Block 13 Pace 2 Prt 1

26 Questions

Settings
Please wait...
Health Care Quizzes & Trivia

Questions and Answers
  • 1. 
    • A. 

      Bacteroides fragilis and viridans group streptococci

    • B. 

      Staphylococcus aureus and viridans group streptococci

    • C. 

      Streptococcus agalactiae and Candida albicans

    • D. 

      Candida albicans and Clostridium sp.

    • E. 

      Escherichia coli and Staphylococcus epidermidis

  • 2. 
    A 27 years old woman has sustained a severe traumatic brain injury. Wallerian degeneration is now occuring in her brain. Wallerian degeneration is the evolution of which of the following?
    • A. 

      Hemorrhage

    • B. 

      Oedema

    • C. 

      Diffuse axonal injury

    • D. 

      Herniation

    • E. 

      Intracranial pressure

  • 3. 
    A 34-year-old man was admitted to the hospital for reduction of a dislocated shoulder. Sedation with diazepam was supplemented with administration of 30% concentration of nitrous oxide. Which of the following effects most likely occurred after nitrous oxide administration?
    • A. 

      General muscle relaxation was excellent

    • B. 

      Analgesia was very pronounced

    • C. 

      Unconsciousness was achieved rapidly

    • D. 

      Blood pressure was sharply decreased

    • E. 

      Respiration was profoundly depressed

  • 4. 
    A child, female, age 7, is experiencing a seizure that involves the muscles of her entire body. At the beginning of the seizure, the muscles become intensely contracted. Then they go through a series of contraction-relaxation. The child is apparently not aware of her environment. Describe the seizure:
    • A. 

      Simple partial

    • B. 

      Complex partial

    • C. 

      Generalized convulsive

    • D. 

      Generalized non convulsive

    • E. 

      Generalized atonic

  • 5. 
    A 4-year old girl suffers from a congenital disease which involves frequent constipation and slow growth. From your medical studies you know that this congenital condition is a result of a blockage of the large intestine due to improper muscle movement in the bowel. Which specific part of the nervous system is absent in this disease?
    • A. 

      Parasympathetic nervous system

    • B. 

      Enteric nervous system

    • C. 

      Sympathetic nervous system

    • D. 

      Central nervous system

    • E. 

      Peripheral nervous system

  • 6. 
    A 2-year-old child is brought to the emergency department following a seizure. His mother reports that he had a cold with cough, congestion, and fever for several days prior to this ED visit. He has been irritable, would not eat, and has been excessively sleepy. His parents are against immunizations based on religious grounds. On physical examination, he is febrile, tachycardic, and appears very ill. He grimaces when you try to bend his neck. No skin rash is noted. A CT scan of his head is normal. A lumbar puncture is performed. CSF analysis reveals the following:   CSF Parameter Results Reference Range Opening pressure 300 mm H2O 100-200 Total WBC count 1,250 cells/mm3 0-5 Differential count 95% PMNs --- Glucose 35 mg/dL 50-80 Protein 100 mg/dL 20-45 Results of the Gram stain of the CSF is shown below:   Which of the following is the most appropriate procedure to definitively identify the causative agent?
    • A. 

      Culture the CSF on blood agar and chocolate agar media

    • B. 

      Perform a catalase test of the isolated organism

    • C. 

      Perform a latex agglutination test to detect the specific antibody in the CSF

    • D. 

      Culture the CSF on mannitol salt agar medium

    • E. 

      Perform a coagulase test of the isolated organism

  • 7. 
    If a 40-year-old man, diagnosed with an acute right subdural hematoma, suddenly develops right ptosis with a dilated pupil non-reactive to light, the most likely cause of these findings is:
    • A. 

      Acute hydrocephalus

    • B. 

      Occipital lobe infarct

    • C. 

      Transtentorial hypoccampal herniation

    • D. 

      Laceration of ipsilateral pedunculus

    • E. 

      Laceration of contralateral pedunculus

  • 8. 
    The following list of primary malignancies accounts for the majority of metastatic brain tumors; choose the best answer.
    • A. 

      Testis, ovary, melanoma

    • B. 

      Lung, prostate, uterus

    • C. 

      Pancreas, melanoma, ovary

    • D. 

      Lung, breast, melanoma

    • E. 

      Salivary gland, ovary, testis

  • 9. 
    A 21-year-old female underwent a craniectomy because of a tumor mass located in the right fronto-parietal region. The pathologist examines the tumor in a hematoxilin-eosin-stained section and would like to identify the cells of astrocytic origin. Which IHQ stain he would most likely order?
    • A. 

      PAS stain

    • B. 

      Vimentin

    • C. 

      S-100 protein

    • D. 

      Bodian stain

    • E. 

      GFAP (Glial fast acidic protein)

  • 10. 
    A 31-year-old man was brought to the hospital emergency room after a he was hit by a car. He was conscious on admission. CT images of the head demonstrated cerebral cytotoxic edema with no evidence of parenchyma or extra-axial hemorrhage. He became tachypneic and hypoxic. The pathologic alteration in this patient’s brain is most likely related to one of the following mechanisms:
    • A. 

      It is associated with dilutional hyponatremia

    • B. 

      Brain herniation is an unusual complication

    • C. 

      It results from and expanding mass lesion in this patient

    • D. 

      It results from a breakdown of the BBB barrier

    • E. 

      It affects mainly the gray matter

  • 11. 
    A 20 year old woman attends to the hospital with rapidly ascending weakness in her distal extremities, to involving proximal muscles. On physical examination there is absence of deep tendon reflexes and a spinal tap reveals the CSF protein to be increased, glucose is half the amount of plasma and scant cells are reported. She had recovered from a viral respiratory tract infection two weeks before. A biopsy study of a peripheral nerve had inflammation and demyelination. The diagnosis in this patient is:
    • A. 

      Guillain-Barre syndrome

    • B. 

      Myasthenia gravis

    • C. 

      Syringomielia

    • D. 

      Charcot-Marie-Tooth disease (Type 1)

    • E. 

      Metabolic neuropathy

  • 12. 
    Your 42-year-old female patient presents with a history of type II diabetes. She complains of dysphoric mood, difficulty concentrating, sleep disturbance, appetite disturbance, back pain, headache and fatigue for the past three weeks. What is the most likely type of mood disorder exhibited by this patient?
    • A. 

      Cyclothymic disorder

    • B. 

      Major depressive disorder

    • C. 

      Dysthymic disorder

    • D. 

      Melancholia

    • E. 

      Mood disorder due to a general medical condition

  • 13. 
    You enter a room at your family practice office to find an adult male patient placing several medical supplies into his backpack. When you ask what he is doing, he explains that he needs the supplies for his wife, who is very ill, and that the couple is unable to afford these materials on their own. When you consult his chart, you find that the patient’s marital status is listed as “single,” and further investigation reveals that this individual was actually using an alias, having apparently stolen both a driver’s license and insurance card from another patient. This individual’s pattern of behavior appears most consistent with which of the following personality disorders?
    • A. 

      Avoidant

    • B. 

      Borderline

    • C. 

      Antisocial

    • D. 

      Narcissistic

    • E. 

      Schizoid

  • 14. 
    A six year old child is brought to the physician by her anxious parents who complain that she is very restless during the day and her teacher complains that she is disruptive in class at school and interferes with the other children. Her hyperactivity has been for the past two weeks and occurs mostly at school but also at home in the evenings which her parents felt was because of her tiredness after a day at school. What condition would you want to evaluate this child for, which after treatment, would result in a resolution of her problem without resorting to the use of stimulant medication or any form of psychotherapy.
    • A. 

      Conduct disorder

    • B. 

      Sleep apnea

    • C. 

      ADHD hyperactive type

    • D. 

      ADHD inattentive type

    • E. 

      Child abuse

  • 15. 
    Mr. Davies is 60 years old. He is a successful businessman and likes to have a drink or two with his associates in the evening. One evening he came home, went to sleep and woke at three a.m. with the worst unilateral headache he’d had to date. His nose was stuffy and eyelid drooping on that side. His face was flushed. He had had a similar headache, but not as severe, 2 days before and also the previous week. In the past these headaches had only lasted a ½ hour, so Mr. Davies felt it wasn’t worth calling the doctor. About every 4 or 5 months Mr. Davies gets a week or so of these bad headaches and then they disappear until the next time. Mr. Davies has a classical case of:
    • A. 

      Migraine with aura

    • B. 

      Complicated migraine

    • C. 

      Cluster headaches

    • D. 

      Trigeminal neuralgia

    • E. 

      Tension headache

  • 16. 
    A 23-year-old female has been doing military maneuvers in the desert all day. She returns to base and then is required to attend a parade which involves standing at attention in the sun for half an hour. After a quarter of an hour she suddenly collapses and passes out. She recovers quickly and, apart from feeling a little shaky, is behaving normally. She has most likely suffered from:
    • A. 

      Vertebrobasilar insufficiency

    • B. 

      Akinetic drop attack

    • C. 

      Generalized seizure

    • D. 

      Vascular syncope

    • E. 

      Heat stroke

  • 17. 
    A 68-year-old male presents with progressive memory difficulties over 3 years, and is now unable to dress properly without his wife laying out his clothes. A diagnosis is made clinically, but for a definitive diagnosis the most characteristic pathological feature/s would be:
    • A. 

      Abnormal Tau protein

    • B. 

      Abnormal APOE4

    • C. 

      Frontal atrophy

    • D. 

      Cerebellar stroke

    • E. 

      Plaques and tangles

  • 18. 
    A 56-year-old right-handed white male presents with a sudden onset of weakness; right upper more than lower extremity. His speech is non-fluent, with poor repetition and word-finding difficulty. There is a past history of uncontrolled hypertension and diabetes. The clinical / pathophysiological correlation most fitting with this case is:
    • A. 

      Anterior cerebral artery distribution stroke

    • B. 

      Middle cerebral artery distribution stroke with an anterior (Broca’s type) aphasia

    • C. 

      Hemorrhagic stroke, based on the risk factors and his race

    • D. 

      Lacunar stroke because of the history of hypertension

    • E. 

      Border-zone stroke

  • 19. 
    A 31-year-old farm worker is brought to the emergency department obtunded with slow regular respirations. There is no visible sign or report of head trauma. His pupils are midposition and 1-2mm with little or no reaction to light. Which of the following conditions should be considered?
    • A. 

      Uncal herniation

    • B. 

      Bilateral Horner’s Syndrome

    • C. 

      Pontine hemorrhage

    • D. 

      Opiate overdose

    • E. 

      Organophosphate poisoning

  • 20. 
    An 18 year-old women presents to the University’s clinic with a behavioral problem. She must get up at 5 am in the morning to get to her first class in time. However, the time needed is expanding and she is now missing her class. She must go through a ritual of dressing, packing her books and going through doors and down steps that is taking more and more time. She has always had to be meticulous to get things done right, but she is now facing the fact that she cannot control it. Besides CBT what is the best pharmacotherapy a physician might prescribe for this condition?
    • A. 

      Alprazolam

    • B. 

      Amphetamine

    • C. 

      Clozapine

    • D. 

      Imipramine

    • E. 

      Sertraline

  • 21. 
    A 32-year old man presents to his family physician with complaints about headaches. He says either a headache or a stomachache seems to interfere with his work and his boss is complaining. Upon questioning he admits that he now finds his work is stressful but hadn’t a year ago, has lost weight over the past 6 months, sleeps all the time on the weekends, finds it hard to get up during the week and is bored with life. His physician rules out physical ailments with several tests and suggests a diagnosis. He recommends they try pharmacotherapy that will work to increase the action of several monoamines and that they may in turn reverse stress induced damage. What is a first line drug for his condition?
    • A. 

      Clomipramine

    • B. 

      Clonazepam

    • C. 

      Chordiazepoxide

    • D. 

      Varenicline

    • E. 

      Venlafaxine

    • F. 

      Sertraline

    • G. 

      Selegiline

  • 22. 
    A 19-year-old girl and her fiancé, come to see her doctor to discuss her present antiepileptic drug therapy,. They are to be married soon, and want to start a family. Her doctor discusses her present diagnosis of complex partial, and secondarily generalized tonic-clonic seizures from which she has suffered over the past three years . She was first treated with drug A which gave her severe gingival hyperplasia , acne , and mental dullness, therefore this drug was stopped. Drug A was followed by Drug B which caused her to gain weight, loose hair, and develop a tremor; Drug B was also was stopped. When she started on drug X, its plasma levels seemed to decrease very quickly and the dose had to be adjusted upwards. Drug X effectively controls her condition, and the doctor says that it is safer than some of the others in pregnancy. Which of the options below correctly identifies drug X?
    • A. 

      Drug X is phenytoin

    • B. 

      Drug X is carbamazepine

    • C. 

      Drug X is valproate

    • D. 

      Drug X is ethosuximide

    • E. 

      Drug X is diazepam

  • 23. 
    A 25-year-old women presented at the emergency room with tremors, hyperreflexia, tachycardia, mydriasis, increased bowel sounds, gait difficulties and delirium. She has a history of depression, anxiety and opiate dependence. She is currently being treated with fluoxetine, olanzepine and methadone. What best explains the symptoms she has presented with?
    • A. 

      Benzodiazepine overdose

    • B. 

      Serotonin syndrome

    • C. 

      Alcohol overdose

    • D. 

      GABA syndrome

    • E. 

      Opiate overdose

  • 24. 
    A 26-year-old women presents to her primary care physician in the winter with a current complaint of a pattern of symptoms. She “hibernates” all winter and has done so since High School. She has gained weight from increased sweets, excessive alcohol use, lack of motivation, negative ruminations, and decreased productivity at work. From a complete history, she has had several episodes of increased mood with overspending and was brought to the emergency room for intoxication. Her physician recommends a specialist who confirms his diagnosis and suggests she start with which pharmacotherapy?
    • A. 

      Sertraline

    • B. 

      Methylphenidate

    • C. 

      Disulfiram

    • D. 

      Quetiapine

    • E. 

      Lithium

  • 25. 
    When the patient, a 26 year old male medical student, exhibits intense sweating, hyperventilation and racing pulse before a test, but in other situations he is only moderately anxious and tries to maintain a healthy lifestyle which statement is most true?
    • A. 

      In the long term, Panic Control Treatment is most effective

    • B. 

      Research shows placebo treatment alone is as effective as anything

    • C. 

      Research shows in the short term talking to the patient will work best

    • D. 

      In the long term Pharmacological Treatment is most effective

    • E. 

      No treatment is needed at this time

  • 26. 
    The patient, a 37 year old female with three children, After a recent strong earthquake she has an intense fear of going in the basement of the house, and is now afraid when using the elevator to get to her work office on the 21st floor. She feels her heart racing; she perspires heavily and says the lights seem to be getting brighter and dimmer as she rides the elevator. This has been going on for the last two weeks, does not seem to be getting any better or worse during that time. Which is the best classification at this time?  
    • A. 

      Acute Anxiety Reaction

    • B. 

      Generalized Anxiety Disorder

    • C. 

      Specific Phobia

    • D. 

      Agoraphobia

    • E. 

      Social phobia