Block 10 Hemodyimic Disorder MCQ's
- 1.A woman in the immediate post-partum period, suddenly and without warning, presents shortness of breath with deep cyanosis. Cardiovascular shock followed rapidly by clonic-tonic convulsions and profound coma and death. 80% of patients with clinical presentation as above, most probably die as a consequence of one of the following conditions:
- A.
Amniotic fluid embolism
- B.
Bilateral cortical necrosis of kidneys
- C.
Gram negative sepsis
- D.
Toxemia of pregnancy
- E.
Neurogenic shock
- 2.A 62 year old woman attends to clinic with a longstanding history of systemic hypertension complaining of breathlessness on exertion. On physical examination her physician finds bibasilar crackles. An ECG reveals left ventricular hypertrophy by voltage criteria but not ST segment elevation or depression. Serum cardiac enzymes levels are within normal limits. An echocardiogram reveals dilatation of the left ventricle. Her breathlessness is most likely due to:
- A.
Right sided CHF due to systolic dysfunction
- B.
Left sided CHF due to diastolic dysfunction
- C.
High output Cardiac Failure
- D.
Pleural effusion due to Right Heart Failure
- E.
ARDS due to hypertension
- 3.A 32 year old man involved in a motor vehicle accident sustains a fracture of his left femur. While in the hospital 2 days after the accident, he is noted to be dyspneic and disoriented, and he develops petechiae on his trunk and axilla. What is the most likely pathology diagnosis in this case?
- A.
Foreign body emboli
- B.
Pulmonary thromboembolus
- C.
Septic emboli
- D.
Air embolus
- E.
Fat embolism
- 4.A 38 year old woman, while recovering bedridden several days after having an abdominal hysterectomy, develops an acute onset of chest pain and shortness of breath. Physical examination finds an afebrile patient who presents moderate respiratory distress. She is somewhat anxious, is breathing quickly, and calf tenderness is present. What would be the most important predisposing factor for the cause of current condition in this patient?
- A.
Prothrombin gene mutation
- B.
Anti-phospholipid antibody syndrome
- C.
Factor V Leiden mutation
- D.
Stasis of blood in lower extremity
- E.
Surgical removal of pelvis vein plexus
- 5.A 60 year old male teacher with diabetes mellitus and hypertension attends to the outpatient clinic complaining of difficulty breathing while walking about 30 yards across the parking lot. He also reports has required up to 3 to 4 pillows to sleep at night. Physical examination reveals bibasilar crackles, pitting edema (3 +) of lower extremities and some pressure sensation in the upper right upper quadrant of the abdomen. Which of the following changes best describes the pathophysiology involved in the production of the changes found in his lungs?
- A.
Decreased plasma oncotic pressure
- B.
Widespread endothelial damage
- C.
Increased vascular permeability
- D.
Increased hydrostatic pressure
- E.
Acute lymphatic obstruction
- 6.A 45-year-old female, bank teller with no medical history and taking no medication; after an 8 hour-shift working, she notices there is swelling of her lower legs and feet. There is no pain or erythema associated with this swelling. Which of the following mechanisms best explains how this phenomenon occurred?
- A.
Increased hydrostatic pressure
- B.
Lymphatic obstruction
- C.
Secondary aldosteronism
- D.
Hypoalbuminemia
- E.
Excessive water intake
- 7.A 68 year-old female suffered a fracture to her right femoral trochanter. Two weeks later her right leg below the knee is markedly swollen and there is tenderness to palpation. She experiences pain on movement of this leg. Which of the following is most likely to occur?
- A.
Gangrenous necrosis of the foot
- B.
Hematoma of the thigh
- C.
Disseminated intravascular coagulation (DIC)
- D.
Pulmonary thromboembolism
- E.
Fat embolism
- 8.Generalized Edema is not a common clinical presentation in one of the following conditions associated to hypoproteinemia (reduced plasma osmotic pressure):
- A.
Crohn´s disease
- B.
Neoplasia
- C.
Malnutrition
- D.
Liver cirrhosis
- E.
Nephrotic syndrome
- 9.68 year old man was taken to the ER after he experienced severe episode of chest pain. He had cardiac arrest and resuscitation maneuvers failed. An autopsy was done and a sample of myocardium was taken. On microscopic examination of this tissue section showed a bright eosinophilic staining area with loss of nuclei and cross striations of myocardial cells. There was no inflammatory infiltrate of hemorrhage. Which of the following conditions was most probably the cause of changes seen in the myocardium?
- A.
A protein deficient diet
- B.
Specific antibodies against myocardium
- C.
Blunt chest trauma
- D.
Coronary artery thrombosis
- E.
Viral infection
- 10.A 56-year-old chronic alcoholic presents with ascites, peripheral edema and jugular venous distention. Which of the following organ: histopathology combinations would you most likely see in relation to his cardiac disease?
- A.
Kidney: hyperplastic arteriolosclerosis
- B.
Heart: amyloid angiopathy
- C.
Brain: basal ganglia hemorrhage
- D.
Liver: centrilobular sinusoidal congestion
- E.
Adrenal gland: cortical hyperplasia
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