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Examples of ovarian stromal tumors include thecomas antibiotics for dogs online 100mg nitrofurantoin visa, fibromas antibiotic tendon rupture buy 50mg nitrofurantoin mastercard, granulosa cell tumors virus replication cycle nitrofurantoin 100mg without a prescription, and Sertoli-Leydig cell tumors virus zero generic nitrofurantoin 100 mg visa. Histologically, thecomas are composed of spindle-shaped cells with vacuolated cytoplasm. They are vacuolate because of steroid hormone (estrogen) production, which can be stained with an oil red O stain. The stromal cells of the ovary are the precursors of endocrine-active cells, so it is easy to understand that neoplasms derived from these stromal cells are often associated with hormone production. For example, granulosa cells normally secrete estrogens, thecal cells normally secrete androgens, and hilar cells (Leydig cells) may secrete androgens. Excess androgen production in females may lead to masculinization and produce symptoms such as amenorrhea, loss of secondary female sex characteristics, and the development of secondary male characteristics, such as hirsutism, temporal balding, and deepening of the voice. Ovarian tumors associated with excess androgen production include androblastomas (Sertoli-Leydig cell tumors). Other ovarian diseases associated with excess androgen production include polycystic ovarian disease and hyperthecosis. Excess estrogen production is associated with precocious puberty in the young and with endometrial hyperplasia and cancer in older women. Ovarian tumors that may secrete estrogens include granulosa cell tumors and thecomas. Causes of secondary amenorrhea include pregnancy (the most common cause), hypothalamic/pituitary abnormalities, ovarian disorders, and end organ (uterine) disease. Withdrawal bleeding following progesterone administration indicates that the endometrial mucosa had been primed with estrogen, which in turn indicates that the hypothalamus/ pituitary axis and ovaries are normal. Decreased gonadotropin levels decrease estrogen levels, which results in amenorrhea and an increased risk for osteoporosis. Because of the decreased estrogen levels, a progesterone challenge does not result in withdrawal bleeding. Ovarian conditions, such as surgical removal of the ovaries, would most likely produce elevated gonadotropin levels due to the lack of negative feedback from estrogen and progesterone. Because of the decreased estrogen levels, a progesterone challenge would not result in withdrawal bleeding. Factors that predispose an individual to abruptio placenta include use of certain drugs (cocaine, alcohol, tobacco), maternal hypertension, preeclampsia, multiparity, and increasing maternal age. Placenta accreta refers to the absence of the decidua and the direct attachment of the placenta to the myometrium. It is an important Reproductive Systems Answers 463 cause of postpartum hemorrhage because the placenta fails to separate from the myometrium at the time of labor. The hemorrhage can be lifethreatening, and a total hysterectomy is the treatment of choice. In both placenta accreta and placenta previa the villi are histologically normal and there is no trophoblastic proliferation. In contrast, gestational trophoblastic disease refers to abnormal proliferation of trophoblastic tissue and includes hydatidiform mole, invasive mole, and malignant choriocarcinoma. The most common location for extrauterine implantation is the fallopian tube (85% of cases), with rare implantation in the ovary or abdomen. It is always worthwhile to repeat a laboratory test when the result is unexpected. Tubal pregnancy is not uncommon and should always be considered if endometrial samples suggest gestational change without chorionic villi. When convulsions develop in an individual with preeclampsia, the condition is then referred to as eclampsia. These signs and symptoms result from abnormal placental implantation with incomplete conversion of the blood vessels of the decidua. Normally the blood vessels of the uterine wall at the site of implantation increase in diameter and lose their muscular components. These changes increase the blood flow to the placenta and are the result of increased production of prostacyclin (a strong vasodilator) and decreased production of thromboxane (a potent vasoconstrictor).
To summarize jm109 antibiotic resistance buy nitrofurantoin canada, type A has no fistula antibiotic examples 100 mg nitrofurantoin overnight delivery, type B connects to the upper segment how quickly do antibiotics for uti work buy discount nitrofurantoin 100mg on line, type C to the lower segment bacteria yersinia enterocolitica nitrofurantoin 50mg overnight delivery, and type D to both segments. These defects are dangerous because material that is swallowed may pass into the trachea (aspiration) either directly (types B, D, and E) or indirectly through reflux in that there is a blind upper pouch present (types A and C). Additionally, gastric dilation can occur due to "swallowed" air in those anomalies in which the trachea communicates with the lower esophagus (types C, D, and E). Also important is the fact that any defect that interferes with fetal swallowing in utero will produce polyhydramnios during pregnancy. This condition results from decreased or absent ganglion cells in the myenteric plexus in the body of the esophagus. Varices occur in about two-thirds of all patients with cirrhosis, and in the majority of patients the etiology is alcoholic cirrhosis. The cirrhosis causes portal hypertension, which shunts blood into connecting channels between the portal and caval systems, such as the subepithelial plexus of veins in the lower esophagus. Varices produce no symptoms until they rupture and cause massive bleeding (hematemesis), which may lead to death. Other diseases, such as gastritis, esophageal laceration (Mallory-Weiss tears), or peptic ulcer disease, may cause hematemesis. It is considered an acquired change resulting from reflux of acidic gastric contents with ulceration of the esophageal squamous epithelium and replacement by metaplastic, acid-resistant, columnar epithelium. Microscopically, intestinal-type epithelium is most common, but gastric-type epithelium is also seen. Virtually all of these tumors are of the adenocarcinoma type and they account for up to 10% of all esophageal cancers. Of these carcinomas, 60 to 70% are squamous cell carcinomas that characteristically begin as lesions in situ. Polypoid lesions are most common, followed by malignant ulceration and diffusely infiltrative forms. Tumors tend to spread by direct invasion of adjacent structures, but lymphatic and hematogenous spread may occur. Infants with congenital hypertrophic pyloric stenosis present in the second or third week of life with symptoms of regurgitation and persistent severe vomiting. Diaphragmatic hernias, if large enough, may allow abdominal contents- including portions of the stomach, intestines, or liver-to herniate into the thoracic cavity and cause respiratory compromise. This results in a functional obstruction and dilation proximal to the affected portion of colon. Acute gastritis refers to the clinical situation of gastric mucosal erosions (not mucosal ulcers). Acute gastritis is also known as hemorrhagic gastritis or acute erosive gastritis. Acute gastritis is associated with the use of nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, and corticosteroids, and also with alcohol, chemotherapy, ischemia, shock, and even severe stress. Grossly acute gastritis appears as multiple, scattered, punctate (less than 1 cm) hemorrhagic areas in the gastric mucosa. This is helpful in differentiating acute gastritis from peptic ulcers, which tend to be solitary and larger. Microscopically the gastric mucosa from a patient with acute gastritis is likely to reveal mucosal erosions, scattered neutrophils, edema, and possibly hemorrhage. It is important to realize that the presence of neutrophils within the glandular epithelium indicates active inflammation and may be the main type of inflammation present (acute gastritis) or may be combined with more numerous chronic inflammations (active chronic gastritis). Chronic gastritis is divided into subgroups based either on etiology (immunologic or infectious), location (antrum or body), histopathology, or clinical features. The therapy for Helicobacter is either triple therapy (metronidazole, bismuth salicylate, and either amoxicillin or tetracycline) or double therapy (omeprazole and clarithromycin). In contrast, autoimmune gastritis, also known as diffuse corporal atrophic gastritis or type A atrophic gastritis, is characterized by the presence of autoimmune antibodies including parietal cell antibodies and intrinsic factor antibodies. Pernicious anemia is the result of decreased intrinsic factor, which in turn produces a vitamin B12 deficiency. This vitamin deficiency causes megaloblastic anemia and subacute combined disease of the spinal cord. Histologically there is diffuse atrophy (reduced mucosal thickness), gland loss, widespread intestinal metaplasia, and variable chronic and acute inflammation. These changes are found predominantly in the body-fundus mucosa (usually absent in the antrum).
R-determinant: resistance genes that code for enzymes that inactivate certain drugs 2 bacteria joint pain order nitrofurantoin online from canada. The widespread use of antibiotics in medicine and agriculture has lead to an increasingnumber of resistant strain pathogens antimicrobial finish proven 50 mg nitrofurantoin. As each nucleoside triphosphate is brought in to add to the 3 end of the growing strand infection lymph node buy cheapest nitrofurantoin, the two terminal phosphates are removed antibiotics strep throat buy cheap nitrofurantoin online. Proteinaceous transcription factors attach to the promoter and help the polymerase find and attach to the initiation site. But, which strand is coding and which silent varies 252 Molecular Biology and Applied Genetics from gene to gene. Triplet Code What is the code by which the nucleotide sequences encode protein sequences If, for example, we let C = proline, this would allow us to encode only 41 = 4 amino acids which is 16 short of the number needed. If we try 3 letter nucleotide words we have plenty of words to specify all the amino acids and lots left over for redundancy and even punctuation. It turns out that the nucleotide code words are indeed composed of three nucleotides and this is known as the triplet code. The genetic code consists of 61 amino-acid coding codons and three termination codons, which stop the process of translation. Codon dictionaries are available; in fact there is one in your text and another in your lab manual. It is essential that the ribosome begin reading at exactly the right position in the nucleotide sequence in order to create the desired protein. For example it determines if the iris cells can produce brown pigment (melanin) and if pancreas cells can produce insulin. Although originally called dogma, this idea has been tested repeatedly with almost no exceptions to the rule being found (save retroviruses). Often many ribosomes will read the same message, a structure known as a polysome forms. Introduction Gene expression is expensive, inappropriate gene expression can be harmful to cells/organisms, the proper expression of the phenotype of an organism is dependent upon expression and lack of expression of genes at appropriate times and in appropriate cells/places. A major difference is the presence in eukaryotes of a nuclear membrane, which prevents the simultaneous transcription and translation that occurs in prokaryotes. Whereas, in prokaryotes, control of transcriptional initiation is the major point of regulation, in eukaryotes the regulation of gene expression is controlled nearly equivalently from many different points. Control of gene expression basically occurs at two levels, prior to transcription and post-transcriptionally. Transcriptional control in nucleus determines which structural genes are transcribed and rate of transcription; includes organization of chromatin and transcription factors initiating transcription. Transcription factors are always present in cell and most likely they have to be activated in some way. Estrogen interferes with action of ribonuclease; prolongs vitellin production in amphibian cells. A functional enzyme is subject to feedback control; binding of an end product can change the shape of an enzyme so it no longer carries out its reaction. Some proteins are not active after translation; polypeptide product has to undergo additional changes before it is biologically functional. Gene Control in Prokaryotes In bacteria, genes are clustered into operons: gene clusters that encode the proteins necessary to perform coordinated function, such as biosynthesis of a given amino acid. In bacteria, control of the rate of transcriptional initiation is the predominant site for control of gene expression. These regulatory proteins can act both positively (activators) and negatively (repressors). The operator region is adjacent to the promoter elements in most operons and in most cases the sequences of the operator bind a -35 position is 274 Molecular Biology and Applied Genetics repressor protein.
One common application is the injection of anesthetic between the first and second caudal vertebrae of the ox as an aid to repairing and reducing uterine infection news trusted nitrofurantoin 100mg, vaginal bacteria jeopardy game buy generic nitrofurantoin 50 mg, or rectal prolapses antibiotic resistance timeline discount nitrofurantoin 50 mg. Spinal nerves are formed by the conjoining of dorsal and ventral roots virus 43215 discount nitrofurantoin amex, which come together as the nerve at the point where the axons exit and enter the vertebral canal. Sensory neuronal cell bodies are present in aggregates, called dorsal root ganglia, lateral to the spinal cord. The neurons within these ganglia are pseudounipolar, and they give rise to processes that enter the dorsal horn of the Dorsal Funiculus Central Canal Sensory Neuron Dorsal Horn Lateral Horn Dorsal Root Dorsal Root Ganglion Dorsal Branch of Spinal Nerve Motor Neuron Spinal Nerve Lateral Funiculus Ventral Funiculus Ventral Horn Ventral Root Ventral Branch of Spinal Nerve Figure 9-12. View is from dorsal side, with the vertebral arches removed to expose the cord within the vertebral canal. The spinal cord is shorter than the vertebral column, so that the more caudal spinal cord segments lie within vertebrae whose name and number are more cranial. The nerve roots are progressively longer in these more caudal parts of the vertebral column as they extend from the cord to the foramen of exit. The processes that extend from the spinal nerve to the spinal cord constitute the dorsal root. The ventral root of the spinal nerve consists of motor fibers that arise from the nerve cells primarily in the ventral horn of the spinal cord. The dorsal and ventral roots unite to form the spinal nerve close to the intervertebral foramen between adjacent vertebrae. The dorsal root ganglion is usually very close to this conjoining of dorsal and ventral roots; it frequently can be found just within the intervertebral foramen. In this location it is susceptible to compression when an intervertebral disk protrudes; to a large degree, it is this compression that causes the intense, electric pain associated with disk disease. Information about pain is carried by a large number of described pathways, but these are often grouped under the names spinothalamic tract or anterolateral system. This large group of fibers is found in a wide band through the lateral and ventral funiculi. Some of these tracts terminate in the brainstem, where they mediate reflexes associated with painful stimuli. Others make connections that alert the entire cortex and initiate aversive behaviors. Still others are relayed directly to the parts of the cortex that create conscious awareness of the painful stimulus. Like pain, touch and temperature sense information is carried in a variety of ascending tracts. Some of these are found in the dorsal columns and others in the anterolateral system. Tracts that carry sensory information are ascending tracts, whereas those carrying motor commands are descending tracts. The white matter of the spinal cord in which the tracts are found can be roughly divided into three columns on each half of the cord: a dorsal funiculus (often called the dorsal column), a lateral funiculus, and a ventral funiculus. The dorsal funiculi contain afferent tracts that carry information about body position from joints, tendons, and muscles. Injury to this pathway produces uncoordinated, inaccurate movements, as the cortex lacks some of the information it needs to make ongoing adjustments in the planning and execution of voluntary movements. Proprioceptive information also ascends the spinal cord in several spinocerebellar tracts, located superficially on the lateral funiculus. As the name suggests, these tracts are headed for the cerebellum, where the proprioceptive information is used to help shape voluntary movements so that they are accurate and smooth. Motor systems are often functionally grouped into two main categories: a ventromedial motor system, largely located in the ventral funiculus, and a dorsolateral motor system, found in the dorsal part of the lateral funiculus. The ventromedial motor system primarily is responsible for activity in the axial and proximal limb muscles, especially extensors and antigravity muscles. Activity in the tracts of this system assists with the support phase of gait, when limbs are in weight-bearing position with joints extended.
Which of the following histologic changes is most likely to be seen when examining microscopic sections from this mass Large cells with prominent eosinophilic cytoplasm containing numerous mitochondria d infection in finger purchase discount nitrofurantoin on line. The mass is removed surgically and microscopic sections reveal undifferentiated mesenchymal cells antibiotic resistance threats in the united states cdc discount nitrofurantoin express, immature tubules antibiotics for sinus infection amoxicillin order nitrofurantoin 100 mg overnight delivery, and abortive glomerular formation viral infection 07999 discount nitrofurantoin 100 mg online. This tumor is most closely associated with abnormalities involving which one of the listed genes Physical examination of a 3-day-old male infant reveals urine leaking from the area of the umbilicus. A 19-year-old man presents with dysuria and a mucoid or watery urethral discharge. Microscopic examination of the discharge reveals numerous neutrophils, but no organisms are seen. Chlamydia trachomatis Escherchia coli Mycoplasma genitalium Mycoplasma hominis Trichomonas vaginalis 352. Which of the following histologic changes is most likely to be seen when examining a mucosal biopsy of the urinary bladder from an individual with acute cystitis due to infection with Escherichia coli An infiltrate of lymphocytes and plasma cells An infiltrate of neutrophils Inflammation with eosinophils Noncaseating granulomas Sheets of macrophages with granular cytoplasm 408 Pathology 353. A 49-year-old man who is a long-term smoker presents with frequency and hematuria. Histologic examination of sections taken from an exophytic lesion of the urinary bladder reveals groups of atypical cells with frequent mitoses forming finger-like projections that have thin, fibrovascular cores. These groups of atypical cells do not extend into the lamina propria and muscularis. Adenocarcinoma, noninvasive Inverted papilloma, noninvasive Transitional cell carcinoma in situ Papillary transitional cell carcinoma, noninvasive Squamous cell carcinoma in situ Urinary System Answers 328. Bicarbonate levels in metabolic acidosis are <21 mM, while those in metabolic alkalosis are >28 mM. In contrast, metabolic acidosis increases serum acid (increased hydrogen ion concentration), which decreases serum pH and decreases serum bicarbonate concentration. The causes of metabolic acidosis are broken down clinically into two groups: those with a normal anion gap and those with an increased anion gap. A normal anion gap metabolic acidosis may result from either loss of bicarbonate (diarrhea) or loss of renal regeneration of bicarbonate, seen with renal tubular acidosis type 1 (decreased excretion of titratable acid, i. The body also compensates through renal mechanisms that increase H-excretion and increase bicarbonate reabsorption. Causes of respiratory alkalosis include diseases or states that cause hypoxemia (such as living at high altitude), psychogenic causes, and ingestion of salicylates (which can cause a mixed respiratory alkalosis and metabolic acidosis). The fetus swallows amniotic fluid (about 400 mL/day), and then absorbs it in the respiratory and digestive tracts. Waste products cross the placental membrane and enter maternal blood in the intervillous space. The oligohydramnios leads to characteristic facial features that include wide-set eyes; low-set, floppy ears; and a broad, flat nose. In two types of cystic renal disease, the numerous cysts are found in both the cortex and medulla. These two types of polycystic disease of the kidney are the infantile type and the adult type. Adult polycystic kidney disease typically presents in adulthood and has an autosomal dominant inheritance pattern. Histologically, the cysts are lined by tubular epithelium, while the stroma between the cysts is normal.
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