q4,5,6 - wwjd

[ArchivalUser]

4. A jaundiced one-day-old premature infant with an elevated free bilirubin
is seen in the premature-baby nursery. The mother received an antibiotic
combination preparation containing sulfamethizole for a urinary tract infection
(UTI) one week before delivery. You suspect that the infant™s findings
are caused by the sulfonamide because of the following mechanism:
a. Enhanced synthesis of bilirubin
b. Competition between the sulfonamide and bilirubin for binding sites on albumin
c. Inhibition of bilirubin degradation
d. Inhibition of urinary excretion of bilirubin


5. A 35-year-old woman who underwent a modified radical mastectomy
of her right breast for infiltrating ductal carcinoma 2 years ago presents
with enlargement of her right breast. The breast has a swollen, reddiscolored
appearance. It is diffusely indurated and tender on palpation.
Multiple axillary lymph nodes are palpable in the lower axilla. The working
clinical diagnosis is inflammatory carcinoma. Microscopic sections
from this red, indurated area are most likely to reveal
a. Duct ectasia with numerous plasma cells
b. Extensive invasion of dermal lymphatics
c. Infiltrating malignant ducts surrounded by numerous neutrophils
d. Malignant vascular tumor forming slitlike spaces
e. Marked dermal desmoplasia


6. A man drinks 2 L of water to replenish the fluids lost by sweating during
a period of exercise. Compared with the situation prior to the period of
sweating,
a. His intracellular fluid will be hypertonic
b. His extracellular fluid will be hypertonic
c. His intracellular fluid volume will be greater
d. His extracellular fluid volume will be greater
e. His intracellular and extracellular fluid volumes will be unchanged

[ArchivalUser]

B, B AND D

[ArchivalUser]

2-4. The answer is b. Sulfonamides should not be
used in pregnant women who are at term because of their ability to cross
the placenta and enter the fetus in concentrations sufficient to produce
toxic effects. Sulfonamides should also not be given to neonates, especially
premature infants, because they compete with bilirubin for serum albumin
binding, resulting in increased levels of free bilirubin, which cause kernicterus.

5. The answer is b. Inflammatory breast carcinoma is
often misunderstood because of the qualifying adjective inflammatory. The
term does not refer to the presence of inflammatory cells, abscess, or any special
histologic type of breast carcinoma; rather, it refers to more of a clinical
phenomenon, in that the breast is swollen, erythematous, and indurated and
demonstrates a marked increase in warmth. These changes are caused by
widespread lymphatic and vascular permeation within the breast itself and in
the deep dermis of the overlying skin by breast carcinoma cells. The clinical
induration and erythema are presumably related to lymphatic-vascular
blockage by tumor cells; if present, these findings mean a worse prognosis.


2-6. The answer is c. Sweat normally contains
about 40 to 60 meq of sodium per liter of fluid. Thus, approximately 100
meq of sodium will be lost from the extracellular fluid during the exercise
period, and when the lost water is replenished, the extracellular fluid will
become hypotonic. The hypotonic extracellular fluid will equilibrate with
the intracellular fluid and make it hypotonic as well. Because the extracellular
fluid volume is dependent on the amount of sodium, the loss of
sodium will result in a decreased extracellular fluid volume and an
increased intracellular fluid volume after water is replaced.

[ArchivalUser]

nice Q wwjd thanks....