Lec Midterm Flashcards
In polyarteriitis nods virtually all the organs and tissues of the body may be involved in the pathological process except?
Vessels of the lungs and arch of the aorta
Which of the following is the most common cause of acute pyelonephritis?
E. Coli
Which of the following signs of nephrotic syndrome dev first?
Proteinuria
Which of the following is the characteristic sign of nephritic syndrome?
Hypertension, RBC casts, azotemia
Which of the following is the most common route by which infection can reach the kidney in acute pyelonephritis?
Ascending
Circulating immune complex GMN is typical example of which of the following type of types of hypersensitivity rxns?
Type 3
Which of the following organs are always involved in Goodpasture’s syndrome?
Lungs and Kidneys
In Henoch-Schonlein purport the kidney involvement is manifested by development of which of the following Syndromes
Rapidly progressive GMN
Wegner’s granulomatosis is associated with which of the following types of rapidly progressive (crescentic) GMN?
Type 3
Which of the following is most common cause of acute proliferative GMN
Beta-Hemolytic Streptococcus Group A
Which of the following is the common complication of subacute bacterial endocarditis?
Stroke
Which of the following is a correct order of frequency of the valvular involvement in rheumatic fever?
Mitral, aortic, tricuspid, pulmonary artery
Aortic stenosis results in hypertrophy of which of the following parts of the heart?
Left Ventricle
Which of the following is the common cause of subacute bacterial endocarditis?
Alpha-hemolytic Streptococcus, aka Strept Viridans aka Strep Mitis
Which of the following heart structures is involved most often in bacterial endocarditis?
Aortic valve
Prizmetal’s angina is characterized by development of acute chest pain due to which of the following pathologies?
Coronary artery spasm
Which of the following patterns of pain is the most typical for angina pectoris?
Diffuse retrosternal chest pain
Which of the following is the correct name of a rheumatic fever manifestation characterized by jerky involuntary movements of facial and extremity muscles?
Syndenham’s chorea
Which of the following pathologies of the heart valves is the most common cause of left atrium enlargement?
Mitral stenosis
Which of the following pathologies of the heart valves leads to dev of very low (sometimes zero) diastolic pressure?
Aortic insufficiency
80% of peptic ulcers dev in the stomach and only 20% in the duodenum
False (20% peptic, 80% duodenum)
Accumulation of gas in the right upper abdominal area could be a sign of which pathologies?
Perforation of peptic ulcer
Stomach peptic ulcer develops predominately in which of the following parts of the stomach?
Lesser curvature
Unlike ulcer, stomach erosions are characterized by superficial damage of the stomach wall and a tendency to be multiple
True
Which of the following is not a complication of duodenal peptic ulcer?
Transformation into cancer
Heliobacter pylori is hound in all patients with duodenal peptic ulcer and in only 70% of ones with stomach peptic ulcer?
True
Wegner’s granulomatosis is associated with which of the following types of rapidly progressive (Crescentic) GMN?
III
In Henoch-Shconlein purport the kidney involvement in manifested by development of which of the following syndromes?
Nephritic
Which of the following is the characteristic sign of the nephritic syndrome?
Hypertension
Which of the following signs of the nephrotic syndrome develops first?
Proteinuria
Which of the following is the characteristic sign of the nephritic syndrome?
Hypertension
Unlike ulcer, stomach erosions are characterized by superficial damage of the stomach wall and a tendency to be multiple
True
Which of the following HLA-antigens is found in majority of rheumatoid arthritis patients?
DR4 and DR1
Which of the following is not a complication of duodenal peptic ulcer?
Transformation into cancer
Which of the following patterns of pain is the most typical for angina pectoris?
Diffuse retrosternal chest pain
Aortic stenosis results in hypertrophy of which of the following parts of the heart?
Left ventricle
Which of the following pathologies of the heart valves leads to development of very low diastolic pressure?
Aortic insuffiency
The juxtaglomerular cells produce ____ in response to low BP
Renin
Heyman GMN, which attacks the podocytes, is what type of hypersensitivity rxn?
None of the Above
Which of the following is incorrect regarding Type 2 Rapidly Progressive Crescentic GMN?
Occurs in young men (more often in Boys)
Good pasture’s Syndrome is characterized by the dev of antibodies against the basement membrane of?
The alveoli & glomerulus
Acute Proliferative (post strep infectious) GMN is caused by Beta hemolytic streptococcus group A and occurs predominantly in children.
True (3-10 YOA)
Necrotic granulomas of the upper and lower respiratory tract is characteristic of which Type 3 Rapidly Progressive GMN
Wegener’s Granulomatosis
The most common cause of GMN in the world is?
IgA Nephropathy and Berger’s Disease
This hereditary GMN is seen with other symptoms such as lens dislocation, cataracts, corneal atrophy and hearing problems
Alport Syndrome
Nephritic syndrome is characterized by which of the following?
Azotemia
Which is NOT seen with DM?
Hence-Schonlein Purpura
Hematuria, oliguria, nitrogen in blood, and hypertension characterize which disease?
Nephritic syndrome
Which is not a sign/symptom of acute pyelonephritis?
Low grade fever
T or F: Acute cystitis is common in males
F
In which organ to peptic ulcers develop most often?
Duodenum
Helicobacter pylori is present in ____% of duodenal peptic ulcer cases
100%
Rank the following sites for peptic ulcers from least to most common in occurrence?
Esophagus, stomach, duodenum
Which of the following defensive mechanism against peptic ulcers is mostly adversely effected by smoking and stress?
Mucosal blood flow
Which is the most common complication of peptic ulcers?
Hemorrhage
Which type of peptic ulcer is most likely to transform into cancer?
Stomach
Gastric pain that occurs b/t 30-60 minutes
Stomach peptic ulcer
Dysphagia, regurgitation, and the predisposition to esophageal adenocarcinoma are signs and symptoms of ?
Achalasia
Zollinger-Ellison Syndrome
Hyper secretion of gastrin
Mallory Weiss syndrome is associated with a tear in the ?
Esophagus
Which type of hernia results in the dev of venous infarction and wet gangrene?
Hiatal paraesophageal hernia
The replacement of normal distal stratified mucous squamous epithelia by metaplastic columnar epithelia that have goblet cells occurs in which of the following?
Barret esophagus
achalasia is associated with neurological problem originating from?
Vagus n and ganglion & the myenteric plexus
Hypertrophic pyloric stenosis?
Is the result of a congenital pathology
List the incidence of valvular involvement in Rheumatic fever from most to least common?
Mitral, aortic, tricuspid, pulmonary
Which is NOT seen with aortic valve stenosis?
Demussette’s sign (syphilis)
Bacterial endocarditis most common effect which valve?
Aortic
Aschoff’s nodes are found in which of the following layers of the heart?
Myocardium
Which of the following is NOT associated with Rheumatic Fever
Chorea, Tonsilitis, Arthritis are all associated with RF
Which is a manifestation of bacterial endocarditis?
Clubbing of the fingernails, retinal hemorrhages, and petechial rash of hands and mouth
Subacute Bacterial Endocarditis is caused by which of the following?
Strep Viridans aka Strep Mitis
Which bacterial endocarditis is more dangerous?
Acute Bacterial endocarditis
Which of the following never results in lumen narrowing?
Monckeberg’s Medial Calcific Sclerosis
Which of the following causes malignant hypertension?
Hyperplastic ateriosclerosis
Which typically effects the femoral, tibial, ulnar, and radial arteries?
Monckeberg’s Medial Calcific Sclerosis
Which of the following is common in ppl w/ DM?
Atherosclerosis
Which of the following causes necrotizing arteriolitis of the kidneys?
Hyperplastic arteriosclerosis
What percentage of vessel obstruction is needed for clinical manifestation?
75%
Which of the following are controllable risk factors of ischemic heart disease?
Smoking, Hypercholesterolemia, hypertension
Which of the following is NOT part of the pathogenesis of ischemic heart disease?
Increased conc of vasodilators released from symp activity
In what percentage of ischemic heart disease cases is sudden cardiac death the first manifestation?
50%
In which of the following type of angina pectoris would the patient experience pain after exertion , after consuming a large meal or after smoking?
Typical/Stable angina
Coronary artery vasospasm (Prinzmetal’s variant) is an increase in the conc of vasoconstrictors (thromboxane) released with sympathetic activity and can cause death
True
Severe squeezing, diffuse retrosternal pain is associated with which of the following?
Angina pectoris
The most common causes of left sided heart failure include?
Mitral or aortic valve disease
The first problem resulting from right sided heart failure is?
Hepatomegaly
Symptoms of congestive heart failure include all except?
Bradycardia
Which substance is NOT secreted by Kidneys?
Leukotriens
In nephrotic syndrome there is a selective significant inc of glomerular permeability for which of the following?
Proteins
Which disease is characterized by formation of cavities in the lungs?
Wegner’s Granulomatosis
Which protein-to-protein ratio is typical for nephrotic syndrome?
Albumin to globulin ratio is less than 1
During regular annual exam of a symptom free pt the high blood level of BUN was found. Which term describes this abnormality the best?
Azotemia
Which pathogenetic mechanism of GMN is associated with immune complex formation outside the kidneys?
Circulating immune complex deposition
Anti-GBM pathogenetic mechanism of GMN corresponds to which subtype of antibody-dependent type of hypersensitivity rxn?
Antibody-mediated cellular dysfxn
Which of the following diseases is NOT associated with Nephrotic Syndrome?
Buerger’s Disease
Which acute GMN associated with nephritic syndrome most often turns into chronic GMN?
Crescentic GMN
Necrotizing papillitis in the kidney develops more often in which of the following disorders?
DM
Kimmelstiel-Wilson disease is characterized morphologically by which of the following?
Ball-like deposits with the mesangium
Which of the following is the most common GMN disease?
Berger’s Disease
In crescentic GMN the crescents in the glomeruli are formed by which of the following?
Hyperplasia of parietal epithelial cells
Pathogenesis of kidney involvement in Goodpasture’s syndrome corresponds to which type of hypersensitivity rxns?
Antibody-Dependent (Type 2)
Which of the following is the most common disorders eventually resulting in ischemic heart disease?
Atherosclerosis
Which organ is NOT typical reservoir of the chronic infection in the body?
Liver
Which kind of angina pectoris is also known as preinfaction angina?
Crescendo
Long-term hypertension eventually leads to congestive heart failure. In this case which of the following signs and consequences of this transformation comes to the clinical attention first?
Pitting edema
Posterior deviation of esophagus on the x-ray film testifies to?
Enlargement of left atrium
What is NOT a part of atheroma?
Siderophages
Migratory arthritis is a typical manifestation of?
Rheumatic fever
What is the best term describing the compensatory run of the left atrial myocardium in mitral stenosis?
Eccentric hypertrophy
Ortopnea means the dev of dyspnea in congestive heart failure in which change of a pt’s position?
Change from standing to lying position
Prinzmetal’s angina means the obstruction of coronary artery b/c of?
Spasm
Onion-skinning is typically accompanied by which pathology?
Necrotizing arteriolitis
Pathogenesis of which disease is known as the molecular mimicry?
Rheumatic fever
Pulmonary artery stenosis develops in which disease?
Pulmonary artery is not involved in atherosclerosis, rheumatic fever, acute bacterial endocarditis, MMCS
Which if the following is associated with right-sided heart failure?
Plural effusion
Cor Pulmonale is NOT associated with?
Exudate accumulation in the pericardial cavity
Left ventricular failure is usually caused by the following disease except?
Bronchiectatis
Which pathology may often be complicated by venous infarction?
Paraesophegeal hernia
Smoking compromises which component of the stomach mucous barrier?
Mucosal blood flow
Boerhaave syndrome is characterized by which of the following?
Esophageal rupture
Helicobacter pylori is found in _____ its with duodenal peptic ulcers and in _____ of ones with stomach peptic ulcers.
100% & 70%
Which disease develops most commonly in alcoholics?
Mallory-Weiss syndrome
What is NOT correct for gastrinomas?
Do not metastasize
Which disease is considered the major cause of esophageal varies?
Liver cirrhosis
Aspirin leads to gastrointestinal side-effects by superior o which component of the mucous barrier?
Elaboration of prostaglandins
Traction diverticulum results from?
Mediastinal lymphadenitis
Which disorder is known to develop multiple peptic ulcers?
Zollinger-Ellison syndrome
Chugs disease is associated with dev of which pathology?
Achalasia
Metaplasia in Barret esophagus is characterized by replacement of _____ epithelial cells to ____ epithelial cells
Squamous to Columnar
Onion-skinning is typically accompanied by which pathology?
Necrotizing arteriolitis
Left ventricular failure is usually caused by the following diseases except?
Lung emphysema
What is the best term describing the compensatory reaction of the left ventricle myocardium in aortic insufficiency?
Eccentric hypertrophy
Ortopnea means the development of dyspnea in congestive heart failure in which change of a pt’s position?
Change from standing to lying position
Cor pulmonale is NOT associated w/
Ascites, hepatomegaly, pedal edema, nutmeg liver are all associated with Cor pumonale
Which of the following is associated with right-sided cardiac failure?
pleural effusion
Pathogenesis of which disease is known as the molecular mimicry?
Rheumatic fever
Which disease could result in ischemic-hemorrhagic stroke?
Subacute BE
Long term hypertension eventually leads to congestive heart failure. In this case which of the following signs and consequences of this transformation comes to the clinical attention first?
Hepatomegaly
Migratory arthritis is a typical manifestation of which disease?
Rheumatic fever
Prinzmetal’s angina means the obstruction of coronary artery b/c of?
Spasm
Which is typical for the nephrotic syndrome?
Albumin to globulin ratio is less than 1
In nephritic syndrome there is a selective increase of glomerular permeability for which of the following
RBCs
Which of the following is the most common glomerular disease?
IgA nephropathy
In nephritic syndrome, which substance eventually resulting in hypertension is secreted primarily
REnin
In crescentic GMN the crescents in the glomeruli are formed by which of the following?
Proliferation of parietal epithelial cells
During regular annual exam of a symptom free pt the high blood level of creatinine was found Which term describes this abnormality the best?
Uremia
Which disease is characterized by formation of cavities in the lungs?
Wegener’s granulomatosis
In Heymann’s nephritis, in which later of the glomerular article wall will the immune complexes be formed or deposited?
Space b/t podocytes and glomerular basement membrane
A characteristic sign of nephritic syndrome is?
Azotemia
Which acute GMN associated w/ nephritic syndrome most often turns into chronic GMN?
Crescentic GMN
Pathogenesis of kidney involvement in polyarteritis nodosa corresponds to which type of hypersensitivity rxn?
None
Kimmelstiel-Wilson disease is characterized morphologically by which of the following?
Ball like deposits within mesangium
Which organ is NOT involved in polyarteritis nodosa?
Lungs
Which of the following diseases more often predisposes to development of pyelonephritis?
Acute cystitis
What is NOT typical for a stomach ulcer?
Tendency to be multiple
Which pathology may often be complicated by venous infarction?
Zener diverticulum
Which disease dev most commonly in alcoholics?
Mallory-Weiss syndrome
What is NOT a complication of duodenal peptic ulcer:
Malignancy
Smoking compromises which component of the stomach mucous barrier
Mucosal blood flow
Aspirin leads to GI side-effects by suppression of which component of the mucous barrier?
Elaboration of prostaglandins
Which diseases is considered the major cause of esophageal varies?
Liver cirrhosis
Which disorder is known to develop multiple peptic ulcers?
Zollinger-Ellison Syndrome
Chagas disease is associated with development of which pathology?
Achalasia
The location of which esophageal diverticulum is near the midpoint of the esophagus?
Traction diverticulum
Boerhaave syndrome is characterized by whcih of the following?
Esophageal rupture