Dr. Forbes Fluid and hemodynamics practice questions Flashcards
A 56-year-old has not received any medical care nor seen a physician for years. He reports reduced exercise tolerance over the past 5 years. On occasion in the past year he has noted chest pain after ascending a flight of stairs. He smokes 2 packs of cigarettes per day. He is found to have a blood pressure of 155/95 mm Hg. His body mass index is 30. Laboratory findings include a total serum cholesterol of 245 mg/dL with an HDL cholesterol that is 22 mg/dL. Which of the following vascular abnormalities is most likely to be his most serious health risk?
A Hyperplastic arteriolosclerosis B Lymphedema C Medial calcific sclerosis D Atherosclerosis E Deep venous thrombosis F Plexiform arteriopathy
D Atherosclerosis
A 55-year-old previously healthy woman is hospitalized for pneumonia. On the 10th hospital day she is found to have swelling and tenderness of her right leg, which apparently has developed over the past 48 hours. Raising the leg elicits pain. An ultrasound examination reveals findings suggestive of femoral vein thrombosis. Which of the following conditions is most likely to have contributed the most to the appearance of these findings? A Trousseau syndrome B Protein C deficiency C Prolonged immobilization D Pregnancy E Chronic alcoholism F Hypertension
C Prolonged immobilization
A 62-year-old man has experienced substernal chest pain upon exertion with increasing frequency over the past 6 months. An electrocardiogram shows features consistent with ischemic heart disease. He has a total serum cholesterol of 262 mg/dL. By angiography, there is 75% narrowing of the left anterior descending artery. Which of the following vascular complications is most likely to occur in this patient?
A A systemic artery embolus from thrombosis in a peripheral vein.
B A systemic artery embolus from a left atrial mural thrombus.
C Pulmonary embolism from a left ventricular mural thrombus.
D A systemic artery embolus from a left ventricular mural thrombus.
E Pulmonary embolism from thrombosis in a peripheral vein.
D A systemic artery embolus from a left ventricular mural thrombus.
On sectioning of an organ from a 60-year-old man at the time of autopsy, a focal, wedge-shaped area that is firm is accompanied by extensive hemorrhage, giving it a red appearance. The lesion has a base on the surface of the organ. In which of the following situations will this lesion most likely occur?
A Lung with pulmonary thromboembolism B Heart with coronary thrombosis C Liver with hypovolemic shock D Kidney with septic embolus E Spleen with embolized mural thrombus F Brain with cerebral arterial aneurysm
A Lung with pulmonary thromboembolism
A 63-year-old man has had increasing exercise intolerance for the past 5 years so that he now becomes short of breath upon climbing a single flight of stairs. Laboratory studies have shown fasting blood glucose measurements from 145 to 210 mg/dL for the past 25 years, but he has not sought medical treatment. If he dies suddenly, which of the following is most likely to be the immediate cause of death?
A Myocardial infarction B Nodular glomerulosclerosis C Cerebral hemorrhage D Hyperosmolar coma E Right lower leg gangrene
A Myocardial infarction
In an experiment, a glass bead is embolized to a branch of the renal artery. A day later there is a focal area in which the renal parenchymal cells in the distribution of the occluded artery show karyolysis and karyorrhexis. The outlines of the cells are still visible, but the nuclei have lost basophilic staining and the cytoplasm is eosinophilic but pale. Which of the following types of cellular necrosis is most likely present?
A Caseous B Coagulative C Fatty D Gangrenous E Liquefactive
B Coagulative
A 49-year-old woman has experienced marked pain in her lower extremities on ambulation more than 300 meters for the past 5 months. On physical examination, her lower extremities are cool and pale, without swelling or erythema. No dorsalis pedis or posterior tibial pulses are palpable. Her body mass index is 32. She is a smoker. Which of the following abnormalities of the vasculature is most likely to account for these findings?
A Lymphatic obstruction B Arteriolosclerosis C Atherosclerosis D Medial calcific sclerosis E Venous thrombosis
C Atherosclerosis
A 55-year-old man with a history of ischemic heart disease has worsening congestive heart failure. He has noted increasing dyspnea and orthopnea for the past 2 months. On physical examination there is dullness to percussion at lung bases. A chest x-ray shows bilateral pleural effusions. A left thoracentesis is performed, and 500 mL of fluid is obtained. Which of the following characteristics of this fluid would most likely indicate that it is a transudate?
A Cloudy appearance
B High protein content
C
C
A 52-year-old woman with no major medical problems takes a long airplane flight across the Pacific Ocean. Upon arrival at Sydney’s Kingsford Smith airport in New South Wales following the flight from Los Angeles, California, she cannot put her shoes back on. There is no pain or tenderness. Which of the following is the most likely explanation for this phenomenon?
A Activation of Hageman factor has led to bradykinin production.
B A lot of drinks were served in the first class section.
C Femoral vein thrombosis developed.
D A cellulitis developed in her legs.
E Venous hydrostatic pressure was increased.
E Venous hydrostatic pressure was increased.
A 56-year-old man has had increasing difficulty breathing for the past week. On physical examination he is afebrile. Auscultation of his chest reveals diminished breath sounds and dullness to percussion bilaterally. There is 2+ pitting edema present to the level of his thighs. A chest radiograph reveals bilateral pleural effusions. Which of the following laboratory test findings is he most likely to have?
A Hypoalbuminemia B Glucosuria C Neutrophilia D Anemia E Hypernatremia
A Hypoalbuminemia
