what to do
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6. A 4-year-old girl is brought to the emergency department because of a 5-day history of fever, diffuse abdominal pain, nausea, vomiting, and diarrhea. Examination shows petechiae, hepatomegaly, and splenomegaly. Hemoglobin concentration is 8.7 g/dL and platelet count is 60,000/mm3. A peripheral blood smear shows erythrocyte fragmentation. Which of the following renal findings is most likely to be associated with her condition?
A ) Glomerular crescent formation
B ) IgG-associated glomerular basement membrane antibody
C ) Membranoproliferative glomerulonephritis
D ) Narrowing of the capillary wall by fibrin deposition
E ) Periglomerular granuloma with giant cells
7. A 45-year-old man has a 6-month history of burning pain that begins in the epigastric area and ascends into the chest. Episodes occur most frequently after large meals and at night. Endoscopic examination shows moderately severe inflammation in the distal 3 cm of the esophagus. Which of the following is the most likely cause of this condition?
A ) Diffuse spasm of the esophageal musculature
B ) Failure of the lower esophageal sphincter to relax after a swallow
C ) Helicobacter pylori infection
D ) Hypersecretion of gastric acid
E ) Inappropriate relaxation of the lower esophageal sphincter
8. A 70-year-old woman has increasing weakness, weight loss, generalized lymph node enlargement, and hepatosplenomegaly. Laboratory studies show absolute lymphocytosis with the majority of cells being CD5+. The patient also has a mild antiglobulin-positive hemolytic anemia. Karyotype is normal. Which of the following is the most likely diagnosis?
A ) Acute lymphoblastic leukemia
B ) Acute promyelocytic leukemia
C ) Chronic lymphocytic leukemia
D ) Chronic myeloid leukemia
E ) Fanconi's anemia
F ) Hairy cell leukemia
G ) Myelodysplastic syndrome
H ) Myeloid metaplasia with myelofibrosis
I ) Polycythemia vera
9. Activation of T lymphocytes is initiated when processed antigen binds to the T lymphocyte receptor on the cell membrane, and phospholipase C is activated. This results in production of which of the following components of signal transduction?
A ) Cyclic AMP
B ) Cyclic GMP
C ) Diacylglycerol
D ) Interleukin-2 (IL-2)
11. A 45-year-old woman has an acute coronary occlusion. Within seconds, the ischemic region shows mitochondrial swelling and depletion of glycogen granules. Which of the following metabolic events is the most likely cause of these cellular changes?
A ) Accumulation of free fatty acids
B ) ATP depletion
C ) Degradation of membrane phospholipid
D ) Efflux of K+
E ) Influx of Na+
13. A 50-year-old man has a 10-year history of poorly controlled hypertension. Vital signs are:
Pulse 96/min
Respirations 16/min
Blood pressure
Left arm 226/120 mm Hg
Right arm 218/118 mm Hg
With the patient in the left lateral decubitus position, a late diastolic sound is heard best with the bell at the apex. Which of the following is the most likely explanation for this auscultatory finding?
A ) Aortic insufficiency
B ) Aortic stenosis
C ) Mitral insufficiency
D ) Mitral stenosis
E ) Opening snap
F ) Pulmonic insufficiency
G ) Pulmonic stenosis
H ) S3
I ) S4
J ) Tricuspid insufficiency
15. A 55-year-old man with a long history of poorly controlled hypertension suddenly develops severe retrosternal chest pain that radiates into the upper back between the scapulae. On examination he has diaphoresis and severe shortness of breath. Pulse is 125/min and regular, and blood pressure is 130/60 mm Hg in the left arm and 80/50 mm Hg in the right arm. There are diffuse, wet, inspiratory crackles in both lung fields, distant heart sounds, and a previously undetected grade 2/6, blowing, early diastolic murmur in the second right and third left intercostal spaces adjacent to the sternum. The most likely diagnosis is
A ) dissecting aortic aneurysm
B ) myocardial infarction
C ) pericarditis with tamponade
D ) pulmonary embolism
E ) ruptured chordae tendineae
F ) ventricular septal rupture
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saif
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| hasan82
Topics: 10
Posts: 31
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6.D
7.E
8.C
9.C
11.C
13. I
15.A
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| NE
Forum Guru
Topics: 53
Posts: 504
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11- it is ATP depletion
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd...
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| johnnyu041
Forum Junior
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I agree with NE, the depletion of ATP due to lack of oxygen results in a failure of the Na-K ATPase pump which then leads to accumulation of Na and water inside the cell and hence the cellular swelling
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| what to do
Forum Senior
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thanx, cuzz i went for the silliest answer, reduced Na. it is the start, ATP depletion
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saif
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| laura81
Forum Elite
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at the question 11 they say its C ...Degradation of membrane phospholipid...is that possible?
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| laura81
Forum Elite
Topics: 32
Posts: 175
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can someone explain also the question 6....
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| ryan_cabrera
Forum Newbie
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sounds like she has henoch-schonlein. maybe im wrong.. im just pulling this from the top of my head
anyway this is associated with crescentc GN.
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| Tammy
Forum Newbie
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6.diarrhea---HUS
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