qus - shab_naj

[ArchivalUser]

1)A 62-year-old man is involved in a head-on automobile collision and is examined by paramedics at the scene of the accident. The patient is conscious and responds to questions. There is marked tenderness along the left and right lower rib cage. No open fractures are noted. His heart rate is 160 beats/min and his blood pressure is 70/40 mm Hg. The skin is cold and clammy. Which of the following hemodynamic changes is most likely to be present?


A. Decreased arterial PO2
B. Decreased hemoglobin concentration
C. Increased left ventricular end-diastolic pressure
D. Increased mixed venous O2 (MVO2) content
E. Increased total peripheral arteriolar resistance

2)A 52-year-old woman had a 10-year history of chronic left-sided and right-sided heart failure and, most recently, pulmonary hypertension. As a child and young adult, she had numerous episodes of pharyngitis. At autopsy, the heart showed thickening of the mitral valve leaflets and fusion of the commissures. There was thickening of the right ventricular wall and atherosclerosis of the pulmonary artery. The pulmonary vessels prominently protruded from the cut surface of the lung parenchyma. Which of the following is the most likely cause of the valvular disease?


A. Ischemic heart disease
B. Libman-Sacks endocarditis
C. Mitral valve prolapse (MVP)
D. Recurrent bacterial endocarditis
E. Recurrent rheumatic fever

3)
A cholecystectomy is performed on a 55-year-old woman, and the incision is not healing properly. When asked about her diet, the woman says that she consumes a diet high in protein but does not eat fruits or vegetables. Which of the following events most likely accounts for the poor wound healing?


A. Decreased synthesis of granulation tissue
B. Decreased synthesis of type III collagen
C. Decreased tensile strength of collagen
D. Defect in fibrillin in elastic tissue
E. Leukocyte adhesion molecule defect

4)A 58-year-old man has a 70-pack-year history of smoking cigarettes. He has had productive cough for every month in the year for the last 10 years. Examination reveals a stocky man with blue discoloration of his mucous membranes and skin. Which of the following laboratory test results is most likely to be reported in this man?


A. Decreased arterial PCO2
B. Increased arterial pH
C. Increased serum aspartate aminotransferase (AST)
D. Increased serum erythropoietin (EPO)
E. Normal oxygen saturation

5)A 13-year-old boy has a tender subareolar mass in the left breast. Physical examination shows normal testicular volume and normal male hair distribution. Which of the following is the next most appropriate step in management?


A. Chromosome analysis
B. Serum gonadotropins
C. Serum β-human chorionic gonadotropin (β-hCG) test
D. Surgical consult
E. No further evaluation

[ArchivalUser]

1. e
2.e
3.b
4. b or d
5. d

[ArchivalUser]

sorry from where are these q , uw...?

[ArchivalUser]

1-E
2-E
3-C
4-D
5-E

[ArchivalUser]

4 is D I was thinking that is decreased ph acidosis b is increased ph so is D
i read it wrong

[ArchivalUser]

4) The patient has chronic bronchitis (CB), which is a clinical diagnosis (productive cough for 3 months out of a year for 2 consecutive years), and clinical evidence of cyanosis. This, by definition, means that his O2 saturation < 80&percnt; (percentage of heme groups occupied by O2). Smokers with CB have respiratory acidosis (retention of CO2). Retention of CO2 raises the alveolar PCO2, which automatically decreases the alveolar PO2. A decrease in alveolar PO2 decreases arterial PO2, which is called hypoxemia. Hypoxemia is a stimulus for the renal release of EPO. EPO stimulates the bone marrow erythroid stem cells to divide, which increases the hemoglobin, hematocrit, and red blood cell count producing secondary polycythemia

[ArchivalUser]

3) This patient is lacking vitamin C due to a lack of fruits and vegetables in her diet. Lack of cross-linking tropocollagen molecules causes decreased tensile strength in collagen and poor wound healing. Vitamin C (ascorbic acid) is important in the hydroxylation of proline and lysine in the initial phases of collagen synthesis by fibroblasts. The sites of hydroxylation are the anchor sites for the cross-links between the tropocollagen molecules.

[ArchivalUser]

thanks shab_naj these are good q more complicated than UW ,