Final 2014 Flashcards
What’s the diagnosis?
atrial flutter
In radioimmunoassay, which tube has the lowest T4 concentration?
a) Tube 1
b) Tube 2
c) Tube 3
d) Tube 4
a) Tube 1
Which of the following accurately describes type II hypersensitivity?
a) An antibody is bound to an Ag on the cell surface
Which substance upon binding leads to ATP -> cAMP “graph of Gs activation” in muscle tissue?
a) insulin
b) Glucagon
c) Epinephrine
c) Epinephrine
This graph represents the polysomnography of a 75-year-old male who complained of snoring that disrupts his sleep, what is the most likely diagnosis
a) obstructive sleep apnea
b) Central sleep apnea
c) Upper airway resistance syndrome
d) Normal sleep pattern
a) obstructive sleep apnea
The above graph represents the rhythm of which of the following hormones?
a) Growth hormone
study was conducted to investigate the survival rate of patients with microglobulinuria and those with normoglobulinuria. Two samples of people with micro and normoglobulinuria were selected and followed up till death occurred, and we got the following Kaplan meier curve. What is the median survival time of people with normoglobulinuria?
a) 17
b) 60
c) 72
d) Non-defined
d) Non-defined
This graph shows blood flow after a period of blood vessel occlusion. What is the reason behind this increased blood flow?
a) Hypoxia
Why does the Hemoglobin structure shifts from A to B conformation in the figure above?
a) 2,3BPG binding
b) Low pH
c) O2 binding
c) O2 binding
A study was conducted to find the prevalence of oropharyngeal cancer in a population and the exposure state was also determined. From the following table, what is the odds ratio of cancer in smokers compared to non-smokers? a) 0.234 b) 4.2 c) 2.2 d) Cant calculate it
b) 4.2
A cohort study was done to examine the association between obesity and type 2 DM. Two groups were selected one of which was obese and the other was normal weight. The participants were followed for different periods of time. What is the RR?
a) 1.4
b) 0.7
c) 2.5
a) 1.4
What is the percentage of Kuwaiti people who are unaware of being hypertensive?
a) 10%
b) 25%
c) 35%
d) 65%
c) 35%
- A 35-year-old woman is known for having SLE and she is taking estrogen supplements, what is your recommendation for her regarding her estrogen supplements and what is your rational behind it?
a) Continue, because it will help in reducing SLE symptoms
b) stop, because it is responsible for the flares
c) continue, because ERT helps improve fertility
b) stop, because it is responsible for the flares
What is the function of aggrecan?
a) Retention of water
Which of these drug regimens is the most appropriate one to treat multi-bacillary lepromatous leprosy?
a) Dapsone and ethambutol for 2 years.
b) Dapsone, rifampicin, and clofazimine for at least 2 years
c) Isoniazid, rifampicin, and ethambutol for 6 months.
d) Dapsone and rifampicin for 6 months.
b) Dapsone, rifampicin, and clofazimine for at least 2 years
Which muscle is not affected by carpal tunnel syndrome? (question got cancelled)
a) Abductor policis
b) Adductor policis
c) Abductor digiti minimi
d) Flexor digiti minimi
e) Opponens digiti
-
Which of the following nerves is responsible for hiccups?
a) Vagus
b) Glossopharyngeal
c) Phrenic
c) Phrenic
What is the most important risk factor for non-cystic fibrosis bronchiectasis?
a) Acute bronchiolitis
b) Lung abscess
c) asthma
d) chronic bronchitis
d) chronic bronchitis
Which of the following would cause an apparent decrease in the DLCO?
a) chronic bronchitis
b) emphysema
c) compression of pulmonary artery
d) left to right shunt
c) compression of pulmonary artery
Which type of blood vessels has thin tunica intima and adventitia but thick tunica media with 7-8 smooth muscle cell layers?
a) muscular artery
b) small arteriole
c) muscular vein
d) elastic artery
e) small artery
e) small artery
What is the rationale behind giving G-CSF for a stem cell donor?
a) To make the stem cells proliferate and differentiate into mature blood cells
b) To mobilize stem cells from bone marrow to the periphery circulation
b) To mobilize stem cells from bone marrow to the periphery circulation
A patient with heart failure with reduced ejection fraction (HF-REF). What should we give him?
a) Diltiazem
b) Nitrates
c) Bisolol (beta blocker)
d) Amlodipine
c) Bisolol (beta blocker)
Which of the following receptors can inhibit the cough reflex sensitivity?
a) TRPA1
b) TRPV1
c) TRPV4
d) TRPM8
d) TRPM8
What is the stage of lung tissue development, during which the mesenchymal tissue between the epithelium of the lung and the endothelium of capillaries is the thinnest?
a) pseudo glandular
b) canalicular
c) terminal sac
d) alveolar
c) terminal sac
a 45-year-old male presents with progressive dyspnea, lung biopsy reveals chronic interstitial inflammation(infiltration) with eosinophils, what is the most probable diagnosis?
a) hypersensitivity pneumonitis
b) good pasture syndrome
c) sarcoidosis
d) amyloidosis
e) adult respiratory distress syndrome
a) hypersensitivity pneumonitis
Which of the following muscles contract during expiration?
a) Sternocleidomastoid
b) Scalene
c) Abdominal external oblique
d) External intercostal
c) Abdominal external oblique
how does phenylephrine decrease congestion?
a) Agonist of beta 2 adrenergic receptor
b) Agonist of alpha 1 adrenergic receptor
c) Activates histamine receptor
d) Degrades mucous by acting as a mucolytic
b) Agonist of alpha 1 adrenergic receptor
which of the following is used in the management of a patient with chronic stable angina? (check answer) a) Diuretic b) Amlodipine c) correcting the patient’s anemia
?
A 43-year-old male presented to the outpatient clinic, upon examination he was anxious with fast heart rate and forceful heartbeat he was also sweating with cold hands, his pupils were dilated. what is the most likely diagnosis?
a) Adrenomedullay tumor
b) Enlargement of the adenohypophysis
a) Adrenomedullay tumor
what is the body compensatory mechanism for congestive heart failure?
a) Decreased catecholamine
b) tachycardia
c) myocardial atrophy
b) tachycardia
what’s the first structure to receive factors coming from hypothalamus into adenohypophysis?
a) Pars distalis
b) Pars nervosa
c) Median eminence
d) Pars tuberalis
c) Median eminence
A patient with history of upper respiratory tract infection complains of enlargement in the neck and tenderness, a biopsy was done. Which of the following is most likely to be found in the biopsy?
a) Excessive lymphocytic infiltration
b) Granulomas
c) Hurthle cell metaplasia
b) Granulomas
A patient with high blood thyroxin and low TSH presented with small/atrophic thyroid gland, what is the most likely cause?
a) The patient is taking thyroid extract
b) The patient is positive for graves’ disease
c) excessive iodine intake
a) The patient is taking thyroid extract
What stimulates the release of both insulin and glucagon?
a) Amino acids
b) Carbohydrates
c) Fatty acids
d) Ketones
a) Amino acids
A female with a normal 28-days menstrual cycle presented to the clinic. 12-hours earlier she had her peak estradiol levels without any significant progesterone. What do you expect after 3 days?
a) Menses
b) Corpus luteum will degenerate
c) Ovulation
c) Ovulation
A 58-year-old Kuwaiti male died from heart attack, how many years of potential life lost (YPLL)?
a) 1
b) 20
c) 40
d) 78
b) 20
Which of the following accumulate in patients with lipoid CAH?
a) ACTH receptor
b) Cholesterol ester
b) Cholesterol ester
To investigate a hemolytic anemia of newborn, what sample do we use in Indirect coombs test?
a) Baby’s serum
b) Baby’s RBC
c) Mother’s RBC
d) Mother’s serum
d) Mother’s serum
Which of the following is a natural anti-inflammatory substance?
a) LTC4
b) LTB4
c) LXA4
d) LTA4
c) LXA4
Which of the following is a powerful chemo-attractant lipid mediator of inflammation?
a) LTA4
b) LTB4
c) LTC4
d) LXA4
e) PGI2
b) LTB4
Which Immune cell is deficient in a patient with recurrent bacterial infections or Patient with repeated (pulmonary) infections and primary immunodeficiency, which of the following immune cell lineages is most likely deficient?
a) T cell
b) B cell
c) Phagocyte
d) Eosinophil
b) B cell
What is the effect of smoking on bone healing?
a) Vasoconstriction which diminishes blood flow to the fractured area
b) Increase the efficiency of bone healing by producing some cytokines
a) Vasoconstriction which diminishes blood flow to the fractured area
Which of the following lies anterior to the transverse sinus?
a) Pulmonary trunk
b) Arch of aorta
c) Left atrium
d) Right atrium
e) Inferior vena cavae
a) Pulmonary trunk
What is true regarding right sided heart failure?
a) Distended painful liver and Lower limb edema
Which of the following choices in the table below indicate the effect of controlling glucose levels on micro and macro diseases?
a. Microvascular not affected, Macrovascular reduced slightly
b. Microvascular reduced significantly, Macrovascular not affected
c. Microvascular reduced significantly, Macrovascular reduced slightly
d. Microvascular reduced slightly, Macrovascular reduced significantly
c. Microvascular reduced significantly, Macrovascular reduced slightly
Which of the following cells work as protective cells in the airway epithelium?
a) Basal cells
b) Brush cells
c) Goblet cells
c) Goblet cells
which of the following decreases hemoglobin affinity to O2?
a) Bisphosphoglycerate mutase
b) Methemoglobin reductase
a) Bisphosphoglycerate mutase
which of the following describes the action of the antirheumatic drug infliximab?
a) blocks DHFR
b) blocks the action of TNF-a
c) inhibits JAK
b) blocks the action of TNF-a
A 45-year-old male come with bradycardia and have first degree heart block. What abnormality can be seen in ECG?
a) ST elevation
b) prolonged PR interval
c) prolonged RR interval
d) ST segment prolonged
b) prolonged PR interval
a 60-year-old man presented with hyponatremia because of overconsumption of water and not because of sodium excretion. he was given tolvaptan and improved. What is the mechanism of action of tolvaptan?
a) Acts as an agonist to ADH v2 receptor
b) Decrease the sensitivity of ADH v2 receptor
c) Blocks ADH v2 receptor
c) Blocks ADH v2 receptor
Which steroid hormone plays a key role in adrenarche?
a) DHT
b) DHEA
c) cortisone
b) DHEA
A Girl had a neck pain which radiates into right shoulder/arm and little finger, what should be the immediate investigation? Check answer
a) Physical examination
b) MRI
c) X-ray
?
what is the origin of the cervical sympathetic nerve supply of the heart?
a) C3-5 cervical
b) T1-5 spinal thoracic
c) T6-10 spinal thoracic
d) Vagus
b) T1-5 spinal thoracic
Removal of the adenohypophysis will result in the atrophy of?
a) Zona glomerulosa
b) Zona fasiculata
c) Zona reticularis
b) Zona fasiculata
A 55-year-old man with milliary TB has suffered from a severe acute adrenal insufficiency. What is the best treatment that should be administered?
a) Cortisol & 9-flurocortisol
b) 9-Flurocortisol & metyrapone
c) Aldosterone & metyrapone
a) Cortisol & 9-flurocortisol
Persistence of which of the following structures leads to the mixture of blood of the pulmonary trunk with the aorta?
a) Ductus venosus
b) Foramen ovale
c) Ductus arteriosus
a) Ductus venosus
A study was conducted to find negative effects of radon gas exposure on the lungs. They gave all the workers radon monitors and masks, and followed them for 5 years. What is the study design?
a) Case control
b) RCT
c) Cross sectional
d) Cohort
d) Cohort
What cell expresses CD34+ on their surfaces?
a) T lymphocytes
b) Multipotent stem cells
c) Pluripotent stem cells
c) Pluripotent stem cells
Familial cardiomyopathies are considered 50% of all cardiomyopathies. What is the mode of inheritance of familial cardiomyopathies?
a) Autosomal recessive
b) X- linked recessive
c) X- linked dominant
d) Autosomal dominant
d) Autosomal dominant
Which of the following accurately describes the anti-inflammatory action of aspirin?
Check answer
a) Irreversible inhibition of COX-1
b) Irreversible inhibition of COX-1 and COX-2
c) Reversible inhibition of COX-1 and COX-2
d) Irreversible inhibition of COX-2
?
A man presented with low WBCs, RBCs, platelets after being treated for his colon cancer. What abnormality could you find?
a) Hypercellular bone marrow
b) Inflammatory cells infiltration in the BM
c) Bone marrow hypoplasia
c) Bone marrow hypoplasia
It has been proven that massaging the carotid artery is helpful in terminating reentry tachycardia, what is the mechanism behind that?
a) Decreases the upstroke of action potential
In which of the following cases is dilution helium test not recommended to be used to estimate the lung volume?
a) COPD
b) Emphysema
b) Emphysema
Which of the following has a positive ionotropic effect?
a) Decrease afterload
Which of the following mechanisms do Th1 cells use to kill intracellular pathogens?
a) activate infected macrophages
b) release TNF-a which activates cytotoxic t-cells
a) activate infected macrophages
Why does warfarin act more efficiently in vivo but not in vitro?
a) Because there are pre-formed coagulation factors in vivo
Damage of which nerve root is responsible for loss of patellar reflex and sensation in the medial part of the leg?
a) L3
b) L4
c) L5
d) S1
b) L4
A young man was playing basketball when his neck was accidentally hyperflexed. Upon physical examination, the lateral part of forearm was numb. Which intervertebral disc is involved?
a) C3/C4
b) C4/C5
c) C5/C6
d) C7/C8
c) C5/C6
Quinidine is a drug that is used to terminate different types of tachyarrhythmias; however, it can lead to increased heart rate, what is the mechanism behind that?
a) Anti-vagal activity
A young female patient presented with symmetrical joints pain of the hand and hip. She also complains of morning stiffness. She told the doctor that she had suffered from an injury to her right elbow few years ago. Upon examination, her hand showed hyperextension of MCP and hyperflexion of both PIP and DIP of the 4th and 5th fingers, what is the deformity called?
a) Mallet finger
b) Swan neck deformity
c) Claw hand
d) Boutonniere’s deformity
c) Claw hand
Which of the following anti- neoplastic drugs is used to inhibit ribonucleotide reductase?
a) 5-Flurouracil
b) 6-Mercapotopurine
c) Methotrexate
d) Hydroxyurea
d) Hydroxyurea
Why is Eplerenone considered an effective drug to use in patients with heart failure?
a) It decreases salt and fluid absorption
What can you conclude form the lung compliance graph?
a) Surface tension reduces lung compliance
Which of these are not characteristic of osteoarthritis?
a) Subchondral cyst
b) Subchondral sclerosis
c) Osteophyte formation
d) Joint space narrowing
e) Erosion of the bone
e) Erosion of the bone
Which of the following lymph nodes drain most lymph from lymphatics that are associated with the cephalic vein?
a) Pectoral
b) Subscapular
c) Humeral
d) Central
e) Apical
e) Apical
What’s the most common risk factor for TB in Africa?
a) Malnutrition
b) Lack of BCG
c) HIV
d) Lack of awareness
c) HIV
What gives the extended structure of proteoglycans?
a) Polysaccharide charges
b) Polysaccharide branches
c) Protein double helix
d) Protein triple helix
a) Polysaccharide charges
A 65-year-old male with recently fractured tibia, bone biopsy shows thickened bone lamella and mosaic pattern, with increase in alkaline phosphatase, what’s the underlying mechanism?
a) Hyperparathyroidism
b) Osteoclast dysfunction
c) Disorder of growth palate
d) Increased vitamin D intake
b) Osteoclast dysfunction
Epistaxis is nose bleeding that is usually associated with low platelet count. Where does the bleeding most commonly occur in the nasal cavity?
a) posteriolateral
b) posterior inferior
c) anterior inferior
c) anterior inferior
A patient with low back pain that radiates to the posterior of the thighs, the pain gets worse with standing and walking and relieved by rest and bending. On examination, the patient has normal sensation and reflexes and no weakness, and 2+ peripheral pulses, straight leg test was negative, the patient didn’t complain of any bowel problems. Which of the following is most likely the diagnosis?
a) Disc herniation
b) Vascular claudication
c) Spinal stenosis
d) cauda equine syndrome
c) Spinal stenosis