Download 5331 MT1 2017 review

OPTO 5331 General Pathology and Medicine 2017
Midterm I – 8 lectures, 8 questions per lecture
DATE
Jan 10
Jan 12
Jan. 17
Jan 19
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Jan. 26
Jan. 26
Jan. 31
Feb. 2
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LECTURER
TOPIC
READING
Dr. Burns
Blood and Lymphoid System D Ch-9
Dr. Otteson
Devel. & Genetic Diseases D Ch-5
Dr. Burns
Respiratory Physiology
B&L 27-31
Dr. Burns
Respiratory Pathology
D Ch-8
Dr. Bergmanson, 2 ocular anatomy lectures - no pathology lecture
Dr. Frishman (9-10:20)
Shock, CV Pathology
D Ch-7
Dr. Redfern
Endocrinology I
B&L 41-51
Dr. Redfern
Endocrinology II
B&L 41-51
Dr. Redfern
Pituitary/adrenal Pathology D Ch-17
Mid-term I Review Questions
Dr. Burns’ Questions on Blood & Lymphoid System
1. Dilutional anemia is characterized by:
A. Macrocytic, hypochromic red blood cells
B. Normocytic, normochromic red blood cells
C. Anisocytosis
D. Microcytic, hypochromic red blood cells
2. Phlebotomy (blood letting) is a treatment for:
A. Leukopenia
B. Thrombocytopenia
C. Paget’s disease
D. Polycythemia vera
3. A patient with decreased intrinsic factor levels following gastric resection is likely to develop:
A. Microcytic anemia
B. Anisocytosis
C. Spherocytosis
D. Megaloblastic anemia
4. Anemia may be a consequence of:
A. Decreased hematopoiesis
B. Abnormal hematopoiesis
C. Increased loss or destruction of red blood cells
D. All of the above
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5. Hemolytic disease of the newborn occurs because of a mismatch in Rh blood groups between a
sensitized mother and her fetus. Hemolysis requires:
A. Anti-Rh antibodies
B. Complement activation
C. RhoGAM injections
D. Choices A and B
6. Neutrophilia is often an indication of:
A. A bacterial infection
B. A viral infection
C. An allergy
D. A parasite infection
7. The spleen is the primary organ that removes old and damaged red blood cells from the circulation.
Hemoglobin is broken down into its components and most of these are recycled. Which of the following
is not a component of adult hemoglobin.
A. Fe2+
B. Delta globin
C. Beta globin
D. Gamma globin
8. Acute myeloid leukemia (AML) affects primarily:
A. Children
B. Adults (20-45 years)
C. Older adults (50+ years)
D. All of the above
Dr. McDermott’s Questions on Developmental and Genetic Disease
9. Which of the following is/are correct about cystic fibrosis?
A. Patients have very viscid GI and respiratory tract secretions and their sweat is very salty
B. Mutated gene causes defective chloride transport
C. Symptoms include recurrent respiratory tract infection, malnutrition
D. Choices A and B
E. Choices A, B and C
10. Agenesis of a kidney means?
A. Kidney did not develop properly
B. Kidney developed in the wrong anatomical location
C. Kidney did not develop at all
D. Kidney grew too large for its normal anatomical location
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11. What is TORCH syndrome?
A. Congenital defects such as microcephaly, eye abnormalities, deafness due to fetal infection in utero
B. Mental retardation and facial features such as small jaw due to maternal alcohol consumption
C. Progressive muscle degeneration due to mutated dystrophin gene
D. Tall male with feminine features such as gynecomastia
E. Short stature, cubitus valgus and amenorrhea in female
12. Which of the following is/are correct about chromosomal abnormalities?
A. A person with trisomy has three copies of one particular chromosome
B. The most common structural abnormalities are deletion and translocation
C. If a person is a mosaic only some of their cells have the abnormality so they are less severely
affected
D. Choices A and B
E. Choices A, B and C
13. Which is/are correct about sex-linked recessive disorders?
A. Males with one copy of the defective gene always show the disease
B. Male children of a normal woman and an affected male will not have the disease
C. The male children of a carrier female have a 50% chance of inheriting the defective gene
D. Choices A and B
E. Choices A, B and C
14. Which is/are correct about phenylketonuria?
A. Is a mitochondrial gene disease
B. Results from accumulation of phenylalanine
C. Is an autosomal recessive disorder
D. Choices A and B
E. Choices B and C
15. Which statement is not correct about familial hypercholesterolemia?
A. Gene for low density lipoprotein receptor is mutated
B. Possible to have the mutated gene but not show clinical symptoms
C. 25% of offspring inherit the mutated gene
D. Signs include atherosclerosis, heart disease, xanthomas
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16. Which of the following is not correct about Down syndrome?
A. Patients have mental retardation
B. Facial features include prominent epicanthal fold, open mouth, large tongue
C. Most cases are due to non-disjunction of paternal chromosomes
D. Heart defects are common and life expectancy is reduced
E. Most common karyotype for male patient would be 47, XY+21
Dr. Redfern’s Questions on Basic Endocrinology
17. Which of the following hormones is a peptide?
A. Dopamine
B. Thyroxine
C. Thyrotropin releasing hormone
D. Aldosterone
E. Cortisol
18. Which of the following is correct regarding hormones?
A. Steroid hormones typically bind to cell surface receptors
B. Steroid hormones are secreted by exocytosis
C. Hormones often exert their functional effects when bound to plasma proteins
D. Catecholamines are typically free floating and unbound to plasma proteins in circulation
E. None of the above
19. Which hormone is secreted by the posterior pituitary?
A. Antidiuretic hormone
B. Growth hormone
C. Prolactin
D. Testosterone
E. None of the above
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20. Which of the following is/are true regarding the hypothalamic-pituitary axis?
A. The hypothalamus is a collection of neurons that regulate pituitary hormones
B. Release of posterior pituitary hormones is under neural control
C. Release of anterior pituitary hormones is by hypothalamic secretion of releasing and inhibiting
hormones
D. The posterior pituitary is a collection of neuronal axons and terminals with cell bodies in the
hypothalamus
E. All of the above
21. Which of the following is false about growth hormone?
A. It stimulates an increase in muscle mass
B. High blood glucose levels stimulate its secretion
C. Growth hormone stimulates the hypothalamus to secrete growth hormone inhibiting hormone (GHIH)
to reduce GH levels
D. It stimulates an increase in bone growth
E. None of the above
22. Which of the following is false regarding thyroid hormones?
A. T3 is the active form
B. Thyroid stimulating hormone from the hypothalamus stimulates thyroid hormone secretion
C. Thyroid hormone is stored bound to thyroglobulin in the colloid of thyroid
D. Once released into the blood stream, thyroid hormone typically binds to thyroxine binding globulin
E. None of the above
23. Which is correct regarding parathyroid hormone (PTH)?
A. Chief cells secrete PTH when blood Ca+2 levels are high
B. PTH acts on osteoblasts to degrade bone matrix
C. PTH leads to the production of active vitamin D
D. PTH inhibits calbindin
E. PTH inhibits the kidneys to reduce blood levels of Ca+2
24. Which hormone regulates prolactin secretion?
A. Prolactin
B. Dopamine
C. Thyrotropin releasing hormone
D. All of the above
E. None of the above
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25. Which is the correct statement regarding catecholamines?
A. Dopamine is produced from epinephrine
B. They are produced by chief cells in the adrenal cortex
C. Epinephrine stimulates glycogenolysis and lipolysis
D. They stimulate pupil constriction
E. Epinephrine reduces heart rate and cardiac contractility
26. The zona fasciculata secretes which hormone?
A. Cortisol
B. Mineralocorticoids
C. Androgens
D. Aldosterone
E. Progesterone
27. Which is true regarding Cortisol?
A. Its secretion is negatively regulated by ACTH
B. It travels in the blood stream in free form
C. It is a peptide hormone
D. Its levels are highest in the morning and lowest at night
E. None of the above
28. Where is aldosterone produced?
A. Adrenal medulla
B. Zona Glomerulosa
C. Zona Reticularis
D. Zona Fasiculata
E. Sertoli Cells
29. What stimulates aldosterone secretion?
A. Reduced plasma volume
B. Reduced renal perfusion pressure
C. Renin-angiotensin system
D. Increased plasma potassium
E. All of the above
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30. Which hormone is produced by the alpha cells of the pancreas?
A. Somatostatin
B. Insulin
C. Glucagon
D. Glycogen
E. Inhibin
31. Which is true regarding insulin?
A. It is released by diffusion
B. Increased glucose levels stimulate insulin secretion
C. Fasting stimulates insulin secretion
D. Insulin inhibits glycogen storage
E. None of the above
32. Which is true regarding gonad hormone regulation or secretion?
A. Leydig cells secret Inhibin
B. The hypothalamus secretes gonadotrophin releasing hormone to inhibit the anterior pituitary gland
production of luteinizing hormone
C. High levels of estradiol stimulate the anterior pituitary to release follicle stimulating hormone
D. Estrogen causes a rise in temperature after ovulation
E. None of the above
Dr. Burns’ Questions on Respiratory System Physiology and Pathology
33. Which of the following statements is true regarding the Type II pneumocyte?
A. It is a squamous epithelial cell
B. It secretes surfactant
C. It accounts for 95% of the alveolar surface
D. Its primary function is gas exchange
E. It forms the epithelium lining the visceral pleura
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34. The apneustic center
A. Activates the dorsal respiratory neurons of the medulla
B. Activates the ventral respiratory neurons of the medulla
C. Inhibits the dorsal respiratory neurons of the medulla
D. Inhibits the ventral respiratory neurons of the medulla
E. Inhibits the pneumotaxic center of the medulla
35. The pH of blood will be approximately 7.4 as long as the ratio of bicarbonate to CO2 is:
A. 1:1
B. 1:10
C. 10:1
D. 20:1
E. 1:20
36. In order for the lungs to function normally, the intrapleural pressure must
A. Be more negative than alveolar pressure
B. Be more positive than alveolar pressure
C. Be the same as atmospheric pressure
D. Alternate between being less than and greater than alveolar pressure
E. Alternate between being less than and greater than atmospheric pressure
37. Air is comprised of various gases including oxygen, nitrogen and carbon dioxide. The relative
proportions of these three gases in dry air is best expressed as:
A. Nitrogen > carbon dioxide >.oxygen
B. Nitrogen > oxygen > carbon dioxide
C. Oxygen > nitrogen > carbon dioxide
D. Oxygen > carbon dioxide > nitrogen
E. Carbon dioxide > oxygen > nitrogen
38. The respiratory system can be subdivided into a conducting zone and a respiratory zone. Which of
the following best describes the conducting zone:
A. Nose and mouth
B. Nose, mouth, pharynx, and larynx
C. Trachea, bronchi, and bronchioles
D. Nose, mouth, pharynx, larynx, trachea, bronchi, bronchioles and terminal bronchioles
E. Trachea, bronchi, bronchioles, and terminal bronchioles
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39. Dry air has a total pressure of 760 mmHg. The partial pressure of oxygen in dry air is 160 mmHg.
As we inhale the dry air it is warmed and moistened such that tracheal air has a measured water vapor
pressure of 47mmHg. According to Dalton’s Law, the partial pressure of oxygen in the tracheal air will
be:
A. Unchanged
B. 150 mmHg
C. 113 mmHg
D. 207 mmHg
E. 47 mmHg
40. If the Tidal volume = 500 ml, Physiologic dead space = 150 ml and Breaths/min = 12 bpm. The
calculated Alveolar Ventilation (VA) is:
A. 5.25 L/min
B. 4.20 L/min
C. 7.80 L/min
D. 6.00 L/min
E. 5.85 L/min
41. Which statement is not correct about emphysema?
A. Patients are referred to as “pink puffers”
B. Patients are barrel chested
C. It can co-exist with chronic bronchitis
D. Sometimes, replacement enzyme therapy is an appropriate therapy
E. Patients typically exhibit signs of cyanosis
42. The four stages of lobar pneumonia occur in the following order:
A. Congestion – resolution – grey hepatization – red hepatitzation
B. Red hepatization – grey hepatization – resolution - consolidation
C. Congestion – red hepatization – grey hepatization – resolution
D. Red hepatization – congestion- grey hepatization – resolution
E. None of the above
43. A purulent nasal discharge associated with an upper respiratory infection (URI) most likely suggests
the patient has:
A. A viral infection
B. An allergy
C. A bacterial infection
D. Malaise
E. Kartagener’s syndrome
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44. Asthma triggered by an extrinsic antigen (e.g., pollen) involves:
A. Type I hypersensitivity
B. Type II hypersensitivity
C. Type III hypersensitivity
D. Type IV hypersensitivity
E. Type V hypersensitivity
45. Which patient characteristic is not a feature of emphysema:
A. Progressive dyspnea
B. Barrel chest
C. Cyanosis
D. Over inflated lungs
E. A history of tobacco smoking
46. Which statement is false regarding atypical pneumonia?
A. The alveolar wall becomes inflamed
B. The causative agent may involve mycoplasma
C. The causative agent may involve viruses
D. The causative agent may involve mycobacteria
E. Lung consolidation is not observed
47. Which statement is false regarding tuberculosis (TB)?
A. Primary TB occurs in someone not previously exposed to the tubercle bacillus
B. The term “Ghon complex” implies the presence of multiple lung lesions
C. Secondary TB is preceded by primary TB
D. Miliary TB involves the spread of tubercle bacilli to distant organs
E. 90% of patients with primary TB heal and recover
48. Which of the following statements is true:
A. Pulmonary neoplasms rarely metastasize
B. Small cell lung carcinoma (SCLC) is not associated with cigarette smoke exposure
C. Most pulmonary neoplasms arise from bronchial epithelial cells
D. The TNM and Staging Systems are used to characterize SCLC
E. The 5 year survival rate is better for SCLC than non-SCLC neoplasms
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Dr. Redfern’s Questions on Pituitary, Adrenal and Endocrine Pathology
49. Which of the following is/are true regarding endocrine pathology?
A. Prolonged hyperstimulation of the gland can lead to hyperfunction and enlargement
B. Neoplastic tumors can lead to hyperfunction of the gland
C. Mass effect can occur when large tumors impinge on endocrine cells and prevent hormone secretion
D. Endocrine symptoms may result from tumors of non-endocrine glands
E. All of the above
50. Which is/are true regarding a prolactin secreting tumor?
A. It can cause galactorrhea
B. It often increases libido
C. It can stimulate gonadotrophin releasing hormone
D. They occur most frequently in men
E. All of the above
51. A 7 yr old prepubescent girl develops a hyperfunctioning adenoma of the anterior pituitary
somatotrophs, which disease is she likely to develop?
A. Gigantism
B. Diabetes Insipidus
C. Cushing’s syndrome
D. Addison’s Disease
E. Acromegaly
52. Which is/are true regarding acromegaly?
A. Patients often have hypoglycemia
B. Patients often have hypotension
C. Surgical removal of the tumor can cause regression of bone changes
D. Patients may have a bitemporal hemianopsia
E. All of the above
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53. In diabetes insipidus, which of the following is true?
A. Insulin levels produced by the pancreas are reduced
B. Patients have increased levels of ADH
C. Patients have reduced blood volume and pressure
D. Patients often report reduced urination
E. None of the above
54. Your patient presents to the clinic with calcification of the cornea, what other signs might they also
have?
A. Kidney stones
B. Muscle weakness
C. Heart conduction defects
D. Elevated levels of parathyroid hormone
E. All of the above
55. Which of the following is correct regarding testing for determining if your patient has Cushing’s
Syndrome?
A. Low blood levels of cortisol after an overnight treatment with dexamethasone indicates Cushing’s
B. High levels of ACTH after treatment with dexamethasone is suggestive of adrenal Cushing’s
C. Low levels of ACTH after treatment with dexamethasone is suggestive of pituitary Cushing’s
syndrome
D. High levels of ACTH after treatment with dexamethasone is suggestive of Ectopic ACTH tumor
E. None of the above
56. Which of the following is correct regarding adrenal gland pathology?
A. Carcinomas of the zona fasiculata can result in androgenital or virilizing syndrome
B. Patients with Addison’s disease often present with hyperpigmentation from increased production of
melanocyte-stimulating hormone
C. Neoplastic chromaffin cells can result in pheochromocytomas that lead to reduced epinephrine
production
D. Neuroblastomas are the most common tumor in adults
E. None of the above
Please continue on the next page..
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Dr. Frishman’s Questions on Shock and CV Pathology
57. An adult male who weighs 70 Kg has about ___ liters of plasma
A. 28
B. 14
C. 7
D. 3.5
E. 2.5
58. Which of the following is/are examples of passive hyperemia?
A. Blushing
B. Increased blood inflow to muscles due to exercise
C. Congestion of lungs caused by increased venous back pressure
D. Choices A and B
E. Choices A, B and C
59. A massive acute hemorrhage of ___________ is (generally) lethal.
A. 250 mL
B. 500 mL
C. 750 mL
D. 1000 mL
E. 1500 mL
60. Heart failure cells are
A. Necrotic left ventricular muscle cells
B. Intra-alveolar macrophages containing hemosiderin
C. Hemolyzed red blood cells
D. Dying alveolar epithelial cells
E. Leukocytes that accumulate in heart and lung
61. All of the following pathogenic factors favor edema EXCEPT:
A. Increased venous pressure
B. Increased permeability of vessel walls
C. Increased oncotic pressure of the plasma
D. Obstruction of lymphatics
E. Retention of sodium and water
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62. Due to injury endothelial cells may
A. Lose their negative charge
B. Release von Willebrand factor
C. Secrete thromboxane A2
D. Choices A and B
E. Choices A, B, and C
63. Following a severe hemorrhage that leads to shock, what early compensatory mechanism(s) are
activated?
A. Reflex peripheral vasodilation
B. Reflex parasympathetic stimulation leading to bradycardia
C. Reduced urine output
D. Choices A and B
E. Choices A, B, and C
64. All of the following are major disorders associated with disseminated intravascular coagulation
(DIC) EXCEPT
A. Gram-negative sepsis
B. Massive tissue injury due to widespread burns
C. Obstetric complications such as toxemia
D. Nephrotic syndrome
E. Neoplasia, e.g. carcinoma of the pancreas
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Key General Pathology MT-I REVIEW
1. B
2. D
3. D
4. D
5. D
6. A
7. D
8. D
9. E
10. C
11. A
12. E
13. E
14. E
15. C
16. C
17. C
18. D
19. A
20. E
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
B
B
C
D
C
A
D
B
E
C
B
C
B
A
D
A
B
D
B
B
41. E
42. C
43. C
44. A
45. C
46. D
47. B
48. C
49. E
50. A
51. A
52. D
53. C
54. E
55. D
56. B
57. D
58. C
59. E
60. B
61. C
62. D
63. C
64. D
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