a = new Array(11); a[0] = "Incorrect" a[1] = "CORRECT. This patient has labyrinthitis, a condition which is caused by inflammation of the semicircular canals of the inner ear. The semicircular canals are sense organs involved with balance and movement control." a[2] = "CORRECT. The parotid glands can become inflamed (parotitis) with mumps infection, which is a common childhood infection." a[3] = "CORRECT. Hyperfunction of the adrenal glands with hyperplasia or a neoplasm can lead to Cushing's syndrome with hypertension, weight gain, osteoporosis, and easy bruisability of skin. The serum cortisol is increased." a[4] = "CORRECT. This is the corpus cavernosum, which is involved with penile erection. Erectile dysfunction may be amenable to treatment with sildenafil (Viagra)." a[5] = "CORRECT. The gallbladder is supplied by blood via the cystic artery, which must be identified and ligated before the gallbladder is removed." a[6] = "CORRECT. Irritation of the diaphragm causes muscular spasms that are manifested as hiccups, typically a common but self-limited phenomenon. The irritation may come from gastric inflammation or distension." a[7] = "CORRECT. Amebiasis is an infection acquired through contaminated food or water. The colon, including the ascending colon shown here, is affected to produce an inflammatory bowel disease with diarrhea." a[8] = "CORRECT. There are a variety of breast 'lumps' in women of reproductive years and beyond. Most are benign. Fibrocystic changes with duct ectasia, epithelial hyperplasia, and adenosis are common." a[9] = "CORRECT. Production of thyroglobulin in the follicles of the thyroid gland is dependent upon adequate intake of iodine. Iodine deficiency may result in a goiter." a[10] = "CORRECT. The spleen can become increased in size in a variety of storage diseases. Lack of glucocerebrosidase results in manifestations of Gaucher disease." a[11] = "CORRECT. Herniation of the intervertebral disk can result in pressure upon spinal nerve roots. This herniation most often occurs in the lower lumbar region, resulting in pain felt in the leg." a[12] = "CORRECT. The hypoglossal nerve, a motor nerve and the twelfth cranial nerve, provides innervation to the genioglossus muscle comprising the tongue." a[13] = "CORRECT. The iliac crest (usually posterior) is a typical place for obtaining a bone marrow biopsy. Cellularity is maintained through adult life, averaging 50% at age 50 and declining about 10% per decade thereafter." a[14] = "CORRECT. Pancreatitis can be suspected on the basis of a rise in serum (or urine) lipase. Serum amylase is also useful. However, not all cases of pancreatitis have a marked rise in lipase and/or amylase." a[15] = "CORRECT. The aorta with superior mesenteric artery branch is often involved with advanced atherosclerosis seen in association with diabetes mellitus. SLE produces vasculitis of smaller arteries. Metastases and thromboemboli just transiently pass through." a[16] = "CORRECT. Hemorrhage from the stomach can result in hematemesis, or vomiting of blood. Gastritis and gastric ulceration are the most likely causes for gastric hemorrhage. H. pylori infection is an underlying factor in many of these cases." a[17] = "CORRECT. The urinary bladder outlet in males includes the prostatic urethra which can become narrowed from enlargement of the prostate, a common condition in older males." a[18] = "CORRECT. The loops of small bowel seen here are jejunum. Diarrhea from malabsorption as a result of inflammation involving the small bowel may stem from a gluten sensitivity, called non-tropical sprue, or celiac disease." a[19] = "CORRECT. A clear cell carcinoma, or renal cell carcinoma, is the most common primary malignancy of the kidney. Urothelial carcinoma may arise in the pelvis, but is less frequent." a[20] = "CORRECT. The liver is involved with viral hepatitis, which may be subclinical in many cases of hepatitis A (usually a mild illness) and hepatitis B. Hepatitis C leads to chronic liver disease, if untreated, in half of cases." a[21] = "CORRECT. This is the descending colon. The symptoms fit with an inflammatory bowel disease, and UC can have a couse marked by remissions and exacerbations. Though there is a long-term risk for development of adenocarcinoma of colon with UC, the onset is usually later and non-remitting. PID is also likely to produce constant symptoms." a[22] = "CORRECT. The inferior vena cava seen here is the route thromboemboli in pelvic and deep leg veins take en route through right heart to pulmonary artery. A large thromboembolus can be life-threatening." a[23] = "CORRECT. The most common intra-ocular tumor in adults is melanoma, though intra-ocular tumors are, overall, not common. Melanomas may arise in pigmented epithelium of the uvea." a[24] = "CORRECT. These findings are highly suspicious for a laryngeal squamous cell carcinoma, which is one of the neoplasms with a strong association with cigarette smoking." a[25] = "CORRECT. Persons with neurologic diseases are at risk for aspiration with development of acute bacterial pneumonias. The right lung, and the lower lobe, as shown here are more likely to be involved with aspiration. Alzheimer¹s patients are usually still mobile and not at great risk for thrombophlebits and thromboembolism with consequent lung infarction." a[26] = "CORRECT. The gluteus maximus muscle provides support (and padding when sitting), but in movement helps most with leg adduction. Sprinters have the best developed gluteal muscles." a[27] = "CORRECT. The umbilical region is a potential weak point in the abdominal wall, though ventral hernias are not nearly as common as inguinal hernias. In addition, adipose tissue is the most likely herniated tissue into an umbilical hernia." a[28] = "CORRECT. This is the deltoid muscle, which is important in abduction of the upper extremity. Brachial plexus injuries can lead to loss of C5-6 function." a[29] = "CORRECT. Compression fractures of the vertebral bodies occur when bone mass is decreased with osteoporosis, a condition most prevalent in post-menopausal women. A compressed fracture can produce back pain and can lead to vertebral column kyphosis." a[30] = "CORRECT. The trapezius muscle can contribute to the 'nuchal rigidity' observed in some cases of bacterial meningitis with irritation of cranial nerve XI." a[31] = "CORRECT. The ACL provides knee joint stability. This ligament is most often torn during sporting activities that strain the knee. An ACL repair can be done with an allograft tendon." a[32] = "CORRECT. Diabetic neuropathy can affect both motor and sensory nerves. The sciatic nerve shown here, like many nerves of the lower extremities, is more often affected, leading to loss of sensation and 'diabetic foot'." a[33] = "CORRECT. The diaphyseal region of long bones is a site for origin of the primitive neuroectodermal tumors, of which Ewing's sarcoma is one. As the tumor grows the cortex is eroded and invaded, producing pain." a[34] = "CORRECT. This is the femoral condyle, an epiphyseal location where a GCT will most often arise. These tumors can be curretted." a[35] = "CORRECT. The first metatarasal-phalangeal joint is a common location for involvement by gouty arthritis. However, not every person with gout has an elevated serum uric acid and not everyone with hyperuricemia has gout. " a[36] = "CORRECT. This is the 'cheek bone' that forms the outline of the face. The bull was retired at the end of the 1998 season." a[37] = "CORRECT. The trachea is a large airway that is unlikely to be obstructed by infection, and it is in a central location not likely to be traumatized. However, an inhaled foreign body such as a balloon or coin, can obstruct this airway." a[38] = "CORRECT. The ceruminous glands of the external auditory canal, in some persons, produce excessive amounts of ear wax that can occlude this canal and diminish hearing. Gentle irrigation with warm water is a good means to remove the wax." a[39] = "CORRECT. The abrupt jerk on the child's arm displaced the annular ligament from the radial head to produce the classic 'nursemaid's elbow'. The cure is multiple pronation and supination movements at the forearm with the arm bent at the elbow." a[40] = "CORRECT. When a rib is broken, the sharp ends may puncture the pleura to allow an air leak that can collapse the lung. Some bleeding is possible, but not usually marked. Closed trauma is unlikely to result in an infection. Neoplasms do not arise from mechanical blunt trauma. The lymphatic channels in the chest wall are too small to be involved with a chylous effusion." a[41] = "CORRECT. Dental caries in teeth can be reduced by small amounts of fluoride in drinking water. Reduction in the amount of sugar in the diet and regular tooth brushing will also help." a[42] = "CORRECT. Secondary tuberculosis (reactivation of previous infection or reinfection) in adults can be marked by healing of the granulomatous inflammation with calcifications. The upper lobes of the lungs (where relatively greater ventilation would carry infectious agents) are more typically involved." a[43] = "CORRECT. Prostatic adenocarcinomas can be detected by an increase in the serum prostate specific antigen (PSA). However, small elevations in the PSA can also occur with nodular prostatic hyperplasia and with chronic prostatitis." a[44] = "CORRECT. Osteosarcomas arise in the metaphyseal region of long bones and, though these neoplasms are not common, they are most likely to arise in young males. The neoplastic cells produce a pink osteoid matrix." a[45] = "CORRECT. the blood supply to the femoral head is tenuous and can become disrupted by trauma. The ligamentum teres from the acetabulum carries a vascular bundle to the femoral head, entering at the fovea." a[46] = "CORRECT. The anterior pituitary gland in the sella turcica can have adenomas arise within it. Such adenomas can have both pressure effects (on the surrounding bone to produce headache and on the optic chiasm to produce bitemporal hemianopsia) from enlargement and hormonal effects. The most common hormonal production is prolactin." a[47] = "CORRECT. This is the vastus lateralis of the quadriceps muscle group on the anterior aspect of the thigh. This muscle contracts to produce the leg extension needed for kicking a ball." a[48] = "CORRECT. The uterine cervix can become infected with HPV, increasing the risk for cervical dysplasias and carcinoma, but such lesions do not typically bleed extensively. Diseases of the uterine corpus, particularly those that involve the endometrium, are more likely to produce significant blood loss over time." a[49] = "CORRECT. This is the gastrocnemius muscle of the lower leg, which is innervated by the tibial nerve with roots S1 and S2." a[50] = "CORRECT. The hemorrhoidal veins of the perianal region can become dilated and thrombose and bleed. Venous stasis can be promoted by either chronic constipation or diarrhea." a[51] = "CORRECT. The scalp is the site of action for this drug for treatment of hair loss. In some cases hair is gained, in others the loss slowed, and in some no effect occurs." a[52] = "CORRECT. This is the thoracic spinal cord, and transection will prevent transmission of motor impulses distal from the site of injury, leading to paraplegia with inability to move the legs." a[53] = "CORRECT. In the nose, the mast cells in submucosal tissues are coated with IgE that results in degranulation when antigens, such as plant pollens, are encountered. This is a form of type I hypersensitivity. The granules contain mediators such as histamine that lead to swelling." a[54] = "CORRECT. The mastoid air cells can become infected from a middle ear infection, and the infection can then spread to the meninges to produce a meningitis. The findings in this case are typical for a Staphylococcus aureus meningitis. With antibiotic therapy of ear infections, mastoiditis is uncommon." a[55] = "CORRECT. This is the crystalline lens of the eye, and cataract formation is not uncommon in older persons. In persons with diabetes mellitus, this process is more likely to occur. The cataract reduces vision, but it can be removed surgically." a[56] = "CORRECT. This is the masseter muscle. Persons with myasthenia gravis experience fatigue with repetitive use of muscles as acetylcholine is depleted. This is a form of type II hypersensitivity. The antibody destroys the receptors at the motor end plate." a[57] = "CORRECT. Such an object striking the skin surface over a broad area supported by the underlying sternocleidomastoid muscle will result in a blunt force injury that leads to disruption of small vessels with localized bleeding and tissue swelling--a bruise." a[58] = "CORRECT. This is the center of the optic chiasm, and a mass such as a pituitary adenoma in the sella turcica below could impinge upon the chiasm, with manifestation of loss of the visual fields laterally." a[59] = "CORRECT. This is the popliteal artery, which supplies the bulk of the arterial blood to the lower extremity. Disruption of this artery leads to ischemia. A below the knee amputation may be necessary." a[60] = "CORRECT. The frontal sinuses are a typical site for involvement by the common cold. There is tissue swelling and fluid accumulation to produce a feeling of discomfort. There are no significant sequelae from these viral infections." a[101] = "QUESTIONS: 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 " a[102] = "QUESTIONS: 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 " a[103] = "QUESTIONS: 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 " a[104] = "QUESTIONS: 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 " a[105] = "QUESTIONS: 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 " a[106] = "QUESTIONS: 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 "