Complications of mitral valve prolapse include all of the following except:
A. Stroke
B. Arrhythmias
C. Infective endocarditis
D. Mitral stenosis
E. Embolism of leaflet thrombi
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Disorders predisposing to cor pulmonale include all of the following except:
A. Cystic fibrosis
B. Chronic obstructive pulmonary disease
C. Left-sided heart failure
D. Kyphoscoliosis.
E. Pulmonary embolism
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Which of the following statements is not true concerning sudden cardiac death?
A. Unexpected death usually occurs within one hour after symptoms, if any, begin.
B. New myocardial infarction found in greater than 75%.
C. Lethal arrhythmia usual mechanism of death
D. Often the first clinical manifestation of IHD.
E. Strikes about 350,000 individuals annually in the U.S.
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All of the following are potential manifestations of ischemic heart disease except:
A. Myocardial infarction
B. Chronic ischemic heart disease
C. Sudden cardiac death
D. Myocarditis
E. Angina pectoris
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Which of the following would be a finding in pure left-sided congestive heart failure:
A. Cor pulmonale
B. Prerenal azotemia
C. Splenic congestion
D. "Nutmeg” liver
E. Ascites
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All of the following are associated with syphilitic aneurysms except:
A. “Cor bovinum” ("cow’s heart”)
B. "Tree-barking”
C. confined to abdominal aorta
D. obliterative endarteritis
E. aortic valvular insuffiency
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The four most significant risk factors for atherosclerosis include all of the following except:
A. Smoking
B. Hypertension
C. “Type A” personality
D. Diabetes
E. Hyperlipidemia
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A 27-year-old, African-American female is brought into the Bellevue Emergency Room. She is experiencing some difficulty in breathing and is hypotensive. The person who brought the patient in said that they were at a party when she collapsed. No other outstanding signs are observed. Which of the following is the most likely option at this point?
- hold the patient until a liver profile and serum acetaminophen, salicylates, and alcohol levels are obtained.
- hold the patient until results for a urine toxicology screen are obtained.
- provide the patient with immediate supportive care.
- call for a Toxicology Consult
- hold the patient, pending blood-gas analysis with whole blood lactate
Answer
A 75 year old woman complains of increasing constipation and has noted bright red blood in her stools recently. She notes that the caliber of her stools has decreased. A hematology consult states she has iron deficiency anemia. You should:
- provide iron supplements
- have the patient eat more red meat and spinach
- work the patient up for colonic carcinoma, which will probably be found on the left side
- perform a total colectomy for ulcerative colitis
- order a barium enema to rule out a colonic carcinoma, probably on the right side
Answer
Antibiotics may interfere with the bacterial synthesis of this vitamin and consequently produce a deficiency in the patient. The vitamin is
A. vitamin E.
B. vitamin K.
C. vitamin A.
D. biotin.
E. ascorbic acid (vitamin C).
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Antibacterial agents may induce a deficiency in
A. vitamin A.
B. vitamin E.
C. vitamin K.
D. selenium.
E. biotin (vitamin H).
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Which of the following vitamins is a potent antioxidant capable of protecting cell membranes from oxidative damage due to free radicals?
A. Vitamin A
B. Vitamin K
C. Vitamin E
D. Vitamin D
E. Vitamin B12
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Sickle cell crisis has been reported after ingestion of large doses of
A. vitamin A.
B. vitamin E.
C. pyridoxine (B6).
D. nicotinic acid (B3).
E. vitamin C.
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If your patient is vitamin B12 deficient, which statement is FALSE?
A. Folate (Folvite) may relieve the anemia.
B. Short-term treatment (one week) with vitamin B12 (Rubramin) cures the patient.
C. Intrinsic factor may be lacking or deficient.
D. Nerve damage may develop with time.
E. Tetrahydrofolate may be trapped as 5-methyltetrahydrofolate.
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Vitamin B12 deficiency may result from
A. kidney disease.
B. liver disese.
C. fish tapeworm infestation.
D. urinary tract infection.
E. use of anticonvulsant drugs.
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Only a few drugs are currently approved for use in the treatment of chronic alcohol dependence. One such drug is disulfiram. Another such drug is
A. methanol.
B. morphine.
C. atropine.
D. prednisone.
E. naloxone.
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Vitamin B12
has all of the following characteristics
EXCEPT:
A. It is a cobalt-containing compound.
B. It is synthesized by bacterial flora in the colon.
C. It is preferentially stored in the bone marrow.
D. It is required for myelin maintenance.
E. It is absorbed with the aid of intrinsic factor.
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Isoniazid (INH) interferes with which of the following vitamins?
A. Pyridoxine (B6)
B. Riboflavin (B2)
C. Thiamine (B1)
D. Nicotinic acid (B3)
E. Pantothenic acid (B5)
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Isoniazid, cycloserine, and penicillamine potentially may induce vitamin X deficiency. Vitamin X is
A. vitamin B6 (pyridoxine).
B. vitamin B3 (nicotinic acid).
C. vitamin B1 (thiamine).
D. vitamin B5 (pantothenic acid).
E. vitamin C (ascorbic acid).
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Deficiency produces pellagra (dermatitis/diarrhea/dementia).
A. Thiamine (B1)
B. Riboflavin (B2)
C. Nicotinic acid (B3)
D. Pyridoxine (B6)
E. Vitamin A
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Component of FMN/FAD; deficiency produces an angular stomatitis, glossitis, and dermatitis.
A. Thiamine (B1)
B. Riboflavin (B2)
C. Nicotinic acid (B3)
D. Pyridoxine (B6)
E. Vitamin A
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One of the side effects associated with this vitamin is flushing of the skin (vasodilation). This vitamin is
A. pyridoxine (vitamin B6).
B. pantothenic acid (vitamin B5).
C. niacin (vitamin B3).
D. riboflavin (vitamin B2).
E. ascorbic acid (vitamin C).
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Deficiency produces a polyneuritis/peripheral neuritis and cardiovascular symptoms.
A. Thiamine (B1)
B. Riboflavin (B2)
C. Nicotinic acid (B3)
D. Pyridoxine (B6)
E. Vitamin A
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All of the following have been associated with H. pylori infection except:
- squamous cell of the esophagus
- adenocarcinoma of the stomach
- duodenal ulcer
- chronic active gastritis
- gastric lymphoma, MALT type (MALToma)
Answer
All of the following are characteristic of adenocarcinoma of the stomach except:
- has been associated with bacterial infection
- has increased in incidence in the United States due to changes in dietary patterns
- is the most common malignant tumor of the stomach
- has a higher incidence in Japan than in the United States
- may arise in gastric polyps
Answer
A 30 year old woman reports a one weak episode of severe watery diarrhea and abdominal pain, which results in a 5 lb. weight loss. An endoscopic biopsy of the colon is reported as normal.
- you conclude the patient was just trying to avoid work
- you perform an upper endoscopy and gastric biopsy
- you work the patient up for a carcinoma of the small intestine
- you check the culture results for a toxin producing organism
- you send the biopsy to a different pathologist because the biopsy obviously has been incorrectly interpreted.
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Effects associated with the deficiency of this vitamin are:
1) an increase in blood pyruvic acid and lactic acid,
2) reduction in red blood cell transketolase,
3) neurologic lesions (peripheral neuritis, Wernicke encephalopathy),
4) cardiac lesions, and
5) nystagmus and diplopia.
This vitamin is
A. ascorbic acid (vitamin C).
B. biotin (vitamin H).
C. thiamine (vitamin B1).
D. pyridoxine (vitamin B6).
E. nicotinic acid (vitamin B3).
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Thiamine deficiency may lead to
A. angular stomatitis (lesions at the corner of the mouth).
B. vasodilation (flushing).
C. scurvy.
D. pellagra.
E. beriberi.
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High in egg yolk/liver; deficiency produces night blindness.
A. Thiamine (B1)
B. Riboflavin (B2)
C. Nicotinic acid (B3)
D. Pyridoxine (B6)
E. Vitamin A
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The following vitamins and their respective deficieny disease/pathology include all of the following EXCEPT:
A. thiamine: beriberi.
B. nicotinic acid: pellagra.
C. ascorbic acid: scurvy.
D. vitamin A: night blindness (nyctalopia).
E. vitamin K: impaired reproduction.
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Megaloblastic anemia should be therapeutically treated with
A. both ferrous sulfate (Feosol) and vitamin B12 (Rubramin).
B. both folic acid (Folvite) and vitamin B12 (Rubramin) simultaneously.
C. iron-dextran (Imferon).
D. either folic acid (Folvite) or vitamin B12 (Rubramin) depending upon the etiology of the deficiency.
E. homocysteine which bypasses the potential methionine deficiency
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Anticonvulsive drugs (phenytoin, phenobarbital) and the antibacterial agent trimethoprim may lead to
A. folate deficiency.
B. iron deficiency.
C. methionine deficiency.
D. homocysteine deficiency.
E. cobalamine (vitamin B12) deficiency.
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Certain anticonvulsant drugs (phenytoin, phenobarbital), trimethoprim, methotrexate and ethanol can all interfere with the metabolism and/or absorption of
A. vitamin B12 (Rubramin).
B. folic acid (Folvite).
C. deferoxamine (Desferal).
D. erythropoietin (Epogen).
E. various myeloid growth factors (G-CSF, M-CSF, GM-CSF).
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