Test 28

Question 1

Physiologic iron loss through menstruation and pregnancy slows the progression of what in women?

Answer 1

hemochromatosis

Question 2

What is wrong in hemochromatosis

Answer 2

defect in intestinal absorption of dietary iron that results in excess absorption and storage of .5 - 1.0 g of iron each year (primarily in parenchymal organs)

Question 3

how much iron needs to accumulate in order for hemochromatosis to manifest? age?

Answer 3

20 g

after age 40

Question 4

classic triad for hemochromatosis

Answer 4

• cirrhosis
• diabetes mellitus
• skin pigmentation (“bronze diabetes”)

Question 5

how does ethanol impact iron

Answer 5

• increase iron absorption
• cause redistribution of body iron stores
• hepatocytes have modest increase in stainable iron

Question 6

role of ascorbic acid (vitamin C) and iron? impact on hemochromatosis

Answer 6

citric acid enhances absorption of inorganic iron in GI

- does not slow progression of hemochromatosis

Question 7

frequent blood transfusions and therapeutic phlebotomy impact on hemosiderosis

Answer 7

transfusion: can lead to
phlebotomy: slows progression

Question 8

how does hemochromatosis impact the heart

Answer 8

dilated cardiomyopathy (reversible)

Question 9

What indicates upper motor lesion?

Answer 9

pyramidal signs such as:

1. babinski sign
2. hyperreflexia
3. spasticity

Question 10

Who has normal Babinski sign? Why

Answer 10

infants up to 12 months

- incomplete myelination of the corticospinal tracts

Question 11

Lower motor neuron lesions cause what

Answer 11

• muscle atrophy
• fasciculations
• loss of tendon reflexes

Question 12

Cogwheel rigidity is a sign of what disease

Answer 12

Parkinson

Question 13

What is cogwheel rididity

Answer 13

pulsing resistance to passive limb movement on PE exam

Question 14

What does positive straight leg raise test a sing for

Answer 14

• sciatic nerve root (L4-S3) irritation

- intervertebral disc herniation causing sciatica

Question 15

Finding of a high peak in the gamma-globulin region on serum protein electrophoresis (SPEP) usually represents what

Answer 15

M protein consisting of over produced monoclonal immunoglobulin

Question 16

What diseases cause an M protein peak on SPEP?

Answer 16

• multiple myeloma
• anemia (weakness)
• lytic bone lesions
• renal insufficiency (amyloid deposition and hypercalcemia)

Question 17

What is wrong in multiple myeloma

Answer 17

neoplastic B-lymphocytes mature into plasma cells that synthesize abnormal (typically large) amounts of monoclonal immunoglobulin