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Answer updated on: 12 Feb 2020
Lactation inhibits secretion of gonadotropin-
releasing hormone14. The correct answer is C. Lactation is maintained by prolactin secretion from the anterior pituitary. Prolactin prevents ovulation by several mechanisms. It inhibits the secretion of gonadotropin-releasing hormone (GnRH) from the hypothalamus and inhibits the action of GnRH at the anterior pituitary, thus decreasing the secretion ...
Answer updated on: 12 Feb 2020
Neural crest15. The correct answer is C. The disorder described in the question is Hirschsprungs disease, a disorder of neural crest cells. Specifically, neural crest cells fail to migrate to distal portions of the colon, leading to a congenital lack of parasympathetic ganglion cells. This produces a functional obstruction of the colon, as peristalsis cannot take place. As a result, the abdomen ...
Answer updated on: 12 Feb 2020
Vision loss in one eye, usually lasting a few daysThe correct answer is E. This patient most likely has multiple sclerosis, a CNS demyelinating disorder characterized by neurologic lesions that produce signs and symptoms that are separated by both time (i.e., episodes greater than 1 month apart) and anatomic location within the white matter of the CNS. Patients typically also have difficulty in ...
Answer updated on: 12 Feb 2020
Legionella pneumophilaThe correct answer is A. The patient has a severe, potentially fatal, pneumonia with prominent systemic
symptoms. Culture on BCYE is the specific clue that the organism is Legionella pneumophila. The disease is
respiratory Legionellosis, also known as Legionnaires disease, because the disease was first described when it
occurred in epidemic form following an American Legion ...
Answer updated on: 12 Feb 2020
Branching, septate hyphaeThe correct answer is B. This is a case of tinea pedis, or athletes foot, caused by a variety of dermatophytic
fungi, which are easily detected on alkali mounts of scraped skin as colorless, branching hyphae with
cross-walls.
Hyphae with rosettes of conidia (choice A) describes the environmental/transmission form for Sporothrix
schenckii, the agent of rose gardeners ...
Answer updated on: 12 Feb 2020
Desmopressin16. The correct answer is B. Desmopressin (dDAVP) is 1-deamino-8-D-arginine vasopressin, an analog of ADH. This woman has central DI caused by trauma to the posterior pituitary. This inhibits secretion of ADH. Repleting her ADH is the most appropriate therapy of the options given. If dDAVP is chosen, the patients sodium and fluid status should be carefully monitored, because acute ...
Answer updated on: 12 Feb 2020
Immediately posterior to the medial malleolus19. The correct answer is E. Recall that blood supply to the entire leg comes from the femoral artery. The femoral artery runs anteriorly on the thigh until reaching the adductor hiatus, where it dives deep and becomes the popliteal artery. The posterior tibial artery branches from the popliteal artery and runs deep in the calf until the ankle, where ...
Answer updated on: 12 Feb 2020
Mycobacterial meningitis21. The correct answer is D. This patient suffered from tuberculous meningitis, which is demonstrated by the characteristic acid-fast bacilli present in the patients brain tissue. Immunocompromised patients are at risk for developing tuberculous meningitis, which occurs after the central nervous system (CNS) is seeded with mycobacteria that subsequently produce a thick, ...
Answer updated on: 12 Feb 2020
Secondary hyperparathyroidism22. The correct answer is E. Patients with significant renal disease are at particularly high risk for developing skeletal complications, generally known as renal osteodystrophy. Renal failure produces numerous downstream consequences that affect bone health, including increased phosphate retention (resulting in calcium phosphate deposition leading to hypocalcemia ...
Answer updated on: 12 Feb 2020
Delayed griefThe correct answer is A. Pathologic grief includes excessive, intense, or prolonged grief as well as grief that is delayed, inhibited, or denied. The patients quick return to work and lack of emotional impact at the time of death, combined with her grief symptoms 1.5 years after her husbands death, most likely reflect a delayed grief reaction. This patient is at higher risk for an ...
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