by which the cardiac output increases in severe anemia?
A. Arteriolar diameter
B. Blood viscosity
C. Peripheral vascular resistance
D. Splanchnic blood flow
E. Tissue oxygen tension
Answer
2 .A 2-year-old retarded child is evaluated by a metabolic
specialist. The child's history is significant for failure to
thrive and progressive neurologic deterioration, including deafness
and blindness. Physical examination is remarkable for hepatosplenomegaly
, as well as a cherry-red spot on funduscopic examination. These symptoms
are consistent with a diagnosis of
A. Hunter syndrome
B. Niemann-Pick disease
C. Pompe's disease
D. tyrosinosis
E. von Gierke's disease
Answer
3. An 8-month-old female child is brought to medica
l attention because her first four teeth show several discrete,
discolored, circumferential bands that show very little enamel.
Excessive levels of which of the following may have produced this defect?
A. Bilirubin
B. Fluoride
C. Parathormone
D. Thyroid hormone
E. Vitamin C
Answer
4.Which of the following complications is currently the majo
r limitation to the long-term success of cardiac transplantation?
A. Allograft rejection
B. Graft arteriosclerosis
C. Graft atherosclerosis
D. Opportunistic infections
E. Lymphoma
Answer
5>.A child develops a tumor of the cerebellum. Biopsy reveals
evidence of both neuronal and glial differentiation. Which of the
following is the most likely diagnosis?
A. Astrocytoma
B. Glioblastoma multiforme
C. Medulloblastoma
D. Meningioma
E. Oligodendroglioma
Answer
6> .A 56-year-old man visits his physician with complaints of
complete exhaustion after mowing the lawn in his small front
yard. He also complains of dizziness, irritability, difficulty
sleeping, and loss of libido. On physical examination, the man's
skin, conjunctiva, and oral mucosa are pale. A blood test indicates
the man's hemoglobin is 7 g/dL. Which of the following findings is
also likely to be present in this man?
A. Bradycardia
B. Cyanosis
C. Low stroke volume
D. Warm hands
E. Wide pulse pressure
Answer
7> .A 55-year-old man had been in good health since receiving a heart
transplant for severe atherosclerotic disease. Five years after
transplantation, the patient died suddenly, without any premonitory
symptoms, while working in his garden. He had been maintained on
cyclosporin since his transplant. Which of the following complications
would most likely be found at autopsy in the transplanted heart?
A. Allograft rejection
B. Atherosclerosis of coronary arteries
C. Graft vascular disease
D. Hyaline arteriolosclerosis
E. Hyperplastic arteriolosclerosis
Answer
8.An elderly lady is brought to the emergency room after drinking
insecticide that she thought was tea. After her stomach is pumped,
her sense of smell is tested and it is found that she can not distinguish
common smells (e.g., an orange, coffee). CT scan of the head demonstrates
a mass in the olfactory groove area. The axons likely compressed by this
mass project to which of the following structures?
A. Insula
B. Nucleus ambiguus
C. Post-central gyrus
D. Pre-central gyrus
E. Pyriform cortex
Answer
9.A 27-year-old man develops bilateral parotid gland swelling and
orchitis, and is generally ill with fever of 102° F. Which of the
following substances is most likely to be significantly elevated in
the patient's serum?
A. Alanine aminotransferase (ALT)
B. Amylase
C. Aspartate aminotransferase (AST)
D. Ceruloplasmin
E. Creatine phosphokinase, MB isoenzyme (CPK-MB)
Answer
10.A 55-year-old man presents to the emergency room with crushing
substernal pain and left shoulder pain of 2 hours duration. The pain
is not relieved by sublingual nitroglycerin, and the electrocardiogram
shows ST elevation in several leads. Aspirin and streptokinase therapy
are initiated, and the patient is admitted to the intensive care unit.
The next morning, serum cardiac enzymes are elevated to 4 times the upper
limit of normal, and the electrocardiographic changes are still present.
Which of the following is the most likely diagnosis?
A. Prinzmetal's angina
B. Stable angina
C. Subendocardial infarction
D. Transmural infarction
E. Unstable angina
Answer
11 Which of the following amino acids is post-translationally
hydroxylated in the cytoplasm of fibroblasts?
A. Cysteine
B. Glycine
C. Proline
D. Serine
E. Tyrosine
Answer
12. Microscopic examination of a cancer cell reveals a cell
in an abnormal telophase in which three clusters of chromosomes
are seen. An abnormality of which of the following would be most
likely to produce this alteration?
A. Chiasma
B. Mitotic spindle
C. Mosaicism
D. Polar body
E. Synapsis
Answer
13.A 58-year-old man with fainting spells and exercise intolerance
is found to have a bicuspid aortic valve with marked aortic stenosis.
Which of the following physical findings would be prominent in this patient?
A. Diastolic murmur
B. Heave at left parasternal border
C. Loud S2 heart sound
D. Loud S3 heart sound
E. Weak peripheral pulse
Answer
14.A 57-year-old female is found unconscious on her kitchen floor after
having suffered a myocardial infarction. She has pulmonary edema and
distended jugular and peripheral veins. A midsystolic gallop is heard
upon chest auscultation. EKG shows prominent Q waves in leads II, III,
and aVF. Which of the following is most consistent with the patient's
condition?
Preload Cardiac output PAWP CVP Vascular resistance Mixed venous oxygen
A. Increased Decreased Decreased Increased Increased Decreased
B. Increased Increased Decreased Decreased Decreased Increased
C. Increased Decreased Increased Increased Increased Decreased
D. Increased Increased Increased Increased Decreased Decreased
E. Decreased Decreased Increased Decreased Increased Decreased
F. Decreased Increased Decreased Increased Decreased Increased
G. Decreased Decreased Increased Decreased Decreased Decreased
Answer
15.A 48-year-old man complaining of chest pain is brought to the
emergency room. Physical examination followed by echocardiography
demonstrates aortic stenosis. His coronary blood flow is increased.
Which of the following is the most likely explanation for the increased
coronary blood flow in this individual?
A. Decreased left ventricular oxygen consumption
B. Decreased left ventricular pressure
C. Decreased left ventricular work
D. Increased cardiac tissue adenosine concentration
E. Increased cardiac tissue oxygen concentration
Answer
16.A 45-year-old man presents to the emergency department with severe
headache and vomiting. A CT scan shows a well-circumscribed cystic lesion
within the 3rd ventricle; there is no calcium deposition. The cyst is
surgically removed. On histologic examination, the wall of the cyst
consists of a single layer of mucin-producing columnar epithelium with
a ciliated apical surface. Which of the following is the most likely
diagnosis?
A. Colloid cyst
B. Craniopharyngioma
C. Cysticercosis
D. Echinococcus cyst
E. Pilocytic astrocytoma
Answer
17.A 36-year-old female is brought to the emergency room by her
husband who says that she "complained of a severe headache then lost
consciousness." She has a history of hypertension and had been on several
different medications. The examining physician notes that she is unable
to move her arms and legs, but can blink her eyes. When the physician asks
her to blink twice if she can hear him, she promptly does so. In which of
the following structures is this woman's lesion most likely located?
A. Cervical spinal cord
B. Medulla oblongata
C. Midbrain
D. Pons
E. Thalamus
Answer
18.A 71-year-old man has been in excellent health, and practicing
competently as an attorney. He is brought to the emergency room
following a motor vehicle accident. A workup, including imaging of
the spine, thorax, and head, is negative, but the patient is admitted
for overnight observation. His injuries include several lacerations to
the face and extremities as well as several contusions to the thorax.
Three weeks later, he is admitted to the hospital for confusion.
A neurologic exam is normal except that he is not oriented to time
or place, and can recall only 1 out of 6 objects after 3 minutes.
Which of the following is the most likely diagnosis?
A. Alzheimer's disease
B. Brain metastases
C. Epidural hematoma
D. Normal pressure hydrocephalus
E. Subdural hematoma
Answer
19 . A work diagram showing changes in left ventricular volume and
pressure during one cardiac cycle is shown above for a normal heart
(diagram A) and following aortic valvular disease (diagram B). Diagram B
shows which of the following compared to diagram A?
A. Decreased work for a greater stroke volume
B. Decreased work for a lower stroke volume
C. Decreased work for the same stroke volume
D. Increased work for a greater stroke volume
E. Increased work for a lower stroke volume
F. Increased work for the same stroke volume
Answer
20.An 80-year-old woman dies after a long history of progressive memory loss,
apraxia, and recurrent episodes of confusion. In the last months of life she
was bedridden and unable to recognize familiar faces and objects. The
pathologist identifies numerous flame-shaped intracytoplasmic inclusions
in neurons of the neocortex and hippocampus. These consist of paired
helical filaments (PHFs) on electron microscopy. Which of the following
biochemical changes most likely accounts for the development of PHFs in
this condition?
A. Abnormal degradation of amyloid precursor protein (APP)
B. Abnormal phosphorylation of tau
C. Accumulation of advanced glycosylation end (AGE) products
D. Increased expression of APP
E. Precipitation of insoluble a-tubulin
Answer
21.The activity of which of the following enzymes is directly affected
by citrate?
A. Fructose-2,6-bisphosphatase
B. Isocitrate dehydrogenase
C. Phosphofructokinase I
D. Pyruvate carboxylase
E. 6-phosphogluconate dehydrogenase
Answer
22.Which of the following structures is found only in Gram-negative
microorganisms?
A. Cell envelope
B. Exotoxin
C. Peptidoglycan
D. Periplasmic space
E. Teichoic acids
23.A scientist wishes to study free radical production under ischemic
conditions. He decides to produce cerebral ischemia by tying off an artery
of the brain. Ligation of which of the following arteries would be most
likely to produce significant ischemic damage?
A. Anterior cerebral artery at its origin from the internal carotid artery
B. Anterior communicating artery
C. Middle cerebral artery at its origin from the internal carotid artery
D. Posterior cerebral artery at its origin from the basilar artery
E. Posterior communicating artery
Answer
24.A 52-year-old woman has long-standing rheumatoid arthritis (RA) and
is being treated with corticosteroids and nonsteroidal anti-inflammatory
drugs (NSAIDs). Which of the following cardiac complications may arise in
this clinical setting?
A. Constrictive pericarditis
B. Dilated cardiomyopathy
C. Hypersensitivity myocarditis
D. Hypertrophic cardiomyopathy
E. Restrictive cardiomyopathy
Answer
Answers
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posted by Tere @ 9:08 PM
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