5.5.2015 Missed Questions Flashcards
A small DNA virus is described that has affinity for stratified squamous epithelium. The virus is most likely to affect which of the following respiratory structures? A. Paranasal sinuses B. Laryngeal vestibule C. False vocal cords D. True vocal cords E. Tracheal bifurcation
D. True vocal cords
27 yo leaves restroom of bar after smoking unknown substance. Becomes disoriented and belligerent. Uncoordinated jerky movements of extremities and assaults bouncer who tries to calm him. Later man doesn't remember event. What potentially lethal sequel at are associated with acute intoxication of this drug? A MI B Resp depression C seizure D stroke E trauma
E trauma
23 yo man being evaluated for myoclonic epilepsy of recent onset. the episodes are short-lived and triggered by startle. physical exam reveals proximal muscle weakness. Gomori trichromatic stain of a muscle biopsy specimen shows muscle fibers with a blotchy red appearance. family history is unavailable because the patient is adopted. what is the probability that this patient's only offspring will have the disease? a 100% b 75% C 50% d 25% E 0%
E 0%
A seven-year-old male has a right leg cast after a bicycle accident. after wearing the cast for some time, he complains of pain and numbness of the dorsum of his right foot and cannot dorsiflexion his right ankle. Which of the following is the most likely site of nerve compression in this patient? A popliteal fossa B fibular head C lateral compartment of the leg D anterior compartment E medial malleolus
B Fibular head
40-year-old man with disease due to type one diabetes mellitus is hospitalized for initiation of hemodialysis. A tunneled dialysis catheter is inserted into the right internal jugular vein. Before he’s able to undergo dialysis treatment, the patient develops bleeding around the catheter exit site that is difficult to control. He has not been treated recently with anticoagulants. Further evaluation of this patient would most likely show which of the following lab abnormalities?
Prothrombin time
Activated partial thromboplastin time
Platelet count
Bleeding time
Normal
Normal
Normal
Prolonged
A 65-year-old male is brought to the ER with severe chest pain, sweating and nausea. EKG showed a ST elevation in Leads two, three, and aVF. Medical management of acute myocardial infarction was initiated. After initial treatment the pain decreased in intensity, but a reperfusion complex ventricular arrhythmia emerged. The arrhythmia was asymptomatic and resolved spontaneously. Which of the following drugs was most likely responsible for rapid reperfusion in this patient?
A heparin B agatroban C warfarin D tPA E aspirin F ticlopidine G abciximab H cilostazol
D tPA
56-year-old man comes to the emergency department due to progressively worsening dyspnea. He can walk only a few blocks before becoming short of breath. He also finds it difficult to sleep lying flat and requires three pillows to prop himself up when sleeping. The patient does not use tobacco, alcohol, or illicit drugs. His other medical problems include chronic hypertension but he takes medication only when experiencing headaches. Blood pressure is 170 over 100 mmHg and pulse is 80 per min. physical exam shows bilateral basilar lung crackles. Jugular venous distension and bilateral lower extremity edema. The chest x-ray reveals cardiomegaly and hilar prominence. And electrocardiogram shows left ventricular hypertrophy. Electrocardiogram shows pulmonary arterial hypertension. The following is most likely underlying mechanism for those patients pulmonary hypertension?
A hypoxia induced pulmonary vasoconstriction
B increased pulmonary artery flow volume
C inflammatory pulmonary vascular disease
D mechanical obstruction of pulmonary arterial tree
E obliteration of pulmonary vascular bed
F vasoconstriction due to pulmonary venous congestion
F vasoconstriction due to pulmonary venous constriction
47 yo man comes to physician for follow-up of his high blood pressure. Medical history significant for stable angina pectoris, for which he takes sublingual nitroglycerin as needed. His BP is 154/107 mm Hg and pulse is 86/min. Exam shows no abnormalities. Started on low dose of atenolol. Which of the following cellular changes will be seen after addition of atenolol?
Cardiocyte cAMP
Juxtaglomerular cell cAMP
Vascular smooth muscle cAMP
A. Decreased decreased decreased B. Decreased decreased No change C. Decreased No change Decreased D. Decreased No change No change E. No change No change No change
23 yo Caucasian male has strong family hx of CF. Younger brother died of the disease and niece recently diagnosed. He wonders if he is a carrier of mutated gene. Which of the following must be known to perform PCR as part of analysis?
A. Nucleotide sequence of target DNA
B. Nucleotide sequence of regions flanking target DNA
C. cDNA nucleotide sequence
D. Restriction enzyme susceptibility sites on target DNA
E. AA sequence of abnormal protein product
B. Nt sequence of regions flanking target DNA
Molecular biologists investigating functional signficance of non-coding RNA molecules isolate large complexes containing both protein and RNA from exocrine pancreatic cells. The complexes are found both freely flaoting in cytoplasm and bound to endoplasmic reticulum. Structural RNA found in these complexes is primarily synthesized at which of the following intracellular sites? A. Rough ER B. Nucleolus C. Nucleus D. Mitochondria E. Exocrine granules
B. Nucleolus
35 yo female hospitalized with headaches and vomiting. Has long hx of psych illness and has eccentric dietary habits. Physical exam: papilledema, dry skin, hepatosplenomegaly. Head CT is negative for intracrainal mass. Which of the following is likely cause of patient's condition? A. Thiamine deficiency B. Niacin deficiency C. vitamin B12 deficiency D. Riboflavin deficiency E. Vitamin C overuse F. Vitamin A overuse
F. Vitamin A overuse
35 yo woman comes with abrupt onset fever, headache, severe muscle aches, and sore throat for last 4 days. PE shows mild erythema of pharynx and nasal congestion. Rapid influenza antigen test is positive. Patient is treated conservatively and condition improves over next several days. Infected respiratory epithelial cells begin secreting increased quantities of interferons. Specific interferons secreted by these cells most likely result in which of the following cellular changes?
A. Decreased apoptosis of infected cells
B. Decreased protein synthesis by infected cells
C. INcreased class II mHC expression
D. INcreased intracellular killing by macrophages
E. Viral mRNA degradation with sparing of host mRNA
B. Decreased protein synthesis by infected cells
4 yo boy with decreased appetitie, abdominal cramps, diarrhea over last 3 days. Stools were watery but now bloody. PE: Temp is 100.4F. Signs of dehydration and mildly distended abdomen with diffuse pain elicited on palpation. Stool studies positive for fecal leukocytes and occult blood. Fecal cultures grow non-lactose fermenting, gram-negative rods on MacConkey agar. Bacteria ferment glucose without gas production, do not generate hydrogen sulfide when grown on triple sugar iron agar and cannot replicate at refrigeration temperatures. Which is most important during pathogenesis of patient's disease? A. Exotoxin production B. Intestinal colonization C. Mucosal invasion D. Proliferation in lymph nodes E. Survival in circulation
C. Mucosal invasion
Mouse fed with food rich in nitrates. Chromosomal DNA of intestinal epithelial cells undergoes accelerated cytosine deamination. Which of the following is correct order of enzymes that repair the damage?
A. Glycosylase, endonuclease, lyase, DNA polymerase, ligase
B. Endonuclease, DNA polymerase, lyase, glycosylase, ligase
C. Lyase, endonuclease, glycosylase, DNA polymerase, ligase
D. Endonuclease, DNA polymerase, glycosylase, lyase, ligase.
E. Glycosylase, ligase, lyase, endonuclease, DNA polymerase
A. Glycosylase, endonuclease, lyase, DNA polymerase, ligase
12 yo male treated with nafcillin for skin infection and shows little response after two days of therapy. Pus microscopy shows Gram positive cocci in clusters and sensitivity testing demonstrates little response to nafcillin but good response to vancomycin. Which of the follwoing would most likely explain treatment failure in this patient?
A. Enzymatic degradation of drug.
B. Poor interaction with binding proteins
C. Mutation in RNA polymerase
D. Active drug transport out of cell
E. Mutation in DNA gyrase
B. Poor interaction with binding proteins
