Anatomy, Physiology, and Pathology

Question 1

Which cytokine produced by bone marrow and thymic stromal cells is a growth factor required for the development of B cells and T cells?

Answer 1

Interleukin 7 (IL-7)

Question 2

What process results in the apoptosis of autoreactive or nonfunctional B-lymphocytes?

Answer 2

Negative selection

Question 3

What condition is associated with hypogammaglobulinemia and thymoma?

Answer 3

Good’s Syndrome

Question 4

What pathogen is frequently associated with gastric MALT lymphoma?

Answer 4

Chronic Helicobacter pylori infection is associated in 72-98% of cases

Question 5

This normal anatomic variant is characterized by a pneumatized cavity within the concha.

Answer 5

Concha bullosa

Question 6

What diseases are associated with congenital thymic aplasia or hypoplasia in human

Answer 6

DiGeorge syndrome, SCID, CHARGE, infant of a diabetic mother

Question 7

What is the name of the junction between the nasal vestibule and main nasal cavity just anterior to the tip of the inferior turbinate?

Answer 7

Nasal valve

Question 8

Physical or functional absence of a spleen is associated with increased susceptibility infections with what pathogens?

Answer 8

Encapsulated bacteria, including Neisseria meningitidis, Haemophilus influenzae, Streptococcus pneumoniae

Question 9

How is nasal airway resistance regulated?

Answer 9

Swelling of the inferior turbinate

Question 10

What family of medications would be best suited to treating clear watery nasal secretions?

Answer 10

Anticholinergic medications (eg, ipratropium bromide nasal spray)

Question 11

How can mucociliary clearance be clinically evaluated?

Answer 11

Saccharin test. This is a timed test where a small amount of saccharin is placed on the anterior end of the inferior turbinate. It is complete when the patient tastes the sweet flavor in the mouth. Normal result is 7-11 minutes.

Question 12

What syndrome is characterized by ciliary dyskinesia, situs inversus, bronchiectasis, and chronic sinusitis?

Answer 12

Kartagener’s syndrome; 50% of individuals with PCD have Kartagener’s syndrome

Question 13

Which sinuses are present at birth?

Answer 13

Maxillary and ethmoid sinuses are present at birth

Question 14

What is the name of the ethmoid air cells found in the infraorbital area?

Answer 14

Haller cells

Question 15

What are displaced sphenoethmoid air cells called?

Answer 15

Onodi cells

Question 16

What is the name of the anterior ethmoid air cells found above the middle turbinate?

Answer 16

Agger nasi cells

Question 17

What are the pathologic features of airway remodeling?

Answer 17

Airway wall thickening with increased collagen deposition and airway smooth muscle, goblet cell hyperplasia, subepithelial fibrosis, and angiogenesis

Question 18

What chymase- and tryptase-containing cells are typically found in the skin, conjunctiva, heart, and intestinal submucosa and have the CD88 receptor?

Answer 18

Connective tissue mast cells (MCTC)

Question 19

What carbohydrate epitope helps dermal T lymphocytes home to the skin?

Answer 19

Cutaneous lymphocyte antigen (CLA)-1

Question 20

Mutations in which gene are associated with ichthyosis vulgaris and atopic eczema?

Answer 20

Filaggrin (FLG)

Question 21

What condition is associated with flaccid bullae affecting the scalp, chest, intertriginous areas, and oral mucosa?

Answer 21

Pemphigus vulgaris

Question 22

A 75-year-old woman complains of a very pruritic rash characterized by tense blisters. Tissue immunofluorescence demonstrates linear basement membrane zone IgG and C3. What condition does she have?

Answer 22

Bullous pemphigoid

Question 23

A 4-year-old boy with a history of chronic diarrhea presents with an itchy rash characterized by small blisters on his elbows and knees. What is the name of his rash?

Answer 23

Dermatitis herpetiformis and celiac disease

Question 24

What is a diagnostic biopsy characteristic for eosinophilic esophagitis (EoE)?

Answer 24

Greater than 15 eosinophils per high-powered field while on a proton pump inhibitor (PPI) for 8 weeks.

Question 25

What Sinuses are the last to develop? What age?

Answer 25

Frontal sinuses; 6 years old

Question 26

What autoimmune condition is associated with dermatitis herpetiformis?

Answer 26

celiac disease

Question 27

What does the CD88 receptor bind to?

Answer 27

C5a anaphylatoxin

Question 28

What paired structures are found on the lateral walls of the nasal cavity in a curled-like shape?

Answer 28

turbinates

Question 29

Cavernous sinus thrombosis is a complication of sinusitis in which sinus cavities?

Answer 29

Sphenoid sinuses

Question 30

What are the ciliated columnar cells sloughed in the bronchial mucosa and are histopathologic findings indicative of asthma?

Answer 30

Creola bodies

Question 31

These microscopic structures are composed of eosinophil protein galectin-1, they stain purplish-red and found in asthma and parasitic pneumonia.

Answer 31

Charcot-Leyden crystals

Question 32

What is the narrowest point of the nasal anatomy?

Answer 32

Nasal valve

Question 33

What condition will demonstrated epidermal IgG and C3 cell surface staining of the suprabasal layers on immunofluorence?

Answer 33

Pemphigus vulgaris

Question 34

Describe symptoms of food protein-induced allergic proctocolitis.

Answer 34

Blood-streaked stool in first few months of life, more common in breastfed babies. Babies are usually healthy otherwise.

Question 35

How does acute FPIES differ from chronic FPIES?

Answer 35

Acute: severe repetitive vomiting and/or diarrhea, lethargy, pallor, hypothermia, hypotension, abdominal distention within 1-3 hours after ingestion; Chronic: chronic intermittent vomiting, watery diarrhea with blood/mucus, lethargy, pallor, weight loss, failure to thrive

Question 36

Where do B-lymphocyte precursors originate?

Answer 36

Bone marrow (where they complete most of their development), fetal liver, and neonatal spleen.

Question 37

Where do T-lymphocyte precursors originate?

Answer 37

Bone marrow

Question 38

Where do T-lymphocyte precursors mature?

Answer 38

Thymus

Question 39

What is the embryonic origin of the thymus?

Answer 39

Endoderm and mesoderm of the third and fourth pharyngeal pouches.

Question 40

What are the 3 parts of the thymic epithelium?

Answer 40

the subcapsular zone, the cortex, and the medulla.

Question 41

During T-cell maturation in the thymus, in which direction do they move?

Answer 41

From the outside (subcapsular zone) inward (medulla).