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Q9
A 31-year old man comes to the ER dept because of 4 hour history of severe cramping pain in this right flank that radiated to his groin. He rates the pain as 10 on 10 point scale. The pain is not reieved by position. His temp is 99 F , pulse is 90/min, respi ae 20/min, and bp is 130/88 mmHg. Physical examination shows tenderness on percussion of the right flank. The appropriate treatment is adminstered and the patient is stabalized. Which of the follwoing dietary changes is most likely to decrease this patient's risk for recurrence of similar symptoms?
A) Dec caffeine
B) Dec calcium
C) Dec fat
D) Increased fluids
E) Increased protein
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1.C
2.G
3.A
4.E i think most likely
5.E hyperresonance on percussion
6.A
7.C
8.D
9.D (kidney stones)
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Q11
A 2-week-old full term female newborn develops pale stools and jaundice. The jaundice progresses; nuclear scans show no excretion of bile. Serum assay rules out apha-anitrpsin deficiency. Examination of tissue obtained on biopsy of the liver shows inflammation and proliferation of small bile ducts and increased portal fibrosis. If not appropriately treated, this newborb is most likely to develop which of the following?
A) Budd-Chiari syndrome
B) End-stage cirrhosis
C) Hepatocellular carcinoma
D) Recurrent episodes of hepatitis
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Q 12
Naive mouse thymocyte presursors are obtained from normal active bone marrow geneticaly to constitutively express the gene, bcl-2, and combined with normal marrow cells for injection into mice whose active marrow has been destroyed by radiation. Control irradiated mice are injected wiht normal marrow alone. After recovery from the procedure, which of the following differences is most likely to be observed in animals receiving the genetially altered cells as compared with the control animals?
A) Dec cell death in the thymic cortex
B) Dec naive B-lymphocyte production by the recontituted marrow
C) Dec number of circulating lymphocytes
D) Dec overall risk if autoimmunity
E) Inc formation o lymphoid nodules in the thymic cortex
F) Inc number of circulation plasma cells
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Q 13
A 26-year old woman has lost 95 kg (209 lb) since undergoing a jejunoileal bypass for treatment of morbid obesity. Fecal fat excretion is excessive. This patient most likley has def in whic of the follwoing nutrients ?
A) Iron
B) Magnesium
C) Niacin
D) Protein
E) Vitamin A
F) Vitamin B1
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Q14
A 35-year od man comes to the physican to dicuss donating a kidney to his 39 year old sister who has type 1 diabetes melitus and chronic renal failure. He has no history of major medical illness, and physical examination shows no abnormalities. Which of the following describes the likelihood that this donor's human leukocyte anitigen type will match that of his sister?
A) 1:1
B) 1:2
C) 1:4
D) 1:6
E) 1:8
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Q15
A 35 year odl woman comes to the physician because of fatigue for the past 3 months. She has follwed a vegetarian diet for the past 12 years. She eats no meat, dairy production, fish, or chicken. Examination shows a loss of vibratory sensation in her lower extremities. Lab studies show
Hemoglobin 9.1 g /dL
Leykocyte count 4900.mm3
Mean corpuscular vol 113
Platelet count 155,000/mm3
which of the following nutritional deficiencies is most likely?
A) Folic acid
B) Iron
C) Vit B12
D) Vit C
E) Vit D
F) Zinc
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Q16
An 18 year old woman has severe, painful blistering following a day at the beah. She is taking antibiotic. Which of the following drugs is the most likely cause?
A) Cephalosporin
B) Ciprofloxacin
C) Erythromycin
D) Penicilln
E) Tetracycline
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Q17
A 3-day old female newborn is brought to the physician by her mother after she notice an unusually sweet odor when changing the newborn's diaper. she has not been feeding well for 1 day. Labaratory studies show hypoglycemia,metabolic acidosis, ketomenia and hyperammonemia. Isoleucine is increased in urine. Which of the following meataboilc patheways is most likely imparied in tthis patient?
A) Branched chain a.a degradation
B) Fatty acid oxidation
C) Glycogenolysis
D) Purine degradation
E) Urea cycle
