5 Written Questions

1. Sx: Slightly high heart rate. Bloating, trouble concentrating, irritable.
   
   Patho: fluctuating estrogen and progesterone levels interact with serotonin, nor-adrenaline, and gamma-aminobutyric acid (GABA). Renin-angiotensin aldosterone system contributes to weight gain. Also hereditary.
2. Sx: Norma vitals, Decreased urinary stream, high fat diet
   
   Patho: Normal PSA but enlarged prostate. Differentiated but oddly shaped cancer cells. Oxidative stress ultimately genetically damages the cells.
3. Sx: High BP, diaphoresis, tachycardia episodes, episodic chest pain.
   
   Patho: acute coronary syndrome that leads to reversible myocardial ischemia. Atherosclerotic plaque leads to periodic episodes of thrombotic vessel occlusion and vasoconstriction at the site of plaque damage.
4. Sx: Normal vitals, but no breast development and short. Lack of menstrual cycle.
   
   Patho: Compartment III disorder of the anterior pituitary. Low LH, FSH and estrogen.
5. Sx: dizziness and blurred vision when standing up.
   
   Patho: physical exhaustion, starvation due to fasting, and probable drug action from antidepressants can cause this. More common in older people. Baroreceptors are sluggish therefore BP maintenance is delayed.

5 Matching Questions

1. Polycystic Ovary Syndrome
2. Disseminated Intravascular Coagulation
3. Hodgkin Lymphoma
4. Rheumatic Fever
5. Acute Lymphocytic Leukemia (ALL)

1. a Sx: Normal vitals, but unable to get pregnant, facial hair, and acne.
   
   Patho: Increased androgen and insulin levels. Increased ovary size. More androgen means more follicle growth. More insulin inhibits apoptosis.
2. b Sx: B symptoms, high body temperature, pruritis, swelling on neck
   
   Patho: Reed-Sternberg cells are present in lymph nodes. B-cell originated
3. c Sx: skin discoloration, petechiae and ecchymosis, enlarged lymph nodes, abdominal swelling, difficulty swallowing, fatigue
   
   Patho: transformed precursor B-cells, mostly in children
4. d Sx: SOB, nose bleeds, vomiting, rash, pain in stomach and joints.
   
   Patho: throat culture done to see if she was positive for the group A beta-hemolytic streptococci. Antibodies directed against the M proteins of the streptococci cross reacts with tissue glycoproteins in the heart, joints, CNS, and skin. It causes an abnormal humoral and cell-mediated immune response and the antigens can bind to receptors on cells in the heart, muscle, brain, and synovial joints. Inflammatory lesions will develop in the connective tissues. Overall heart valves will be damaged.
5. e Sx: hypoxia, tachypnea, excessive bleeding from the gums and nose, dizzy
   
   Patho: gram-negative endotoxins from bacterial infection, coagulation cascade decreases availability of platelets in blood, severe bleeding can occur,

5 Multiple Choice Questions

1. Sx: Vaginal bleeding, pain in abdomen and legs. Dyspepsia and vomiting.
   
   Patho: "Silent Killer", No known cause, Inflamed ovaries shown in the MRI. Epithelial form of this cancer is in adults, Germ-cell neoplasm is in children/adolescents.
   1. Rheumatic Fever
   2. Testicular cancer
   3. Prostate Cancer
   4. Ovarian Cancer
2. Sx: Swollen lymph nodes. Enlarged testicle. Difficulty swallowing, back/abdominal pain, trouble seeing.
   
   Patho: Increased tumor markers and mass in testicle. Idiopathic. 90% germ-cell. Two types: seminomas(common and not aggressive) and nonseminomas (rare and aggressive) .Risks are genetic predisposition, cryptochordism, and Kleinfeldter's syndrome.
   1. Prostate Cancer
   2. Ovarian Cancer
   3. Testicular cancer
   4. Stable Angina
3. Sx: Normal vitals, burning sensation in feet, headaches, numbness, dizziness, paresthesias
   
   Patho: Elevated platelet count from CBC, hyperplasia in megakaryocyte progenitor cells in the bone marrow, thrombosis can occur.
   1. Hemolytic Anemia
   2. Thrombocytopenia
   3. Thrombocythemia
   4. Thalassemia
4. Sx: lymph node swelling, difficulty swallowing, B symptoms, pyrexia and pharyngitis.
   
   Patho: Epstein-Barr virus (EBV), 50% lymphocytes and 10% of atypical lymphocytes in blood, aka 'kissing disease.
   1. Aortic Stenosis
   2. Testicular cancer
   3. Pernicious Anemia
   4. Infectious mononucleosis
5. Sx: Normal vitals, fatigue, weight loss, rib pain, headache followed by blurred vision.
   
   Patho: Increased M protein, Bence Jones protein, malignant plasma cells, osteoclasts are stimulated and cause hypercalcemia and bone lesions.
   1. Multiple Myeloma
   2. Aortic Stenosis
   3. Unstable Angina
   4. Stable Angina

5 True/False Questions

1. Aplastic anemia (Parvovirus B19) → Sx: flu-like symptoms, fever, pale, reddish-brown urine, URI, pronounced facial structures
   
   Patho: IgG autoantibodies against the P blood group antigen in colder portions of the body, like fingers and toes. Cells are destroyed as erythrocyte recirculate and enzymes of the complement cascade are activated.

   True        False

2. Thalassemia → Sx: Lower back pain, stomach pain
   
   Patho: Smoking/ nicotine/high fat can coat and clog the artery walls with plaque causing atherosclerosis

   True        False

3. Hemolytic Anemia → Sx: fatigue, mood swings, stomach pain. Bright yellow skin.
   
   Patho: Low vitamin B12 means less intrinsic factor, This leads to gastric atrophy.

   True        False

4. Non-Hodgkin Lymphoma → Sx: leg swelling, swollen femoral lymph nodes, back pain
   
   Patho: mutation on the proto-oncogenes and tumor suppressor genes can occur in B or T cells, natural killer cells and rarely macrophages.

   True        False

5. Pericardial Effusion → Sx: Dull chest pain, muffled heart sounds, poor and palpable pulse rate, and dyspnea on exertion. Distention of the jugular veins, edema, and hepatomegaly.
   
   Patho: Effusion with high fluid levels indicates pericardial inflammation This high pressure can cause tamponade.The pressure exerted by the pericardial fluid will eventually equal the diastolic pressure within the heart chambers, preventing right atrial filling.

   True        False