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MEDS 530C Final > TEST Qs > Flashcards

TEST Qs Flashcards

1
Q

Which is the most common cause of microcytic hypochromic anemia in America women aged 20 to 50 years old?

a. Autoimmune hemolysis
b. Iron deficiency
c. Vitamin B12 deficiency
d. Thalassemia minor
e. Viral infection

A

b. Iron deficiency

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2
Q

The most common form of autosomal dominant hereditary spherocytosis is caused by a mutation of the gene encoding which of the following proteins?

a. Ankyrin
b. Spectrim
c. Protein 4.1
d. Hemoglobin A
e. Transferrin

A

A. Ankyrin

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3
Q

Aplastic crisis, which is can be encountered in patients with hereditary spherocytosis or sickle cell anemia, is most often precipitated by

a. deficiency of erythropoietin
b. negative feedback inhibition by bilirubin
c. adverse effect of iron released from hemolyzed erythrocytes
d. autoimmune mechanisms
e. parvovirus infection

A

E parvovirus infection

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4
Q

The deletion of two a-globin chains of hemoglobin is the cause of

a. a-thalassemia trait
b. a-thalassemia minor
c. salient carrier state
d. hemoglobin H disease

A

A. a-thalassemia trait

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5
Q

Normocytic normochromic anemia, associated with low serum iron, reduced total-iron binding capacity, and abundant iron stores, as seen in the bone marrow biopsy, are laboratory findings typically found in anemia of

a. iron deficiency
b. chronic disease
c. thalassemia minor
d. thalassemia trait
e. vitamin B12 deficiency

A

B chronic disease

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6
Q

The most common cause of myelophthisic anemia is

a. metastatic carcinoma to the bones
b. multiple myeloma
c. lymphoma
d. leukemia
e. osteosclerosis

A

A metastatic carcinoma to the bones

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7
Q

Which test is abnormal in hemophilia A?

a. Bleeding
b. Platelet count
c. Prothrombin time
d. Partial thromboplastin time
e. Clot retraction

A

D. Partial thromboplastin time

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8
Q

What are the mechanisms of thrombocytopenia in patients who have giant
hemangiomas?

a. Autoimmune destruction of platelets
b. Inhibition of bone marrow
c. Mechanical destruction of platelets
d. Increased consumption of platelets in peripheral blood vessels
e. Disseminated intravascular hemolysis

A

C. Mechanical destruction of platelets

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9
Q

Hemolytic uremic syndrome (HUS) shares many features with thrombotic thrombocytopenic purpura (TTP), but in contrast with patients with TTP, those with HUS
do NOT have

a. anemia
b. renal failure
c. neurologic deficits
d. fever
e. thrombocytopenia

A

c. neurologic deficits

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10
Q

Which of the following bleeding test is abnormal in patients with von Willebrand disease?

a. Prolonged bleeding time
b. Thrombocytopenia
c. Prolonged prothrombin time
d. Shortened partial thromboplastin time
e. increased levels of factor VIII in plasma

A

a. Prolonged bleeding time

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11
Q
  1. Severe hemophilia develops in patients who have factor VIII reduced below?

a. 1%
b. 5%
c. 10%
d. 20%
e. 25%

A

A 1%

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12
Q

The lab reports for a patient with low MCV show high serum ferritin and low total iron-binding capacity (TIBC). What is the most likely cause for this patient’s anemia?

a. Iron deficiency
b. Anemia secondary to inflammation
c. Thalassemia
d. Hemoglobinopathy
e. Folate deficiency

A

b. Anemia secondary to inflammation

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13
Q
  1. What percent of cobalamin can be absorbed orally?

a. 0.01
b. 0.5
c. 1%

A

c. 1%

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14
Q

What is the most common anemic disorder?

A

iron deficient anemia??

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15
Q

Where in the body is iron absorbed?

a. liver
b. stomach
c. duodenum
d. colon
e. large intestine

A

C. Duodenum

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16
Q

Which of the following red cell indices tells you how big a patient’s red cells are?

a. RBC
b. Hgb
c. MCV
d. RDW
e. MCHC

A

C. MCV

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17
Q

“Chromasia” refers to:

a. how big the red cells are
b. how widely spaced the red cells are?
c. how much hemoglobin is in the red cells
d. what color the red cells are
e. the age of the red cell

A

C. how much hemoglobin is in the red cells

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18
Q

Which of the following statements about red blood cells is incorrect?

a. Mature red blood cells lack nuclei
b. Red blood
c. Deoxyhemoglobin carries oxygen

A

c. Deoxyhemoglobin carries oxygen

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19
Q

The precursor of all lines of blood cells is:

a. red blood cell
b. monocyte
c. hemocyte

A

c. hemocyte

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20
Q

The esophageal diverticulum located above the upper esophageal sphincter is called the

a. congenital diverticulum
b. post inflammatory diverticulum
c. traction diverticulum
d. epiphrenic diverticulum
e. Zenker diverticulum

A

e. Zenker diverticulum

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21
Q

Basal zone hyperplasia exceeding 20% of the thickness of the esophageal epithelium, accompanied by elongation of lamina propria papillae and by inflammatory infiltrates that contain eosinophils is a histologic finding most typical of what disease?

a. Reflux esophagitis
b. Viral esophagitis
c. Barrett esophagus
d. Mallory-Weiss syndrome
e. Boerhaave syndrome

A

a. Reflux esophagitis

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22
Q

Carcinoma of the esophagus most often presents on …

a. Polypoid exophytic lesion
b. The induration of the mucosa
c. Volcano-like excavation lesion
d. Diffuse…

A

a. Polypoid exophytic lesion

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23
Q

Autoimmune atrophic gastritis and pernicious anemia:

a. Helicobacter pylori infection
b. Peptic ulceration of the duodenum
c. Menetrier disease
d. Hashimoto thyroiditis

A

d. Hashimoto thyroiditis

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24
Q

Protein-losing gastroenteropathy will most likely develop in patients who have

a. Acute erosive gastritis
b. Chronic Helicobacter pylori related gram
c. Autoimmune astrophic gastritis
d. Hypertrophic gastropathy
e. Gastric peptic ulcer

A

d. Hypertrophic gastropathy

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25
Q

Which of the following is true about the hormone gastrin:

a. Produced in the ____ of the stomach
b. Stimulates production of acid by the stomach
c. Associated with presence of Helicobacter pylori
d. Absorbs water and electrolytes

A

b. Stimulates production of acid by the stomach

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26
Q

In Barrett’s esophagus, the changes as the epithelial mucosa from one type of cell to another is an example of

a. Anaplasia
b. Hypoplasia
c. Hyperplasia
d. Dysplasia
e. Metaplasia

A

e. Metaplasia

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27
Q

Most gastric polyps are microscopically classified as

a. tubular adenomas
b. villous adenomas
c. hyperplastic polyps
d. fundic gland polyps
e. carcinoids

A

c. hyperplastic polyps

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28
Q

???

a. ?
b. Early symptoms include melana and blood in the feces as seen in a positive fecal blood test
c. Most often occurs in the transverse colon
d. A good prognosis is given when the carcinoma is limited to the mucosa

A

c. Most often occurs in the transverse colon

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29
Q

Which of the following is more likely to be associated with Crohn’s disease than which ulcerative colitis?

a. Is a continuous mucosal disease diffusely distributed in the colon only
b. Inflammation involves full thickness of the bowel wall (in all layers); appears as a patchy lesion
c. Inflammation involves only a superficial ulceration of the mucosa
d. Left-side distal involvement of the intestine is typically most severe

A

b. Inflammation involves full thickness of the bowel wall (in all layers); appears as a patchy lesion

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30
Q

Nonbacterial gastroenteritis in adults presenting with nausea, vomiting, watery diarrhea, and abdominal pain in most instances is caused by

a. astrovirus
b. Norwalk-virus
c. Rotavirus
d. Enteric adenovirus
e. Poliovirus

A

b. Norwalk-virus

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31
Q

The finding of anti-endomviral antibodies in a person with intestinal malabsorption strongly favors diagnosis of

a. Whipple disease
b. Celiac sprue
c. Tropical sprue
d. Lactase deficiency
e. Abetalipoproteinemia

A

b. Celiac sprue

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32
Q

Which of the following is the least likely cause of a bowel obstruction?

a. Volvulus
b. Crohn’s disease
c. Ulcerative colitis
d. Intussusception

A

c. Ulcerative colitis

33
Q

Fat absorption will be defective and fat will appear in excessive amounts in feces (a condition known as Steatorrhea) in all of the following cases except

a. Lack of bile salts in the intestine due to obstruction of the bile duct
b. Disease of the large intestine such as diverticulitis
c. Lack of absorptive area due to excessive surgery of the small intestine
d. Disease of the pancreas decreasing exocrine gland secretion

A

b. Disease of the large intestine such as diverticulitis

34
Q

Ulcers of chronic peptic ulcer disease occur in all of the following areas except:

a. Pylorus
b. Gastric fundus
c. Duodenum
d. Gastric
e. Meckel’s diverticulum

A

b. Gastric fundus

35
Q

Complications of peptic ulcer disease include all except?

a. gastric mucosal …..
b. ???
c. ???

A

a. gastric mucosal

36
Q

Which intestinal malabsorption syndrome is accompanied by a complete absence of chylomicrons, very low-density lipoproteins, and low-density lipoproteins in plasma?

a. Crohn disease
b. Celiac sprue
c. Tropical sprue
d. Lactase deficiency
e. Abetalipoproteinemia ***

A

e. Abetalipoproteinemia ***

37
Q

Crohn disease is most often diagnosed in which age group?

a. 5-10 years
b. 15-25 years
c. 40-50 years
d. 60-70 years
e. Older than 80

A

b. 15-25 years

38
Q

Diarrhea associated with cholera is best explained by which of the following mechanisms?

a. Massive hemorrhage from gut wall ulceration caused by invasive bacteria
b. Decreased permeability to water due to inflammation of the gut wall
c. An osmotic effect of bacteria in the gut lumen
d. Increased secretion of fluid and electrolytes due to the effect of a bacterial….
e. Gut lining inflammation and associated edema

A

d. Increased secretion of fluid and electrolytes due to the effect of a bacterial….

39
Q

Many malignant tumors of the gastrointestinal tract, including esophagus, stomach and gallbladder have a very low percentage of patients surviving to five years after diagnosis. For this group of tumors, the usual reason for this low survival rate is:

a. The patients are usually older and deny their symptoms longer
b. The lesions are very difficult for the pathologist to diagnose once a biopsy is performed
c. The tumors produce few clinical symptoms until they are advanced lesions
d. The gastrointestinal tract wall is so thin that the tumors invade and spread much faster

A

c. The tumors produce few clinical symptoms until they are advanced lesions

40
Q

Adenocarcinomas of the colon spread via blood in the portal venous system to the

a. Lungs
b. Liver
c. Brain
d. Vertebral column

A

b. Liver

41
Q

Angiodysplasia causing lower intestinal bleeding is the most common

a. jejunum
b. ileum
c. cecum
d. transverse colon
e. rectum

A

c. cecum

42
Q

In adults which part of the intestine is most often involved in volvulus?

a. Jejunum
b. Ileum
c, Cecum
d. Transverse colon
e. Sigmoid colon

A

Sigmoid colon

43
Q

T-cell lymphoma was diagnosed in a 55-year old man who had a lengthy history of intestinal disease. Which of the following diseases most likely preceded this malignancy?

a. Celiac disease
b. Whipple disease
c. Crohn disease
d. Abetalipoproteinemia
e. AIDS

A

a. Celiac disease

44
Q

A 60-year old man who complained of persistent right lower quadrant pain underwent an appendectomy. The appendix appeared globular and dilated due to an obstruction by a fecalith. It was filled with mucus. Histologically, the cavity was lined with normal appendiceal mucosa; there was no evidence of neoplasia. This lesion most likely represents a

a. mucocele
b. . mucinous cystadenoma
c. mucinous cystadenocarcinoma
d. pseudomyxoma peritonei
e. pseudocyst

A

a. mucocele

45
Q

Primary tumors of the peritoneum are called

a. adenocarcinomatosis peritonei
b. pseudomyxoma peritonei
c. peritoneal sarcoma
d. mesothelioma
e. myxomastous

A

d. mesothelioma

46
Q

Carcinomas of the colon is most often located in the:

a. Sigmoid colon and rectum
b. Cecum
c. Splenic flexure of the colon
d. Transverse colon
e. Descending colon

A

a. Sigmoid colon and rectum

47
Q

Traveler’s diarrhea is probably a secretory diarrhea caused by:

a. Food allergy
b. Infection
c. Salts in water
d. Fruits
e. Stress

A

b. Infection

48
Q

(PICTURE) This esophageal carcinoma developed in a 65-year old man who had reflux esophagitis for 15 years. Most likely this tumor was histologically classified as:

a. adenocarcinoma
b. squamous cell carcinoma
c. transition cell carcinoma
d. basal cell carcinoma
e. oat cell carcinoma

A

a. adenocarcinoma

49
Q

(PICTURE) This small intestinal lesion was removed from a 56- year old woman and is most likely a

a, tubular adenoma

b. hamartoma
c. carcinoma
d. sarcoma
e. pseudopolyp

A

C carcinoma

50
Q

(PICTURE) This slide illustrates the lesions seen in the partial colectomy specimen obtained from a 78-year-old man who has chronic constipation, left lower quadrant pain, and fever. On cross section this sigmoid colon shows changes most consistent with the diagnosis of

a. Crohn disease
b. Toxic megacolon
c. Carcinoma of the colon
d. Carcinoid
e. Diverticulitis

A

e. Diverticulitis

51
Q

(PICTURE) This nephrectomy specimen shows a lesion in the kidney of a 63-year old man. This lesion is most likely related to a(n)

a. deletion of von Hippel-Lindau (VHL) tumor suppresso
b. . mutation of myc oncogene
c. amplification of ras oncogene
d. loss of bcl-2 proapoptotic gene
e. aflatoxin related carcinogen

A

A. deletion of von Hippel-Lindau (VHL) tumor suppressor

52
Q

Which of the following statements about polyuria is not true?

a. Polyuria occurs when too much anti-diuretic hormone is produced by the pituitary gland
b. Patients with diabetes mellitus present with polyuria because of the increased amount of filtered solute, i.e. glucose
c. Polyuria may be caused by drinking too much water
d. Polyuria refers to the excretion of more than 2 liters of water per day

A

a. Polyuria occurs when too much anti-diuretic hormone is produced by the pituitary gland

53
Q

The normal glomerular basement is composed of which types of collagen?

a. Type I
b. Type II
c. Type III
d. Type IV
e. Type V

A

d.Type IV

54
Q

Which of the following is not a primary function of the kidney:

a. Regulation of acid-base balance
b. Regulation of antidiuretic hormone
c. Secretion of angiotensinogenase
d. Excretion of nitrogenous waste products
e. Production of erythropoietin

A

b. Regulation of antidiuretic hormone

55
Q

The presence of which of the following is not part of “active urinary sediment”?

a. Red blood cells
b. White blood cells
c. Blood cell cast
d. Bacteria

A

d. Bacteria

56
Q

Which of the following glomerulonephritic diseases is not accompanied by low serum complement (C3) levels?

a. Lupus erythematosus nephritis
b. Membranoproliferative glomerulonephritis
c. Post-streptococcal glomerulonephritisis
d. IgA nephropathy (Berger’s Disease)
e. Lupus nephritis

A

d. IgA nephropathy (Berger’s Disease)

57
Q

The PKD1 gene encoding polycystin-1 is a large integral membrane protein. It is typically found in persons who have which of the following diseases?

a. Childhood polycystic kidney disease
b. Adult polycystic disease
c. Adult onset renal medullary cystic disease
d. Glomerulocystic disease
e. Acquired renal cystic disease

A

b. Adult polycystic disease

58
Q

Which of the following is associated with acute tubular necrosis?

a. Damage to glomeruli is noted
b. IgA deposited in glomerular mesagrim
c. Sloughing of renal tubular cells in the renal tubules
d. Presence of multiple cysts in the kidney
e. Nephrolithiasis formation

A

c. Sloughing of renal tubular cells in the renal tubules

59
Q

A 30-year-old heroin addict who is positive for the human immunodeficiency virus (HIV) is hospitalized because of generalized edema. Laboratory studies show proteinuria, hypoalbuminemia, hyperlipidemia, and lipiduria. Which of the following diseases is most likely to be diagnosed by a
biopsy of the kidney

a. Lipoid nephrosis
b. Focal segmental glomerulosclerosis
c. Membranous nephropathy
d. IgA nephropathy
e. Amyloidosis

A

b. Focal segmental glomerulosclerosis

60
Q

Which kidney disease characterized by nephrotic syndrome, microscopic hematuria, and glomerular deposits of C3 complement and properdin is caused by an autoantibody called C3 nephritic factor?

a. Membranoproliferative glomerulonephritis type II
b. Focal segment glomerulosclerosis
c. Membrane nephropathy
d. IgA nephropathy
e. Acute postinfection glomerulonephritis

A

a. Membranoproliferative glomerulonephritis type II

61
Q

Which of the following is an immune-complex mediated disease

a. Acute pyelonephritis
b. Polycystic kidney disease
c. Chronic kidney disease
d. Post infection acute glomerulonephrtitis
e. Nil lesion nephrotic syndrome

A

Post infection acute glomerulonephrtitis

62
Q

Which of the following is generally true about post infection glomerulonephritis?

a. Can fellow an untreated group A α-hemolytic streptococcal throat infection
b. Can fellow an untreated group A β-hemolytic streptococcal throat infection
c. Can fellow an untreated group A γ-hemolytic streptococcal throat infection
d. Can fellow an untreated group A Δ-hemolytic streptococcal throat infection
e. Does not spontaneously remit; needs aggressive therapy

A

Can fellow an untreated group A β-hemolytic streptococcal throat infection

63
Q

What is the generally accepted concentration of bacteria present in a quantitative urine culture that is diagnostic of a urinary tract infection?

a. >1.0 x 10^5 cfus/mL
b. >1.0 x 10^6 cfus/mL
c. >1.0 x 10^2 cfus/mL
d. >1.0 x 10^3 cfus/mL
e. >1.0 x 10^4 cfus/mL

A

a. >1.0 x 10^5 cfus/mL

64
Q

In the normal kidney glomerulus, the glomerular basement membrane is responsible for which one of the following?

a. Blood present content
b. A…. release
c. Absorption of renin
d. Filtration barrier for plasma proteins

A

d. Filtration barrier for plasma proteins

65
Q

Which kidney disease is not mediated by immune complexes?

a. Post-streptococcal glomerulonephritis
b. Nil lesion nephrotic syndrome
c. Systemic lupus erythematosus (lupus nephritis)
d. Membranoproliferative glomerulonephritis
e. Serum sickness

A

b. Nil lesion nephrotic syndrome

66
Q

Creatinine is produced at a constant rate each day by muscles metabolism and is measured in blood and urine to calculate creatinine clearance by the kidneys. Which is not true about creatinine clearance?

a. Standard clearance calculation requires subject’s height and weight
b. Approximates the glomerular filtration rate
c. Represents both glomerular filtration and tubular secretion
d. Is decreased in chronic renal failure
e. Approximates the fluid flow rate between the glomerular capillaries and the Bowman’s capsule

A

c. Represents both glomerular filtration and tubular secretion

67
Q

Which of the following is not associated with a significant loss of kidney function?

a. Childhood nil lesion nephrotic syndrome
b. Low creatinine clearance by the kidneys
c. Elevated serum BUN (blood urea nitrogen) level
d. Severe proliferative glomerulonephritis
e. Having two copies of the APOL1 gene

A

a. Childhood nil lesion nephrotic syndrome

68
Q

Which of the following is not a cause of microcytic anemia?

A. Lead poisoning 
B. Iron deficiency anemia 
C. Anemia of chronic disease 
D. Thalassemia 
E. Pancytopenia
A

E. Pancytopenia

69
Q

Polyps for Peutz-Jeghers Syndrome are best classified as:

A. serated adenomas
B. hyperplastic polyps 
C. tubular adenomas
D. villous adenomas
E. hamartomas
A

E. hamartomas

Polyps of Peutz-Jeghers syndrome are hamartomas, composed of branching fibromuscular network enclosing glands lined by normal intestinal epithelium with numerous goblet cells.

70
Q

Which cells in the intestines are precursors of carcinoids?

A. Goblet Cells
B. Enterocytes
C. Paneth Cells
D. Neuroendocrine Cells
E. Stromal Cells
A

D. neuroendocrine cells

Carcinoids originate from resident neuroendocrine intestinal cells.

71
Q

T-cell lymphoma was diagnosed in a 55-year old man who had a lengthy history of intestinal disease. Which of the following diseases most likely preceded this malignancy?

A. Celiac Disease
B. Whipple Disease
C. Crohn Disease
D. Abetalipoproteinemia
E. AIDS
A

A. Celiac Disease

Most likely this man had celiac sprue, a disease associated with a disproportionately high incidence of T-cell lymphomas.

72
Q

The slide shows a muscle layer of a stomach that was removed from a 60-year-old-man who complained of dyspepsia and bleeding. The tissue section was taken from underneath a large prepyloric ulcer. Which of the following is the most likely diagnosis?

A. Peptic ulcer disease
B. Helicobacter pylori-related gastritis
C. Autoimmune gastritis
D. Hyperplastic Gastropathy
E. Adenocarcinoma
A

E. Adenocarcinoma

The muscle layer of this stomach is infiltrated with adenocarcinoma cells forming irregular tubular and gland-like structures.

73
Q

The figure shows a portion of the mesentary and omentum removed during a work-up of a 60-year-old-women with ascites and large multicystic ovarian masses. The lesions seen here are most consistent with the diagnosis of

A. primary peritoneal benign tumor
B. primary peritoneal malignant tumor
C. metastatic carcinoma
D. metastatic sarcoma
E. lymphoma
A

C. metastatic carcinoma

The white nodules in the omentum most likely represent metastases of an ovarian carcinoma. The ovarian masses, described above, most likely represent ovarian carcinoma, which is often bilateral and typically metastasizes by seeding through the peritoneal cavity.

74
Q

Aplastic Anemia

A

Bone marrow suppression due to radiation or disease results in aplastic anemia

75
Q

Diverticulosis

A

Diseases of the large intestine such as diverticulosis are often associated with ruptures in the colon wall rather than absorption issues

76
Q

Acute Tubular Necrosis

A

Acute tubular necrosis is often characterized by a reversible decreased urine output, constant support and dialysis, and the presence of muddy casts in urinalysis.

77
Q
  1. Membranoproliferative glomerulonephritis caused by mixed cryoglobulinemia is most often secondary to which of the following diseases?

a. Diabetes mellitus
b. Multiple myeloma
c. Membranous nephropathy
d. Amyloidosis
e. Human immunodeficiency virus infection

A

C. Membranous Nephropathy

Membranoproliferative glomerulonephritis caused by mixed cryoglobulinemia is most often a complication of viral hepatitis C. The glomeruli contain deposits of IgG-IgM cryoglobulins, which are also found in the small blood vessels of the skin and joints, resulting in cutaneous vasculitis with petechial hemorrhages and synovitis.

78
Q

A 6-year-old boy is taken to the pediatrician because of generalized facial edema and somnolence. He has been passing dark brown urine. Physical examination reveals hypertension. Urinalysis shows oliguria, hematuria, proteinuria, and red blood cell casts. Which of the following is the most likely diagnosis?

a. Nephritic syndrome
b. Nephrotic syndrome
c. Rapidly progressive acute renal failure
d. Chronic uremia
e. Nephrolithiasis

A

A. Nephritic Syndrome

These clinical findings are typical signs and symptoms associated with nephritic syndrome, which is most likely caused by acute glomerulonephritis.

79
Q

Diabetes Mellitus

A

Measuring microalbuminuria is critical in treating diabetes mellitus in order to prevent edema

MEDS 530C Final (7 decks)

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