Block 9 Pace 2 Part 2

19 Questions | Total Attempts: 101

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Block 9 Pace 2 Part 2 - Quiz

Oct 2011


Questions and Answers
  • 1. 
    Pathology: Dr Jo   This section of heart shown was taken during an autopsy from a 45 year old man with a history of familial hypercholesterolemia.  Which of the following is most consistent with the section shown?
    • A. 

      Healing by regeneration and repair

    • B. 

      Healing by repair via secondary union

    • C. 

      Healing by repair via primary intention

    • D. 

      Healing by regeneration via primary union

    • E. 

      Healing by regeneration via secondary intention

  • 2. 
    A 65 year old alcoholic man is diagnosed with cirrhosis after 40 years of heavy drinking.  Which of the following is most likely associated with his diagnosis?
    • A. 

      Fibrosis

    • B. 

      Regeneration

    • C. 

      Repair

    • D. 

      Regeneration & repair

    • E. 

      Repair & Fibrosis

  • 3. 
    Behavioral: Dr Fo During your inquiry of his past medical history, your new patient, a 35-year-old male, reports that you are the 5th primary care doctor he has had during the past 7 years. Upon further inquiry, the patient informs you that, at first, he likes his doctors, but eventually they frustrate him by not listening to him, at which point he confronts them. Such confrontation inevitably results in him firing his physician and finding another one. Which of the following most accurately describes this patient’s interpersonal process with his physicians?
    • A. 

      Counter-transference

    • B. 

      Emotionally corrective experience

    • C. 

      Evenly hovering attention

    • D. 

      Parapraxis

    • E. 

      Repetition-compulsion

  • 4. 
    behav Dr Rick   A comparison of clinically diagnosed versus autopsy-confirmed gastric and peptic ulcers was performed on 100,000 consecutive diseased patients in several large hospitals as shown in the following table. From these data, the sensitivity of clinical diagnosis was
    • A. 

      2,500/4,000

    • B. 

      1,500/1700

    • C. 

      200/96,000

    • D. 

      95,800/96,000

    • E. 

      1,500/4,000

  • 5. 
    H_BHS: Validity of screening tests The strength of the association between smoking and coronary heart disease is best demonstrated by:
    • A. 

      Incubation period

    • B. 

      Incidence of coronary heart disease

    • C. 

      Relative risk for smokers compared to non-smokers

    • D. 

      Prevalence of smoking

    • E. 

      Risk difference for smokers’ vs non-smokers

  • 6. 
    H_BHS: Measures of effect The epidemic curve below is for an outbreak of fever and rash among school-children who were subsequently shown to have had exposure to a confirmed case of rubella on June 6. The minimum incubation period for rubella in this outbreak is
    • A. 

      15 days

    • B. 

      8 days

    • C. 

      19 days

    • D. 

      23 days

    • E. 

      25 days

  • 7. 
    Microbiology: Dr Sl A 44-year-old man is given an intramuscular high dose of penicillin.  About 8 days later, he develops chills, fever  and a rash.  If his symptoms are due to an immune reaction to the drug, what type of reaction is this considered?
    • A. 

      Type I Hypersensitivity reaction

    • B. 

      Type II Hypersensitivity reaction

    • C. 

      Type IV Hypersensitivity reaction

    • D. 

      Anaphylactoid reaction

    • E. 

      Type III Hypersensitivity reaction

  • 8. 
    The vaccine for Anthrax is a killed cell vaccine.  Because of the fact that this vaccine is comprised of killed organism, what is a disadvantage of the vaccine? 
    • A. 

      There is a risk that the vaccine components will secrete the toxins that cause the disease.

    • B. 

      The immunity to the organism will wane as soon as the vaccine components are cleared from the body.

    • C. 

      This vaccine is not appropriate for use in immuncompromised persons

    • D. 

      Immunity to this organism is not typically life-long and sustained immunity will require booster shots.

    • E. 

      Maintaining viability of the vaccine is a concern.

  • 9. 
    Micro Dr Sch   The virulence factor CagA encoded by a specific pathogen is associated with gastric adenocarcinoma. CagA is encoded within a pathogenicity island and transferred into host cells via a Type IV secretion system. Which of the following pathogens encodes CagA?
    • A. 

      Candida albicans

    • B. 

      Escherichia coli

    • C. 

      Streptococcus lactis

    • D. 

      Helicobacter pylori

    • E. 

      MRSA – methicillin resistant Staphylococcus aureus

  • 10. 
    Micro Dr Ber    Researchers discover a new molecule they think could be used as an antiviral against picornaviruses. To test their hypothesis, they perform the following experiment using a cell line permissive to picornavirus infection:   Condition 1: The cells are neither treated with the test compound nor exposed to the virus.   Condition 2: The cells are not treated with the test molecule but are infected with the virus.   Condition 3: The cells are treated with the test molecule but are not exposed to the virus.   Condition 4: The cells are treated with the test compound and exposed to the virus.   After a 5 minute incubation period, all cell cultures are thoroughly washed to eliminate the test molecule and virus. A fluorescent nucleic acid probe, complementary to the viral RNA, is then used to demonstrate the presence of viral RNA inside the cells by fluorescence microscopy.   Results are as follow: Which viral molecule is the most likely target of this potential antiviral?
    • A. 

      RNA

    • B. 

      RNA polymerase

    • C. 

      Capsid protein

    • D. 

      Envelope glycoprotein

    • E. 

      Envelope lipid

  • 11. 
    An 8-year-old girl presents to the school nurse complaining of an itchy rash. The rash is composed of a mixture of erythematous macules, papules, vesicles, pustules, and crusts, mostly confined to the face and trunk. The prupritus and characteristic rash allows the nurse to conclude that the child has varicella (chickenpox). Human herpesvirus 3 (Varicella-zoster virus), the causative agent of chickenpox and shingles, interferes with the Jak/STAT pathway of antigen presenting cells thereby reducing IFN-g-mediated expression of MHC-II. Which cytokine necessary for defending against viruses would be inhibited in this case of viral immune evasion?
    • A. 

      IL-12

    • B. 

      IFN-y

    • C. 

      IL-4

    • D. 

      TNF-a

    • E. 

      A & B

  • 12. 
    Micro Dr Ad   A 15-month-old female child has a history of recurrent infections with multiple agents, including cytomegalovirus, Candida, and staphylococci.  Her mother takes her to the pediatrician concerned that she has not yet begun to walk.  Two months ago she was able to pull herself up to stand at the coffee table, but has not progressed beyond that stage.  A careful family history and pedigree analysis reveals this to be a genetic disorder that is inherited in an autosomal recessive pattern.   Of the laboratory tests listed (all of which are relevant), which one is likely to be the most useful in establishing the underlying mechanism of the immunodeficiency?
    • A. 

      Adenosine deaminase levels in leukocytes

    • B. 

      Test of neutrophil function

    • C. 

      Enumeration of B cells in the blood

    • D. 

      Enumeration of CD3 lymphocytes in the blood

    • E. 

      Quantitative serum immunoglobulin levels

  • 13. 
    Micro Dr Drum In May 2011, an outbreak of foodborne illness, presenting with bloody diarrhea and complicated in many cases by hemolytic uremic syndrome, was seen in Germany. In thousands of patients, the causative agent was identified as a lactose-fermenting, Gram-negative, oxidase-negative rod of the novel O104:H4 serotype. Interestingly, while the pathogen causes a disease similar to that caused by the O157:H7 strain, it does not have the attaching/effacing genes found in this latter organism. What virulence factor is most likely responsible for the similarities in clinical presentation between the new strain and the O157:H7 strain?
    • A. 

      Intimin

    • B. 

      Endotoxin

    • C. 

      Exotoxin A

    • D. 

      Shiga toxin

    • E. 

      Alpha hemolysin

  • 14. 
    An 18-year-old college student presents with fever, headaches, photophobia, nuchal rigidity, and petechiae. Gram-staining of both blood cultures and cerebrospinal fluid reveals red pairs of kidney bean-shaped bacterial cells. One of the ways this organism is able to survive in the bloodstream is by evading phagocytosis. What is the general structure of the virulence factor most responsible for this ability?
    • A. 

      Trimeric protein embedded in the outer membrane

    • B. 

      Short surface protein filaments

    • C. 

      Surface-anchored polysaccharide

    • D. 

      Crystalline layer of self-assembling surface proteins

    • E. 

      Polymer of sugars cross-linked via peptides

  • 15. 
    Pharmacology: Dr B  A new synthetic drug X was studied for its cardiovascular effects. The drug was given IV to four laboratory animals while the heart rate was recorded. The animals had received either no pretreatment or an effective dose of the drugs indicated below. The NET CHANGES (+ or -) induced by drug X (not by the pretreatment) are shown in the following table. Which of the following drugs did the new agent most resemble?
    • A. 

      Propranolol

    • B. 

      Acetylcholine

    • C. 

      Albuterol

    • D. 

      Norepinephrine

    • E. 

      Isoproterenol

  • 16. 
    A 35-year-old man admitted to the hospital because of a car accident, started a blood transfusion. Few minutes later he complained of nausea and pruritus and developed dyspnea with audible wheezing. His skin was mottled and cold, heart rate was 120 bpm and blood pressure fell to 80/50 mm Hg. An injection of epinephrine was given. Which of the following actions most likely contributed to the therapeutic efficacy of the drug in the in the patient’s disease?
    • A. 

      Inhibition of mast cell degranulation

    • B. 

      Stimulation of eicosanoid biosynthesis

    • C. 

      Beta-2 receptor mediated vasodilation

    • D. 

      Inhibition of insulin secretion

    • E. 

      Stimulation of platelet aggregation

  • 17. 
    Metoprolol was given IM to several dogs during a lab experiment. One hour later each dog received an autonomic drugs and the effects of that drug were recorded. Which of the following drug-induced effects was most likely best counteracted by metoprolol pretreatment?
    • A. 

      Isoproterenol-induced hyperglycemia

    • B. 

      Albuterol-induced bronchodilation

    • C. 

      Dopamine-induced renal vasodilation

    • D. 

      Atropine-induced mydriasis

    • E. 

      Dobutamine-induced tachycardia

  • 18. 
    A 35-year-old farmer was brought to the emergency room complaining of severe abdominal cramps, vomiting and excess salivation. His skin was flushed, warm, and moist to the touch. He stated that he was working in his field with an organophosphate pesticide. Which of the following molecular actions most likely mediated the flushed skin in this patient?
    • A. 

      Increase in intracellular Ca ++

    • B. 

      Increased cGMP synthesis

    • C. 

      Opening of Na+ channels

    • D. 

      Increased cAMP synthesis

    • E. 

      Increased IP3/DAG synthesis

  • 19. 
    A 69-year-old man recently diagnosed with a Proteus mirabilis infection started a treatment with a daily IM injection of gentamicin, an aminoglycoside antibiotic. Which of the following pairs of properties best explains why the drug is usually administered once daily despite the short half-life of gentamicin (about two hours)?
    • A. 

      Time-dependent killing and bactericidal effect

    • B. 

      Extensive plasma protein binding and bactericidal effect

    • C. 

      Dose-dependent renal impairment and bacteriostatic effect

    • D. 

      Concentration-dependent killing and long postantibiotic effect

    • E. 

      Time-dependent killing and long postantibiotic effect

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