Step 1 high yield questions (Uworld)
Terms in this set (225)
Atypical CD 8+ lymphocytes associated with EBV (mononucleosis)
Why do you have a decrease in calcium when given units of packed red blood cells?
Calcium chelation by a substance in the transfused blood (Citrate).
Auer rods, associated with AML (15;17).
germ tubes: incubated for 3 hours at 37 C
What do you monitor for Heparin and what is its treatment for overdose?
PTT and Protamine sulfate
What do you monitor for Warfarin and what is its treatment for overdose?
PT and vitamin K & fresh frozen plasma.
African boy with a large mass on the mandible what is the virus associated?
60-yr old man with complaints at becoming increase fatigue, Lab results show Teardrop cells. What is the disease?
Increase bleeding from mucus membrane, increase PTT, increase BT, normal PC, What is the disorder?
Von Willebrand factor
increase bleeding from membrane, decrease PC
Idiopathic thrombocytopenia purea (ITP)
What disease has the side effects of neurologic, renal, fever, thrombocytopenia, microangiopathic hemolytic anemia?
Thrombi thrombocytopenia purea (TTP)
What antibiotic has an adverse effect of hemolytic anemia?
What antibiotic has an adverse effect of neurotoxicity and nephrotoxicity?
What HIV antibiotic has an adverse effect of nausea, diarrhea, hyperglycemia, and lipodystrophy?
Saquinavir (navir) - protease inhibitor
The drug used for metastatic breast cancer caused by HER2 (ERBB2)
The drug used for Breast cancer treatment by estrogen receptors?
What drug is used to treat Colon cancer, basal cell carinoma, and inhibits thymidylate synthase?
What drug is an M-phase specific chemotherapeutic agent that prevent mitotic spindle assembly?
What drug is an M-phase specific chemotherapeutic agent that prevents break down of mitotic spindle?
Positive family history; Treatment: splenectomy, and lab results are positive for osmotic fragility. What is the disorder?
A person from the Middle East, presents with Liver and spleen granulomas, fever, myalgia, diarrhea, Katayama, and exposed to river water, What is the pathogen responsible for these symptoms?
What disorder is caused by inhibition of porphobiliogen deaminase that causes an increase in Prophobilinogen, ALA, and uroporphyrin?
65-yo African-American presents with broken bone, lytic bone lesions, an increase in plasma and IgG what is the disorder?
Women of Mediterranean descent, increase in transferrin saturation, required blood transfusions (life long), discomfort in right upper abdominal, What is the disorder?
Patient has a history of diabetes, thrombus in the aorta, What is the causal agent?
What organ is spared from the effect of ischemic injury do to dual blood supply?
Patient has axillary lymph node dissection, develop marked swelling in a different locations, What can cause this?
What is most likely to limit thrombus formation to the local area?
Patients has a fracture of the femur, Pelvis & humerus, swelling and warmth in legs occurring in femoral vein, what can this cause?
Phlebothrombosis (venous thrombosis)
Patients has an increase in PT, and normal PTT, PC, and platelet function, what can be a cause of these symptoms?
What reduce blood loss, seconds after an bleeding injury?
What is it called when there is a nodular or lesion on a heart valve?
Patients has Fractures to femur (bone), and 2-days later has respiratory difficulty what can be the cause?
What can cause a patient to have lower leg swelling with grade 2+ pitting edema?
congestive heart failure
What are the two most common causes of thrombosis of deep veins?
Immobilization & venous stasis
Most common thrombolytic therapy?
Tissue plasminogen activator
What can cause skin overlying the breast to become thickened, and reddish orange?
What can be a result of fracturing a long bone
What induces platelet aggregation, from dense bodies?
Adenosine diphosphate (ADP)
What is an anticoagulant that activates Protein C
Patients has severe abdominal pain, paranoid and combative. Test for urine Porphobilinogen are positive, What enzyme is affected?
What disorder is caused by inactivation of URO decarboxylase, and the patient presents with photosensitivity, chronic blistering lesion, and absence of neuropsychiatric signs?
Porphyria cutanea tarda
What type of DNA repair would you see with a family history of hereditary nonpolyposis colon cancer?
What type of repair would you see with ultraviolet light that give you Xeroderma pigmentosa?
Pyrimidine dimer repair
Man is significantly jaundiced, no abdominal pain, and the physician is concerned about patient's enlarged gallbladder, What type of cancer can cause these findings?
Patients has tenderness in the right upper quadrant , what are they most likely to have?
What drugs can be used for a non-Hodgkin's lymphoma, that is cell cycle nonspecific?
An immigrant from China, has an elevated a-fetoprotein and a enlarged nodular liver, What type of infection are they most like to have?
Patients has a hepatocellular carcinoma that is preceded by cirrhosis, what type of infection are they most likely to have?
What medication irreversibly blocks adenosine diphosphate receptors?
What drug has an adverse effect of hair loss, nausea, vomiting, and hearing loss?
What agent can cause diffuse interstitial fibrosis of the lungs, and fingers that are tapered and claw-like?
What is likely to occur with immunofluoresent with antibody to IgG appearances of a skin biopsy?
Chronic renal failure (SLE)
A patient has received multiple blood transfusions, and becomes tachycardic and hypotensive with pink-colored urine, What most like happened?
Complement-mediated lysis of RBCs (hypersensitivity type 2)
What is a X-linked recessive disorder that has normal PC, BT, PT and increase PTT?
What drug can inhibit a critical oncogene (CML)?
(Imatinib) Tyrosine receptor kinase signaling
What drug is used for testicular cancer and has an adverse of Pulmonary fibrous tissue?
(Bleomycin) - Induces formation of free radicals during the G2 phase of the cell cycle.
Patients has painful osteoarthritis that over dosed on aspirin, what will they complain of?
Ringing in his ears (tinnitus)
Patients went on a mission to Central Africa, and on blood smear is shows malaria, What do they most like have?
what can prolong activated (aPTT) and (PT) , bu no effect on thrombin time (TT)?
Direct factor Xa inhibitor
Patients has hoarseness and difficulty swallowing, loss of gag reflex and uvula deviation, what foramen is effected?
Jugular foramen (IX,X,XI)
11-yo African American, has dark inclusion bodies in RBCs (Heinz bodies), hormocytic anemia, What is reduced in this patient?
What drug MOA that is paired with a platinum agent for a combination therapy?
The inhibition of topisomerase ll, leading to increased DNA degradation (Etoposide)
What is the MOA of the antibiotic that treats urinary tract infection?
bacteriostatic, blocks dihydropteroate synthetase (Sulfonamides).
19-yo boys has a large mediastinal mass, and labs show blasts cells in the bone marrow, what is most likely disorder?
Red blood cell membrane cytoskeleton abnormalities (Hereditary spherocytosis)
6-yo has prolonged bleeding after having a tooth extracted, Family history is significant for a maternal uncle who suffered from recurrent bleeding in his joints. What will be abnormal in this patient?
Partial thromboplastin time (PTT)
A physical examination reveals cyanosis that is not corrected by oxygen supplementation. What is most likely to be normal in this patient?
Partial pressure of oxygen in the arterial blood.
A patient complains of difficulty swallowing, and spooned shaped finger nails on photograph. What is the best treatment for this patient?
A patient physical examination reveals mild hepatomegaly, with MCV of 115fl, What is the process that is most likely the cause of this patients anemia?
Diminished thymidine synthesis
A patient noted a decreased urine output, Laboratory analysis shows increased levels of blood urea nitrogen and creatinine. What agent would have prevented this patients renal's impairment?
Rasburicase and allopurinol
Von Willebrand's disease normally binds to what?
A patient has a bone marrow biopsy performed, and found plasma cells, This patient is at greatest risk of what?
A patient is given high-dose ganciclovir. Giving Zidovudine to this patient is most likely to precipitate what condition?
A patients tries to control intra-abdominal bleeding, had blunt abdominal trauma, loss of splenic processing, what is most likely to show on peripheral blood smear?
What cells secrete a substance that controls iron storage and release by other cells involved in iron homeostasis?
Hepatic Parenchymal cells
What is the calculating for the % of disease that can be attributed to exposure?
ARP= (RR-1)/ RR
The baby's blood is A negative while mother is B negative, hemolysis did not occur in the baby. What are was the class of the antibodies?
5-yo with diarrhea that became bloody, and has fragmented erythrocytes, What did he most likely eat?
Undercooked beef (HUS-EHEC)
Relative risk reduction calculation
RRR = (AR control- AR treatment)/ AR control --> AR treatment = AR control -(RRR * AR control)
A patient has bleeding following a tooth extraction, and episodes of painful joint swelling, that was an inherited disorder. What is the most likely disorder?
Hemophilia (X-linked recessive)
What virus has a complement receptor CD21 on the surface of B-lymphocytes?
Epstein-Barr virus (EBV)
What can cause onset of ST elevation in myocardial infarction (MI), Can cause rapid reperfusion?
Tissue plasminogen activator
A patient has red flushed cheeks with circumoral pallor, low grade fever over the last few days that goes away. What is the organ is effected in this patient?
Bone marrow (parvovirus B19)
What can be a symptom of Vincristine overdose?
Finger numbness and tingling (neurotoxicity)
There is a deletion in the platelet endothelial cell adhesion molecule 1 (PECA-1) gene. What is the process that is effected?
How do you calculate the number needed to harm?
1/attributable risk, Attributable risk = Event rate (treatment) - Event rate (placebo) = Dead/ Dead + alive (treatment) - Dead/ Dead + alive (placebo)
Methotrexate is given to treat a condition, what is accumulating in embryonic tissue as a result?
Messenger RNA is isolated from several tissues, subjected to electrophoresis, exon 4 from that gene. What is the most likely function?
Alternate RNA Splicing
A significant increase in Pol gene mutations, what is this observed finding most likely related to?
Antiretroviral chemotherapy (HAART)
Candidia extract injection results in a large indurated nodule (T-lyphocytes functioning), repeated lower respiratory infections. lymph nodes lack what structure?
What is the patient most likely to present, that was infected by a non-enveloped Single-Stranded DNA?
A patient reveal numerous apical granulomus with central caseous necrosis, necrotic area are large cells with abundant pale cytoplasm. What is the surface marker?
What is the MOA of argatroban?
Binds to the thrombin active site
The binding of oxygen to hemoglobin in increase, What is more likely to be released?
Mature B lymphocytes exposed to a specific virus in vitro acquire ability to proliferate indefinitely. Confirmation of this infection is established with?
Heterophil antibodies (EBV)
A patients has sever osteoarthritic back pain, what past medical history would make celecoxib the preferred treatment?
peptic ulcer disease
A patient has a hemoglobin abnormality that decreases the partial pressure at which hemoglobin is 50% saturated (P50) from 26 t0 20. What sequelae is the patient most likely to develop?
Detecting prostate cancer is negative in 95% of patients who do not have the disease. What is the probability of getting at least 1 positive test result?
A 7-yo male, colicky abdominal pain and arthralgies, palpable lesions over his lower extremities. What is the most likely cause?
Circulating immune complexes.
A mean of 5.0 and standard deviation of 0.5, 95% of patients will be between what?
4.0 and 6.0
A patient has an enzyme assays performed on circulating blood cells demonstrate low pyruvate kinase activity. What is the most likely cause of the patients splenomegaly?
Glanzman thrombasthemia, caused by a lack of functional platelet surface receptors necessary for aggregation. What drug mimic this?
14-yo African American with sickle cell anemia, Lab reveals hematocrit of 18% and reticulocyte of 0.5%. What viruses is responsible?
Non-enveloped single stranded DNA virus (Parvo-B19)
A case-control study is designed to evaluate the hospital officials, claim that exposure to chemical waste increases the risk for developing AML is childhood. What would be the control group?
Children both with and without exposure to the chemical waste who do not suffer from AML.
67-yo has decreased vision in his right eye over the past 2 weeks, describes his right- eye vision as blurry and distorted. Treatment should target what?
Vascular endothelial growth factor
Pulmonary ventilation/Perfusion scanning reveals a large mismatched defect in the lower lobe at the right lung. The agent for long-term therapy to prevent recurrences has what MOA?
Blocks glutamate residue carboxylation (Warfarin)
HbS disease generally causes a more severe condition compared to HbC disease because HbS disease?
Allows hydrophobic interact ion among hemoglobin molecules.
Energy-dependent organic anion transport across the hepatocellular membrane is selectively inhibited. What will be the result?
Increased bilirubin excretion in the urine
18-yo male, evaluated for an eczematous skin rash, Several bouts of severe respiratory infectious, platelet count of 40,000. The platelets seem abnormally small and deformed. What is the syndrome?
Wiskott- Aldrich syndrome
Which best describes the mechanism of action of hydroxyurea?
Increases hemoglobin F synthesis
Tumor cell lines can become resistant after exposure to various anticancer agents. The cell surface glycoprotein of these cells has what function?
Antivirus agent shown to selectively bind to the HIV gp41 protein. It will inhibit what process?
viral attachment target cell
A African American male begins a treatment with trimethoprim-sulfamethoxazole, but develops dark urine with a hight reticulocyte count. What is the best explanation for the observed findings?
Hereditary erythrocyte enzyme deficiency (G6PD)
A male comes to you complaining of mouth ulcers and fever, he has a past medical history of long-term hypertension and an episode of transient ischemic attack, lab shows WBC 1,100. What drug is most likely associated with this patients condition?
An elderly patient is diagnosed with aggressive non-Hodgkin's lymphoma. the tumor cells are shown to stain strongly strongly for the CD20 marker. What treatment can be added to help improve the treatment response?
A patient receives desmopressin which effectively stops the bleeding. Which of the following is the most likely target for the drug?
A man's physical examination reveals plethora and ruddiness of the face and moderate splenomegaly, Hematocrit 64%. This is caused by mutation in what type of protein?
Non-receptor tyrosine kinase (Polycythemia vera).
Bone marrow biopsy shows absence of erythroid precursors but preserved myeloid and megakaryocytic elements. Further workup would show what?
Thymic tumor (pure red cell aplasia)
The structure shown contains cells undergoing Isotype switching.
A radioactive protein that combines with antibody-protein complex is used to determine whether the test is positive. This type of analysis is called a?
You Suspect that your patient has a valine for glutamic acid substitution at position 6 of the B-globin chain of the hemoglobin molecule. This patient's hemoglobin would most likely aggregate upon?
a low-magnification image of the lymph node histology shows BCL-2 overexpression (follicular lymphoma).
A female presents with a right-sided ovarian mass, her bloodwork shows a marked elevation of CA-125. What would most likely prevent this patient's condition?
Rats exposed to high concentrations of carbon tetrachloride suffer rapid and extensive liver damage. These changes are the result of?
Free radical injury.
T cell receptors of many lymphocytes demonstrate a very high-affinity interaction with MHC molecules expressed on thymic medullary epithelial and dendritic cells. What is this process called?
The size of the lymph node fluctuates over time. The biopsy is most likely to show?
Follicular small cleaved cell lymphoma.
Glutamate residues of some proteins newly synthesized in this infant's liver fail to be carboxylated. Which nutrient deficiency is most responsible for this finding?
A 7-yo boy develops acute renal failure after bloody diarrhea. A blood count shows anemia and thrombocytopenia. What the most likely cause of this anemia?
Microangiopathic hemolytic anemia
The etoposide-killed cancer cells are due to a dysfunction of what?
Man spends five hours in the sun. What is most likely to happen to the patient's skin cells?
Specific endonuclease nicks the damaged DNA strand.
A man is is being evaluated for fatigue, mild normocytic anemia and anorexia, he lost 10 pounds and x-ray reveals an irregular perihilar mass in the right lung field. administration of what can mimic this person symptoms?
This evening a neighbor found him in a closed garage with the car running. he loses consciousness and begins to seize. The toxic substance causing this affects hemoglobin by?
Competitive binding to heme.
A boy with throat pain, tachypnea, and inspiratory stridor, has worsening dysphagia with solid foods. Lab reveals many immature hematopoietic cells (blast) in the blood smear. The neoplastic cells causing patients condition give rise to what?
What process is unique to the daughter strand that is synthesized in the opposite direction of the growing replication fork?
Synthesis of multiple, short DNA fragments (Okazaki fragments).
His hemoglobin electrophoresis shows: Hb A 60% and Hb S 40%. What is true about this patient?
He is protected from Plasmodium falciparum.
A women develops severe nausea and vomiting soon after receiving high-dose chemotherapy. What agents would be most helpful to treat her symptoms?
Suffered a severe allergic reaction to penicillin, her CBC shows erythrocyte count: 2.2, leukocyte count: 2,500, platelets: 90,000. The patient most likely received treatment with?
Chloramphenicol (aplastic anemia)
a solution is created that contains only monomeric beta hemoglobin subunit. The oxygen dissociation curve would most like resemble?
increase affinity (myoglobin).
A single amino acid residue replacement (serine instead of histidine) in the hemoglobin B-subunit result in poor interaction with 2,3-biphosphoglycerate. The hemoglobin has properties of what type of hemoglobin?
Her peripheral smear shows red blood cell fragments, "burr cells," and helment cells. What could be the most likely cause of her condition?
Past medical history shows sever aortic stenosis that required aortic valve replacement. What is the most likely findings in this patient?
Decreased serum haptoglobin level.
What markers would favor a diagnosis of small cell carcinoma?
A women has recurrent nosebleeds, prolonged bleeding time, and scattered ecchymoses over her arms and legs. What is the most likely cause of the condition?
immune destruction of platelets (ITP)
He subsequently develops tingling of his hands and feet, symptoms which are suspected to be a drug side effect. Because of the drug the cells stop proliferating during which cell cycle stage?
A male is treated with Drug A are unable to synthesize viral DNA from the RNA template. Drug A is not phosphorylated intracellularly and is structurally unrelated to nucleosides. What is drug A?
A African American diagnosed with a mild urinary tract infection. Anemia is evident and erythrocyte fragment. What substrate flow pathways is likely deficient?
G6P -(G6PD)-> 6PG
If xeroderma pigmentosum is a diagnosis. What enzyme is most likely nonfunctional if the diagnosis is correct?
What feature would carry the worst prognosis?
Tumor penetration into the muscularis propria (Stage)
A female present with a breast mass found to be malignant, ten years ago she was diagnosed with osteosarcoma. Her mother died from a brain tumor and her aunt suffered from rhabdomyosarcoma. What gene mutation is responsible for this patients condition?
A man comes to the physician with a skin rash, he was treated with painful oral ulcers 6 months ago. He frequently uses illicit drugs. Examination shows a widespread rash consisting of lesions, What is the most likely cause of this patient's condition?
Human herpes virus type 8 (Kaposi's sarcoma).
An external stimulus applied to a cell increases the activity of several enzymes. What immediately precedes the observed effect?
Retinoblastoma protein phosphorylation (RB)
Positive immunohistochemical staining for cytokeratin. These cells most likely belong to which of the following lineages?
What would be most consisten with malignancy in this patient?
Monoclonal T-cell receptor gene rearrangements
A female has been treated with warfarin. Her PT is found to be sub-therapeutic. What concurrent medications is she most likely taking?
Phenytoin (decreased efficacy of warfarin)
Laboratory analysis shows a hemoglobin A2 level of 7.5% (normal: 1.5%-3.5%). What is the most likely explanation for this patients abnormal findings?
A certain antineoplastic drug is an analog of adenosine, and is resistant to adenosine deaminase. What is the drug that is being described?
A women is started on raltegravir. What step of viral replication is most likely impaired as a result of the treatment?
Messenger RNA transcription.
The bruise has a greenish color that is best explained by the action of?
A 50-yo is started on warfarin therapy for new-onset atrial fibrillation. He develops a painful lesion on his arm. What is the most likely cause of this lesion?
Protein C deficiency
A 76-yo man comes to the physician for back pain, he has urinary urgency and frequency. What processes is most likely to be responsible for his back pain?
Foreign antigen recognition at the cell surface by cytotoxic T-lymphocytes stimulates a response that results in rapid cell death. What act as effectors of this response?
A 23-yo African-American has yellow sclerae and hemoglobin is 6.7. Histopathologic evaluation of his spleen is most likely to reveal what?
Fibrosis and atrophy
This patient's markedly increased macrocytosis is most likely caused by what?
Folic acid deficiency
A peripheral blood smear demonstrates numerous enlarged red blood cells that appear blue on Wright-Giemsa stain. The bluish color of these red blood cells is best explained by the presence of what?
Prior to intubation, a skeletal muscle relaxant is administered and the patient goes into cardiac arrest, his serum potassium level is 10.0mEq/L. Administration of what agents is most likely responsible for his condition?
Etancercept is added to her treatment regimen. This medication is best characterized as what?
Soluble receptor decoy protein.
A homeless male comes into the ER because or recurrent nosebleeds. Physical exam shoe swollen gums, ecchymoses and hyperkeratosis. His condition is most likely related to?
Abnormal proline hydroxylation (Vitamin C deficiency)
A male who experienced head trauma, has the nasogastric tube placed in and drains blood. This patient most likely suffers from?
Stress-related mucosal erosions
pseudocyst lined by fibrous and granulation tissue not epithelium
What are Carcinoid tumor derived from?
neuroendocrine cells or endocrine cells
A male with abdominal pain shows chalky white lesions in the mesentery. Histologic evaluation of the lesions reveals fat cell destruction and calcium deposition. The patient most likely suffers from?
A African-American women complains of periodic abdominal pain and explosive diarrhea. A diet free of milk-containing products relieves her symptoms. Light microscopy of her intestinal mucosa shows what?
Normal intestinal mucosa
A man has a AST level of 156 and ALT level of 44. The diagnosis of pancreatitis is made. What additional laboratory findings is characteristic of the underlying etiology?
Mean corpuscular volume of 108 fL
A male presents with an ulcer in the distal duodenum. His basal gastric acid secretion is high with the ratio of basal to maximal acid output. This patient's condition is most likely caused by what?
Non-gastric neoplasm (Duodenal ulcer)
A male return from a trip from Latin America, complaining of fever and watery diarrhea, Physical examination reveals hepatosplenomegaly, and rose-colored spots at the periumbilical area. What organism is the cause of this patient's symptoms
What picornaviruses are the most acid-labile (killed by acid)?
What is the most common location of colon cancer?
A male have several small pouches composed of a mucosal layer and compressed submucosa. The diverticula in this patient is best described by?
A male presents with right lower quadrant tenderness with rebound as well as a palpable mass. CT scan of the abdomen and pelvis demonstrates a periappendiceal fluid collection. Culture of this fluid would indicate what organism?
A male lost several pounds because he eats less for fear of pain, past medical history is significant for hypertension, hyperlipidemia, coronary artery bypass grafting, and right -sided carotid endarterectomy. The pathophysiology of this patient indicates what?
A man with abdominal pain and periodic diarrhea is found to have heme-positive stools. What does this patient most likely suffers?
A girl has abdominal distention, periodic diarrhea, and difficulty gaining weight. What would most likely improve her symptoms?
Special diet (celiac sprue)
A 3-week-old-girl in the neonatal intensive care develops abdominal distension, vomiting, and blood-streak stools. Abdominal x-ray shows thin curvilinear areas of lucency that that parallel the bowel wall lumen. What is the most likely diagnosis?
A male complains of nocturnal cough, findings of the esophageal biopsy finds elongation of the lamina propriae, man eosinophils, and occasional neutrophils within the squamous epithelium. what is most likely the cause of his symptoms?
Gastroesophageal junction incompetence
A 23- yo male with a history of abdominal pain, periodic diarrhea, low-grade fever, and easy fatigability is found to have an enteroenteric fistula on radiography. Colonoscopy shows cobblestone mucosa that has linear ulcerations with skip areas of normal bowel wall. What is the most likely explanation of fistula formation in this patient?
A 65-yo man complains of progressive weight loss, jaundice, and anorexia for the last 3 months. He notes that his urine has been dark and his stools have been pale. His gallbladder is found to be enlarged by nontender. What is the most important risk factor predisposing to this patient's condition?
Smoking (pancreatic cancer)
A gastric biopsy taken from a male with upper abdominal discomfort is placed into a urea-containing solution containing a pH indicator. 30 mins later, the solution has turned pink, indicating a pH increase. The test result suggests what?
Measuring the level of carcinoembryonic antigen (CEA) in this patient would be helpful for?
Monitoring for tumor recurrence
A male presents to the ER with abdominal pain that started around his bellybutton, then moved to the right lower abdominal quadrant. What most likely initiated this patient's condition?
A female physical examination reveals fingertip ulceration and multiple telangiectasias. What is the most likely cause of this patient's heart burn?
Fibrous replacement of muscularis
A 2-yoboy is hospitalized with abdominal pain and vomiting. The patient most likely suffers from?
Barium enema performed shows a relatively-narrow rectum and rectosigmoid area. The rest of the colon is significantly dilated. Sampling from what area would be most useful for making diagnosis?
Submucosa of the narrow part
A male presents with fever, bloody diarrhea, and abdominal distention. He was found to have ulcerative colitis. What is the next step in this patient's work-up?
Flat plain X-ray
Genetic analysis shows that the patient most likely over expresses transcription factor NF-kB, which stimulates:
A Caucasian male has suffered from recurrent pulmonary infections and occasional sinusitis, he has also been diagnosed with steatorrhea. At autopsy, the pancreas is most likely to show what abnormality?
Ducts filled with mucous plugs
A female has episodic cutaneous flushing, watery diarrhea, and dyspnea associated with wheezing. Urinary excretion of 5-(HIAA) over 24 hours is increased. Abdominal imaging shows a tumor in the small bowel. This tumor is most likely of what kind?
A male with vague abdominal pain, low-grade fever, and diarrhea has no improvement with antibiotics, he develops a skin lesion in his right lower abdominal quadrant that turns out to be an enterocutaneous fistula. The patient most likely suffers from what?
A male is found to have a mass lesion in his ascending colon. The mass biopsy is consistent with colon cancer. This patient presents with what symptoms?
Weight loss and progressive fatigue
A barium swallow study shows an esophageal mass that significantly narrows the lumen. Endoscopic biopsy reveals moderately differentiated tumor cells with keratin nests and pearls. This patient's condition is most likely related to what?
Alcohol consumption and tobacco smoking (squamous cell carcinoma).
A man has acute pancreatitis that resolves rapidly on fasting. Everything is normal and he does not consume alcohol. what test should be considered during the workup?
Serum triglycerides (acute pancreatitis)
A alcoholic male is brought to the ER with hematemesis. He has had three episodes of vomiting. Endoscopy shows longitudinal mucosal tears at the gastroesophageal junction. This patient's condition is most likely related to what?
intraabdominal pressure and intraluminal gastric pressure.
A man complains of dysphagia histogram is shown.
Malignancy with probable poor prognosis (squamous cell carcinomas)
Compared to sporadic colorectal carcinoma, colorectal malignancy arising in this patient would most likely exhibit what feature?
Be multifocal in nature
A women presents with diarrhea containing a lot of mucoid material. Colonoscopy is scheduled and reveals a cauliflower-like mass in the sigmoid colon. The patient most likely suffers from what?
A man presents with pain on defecation. He notes spots of bright red blood on the toilet paper. Rectal examination reveals a tear of the anal mucosa. Such tears are most commonly found where?
Posterior midline distal to the dentate line.
A man comes in complaining of intermittent, bloody diarrhea and abdominal pain. He was diagnosed with HIV five years ago. Colonosocpy reveals multiple hemorrhagic polypoidal lesions. Biopsy of the lesion reveals spindle cells with surrounding blood vessel. What is most likely the cause of this patient diarrhea?
A male review of symptoms reveals periodic abdominal discomfort and diarrhea in this patient. Duodenal biopsy shows flat intestinal epithelium. The patient most likely suffers from what
A male presents with abdominal discomfort, greasy stool and weight loss. intestinal biopsy shows multiple macrophages loaded with PAS-positive granules in the lamina propria. This patient should be treated with?
Intestinal biopsy is performed and periodic acid-Schiff (PAS) reaction is used on the sample. The intense pink discoloration demonstrated on the slide most likely indicates the presence of?
What cells are primarily responsible for the uptake of Shigella that initiates the infection?
Antigen-sampling M cells
The epithelial cells forming the lesion has a APC gene mutation?
tubulovillous adenomatous polyp
A male presents with recent weight loss. He also complains of epigastric discomfort after meals. The lesion most likely demonstrates what?
infiltrative growth within the stomach wall (signet ring cells)
If the ovaries are secondarily involved, where is the most likely primary sight of metastasis?
Increased activity of what is most likely to promote recurrent adenoma development?
A male develops hypotension then postoperatively, develops abdominal pain and bloody diarrhea. What portion of large bowel most likely is affected in this patient?
A man presents with periodic diarrhea and recent weight loss. His stools are foul-smelling, bulky, and frothy. What is the most appropriate next step in assessing for impaired nutrient absorption?
A man presents with new-onset dyspnea and wheezing. He also reports facial flushing and diarrhea. Scan shows mass lesions in right liver lobe and appendix. What medications can be used to relieve the patient's symptoms?
E. coli isolated from a patient with diarrhea does not ferment sorbitol and does not produce glucuronidase. The toxin produced by these bacteria would most likely do what?
inactivate ribosomal subunits (EHEC: 157:H7)
A man started taking clindamycin and a few days after develops watery diarrhea and abdominal cramps. The complete blood count shows leukocytosis. The toxin primarily damages which of the components of intestinal mucosal cells?
A water-born gstroenteritis is caused by oxidase-positive, gram-negative, coma-shaped rods that can survive on alkaline media. Stool in these patients is expected to demonstrate?
Mucus and some epithelial cells
A male presents with severe nausea and vomiting two hours after consuming a mayonnaise-containing salad. Condition improved in several hours. His symptoms were caused by what?
Exotoxin formed prior to ingestion (Staphylococcus aureus).
Healthy volunteers inoculated with Clostridium difficile do not develop signs of infection. What protective mechanisms is most likely responsible?
A male presents with history of fever, abdominal pain and diarrhea. The patients pet puppy had diarrhea one week ago. What pathogen most likely the cause of his symptoms?
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