02-17-2005, 02:27 AM
1. When looking in a mirror, a patient notices that the left side of his face droops. The patient also reports having to put the telephone receiver right next to his right ear to hear. Upon examination, the patient is found to have a complete hearing loss in the left ear, cannot close the left eye, and has no tear production in the left eye. When fluid is taken into the mouth, it dribbles from the left corner of his mouth. The patient is also unable to wrinkle the left side of his forehead. A lesion in which of the following anatomical locations best explains the patient's presentation?
A. Cavernous sinus
B. Floor of the middle cranial fossa in the trigeminal dural cave
C. Internal auditory meatus
D. Jugular foramen
E. Superior orbital fissure
2. A 28-year-old white female presents with a diffuse rash. The rash involves hair follicles, with apparent pustules. The patient reports a history of recent hot tub use. What are the characteristic findings regarding the responsible bacterium?
A. Colorless colonies on MacConkey agar; oxidase positive; blue-green pigment on nutrient agar
B. Colorless colonies on MacConkey agar; urease positive; blackens triple sugar iron agar
C. Colorless colonies on MacConkey agar; oxidase negative; no gas on triple sugar iron agar
D. Colored (pink) colonies on MacConkey agar; urease positive
E. Colored (pink) colonies on MacConkey agar; metallic green sheen on EMB agar
3. A patient comes to see you because he has been weak and falling down frequently. During the interview, you note that he is suspicious and irritable. On physical examination, you note that his skin is pale, his tarsal plates are pale, and he has a loss of vibration sense over his legs and trunk. His legs show a symmetric weakness with decreased deep tendon reflexes. The leading theory for the pathophysiology of this disorder relates to which of the following?
A. Anamolous insertion of even-chain fatty acids into membrane lipids
B. Anomalous insertion of odd-chain fatty acids into membrane lipids
C. Increased vitamin A intake
D. Lack of methylmalonyl CoA
E. Lack of propionyl CoA
4. A 18-year-old male comes to see his physician saying that he is going away to college next fall. He has had nightmares from which he wakes up screaming ever since he was a child. He never remembers the dream. He wonders if the doctor can prescribe anything to stop his nightmares, because he is planning to live in the dorm and it will be embarrassing if the problem continues. What is the proper response?
A. Prescribe a trial of ativan
B. Prescribe a trial of imiprimine
C. Prescribe a trial of phenobarbital
D. Psychiatric referral for forgotten trauma
E. Tell the patient that you are sorry but there is nothing that you can offer him
5. Which hormone is responsible for insulin resistance in gestational diabetes mellitus?
A. hCG
B. hPL
C. Estrogen
D. LH
E. Progesterone
6. You are in the operating room observing a gallbladder removal. While the surgeon is dissecting in the area of the cystohepatic triangle, a large amount of bright red blood comes pulsing from the area. Which structure has most likely been damaged?
A. Common hepatic artery
B. Cystic artery
C. Left hepatic artery
D. Right gastric artery
E. Right hepatic artery
7. A 20-year-old student, who was previously HIV negative, has unprotected sexual relations with a person whom he later finds out is HIV positive. One month after the unprotected sexual encounter, the now HIV-infected student volunteers for a research study, in which he undergoes extensive blood tests. What would you expect to see in the patient's lab tests?
A. Decreased number of CD4 count and increased p24 antigen
B. Increased anti-gp120 antigen
C. Increased anti-p24 antigen
D. Normal CD4 count and increased p24 antigen
E. Normal CD4 count and undetectable p24 antigen
8. A four-year-old white female presents to the pediatric clinic for follow-up due to developmental delay. Her medical history reports frequent episodes of otitis media, bronchitis, and pneumonia. Physical examination reveals coarse facial features, gingival hypertrophy, joint stiffness, claw hand deformity, and generalized hypotonia. Significant motor delay is appreciated. Electron microscopy of muscle biopsy demonstrates numerous intracytoplasmic inclusions, which are membrane-bound vacuoles filled with fibrillogranular material. I-cell disease is suspected. What is the function of the deficient enzyme?
A. Breakdown of dermatan sulfate and heparan sulfate
B. Cleavage of disaccharides
C. Cleavage of fructose
D. Degradation of sphingolipids
E. Metabolism of galactose
F. Phosphorylation of mannose residues
Wait for your answers!
A. Cavernous sinus
B. Floor of the middle cranial fossa in the trigeminal dural cave
C. Internal auditory meatus
D. Jugular foramen
E. Superior orbital fissure
2. A 28-year-old white female presents with a diffuse rash. The rash involves hair follicles, with apparent pustules. The patient reports a history of recent hot tub use. What are the characteristic findings regarding the responsible bacterium?
A. Colorless colonies on MacConkey agar; oxidase positive; blue-green pigment on nutrient agar
B. Colorless colonies on MacConkey agar; urease positive; blackens triple sugar iron agar
C. Colorless colonies on MacConkey agar; oxidase negative; no gas on triple sugar iron agar
D. Colored (pink) colonies on MacConkey agar; urease positive
E. Colored (pink) colonies on MacConkey agar; metallic green sheen on EMB agar
3. A patient comes to see you because he has been weak and falling down frequently. During the interview, you note that he is suspicious and irritable. On physical examination, you note that his skin is pale, his tarsal plates are pale, and he has a loss of vibration sense over his legs and trunk. His legs show a symmetric weakness with decreased deep tendon reflexes. The leading theory for the pathophysiology of this disorder relates to which of the following?
A. Anamolous insertion of even-chain fatty acids into membrane lipids
B. Anomalous insertion of odd-chain fatty acids into membrane lipids
C. Increased vitamin A intake
D. Lack of methylmalonyl CoA
E. Lack of propionyl CoA
4. A 18-year-old male comes to see his physician saying that he is going away to college next fall. He has had nightmares from which he wakes up screaming ever since he was a child. He never remembers the dream. He wonders if the doctor can prescribe anything to stop his nightmares, because he is planning to live in the dorm and it will be embarrassing if the problem continues. What is the proper response?
A. Prescribe a trial of ativan
B. Prescribe a trial of imiprimine
C. Prescribe a trial of phenobarbital
D. Psychiatric referral for forgotten trauma
E. Tell the patient that you are sorry but there is nothing that you can offer him
5. Which hormone is responsible for insulin resistance in gestational diabetes mellitus?
A. hCG
B. hPL
C. Estrogen
D. LH
E. Progesterone
6. You are in the operating room observing a gallbladder removal. While the surgeon is dissecting in the area of the cystohepatic triangle, a large amount of bright red blood comes pulsing from the area. Which structure has most likely been damaged?
A. Common hepatic artery
B. Cystic artery
C. Left hepatic artery
D. Right gastric artery
E. Right hepatic artery
7. A 20-year-old student, who was previously HIV negative, has unprotected sexual relations with a person whom he later finds out is HIV positive. One month after the unprotected sexual encounter, the now HIV-infected student volunteers for a research study, in which he undergoes extensive blood tests. What would you expect to see in the patient's lab tests?
A. Decreased number of CD4 count and increased p24 antigen
B. Increased anti-gp120 antigen
C. Increased anti-p24 antigen
D. Normal CD4 count and increased p24 antigen
E. Normal CD4 count and undetectable p24 antigen
8. A four-year-old white female presents to the pediatric clinic for follow-up due to developmental delay. Her medical history reports frequent episodes of otitis media, bronchitis, and pneumonia. Physical examination reveals coarse facial features, gingival hypertrophy, joint stiffness, claw hand deformity, and generalized hypotonia. Significant motor delay is appreciated. Electron microscopy of muscle biopsy demonstrates numerous intracytoplasmic inclusions, which are membrane-bound vacuoles filled with fibrillogranular material. I-cell disease is suspected. What is the function of the deficient enzyme?
A. Breakdown of dermatan sulfate and heparan sulfate
B. Cleavage of disaccharides
C. Cleavage of fructose
D. Degradation of sphingolipids
E. Metabolism of galactose
F. Phosphorylation of mannose residues
Wait for your answers!