vickimed
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Posts: 8
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1. A 74 yr old man has a cough. On auscultation of the right posterior chest, the patient’s spoken “ee” sounds more like “ay”. Which of the following conditions on the right is most likely:
A. Bronchopleural Fistula
B. Lower lobe consolidation
C. Midde lobe atelectasis
D. Pleural effusion
E. Pleural plaque
F. Pneumothorax
G. Sequestration
2. A homeless 38 yr-old man has a 3-month history of decreased appetite, generalized wasting, a low-grade fever, and worsening cough productive of blood, mucopurulent sputum. He has a 3-yr history of alcohol abuse. X-ray films of the chest show consolidation and cavitary lesions in the apices of the lungs. Which of the following is the most likely inflammatory and/or immune response in the lung?
A. Endothelial cell proliferation, vascular budding, fibroblasts
B. Epithelioid cells, multinucleated giant cells, caseation necrosis
C. Fibroblasts, Collagen deposition, replacement of intrinsic tissue
D. Macrophages, lymphocytes, hypergammaglobulinenia
E. Neutrophils, vascular congestion, exudate
3. After taking an overdose of propranolol, a 35 yr old woman developes sinus bradycardia and syncope. In order to stimulate the same second messenger system that is activated by β-adrenergic receptors, which of the following drugs will be most effective to increase her heart rate?
A. ADH (Vasopressin)
B. Atrial Natriuretic peptide
C. Clonidine
D. Glucagon
E. Phenylephrine
4. Mutations in the cystic fibrosis trans-membrane conductance regulator (CFTR) protein alter which of the following ion transport mechanisms?
A. Ca2+ activated Cl- secretion
B. Ca2+ activated Cl- uptake
C. Cyclic AMP(cAMP)-stimulated Cl- secretion
D. cAMP- stimulated Na+ secretion
E. cAMP- stimulated Na+ uptake
5. A clone of cancer cells is resistant to vincristine, doxorubicin, and dactinomycin but not to methotrexate and various alkylating agents.
The mechanism of resistance is most likely to involve;
A. Absence of superoxide dismutase
B. Altered DNA Polymerase
C. Enhanced drug transport out of the cell
D. Inability to form polyglutamates
E. Increased DNase
6. The genotype of the cells of the chorionic villi that comprise the human placenta is
A. Fetal
B. Maternal
C. Maternal and fetal
D. paternal
Thanks and Good luck to All.
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| skyhigh
Forum Guru
Topics: 105
Posts: 561
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i think
C, E, D, C, B, B.
Must rethink about 1 and 3
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| doc179
Forum Guru
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2) E
3) D
4) C
6) A
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| skyhigh
Forum Guru
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Posts: 561
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oops, 6 is A(fetal)
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| lalitha
Forum Junior
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1. b 2. b 3. d 4. ? 5.c 6. a
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| skyhigh
Forum Guru
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Posts: 561
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isn't #2 referring to abcess formation, hence E?
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| vickimed
Forum Newbie
Topics: 5
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skyhigh,
Could you please expalin question5?
Why question 1 is C, not B? Thanks.
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| doc179
Forum Guru
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Posts: 1,217
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yes its abcess formation so it must be E
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| robin082006
Forum Hero
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I Agree with other answers, but for q5 I go with C
5. A clone of cancer cells is resistant to vincristine, doxorubicin, and dactinomycin but not to methotrexate and various alkylating agents.
The mechanism of resistance is most likely to involve;
A. Absence of superoxide dismutase
B. Altered DNA Polymerase
C. Enhanced drug transport out of the cell
D. Inability to form polyglutamates
E. Increased DNase
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The Key to Succeed is Patience.
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| skyhigh
Forum Guru
Topics: 105
Posts: 561
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ok #1 has to be B, i checked Goljan's note. It's typical pneumonia, so lower lobe consolidation.
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| skyhigh
Forum Guru
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Posts: 561
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Q5. Dactinomycin and doxirubicin inhibit DNA and RNA Synthesis. So, altered DNA Polymerase could lead to resistance. I might be wrong.
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| robin082006
Forum Hero
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How do you explain Vincristine skyhigh? (acts on M phase)
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The Key to Succeed is Patience.
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| chazan
Forum Senior
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Posts: 53
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Vincristine works by blocking polymerization of microtubles...so i think the answer is B
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| druas
Forum Elite
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Posts: 339
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1.b, 2.E, 3.D..4..C, 5,b(got confused b/w b and e),
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| paba
Forum Senior
Topics: 15
Posts: 57
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why Q2 is not B
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| ManuNastai
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hi. question 6 has been already discussed, so I don't get it why do people respond anything else but A (it's fetal)
at question 2, that's a tipical Pulmonary (very probable secondary) TB which has spread through the bronchi, so th answer is B
C, in think wants to be some kind of pathological process that forms a scar (maybe a Scarred TB lesion) so it's not the case here
A, I think is a Pulmonary Neoplasm. It's not the case here even if the lesions could be cavitary after a bacterial infection and elimimination of neo cells in the bronchi.but the lesions are bilateral (unusual), at the apices (it's more often located near the hilus), there is no limfadenopathy in the hilus.
D, I don't know what it is
E, it's an abcess. It couldn't be because usually is not located at the apex. In drunks, they develop abcesses after they fall in some ditches, drunk, in a coma and they aspire their secretions. So, abcesses are located at the bases of the lungs, usually right lung. And also, abcesses go with high fever untill they eliminate their content
B, is TB. It could be Secondary TB (bilateral) but the sputum is purulent and you don't have pus in TB. But, it could be an suprainfection with Staph or whatever that could determin the formation of pus. I think is a Pulm TB which has eliminated it's caseum and has suprainfected so I'll go with E
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| ManuNastai
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sorry, I changed my mind while I was writting the post  and I forgot to erase my first choice. My final answer is E 
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| yasmeen
Forum Guru
Topics: 68
Posts: 940
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hay 1 is b lower lobe lies on back.q 2 is b its t.b cavities in apices which has evolved into bronchiectasis .q3 is d .q4 is c .q5 maybe b. and 6 is c as placenta has both fetal and maternal component
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| doc179
Forum Guru
Topics: 67
Posts: 1,217
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yasmeen the Q asks the genotype of chorionic villi in the placenta...not the whole placenta
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| ManuNastai
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hi, I know that this thread should be closed by now, but does somebody consider that 2nd question to be a pneumonia with klebsiella? goljan says that it goes with cavities, bloody sputum, high fever, all that.. in alcoholics 
just asking..
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| yasmeen
Forum Guru
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three month history plus low grade fever . i,ll go with t.b
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| ManuNastai
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yes you're right
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| linaorvos
Forum Elite
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Posts: 258
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so the 2nd Q is B??
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| ManuNastai
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E
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| jagian75
Forum Newbie
Topics: 3
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in katzung for vincristine the resistance mech is enhanced drug transport out of the cell.
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