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Finals 3rd year > Final 2016 > Flashcards

Final 2016 Flashcards

1
Q

What is exposed to the surface of the cell that triggers apoptosis?

  1. Phosphatidylserine
  2. Phosphatidylcholine
A
  1. Phosphatidylserine
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2
Q

How does binding of 2,3 BPG to hemoglobin affect binding of O2 in human erythrocytes?
A-Compete with oxygen in binding to heme groups.
B- Decrease hemoglobin oxygen binding capacity by 50%.
C- Lower oxygen affinity by stabilizing deoxy conformation.
D- increase affinity of RBC to the bound O2

A

C- Lower oxygen affinity by stabilizing deoxy conformation.

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3
Q

What is the mechanism produced by Th1 to kill intercellular pathogen?

a) activation of infected macrophages
b) TNF-y mediated t cell cytotoxicity
c) IL-10

A

a) activation of infected macrophages

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4
Q

Patient with hypoxia and acute renal failure? What hematopoietic stem cells are affected?

a) myeloid
b) monoblast
c) proerythroblast
d) B -lymphocytes

A

c) proerythroblast

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5
Q

a 35-yr. old female with postpartum pulmonary embolism as she was being treated with heparin, then we followed her treatment by giving her warfarin, what is the appropriate mode of monitoring the long-term effect of warfarin?

a) measure of factor 2,7,9,10 levels
b) measure vitamin-K level
c) prothrombin time
d) D - doppler tests?
e) platelet function?

A

a) measure of factor 2,7,9,10 levels

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6
Q

What consequences would you expect in a patient who was found to have deficiency in surfactant SP-D?

A

a) Lower innate immunity

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7
Q

Female in 30 has facial rash, joint/ leg swelling, prolonged APTT, what is the pathogenesis? a) vWF deficiency

a) Acquired def. of factor 7, 9 “not sure”
b) Anti-phospholipids antibodies
c) DIC

A

b) Anti-phospholipids antibodies

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8
Q

A mutation in vWF will cause degeneration of which factor?

a) Factor V
b) Factor VII
c) Factor IX
d) Factor X
e) Factor XI
f) vWF
g) Factor VIII
h) Protein C

A

g) Factor VIII

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9
Q

a 5-year-old female with sickle cell presents with severe anemia, after 1 week she developed rash, joint pain, and viral DNA was detected in her blood, what’s the causative virus?

a) EBV
b) CMV
c) HIV
d) HCV
e) HTLV type 1
f) parvovirus B19
g) HBV
h) HTLV type 2

A

f) parvovirus B19

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10
Q

a 55-year-old man with Burkitt’s lymphoma, what’s the causative virus?

a) EBV
b) CMV
c) HIV
d) HCV
e) HTLV type 1
f) parvovirus B19
g) HBV
h) HTLV type 2

A

a) EBV

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11
Q

They showed us a similar picture in exam and asked us What causes the shift of curve (black line) to A or B?

a) B: High H+, High BPG
b) A: High H+, High Co2
c) B: low H+, Low BPG
d) A: High H+, High BPG

A

a) B: High H+, High BPG

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12
Q

What is the difference between myoglobin and hemoglobin?

a) Hemoglobin is tetramer while myoglobin is monomer
b) Fe +2 in hemoglobin/ Fe+3 in myoglobin

A

a) Hemoglobin is tetramer while myoglobin is monomer

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13
Q

in a patient branch of LAD supplying the septomarginal trabeculae showed occlusion. Which part of the ventricles will have loss of stimulation from purkinje fibers?

a) anterolateral papillary muscles
b) left posterior papillary muscles
c) septal papillary muscles
d) Lower part of interventricular septum
e) wall of right ventricle

A

a) anterolateral papillary muscles

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14
Q

Liver enlargement as a result of severe tricuspid valve insufficiency?

a) ascites
b) Heart failure cells
c) Passive chronic congestion
d) Corpulmonale
e) High output failure

A

c) Passive chronic congestion

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15
Q

Right ventricular heart failure with isolated interstitial lung disease?

a) ascites
b) Heart failure cells
c) Passive chronic congestion
d) Cor pulmonale
e) High output failure

A

d) Cor pulmonale

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16
Q

18-year-old male complaining of severe chest pain which is not relieving neither by rest nor vasodilator. What is the cause?

A

?

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17
Q

A 37-year-old male has a severe aortic stenosis and complains of angina on exertion. He is normotensive. Recent coronary angiography revealed normal coronary arteries. Which of these would likely reduce his angina?

a) Increase ventricular contractility
b) Increase venous return
c) Increase diuresis
d) Isolated diastolic hypertension
e) Coronary angioplasty

A

d) Isolated diastolic hypertension

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18
Q

A surgeon wanted to see the vertebra from the front, he removed the heart and along with it had to remove another structure, what is this structure?

  1. Esophagus
  2. Azygous vein
  3. Trachea
  4. Pulmonary trunk
  5. Vena cava
A
  1. Esophagus
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19
Q

A 36-year-old female with recurrent syncope, which is relieved by muscarinic receptor blocker, increase of what is responsible for relieving her symptoms?

b) ejection fraction
c) heart rate
d) plasma adrenaline level
e) stroke volume

A

c) heart rate

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20
Q

During the cardiac cycle, what will happen immediately after the beginning of the QRS wave? a) diastasis

b) isovolumic contraction
c) -ventricular ejection
d) -isovolumic relaxation
e) atrial diastole

A

b) isovolumic contraction

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21
Q

Patient taking disopyramide has tachycardia, what is it due to?

A

Antivagal activity

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22
Q

Image of hyperdiastolic orthostatic hypotension in a pt with drowsiness. her BP and HR were measure in supine and standing position, what is the cause of the changes seen in pic?

b) Antihypertensive drugs with vasodilators
c) Exacerbated parasympathetic activity
d) Regular stimulation
e) Delayed sympathetic activation
f) Normal change in standing

A

b) Antihypertensive drugs with vasodilators

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23
Q

Hypertensive patient, what will be seen in artery?

A

thickening of tunica media

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24
Q

Patient when injected with Acetylcholine, vasoconstriction happened in the coronary arteries. What is this due to?

a) Endothelial dysfunction
b) Endothelin

A

a) Endothelial dysfunction

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25
Q

MOA of clofibrate

a) PPAR Alpha
b) PCSK9
c) Inhibits cholesterol absorption in GI

A

a) PPAR Alpha

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26
Q

37-year-old man with severe upper respiratory tract infection soon develops acute myocardial dysfunction with left ventricular failure. He died despite therapy. At postmortem his heart showed extensive cardiac myocyte necrosis without any inflammatory reaction

a) Diphtheria Myocarditis
b) Toxoplasmosis Myocarditis
c) Viral Myocarditis
d) Bacterial Myocarditis
e) Giant cell Myocarditis
f) Hypersensitivity myocarditis
g) Rheumatic myocarditis

A

a) Diphtheria Myocarditis

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27
Q

something about taken drug then got sudden cardiac death?

a) Diphtheria Myocarditis
b) Toxoplasmosis Myocarditis
c) Viral Myocarditis
d) Bacterial Myocarditis
e) Giant cell Myocarditis
f) Hypersensitivity myocarditis
g) Rheumatic myocarditis

A

f) Hypersensitivity myocarditis

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28
Q

Caused by thyrotoxicosis

a) Supraventricular tachycardia.
b) Ventricular Fibrillation.
c) Sinus tachycardia
d) Complete heart block (3rd degree AV dissociation)
e) Atrial tachycardia.

A

c) Sinus tachycardia

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29
Q

Common in pregnancy.

a) Supraventricular tachycardia.
b) Ventricular Fibrillation.
c) Sinus tachycardia
d) Complete heart block (3rd degree AV dissociation)
e) Atrial tachycardia.

A

c) Sinus tachycardia

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30
Q

Which fuel is mostly oxidized in cardiomyocytes when the level of AMP is high?

a) Glycogen
b) Glucose
c) Lactate
d) Pyruvate
e) Triglyceride
f) Ketone bodies

A

e) Triglyceride

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31
Q

Which fuel is least used up when the level of fatty acid is high?

a) Glycogen
b) Glucose
c) Lactate
d) Pyruvate
e) Triglyceride
f) Ketone bodies

A

b) Glucose

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32
Q

Demarcates the line where the sinus venous is absorbed into the primitive atrium?

A

Crista terminalis

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33
Q

what forces the heart to work on a depressed frank starling curve?

  1. Sarcomeres length
  2. Positive inotropy
  3. Negative inotropy
  4. Positive dromotropy
  5. Negative dromotropy
  6. Positive chronotropy
  7. Negative chronotropy
  8. Treppe effect
A
  1. Negative inotropy
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34
Q

what phenomena results from accumulation of ca in the cytosol

  1. Sarcomeres length
  2. Positive inotropy
  3. Negative inotropy
  4. Positive dromotropy
  5. Negative dromotropy
  6. Positive chronotropy
  7. Negative chronotropy
  8. Treppe effect
A
  1. Treppe effect
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35
Q

What is an alpha2 agonist?

A

Methyldopa

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36
Q

What can an inclusion in the proximal end of LAD cause?

  • left atrial embolism
  • left ventricular embolism
  • right atrial embolism
  • right ventricular embolism
A
  • left ventricular embolism
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37
Q

A 45 year old woman dies suddenly. During the post mortem dissection, the four chambers of
the heart were found dilated. What might be the cause of her condition?
- Genetics (genetical/ congenital defect)
- Chronic ischemia.

A
  • Genetics (genetical/ congenital defect)
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38
Q

Tension pneumothorax on x-ray?

  • Contralateral mediastinal tracheal shift
  • Ipsilateral mediastinal tracheal shift
  • ipsilateral dome elevation
A

Contralateral mediastinal tracheal shift

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39
Q

Why do we use carbon monoxide although it has poisonous effects?

A

Because it is diffusion limited

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40
Q

Bind D-Ala D-Ala inhibiting cross linking?

A

Vancomycin

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41
Q

Gyrase inhibitor?

A

ciprofloxacin

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42
Q

When chest wall expands during contraction of inspiratory muscles the lungs follow, what is the reason that makes the lungs follow chest wall and do not detach?

  • surface tension of the pleural cavity
  • positive alveolar pressure
A

surface tension of the pleural cavity

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43
Q

Which if the following is a sensitization route for Der P1 allergen?

A

Der p1 specific IgE binds to mast cells and trigger their degranulation

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44
Q

which of the following is an important histopathological feature of chronic bronchitis? - Eosinophilic infiltrate in the mucosa
- Lymphocytic infiltration
- Something about
neutrophilic exudate
- Hyperplasia and hypertrophy of mucus gland

A

Hyperplasia and hypertrophy of mucus gland

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45
Q

Why is the net fluid movement directed inwards in the pulmonary circulation compared to systemic circulation?

a) Less hydrostatic pressure of pulmonary circulation
b) Less oncotic pressure in the pulmonary vessels

A

a) Less hydrostatic pressure of pulmonary circulation

46
Q

Why is dextromethorphan preferred over clonidine

A

no inhibition of ciliary activity

47
Q

Case in ICU sepsis patient with ventilator, organism oxidase positive and green pigment, what’s the causative organism?

A

P. Aeruginosa

48
Q

How to detect ultrastructural defects in cilia?

a) TEM
b) High-speed video microscopy
c) Nasal nitric oxide

A

a) TEM

49
Q

which of the following factors has the highest risk of M tuberculosis infection in non-infected contact

a) delayed diagnosis and treatment of pulmonary Tb index positive individuals.
b) old and young age, particularly with diabetes
c) incomplete immunization in children and waning immunity in elderly
d) daily contact and effective contact with TB infected individuals

A

d) D-daily contact and effective contact with TB infected individuals

50
Q

which muscles of larynx recover first after laryngeal trauma

a) Adductors
b) Abductors

A

a) Adductors

51
Q

Central chemoreceptors play an important role in breathing. What is detected by them?

a) H+ in CSF
b) PAO2
c) PaO2
d) Ph of plasma
e) PaCo2

A

a) H+ in CSF

52
Q

Club cells and cuboidal epithelium found in what?

a) Respiratory bronchiole
b) Conducting bronchiole
c) Bronchi
d) Terminal bronchiole

A

d) Terminal bronchiole

53
Q

Someone with epistaxis. what arteries are involved?

A

?

54
Q

what makes streptomycin selective to bacteria?

A

Something about ribosomes being different in humans vs bacteria

55
Q

the condition that leads to slightly low paO2 and very high DLCO

a) left to right shunt
b) hypo ventilation
c) v/Q mismatch

A

a) left to right shunt

56
Q

patient with allergic disease unable to sleep because of intense itching

A

Doxylamine

57
Q

high levels of this, in premature infants, will cause lack of surfactant activity

  1. spA
  2. spB
  3. spC
  4. spD
  5. Triglyceride
  6. Sphingomyelin
  7. cholesterol
  8. fatty acid
A
  1. Sphingomyelin
58
Q

high levels of this in adults, will cause less surfactant activity with lung injury?

  1. spA
  2. spB
  3. spC
  4. spD
  5. Triglyceride
  6. Sphingomyelin
  7. cholesterol
  8. fatty acid
A
  1. cholesterol
59
Q

20yr old female presented with weakness, occasional vomiting, and hypotension and positive for skin and mucous membrane pigmentation what test is best to diagnose?

a) Metyrapone test
b) basal plasma cortisol level
c) 24 urinary 1ketosteroid
d) ACTH stimulation test
e) early urinary cortisol level

A

d) ACTH stimulation test

60
Q

patient went to an ophthalmologist and had a 20/20 sight vision with bitemporal hemianopia and had coarse features, what is the most likely cause?

a) Prolactinoma
b) growth hormone adenoma

A

b) growth hormone adenoma

61
Q

Parasympathetic stimulation of islets of Langerhans results in?

A

Stimulation of beta cells

62
Q

Which of the following explains the actions of eplerenone

a) a1 adrenoceptor agonist
b) Phosphodiesterase inhibitor
c) Block binding of aldosterone
d) Inhibit renin

A

c) Block binding of aldosterone

63
Q

Role of UCP1 in heat production in brown tissue?

A

it works just like the uncoupler, it gives a pathway for protons to go through in the mitochondrial membrane without going through the atpase

64
Q

Male with multiple lymph node and hepatic metastasis, and isolated tumor in the tail of pancreas What’s the diagnosis?

a) insulinoma
b) VIPOMA
c) Somatostatinoma d) MEN1
e) Galactoma

A

a) insulinoma

65
Q

in an open thoracic surgery at the hilum of lung, there is a structure located anteriorly the root of the lung and it should be moved to a safe location, what is this structure?

a) sympathetic trunk
b) vagus nerve
c) phrenic nerve
d) cardiac neve

A

c) phrenic nerve

66
Q

61- What happens when Angiotensin II binds to AT2 receptor?

a) vasoconstriction
b) vasodilation
c) directly activate sympathetic
d) activate Na/H channel

A

b) vasodilation

67
Q

which of the following is not associated with Conn’s syndrome?

a) polyuria
b) sodium retention
c) potassium retention
d) metabolic alkalosis

A

c) potassium retention

68
Q

Patient with SIADH, what drug is taken orally?

a) Demeclocycline
b) Conivaptan
c) Tolvaptam

A

c) Tolvaptam

69
Q

Which nerve provide preganglionic sympathetic innervation to the medulla of the Supra renal?

a) lumbar splanchnic nerve
b) sacral splanchnic nerve
c) pelvic splanchnic nerve
d) greater splanchnic nerve

A

d) greater splanchnic nerve

70
Q

By preventing iodine deficiency, there will be a reduces risk of what?

a) Thyroid cancer
b) Mental retardation

A

b) Mental retardation

71
Q

Patient have difficulty in seeing the side mirror when he is driving his car. Went to the doctor and got diagnosed with bitemporal hemianopia, also the doctor noticed coarse facial features.
What hormone is secreted from the tumor?
a) Growth hormone
b) Prolactin

A

a) Growth hormone

72
Q

what is true regarding Clomiphene?

a) Treatment of polycystic ovarian syndrome
b) Removes negative inhibition of estrogen

A

b) Removes negative inhibition of estrogen

73
Q

Involved in Nezelof syndrome

A

3rd pouch

74
Q

stimulates follicles in ovaries

a) Somatotrophs
b) Mammotrophs
c) Gonadotrophs
d) Thyrotrophs
e) Corticotrophs

A

c) Gonadotrophs

75
Q

stimulates epiphyseal chondrocytes

a) Somatotrophs
b) Mammotrophs
c) Gonadotrophs
d) Thyrotrophs
e) Corticotrophs

A

a) Somatotrophs

76
Q

Glucocorticoid drug with high salt retaining activity, low glucocorticoid activity, long duration of action

A

Fludrocortisone

77
Q

Channel that removes the calcium in the cytosol and refills intracellular calcium stores.

a) PM calcium channel
b) Carbonic anhydrase
c) ER calcium channel
d) Ca-Na pump
e) L-type Ca channel

A

c) ER calcium channel

78
Q

low affinity high capacity for Ca, supplies ca for bone formation in osteoblasts

a) -Na Ca exchanger
b) -PM Ca pump

A

a) -Na Ca exchanger

79
Q

Mutation to this causes osteopetrosis

A

Carbonic anhydrase

80
Q

Which hormone has a role in positive feedback before ovulation?
a -estrogen
b -LH

A

a -estrogen

81
Q

A 55-year-old female presented with tiredness and weight loss, during physical examination there was dark buccal, and lab tests showed low sodium and high potassium
a Addison disease
b cushion syndrome
c pituitary dwarfism

A

a Addison disease

82
Q

a 65-year-old male with diabetic nephropathy complaining of constipation, abdominal pain and weight loss, calcium level (3.2mmol/L) (normal is 2.2-2.7mmol/L) and normal parathyroid hormone level

a) osteoporosis
b) tertiary hyperparathyroidism
c) parathyroid adenoma
d) papillary carcinoma

A

b) tertiary hyperparathyroidism

83
Q

A female presents with depression for the last 3 months, abdominal pain and lower limb pain, her calcium level is 2.8mmol/L and PTH 5pg/mL (normal level is 10-65pg/ml)

a) osteoporosis
b) tertiary hyperparathyroidism
c) parathyroid adenoma
d) papillary carcinoma

A

a) osteoporosis

84
Q

They showed as similar picture to this in exam but without the arrow and asked us about the directions (they indicated which side is cytosol tho)

A

Both sodium and iodide move intracellularly from circulation to cytosol (symporter)

85
Q

They showed us this picture but without the “growth hormone” label, and asked us about what hormone has this cycle

A

-

86
Q

a female with bone pain taking alendronate, what another symptom might show?

a) -erosive esophagitis
b) -kidney stones
c) -diarrhea
d) -constipation

A

a) -erosive esophagitis

87
Q 
A tumor affecting the superior parathyroid gland is least likely to affect which of the following structures initially?
A. Trachea
B. Esophagus
C. External laryngeal 
D. Common carotid
E. Recurrent laryngeal
A

?

88
Q

selective alpha1-adrenoreceptor antagonist used in erectile dysfunction?

A

Tamsulosin

89
Q

What is true about somatrem?

  • It has the same amino acid sequence as growth hormone.
  • When administered chronically, it inhibits glucose release
A
  • When administered chronically, it inhibits glucose release
90
Q

Which of the following bone scan protocols is preferable in a 13-yr. old girl with a swelling and pain in the
ankle?
a) delayed whole bony scan
b) tomographic SPECT imagining of the ankle
c) magnified static imaging of the ankle
d) 3-phase bone scan of the feet

A

a) delayed whole bony scan

91
Q

why does the voltage dependent gate open?

A

a Depolarization activates its gating mechanism

92
Q

34-year-old male suffers from weak abduction and adduction if fingers, but no problem with flexion. There is loss of sensation in the palmar surface of ring finger and small finger. Which nerve is affected?

a) Median nerve in carpal tunnel
b) Median nerve between two heads of pronator there’s
c) Ulnar nerve near pisiform
d) Ulnar nerve posterior to medial epicondyle

A

c?

93
Q 
While inspiration, the ribs are rotating in a pump-handle movement to increase the antero-posterior dimension. Which part of the rib bone act as an axis for the rotation?
a angle
b head
c neck 
d body
A

c neck (correct according to book)

94
Q

What is the proximal attachment of palmar aponeurosis of foot?
a Medial tubercle of calcaneus
b Lateral tubercle of calcaneus
c Navicular

A

a Medial tubercle of calcaneus

95
Q

What makes aspirin effective?

a) selective COX2 activation
b) irreversible inhibition of COX

A

b) irreversible inhibition of COX

96
Q

Total Tension in muscles means?

A

Both Passive and active tension

97
Q

Pt with Prominent spine of scapula why?
a Injury to long thoracic nerve
b Injury of suprascapular nerve
c injury to subscapular nerve

A

b Injury of suprascapular nerve

98
Q

Joint aspirate reveals rhomboid crystals, what is the diagnosis?
a Pseudogout
b Gout

A

Pseudogout

99
Q

Goes into adductor hiatus

a) Femoral (it literally just said Femoral in exam)
b) Obturator
c) Saphenous

A

a) Femoral

100
Q

most medial structure in
femoral sheath

a) Femoral (it literally just said Femoral in exam)
b) Obturator
c) Saphenous

A

a) Femoral

101
Q

what causes the Na voltage channel to close?

a) Hyperpolarization
b) Depolarization
c) Ca+2 entry
d) Refractory period?
e) NA overshoot
f) Resting potential
g) K+ conductance

A

(e) sure bcz asked the Dr.

102
Q

Increase in potassium gradient & action potential termination occurs during?

a) Hyperpolarization
b) Depolarization
c) Ca+2 entry
d) Refractory period?
e) NA overshoot
f) Resting potential
g) K+ conductance

A

?

103
Q

which drug in low doses can impair the secretion of uric acid?

A

Aspirin

104
Q

Increase in its frequency causes high contraction force, what is it?

A

Action potential

105
Q

Injury to the medial collateral compartment will lead to what?
a Abduction of the knee when its extended
b Posterior dislocation of the tibia
c Anterior dislocation of the fibula
d Anterior dislocation of the tibia

A

a Abduction of the knee when its extended

106
Q

Development of the musculoskeletal system:

  • Hypoxial myotome -> ventral aspect -> innervation; ventral ramus
  • Epaxial myotome -> dorsal aspect -> innervation; dorsal ramus
A

-

107
Q

Fungi that show endosporulating spherules:

  • Coccidioidomycosis
  • Cryptococcosis
  • Histoplasmosis
  • Blastomycosis
A
  • Coccidioidomycosis
108
Q

29yr old man with diabetes wanted to know the effect of smoking 10 cigarettes per day on his diabetes.

a) No effect on diabetes up to 20 cigarettes
b) Smoking worsens insulin resistance
c) Nicotine causes vasodilation of blood vessels
d) Smoking doesn’t affect type 2 diabetes
e) helps in type 2 diabetes because it decreases the appetite

A

b) Smoking worsens insulin resistance

109
Q

In which study design we can use Kaplan-Meyer curve?

a) Case control and rct
b) Cohort and case control
c) Cross sectional and rct
d) Rct and cohort

A

d) Rct and cohort

110
Q 
there was a table between the risk of diabetes and age groups What are the types of
data?
a binary, binary
b continuous, binary
c categorical nominal, binary
d categorical ordinal, binary
A

?

111
Q

A 58-year old Kuwaiti died from heart attack, how many years of potential life are lost (YPLL)?

a) 1
b) 20
c) 40
d) 78

A

b) 20

112
Q

A heart transplant unit kept patient record of heart-lung transplants for the last 15 years. They used the data of patient that had pre-transplant pulmonary arterial pressure (exposure). And records of patient who died (outcome) in the last 15 years, time of death. What type of study is done?

a) Nested case-control
b) Concurrent cohort
c) Non-concurrent cohort
d) RCT

A

c) Non-concurrent cohort

Finals 3rd year (4 decks)

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