Review Quiz 1 - Answer Key
1 - B. This large necrotic tumor mass is most consistent with a glioblastoma multiforme, the worst kind of glioma. CNS tumors tend to elevate the CSF protein.
2 - D. This is a hypersegmented neutrophil, typical for a megaloblastic anemia that can be caused by vitamin B12 deficiency.
3 - A. This is micronodular cirrhosis, which leads to portal hypertension and esophageal varices. One of the most common causes for micronodular cirrhosis is chronic alcoholism.
4 - C. This columnar metaplasia is typical for Barrett esophagus, which carries a small long-term risk for development of esophageal adenocarcinoma.
5 - E. This is an acute myocardial infarction with an area of yellowish necrosis and a hyperemic border. Troponin I will still be elevated several days following the onset of the acute MI.
6 - B. She has infectious mononucleosis. Her monospot test would probably be positive. This is a self-limited disease that can last for weeks. The atypical lymphocytes are a characteristic peripheral blood finding.
7 - A. He has marked hypoglycemia. An insulinoma could function to secrete enough insulin to lower the blood glucose.
8 - D. The elevated liver enzymes with hyperbilirubinemia suggest a hepatitis. There is a small but real risk for transfusion-associated hepatitis C.
9 - B. She has findings most suggestive of chronic lymphocytic leukemia, an indolent but progressive form of leukemia most prevalent in older adults.
10 - D. The rupture of the skin with irrregular tearing of the soft tissues is typical for a laceration. Abrasions involve only the superficial epidermis, but may be at the margin of a laceration. A contusion is a bruise to the underlying soft tissue without a breakage of the skin. An incision is made with a sharp object and has neat edges. A puncture is made with a sharp, pointed object to leave a small, narrow break in the skin.
11 - C. MCTD is a condition with elements of several collagen vascular diseases, including SLE, polymyositis, Sjogren syndrome, and rheumatoid arthritis. The RNP antibodies are suggestive of this disorder. Renal disease is not typically part of MCTD.
12 - E. Rhabdomyosarcomas can appear in children in soft tissues of the neck, in the genitourinary tract, and in the extremities. Wilms tumors arise in the kidney. Astrocytomas occur in the posterior fossa. Lymphomas typically involve lymph nodes. A neuroblastoma is usually a mass lesion in the retroperitoneum.
13 - A. The chest pain along with the friction rub suggests a fibrinous pericarditis. The most common cause for this is uremia from renal failure, a complication of long-standing diabetes mellitus.
14 - E. He has findings of cystic fibrosis, which results in abnormal mucus secretions from an abnormal CFTR gene that lead to pancreatic acinar atrophy.
15 - E. The memory problems suggest a senile dementia of the Alzheimer type. There are increased cerebral cortical neuritic plaques and neurofibrillary tangles with Alzheimer's disease.
16 - B. She has features of Turner syndrome, but has survived to adulthood, so she is likely to be a mosaic.
17 - A. He has findings of ankylosing spondylitis, one of the spondyloarthropathies.
18 - D. She has findings that strongly suggest hyperthyroidism, most likely Graves disease. The serum thyroxine will be increased while the serum TSH will be decreased.
19 - E. The findings are classic for Pneumocystis carinii pneumonia, a common opportunistic infection in persons with the acquired immunodeficiency syndrome.
20 - D. The findings of erythema chronicum migrans followed by the arthritis of large joints suggests Lyme disease from infection with the spirochete Borrelia burgdorferi.
21 - B. This child has phenylketonuria (PKU), a disease that can be tested for at birth. If phenylalanine is not removed from the diet, then marked neurologic damage results.
22 - C. The increase in P-glycoprotein, which pumps the anti-cancer drugs out of the cells, results in increased resistance to many drugs, including those that have not been used.
23 - A. These findings suggest an acute rheumatic fever, a form of autoimmune disease resulting from a cross-reactivity to streptococcal M proteins and cardiac muscle proteins.
24 - B. He has findings that point to acute appendicitis, which is treated surgically.
25 - C. The proliferative retinopathy can be a finding with long standing diabetes mellitus.
26 - D. This is respiratory distress of the newborn, which in a premature baby is almost always due to pulmonary immaturity with a lack of sufficient surfactant to maintain proper aeration. This results in the appearance of hyaline membrane disease soon after birth.
27 - C. Cigarette smoking is the etiology behind the increase in cases of emphysema for the past several decades. Unlike the risk for lung cancer, which decreases with cessation of smoking, the loss of alveoli with emphysema is permanent.
28 - H. Radon gas is considered the second most common etiology for lung cancers, after smoking. There is natural seepage of radon gas from soil that can collect in houses.
29 - G. Herpetic ulcerations are more of a nuisance in immunocompromised patients than a life-threatening situation.
30 - B. The most common cause for myocarditis is a viral myocarditis, and one of the most common etiologies is Coxsackie B virus. Many of these infections are probably subclinical, while a few may lead to sudden death.