path final review

Nonspecific interstitial pneumonia differs from usual interstitial pneumonia by the absence of ____,____,___ membranes and ____.

1. Fibroblastic foci 2. Honeycombing 3. Hyaline 4. Granulomas

55- year old man had gradual increasing dyspnea. He is a heavy smoker he had a barrel shaped chest. He had pursed lips while breathing. His chest X-ray revealed bilateral hyperinflation of lungs more in upper lobes. Which of following points contribute to pathogenesis of his lung disease? A. Impaired production of alpha 1 antitrypsin B. Recruitment of eosinophils in bronchial mucosa

A

The inherited syndrome which increases polyp formation and greatly increases colon cancer risk. A. Diverticulosis B. Inflammatory bowel disease C. Zollinger-Ellison syndrome D. Familial adenomatous polyposis

Familial adenomatous polyposis

Maximum flow achieved during expiration

PEF

Risk factors of DVT include ____, ____, increased ____ and certain ____ illnesses.

1. Damage to vein 2. Stasis. Of flow 3. Estrogen 4. Chronic

11 year old boy complained of a cough wheezes and difficulty in breathing. The attacks are common in spring. During the attack her is a febrile. The lungs are hyper resonant. Laboratory finding showed high IgE level and eosinophils. Which of the following histological feature are characteristic for the patients acute condition?? A. Thickening of bronchial sub basement membrane by collagen and hyperplasia of smooth muscle B. Dilation of the bronchi with inflammatory destruction of the walls C. Patchy areas of consolidation surrounding the bronchioles with neutrophilic infiltrate in affect alveioli D. Dilation of the respiratory bronchiole and distinction of alveoli

A

45 year old man had a persistent cough with hemoptysis for 2 weeks. He was feverish. Chest x-ray revealed an area of consolidation in the right upper lobe. After antibiotic therapy, his fever improved but the cough and hemoptysis did not improve. Repeated chest x-ray revealed a right upper lobe collapse. Bronchoscope examination revealed an obstructing spherical polyploid mass arising from the main bronchus. Which of the following tumor is the most likely the diagnosis? A. Carcinoid tumor B. Hamartoma C. Adenocarcinoma D. Large cell carcinoma

A

A 45-year-old man had persistent cough with hemoptysis for 2 weeks. He was feverish. Chest e-ray revealed an area of consolidation in the right upper lobe. After antibiotic therapy, his fever improved but the cough and hemoptysis did not improve. Repeated chest e-ray revealed right upper lobe collapse. Bronchoscopic examination revealed an obstructing spherical polypoid mass arising from the main bronchus. Which of the following tumor is the most likely the diagnosis? a. Carcinoid Tumor b. Large cell carcinoma c. Adenocarcinoma d. Hamartoma

A

A patient present with hemoptysis, and is positive for autoantibodies against type IV collagen. Which disorder would fit this description? a. Goodpasture syndrome b. Wegnener Granulomatosis c. Miliary tuberculosis d. Aspiration pneumonia

A

A person who works at a foundry, or mines hard rocks, or sandblasts would more likely develop which of these? a. Silicosis b. Coal worker's lung c. Asbestosis d. Sarcoidosis

A

Chronic pneumonia caused by mycobacteria... a. Tuberculosis b. Histoplasmosis c. Pulmonary abscess d. Cysticercosis

A

Common triggers to non-atopic asthma include... a. Viral upper respiratory infection (e.g. rhinovirus) b. Allergens like pollen,or animal dander c. Pharmacologic agents d. Chemicals like formaldehyde, or epoxy resins

A

How does COPD or interstitial lung disease progreass to pulmonary hypertension? a. Destruction of lung tissue reduces capillary numbers therefore increasing pulmonary artery resistance. b. Leads to production of prostaglandins and pulmonary vasospasm c. Decreases alpha-1 antitrypsin activity leading to inflammation d. It is idiopathic

A

Hyaline membranes" are most associated with... a. Acute respiratory distress syndrome b. Intralobar sequestration c. Contraction atelectasis d. Acute interstitial pneumonia

A

In compression atelectasis the mediastinum shifts away from the affected lung A. True B. False

A

In silicosis the disease may continue to worsen even if the patient is no longer exposed. A. True B. False

A

In the TNM system for lung cancer staging, what does the "T" stand for? a. Tumor size/local invasion b. Tumor metastasis c. Tumor in lymph nodes d. Tumor curable by surgery

A

Non-smokers are most likely to get this kind of lung cancer. a. Adenocarcinoma b. Squamous cell carcinoma c. Large cell carcinoma d. Small cell carcinoma

A

Patient present with hemoptysis and is positive of autoantibodies against Tyler IV collagen. Which disorder would fit this description? A. Goodpasture syndrome B. Aspirations pneumonia C. Werner granulomatosis D. Military tuberculosis

A

Select the feature NOT seen on X-ray with emphysema A. Increased vascular markings B. Increased a-p diameter of the chest C. Vertical heart D. low set diaphragm

A

Select the feature found in chronic bronchitis. a. Referred to as "blue bloater" b. Infections are rare c. Hyperinflation of the chest d. Older and thin

A

Select the true statement regarding compression atelectasis? A. Pneumothorax is an example B. Mediastinum shifts toward the affected lung C. Is associated with fibrotic changes in the lung D. It. Is not reversible

A

Several heart and lung diseases can lead to finger "clubbing" particularly in this pulmonary diseases a. Interstitial pulmonary fibrosis b. COPD c. Asthma d. Pneumothorax

A

Small pulmonary emboli may elicit transient chest pain and may be associated with pleural friction rub. A. True B. False

A

Sputum sample may contain Curschmann's spirals and Charcot-Leyden crystals in___. a. Severe asthma b. Chronic bronchitis c. Pneumoconiosis d. Histoplasmosis

A

The majority (95%) of pulmonary emboli originate from a ____. a. Deep vein thrombosis b. In situ granuloma c. Pulmonary aneurysm d. Arterial embolism

A

The most common hemodynamic mechanism of pulmonary edema is: A. Increase hydrostatic pressure B. Lymphatic obstruction C. Decreased on optic pressure D. Increased on optic pressure

A

Select the disease that is most likely to present with melena. A. Internal hemorrhoids B. Acute gastritis C. Ulcerative colitis D. Diverticulitis

Acute gastritis

Upper abdominal pain that feels like it is boring through to the back refers to the left shoulder. In a patient with a history of alcohol use or choledocholithiasis, this is likely... A. Ulcerative colitis B. Hepatitis A C. Acute pancreatitis D. Crohn's disease

Acute pancreatitis

A 3-month old male infant was born at term with no congenital anomalies noted. His mother now notes that he has marked abdominal enlargement along with infrequent bowel movements for the past week. On examination, the abdomen is distended but there does not appear to be appreciable tenderness. A plain film abdominal radiograph reveals marked colonic dilation. What pathological findings would be most likely found in this setting? A. Aganglionic colonic segment B. Volvulus C. Intussusception D. Meconium ileus

Aganglionic colonic segment

A homeless person was admitted to the hospital with chronic productive cough, night sweats, and pain during breathing. A chest x-ray was taken and it showed a singular small Ghon complex. This patient was diagnosed to have: a. Coccidioidomycosis b. Tuberculosis c. Blastomycosis d. Histoplasmosis

B

The most common cause of esophageal varices is... A. Hepatitis A infection B. Esophageal dysmotility C. Infectious esophagitits D. Alcoholic cirrhosis

Alcoholic cirrhosis

Schatzki rings are... A. Found in the large intestine B. Associated with Plummer-Vinson syndrome C. Associated with Barrett's esophagus D. A form of esophageal atresia

Associated with Barrett's esophagus

Primary Raynaud... Commonly causes gangrene Is caused by an underlying condition such as scleroderma Affects large vessels such as aorta and its branches Associated with hyper-responsiveness to cold or emotional stresses

Associated with hyper-responsiveness to cold or emotional stresses

A 56-year-old man reports reduced exercise tolerance over the past 5 years. In the past year, he has noted chest pain after ascending a flight of stairs. He smokes 2 packs of cigarettes per day. On examination, he has a blood pressure of 115/95 mmHg. His BMI is 30. Laboratory findings include a total serum cholesterol of 25 mg/dL with an HDL cholesterol of 22 mg/dL. Which of the following vascular abnormalities is he most likely to have? A. Hyperplastic arteriolosclerosis B. Medial calcific sclerosis C. Atherosclerosis D. Plexiform arteriopathy

Atherosclerosis

Irreversible pulmonary hypertension is least like in ______ A. Ventricular septal defect B. Atrial septal defect C. Persistent truncus arteriosus D. Tetralogy of Fallot

Atrial septal defect

44 year old woman non smoker has had a fever and cough for the past 4 days she does not have hemoptysis. She has not experienced weight loss, malaise, nausea or vomiting. On physical examination her temperature is 37.6. There are decreased breath sounds over the right upper lung. A chest x ray reveals a 6cm area of infiltrated in the right upper lobe. She is given a course of antibiotic therapy, but her cough persists. A month later her chest x rainbow reveals a 3cm peripheral mass in right upper lobe. Which of the following neoplasms is most likely to be present in this woman? A. Squamous cell carcinoma B. Adenocarcinoma C. Carcinoid tumor D. Mesothelioma

B

60 year old man heavy smoker had a persistent cough for the past 6 months. Chest X-ray revealed a lung lesion near the right helium. His laboratory findings were normal except for evidence of hyper Alice Mia. Bronchoscope revealed a right bronchial mass obliterating its lumen. What is the possible diagnosis? A. bronchioalveolar carcinoma B. Squamous cell carcinoma C. Adenocarcinoma D. Hamartoma

B

A 44-year-old woman, a non-smoker, has had a fever and cough for the past 4 days. She does not have hemoptysis. She has not experienced weight loss, malaise, nausea, or vomiting. On physical examination, her temperature is 37.6o C. There are decreased breath sounds over the right upper lung. A chest X-ray reveals a 6 cm area of infiltrates in the right upper lobe. She is given a course of antibiotics therapy, but her cough persists. A month later herchest x-ray now reveals a 3 cm peripheral mass in the right upper lobe. Which of the following neoplasms is most likely to be present in this woman? a. Squamous cell carcinoma b. Adenocarcinoma c. Mesothelioma d. Carcinoid tumor

B

A 55-year-old man had gradual increasing dyspnea. He is a heavy smoker. He had a barrel-shaped chest. He had pursed lips while breathing. His chest x-ray revealed bilateral hyperinflation of lungs more in the upper lobes. Which of the following points contributes to the pathogenesis of his lumg disease? a. Release of elastase from the neutrophils b. Impaired production of alpha1-antitrypsin c. Decreased ciliary motility d. Recruitment of eosinophil in bronchial mucosa

B

A congenitital defect in which a part of a lung does not connect to the tree, and is anatomically separate from the rest of the lung, inhabiting its own pleural sac. a. Intralobar sequestration b. extralobar sequestration c. pulmonary fistula d. contraction atelectasis

B

A man worked in a shipyard for 20 years. He complained of progressive dyspnea. Chest x-ray revealed a mass ensheathing the left lung. Within the lung parenchyma adjacent to the mass many golden brown beaded rods and fusiform bodies are seen. Which of the following is a possible chest e-ray finding? a. Left upper lobe cavity lesion b. Left calcified pleural plaques c. Left lower lobe bronchial dilatation d. Left lower lobe consolidation

B

Congenital defect in which part of lung does not connect to bronchial tree tree and lies within the same visceral pleura as the lobe in which occurs. A. Contraction atelectasis B. Extralobar sequestration C. Intralobar sequestration D. Pulmonary fistula

B

How does COPD or interstitial lung disease progress to pulmonary hypertension? A. Decrease alpha 1 anti trypsin activity leading to inflammation B. Destruction of lung tissue reduces capillary numbers therefore increasing pulmonary artery resistance C. Leads to production of prostaglandins and pulmonary vasospasm

B

Majority of pulmonary emboli originate from varicose veins. A. True B. False

B

Man worked in a shipyard for 20 years. He complained of progressive dyspnea. Chest X-rays revealed a mass ensheathing the left lung. Within the lung parenchyma adjacent to the mass many golden brown beaded rods and fuse form bodies are seen. Which of the following is possible chest X-ray findings? A. Left lower lobe consolidations B. Left calcified pleural plaques C. Left upper lobe cavity lesion D. Left lower lobe bronchial dilation

B

Only 10-15% of cases of streptococcus pneumonia will have positive blood cultures in the early phase of illness. A. True B. False

B

Pulmonary hypertension develops when pulmonary pressure becomes more than a 1/3rd of the pressure in the systemic circulation. A. True B. False

B

Risk factors for deep vein thrombosis include... a. Atherosclerosis b. Immobilization c. Exercese d. Hyperthyroidism

B

Select the true statement regarding compression atelectasis a. Mediastinum shifts toward the affected lung b. Pneumothorax is an example c. Is associated with fibrotic changes in the lung d. It is not reversible

B

Simple coal worker pneumoconiosis always give rise to centrilobular emphysema A. True B. False

B

The hallmark of this disease is airway hyper-responsiveness to stimuli resulting in bronchoconstriction a. Chronic bronchitis b. Asthma c. Bronchiectasis d. Bronchiolitis

B

Very little mucus leads to secondary infection. A. True B. False

B

What type of patient would most likely suffer aspiration pneumonia? a. A 65-year-old transplant patient of immunosuppressant drugs b. A 70-year-old who recently had a brain stem stroke and has trouble swallowing. c. A child exposed to mycoplasma pneumoniae at school d. A patient that had a catheter when they were in the hospital

B

Which is consistent with a micro vascular cause of pulmonary edema? A. Pulmonary pressure is markedly elevated B. Is most likely caused by pneumonia C. Is associated with volume overload (blood volume) D. Is most likely caused by left heart failure

B

Autoimmune gastritis interferes with HCL production and vitamin B12 absorption due to antibodies against... A. Chief cells B. Pancreatic islet cells C. Parietal cells D. Goblet cells

C. Parietal cells

A "twisting" of a segment of bowel (most commonly the sigmoid colon). A. Volvulus B. Intestinal atresia C. Intussusception D. Omphalocele

Volvulus

40 year old woman had suffered from multiple attacks of necrotizing pneumonia. She now had a productive cough of a large amount of purple tissue sputum. The chest x-ray suggested dilation of right lower lobe bronchi. Which of the following mechanisms is the cause of bronchial dilation? A. Damage to bronchial mucosa by inflammatory mediators B. Unopposed action of neutrophil derived elastase C. Destruction of bronchial walls by recurrent inflammation D. Congenital weakness of supporting structures of the bronchial wall

C

6 years old girl had a cough headache and fever. She also suffered from respiratory difficulty for 5 days. Influenza virus was isolated from the sputum sample. Which of the following chest x-ray finding is most likely to be present? A. Upper lobe cavitation B. A peripheral mass C. Lobar consolidation Interstitial infiltrate

C

A 40-year-old woman had suffered from multiple attacks of necrotizing pneumonia. She now has a productive cough of a large amount of purulent sputum. The chest x-ray suggested dilatation of right lower lobe bronchi. Which of the following mechanisms is the cause of bronchial dilatation? a. Unopposed action of neutrophil-derived elastase b. Congenital weakness of supporting structures of the bronchial wall c. Destruction of bronchial mucosa

C

A 60-year-old man, heavy smoker had a persistent cough for the past 6 months. Chest x-ray revealed a lung lesion near the right hilum. His laboratory findings were normal except for evidence of hypercalcemia. Bronchoscopy revealed a right bronchial mass obliterating its lumen. What is the possible diagnosis? a. Bronchioalveolar carcinoma b. Adenocarcinoma c. Spuamous cell carcinoma d. Hamartoma

C

A patient with lunc cancer develops a droopy eyelid, a constricted pupil, and does not sweat on one side. This is termed... a. Goodpasture syndrome b. Cushing's syndrome c. Horner's syndrome d. Sarcoidosis

C

A patient working in sandblasting business for 20 years complained of a cough and increasing dyspnea with no fever or sputum production. Which of the following cells are responsible for the pathogenesis of his disease? a. Eosinophils b. Mast cells c. Macrophages d. Neutrophils

C

A systemic disease that may affect the lungs is characterized by non-caseating granulomas. Bilateral hilar adenopathy is common (bat-wing) on x-ray. a. Interstitial pulmonary fibrosis b. Hypersensitivity pneumonitis c. Sarcoidosis d. Asbestos

C

A young child presents with sudden onset of fever and malaise, cough with purulent sputum or blood. Examination of the sputum showed neutrophils with G+ lancet shaped diplococci. Which bacterium could cause these symptoms? a. Haemophilus influenza b. Staphylococcus aureus c. Streptococcus pneumoniae d. Legionella pneumophila

C

Complete obstruction of an airway leads to what type of aterlectasis? a. Compression b. Contraction c. Resorption d. Atretic

C

Non-smokers are most likely to get this kind lung cancer. A. Squamous cell carcinoma B. Large cell carcinoma C. Adenocarcinoma D. Small cell carcinoma

C

Patient with lung cancer develops a droopy eyelid a constricted pupil and does not sweat on one side this is termed? A. Goodpasture syndrome B. Sarcoidosis C. Horners syndrome D. Cushing syndrome

C

Permanent dilation bronchi and bronchioles caused by chronic necrotizing infections best describes... a. Chronic bronchitis b. Asthma c. Bronchiectasis d. Bronchiolitis

C

The genetic predisposition to make IgE antibodies describes this category of asthma the best. a. Drug-induced b. Occupational c. Atopic d. Non-atopic

C

Which of the following is a pneumoconiosis condition? a. Farmer's lung b. Bird breeder's lung c. Coal worker's lung d. Hot tub lung

C

Presence of (ANCAs)

Wegener granulomatosis

In CREST syndrome, which gastrointestinal disorder is not present? A. Raynaud's phenomenon B. Crohn's disease C. Esophageal dysmotility D. Stenosis of the pylorus

Crohn's disease

Positive serology (antibodies) and billows atrophy are found in this disease. A. Acute pancreatitis B. Celiac disease C. Acute gastritis D. Ischemic bowel disease

Celiac disease

A 43-year-old previously healthy woman has noted bouts of sharp upper abdominal pain along with nausea for 3 weeks. On physical examination, she has tenderness to palpation of the right upper quadrant. She has yellowish discoloration of the sclera. A liver biopsy is performed and on microscopic examination shows intracanalicular cholestasis in the centrilobular regions, along with swollen liver cells and portal tract edema. There is no necrosis and no fibrosis. Which of the following is the most likely diagnosis? A. Chronic passive congestion B. Extrahepatic biliary atresia C. Hepatic veno-occlusive disease D. Choledocholithiasis

Choledocholithiasis

The majority of gallstones are comprised of... A. Oxidized polymers of calcium slats B. Unconjugated bilirubin C. Cholesterol D. Mucin glycoprotein

Cholesterol

Skip lesions are a characteristic of which of the following? A. Diverticulosis B. Crohn's disease C. Ulcerative colitis D. Adenocarcinoma

Crohn's disease

The congenital heart defect in which all four chambers of the heart are in communication with each other is known as... A. Tetralogy of Fallot B. Complete atrioventricular septal defect C. Transposition of the great vessels D. Coarctation of the aorta

Complete atrioventricular septal defect

Pathogenesis of GERD is best associated with... A. Conditions that decrease lower esophageal sphincter tone B. Increased gastric emptying C. Conditions that decrease abdominal pressure D. Impaired Gastric production

Conditions that decrease lower esophageal sphincter tone

Hirschsprung disease is best described as... A. Congenital absence of ganglion cell in the large intestines B. Failure of abdominal wall closure and herniation C. Autoimmune destruction of enteric nervous system D. Multiple ulcerations of the large intestine

Congenital absence of ganglion cell in the large intestines

The most frequent etiologies for hemorrhoids in a young person is/are A. Constipation or pregnancy B. Liver diseases C. Pancreatitis D. Diarrhea or steatorrhea

Constipation or pregnancy

38 year old man had a persistent cough with hemoptysis for 2 weeks. Chest x-ray revealed an area of consolidation in the right upper lobe. After antibiotic therapy the cough and hemoptysis did not improve. Repeated chest x-ray revealed right upper lobe collapse. Bronchoscope examination revealed an obstructing spherical polypoid mass arising from the main bronchus. Which of the following tumor is the most likely the diagnosis? A. Hamartoma B. Large cell carcinoma C. Adenocarcinoma D. Carcinoid tumor

D

Asbestosis is associated with which pulmonary tumor? a. Adenocarcinoma b. Small cell carcinoma c. Large cell carcinoma d. Mesothelioma

D

On routine chest x-ray for a 45-year-oldman, revealed a 3cm. well circumscribed opaque peripheral mass. A wedge resection of the lobe ws done. The gross description of the pathologist was a well-circumscribed mass having a greyish white gelatinous glistening lobulated cut surface with few clefts. Histology revealed Nodules of connective tissue intersected by epithelial clefts. What is your diagnosis? a. Adenocarcinoma b. Bronchioalveolar carcinoma c. Squamous cell carcinoma d. Hamartoma

D

Patient working in sandblasting business for 20 years complained of a cough and increasing dyspnea with no fever sputum production. Which of the following cells are responsible for the pathogenesis of his disease? A. Neutrophils B. Mast cells C. Eosinophils D. Macrophages

D

Select the feature NOT seen on X-ray with emphysema. a. Low set diaphragm b. Vertical heart c. Increased A-P diameter of the chest d. Increased vascular markings

D

Select the feature common to obstructive diseases a. Increased resistance to air flow b. Increased total lung capacity c. Increased residual volume d. All of the above

D

Select the feature common to restrictive disease A. Decreased expansion of lung tissue B. Decreased total lung capacity C. Decreased residual volume D. All of the above

D

Systemic disease that may affect the lungs is characterized by non-caseating granulomas. Bilateral hilar adenocarcinoma is common on X-ray. A. Asbestosis B. Hypersensitivity pneumonitis C. Interstitial pulmonary fibrosis D. Sarcoidosis

D

The lung carcinoma most associated with ectopic hormone production. a. Adenocarcinoma b. Squamous cell carcinoma c. Mesothelioma d. Small cell carcinoma

D

The most common cause of community-acquired pneumonia is... a. Haemophilus influenza b. Legionella pneumoniae c. Klebsiella pbeumonia d. Streptococcus pneumonia

D

This form of lung cancer is almost always metastatic incurable by surgery but responds initially to radiation. a. Adenocarcinoma b. Squamous cell carcinoma c. Mesothelioma d. Small cell carcinoma

D

Which is consistent with a microvascular cause of pulmonary edema? a. Pulmonary pressure is markedly elevated b. Is most likely caused by left heart failure c. Is associated with volume overload (blood volume) d. Is most likely caused by pneumonia

D

Which can be described as an out-pocketing of the colonic wall that may be prevented with a diet rich in fiber? A. Diverticulosis B. Benign colon polyps C. Hamartoma D. Adenocarcinoma

Dicerticulosis

The WHO classified pulmonary hypertension into Five groups:

Disorders that involve small pulmonary muscular arteries Secondary to left heart failur Due to lung parenchyma disease or hypoxia Chronic thromboembolic Multiple factors (Name the group I-VI)

Gram-negative bacilli that normally colonized that GI tract, but enterohemorrhagic strains can be life threatening. A. E. Coli B. Salmonella enterica C. Yersinia enterocolitica D. Campylobacter enterocolitis

E. Coli

This autosomal dominant gene is associated with numerous colorectal polyps that often appear by the early teens. A. FAP (APC) B. P53 C. HNPCC D. KRAS

FAP (APC)

Air flow halfway thru exhalation (25% to 75%):

FEF 25-75

Amount of air exhaled in second after full inhalation (L).

FEV1

Amount of air you can exhale forcefully after full inhalation

FVC

In coarctation of the aorta, there is hypertension in the lower extremities. A. True B. False

False

Myocardial infarction or angina always precede sudden cardiac death. A. True B. False

False

Liver "steatosis" means... A. Development of hyperplastic nodules B. Biliary stasis C. Fatty change D. Portal hypertension

Fatty change

Cardiac disease is found in 20-40% of patients with longstanding crippling rheumatoid arthritis. Which of the following is the most common cardiac disease to encounter in patients who have RA? A. Valvular endocarditis B. Mural endocarditis C. Valvular calcifications D. Fibrinous pericarditis

Fibrinous pericarditis

What are Aschoff bodies? A. Calcific deposits found in the mitral or aortic valves B. Fibrous deposits on atherosclerotic plaques C. Focal inflammatory lesions found in all layers of the heart D. Vegetation's on the aortic valve

Focal inflammatory lesions found in all layers of the heart

The likely cause of infective endocarditis in which streptococcus viridans is involved, is... A. Following a dental procedure B. IV drug abuse C. Congenitally bicuspid aortic valve D. Pancarditis of rheumatic fever

Following a dental procedure

Edema secondary to liver failure is most likely due to... A. Hyperammonemia B. Hyperestrogenemia C. Hypoalbuminemia D. Hyposecretion of clotting factors

Hypoalbuminemia

Any older patient with iron deficiency anemia should be evaluated for ______. A. GI cancer B. Hepatitis C. Crohn's disease D. Gluten hypersensitivity

GI cancer

Zollinger-Ellison syndrome is best described as... A. Gastrinoma B. Infection by H. Pylori C. Menetrier disease D. Linitis plastic

Gastrinoma

A 25-year-old man complains of a low volume but chronic, foul smelling diarrhea for the past year. He has no nausea or vomiting. On physical examination, there is no abdominal pain or masses and bowel sounds are present. His stool is negative for occult blood. Laboratory studies include a quantitative stool fat of 10g/day. Upper GI endoscopy is performed with biopsies taken of the duodenum, and on microscopic examination show billows atrophy, increased surface intraepithelial lymphocytes, and hyperplastic appearing crypts. Which of the following therapies is most likely to be useful for this man? A. Antibiotics B. Gluten-free diet C. Selective vagotomy D. Corticosteroids

Gluten-free diet

Autoantibody against Tyler IV collagen:

Goodpasture syndrome

Which viral hepatitis is least likely to progress to chronic liver disease or hepatocarcinoma? A. HAV B. HBV C. HCV D. All are equally likely

HAV

A 35-year-old HIV-positive woman known has had pain on swallowing for the past week. No abdominal physical examination findings are noted. Upper GI endoscopy is performed. There are 3 sharply circumscribed 0.3 to 0.8 cm ulcers in the lower esophagus. She is most likely to have an infection with which of the following organisms? A. Helicobacter pylori B. Herpes simplex virus C. Cytomegalovirus D. Cryptococcus neoformans

Herpes simplex virus

Squamous cancers of the anus are associated with which infection? A. E. Coli B. Human papillomavirus C. Staphylococcus D. Cytomegalovirus

Human papillomavirus

Thick myocardial wall, small chamber size, and abnormal diastolic filling often due to genetic inheritance of abnormal sarcomere proteins. A. Dilated cardiomyopathy B. Hypertrophic cardiomyopathy C. Restrictive cardiomyopahty

Hypertrophic cardiomyopathy

A 50-year-old man with chronic alcoholism was hospitalized for congestive heart failure. The left ventricular ejection fraction was 35%, and the heart appeared enlarged on radiographs. Myocardial biopsy was performed, and the biopsy specimen most likely showed... A. Infiltrates of eosinophils B. Foci of cardiac cell necrosis surrounded by neutrophils C. Hypertrophy of cardiac myocytes and interstitial fibrosis D. Foci of chronic inflammation containing plasma cells and lymphocytes

Hypertrophy of cardiac myocytes and interstitial fibrosis

No anti-basement antibodies:

Idiopathic pulmonary hemosiderosis

This type of a hernia is common in males, where a loop of intestines protrudes into the inguinal canal itself. A. Epigastric hernia B. Indirect inguinal hernia C. Direct inguinal hernia D. Femoral hernia

Indirect inguinal hernia

A mother brings her 2-month-old infant to the ER that has been crying all day and has vomited multiple times and passed loose bloody stool. On examination, the infant has a mild fever and a sausage-shaped mass in the abdomen. What would be the possible diagnosis? A. Volvulus B. Hernia C. Appendicitis D. Intussusception

Intussusception

Select the disorder that is least likely to cause visible pathological changes in the intestinal tract. A. Irritable bowel syndrome B. Crohn's disease C. Celiac disease D. Barrett esophagus

Irritable bowel syndrome

Which congenital anomaly would most likely present regurgitation but not aspiration? A. Isolated esophageal atresia B. Esophageal atresia with proximal tracheal fistula C. Tracheoesophageal fistula D. Esophageal atresia with double tracheoesophageal fistula

Isolated esophageal atresia

A 53-year-old man has the sudden onset of chest pain. He is found to have high cardiac enzymes. A year later he has reduced exercise tolerance. He then experiences a transient ischemic attack (TIA). Thrombus formation involving which of the following locations is most likely to have put him at greatest risk for the TIA? A. Vertebral artery B. Superior vena cava C. Left ventricle D. Coronary artery

Left ventricle

Mitral valve disease A. Left-sided CHF B. Right-sided CHF

Left-sided CHF

Pulmonary congestion and edema are characteristic of... A. Right ventricular hypertrophy B. Left-sided CHF C. Right-sided CHF D. Ventricular septal defect

Left-sided CHF

Systemic Hypertension A. Left-sided CHF B. Right-sided CHF

Left-sided CHF

Which is NOT a typical complication following MI? A. Mural thrombus B. Pericarditis C. Myocardial Rupture D. Malignant Hypertension

Malignant hypertension

Bouts of retching and vomiting as a binge drinker might do, is best associated with which this acute esophageal bleeding problem? A. Mallory-Weiss syndrome B. Esophageal varices C. Achalasia D. Barrett esophagus

Mallory-Weiss syndrome

The left AV valve leaflet is described as "balloon-like" or "hooded" in: A. Infective endocarditis B. Restrictive cardiomyopathy C. Mitral valve prolapse D. Libman-stacks endocarditis

Mitral valve prolapse

The most common cause of sudden cardiac death, defined as occurring within 1 hour after the first symptoms in a 50-year-old man is... A. Aortic valve stenosis B. Mitral valve stenosis C. Myocardial ischemia D. Cardiomyopathy

Myocardial ischemia

Characteristics of angina pectoris do NOT include... A. Constricting, squeezing, knife-like chest pain B. Myocyte damage C. Relieved by nitroglycerine D. Transient, recurrent episodes

Myocyte damage

A mother brings her 6-month old child to the ER with abdominal distinction and signs of circulatory collapse. When asked about the history of the condition; the mother mentions that she started oral feeding 2 days ago. The child possibly has A. Volvulus B. Necrotizing enterocolitis C. Appendicitis D. Parasitic enterocolitis

Necrotizing enterocolitis

A 25-year-old man has noted cramping abdominal pain for the past week associated with fever and low-volume diarrhea. On physical examination, there is right lower quadrant tenderness. Bowel sounds are present. His stool is positive for occult blood. A colonoscopy reveals mucosal edema and ulceration having a cobblestone appearance in the ascending colon, but the transverse and descending portions of the colon are not affected. Which of the following microscopic findings is most likely to be present in biopsies from his colon? A. Crypt abscesses B. Adenocarcinoma C. Non-caseating granulomas D. Necrotizing vasculitis

Non-caseating granulomas

The congenital anomaly in which abdominal contents herniate into the umbilical cord membranous sac. A. Gastroschisis B. Meckel's diverticulum C. Hirschprung D. Omphalocele

Omphalocele

Sterile vegetations, myocarditis, and fibrinous pericarditis are associated with... A. Valve disease following a dental procedure B. IV drug abuse C. Congenitally bicuspid aortic valve D. Pancarditis of rheumatic fever

Pancarditis of rheumatic fever

Non-ST-segment myocardial infarction (NSTEMI) is associated with A. Partial thickness damage to the myocardium B. Transmural damage C. Coronary artery disease with thrombosis D. Normal ECG

Partial thickness damage to the myocardium

Many congenital heart defects cause a murmur. Which one is described as "machine-like"? A. Atrial septal defect B. Ventricular septal defect C. Patent ductus arteriosus D. Atrioventricular septal defect

Patent ductus arteriosus

Coughing or sneezing (but not at any other times) may cause a mild shunt from the right atrium to the left atrium in... A. Patent foramen ovale B. Atrial septal defect C. Patent ductus arteriosus D. Atrioventricular septal defect

Patent foramen ovale

Which is NOT part of the Tetralogy of Fallot? A. Pulmonary stenosis B. Right ventricular hypertrophy C. Overriding aorta D. Patent foramen ovale

Patent foramen ovale

In heart failure, the term "backward failure" is referring to what observation? A. Decreased cardiac output B. Pooling of blood in the venous circulation C. Decreased kidney perfusion D. Left heart failure's tendency

Pooling of blood in the venous circulation

Atherosclerotic obstruction is LEAST likely to occur in which artery? A. Left Anterior Descending (LAD) B. Left Circumflex (LCX) C. Right Coronary Artery (RCA) D. Posterior Descending Artery (PDA)

Posterior descending artery (PDA)

Portal hypertension that leads to esophageal varices and caput medusa most caused by this... Cirrhosis Portal vein thrombosis Pregnancy Chronic constipation

cirrhosis

A 23-year-old primigravida gives birth at term following an uncomplicated pregnancy to a male infant with no apparent congenital anomalies. At 3 weeks of age, the infant begins to exhibit projectile vomiting after each feeding. The infant had been fine previously and gaining weight normally. Which of the following conditions is the probable cause for his vomiting? A. Congenital duodenal atresia B. Mallory-Weiss syndrome C. Tracheoesophageal fistula D. Pyloric stenosis

Pyloric stenosis

Chronic Obstructive Pulmonary Disease A. Left-sided CHF B. Right-sided CHF

Right-sided CHF

Severe Asthma A. Left-sided CHF B. Right-sided CHF

Right-sided CHF

Which of these lesions refers to red patches in the fundus (retina) in patients with infective endocarditis? A. Roth spots B. Petechial rash C. Splinter hemorrhage D. Osler's nodes

Roth spots

The most common location of atrial septal defects is in the area of the... A. Secundum B. Sinus Venosus C. Primum D. Coronary Sinus

Secundum

A 75-year-old man develops angina, has no history of coronary artery disease, nor rheumatic fever. Imaging and examinations show heaped up calcified masses on the aortic valve. What is the likely diagnosis? A. Senile calcific aortic stenosis B. Post-streptococcal valve disease C. Mitral annular calcification D. Calcific mitral and bicuspid aortic valve

Senile calcific aortic stenosis

Physiologic hypertrophy due to "cardio" exercise; differs from pathologic hypertrophy in what way? Physiologic hypertrophy... A. Has extensive fibrosis B. Shows an increase in myocyte length more than width C. Occurs more in the right heart than the left heart D. Has less abundant capillary growth

Shows an increase in myocyte length more than width

Stable angina, the most common form of angina pectoris, is caused by... A. Stenosis of coronary arteries B. Lipid-rich atheromas C. Ruptured atheromas D. Thrombi overlying partially ruptured atheromas

Stenosis of coronary arteries

In bronchial asthma:

Sub-epithelial fatal receptors in respiratory mucosa are insensitive to irritants

Genetic factors that lead to the development of idiopathic pulmonary fibrosis include the loss of function mutations in the ____and ___ genes which encode components of ___.

TERT TERC Telomerase

Features of Hypertrophic cardiomyopathy include all of the following except... A. Harsh systolic ejection murmur B. The presence of mitochondrial anomalies C. Atrial fibrillation D. Mural thrombus formation and embolization

The presence of mitochondrial anomalies

Transposition of the great vessels is incompatible with life unless... A. There is also a ventricular septal defect B. If the foramen ovale closes at birth C. If the ductus arteriosus closes at birth D. There is also a pulmonary stenosis

There is also a ventricular septal defect

Which congenital disorder exhibits a hypoplastic left atrium, but a normal left ventricle, and a patent foramen ovale or an atrial septal defect? A. Ventricular septal defect B. Total anomalous pulmonary venous connection C. Right ventricular hypertrophy D. Coarctation of the aorta

Total anomalous pulmonary venous connection

Select the right to left shunt. A. Transposition of the great vessels B. Ventricular septal defect C. Patent ductus arteriosus D. Atrial ductus arteriosus

Transposition of the great vessels

In Restrictive Cardiomyopathy, there is diastolic dysfunction. A. True B. False

True

Most infarcts become transmural. A. True B. False

True

The disease least commonly associated with chronic malabsorption is... A. Pancreatic insufficiency B. Celiac disease C. Crohn's disease D. Ulcerative colitis

Ulcerative colitis

The inflammatory bowel disease that is described as "continuous" and always involves the rectum. A. Mallory-Weiss syndrome B. Celiac disease C. Ulcerative colitis D. Crohn's

Ulcerative colitis

Select a change that is typical of an aging heart. A. Decreased epicardium fat B. Valvular and annular calcification C. Increased ventricular size D. Decreased collagen connective tissue

Valvular and annular calcification

The most common congenital heart malformation is... A. Tricuspid atresia B. Aortic stenosis C. Patent ductus arteriosus D. Ventricular septal defect

Ventricular septal defect

Kaiser-Fleischer rings are associated with which disorder? A. Non-alcoholic fatty liver disease B. Wilson disease C. Hemochromatosis D. Cirrhosis

Wilson disease

A patient with dysphasia, halitosis, and a feeling of a lump in the neck. What is the most likely diagnosis? A. Mallory- Weiss B. Reflux esophagitis C. Zenker diverticulum D. Achalasia

Zenker diverticulum

The type of an aneurysm found at branch points of the Circle of Willis. It is the most frequent cause of subdural hemorrhage. Fibromuscular dysplasia Aortic dissection Cavernous hemangioma A berry aneurysm

a berry aneurysm

Select the feature most characteristic of giant cell arteritis. Weak upper extremity pulses and blood pressure Renal failure A headache along the temples Occurs most often in children

a headache along the temples

Select the infectious vasculitis Aspergillus vasculitis Mixed cryoglobulinemia Rheumatoid arthritis associated vasculitis Thromboangitis obliterans

apergillus vasculitus

Which of the following is NOT directly related to Kawasaki disease? Lymph node enlargement Desquamative rash Conjunctiva Arthritis

arthritis

What is the most common cause of abdominal aortic aneurysms in the elderly? Marfan syndrome artherosclerosis acute inflammation autoimmune disease

atherosclerosis

Benign vascular neoplasm composed of numerous deep highly dilated capillaries that usually don't regress. These are also part of the von Hippel-Lindau disease. Nevus flammeus Cavernous hemangioma Simple lymphangioma Telangiectasia

cavernous hemangioma

Affects the upper lobes of the lungs

centriacinar emphysema

Which type of vasculitis is typically associated with asthma? Takayasu arteritis Kawasaki disease Chrug-strauss syndrome Henoch-schonlein purpura

chrug-strauss syndrome

A tear in the tunica intima that leads to blood flowing between the layers of the tunica media creating a pseudo-channel is known as a ... Saccular aneurysm Hematoma Fusiform aneurysm Dissection

dissection

Along areas of previous lung disease

distal acinar emphysema

An atherogenesis study was performed. There is a propensity for atheromas (initial stage of plaque formation) to form, at muscular arterial branch points, such as the carotid and aortic bifurcations. Which of the following events in the arteris at these locations is most likely to initiate atherogenesis? a. Collagen synthesis b. Endothelial dysfunction c. Lactic acidosisd. Cholesterol Breakdown

endothelial dysfunction

95% of hypertension cases are due to renal, hormonal, cardiovascular or neurological disorders. true false

false

Immunosuppression is the underlying etiologic agent behind most forms of Kaposi sarcoma True False

false

Aneurysms caused by weakening or destruction of the arterial wall causing circumferential dilation of the vessel are called Fusiform aneurysms Berry aneurysms Saccular aneurysms Mycotic aneurysms

fusiform aneurysms

A very painful hemangioma-like lesion that is usually found under the fingernail is called a... Glomus tumor Strawberry hemangioma Nevus flammeus Kaposi sarcoma

glomus tumor

__________are characterized by increased numbers of vessels filled with blood. Glomus tumors Vascular ectasias Hemangiomas Lymphangioma

hemangiomas

??????????(my picture was cut off oops) . Lymphangioma Hemangiopericytoma Angiosarcoma

hemangiopericytoma

Which is NOT a risk factor for varicose veins Obesity Pregnancy Long-term standing Hypercoagulability

hypercoagulability

the form of arteriosclerosis that is asscoiate with onion-skin lesions and sever hypertension atherosclerosis mokenburg medial sclerosis hyaline arteriosclerosis hyperplastic arteriosclerosis

hyperplastic arteriosclerosis

the vasculitide that present with a strawberry tongue, conjunctivitis, desquamation of skin and rash. Kawasaki syndrome Wegener's granulomatosis Microscopic polyangitis Takayasu arteritis

kawasaki syndrome

The likely clinical significance of an arteriovenous fistula is that it may rupture, or lead to high cardiac output Accelerate development of atherosclerosis Develop gangrene Lead to ischemic injury

lead to high cardiac output

The most significant complication of deep venous thrombosis is... Pulmonary hypertension Pulmonary embolism stroke edema

pulmonary embolism

The usual (healthy) result of acute inflammation is Suppuration Resolution Fibrosis Chronic inflammation

resolution

Fatty streaks are composed of ... Fibrous connective tissue Lipid-filled foamy macrophages Calcium Fibrin clots

lipid-filled foamy macrophages

Red painful subcutaneous streeks" best describes... Lymphangitis Polyarteritis nodosa Lymphedema Cavernous hemangioma

lymphangitis

o​ A 23- year-old man experiences sudden onset of severe, sharp chest pain. On physical examination , his temperature is 36.9​ C, and his lungs are clear on auscultation. A chest radiograph shows a widened mediastinum. Transesophageal echocardiography shows a dilated aortic root and arch, with a tear in the aortic intima 2cm distal to the great vessels. Therepresentative microscopic appearance of the aorta withelastic stain is showin in the figure. Which of the following is the most likely cause of these findings Systemic hypertension Wegener granulomatosis Marfan syndrome Takayasu arteritis

marfan syndrome

Which disorder is most likely an incidental finding and doesn't occlude the vessel lumen? Hyaline arteriolosclerosis Monkeberg medial sclerosis Fibromuscular dysplasia Takayasu arteritis

monkenburg medial sclerosis

Which of the following is NOT directly related to Buerger's disease? Thromboangitis obliterans Claudication Night sweats Poor tolerance of cold

night sweats

Filarial worms (Wuchereria bancrofti) enter the body via mosquito bites leads to "elephantiasis" (aka ______). lymphangioma portal hypertension primary lymphedema Obstructive lymphedema

obstructive lymphedema

Affects the lower lungs:

panacinar emphysema

Esophageal varices, caput medusa, and hemorrhoids can occur due to _________. Pulmonary hypertension Systemic arterial hypertension Portal hypertension Atherosclerosis

portal hypertension

Features of physical examination of patient with emphysema:

prolong expiration, use of accessory muscles, breathing through pursued lips.

Increased numbers of small lymph channels forming a lesion less than 2cm; often found in the head, neck, and axilla. They contain NO red blood cells. Cavernous lymphangioma Simple (capillary) lymphangioma Cavernous hemangioma Spider telangiectasia

simple (capillary) lymphangioma

In Emphysema

smokers have an increased number of macrophages in bronchi

Buerger's disease has a high correlation with what modifiable risk factor? Hypertension Hyperhomocysteinemia Diabetes Smoking

smoking

The ectasia associate with high estrogen levels and "blanches" when pressed upon... Sturge-Weber syndrome Nevus flammeus Spider telangiectasia Lymphadenopathic KS

spider telangiectasia

A 30-year-old woman has had coldness and numbness in her arms and decreased vision in the right eye for the past 5 months. On physical examination, she is afebrile. Her blood pressure is 100/70 mm Hg. Radial pulses are not palpable, but femoral pulses are strong. She has decreased sensation and cyanosis in her arms, but no warmth or swelling. A chest radiograph was taken. Laboratory students negative ANCA test result. Her condition remains stable for the next year which of the following is the most likely diagnosis? Aortic dissection Kawasaki disease Microscopic polyangitis Takayasu arteritis

takayasu arteritis

Anti-Neutrophil Cytoplasmic antibodies (ANCAs) are useful diagnostic markers. True False

true

Most strawberry hemangiomas regress by age 7. True False

true

In response to injury, smooth muscle cells infiltrate the _____, proliferate and produce matrix proteins, therefore, thickening it. tunica intima Tunica adventia Basement membrane Tunica media

tunica intima

Which condition features dilated, elongated, torturous alteraction of the superficial vein? Varicosity Telangiectasia Phlebothrombosis Filariasi

varicosity

Antineutrophil cytoplasmic antibodies (PR-ANCAs) showing widespread cytoplasmic staining of neutrophils in an indirect immunofluorescence test, are found in 95% of cases in which disease? Microscopic polyangitis Wegener granulomatosis Churg-Strauss syndrome Kawasaki syndrome

wegener granulomatosis

A 40-year-old male with severe sinusitis, nose bleeds and sores in the nose comes to your office. You perform a chest film and note multiple nodules and masses in the lungs. You suspect a vasculitide. Which one is most consistent with your findings? Kawasaki syndrome Microscopic polyangitis Wegener's granulomatosis Takayasu arteritis

wegeners granulomatosis