In the vast majority of cases of delayed puberty, the problem is:
A 6-year-old female is showing growth of pubic hair. All other physical characteristics appear normal.
The correct diagnosis would be:
incomplete precocious puberty
A 7-year-old male presents to his physician because of breast enlargement. A CT scan reveals adrenal hyperplasia. What is the most likely diagnosis?
Heterosexual precocious puberty
An I8-year-old female is diagnosed with dysmenorrhea. Which of the following symptoms will she most likely experience?
A 20-year-old female presents with pelvic and back pain severe enough to miss work. She reports that the pain occurs with the onset of menses. Physical examination fails to find pelvic pathology. The most likely cause of her condition is:
A 20-year-old female presents with irregular and heavy bleeding, passage of large clots, and anemia.
She is most likely experiencing:
By definition, dysfunctional uterine bleeding is abnormal uterine bleeding resulting from:
disturbances in menses
A 25-year-old female presents with amenorrhea and hirsutism. She is diagnosed with polycystic ovarian syndrome. Lab testing will most likely reveal:
A 30-year-old female with newly diagnosed polycystic ovarian syndrome is being counseled by her OB-GYN. The physician indicates that this condition often results in:
A 23-year-old sexually active female presents with white copious discharge and itch. She is diagnosed with yeast vaginitis caused by overgrowth of which microorganism?
The descent of the bladder and the anterior vaginal wall into the vaginal canal is called a:
During a routine pelvic exam, a 34-year-old female is found to have an ovarian cyst containing skin, hair, cartilage, and bone. This cyst is classified as a(n):
A 40-year-old female presents with cramping and excessive vaginal bleeding. Ultrasound reveals beni~ uterine tumors in the smooth muscle cells of the myometrium. These tumors are commonly called:
A 35 y/o female is dx with endometriosis. Suppressing which of the following would be the most appropriate medical tx for this dz?
A 21 y/o female is infected with HPV following unprotected sexual ic with a male she recently met. She is now at higher risk of developing which of the following cancers?
A 38-year-old female was recently diagnosed with cancer. She learns that her mother almost miscarried while pregnant with her and was given diethylstilbestrol (DES) to prevent it. Which of the following cancers does she most likely have?
The most commonly occurring cancer of the female reproductive tract is
A 35-year-old female is diagnosed with ovarian cancer. CT scan reveals that the cancer is limited to the ovaries. It would be classified as stage:
An 18-year-old male presents with urethral itching and burning and increased frequency and urgency with urination. He reports recently having unprotected sex with a new partner. What is the most likely cause of his symptoms?
A 30-year-old male presents with penile tenderness and discharge. Physical examination reveals that his foreskin cannot be retracted back over the glans penis. He is suffering from:
An 18-year-old male presents complaining of difficulty having sexual intercourse. He reports that his penis curves during erection. This condition is referred to as:
________ is inflammation of the glans penis.
Cryptorchidism can be defined as:
problems with testicular descent
A 21-year-old male presents with inflammation of the testes. He has a high fever and edema and redn of the testes. Which organism is the most likely the cause of his symptoms?
The risk of testicular cancer is greater for men with a history of:
An important risk factor in the development of benign prostatic hypertrophy (BPH) is:
A middle-aged male speaks to his physician about benign prostatic hypertrophy. He reveals that his father was recently diagnosed with this condition, and he wants to know if he could have it. The physician tells him that a common complaint from men with mild to moderate benign prostatic hypertrophy is:
decrease urinary stream
Symptoms of prostatitis are similar to symptoms of:
is the leading type of ca in men in the US
A 40 y/o male is concerned about the possibility of developing prostate ca. He reports that his father died of prostate ca, and he wants to take all preventative measures. He is told to consume a diet low in:
A 35-year-old nonpregnant female presents complaining of breast discharge. This condition is most likely caused by:
Which of the following signs is usually the first clinical manifestation of breast cancer?
A painless lump
overdevelopment of breast tissue in males
A 35-year-old female presents with infertility and gradual blindness. She reports that she has otherwise been healthy. History reveals that she was promiscuous and had unprotected sexual intercourse several times when she was younger. Which oft he following sexually transmitted infection does she most likely) have?
A 19-year-old female presents with genital warts. Which of the following would cause this condition?
A 25-year-old sexually active female presents with pain during intercourse, dysuria, and spotting. She is diagnosed with trichomoniasis, which is a:
An example of a parasitic sexually transmitted infection that is transmitted through close skin-to-skin contact is:
The incidence of fractures of the pelvis is highest in:
A 65-year-old Hispanic female is admitted to the hospital with a pathologic, compound, oblique fracture of the femur. Which of the following statements best describes this type of fracture?
The fracture line is diagonal to the shaft of the bone
A 70-year-old female with osteoporosis fractures her leg at a location of preexisting abnormality. She reports that the fracture occurred following a minor fall. Which of the following best describes the fracture?
A 32-year-old obese male begins a jogging routine. A week after beginning, he fractures his leg. This fracture is referred to as a ________ fracture.
Transchondral fractures are most prevalent in:
A 35-year-old female suffers a broken clavicle following a motor vehicle accident. X-ray reveals that i bone surfaces in the joint partially lost contact with each other. This condition is called:
A 12-year-old female hurts her ankle while playing basketball. Tests reveal that she tore a ligament. TJ condition is known as a:
A 36-year-old male complains of pain and weakness in the elbow. He reports that he is a warehouse worker and lifts boxes daily. MRI reveals inflammation of the tendon where it attaches to bone. This condition is called:
After the Boston Marathon, seven runners were admitted to local hospitals with suspected myoglobinuria (rhabdomyolysis). What is the most likely cause of myoglobinuria in these athletes?
Excessive muscular atrophy
Which of the following hospital patients is at the highest risk for developing myoglobinuria (rhabdomyolysis )?
Admitted to the hospital for hip surgery and has had problems with anesthesia in the past
A 70-year-old female presents with a hip fracture. She is diagnosed with osteoporosis. This condition is caused by an increase in bone:
A 70-year-old female presents with a hip fracture. She is diagnosed with osteoporosis. One factor that most likely contributed to her condition is:
decreased estrogen levels
A 76-year-old female was diagnosed with osteoporosis by radiologic exam. She is at high risk for:
An 80-year-old male presents with skeletal pain and tenderness, especially in the hips. He is diagnosed with osteomalacia caused by:
inadequate bone mineralization
A 56-year-old male was admitted to the hospital with a diagnosis of osteomalacia. History reveals that he takes anticonvulsants, underwent small bowel resection 3 years earlier, and suffers from chronic pancreatitis. What is the common link between these three factors and the development of osteomalacia?
Vit D deficiency
Although ______ is similar to osteomalacia, it occurs in growing bones of children.
A 35-year-old female presents with impaired motor function, gradual deafness, and visual disturbances. Physical examination reveals asymmetric shape of skull and displaced teeth. X-ray reveals thickened and disorganized bones caused by abnormal and excessive bone remodeling. This condition is referred to as:
The cause of Paget disease is:
unknown at present
A 70-year-old male presents wlback pain, fever, & weight loss. He reports he had a recent respiratory infection from which he thought he recovered. Tests revealed increased WBC count, & a diagnosis of endogenous osteomyelitis was made. The organisms causing this condition entered the bone through:
Noninflammatory joint disease is differentiated from inflammatory joint disease by all of the following factors except:
the presence of pain
A 54-year-old female was recently diagnosed with degenerative joint disease. This condition causes:
degeneration and loss of articular cartilage
A 54-year-old male was recently diagnosed with osteoarthritis. Which of the following symptoms is he most likely experiencing?
Researchers have now determined that rheumatoid arthritis:
is an autoimmune dz
A 34-year-old female was recently diagnosed with rheumatoid arthritis. Physical examination revealed that inflammation started in the:
A 21-year-old female presents with low back pain and stiffness that is alleviated by physical activity.
She was diagnosed with ankylosing spondylitis. Which of the following joints would be most affected?
Vertebral and sacroiliac
A 29-year-old male was recently diagnosed with ankylosing spondylitis. He is interested in obtaining more information about his disease. Patient teaching would include all of the following statements except:
the more common s/s of early dz include restricted joint movement and increased pain after physical activity
Which of the following .Qeople is at highest risk for the development of gout?
Men age 40 to 50
A 46-year-old male presents with severe pain, redness, and tenderness in the right big toe. He was diagnosed with gouty arthritis. The symptoms he experienced are caused by the crystallization of __ within the synovial fluid.
A 46-year-old male presents with severe pain, redness, and tenderness in the right big toe. He was diagnosed with gouty arthritis. He is at risk for developing:
A 51-year-old male experienced severe acute gouty arthritis. Which of the following is the most common trigger for the symptoms?
The final stage of gout, characterized by crystalline deposits in cartilage, synovial membranes, and soft tissue, is called:
A 32-year-old male was injured in a motor vehicle accident and confined to bed for 3 weeks. During this time, the size and strength of muscle fibers decreased, a condition referred to as:
Fibromyalgia is a chronic musculoskeletal disorder characterized by:
diffuse pain, fatigue, and point tenderness
A 32-year-old female presents to her physician asking for something to ease her pain. She was previously diagnosed with fibromyalgia. Her pain is most likely caused by:
alterations in pain tolerance
Myotonia is characterized by:
prolonged depolarization of muscle cell membranes
The pattern of bone destruction indicative of an aggressive malignant tumor is known as a:
A 13-year-old female is admitted to the hospital for evaluation and treatment of an osteosarcoma in her left distal femur. Which statement best describes osteosarcoma?
Osteogenic, most often develops in the bone marrow
A 60-year-old male presents with swelling and pain in the knee. CT reveals a cartilage-forming tumor. His diagnosis would be:
Myeloma is a cancer that originates in which bone marrow cell?
A malignant tumor of skeletal muscle tissue origin is called:
A 2-month-old female was diagnosed with developmental dysplasia of the hip. If left untreated, she may develop hip:
A 9-month-old male was diagnosed with osteogenesis imperfecta following recurrent fractures and findings of osteopenia. This disease is caused by:
a genetic defect
A 9-month-old male was diagnosed with osteogenesis imperfecta following recurrent fractures and findings of osteopenia. This disease is caused by errors in the synthesis of:
Children with osteogenesis imperfecta suffer from frequent:
A I-year-old female was diagnosed with osteogenesis imperfecta. Which of the following could be a life-threatening complication in this patient?
A 6-year-old male presents with fever, pain, swelling, and warmth. Tests reveal osteomyelitis and development of an involucrum. Treatment should include:
surgical debridement and abx
Polyarthritis is a type of juvenile arthritis in which:
more than three joints are affected
A 5-year-old female was diagnosed with juvenile rheumatoid arthritis. The treatment option for this disease is:
Incidence of Legg-Calve-Perthes disease peaks at age:
Legg-Calve-Perthes disease affects which of the following joints?
Osgood-Schlatter disease causes inflammation of the:
Structural scoliosis with no known cause, termed ________ scoliosis, accounts for at least 65% of the cases.
A 3-year-old male presents with developmental delay. Testing reveals that the child has muscular dystrophy. This disease causes:
degeneration of skeletal muscle fibers
Which protein is present in normal muscle cells and absent in muscle cells affected by Duchenne muscular dystrophy?
Duchenne muscular dystrophy has a(n) __ inheritance pattern.
Seventy-five percent of individuals with Duchenne muscular dystrophy will die before age:
A 22-year-old female has a brother with Duchenne muscular dystrophy and wants to know if her children will inherit it. A fairly accurate test to identify female carriers of the disease is measurement of serum levels of:
A 13-year-old female presents with pain at night, cough, and dyspnea. Testing reveals a malignant bone tumor. The most likely type of tumor is:
There is a link between osteosarcoma and:
A 16-year-old male was recently diagnosed with osteosarcoma. The tumor is most likely present in the __ of long bones.
Ewing sarcoma originates from:
the bone marrow
A major predictor of prognosis for Ewing sarcoma is:
presence of metastasis
Dermal appendages include all of the following structures except:
A 12-year-old female notices her hair and skin feel more oily than normal. Her physician explains that during puberty her sebaceous glands enlarge and are stimulated by:
Of the sweat glands, the______ glands are most abundant in the axilla and genital areas.
Keratinocytes are found in which layer of the skin?
Which cells are involved in initiating immune responses in the skin?
More heat may be conserved by the body if blood is shunted away from the arteriovenous anastomoses in the:
A 70-year-old male nursing home resident developed a dermal pressure ulcer. This condition is most often caused by:
A 25-year-old paralyzed male develops a dermal pressure ulcer. The first indication of this ulcer was:
To promote efficient wound healing, dressings applied to a dermal pressure ulcer should be:
flat and moist
Individuals of _______ descent are more prone to developing keloids
A 23-year-old male received a knife wound in a fight. His scar was sharply elevated, irregularly shaped, and progressively enlarging. This condition is caused by excessive amounts of _____ in the corneum during connective tissue repair.
A 23-year-old male opiate abuser develops pruritus. An increase in which of the following is associated with pruritus?
A 19-year-old female developed a circular, demarcated, and salmon-pink lesion. Two weeks later she developed more lesions over the trunk and upper part of the extremities. This disorder is caused by a:
A 12-year-old female visits her physician to obtain acne medication for recurrent acne vulgaris. This condition is an inflammatory disorder of the:
A 42-year-old female presents with raised red lesions with a brownish scale. She was diagnosed with discoid lupus erythematosus. This disorder is caused by:
In discoid lupus erythematosus, skin lesions are often accompanied by:
vasospasm in the extremities
A 45-year-old male presents with a chronic blister-forming disease of the skin and oral mucous membranes. This condition is referred to as:
A 9-year-old male presents with severe erythematous bullous lesions. Which of the following is the most likely diagnosis?
A 50-year-old male recently underwent a liver transplant and is taking immunosuppressive drugs. He now has pain and vesicular eruptions on the face and trunk. He reports that he had chickenpox as a child. Which of the following is the most likely diagnosis?
Tinea corporis (ringworm) is a __ infection of the skin.
A 20-year-old female presents with vaginal itch and thin-walled pustular lesions. She is diagnosed with candidiasis. This condition is caused by a(n):
A 30-year-old female has a history of frequent candidiasis. The region most likely affected is the:
Candidiasis is likely to be exacerbated by:
A 10-year-old male is given penicillin for an infection. He has an allergic reaction, during which he develops urticarial lesions. These lesions are mediated by the release of:
Scleroderma involves___________of the skin
A 52-year-old female is diagnosed with scleroderma. Which complication results in skin ulcers to the fingers and nail shedding?
What is the prognosis for patients with scleroderma?
There is no cure, and many individuals with scleroderma die within 5 yrs
A 13-year-old female is concerned about several pigmented skin lesions on her body. Her physician tells her that these lesions must be monitored because of their ability to transform into malignant melanoma. These lesions are referred to as:
Which of the following malignant skin lesions is the most serious?
A 40-year-old female is diagnosed with skin cancer. Her physician explains that the most important risk factor for skin cancer is:
amount of direct sun exposure at a young age
A 27-year-old male AIDS patient developed Kaposi sarcoma. Which of the following is the most likely risk factor associated with his disease?
A 29-year-old female is burned through all her dermis with only a few epidermal appendages intact. This burn is classified as:
Which of the following burns is the most painful?
Superficial partial thickness
A 10-year-old male is playing with matches and gets burned. His burn develops large water-filled blisters immediately after the injury. This burn is classified as:
Superficial partial thickness
In burn injury patients, the Rule of NiSignificant decrease in systemic vascular resistance nes and the Lund and Browder chart are used to estimate:
total body surface area burned
A 30-year-old male fire fighter is badly burned and is admitted to the emergency department. Which of the following would be expected in the first 24 hours?
Significant decrease in systemic vascular resistance
Hypovolemia in the early stages of burn shock is directly related to:
increased capillary permeability and evaporative water loss
A 28-year-old male is admitted to the burn unit 2 hours after receiving second- and third-degree burns over 50% of his body surface in an industrial explosion. Abnormal vital signs include low blood pressure and tachycardia. Lab results show a high hematocrit. Urine output is low, and he is developing generalized edema. These clinical manifestations of the systemic response to the burn injury can be attributed to:
loss of capillary seal
Increased blood viscosity in the first 24 hours of burn shock predisposes the patient to:
A 36-year-old male is experiencing frontotemporal hair recession. He is diagnosed with male pattern baldness, a form of:
A 15 y/o female complains of hair growth on her face and body. This condition is referred to as:
A 4-month-old male is brought to his physician for severe itching and skin lesions. He is diagnosed with atopic dermatitis. Which of the following would be elevated in this patient?
A 4-month-old female is diagnosed with atopic dermatitis. Which of the following most likely led to this diagnosis?
Dry, itchy skin
A 2-month-old female develops diaper dermatitis. This condition is frequently accompanied by a secondary infection with:
Acne vulgaris involves inflammation of the:
A 14-year-old female presents with severe acne. Which ofthe following promotes acne development
Bullous impetigo is caused by a strain of _____ that produces an exfoliative toxin that disrupts cellular adhesion.
A lO-year-old female presents with vesicles consistent with vesicular impetigo. Which of the following causes this condition?
A 3-year-old male develops tinea capitis after playing with the family dog. This infection is caused by a:
A 5-year-old male is diagnosed with tinea corporis following development of lesions on the nonhairy parts of his face, trunk, and limbs. A common source of this condition is:
________ is also referred to as ringworm.
A 4-month-old female develops white spots and shallow ulcers in her mouth. Her pediatrician diagnoses her with thrush. This condition is caused by:
Thrush is characterized by:
the presence of white plaques in the mouth
A 6-year-old male presents with slightly umbilicated, dome-shaped lesions on the skin of the trunk, face, and extremities. He is diagnosed with molluscum contagiosum caused by a highly contagious:
Molluscum contagiosum affects the skin and:
Which of the following viral diseases has an incubation period of 14 to 21 days and a duration of 1 to 3 days?
Rubella, rubeola, and roseela are common communicable diseases caused by:
MMR vaccine should be administered after 15 months of age because:
by that time maternally acquired passive immunity has been depleted
A 5-year-old female develops chickenpox after exposure at her day care center. This disease is caused by:
a herpes virus
A fetus is most likely to be malformed if the mother contracts chickenpox during the ______ of pregnancy.
first 4 months
The etiologic agent of smallpox is (are): a.
Scabies is more common among children who:
live in crowded, unsanitary conditions
Arousal is mediated by the:
reticular activating system
A 20 y/o suffers a severe closed head injury in a motor vehicle accident. He remains in a vegatative state 1 month after the accident. Which of the following is the most likely dx?
A 16 y/o male took a recreational drugthat altered his level of arousal. PE revelaed an absent babinski sign, equal and reactive pupils, and roving eye movements. Which of the following is the most likely dx?
Metabolically induced coma
The breathing patteren that reflects respirations based primarily on CO2
A 45 y/o female presents to the ER c/o vomiting. A CT scan of the brain reveals a mass in the:
A teenage boy sustains a severe closed head injury following an ATV accident. He is in a state of deep sleep that requires vigorous stimulation to elicit eye opening. Which of the following describes his condition?
Dilated and fixed pupils can be cx by:
brain stem hypoxia
For legal purposes, brain death is defined as:
Cessation of brain function
A 10 y/o female was brought to the ER following a sudden onset of convulsions. The physicians think that she experienced an explosive, disorderly discharge of cerebral neurons referred to as:
A 30 y/o female had a seizure that started with her fingers and progressively spread up her arm and then extended to her leg. This condition is known as:
Focal motor seizure
A 20 y/o male was at the supermarket when he fell to the ground. Bystanders reported that he lost consciousness and his body tensed up then relaxed, then tensed and relaxed, several times. He most likely was experiencing a:
A peculiar sensation that immediately precedes a seizure is called a:
Neural networks basic to cognitive function include:
Memory and language networks
The cognitive disorder that results in the loss of memory of events that occurred before a head injury is:
A 65 y/o male is recently suffered a cerebral vascular accident. He is now unable to recognize and identify objects by touch because of injury to the sensory cortex. The condition is a form of:
An alcoholic checked into a rehab center. He experiences delirium, inability to concentrate, and is easily distracted. From which of the following is he most likely suffering?
Acute confusional state
Dementia is manifested by:
loss of recent and remote memory
A decrease in cerebral perfusion pressure us r/t which of the following changes?
Increase in ICP
A compensatory alteration in the diameter of cerebral blood vessels in response to increased ICP is called:
Cerebral edema is an accumulation of fluid in the:
Vasogenic edema is clinically important because:
the BBB is disrupted
A 51 y/o male is admitted to the neuro critical care unit with a severe closed head injury. All four extremities are in rigid extension, his forearm is hyperpronated, and his legs are in plantar extension. This condition is known as:
A 20 y/o male is admitted to the neuro critical care unit with a severe closed head injury. When am intraventricular catheter is inserted, the ICP is recorded at 24 mm Hg. This reading is:
higher than normal
A 15 y/o female is admitted ICU with a severe closed head injury. This dx puts her at risk for:
A 70 y/o female is being closely monitored in the neuro critical care unit for a severe closed head injury. After 48 hours, her condition begins to deteriorate. Her pupils are small and sluggish, pulse pressure is widening, and she is bradycardic. These clinical findings are evidence of what stage of intracranial HTN?
An infant is dx with non-communicating hydrocephalus. An immediate concern for this pt
Hydrocephalus in adults is most common cx by:
defective CSF reabsorption
A 16 y/o male fell off the bed of a pickup truck and hit his forehead on the road. He now has resistance to passive movement that varies proportionally with the force applied. He is most likely suffering from:
Paralysis of the lower extremities is called:
A disorder that cxs excessive movement is:
Spinal shock is characterized by:
cessation of spinal cord function below the lesion
A 40 y/o male c/o abnormal movement and progressive dysfunction of intellectual and thought processes. He is experiencing movement problems that begins in the face and arms and eventually affect the entire body. The most likely dx is:
The most severe brain injury cx by rotational acceleration is most likely to be located:
more peripheral to the brain stem
The most common type of traumatic brain injury is:
A 15 y/o male suffered diffuse brain injury after wrecking an all-terrain vehicle. He had momentary confusion and retrograde amnesia after 5 to 10 minutes. His injury could be categorized as:
The main source of bleeding in extradural (epidural) hematomas is:
A 69 y/o male with a hx of alcohol abuse presents presents to the ER after a month long episode of headaches and confusion. Based on his alcoholism, a likely cx of his neurologic sxs is:
chronic subdural hematoma
A 15 y/o male was struck by a motor vehicle and suffered a traumatic brain injury. Paramedics found him unconscious at the scene of the accident. During the ambulance ride, he regained consciousness and was able to maintain a conversation with the medical staff. Upon arrival to the hospital, he was alert and orientated. PE reveals confusion and impaired responsiveness. What is the probable nature of his brain injury based on this hx?
Extradural (epidural) hematoma
Mild concussion is characterized by:
A 39 y/o male suffers a severe brain injury when he falls off a building while working. CT scan reveals that he has a basilar skull fractures. One major concern for this pt is:
A 65 y/o female loses her balance while walking in the woods
lO-year-old male was climbing on a house and fell. He suffered a severe brain injury. His Glasglow Coma Scale was 5 initially and 7 after 1 day. He remained unconscious for 2 weeks, then was confused and suffered from anterograde amnesia. Which of the following is he most likely experiencing?
Moderate diffuse brain injury
An initial clinical manifestation associated with acute spinal cord injury is:
loss of voluntary control below the injury
The transient nature of spinal shock is directly related to which of the following mechanisms?
Accumulation of edema within the spinal cord
A I7-year-old male is brought to the emergency department for treatment of injuries received in a motor vehicle accident. A spinal cord injury is suspected. The two regions most likely to be
damaged are the:
cervical and lumbar regions
A 33-year-old male is brought to the emergency department for treatment of injuries received in a motor vehicle accident. An MRI reveals an injury of the cervical cord. Cord swelling in this region may be life threatening because:
diaphragm function may be impaired
A 15-year-old male is brought to the emergency department for treatment of injuries received in a motor vehicle accident. An MRI reveals spinal cord injury, and his body temperature fluctuates markedly. The most accurate explanation of this phenomenon is that:
His sympathetic nervous system has been damaged and thermal control disturbed
Six weeks ago a female patient suffered a T6 spinal cord injury. She then developed a blood pressure of 200/120, a severe headache, blurred vision, and bradycardia. She is likely experiencing:
20-year-old female suffered from spinal cord injury that resulted from a motor vehicle accident. She had spinal shock lasting 15 days and is now experiencing an uncompensated cardiovascular response to sympathetic stimulation. This condition may accompany:
a distended bladder or rectum
A 50-year-old male presents with low back pain.
He denies trauma and says he just woke up and it was hurting. An MRI reveals that the vertebra at L5 slid forward relative to those above and below it. This condition is called:
A 30-year-old white male recently suffered a cerebrovascular accident. Which of the following is the most likely factor that contributed to his stroke?
One risk factor for thrombotic stroke is:
Of the following groups, who are at highest risk for a cerebrovascular accident?
Blacks over 65 years of age
A 72-year-old male demonstrates left-sided weakness of upper and lower extremities. The symptoms disappear in 24 hours. He most likely experienced a(n):
A major contributing process in cerebrovascular accidents (CVA) is the development of atheromatous plaques in cerebral circulation. These most commonly form:
in cerebral arteries
A 75-year-old male experienced a lacunar stroke. This type of stroke is most often associated with:
A 25-year-old male died from a gunshot wound to the heart. Upon autopsy, abnormalities in the media of the arterial wall and degenerative changes were detected. Which of the following most likely accompanied this finding?
A 48-year-old female presents at the emergency department complaining of an acute severe headache, nausea, photophobia, and nuchal rigidity. These signs and symptoms are probably caused by:
A cause of hydrocephalus in subarachnoid hemorrhage is:
scarring of meninges and impairment of CSF resorption
A 65-year-old male suffers a subarachnoid hemorrhage secondary to uncontrolled hypertension. He appears drowsy and confused with pronounced focal neurologic deficits. This condition is a grade:
A 25-year-old female presents to her physician complaining of fever, headache, nuchal rigidity, and decreased consciousness. She was previously treated for sinusitis. Which of the following is the most likely diagnosis?
Most causes of encephalitis are:
A 15-month-old child from Pennsylvania was brought to the ER for fever, seizure activity, cranial palsies, and paralysis. Which of the following is the most likely cause?
Eastern equine encephalitis
A 23-year-old female begins having problems with tiredness, weakness, and visual changes. Her diagnosis is multiple sclerosis (MS). The pathogenic model of multiple sclerosis includes:
demyelination of nerve fibers in the CNS
The cause of multiple sclerosis (MS) seems to be an interaction between:
autoimmunity and genetic susceptibility
Classic amyotrophic lateral sclerosis (ALS) presents with:
muscle weakness and atrophy
Myasthenia gravis results from:
autoimmune injury at the neuromuscular junction
Patients with myasthenia gravis often have tumors or pathologic changes in the:
The most common primary CNS tumors in adults are:
A 45-year-old male presents with seizures. An MRI reveals a meningioma most likely originating from the:
dura mater and arachnoid membrane
The first reflex of infancy to disappear is:
A 10-month-old infant presents for a well-baby visit. Which of the following reflexes should be present at this age?
During infancy, what is the fastest growing part of the body?
________defects of neural tube closure are most common.
An example of an anterior midline defect of neural tube closure is:
A newborn child has a hernial protrusion of a saclike cyst through a defect in the posterior arch of a vertebra. This condition is referred to as:
A newborn child is diagnosed with a vertebral arch defect and meningocele. This condition would most likely result in:
A 19-month-old boy developed a premature closure of one or more of the cranial sutures. The most likely diagnosis is:
True microcephaly can be caused by:
an autosomal recessive gene
An infant is diagnosed with congenital hydrocephalus. Which of the following characteristics would you expect to see?
The most common type of cerebral palsy is:
A child is diagnosed with cerebral palsy, characterized by extreme difficulty in fine motor coordination and purposeful movement. Which of the following types of cerebral palsy is he experiencing?
Which of the following diseases is screened for in all newborns?
Parents of a 3-month-old infant bring him to the emergency room after he has had a seizure. He has muscle rigidity, and the parents report they are of Jewish ancestry. For what genetic disease should this infant be screened?
A child is brought to the emergency room. Initial examination documents the following clinical manifestations: tissue ischemia, anemia, and an apparent decrease in normal growth rate. Which of the following poisons would most likely be the cause?
To prevent Reye syndrome in infants, which of the following instructions should be given to parents?
Tx fevers with acetaminophen not, Asa
A child presents to his physician with disorientation, delirium, aggressiveness, and stupor. His parents report that he was recently ill with an upper respiratory infection, which they treated with aspirin. Which of the following is the most likely diagnosis?
often occurs with measles, mumps, or herpes
A 3-year-old African-American child was diagnosed with sickle cell disease. She is now suffering from meningitis. The most likely cause of the meningitis is:
The majority of children with AIDS were exposed to HIV:
in the uterus
The most common site of HI V infection in children is:
A 10-year-old male presents with visual disturbances. CT scan reveals a tumor that is located near the optic chiasm. Which ofthe following is the most likely tumor type?
A lO-year-old female develops pneumonia following a urinary tract infection. Physical exam reveals subcostal and intercostal retractions. She reports that breathing is difficult and she feels she cannot get enough air. This condition is referred to as:
A 50-year-old diabetic male did not take his medication and is now in metabolic acidosis. He is experiencing Kussmaul respirations that can be characterized by:
a slightly increased ventilatory rate, large tidal volumes, and no expiratory pause
A 30-year-old female received a severe head injury in a motor vehicle accident. She is now experiencing respiratory abnormalities characterized by alternating periods of deep and shallow breathing. This condition is referred to as:
Paroxysmal nocturnal dyspnea generally occurs with:
left ventricular failure
A 20-year-old male is in acute pain. An arterial blood gas reveals decreased carbon dioxide levels. Which of the following is the most likely cause?
A 65-year-old female with emphysema presents to the ER for difficulty breathing. Physical exam reveals bluish skin and mucous membranes. This condition is referred to as:
A 28-year-old male complains to his physician that he has had a cold for a week and is coughing up bloody secretions. This condition is referred to as:
Reduced oxygenation of arterial blood is called:
A group of mountain climbers experience confusion, tachycardia, edema, and decreased renal output after climbing Mount Rainier. This condition is caused by:
decreased inspired oxygen
A low ventilation-perfusion ratio results in:
The condition in which a series of alveoli in the left lower lobe receive adequate ventilation but do not have adequate perfusion is called:
alveolar dead space
A 30-year-old male is involved in a motor vehicle accident and sustains trauma to the lungs and chest wall. He experiences respiratory failure. Which of the following lab values would be expected?
The most common cause of pulmonary edema is:
A 47-year-old male is diagnosed with pulmonary edema. Which of the following would be expected with this condition?
Pink, frothy sputum
A 65-year-old male recently had a cerebrovascular accident that resulted in dysphagia. He now has aspiration of gastric contents. This condition could cause:
pneumonitis and pneumonia
A 26-year-old female recently underwent surgery and is now experiencing dyspnea, cough, fever, and leukocytosis. Tests reveal that she has a collapsed lung caused by removal of air from obstructed alveoli. This condition is called:
A 45-year-old male undergoes lung transplantation. He now suffers from airway occlusion secondary to fibrosis. The most likely diagnosis is:
A 50-year-old male presents with hypotension, hypoxemia, and tracheal deviation to the left. Tests reveal that the air pressure in the pleural cavity exceeds barometric pressure in the atmosphere. The most likely diagnosis is:
A 60-year-old female with a history of cirrhosis presents with dyspnea, impaired ventilation, and pleural pain. A diagnosis of pleural effusion is made and a watery fluid is drained. This fluid is referred to as:
A 57-year-old male presents with cough, sputum production, dyspnea, and decreased lung volume. He is diagnosed with pneumoconiosis. His illness is probably caused by:
inhalation of silica, asbestos, mica
A 42-year-old female presents with dyspnea, rapid, shallow breathing, inspiratory crackles, decreased lung compliance and hypoxemia. Tests reveal a fulminant form of respiratory failure characterized by acute lung inflammation and diffuse alveolocapillary injury. Which of the following is the most likely diagnosis?
A 60-year-old female with emphysema is having difficulty expiring a given volume of air. She is most likely experiencing __ pulmonary disease.
Asthma is thought to be caused by:
interactions between genetic and environmental factors
Asthma is classified by:
Airway hyperresponsiveness in asthma is related to:
exposure to an allergen cx mast cell degranulation
Airway obstruction contributing to increased airflow resistance and hypoventilation in asthma is caused by:
mucus secretion, bronchoconstriction, and airway edema
A 22-year-old female presents with chronic bronchitis. Tests reveal closure of the airway during expiration. This condition is most likely caused by:
thick mucus from hypertrophied glands
A 25-year-old male presents with chronic bronchitis of 5 months' duration. Which of the following is most likely to cause this condition?
A 25-year-old male presents with chronic bronchitis of 5 months' duration. Which of the following is the most significant concern in this patient?
Recurrent pulmonary infections
A 53-year-old male with a 20-year history of smoking is diagnosed with emphysema. His airways are obstructed because of:
loss of elastic recoil
A 53-year-old male with a 20-year history of smoking is diagnosed with emphysema. Changes in his lungs are caused by:
Individuals with a recent diagnosis of emphysema most often present with:
A 60-year-old female with a 25-year history of smoking is diagnosed with emphysema. She has an increased anterior-posterior chest diameter because of:
Pneumonia is caused by:
viral or bacterial infections
Nosocomial pneumonia is generally acquired:
A 30-year-old male prison inmate contracted tuberculosis during an outbreak. The organism that caused this condition is a:
A 30-year-old male prison inmate contracted tuberculosis during an outbreak. He can transmit this disease through:
A 70-year-old female is in the hospital for pelvic fracture. She develops pulmonary thromboembolism. This condition is the result of occlusion of a portion of the pulmonary vascular bed by an embolus of:
Which of the following patients is at highest risk for developing a pulmonary embolus?
72 y/o male who is recovering from hip- replacement surgery in the hospital
Which of the following shows a correct sequence of events in pulmonary embolism?
Hypoxemia inhibits the production of surfactant, cx alveolar collapse
An 80-year-old female is in the hospital for bone fracture. While there she develops a large, nonlethal pulmonary embolus. Which of the following is a direct result of the obstruction to blood flow?
A massive pulmonary embolism will most likely lead to:
shock and death
A 50-year-old male is diagnosed with pulmonary embolism. Which of the following symptoms most likely occurred before treatment?
chest pain and SOB
A 60-year-old male undergoes surgery for a bone fracture. Which ofthe following measures would be most effective for preventing pulmonary emboli in this patient?
Prevent DVT formation
Pulmonary hypertension is defined as a rise in pulmonary artery pressure of __ mm Hg above normal.
5 to 10
Secondary pulmonary hypertension is usually caused by:
chronic pulmonary dz
A 50-year-old male with a 30-year history of smoking was diagnosed with lung cancer. He was previously exposed to air pollution, asbestos, and radiation at his job. Which of the following most likely had the greatest impact on development of his cancer?
A 60-year-old male with a 40-year history of smoking presents with chest pain, cough, sputum production, and pneumonia. Tests reveal widespread metastatic cancer. Which of following is the most likely type of cancer?
Non-small cell carcinoma
A 1-year-old female is diagnosed with croup. The most likely cause of this disease is:
A 1-year-old female is diagnosed with croup. Which of the following symptoms is most likely present?
respiratory stridor and braking cough
Respiratory distress and hypoxemia in laryngotracheobronchitis are caused by:
mucosal edema and laryngeal secretions
A 10-year-old male was diagnosed with obstructive sleep apnea. Which of the following treatments would most likely be tried first?
A newborn has respiratory distress syndrome. Which of the following is the most important predisposing factor for this condition?
A newborn has respiratory distress syndrome. He develops atelectasis because of:
lack of surfactant
Cardiovascular alterations seen in respiratory distress syndrome include:
opening of fetal shunt pathways
A newborn has respiratory distress syndrome. This condition appeared:
within minutes of birth
During a respiratory assessment of an infant with respiratory distress syndrome, a sinking in the supraclavicular and intercostal areas of the thorax was noted with inspiration. This observation is called:
An infant was born 10 weeks premature and put on mechanical ventilation. Two months later he presents with hypoxemia and hypercapnia. Which ofthe following is most likely diagnosis?
Bronchiolitis mainly occurs in children under the age of:
A 6-month-old female presents with rhinorrhea, cough, poor feeding, lethargy, and fever. She is diagnosed with bronchiolitis. Which of the following is most likely causing her condition?
Respiratory Syncytial Virus
A 2-year-old male presents with fever and cough. He is diagnosed with pneumonia. Which ofthe following is the most likely cause?
An 11-year-old female presents with a low-grade fever and cough. She is diagnosed with atypical pneumonia. This condition is also known as:
A 2-week-old female presents with fever, cough, respiratory distress, and empyema. Which of the following is the most likely diagnosis?
A 9-year-old male contraCted influenza. Which ofthe following complications is of greatest concern?
In asthma, __ is (are) reduced.
expiratory flow rates
A 14-year-old male is experiencing an asthma exacerbation. Which of the following cells in the submucosa promote this inflammatory response?
A 13-year-old female is diagnosed with asthma. Which of the following should she recognize as part of an asthmatic attack?
Cystic fibrosis is an:
autosomal recessive dz
A 2-year-old female fell in a swimming pool and nearly drowned. She then developed acute respiratory distress syndrome. Which of the following did she most likely experience?
A l-year-old child with cystic fibrosis would demonstrate elevated levels of which of these compounds in both sweat and salivary gland secretions?
A 7-month-old male presents with failure to thrive and frequent, loose, and oily stools. Sweat testing reveals increased chloride. Which of the following would also accompany this disease?
A thick mucous
Sudden infant death syndrome (SIDS) occurs most often between __ months of age.
3 and 4
To prevent sudden infant death syndrome, parents should be instructed to:
always lay infants down on their back to sleep
The vomiting reflex can be stimulated by:
The adult intestine processes approximately __ liters of luminal content per day, of which 99% of the fluid is normally reabsorbed.
A 34-year-old male was diagnosed with a bacterial gastrointestinal infection. Which of the following types of diarrhea would most likely occur with his condition?
A 20-year-old male was recently diagnosed with lactose intolerance. He eats an ice cream cone and develops diarrhea. His diarrhea can be classified as:
A 45-year-old female presents to her physician with chronic constipation, fatigue, and cold intolerance.
Which of the following could be the cause?
A 40-year-old female presents complaining of pain near the midline in the epigastrium. Assuming the pain is caused by a stimulus acting on an abdominal organ, the pain felt is classified as:
The most common disorder associated with upper gastrointestinal bleeding is:
A 52-year-old presents with bleeding from the rectum. This condition is referred to as:
A 22-year-old male presents with difficulty swallowing. Tests reveal a loss of esophageal peristalsis and failure of the lower esophageal sphincter to relax. Which of the following is the most likely cause?
A 50-year-old male is experiencing reflux of chyme from the stomach. He is diagnosed with gastroesophageal reflux. This condition is caused by:
loss of muscle tone at the lower esophageal sphincter
Reflux esophagitis is defined as:
an inflammatory repsponse to gastroesophageal reflux
A 45-year-old male complains of heartburn after eating and difficulty swallowing. He probably has:
A serious complication of paraesophageal hiatal hernia is:
A 38-year-old female complains of epigastric fullness following a meal, nausea, and epigastric pain. Tests reveal narrowing of the opening between the stomach and the duodenum. This condition is referred to as:
The cardinal sign of pyloric stenosis caused by ulceration or tumors is:
A 29-year-old male presents complaining of colicky pain followed by vomiting, sweating, nausea, and hypotension. Testing reveals a condition in which one part of the intestine telescopes into another. From which type of intestinal obstruction is he suffering?
A 40-year-old female develops an intestinal obstruction that causes injury to the gut lumen proximal to the obstruction. This condition is related to:
decreased blood flow from increasing inraluminal pressure
Hypotension and shock are serious consequences of bowel obstruction caused by:
a shift of fluids to the peritoneal cavity
Chronic gastritis is classified according to the:
location of lesions
A 54-year-old male is diagnosed with peptic ulcer disease. This condition is most likely caused by:
breaks in the mucosa and presence of corrosive secretions
The primary cause of duodenal ulcers is:
A 60-year-old male presents with gastrointestinal bleeding and abdominal pain. He reports that he takes nonsteroidal antiinflammatory agents (NSAIDs) daily to prevent heart attack. Tests reveal that he has a peptic ulcer. The most likely cause of this disease is:
inhibiting mucosal prostaglandin synthesis
A 39-year-old female presents with chronic intermittent pain in the epigastric area 2 to 3 hours after eating. She is diagnosed with a duodenal ulcer associated with:
increased acid secretion
A 46-year-old female is diagnosed with gastric ulcers. This disease is associated with:
an increased risk of gastric ca
A 24-year-old male sustained a head injury and fractured femur. He develops an ulcer caused by:
over-stimulation of the vagus nerve
A 3-month-old female develops colicky pain, abdominal distention, and diarrhea after drinking cow's milk. The best explanation for her symptoms is:
an excess of undigested lactose in her digestive tract, resulting in increased fluid movement into the digestive lumen and increased bowel motility.
Clinical manifestations of bile salt deficiencies are related to poor absorption of:
fats and fat-soluble vitamins
A 30-year-old obese female underwent gastric resection in an attempt to lose weight. Which of the following complications could the surgery cause?
A 50-year-old male complains of abdominal pain, diarrhea, and bloody stools. A possible diagnosis would be:
Which ofthe following symptoms would help a health care provider distinguish between ulcerative colitis and Crohn disease?
Malabsorption and steatorrhea
A 16-year-old female presents with abdominal pain in the right lower quadrant. Physical examination reveals rebound tenderness and a low-grade fever. A possible diagnosis would be:
Common symptoms of acute vascular insufficiency include:
cramping abdominal pain and abdominal distension
Problems associated with chronic vascular insufficiency include:
malabsorption and alterations in bowel functions
A 13-year-old female confides to her mother that she binge eats and induces vomiting to prevent weight gain. This disease is referred to as:
A l6-year-old female is diagnosed with anorexia nervosa. Excessive weight loss can cause:
A 54-year-old male complains that he has been vomiting blood. Tests reveal portal hypertension. Which of the following is the most likely cause of his condition?
Cirrhosis of the liver
A common clinical manifestation of portal hypertension is:
A 60-year-old female with a history of alcoholism complains of recent weight gain and right flank pain. Physical examination reveals severe ascites. This condition is caused by:
decreased albumin and capillary oncotic pressure
Problems associated with hepatic encephalopathy from chronic liver disease are the result of:
impaired ammonia metabolism
An increase in the rate of red blood cell breakdown causes which form of jaundice?
Intrahepatic obstructive jaundice is characterized by elevated levels of serum:
unconjugated and conjugated bilirubin
A 55-year-old male IV drug user with a history of advanced liver disease presents with oliguria, jaundice, ascites, and gastrointestinal bleeding. He is diagnosed with hepatorenal syndrome. Which of the following would aid in this diagnosis?
Portal HTN and renal failure cx by circulatory problems
Hepatitis A is characterized by:
an acute onset with fever
A 40-year-old female presents with right flank pain. Testing reveals severe hepatic necrosis, encephalopathy, and organ failure. From which ofthe following types of hepatitis is she most likely suffering?
The icteric phase of hepatitis is characterized by which of the following clinical manifestations?
Jaundice, dark urine, and enlarged liver
A 55-year-old male died in a motor vehicle accident. Autopsy revealed an enlarged liver caused by fatty infiltration, testicular atrophy, and mild jaundice secondary to cirrhosis. The most likely cause of his condition is:
In alcoholic cirrhosis, hepatocellular damage is caused by:
A 39-year-old female presents with abdominal pain and jaundice. She is diagnosed with gallstones and undergoes cholecystectomy. An analysis of her gallstones would most likely reveal a high concentration of:
A 55-year-old female has general symptoms of gallstones but is also jaundiced. IV cholangiography would most likely reveal that the gallstones are obstructing the:
common bile duct
Acute pancreatitis often manifests with pain to which of the following regions?
Shock can develop with acute pancreatitis for which of the following reasons?
Vasoactive inflammatory mediators are released into the blood stream
A 31-year-old female presents with midabdominal pain. She is expected to have acute pancreatitis. Which of the following lab results is (are) most specific to this diagnosis?
Elevated serum lipase
Pancreatic insufficiency seen in chronic pancreatitis results from:
chronic inflammation leading to injury and scarring of the pancreas
A 60-year-old male is diagnosed with cancer of the esophagus. Which of the following factors most likely contributed to his disease?
Which of the gastrointestinal cancers has the highest rate of incidence and is responsible for the highest number of deaths?
A 40-year-old male who consumes a diet high in fat and low in fiber is at risk for:
ca of the colon and rectum
Which modifiable risk factor is associated with esophageal, stomach, and colorectal cancer?
Cigarette and ETOH use
A 3D ultrasound of a 9-week fetus revealed incomplete fusion of the nasomedial or intermaxillary process. This child will be born with:
Examination of a newborn female revealed that the esophagus ends in a blind pouch. This condition is referred to as:
A condition that occurs in many mothers carrying fetuses affected by esophageal malformations is:
excessive amniotic fluid
A mother brings her 2-week-old infant to the pediatrician because he vomits forcefully for no apparent reason and food sometimes is regurgitated through his nose. The infant is most likely suffering from:
A sign that a newborn infant is suffering from pyloric stenosis is:
vomiting s/p feeding
A 2 Month-old female is brought to the ER for persistent bile-stained vomiting after feeding. Physical examination reveals dehydration, and x-ray reveals that the colon is located in the upper right quadrant. The most likely cause of this condition is:
A newborn male begins vomiting a few hours after birth. Physical examination reveals tachypnea, intercostal retractions, and grunting respiration's. The next day he develops abdominal distention. The child's symptoms are most likely caused by:
abnormally sticky meconium
A newborn male begins vomiting a few hours after birth. Physical examination reveals tachypnea, intercostal retractions, and grunting respirations. The next day he develops abdominal distention. The child should be screened for:
Congenital __ is a functional obstruction of the colon caused by inadequate motility.
A 2-month-old female with Down syndrome is diagnosed with Hirschsprung disease following chronic constipation. The most likely cause of these symptoms is a malformation in the:
Parasympathetic nervous system
The primary characteristic of Hirschsprung disease is:
bowel dilation and fecal impaction
A 6-month-old male infant is brought to the ER after the sudden development of abdominal pain, irritability, and vomiting followed by passing of "currant jelly" stool. Ultrasound reveals intestinal obstruction in which the ileum collapsed through the ileocecal valve and invaginated into the large intestine. This type of obstruction is referred to as:
An 8-week-old female is diagnosed with a congenital heart disease and Down syndrome. Her parents report that she has difficulty defecating. X-ray reveals anorectal malformation that causes complete obstruction often referred to as:
Occurrence of gastroesophageal reflux is highest in which pediatric population?
An 8-week-old male was recently diagnosed with cystic fibrosis. Which of the following digestive alterations would be expected?
A 13-month-old infant presents with vomiting; abdominal pain; and pale, bulky, greasy, and foul-smelling stools. A possible diagnosis would be:
Celiac disease or sprue is caused by alterations of the intestinal:
Kwashiorkor is a severe dietary deficiency of:
Prolonged diarrhea is more serious in children than adults because:
fluid reserves are lower in children
Increased bilirubin production and impaired hepatic excretion of bilirubin can lead to:
A 7-month-old female presents with jaundice, clay-colored stool, and failure to gain weight. Testing reveals the absence of intrahepatic bile ducts. This condition is referred to as:
A 7-month-old female presents with jaundice, clay-colored stool, and failure to gain weight. Testing reveals the absence of intrahepatic bile ducts. If left untreated, the child may develop:
The primary clinical manifestation of biliary atresia is:
Outbreaks of hepatitis __ often occur in young children attending day care centers and can be attributed to poor hand washing.
Extrahepatic portal hypertension is caused by an obstruction in the:
hepatic portal vein
Early identification and treatment for metabolic disorders is important because:
permanent damage to vital organs can be prevented
A 3-month-old female presents with intention tremors, dystonia, greenish yellow rings in the cornea, and hepatomegaly. Tests reveal a defect on chromosome 13. Which ofthe following is the most likely diagnosis?
A 27-year-old male presents with fever, gastrointestinal bleeding, hepatomegaly, and transient joint pain. He reports that as a child he received blood transfusions following a motor vehicle accident. He also indicates he was vaccinated against hepatitis B. Which of the following types of hepatitis does he most likely have?