DIT Questions & Answers, 100% Accurate, Question Bank. Graded A+. Latest Version.

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DIT Questions & Answers, 100% Accurate, Question Bank. Graded A+. Latest Version. How does standard deviation differ from standard error of the mean? (FA p54)Which is used in calculating confid... ence intervals? (FA p55) - ✔✔-Standard error is used to calculate CI What problem / abnormality is associated with the following congenital buzzwords? (FA p267) bootshaped heart - ✔✔-Tetralogy of Fallot What problem / abnormality is associated with the following congenital buzzwords? - (FA p268) continuous machine-like murmur - ✔✔-Patent ductus arteriosus What problem / abnormality is associated with the following congenital buzzwords? - (FA p485) webbing of the neck - ✔✔-Turner Syndrome (XO) What problem / abnormality is associated with the following congenital buzzwords? - (FA p485) Barr body - ✔✔-Klinefelter's syndrome (XXY) What problem / abnormality is associated with the following congenital buzzwords? - (FA p88) simian crease - ✔✔-Down's syndrome A mother brings her infant to your clinic. The infant has markedly fair skin and a mousy odor. What are the downstream substances this child is missing because of his inborn error of metabolism? What substances are derived from the amino acid tryptophan? (FA p106, FA p107) - ✔✔-Patient has PKU. Child is missing phenylalanine hydroxylase or tetrahydobiopterin cofactor. Niacin and serotonin/melatonin are derived from tryptophan. A 12-year-old female develops a rapid strep positive exudative pharyngitis and is treated with penicillin V for the 10 days. If the patient happens to have a penicillin allergy, an alternative to using penicillin V is to use a macrolide antibiotic. What is the mechanism of action of penicillin? Is it a bacteriostatic or bactericidal antibiotic? What is the mechanism of action of the macrolides? Are they bacteriostatic or bactericidal? (FA p184, p185, p188) - ✔✔-Penicillin: block cell wall synthesis by inhibiting peptidoglycan cross-linking -Bactericidal Macrolides: inhibit protein synthesis by blocking translocation; bind to 23S rRNA of the 50S ribosomal subunit -Bacteriostatic You are conducting a study trying to determine the reduction in risk of developing a relapsing depressive episode with antidepressant X when compared to a placebo treatment. What is this determination called? What is attributable risk, and how is it calculated? (FA p52) - ✔✔-Called Relative Risk (RR) = relative probability of getting a dz in the exposed group compared to unexposed group Attributable Risk = Difference b/t exposed and unexposed group = proportion of dz occurrences that are attributable to the exposure A 53-year-old male presents by EMS to the ER with left-sided chest pain, dyspnea, diaphoresis and leftsided arm pain. An EKG reveals a ST elevation and Q-waves in leads II, III and aVF. The patient is quickly taken to the heart catheterization lab for further evaluation and treatment of an acute myocardial infarction. Which coronary artery is most commonly involved in an acute MI? What is the most likely involved artery on this clinical situation? (FA p271 and p272) - ✔✔-LAD > RCA > circumflex LAD (ant wall) = Q waves in V1-V4 LAD (anteroseptal) = V1-V2 LAX (anterolateral) = V4-V6 LCX (Lateral wall) = I, aVL RCA (inferior wall) = II, II, aVF Identify the following types of aphasia and location of the brain lesion with the following clinical presentations? (FA p404) Is unable to repeat phrase, "No ifs, ands, or buts" - ✔✔-Arcuate fasiculus Identify the following types of aphasia and location of the brain lesion with the following clinical presentations? (FA p404) Nonfluent aphasia with comprehension intact - ✔✔-Broca's area Identify the following types of aphasia and location of the brain lesion with the following clinical presentations? (FA p404) Fluent aphasia with impaired comprehension - ✔✔-Wernicke's area A 40-year-old female treated with lisinopril for stage I hypertension becomes pregnant. The patient's ACE inhibitor (lisinopril) should be stopped immediately. What centrally acting α2-agonist is often used to treat hypertension in pregnancy? (FA p241) - ✔✔-Mirtazapine? A 23-year-old male complains of a yellowish skin and eye discoloration for the past two days. The patient otherwise has no complaints or physical exam findings. The patient's laboratory workup reveals a conjugated hyperbilirubinemia. Which hereditary hyperbilirubinemia syndromes present with a conjugated hyperbilirubinemia? Which present with an unconjugated hyperbilirubinemia? (FA p333) - ✔✔-Gilbert's = prob w/ bilirubin uptake --> unconjugated bilirubinemia Crigler-Najjar = prob w/ bilirubin conjugation --> unconjugated bilirubinemia Dubin-Johnson = prob w/ excretion of conjugated bilirubin --> conjugated bilirubinemia A physician while working with a humanitarian aid organization in Africa is seeing a 30-year-old male patient with HIV. The patient complains of fever, weight loss and a cough associated with hemoptysis over the past two months. A chest X-ray reveals perihilar lymphadenopathy and a left lower lobe granulomatous formation. What the name for these X-ray findings? What other Mycobacteria species cause pulmonary disease? What are the potential extrapulmonary manifestations of Mycobacterium tuberculosis? (FA p148 and p149) - ✔✔-x-ray findings = Ghon complex = calcified focus of infection + assoc hilar lymph node Mycobacterium TB M. kanasii (pulm TB like sx) M. avium TB sx include fever, night sweats, weight loss, hemoptysis Aztreonam and penicillins both bind to penicillin-binding proteins. Can aztreonam be used in patients with a penicillin allergy? In which patient populations is aztreonam a good choice? Against which organisms is this antibiotic effective? (FA p185 and p186) - ✔✔-Aztreonam works the same way as penicillins = block cell wall synthesis by inhibiting peptigoglycan cross-linking by binding to PBP3 No cross-sensitivity w/ penicillins or cephalosporins Use against Gram-negative rods only Wallenberg syndrome is an injury of the lateral medulla that presents with a constellation of neurologic symptoms, including difficulty with swallowing (dysphagia), hoarseness and difficulty with palate elevation. Which part of the lateral medulla is responsible for swallowing and palate elevation? What other cranial nerves can be involved with this region? (FA p417) - ✔✔-Nucleus ambiguus = motor innervation of pharynx, larynx, upper esophagus (swallowing, palate elevation) CN IX, X, XI go through nucleus ambiguus An echocardiogram reveals a dilated cardiomyopathy in the evaluation of a 53-year-old man with chest pain. You discover in the patient's history that the patient does not drink alcohol. Other than chronic alcohol abuse, what are some other potential causes of dilated cardiomyopathy? What heart sounds might be present in a patient with dilated cardiomyopathy? (FA p273) - ✔✔-Dilated cardiomyopathy = congestive Alcohol abuse Beriberi (wet) Coxasackie B virus myocarditis Cocaine use Chagas' disease Doxorubicin toxicity Hemochromatosis Peripartum cardiomyopathy Expect to hear S3 A 60-year-old noncompliant male complains of shortness of breath on exertion and bilateral lower extremity edema. His family physician was constantly expressing the importance of antihypertensive treatment. The patient has an echocardiogram that reveals an ejection fraction of 30 percent. The patient is placed on a diuretic, an ACE inhibitor and digoxin. By what mechanism is digoxin a positive inotrope? What is the cause of this patient's shortness of breath on exertion and lower extremity edema? (FA p274 and p283) - ✔✔-CHF Digoxin increases [Ca] by directly inhibiting Na/K/ ATPase which indirectly inhibits Na/Ca exchanger What is p value? What is normally an acceptable level of p value? (FA p54) - ✔✔-p = probability of making a type I error (ie: stating that there IS an effect or difference when none exists = mistakenly accepting the experimental hypothesis and rejecting the null hypothesis) p < 0.05 Homocystinuria is one of the few diseases that can result in subluxation of the lens. What are the different causes of homocystinuria? How does the treatment differ for each? (FA p108) - ✔✔- Cystathione synthase def -DEC methionin, INC cys, INC B12, INC folate in diet DEC affinity of cystathionine synthase for pyridoxal phosphate -INC vit B6 in diet Homocysteine methyltransferase def A 50-year-old patient with gastroesophageal reflux disease (GERD) has been treated with a proton pump inhibitor for the past 10 years. The patient has an evaluation with upper endoscopy for his long-standing GERD. Why is it important to have an upper endoscopy with longstanding GERD? What are some other causes of esophageal cancer? (FA p322 and p323) - ✔✔-Risk of developing Barrett's esophagus Alcohol/Achalasia Barrett's Cigarettes Diverticuli (Zenker's) Esophageal web Esophagitis Familial A 1-year-old male child is brought to the ER for seizure activity. The seizure was quickly identified as being attributed to severe hypoglycemia. After stabilizing the seizure activity, the initial laboratory work reveals a metabolic acidosis. The patient's exam reveals hepatomegaly. You think this patient might have a glycogen storage disease (GSD). What GSD is most consistent with this clinical picture? Which GSDs are characterized by hypoglycemia? What is the difference between Cori's disease (GSD-type III) and Von Gierke's disease (GSD-type I)? (FA p110) - ✔✔-Von Gierke's = glucose-6-phosphatase def = severe fasting hypoglycemia, INC glycogen in liver, INC blood lactate, hepatomegaly Pompe's = lysosomal alpha-1,4-glucosidase (acid maltase) = cardiomegaly + systemic findings (early death) Cori's = Debranching alpha-1,6-glucosidase = milder form of Von Gierke's w/ nl blood lactate McArdle's = skeletal muscle glycogen phosphorylase = INC glycogen in muscle, but cannot break it down --> painful muscle cramps, myoglobinuria w/ strenuous exercise Sertoli cells release a substance that acts on the paramesonephric ducts in order to prevent the formation of what structures in a normal male fetus? What other name is given to the paramesonephric ducts? (FA p133) - ✔✔-Paramesonephric duct = mullerian duct that develops into fallopian tubes + uterus + upper 1/3 of vagina A 60-year-old male with a family history of Parkinson's disease is concerned that he may be in the early stages of the disease. What are some of the signs and symptoms of Parkinson's disease? (FA p401) - ✔✔-Tremor, rigidity, bradykinesia, postural instability Your patient develops a cough with the new antihypertensive drug you prescribed her. What are some other side effects associated with this medication? (FA p475) - ✔✔-Symptoms = CAPTORPRIL = cough, angioedema, proteinuria, taste changes, hypOtension, pregnancy problems, rash, increased renin, lower angiotensin II. Also hyperkalemia. A 7-year-old child is brought to the ER with bloody diarrhea. Imaging studies and physical exam do not reveal an anatomic cause of the child's illness, but the mother mentions that the patient recently ate pork tacos at her brother's house. Her brother has been having a similar illness as well. Fecal gram staining reveals gram-negative, comma-shaped organisms. What organism is likely responsible for this patient's illness? (FA p152) - ✔✔-campybacter jejuni Clopidogrel (Plavix) and ticlopidine are commonly used after MI or cardiac cath with stent placement. What is the mechanism of these drugs? (FA p363) - ✔✔-Inhibit platelet aggregation by irreversibly blocking ADP receptors --> inhibit fibrinogen binding by preventing glycoprotein Iib/IIIa expression. A 31-year-old patient of yours complains of chronic back stiffness and pain. X-ray reveals a spine that looks similar to bamboo. What other symptoms may be present with this disease, and into what category of diseases does this one fall? (FA p385) - ✔✔-seronegative spondlyoarthropathies = arthritis without RA factor. This pt has ankylosing spondylitis What are the potential metabolic fates of pyruvate? (FA p99) - ✔✔-Lactate or oxaloacetate or AcetylCoA Membranous glomerular diseases involve thickening of what structure? (FA p466) - ✔✔-Glomerular BM A 22-year-old man lost his leg last week in a tragic accident involving alcohol and heavy machinery. He is medically able to be discharged home tomorrow, and the paperwork is already set up so he can leave in the morning. However, the nurse pulls you aside and informs you that the patient has been very depressed about his lost limb, and she overheard him talking to a friend about just ending his life with his dad's gun when he gets out of the hospital. What must be done? (FA p59) - ✔✔-Suggest the pt remain in the hospital. If pt says no, then keep him against his will. The Pneumovax vaccine contains the polysaccharide antigens of the 23 most prevalent types of Streptococcus pneumoniae. In order for the Pneumovax vaccine to confer long term immunity what must be done to the polysaccharide antigens? (FA p139) - ✔✔-Polysaccharide antigens must be conjugated to promote T cell activation and subsequent class switching (b/c polysaccharide antigen alone would not be recognized so it would not be presented by T cells and therefore only IgM ab would be produced) A 10-year-old boy is receiving poor grades in school. His teachers and parents report that he has normal intelligence but that he is very distractible and full of excess energy. What medication might help this boy? (FA p452) - ✔✔-Methylphenidate (Ritalin) or amphetamines (Dexedrine) What B-cell surface protein does the monoclonal antibody rituximab target? (FA p368) - ✔✔-CD20 (found on most B-cell neoplasms) IFN-γ stimulates macrophages and inhibits T2 helper cells. What cell type releases IGN-γ? (FA p204) - ✔✔-Th1 cells Many factors are involved in the proper morphogenesis of organs in utero. In the case of oligohydramnios, lack of fluid flowing in and out of the fetal lungs leads to pulmonary hypoplasia. This is an example of which type of error in organ morphogenesis? (FA p119) - ✔✔-Hypoplasia You are caring for a female with borderline personality disorder on the inpatient service. On morning rounds, she makes romantic advances towards you and comments on how soft your hands are. What should you never say in this situation? (FA p59) - ✔✔-Ask direct, close-ended questions. Use a chaperone if necessary You have an adult patient that has failed conventional treatment (5-ASA, steroids, and immunosuppressants) for his active Crohn's disease. Another option available to you is to target TNF-α with which drug(s)? (FA p217) - ✔✔-Infliximab or Adalimumab - target TNF-alpha You are educating the parents of an 8-month-old male patient with cryptorchidism. During your explanation you use an anatomic diagram, and you point to the fibrous band attached between each testis and the scrotum that aids in normal testicular descent. In an adult female, what does that band of tissue become? (FA p134) - ✔✔-Ovarian ligament + round ligament of uterus This medicine used against helminth organisms, especially those causing river blindness (onchocerciasis), ratchets up the neurotransmission of GABA so that the organism becomes immobilized. What is this drug? (FA p194) - ✔✔-Ivernectin A 66-year-old male crashes his new motorcycle and has to be treated at the local hospital's trauma center. Which part of Medicare will cover his inpatient needs? (FA p56) - ✔✔-Medicare Part A A 55 year old alcoholic is admitted to the hospital for upper GI bleed. A ruptured esophageal varix is found to be the cause. What is the preferred medical treatment for this condition? (FA p338) - ✔✔- Octreotide A 23-year-old male comes to your clinic with a fever >39°, a headache, and myalgias. This is the second fever he has had in the last two weeks. He recently finished treatment to eradicate the lice infestation that he acquired during a recent trip to Mexico. What organism might be responsible for this man's recurrent fever? (FA p154) - ✔✔-Borrelia recurrentis Which antifungal drug fits the following description? (FA p192- FA p193) swish and swallow for oral candidiasis (thrush) - ✔✔-Nystatin Which antifungal drug fits the following description? (FA p192- FA p193) side effect: nephrotoxicity - ✔✔-Amphotericin [Show More]

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