THE MOTHERLOAD OF QUESTIONS Flashcards
A 38-year-old female complains of 5 days of nasal congestion, sinus pressure, and postnasal drip. On examination her vitals are stable with a temp of 100F. Nasal discharge is yellow and the posterior pharynx is slightly erythematous. Tapping over the maxillary sinuses elicits mild pain. Which of the following is the most appropriate treatment for this patient?
(A) treatment of symptoms (analgesics,antipyretics, decongestants)
(B) 7-day course of amoxicillin
(C) 10-day course of amoxicillin clavulanic acid
(D) 14-day course of clarithromycin
(A) treatment of symptoms (analgesics,antipyretics, decongestants)
A 32-year-old male is evaluated for acute low back pain that started yesterday afternoon. He states he was playing tennis when he hyper-extended his upper body with immediate pain in his low back. The pain does not radiate and he feels well otherwise. He denies any chronic illnesses and does not take any medications.
Which of the following is the most appropriate next step?
A. CT of the lumbar spine
B. Exercise therapy
C. Narcotic pain medication on an as needed basis
D. Spinal manipulation using Osteopathic manipulative treatment
E. X-ray of lumbar spin
D. Spinal manipulation using Osteopathic manipulative treatment*
A 44-year-old male presents to the clinic with complaints of a popping noise when he sneezes. He denies pain, but localizes the popping by pointing to his sternal angle (of Louis), which is located \_\_\_\_\_\_\_\_\_\_ to the manubrium and \_\_\_\_\_\_\_\_\_\_ to the body of the sternum. A. dorsal / caudal B. inferior / superior C. lateral/ medial D. medial / lateral E. superior / inferior
B. inferior / superior *
Medical humanities should be considered \_\_\_\_\_\_ to clinical medicine. A. additive B. complementary C. equal D. inferior E. superior
B. complementary *
To increase a patient’s adherence to medical advice which of the following factors are most important?
A. Acute illness, peer support and verbal instructions
B. Chronic illness, verbal instruction and complex treatment schedule
C. Complex treatment schedule, peer support and acute illness
D. Good physician/patient relationship, recommending multiple behavior changes and written instructions
E. Good physician/patient relationship, acute illness and peer support
E. Good physician/patient relationship, acute illness and peer support ***
What is a major barrier to rapport building during the medical encounter? A. Cultural Competency B. Language barriers C. Miscommunication D. Patient non-adherence E. Time constraints
E. Time constraints ***
Which procedure is of historical interest and is no longer used today? A. Barium enema B. Cholangiography C. Fluoroscopy D. HIDA Scanning E. Pneumoencephalography
E. Pneumoencephalography*
A 77-year-old male presents to the clinic for a routine physical exam. His only complaint is feeling dizzy when he stands up too quickly getting out of bed. His blood pressure lying down was 140/80. After two minutes of quiet standing his blood pressure was 115/65. He has not changed his fluid intake and maintains a good diet. His medical history is significant for an enlarged prostate but he has no urinary changes. His only medication is a baby aspirin. He denies any smoking, alcohol, or illegal drugs. Given the above information what is this patient’s diagnosis and probable cause?
E. Orthostatic hypotension, impaired baroreceptors
The activity of alpha-ketoglutarate dehydrogenase is expected to produce which high energy compound?
E. NADH
Triose phosphate isomerase converts dihydroxyacetone phosphate to glyceraldehyde-3-phosphate. The energy of dihydroxyacetone phosphate is expected to be _________________ that of glyceraldehyde-3-phosphate:
A. significantly higher than
B. similar to
C. significantly lower than
B. similar to
The cell bodies for the post-synaptic sympathetic neurons are located in the A. cerebellum. B. dorsal (posterior) root ganglia. C. medulla oblongata. D. piloerector muscles. E. sympathetic chain ganglia.
E. sympathetic chain ganglia.
Which of the following substances provided by the endothelium have a role in blood pressure regulation?
A. Angiotensin II
B. Interleukin 6 and 8
C. Prostacyclin
D. TNF alpha (tumor necrosis factor)
A. Angiotensin II
Through which messengers does the endothelium and the immune system communicate?
A. Nitric oxide
B. Prostacyclin
C. Thromboxane A2
D. TNF-alpha and Interleukin 6 and 8
D. TNF-alpha and Interleukin 6 and 8
Name the components of Virchow’s triad.
A. Genetic predisposition, stasis, endothelial damage
B. Hypercoagulable state, genetic etiology, stasis
C. Hypercoagulable state, stasis, endothelial damage
D. Hypercoagulable state, stasis, genetic etiology
C. Hypercoagulable state, stasis, endothelial damage
Which of the following factors will increase the diffusive clearance of solutes across the semipermeable dialysis membrane?
A. Area of the membrane increases
B. Concentration gradient for the solute decreases
C. Lipid solubility of the solute decreases
D. Size of the solute molecules increase
E. Thickness of the membrane increases
A. Area of the membrane increases
Layers of the arterial and venous anatomy listed from inside to outside include:
A. tunica interna, smooth muscle cells, external elastic lamina, tunica media, tunica externa
B. tunica interna, tunica media, external elastic lamina, tunica adventitia
C. tunica intima, internal elastic lamina, tunica media, external elastic lamina, tunica externa
D. tunica intima, smooth muscle cells, internal elastic lamina, tunica media, external elastic lamina, tunica adventitia
C. tunica intima, internal elastic lamina, tunica media, external elastic lamina, tunica externa **
Which of the following transporters are the greatest contributors to the electrochemical gradient across the membrane?
A. Ca++/Mg++ ATPase
B. Cl-/HCO3- exchanger
C. GLUT 4 transporter
D. Na+/K+ ATPase
D. Na+/K+ ATPase **
The resting membrane potential is normally -70 to -80 mV because, at rest, the
A. equilibrium potential for K+ is approximately +70 mV.
B. equilibrium potential for Na+ is approximately +70 mV.
C. equilibrium potential for Na+ is approximately -70 mV.
D. neuronal membrane is permeable to K+ and Cl-.
E. neuronal membrane is permeable to Na+ and Ca2+.
D. neuronal membrane is permeable to K+ and Cl-. *
In both hypokalemia and hyperkalemia, action potential frequency \_\_\_\_\_\_ because in hypokalemia the resting membrane potential \_\_\_\_\_ and in hyperkalemia the inactivation gates of the voltage-gated Na+ channels are \_\_\_\_\_. A. decreases ; depolarizes ; closed B. decreases ; depolarizes ; open C. decreases ; hyperpolarizes ; closed D. decreases ; hyperpolarizes ; open E. increases ; depolarizes ; closed F. increases ; depolarizes ; open G. increases ; hyperpolarizes ; closed H. increases ; hyperpolarizes ; open
C. decreases ; hyperpolarizes ; closed *
A drug that binds to a G-protein coupled receptor and that prevents binding of hormone, but has no other effect on the receptor would be called a/an A. antagonist. B. full agonist. C. inverse agonist. D. partial agonist.
A. antagonist. *
An experimental beauty aid relaxes specific striated skeletal facial muscles by interfering with the process of excitation-contraction coupling in the muscles. The most likely mechanism of action would be
A. binding Ca2+ in the sarcoplasmic reticulum.
B. closing voltage-gated Ca2+ channels in the sarcolemmal membrane.
C. depolarization of the sarcolemmal membrane.
D. inhibiting the sarcoplasmic endoplasmic reticulum Ca2+ ATPase (SERCA) pumps.
E. opening voltage-gated Ca2+ channels in the sarcolemmal membrane.
A. binding Ca2+ in the sarcoplasmic reticulum. *
A motorcyclist experiences a severe fright as he narrowly avoids being cut off by a unattentative driver. What change in autonomic nervous system functioning would occur as a result of this event?
A. Alpha-1-adrenergic receptor activation would dilate the pupils through stimulation of adenylyl cyclase.
B. Beta-1-adrenergic receptor activation would depolarize cardiac pacemaker cells by stimulating production of intracellular cAMP.
C. Beta-2-adrenergic receptor activation would cause bronchodilation by increasing intracellular calcium in smooth muscle cells.
D. Beta-2-adrenergic receptor activation would contract arteriolar smooth muscle by decreasing intracellular inositol triphosphate and diacylglycerol.
E. Muscarinic cholinergic receptor activation would depolarize cardiac pacemaker cells by stimulating production of intracellular cAMP.
B. Beta-1-adrenergic receptor activation would depolarize cardiac pacemaker cells by stimulating production of intracellular cAMP. **
____ bones that form the longitudinal axis of the body
A. appendicular skeleton B. axial skeleton C. cancellous bone D. capitulum E. cortical bone F. diaphysis G. epiphysis H. facet I. malleolus J. trochlea
B. axial skeleton
____ compact bone that provides strength for weight-bearing
A. appendicular skeleton B. axial skeleton C. cancellous bone D. capitulum E. cortical bone F. diaphysis G. epiphysis H. facet I. malleolus J. trochlea
E. cortical bone
____ shaft of a long bone
A. appendicular skeleton B. axial skeleton C. cancellous bone D. capitulum E. cortical bone F. diaphysis G. epiphysis H. facet I. malleolus J. trochlea
F. diaphysis
____ spool-like articular process or process that acts as a pulley
A. appendicular skeleton B. axial skeleton C. cancellous bone D. capitulum E. cortical bone F. diaphysis G. epiphysis H. facet I. malleolus J. trochlea
J. Trochlea
____ smooth flat area, usually covered with cartilage, where two bones articulate
A. appendicular skeleton B. axial skeleton C. cancellous bone D. capitulum E. cortical bone F. diaphysis G. epiphysis H. facet I. malleolus J. trochlea
H. facet
An 11-year-old gymnast reports to the emergency room after a fall from the parallel bars. She complains of pain localized to the proximal left femur, and refuses to bear weight through the affected lower extremity. Based on her age and the location of her pain, the most likely diagnosis is
A. avulsion of the tibial tuberosity.
B. fracture through her medial femoral condyle.
C. inversion sprain at her lateral malleolus.
D. patellar dislocation.
E. slipped capital femoral epiphysis .
E. slipped capital femoral epiphysis .*
An 80-year-old male presents with shoulder pain and asymmetry following a stroke. Radiographic studies confirm shoulder subluxation. The patient’s loss of shoulder stability can most likely be attributed to which of the following?
A. Change in the proportion of articulating surfaces over time
B. Loose joint ligaments
C. Loosening of the joint capsule
D. Poor posture
E. Weakened rotator cuff musculature
D. Weakened rotator cuff musculature *
Which of the following best describes motion that occurs in the transverse plane, around a longitudinal axis through the femur?
A. Abduction of the thigh at the hip joint
B. Circumduction of the thigh at the hip joint
C. Dorsiflexion
D. Flexion of the thigh at the hip joint
E. Medial rotation of the thigh at the hip joint
E. Medial rotation of the thigh at the hip joint *
A 47-year-old male steps on a nail in the middle of his foot at a construction site. The nail pierces through his skin, superficial fascia, and \_\_\_\_\_\_\_\_\_\_\_ fascia. A. crural B. gluteal C. palmar D. plantar E. popliteal
D. plantar *
A 3-year-old male is in a persistent vegetative state. The parents request that you discontinue life support for the child. Under the ruling in the Nancy Cruzan case,
A. it is never permissible to discontinue life support.
B. the hospital ethics committee may authorize discontinuing the life support.
C. the ruling does not apply to this situation.
D. the state may require clear and convincing evidence of the child’s wishes.
E. you may discontinue life support in accord with the parent’s wishes.
C. the ruling does not apply to this situation. **
