test 50: Pathology

Question 1

In developed countries, aortic regurgitation is most commonly caused by what

Answer 1

aortic root dilation

Question 2

What type of syndrome is seen in Hep B

Answer 2

Serum sickness-like ( fever, arthralgia, rash)

Question 3

What characterizes acute HBV infection

Answer 3

elevations in aspartate aminotransferase and alanine aminotransferase

Question 4

characterize Gilbert Syndrome

Answer 4

mild unconjugated hyperbilirubin

Question 5

Chronic cough and recurrent sinusitis in a young Caucasian individual should raise suspicion of what

Answer 5

Cystic fibrosis

Question 6

In respiratory and gastric glands, impaired functioning of CFTR does what

Answer 6

• reduces chloride secretion from cell to mucous

- increases sodium and net water absorption

Question 7

In sweat glands, abnormal CFTS causes what

Answer 7

• reduced chloride secretion back into cell

- increase Cl- content in sweat

Question 8

Combination of acute-onset polyuria, polydipsia, volume depletion, and a fruity order in urine or breath suggests

Answer 8

diabetic ketoacidosis

Question 9

how does the body react to diabetic ketoacidosis

Answer 9

1. primary metabolic acidosis
2. primary compensatory respiratory alkalosis
   - Kussmaul respirations

Question 10

Severe DKA, with low bicarb levels and no compensation in CO2 levels, has what organ failure

Answer 10

respiratory failure

Question 11

Is there sensory loss is ALS

Answer 11

no

Question 12

Combination of fixed segmental loss of upper extremity pain and temperature sensations, upper extremity lower motor neuron signs, and/or lower extremity upper motor neuron signs in setting of scoliosis suggests

Answer 12

syringomyelia

Question 13

Patient with secondary amenorrhea associated with low body weight, frequent strenuous exercise, and lanugo ( fine hair indicating inadequate caloric intake) suggests

Answer 13

functional hypothalamic amenorrhea

Question 14

Why would amenorrhea cause functional hypothalamic amenorrhea

Answer 14

• decrease adipose tissue stores
• decrease circulating leptin levels
• decreased leptin inhibits pulsatile gonadotropin-releasing hormone (GnRH) release

Question 15

What is released by heart ventricles when they are stretched as they often are in CHF from systolic dysfunction

Answer 15

BNP

brain natriuretic peptide

Question 16

role of BNP brain natruretic peptide

Answer 16

• vasodilation and diuresis

- activates gaunylate cyclase, increase cGMP

Question 17

role of endothelin

Answer 17

vasoconstrict

Question 18

in pulmonary venous congestion what happens

Answer 18

1. endothelial damage
2. decrease NO production
3. Increase endothelin production

Question 19

What are insulin, LH and androgen levels in polycystic ovarian syndrome

Answer 19

• insuline resistance
• increase LH
• increase androgens

Question 20

patient wants to get pregnant with polycystic kidney disease, what do you give her

Answer 20

• Clomiphene: estrogen receptor modulator that decrease negative feedback inhibition on hypothalamus by circulating estrogen, thereby decreasing gonadotropin production

Question 21

young male patient with sudden-onset unilateral chest pain, dyspnea and absent breath sounds on examination probably has

Answer 21

primary spontaneous pneumothroax

Question 22

Most important risk factor for primary spontaneous pneumothroax

Answer 22

smoking

Question 23

How does primary spontaneous pneumothroax occur

Answer 23

• no preexisting pulmonary disease
• large change in alveolar or intrapleural pressure
• break in visceral pleura ( superficial bleb)
• pleura and air trapping between pleural spaces

Question 24

Small cell lung carcinoma is associated with what risk factor and where is it located

Answer 24

• smoking

- centrally

Question 25

Immunohistochemical stains are positive for what in small cell carcinoma of lung

Answer 25

Chromogranin

Question 26

Small cell carcinoma of lung arise from what

Answer 26

- primitive cells of basal layer of bronchial epithelium

Question 27

What should be suspected in a patient with triad of muffled heart sounds, jugular venous distention and hypotension

Answer 27

cardiac tamponade