Section 1
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22. The most common clinical consequence of benign prostatic hyperplasia is:
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Section 1
(50 cards)
22. The most common clinical consequence of benign prostatic hyperplasia is:
c. urinary tract obstruction
6. A 40 year old woman presents with ptosis, diplopia and dysarthria, which worsens as the day progresses. Edrophonium (an acetyl-cholinesterase inhibitor) is administered and after a minute, there is a striking improvement in muscle strength. Which of the following is characteristic of this disorder
b. autoantibodies to acetylcholine receptors
12. Fluid is aspirated from the grossly distended abdomen of a 47 year old chronic alcoholic man. The fluid is straw color and clear. Which of the following is a major contributor to the fluid accumulation of this patient.
b. decreased oncotic pressure
46. A 36 year old man presents to his primary care physician complaining of painless enlargement of the testis. Further laboratory studies reveal an increase in serum human chorionic gonadotropin. Which of the following is the most likely diagnosis?
c. seminoma
33. A 45 year old man complains of heartburn and burning epigastric pain, relieved by antacids and triggered by eating spicy or acidic foods or by assuming a recumbent position. The patient smokes two packs of cigarettes a day and consumes several alcoholic drinks each evening. Which of the following is the usual cause of this patient's condition?
e. hiatal hernia and incompetent lower esophageal sphincter
24. A 60 year old man with a 5 year history of GERD presents with persistent heartburn (pyrosis) and acid regurgitation. Because this patient has a long history of GERD, an esophagogastroduodenoscopy is performed to screen for Barrett esophagus, which confirmed disease. Which of the following is true of Barrett's esophagus?
b. it is a known precursor of adenocarcinoma of the esophagus
26. Peptic ulcer of the stomach is characterized etiologically by.
c. association with H. pylori
8. A 23 year old man undergoes surgery for fractures of the pelvis and left femur resulting from a high speed motor vehicle accident. The next day he develops dyspnea, speech difficulties, and petechial skin rash. Which of the following types of embolism is the likely cause of these findings?
d. fat embolization
50. 'Krukenberg tumor' of the ovary is which of the following?
a. metastatic stomach carcinoma
11. Which of the following serum values is likely to be elevated in patients with hyperparathyroidism
a. calcium
17. Which of the following laboratory results is a diagnostic of acute pancreatitis?
b. elevated serum lipase, amylase
28. The following are characteristics features of features of Waterhouse-Friderichsen Syndrome EXCEPT: Waterhouse-Friderichsen should cause HYPOtension
d. hypertension
44. Which of the following skin lesions may be associated with hyperlipidemia?
d. xanthalesmas
41. The following ar characteristic features in Duchenne Muscular Dystrophy except:
c. loss of acetylcholine receptors
40. The most common characteristic finding in intestinal malabsorption syndrome is:
e. steatorrhea
34. Ascites, which is a complication of alcoholic liver disease, develops as a result of the following except:
e. tumor producing portal hypertension
21. The chest radiograph of a 23- year old student reveals a calcified pulmonary lesion. The tuberculin test is positive, but sputum smears and cultures are negative for Mycobacterium tuberculosis. A presumptive diagnosis of secondary TB is made. If further studies, including biopsy were performed, which of the following findings would justify the diagnosis of secondary TB as contrasted to primary TB.
c. cavitation
35. The most common cause of "massive" hematemesis in alcoholics is
d. Mallory-weis syndrome
25. Which of the following is the most common skin cancer?
b. basal cell carcinoma
10. Transudate results from which of the following disorders?
b. non-inflammatory edema fluid results from altered intravascular hydrostatic or osmotic pressure
48. An 8 year old boy is referred to the dermatologist for numerous 'suspicious' pigmented lesions on the face and neck. Further history reveals that the patient has had difficulty seeing out of his right eye; he is referred to the opthamologist, who diagnosis an ocular melanoma. Which of the following is the most likely diagnosis?
c. Xeroderma pigmentosum
15. A 38 year old female suffering from progressive weakness, hypotension, craving for salty food, and generalized bronzing of the skin. Lab test showing low blood cortisol. Which of the following is the most likely diagnosis.
d. addison's disease
14. Chronic passive congestion of the lungs is characterization by:
e. heart failure cells within the alveolar spaces
42. Which of the following is the classic sign/symptom of coronary artery disease?
a. angina pectoris
38. The histopathologic feature of thyroidization in the kidney sections is primarily seen in:
c. chronic pyelonephritis
27. A 25 year old man presents with a low grade fever, weight loss, fatigue, abdominal pain, episodic diarrhea, and postprandial bloating. Right lower quadrant tenderness is elicited on palpation of the abdomen. A capsule endoscopy reveals thickening of the terminal "ileum", edema, marked luminal narrowing, and a cobblestone appearance of the mucosa. Which of the following is characteristic of this condition. Anyone know what condition this is? Crohn's I think, it is Crohns, same as Ulcerative colitis except U.C. affects a uninterrupted area of the descending colon while Crohns is patches throughout the gut of inflammation. Ulcerative colitis -->limited to large intestine (colon). Crohn's -->S/L intestine. Case is in the ileum.
d. it can cause fistula formation between loops of affected bowel
3. Which of the following shows "non-necrotizing granuloma"?
sarcoidosis
13. The most likely diagnosis for a patient with dysphonia, weight loss and a history of heavy smoking is:
e. carcinoma of the larynx
19. A 50 year old woman has been immobilized in bed for several days after a motor vehicle accident. She had been improving, but this morning she suffered the sudden onset of chest pain, hemoptysis, tachypnea, tachycardia, and dyspnea. What is the likely basis of this set of findings?
c. deep venous thrombus of the lower extremities with embolization to branches of the pulmonary artery
29. Right sided heart failure affects the kidneys by causing
e. all of the above
43. Which of the following hormones is missing in the feedback loop in Addison disease that causes excessive pigmentation of skin and mucosa?
d. cortisol
7. Left sided-heart failure is generally associated with
c. pulmonary edema
39. Hypertension is typically associated with which of the following?
d. left ventricular hypertrophy
31. Which of the following is a significant effect of pheochromocytoma?
d. hypertension
1. Which of the following represents Barrett's esophagus?
metaplasia (metaplastic columnar epithelium above J-line)
5. Which of the following diseases is characterized by high levels of alkaline phosphatase, normal levels of calcium and phosphorus, with enlargement of skull bones?
Paget's disease of bone
36. A 45 year old female with lower neck symmetric swelling and clinical signs and symptoms of hypothyroidism. This condition is referred to as:
b. hashimotos disease
47. a 35 year old woman is seen 6 months after giving birth to a normal infant. She now complains of continued amenorrhea, fatigue, loss of weight and muscle strength. Further investigation might be expected to demonstrate which of the following?
a. Sheehan syndrome (Postpartum hypopituitary necrosis
4. A nutmeg liver is a term used in which of the following?
Chronic passive congestion of liver
2. An infarct is seen in which of the following conditions?
heart attack
16. A 4-year old boy is brought to the pediatric unit because of the concern about progressive bowing of the legs and the costochondral junctions. The underlying defect in this child is a defect in:
a. calcification of osteoid matrix
49B. An 8 year old boy is referred to the dermatologist for numerous 'suspicious' pigmented lesions on the face and neck. Further history reveals that the patient has had difficulty seeing out of his right eye; he is referred to the opthamologist, who diagnosis an ocular melanoma. This condition results from:
b. an inborn defect in DNA repair genes
23. A periapical granuloma consists of the following except:
d. epitheliod cells
18. A 21-year old man was referred to the oral surgery department for evaluation of a progressively enlarging submandibular mass and to rule out dental etiology. The patient's PMH is insignificant. After careful clinical and radiographic examination, dental infection was ruled out as a cause. A trial course of antibiotic did not resolve the swelling. An open biopsy was performed. Based on the clinical and histopathologic features, what is your diagnosis?
d. Hodgkin lymphoma
20. Which of the following histopathological findings during autopsy suggests that the person had rheumatic carditis
c. aschoff bodies in the heart muscle
30. The majority of pulmonary emboli originate from
b. deep vein thrombosis
37. The classic "wire loop" lesion seen microscopically in the glomeruli of the kidney are most likely associated with which of the following diseases?
c. systemic lupus erythematosus
9. The renal lesion typically associated with benign hypertension is termed:
d. hyaline arteriosclerosis
45. Two weeks after recovery from a severe bout of pharyngitis an 11 year old girl is seen because of the acute onset of periorbital edema, hematuria, malaise, nausea and headache. Which of the following is expected?
b. Increased anti-streptolysin O titer
32. Which of the following has been associated with ingestion of food contaminated with aflatoxin B1-inducing Aspergillus?
c. hepatocellular carcinoma
Section 2
(50 cards)
1.Gross and microscopic changes in injured liver or kidneys occur earlier than any other identifiable alterations. Biopsies of injured liver or kidneys are more reliable than blood tests for early diagnosis of damage
c. both statements are false
53. Obesity, moon face, osteoporosis, facial plethora and hypertension indicate which of the following diseases?
a. cushing syndrome
2. A 17 year old male sustained blunt trauma to the abdomen in a MVA. A portion of his liver had to be removed. A CT during followup several weeks later showed that the liver nearly regained its normal size. Which of the following processes best explains the CT results.
d. hyperplasia
68. The intrinsic causes of ureter obstruction include the following except:
c. pregnancy
56. Appendicitis is characterized by the following except:
e. ascites
51. A 2 year old boy presents with his third bone fracture within the past several months. There is no evidence of trauma. His older sibling has a similar history. The boy is small for his age, and his sclerae are tinged a bluish color. Radiographs reveal generalized osteopenia and evidence of multiple fractures, both old and new. Which of the following is the usual mode of inheritance of this disorder?
a. autosomal dominant
59. Ten days after hospitalization for a large, incapacitating myocardial infarction, a 58 year old man suddenly develops paralysis of the right side of his body. The best explanation for this hemiparalysis is:
e. detachment of a mural thrombus from the left ventricle
63. clinical signs and symptoms of congestive heart failure including the following except:
d. dysphagia
84. A 77 year-old man has had increasing difficulties with urination for the past 2 years. He has difficulty starting and stopping urine stream. On physical examination, his temperature is 37.0◦C, and blood pressure ism 138/85mm Hg. Which of the following would be the cause of this
c Dihydrotestosterone
79. An 88 year old woman with marked kyphosis and loss of height that has been gradually progressive over many years experiences sudden onset of acute back pain following a sudden change in position. Radiographic examination demonstrates generalized osteopenia and a fracture of lower thoracic vertebra. Which of the following is an association or characteristic of the patient's generalized bone disorder?
b. postmenopausal state and estrogen deficiency
82A. A 7 year old boy is recovering from impetigo. Physical examination shows a few honey-colored crusts on his face. The crusts are removed and a culture of the lesions shows group A streptococcus pyogenes. He is treated with a course of antibiotics. One week later, he develops malaise with nausea and a slight fever, and passes 'tea colored' urine. What is the most likely diagnosis?
c. acute proliferative glomerulonephritis
11. A 19-year-old female gets her nose pierced and the skin becomes infected with bacteria. Leukocytes respond by exiting the vasculature and migrating into the infected site. Which of the listed substances is the most likely mediator of leukocyte migration?
d. Chemokines
8. A 65 yo woman suddenly lost consciousness, and an hour later, when she woke up, could not move her right arm or leg. A few weeks later, a CT scan of her head showed a large cyst like space in the left parietal lobe. The most likely pathologic process that occurred in the brain is called:
e. liquefactive necrosis
81. A 3 year old previously healthy boy has become increasingly lethargic for the past 3 weeks. On physical examination, his temperature is 37C, pulse 80/min, respiration 15/min, and BP 140/90 mm Hg. Periorbital edema is evident. Urine analysis shows 4+ proteinuria, but no blood or glucose. Which of the following is the best information that the physician could give the boy's parents about this condition?
d. corticosteroid therapy should alleviate this problem
71. Oropharyngeal infection with Beta Hemolytic streptococci may cause which of the following?
d. acute glomerulonephritis
4. A 25 year old female breaks the left femur in a skiing accident. After several weeks of immobilization in a cast, the diameter of the left calf decreased. What is the explanation for the change in the muscles of the cell?
c. atrophy
55. A 20 year old man is evaluated for recurrent peptic ulcer disease, apparently refractory to pharmacologic intervention. Serum gastrin is markedly elevated. These findings are most characteristic of which of the following?
c. zollinger-ellison syndrome
3. A 51 year old man present with blood pressure of 150/95. The physician explained if this man's blood pressure remains elevated for years, there will be important alterations in the myocardium. Which alterations are most likely?
e. hypertrophy
5. A 43 yo male with a many month history of heartburn and gastric acid reflux. Upper GI endoscopy with esophageal biopsy revealed changes in the epithelial lining. What are these changes? Always name it according to the tissue the site is changing to
c. columnar metaplasia (squamous-->columnar)
6. The term "hyperplasia" means the exact opposite of the term "metaplasia". Both metaplasia and hyperplasia are reversible tissue adaptations to non-lethal injury.
b. statement 1 is false but statement 2 is true
83b. A 55 year-old male with a history of mitral valve stenosis secondary rheumatic carditis since he was a child. The patient was found by his daughter to have slurred speech and facial paralysis, while visiting. If this is the result of an embolic event, select the correct pathogenic mechanism.
d. Thromboembolism arising from valve leaflet
57. 'mallory bodies' are generally seen in the following liver diseases except:
b. hemochromatosis
82B. A 7 year old boy is recovering from impetigo. Physical examination shows a few honey-colored crusts on his face. The crusts are removed and a culture of the lesions shows group A streptococcus pyogenes. He is treated with a course of antibiotics. One week later, he develops malaise with nausea and a slight fever, and passes 'tea colored' urine. Which of the following laboratory tests should be performed?
b. ASO
67. The following are risk factors for artherosclerosis except:
d. increased levels of high density lipoproteins
52. A 35 year old female presents with amenorrhea and weight loss despite increased appetite. The history and physical examination reveal exophthalmos, fine resting tremor, tachycardia, and warm moist skin. Laboratory tests for thyroid function would be expected to yield which of the following?
d. thyroid stimulating immunoglobulin (TSI)
77. Which of the following refers to an elevated BUN, indicating the retention of 'nitrogenous compounds'?
b. azotemia
78. A patient complaining of lower back pain, fever, dysuria and pyuria most likely has:
d. acute pyelonephritis
74. The following statements regarding carcinoma of the pancreas are correct except:
c. the cancer in the tail of the pancreas induces jaundice early in its cause
61. During a routine health maintenance examination of a 40 year old man, a tool guaiac test result was positive. A follow-up sigmoidoscopy showed a 1.5 cm circumscribed, pedunculated mass on a short stalk, located in the upper rectum. Which of the following best describes this lesion?
a. adenoma
13. A 39 year-old patient presents with pain, erythema and swelling of the left cheek present for one day. The swelling developed after a bee sting. The earliest event in the acute inflammatory response to the bee sting is
b. Edema
72. Heberden nodes are generally diagnostic of:
d. osteoarthritis
75. A 1 year old male infant is hospitalized for pneumonia. The baby has been hospitalized twice before for severe respiratory infections. His mother pointed out that when she kisses her child, he tasted 'salty'. The child has weight loss that the mother attributes to frequent vomiting and diarrhea with bulky, foul-smelling fatty stools. Which of the following is the most likely diagnosis?
c. cystic fibrosis
10. Which subjective findings are most likely to be reported by individuals receiving COX-2 inhibitors relative to those receiving placebo in a 6-mo trial? Note that the two groups show no significant differences in WBC count, platelet count, hemoglobin, or creatinine.
e. Decrease in arthritis pain
54. Cirrhosis due to alterations in copper metabolism is known as:
a. Wilson's disease
9. A 45 year old male receives chemotherapy from lung adenocarcinoma. There is reduction in the size of the primary tumor, however, the patient dies due to complications of therapy. Histopathologic features of the primary tumor show foci shrunken tumor cells with condensed nuclear chromatin and deeply eosinophilic cytoplasm. What is the most likely trigger of the changes seen in the tumor cells?
a. release of cytochrome c
14. After extraction of a carious tooth, incision and drainage of the associated swelling and a course of antibiotics, the patient's condition improves and the area begins to heal. Which of the listed leukocytes are most important for this repair process?
c. Macrophages
70. The clinical manifestations of acromegaly include the following except:
c. microglossia
64. A 17 year old boy presents with pain and swelling about the left knee for the past month. He thought that this resulted from an old football injury and that it would resolve without incident. However, the pain has persisted and is severe enough to cause him to limp. Radiographs of the knee demonstrate a lifting of the periosteum and a speculated 'sunburst' pattern in the distal femur. Which of the following is the most likely diagnosis?
c. osteosarcoma
60. During a yearlong training program, a 23 year old female Air Force officer falls in class rank from first place to last place. She has a lower pitch to her voice and corsening of her hair, along with increased tendency toward weight gain, and increasing intolerance to cold. Which of the following laboratory abnormalities is expected?
a. Decreased serum T3 and T4
76. The predisposing factors of bladder cancer are those listed except:
e. testosterone sensitivity
83A. A 55 year old male with a history of mitral valve stenosis secondary to rheumatic carditis since he was a child. The patient was found by his daughter to have slurred speech and facial paralysis, while visiting. What is the most likely explanation for this patient's recent clinical findings?
c. embolic event
58. A 10 year old boy presents with frequent headaches, constant feeling of thirst, and polyuria. He was found to have bilateral hemianopia. A skull film shows a suprasslar mass with evidence of calcification. A computer-guided stereotactic biopsy revealed a lesion exhibiting features microscopically resembling the enamel organ of a developing tooth. What is the most likely diagnosis?
b. craniopharyngioma
80. A 50 year old woman of Eastern European Jewish descent presented with a history of recurrent fractures, and easy bruising and is found to have hepatosplenomegaly and anemia. Serum assays revealed elevation of the angiotensin-converting enzyme. Which of the following will also be found as 'deficient' in further investigation?
a. glucocerebrosidase
69. The following statements regarding invasive ductal carcinoma of the breast are correct except:
e. hypoesterism is a major etiologic factor
62. Which of the following cardiac disorders may develop infective endocarditis secondary to bacteremia from oral organisms?
e. all of the above
65. which of the following is not necessarily a feature of the nephritic syndrome?
a. generalized edema
7. A myocardial or renal infarct is characterized by what type of necrosis?
d. coagulative necrosis
66. which of the following is not a feature of the nephrotic syndrome?
e. azotemia
12. A patient presents with pain and swelling of 2 days duration adjacent to a carious mandibular first molar with a non-viable pulp. Incision and drainage of the swelling produces tan-yellow, viscous fluid. Which host cells are most significantly represented in this fluid?
b. Neutrophils
73. Consequences of liver cirrhosis include the following except:
c. atherosclerosis
Section 3
(20 cards)