Rite I 11/2017

Question 1

Normal Reticulocyte count

Answer 1

1-2%

Question 2

Change in pH with pCO2 per 10 mmHg in acute state

Answer 2

0.08 units

Question 3

40 year old male with triglyceride 240mg/dl, what is the most important initial test must be requested?

Answer 3

Liver function test

Question 4

35 year old female with body mass< 21. No fever nor anorexi. with palpitation. DTR hyperreflexia. The priority lab test

Answer 4

Thyroid function Test

Question 5

20 y/o male admitted 1 day history of intractable vomiting and diarrhea after eating fish balls from street vendor. Fecalysis negative for leucytes w/ no increase in fecal lactoferr

Answer 5

Vibrio cholera

Question 6

C-reactive protein is an acute phase protein synthesized by hepatocytes in response to which pro-inflammatory cytokines?

Answer 6

IL-6

Question 7

Anti-HTN edema formation

Answer 7

Hydralazine

Question 8

Parameters will differentiate fever from hyperthermia

Answer 8

Hypothalamic regulatory set point

Question 9

A 25 y/o female w/ facial edema and BP of 150/100. Urinalysis shows (+++) protein. To approximate the 24 hour albumin excretion. What test can quantitate the urinary albumin on a spot morning urine sample?

Answer 9

Albumin-to-creatinine ratio

Question 10

Fever of Unknown Origin is defined as

Answer 10

An illness of >3 weeks’ duration with fever of ≥38.3°C (101°F) on two occasions and an uncertain diagnosis despite 1 week of inpatient evaluation.

Question 11

What is the reason why serum creatinine is a better guage of GFR than BUN?

Answer 11

Creatinine is useful for estimating GFR because it is a small, freely filtered solute that is not reabsorbed by the tubules.
PCr levels can increase acutely from dietary ingestion of cooked meat, however, and creatinine can be
secreted into the proximal tubule through an organic cation pathway (especially in advanced progressive chronic kidney disease), leading to overestimation of GFR.

Question 12

Enzymes that reflect cholestasis

Answer 12

The activities of three enzymes (alkaline phosphatase, 5ʹ-nucleotidase, and γ-glutamyl transpeptidase
(GGT)) are usually elevated in cholestasis

Question 13

Lean body mass starts to decline at rate of 0.3kg per year in what decade of life?

Answer 13

3rd decade of life

Question 14

Pulse oximeter detect

Answer 14

Arterial blood O2 saturation

Question 15

In recent years, there have been strong interest in the association of increase in RDW with what condition

Answer 15

Cardiovascular disease

Question 16

These changes in lean body mass largely reflect the age-dependent decline in growth
hormone secretion and, consequently, circulating levels of

Answer 16

insulin like growth factor type I (IGF-I) that occur with normal aging.

Question 17

30/F complained of weakness in afternoon and improves with rest. Fatigued on repetitive actions. On PE, reflex intact, no sensory deficit. Unable to sustain movements.

Answer 17

Myasthenia Gravis
Neuro Muscular Junction

Fatigable weakness is suggestive of disorders of the neuromuscular junction, which cause functional loss of muscle fibers due to failure of their activation.

Question 18

Refers to an inherently subjective human experience of physical and mental weariness, sluggishness,
and exhaustion.

In the context of clinical medicine, it is
most typically and practically defined as difficulty initiating or maintaining
voluntary mental or physical activity

Answer 18

Fatigue

Question 19

Area of abdomen will referred pain T10

Answer 19

T10 umbilicus

Question 20

Mechanism of glucocorticoid as an antipyretic agent

Answer 20

As effective antipyretics, glucocorticoids act at two levels

1. Reduce PGE2 synthesis by inhibiting the activity of phospholipase A2, which is needed to release arachidonic acid from the cell membrane
2. block the transcription of
   the mRNA for the pyrogenic cytokines.

Question 21

A false-positive dipstick for hematuria (where no RBCs areseen on urine microscopy) may occur when

Answer 21

myoglobinuria is present, often in the setting of rhabdomyolysis.