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A 33-year-old woman has had increasing lethargy and decreased urine output for the past week. Laboratory studies show serum creatinine level of 4.3mg/dL and urea nitrogen level of 40mg/dL. A renal biopsy is performed, and the specimen is examined using electron microscopy. Which of the following morphologic changes most likely suggests a diagnosis of acute tubular necrosis? In an experiment involving observations on wound healing, researchers noted that intracytoplasmic cytoskeletal elements, including actin, interact with the extracellular matrix to promote cell attachment and migration in wound healing. Which of the following substances is most likely responsible for such interaction between the cytoskeleton and the extracellular matrix? A 70-year-old man seeks medical attention because of shortness of breath on minimal exertion. A posteroanterior chest radiograph reveals blunting of the right costophrenic sulcus interpreted as a right-sided pleural effusion. The aspirated fluid is straw colored and clear. The protein concentration is low, and the specific gravity is 1.011. Microscopic examination reveals an occasional mesothelial cell. Which of the following is the most likely cause of the effusion?A 56-year-old man has had increasing dyspnea for 6 years. He has no cough or fever. He had chronic exposure to inhalation of silica dust for many years in his job. A chest x-ray now shows increased interstitial markings and parenchymal 1 to 3 cm solid nodules.His pulmonary problems are most likely to be mediated through which of the following inflammatory processes?A:Mitochondrial swelling B:Plasma membrane blebs C:Chromatin clumping D:Nuclear fragmentation E:Ribosomal disaggregation 答案: Nuclear fragmentation A:Epidermal growth factor B:Fibronectin C:Integrin D:Platelet-derived growth factor E:Type IV collagen F:Vascular endothelial growth factor 答案: IntegrinA:Decreased oncotic pressure B:Left ventricular heart failure C:Mesothelioma D:Pneumonia E:Tuberculosis 答案: Left ventricular heart failureA:Neutrophilic infiltrates producing leukotrienes B:Foreign body giant cell formation C:Plasma cell synthesis of immunoglobulins D:Mast cell histamine release E:Macrophage elaboration of cytokines 答案: Macrophage elaboration of cytokines
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