physio block 3
DESCRIPTION
medTRANSCRIPT
1.A mother brings her 6-yr-old son to his pediatrician because he has been having recurrent nosebleeds. Physical examination reveals diffuse petechiae and purpura. Laboratory studies show a Hb of 9.0 g/L, platelet count of 20,000/cu.mm, & leukocyte count of 14,500/cu mm. Bone marrow smear is shown below. The large cells are most probably precursors of
HTMLCONTROL Forms.HTML:Hidden.1 a.Eosinophils
HTMLCONTROL Forms.HTML:Hidden.1 b.Basophils
HTMLCONTROL Forms.HTML:Hidden.1 c.Neutrophils
HTMLCONTROL Forms.HTML:Hidden.1 d.Lymphocytes
HTMLCONTROL Forms.HTML:Hidden.1 e.Monocytes
HTMLCONTROL Forms.HTML:Hidden.1 f.RBC
HTMLCONTROL Forms.HTML:Hidden.1 g.Platelets
2.Release of which of the following peptides leads to an increase in the secretion of pancreatic bicarbonates into the small intestine?
HTMLCONTROL Forms.HTML:Hidden.1 a.Cholecystokinin
HTMLCONTROL Forms.HTML:Hidden.1 b.Gastrin
HTMLCONTROL Forms.HTML:Hidden.1 c.Motilin
HTMLCONTROL Forms.HTML:Hidden.1 d.Secretin
HTMLCONTROL Forms.HTML:Hidden.1 e.Somatostatin
3.A 6 -year-old boy playing in a dusty field in windy weather inhales many very small particles that become lodged in his terminal bronchioles. Which of the following are most important in cleaning the particles?
HTMLCONTROL Forms.HTML:Hidden.1 a.Type I pneumocytes
HTMLCONTROL Forms.HTML:Hidden.1 b.Type II pneumocytes
HTMLCONTROL Forms.HTML:Hidden.1 c.Alveolar macrophages
HTMLCONTROL Forms.HTML:Hidden.1 d.Submucosal glands
HTMLCONTROL Forms.HTML:Hidden.1 e.Ciliated cells
4.Which of the following substances use a protein-carrier molecule to traverse the cell membrane?
HTMLCONTROL Forms.HTML:Hidden.1 a.Water
HTMLCONTROL Forms.HTML:Hidden.1 b.Oxygen
HTMLCONTROL Forms.HTML:Hidden.1 c.Glucose
HTMLCONTROL Forms.HTML:Hidden.1 d.Alcohol
HTMLCONTROL Forms.HTML:Hidden.1 e.Glycerol
5.A 78-year-old woman has a mean arterial pressure of 100 mm Hg and a heart rate of 62/min. She has a stroke volume of 80 mL and a right atrial pressure of 0 mm Hg. What is the total peripheral resistance (in mm Hg/mL/min) in this woman?
HTMLCONTROL Forms.HTML:Hidden.1 a.0.2
HTMLCONTROL Forms.HTML:Hidden.1 b.0.1
HTMLCONTROL Forms.HTML:Hidden.1 c.0.5
HTMLCONTROL Forms.HTML:Hidden.1 d.0.3
HTMLCONTROL Forms.HTML:Hidden.1 e.0.4
6.An 8-yr-old boy has had an upper respiratory infection for the past 3 days. Today, he is brought to the pediatrician by his mother, who says that he looks yellow. Physical examination shows pallor and icterus. Laboratory studies reveal a Hb of 9.0 g/L, reticulocytes constituting 10.8%, platelets of 218,000/cu mm, and leukocyte count of 7,500/cu mm. A probable diagnosis of spherocytosis was made. The peripheral smear which is shown below indicates
HTMLCONTROL Forms.HTML:Hidden.1 a.Normal RBC
HTMLCONTROL Forms.HTML:Hidden.1 b.Hypochromic RBC
HTMLCONTROL Forms.HTML:Hidden.1 c.Defect in Spectrin
HTMLCONTROL Forms.HTML:Hidden.1 d.Microcytic RBC
7.A 34-year-old male patient visited the emergency room with complaints of severe vomiting. Laborotaory examination of the vomitus is found to contain gastric contents including hydrochloric acid. The patients condition is most likely associated with which of the following acid-base disturbances?
HTMLCONTROL Forms.HTML:Hidden.1 a.High anion gap metabolic acidosis
HTMLCONTROL Forms.HTML:Hidden.1 b.Normal anion gap metabolic acidosis
HTMLCONTROL Forms.HTML:Hidden.1 c.Respiratory acidosis
HTMLCONTROL Forms.HTML:Hidden.1 d.Respiratory alkalosis
HTMLCONTROL Forms.HTML:Hidden.1 e.Metabolic alkalosis
8.Basophils are increased in which of the following conditions?
HTMLCONTROL Forms.HTML:Hidden.1 a.Acute infection
HTMLCONTROL Forms.HTML:Hidden.1 b.Chronic infection
HTMLCONTROL Forms.HTML:Hidden.1 c.Parasitic infestation
HTMLCONTROL Forms.HTML:Hidden.1 d.Allergic reaction
9.A researcher is studying the effect of various manipulations on kidney blood flow and glomerular filtration. Which of the following is most likely to increase both renal plasma flow and peritubular capillary pressure but decrease the glomerular capillary pressure?
HTMLCONTROL Forms.HTML:Hidden.1 a.Constrict afferent arteriole
HTMLCONTROL Forms.HTML:Hidden.1 b.Dilate afferent arteriole
HTMLCONTROL Forms.HTML:Hidden.1 c.Constrict efferent arteriole
HTMLCONTROL Forms.HTML:Hidden.1 d.Dilate efferent arteriole
10.If the above researcher dilates the afferent arteriole then which of the following changes will be seen in renal plasma flow, peritubular capillary pressure, and glomerular capillary pressure respectively?
HTMLCONTROL Forms.HTML:Hidden.1 a.Increases, increases, and increases
HTMLCONTROL Forms.HTML:Hidden.1 b.Decreases, decreases, and decreases
HTMLCONTROL Forms.HTML:Hidden.1 c.Decreases, decreases, and increases
HTMLCONTROL Forms.HTML:Hidden.1 d.Increases, increases, and decreases
11.The vascular systems of five organs are arranged as shown in the drawing below. The vascular resistance of each organ is the same and the total resistance of the entire circuit is 2.0 mm Hg/mL/min. What is the individual vascular resistance (mm Hg/mL/min) of each organ?
HTMLCONTROL Forms.HTML:Hidden.1 a.10
HTMLCONTROL Forms.HTML:Hidden.1 b.8
HTMLCONTROL Forms.HTML:Hidden.1 c.6
HTMLCONTROL Forms.HTML:Hidden.1 d.4
HTMLCONTROL Forms.HTML:Hidden.1 e.2
HTMLCONTROL Forms.HTML:Hidden.1 f.1
12.In the above picture, which of the following values is the total resistance of the entire circuit if another organ with the same invidual vascular resistance (mm Hg/mL/min) was added to the circuit shown in the picture above?
HTMLCONTROL Forms.HTML:Hidden.1 a.0.6
HTMLCONTROL Forms.HTML:Hidden.1 b.1.0
HTMLCONTROL Forms.HTML:Hidden.1 c.1.6
HTMLCONTROL Forms.HTML:Hidden.1 d.2.0
HTMLCONTROL Forms.HTML:Hidden.1 e.2.6
13.A 65-year-old male was brought to the ER with severe chest pain, sweating and nausea. EKG showed ST elevation in leads II, III and aVF. Medical management of acute myocardial infarction was initiated. After initial treatment the pain decreased in intensity, but a reperfusion complex ventricular arrhythmia emerged. The arrhythmia was asymptomatic and resolved spontaneously. Which of the following drug was most likely responsible for rapid reperfusion in this patient?
HTMLCONTROL Forms.HTML:Hidden.1 a.Heparin
HTMLCONTROL Forms.HTML:Hidden.1 b.Argatroban
HTMLCONTROL Forms.HTML:Hidden.1 c.Warfarin
HTMLCONTROL Forms.HTML:Hidden.1 d.tPA
HTMLCONTROL Forms.HTML:Hidden.1 e.Aspirin
14.A 54-year-old male is being evaluated for lung disease. Ventilator function testing reveals a decreased forced vital capacity, and a FEV1 /FVC ratio of 60%. The most likely diagnosis in this patient is
HTMLCONTROL Forms.HTML:Hidden.1 a.Pulmonary fibrosis
HTMLCONTROL Forms.HTML:Hidden.1 b.Interstitial lung disease
HTMLCONTROL Forms.HTML:Hidden.1 c.Pleural effusion
HTMLCONTROL Forms.HTML:Hidden.1 d.Pericardial effusion
HTMLCONTROL Forms.HTML:Hidden.1 e.Emphysema
15.Which of the following factors inhibit erythropoietin production?
HTMLCONTROL Forms.HTML:Hidden.1 a.Low blood volume
HTMLCONTROL Forms.HTML:Hidden.1 b.Anemia
HTMLCONTROL Forms.HTML:Hidden.1 c.Low Hb
HTMLCONTROL Forms.HTML:Hidden.1 d.Normal blood flow
HTMLCONTROL Forms.HTML:Hidden.1 e.Pulmonary diseases
16.A patient came with bone pain and abdominal cramps. Examination revealed depressed mood. X-ray revealed a 0.5 mm stone in the left ureter. Based on these findings, which of the following is the likely diagnosis in this patient?
HTMLCONTROL Forms.HTML:Hidden.1 a.Hyperparathyroidism
HTMLCONTROL Forms.HTML:Hidden.1 b.Hypoarathyroidism
HTMLCONTROL Forms.HTML:Hidden.1 c.Hyperthryoidism
HTMLCONTROL Forms.HTML:Hidden.1 d.Hypopituitarism
HTMLCONTROL Forms.HTML:Hidden.1 e.Hyperpituitarism
17.During a fast, a brief phase of intense sequential contractions begins in the stomach and gradually migrates to the ileum. Release of which of the following intestinal hormones is most likely responsible for this observedeffect?
HTMLCONTROL Forms.HTML:Hidden.1 a.Cholecystokinin
HTMLCONTROL Forms.HTML:Hidden.1 b.Gastrin
HTMLCONTROL Forms.HTML:Hidden.1 c.Gastrin-releasing peptide
HTMLCONTROL Forms.HTML:Hidden.1 d.Motilin
HTMLCONTROL Forms.HTML:Hidden.1 e.Secretin
HTMLCONTROL Forms.HTML:Hidden.1 f.Somatostatin
18.A 55-year-old caucasian female presents to the clinic complaining of weight gain and easy fatiguability. She takes a multi-vitamin and some over-the-counter medications for constipation. Her blood pressure is 140/96 mm Hg and her heart rate is 55/min. Physical examination reveals a delayed relaxation of the knee and ankle reflexes. Skin is very dry and thick. What is the most likely diagnosis in this patient?
HTMLCONTROL Forms.HTML:Hidden.1 a.Hyperthyroidism
HTMLCONTROL Forms.HTML:Hidden.1 b.Hyperparathyroidism
HTMLCONTROL Forms.HTML:Hidden.1 c.Hypothyroidism
HTMLCONTROL Forms.HTML:Hidden.1 d.Hypoparathyroidism
HTMLCONTROL Forms.HTML:Hidden.1 e.Hyperaldosteronism
19.Which of the following parameters will be seen in the base of the lung in comparision to the apex in a normal healthy individual?
HTMLCONTROL Forms.HTML:Hidden.1 a.Perfusion decreased, V/Q increased
HTMLCONTROL Forms.HTML:Hidden.1 b.Perfusion increased, V/Q decreased
HTMLCONTROL Forms.HTML:Hidden.1 c.Perfusion decreased, V/Q decreased
HTMLCONTROL Forms.HTML:Hidden.1 d.Perfusion increased, V/Q increased
20.Gastric inhibitory peptide is an important gastrointestinal hormone. The cells producing it and the functions of the peptide respectively are
HTMLCONTROL Forms.HTML:Hidden.1 a.K cells and inhibits insulin release
HTMLCONTROL Forms.HTML:Hidden.1 b.M cells and stimulates gastric motility
HTMLCONTROL Forms.HTML:Hidden.1 c.S cells and inhibits gastric acid secretion
HTMLCONTROL Forms.HTML:Hidden.1 d.M cells and stimulates intestinal motility
HTMLCONTROL Forms.HTML:Hidden.1 e.K cells and stimulates insulin release
HTMLCONTROL Forms.HTML:Hidden.1 f.S cells and stimulates pepsin secretion
21.In the ECG given below, what is the most likely diagnosis?
HTMLCONTROL Forms.HTML:Hidden.1 a.RBBB
HTMLCONTROL Forms.HTML:Hidden.1 b.RVH
HTMLCONTROL Forms.HTML:Hidden.1 c.LBBB
HTMLCONTROL Forms.HTML:Hidden.1 d.LVH
22.A person who is suffering with severe claustrophobia (fear of closed spaces) was locked accidentally in a closet for some amount of time. If the blood of this patient was analyzed then which of the following sets of lab findings is most likely to be found in this patient?
HTMLCONTROL Forms.HTML:Hidden.1 a.1. pH of 7.29; PaCO2 of 50 mmHg; & HCO3- of 18 mEq/L
HTMLCONTROL Forms.HTML:Hidden.1 b.2. pH of 7.61; PaCO2 of 32 mmHg; & HCO3- of 28 mEq/L
HTMLCONTROL Forms.HTML:Hidden.1 c.3. pH of 7.32; PaCO2 of 34 mmHg; & HCO3- of 18 mEq/L
HTMLCONTROL Forms.HTML:Hidden.1 d.4. pH of 7.43; PaCO2 of 50 mmHg; & HCO3- of 40 mEq/L
HTMLCONTROL Forms.HTML:Hidden.1 e.5. pH of 7.26; PaCO2 of 50 mmHg; & HCO3- of 35 mEq/L
HTMLCONTROL Forms.HTML:Hidden.1 f.6. pH of 7.52; PaCO2 of 30 mmHg; & HCO3- of 18 mEq/L
23.In the above sets of lab findings, which set will correspond to a patient suffering with Conns syndrome?
HTMLCONTROL Forms.HTML:Hidden.1 a.1
HTMLCONTROL Forms.HTML:Hidden.1 b.2
HTMLCONTROL Forms.HTML:Hidden.1 c.3
HTMLCONTROL Forms.HTML:Hidden.1 d.4
HTMLCONTROL Forms.HTML:Hidden.1 e.5
HTMLCONTROL Forms.HTML:Hidden.1 f.6
24.Transport of glucose from the intestinal lumen into a small intestinal cell is inhibited when the usual Na+ gradient across the membrane is abolished. This would suggest inhibition of which of the following transport mechanisms?
HTMLCONTROL Forms.HTML:Hidden.1 a.Simple diffusion
HTMLCONTROL Forms.HTML:Hidden.1 b.Facilitated diffusion
HTMLCONTROL Forms.HTML:Hidden.1 c.Primary active transport
HTMLCONTROL Forms.HTML:Hidden.1 d.Cotransport
HTMLCONTROL Forms.HTML:Hidden.1 e.Countertransport
25.On routine physical examination, a 21-year-old Caucasian male is found to have only one testis in his scrotum. Further evaluation reveals an elevated serum FSH level and a normal serum LH level. Production of which of the following substances is likely to be impaired in this patient?
HTMLCONTROL Forms.HTML:Hidden.1 a.Testosterone
HTMLCONTROL Forms.HTML:Hidden.1 b.Dihydrotestosterone
HTMLCONTROL Forms.HTML:Hidden.1 c.DHEA
HTMLCONTROL Forms.HTML:Hidden.1 d.Inhibin B
HTMLCONTROL Forms.HTML:Hidden.1 e.Cortisol
26.The blood of a patient is tested in the lab for grouping and typing. The blood did not react when A and B antibodies were added but reacted when D antibodies are added. The patient's blood group based on the above reactions is
HTMLCONTROL Forms.HTML:Hidden.1 a.A positive
HTMLCONTROL Forms.HTML:Hidden.1 b.B positive
HTMLCONTROL Forms.HTML:Hidden.1 c.AB positive
HTMLCONTROL Forms.HTML:Hidden.1 d.O positive
HTMLCONTROL Forms.HTML:Hidden.1 e.A negative
HTMLCONTROL Forms.HTML:Hidden.1 f.B negative
HTMLCONTROL Forms.HTML:Hidden.1 g.AB negative
27.A series of photographs taken of a middle-aged man over a period of two decades demonstrates gradual coarsening of facial features and progressive protrusion of the brows. Upon questioning, the patient reports having to wear larger shoes than he did as a young man. MRI scan revealed the presence of hypothalamic tumor. Which of the following changes can be seen in this partiular case?
HTMLCONTROL Forms.HTML:Hidden.1 a.GH increase, GHRH decrease, Somatostatin decrease
HTMLCONTROL Forms.HTML:Hidden.1 b.GH decrease, GHRH increase, Somatostatin decrease
HTMLCONTROL Forms.HTML:Hidden.1 c.GH increase, GHRH increase, Somatostatin increase
HTMLCONTROL Forms.HTML:Hidden.1 d.GH increase, GHRH decrease, Somatostatin increase
HTMLCONTROL Forms.HTML:Hidden.1 e.GH decrease, GHRH decrease, Somatostatin decrease
28.Which of the following characteristics is shared by simple and facilitated diffusion of glucose?
HTMLCONTROL Forms.HTML:Hidden.1 a.Is saturable
HTMLCONTROL Forms.HTML:Hidden.1 b.Requires metabolic energy
HTMLCONTROL Forms.HTML:Hidden.1 c.Is inhibited by the presence of galactose
HTMLCONTROL Forms.HTML:Hidden.1 d.Occurs down an electrochemical gradient
HTMLCONTROL Forms.HTML:Hidden.1 e.Requires a Na+ Gradient
29.Which of the following tests is used for measuring specifically intrinsic pathway?
HTMLCONTROL Forms.HTML:Hidden.1 a.Prothrombin time
HTMLCONTROL Forms.HTML:Hidden.1 b.Bleeding time
HTMLCONTROL Forms.HTML:Hidden.1 c.Clotting time
HTMLCONTROL Forms.HTML:Hidden.1 d.aPTT (partial thromboplastin time)
30.Prior to a major abdominal surgery a patient was found to have low levels of vitamin K. Which of the following clotting factors would be decreased in this patient?
HTMLCONTROL Forms.HTML:Hidden.1 a.I
HTMLCONTROL Forms.HTML:Hidden.1 b.III
HTMLCONTROL Forms.HTML:Hidden.1 c.V
HTMLCONTROL Forms.HTML:Hidden.1 d.VII
HTMLCONTROL Forms.HTML:Hidden.1 e.XI
31.On performing an arterial blood analysis in a patient the physician noted that the pH and HCO3- levels are decreased but PCO2 level is increased. Which of the following conditions best describes this patients problem?
HTMLCONTROL Forms.HTML:Hidden.1 a.Respiratory acidosis
HTMLCONTROL Forms.HTML:Hidden.1 b.Respiratory alkalosis
HTMLCONTROL Forms.HTML:Hidden.1 c.Metabolic acidosis
HTMLCONTROL Forms.HTML:Hidden.1 d.Metabolic alkalosis
HTMLCONTROL Forms.HTML:Hidden.1 e.Mixed acidosis
HTMLCONTROL Forms.HTML:Hidden.1 f.Mixed alkalosis
32.Which of the following is true about the secretion from the exocrine pancreas?
HTMLCONTROL Forms.HTML:Hidden.1 a.It has a higher Cl- concentration than does plasma
HTMLCONTROL Forms.HTML:Hidden.1 b.It is stimulated by the presence of HCO3- in the duodenum
HTMLCONTROL Forms.HTML:Hidden.1 c.Pancreatic secretion is increased by gastrin
HTMLCONTROL Forms.HTML:Hidden.1 d.Pancreatic enzyme secretion is increased by cholecystokinin (CCK)
HTMLCONTROL Forms.HTML:Hidden.1 e.It is hypotonic
33.Which of the following hormones maintains the corpus luteum of pregnancy?
HTMLCONTROL Forms.HTML:Hidden.1 a.GnRH
HTMLCONTROL Forms.HTML:Hidden.1 b.FSH
HTMLCONTROL Forms.HTML:Hidden.1 c.hCG
HTMLCONTROL Forms.HTML:Hidden.1 d.Progesterone
HTMLCONTROL Forms.HTML:Hidden.1 e.Estrogen
HTMLCONTROL Forms.HTML:Hidden.1 f.Prolactin
34.The hormone responsible for stimulating milk production from a lactating mammary gland is
HTMLCONTROL Forms.HTML:Hidden.1 a.Prolactin
HTMLCONTROL Forms.HTML:Hidden.1 b.Vasopressin
HTMLCONTROL Forms.HTML:Hidden.1 c.Oxytocin
HTMLCONTROL Forms.HTML:Hidden.1 d.FSH
HTMLCONTROL Forms.HTML:Hidden.1 e.LH
35.A 59-yr-old male patient is brought to the ER with complaints of chest pain, breathlessness, palpitations, & sweating. Blood tests, ECG and Angiogram were done in this patient and flow rates were measured. It is a known fact that for a given vessel length, flow depends on radius, pressure gradients, and viscosity. Angiogram revealed an atherosclerotic plaque in the LAD that has reduced the radius of the vessel by a factor of 2. The flow change only due to the plaque is:
HTMLCONTROL Forms.HTML:Hidden.1 a.Increase by a factor of 2
HTMLCONTROL Forms.HTML:Hidden.1 b.Decrease by a factor of 2
HTMLCONTROL Forms.HTML:Hidden.1 c.Increase by a factor of 8
HTMLCONTROL Forms.HTML:Hidden.1 d.Decrease by a factor of 8
HTMLCONTROL Forms.HTML:Hidden.1 e.Increase by a factor of 16
HTMLCONTROL Forms.HTML:Hidden.1 f.Decrease by a factor of 16
36.In the above patient, blood tests revealed that the patient is suffering with severe anemia with low RBC count that reduced the hematocrit to 1/4th of its original value. The flow change only due to the hematocrit variation is:
HTMLCONTROL Forms.HTML:Hidden.1 a.Increase by a factor of 2
HTMLCONTROL Forms.HTML:Hidden.1 b.Decrease by a factor of 2
HTMLCONTROL Forms.HTML:Hidden.1 c.Increase by a factor of 8
HTMLCONTROL Forms.HTML:Hidden.1 d.Decrease by a factor of 8
HTMLCONTROL Forms.HTML:Hidden.1 e.Increase by a factor of 4
HTMLCONTROL Forms.HTML:Hidden.1 f.Decrease by a factor of 4
37.In the above patient, BP monitoring of the patient revealed a raise of systolic pressure from 120 to 160 while the diastolic pressure remained at 80 mm Hg. The flow change only due to the pressure gradient is:
HTMLCONTROL Forms.HTML:Hidden.1 a.Increase by a factor of 2
HTMLCONTROL Forms.HTML:Hidden.1 b.Decrease by a factor of 2
HTMLCONTROL Forms.HTML:Hidden.1 c.Increase by a factor of 8
HTMLCONTROL Forms.HTML:Hidden.1 d.Decrease by a factor of 8
HTMLCONTROL Forms.HTML:Hidden.1 e.Increase by a factor of 4
HTMLCONTROL Forms.HTML:Hidden.1 f.Decrease by a factor of 4
38.In the above patient, what would be the overall change in flow if we take into consideration all the 3 variations mentioned above together?
HTMLCONTROL Forms.HTML:Hidden.1 a.Increase by a factor of 2
HTMLCONTROL Forms.HTML:Hidden.1 b.Decrease by a factor of 2
HTMLCONTROL Forms.HTML:Hidden.1 c.Increase by a factor of 8
HTMLCONTROL Forms.HTML:Hidden.1 d.Decrease by a factor of 8
HTMLCONTROL Forms.HTML:Hidden.1 e.Increase by a factor of 4
HTMLCONTROL Forms.HTML:Hidden.1 f.Decrease by a factor of 4
39.A patient presents with complaints of chest pain, breathlessness on exertion, & syncope. After performing an ECG exam on the patient they physician came to the conclusion that the patient is suffering with second-degree heart block. Which of the following ECGs represents this type of heart block?
HTMLCONTROL Forms.HTML:Hidden.1 a.1
HTMLCONTROL Forms.HTML:Hidden.1 b.2
HTMLCONTROL Forms.HTML:Hidden.1 c.3
HTMLCONTROL Forms.HTML:Hidden.1 d.4
HTMLCONTROL Forms.HTML:Hidden.1 e.5
HTMLCONTROL Forms.HTML:Hidden.1 f.6
40.If the above patient was diagnosed to be suffering with atrial fibrillation then which of the above ECGs will be seen in the patient?
HTMLCONTROL Forms.HTML:Hidden.1 a.1
HTMLCONTROL Forms.HTML:Hidden.1 b.2
HTMLCONTROL Forms.HTML:Hidden.1 c.3
HTMLCONTROL Forms.HTML:Hidden.1 d.4
HTMLCONTROL Forms.HTML:Hidden.1 e.5
HTMLCONTROL Forms.HTML:Hidden.1 f.6
41.In the above patient, if the diagnosis was changed to ventricular fibrillation then the above ECGs will corresponding to this new diagnosis
HTMLCONTROL Forms.HTML:Hidden.1 a.1
HTMLCONTROL Forms.HTML:Hidden.1 b.2
HTMLCONTROL Forms.HTML:Hidden.1 c.3
HTMLCONTROL Forms.HTML:Hidden.1 d.4
HTMLCONTROL Forms.HTML:Hidden.1 e.5
HTMLCONTROL Forms.HTML:Hidden.1 f.6
42.A 65-year-old male with long history of chronic obstructive pulmonary disease (COPD) is brought to the emergency room complaining of shortness of breath, fever, yellow sputum and lower extremity edema. Physical examination reveals cyanosis, finger clubbing and bilateral lung wheezes. Which of the following findings is the most likely in this patient?
HTMLCONTROL Forms.HTML:Hidden.1 a.Normal arterial blood oxygen content
HTMLCONTROL Forms.HTML:Hidden.1 b.Normal mixed venous blood oxygen content
HTMLCONTROL Forms.HTML:Hidden.1 c.Increased pH of the arterial blood
HTMLCONTROL Forms.HTML:Hidden.1 d.Increased pulmonary arterial resistance
HTMLCONTROL Forms.HTML:Hidden.1 e.Increased cerebral vascular resistance
43.Anemia is usually characterized by an increased:
HTMLCONTROL Forms.HTML:Hidden.1 a.Hematocrit
HTMLCONTROL Forms.HTML:Hidden.1 b.Blood viscosity
HTMLCONTROL Forms.HTML:Hidden.1 c.Total peripheral resistance
HTMLCONTROL Forms.HTML:Hidden.1 d.Exercise performance
HTMLCONTROL Forms.HTML:Hidden.1 e.Work load on the heart
44.A young boy presents with failure to thrive. Biochemical analysis of a duodenal aspirate after a meal reveals a deficiency of enteropeptidase (enterokinase). The levels of which of the following digestive enzymes would be affected?
HTMLCONTROL Forms.HTML:Hidden.1 a.Amylase
HTMLCONTROL Forms.HTML:Hidden.1 b.Colipase
HTMLCONTROL Forms.HTML:Hidden.1 c.Lactase
HTMLCONTROL Forms.HTML:Hidden.1 d.Pepsin
HTMLCONTROL Forms.HTML:Hidden.1 e.Trypsin
45.The partial pressure of oxygen in the tracheal air of a resting, young, healthy patient is known to be 150 mmHg, however, when the alveolar oxygen partial pressure is tested, the pressure reads 80 mmHg. This finding mostly likely indicates which of the following about this patient?
HTMLCONTROL Forms.HTML:Hidden.1 a.A normal alveolar ventilation and perfusion
HTMLCONTROL Forms.HTML:Hidden.1 b.Poor alveolar ventilation
HTMLCONTROL Forms.HTML:Hidden.1 c.Poor alveolar perfusion
HTMLCONTROL Forms.HTML:Hidden.1 d.Diffusion limited gas exchange
HTMLCONTROL Forms.HTML:Hidden.1 e.Arteriovenous blood shunting
46.Carbon monoxide is a deadly gas and binds to hemoglobin when inhaled. It creates problems because it binds to the same site as oxygen does, competing for the same binding site. This ultimately causes the erythrocyte to deliver carbon monoxide instead of oxygen to the tissues. Which of the following is the binding site for carbon monoxide?
HTMLCONTROL Forms.HTML:Hidden.1 a.globin
HTMLCONTROL Forms.HTML:Hidden.1 b. amino acid
HTMLCONTROL Forms.HTML:Hidden.1 c.copper
HTMLCONTROL Forms.HTML:Hidden.1 d.iron
HTMLCONTROL Forms.HTML:Hidden.1 e.manganese
47.A patient presents with fatigue and generalized weakness. Examination revealed significant pallor. Peripheral blood smear which is shown below shows small and pale RBC. The patient will benefit with intake of
HTMLCONTROL Forms.HTML:Hidden.1 a.Iodine
HTMLCONTROL Forms.HTML:Hidden.1 b.Iron
HTMLCONTROL Forms.HTML:Hidden.1 c.Vitamin B12
HTMLCONTROL Forms.HTML:Hidden.1 d.Riboflavin
HTMLCONTROL Forms.HTML:Hidden.1 e.Vitamin A
48.Angiography on a 63-year-old male reveals atherosclerotic narrowing of the right renal artery. The left renal artery is intact. You conclude that the flow in the right-sided artery is decreased by a factor of 16 compared to the left. Thus, the degree of stenosis in the right renal artery is
HTMLCONTROL Forms.HTML:Hidden.1 a.25%
HTMLCONTROL Forms.HTML:Hidden.1 b.33%
HTMLCONTROL Forms.HTML:Hidden.1 c.50%
HTMLCONTROL Forms.HTML:Hidden.1 d.75%
HTMLCONTROL Forms.HTML:Hidden.1 e.90%
49.Which of the following mechanisms help in acclimatization to high altitude?
HTMLCONTROL Forms.HTML:Hidden.1 a.Decrease in pulmonary ventilation
HTMLCONTROL Forms.HTML:Hidden.1 b.Decreased numbers of red blood cells
HTMLCONTROL Forms.HTML:Hidden.1 c.Increased diffusing capacity of the lungs
HTMLCONTROL Forms.HTML:Hidden.1 d.Decreased vascularity of the peripheral tissues
HTMLCONTROL Forms.HTML:Hidden.1 e.Decreased ability of the tissue cells to use oxygen despite low Po2
50.A 70-year-old woman undergoes a gastrectomy for Zollinger-Ellison syndrome. Her doctor informs her that she will need to take intramuscular vitamin B12 shots for the rest of her life. Absence of which of the following cell types is responsible for this vitamin replacement requirement?
HTMLCONTROL Forms.HTML:Hidden.1 a.Chief cells
HTMLCONTROL Forms.HTML:Hidden.1 b.G cells
HTMLCONTROL Forms.HTML:Hidden.1 c.Goblet cells
HTMLCONTROL Forms.HTML:Hidden.1 d.Mucous neck cells
HTMLCONTROL Forms.HTML:Hidden.1 e.Parietal cells
51.The pulmonary volume curve for a 34-year-old male is shown on the slide below in comparison with a normal curve (dashed line). Which of the following measures is increased in this patient?
HTMLCONTROL Forms.HTML:Hidden.1 a.Forced vital capacity (FVC)
HTMLCONTROL Forms.HTML:Hidden.1 b.Forced expiratory volume in one second (FEV1)
HTMLCONTROL Forms.HTML:Hidden.1 c.FEV1/FVC
HTMLCONTROL Forms.HTML:Hidden.1 d.Residual volume
HTMLCONTROL Forms.HTML:Hidden.1 e.Tidal volume
52.A 24-yr-old male person was brought to the ER with severe hypovolemia following severe burns. How does his Osmolality and volume for ECF and Osmolality and volume for ICF change respectively?
HTMLCONTROL Forms.HTML:Hidden.1 a.Decrease, increase, decrease, and increase
HTMLCONTROL Forms.HTML:Hidden.1 b.Decrease, decrease, decrease, and increase
HTMLCONTROL Forms.HTML:Hidden.1 c.No change, increase, no change, and no change
HTMLCONTROL Forms.HTML:Hidden.1 d.No change, decrease, no change, and no change
HTMLCONTROL Forms.HTML:Hidden.1 e.Increase, increase, increase, and decrease
HTMLCONTROL Forms.HTML:Hidden.1 f.Increase, decrease, increase, and decrease
53.Which of the following areas represents the volume of air inhaled or exhaled with each breath?
HTMLCONTROL Forms.HTML:Hidden.1 a.BC
HTMLCONTROL Forms.HTML:Hidden.1 b.CD
HTMLCONTROL Forms.HTML:Hidden.1 c.DE
HTMLCONTROL Forms.HTML:Hidden.1 d.BE
HTMLCONTROL Forms.HTML:Hidden.1 e.CE
HTMLCONTROL Forms.HTML:Hidden.1 f.AB
54.In the above picture, which area represents inspiratory capacity?
HTMLCONTROL Forms.HTML:Hidden.1 a.CE
HTMLCONTROL Forms.HTML:Hidden.1 b.DE
HTMLCONTROL Forms.HTML:Hidden.1 c.BC
HTMLCONTROL Forms.HTML:Hidden.1 d.AC
HTMLCONTROL Forms.HTML:Hidden.1 e.BD
HTMLCONTROL Forms.HTML:Hidden.1 f.BE
55.In the above picture, the area BE represents
HTMLCONTROL Forms.HTML:Hidden.1 a.Tidal volume
HTMLCONTROL Forms.HTML:Hidden.1 b.Forced inspiratory volume
HTMLCONTROL Forms.HTML:Hidden.1 c.Inspiratory capacity
HTMLCONTROL Forms.HTML:Hidden.1 d.Forced expiratory volume
HTMLCONTROL Forms.HTML:Hidden.1 e.Vital capacity
HTMLCONTROL Forms.HTML:Hidden.1 f.Functional residual capacity
56.In the above picture, the area AC represents
HTMLCONTROL Forms.HTML:Hidden.1 a.Tidal volume
HTMLCONTROL Forms.HTML:Hidden.1 b.Forced inspiratory volume
HTMLCONTROL Forms.HTML:Hidden.1 c.Inspiratory capacity
HTMLCONTROL Forms.HTML:Hidden.1 d.Forced expiratory volume
HTMLCONTROL Forms.HTML:Hidden.1 e.Vital capacity
HTMLCONTROL Forms.HTML:Hidden.1 f.Functional residual capacity
57.A patient visits the clinic complainig of confusion and disoreinetation. Investigations revealed cerebral edema. CT chest revealed a lung tumor. Which of the following abnormalities would one find in this patient?
HTMLCONTROL Forms.HTML:Hidden.1 a.Hyponatremia due to excess water
HTMLCONTROL Forms.HTML:Hidden.1 b.Hyponatremia due to excess sodium loss
HTMLCONTROL Forms.HTML:Hidden.1 c.Hypernatremia due to dehydration
HTMLCONTROL Forms.HTML:Hidden.1 d.Hypernatremia due to excess sodium intake
58.A patient presents to the clinic with complaints of breathlessness and cough with sputum production. The breathlessness has increased in recent days. X-ray and CT scan revealed the presence of a collapsed lobe in the right lung. This condition leads to
HTMLCONTROL Forms.HTML:Hidden.1 a.Wasted ventilation (dead space)
HTMLCONTROL Forms.HTML:Hidden.1 b.Venous admixture
HTMLCONTROL Forms.HTML:Hidden.1 c.Wasted perfusion (shunt)
HTMLCONTROL Forms.HTML:Hidden.1 d.Shifting in the hemoglobin diffusion curve
HTMLCONTROL Forms.HTML:Hidden.1 e.Decreased tissue O2 utilization
59.What is the direction of the flow of the fluid in relation to the capillaries and what is the net outward/inward pressure in a given tissue if the pressures are as followsCapillary hydrostatic pressure 55 mm HgCapillary oncotic pressure 34 mmHgInterstitial fluid hydrostatic pressure 28 mm HgTissue oncotic pressure 4 mmHg
HTMLCONTROL Forms.HTML:Hidden.1 a.Inwards and 45 mm Hg
HTMLCONTROL Forms.HTML:Hidden.1 b.Outwards and 3 mm Hg
HTMLCONTROL Forms.HTML:Hidden.1 c.Inwards and 3 mm Hg
HTMLCONTROL Forms.HTML:Hidden.1 d.Outwards and 57 mm Hg
HTMLCONTROL Forms.HTML:Hidden.1 e.Inwards and 57 mm Hg
HTMLCONTROL Forms.HTML:Hidden.1 f.Outwards and 45 mm Hg
60.In the above question, if the Interstitial fluid hydrostatic pressure was changed to negative 10 mm Hg (-10 mm Hg), then what is the direction of the flow of the fluid in relation to the capillaries and what is the net Outward/Inward pressure?
HTMLCONTROL Forms.HTML:Hidden.1 a.Inwards and 35 mm Hg
HTMLCONTROL Forms.HTML:Hidden.1 b.Outwards and 7 mm Hg
HTMLCONTROL Forms.HTML:Hidden.1 c.Inwards and 7 mm Hg
HTMLCONTROL Forms.HTML:Hidden.1 d.Outwards and 83 mm Hg
HTMLCONTROL Forms.HTML:Hidden.1 e.Inwards and 83 mm Hg
HTMLCONTROL Forms.HTML:Hidden.1 f.Outwards and 35 mm Hg
61.A 16-year-old male patient visited the emergency room with complaints of deep, rapid breathing, dry skin and mouth, and flushed face. Laboratory examination revealed very high levels of glucose and ketone bodies. The patients condition is most likely associated with which of the following acid-base disturbances?
a.High anion gap metabolic acidosis
b.Normal anion gap metabolic acidosis
c.Respiratory acidosis
d.Respiratory alkalosis
e.Metabolic alkalosis
62.A 24-yr-old male person was brought to the ER with severe hemorrhage following a motor vehicular accident. How does his Osmolality and volume for ECF and Osmolality and volume for ICF change respectively?
a.Decrease, increase, decrease, and increase
b.Decrease, decrease, decrease, and increase
c.No change, increase, no change, and no change
d.No change, decrease, no change, and no change
e.Increase, increase, increase, and decrease
f.Increase, decrease, increase, and decrease
63.A patient presents with complaints of breathlessness, puffiness of face, swollen legs, & bloated abdomen. Examination revealed pitting edema of legs, pleural effusion, & ascites. Urinalysis revealed a proteinuria of 4.5 g/day. A diagnosis of nephrotic syndrome with chronic renal failure was made. Which of the following characteristics will be seen in this patient?
a.Metabolic alkalosis
b.Hypophosphatemia
c.Hyperkalemia
d.Decreased blood urea levels
e.Megaloblastic anemia
64.The blood of a patient is tested in the lab for grouping and typing. The blood did reacted when A and B antibodies were added but did not react when D antibodies are added. The patient's blood group based on the above reactions is
a.A positive
b.B positive
c.AB positive
d.O positive
e.A negative
f.B negative
g.AB negative
65.A 28-year-old male patient was brought to the hospital after collapsing at a construction site where he worked all day long in the summer heat without taking enough breaks. History given by co-workers confirmed that he was sweating excessively. Which of the following Darrow-Yannet diagrams would be representative of this patient's condition?
a.A
b.B
c.C
d.D
e.E
f.F
http://medicowesome.blogspot.com/2013/08/darrow-yannet-diagrams-simplified.html
66.Which of the Darrow-Yannet diagrams shown above corresponds to kidney disease leading to increased salt excretion?
http://medicowesome.blogspot.com/2013/08/darrow-yannet-diagrams-simplified.html
a.A
b.B
c.C
d.D
e.E
f.F
67.A prematurely born infant is found to exhibit polyuria, polydipsia, muscle weakness, vomiting, & high heart rate. Examination revealed normal blood pressure & sensorineural deafness. Investigation revealed hypokalemia, hypocalcemia, & hypomagnesemia. A diagnosis of Bartter's syndrome was given. The pathophysiology of this disease is similar to the mechanism of action of which of the following drugs?
a.Acetozolamide
b.Hydrochlorthiazide
c.Furosemide
d.Mannitol
e.Amiloride
f.Spironolactone
68.A 22-year-old man participates in a research experiment in which the ICF must be determined. His inulin space is 15.2 L, 125I-albumin space is 2.9 L, 3H2O space is 41.3 L, and his hematocrit is 43%. What is the ICF of this man (in L)?
a.5.3
b.12.3
c.13.2
d.18.1
e.20.3
f.26.1
69. A 42-year-old obese woman experiences episodic abdominal pain. She notes that the pain increases after the ingestion of a fatty meal. The action of which of the following hormones is responsible for the postprandial intensification of her symptoms?
A. Cholecystokinin B. Gastrin
C. Pepsin
D. Secretin
E. Somatostatin
71.A patient undergoes a total gastrectomy because of a proximally located gastric cancer. After the surgery, which of the following digestive enzymes will be produced in inadequate amounts?
A. Amylase
B. Chymotrypsin
C. Lipase
D. Pepsin E. Trypsin
72. A 42-year-old obese woman experiences episodic abdominal pain. She notes that the pain increases after the ingestion of a fatty meal. The action of which of the following hormones is responsible for the postprandial intensification of her symptoms?
A. Cholecystokinin B. Gastrin
C. Pepsin
D. Secretin
E. Somatostatin
73. A pregnant woman in her second trimester complains of heat intolerance and palpitations. Physical examination reveals a slightly enlarged, non-tender thyroid gland, and a normal cardiac exam. The serum thyroxine (T4) level is increased; however, the serum thyroid-stimulating hormone (TSH) is normal. Which of the following best explains the laboratory findings in this patient?
A. Decreased estrogen
B. Increased free thyroxine (T4)
C. Increased progesterone
D. Increased serum triiodothyronine (T3)
E. Increased thyroid-binding globulin (TBG)74. Two normal, healthy subjects volunteer for a study on insulin secretion. In Patient 1, blood glucose is increased to 150 mg/dL by direct intravenous infusion. In Patient 2, blood glucose is increased to 150 mg/dL by ingestion of oral glucose. The peak plasma insulin concentration produced in Patient 1 is 70 U/mL while in Patient 2, it is 95 U/mL. Which of the following best explains the higher insulin concentration in Patient 2?
A. Ingested glucose activates a sympathetic reflex that increases cell release of insulin
B. Ingested glucose increases duodenal secretion of gastric inhibitory peptide (GIP), increasing cell release of insulin C. Intravenous glucose increases islet cell secretion of somatostatin, inhibiting cell release of insulin
D. Intravenous glucose increases islet cell secretion of glucagon, inhibiting cell release of insulin
75. An XX genotypic infant is born with ambiguous genitalia. Laboratory examination reveals hypoglycemia hyperkalemia, and salt wasting. Serum 17-OH progesterone is markedly increased. Which of the following is the most likely diagnosis?
A. 5-alpha-reductase deficiency
B. 11-beta-hydroxylase deficiency
C. 17-alpha-hydroxylase deficiency
D. 21-hydroxylase deficiency E. Complete androgen resistance
76. Most of the testosterone secreted by the testes exists in the plasma in the form of A. dihydrotestosterone bound to gonadal steroid-binding hormone
B. free dihydrotestosterone
C. free testosterone
D. testosterone bound to albumin
E. testosterone bound to sex-steroid-binding globulin77. Which of the following directly inhibits insulin secretion?
A. Alpha2-adrenergic agonist
B. Beta2-adrenergic agonist
C. Cholecystokinin
D. Glucagon
E. Ingestion of a high-sugar meal
F. Muscarinic agonists78. Endometrial biopsy demonstrates a thick endometrium with long, coiled glands lined by a columnar epithelium with prominent cytoplasmic vacuoles adjacent to the gland lumen. Earlier in the menstrual cycle, the glands were much smaller and were lined with cells that did not have vacuoles. Which of the following hormones is primarily responsible for inducing this change in appearance?
A. Aldosterone
B. Cortisol
C. Estrogen
D. Progesterone E. Thyroxine79. A 55-year-old woman stopped menstruating approximately 3 months ago. Worried that she may be pregnant, she decided to have a pregnancy test. The test came back negative. Which of the following series of tests resultswould confirm that the woman is postmenopausal?
A. Decreased LH, decreased FSH, increased estrogen
B. Decreased LH, increased FSH, decreased estrogen
C. Increased LH, decreased FSH, decreased estrogen
D. Increased LH, increased FSH, decreased estrogen E. Increased LH, increased FSH, increased estrogen80. Which of the following hormones is most important in initiating gall bladder contraction?
A. Cholecystokinin (CCK) B. Gastric inhibitory peptide (GIP)
C. Gastrin
D. Secretin
E. Vasoactive intestinal polypeptide (VIP)81. In the transition from a Graafian follicle to a functional corpus luteum, which of the following cellular events occurs?
A. Granulosa cells begin to express aromatase
B. Granulosa cells begin to express FSH receptors
C. Granulosa cells begin to express LH receptors D. Theca cells begin to express LH receptors
E. Theca cells begin to express side-chain cleavage enzyme
82. Which of the following areas of the adrenal gland would you expect to increase in activity in a patient subjected to salt restriction?
A. Adrenal medulla
B. Zona fasciculata of the adrenal cortex
C. Zona glomerulosa of the adrenal cortex D. Zona reticularis of the adrenal cortex
83. A normal, healthy, 24-year-old woman has regular menstrual cycles, each lasting about 28 days. Daily serum samples from the woman reveal decreasing progesterone and 17--estradiol levels. Serum LH and FSH levels are low, and begin rising. Basal body temperature begins falling. Within three days, which of the following events would be expected to occur?
A. Markedly increased inhibin levels
B. Menstruation C. Ovulation
D. Rapidly decreased LH levels
E. Significantly increased basal body temperature
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