulin administration, a: FALSE! On insulin administration, a: FALSE!
muscle and fat cells will show accelerated glucose uptake from the blood liver glycogen reserves will be built up
the rate of gluconeogenesis will decline acetyl CoA levels will rise in liver mitochondria to sustain ketogenesis the activity of glycogen phosphoylase will decline in muscle and fat cells
The rationale for the use of undernutrition as a strategy used in treating Type I diabetics before 1922-23 was that the use of fewer calories than needed per day reduces hyperglycemia and ketonemia a: True The rationale for the use of undernutrition as a strategy used in treating Type I diabetics before 1922-23 was that undernutrition was designed principally to lower ammonia and urea production a: FALSE! The rationale for the use of undernutrition as a strategy used in treating Type I diabetics before 1922-23 was that undernutrition for Elizabeth Hughes meant a diet of low fat red meat and high fat nuts and vegetables, such as avocadoes, to promote muscle mass a: FALSE! The rationale for the use of undernutrition as a strategy used in treating Type I diabetics before 1922-23 was that the diet focused principally on protein with the exclusion of fat and carbohydrates to eliminate the need for fat mobilization a: FALSE! The rationale for the use of undernutrition as a strategy used in treating Type I diabetics before 1922-23 was that the diet excluded protein and fat to reduce transdeamination reactions that utilized ammonia as substrate? a: FALSE!
The absence of glucose in the urine would make a diagnosis of diabetes unlikely a: FALSE! In the presence of high fasting glucose levels and high HbA1c levels, it is likely that the hyperglycemia has been present for three months or more a: True
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If a patient has an HDL-C <0.9 mmol/L a: True If a patient has an HDL-C <0.9 mmol/L a: True If a patient has an HDL-C <0.9 mmol/L a: FALSE! If a patient has an HDL-C <0.9 mmol/L a: True If a patient has an HDL-C <0.9 mmol/L a: True
(low), (s)he can raise it by increased exercise (low), (s)he can raise it by body weight reduction
(low), (s)he can raise it by increased sugar intake as a proportion of energy (low), (s)he can raise it by increased monounsaturated fat intake (low), (s)he can raise it by increased soy consumption
If a patient has a TG level above 3.00 mmol/L a: True If a patient has a TG level above 3.00 mmol/L a: True If a patient has a TG level above 3.00 mmol/L energy a: True If a patient has a TG level above 3.00 mmol/L a: FALSE! If a patient has a TG level above 3.00 mmol/L a: True
(raised), (s)he can lower it by increased exercise
(raised), (s)he can lower it by body weight reduction (raised), (s)he can lower it by decreased sugar intake as a proportion of
(raised), (s)he can lower it by increased alcohol consumption (raised), (s)he can lower it by increased soy consumption
Lowering the glycemic index of the carbohydrate foods eaten will reduce HbA1c concentration a: True Eating diets containing more viscous fibre (oats, barley, etc.) will reduce HbA1c concentration a: True Losing weight will reduce HbA1c concentration a: True Increasing exercise will reduce HbA1c concentration a: True Only cutting out all foods in the diet containing fructose will reduce HbA1c concentration a: FALSE A patient’s exposure to sunlight is NOT a consideration when ergocalciferol (Vitamin D2) is used therapeutically a: FALSE! (It is a consideration!) A patient’s renal function is NOT a consideration when ergocalciferol (Vitamin D2) is used therapeutically a: True (It is NOT a consideration!) A patient’s liver function is NOT a consideration when ergocalciferol (Vitamin D2) is used therapeutically a: True (It is NOT a consideration!) Co-therapy with glucocorticoids is NOT a consideration when ergocalciferol (Vitamin D2) is used therapeutically a: True (It is NOT a consideration!) Co-therapy with anticonvulsants is NOT a consideration when ergocalciferol (Vitamin D2) is used therapeutically a: True (It is NOT a consideration!)
PTH stimulates secretory activity of the osteoblast a: True PTH stimulates 25-hydroxylation of Vitamin D in the kidney a: FALSE! PTH stimulates osteoclast activity a: True PTH stimulates renal reabsorption of calcium from the distal tubule a: True PTH stimulates increased flux of calcium into plasma from bone fluid a: True
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Hypertriglyceridemia is a common feature of diabetic dyslipidemia which is also associated with low plasma HDL-C a: True Increased plasma ApoE is a hallmark of diabetic dyslipidemia a: FALSE! New ATPIII guidelines have classified diabetes as a CHD risk equivalent a: True
HDL-C tends to be low when plasma triglyceride is high a: True Some HMG-CoA reductase inhibitors significantly reduce plasma triglyceride while increasing plasma HDL-C a: True Triglyceride enrichment of HDL3 particles is mediated by the action of LCAT and results in the formation of larger HDL2 particles a: FALSE! Triglyceride-enriched HDL2 particles are a substrate for hepatic lipase a: True
Increased plasma ApoB together with a small dense LDL particle profile are strong risk factors for the development of ischemic heart disease a: True Lipoprotein (a) is considered as an independent risk factor for CHD a: True High plasma homocysteine may be directly related to atherosclerosis development and appears to be linked to reduced folic acid, B12, and/or B6 vitamins. a: True Presence of an ApoE4/E4 genotype is associated with hypertriglyceridemia due to development of dysbetalipoproteinemia (Type III hyperlipidemia) a: FALSE!
Increased intake of beef will tend to reduce LDL cholesterol a: FALSE! Increased intake of plant sterols will tend to reduce LDL cholesterol a: True Increased intake of raw or dry roasted nuts will tend to reduce LDL cholesterol a: True Increased intake of soy protein food will tend to reduce LDL cholesterol a: True Increased intake of viscous fibre (oats, barley, etc.) will tend to reduce LDL cholesterol a: True
HDL synthesis is initiated by the synthesis of ApoAI which binds cholesterol forming discoidal (having a flat circular shape) HDL a: True Discoidal HDL requires lipoprotein lipase (LPL) to form mature HDL a: FALSE! HDL2 interacts with the scavenger receptor (SR-BI) in the liver allowing for selective cholesterol ester uptake a: True Mutations in LCAT can significantly reduce reverse cholesterol transport leading to low plasma HDL-C a: True
Patients with Type 2 diabetes mellitus are at no added risk for coronary heart disease as long as they maintain good glycemic control a: FALSE! A combination of elevated triglyceride and low HDL-C is entirely uncharacteristic of lipoprotein changes seen in diabetics. Therefore, an alternate cause for these changes must be sought in a diabetic patient with slightly high total cholesterol, low HDL-C, high triglyeride, and high calculated LDL-C. FALSE!
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cholesterol, low HDL-C, high triglyeride, and high calculated LDL-C. a: FALSE! Statins are the only lipid modifying drugs with clinically proven efficacies in reduce the coronary risk for a patient with slightly high total cholesterol, low HDL-C, high triglyeride, and high calculated LDL-C. a: FALSE!
Administration of somatostatin would suppress IGF-1 levels. a: True Administration of dexamethasone would decrease cortisol levels. a: True Administration of somatostatin would not affect TSH levels a: FALSE! Administration of insulin to induce hypoglycemia would increase a patientâ&#x20AC;&#x2122;s cortisol levels a: True Administration of TRH would increase a patientâ&#x20AC;&#x2122;s prolactin levels a: True
The most likely cause for a patient experiencing headaches, occasional episodes of blurred vision, and irregular periods over the last couple of months would be elevated plasma ACTH, LH and FSH concentrations. a: FALSE! The most likely cause for a patient experiencing headaches, occasional episodes of blurred vision, and irregular periods over the last couple of months would be elevated plasma prolactin and reduced LH and FSH concentrations a: True The most likely cause for a patient experiencing headaches, occasional episodes of blurred vision, and irregular periods over the last couple of months would be elevated plasma prolactin, LH and FSH concentrations a: FALSE! The most likely cause for a patient experiencing headaches, occasional episodes of blurred vision, and irregular periods over the last couple of months would be elevated growth hormone and reduced LH and FSH concentrations a: FALSE! The most likely cause for a patient experiencing headaches, occasional episodes of blurred vision, and irregular periods over the last couple of months would be elevated growth hormone, LH and FSH concentrations FALSE!
The placenta lacks the enzyme aromatase a: FALSE! Estradiol is the primary estrogen in pregnancy a: FALSE! Progesterone levels in the maternal plasma can be used as an index of fetal health a: FALSE! Androgens secreted by the fetal liver will be converted to estrogen in the placenta a: True The ovary is a critical source of progesterone throughout pregnancy a: FALSE!
A child is now two years old and was breast fed when younger, thus it was reasonable to give this child a source of iron (cereal foods) after six months of exclusive breast feeding a: True A child is now two years old and was breast fed; as the child was born in the winter, it was appropriate to give her a vitamin D supplement a: True A child is now two years old and was breast fed; however, by 9 months the child was excessively fat and the mother was correct to give her skim milk exclusively a: FALSE! A child is now two years old and was breast fed; in addition, the child was weaned onto rice and vegetables because it was considered wise to delay the introduction of wheat gluten into the diet a: True A child is now two years old and was breast fed; in addition, it made sense to keep solid foods such as large boiled
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candies and nuts out of the reach of this child to avoid the risk of choking. a: True
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The liver is the only organ that synthesizes albumin a: True The liver is the only organ that conjugates bilirubin a: True The liver is the only organ that synthesizes bile salts a: True The liver is the only organ that synthesizes immunoglobulins a: FALSE! The liver plays a major role in urea production from ammonia a: True
Fat is broken down in the stoamch into smaller particles (<1mm) by the process of emulsification a: True Cholecystokinin stimulates bicarbonate secretion by pancreatic ductal cells and gallbladder contraction for the unlaoding of bile acids into the duodenum a: FALSE! Bicarbonate, co-lipase and bile acids are critical in optimizing pancreatic lipase activity a: True The fatty acids traverse the unstirred water layer within micelles formed by the bile acids a: True Fatty acids are re-conjugated in the intestinal epithelial cell and packaged into chylomicrons for export to the circulation a: True
Ascites is NOT a parameter suggesting that hepatic drug metabolism may be impaired. a: FALSE! Hypoalbuminemia is NOT a parameter suggesting that hepatic drug metabolism may be impaired. a: FALSE! ALT = 135 is NOT a parameter suggesting that hepatic drug metabolism may be impaired. a: True (It is NOT a parameter) PT twice the upper limit of normal is NOT a parameter suggesting that hepatic drug metabolism may be impaired. a: FALSE! Jaundice is NOT a parameter suggesting that hepatic drug metabolism may be impaired. a: FALSE!
A patient who has been a heavy alcohol drinker for the past 15 years would MOST LIKELY be deficient in ascorbate (Vitamin C) a: FALSE! A patient who has been a heavy alcohol drinker for the past 15 years would MOST LIKELY be deficient in Nicotinic Acid a: FALSE! A patient who has been a heavy alcohol drinker for the past 15 years would MOST LIKELY be deficient in B12 a: FALSE! A patient who has been a heavy alcohol drinker for the past 15 years would MOST LIKELY be deficient in Folate a: True! A patient who has been a heavy alcohol drinker for the past 15 years would MOST LIKELY be deficient in Pyridoxine (Vitamin B6) a: FALSE!
Alcoholics are typically MOST LIKELY to be deficient in Ascorbate (C) FALSE!
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a: FALSE! Alcoholics are typically MOST LIKELY to be deficient in nicotinic acid a: FALSE! Alcoholics are typically MOST LIKELY to be deficient in B12 a: FALSE! Alcoholics are typically MOST LIKELY to be deficient in folate a: True Alcoholics are typically MOST LIKELY to be deficient in Pyridoxine (B6) q: FALSE!
If someone has ingested excessive acetaminophen, then taking a drug that induces hepatic CYP3A4 will contribute to further damage to their liver a: FALSE! If someone has ingested excessive acetaminophen, then taking a drug that inhibits CYP3A4 will contribute to further damage to their liver a: FALSE! If someone has ingested excessive acetaminophen, then having a genetic polymorphism that makes one a â&#x20AC;&#x153;slow metabolizerâ&#x20AC;? for the hepatic CYP2D6 pathway will contribute to further damage to their liver a: FALSE! If someone has ingested excessive acetaminophen and, due to a genetic polymorphism, their hepatic capacity for glucuronidation is twice as high as the mean for his/her age group, then this will contribute to further damage to their liver a: FALSE! If someone has ingested excessive acetaminophen and has been exposed to some additional xenobiotic agent that depletes hepatic glutathione, then this will contribute to further damage to their liver a: True
A fasting blood sample may reveal a slightly raised fasting blood glucose concentraiton a: True A fasting blood sample may reveal a low Hb concentration a: True A fasting blood sample may reveal a raised serum insulin concentration a: True A fasting blood sample may reveal an above normal NH3 concentration a: True A fasting blood sample may reveal high branched chain (insulin sensitive) amino acid levels a: FALSE!
Ethanol is a good caloric fuel for liver a: True Metabolism of ethanol would initially generate acetaldehyde by the action of alcohol dehydrogenase a: True Levels of liver NADH would be increased in a hypoglycemic crisis a: True Levels of pyruvate and oxaloacetate would be elevated in liver in a hypoglycemic crisis a: FALSE! The rate of gluconeogenesis would be compromised in a hypoglycemic crisis a: True
One of the things to consider in dietary treatment of a Type 2 diabetic, elderly patient, prior to prednisone treatment would be weight reduction a: True One of the things to consider in dietary treatment of a Type 2 diabetic, elderly patient, prior to prednisone treatment would be consumption of low glycemic index foods True
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a: True One of the things to consider in dietary treatment of a Type 2 diabetic, elderly patient, prior to prednisone treatment would be consumption of viscous soluble fiber foods (eg. Oats, barley) a: True One of the things to consider in dietary treatment of a Type 2 diabetic, elderly patient, prior to prednisone treatment would be low saturated fat (less than or equal to 7% of dietary calories) a: True One of the things to consider in dietary treatment of a Type 2 diabetic, elderly patient, prior to prednisone treatment would be consumption of fish oil capsules a: FALSE! (this would not be something to consider)
Being overweight increases oneâ&#x20AC;&#x2122;s risk for Type 2 diabetes? a: True Type 2 diabetics typically have decreased levels of C peptide in their plasma as compared to normal individuals a: True Type 2 diabetics may exhibit symptoms of dehydration secondary to osmotic diuresis a: True In a patient taking prednisone, hyperglycemia may be due, in part, to the effects of prednisone to increase proteolysis a: True Immediate rehydration of a Type 2 diabetic with saline will reduce their hpyerlgycemia thorugh its effects on kidney function a: FALSE!
Crystalline zinc insulin is often administered by subcutaneous injection a: True Crystalline zinc insulin may be administered by intravenous injection a: True Crystalline zinc insulin must be administered several times each day to control blood sugar effectively a: True Crystalline zinc insulin has a prolonged duration of action when combined with protamine a: True When mixed with insulin, protamines slow down the onset and duration of insulin action (see NPH insulin). Pasted from <http://en.wikipedia.org/wiki/Protamine>
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Crystalline zinc insulin has actions that are antagonized by propranolol (a beta-adrenergic antagonist) a: FALSE!
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After insulin administration, a: True After insulin administration, a: FALSE! After insulin administration, a: True After insulin administration, a: True After insulin administration, Krebs cycle a: True
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fat mobilization in adipocytes is shut down hormone sensitive lipase in liver is active (in a phosphorylated state) few or no calories are derived from fatty acids as fuel compounds
the carnitine shuttle system is inactive in liver most of the energy needs of liver are met using glucose, with glycolysis feeding into the
Following HumulinTM administration, there is increased entry of glucose into insulin-sensitive tissues facilitated by increased numbers of glucose transporters at the cellular plasma membranes a: True Following HumulinTM administration, there is increased synthesis of glycogen, and increased liver glycogen stores
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a: True Following HumulinTM administration, there is increased synthesis of malonyl CoA generated by the active (dephosphorylated) form of acetyl CoA carboxylase a: True Following HumulinTM administration, there is increased utilization of citrate in the cytoplasm as a substrate in the production of cytoplasmic acetyl CoA a: True Following HumulinTM administration, there is increased rates of long chain fatty acid synthesis utilizing fatty acid synthase, a complex enzyme carrying the coenzyme biotin a: FALSE! Prosthetic groups of Fatty Acid Synthase include: • the thiol of the side-chain of a cysteine residue in the Condensing Enzyme domain of the complex. • the thiol of phosphopantetheine, which is equivalent in structure to part of coenzyme A (structures at right & below). Pasted from <http://www.rpi.edu/dept/bcbp/molbiochem/MBWeb/mb2/part1/fasynthesis.htm>
The input to fatty acid synthesis is acetyl-CoA, which is carboxylated to malonyl-CoA. The ATP-dependent carboxylation provides energy input. The CO 2 is lost later during condensation with the growing fatty acid. The spontaneous decarboxylation drives the condensation.
Acetyl-CoA Carboxylase catalyzes the 2-step reaction by which acetyl-CoA is carboxylated to form malonyl-CoA.
As with other carboxylation reactions (e.g., Pyruvate Carboxylase), the enzyme prosthetic group is biotin. ATP-dependent carboxylation of the biotin, carried out at one active site (1), is followed by transfer of the carboxyl group to acetyl-CoA at a second active site (2). Pasted from <http://www.rpi.edu/dept/bcbp/molbiochem/MBWeb/mb2/part1/fasynthesis.htm>
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Amino acids can be synthesized using glutamate and appropriate carbon skeletons a: True Transamination reactions are important in the synthesis of amino acids a: True ALT utilizes pyruvate and glutamate in thesyntehsis of alanine a: True In the synthesis of aspartate by AST, pyridoxal phosphate serves as a source of C atoms invovled in aspartate synthesis a: FALSE!
GlucoNormTM (Repaglinide) affects ATP-dependent K+ channels on pancreatic β-cells a: True GlucoNormTM (Repaglinide)’s major action is to stimulate insulin secretion a: True GlucoNormTM (Repaglinide) has a possible side effect of hypoglycemia a: True GlucoNormTM (Repaglinide) is taken at least one hour before meals for optimal control of glycemia a: FALSE! q:
Doses are usually taken within 15 minutes of a meal , but can be taken at any point starting from 30 inutes before the meal , up to immediately prior to the meal. Pasted from <http://www.islandnet.com/~rinfocan/noframes/hypoglyc.htm>
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GlucoNormTM (Repaglinide) can be used in combination with other anti-diabetic agents such as metformin a: True
PTH activates osteoclasts indirectly via release of an activating factor from the osteoblasts
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PTH activates osteoclasts indirectly via release of an activating factor from the osteoblasts a: True Post-menopausal loss of estradiol in a person would contribute to a decrease in bone density a: True 1,25 dihydroxy Vitamin D3 stimulates transcription of the gene for a calcium pump that rapidly moves calcium from the bone ECF to the plasma a: True q:
Vitamin D acts also to increase blood concentrations of calcium. It is generated through the activity of parathyroid hormone within the kidney. Vitamin D is to increases absorption of calcium from the small intestine. In concert with parathyroid horm one, vitamin D also enhances fluxes of calcium out of bone. Pasted from <http://www.zoology.ubc.ca/~auld/bio456/lectures/lecture_calcium_reg.html>
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Calcitonin is essential for the preservation of bone mass in post-menopausal women a: FALSE Activation of PTH receptors in the kidney reduces calcium loss in the urine through stimulation of tubular calcium reabsorption a: True
If a patient does develop osteoporosis, bisphosphonates would NOT be used to treat his/her condition a: FALSE! It would be used! If a patient does develop osteoporosis, calcium supplements would NOT be used to treat his/her condition a: FALSE! It would be used! If a patient does develop osteoporosis, plicamycin (mithramycin) would NOT be used to treat his/her condition a: True. Used to reduce high levels of calcium in the blood; appears to lower serum calcium concentrations by blocking the hypercalcemic action of Vitamin D; may also inhibit the effect of parathyroid hormone on osteoclasts (decreases in serum phosphate and urinary calcium excretion accompany the lowering of serum calcium)
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If a patient does develop osteoporosis, low, intermittent doses of PTH would NOT be used to treat his/her condition a: FALSE! It would be used! If a patient does develop osteoporosis, Vitamin D supplements would NOT be used to treat his/her condition a: FALSE! It would be used!
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Lipitor at higher doses commonly causes mild hypertriglyceridemia and therefore should not be considered a: FALSE! q: Adding a fibrate drug to cholesterol therapy will significantly increase HDL-C and lower TG levels a: True q:
Low plasma HDL cholesterol concentration is a feature of typical dyslipidemia of insulin resistant states and type 2 diabetes a: True q: Elevated plasma triglycerides is a feature of typical dyslipidemia of insulin resistant states and type 2 diabetes a: True q: Elevated plasma LDL cholesterol concentration is a feature of typical dyslipidemia of insulin resistant states and type 2 diabetes q:
NOT
FALSE! Elevated plasma LDL cholesterol concentration is a feature of typical dyslipidemia of insulin resistant states and type 2 diabetes q: Small and dense LDL particles is a feature of typical dyslipidemia of insulin resistant states and type 2 diabetes a: True q: Elevated total cholesterol/HDL cholesterol ratio is a feature of typical dyslipidemia of insulin resistant states and type 2 diabetes a: True a:
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Cholesterol uptake by HDL from peripheral tissues mediated by ABCA1 transporter is an important step in the reverse cholesterol transport pathway a: True CETP-mediated heteroexchange of cholesterol and triglycerides between HDl and ApoB-containing lipoproteins is an important step in the reverse cholesterol transport pathway a: True L-CAT mediates esterification of free cholesterol is an important step in the reverse cholesterol transport pathway a: True Hepatic lipase catabolism of remnant lipoproteins is an important step in the reverse cholesterol transport pathway a: FALSE! SR-B1 medated selective choesteryl ester uptake from HDL by the liver is an important step in the reverse cholesterol transport pathway a: True Abdominal obesity is a well recognized feature of the metabolic (insulin resistant) syndrome? a: True Hypertension is a well recognized feature of the metabolic (insulin resistant) syndrome? a: True Hypertriglyceridemia is a well recognized feature of the metabolic (insulin resistant) syndrome a: True Low HDL cholesterol is a well recognized feature of the metabolic (insulin resistant) syndrome a: True Ketoacidosis is a well recognized feature of the metabolic (insulin resistant) syndrome a: FALSE! Hepatic VLDL synthesis requires the synthesis of ApoB and availability of TG and cholesterol ester a: True VLDL is metabolized in the circulation following hydrolysis of VLDL triglyceride and cholesterol ester a: True VLDL hydrolysis generates smaller lipoprotein particles called IDL which are either directly cleared by the liver or are further hydrolyzed to the LDL particles a: True Hepatic clearance of LDL particles inplasma requires both the LDL receptor and LRP a: FALSE! ApoE is an important component of VLDL and can interact with the LDL-receptor or LRP on the cell surface a: True Diabetes is now regarded as CHD risk equivalent; this is a key feature of the new ATPIII guidelines established by the National Cholesterol Education Program. a: True Recommendations to use Framingham projections of 10 year CHD risk; this is a key feature of the new ATPIII guidelines established by the National Cholesterol Education Program. a: True Higher TG classification cut points; this is a key feature of the new ATPIII guidelines established by the National Cholesterol Education Program. a: FALSE! Identify patients with multiple risk factors for more intensified treatment; this is a key feature of the new ATPIII guidelines established by the National Cholesterol Education Program. a: True Higher cut-off point for HDL-C or HDL-C >1.0 mmol/L; this is a key feature of the new ATPIII guidelines established by the National Cholesterol Education Program. a: True
Plant sterols will lower LDL cholesterol a: True q: Viscous fibers will lower LDL cholesterol a: True q: Saturated fatty acids will raise with LDL and HDL choelsterol a: True q:
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Trans fatty acids will raise both LDL and HDL cholesterol a: FALSE! q: Vegetable proteins (eg. Soy) may lower LDL cholesterol a: True q:
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Increasing monounsaturated fat (eg. Olive oil) consumption will lower one’s TG level a: True Increasing physical activity will lower one’s TG level a: True Reducing body weight will lower one’s TG level a: True Reducing sugar (especially fructose) intake will lower one’s TG level a: True Increasing alcohol consumption will lower one’s TG level a: FALSE! Eliminate all simple sugars including the hard candy and alcohol to reduce triglycerides. Pasted from <http://www.dietitian.com/triglyce.html>
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Hydrogenated fat margarine will be solid at room temperature and spread like butter a: True Hydrogenated fat margarine will aid in weight loss a: FALSE! Hydrogenated fat margarine will lower blood pressure a: FALSE! Hydrogenated fat margarine will improve blood glucose a: FALSE! Hydrogenated fat margarine will reduce one’s risk of CHD a: FALSE!
Approximately 80% of cholesterol in steroidogenic cells is derived from LDl transported across the plasma membrane and 20% is produced de novo within the cell a: True q: Cortisol is produced by the enzymatic actions of 11-hydroxylase (p450c11) in the mitochondria a: True q:
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17alpha hydroxylase is not present in the zona glomerulosa a: True q: 17-alpha hydroxylase is not present in the zona glumerulosa a: True q: StAR is responsible for shuttling of cholesterol across the plasma membrane a: FALSE! q:
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steroidogenic acute regulatory protein (StAR) Multiple lines of evidence show that StAR moves cholesterol from the outer to inner mitochondrial membrane, but acts exclusively on the outer membrane.
DHEA is produced from 17-hydroxypregnenalone, and this conversion is medated by 17,20 lyase activity a: True
Growth hormone is secreted in a circadian rhythm, peaking in early nighttime a: True q: Prolactin secretion is maintained at low levels in non-pregnant adults through release of somatostatin into the Hypothalamo-Pituitary-portal circulation a: FALSE! q: Ultradian secretion of TSH leads to multiple peaks in T4 levels during the day a: FALSE! q:
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Ultradian denotes biologic activities that recur in physiological cycles of 20 hours or less. They are independent of illumination factors. Pasted from <http://en.wikipedia.org/wiki/Ultradian>
Secretion of CRH is decreased by hyperglycemia a: FALSE! q: Insulin inhibits release of GH through stimulation of somatostatin secretion a: FALSE! q:
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Going on the oral contraceptive a: FALSE! Going on the oral contraceptive a: FALSE! Going on the oral contraceptive a: FALSE! Going on the oral contraceptive a: FALSE! Going on the oral contraceptive a: True
pill puts you at increased risk for osteoporosis pill puts you at increased risk for uterine cancer pill puts you at increased risk for ovarian cancer
pill puts you at increased risk for iron deficiency anemia pill puts you at increased risk for blood clots
5alpha reductase (type 1) is expressed primarily in the skin, body, scap, while the type 2 enzyme is localized to reproductive tissues True
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a: True The sertoli cells has a relatively low capacity to convert testosterone to estrogen a: True q: The androgen receptor has lower affinity for testosterone than DHEA a: True q: Leydig cells produce androgen binding protein to maintain high testosterone levels in the testes a: FALSE! q: Inhibin produced by the sertoli cell feeds back negatively at the level of the pituitary to specifically inhibit FSH release a: True q:
The presence of a functional ovary is critical for maintaining pregnancy at 8 weeks time a: FALSE! q: The ovary is the only source of estrogen and progesterone at 8 weeks time a: FALSE! q: hCG is produced by the syncytiotrophoblasts at 8 weeks time a: True The human placenta is of chorioallantoic type, consisting of 2 components: 1. The chorion, or outer layers of the chorionic cavity, including: 1. The syncytiotrophoblast 2. The cytotrophoblast 3. The extraembryonic mesoderm â&#x20AC;˘ There are 2 types of cytotrophoblast cells: 1. Darker syncitiotrophoblast cells that produce hCG 2. Langhans trophoblastic cells in the villi q:
Pasted from <http://download.videohelp.com/vitualis/med/placenta.htm>
Placental lactogen is used as the basis of the pregnancy test at 8 weeks time a: FALSE! q: hCG is important in directly modifying maternal metabolism at 8 weeks time a: FALSE! q:
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