Antibody Absorption ABS Exam: Quiz!

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ABS Exam Quizzes & Trivia

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Questions and Answers
  • 1. 

    Your patient has a negative RPR, but a positive treponemal test (FTA-ABS).  Which of the following is NOT a possible explanation?

    • A.

      Lyme disease

    • B.

      Untreated early syphilis

    • C.

      Adequately treated syphilis

    • D.

      Untreated late syphilis

    • E.

      All of the above are possibilities

    Correct Answer
    E. All of the above are possibilities
    Explanation
    microbiology ppt slide 41

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  • 2. 

    When making a wet mount slide for evaluation of your patient’s vaginitis, the KOH prep (potassium hydroxide) is used for:

    • A.

      Checking for GNIDS (gram negative intracellular bacteria)

    • B.

      Checking for hyphae and spores of fungal infections

    • C.

      Viewing aclue cells

    • D.

      Keeping trichomonads motile

    Correct Answer
    B. Checking for hyphae and spores of fungal infections
    Explanation
    The correct answer is checking for hyphae and spores of fungal infections. KOH prep is commonly used in the evaluation of vaginal discharge to detect fungal infections. The KOH solution dissolves the cells and mucus, allowing for better visualization of the hyphae and spores of fungi under a microscope. This helps in diagnosing conditions such as Candida albicans, which is a common cause of vaginal yeast infections.

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  • 3. 

    The first serology test to detect Hepatitis A virus infection is:

    • A.

      Anti-hepatitis B core

    • B.

      IgM anti-HAV antibody

    • C.

      IgG anti-HAV antibody

    • D.

      Hepatitis A antigen

    Correct Answer
    B. IgM anti-HAV antibody
    Explanation
    The correct answer is IgM anti-HAV antibody. IgM anti-HAV antibody is the first serology test used to detect Hepatitis A virus infection. IgM antibodies are produced early in the infection and can be detected within 2-3 weeks after exposure. They indicate an acute or recent infection. IgG anti-HAV antibodies, on the other hand, are produced later in the infection and can be detected during the convalescent phase and provide long-term immunity. Anti-hepatitis B core and Hepatitis A antigen are not specific tests for Hepatitis A virus infection.

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  • 4. 

    Which serology test indicates immunity and confirmation of Hepatitis A?

    • A.

      Anti-hepatitis A IgG antibody

    • B.

      Hepatitis A serum antigen

    • C.

      Transaminases

    • D.

      Anti-hepatitis A IgM antibody

    Correct Answer
    A. Anti-hepatitis A IgG antibody
    Explanation
    The correct answer is Anti-hepatitis A IgG antibody. This serology test indicates immunity and confirmation of Hepatitis A because the presence of IgG antibodies suggests that the person has been previously infected with the virus or has received a vaccination. IgG antibodies are produced in response to an infection and provide long-term immunity. IgM antibodies, on the other hand, indicate acute or recent infection. Hepatitis A serum antigen and transaminases are not specific serology tests for indicating immunity or confirmation of Hepatitis A.

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  • 5. 

    The first serological marker to appear in a person with  Hepatitis B is the:

    • A.

      Hepatitis B core antigen

    • B.

      Hepatitis B IgM antibody

    • C.

      Hepatitis B IgG antibody

    • D.

      Hepatitis B surface antigen

    Correct Answer
    A. Hepatitis B core antigen
    Explanation
    Hep B core antigen rises before the B surface antigen. See Bakerman's pg 294. Thanks, Judith!

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  • 6. 

    A serology test that is helpful in detecting Hepatitis B infections during the “window” period:

    • A.

      IgM antibody Hepatitis B

    • B.

      IgG antibody Hepatitis B

    • C.

      IgE antibody Hepatitis B

    • D.

      IgC antibody Hepatitis B

    Correct Answer
    A. IgM antibody Hepatitis B
    Explanation
    The IgM antibody for Hepatitis B is helpful in detecting infections during the "window" period. This is because IgM antibodies are the first type of antibodies produced by the immune system in response to an infection. During the window period, the body is still in the early stages of fighting the infection and may not have produced enough IgG antibodies yet. Therefore, testing for IgM antibodies can provide an early indication of a Hepatitis B infection.

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  • 7. 

    Which serology marker, when persistently present in the blood beyond 6 months, indicates development of chronic Hepatitis B?

    • A.

      Hepatitis B core antigen antibody

    • B.

      IgG antibody HepatitisB

    • C.

      Hepatitis B surface antigen

    • D.

      IgM antibody Hepatitis B

    Correct Answer
    C. Hepatitis B surface antigen
    Explanation
    http://enotes.tripod.com/hepatitisserology.htm

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  • 8. 

                          A screening test for Hepatitis C in a high risk patient is the:      

    • A.

      ELISA

    • B.

      EIA-III

    • C.

      Hepatitis C surface antigen

    • D.

      Heptitis C antigen antibody

    Correct Answer
    A. ELISA
    Explanation
    Hep C screening is done by ELISA method-Bakerman's pg 296. Thanks Judith!

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  • 9. 

    The above screening test for Hepatitis C is positive.  This indicates the patient has which form of the disease?

    • A.

      Acute

    • B.

      Chronic

    • C.

      Resolved infection

    • D.

      The test does not differentiate stages of infection

    Correct Answer
    D. The test does not differentiate stages of infection
    Explanation
    The given screening test for Hepatitis C is positive, but it does not provide any information about the specific form or stage of the disease. It only indicates that the patient has been infected with Hepatitis C, but it does not differentiate between acute, chronic, or resolved infection. Therefore, the test result alone cannot determine the form of the disease.

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  • 10. 

    Confirmation of Hepaitis C is determined by a second test which is the:    

    • A.

      Recombinant Immunoblot (RIBA)

    • B.

      DNA quantification

    • C.

      HCV antibody titer

    • D.

      HCV surface antibody

    Correct Answer
    A. Recombinant Immunoblot (RIBA)
    Explanation
    The correct answer is Recombinant Immunoblot (RIBA). This test is used as a confirmatory test for Hepatitis C. It detects specific antibodies against the virus in the blood. The RIBA test is highly specific and can help to confirm the presence of Hepatitis C infection. It is often used after an initial screening test, such as an HCV antibody test, comes back positive. The RIBA test helps to rule out false-positive results and provides a more accurate diagnosis of Hepatitis C.

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  • 11. 

    In order for a positive diagnosis of an HIV infection, two test must be positive. They are:

    • A.

      RNA viral load and RIBA

    • B.

      ELISA and Western Blot

    • C.

      CD4 and HIV-1 RNA

    • D.

      BDNA and HIV-1 RNA

    Correct Answer
    B. ELISA and Western Blot
    Explanation
    ELISA and Western Blot are used as confirmatory tests for HIV infection. ELISA (Enzyme-Linked Immunosorbent Assay) is a screening test that detects HIV antibodies in the blood. If the ELISA test is positive, a Western Blot test is performed to confirm the results. Western Blot is a more specific test that detects specific HIV proteins in the blood. Both tests together provide a higher level of accuracy in diagnosing HIV infection. Therefore, the correct answer is ELISA and Western Blot.

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  • 12. 

    You perform iron studies to try to discern whether your patient with microcytic, hypochromic anemia has anemia of chronic disease or iron deficiency anemia.  Which of the following findings would indicate anemia of chronic disease

    • A.

      Low serum iron, elevated TIBC, low serum ferritin

    • B.

      Elevated serum ferritin, elevated TIBC, elevated transferrin, elevated serum iron

    • C.

      Low serum iron, low TIBC, elevated transferrin, elevated serum iron

    • D.

      Low serum iron, low TIBC, low transferrin, elevated ferritin

    Correct Answer
    D. Low serum iron, low TIBC, low transferrin, elevated ferritin
    Explanation
    In anemia of chronic disease, the body's iron stores are normal or high, but the iron is not available for use in the production of red blood cells. This is reflected in the low serum iron, low TIBC (total iron-binding capacity), and low transferrin levels. However, ferritin, which is an indicator of iron stores, is elevated as the body tries to sequester iron. Therefore, the correct answer is "Low serum iron, low TIBC, low transferrin, elevated ferritin."

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  • 13. 

    Which of the following is NOT a secondary cause for hyperlipidemia?

    • A.

      Hypothyroidism

    • B.

      Diabetes Mellitus

    • C.

      Addison’s disease

    • D.

      Nephrotic syndrome

    • E.

      Alcohol abuse

    Correct Answer
    C. Addison’s disease
    Explanation
    Addison's disease is not a secondary cause for hyperlipidemia. Hyperlipidemia refers to high levels of lipids (such as cholesterol and triglycerides) in the blood. It can be caused by various factors, including hypothyroidism, diabetes mellitus, nephrotic syndrome, and alcohol abuse. However, Addison's disease, which is a condition characterized by insufficient production of adrenal hormones, is not directly associated with hyperlipidemia.

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  • 14. 

    An elevation or decrease of which electrolyte can be especially dangerous for heart muscle?

    • A.

      Sodium

    • B.

      Bicarbonate

    • C.

      Potassium

    • D.

      Chloride

    • E.

      Magnesium

    Correct Answer
    C. Potassium
    Explanation
    An elevation or decrease in potassium levels can be especially dangerous for the heart muscle. Potassium plays a crucial role in maintaining the electrical activity of the heart and ensuring proper heart function. Abnormal levels of potassium can disrupt the heart's rhythm, leading to potentially life-threatening conditions such as arrhythmias or cardiac arrest. Therefore, any imbalance in potassium levels can have severe consequences for the heart muscle.

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  • 15. 

    Which of the following is often seen in liver disease?

    • A.

      Hyperglycemia

    • B.

      Elevated serum albumin

    • C.

      Enhanced production of clotting factors

    • D.

      Hypoglycemia

    Correct Answer
    D. Hypoglycemia
    Explanation
    Hypoglycemia is often seen in liver disease because the liver plays a crucial role in regulating blood sugar levels. In liver disease, the liver may not be able to produce enough glucose or store glycogen properly, leading to low blood sugar levels. This can cause symptoms such as weakness, confusion, and sweating. Elevated serum albumin, hyperglycemia, and enhanced production of clotting factors are not typically associated with liver disease.

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  • 16. 

    Which of the following is most consistent with the hepatic enzyme profile of a person who abuses alcohol?

    • A.

      AST 98 U/L, ALT 210 U/L

    • B.

      AST 1208 U/L , ALT 560 U/L

    • C.

      AST 101 U/L, ALT 53 U/L

    • D.

      AST 678 U/L , ALT 990 U/L

    Correct Answer
    C. AST 101 U/L, ALT 53 U/L
    Explanation
    e-reserves "abnormal liver studies" by Askey. Pg 27. thanks michele!

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  • 17. 

    A 21yr old febrile woman presents with a total WBC of 15,200.  The most likely cause for this is

    • A.

      Malignancy

    • B.

      Viral infection

    • C.

      Bacterial infection

    • D.

      Inflammation

    Correct Answer
    C. Bacterial infection
    Explanation
    The most likely cause for a febrile woman with a total WBC count of 15,200 is a bacterial infection. Bacterial infections often cause an increase in the total white blood cell count, known as leukocytosis. This is because the body's immune system responds to the infection by producing more white blood cells to fight off the bacteria. In contrast, viral infections usually do not cause as significant of an increase in the total white blood cell count. Other causes such as malignancy or inflammation can also lead to an elevated white blood cell count, but a bacterial infection is the most likely explanation in this case.

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  • 18. 

    Macrocytes may be seen on the peripheral smear of all of the following except:

    • A.

      Alcoholism

    • B.

      Folate deficiency

    • C.

      Iron deficiency

    • D.

      Vitamin B12 deficiency

    Correct Answer
    C. Iron deficiency
    Explanation
    Macrocytes are larger than normal red blood cells and can be seen on a peripheral smear. They are typically associated with certain conditions, such as alcoholism, folate deficiency, and vitamin B12 deficiency. However, iron deficiency is not typically associated with macrocytes. Iron deficiency anemia is characterized by microcytic red blood cells, which are smaller than normal. Therefore, macrocytes would not be seen on the peripheral smear of a patient with iron deficiency.

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  • 19. 

    In health, the absolute band count is usually below:

    • A.

      1500

    • B.

      1000

    • C.

      800

    • D.

      500

    • E.

      200

    Correct Answer
    D. 500
    Explanation
    In health, the absolute band count is usually below 500. This means that in a normal and healthy individual, the number of immature white blood cells known as bands is typically lower than 500. An elevated band count can indicate an infection or inflammation in the body.

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  • 20. 

    After migration into tissue basophils undergo transformation into

    • A.

      Kupffer cells

    • B.

      Mast cells

    • C.

      Cochle bodies

    • D.

      Macrophages

    Correct Answer
    B. Mast cells
    Explanation
    After migration into tissue, basophils undergo transformation into mast cells. Mast cells are a type of white blood cell that play a crucial role in the immune response. They are responsible for releasing histamine, which is involved in allergic reactions, and other inflammatory mediators. This transformation allows basophils to differentiate into mast cells and carry out their specialized functions in the immune system.

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  • 21. 

    Patients with Pheochromocytoma exhibit a triad of symptoms to include all of the following EXCEPT:

    • A.

      Diaphoresis

    • B.

      Hypotension

    • C.

      Palpitations

    • D.

      Headache

    Correct Answer
    B. Hypotension
    Explanation
    Patients with Pheochromocytoma exhibit a triad of symptoms including diaphoresis, palpitations, and headache. However, hypotension is not typically seen in patients with Pheochromocytoma. This is because Pheochromocytoma is a tumor of the adrenal glands that causes excessive secretion of catecholamines, leading to increased blood pressure. Therefore, hypotension would be contradictory to the pathophysiology of Pheochromocytoma.

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  • 22. 

    The most common disorder of the anterior pituitary is:

    • A.

      SIADH

    • B.

      Diabetes Insipidus

    • C.

      Hypogonadism

    • D.

      Hyperprolactinemia

    Correct Answer
    D. Hyperprolactinemia
    Explanation
    Hyperprolactinemia is the most common disorder of the anterior pituitary. This condition is characterized by an overproduction of prolactin, a hormone responsible for milk production in women. Hyperprolactinemia can cause a variety of symptoms such as irregular menstrual periods, infertility, decreased libido, and milk production in non-lactating individuals. It can be caused by various factors including tumors in the pituitary gland, certain medications, and hormonal imbalances. Treatment options for hyperprolactinemia may include medication to reduce prolactin levels or surgery to remove the tumor if present.

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  • 23. 

    When looking at a chest x-ray an area of the lung that is filled with fluid, will appear:

    • A.

      White or light gray

    • B.

      Radiolucent

    • C.

      Black or very dark

    • D.

      Marbled

    Correct Answer
    A. White or light gray
    Explanation
    When looking at a chest x-ray, an area of the lung that is filled with fluid will appear white or light gray. This is because fluid in the lungs, such as in cases of pneumonia or pulmonary edema, will block the passage of x-rays and appear as a white or light gray opacity on the x-ray film. This is in contrast to normal lung tissue, which appears darker on the x-ray due to its ability to allow x-rays to pass through.

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  • 24. 

    When ordering a chest x-ray for a patient with a cough and fever, the appropriate outpatient view is:

    • A.

      AP and lateral

    • B.

      PA and lateral

    • C.

      AP and decubitus

    • D.

      PA and decubitus

    Correct Answer
    B. PA and lateral
    Explanation
    The appropriate outpatient view for ordering a chest x-ray for a patient with a cough and fever is PA and lateral. PA stands for Posteroanterior, which means that the x-ray beam enters the patient's back and exits through the front of the chest. This view is commonly used for chest x-rays as it provides a clear image of the lungs and other structures in the chest. The lateral view is taken from the side of the patient and helps to provide a comprehensive view of the chest. Together, these views can help to identify any abnormalities or infections in the lungs.

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  • 25. 

    There are four densities (fat, water, air, metal) in the human body which absorb varying degrees of radiation.  Which of the following correctly ranks these densities from most radiolucent to most radiodense?

    • A.

      Air, fat, water, metal

    • B.

      Fat, water, air, metal

    • C.

      Metal, water, fat, air

    • D.

      Air, water, fat, metal

    Correct Answer
    A. Air, fat, water, metal
    Explanation
    Air is the most radiolucent density because it absorbs the least amount of radiation. Fat is less radiolucent than air but more radiolucent than water and metal. Water is less radiolucent than both air and fat but more radiolucent than metal. Metal is the most radiodense density because it absorbs the most amount of radiation. Therefore, the correct ranking from most radiolucent to most radiodense is air, fat, water, metal.

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  • 26. 

    A distortion commonly seen in a portable chest radiograph is:

    • A.

      Expanded view of the right atrium and ventricle

    • B.

      The chest is not fully expanded but the diaphragm is descended

    • C.

      The heart is enlarged

    • D.

      The absence of pulmonary edema that may be clinically present

    Correct Answer
    C. The heart is enlarged
    Explanation
    http://books.google.com/books?id=fvM-QJaRzsgC&pg=PA116&lpg=PA116&dq=portable+chest+radiograph+distortion+enlarged+heart&source=web&ots=scxSGm8vJx&sig=rqpnF5wJ7-NoFfJxczhCaF8-JfY&hl=en&sa=X&oi=book_result&resnum=6&ct=result#PPA117,M1

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  • 27. 

    When evaluating chest radiographs, a generalized decrease in vascular markings as you view outward to the periphery may be suggestive of:  (not sure)

    • A.

      Pneumothorax

    • B.

      Pneumonia

    • C.

      Pulmonary Stenosis

    • D.

      Fluid overload or CHF

    Correct Answer
    C. Pulmonary Stenosis
    Explanation
    Molly's radiology lecture. Thanks Judith!

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  • 28. 

    A blunted or obscured costophrenic angle on a chest x-ray is most likely due to

    • A.

      Pneumothorax

    • B.

      Pleural effusion

    • C.

      Fibrosis

    • D.

      Lobar pneumonia

    Correct Answer
    B. Pleural effusion
    Explanation
    A blunted or obscured costophrenic angle on a chest x-ray is most likely due to pleural effusion. Pleural effusion refers to the accumulation of fluid in the pleural space, the space between the lungs and the chest wall. This fluid accumulation can cause the costophrenic angle, which is the sharp angle formed by the diaphragm and the ribs, to appear blunted or obscured on a chest x-ray. This finding is a common sign of pleural effusion and can help in diagnosing this condition.

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  • 29. 

    If you suspect a pneumothorax, you should order which type of chest x-ray

    • A.

      Portable

    • B.

      Lateral

    • C.

      Expiratory

    • D.

      Inspiratory

    Correct Answer
    C. Expiratory
    Explanation
    Suspected pneumothorax: Forcing air out of the lungs allows the visceral pleura and the air in the pleural
    space to be observed to greater advantage. When the air inside the lung is forced out by expiration,
    the density of the lung increases. The air trapped in the pleural space remains low in density
    (air density shows as black). The trapped air in the pneumothorax then becomes easier to identify

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  • 30. 

    At what age should initial cholesterol and lipid screening begin

    • A.

      Age 35

    • B.

      At the age of 40 for men, 50 for women

    • C.

      Between the ages of 30-40

    • D.

      Between the age of 18-21

    Correct Answer
    D. Between the age of 18-21
    Explanation
    Cholesterol and lipid screening should begin between the ages of 18-21 because it is important to identify any potential risk factors for cardiovascular disease early on. This age range allows for early detection and intervention if necessary, as high cholesterol levels can lead to the development of heart disease later in life. Starting screening at a younger age also provides an opportunity for lifestyle modifications and preventive measures to be implemented, reducing the risk of future complications.

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  • 31. 

    Which of the following is considered a single gene disorder

    • A.

      Parkinson’s disease

    • B.

      Alzheimer’s disease

    • C.

      Hemachromatosis

    • D.

      Hypertensiosn

    Correct Answer
    C. Hemachromatosis
    Explanation
    Hereditary hemochromatosis is the most common inherited single-gene disorder in people of northern European descent

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  • 32. 

    A person with a BRCA1 mutation has an increased risk of which of the following cancer(s)? 1. Breast 2. Ovarian 3. Colon 4. Prostate

    • A.

      1 only

    • B.

      Answers 1 and 2

    • C.

      All of the above

    • D.

      None of the above

    Correct Answer
    C. All of the above
    Explanation
    genetics ppt slide 22

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  • 33. 

    Joey Fastdriver was in a head on collision. He reports hitting his head on the windshield. His neuro exam is wnl, however you still would like to rule out any lesions that might need immediate surgical intervention.  The best test to choose is:

    • A.

      Head CT with contrast

    • B.

      Head CT without contrast

    • C.

      MRI of the head

    • D.

      CT angiography

    Correct Answer
    B. Head CT without contrast
    Explanation
    A head CT without contrast is the best test to choose in this scenario because it is a quick and effective way to evaluate for any acute intracranial lesions that may require immediate surgical intervention. This test can help identify any fractures, hemorrhages, or other abnormalities in the brain that may not be visible on a neuro exam. Contrast is not necessary in this case as it primarily helps to enhance the visualization of blood vessels, which is not the main concern in ruling out lesions that require surgical intervention.

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  • 34. 

    What test must be checked before spinal puncture to rule out increased intracranial pressure?

    • A.

      MRI

    • B.

      PET scan of the brain

    • C.

      CT of the head

    • D.

      Blood pressure is sufficient

    Correct Answer
    C. CT of the head
    Explanation
    Before performing a spinal puncture, a test that must be checked to rule out increased intracranial pressure is a CT scan of the head. This test can provide detailed images of the brain and is useful in identifying any abnormalities or signs of increased pressure within the cranial cavity. It helps in assessing the risk of complications during the spinal puncture procedure and ensures the safety of the patient. MRI and PET scan of the brain may also provide valuable information, but CT of the head is specifically mentioned as the correct answer in this case. Blood pressure alone is not sufficient to rule out increased intracranial pressure.

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  • 35. 

    You have a patient who is complaining of numbness and tingling of the first 3 fingers in her right hand.  She is a painter, but she also was in a MVA six months ago.  What tests would you order to differentiate a cervical radicular lesion from carpal tunnel syndrome?

    • A.

      EMG and ENG

    • B.

      EEG

    • C.

      MRI of the cervical spine

    • D.

      X-ray of the right wrist

    Correct Answer
    A. EMG and ENG
    Explanation
    To differentiate between a cervical radicular lesion and carpal tunnel syndrome, EMG (electromyography) and ENG (nerve conduction study) tests would be ordered. These tests can help evaluate the function of the nerves and muscles in the affected hand and arm. By measuring the electrical activity, these tests can identify if there is nerve compression or damage occurring at the level of the cervical spine or if the symptoms are due to carpal tunnel syndrome. EEG (electroencephalogram) is not relevant in this scenario as it measures brain activity and is not specific for diagnosing nerve-related conditions. An MRI of the cervical spine would be useful to visualize any structural abnormalities, while an X-ray of the right wrist would only assess the bones and not provide information about nerve involvement.

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  • 36. 

    In which of the following conditions might you find an elevated PSA?

    • A.

      Prostatitis

    • B.

      Prostate cancer

    • C.

      BPH

    • D.

      All of the above

    • E.

      Prostate cancer and BPH

    Correct Answer
    D. All of the above
    Explanation
    An elevated PSA (prostate-specific antigen) can be found in all of the given conditions: prostatitis, prostate cancer, and BPH (benign prostatic hyperplasia). Prostatitis is the inflammation of the prostate gland, which can cause an increase in PSA levels. Prostate cancer is a malignant growth in the prostate gland, and it often leads to elevated PSA levels. BPH is a non-cancerous enlargement of the prostate gland, which can also cause elevated PSA levels. Therefore, all three conditions can result in an elevated PSA.

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  • 37. 

    Tumor markers are useful for everything below except:

    • A.

      Cancer screening

    • B.

      Monitoring the effects of therapy

    • C.

      Detecting recurrences of cancer

    • D.

      Pinpointing tissue of origin

    • E.

      Folowing the clinical course

    Correct Answer
    A. Cancer screening
    Explanation
    genetics ppt, slide 30

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  • 38. 

    Your patient’s Western Blot was positive for HIV.  What further testing would you do now?

    • A.

      Chest x-ray

    • B.

      CD4 counts and viral load

    • C.

      Coagulation studies

    • D.

      Immunoflourescent panel

    Correct Answer
    B. CD4 counts and viral load
    Explanation
    CD4 counts and viral load testing are essential in managing HIV infection. CD4 counts determine the level of immune system damage caused by the virus, while viral load measures the amount of HIV in the blood. These tests help in assessing disease progression, guiding treatment decisions, and monitoring the effectiveness of antiretroviral therapy. Chest x-ray is not directly related to HIV diagnosis or management. Coagulation studies are not necessary unless there are specific indications. Immunofluorescent panel is not typically used for HIV testing.

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  • 39. 

    A definitive diagnosis fo DVT is most often made with

    • A.

      Positive Homan’s sign

    • B.

      Contrast venography

    • C.

      Doppler Ultrasonography

    • D.

      Magnetic Resonance angiography (MRA)

    Correct Answer
    B. Contrast venography
    Explanation
    Contrast venography is the most common method used to definitively diagnose deep vein thrombosis (DVT). This procedure involves injecting a contrast dye into the veins and then taking X-ray images to visualize the blood flow and identify any blockages caused by blood clots. It provides a detailed and accurate assessment of the veins and is considered the gold standard for diagnosing DVT. Doppler ultrasonography and magnetic resonance angiography (MRA) are also used in diagnosing DVT, but they are not as definitive as contrast venography. Positive Homan's sign is a clinical test that is not specific to DVT diagnosis and is not considered a reliable method on its own.

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  • 40. 

    Harry Grant is a 47 yr old caucasian who had a previous history of IV drug abuse. His only complaint is fatigue Liver enzymes and hepatitis screen were ordered.  What would these results indicate to you? HBsAG positive HBcAB positive Anti HBe positive HBe antigen negative Anti-HBs negative

    • A.

      Harry has active hepatitis B and is infectious

    • B.

      The positive core antibody indicates previous infection and present immunity

    • C.

      The positive surface antigen and core antibody, and antibody to e antigen indicate that he is a chronic carrier with low risk of infectivity

    • D.

      The negative hepatitis B e antigen indicates that Harry is highly infectious

    Correct Answer
    C. The positive surface antigen and core antibody, and antibody to e antigen indicate that he is a chronic carrier with low risk of infectivity
    Explanation
    The presence of the positive surface antigen and core antibody, along with the antibody to e antigen, suggests that Harry is a chronic carrier of hepatitis B. However, the low risk of infectivity indicates that he is less likely to transmit the infection to others.

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  • 41. 

    Anita Bruno is a 55-yr old schoolteacher with type II diabetes who presents to your office with the complaints of low-grade fever for 3 days and cramping right upper quadrant pain, radiating to the right scapula. You suspect cholecystitis.  Which is the best test to choose first?

    • A.

      KUB

    • B.

      Upper endoscopy

    • C.

      Upper GI series with small bowel follow through

    • D.

      Ultrasound and hepatobiliary imaging (HIDA scan) of the gall bladder

    Correct Answer
    D. Ultrasound and hepatobiliary imaging (HIDA scan) of the gall bladder
    Explanation
    The best test to choose first in this scenario is ultrasound and hepatobiliary imaging (HIDA scan) of the gall bladder. This is because the patient's symptoms, including cramping right upper quadrant pain and radiating pain to the right scapula, are consistent with cholecystitis, which is inflammation of the gall bladder. Ultrasound and HIDA scan can help to confirm the diagnosis by evaluating the gall bladder for signs of inflammation or gallstones. Other options such as KUB, upper endoscopy, and upper GI series with small bowel follow through are not the most appropriate tests for evaluating cholecystitis.

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  • 42. 

    Laboratory evaluation of hematuria begins with:

    • A.

      Cystoscopy

    • B.

      IVP (intravenous pyelogram)

    • C.

      Serum BUN and creatinine

    • D.

      Urinalysis and urine culture

    Correct Answer
    D. Urinalysis and urine culture
    Explanation
    The correct answer is urinalysis and urine culture. This is because hematuria, which is the presence of blood in the urine, can be caused by various conditions such as urinary tract infections, kidney stones, or bladder cancer. Urinalysis and urine culture can help identify the presence of red blood cells, white blood cells, bacteria, or other abnormalities in the urine, which can provide valuable information about the underlying cause of hematuria. This initial evaluation is less invasive and more cost-effective compared to cystoscopy or IVP, which are typically reserved for further evaluation if necessary.

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  • 43. 

    Findings suggestive of bacterial vaginosis on wet mount include:

    • A.

      Budding hyphae

    • B.

      Clue cells

    • C.

      Lactobacilli

    • D.

      Trichomonas vaginalis

    Correct Answer
    B. Clue cells
    Explanation
    Clue cells are epithelial cells from the vagina that are coated with bacteria, giving them a stippled or "clue-like" appearance. The presence of clue cells on a wet mount is suggestive of bacterial vaginosis, a common vaginal infection caused by an imbalance of bacteria in the vagina. This finding is important for diagnosing and managing bacterial vaginosis.

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  • 44. 

    Which of the following intial tests are most appropriate when one suspects osteoporosis?

    • A.

      CT scan of the L-S spine, serum PTH

    • B.

      DEXA scan of the L-S spine, serum calcium, and alkaline phosphatase

    • C.

      Thyroid scan and CBC

    • D.

      Serum vitamin D levels, x-rays of the L-S spine

    Correct Answer
    B. DEXA scan of the L-S spine, serum calcium, and alkaline phosphatase
    Explanation
    The most appropriate initial tests when one suspects osteoporosis are a DEXA scan of the L-S spine, serum calcium, and alkaline phosphatase. A DEXA scan is a specialized X-ray that measures bone mineral density and can accurately diagnose osteoporosis. Serum calcium levels are important to assess for any abnormalities in calcium metabolism, which can contribute to bone loss. Alkaline phosphatase levels can indicate increased bone turnover, which is often seen in osteoporosis. These tests together provide a comprehensive evaluation of bone health and help in diagnosing osteoporosis.

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  • 45. 

    What laboratory tests do you order to confirm a diagnosis of syphillis?

    • A.

      ELISA and confirm with Western Blot

    • B.

      VDRL or RPR and confirm with specific treponemal tests

    • C.

      VDRL and serology, confirm with a blood culture

    • D.

      ELISA and Western Blot, confirm with treponemal tests

    Correct Answer
    B. VDRL or RPR and confirm with specific treponemal tests
    Explanation
    The correct answer is VDRL or RPR and confirm with specific treponemal tests. This is because VDRL (Venereal Disease Research Laboratory) and RPR (Rapid Plasma Reagin) tests are commonly used screening tests for syphilis. However, these tests can sometimes give false positive results. Therefore, if the initial screening test is positive, it is important to confirm the diagnosis with specific treponemal tests such as the Treponema pallidum particle agglutination (TP-PA) test or the fluorescent treponemal antibody absorption (FTA-ABS) test. These tests detect antibodies against the bacteria that causes syphilis and provide a more definitive diagnosis.

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  • 46. 

    Your patient who returned from a camping trip in the northeast a few weeks ago is complaining of an erthematous lesion on her right forearm that is increasing in size, a mild headache, malaise and occasional fever and chills. You suspect lyme disease.  Which tests do you order?

    • A.

      IgG and IgM for B. burgforferi antibodies

    • B.

      ELISA

    • C.

      Western Blot

    • D.

      All of the above

    Correct Answer
    D. All of the above
    Explanation
    All of the above tests should be ordered to confirm the diagnosis of Lyme disease. IgG and IgM tests for B. burgdorferi antibodies can help detect the presence of antibodies in the patient's blood, indicating an immune response to the Lyme disease bacteria. ELISA (enzyme-linked immunosorbent assay) is a screening test that can detect antibodies against B. burgdorferi, and if positive, a Western Blot test can be done to confirm the diagnosis. Therefore, ordering all of these tests would provide a comprehensive evaluation for Lyme disease.

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  • 47. 

    What are the screening guidelines for lung cancer?

    • A.

      According to the American Cancer Society (ACS) guidelines, chest x-rays should be performed for all smoking and high risk patients over the age of 45.

    • B.

      According to the American Cancer Society’s guidelines, early morning sputum should be obtained x 3 for cytology

    • C.

      According to the National Cancer Institute (NCI), there are no beneficial, cost effective screening tools available for asymptomatic, high-risk persons

    • D.

      According to the NCI, both sputum cytology and chest x-rays should be used as screening tools in asymptomatic, high risk persons

    Correct Answer
    C. According to the National Cancer Institute (NCI), there are no beneficial, cost effective screening tools available for asymptomatic, high-risk persons
    Explanation
    us preventive guidelines booklet. thanks michele!

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  • 48. 

    CEA antigen is a useful test for screening for gastric carcinomas, pancreatic carcinoma, breast cancer, lung cancer, ovarian cancer

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Not all cancers produce CEA; therefore, the CEA test is not used for screening the general population.

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  • 49. 

    CA 125 is an excellent screening test to use to rule out ovarian cancer.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    CA 125 is not an excellent screening test to use to rule out ovarian cancer. While CA 125 levels can be elevated in women with ovarian cancer, they can also be elevated in other conditions such as endometriosis or pelvic inflammatory disease. Therefore, CA 125 is not specific enough to be used as a reliable screening test for ovarian cancer and should not be solely relied upon to rule out the disease.

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  • 50. 

    What is the percentage of people experiencing an acute MI with a non-diagnostic EKG

    • A.

      25%

    • B.

      50%

    • C.

      75%

    • D.

      100%

    Correct Answer
    B. 50%
    Explanation
    The correct answer is 50% because a non-diagnostic EKG means that the electrocardiogram does not show any clear signs of an acute myocardial infarction (heart attack). However, it does not rule out the possibility of a heart attack completely. Therefore, approximately 50% of people experiencing an acute MI may have a non-diagnostic EKG.

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