BMED 3101 and 4295

a 32 year-old man experiences "heartburn" and gastric reflux after eating a meal. After many months of symptoms, he undergoes upper GI endoscopy, biopsy specimen of the esophageal epithelium is obtained. which of the following changes has most likely occurred?

Metaplasia

Stimuli causing cellular injury do so by which of the following mechanism:

All of the above

A 4 year old boy has a broken arm. After his cast is removed 6 weeks later, his healing arm is markedly smaller than his normal arm. The mechanism of atrophy in this case is:

Disuse atrophy

Which of the following accurately defines cellular adaptation?

Development of a new, altered steady state

A 16-year old boy sustained blunt trauma to the abdomen when the vehicle he was driving struck a bridge abutment at high speed. Peritoneal lavage shows a hemoperitoneum, and at laparotomy, a small portion of the left lobe of the liver is removed because of the injury. Several weeks later, a CT scan of the abdomen shows that the liver has nearly regained its size before the injury. which of the following processes best explains this CT scan finding?

Hyperplasia

On a routine visit to the doctor, an otherwise healthy 51 year-old man has a blood pressure of 150/95. If his hypertension remains untreated for years, which of the following cellular alterations would most likely be seen in his myocardium?

Hhypertrophy

A 10 yo black man with a known history of Sickle cell disease presents to the ER complaining of left upper quadrant pain suggestive of a splenic infarct. Microscopic examination of the spleen would most likely reveal?

Coagulative necrosis

a 69-year old man has had difficulty with urination, including hesitancy and frequency, for the past 5 years. A digital rectal examination reveals that the prostate gland is palpably enlarged to about twice normal size. A transurethral resection of the prostate is performed, and the microscopic sample obtained is that of nodules of glands. which of the following pathologic processes has most likely occurred in the prostate

Hyperplasia

On day 28 of her menstrual cycle, a 23-year-old woman

experiences onset of menstrual bleeding that lasts for 6 days. She

has had regular cycles since menarche. Which of the following

processes most likely occurs in her endometrial cells to initiate

the onset of menstrual bleeding?

Apoptosis

Which of the following is not considered an adaptive response?

Dysplasia

Which is the only leukocyte that, after entering the connective tissue from the bloodstream, can re-enter the bloodstream?

Lymphocytes

What are the cardinal signs of inflammation?

calor, rubor, tumor, dolor, functio laesa

What is the first response of arterioles to injury?

vasoconstriction

a 50-year-old man has experienced midabdominal pain for several weeks. he is afebrile. there is mild upper abdominal tenderness on palpation, and bowel sounds are present. Stool is positive for accult blood. An upper GI endoscopy is performed, and biopsy specimens are taken. The figure shows microscopic examination of a biopsy specimen of a gastric region. which of the following best describes this lesion?

Ulceration

What are the different types of Acute inflammation?

Serous, fibrinous, purulent, and ulcerative

A woman who is allergic to cats visits a neighbor who has several cats. During the visit, she inhales cat dander, and within minutes, she develops nasal congestion with abundant nasal secretions. Which of the following substances is most likely to produce these findings?

Histamine

a 5-year-old child reaches up to the stove and touches a pot of boiling water. Within several hours, there is a marked erythema of the skin of the fingers on the child's right hand, and smaller blisters appear on the finger pads. which of the following best describes this process?

Serous inflammation

All of the following conditions are examples of Granulomatous inflammation except:

Pericarditis

The process by which the cytoplasm of the PMN surrounds the bacteria and encloses it into an invagination of the cell membrane is known as what?

phagocytosis

What is the name for the protein-rich extravascular fluid produced in inflammation?

Exudate

Every Spring time, a young healthy man is bothered by episodes of nasal congestion accompanied by sneezing and watery eyes. He has no cough. On physical examination he is febrile. There is swelling of his nasal passageways, but no other findings. His condition improves with use of loratadine. His problems are most likely produced by the release of chemical mediators from which of the following cell types?

Mast cells

Within minutes after a bee sting, a 15 year old girl suddenly has difficulty breathing. There is a marked urticaria and marked edema of the hand that has stung. Which of the following is the best pharmacologic agent to treat these signs and symptoms?

Epinephrine

A 28 yo woman is given intravenous penicillin to treat infective endocarditis. Within minutes of starting this therapy, she begins to have severe difficulty breathing with respiratory stridor and tachypnea. She suddenly develops an erythematous skin rash over most of her body. Her symptoms are most likely to be produced by release of which of the following chemical mediators?

Histamine

a 48 yo man has a chronic cough with fever for 2 months. On PE his temperature at 37.90C. A chest X-ray reveals a diffuse bilateral reticulonodular pattern. A transbronchial biopsy is performed and microscopic examination shows focal areas of inflammation containing epitheliod macrophages, Langhans giant cells, and lymphocytes. These findings are most typical of which of the following immunologic responses?

Type IV hypersensitivity

The type of immunity that develops as a result of natural exposure to an antigen in the environment is

Naturally acquired active immunity

Newborn infants gain most of their immunity from

antibodies passed from the mother across the placenta

The secondary pregnancy of a 23 year old woman appears uncomplicated until ultrasound performed at 19 weeks shows hydrops fetalis. The fetal organ development is consistent for 19 weeks, and no congenital anomalies are noted. Her first pregnancy was uncomplicated and resulted in the birth of a normal girl at term. The current pregnancy ends with a birth of a baby boy at 32 weeks gestation. On examination the baby has marked icterus. Laboratory studies show a hemoglibin of 7.5 g/dL, and nenonatal exchange transfusion is performed. Which of the following immunologic mechanism best explains this infant's findings?

Type II hypersensitivity

A 9 year old boy has a sore throat. A throat culture grows group A hemolytic Streptococcus. He receives antibiotic therapy. However, 17 days later he developed dark-colored urine. Lab studies show 3+ blood urinalysis. A renal biopsy is performed. On immunofluorescence staining the biopsy shows granular deposition of IgG and complement around glomerular capillary loops. Which of the following immune hypersensitivity mechanisms is most likely responsible for this pattern of findings?

Type III hypersensitivity

A 15-year-old healthy girl with no major medical problems notes blotchy areas of erythema that are pruritic over the skin of her arms, legs, and trunk within an hour every time she eats seafood, followed by diarrhea. These problems abate within 3 hours, and then physical examination reveals no abnormal findings. Which of the following immunologic abnormalities is she most likely to have?

Type I hypersensitivity

Twelve hours after going on a hike through dense foliage, a 40 yo man notices a slightly raised and tender irregular reddish rash on one forearm that was not covered with clothing. This rash gradually increases in integrity for 2 days and then fades away after two weeks. Which of the following forms of immunologic hypersensitivity is most likely demonstrated in this palert?

Type IV hypersensitivity

A(n) ___ occurs when an infectious agent enters the body and begins to reproduce may or may not lead to disease

Infection

Prions are responsible for the development of all of the following clinical conditions, except

Mononucleosis

Bacilli are

rod shaped

Ascariasis is an example of disease caused by

helminths

Are re-emerging diseases a health problem?

Yes, for significant portion of the population

_____ transmission occurs when the unborn child acquires a pathogen from an infected mother

Vertical

What is a pandemic disease?

The rapid spread of disease across the world

Which type of microorganism are most pathogenic?

Viruses

A 20 year old man who has multiple sexual partners and does not use barrier protections comes to the physician complaining of a nontender ulcer on the penis that has been present for one week. On Pe, the 0.6 cm lesion has a firm, erythematous base and sharply demarcated borders. The lesion is scraped, and darkfield examination is positive for spirochetes consistent with Treponema pallium. Which of the following is most likely to be seen microscopically in the specimen?

Granulomatous inflammation

What is a "superbug"?

Bacteria that are resistant to most antibiotics.

While attending a party, a 19 year old university student drinks 2L of mixed alcoholic beverages containing 50% ethanol by volume over 30 minutes. He usually does not drink much alcohol. His major use of drugs consist of acetaminophen for headaches. Which of the following complications is most likely to occur?

coma and death

A case-control study to identify long-term effects of hormone replacement therapy (HRT) in postmenopausal women receiving exogenous estrogens coupled with progestins compared with a control group not receiving this therapy. The medical records of the women who received HRT have a decreased incidence of osteoporosis and its complication, but an increased risk of breast carcinoma. Which of the following conditions, in addition to these findings, is most likely to be observed in the women receiving HRT?

thromboembolism

During a qualifying match for World Cup, the goalkeeper is hit in the chest by a soccer ball kicked from 10m away. He stays in the game. Which of the following injury patterns is most likely to be seen over the chest of the goalkeeper?

Contusion

A 20 year old star football player suddenly collapses during practice and has a cardiac arrest and cannot be resuscitated. The medical examiner is called to investigate this sudden death. At autopsy, there is marked coronary atherosclerosis and histologic evidence of hypertension in the renal blood vessels. Use of which of the following substances is most likely to contribute to these findings?

Cocaine

A clinical trial involves patients with a diagnosis of cancer who have intractable nausea as a result of chemotherapy: The patients are divided into two groups : one group is given a placebo, and one group is given a drug, the group receiving the drug is found to have reduced self-reported nausea and diminished weight loss compared with the placebo group. The patients receiving the drug seem to have no major adverse side effects. Of the following agents, classified as drugs of abuse in parts of the world, which is most likely to have the beneficial effects in this study?

Marijuana

A 50 year old man with a history of chronic alcoholism has had an increasing congestive heart failure for the past year. For the past month, he has experienced increasing confusion, disorientation, and difficulty ambulating. Physical examination shows nystagmus, ataxia of gait, and decreased sensation in the lower extremities. Laboratory studies show hemoglobin, 13.1 g/dL; hematocrit, 39.3%, MCV, 90um3; platelet count 269,300/mm3; and WBC count 7120/mm3. A long-term dietary deficiency of which of the following nutrients is most likely to produce these findings?

Thiamine

For the past 3 years, a 72 year old man has noticed a gradually enlarging nodule on the right lower eyelid. On physical ecxamination, the 0.8-cm nodule is firm and has a smaller central area of ulceration. The nodule is excised, and plastic repair to the eyelid is performed. which of the following forms of electromagnetic radiation most likely played the greatest role in the development of this lesion?

UV rays

An epidemiologic study observes increased numbers of respiratory tract infections among children living in a community in which most families are at the poverty level. The infectious agents include Streptococcus pneumonia, Haemophilus influenza, and Klebsiella pneumoniae. Most of the children have had penumonitis and rubeola infection. The study documents increased rawtes of keratomalacia, urinary tract calcali, and generalized papular dematosis in these children. The children are most likely to have deficiency of which of the following to have a deficiency of which of the following vitamins?

Vitamin A

A 20-year-old man is trying to repair an old electrical appliance in his garage. While testing the function of the appliance, his right hand comes in contact with a frayed electrical cord carrying 120-V, 10-amp alternating current. which of the following is most likely to develop as a consequence of this electrical injury?

Ventricular fibrillation

Histological grading depends on the _____ and number of proliferative cells.

Anaplasia

What does TNM stand for?

tumor size, lymph nodes, metastasis

A report came back with anaplasia, pleomorphism, and multiple mitosis. what can we assume?

Malignancy

What does pleomorphism mean?

Different size and shape

A 50 year old woman was found to have cervical cancer, she has a history of being a sex worker for 10 years. she has glucose levels of 150. what is most likely the cause?

HPV

A patient has a small dark spot on the skin that has not changes in shape of size since it started. what is most likely the cause?

UV radiation

Which is most likely to be malignant?

Ulcerative Colitis

Patient had a tumor that has an envelope and has not grown on top of the uterus, what would be the cancer?

Leimyoma

What would most likely be an indicator of malignancy?

Invasion

TNM score....

M1 ending.

A 55 year old woman has been steadily gaining weight for the () years. The medical history includes a cholecystectomy for chole... years ago . she does not smoke. She is now 164 cm (5ft 4in) tall and weighs 126 kg (BMI 47). On physical examination, she has decreased range of motion with pain on movement of the knees. Laboratory studies show a serum glucose level of 176 mg/dL. This patient is at greatest risk of developing which of the following neoplasms?

endometrial carcinoma

A 29-year-old, previously healthy man suddenly collapses at a party where legal and illicit drugs are being used. En route to the hospital, he requires resuscitation with defibrillation to establish a normal cardiac rhythm. His vital signs are temperature, 40°C; respirations, 30/min; heart rate, 110/min; and blood pressure, 175/90 mm Hg. Physical examination shows dilated pupils, a perforated nasal septum, and a prominent callus on the right thumb. CT scan of the head shows an acute right frontal lobe hemorrhage. Which of the following substances detectable in blood and urine is most likely responsible for these findings?

cocaine

A 22-year-old man is brought to the hospital emergency department by a friend, who found him unconscious in his apartment after trying to contact him for 3 days. On arrival, the patient is in a state of respiratory depression. He experiences convulsions for several minutes, followed by cardiac arrest. Advanced cardiac life support measures are instituted, and he is stabilized and intubated. On physical examination, there are needle tracks in the left antecubital fossa, and a loud diastolic heart murmur is audible. The patient has a temperature of 39.2°C. Use of which of the following substances most likely produced these findings?

Heroin

A 7-year-old boy falls off his bicycle while riding down the street at 5 km/hr. The skin of his right calf and right arm scrape along the pavement, and the top layer of epidermis is removed. Which of the following terms best describes this injury?

Abrasion

A 40-year-old man with a family history of colon carcinoma asks the physician how best to reduce his risk of developing this type of cancer. Which of the following dietary practices should he be advised to follow each day?

eat more vegetables

In a study of lifestyle influences on health, investigators observe that sending children outside to play instead of letting them sit for hours in front of the television can have long-term health benefits. Which of the following tissues is most likely to be in better condition by middle age from this lifestyle change?

bones

A 72-year-old man has had increasing dyspnea for the past year. Decreased breath sounds are heard on auscultation of the right side of the chest. A chest radiograph shows a large pleural mass that nearly encases the right lung. A pleural biopsy specimen shows a malignant mesothelioma. Exposure to which of the following is most likely to be associated with these findings?

Asbestos

A 26-year-old woman has had amenorrhea for the past 8 years. She fractured her right wrist 1 year ago after a minor fall to the ground. On physical examination, she is 175 cm (5 ft 7 in) tall and weighs 52 kg (BMI 17). She has normal secondary sex characteristics. There are no abnormal findings. Radiographic measurement of bone density by dual- energy x-ray absorptiometry shows a bone mineral density that is 1.5 standard deviations below the young adult reference range. Laboratory findings include anemia and hypoalbuminemia. Which of the following is the most likely diagnosis?

anorexia nervosa

A 30-year-old woman is found dead in her hotel room 3 hours after firemen extinguish a fire on the floor below.Investigation of the scene shows no signs of fire within her room, and the medical examiner observes no external findings on the body. Which of the following injuries best explains the woman's death?

pulmonary edema