Block 9 Pace 1 Part 2

21 Questions | Total Attempts: 188

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Block 9 Pace 1 Part 2

Sept 2011


Questions and Answers
  • 1. 
    The figure below depicts the log dose-response curves of five different drugs (A, B, C, D, E) tested in an in vitro system. Which of the following pairs of drugs can fully activate the same receptors?
    • A. 

      Drug A and B

    • B. 

      Drug A and C

    • C. 

      Drug B and C

    • D. 

      Drug D and E

    • E. 

      Drug A and D

  • 2. 
    A 65 year old post-menopausal woman complains of vaginal bleeding. An endometrial dilatation and curettage is performed and reveals an increase in normal appearing endometrial tissue. What is the most likely diagnosis?
    • A. 

      Pathologic endometrial hyperplasia

    • B. 

      Pathologic endometrial metaplasia

    • C. 

      Physiologic endometrial hypertrophy

    • D. 

      Physiologic endometrial hyperplasia

    • E. 

      Pathologic endometrial hypertrophy

  • 3. 
    A 50 year old Caucasian man complains of chest pain which radiates to the left arm. His past medical history is significant for poorly controlled hypertension. Physical exam reveals an obese diaphoretic man in acute distress. His vital signs reveal an increase in the respiratory and pulse rates as well as an elevated blood pressure. A complete blood count with differential and chemistry panel was done upon arrival to the ER and showed a neutrophilic leukocytosis. His EKG was abnormal with S-T segment elevations. Despite thrombolytic therapy the patient dies. A consent for autopsy was obtained from his wife. What would you expect to find upon microscopic examination of the heart?
    • A. 

      Neutrophils invading the hyperplastic myocardial cells

    • B. 

      Neutrophils invading the hypertrophied myocardial cells

    • C. 

      An acute inflammatory infiltrate invading apoptotic myocardial cells

    • D. 

      A chronic inflammatory infiltrate invading necrotic myocardial cells

    • E. 

      Neutrophils invading necrotic myocardial cells

  • 4. 
    Micro Dr Drum A clinical specimen is examined by light microscopy using a variety of staining techniques. The first image shows the results of a Gram stain (cells marked by arrows) and the second those obtained by Ziehl-Neelsen staining (make sure you look at the colour versions!). To what genus does the organism most likely belong?
    • A. 

      Ureaplasma

    • B. 

      Chlamydophila

    • C. 

      Mycobacterium

    • D. 

      Streptococcus

    • E. 

      Leptospira

  • 5. 
    When transcription terminates after a stem-loop structure is formed in the messenger RNA the process is called:
    • A. 

      Sigma factor-dependent termination

    • B. 

      Rho-independent termination

    • C. 

      Elongation factor closing

    • D. 

      DNAse-dependent termination

    • E. 

      Rho-dependent termination

  • 6. 
    What is the name for a set of genes that share a common promoter?
    • A. 

      Operator

    • B. 

      Operon

    • C. 

      Negative regulation

    • D. 

      Positive regulation

  • 7. 
    bacterial culture expressing virulence factor VF (VF+) is treated with DNAse after reaching decline phase causing DNA fragmentation. A cell-free extract of culture VF+ is added to a culture lacking VF (VF-) followed by incubation for 24 hours. Which of the following processes would be necessary to achieve growth of VF+ microbes in this system?
    • A. 

      Induction

    • B. 

      Lysogeny

    • C. 

      Transduction

    • D. 

      Transformation

    • E. 

      Conjugation

  • 8. 
    Micro Dr Ad What cytokines are produced by Th1 cells for the promotion of cell-mediated immune responses?
    • A. 

      IL-1 and IL-6

    • B. 

      IL-4 and IL-5

    • C. 

      IL-10 and IL-12

    • D. 

      IL-2 and IFN-γ

    • E. 

      TNF-α and FasL

  • 9. 
    Cytokine receptors are essential for the mediation of a number of important  immunological functions. Which of the following property is characteristic of  CR1?
    • A. 

      Functions by binding and inactivating complement proteins

    • B. 

      Present on erythrocytes and binds immune complexes for removal

    • C. 

      Found on macrophages and signals host cells to make opsonin

    • D. 

      Activates complement on the surface of pathogens

    • E. 

      Inhibits complement attachment to the surface of host cells

  • 10. 
    Pharmacology: Dr B A 35-year-old man was admitted to the hospital because of anorexia, weight loss and fever for the past three weeks. Lab exams confirmed the diagnosis of endocarditis due to Enterococcus faecalis. An appropriate therapy was started which included an IV injection of amikacin. The drug has a Vd of about 20 L and a half-life of about 2 hours. A blood test showed that the plasma concentration of the drug was 2.5 mg/L, 4 hours after administration. Which of the following was most likely the dose given to the patient (in mg)?
    • A. 

      200

    • B. 

      85

    • C. 

      50

    • D. 

      125

    • E. 

      400

  • 11. 
    Immune Dr Sl As a researcher, you’re trying to develop a therapeutic antibody. You’ve immunized rabbits with an antigen X and isolated the rabbit anti-X antibodies (rAnti-X). You’re concerned that introduction of those rabbit antibodies into humans would cause the formation of human antibodies against the rabbit Fc region of rAnti-X antibodies. You want to treat the rAnti-X antibodies with an enzyme that will cleave the Fc portion away but leave the 2 antigen-binding domains remain linked. Cleavage of rAnti-X with which enzyme or chemical would produce this product?
    • A. 

      Pepsin

    • B. 

      Papain

    • C. 

      Pepsin + Papain

    • D. 

      Betamercaptoethanol (cleaves disulfide bonds)

    • E. 

      None of the above

  • 12. 
    A specimen collected from the sinuses of a 65-year old man is positive for Actinomyces sp. Which image below best represents the appearance of a Gram-stain of this organism?
    • A. 

      A

    • B. 

      B

    • C. 

      C

    • D. 

      D

  • 13. 
    A 4-month old child is referred to a specialist because she has had recurrent severe infections, chronic diarrhea and failure to thrive. Her lymphocyte counts are low, and a detailed analysis reveals that she has normal numbers of CD8 T cellsand a total absence of CD4 T cells. Failure to express which of the following would potentially lead to this phenotype?
    • A. 

      RAG-1 and RAG-2

    • B. 

      MHC Class I

    • C. 

      MHC Class II

    • D. 

      CD28

    • E. 

      IL-2

  • 14. 
    Clostridium difficile is an important cause of nosocomial diarrhea and disease in C. difficile colitis is mediated by toxins produced by the organism. Which type of laboratory test would be the most rapid and efficient way of confirming infection with this organism?
    • A. 

      Cultivation of the microbe on semi-solid media

    • B. 

      Detection of the patient’s immune response against the organism

    • C. 

      Cultivation of the microbe in cell lines

    • D. 

      Detection of the toxin produced by the organism

    • E. 

      Gram stain of specimen

  • 15. 
    A 52-year-old woman, suffering from generalized anxiety disorder, started a therapy with paroxetine, 10 mg tablet daily. Paroxetine has a half life of about 18 hours and a Vd of 1200 L. Which of the following will be the time (in hours) to reach one half of steady-state plasma drug concentration in this patient?
    • A. 

      72

    • B. 

      18

    • C. 

      36

    • D. 

      144

    • E. 

      9

  • 16. 
    Five new antihypertensive drugs have been tested on hypertensive patients. Each drug has a unique overdose toxicity. The results are reported below. Which of the  drugs has the highest risk of overdose toxicity?
    • A. 

      A

    • B. 

      B

    • C. 

      C

    • D. 

      D

    • E. 

      E

  • 17. 
    A 23 year old Asian woman complains of fever, chills, malaise, loss of appetite, and sleeping more than usual. Her vital signs are significant for an increase in pulse, respiratory rate, blood pressure and temperature. You are asked to draw a blood sample and order a complete and differential blood count. The patient is afraid of needles and reluctant to have you draw blood. She does not want to be stuck with a needle, unless it is absolutely necessary. Which of the following explanations is correct in convincing this patient of the importance of this blood test?
    • A. 

      Identifying increases in white blood cell counts is critical to diagnosing infections and proper treatment

    • B. 

      Identifying the specific type of virus, bacteria, or parasite is vital to diagnosis and treatment

    • C. 

      Identifying any abnormalities in the type and number of white blood cells is critical to diagnosing and treating the cause of her illness

    • D. 

      Identifying increases and decrease in blood cells must be done on every patient with her symptoms

    • E. 

      Drawing blood and ordering test are important to making any diagnosis

  • 18. 
    A 65 year old breast cancer survivor complains of feeling multiple small subcutaneous nodules at her healed surgical incision site. A biopsy of one of the nodules reveals a collar of lymphocytes surrounding an area with multinucleated giant cells and central necrosis. The patient is anxious and believes her breast cancer has reoccurred and spread. Which of the following explanations would you offer?
    • A. 

      This is most likely an abscess that resulted from infection at the incision site

    • B. 

      This is most likely a foreign body granuloma that has resulted from a chronic inflammatory response to sutures

    • C. 

      This is most likely a foreign body granuloma that has resulted from suppurative inflammation

    • D. 

      This is most likely metastatic breast cancer that has outgrown its blood supply and become necrotic

    • E. 

      This is most likely a focus of acute inflammation that has resulted from bacterial infection surrounding the suture site

  • 19. 
    Behavioral Science: Dr. Sa A group of physicians wishes to develop a test to assess the mood of their patients. Given that the construct of "mood" is theorized to be highly variable, even within a single individual, which of the following test characteristics can be largely ignored by the test developers?
    • A. 

      Construct-related validity

    • B. 

      Content-related validity

    • C. 

      Criterion-related validity

    • D. 

      Internal consistency

    • E. 

      Test-retest reliability

  • 20. 
    behav Dr. Ab Dr. Suave, upon entering the examination room, observed an Asian female patient who appeared to be approximately 50 years of age. As Dr. Suave commenced to interview the patient, he quickly became aware of the fact that the patient was avoiding eye contact. Dr. Suave had the urge to request that the patient look at him when she spoke. Dr. Suave refrained. He remembered a communication skill which he had learned 27 years ago in Dr. Abney’s lecture at Ross. Which of the communication skill sets below best describes the skill set which the doctor remembered?
    • A. 

      Ethics and multicultural competencies

    • B. 

      Attending behaviors

    • C. 

      Observation skills

    • D. 

      Paraphrasing

    • E. 

      Authenticity or congruence

  • 21. 
    Behavior Dr. Sh A 24-year-old female has the persistent belief that she has a heart condition that would likely lead to a heart attack. She complains of recurring palpitations for the past six months which started after a relationship break up. She has seen several doctors and has had a complete cardiac work-up including cardiac enzymes, EKG, and echo cardiogram, which have all been negative. In addition she has had all baseline studies and other relevant specialized studies including thyroid function tests, which were all normal. She was told by one physician that she was a hypochondriac. She reacted angrily to that information and is now seeking your advice and treatment to prove that she does have something wrong with her heart. You take a detailed and careful history and complete your own physical examination of her. You find nothing physically wrong with her. Which of the following represents the most appropriate approach to managing this patient?
    • A. 

      Tell her that nothing is wrong physically

    • B. 

      Refer her to a psychiatrist

    • C. 

      Redo all of the previous tests to finally confirm that she is normal

    • D. 

      Be prepared to provide long term supportive therapy.

    • E. 

      Insist that she sees a counselor.

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