Pathology Final Exam Practice Questions
A 60-year-old man with hypertension and diabetes mellitus type 2 presents to the emergency department with shortness of breath. The patient says that for the past several months he has had difficulty sleeping flat and has noticed increased leg swelling. The patient denies chest pain and pressure. Blood pressure is 160/99 mm Hg, pulse is 90/min, respirations are 24/min, and oxygen saturation is 87% on room air. Physical examination reveals an extra heart sound during diastole, bilateral rales, and 2+ pitting edema in the lower extremities bilaterally. Initial ECG is noncontributory and troponin levels are not elevated. X-ray of the chest is suggestive of pulmonary edema. Inhibition of which nephron segment with a diuretic agent would cause renal magnesium loss? A. Ascending limb of the loop of Henle B. Collecting Duct C. Distal convoluted tubule D. Proximal tubule
A. Ascending limb of the loop of Henle
Chronic Bronchitis is associated with A. Dilatation B. no pits C. a basement membrane D. no glands
A. Dilatation
Hepatitis is associated with A. Subacute/chronic abdominal pain B. Recurrent episode of pain C. acute episode of pain D. acute long lasting pain
A. Subacute/chronic abdominal pain
Mrs. Woodstein, a 72-year-old woman has been complaining of low-grade fever and dyspnea for two weeks. She has a 10- year history of scleroderma with involvement of the digits and the esophagus. She also has a 30 pack year history of cigarette smoking but quit eight years ago. On chest radiograph, she has a nodular infiltrate in the right lower lobe. Positive emission tomography (PET) CT shows the right lower lobe lesion to be 3centimeters in diameter with nodular infiltrative characteristics and an enhanced FDG uptake. Which of the following statements about Mrs. Woodstein is most accurate? A. additional diagnosis studies are indicated B. the findings on PET CT make infection very likely C. the findings of PET CT make infection very unlikely D. the findings of the PET CT make malignancy very likely
A. additional diagnosis studies are indicated
When you initially encounter a patient with chest pain, you should have a rather large list in mind regarding the potential causes. In evaluating chest pain you should first A. develop and complete history, physical exam and lab test B. treat patient with naproxen C. immediately evaluate for infection D. if no substernal chest pressure assume the patient is not having a MI
A. develop and complete history, physical exam and lab test
Upon examination a patient presents with a gum infection following dental extraction and petechial rash on lower extremities . Fever of 101 . What is a possible differential diagnosis A. endocarditis B. viral pneumonia C. bacterial pneumonia D. shigella
A. endocarditis
The patient arrives in your emergency department (ED). She is alert with stable vital signs. The mother states she now believes the ingestion occurred about 50 minutes ago as her child told her she found the bottle in the bathroom when she woke up from her nap. You contemplate gastrointestinal (GI) decontamination. Which of the following statements is true about gastric lavage? A. except in extraordinary circumstances it should only be done in the first hour after an overdose B. there are no side effects of gastric lavage C. patients with gastric lavage have a low incidence of esophageal perforation D. it will have no impact on the pylorus
A. except in extraordinary circumstances it should only be done in the first hour after an overdose
16-year-old star female gymnast presents to your office complaining of fatigue, diffuse weakness, and muscle cramps. Chief complaint is fatigue, diffuse weakness and muscle cramps. She speaks of no previous medical history. BMI is 17kg/m . This 16 year old presents with hypokalemia and metabolic alkalosis. What is a possible issue A. excessive use of Lasix B. hypoactive thyroid C. high levels of magnesium D. autosomal recessive disorder
A. excessive use of Lasix
Aspiration Pneumonia can occur as a result of A. gastric reflux B. decreased production of HCL C. decreased production of insulin D. lack of digestion at the level of the esophagus
A. gastric reflux
Most nutrient absorption occurs in the small intestine. The mucosal villus architecture provides maximal surface area for absorption and is endowed with specialized enzymes and transporters. Triturated food from the stomach mixes with A. pancreatic juice and bile in the duodenum to prepare for this absorption B. HCL in the stomach to prepare food substances for this absorption C. HCL and pancreatic juice in the stomach to prepare food substances for this absorption D. pancreatic juice in the stomach and duodenum to prepare for this absorption
A. pancreatic juice and bile in the duodenum to prepare for this absorption
When evaluating abdominal pain in the right upper abdominal quadrant one might assess for A. possible jaundice caused by hepatitis B. possible kidney stones C. possible AAA D. hypotension
A. possible jaundice caused by hepatitis
Hepatitis and Diverticulitis can generate pain in the A. right upper quadrant of the abdomen B. lower left quadrant of the abdomen C. lower mid abdomen D. upper left quadrant of the abdomen
A. right upper quadrant of the abdomen
Polyuria, polydipsia and nocturia are associated with A. severe hypertension and hypokalemia B. severe hypotension and hyperkalemia C. severe hypotension and hypokalemia D. severe hypertension and hyperkalemia
A. severe hypertension and hypokalemia
The disruption of the respiratory effort (work of breathing) likely arises from A. signals transmitted from the motor cortex to the sensory cortex directly related to hypoxemia B. signals transmitted from the frontal lobe to the alveoli C. signals transmitted from the sensory cortex to the motor cortex D. signals transmitted from the brain stem related to O2 saturations
A. signals transmitted from the motor cortex to the sensory cortex directly related to hypoxemia
A patient presents with hypotension, the mediastinum is shifted toward the opposite hemithorax, Patient is tachycardic, tachypneic and hypoxic, Jugular venous distension and tracheal deviation away from the pneumothorax . Patient is presenting with A. tension pneumothorax B. myocardial infarct C. emphysema D. bronchitis
A. tension pneumothorax
Mrs. Woodstein, a 72-year-old woman has been complaining of low-grade fever and dyspnea for two weeks. She has a 10- year history of scleroderma with involvement of the digits and the esophagus. She also has a 30 pack year history of cigarette smoking but quit eight years ago. On chest radiograph, she has a nodular infiltrate in the right lower lobe. This nodule is right lower lobe lesion to be 3centimeters in diameter with nodular infiltrative characteristics. Is this patient at high risk for lung cancer and why? A. yes because of age and 30 pack year smoking history B. no because she is 72 and has not had any problems C. no she is at low risk because of scleroderma D. yes because of the presence of infection
A. yes because of age and 30 pack year smoking history
A patient comes to emergency room with tightness of chest and dyspnea and feeling of panic or doom. Patient presents with not significant EKG abnormalities. Lab work is normal . Patient has a history of depression. Patient presents with significant rib pain in a defined dermatome with limited redness and slight present of vesicles . Patient is presenting with A. 75% chance of myocardial infarct B. 90% chance of a panic attack secondary to possible shingles in early stages C. 50% chance of pulmonary edema secondary to mitral valve disease D. 75% chance of ruptured cervical disk
B. 90% chance of a panic attack secondary to possible shingles in early stages
The A of ASAP stands for A. Arrhythmia B. Airway obstruction C. Aortic Stenosis D. Anaphylaxis
B. Airway obstruction D. Anaphylaxis
A 54-year-old man is evaluated by a gastroenterologist for diarrhea that has been present for approximately one month. He reports that his stools float and are difficult to flush down the toilet. These stools can occur at any time of the day or the night, but seem worsened by fatty meals. What type of diarrhea is this? A. Acute gastritis B. Chronic diarrhea C. Diarrhea secondary to H-Pylorus D. Diarrhea secondary to infection
B. Chronic diarrhea
Recurrent Episodic left lower sided abdominal pain is often associated with A. AAA B. Diverticulitis C. Ectopic pregnancy D. Small Bowel Obstruction
B. Diverticulitis
A patient presents with dyspnea and plus 4 pitting edema in both lower extremities. An angiogram is performed which reveals a RCA not occluded and lad occluded and ejection fraction of 20% . This confirms A. COPD B. HF C. Emphysema D. PE
B. HF
Over the last 2 years, Mr. C has noticed worsening dyspnea on exertion. He now complains of shortness of breath with minimal exertion. He is unable to walk around his house without resting to catch his breath. Several years ago, Mr. C could walk several blocks without any difficulty. He notes that he is unable to sleep lying flat due to shortness of breath (orthopnea), and he has slept on a recliner for the last 6 months. Occasionally, he awakes from sleep acutely short of breath (paroxysmal nocturnal dyspnea). He complains that his feet are swollen. Past medical history is notable for an MI 2 years ago. Vital signs are temperature, 37.0°C; RR, 24 breaths per minute; pulse, 110 bpm; BP, 120/78 mm Hg. His pulse is regular with an occasional irregularity. Cardiac exam reveals JVD to the angle of the jaw in the upright position, a grade II/VI systolic murmur at the apex, and a positive S3 gallop. Lung exam reveals crackles half of the way up from the bases bilaterally. He has 2+ pretibial edema to the knees. JVD and crackles are indicators of A. COPD B. HF C. Asthma D. Pneumonia
B. HF
A patient presents with tightness, squeezing, heaviness, and burning . He complains of retrosternal ; neck and jaw pain, as well as epigastric symptoms. He presents with S4 gallop during pain . Time frame of pain last greater than 30 minutes . A high probably of diagnosis is A. Pericarditis B. Myocardial Infarction C. Pulmonary embolism D. Peptic Ulcer
B. Myocardial Infarction
Hypotension is more commonly seen in patients with A. Right Atrium infarct B. Right Ventricle Heart Failure C. Left Ventricular Heart Failure D. Pulmonary Hypotension
B. Right Ventricle Heart Failure
A pathology which is considered to be immediate threat of life is A. pneumonia B. anaphylaxis C. COPD D. pulmonary embolism
B. anaphylaxis
Mr. C felt well until the onset of pain several hours ago. He reports that the pain is a pressure like sensation in the mid/upper abdomen, which is not particularly severe. He had never had this symptom before. He reports no fever, nausea, vomiting, or diarrhea. His appetite is diminished, and he has not had a bowel movement since the onset of pain. He reports no history of urinary symptoms such as frequency, dysuria, or hematuria. His past medical history is unremarkable. On physical exam, his vital signs are temperature, 37.0°C; RR, 16 breaths per minute; BP, 110/72 mm Hg; and pulse,85 bpm. His HEENT, cardiac and pulmonary exams are normal. Abdominal exam reveals a flat abdomen with hypoactive but positive bowel sounds. He has no rebound or guarding; although he has some mild diffuse tenderness, he has no focal or marked tenderness. There is no hepatosplenomegaly. Rectal exam is nontender, and stool is guaiac negative. At this point, what is the leading hypothesis? A. inguinal hernia B. appendicitis C. pancreatitis D. colon cancer
B. appendicitis
Esophageal dysfunction can place a person at risk for A. scleroderma B. aspiration pneumonia C. lung cancer D. high blood pressure
B. aspiration pneumonia
A 65 year old female has experienced pain in the left lower quadrant of the abdomen intermittently for the last three months. She explains that the pain might last 2o minutes but resolves with physical activity. She explains that her bowel movements are regular and consistency of bowel is normal . A CAT scan is completed on the abdomen and it is noted that there is a mass present in the gallbladder that is the size of an avocado. This may have impact on the flow of A. amylase to the duodenum B. bile to the duodenum C. urea to the kidney D. Sodium to the pancreas
B. bile to the duodenum
A person presenting with COPD often times has lesions in the bronchi that are described as A. narrowing of the bronchi B. bronchial pits and bands of hypertrophic smooth muscle C. a smooth lumen D. limited mucus present in the lumen
B. bronchial pits and bands of hypertrophic smooth muscle
Often in relationship to Cardiac function and Ejection Fraction we find that the Patient who has decrease in these areas will experience A. improved renal function B. decreased renal function C. increased urinary frequency D. hypotension as a result of renal function
B. decreased renal function
Impaired pancreatic enzyme release in chronic pancreatitis A. increases intraluminal digestion B. decreases intraluminal digestion C. has no impact o digestion D. increases production of gastric acids
B. decreases intraluminal digestion
A 13-year-old boy is brought to the clinic by his mother because of a 3-day history of vomiting, severe diarrhea, and night sweats. Further evaluation reveals an estimate of significant loss of total body water in excess of solute loss. What is the possible presentation of pathology A. edema B. dehydration C. decreased sodium levels D. decreased potassium levels
B. dehydration
A patient presents with frequent acute episodes of diarrhea and initial presentation of delirium. What is possible pathology and site of pathology? A. small intestines and nutrient absorption B. descending colon and water absorption secondary to c. diff C. pancreatitis and h-pylorus D. hepatic encephalopathy
B. descending colon and water absorption secondary to c. diff
The decreased production of bile secondary to cirrhosis causes the digestive process to be disrupted at the level of A. stomach and production of gastric enzymes B. duodenum and the breakdown of fat C. rectum and the elimination of waste D. pancreas and production of amylase
B. duodenum and the breakdown of fat
A 47-year-old woman comes to the clinic with bilateral lower extremity edema. She is otherwise healthy and not taking any medications. Physical examination is notable for hypertension, normal heart and lungs, and bilateral lower extremity pitting edema. Laboratory tests reveal hypoalbuminemia and hypercholesterolemia but normal levels of electrolytes, BUN, and creatinine. Urinalysis reveals heavy proteinuria but no cells or casts. What medication should be prescribe for this patient A. amoxicillin B. furosemide C. vancomycin D. increase hypertensive medication dose
B. furosemide
Lactase deficiency produces A. malabsorption of vitamin k B. gas and diarrhea with no adverse outcomes C. malabsorption of vitamin a D. anemia
B. gas and diarrhea with no adverse outcomes
An individual is found unconscious and is not responsive but has normal pulse and blood pressure is normal . After a few seconds patient begins to response and returns to normal . Upon evaluation of the patients urine what would you expect to find A. low levels of glucose in urine B. high levels of glucose in urine C. no presents of glucose in urine D. high levels of bacteria in urine
B. high levels of glucose in urine
Heart Diseases has rose in adults ages 45 to 64 between 2010 and 2020 secondary to A. food additives B. increased unhealthy food consumption and lack of exercise C. the typical aging process D. climate change
B. increased unhealthy food consumption and lack of exercise
Emphysema is derived from Greek and means A. deflated pockets B. inflated or voluminous lung tissue C. obstructed bronchi D. obstructed dead space
B. inflated or voluminous lung tissue
Which organ is responsible for eliminating excess sodium from your body? A. colon B. kidney and skin C. cardiovascular system D. nervous system
B. kidney and skin
Patients with a history of Scleroderma frequently are at high risk for A. infections secondary to the issue of low levels of physical activity B. malignancy secondary to their immunosuppressive status C. acute osteoporosis D. chronic osteoporosis
B. malignancy secondary to their immunosuppressive status
Loss of water in excess of solute (ie sodium, potassium) would cause a patient's serum to be A. less concentrated B. more concentrated C. less hypertonic D. hypotonic serum
B. more concentrated
Inducing vomiting is A. a safe way of eliminating substances that are toxic to the stomach B. not recommended because it can case aspiration C. only done if a toxic substance has been consumed upon immediate observation after consumption D. acceptable because after 90 minutes the medication left in stomach continues to be significant
B. not recommended because it can case aspiration
In the process of digestion enzymes are derived from the A. duodenum B. pancreas and liver C. liver D. small intestine
B. pancreas and liver
Patient presents with acute Hypertension and changes in frequency of urination which has increased significantly. Patient presents with low grade fever and obvious inflammation of the renal artery. What would be first treatment to decrease the inflammatory process A. diuretic B. prednisone C. antibiotic D. increased hydration
B. prednisone
The Hepatic Portal System is a vascular system that is connected A. to the small intestines and moves nutrients to the liver via the arterial vascular system B. to the small intestines and moves nutrients to the liver via the venous vascular system C. to the colon and moves water to the stomach via the arterial vascular system D. to the small intestines and moves waste to the large intestine
B. to the small intestines and moves nutrients to the liver via the venous vascular system
Oliguria refers to A. increased urine output B. urine output less than 500ml/day C. urine output greater then 500 ml/ day D. urine output greater the 500 ml/day with increased protein present
B. urine output less than 500ml/day
It is estimated that patients coming to the ED with severe substernal chest pressure and are having an MI is A. 90% B. 50% C. 25% D. 75%
C. 25%
Distention and severe pain in the mid lower abdomen in a male can be associated with A. Splenic injury B. Renal Colic C. AAA D. Ruptured ectopic pregnancy
C. AAA
Slow insidious, progressive decreases in kidney mass and renal function is considered A. Acute Renal Failure B. Renal Hypertension C. Chronic Renal Failure D. Renal Acidosis
C. Chronic Renal Failure
A 35-year-old man is admitted to the hospital after presenting to the emergency department with hemoptysis, gross hematuria, and acute kidney injury. He was previously healthy and denies a prior history of vasculitis. Pulse is 120/min, respirations are 24/min, blood pressure is 158/92 mm Hg, and oxygen saturation is 92% on room air. Nasopharyngeal examination is normal, and his heart sounds are normal without murmur, rubs, or gallop. He has coarse breath sounds bilaterally. Skin is clear. The patient's laboratory findings are significant for anemia but are otherwise normal. His chemistry panels are noteworthy for an elevated creatinine level of 2.1 mg/dl over a previous baseline of 0.9 mg/dl. The elevated creatinine level of 2.1/mg/dl is and indication of A. increased GFR B. Normal GFR C. Decreased GFR D. Increased ejection fraction
C. Decreased GFR
On a chest ex-ray there is evidence of a nodular infiltrate in the right lower lobe. Patient presents with dyspnea for the past four weeks . What is causing the shortness of breath with a pulse ox of 92 % A. Obstruction of the right bronchi B. Obstruction of the right lower lobe bronchiole C. Decreased number of alveoli secondary to the presence of the nodular infiltrate D. Increased number of alveoli secondary to the presence of the nodular infiltrate
C. Decreased number of alveoli secondary to the presence of the nodular infiltrate
Asthma is different the COPD in that A. In COPD the airways are restricted B. In Asthma bronchial pits are standard C. In asthma airways are not dilated D. In Asthma walls are thinner
C. In asthma airways are not dilated
A 47-year-old woman comes to the clinic with bilateral lower extremity edema. She is otherwise healthy and not taking any medications. Physical examination is notable for hypertension, normal heart and lungs, and bilateral lower extremity pitting edema. Laboratory tests reveal hypoalbuminemia and hypercholesterolemia but normal levels of electrolytes, BUN, and creatinine. Urinalysis reveals heavy proteinuria but no cells or casts. Furosemide is prescribed. In addition to treating her primary renal disease and lowering her proteinuria, which of the following treatments would be most effective in reducing her edema? A. decreasing her blood pressure B. decreasing her serum albumin concentration C. Increasing renal sodium excretion D. increasing her cardiac output
C. Increasing renal sodium excretion
A patient presents with an ejection fraction of 18% and marked systolic dysfunction. This pathology is related to A. Right Ventricular Infarct B. Pulmonary Hypertension C. Left Ventricular Cardiomegaly and previous MI of LV D. Cardiomegaly and PE
C. Left Ventricular Cardiomegaly and previous MI of LV
A 60-year-old woman is brought to the hospital by her husband due to severe productive bloody cough, dyspnea, and tachypnea. She fell at home, injuring her left arm and chest wall. Temperature is 38.2°C (100.8°F), pulse is 98/min, respirations are 22/min, and blood pressure is 130/84 mm Hg. Physical examination reveals left-sided inspiratory crackles, egophony, dullness to percussion, and decreased tactile fremitus. The right chest is normal. Serum studies show a glucose level of 120 mg/dL and LDH of 150 U/L. X-ray of the chest reveals a moderate left-sided pleural effusion. Thoracentesis of the left lung shows the following: pH: 7.40 Glucose: 30 mg/dL Pleural fluid/serum LDH: 1.33 Pleural protein/serum protein: 1.5Color of fluid: yellow LDH: 200 U/LWBCs: 15,000 cells//mm³RBCs: 6 cells/mm³. Which of the following is the most likely diagnosis? A. Asthma B. COPD C. Pneumonia D. CHF
C. Pneumonia
Combination of fever, crackles, and decreased breath sounds is often associated wit A. Pericarditis B. Heart Failure C. Pneumonia D. DVT
C. Pneumonia
Postrenal states accompanied by anuria suggest A. Vascular infections of the renal artery B. vascular infections of the renal vein C. Postrenal states accompanied by anuria suggest complete obstruction to the flow of urine D. none of above
C. Postrenal states accompanied by anuria suggest complete obstruction to the flow of urine
Plasma Renin and Aldosterone levels are related to A. number of white blood cells produced B. number of leucocytes present secondary to an infection C. RBC's generate at the level of bone marrow D. hemoglobin present in the circulatory system
C. RBC's generate at the level of bone marrow
Anemia and the condition of decreased RBCs in the circulatory system is closely related to A. Pulmonary issues B. Cardiac Hypertension C. Renal issues D. Neurological Issues
C. Renal issues
A patient presents with nose, sinuses, throat, and lungs inflamed . slight temperature. Patient presents with abnormal onset of an autoimmune response. Patient have been diagnosed with vasculitis. This is a pathological presentation of A. azotemia B. dehydration C. Wegener's disease D. sepsis
C. Wegener's disease
In COPD, An inflammatory response occurs throughout the proximal and peripheral airways, lung parenchyma, and pulmonary vasculature. which has impact on A. the number of functional bronchiole B. amount of pulmonary vascular profusion C. airflow which is both progressive and associated with an abnormal inflammatory response of the lungs D. improved airflow with decreased mucus present in the bronchi
C. airflow which is both progressive and associated with an abnormal inflammatory response of the lungs
The sensation of air hunger is produced by the pathology of A. amount of O2 in the lungs B. amount of CO in the lungs C. amount of CO2 being sensed by the central nervous system D. pulmonary vascular receptors
C. amount of CO2 being sensed by the central nervous system
33-year-old man is brought into the emergency department after he was hit head on by a car while riding his bicycle. He was thrown from his bike and briefly lost consciousness. Temperature is 37.2°C(99.0°F), respirations are 32/min, blood pressure is 90/55 mm Hg, and O2 saturation is 80% on 6 L of oxygen nasal cannula. On physical examination the patient is cold and clammy with distended neck veins. There are numerous bruises and abrasions on the patient's lower extremities, abdomen, and chest. There are absent breath sounds over the left chest. While he is being examined, he becomes unresponsive and unarousable. Where is air most likely accumulating in this patient? 33-year-old man is brought into the emergency department after he was hit head on by a car while riding his bicycle. He was thrown from his bike and briefly lost consciousness. Temperature is 37.2°C(99.0°F), respirations are 32/min, blood pressure is 90/55 mm Hg, and O2 saturation is 80% on 6 L of oxygen nasal cannula. On physical examination the patient is cold and clammy with distended neck veins. There are numerous bruises and abrasions on the patient's lower extremities, abdomen, and chest. There are absent breath sounds over the left chest. While he is being examined, he becomes unresponsive and unarousable. Where is air most likely accumulating in this patient? A. Between the chest wall and sub cutaneous tissue B. between the parietal pleura and chest wall C. between the visceral and parietal pleura D. between the visceral pleura and alveoli
C. between the visceral and parietal pleura
We're looking at a crisis in terms of lowering life expectancy for the first time in decades secondary to A. climate change B. nutrition standards C. covid and opioid crisis D. access of healthcare
C. covid and opioid crisis
An increased creatinine level is an indication of A. increased GFR B. decreased sodium reabsorption with no edema C. decrease GFR with edema D. normal conditions
C. decrease GFR with edema
Patient presents with complaints of dry mouth, loss of appetite, dry skin and increased frequency. Patient is 45 year old male with no prior medical conditions. He has a BMI of 30. His chief complaint is dry mouth, fatigue and frequency at this point. What impact does the dry mouth have on is digestive system? A. improves the chemical process of digestion at level of oral cavity B. decreases the mechanical process of digestion at the level of the oral cavity C. decreases the chemical process of digestion at level of oral cavity D. reduces the production of HCL at the level of the stomach
C. decreases the chemical process of digestion at level of oral cavity
A treatment for dyspnea in a Heart Failure Patient who presents with a weight gain of 20 lbs and plus 5 pitting edema in both lower extremities would be A. artery bypass surgery B. cardiac defibrillator C. diuresis D. increased Na intake
C. diuresis
Diarrhea is a result of A. lack of water absorption at the level of the small intestine B. increase water secretion at the level of the descending colon C. lack of fluid absorption at the level of the proximal colon D. lack of peristaltic contraction and movement of stool
C. lack of fluid absorption at the level of the proximal colon
FDG is a radio-labeled glucose analog and can accumulate anywhere in the body that has high areas of metabolism. In a PET Scan using FDG is for proposes of identifying A. diffuse viral infection B. lesions that are benigh C. lesions that are cancerous and malignant D. normal alveolar function
C. lesions that are cancerous and malignant
Most nutrient absorption occurs in the small intestine. The mucosal villus architecture provides maximal surface area for absorption and is endowed with specialized enzymes and transporters A. stomach B. mucosal villus of the duodenum C. mucosal villus of the small intestine D. mucosaI villus of the small and large intestine
C. mucosal villus of the small intestine
AKI is defined by the retention of A. glucose B. potassium C. nitrogenous solutes such as urea, uric acid and creatinine D. magnesium
C. nitrogenous solutes such as urea, uric acid and creatinine
A person presents with issues of constipation for the last five days. The person says they have not had a bowel movement in that five days The patient presents with significant distention and no bowel sounds . This is an indication of A. pathology at the level of the stomach B. pathology at the level of the small intestine C. pathology at the level of the large intestine D. pathology at the level of the liver
C. pathology at the level of the large intestine
A 68-year-old man comes to the emergency department with a 48-hour history of burning on urination, increased urinary frequency, and pain over the left flank radiating to the groin. His temperature is 38 °C (100.4 °F), and left flank tenderness is detected. Urinalysis reveals a pH of 8.0, many bacteria, many red blood cells, 3+ leukocyte esterase, and 2+ nitrite. Urine culture reveals a nonlactose-fermenting organism (>100,000 cfu/mL) growing on MacConkey agar. What is this evidence of A. toxic pb in the urine B. presents of increased hydrogen ions in urine C. possible UTI D. renal acidosis
C. possible UTI
The stomach is used as a A. primary site for absorption of nutrients over a 3 hour period after food consumption B. primary site for breaking down fat in the digestive process C. primary site for storage of bolus in the initial process of digestion and is 3 hrs in duration D. primary site of absorption of nutrients with a large surface area made of microvilli
C. primary site for storage of bolus in the initial process of digestion and is 3 hrs in duration
You get a call from a panicked mother because her 4-year-old drank a bottle of children's Tylenol. She found the empty bottle in her child's bed after a nap, and her child had been in bed for 90 minutes. She thinks there were about 3 ounces of liquid left in the bottle. She is about 35 minutes from the hospital. She states her child weighs 15 kg.Your advice to her is: A. induce vomiting to reduce acetaminophen absorption B. hydrate the child with 8 ozs of water and observe C. proceed to hospital D. breathe deeply and calm down; the amount of acetaminophen this child could have ingested is harmless
C. proceed to hospital
Patients that are age 55 to 74 who smoke and have scleroderma should be screened for A. asthma B. colon cancer early on C. should have a low-dose CT scan to rule out lung cancer D. hyperthyroidism
C. should have a low-dose CT scan to rule out lung cancer
My Boyle is a19 year old college student who has a known history of cystic fibrosis . While studying for midterm examinations, he suddenly begins coughing up large volumes of bright red blood. Emergency medical personnel are called rapidly and they transfer him to the nearby university hospital emergency department where you are working. His blood pressure is 70 systolic, his heart rate is 145, his oxygen saturation is 85% on room air, and he's breathing in excess of 40 times per minute. He's barely able to speak to the three word phrases, he appears pale and in definite respiratory distress. Auscultation of the lungs reveals diminished breath sounds on the right with good air movement on the left. An emergent chest radiograph shows dense opacification of the right lung. As a result of the hemoptysis and bleeding at the level of the bronchial artery it is necessary first A. do a tracheostomy B. bronchoscopy examination of airway C. stabilize him and begin IV fluids, secure airway and intubate and mechanically ventilate him D. angiography
C. stabilize him and begin IV fluids, secure airway and intubate and mechanically ventilate him
A lack of salivary amylase being produced will have impact on A. the ability of waste to be eliminated B. the ability for the water to be reabsorbed into the circulatory system C. the beginning of the digestive process to occur at the level of the oral cavity D. the pancreas to produce insulin
C. the beginning of the digestive process to occur at the level of the oral cavity
The structure responsible for increasing urinary frequency for the patient is A. the glomeruli activated by bicarbonate B. the villi activated by Lasix C. the loop of Henle activated by Lasix D. the ureters activated by aspirin
C. the loop of Henle activated by Lasix
The duodenum is directly connected to the A. 3 ancillary organs ie (liver, spleen, and gallbladder) B. 4 ancillary organs ie (liver spleen gallbladder and small intestine) C. 2 ancillary organs ie (pancreas and gallbladder) D. 3 ancillary organs ie (liver, gallbladder, and pancreas)
D. 3 ancillary organs ie (liver, gallbladder, and pancreas)
Recurrent episode of pain is associated with A. Biliary Disease B. Pancreatitis C. AAA D. A and B
D. A and B
Dyspnea (short of breath) is the most common sign and symptoms of disorders related to A. Heart Disease B. Reduced GFR C. Lung Disease D. A and C
D. A and C
The most common cause for hospital admission in the United States is A. Migraine B. Infection C. Cardiac Arrest D. Abdominal pain
D. Abdominal pain
Acute renal failure can be a result of A. increase in GFR B. decrease in GFR C. glomerulitis D. B and C
D. B and C
A 74-year-old man presents to the emergency department with progressive shortness of breath over the past few months. He denies cough or chest pain, but he sometimes wakes up at night with a choking sensation. He has also noticed swelling in his feet and legs. He takes no medications, and he does not smoke, drink, or use any recreational drugs. His temperature is 36.7°C (98.1°F), pulse is 86/min, and blood pressure is 168/74 mm Hg. His respirations are approximately 8/min and irregular; he is taking progressively deeper breaths for a few seconds and then becoming apneic for 10-15 seconds. His O2 saturation is 91% on room air. On physical examination, there are crackles at the bases of both lungs that extend about halfway up his chest. There are no wheezes or stridor. Cardiac examination reveals an S3 gallop. There are no murmurs. An echocardiogram shows reduced left ventricular function consistent with systolic heart failure. What is a possible diagnosis which matched the pathology he is presenting with at this time A. RSV B. Asthma C. Wegner's D. COPD
D. COPD
A patient presents with bronchitis, dyspnea pursed lip breathing, using abdomen muscles to exhale. Patient complains of ongoing shortness of beath when going up the stairs for the last 6 months. Patient has smoked a pack a day of cigarettes for 20 years and presenly continues to smoke. The patient is 55 and 250 pounds. 6 feet tall. Patient presents with a barrel chest. What is the chronic diagnosis. A. Chronic Bronchitis B. Acute Aspiration Pneumonia C. Viral Pneumonia D. COPD
D. COPD
A 7-year-old boy is brought into the emergency department by ambulance for severe difficulty breathing and facial swelling. He had been at a restaurant eating with his family at the onset of his symptoms, and he had just tried some lobster from his father's plate when his symptoms started. He is also complaining of itching and swelling in his lips. He has a past history of food allergies. His temperature is 36.7°C (98.1°F), pulse is 78/min, respirations are 32/min, blood pressure is 115/76 mm Hg, and oxygen saturation is 86% on room air. On examination, he is in moderate distress and has subcostal retractions. There is severe swelling of his lips and oropharynx. His lungs exhibit diffuse wheezing. His father gives him an epinephrine injection at the instructions of his pediatrician, who instructed him about the symptoms of allergic anaphylactic reactions. His son immediately improves. Which of the following factors is contributing most to this patient's increased airway resistance ? A. Decreased percentage of inspired oxygen B. Hyper viscosity of inspired oxygen C. impaired generation of negative intrathoracic pressure D. Decreased airway diameter
D. Decreased airway diameter
A 25 y/o man presented with anuria and bilateral leg pain 2 days after an alcoholic binge. He subsequently developed rhabdomyolysis with compartment syndrome of both lower legs. What organs were most severely damaged as a result A. Heart B. Liver C. Pancreas D. Kidneys
D. Kidneys
A 43-year-old man comes to the clinic for an annual physical exam. He drinks 12 cans of beer per day and consumes fast food two or three days per week. He has smoked two packs of cigarettes a day for 35 years. He was diagnosed with Helicobacter pylori-induced gastritis 1 year ago and has since recovered. His father died at the age of 35 years of sudden cardiac arrest, and his grandmother died of colorectal carcinoma at the age of 72 years. Which of the following risk factors in this patient's history is most concerning for malignancy? A. Alcohol consumption B. Diet C. family history D. Smoking
D. Smoking
Emphysema is defined in terms of A. lung function B. found at the level of alveoli C. found at level of bronchiole D. all above
D. all above
A person presents with low grade fever and left lower quadrant pain which occurs four days after the Super Bowl Party at a friends house. The person says that at the party he had over eat and drank. The pain is described as acute and over last four days has become worst with fever fluctuating from low grade to 102 . At the Super Bowl Party the appetizers were thinks like Mexican. Nuts and corn were part of the base of some of the dips. A possible diagnosis is A. gastritis B. pancreatitis C. hepatitis A D. diverticulitis
D. diverticulitis
A 52-year-old woman comes to her physician with marked leg swelling after completing a 2-day bus ride from California to Chicago to see her son. She has rheumatoid arthritis and only ambulates slowly with a cane, and she walked very little during the bus trip. Which of the following physical exam findings would most support a diagnosis other than deep vein thrombosis (DVT) A. calf redness B. calf tenderness C. increased pain with passive dorsiflexion D. legs equal bilateral leg swelling
D. legs equal bilateral leg swelling
A four year old has ingested 3 ozs of acetaminophen 90 minutes ago. You are assessing his patient in the ER. Her physical exam is normal other than some dried sticky liquid on her face, shirt and hands that smells like cherry flavoring, The next best step to take in this patient is to: A. recommend immediate hemodialysis B. start treatment with N-acetylcysteine C. treat patient for seizures using phenytoin D. observe and measure acetaminophen level at 4 hours after ingestion
D. observe and measure acetaminophen level at 4 hours after ingestion
Chronic Hypertension can be classified as A. neurological B. renal C. pulmonary D. renal or cardiac
D. renal or cardiac
A patient enters your office with a productive cough that has lasted four days with no relief. What would be the first step in identifying the best plan for this patient A. recommend a cough suppressant and send home B. complete an invasive study to determine what is happening at level of bronchi C. complete a bronchoscopy D. sample of sputum
D. sample of sputum
Opioid use typically does not cause A. metabolic alkalosis B. digestive complication C. hypokalemia D. UTI E. A and C
E. A and C
A rare blood vessel disease that affects the ears, nose ,throat lungs and kidney is A. Hashimoto B. Wegener's C. Scleroderma D. Pneumonia of Lungs E. B and C
E. B and C
Lori Kubitz's eyes popped open at 4 a.m. "like an alarm went off in my brain." She could barely breathe. The pain in her chest felt like a bonfire. Her jaw hurt so much that she thought it would explode. As the sun rose over her lakeside cabin in Pelican Rapids, Minnesota, her husband rushed her to the nearest hospital, some 30 minutes away. The pathology which caused this condition is a. RAD blockage b. LAD blockage c. elevated BMI d. elevated cholesterol levels
b. LAD blockage
Fever, cough and runny nose x2 days Mildly lethargic 2 y/o afebrile male with no significant pmhx c/o fever, cough and runny nose for last two days. The mother reports moving here from another country but patient is up to date on his vaccinations. She describes his cough as croupy which brings up phlegm while his nasal congestion is clear. No difficulty breathing, chest pain, sore throat, ear pain, difficulty swallowing, difficulty hearing, nausea, or vomiting. According to the mother, no hx of allergies or asthma. Sig Pmhx: none Sig Surgical hx: vaccinations up to date Sig Fam hx: none Sig social hx: he attends preschool . What is a possible differential diagnosis a. chicken pox b. RSV c. asthma d. measles
b. RSV
