Block 11 - Week 14 - CV & Respiratory Clinical Application

10 Questions | Total Attempts: 187

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Block 11 - Week 14 - CV & Respiratory Clinical Application - Quiz

Questions and Answers
  • 1. 
    A 35-year-old man returned last weekend from a vacation in Kenya, where he went on safari with his wife.  He presents with fever, chills, headache, nausea, and weakness.  On physical examination, he is found to have an enlarged, tender lymph node in his groin.  A bipolar-staining, Gram-negative rod is isolated from blood cultures and culture of an aspirate from the lymph node. Which of the following virulence factors is important in the transmission of the causative agent by the vector?
    • A. 

      Plasminogen activator protease

    • B. 

      Capsule

    • C. 

      Endotoxin

    • D. 

      Outer membrane proteins

    • E. 

      Coagulase

  • 2. 
    A 25-year-old African man living in a village in Zimbabwe without access to health care developed a 6-month-long illness characterized by fever, anorexia, cough, hemoptysis, and 50-pound weight loss. He was transported to a distant clinic where a x-ray showed bilateral cavitary pneumonia in his upper lobes. He died the next day.  What would you expect the lungs to show at autopsy?
    • A. 

      Ghon complex with fibrosis and large mediastinal lymph nodes

    • B. 

      Ischemic necrosis with blackened upper lobes

    • C. 

      Fungal hyphae invading blood vessels

    • D. 

      Multiple abscesses containing polymorphonuclear leukocytes and foul-smelling pus

    • E. 

      Caseous necrosis and Langhan’s giant cells

  • 3. 
    An old hypertensive man presents with shortness of breath and a left pleural effusion. The pleural fluid is clear, serous, has a specific gravity of 1012 and shows low protein content. Cytology reveals only a few mesothelial cells. The pleural effusion is MOST LIKELY due to:
    • A. 

      Bronchopneumonia

    • B. 

      Lobar pneumonia

    • C. 

      Left sided heart failure

    • D. 

      Pulmonary tuberculosis

    • E. 

      Bronchogenic carcinoma

  • 4. 
    A 58-year-old man has observed increasing dyspnea and 30 pound weight loss over the past month. He tells his physician that he has always tried to keep fit through exercise and healthy eating habits and does not smoke or drink. Further history taking reveals that he worked in a naval shipyard about 30 years ago at which time his duties included applying asbestos insulation to the ship’s lead piping. At this point, his physician suspects:
    • A. 

      Hypersensitivity pneumonitis related to lead exposure

    • B. 

      Mesothelioma

    • C. 

      Bronchial asthma

    • D. 

      Viral pneumonia

    • E. 

      Chronic bronchitis

  • 5. 
    A 20-year-old man accidentally drives his car into a brick wall and sustains severe chest injuries including several rib fractures, hemothorax and a collapsed lung on the side of the hemothorax. The lung has almost certainly collapsed on the basis of:
    • A. 

      Ruptured bullae

    • B. 

      Air embolism

    • C. 

      Compressive atelectasis

    • D. 

      Bone marrow embolism

    • E. 

      Absorptive atelectasis

  • 6. 
    Your patient is an 82- year old female who after a lifetime of cigarette smoking had been diagnosed with COPD.  She has been living at home, but has just arrived at the hospital presenting with dyspnea, a fever of 102oF and considerable distress.  The Gram-stained sputum shows a predominance of Gram-negative diplococci.  Which organism is most likely to be causing the patient’s condition?
    • A. 

      Neisseria meningitides

    • B. 

      Moraxella catarrhalis

    • C. 

      Haemophilus influenzae type b

    • D. 

      Streptococcus pneumoniae

  • 7. 
    A 65-year-old textile worker has had no major medical problems prior to the past year, when he noted increasing malaise along with a 7 kg weight loss. He is a non-smoker but enjoys at least 5 drinks a day.  On physical examination, he has non-tender supraclavicular lymphadenopathy. The lungs are clear to auscultation but chest x-ray shows multiple solid nodules ranging from 1 to 3 cm scattered throughout all lung fields. No infiltrates or areas of consolidation are noted. Laboratory studies show Hgb 10.6 g/dL, Hct 30.7%, MCV 79 fL, and WBC count 6280/microliter. Which of the following pathologic processes in his lungs is most likely to account for these findings?
    • A. 

      Pulmonary infarctions

    • B. 

      Foreign body aspiration

    • C. 

      Metastatic carcinoma

    • D. 

      Sarcoidosis

    • E. 

      Silicosis

  • 8. 
    A 34-year-old man with a 10 kg weight loss over the past 3 months now has had worsening fever, non-productive cough, and dyspnea for the past 3 days. His temperature is 38.2 C and there are diffuse rales in both lungs on auscultation. A chest radiograph shows patchy infiltrates in both lungs. Laboratory studies show a WBC count of 3250/microliter with differential of 78 segs, 3 bands, 5 lymphs, 11 monos, 2 eosinophils, and 1 basophil, Hgb 111.8 g/dL, Hct 35.4%, MCV 91 fL, and platelet count 317,000/microliter. His CD4 lymphocyte count is 79/microliter. Cryptosporidium organisms are found in a stool specimen. A bronchoalveolar lavage (BAL) is performed, yielding fluid that microscopically demonstrates pink, foamy exudate with little inflammation. Which of the following additional findings on microscopic examination is he most likely to have in the BAL specimen?
    • A. 

      Acid fast bacilli

    • B. 

      Branching septate hyphae

    • C. 

      GMS positive cyst-like organisms

    • D. 

      Hemosiderin-laden macrophages

    • E. 

      Short gram- positive rods

  • 9. 
    A 50 year old male comes to you for routine physical examination. He tells you that for the past 4 months he has been gradually decreasing hid activity because he gets breathless. You note a smell of tobacco on his fingers and that there is clubbing. Which of the following X-ray findings would be consistent with this presentation?
    • A. 

      Consolidation in the left lung base

    • B. 

      A solitary nodule in the Right upper lobe

    • C. 

      Cavitation in the Right middle lobe

    • D. 

      A congenital bulae in the left upper lobe

  • 10. 
    A 60 year old chronic smoker with a diagnosis of COPD comes for evaluation due to difficulty sleeping at night and increasing dyspnea. One complication he is likely to have is:
    • A. 

      Portal hypertension

    • B. 

      Cor Pulmonale

    • C. 

      Renal failure

    • D. 

      DVT

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