11-14-2011, 09:31 AM
FORM 7.1
24. 5 year old girl brought to physician by her parents for initial PE. they recently moved to town and they failed to bring any records. They say child was behind in most of her developmental milestones, and teeth erupted late. during the last 3 years, she has sustained fractures of both upper extremities as well as her left lower extremity. They physician notes a distrinct nasal quality to child's voice. her height is 10 percentile and weight is 30 percentile. PE shows frontal bossing of the skull. X-ray confirm the healed fractures and show generalized increase in bone density, and widening of the metaphyses and diaphysis of the long bones. Which of the following are most likely to be defective in patient?
a. chondroblasts
b. chondrocytes
c. myocytes
d. osteoblasts
e. osteoclasts
f. osteocytes
30. A 3 year old boy with sickle cell disease is brought to the ER because of severe leg pain for 2 hours. PE shows hepatosplenomegaly and tenderness over lower extremities. His Hemoglobin is 7. Peripheral blood smear shows target cells, polikilocytes, and many sickled erythrocytes. Which of the following describes the molecular bassis for the sickling?
a. gain of stabilizing hydrophobic interactions in the deoxygenated form of hemoglobin S
b. gain of stabilizing hydrophoci interaction in the oxygenated form of hemoglobin S
c. loss of stabilizing hydrogen bonds between water and surgace of hemoglobin S in oxygenated state
d. loss of stabilizing salt bridges in deoxy form of hemo S
e. loss of stabilizing salt bridges in oxy form of hemo S
32. study conducted to estimate the number of procedures performed by general internal medicine physicians. The questionnaire is mailed to 8000 randomly selected phsicians. Of there 5680 71% respond. Which following measurements most strongly suggests that the respondents represent a heterogeneous population with respect to the number of different procedures performed?
MEAN number procedures standard deviation
a. 4 0.1
b. 7 1.8
c. 11 0,5
d. 13 5.1
34. a 36 year old woman is brought to the ER by husband because of a 3 day history of fever and increasing confusion. She is awake but slow to respond. Temp is 101.1 Physicial no abnormalities CSF shows:
Pressure normal
Appreance: clear
Glucose: 65
Leukocyte count: 85
Lymphocytes: 98%
Erythrocyte: 3/mm
Gram stain shows no bacteria. CT head shows enhancing lesions within the right temporal lobe. Which is appropriate test to confirm?
A. csf antibody --- la crosse
b. csf culture--- herpes simplex
c. cs culture--- la crosse
d. csf culture--- poliovirus
e. csf polymerase chain reaction===herpes simplex
f. stool culture—poliovirus
44. a 45 year old man who works at a nuclear power plant is brought to the ER 1 hour following an accident in which he as exposed to the high levels of radiation. The amount of exporsure is not believed to be fatal. He appears agitated and fearful, but he currently has no symptoms. The patient is most likely to initially show which of the following types of symptoms?
a. cardio
b. gasto
c. renal
d. reproductive
e. respiratory
48. 50 year old woman dies of a MI. photograph of brain obtained at autopsy shown. Aroors indicate abnormality based on image, which following findings was most likely present prior to death?
a. decreased visual acuity
b. difficulty swallowing
c. double vision
d. hearing loss
e. loss sense of smell
SECTION 2
10. 25 year old woman has increasingly severe pain of right hip during past week. She runs 5 miles daily and recently changed route because of construction. She now runs on uneven ground rather than pavement. Range of motion of hip is full.Pain exacerbated by flexion and internal rotaion of hip and by direct palpation over the lateral aspect of the hop, which structre involved?
a. anserine bursa
b.ischial bursa
c.psoas bursa
d.sacroiliac joint
e. sciatic nerve
15. 9 month old girl brought to ER 30 min after she had a generalized tonic-clonic seizrure. She failure to thrive and developmentsal delay since birth. She is at the 3rd percentile for length and weight. PE shows microcephaly, tachypnea, and hypotonia. Labs show hypoglycemia, hyperalaniemia, lactic acidosis. After IV glucose, serum glucose concentration returns to regerence range. Patient has deficiency in which enzyme activity?
a. glucokinase
b. glyceraldehyde-30phosphate dehydrogenase
c. hexokinase
d. pyruvate carboxylase
e. triose-phosphate isomerase
healthy 54 year old woman undergoes exercise stress test. During moderate phase of exercise pulse is 140 respirations 25 and bp 130/90 which of following is the relative proportion of coronary oxygen delivery during the rest nad during the exercise times?
Rest—moderate exercise
a. systolic > diastolic--- systolic>diastolic
b. systolic> diastolic--- systolic< diasoltic
c. systolic < diastolic--- systolic>diastolic
d. systolic < diastolic--- systolicdiastolic
f. systolic = diastolic--- systolic
24. 5 year old girl brought to physician by her parents for initial PE. they recently moved to town and they failed to bring any records. They say child was behind in most of her developmental milestones, and teeth erupted late. during the last 3 years, she has sustained fractures of both upper extremities as well as her left lower extremity. They physician notes a distrinct nasal quality to child's voice. her height is 10 percentile and weight is 30 percentile. PE shows frontal bossing of the skull. X-ray confirm the healed fractures and show generalized increase in bone density, and widening of the metaphyses and diaphysis of the long bones. Which of the following are most likely to be defective in patient?
a. chondroblasts
b. chondrocytes
c. myocytes
d. osteoblasts
e. osteoclasts
f. osteocytes
30. A 3 year old boy with sickle cell disease is brought to the ER because of severe leg pain for 2 hours. PE shows hepatosplenomegaly and tenderness over lower extremities. His Hemoglobin is 7. Peripheral blood smear shows target cells, polikilocytes, and many sickled erythrocytes. Which of the following describes the molecular bassis for the sickling?
a. gain of stabilizing hydrophobic interactions in the deoxygenated form of hemoglobin S
b. gain of stabilizing hydrophoci interaction in the oxygenated form of hemoglobin S
c. loss of stabilizing hydrogen bonds between water and surgace of hemoglobin S in oxygenated state
d. loss of stabilizing salt bridges in deoxy form of hemo S
e. loss of stabilizing salt bridges in oxy form of hemo S
32. study conducted to estimate the number of procedures performed by general internal medicine physicians. The questionnaire is mailed to 8000 randomly selected phsicians. Of there 5680 71% respond. Which following measurements most strongly suggests that the respondents represent a heterogeneous population with respect to the number of different procedures performed?
MEAN number procedures standard deviation
a. 4 0.1
b. 7 1.8
c. 11 0,5
d. 13 5.1
34. a 36 year old woman is brought to the ER by husband because of a 3 day history of fever and increasing confusion. She is awake but slow to respond. Temp is 101.1 Physicial no abnormalities CSF shows:
Pressure normal
Appreance: clear
Glucose: 65
Leukocyte count: 85
Lymphocytes: 98%
Erythrocyte: 3/mm
Gram stain shows no bacteria. CT head shows enhancing lesions within the right temporal lobe. Which is appropriate test to confirm?
A. csf antibody --- la crosse
b. csf culture--- herpes simplex
c. cs culture--- la crosse
d. csf culture--- poliovirus
e. csf polymerase chain reaction===herpes simplex
f. stool culture—poliovirus
44. a 45 year old man who works at a nuclear power plant is brought to the ER 1 hour following an accident in which he as exposed to the high levels of radiation. The amount of exporsure is not believed to be fatal. He appears agitated and fearful, but he currently has no symptoms. The patient is most likely to initially show which of the following types of symptoms?
a. cardio
b. gasto
c. renal
d. reproductive
e. respiratory
48. 50 year old woman dies of a MI. photograph of brain obtained at autopsy shown. Aroors indicate abnormality based on image, which following findings was most likely present prior to death?
a. decreased visual acuity
b. difficulty swallowing
c. double vision
d. hearing loss
e. loss sense of smell
SECTION 2
10. 25 year old woman has increasingly severe pain of right hip during past week. She runs 5 miles daily and recently changed route because of construction. She now runs on uneven ground rather than pavement. Range of motion of hip is full.Pain exacerbated by flexion and internal rotaion of hip and by direct palpation over the lateral aspect of the hop, which structre involved?
a. anserine bursa
b.ischial bursa
c.psoas bursa
d.sacroiliac joint
e. sciatic nerve
15. 9 month old girl brought to ER 30 min after she had a generalized tonic-clonic seizrure. She failure to thrive and developmentsal delay since birth. She is at the 3rd percentile for length and weight. PE shows microcephaly, tachypnea, and hypotonia. Labs show hypoglycemia, hyperalaniemia, lactic acidosis. After IV glucose, serum glucose concentration returns to regerence range. Patient has deficiency in which enzyme activity?
a. glucokinase
b. glyceraldehyde-30phosphate dehydrogenase
c. hexokinase
d. pyruvate carboxylase
e. triose-phosphate isomerase
healthy 54 year old woman undergoes exercise stress test. During moderate phase of exercise pulse is 140 respirations 25 and bp 130/90 which of following is the relative proportion of coronary oxygen delivery during the rest nad during the exercise times?
Rest—moderate exercise
a. systolic > diastolic--- systolic>diastolic
b. systolic> diastolic--- systolic< diasoltic
c. systolic < diastolic--- systolic>diastolic
d. systolic < diastolic--- systolicdiastolic
f. systolic = diastolic--- systolic