Patho Unit 3 Student Questions
The descending loop of Henle is permeable to water, but is impermeable to what? a. Glucose b. Proteins c. Ions d. Blood
c. Ions
32-yo female presents with paresthesias and bilateral weakness. The weakness began in her legs, but now it seems the weakness is progressing upward. Lately, she has been feeling tired, and feels shortness of breath, and just not herself. She even feels like she has some brain fog and thinks even her vision seems to be a little blurry lately. Shebelieves she is just suffering from long-Covid, but the symptoms have been affecting her day-to-day life and she needs a resolution and has come in for help. Although the patient believes her diagnosis is long-Covid, what is another most likely culprit/diagnosis? (a) fibromyalgia (b) Guillain-Barre (c) Parkinson disease (d) Multiple Sclerosis (e) ALS
(b) Guillain-Barre
Which of the following lab findings would indicate Interstitial intrarenal Acute Kidney Injury? A) eosinophils on the urinalysis B) rbc cast C) coca-cola urine D) neutrophils on the urinalysis
A) eosinophils on the urinalysis
A 60 year old patient is admitted to the hospital due to worsening fever, jaundice,altered mental status, and multiple purpura over his extremities. The patient is diagnosed with thrombotic thrombocytopenic purpura (TTP), and plasmapheresis isinitiated. This patient is at high risk for what type of acute kidney injury? A. Postrenal B. Intrarenal C. Prerenal D. Pyelonephritis
B. Intrarenal
What is an alcoholic patient the MOST at risk for when it comes to bone fractures?A. Hematoma due to delay in periosteal reaction B. Osteopenia due to decreased osteoblast activity C. Arterial disease development due to reduced blood supply and oxygen delivery D. Decreased albumin due to malnutrition
B. Osteopenia due to decreased osteoblast activity
A 65-year old female patient is seeing her PA for her annual check up. The patient states she exercises regularly, drinks 1 glass of red wine per night and does not smoke. The patient follows a plant-based diet. Her DEXA scan results reveal a T-score of more than 3 standard deviations below the average. Which of the following best explain the pathophysiology behind her DEXA results? A) Increased osteoclast breakdown of bone with increased osteoblasts unable to compensate for the resorptive process B) Osteocyte degradation by macrophages C) Decreased osteoblasts and normal osteoclasts from loss of estrogen D) Trabecular bone breakdown by osteoblasts
A) Increased osteoclast breakdown of bone with increased osteoblasts unable to compensate for the resorptive process
A 58-year-old male patient presents with weakness and stiffness of their legs and hands that originally began with his left hand. The patient notes they have been experiencing fatigue throughout the past two weeks. The patient's wife noted that the patient has had some slurred speech throughout the day for the the past 5 days. The patient has a positive Babinski sign. What diagnostic test would you order? A) EMG B) CT of the head C) Brain biopsy D) Glucose
A) EMG
A 70 year old female presents with a fracture to her right femoral neck. She has poorly controlled diabetes mellitus and is worried about the amount of time this fracture will take to heal. You explain to her that due to her age and poorly managed DM she will have a longer healing time than most. She is a very inquisitive woman and asks if you can explain to her why that is. Which of the following pathologies covers the impaired wound healing caused by both of her conditions (age and DM)? Select all that apply A. Due to her age she may have issues with bone formation and cell differentiation. B. The may be an inhibition of growth factor and a weaker callus formed. C. She has an unmet increased metabolic requirement, such as a lack of B6 and albumin due to her diabetes. D. Her secondary bone healing is the only thing affected.
A. Due to her age she may have issues with bone formation and cell differentiation.
A 74 y/o male patient presents to the clinic with paresthesia of extremities, bilateral ascending weakness of limbs, facial weakness, and constipation. Patient also reports he had the flu about 3 weeks ago. What is the most likely diagnosis for this patient? A. Guillain-Barre Syndrome B. Myasthenia Gravis C. Infection D. TBI
A. Guillain-Barre Syndrome
Which of the following lab results is not a common clinical manifestation of acute kidney injury? A. Hypernatremia B. Hyperkalemia C. Increased Creatinine D. Increased BUN
A. Hypernatremia
What is one of the pathophysiologies behind the drop in GFR in Obstructive Postrenal Acute Kidney Injury? A. Increase in the hydrostatic pressure in Bowman's space B. Decrease in hydrostatic pressure in Bowman's space C. Increase in Oncotic Pressure in the glomerulus D. Decrease in oncotic pressure in the glomerulus
A. Increase in the hydrostatic pressure in Bowman's space
A 26-year-old man presents with four days of progressive, bilateral, lower extremity weakness and dysesthesia. The patient denies any history of trauma, but states that he stayed home from work last week because of a fever accompanied by diarrhea. Neurologic examination demonstrates the absence of reflexes in the lower extremities with no cranial nerve deficits. What is the best therapy for this patient's condition? A. Plasmapheresis and immunoglobulin B. Glucocorticoids C. Acetaminophen D. Radiation therapy E. Rest and elevation of the lower extremities
A. Plasmapheresis and immunoglobulin
A 24-year-old female presents with noticeable drooping of her right eyelid that appeared 10 days ago. The patient is beginning to notice changes in vision stating that she has been experiencing double vision. The patient denies having any recent illnesses but reports generalized weakness that improves in the morning after rest but worsens throughout the day. Patient is not having issues speaking, but states that she has had difficulty swallowing. Which of the following tests should be used to diagnose this patient? A. Serum Assay B. X-ray of the thorax C. CBC D. MRI
A. Serum Assay
What is the pathophysiology behind cerebrovascular disease being a precursor to Dementia? A. Tau protein becomes hyperphosphorylated B. Patient experiences many infarcts over time which eventually lead to an ischemic brain injury. C. Low levels of thyroid hormone D. A and B
B. Patient experiences many infarcts over time which eventually lead to an ischemic brain injury.
Shrek has been your patient for years and now that he turned 65, he is experiencing shaky hands while at rest . Once he starts to move the hands go back to normal. What part of the Basal Ganglia is affected? A) Thalamus B) Para Compacta C) Para Reticulata D) Putamen
B) Para Compacta
Which of the following is true about the myelin sheath in an axon? A) The myelin sheath is a layer of protein that covers the dendrites of a neuron. B) The myelin sheath is made of Lipids, an insulating layer that covers the axon of a neuron. C) The myelin sheath is a cluster of cell bodies that surrounds the axon. D) The myelin sheath is a structure found in the synapse that helps transmit signals between neurons
B) The myelin sheath is made of Lipids, an insulating layer that covers the axon of a neuron.
In which location is Angiotensin I converted into Angiotensin II? A. kidneys B. lungs C. liver D. bone marrow
B. lungs
Which is not a mechanism of hyperkalemia? a. insulin deficiency preventing K being pumped in the cells b. hyperaldosteronism causing less K to being secreted c. acute kidney injury causing decrease in GFR d. ACE inhibitors that block aldosterone effects
b. hyperaldosteronism causing less K to being secreted
Sally is a 76-year-old female presenting to the ED with an open fracture of her left humerus after falling off her porch. She has type 2 diabetes and does not follow her PCP's glucose control regimen or lifestyle recommendations. She is a former smoker but does not currently smoke tobacco products. Sally plays bridge every week and worries about how long the cast for her broken arm will affect her game. Which of the following risk factors will not hinder Sally's humerus from healing? A). Uncontrolled diabetes B). Use of nicotine patches C). Age D). Infection
B). Use of nicotine patches
Patient presents to the emergency department after having gastritis for a week with vomiting and diarrhea. For the past day, patient is reporting confusion and intensemuscle cramps. After deciding to take a urine sample, the urine sodium levels are <20 mEq/L. What is the likely mechanism of this diagnosis? A. Increased water retention B. Active transport of sodium into the GI tract C. Excessive beer drinking D. Excessive protein concentration altering lab equipment and giving a false sodium reading
B. Active transport of sodium into the GI tract
What is the most common neurodegenerative dementia? A. Cerebrovascular disease B. Alzheimer disease C. Hypothyroidism D. Neurosyphilis
B. Alzheimer disease
73 year old F presents to the clinic with c/o painful joints of the fingers X3mo. Patient states it is worse in the morning but subsides with some time. You perform an X-ray which indicate soft tissue swelling to the affected joints and low bone density. Pt notes she has not had a DEXA in the past. Bloodwork comes back elevated for ESR/CRP. What would likely be the patho cause of the patient's diagnosis? A. IL-6 B. CD4+ T cells C. MSU D. HGPRT
B. CD4+ T cells
A 45 year old female presents to the emergency department with muscle spasms. She reports that she notices her legs twitching while she watches tv on the couch. Upon examination in the ER the patient begins to seize. Her EKG also shows prolonged QT waves. Which of the following would you not expect with her condition? A. Positive Chvostek sign B. Decreased CNS activity/ irritability C. Positive Trousseau sign D. Paresthesias
B. Decreased CNS activity/ irritability
A patient presents to you with hypertension and you decide to start the patient on lasix (a diuretic) knowing this will prevent water reabsorption from what part of the renal tubule? A. Ascending loop of Henle B. Descending loop of Henle C. Proximal convoluted tubule D. Distal convoluted tubule
B. Descending loop of Henle
Clinically, which of the following diseases is most known to result in a high rate of non-union or delayed union when it comes to bone fractures? A. Obesity. B. Diabetes C. Lupus. D. Intermittent anorexia
B. Diabetes
A 55 year old female patient presents to her PCP office with a fairly recent onset of swollen, warm, red and painful joints. She reports that her symptoms are occurring in her wrists, MCP, and MTP joints. She also reports some fatigue, generalized weakness and decreased appetite. You decide to run some blood tests based on these symptoms.What would you most likely find on her labs? A. Decreased serum calcium B. Elevated rheumatoid factor C. Elevated troponin D. Increased uric acid
B. Elevated rheumatoid factor
What is not true about the central nervous system? A. A bundle of cell bodies is called a nucleus B. Grey matter is due to myelin sheath being made of lipids C. Consists of brain and spinal cord D. The vertebral artery is the main blood supply of the brain
B. Grey matter is due to myelin sheath being made of lipids
Your patient is a 35 year old female who has been diagnosed with relapsing-remitting multiple sclerosis. She describes that every few months she would have "flare ups" that would improve after, but she would never quite return back to normal. However, on this most recent exacerbation, she has not noticed improvement, and is actually noticing that her symptoms are getting worse and not stopping like she is used to. What are you concerned about with your patient? A. Her RRMS could have progressed to primary progressive multiple sclerosis B. Her RRMS could have progressed to secondary progressive multiple sclerosis C. Her RRMS could have progressed to progressive relapsing multiple sclerosis D. Her RRMS is not progressing to anything else, this is a typical progression of the disease.
B. Her RRMS could have progressed to secondary progressive multiple sclerosis
You're working the finish line medical tent at a marathon when a 45yo male is carried into the tent by EMTs from the finish line. The patient reports feeling dizzy and lightheaded and extremely thirsty. You notice the patient has sunken eyes, a very dry mouth and he states he feels like he's going to pass out. When asked where he his, he is unable to answer. The EMTs state that he vomited after crossing the finish line. What is the strongest differential diagnosis for this patient? A. Hyponatremia B. Hypernatremia C. Hyperaldosteronism D. Micturition
B. Hypernatremia
Which of the following is a primary pathological mechanism involved in acute kidney injury? A. Increased glomerular filtration rate B. Tubular epithelial cell damage C. Formation of renal calculi D. Hypertrophy of glomeruli
B. Tubular epithelial cell damage
In the inner synovial membrane which cell has the function to produce and secrete hyaluronic acid? What type of joint are they found in? A. Osteoblasts, Fibrous Joints B. Type B cells, Synovial Joints C. Type A cells, Synovial Joints D. Myocytes, Fibrous Joints
B. Type B cells, Synovial Joints
A 42-year-old man presents to your clinic complaining of ankle and wrist pain for the past 2 weeks. Patient reveals he drinks copious amounts of alcohol, loves eating seared steak, but is not motivated to lose weight (BMI 32). He recalls having an episode of severe pain in his foot, specifically his big toe, that resolved but is now getting worse and spreading. You have a good hunch of the suspected diagnosis and send the patient for a fluid analysis. What do you expect to see on the microscopy results? A. Calcium pyrophosphate crystals - negatively birefringent B. Urate crystals - negatively birefringent C. Needle-shaped crystals - positively birefringent D. Urate crystals - positively birefringent
B. Urate crystals - negatively birefringent
The kidney balance calcium via activation of Vitamin D which in an AKA the kidney willactivate less Vitamin D lowering Ca2+ absorption which then leads to hypocalcemia. The loss of calcium leads to what pathologies over time except? A: Renal osteodystrophy B: Osteoblasts hyperactivity C: Osteoporosis D: Rickets
B: Osteoblasts hyperactivity
Which of the following is a neurological disorder characterized by the presence of abnormal proteins in the brain that disrupt the functioning of neurotransmitters? A) Huntington's disease B) Multiple sclerosis C) Alzheimer's disease D) Parkinson's disease
C) Alzheimer's disease
A 77-year old male patient presents to the emergency room complaining of extreme fatigue and a rapid onset loss of sensation to his lower limbs. The patient discloses his diabetic medical history along with his recent Epstein-Barr virus infection that had resolved more than two weeks from today's date. He states that he is afraid that his bilateral loss of sensation will continue to ascend towards the trunk of his body. The Physician Assistant decides to investigate the protein levels in his CSF levels followed by a lumbar puncture because the patient shows symptoms of a potential _______diagnosis: A) Myasthenia Gravis B) Amyotrophic Lateral Sclerosis C) Guillain-Barre Syndrome D) Traumatic Brain Injury
C) Guillain-Barre Syndrome
Which of the following best describes the mechanism of action of angiotensin-converting enzyme (ACE) inhibitors in controlling blood pressure and preventing or slowing kidney damage? A) They result in systemic vasodilaton B) They increase renal tubular excretion of sodium C) They result in dilation of the efferent arteriole, reducing glomerular pressure D) They block the angiotensin II receptor on the cell membrane E) They reduce production of angiotensinogen, the precursor to angiotensin I
C) They result in dilation of the efferent arteriole, reducing glomerular pressure
A patient presents with a rise of serum creatine of 1.8mg/dl which has been increased by 1.5x from baseline (within 7 days). Which pathophysiologic process is consistent with the given information? A) pyelonephritis B) acute tubular necrosis C) acute kidney injury
C) acute kidney injury
A 34 year old female presents to your office with generalized fatigue and weakness that worsens after she goes on her daily walks but gets better with rest. She says " I feel so weak at night." She also notes some difficulty with chewing and you notice some ptosis.After serum assay testing, EMG and Tensilon testing, you believe your patient has Myasthenia Gravis. Which of the following best describes the pathophysiology for Myasthenia Gravis? A. Trauma to the brain causes extraaxial injuries (hematomas) B. Amyloid precursor protein breaks down and results in plaque formation C. Autoantibodies are produced against ACh receptors which leads to no action potential in neurons and lack of muscular contraction D. Atherosclerosis in the vascularity of the brain results in atherothrombosis and leads to ischemia
C. Autoantibodies are produced against ACh receptors which leads to no action potential in neurons and lack of muscular contraction
A 30-year-old female presents to your clinic 3 months post L-Ankle Fracture complaining of continued pain and discomfort. When you saw this patient 3 months prior, she had a clean, closed fracture of her L ankle, peripheral pulses were intact at the time of the visit. You suspect that the patient is having prolonged healing of her fractured ankle butare struggling to pinpoint why. The patient denies smoking and excessive alcohol consumption. Pt states that, at her last PCP appointment, they drew blood, and her thyroid levels were normal. The patient denies a history of Diabetes, and the only medication she takes is a Corticosteroid for her IBD that she claims to have been on "for the last 5 years or so." Which of the following risk factors most likely explains the patients prolonged fracture healing? A. Patient's Age B. Left Ankle Fracture over Right Ankle Fracture C. Chronic Corticosteroid Use D. Patient's Gender
C. Chronic Corticosteroid Use
A 45 y.o. patient presents to the ED with sudden onset weakness and slurred speech. No past medical history of note other than controlled hypertension. Upon physical examination, you suspect a cerebrovascular accident (stroke). Because you are a stellar provider who is an expert in neurology, which diagnostic test would be conducted first to confirm your diagnosis? A. CT with contrast B. EKG C. Point of Care Glucose D. Brain biopsy
C. Point of Care Glucose
A 55-year-old male presents to the ED with hematemesis, nausea and vomiting,fatigue, and anuria. Additionally, the patient has a recent history of knee arthroplasty due to degenerative osteoarthritis. Labs revealed increased BUN and creatinine, while serum electrolyte labs depicted normal pH. But, endoscopy revealed a massive GI bleed.What is the most likely diagnosis? A. Post-renal B. Intra-renal C. Pre-renal D. Intrinsic renal
C. Pre-renal
An Egyptian pyramid explorer, named Camel Grylls, was traveling via his jeep back to his camp when his jeep broke down and left him stranded in the desert for days. To preserve his fluid lost, he dug a hole underneath his jeep between the front and the back wheels. Here, I slept during the daytime on a blanket over this dugout hold while underneath the jeep. While trying to preserve his bodily fluid from minimizing sun and wind exposure, physiologically what one of two hormones was released from the posterior pituitary to allow the aquaporin 2 reabsorption of sodium and thus water via osmosis at the distal tubule in attempts to preserve the euvolemic state? A. Aldosterone B. Renin C. Vasopressin D. Oxytocin
C. Vasopressin
Which of the following is NOT an intra-renal cause of acute kidney injury? A. nephrotoxins B. glomerulonephritis C. kidney stones D. tubular disease
C. kidney stones
An 81-year-old woman has a chief complaint of right knee pain for the past 7 months.She retired 20 years ago from teaching and now enjoys spending time with her grandkids. For the past 5 years she's been a part of a local walking group in her community, where she walks one mile in the evening, 4 days a week, but she reports her pain is more prevalent in the evening time, so her physical activity has been limited.Past medical history includes hypertension, iron-deficiency anemia, and total hysterectomy. Temperature is 37.2°C (99.0°F), blood pressure is 137/85 mmHg, and body mass index is 28kg/m2. On the physical examination you make note of crepitus anda reduction in range of motion in her right knee. No erythema or warmth is noted at the affected joint. Cardiac, pulmonary, and abdominal examinations are noncontributory.You decide to order a synovial fluid analysis to help confirm your top diagnosis. What do you expect the results from this analysis to indicate? A. elevated white blood cell count B. normal white blood cell count C. low white blood cell count D. elevated white blood cell count
C. low white blood cell count
A 54 yo male is presenting with hypotension and hyponatremia, which is odd considering he has a history of hypertension. What might be causing this presentation? A.) Patient has been neglecting to take his prescribed thiazide diuretic. B.) Patient has been on a low-sodium diet for the past 4 days. C.) Patient has been accidentally taking too many of his prescribed loop diuretics. D.) Patient has internal bleeding present somewhere.
C.) Patient has been accidentally taking too many of his prescribed loop diuretics.
A 28 year old female patient with a history of type 1 diabetes comes into the ER while you are on rotation. She complains of weakness, cramps, and "floppy limbs." Upon further inquiry, she tells you that she "may have injected a little too much insulin." What electrolyte imbalance would you expect to see in this patients blood work? A. Hypercalcemia B. Hypocalcemia C. Hyperkalemia D. Hypokalemia
D. Hypokalemia
A 65-year-old male with PMH of Diabetes and Hypertension presents to your clinic with a chief complaint of "my legs are all swelled up and I just feel confused and tired." You perform diagnostic lab testing of a Complete Metabolic Panel to confirm your suspected differential diagnosis of Acute Kidney Injury. Which of the following is not a clinical manifestation you would expect to find in this patient? A) Increase in Blood Urea Nitrogen (BUN > 20 mg/dL) B) Decreased Urine Output (Urine Output <0.5 ml/kg/hour x 6 hours) C) Increase in Serum Creatinine (Cr ≥ 1.5x baseline within past 7 days) D) Decreased Serum Potassium (K < 3.5 mEq/L)
D) Decreased Serum Potassium (K < 3.5 mEq/L)
A 60 year old woman who presents with complaints of knee pain and stiffness that have been progressively worsening over the past year. Physical examination reveals tenderness and crepitus on palpation of the knee joint, as well as limited range of motion. Imaging studies show a decrease in the amount of proteoglycans within the articular cartilage. Which of the following is a function of proteoglycans in cartilage and is therefore likely to be affected in this patient? A) Promotion of angiogenesis B) Maintenance of joint flexibility C) Promotion of inflammation D) Promotion of cartilage stiffness
D) Promotion of cartilage stiffness
A 68-year-old male presents with a hip fracture secondary to osteoporosis. This condition is caused by an increase in bone....? A) Formation B) Density C) Mineralization D) Resorption
D) Resorption
A 25 year old male patient presents to your clinic and says he wakes up in the mid of the night feeling his big toe is on fire. The pain lasts for several hours and has been happening everyday for the past 4 weeks. Upon examination of his toe, you notice it is erythemous, swollen with decreased range of motion. Synovial fluid analysis shows birefringent crystals. Which of the following is not a risk factor in developing this patient's condition? A) patient is an alcoholic and has increased uric acid production B) patient is obese C) patient is a diabetic D) patient has lupus
D) patient has lupus
When an individual is dehydrated, what helps to increase blood pressure and hydration? A. Aldosterone is released, so sodium and water are reabsorbed B. ADH allows water to be passively reabsorbed C. Diuretics allow for water reabsorption D. Both A and B
D. Both A and B
A 45 year old woman comes to her primary care PA for evaluation of joint pain and stiffness. Her symptoms are most prominent in the hands, worse in the morning and gradually improves after two hours of physical activity. In addition, she complains of malaise and decreased appetite for the past several months. The patient has a 40-pack-year smoking history. Vitals are within normal limits. Physical examination reveals swelling of the bilateral proximal interphalangeal joints. Ulnar deviation is observed at the bilateral metacarpophalangeal joints. Serology testing is notable for elevated anti-cyclic citrullinated peptide antibodies. Which of the following is the most common cause of mortality in patients with this condition? A. Spinal cord compression B. Pulmonary fibrosis C. Kidney failure D. Cardiovascular disease E. Septic shock
D. Cardiovascular disease
A patient with a history of diabetes presents with polyuria, polydipsia, and uncontrolled blood glucose levels. A urinalysis reveals glycosuria and proteinuria. Which of the following best describes the underlying pathophysiology in this patient? A. Impaired glucose transport in the proximal tubule B. Decreased renin secretion in the juxtaglomerular apparatus C. Increased aldosterone secretion in the adrenal cortex D. Glomerular basement membrane damage in the renal corpuscle E. Decreased filtration pressure in the glomerulus
D. Glomerular basement membrane damage in the renal corpuscle
A 60-year-old male with a history of hypertension and diabetes presents with loss of appetite, fatigue, and lower extremity edema. After running some tests, you come to find that he has chronic kidney disease. What diagnostic result would you expect to see? A. Metabolic alkalosis B. Increased kidney volume C. Decreased BUN D. Low EPO
D. Low EPO
Following a subarachnoid hemorrhage, which of the following is not a possible complication? A. Vasospasm B. Hydrocephalus C. Hyponatremia D. Peripheral Edema E. Seizures
D. Peripheral Edema
An admitted patient is suspected to have myasthenia gravis. Which finding is usually associated with a diagnosis of myasthenia gravis? A. Visual disturbances, including diplopia B. Ascending paralysis and loss of motor function C. Cogwheel rigidity and loss of coordination D. Progressive weakness that is worse at the day's end
D. Progressive weakness that is worse at the day's end
Where do the majority of neurons found in the corticospinal tract decussate? A. C5 B. Dorsal Root ganglion C. Area Postrema D. The medulla
D. The medulla
While visiting your grandma Meemaw, you notice she has developed a short-stepped shuffle. Additionally, when reminiscing on old family stories, you notice that Meemaw doesn't remember significant details. You think maybe she just needs some rest and ask if she wants to lie down for a bit. She agrees, but then cannot find her way to her bed without your help. What testing can be done to diagnose Meemaw's most likely condition? A. CT scan B. EEG C. Lumbar puncture D. There is no definitive diagnostic test for Meemaw's most likely condition.
D. There is no definitive diagnostic test for Meemaw's most likely condition.
A 56 year old female presents with numbness/ tingling that started in the feet 1 week ago and has progressed up the legs. The pt is a smoker, obese and hypertensive. Shedoes recall an acute bacterial URI 3 weeks ago. A lumbar puncture performed shows a normal cell count with increased protein levels. EMG shows decreased nerve function.Considering your most likely diagnosis, what major risk factor likely triggered this condition? A: smoking B: Obesity C: Hypertension D: Recent viral URI
D: Recent viral URI
Which of these following options describing resting membrane potential is correct? a. -65 mV; voltage-gated sodium and potassium channels are closed b. -55 mV; voltage-gated sodium channels are open and potassium channels are closed c. +40 mV; voltage-gated sodium channels are closed and potassium channels are closed d. -65 mV; voltage-gated sodium and potassium channels are open
a. -65 mV; voltage-gated sodium and potassium channels are closed
Sarah, a 25 year-old woman presents with generalized weakness and fatigue that gets worse later in the day, ptosis, and difficulty chewing. A CT of the thorax shows thymoma. Which of the following accurately describes the pathophysiology of this disease? a. Autoantibodies produced against Ach receptors on the postsynaptic terminal, causing insufficient binding of ACh B. Mutation in superoxide dismutase 1 causing damage to motor neuron cytoskeleton C. Shearing forces causing neuron damage D. Autoantibodies produced against Norepinephrine receptors
a. Autoantibodies produced against Ach receptors on the postsynaptic terminal, causing insufficient binding of ACh
Susan is a 50 year old female who has been a vegan for the past 10 years. Her friends have to constantly remind her of their lunch dates because she keeps forgetting them along with other things. Sometimes when they are all together, her friends even say she looks disoriented. She has agreed to go to the doctor's because her friends are so concerned about it. What most likely is causing Susan's memory loss and disorientation? a. B12 deficiency dementia b. Alzheimer's Disease c. Cerebrovascular disease d. Her age
a. B12 deficiency dementia
Drago and Creed are in the boxing ring for the heavyweight championship. Creed takes some heavy hooks to his temporal region from Drago. Despite looking dazed and leaning up against the ropes, he tells Rocky not to throw in the towel. Drago gives Creed another blow to the head. Creed losses consciousness. Upon CT imaging it was noticed that the cause of death was from the middle meningeal artery hemorrhaging. Which Intracranial Hemorrhage caused Creed's death. a. Epidural Hemorrhage b. Intracerebral Hemorrhage c. Subarachnoid Hemorrhage d. Subdural hemorrhage
a. Epidural Hemorrhage
A patient referred to you, a neurology PA, explains that after returning from spring break in the Dominican Republic about 2 weeks ago (where she may or may not have drunkenly consumed large amounts of tap water) she was diagnosed with a GI tract infection. Ever since then, the patient reports trouble walking and other symptoms such as dysphagia and diplopia. During the physical exam, you note an absent patellar tendon reflex. The results of a lumbar puncture show albuminocytologic dissociation.Considering all of the above information makes you confident in your most likely diagnosis. What education should you provide to the patient? a. Inform the patient that if she starts to notice new symptoms affecting her respiratory function, like shortness of breath or dyspnea on exertion, to call you immediately b. Inform her that her symptoms should improve within 1 year c. Inform her that the symptoms she is experiencing are due to a build up of free radicals caused by a mutation of superoxide dismutase 1 d. Inform her that constipation or urinary incontinence are also possible symptoms of her diagnosis
a. Inform the patient that if she starts to notice new symptoms affecting her respiratory function, like shortness of breath or dyspnea on exertion, to call you immediately
Prolonged use of NSAIDS can cause acute kidney injury (AKI). What is the best explanation for this? a. NSAIDS are a COX inhibitor which decreases renal perfusion b. NSAIDS block the RAAS system which decreases renal perfusion c. NSAIDS cause vasodilation which decreases BP, therefore decreasing renal perfusion d. NSAIDS cause narrowing of renal arteries which decreases renal perfusion
a. NSAIDS are a COX inhibitor which decreases renal perfusion
Choose all of the factor(s) that can be associated with gout (select all that apply) a. Podagra b. Coryza c. Boutonniere deformity d. Tophi e. Chondrocyte disfunction
a. Podagra d. Tophi
You are a PA working in orthopedics. A 65-year-old patient presents to your office with pain in the area at her hip joint. The patient states that she has trouble walking and is constantly feeling pain in the hip region. She tells you she recently had blood work done and brings her results with her, one result that you notice is a decreased estrogen level.You are concerned that this patient may have? a. Postmenopausal Osteoporosis b. Senile Osteoporosis c. Premenopausal Osteoporosis d. Osteoperiostitis
a. Postmenopausal Osteoporosis
A 56yo male presents to the ED with abdominal distention x3 days with 7/10 hypogastric pain. The patient has a history of recurrent kidney stones and diabetes. The patient's vitals are as follows: BP = 158/96, HR = 98, RR = 20, POC = 111, SpO2 = 99% on room air. During physical exam you find a palpable bladder and upon rectal examination the patient has an enlarged prostate. What diagnosis is most appropriate for this patient? a. Postrenal Azotemia b. GI Bleed c. Renal Azotemia d. Chronic Kidney Disease
a. Postrenal Azotemia
A 67 yo patient comes into clinic with heberden nodes on her 3rd MCP joint. What diagnostic test would you do to confirm your diagnosis? a. Radiography b. CBC c. DEXA scan d. RF titers
a. Radiography
A 67 yo female with a history of hypertension, diabetes, and drug abuse presents to theED with weakness and numbness on the right side of the body, slurred speak, and a sudden, severe headache that she described as a "thunderclap". What is the most likely diagnosis and pathology of the patient's symptoms? a. Subarachnoid hemorrhage due to a burst aneurysm b. Ischemic stroke due to atherosclerosis c. Hypoglycemia due to taking too much insulin d. Ischemic stroke due to recent cocaine use
a. Subarachnoid hemorrhage due to a burst aneurysm
A 45-year-old male patient presents to the clinic complaining of stiffness in his left knee in the morning for about 30 minutes before his coffee along with aching pain in the same left knee that is sharp and worse when gardening in his yard. The patient states this has been an ongoing issue for a few years, he does stretches at night and sleeps okay until the next day the issues reoccur. The patient has images taken of the knee joint using X-rays, which showed loss of joint space, bone damage, bone remodeling,bone spurs and evidence of effusion around the knee joint. A synovial fluid analysis is also done, which showed a production of synovial fluid (that was 3 times as much as normal). What is the cause of synovitis in this type of arthritic disease affecting this patient's left knee joint? a. Synovitis from type A cells attempting to remove the debris of joint mice b. Synovitis from type B cells attempting to remove the debris of joint mice c. Synovitis from macrophages eating joint mice and releasing CD977 d. None of the above
a. Synovitis from type A cells attempting to remove the debris of joint mice
_____ is released from the sarcoplasmic reticulum and binds to troponin during muscle contraction a.) Calcium b.) Sodium c.) Myosin d.) Acetylcholine
a.) Calcium
An 80 yo patient with chronic corticosteroid use breaks their humerus after a tumble.What is the correct explanation for their bone growth response? a) the patient will heal well due to increased growth factor and tight glycemic control b) the patient will heal poorly due to a delay in cell differentiation, and inhibition of IGF-1 and TGF-beta c) the patient will never heal because of osteoporosis risk d) the patient won't heal because of the increased risk of trauma and IL-1 and TNF- alpha antagonists role in healing
b) the patient will heal poorly due to a delay in cell differentiation, and inhibition of IGF-1 and TGF-beta
Select the one true description of the following neurological pathologies: a. Myasthenia gravis involves antibodies that destroy acetylcholine, causing inability for muscles to appropriately contract. b. Amyotrophic lateral sclerosis affects the anterior horn cells and corticospinal tract, often leading to both upper and lower neuron denegation, resulting in muscular abnormalities, but no sensory abnormalities. c. Guillain Barre Syndrome involves the rapid onset immune-mediated demyelination of the central nervous system, often resulting in both sensory and motor deficits. d. Multiple sclerosis is an autoimmune disease and type IV hypersensitivity reaction that involves demyelination of the peripheral nervous system, resulting in sensory and muscular deficits.
b. Amyotrophic lateral sclerosis affects the anterior horn cells and corticospinal tract, often leading to both upper and lower neuron denegation, resulting in muscular abnormalities, but no sensory abnormalities.
During his high school years, a 68-year-old man has struggled with alcoholism and continues to do so to this day. The patient recently suffered a wrist fracture and informed the physician that he is hoping to recover soon so that he can return to his weekly bingo games. In light of the patient's history of alcohol misuse and age, which ofthe following is NOT consistent with wound healing for this gentleman. a. Osteopenia is likely to be a factor in healing due to chronic alcohol use b. As a result of this patient's age, the pace of healing is considerably faster, indicating that bone development is already underway c. This patient was at increased risk of trauma due to weakened skeleton d. This patient's age and alcohol dependency implies that he will likely have a very extended recovery time for his wrist fracture
b. As a result of this patient's age, the pace of healing is considerably faster, indicating that bone development is already underway
A 47-year-old female scheduled an appointment with her PA because she has been nauseous, vomiting, and has been urinating more frequently than usual. Her PA decided to run some tests, and her blood potassium level came back with a result of 2.7mEq/L.Her ECG also presented U waves and flattened/inverted T waves. The PA noticed that her patient was taking a medication that could potentially be causing this hypokalemia.What is the most likely drug class behind her symptoms? a. Proton pump inhibitors b. Beta2-adrenergic agonists c. Antihistamines d. Beta2-adrenergic antagonists
b. Beta2-adrenergic agonists
You have a 78-year-old patient in the ED who is waiting on her CT scan with contrast.She asks you why you have to draw blood first and can't just do that after. You tell her that you need to check if her kidneys will be able to handle the job of filtering the radioiodine out of her body. What lab value will tell you this? a. BUN b. Creatinine c. Glucose d. Albumin
b. Creatinine
A 68 year old woman presents to you, her pcp, with pain in her fingers and toes that has been gradually worsening over the course of three months. She is very active for herage, goes on long walks every day, and does light bodyweight exercises three times a week. She is a non-smoker, but her husband of 45 years has been a long-time smoker. Upon examination, you palpate a small nodule on her right elbow and ask her about it,to which she replies that she thought it was a callous from doing planks. She reports that the pain is the worst in the morning when she wakes up, or if she sits and works on knitting sweaters for a while. The following you expect to see in her blood tests EXCEPT: a. Anemia b. Elevated troponin levels c. Elevated myoglobin d. Anti-citrullinated peptide e. Rheumatoid factor
b. Elevated troponin levels
You are seeing a patient with a suspected acute kidney injury. You order a urinalysis and notice urine the color of Coca-Cola. Out of possible pathologies for intrarenal acute kidney injuries, which of the following is "Coca-Cola urine" most consistent with? a. Acute tubular necrosis b. Glomerular problem c. Interstitial problem d. Vascular problem
b. Glomerular problem
A 78-year old male is a new patient at your primary care office. He hasn't seen a doctor in one year. He knows he has been diagnosed with 3 diseases in the past but only remembers hypertension and diabetes. He has not refilled his medications in over 6 months. He remembers taking baby aspirin every night but that is all. His vital signs are: temperature 37 C, HR 86 bpm, BP 152/90 mmHg, RR is 16, and BMI 31. During the physical exam, you notice his right big toe is red, swollen, and tender to palpation. The patient states pain in that area that lasts for hours. You realize the forgotten diagnosis!What is its pathophysiology? a. CD4+ cells release cytokines, which increases macrophages in joint space b. High uric acid levels leads to monosodium urate crystals depositing into joints c. Autoantibodies decrease acetylcholine receptors in postsynaptic cleft d. Chondrocytes increase degradative enzyme production decreasing cartilage in the joints e. None of the above
b. High uric acid levels leads to monosodium urate crystals depositing into joints
When combined with kidney issues, strenuous exercise can lead to a. Hypercalcemia b. Hyperkalemia c. Hypocalcemia d. Hypokalemia
b. Hyperkalemia
Hyperaldosteronism can result in which of the following conditions? a. Hypocalcemia b. Hypokalemia c. Hypercalcemia d. Hyperkalemia
b. Hypokalemia
All of the following are a result of peripheral nervous system sympathetic stimulation EXCEPT: a. Increased heart rate and cardiac output b. Increased blood flow to the GI tract c. Dilated pupils d. Increased blood flow to skeletal muscles
b. Increased blood flow to the GI tract
A 65yo woman goes to her PCP for an annual wellness exam. She has no acute complaints. Past medical history is notable for type 2 diabetes mellitus and hypertension, for which she is currently taking metformin and lisinopril, respectively.She frequently engages in outdoor exercise and eats a diet rich in protein and vegetables. Lab studies show a serum creatinine within normal limits. A dual-energy X-ray absorptiometry test is ordered and the results show that the patient's T-score is more than three standard deviations below the mean. Which of the following best explains the pathophysiology of this patient's condition? a. over production of parathyroid hormone b. Increased osteoclast bone breakdown c. reduced osteoclast bone reabsorption d. Impaired activation of Vitamin D
b. Increased osteoclast bone breakdown
A 68-year-old woman comes to your primary care clinic complaining of right hip pain.She states that the hip has been hurting for over 2 years now and has been steadily getting worse. She reports that the pain is sharp with a burning sensation and gets progressively worse with prolonged activity but improves with rest. Most recently she has been taking ibuprofen almost daily for tolerable pain control. On physical examination you note limited range of motion of the right hip. Vitals: Weight: 215lbs, BP: 132/78, HR: 97bpm, RR: 14, O2: 98% Based on the information what is the most likely diagnosis? a. Gout b. Osteoarthritis c. Rheumatoid Arthritis d. Osteoporosis
b. Osteoarthritis
69 y/o male with a history of atrial fibrillation presents to the ED with his husband with symptoms of unilateral arm weakness and numbness throughout his L arm. Throughout your exam, his speech is slurred and he keeps forgetting where he is. You also. notice he has a facial droop. Your team expects a stroke and he is quickly rushed to get a CT. Just before he goes, you remember that your team forgot one crucial diagnostic test before his CT scan. What is it? a. EKG b. POC glucose c. chest x-ray d. hemoccult
b. POC glucose
Which of the following is a manifestation of a joint disease caused by autoimmune inflammation of a joint? a. RANKL on T cells activates osteoblasts causing excessive bone production b. RANKL on T cells activates osteoclasts causing bone resorption c. Eburnation d. Type 2 collagen cells replaced by type 1 collagen cells
b. RANKL on T cells activates osteoclasts causing bone resorption
Which of the following is a common symptom of chronic kidney disease? a. Chest pain b. Rapid Weight Gain c. Blurred Vision d. Muscle weakness
b. Rapid Weight Gain
A 67 yo patient with diabetes and chronic kidney disease reports to the ED with complaints of swelling in their elbow that started a few hours ago. Patient states that they started to notice warmth in the area within the last few hours and it has since become tender to move. Patient does not recall any trauma to the area. Which of the following would most likely true? a. They are lacking factor 8, causing hemarthrosis b. Reduced clearance of uric acid is occurring c. T-helper cells and antibodies are eroding bone and affecting hematopoiesis d. Osteoclasts are exceeding osteoblasts, causing a porous bone
b. Reduced clearance of uric acid is occurring
A 59-year-old male presents to the emergency department because he has beenexperiencing nausea, vomiting, decreased urine output, and a general malaise feelingfor the past couple of days. Among other diagnostic tests, you order a urinalysis, whichshows proteinuria and the presence of red blood cells, and his urine was noted to be thecolor of Coca-Cola. What further testing is required to make an official diagnosis of yoursuspected diagnosis? a. Blood glucose testing b. Renal biopsy c. Post-void bladder scan d. Serum albumin levels
b. Renal biopsy
Abnormalities of HLA-DR1 and HLA-DR4 are associated with which pathology? a. Osteoarthritis b. Rheumatoid arthritis c. Gout d. Osteoporosis
b. Rheumatoid arthritis
Where do the pathologic changes associated with Alzheimer's Disease typically begin? a. Primary motor and sensory cortices b. Temporal cortex c. Frontal association cortices d. Parietal cortex
b. Temporal cortex
Which of the following statements about how age affects fracture healing is false? a. Older age causes a delay in cell differentiation b. Younger age is at an increased risk of comorbidities c. Older age decreases bone formation and possible delayed neovascularization d. Younger age is related to a quicker rate of healing and bone growth is already occurring
b. Younger age is at an increased risk of comorbidities
What binds troponin and causes a structural change and tropomyosin moving out of the way to reveal actin? a. acetylcholine b. calcium c. sodium d. ADP
b. calcium
Which of the following is not a part of the pathophysiology of multiple sclerosis? a. damage to the oligodendrocytes b. excitotoxicity c. loss of axons over time d. type IV hypersensitivity reaction
b. excitotoxicity
A patient comes in for a follow-up 4 weeks after having fractured their right ulna. The cast is removed and imaging shows that the fracture has not formed an adequate callous and has poor union. What factor is most likely causing this delayed fracture healing? a. Decreased circulation causing increased oxygen at the fracture site. b. Hypercalcemia c. Hg A1c of 17 d. They are female and 18 y/o
c. Hg A1c of 17
A 65-year old biological male presents to your clinic with a 5-day history of decreased urine output and malaise. His BUN and creatinine are elevated and ultrasound of the kidneys and bladder shows hydroureters and hydronephrosis. What is the most likely cause of his condition? a) Hypersensitivity reaction with immune complex deposition causing interstitial fibrosis b) Protracted vomiting and diarrhea leading to decreased renal perfusion c) Benign prostatic hypertrophy causing obstruction to the outflow of urine d) Pyelonephritis causing tubular disease e) Thromboembolic disease of the renal arteries causing ischemic kidney injury
c) Benign prostatic hypertrophy causing obstruction to the outflow of urine
A 26 year old female reports to your office complaining of blurred vision in one eye. The vision problem has been getting progressively worse over the past few days and she states that it's becoming painful. She also mentions she's been feeling extremely tired lately and her brain feels "foggy." You decide to order an MRI. What are the most likely findings? a) Atrophy of the midbrain with enlargement of the third ventricle b) Thickening and marked enhancement of the anterior spinal nerve roots c) Multiple white matter lesions d) Cortical atrophy
c) Multiple white matter lesions
What is the recovery of the resting membrane potential called? a) Relative Refractory Period b) Absolute Refractory Period c) Repolarization d) Depolarization
c) Repolarization
What is the cause of Azotemia? a. Less K+ is excreted and it builds up in the blood b. A lack of Vitamin D c. A decreased GFR results in urea build up in the blood d. Excess of glucose in the blood starts sticking to proteins making the efferent arteriole more stiff and narrow
c. A decreased GFR results in urea build up in the blood
Which disorder can carry a mutation in Superoxide Dismutase 1? a. Guillain-Barre b. Myasthenia Gravis c. ALS d. Hypertrophic Cardio Myopathy
c. ALS
We know that this condition is due to the osteoclasts breaking down bone faster than it can be rebuilt by osteoblasts. This results in which of the following? a. A greater amount of trabeculae in the spongy bone b. Thickening of the cortical bone c. An increased risk for fractures d. A decreased risk for fractures
c. An increased risk for fractures
An 80 year old male present to your Urgent Care with a left tibial fracture. Which of the following mechanisms or findings is most consistent with this patient's ability to heal a bone fracture. a. Quick callus formation b. Large hematoma formation c. Delay in neovascularization d. A thick periosteum
c. Delay in neovascularization
A 71-year-old female presented to the clinic with a sudden onset of left knee pain. The patient reports the pain to be a 9 out of 10 (on a scale of 0-10 with 10 being the worst). The patient reports a PMHx of generalized joints pain that usually subsides with rest. Past medical history is significant for hypertension and hyperlipidemia. Medications include pravastatin and hydrochlorothiazide. Temperature is 37.1°C (98.7°F), pulse is 84/min, respirations are 16/min, and blood pressure is 135/92 mmHg. Physical examination reveals swelling, erythema, and warmth of the left knee joint. The left knee is tender to palpation with decreased active and passive range of motion. Arthrocentesis of the joint yields turbid fluid with a leukocyte count of 18,300/mm3. Additionally, polarized light microscopy shows yellow, negatively birefringent needle-shaped crystals.What is the most likely diagnosis for this patient? a. Rheumatoid arthritis b. Pseudogout c. Gout d. Osteoarthritis
c. Gout
Which of the following is NOT a potential cause for decreased renal perfusion leading to an Acute Kidney Injury? a. Heart Failure b. Sepsis c. Hypervolemia d. NSAIDs
c. Hypervolemia
A 68 y/o M presents to the ED w/ complaints of worsening N/V x 2 days. PE exam demonstrates muscle weakness and an EKG shows a short QT interval and mild ST segment depression. Labs reveal potassium > 5.5mEq/L. What would NOT be a likely cause of the patient's hyperkalemia? a. Adrenal insufficiency b. ACE inhibitors c. Low protein diet d. Uncontrolled Type I DB
c. Low protein diet
A 30 yo male with past medical history including obesity, chronic kidney disease, and diabetes mellitus presents to your primary care office with complaints of pain in his right great toe ongoing 1 week. He states one morning he woke up and had an immediate sensation of his great toe "being on fire". He had severe pain for a few hours upon wakening. He describes his great toe as also being warm and swollen. He was having difficulty walking due to pain. His symptoms have since decreased in severity, but he continues to have pain, swelling, and warmth. Based on his complaints, you are concerned for an acute episode of gout. You know that gout is caused by hyperuricemia. What is the most common source of uric acid? a. Proteoglycans b. Precipitate crystals c. Monosodium urate d. Heterocycles
c. Monosodium urate
Using cool bone technology, your PA friend sees widened Haversian canals in a 70 year old female w/ known history of alcohol consumption and smoking. Your friend remembers that these canals contain vasculature and nerves for the bones, but they can't remember what disease process is associated w/ these widened canals. You know the answer! Widened Haversian canals are associated with: a. Gout b. Rheumatoid arthritis c. Osteoporosis d. Osteoarthritis
c. Osteoporosis
Which of the following is not a clinical manifestation of prerenal AKI? a. Hyperkalemia b. Decreased urine output/anuria c. RBCs in urine d. Malaise
c. RBCs in urine
A patient presents to the ER because he was awoken in the middle of the night and says his big toe feels like it's on fire. What diagnostic test would you perform and what would you expect to find? a. Synovial fluid analysis: negatively birefringent rhomboid shaped calcium pyrophosphate crystals b. Synovial fluid analysis: positively birefringent rhomboid shaped calcium pyrophosphate crystals c. Synovial fluid analysis: negatively birefringent needle-shaped urate crystals d. Synovial fluid analysis: positively birefringent needle-shaped urate crystals
c. Synovial fluid analysis: negatively birefringent needle-shaped urate crystals
A 67 y/o male with no significant PMHx presents to his primary care physician with the complaint of frequent falls over the past several months. In discussion, he mentions to the physician that he is often anxious and has noticed himself becoming more forgetful lately. He was given a MoCA assessment which revealed mild cognitive impairment.Upon exam, there were no signs of muscle weakness, however, rigidity in the lower extremities was noted and it was observed that he walks with a shuffling gait. What pathology is most likely causing the patient's symptoms? a. improper breakdown of amyloid precursor protein b. production of antiganglioside antibodies leading to demyelination of axons c. degeneration of dopamine producing neurons in the substantia nigra d. damage to motor neuron cytoskeleton
c. degeneration of dopamine producing neurons in the substantia nigra
A 40 yo male patient presents to the ER with unexplained symptoms of paralysis in the lower extremities. The patient states that he experienced some weakness and trouble walking and woke up this morning not being able to walk or move the lower limbs at all.The patient reports having the flu virus 2 weeks ago, but no other significant health history. You are the PA working today and suspect that this patient has Guillain-Barre' Syndrome. You need to quickly do a work up on the patient, which of the following which test would be most helpful? a. CBC with differential b. MRI of the lower extremity c. lumbar puncture to obtain cerebrospinal fluid for analysis d. Genetic testing
c. lumbar puncture to obtain cerebrospinal fluid for analysis
A 28 y/o female comes into the clinic with vague complaints of nausea and a decreased appetite. On physical examination, cardiac arrhythmias are found. The patient mentions that she was diagnosed with Lupus around 5 years ago. The patient undergoes testing and is found to have a GFR of 87mL/min/1.73m2. Which of the following best indicates the patho related to this patients condition? a. Excess glucose causing increased pressure or hyper filtration due to hyaline-arterial sclerosis b. More K+ excreted in the blood leading to cardiac arrhythmias c. A decrease in GFR causing more urea to be excreted in the urine d. A buildup of urea in the blood, hyperkalemia, and hypocalcemia
d. A buildup of urea in the blood, hyperkalemia, and hypocalcemia
Which of the following is a true statement regarding Amyotrophic Lateral Sclerosis(ALS)? a. Genetic factors account for the majority of ALS incidences b. ALS will ultimately affect the upper motor neurons, lower motor neurons and sensory neurons c. There is a 100% mortality rate at 5 years for patients with ALS d. ALS will often initially manifest with unilateral muscle weakness
d. ALS will often initially manifest with unilateral muscle weakness
56 years old woman underwent emergent laparotomy after a motor vehicle collision. 2 days post op, she develops decreased urine output. Patient's vital signs are within normal limits. On physical examination, the surgical incision is healing with hematocrit of 28%, platelet count of 400,000/mm3, serum creatinine is 3.8mg/dl and serum urea nitrogen concentration is 29mg.dl. Urine analysis shows brown granular cast. Which ofthe following is the most likely cause of the findings above? a. Rapidly progressive glomerulonephritis. b. Focal segmental glomerulosclerosis. c. Acute renal infarction d. Acute tubular necrosis e. Allergic interstitial Nephritis
d. Acute tubular necrosis
Which of the following are predisposing factors to a hemorrhagic stroke? a. Hypertension b. Excessive alcohol use c. AVM d. All of the above
d. All of the above
Which of the following is not a primary injury in TBI? a. Shearing forces b. Direct neuron damage c. Contusions d. Excitotoxicity
d. Excitotoxicity
What is the big picture pathological disorder in Parkinson's Disease? a. Gradual disappearance of the Thalamus portion of the brain → underproduction of norepinephrine → no neurotransmitter to prevent excessive movement b. Over stimulation of the Subthalamic nucleus portion of the brain →overproduction of epinephrine → neurotransmitter enables excessive movement c. Gradual disappearance in the Substantia nigra portion of the brain →underproduction of epinephrine → no neurotransmitter to prevent excessive movement d. Gradual disappearance of the Substantia nigra portion of the brain →underproduction of dopamine → no neurotransmitter to prevent excessive movement
d. Gradual disappearance of the Substantia nigra portion of the brain →underproduction of dopamine → no neurotransmitter to prevent excessive movement
A patient presents to your clinic complaining of a loss of sensation in their extremities,weakness that has been moving up their arms, and periods of double vision. After learning they recently had the flu, you complete a lumbar puncture which confirms your suspicion of an immune-mediated demyelinating disease of the peripheral nervous system. This diagnosis is most likely: a. Multiple Sclerosis b. Parkinson's Disease c. Amyotrophic Lateral Sclerosis d. Guillain-Barre Syndrome
d. Guillain-Barre Syndrome
What disease process is associated with the blockage of nerve transmission from nerve to muscle due to antibodies attacking the body? a. Osteoarthritis b. Bells Palsy c. Stroke d. Myasthenia Gravis
d. Myasthenia Gravis
A 54-year-old male presents to the ER with persistent muscle weakness over the last 2 weeks. He states it is a pattern of waking up feeling fine but increasing weakness throughout the day. He decided to come in today because he noticed his muscle weakness was accompanied by his left eyelid drooping and he believes he may behaving what his co-workers call "mini strokes." You've seen this before and have an idea that it may be __________ and order ________ since it is the first line for diagnostic testing. a. CVA; CT Head with contrast b. Plica semilunaris; ophthalmology consult c. Freezing phenomenon (Parkinson's)/ neurology consult d. Myasthenia Gravis; Acetylcholine Serum Assay
d. Myasthenia Gravis; Acetylcholine Serum Assay
A 72-year-old man presents to his primary care physician for his annual exam. He has a very stoic personality and says that he is generally very healthy and has "the normal aches and pains of old age." On further probing, you learn that he does have pretty significant back and hip pain that worsens throughout the day. On physical exam you note bony enlargement of the distal interphalangeal joints bilaterally. Which of the following is the likely cause of his symptoms? a. Gout b. Pseudogout c. Rheumatoid arthritis d. Osteoarthritis e. Osteopenia
d. Osteoarthritis
A 65-year-old female patient is admitted to the ER with a massive GI bleed. This patient is at-risk for what type of acute kidney injury? a. Intra-renal b. Post-renal c. Glomerular-renal d. Pre-renal
d. Pre-renal
Which of the following is NOT correct regarding Rheumatoid arthritis? a. Pathogenesis of RA involves Anti-CCP antibody attacking citrullinated proteins b. RA triggers IL-1 and IL-6 causing fever c. RA causes Boutonniere and Swan Neck Deformities d. RA involves typically 5 or more joints asymmetrically e. The PIP joint is more commonly in involved in RA than the knee joint.
d. RA involves typically 5 or more joints asymmetrically
What clinical manifestations distinguish osteoarthritis from Rheumatoid arthritis? A. In osteoarthritis, a patient may experience stiffness in the morning that lasts less than 1 hour and no joint swelling. b. In osteoarthritis, a patient may experience morning stiffness that lasts longer than 1 hour and joint swelling. c. In rheumatoid arthritis, a patient may experience stiffness that lasts less than 1 hour and has no joint swelling. d. In rheumatoid arthritis, a patient may experience stiffness that lasts longer than 1 hour and has painful joint swelling. e. A and D f. B and C
e. A and D
Which of the following should be avoided in patients who have an acute kidney injury? a. NSAIDs b. Aminoglycosides c. Macrolides d. Acetaminophen e. Both A and B
e. Both A and B
A 75-year-old male presents to your primary care office with bilateral stiff and painful elbows that began several months ago but is currently warm, red, and swollen. Hestates the stiffness is usually worse in the morning when he wakes up and improves with activity. He also states he has been having other joint stiffness and pain throughout the years but thought it was just old age. Upon inspection, you notice he has DIP flexion and PIP hyperextension. Which of the following clinical manifestations is NOT consistent with the likely diagnosis? a. Interstitial lung fibrosis b. Pannus formation c. Vasculitis d. Atherosclerosis e. Hyperuricemia
e. Hyperuricemia